Upload
joshua-arcaira
View
226
Download
0
Embed Size (px)
Citation preview
8/3/2019 Research Protocol 1st Submission
1/31
DE LA SALLE HEALTH SCIENCES INSTITUTECOLLEGE OF MEDICINE
DEPARTMENT OF FAMILY AND COMMUNITY MEDICINE
CM2 SY 2011-2012
OUTPUT 7: RESEARCH PROTOCOL
Exposure to Air-conditioning Systems in Classrooms Leads to Mild Severity of Allergic Rhinitis in
Second Year High School Students of Selected Schools in Dasmarias City, Cavite: A Cross-
Sectional Study.
SUBMITTED ON:
October 13, 2011
SUBMITTED TO:
DR. JOVILIA M. ABONG
SUBMITTED BY:
GROUP 1A
ARCAIRA, JOSHUA A.
ABAD, MARY RAINA ANGELI
ANCHETA, JONATHAN
BASUL, CHARINE
CARAVEO, JULIEN NICOLE
CRUZ, SPICA
ESPINOZA, FAITH KRISTINE
GARCIA, RAY WILSON
KALALO, GERARD MICHAEL
8/3/2019 Research Protocol 1st Submission
2/31
1
OUTPUT 7: RESEARCH PROTOCOL
GROUP 1A, DR. JOVILIA M. ABONG
I. INTRODUCTION
Research Question and Hypothesis
Research Question:
Among second year high school students with allergic rhinitis of selected schools in Dasmarias, Cavite,
will exposure to air-conditioned school rooms affect the severity of their allergic rhinitis?
Research Hypothesis:
Exposure to air-conditioned rooms alleviates the symptoms and occurrence of allergic rhinitis and poor
ventilation leads to its severity.
Background of the Research Question
The researchers are concerned with the fact that more than 20% of the American population is affected by
allergic rhinitis (AR) [1] and moreover, the Philippines has ranked with the highest prevalence of rhinitis
and asthma among other Asian countries. [2] With this the researchers deemed to determine the factors that
may lead to the exacerbation of allergic rhinitis and in turn discover methods of how to prevent the
progression of its severity. AR has been shown to decrease performance of students in school leading to
absenteeism of students. [3] Poor ventilation in the classrooms lead to increased exposure to allergens such
as pollen, cockroaches, and molds that may ultimately lead to the exacerbation of the students AR
interfering with the students capacity to do his/her daily activities. [4], [5] Hence the researchers wish to
determine if there is an association between exposure to air-conditioning systems in the classrooms and
the occurrence of mild allergic rhinitis.
Significance of the Study
In attempt to determine the classroom environment that would lead to less occurrence of symptoms of AR
leading to mild severity AR, the researchers would like to contribute somehow in helping the students
cope with their condition and be able to maximize their potential in school.
II. RESEARCH OBJECTIVES
General Objective: To determine if the exposure to the air-conditioning system affects the severity
of allergic rhinitis in second year high school students of selected schools in Dasmarias, Cavite.
Specific Objectives:
1. To identify the prevalence of allergic rhinitis among second year high school students of
selected schools in of Dasmarias, Cavite based on their exposure to air-conditioned rooms.
2. To identify the prevalence of allergic rhinitis among second year high school students of
selected schools in Dasmarias, Cavite based on their exposure to non-air-conditioned
classrooms.
8/3/2019 Research Protocol 1st Submission
3/31
2
3. To determine the severity of allergic rhinitis according to ARIA classifications.
4. To identify the risk factors of allergic rhinitis present in the classroom or school, such as the
presence of molds, chalk dust, house dust, and cockroaches.
5. Compare the severity of allergic rhinitis in students who are exposed to air-conditioned
classrooms and those who are not exposed to air-conditioned classrooms.
III. LITERATURE REVIEW
Epidemiology of Disease of interest
According to a demographic and epidemiologic study by Settipane, allergic rhinitis affects more than
20% of the American population. [1] This percentage is alarming on its own, making allergic rhinitis fairly
common among the population. Furthermore, it was observed by the ISAAC (International Study of
Allergy and Asthma in Children) that the Philippines was ranked with the highest prevalence rate of
common allergies (rhinitis and asthma) - encompassing countries like Thailand, Indonesia, and South
Korea. These studies have triggered interest into the disease and have inspired us to study the diseasefurther as well. [2]
From the same study by the ISAAC, they discovered that among Filipino teenagers, 13-14 year-
olds presented with the highest prevalence rate among age groups with 32.5% of them having allergic
rhinitis. [2] Hence, our study will be focusing on the high school year level where the specific age group
mentioned is found.
Ventilation and air-conditioning systems can be sources of microbial aerosols either from
contaminated air entering the system or directly from microbial growth within the system. Poor
ventilation may allow an accumulation of particulates, pollutants, and allergens inside school buildings
and decreased air circulation may increase transmission of respiratory infections. Building structural
problems, such as heating or air conditioning systems venting near an air intake may contribute to these
exposures. Due to this, the associations between school absenteeism and poor ventilation, vermin, and
cumulative exposure to building condition problems are greater for younger students. Young children,
aged 5 to 18 years old,are also known to bemore susceptible to airborne pollutants than adults because of
their greater activity, smaller airways, and faster ventilation rates.[3] Therefore, it is important to look into
which of the learning environments is more likely to help students achieve their full potential and keep
them healthy.
According to Meltzer, approximately one in five children will develop symptoms of allergic
rhinitis by two to three years of age. In children who are six years of age, about 40% of them will have
symptoms and up to 30% will be affected during their adolescence. [4] Furthermore, a study by Blaiss
pointed out that allergic rhinitis can interfere with a childs daily activities such as learning in school. It
also affects a childs behavior and psychosocial health thus affecting the childs quality of life overall.Due to this, a consensus panel was formed in 2004 to assess the impact allergic rhinitis has on school
children and determine how to improve prevention and treatment, so an affected childs quality of life and
school performance could improve. One of the things they considered in this consensus is that poor
environmental conditions, such as places that have inadequate ventilation or poor indoor quality, can
exacerbate allergic rhinitis. It is advised that the best way to prevent allergic rhinitis from occurring is by
providing clean indoor environments that will reduce the amount of allergens present indoors. This
includes having an air-conditioning system and proper ventilation.[4], [5]
8/3/2019 Research Protocol 1st Submission
4/31
3
Risk factors and possible Confounding variables of the study
Allergens/Irritants
Allergens and irritants present in the environment are part of the confounding variables of the study. One
of the allergens that commonly trigger allergic rhinitis is pollen. In a cohort study conducted in Sweden in
2003, it has been identified that pollen accounted for seventy-three percent (73%) of the trigger factorsthat cause allergic rhinitis.
[6]Moreover, the incidence of allergic disease has been thought to be
constantly increasing [7] and this has been attributed to the increased exposure of children to air pollution,
probably because of the presence of particulates in the air. [8]. The condition of the classroom, as will be
surveyed upon implementation of the study, is a confounding variable to this research because as already
mentioned, allergens comprise a big part of the triggers of allergic rhinitis and these allergens or irritants
may be present in the classroom in the form of dust from unwashed curtains, carpets, or table cloths that
may trigger a more severe allergic reaction. Furthermore, exposure to chalk dust, especially in a poorly
ventilated classroom, may also trigger allergic rhinitis of the affected students.
