TABLE 3.

—Priority Research Needs for Improving Health of US Workers: Causes and Prevention of Building-Related Health Effects

Building-influenced communicable respiratory infections

• Document and quantify the association of communicable respiratory infections among indoor workers with specific characteristics of indoor work environments (e.g., ventilation rate, filtration, pattern of outside airflow, density of occupancy, and physical separation of occupants)

• Estimate the proportion of these infections preventable by specific building practices

• Improve and apply tools (e.g., in molecular biology) to identify specific viral infections, their routes of transmission, and periods of infectivity and to assess exposure to infectious agents and agents that may alter susceptibility

Building-related asthma and other allergic disease

• Quantify, for hypersensitivity pneumonitis, asthma, and allergic rhinitis, the associations between onset or exacerbation of disease and specific characteristics of indoor work environments (e.g., ventilation rate, ventilation design and maintenance, sources of moisture or allergens indoors or in ventilation system, surface materials, housecleaning, air and surface dust)

• Estimate the proportion of causation or exacerbation of these diseases attributable to specific indoor environmental characteristics and the proportions preventable by specific exposure-reduction practices

• Improve and apply quantitative exposure assessment measures for bioaerosols, particularly their bioactive components (e.g., toxins, allergens, immunogens, and adjuvants)

• Develop appropriate uses in this area for human biomarkers of exposure or disease

• Evaluate the impact of exposure-reduction strategies on reducing relevant bioaerosol exposures

• Characterize exposure–response relationships for these diseases and measured indoor contaminants

Nonspecific building-related symptoms

• Quantify the relationships between building-related symptoms or sensory reactions and factors of building design, operation, maintenance, furnishings, equipment, and occupancy (with selection of research targets based on existing scientific evidence, further analyses of relevant existing data sets, and current empirically based knowledge, e.g., standards of best building practice among indoor environmental professionals)

• Quantitatively evaluate effectiveness of preventive measures

• Identify physiological processes and biochemical parameters that are associated with building-related symptoms or sensory reactions and identify or develop assessment tools

• Improve and apply strategies to identify chemical, microbiological, and physical exposures that are toxic, irritant, allergenic, or highly odorous and that cause occupant symptoms or sensory reactions in buildings; consider improving methods to predict adverse effects of indoor exposures, singly or in combination (e.g., prediction from known “structure-activity relationships” for related chemicals) (see also Table 4 ▶)

• Quantify exposure–response relationships for measured indoor contaminants and specific health effects represented by building-related symptoms

• Establish the mechanisms by which causal agents alter the occurrence of nonspecific symptoms or sensory reactions