Ocular symptoms and tear film break up time (BUT) among junior high school students in Penang, Malaysia - Associations with fungal DNA in school dust

• Background: There are few studies on ocular effects of indoor mould exposure in schools, especially in the tropicsObjective: To study associations between eye symptoms and tear film break up time (BUT) in students and demographic data and fungal DNA in schools.Methods: A school environment study was performed among randomly selected students in eight randomly selected secondary schools in Penang, Malaysia. Information on eye symptoms and demographic data was collected by a standardised questionnaire. BUT was measured by two methods, self-reported BUT (SBUT) and by the non-invasive Tearscope (NIBUT). Dust was collected by vacuuming in 32 classrooms and analysed for five fungal DNA sequences. Geometric mean (GM) for total fungal DNA was 7.31*10(4) target copies per gram dust and for Aspergillus/Penicillium DNA 3.34*10(4) target copies per gram dust. Linear mixed models and 3-level multiple logistic regression were applied adjusting for demo-graphic factors.Results: A total of 368 students (58%) participated and 17.4% reported weekly eye symptoms the last 3 months. The median SBUT and TBUT were 15 and 12 s, respectively. Students wearing glasses (OR 2.41, p=0.01) and with a history of atopy (OR= 2.67; p=0.008) had more eye symptoms. Girls had less eye symptoms than boys (OR= 0.34; p=0.006) Indoor carbon dioxide in the classrooms was low (range 380-720 ppm), temperature was 25-30 degrees C and relative air humidity 70-88%. Total fungal DNA in vacuumed dust was associated with shorter SBUT (4s shorter per 10(5) target copies per gram dust; p=0.04) and NIBUT (4s shorter per 105 target copies per gram dust; p < 0.001). Aspergillus/Penicillium DNA was associated with shorter NIBUT (5 s shorter per 105 target copies per gram dust; p=0.01).Conclusion: Fungal contamination in schools in a tropical country can be a risk factor for impaired tear film stability among students.

Nyckelord

Tear film break up time (BUT)

Eye symptoms

Mould

School environment

Fungal DNA

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art (ämneskategori)