Epidemiology of Exposure/Factor of interest
According to Busse, an allergic reaction is usually caused by an allergen. In the cases of people with
allergic rhinitis, when they breathe in these allergens such as pollens or dust, these cause their bodies to
release certain chemicals like histamine, bradykinin, and the like. These chemicals cause the persons with
AR to experience symptoms of allergic reactions such as itching, swelling, and mucous production.
Pollens that cause AR may differ depending on the person who inhales such pollens. Usually the smaller,
hard-to-see pollens cause AR more often than the bigger ones. Examples of plants that produce the said
pollens are deciduous and evergreen trees, grasses, and ragweed. Development of symptoms may depend
on the amount of pollen present in the air. During dry, hot, windy days there may be more pollens present
in the air thus, the increasing the probability of developing symptoms of AR. However, during cool,
damp, rainy days pollens may not be abundant in the air since they would most likely be washed in the
ground. Reactions to allergens may also include eczema and asthma which are also part of the allergic
reaction. The most common cause of developing AR is still genetic in nature. The chance of having AR is
high if both parents have the disease.[9]
Togias stated that inflammatory mediators produced by mast cells that are activated by antigen-
IgE cause the symptoms of AR. The mediators directly or indirectly target the end organs. For example,
the histamine released by mast cells stimulates the sensory nerves which lead to sneezing, pruritus,
rhinorrhea, and nasal congestion. Symptoms may also arise due to the phenomenon of hyper-
responsiveness to non-allergenic stimuli like cold air and other irritants. The phenomenon is believed to
have arisen from the allergic inflammation on the sensory nerves that supply the mucosa of the upper
respiratory tract mucosa. Different kinds of non-allergenic triggers were shown to act on the nasal mucosaby the means of sensorineural stimulation. The responsiveness to these stimuli is also heightened in AR
compared to healthy individuals. Also, stimulation of sensory nerves can produce inflammatory changes
in AR. Such inflammation is called neurogenic inflammation but the mechanism behind this is not yet
known. However, Alkis also stated that evidence exists that neurotrophin nerve growth factor, the one
responsible for the changes in the sensory nerves, is found in elevated levels in the nasal secretions of
persons with perennial AR compared to healthy individuals. The nerve growth factor is also acutely
8/3/2019 Research Protocol 1st Submission
5/31
4
released into nasal fluids after being triggered by allergens in patients with allergic disease. AR is also
very common among patients with asthma of atopic origin.[10]
Accurate records on the prevalence of allergic rhinitis are lacking before the 20th
century.
According to a demographic and epidemiologic study by Settipane, allergic rhinitis affects more than
20% of the American population.[9]
The study showed that 64% of 1836 students originally tested 23
years ago were followed up. Seventeen new cases of asthma (10.5%) have developed in the 162 subjectswho previously suffered from seasonal AR. Nineteen new cases of asthma (3.6%) had developed in the
528 subjects without previous symptoms. Subjects without symptoms but had previous positive skin prick
tests were somewhat more likely to have developed asthma compared to people with negative tests
(10.6% versus 3.2%).[11], [12]
Summary of Related Studies
According to Kutintara, allergic rhinitis (AR) is the most common of all allergic diseases. The prevalence,
which ranges from 4% to 40%, of this disease is spreading worldwide, including the Asia Pacific region.
It has a great impact on a persons daily life. 82% of AR sufferers in the United States reported that theyalways or usually have symptoms at work or school. It is responsible for about 2 million lost school-days
each year in the United States and a significant large number of Thai children indicated that their allergysymptoms were severe enough to limit their activities. [13]
Another study in Spain conducted by Jauregui et. al. states that AR is the most common chronic
disorder that affects the pediatric population.[16]
Data shows that AR and rhinoconjunctivitis represent the
main cause of 55.5% of all patients seen in Spanish allergology clinics. Again, it is important to note thata third of the population of 13-14 year-old teenagers suffer from the symptoms of AR. [17] It has been also
stated in the study that AR somehow impairs daily activities such as visual coordination, retention
capacity, and reaction time of students. [18]
Avoidance is the primary method in treating AR. Those with allergies can reduce their allergic
symptoms by reducing their exposure to allergens. This includes promoting a healthy indoor environment.
The main allergens that are found indoors are allergens from dust mites, cockroaches, and molds. Theseallergens can be avoided by knowing how to eliminate them. These allergens commonly survive in
environments that are warm, moist and humid. Dust mites cannot live in an environment that has a
relative humidity of less than 50% while cockroaches and molds only thrive in areas of warmth and
humidity. Therefore, other than keeping an AR patients surrounding environment clean, it is alsorecommended to have an air-conditioning system or proper ventilation system so that it can reduce the
amount of allergens present in the patients environment by reducing the humidity and heat levels. [13]
In congruence with the aforementioned study, according to Zacharisen, a member and a fellow of
the American Academy of Asthma, Allergy, and Immunology, the key to reducing the severity of
symptoms a child experiences at school is avoidance of these allergens. If it is possible, parents should
talk to school personnel to make them aware of the allergy triggers of their children so as to avoid
aggravating their allergies. [14]
A study in Boston conducted by Blaisse stated that the symptoms of allergic rhinitis and the
adverse effects of medications taken can diminish or lessen the cognitive function and learning of
students. This can also affect the quality of student-life if aggravated. What is unfortunate is that most
conditions are left under-diagnosed or under-treated because symptoms are often discounted by parents as
just allergies. [15] The study further noted that aside from the loss of cognitive function in children with
8/3/2019 Research Protocol 1st Submission
6/31
5
moderate to severe AR, this can also cause irritability and fatigue leading to the inattentiveness and
difficulty in concentrating in school. One of the most important components of management, according
to the study, is to educate the patient and the family about avoiding the allergens that the children are
allergic to.
Sleep disturbances were caused by nasal congestion/blockade and also frequent awakenings
during at night due to allergic inflammation. AR causes sleep disturbances, daytime sleepiness,
absenteeism, presenteeism, irritability, restlessness, mood disorders, and an altered social life.
Presenteeism is the inattention, distraction, and lack of attention of the students while inside the
classroom due to the symptoms of AR. Obviously, one of the main causes of learning difficulty and
school failure is the students inability to concentrate due to untreated ARgiven that it is in fact one of
the most common chronic illnesses that hits children and teenagers.[16], [19]
Focusing on the building conditions wherein classrooms are situated, a study that concerns
transmission of airborne diseases was conducted in Peru. Rooms that only had natural measures for
encouraging airflow were compared with mechanically ventilated rooms that were built much more
recently. A comparison was also done between naturally ventilated rooms in old hospitals and naturallyventilated rooms in newer hospitals. Results showed that natural ventilation had high rates of air
exchange, with an average of 28 air changes per hour. 50 year old hospitals had the highest ventilation
with an average of 40 air changes per hour due to its structure. This rate is far higher compared to the 17
air changes per hour in naturally ventilated rooms in modern hospitals, which have lower ceilings and
smaller windows. [20]
In line with this, a study about the impact of school building conditions on student absenteeism in
Upstate New York, researchers investigated this by obtaining data from the 2005 Building Condition
Survey of Upstate New York schools with 2005 New York State Education department students
absenteeism data at the individual school level and evaluated associations between building conditions
and absenteeism at or above the 90th
percentile. As a result, researchers associated absenteeism withvisible molds, humidity, poor ventilation, vermin, building condition problems, and building system or
structural problems related to these conditions. They also saw that schools in lower socioeconomic
districts and schools attended by younger students showed the strongest association between poor
building conditions and absenteeism. With this study, there were some limitations. Some confounding
variables were the external exposures such as traffic pollution and exposures from a students home could
have affected this study. In addition, absenteeism due to illness or other reasons could not be
distinguished. The study's ecological design did not allow collection of information on individual health
outcomes or reasons for absenteeism. In conclusion, they found associations between student absenteeism
and adverse school building conditions. As a recommendation, further studies should confirm these
findings and prioritize strategies for school condition improvements.[3]
8/3/2019 Research Protocol 1st Submission
7/31
6
Conceptual Framework
Figure 1. Conceptual framework of the research study. Exposure to air-conditioning systems in the
classrooms lead to less presence of allergens or irritants such as molds, cockroaches, house and chalk dust
ultimately leading to mild (decreased) severity of AR.
