Sept. 3, 2008— -- About once a month, Desiree DeFlorimonte had to change a ceiling panel in one corner of her office at work, encrusted as it was with black mold. This pattern continued for seven years, over the course of which DeFlorimonte, 60, suffered from a barrage of respiratory problems.
"It was hell living through it," DeFlorimonte said. "I was at the doctor's office every few months," constantly sneezing, coughing, and experiencing respiratory infections, she said.
Her mold allergies, and the medications she took to relieve them, made DeFlorimonte, a reading specialist at a Maryland grade school, miserable -- and less productive.
But many go through the work day under similar duress, enduring allergies and allergy-like symptoms caused by their work environment.
"Allergies in the workplace is a bigger issue than a lot of employers give credit for," said Mike Tringale, director of External Affairs at the Asthma and Allergy Foundation of America. "Many employers have not stepped up to that plate."
While prevention may be difficult, or in some cases impossible, there are a few proactive things one can do in order to make the itchy, watery, fatigue-causing symptoms less problematic.
Diagnosing an allergy or a sensitivity can help determine what the problem is and where it might be coming from. DeFlorimonte's doctor diagnosed her with a severe mold allergy, one that did not bother her when she took time away from the office.
But often symptoms are non-specific and can include irritation in the air and nasal passages, burning eyes, headaches and fatigue. If these types of symptoms come on after an hour in the workplace and resolve within an hour after leaving, the office environment itself may be to blame, according Dr. Karin Pacheco, an occupational medicine specialist at the National Jewish Medical and Research Center in Denver, Colorado.
The two elements that can wreak havoc on buildings and sicken employees are water and air. Dampness, from leaks or condensation, creates ideal conditions for irritants like mold. Poor ventilation and filtration means the air stagnates and can contain higher concentrations of those mold spores or other irritants.
In most cases, doctors recommend bringing the problem up with a manager or supervisor, as well as the building's health and safety officer, if there is one, in order to attack the problems at their root.
Solutions could include fixing leaks and plumbing problems and replacing old, moldy carpet and furniture, which can also have dust mites in them, another common indoor allergen. Better ventilation and filtration systems can help refresh the air and clear it of irritants.
"The only solution is getting that underlying exposure cleared up," said Dr. James Sublett, section chief of Pediatric Allergy and Immunology at the University of Louisville School of Medicine in Louisville, Ky. "You can't just clean it up and not fix the underlying problem."
Although repairing and maintaining the infrastructure of a work environment in order to keep it up to snuff can be very expensive, "more and more people are seeing the economic arguments for doing so," said Andy Persily, vice president of the American Society of Heating, Refrigerating and Air-Conditioning Engineers.
"The most expensive thing in the building is not the energy, it's the salaries of the people," Persily pointed out. And unproductive employees can cost a company far more than a leaky roof.
Sometimes fragrances or chemicals from new furniture or cleaning supplies may be to blame for those nonspecific symptoms, Pacheco said. In these cases, an employee might propose implementing a fragrance-free office environment, with help from management.
Occasionally, a work allergy has an easy fix. Sublett recalled a patient of his who came to him reporting terrible allergic symptoms and he discovered she was allergic to cats. It turned out that her cubby-mate at work had three cats and was exposing her co-worker to those allergens.
"As allergists, we're environmental detectives," Sublett said. What the patient says, the clinical diagnosis and environmental evaluation can all help to connect the dots.
The phenomenon where people are only ill inside a particular building is often nebulously dubbed Sick Building Syndrome or Building Related Illness because of the location-specific but non-specific symptoms. These names and the number of scenarios to which they can be applied underscore Pacheco's point that this problem is difficult to identify, diagnose, and treat.
For any affliction of this type, management support and attention to detail is crucial. Without care, the underlying cause may never be corrected, as happened to DeFlorimonte.
"I didn't feel they were doing all they could," DeFlorimonte said of the administration at her school. Though she brought up her mold allergy and its resulting symptoms with the principal and vice principal often, they only went as far as changing the ceiling panels without fixing the building leaks.
"It was putting a band-aid on the problem," she said
After seven years of her mold-infested work environment, DeFlorimonte took a year-long sabbatical to get some rest and work on other projects. Her respiratory problems cleared up right away.
"It was dramatic, it was a dramatic change," she said. The feeling was such a revelation, Deflorimonte decided not to return to her old job and began working at another school in Maryland.
"I've been fine," she said. "I haven't even had a cold."
DeFlorimonte's decision to quit her job represents one extreme solution for allergy sufferers at work.
Unfortunately, as Pacheco pointed out, work-related allergies may not lend themselves to too much self help. Using facemasks, fans or applying hand sanitizer are not effective ways to combat the irritating symptoms because they don't tackle the source of the problem.
"People need a higher level of awareness and an interest in doing it right," Persily said.