HITEA (2008-2012)

Health Effects of Indoor Pollutants: Integrating microbial, toxicological and epidemiological approaches

Study objective:
To identify the role of biological agents among the multiple indoor exposures that lead to long term respiratory, inflammatory and allergic health impacts among children. The focus is on microbial exposures due to dampness and moisture problems of buildings. Since multiple exposures are typical for indoor environments, other indoor exposures and factors, like allergens, chemicals, cleaning agents, traffic exhaust and poor ventilation, will also be studied.

Specific aims:

  1. to characterize the microbial, immunological, toxicological, and dampness-related properties of indoor air in school buildings in three climatic regions across Europe,
  2. to study the long term respiratory, inflammatory and allergic health impacts on children and adults associated with these exposures,
  3. to study among children and adults the short term health effects, potentially leading to longterm impacts, associated with indoor air exposures in schools with special emphasis on markers of inflammation,
  4. to reveal the mechanisms underlying the health effects, in connection to exposure to  non-infectious microbial particles,
  5. to apply new and innovative approaches to characterize indoor biological exposures, especially by using novel methods to measure airborne exposure and by characterizing the house dust for its in vitro toxicity, inflammatory properties and microbial toxin content,
  6. to study how the health effects among the occupants associate with the microbial and toxic exposures of indoor environments
  7. to develop guidelines for health professionals on how indoor microbial pollution should be studied and to develop rapid direct reading approaches for a limited number of microbial markers.

Study design:

  1. In the first part, the study will focus on dampness and moisture problems and associated exposures to biological agents in schools across Europe by means of  a  longitudinal field study in schools.  
  2. The second part will carry out extensive exposure assessment to biological and other agents of interest in indoor environments in several regions of Europe by analysing data from the existing population cohorts studies. Existing sample materials are exploited, completed with a strictly defined collection of new samples. The laboratory analyses of the samples from the school study will also be done here. Analyses to be performed include both previously validated parameters (endotoxin, 1,3-ß-glucan) and novel technologies (chemical markers, DNA-based methods, toxin analyses, new immunochemical markers of fungi) for maximal possible benefit from method comparisons.  This part also involves toxicological characterization of the multiple exposures in house dust samples, focusing especially on markers of cytotoxicity, inflammation and oxidative stress.
  3. The third part, the framework of which consists of several European-wide population cohorts, will emphasize on the long term health impacts of biological agents. Exposure data from different time points during life is combined with the comprehensive information on children’s and adults’ health already collected in these cohorts.


Study population:

  1. A random sample of 60 schools in three European countries (Nl, Sp, Fin) to represent three climatic regions.
  2. Four existing European birth cohorts: LISA in Munich, PIAMA in The Netherlands, INMA in the Menorca, and LUKAS in Finland
  3. The existing European-wide adult cohort ECRHS

Study period:
2008 - 2012

Current status:
The dust sampling and dust analysis is successfully completed and publications on the findings are currently in preparation.

Chih-Mei Chen, Christina Tischer (PhD student), Joachim Heinrich (co-investigator from the Institute of Epidemiology, Helmholtz Zentrum München)

Aino Nevalainen, Anne Hyvärinen, Juha Pekkanen
Kansanterveyslaitos (National Public Health Institute), KTL, Finland

Prof. Heederik, Dr. Doekes, Dr. I. Wouters, Prof. Brunekreef
Universiteit Utrecht, (UU), Netherlands

Jordi Sunyer, Jean Paul Zock, Josep M. Antó, Estel Plana
Centre de Recerca en Epidemiologia AmbientaL, CREAL, Spain

Maija-Riitta Hirvonen, Marjut Roponen
University of Kuopio, (UKU) Finland

Wolfgang Bicker
University of Natural Resources and Applied Life Sciences, Vienna (BOKU), Austria

Lennart Larsson, Bogumila Szponar, Christina Pehrson
Lund University (ULUND), Sweden

Debbie Jarvis; Respiratory Epidemiology and Public Health Group,National Heart and Lung Institute, Imperial College, U.K.


Marie Standl
Helmholtz Zentrum München

German Research Center for Environmental Health

Institute of Epidemiology
Ingolstädter Landstr. 1

D-85764 Neuherberg
Tel: +49 89 3187 2952
Fax: +49 89 3187 3380

Related publications:

HITEA General Assembly Meeting in Munich, 2011:


From left to right, 4th row:
Michael Sulyok (Austria), Jordi Sunyer (Spain), Martin Täubel (Finland), Gert Doekes (Netherlands)
3rd row:
Maija-Riitta Hirvonen (Finland), Torben Sigsgaard (Sweden), Dick Heederick (Netherlands), Juha Pekkanen (Finland), Joachim Heinrich (Germany), Anne Hyvärinen (Finland), Maria Valkonen (Finland)
2nd row:
Kati Huttunen (Finland), Aino Nevalainen (Project Co-ordination, Finland), Jan-Paul Zock (Spain), Christina Tischer (Germany), Tiina Reponen (USA), Lidia Casas (Spain), Inge Wouters (Netherlands)
1rst row:
José Jacobs (Netherlands), Esmeralda Krop (Netherlands), Maties Torrent (Spain), Alicia Borras (Spain)


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