"After-Allison" Respiratory Effects Studied

In the year since Tropical Storm Allison hit, Gailen Marshall, M.D., associate professor in the department of internal medicine, and director of the division of allergy and clinical immunology at The University of Texas Medical School at Houston, is still hard at work assessing how the respiratory function of occupants in the medical school building may have been affected.

Soon after the flood, Marshall posted a general e-mail notice to UT-Houston Medical School students, faculty, and staff, inviting their participation in a respiratory health questionnaire. Marshall’s post-Allison questionnaire followed a multiple-choice format and encompassed a list of 18 potential symptoms. The respondents were asked to identify any symptoms they experienced after Allison.

All respondents who stayed with the study were tested for allergy symptoms. Marshall and his colleagues found through the initial questionnaire that some allergy responses and immune changes that seemed related to the stress caused by the flood were evident in the majority of respondents.

"There were a number of people working here whose symptoms correlated with the level of anxiety," Marshall said.

Symptoms listed on the questionnaire included nasal congestion, runny nose, daytime fatigue, difficulty sleeping, wheezing, coughing, or tightness in the chest. Participants were asked to rank their responses on a scale from zero to four, with zero being no symptoms and four being incapacitating symptoms. Marshall was interested in looking at why so many individuals reported getting ill from mold exposures.

The questionnaire, with an initial response of 140 (out of 3,000 building occupants), was entirely voluntary, and replies were kept anonymous. Marshall said that at no time did either UT-Houston Health Science Center President James Willerson or UT-Houston Medical School Dean Max Buja ask him to reveal the responses.

"Only in the case of an identifiable health problem where corrective health measures would need to be taken, would I have had to contact the administration," Marshall said.

Three conditions are necessary for mold, the primary suspect in Marshall’s questionnaire, to exist – temperature, humidity, and a food source. The post-Allison medical school building was without power for a period of four weeks, during the hottest quarter of Houston’s climate, and was a prime breeding ground for toxins like mold to proliferate.

"Mold is in the Gulf Coast area from Mexico to the tip of Florida in everybody’s homes and office buildings," Marshall said. "The objective is to prevent mold from taking hold by controlling conditions that are favorable to mold. That’s normally accomplished in interior environments in Houston with good air conditioning systems."

Marshall said he plans to use the results of this initial study to obtain a National Institutes of Health grant to further investigate other mold-related illnesses in homes and other buildings.

"There will almost certainly be some flooding somewhere in our area every year," Marshall said.

The study should be finished this month, and Marshall intends to publish the findings. He also intends to further study how stress impacts allergy symptoms and immune changes.

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©2006 Texas Medical Center

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