Immune Respiratory Disease Associated with the Inadequate Control of Indoor Air Quality

The prevalence of immunologically determined respiratory diseases is in creasing throughout the world and this has been associated with an increased mortality from bronchial asthma. Consequently, there has been considerable interest in the factors that may influence the development of allergic disor ders. The first few weeks following birth have been identified as important in determining the development of sensitivity to airborne allergens and subse quent allergic respiratory disorders. The expression of allergic diseases is both genetically determined and influenced to a significant degree by environmen tal factors related to indoor air quality. As well as possibly initiating allergic disease in the post-natal period, poor indoor air quality may cause respiratory disease in later life. These diseases may be allergic in origin (bronchial asthma or allergic alveolitis) or may be due to infections (Legionnaires' disease). The contamination of indoor air by micro-organisms may occur from the structure of the building, the ventilation system or be introduced into the building from the outside air. The off-gassing of chemicals within buildings has attracted considerable attention over the past few years, but the evidence that this pro cess can cause immunological disease in man is very limited. It is concluded that indoor air quality is an important potential cause of immunological respi ratory disease in man which has been and still is frequently neglected.