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Doctor notes flaws in 'sick school' study


The survey done this month of Mount Airy Elementary School first- and second-graders is flawed and may not shed much light on whether something in the building is making some of them sick, said a physician from the Maryland Department of the Environment.

School officials are nonetheless testing for contaminants in the air and ventilation system and capping off old water and sewage pipes left above the ceiling since a 1987 renovation, said Vernon Smith, director of support services for the county school system.

He said enough students have reported headaches, coughing, nasal congestion and throat irritation to cause concern. The survey indicates that one-third of the respondents had those symptoms, but it is unclear whether they are caused by the building.

"It will be helpful" to identify the cause so that school officials can correct the problem, said Shirin de Silva, a physician with the Maryland Department of the Environment.

If a cause cannot be pinpointed, officials will use other tests to determine whether the problem is affecting many children or just a few who are chemically sensitive, she said.

The school has switched one first-grade class with the music room, in a portable building outside the school. That move eased the symptoms of a first-grader and her teacher, Dr. de Silva said.

The first-grader's mother was the first parent to ask for testing of the room, after doctors ruled out allergies and other causes of her daughter's health problems. In addition to sinus problems and coughing, the girl suffered extreme fatigue, trouble concentrating, and heart palpitations, her mother said.

Dr. de Silva said the symptoms suffered by that student and her teacher were somewhat different from the ones described by the other survey respondents.

Dr. de Silva ruled out anxiety over school as the problem because the student and teacher always felt better Monday morning, after being out of the building for two days, and worse on Saturday morning.

"Assuming we can't [find the cause], we will have to decide whether the room is safe for an average child, without worrying about the needs of people who are unusually sensitive," said Dr. de Silva, whose specialties include environmental and occupational health.

The more sensitive students and teacher can be moved elsewhere in the building, she said.

She said she is still studying the responses.

However, she cited the following as flaws in the survey, compiled by the state Department of Education:

* There is no control group to show how these children's symptoms differ from ordinary colds.

* Of 280 surveys sent home with children, only 113 were returned.

* Many of the parents filled out only the first page, a list of symptoms and their duration. The second page asked what days of the week and what months those symptoms were worse, which would have helped pinpoint any connection to school, Dr. de Silva said.

Another option would be to survey another school, she said, but parents there might not be as motivated to return the survey if there were no problem at their school.

If the survey is repeated at Mount Airy, the control group would have to be surveyed twice, Dr. de Silva said.

"Each time you ask the question, you're giving people the opportunity to say, 'There was that one day when . . . ' If you only asked the question once, they wouldn't have remembered it," she said.

A more thorough option, with its own set of problems, might be to conduct tests on children before and after exposure to the rooms in question, and exposure to other rooms.

But there is no money and not enough time to do that before the end of the school year, Dr. de Silva said.

Parents would have to agree to the testing, which requires approaching them carefully, she said.

She said the surveys returned this month indicate that some parents took offense, thinking the school was implying their child was sickly.

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