IV. METHODOLOGY
Research Design
The type of study that the researchers are going to be implementing is a cross-sectional research design.
The researchers deem this the most necessary research design just to see whether or not there is a
relationship between the number of hours exposed to air-conditioning systems and the exacerbation of
Allergic Rhinitis. Moreover, this research design is appropriate because the Disease Variable of the
research, which is Allergic Rhinitis, is not a rare disease (thus eliminating the use of a case-control study).
However, in doing a cross-sectional study, the researchers must take note of and control the confoundingvariablesways of which will be discussed in the latter part of the description of the research design.
Definition of Study Population / Study Groups
The study population will be 2nd year highschool studentsin the Philippine setting. From this population,
a sample of students who have AR will be considered for the study.
Source of Subjects
The sample populations will be gathered from select schools in Dasmarias, Cavite, ideally one private
and public school in order to acquire subjects that have exposure to an air conditioned school environment
and one that is not.
Operational Definition of Variables
Dependent VariableAllergic Rhinitis
Allergic rhinitis (often called allergies or hay fever) occurs when the immune system
overreacts to particles in the air that you breathe. When the immune system attacks the particles in
the body, it causes symptoms such as sneezing and a runny nose. Over the time, allergens may
begin to affect you less, and the severity of the symptoms also decreases.[21]
It is characterized as
8/3/2019 Research Protocol 1st Submission
8/31
7
the inflammation of nasal passages, usually associated with watery nasal discharge and itching of
the nose and eyes after exposure to the allergen.
Around two-thirds of people with allergic rhinitis manifest the symptoms before the age of 30
but the age at which the symptoms occur may vary. Genetics greatly affects the chance of having
allergic rhinitis of an individual. Usually if one or both parents have the disease, their offspring
will have a high chance of inheriting the disease. People with allergic rhinitis can also be restrictedby the disease in their day to day activities and this may result to increase in time away from
school or work. Also, in the US, millions of dollars are spent every year for doctor services and
medicine for treating the chronic illness. Symptoms of this illness are triggered by many different
allergens and these usually include plant pollens, molds, dust, and allergens produced by cats or
dogs. The amount of these allergens is affected by the season as the spread of pollens and spores
are determined by the amount of wind in a particular season. [22]
Independent VariableAir-conditioning System
According to the Department of Health of Hong Kong, sudden change in temperature both
indoor and outdoor may activate the release of inflammatory agents. They stated that the room
should be maintained at around 25 degrees Celsius.[23]
The air conditioner is a common appliance usually found in many buildings both private and
public. It is used to cool the air found indoors to make the people inside the building more
comfortable. Air conditioners nowadays are not only used for cooling the air, some types of air
conditioners can warm the indoor air especially those that are found in places where people
experience the winter season. In addition to their air temperature changing capability, the air
conditioners nowadays are also capable of filtering, disinfecting and dehumidifying the air to make
the people using the appliance more comfortable that is why the air conditioner is also regarded as
comfort-making-machine by some people. [24]
Confounding Variables:
Allergens are substances or particles that are foreign to the body and can cause allergic
reaction in certain people. Pollens, molds, cockroaches, and dusts are examples of allergens whichcan be found in the environment. In managing allergies, it is suggested to reduce the level of
exposure to these allergens.[27]
According to an article by deShazo and Kemp, the spores coming from molds can be a trigger
in releasing the symptoms of allergic rhinitis. Also, according to them, molds thrives in damp
environments such as air-conditioning vents, water traps, refrigerator drip trays, shower stalls,
leaky sink and damp basements if not cleaned regularly and under certain conditions, the growth
of these organisms can be considerable and exacerbate allergy symptoms.[25]
Since allergic rhinitis
is difficult to cure, the focus is on preventing the attack of the symptoms. Molds are seen as
cotton-like element that is usually in the color of gray, green, black or white. These molds produce
strong earthy and musty odors, although some are odor-free. The smell could be an indication of
infection.[28]
Many different triggers that may cause a student to experience symptoms of asthma and
allergy are found inside a typical classroom. These triggers include the pollens from the plants
found near or inside a classroom, dust mites and mold spores. The cleanliness of the room may
also play a factor in triggering the allergic reactions. The students themselves may also carry
allergens produced by their pet cats or dogs that may be attached to their clothes and these
allergens can be in contact with the students with asthma or allergy. Chalk dusts are also usually
8/3/2019 Research Protocol 1st Submission
9/31
8
the causes of allergic reactions inside the classroom since the teachers usually use chalks for
writing on the green boards.[26]
Chalk dusts are particles produced when a chalk crayon is used to write on chalkboards.
These usually remain suspended in the air because these particles are not so heavy so as a result,
teachers and students usually inhale small amount of these and become trapped in the mucous
layers of the throat and upper lungs. This does not usually pose a threat to normal persons becausethe accumulated chalk dust is naturally expelled out through coughing and the remaining chalk
dust is safely absorbed by the body. However, in persons with chronic breathing issues or allergic
rhinitis these chalk dust can irritate their upper respiratory tract and trigger their symptoms and can
be dangerous for the person who inhaled the chalk dust.[29]
Cockroaches are recognized as powerful indoor allergens. They are among the oldest living
species residing the earth. These creatures are hardy and adaptable that thrives in areas where food
and water supplies are plentiful. They can be found around dripping faucets and kitchen areas. The
allergen produced by cockroaches is from the saliva, body parts and even their digestive enzymes.
These particles become airborne when disturbed by motion in the room.[27]
Steps to be Undertaken
These are the steps to be done in our procedure to collect data for this project:
1. Randomly select four (4) High Schools in Dasmarias, Cavite. Classify into with air-
conditioning system and without air-conditioning system by contacting the principal of the selected
schools.
2. Evaluate the classroom conditions of each school.
The group will visit each high school and evaluate the environmental conditions of each classroom
that will be part of the research. An integrated checklist from Health Canada and IAQ Tools for
Schools [30], [31] will be given to teacher or adviser of each classroom document and evaluate the
conditions.
3. Screen students for allergic rhinitis.Each student will be screened through a questionnaire, based sections of the ISAAC questionnaire, to
eliminate those who do not have allergic rhinitis from the study group. [32] This will help in making
the research study more specific to those who have allergic rhinitis and how the classroom conditions
can alleviate or exacerbate their symptoms.4. Sections of the ARIA questionnaire will be given to each student who has AR in which it will ask
them if their symptoms are better or worse when they are in the classroom and what specific
conditions help or harm them. [33]
5. Evaluate each students questionnaire.
Each students questionnaire will be evaluated to see what particular conditions affect the severity of
their AR. There will also be a particular focus on whether having an air-conditioning system present
or not alleviates or worsens each students AR symptoms.
