Building-associated pulmonary disease from exposure to Stachybotrys chartarum and Aspergillus versicolor
Building-associated pulmonary disease from exposure to Stachybotrys chartarum and Aspergillus versicolor
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DOI：
10.1097/00043764-199803000-00006
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发表时间：
1998-03-01
影响因子：
3.2
通讯作者：
Storey, E
中科院分区：
文献类型：
--
作者：
Hodgson, MJ;Morey, P;Storey, E
作者提出了一个疾病爆发与接触葡萄酒和曲霉属物种。自最初入住以来，一座法院和两座相关的办公楼已经在员工中产生了两年的不适感。多次干预均未成功。对14名个体的初步评估确定了3名潜在的哮喘患者和3名症状与间质性肺病一致的患者。一项临床筛选方案确定了3名可能和7名可能与建筑物有关的哮喘患者。详细的环境和工程评估的建设确定的主要问题，机械系统设计，建筑施工和运营策略贷款过多的水分和相对湿度升高。两栋建筑物内表面的潮湿损坏都受到了S。chartarum，A. versicolor和Penicillium物种。曲霉属菌种，尤其是A.在正常操作条件下，浓度为10（1）至10（4）/m（3）的杂色占主导地位的室内空气。散装样品还发现了大量的水苏糖。对三个病例和两个对照建筑物的问卷调查记录了症状增加了3到15倍。一项巢式病例对照研究表明，符合病例问卷定义的个体中存在肺气肿样疾病。重复类似的既往研究中使用的分析策略表明，症状恶化与肺弥散功能下降之间存在相关性。神经心理学措施的表现是相似的病例和对照组，虽然工人的症状报告增加的水平，目前，但不是过去的精神病学。化学分析表明存在satratoxins G和H。细胞毒性实验室分析证明散装材料中存在具有生物学有效性的试剂。IgE或IgG抗体与疾病的存在之间没有相关性。这次爆发可能是人类对室内环境中吸入真菌毒素的反应。室内湿度代表了一个公共卫生问题，目前没有得到充分解决的建筑，健康或住房法规。
The authors present an outbreak of disease associated with exposure to Stachybotrys chartarum and Aspergillus species. A courthouse and two associated office buildings had generated discomfort among employees for two years since initial occupancy. Multiple interventions had been unsuccessful. An initial evaluation of 14 individuals identified three with potential asthma and three with symptoms consistent with interstitial lung disease A clinical screening protocol to identify individuals who should be removed from work identified three likely and seven possible cases of building-related asthma. Detailed environmental and engineering assessments of the building identified major problems in mechanical system design, building construction, and operational strategies lending to excess moisture and elevated relative humidities. Moisture-damaged interior surfaces in both buildings were contaminated with S. chartarum, A. versicolor, and Penicillium species. Aspergillus species, especially A. versicolor, at concentrations of 10(1) to 10(4)/m(3) dominated the indoor air under normal operating conditions. Bulk samples also revealed large quantities of Stachybotrys. A questionnaire survey of the three case and two control buildings documented between three-and 15-fold increases in symptoms. A nested case-control study suggested emphysematous-like disease in individuals meeting questionnaire definitions for cases. Replication of analysis strategies used in similar previous investigations suggested an association between worsening symptoms and decreased diffusing capacity of the lung. Performance on neuropsychological measures was similar for both cases and controls, although workers with symptoms reported increased levels of current but not past psychiatric symptomatology. Chemical analyses demonstrated the presence of satratoxins G and H. Cytotoxic laboratory analyses demonstrated the presence of agents with biological effectiveness in bulk materials. No association was seen between IgE or IgG antibodies and the presence of disease. This outbreak represents a likely human response to inhaled fungal toxins in indoor environments. Moisture indoors represents a public health issue currently inadequately addressed by building, health, or housing codes.