Hydrophilic Fungi and Ergosterol Associated with Respiratory Illness in a Water-Damaged Building

• Published in: Environmental health perspectives Vol. 116; no. 1; pp. 45 - 50
• Main Authors: Park, Ju-Hyeong, Cox-Ganser, Jean M., Kreiss, Kathleen, White, Sandra K., Rao, Carol Y.
• Format: Journal Article
• Language: English
• Published: United States National Institute of Environmental Health Sciences. National Institutes of Health. Department of Health, Education and Welfare 01-01-2008; National Institute of Environmental Health Sciences
• Subjects: Air Pollutants - analysis; Air Pollution, Indoor - analysis; Allergens; Allergens - analysis; Animal allergies; Asthma; Asthma - epidemiology; Asthma - microbiology; Case-Control Studies; Chairs; Colony Count, Microbial; Dampness in buildings; Diseases; Dust - analysis; Endotoxins; Environmental Monitoring; Epidemiological Monitoring; Ergosterol; Ergosterol - analysis; Female; Fungi; Fungi - isolation & purification; Health aspects; Health outcomes; Humans; Male; Middle Aged; Occupational Exposure - adverse effects; Occupational Exposure - analysis; Office buildings; Risk factors; Water; Yeasts; USA, Washington; respiratory symptoms; exposure; water damage; dampness; hydrophilic fungi; asthma; office building; endotoxin; ergosterol
• ISSN: 0091-6765; 1552-9924
• DOI: 10.1289/ehp.10355

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 post-occupancy 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 out-comes 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.