8/3/2019 Research Protocol 1st Submission
10/31
9
Schematic Diagram of the Design
Fig 2. Schematic diagram showing the exposures and the possible outcomes of the study
Possible Biases and Plans to Control / Minimize these Biases
Enumeration of all biases/limitations
The study will only focus on the role of ventilation inside the classrooms in the relief and
exacerbation of allergic rhinitis among 2nd year highschool students studying in Dasmarias,
Cavite. It will not include other respiratory diseases and illness that may be affected by the
difference in ventilation.
The possible biases in the study are:
Selection bias
Expectation bias
Plan to minimize these biases in the study
Selection bias may happen when subjects being compared are not similar, and may result to
data that is not representative of the population of interest.[34]
With the use of proper screening
methods for the study population, we will select subjects that are similar in almost all aspects in
order to gather a more representative and comparable data.
Expectation bias happens when there is no masking or blinding implemented in the study
and this may influence and tarnish the data to be gathered towards the expected or desired
outcome.[34]
To minimize this bias, a high level of objectivity must be maintained with each of the
members of the group of researchers in the gathering of data and its analysis.
Sampling Method
Firstly, in selecting for the respondents of the study, a list of all the schools in Dasmarinas City, both
public and private, was obtained. Two schools with air conditioning systems will be randomly chosen
from the list and two schools without air conditioning systems will also be randomly chosen. Fish bowl
method will be used in selecting for both schools. However, before selecting for the schools, those with
8/3/2019 Research Protocol 1st Submission
11/31
10
air conditioning systems and those without must be identified first. To do this, the principals of the
schools will be contacted through telephone calls and be politely asked to elicit the presence of air-
conditioning systems in their classrooms and the number of second year students they have.
Selection of Cases
For the selection of cases, among the students of the selected schools with air conditioning
systems, random sections per school will be selected via the fish bowl method . The students of
the selected sections will be given ISAAC questionnaires for screening and selection of students
with allergic rhinitis.
Selection of Controls
For the selection of controls, the same process in the selection of the cases will be utilized but
instead of choosing from the list schools with air conditioning system, list of schools without air
conditioning systems will be used.
Fig 3. Schematic diagram of the method to be employed in selection of cases and controls in the study.
Sample Size
Definition of variables used in the calculations
1. p1The p1 variable is the estimate of the sample population for the high school students who study in
air-conditioned classrooms that have mild allergic rhinitis.
2. p2The p2 variable is the estimate of the sample population for the high school students who study in
non-air-conditioned classrooms that have mild allergic rhinitis.
8/3/2019 Research Protocol 1st Submission
12/31
11
3. Alpha ()Alpha is the probability of committing a type I error, which means rejecting the null hypothesis
when in fact the null hypothesis is true. In the study, this is when results show that there is no
association between exposure to air-conditioning system and alleviation of severity of AR when
in fact there is.
4. Beta ()
Beta is the probability of committing a type II error, which means retaining the null hypothesiswhen the null is false. In the study, this is when we fail to reject the null hypothesis even if there
is sufficient evidence to state otherwise.
5. Direction of TestThe study is a one tailed test because we are leaning towards the result of which air-conditioning
helps in alleviating the severity of AR.
Values
p1 30.7
p2 13.4
0.95
0.80
The p1 and p2 values were based on the following study:
Mendell, M.J. & Smith, A.H. (1990). Consistent Pattern of Elevated Symptoms in
Airconditioned Office Buildings: A Reanalysis of Epidemiologic Studies.
American Journal of Public Health. (80) 10.
Computation Using a Computer Program (Open Epi)
Figure 3. Inputted values in Open Epi in the computation of a computer-generated sample size.
8/3/2019 Research Protocol 1st Submission
13/31
12
Figure 4. Total sample size computed was 202, meaning 101 students will comprise the exposed group
and the other 101 students will be the unexposed group.
Data Collection
Method of Data Collection
The researchers method of data collection will primarily include the use of questionnaires and checklists.
The questionnaires (ISAAC-based) shall first be given to students to screen each whether or not they have
Allergic Rhinitis. After being able to screen the students, we shall be administering questionnaires to the
students who are positive for Allergic Rhinitis. The questions are primarily based on the ARIA
classification of severity for Allergic Rhinitis. This will enable the researchers to determine whether or
not there is exacerbation of the students Allergic Rhinitis due to exposure to air-conditioned rooms and
non air-conditioned rooms and to classify them as to mild or severe to moderate Allergic Rhinitis.
Moreover, the researchers will also use a checklist to survey the classroom conditions the
students are exposed to. These will include conditions inside and outside of the room that could possibly
affect the students conditions.
8/3/2019 Research Protocol 1st Submission
14/31
13
Source of Data
Sources for the researchers data will primarily come from second year high school students of the
selected schools that will be included in the study. Moreover, observation will also be used to survey the
environmental conditions inside and outside of the students classrooms to identify possible attributing
factors to the trigger and exacerbation of ones Allergic Rhinitis.
Data Collection Tool
The researchers tools will include:
1. ISAAC-based questionnaires to screen for Allergic Rhinitis
2. ARIA Classification questionnaire for determining the severity of the students
Allergic Rhinitis
3. Checklist for Classroom Conditions
Please see attached questionnaires and checklist.
8/3/2019 Research Protocol 1st Submission
15/31
14
1. ISAAC QUESTIONNAIRE FOR SCREENING STUDENTS
Study Instruments for 13/14 year olds
Instructions for Completing Questionnaire and Demographic Questions (Section 7.1)
On this sheet are questions about your name, school, and birth dates. Please write your answers to thefollowing questions in the space provided.
All other questions require you to tick (check) your answer in a box. If you make a mistake, put a cross in
the box and tick the correct answer. Tick only one option unless otherwise instructed.
___________________________________________________________________________________
SCHOOL:
TODAYS DATE:
Day Month Year
YOUR NAME:
YOUR AGE: years
YOUR DATE OF BIRTH:
Day Month Year
(Tick all your answers for the rest of the questionnaire)
Are you: MALE FEMALE
8/3/2019 Research Protocol 1st Submission
16/31
15
Core Questionnaire for Allergic Rhinitis (Section 7.3)
All questions are about problems which occur when you DO NOT have a cold or the flu.
1 Have you ever had a problem with sneezing, or a runny, or
blocked nose when you DID NOT have a cold or the flu?
Yes
No
IF YOU HAVE ANSWERED NO PLEASE SKIP TO QUESTION 4.
2 In the past 12 months, have you had a problem with sneezing,
or a runny, or blocked nose when you DID NOT have a cold
or the flu?
Yes
No
IF YOU HAVE ANSWERED NO PLEASE SKIP TO QUESTION 4.
3 In the past 12 months, has this nose problem been
accompanied by itchy-watery eyes?
Yes
No
4 Have you ever had hay fever? Yes
No
8/3/2019 Research Protocol 1st Submission
17/31
16
2. ARIA QUESTIONNAIRE
1. What symptoms do you have?(Answer Yes for any of the symptoms listed below that apply. Answer No for all that do not.)
Watery runny nose Yes No
Sneezing (especially violent and in bouts) Yes NoNasal obstruction (feeling of being unable to breathe through your nose) Yes No
Itchy nose Yes No
Watery, red, itchy eyes Yes No
2. How long do your symptoms last?(Answer Yes or No for each time frame below.)
More than four days a week Yes No
More than four weeks in a row Yes No
3. How do your symptoms affect you?(Answer Yes for any of the symptoms listed below that apply. Answer No for all that do not.)
