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The client in this case seems to suffer from Sick Building Syndrome (SBS), which is defined by WHO as suffering from some symptoms that can be related to exposure to building variables without other known etiology. Many factors can refer to this condition in this case. She is working in an old building that is aged over than 100 years, which increases the possibility of exposure to dampness and associated problems such as growth of mold. Also, her history does not include other risk factors for her respiratory illness such as tobacco smoking. Moreover, her symptoms have appeared after starting work in that building. In addition, she pointed to sharing this illness with her coworkers. Furthermore, she mentioned that her illness is not related to seasonal variations, and this should increase the possibility of indoor fungal spores exposure rather that outdoor exposure. In outdoor fungal spores exposure, symptoms become more evident with the increase of fungal sporulation, which occurs in summer and autumn months (Osborne, Thornton, & Sharpe, 2015).
Many studies have proved that exposure to dampness may increase the risk for developing many respiratory problems. There is an association between dampness and the incidence and exacerbation of asthma. Moreover, dampness can be associated with rhinitis, bronchitis and respiratory infections affecting both upper and lower respiratory tracts (Norback, et al., 2017). Besides, the patient is 55 years old, and age is regarded as a risk factor for developing respiratory problems. Normally, ageing raises vulnerability to diseases in different organs of the body. A progressive decline in lung function and chest wall compliance can be observed after the age of 25 years, which can worsen the outcome of exposure to micro-organisms and allergens (MacNee, 2015). Increasing the severity of respiratory illness, with subsequent affection of other body systems mainly the cardiovascular system, is directly related to continuous exposure to the attributing factors; which can be referred as dampness in such old building in this particular case.
Dampness enhances the growth of many biological agents such as fungi and bacteria. Molds need moisture to grow, so their existence indicates presence of water damage. Water damage can be contributed to many factors such as defective pluming installations, rising damp, or leakage of water through the roofs. Also, molds are more likely to grow in organic building materials that contain cellulose such as wallpaper, cardboard and wood. Additionally, the presence of mold odor may point to the occurrence of microbial volatile organic compounds that can result from active metabolism. These microbial agents can cause various respiratory infections. Several microbial agents can be promoted to proliferate by dampness such as allergens, cell fragments having toxins and intact spores, and inflammatory substances. This humid environment is also suitable for reproduction of house dust mite, which is known as a common allergen (Norback, et al., 2017). In addition to the fact that molds and microbial agents can lead to the development of asthma and respiratory infections, some studies claimed that they can exacerbate an already present respiratory illness (Gautier, et al., 2016). This concept can be explained in this case, as the client mentioned that when there is a certain respiratory condition among population during specific period of the year, she and her coworkers are getting sicker than everyone else suffering from this condition. The effect of dampness on respiratory system is still poorly understood and many researches are being conducted for better clarification of this topic.
References
Gautier, M., Normand, A. C., Lollivier, C., Cassagne, C., Reynaud-Gaubert, M., Dubus, J. C., & Piarroux, R. (2016). Aspergillus tubingensis : a major filamentous fungus found in the airways of patients with lung disease. Medical Mycology, 54(5): 459-70.
MacNee, W. (2015). The Ageing Lung. Monografias de Archivos de Bronconeumologia, 2(3): 6163
Norback, D., Zock, J. P., Plana, E., Heinrich, J., Tischer, C., Jacobsen Bertelsen, R., & Verlato, G. (2017). Building dampness and mold in European homes in relation to climate, building characteristics and socio-economic status: The European Community Respiratory Health Survey ECRHS II. Indoor Air, 27(5): 921-932.
Osborne, N. J., Thornton, C. R., & Sharpe, R. A. (2015). Indoor Fungal Exposure and Allergic Respiratory Disease. Current Allergy and Asthma Reports, 15(12): 71.
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