Environmental histories are taken of the home, workplace, and any other closed environment in which the patient spends a considerable amount of time on a continuous basis. Clues from this history are utilized to direct the patient, family member, or a contractor in obtaining specimens from the most likely causative environment.
The below questionnaire has proven very useful in the South Texas. There may be other questions from other regions of the world that need be considered depending upon life styles, building construction, climate conditions, and agricultural and industrial differences.
1. What type of dwelling? House/Apartment/Condo/Trailer 2. Location? Inner City___ Suburbs___ Rural___ Town___ 3. Type of foundation? Slab___ Pier and Beam___ Mix___ 4. Air conditioning? Central___ Window units___ Water Cooler___ 5. How old is the home? _____How long have you lived there?____ 6. Has the building been remodeled or added onto? Yes/No 7. Is the building structurally sound? Yes/No 8. Is there any odor upon entering the home? Yes/No 9. Are animals or birds allowed inside? Yes/No 10. How often do you clean the bird's cage?____________ 11. Do you have "kitty-litters" in the home? Yes/No 12. How often do you clean the "kitty litter"?____________ 13. Do animals mark territory, urinate, or spray in the home? Yes/No 14. Do animals sleep in your bed/bedroom? Yes/No 15. How many plants are in the home?____________ 16. Are any hanging or sitting over areas of carpet? Yes/No 17. Is there a hot tub /Jacuzzi/ steam room in the house? Yes/No 18. Do you utilize a humidifier, vaporizer, or misting fountain? Yes/No 19. Have there been any floods from plumbing/roof leaks/ outside water/ air conditioning condensate? 20. Has the home had fire and water damage? Yes/No 21. Is there a basement/half-basement/wine cellar? Yes/No 22. Are there any areas of chronic moisture? Yes/No 23. Have you seen mold or mildew growing in the home? Yes/No 24. Do garments or shoes develop mildew in your closet? Yes/No 25. Do bread or fruits spoil or develop mildew easily in your home? Yes/No 26. Have you checked the condensate pan under frost-free freezers? Yes/No 27. Have there been any air conditioning problems? Yes/No 28. Is there any dust exiting from the A/C ducts? Yes/No 29. Had the A/C condensate line become blocked? Yes/No 30. Is the utility room inside the home? Yes/No 31. Are any hobbies practiced in the home?_____________ 32. Have you had termites?________________ 33. Is there a trash masher in the home? Yes/No 34. Is trash left in the house overnight? Yes/No 35. Is there a garbage disposal on the kitchen sink? Yes/No 36. What temperature is the A/C system operated?________ 37. Are ceiling fans utilized? Yes/No 38. What type of filters are in use in the home? Fiberglass/pleated/electrostatic/electronic/HEPA 39. Are closets in your home ventilated by A/C ducts? Yes/No 40. Is your home cluttered? Yes/No. If yes, with what? 41. Is your garage filled with clutter or chemicals? Yes/No 42. What type floor covering? Carpet_____Hard surface_____ 43. Do you monitor humidity in your home? Yes/No 44. What is the average humidity of your home when closed?_______ 45. Do you sleep on a feather pillow, or under a feather duvet? Yes/No
WORKPLACE In our experience, the workplace has been rarely involved. The cases in which the workplace played a role were caused by microbial contamination similar to that seen in homes. Workplaces have long been recognized to cause hypersensitivity pneumonia usually caused by material being manufactured, processed, or secondary contamination associated with the primary objective. Examples include farmers working with moldy hay, workers in the sugar cane industry, mushroom workers, wood workers, and plastic and paint workers.
Histories will usually identify these patients and they do not fit a category of idiopathic interstitial lung disease.