My symptoms disturb my sleep. Yes No
My symptoms restrict my daily activities (sports, leisure, etc.) Yes No
My symptoms restrict my participation in school or work. Yes No
My symptoms are troublesome to me. Yes No
4. How much do your symptoms bother you?(On a scale of 0 to 10, with 0 being Not at all and 10 as Very much, indicate how much yoursymptoms bother you Tick only
one.)
0 4 8
1 5 9
2 6 10
3 7
8/3/2019 Research Protocol 1st Submission
18/31
17
3. CHECKLIST FOR CLASSROOM CONDITIONS
Checklist for the presence of MOLDS (http://www.moldunit.com/mold-detection.html)
Yes No 1. Presence of water leaks coming from either rain or air-conditioning units apparent on
the ceiling, walls and pipes or stagnant water.Yes No 2. Wet cellulose materials such as paper, cardboard, ceiling tiles and wood products.
Yes No 3. Appearance of a cottony, velvety, granular or leathery like dirt (in any shade of color)near or within the area where there are water leaks.
Yes No 4. Inspect walls, under carpeting, under cabinets and air ducts for hidden molds.
Checklist for the presence of COCKROACHES(http://www.ehow.com/how_7744440_tell-
roaches.html) (http://www.roebourne.wa.gov.au/Assets/environment/hs-
0025%20cockroach%20management.pdf)
Yes No 1. Presence of dripping faucets and bathrooms.
Yes No 2. Presence of eggs of roaches, dead roaches, insect parts or feces (black gritty substance,
pepper-like) under the cabinets or behind walls and appliances, and sight of cockroaches
themselves.
Yes No 3. Evidence of holes from chewing such as paper and cardboards.
Checklist for the presence of HOUSE DUST
Yes No 1. Presence of curtains, pillows, carpets
Yes No 2. Presence of dust when you touch or rub with your hand the materials mentioned
above.
Yes No 2. Presence of dust above the tables, chairs, window sills, and the floor.
Checklist for the presence of CHALK DUST
Yes No 1. Presence of chalk (for writing on the board) and specify if it is dustless or not.
Yes No 2. Presence of chalk dust in corners of the board and on the board eraser.
Yes No 3. Presence of a wet rag for cleaning the chalk board.
Yes No 4. Presence of a box for cleaning the board eraser.
8/3/2019 Research Protocol 1st Submission
19/31
18
V. BIBLIOGRAPHY
[1] Settipane, R.A. (2001). Demographics and Epidemiology of Allergic and Nonallergic Rhinitis
[Abstract]. Allergy Asthma Proc. 22(4): 185-9. Retrieved July 8, 2011 from:
http://www.medscape.com/medline/abstract/11552666.
[2] Philippine Star (2008). Allergic Rhinitis Prevalent among Pinoys. Retrieved July 8, 2011 from:
http://library.pchrd.dost.gov.ph/index.php/news-archive/1080.
[3] Simons, E., Hwang, S., Fitsgerald, E., Keilb, C. & Lin, S. (2009). The Impact of School Building
Conditions on Student Absenteeism in Upstate New York. 100 (9). Research and Practice.
[4] Blaiss, MS. Allergic rhinitis and impairment issues in schoolchildren: a consensus report. Current
Medical Research and Opinion. 2004 Dec; 20(12):1937-52. From:
http://www.redorbit.com/news/health/131029/allergic_rhinitis_and_impairment_issues_in_school
children_a_consensus_report/index.html
[5]Meltzer, E.O. (1998). Treatment Options for the Child with Allergic Rhinitis. Clinical Pediatrics. Jan
1998; 37, 1; ProQuest Research Library. Accessed July 7, 2011.
[6] Alm B, Gokso r E, Thengilsdottir H, Pettersson R, Mo llborg P, Norvenius G, Erdes L, A berg N,
Wennergren G. Early protective and risk factors for allergic rhinitis at age 4 years. Pediatric Allergy and Immunology 2011; 22: 398404. Retrieved July 22, 2011 from
http://onlinelibrary.wiley.com/doi/10.1111/j.1399-3038.2011.01153.x/pdf
[7] Nakagomi T, Itaya H, Tominaga T, et al. (1994). Is atopy increasing? Lancet 1994;343:1212.
Retrieved July 22, 2011 from http://www.ncbi.nlm.nih.gov/pubmed/7903758
[8] Hajat S, et al. Association between air pollution and daily consultations with general practitioners for
allergic rhinitis in London, United Kingdom. American Journal of Epidemiology (2001) 153 (7):
704-714. Retrieved July 22, 2011 from http://aje.oxfordjournals.org/content/153/7/704.full
[9] Busse, P. (2010). Allergic rhinitis. Medlineplus. Retrieved July 16, 2011, from
http://www.nlm.nih.gov/medlineplus/ency/article/000813.htm.
[10] Togias, A. (2004). Unique mechanistic features of allergic rhinitis. Journal of allergy and clinicalimmunology. Retrieved July 16, 2011, from
http://www.sciencedirect.com/science/article/pii/S0091674900093143.
[11] Cauwenberge, et. al. (2004). Epidemiology of Allergic Rhinitis. The UCB Institute of Allergy,
Brussels.
[12] Settipane, R.J., Hagy, G.W., Settipane, G.A.(1994). Long-term risk factors for developing asthma
and allergic rhinitis: a 23-year follow-up study of college students. Allergy Proc. 15: 21-25.
[13] Kutintara, Benjamas. "Home Environments and Allergen Avoidance Practices in a Hot, Humid
Climate." Virginia Polytechnic Institute and State University, 2002. United States -- Virginia:
ProQuest Dissertations & Theses (PQDT). Web. 17 July 2011.
[14] Health risks in the classroom: children with asthma and allergies need to take special precautions atschool. (2007). American Academy of Asthma, Allergies, and Immunology. Retrieved July 15,
2011 from http://www.kidneeds.com/diagnostic_categories/articles/classrisks02.htm
[15] Mahoney, D. (2005). Allergic rhinitis hits hard in the classroom. Retrieved July 16, 2011 from The
CBS Interactive Business Network website:http://findarticles.com/p/articles/mi_hb4384/is_3_39/ai_n29168995/pg_2/?tag=mantle_skin;conte
nt
8/3/2019 Research Protocol 1st Submission
20/31
19
[16] Jauregui, I. et al. (2009). Allergic rhinitis and school performance. J Investig Allergol Clin Immunol.
19, 1: 32-39. Retrieved July 16, 2011 from http://www.jiaci.org/issues/vol19s1/6.pdf
[17] Asher MI, Montefort S, Bjorksten B, Lai CK, Stachan DP, Weiland SK et al. Worldwide time trends
in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood:
ISAAC Phases One and Three repeat multi-country crosssectional surveys. Lancet 2006; 368:733-
743. Retrieved July 16, 2011 from http://www.ncbi.nlm.nih.gov/pubmed/16935684
[18] Wilken JA, Berkowitz R, Kane R. Decrements in vigilance and cognitive functioning associated with
ragweed-induced allergic rhinitis. Ann Allergy Asthma Immunol 2002;89:372380. Retrieved July16, 2011 from http://www.sciencedirect.com/science/article/pii/S1081120610620388
[19] Karande S, Kulkarni M. Poor school performance. Indian J Pediatr 2005; 72(11):961-967. Retrieved
July 16, 2011 from http://www.ncbi.nlm.nih.gov/pubmed/16391452
[20] Siriaksorn, S. (2011). Allergic rhinitis and immunoglobulin deficiency in preschool children with
frequent upper respiratory illness. PubMed. 29(1):73-7. Retrieved July 8, 2011 from
http://www.ncbi.nlm.nih.gov/pubmed/21560491.
