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Health and immunologv study following exposure to toxigenic fungi (Stachybotrys chartarum) in a water-damaged office environment

Abstract

There is growing concern about adverse health effects of fungal bio-aerosols on occupants of water damaged buildings. Accidental, occupational exposure in a nonagricultural setting has not been investigated using modern immunological laboratory tests. The objective of this study was to evaluate the health status of office workers after exposure to fungal bio-aerosols, especially Stachybotrys chartarum (atra) (S. chartarum) and its toxigenic metabolites (satratoxins), and to study laboratory parameters or biomarkers related to allergic or toxic human health effects. Exposure characterization and quantification were performed using microscopic, culture, and chemical techniques. The study population (n = 53) consisted of 39 female and 14 male employees (mean age 34.8 years) who had worked for a mean of 3.1 years at a problem office site; a control group comprised 21 persons (mean age 37.5 years) without contact with the problem office site. Health complaints were surveyed with a 187-item standardized questionnaire. A comprehensive test battery was used to study the red and white blood cell system, serum chemistry, immunology/antibodies, lymphocyte enumeration and function. Widespread fungal contamination of water-damaged, primarily cellulose material with S. chartarum was found. S. chartarum produced a macrocyclic trichothecene, satratoxin H, and spirocyclic lactones. Strong associations with exposure indicators and significant differences between employees (n = 53) and controls (n = 21) were found for lower respiratory system symptoms, dermatological symptoms, eye symptoms, constitutional symptoms, chronic fatigue symptoms and several enumeration and function laboratory tests, mainly of the white blood cell system. The proportion of mature T-lymphocyte cells (CD3%) was lower in employees than in controls, and regression analyses showed significantly lower CD3% among those reporting a history of upper respiratory infections. Specific S. chartarum antibody tests (IgE and IgG) showed small differences (NS). It is concluded that prolonged and intense exposure to toxigenic S. chartarum and other atypical fungi was associated with reported disorders of the respiratory and central nervous systems, reported disorders of the mucous membranes and a few parameters pertaining to the cellular and humoral immune system, suggesting a possible immune competency dysfunction.

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References

  • Auger PL, Gourdeau P, Miller D (1994) Clinical experience with patients suffering from chronic fatigue-like syndrome and repeated upper respiratory infections in relation to air-borne molds. Am J Ind Med 25:41–42

    PubMed  Google Scholar 

  • Corrier DE (1991) Mycotoxicosis:mechanism of immunosuppression. Vet Immunol Immunopathol 30:73–87

    Article  PubMed  Google Scholar 

  • Croft WA, Jarvis BB, Yatawara CS (1986) Airborne outbreak of trichothecene toxicosis. Atmos Environ 20:549–552

    Article  Google Scholar 

  • Dales RE, Burnett R, Zwanenburg H (1991) Adverse health effects among adults exposed to home dampness and molds. Am Rev Respir Dis 143:505–509

    PubMed  Google Scholar 

  • Eduard W (1993) Assessment of mold spore exposure and relations to symptoms in wood trimmers. Proefschrift, CIP-Gegevens Koninklijke, Den Haag, Netherlands

    Google Scholar 

  • Flannigan B, McCabe ME, McCarry F (1991) Allergenic and toxigenic micro-organisms in houses. J Appl Bacteriol 70 (Suppl):61–73

    Google Scholar 

  • Forgacs J (1972) Stachybotryotoxicosis. In: Ciegler A, Kadis S, Ajl SJ (eds) Microbial toxins, Vol VIII. Academic Press, New York

    Google Scholar 

  • Forth W, Fichtl B, Hunder G (1990) Elaboration of a therapy in trichothecene toxicosis. Report of the medical military research. Federal ministry of defence—InSan L, Germany, September 1990

    Google Scholar 

  • Goodwin W, Haas CD, Fabian C, Heller-Bettinger I, Hoogstraten B (1978) Phase I evaluation of anguidine (diacetoxyscirpenol, NSC-141537). Cancer 42:23–26

    PubMed  Google Scholar 

  • Hendry KM, Cole EC (1993) A review of mycotoxins in indoor air. J Toxicol Environ Health 38:183–198

