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John F. Brundage, MD; Robert McN. Scott, MD; Wayne M. Lednar, MD; David W. Smith, MS; Richard N. Miller, MD

JAMA. 1988;259(14):2108-2112.

Abstract
Airborne transmission of infectious agents and associations of indoor air pollutants with respiratory illnesses are well documented. We hypothesized that energy conservation measures that tighten buildings also increase risks of respiratory infection among building occupants. At four Army training centers during a 47-month period, incidence rates of febrile acute respiratory disease were compared between basic trainees in modern (energy-efficient design and construction) and old barracks. Rates of febrile acute respiratory disease were significantly higher among trainees in modern barracks (adjusted relative risk estimate, 1.51; 95% confidence interval, 1.46 to 1.56), and relative risks were consistent at the four centers. These results support the hypothesis that tight buildings with closed ventilation systems significantly increase risks of respiratory-transmitted infection among congregated, immunologically susceptible occupants.

(JAMA 1988;259:2108-2112)

Author Affiliations
From the Divisions of Preventive Medicine (Drs Brundage, Lednar, and Miller and Mr Smith) and Communicable Diseases and Immunology (Dr Scott), Walter Reed Army Institute of Research, Washington, DC.

Footnotes
Read in part before the 114th annual meeting of the American Public Health Association, Las Vegas, Sept 29,1986.

The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the Army or the Department of Defense.

Reprint requests to Department of Epidemiology, Division of Preventive Medicine, Walter Reed Army Institute of Research, Washington, DC 20307-5100 (Dr Brundage).

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