[21] Healthwise Staff, Allergic Rhinitis, In: Thompson, E.G. MD, Nelson, H.S. MD, editor, AllergicRhinitis [cited 2011 July 31] Available from: http://www.webmd.com/allergies/tc/allergic-rhinitis-overview
[22] Allergic rhinitis. (2010).Health encyclopedia diseases and conditions.Retrieved July 10, 2011,from http://www.healthscout.com/ency/68/208/main.html.
[23] Retrieved on July 30, 2011 from
http://www.studenthealth.gov.hk/english/health/health_ophp/health_ophp_nos.html
[24] Air conditioner. (2009).Air conditioning and refrigeration information.Retrieved July 30, 2011,
from http://www.air-conditioning-and-refrigeration.com/air-conditioner.html.
[25] deShazo R., Patient Information: Trigger avoidance in allergic rhinitis. Retrieved on July 30, 2011from http://www.uptodate.com/contents/patient-information-trigger-avoidance-in-allergic-rhinitis
[26] Health risks in the classroom: children with asthma and allergies need to take special precautions at
school. Retrieved July 30, 2011, fromhttp://www.kidneeds.com/diagnostic_categories/articles/classrisks01.htm.
[27] Stppler, M.C., MD. Indoor Allergens In: Shiel, W.C. Jr., MD. FACP.FACR., editor, [cited 8August 2011] Available from http://www.medicinenet.com/indoor_allergens/article.htm
[28] Oliver, S., Mold DetectionHow to Detect Toxic Mold in your Home? [cited 8 August 2011]Available from http://ezinearticles.com/?Mold-Detection---How-to-Detect-Toxic-Mold-in-Your-
Home?&id=2589917
[29] Pollick, M. (2011). Is chalk dust harmful? Wise geek: clear answers for common questions.Retrieved August 8, 2011, from http://www.wisegeek.com/is-chalk-dust-harmful.htm.
[30] Classroom Checklist(2007). Health Canada [Website]. Available from: http://www.hc-sc.gc.ca/ewh-
semt/pubs/air/tools_school-outils_ecoles/classroom-salle_classe-eng.php
[31]IAQ tools for Schools. North Hunderton-Voorhees Regional District High School [Website].
Available from: http://www.nhvweb.net/VHS/Math/ABlaustein/toolsforschools/teacher.pdf
8/3/2019 Research Protocol 1st Submission
21/31
20
[32]ISAAC Questionnaire . International Study of Asthma and Allergies in Childhood,[Website]. 2011
[cited 2011 August 8]. Available from
http://isaac.auckland.ac.nz/phases/phasethree/corequestionnaire.pdf.
[33]ARIA Questionnaire . Allergic Rhinitis and its Impact on Asthma [Website]. 2011 [cited 2011 July
30]. Available from http://www.whiar.org/docs/ARIA_OnlineQuestionnaireGuidewm3-
8sp.pdf
[34] Hartman, J.M., Forsen, J.W., Wallace, M.S., Neely, J.G. (2002). Tutorials in clinical research: Part
IV: Recognizing and controlling bias.Laryngoscope, 112, 23-31.
8/3/2019 Research Protocol 1st Submission
22/31
21
VI. APPENDICES
APPENDIX A
Excerpt from the study Consistent Pattern of Elevated Symptoms in Airconditioned Office Buildings: A
Reanalysis of Epidemiologic Studies by Mendell & Smith (1990) in which the values were obtained.
8/3/2019 Research Protocol 1st Submission
23/31
22
APPENDIX BLetter to the School Principals
De La Salle Health Science Institute College of Medicine
Dasmarias, Cavite 4114
Date:
Name of Principal:
Position:
Name of School:
Address:
Dear Sir/Maam,
Greetings!
We, Second Year Medical students of De La Salle-Health Sciences Institute College of Medicine, are happy to
inform you that your school has been selected to take part in our research study. In line with this, we would
like to ask your permission to include your school in our study.
The research study is about the effects of exposure to air-conditioned rooms and non air-
conditioned rooms on the severity of Allergic Rhinitis among second year high school students in Dasmarias
City, Cavite. In line with this, we are asking for your kind consideration to let us include your school in our
research endeavor.
Our study will include the surveying and screening of second year high school students for AllergicRhinitis and surveying the environmental conditions in which students are exposed to both inside and outside
of the classroom.
We can assure you that all information will be kept confidential and that these bodies of information
will be used solely for the purpose of the study. If you have further questions or queries with regard to our
request, please feel free to contact us through the number provided below.
We are hoping for your kind consideration. Thank you very much.
Yours in St. La Salle,
Joshua A. ArcairaGroup Leader (09159084464)
NOTED BY:
Dr. Jovilia M. Abong
Group Preceptor
Dr. Isaac A. Ilano
2nd
Year Coordinator, Community
Medicine
Dr. Christine S. Tinio
Chair, Family and Community
Medicine Department
8/3/2019 Research Protocol 1st Submission
24/31
23
APPENDIX CInformed Consent Letter for the Parents of the Students (English Version)
October 12, 2011
Dear Parents,
My name is Joshua Arcaira. I am a second year medical student at De La Salle Health SciencesInstitute and leader of our group in Family and Community Medicine conducting a study entitled,Exposure to Air-conditioning Systems in Classrooms Leads to Mild Severity of Allergic Rhinitis in SecondYear High School Students of Selected Schools in the City of Dasmarias, Cavite: A Cross-SectionalStudy. Our study will have the following objectives:
General Objective: To determine if the exposure to the air-conditioning system affects the severityof Allergic Rhinitis in second year high school students of selected schools in the City ofDasmarias, Cavite.
Specific Obejectives:1. To identify the prevalence of Allergic Rhinitis among second year high school students ofselected schools in the City of Dasmarias, Cavite based on their exposure to air-conditioned
rooms.2. To identify the prevalence of Allergic Rhinitis among second year high school students ofselected schools in the City of Dasmarias, Cavite based on their exposure to non air-conditionedrooms.3. To determine the severity of Allergic Rhinitis according to ARIA classifications.4. To identify the risk factors of Allergic Rhinitis present in the classroom or school, such as thepresence of molds, chalk, dust, and cockroaches.5. Compare the severity of Allergic Rhinitis in students who are exposed to air-conditionedclassrooms and those who are not exposed to air-conditioned classrooms.
Since our study requires the participation of second year high school students with AllergicRhinitis, your child has been chosen to be included as a participant in our research project.
With your permission, I will ask your child to complete a short four-item questionnaire that wouldtake no longer than 10 minutes to answer to assess the severity of your childs Allergic Rhinitis. Yourchilds participation in this study is completely voluntary and will not affect his/her grades in anyway. There are no known risks involved in this study and, as a benefit, you and your child will be able tolearn more about the severity of your childs Allergic Rhinitis. To protect your childs confidentiality, thequestionnaire will not be shared with anyone, including school authorities, other parents, or any otherstudents, unless required by law.Your child may quit this study at any time by writing Stop or I do notwish to participate on the questionnaire. The questionnaire given will be kept by our preceptor, Dr. JoviliaAbong, and by my groupmates and me.
