| Hydrophilic Fungi and Ergosterol
Associated with Respiratory Illness
in a Water-Damaged
Building Ju-Hyeong Park, Jean M. Cox-Ganser,
Kathleen Kreiss, Sandra K. White, and Carol Y. Rao Division of Respiratory Disease Studies,
National Institute for Occupational Safety and Health,
Morgantown, West Virginia, USA Abstract
Background: Damp building–related respiratory illnesses are an important public health issue. Objective: We compared three respiratory case groups defined by questionnaire responses [200 respiratory cases, 123 of the respiratory cases who met the epidemiologic asthma definition, and 49 of the epidemiologic asthma cases who had current physician-diagnosed asthma with postoccupancy onset] to a comparison group of 152 asymptomatic employees in an office building with a history of water damage. Methods: We analyzed dust samples collected from floors and chairs of 323 cases and comparisons for culturable fungi, ergosterol, endotoxin, and cat and dog allergens. We examined associations of total fungi, hydrophilic fungi (requiring water activity ≥ 0.9) , and ergosterol with the health outcomes using logistic regression models. Results: In models adjusted for demographics, respiratory illnesses showed significant linear exposure–response relationships to total culturable fungi [interquartile range odds ratios (IQR-OR) = 1.37–1.72], hydrophilic fungi (IQR-OR = 1.45–2.19) , and ergosterol (IQR-OR = 1.54–1.60) in floor and chair dusts. Of three outcomes analyzed, current asthma with postoccupancy physician diagnosis was most strongly associated with exposure to hydrophilic fungi in models adjusted for ergosterol, endotoxin, and demographics (IQR-OR = 2.09 for floor and 1.79 for chair dusts) . Ergosterol levels in floor dust were significantly associated with epidemiologic asthma independent of culturable fungi (IQR-OR = 1.54–1.55) . Conclusions: Our findings extend the 2004 conclusions of the Institute of Medicine [Human health effects associated with damp indoor environments. In: Damp Indoor Spaces and Health. Washington DC: National Academies Press, 183–269] by showing that mold levels in dust were associated with new-onset asthma in this damp indoor environment. Hydrophilic fungi and ergosterol as measures of fungal biomass may have promise as markers of risk of building-related respiratory diseases in damp indoor environments. Key words: asthma, dampness, endotoxin, ergosterol, exposure, hydrophilic fungi, office building, respiratory symptoms, water damage. Environ Health Perspect 116:45–50 (2008) . doi:10.1289/ehp.10355 available via http://dx.doi.org/ [Online 9 October 2007]
Address correspondence to J.-H. Park, National Institute for Occupational Safety and Health, Division of Respiratory Disease Studies, MS 2800, 1095 Willowdale Rd., Morgantown, WV 26505 USA. Telephone: (304) 285-5967. Fax: (304) 285-5820. E-mail: gzp8@cdc.gov We thank the NIOSH field team for their assistance with data collection ; E. Storey and her colleagues at the University of Connecticut for their help with the study ; M. Virji and Y.Y. Iossifova for reviewing the manuscript ; and all study participants, agency management, and labor unions in the building. The findings and conclusions in this paper have not been formally disseminated by the National Institute for Occupational Safety and Health and should not be construed to represent any agency determination or policy. The authors declare they have no competing financial interests. Received 12 April 2007 ; accepted 8 October 2007.
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