CASE # 3: ABOUT ENVIROMMENTAL HEALTH
John J. is a school nurse at Jackson Elementary School, which was built in 1960. Nurse John has noticed
that many students from Ms. Zee’s second grade class have come to the clinic complaining about
coughing, sneezing, runny nose, and watery eyes. Nurse John has also observed that Steven Tea, the
only asthmatic student in Ms. Zee’s class, has had more asthma attacks this year than he did last year.
Because the rest of the school is not experiencing the same respiratory problems, Nurse John is
concerned that something in Ms. Zee’s classroom is causing students to feel ill.
Nurse John decides to visit Ms. Zee’s classroom. Upon entering the classroom, one of the few located in
the school’s basement, John is struck by the powerful musty smell that inhabits the room. While talking
to Ms. Zee, John learns that the classroom has “smelled bad for years,” and that students from previous
years have complained about respiratory problems. Nurse John notes that Ms. Zee has stuffed a blanket
at the base of the classroom’s small rectangular window near the ceiling because the window does not
close completely.
John suspects that Ms. Zee’s classroom walls are contaminated with mold. Upon further research, Nurse
John learns that if water gets between the exterior and the interior of a building’s wall, mold can grow in
the moist environment. This situation can occur as the result of construction defects in the building (e.g.,
leaky windows). Nurse John also learns that people who are exposed to extensive mold growth may
experience allergic reactions, such as hay fever-like allergy symptoms, and that people who already have
a chronic respiratory disease, such as asthma, may experience difficulty breathing when exposed to
mold. Nurse John is concerned about the possible mold contamination effect on his asthmatic student,
Steven.
Questions
1. Identify the agent, host, and environment in this case study, and describe how
they interacted to bring about the occurrence of disease.
Based on the information gathered, it is highly likely that the respiratory problems and increased
asthma attacks experienced by the students in Ms. Zee’s class are caused by mold contamination
in the classroom walls. The musty smell, the presence of moisture from the window that does not
close completely, and the history of complaints from previous students all point towards a mold
problem.
Mold is a type of fungus that can grow in damp or humid environments, and it releases spores
that can cause allergic reactions in some people. This can lead to respiratory symptoms such as
coughing, sneezing, runny nose, and watery eyes. In addition, mold can also exacerbate asthma
symptoms in individuals who already have the condition.
Since Steven Tea is the only asthmatic student in Ms. Zee’s class and has experienced more
asthma attacks this year than last year, Nurse John is right to be concerned about the effects of
mold exposure on his health. Asthma attacks can be triggered by various factors, including
exposure to allergens like mold spores.
It is important for Nurse John to take action to address the mold contamination in Ms. Zee’s
classroom. He should report the issue to the school administration and request that a professional
mold remediation company be brought in to assess and address the problem. In the meantime,
Nurse John can advise Ms. Zee to keep the classroom as clean and dry as possible, and to avoid
activities that could promote mold growth, such as leaving wet items (e.g., towels, clothes) in the
classroom. Nurse John can also work with Steven Tea’s parents and doctor to ensure that he
receives appropriate treatment and medication to manage his asthma symptoms.
1. Identify the agent, host, and environment in this case study, and
describe how they interacted to bring about the occurrence of disease.
The agent in this case study is mold, which is a type of fungus that grows in damp or humid
environments. The host is the students in Ms. Zee’s second grade class, including Steven Tea,
who is asthmatic. The environment is Ms. Zee’s classroom, which is located in the basement of
Jackson Elementary School and has a history of musty odors and complaints of respiratory
problems.
The interaction between the agent, host, and environment in this case study is as follows:
The environment provided favorable conditions for the growth of mold, including
moisture from a window that does not close completely and a history of musty odors.
The mold, which is the agent, grew in the walls of the classroom and released spores into
the air.
The students in Ms. Zee’s class, including Steven Tea who is asthmatic, are the hosts.
When exposed to the mold spores, they experienced respiratory symptoms such as
coughing, sneezing, runny nose, and watery eyes. Steven Tea also experienced more