This letter will serve as a consent form for your childs participation and will be kept in the Familyand Community Medicine Department at the College of Medicine at De La Salle Health Sciences Institute.
If you have any questions or concerns about this study, please feel free to approach me or ouradvisor. You may contact me at 09159084464. Thank you for your kind consideration.
Please have your child return this form to his/her class advisor by (date).
Sincerely yours,
Joshua Arcaira
8/3/2019 Research Protocol 1st Submission
25/31
24
Agreement
Statement of Consent
I read the above consent form. The nature, demands, risk, and benefits of the project have beenexplained to me. I am aware that I have the opportunity to ask questions about this research. I
understand that I may withdraw my consent and discontinue m y childs participation at any time withoutpenalty.
Students Name (Please Print) Date Parents Name andSignature
I certify that I have explained to the above named individual the nature and purpose, the potential benefitsand possible risks associated with participation in this research study. I have answered all questions thathave been raised by this parent. I have provided the participants legal guardian with a copy of thissigned consent form.
Student Researcher Date
8/3/2019 Research Protocol 1st Submission
26/31
25
APPENDIX DInformed Consent Letter for the Parents of the Students (Filipino Version)
KAALAMANG PAGPAYAG NA SULAT
Oktubre 12, 2011
Mahal kong mga Magulang:
Ang pangalan ko po ay Joshua Arcaira. Ako po ay nasa pangalawang taon ng kursongMedisina sa De La Salle Health Sciences Institute at lider ng aming grupo sa Family and CommunityMedicine. Kami po ay nagsasagawa ng isang pag-aaral na pinamagatang Exposure to Air-conditioningSystems in Classrooms Leads to Mild Severity of Allergic Rhinitis in Second Year High School Studentsof Selected Schools in Dasmarias City, Cavite: A Cross-Sectional Study. Ang aming pag-aaral aymayroong mga sumusunod na layunin:
Pangkalahatang Layunin: Upang matukoy kung ang pagkakalantad sa silid-aralan na may air-condition ay nakakaapekto sa kalubhaan ng Allergic Rhinitis sa mga mag-aaral na nasaikalawang antas ng sekundarya sa mga napiling paaralan sa Lungsod ng Dasmarias, Cavite.
Tiyak na mga Layunin:
1. Upang malaman ang lawak ng pagkakaroon ng Allergic Rhinitis sa mga mag-aaral na nasaikalawang antas ng sekundarya sa mga napiling paaralan sa Lungsod ng Dasmarias, Caviteayon sa kanilang pagkakalantad sa air-conditioned na silid-aralan.
2. Upang malaman ang lawak ng pagkakaroon ng Allergic Rhinitis sa mga mag-aaral na nasaikalawang antas ng sekundarya sa mga napiling paaralan sa Lungsod ng Dasmarias, Caviteayon sa kanilang pagkakalantad sa mga silid-aralan na walang air-condition.
3. Upang malaman ang kalubhaan ng Allergic Rhinitis ayon sa klasipikasyon ng ARIA.4. Upang malaman ang mga kondisyon sa loob ng silid-aralan na maaaring magdulot ng
Allergic Rhinitis tulad ng lumot, tisa/yeso(chalk), alikabok at ipis.5. Ihambing ang kalubhaan ng Allergic Rhinitis sa ma mag-aaral na lantad sa air-conditioned na
ma silid-aralan at sa mga mag-aaral na hindi lantad sa air-conditioned na silid-aralan.
Sapagkat ang aming pagsasaliksik ay nangangailangan ng partisipasyon ng mga mag-aaral saikalawang antas ng sekundarya na mayroong Allergic Rhinitis, ang inyong anak ay napili namin upangmaging kalahok sa aming pananaliksik.
Sa inyong pahintulot, humihiling po ako sa inyong anak na kumpletuhin ang isang maikling
palatanungan na binubuo ng apat na tanong lamang at ang pagsagot nito ay hindi hihigit sa sampung
minute upang matukoy ang kalubhaan ng Allergic Rhinitis ng inyong anak. Ang paglahok ng inyong anak
ay kusang-loob at hindi makakaapekto sa kanyang marka sa anumang paraan. Sinisiguro po na naming
walang kaakibat na panganib ang pakikilahok sa pag-aaral na ito at bilang benepisyo, malalaman niyo rin
po at ng inyong anak ang kalagayan ng kanyang Allergic Rhinitis. Para mapanatili ang pagiging
kompidensiyal ng mga kaalamang ibabahagi sa amin ng inyong anak, ang palatanungan ay hindi
kailanman ibibigay sa sinumang nanunungkulan sa paaralan, sa ibang mga magulang at ang iba pangmga mag-aaral, maliban kung kinakailangan ng batas. Maaari pong itigil ng inyong anak ang pakikilahok
sa pag-aaral sa anumang oras sa pamamagitan ng pagsulat lamang sa palatanungan ng Hinto o Hindi
ko nais na lumahok. Ang mga palatanungan na ito ay itatago ng aming preceptor na si Dr. Jovilia
Abong, maging ako at aking mga kasama ko sa grupo.
Ang sulat na ito ay nagsisilbing kaalamang pagpayag na sulat para sa pakikilahok ng inyong
anak at itatago sa Family and Community Medicine Department ng College of Medicine sa De La Salle
Health Sciences Institute.
8/3/2019 Research Protocol 1st Submission
27/31
26
Kung mayroon kang mga katanungan ukol sa pag-aaral na ito, huwag kang mag-alinlangangmakipag-usap sa akin o sa iyong tagapayo sa klase. Maaari mo akong tawagan o i-text sa numerong09159084464. Maraming salamat po sa inyong pag-unawa at pagpapahintulot.
Mangyari lamang po na ibalik ng inyong anak ang sulat na ito sa tagapayo sa klase sa (petsa).
Lubos na gumagalang,
Joshua Arcaira
Kasunduan
Nabasa ko ang kaalamang pagpayag na sulat. Ang mga detalye, pangangailangan, panganib at
benepisyo ng proyektong ito ay naipaliwanag sa akin. Alam ko na ako ay maaaring magtanong ukol sa
pananaliksik na ito. Naiintindihan ko na maaari kong alisin ang aking pagpayag at ihinto ang pakikilahok
ng aking anak sa anumang oras nang walang parusa.
Pangalan ng Mag-aaral (paki-print) Petsa Pangalan at Pirma ng Magulang
Ipinaliwanag ko ang detalye, dahilan, benepisyo at mga posibleng panganib sa pakikilahok sapananaliksik na ito. Nasagot ko lahat ng mga katanungan ng magulang na ito. Binigyan ko ang legal natagabantay ng kalahok ng kopya ng pirmadong kaalamang pagpayag na sulat.
Mag-aaral na Tagapagsaliksik Petsa
8/3/2019 Research Protocol 1st Submission
28/31
27
APPENDIX EInformed Assent Letter for the Students (English Version)
INFORMED ASSENT LETTER
October 12, 2011
Dear Student:
My name is Joshua Arcaira. I am a second year medical student at De La Salle Health SciencesInstitute and leader of our group in Family and Community Medicine conducting a study entitled,Exposure to Air-conditioning Systems in Classrooms Leads to Mild Severity of Allergic Rhinitis in SecondYear High School Students of Selected Schools in Dasmarias City, Cavite: A Cross-Sectional Study.Our study will have the following objectives:
General Objective: To determine if the exposure to the air-conditioning system affects the severityof Allergic Rhinitis in second year high school students of selected schools in the City ofDasmarias, Cavite.
Specific Obejectives:
1. To identify the prevalence of Allergic Rhinitis among second year high school students ofselected schools in the City of Dasmarias, Cavite based on their exposure to air-conditionedrooms.2. To identify the prevalence of Allergic Rhinitis among second year high school students ofselected schools in the City of Dasmarias, Cavite based on their exposure to non air-conditionedrooms.3. To determine the severity of Allergic Rhinitis according to ARIA classifications.4. To identify the risk factors of Allergic Rhinitis present in the classroom or school, such as thepresence of molds, chalk, dust, and cockroaches.5. Compare the severity of Allergic Rhinitis in students who are exposed to air-conditionedclassrooms and those who are not exposed to air-conditioned classrooms.
Since our study requires the participation of second year high school students with Allergic
Rhinitis, you have been chosen to be included as a participant in our research project.
I kindly ask that you complete a short four-item questionnaire that would take not longer than 10minutes to answer to assess the severity of your allergic rhinitis. Your parent(s) or legal guardian(s) havealready given permission for you to be a part of this study, but if you do not wish to participate, you maychoose not to. Your participation in this study will not affect your grades in any way. There are no knownrisks involved in this study and you will be able to learn more about the severity of your Allergic Rhinitis.To protect your confidentiality, the questionnaire will not be shared with anyone, including schoolauthorities, your parents, or any other students, unless required by law. You may quit this study at anytime by writing Stop or I do not wish to participate on the questionnaire. The questionnaire given will bekept by our preceptor, Dr. Jovilia Abong and by my groupmates and me.
If you have any questions or concerns about this study, please feel free to approach me or your
class advisor. You may also contact me at 09159084464. Thank you for your kind consideration.
Sincerely yours,
Joshua Arcaira
8/3/2019 Research Protocol 1st Submission
29/31
28
Agreement
I agree to participate in this research project and I have received a copy of this form.
Students Name (Please Print) Date Students Signature
I have explained to the above named individual the nature and purpose, benefits and possible risksassociated with participation in this research. I have answered all questions that have been raised and Ihave provided the participant with a copy of this form.
Student Researcher Date
8/3/2019 Research Protocol 1st Submission
30/31
29
APPENDIX FInformed Assent Letter for the Students (Filipino Version)
KAALAMANG PAGPAYAG NA SULAT
Oktubre 12, 2011
Mahal kong Mag-aaral:
Ang pangalan ko ay Joshua Arcaira. Ako ay nasa pangalawang taon ng kursong Medisina sa DeLa Salle Health Sciences Institute at lider ng aming grupo sa Family and Community Medicine nanagsasaliksik sa isang pag-aaral na pinamagatang Exposure to Air-conditioning Systems in ClassroomsLeads to Mild Severity of Allergic Rhinitis in Second Year High School Students of Selected Schools inDasmarias City, Cavite: A Cross-Sectional Study. Ang aming pag-aaral ay mayroong mga sumusunodna layunin:
Pangkalahatang Layunin: Upang matukoy kung ang pagkakalantad sa silid-aralan na may air-condition ay nakakaapekto sa kalubhaan ng Allergic Rhinitis sa mga mag-aaral na nasaikalawang antas ng sekundarya sa mga napiling paaralan sa Lungsod ng Dasmarias, Cavite.
Tiyak na mga Layunin:
6. Upang malaman ang pagkakaroon ng Allergic Rhinitis sa mga mag-aaral na nasa ikalawangantas ng sekundarya sa mga napiling paaralan sa Lungsod ng Dasmarias, Cavite ayon sakanilang pagkakalantad sa air-conditioned na silid-aralan.
7. Upang malaman ang pagkakaroon ng Allergic Rhinitis sa mga mag-aaral na nasa ikalawangantas ng sekundarya sa mga napiling paaralan sa Lungsod ng Dasmarias, Cavite ayon sakanilang pagkakalantad sa mga silid-aralan na walang air-condition.
8. Upang malaman ang kalubhaan ng Allergic Rhinitis ayon sa klasipikasyon ng ARIA.9. Upang malaman ang mga kondisyon sa loob ng silid-aralan na maaaring magdulot ng
Allergic Rhinitis tulad ng lumot, tisa/yeso(chalk), alikabok at ipis.10. Ihambing ang kalubhaan ng Allergic Rhinitis sa ma mag-aaral na lantad sa air-conditioned na
ma silid-aralan at sa mga mag-aaral na hindi lantad sa air-conditioned na silid-aralan.
Sapagkat ang aming pagsasaliksik ay nangangailangan ng partisipasyon ng mga mag-aaral saikalawang antas ng sekundarya na mayroong Allergic Rhinitis, ikaw ay napili namin upang magingkalahok sa aming pananaliksik.
Ako ay humihiling sa iyo na sagutan ang isang maikling palatanungan na binubuo ng apat na
katanungan lamang at ang pagsagot nito ay hindi tatagal ng higit sa sampung minute upang malaman
natin ang kalagayan ng iyong Allergic Rhinitis. Ang iyong mga magulang o legal na tagapag-alaga ay
nagbigay na ng pahintulot para sa iyo upang lumahok sa pag-aaral ngunit maaari kang hindi sumali kung
iyong nanaisin. Ang iyong pagsali sa pag-aaral na ito ay hindi makakaapekto sa iyong marka sa anumang
paraan. Walang anumang panganib ang nakaakibat sa pag-aaral na ito at malalaman mo rin mula rito
ang kalubhaan ng iyong Allergic Rhinitis. Upang mapanitili ang pagiging kumpidensyal ng impormasyong
ibabahagi mo sa amin, ang palatanugnan ay hindi kailan man ibabahagi sa sinuman sa mga
namamahala ng inyong paaralan, ang iyong mga magulang at ang iba pang mga mag-aaral, malibankung kakailanganin ng batas. Maaari mong itigil ang pagsali sa pag-aaral sa anumang oras sa
pamamagitan ng pagsulat lang sa palatanungan ng Hinto o Hindi ko nais na lumahok. Ang mga
palatanungan na ito ay itatago ko at aking mga kagrupo maging ang aming preceptor na si Dr. Jovilia
Abong.
8/3/2019 Research Protocol 1st Submission
31/31
Kung mayroon kang mga katanungan ukol sa pag-aaral na ito, huwag kang mag-alinlangang makipag-
usap sa akin o sa iyong tagapayo sa klase. Maaari mo akong tawagan o i-text sa numerong
09159084464. Maraming salamat sa iyong pag-unawa.
Lubos na gumagalang,
Joshua Arcaira
Kasunduan
Sumasang-ayon ako na lumahok sa proyektong ito ng pananaliksik at ako ay nakatanggap ng
isang kopya ng form na ito.
Pangalan ng Mag-aaral (paki-print) Petsa Pirma ng Mag-aaral
Ipinaliwanag ko sa pinangalanang indibidwal ang pinagmulan at layunin, mga benepisyo at posibleng
panganib nakaugnay sa pakikilahok sa pananaliksik na ito. Sinagot ko ang lahat ng mga katanungan nainilahad at binigyan ko ang kalahok ng isang kopyang form na ito.
Mag-aaral na Tagapagsaliksik Petsa