    PubMed  Google Scholar 

  • Hintikka EL (1987) Human stachybotryotoxicosis. In: Wyllie TD, Morehouse IG (eds) Mycotoxic fungi, mycotoxins, mycotoxicosis, vol 3. Marcel Dekker, New York, pp 87–89

    Google Scholar 

  • IARC (1993) Monographs in the evaluation of carcinogenic risks to humans. World Health Organization 56:245–523

    Google Scholar 

  • Jarmai K (1929) Viskosusseptikämien bei älteren Fohlen und erwachsenen Pferden. Dtsch Tierärztl Wochenschr 33:517–519

    Google Scholar 

  • Jarvis BB (1990) Mycotoxins and indoor air quality. In: Morey PR, Feeley JC, Otten JA (eds) Biological contaminants in indoor environments. ASTM, Philadelphia, pp 201–213

    Google Scholar 

  • Jarvis BB (1991) Macrocyclic trichothecenes. In: Sharma RP, Salunkhe DK (eds) Mycotoxins and phytoalexins in human and animal health. CRC Press, Boca Raton, Fl., pp 361–421

    Google Scholar 

  • Jarvis BB, Mazzola EP (1982) Macrocyclic and other novel trichothecenes: their structure, synthesis, and biological significance. Acc Chem Res 15:388–395

    Google Scholar 

  • Jarvis BB, Salemme J, Morais A (1995) Stachybotrys toxins. 1. Natural Toxins 3:10–16

    PubMed  Google Scholar 

  • Johanning M, Morey P, Jarvis B (1993a) Clinical-epidemiological investigation of health effects caused by Stachybotrys atra building contamination. Indoor Air `93 Proceedings 1:225–230. Helsinki, Finland

    Google Scholar 

  • Johanning P, Morey P, Goldberg M (1993b) Remedial techniques and medical surveillance guidelines for handling of toxigenic Stachybotrys atra. Indoor Air `93 Proceedings 4:311–316. Helsinki, Finland

    Google Scholar 

  • Keren DF, Hansen CA, Hurtubise (1994) Flowcytometry and clinical diagnosis. ASCP Press, Chicago

    Google Scholar 

  • Kozak PP, Gallup J, Cummins LH, Gillman SA (1979) Currently available methods for home mold surveys. Ann Allergy 45:167–176

    Google Scholar 

  • Kuzák V, Jelínek S, Sula J (1970) Possible role of Aspergillus flavus in the pathogenesis of Schneeberg and Jáchymov disease. Neoplasma 1:441–449

    Google Scholar 

  • Leary HL, Halsey JF (1984) An assay to measure antigen-specific immune complexes in food-allergy patients. J Allergy Clin Immunol 74:190–195

    PubMed  Google Scholar 

  • McLaughlin CS, Vaughan MH, Campbell IM, Wei CM, Stafford ME, Hansen BS (1977) Inhibition of protein synthesis by trichothecens. In: Rodricks JV, Hesseltine CM, Mehlman MA (eds) Mycotoxins in human and animal health. Pathotox, Park Forest Sount, Ill., pp 263–273

    Google Scholar 

  • Miller JD (1992) Fungi as contaminants in indoor air. Atmos Environ 26A:2163–2172

    Google Scholar 

  • Moss MO, Frank M (1987) Prevention: effects of biocides and other agents on mycotoxin production. In: Watson DH (ed) Natural toxicants in food. Ellis Horwood, New York, pp 231–251

    Google Scholar 

  • Nikulin M, Pasanen AL, Berg S, Hintikka EL (1994) Stachybotrys atra growth and toxin production in some building materials and fodder under different relative humidities. Appl Environ Microbiol 60:3421–3424

    Google Scholar 

  • NYC-DOH (1993) Guidelines on assessment and remediation of Stachybotrys atra in indoor environments. New York City, Dept. of Health. Summary of expertise. 7 May 1993.

    Google Scholar 

  • Ozegovics L (1971) Straw related disease in farm workers (in Russian) Veterinaria 20:263–267

    Google Scholar 

  • Paolo ND, Guarieri A, Loi F, Sacchi G, Mangiorotti AM, Paolo MD (1993) Acute renal failure from inhalation of mycotoxins. Nephron 64:621–625

    PubMed  Google Scholar 

  • Pestka JJ, Moorman MA, Warner RL (1989) Dysregulation of IgA production and IgA nephropathy induced by trichothecene vomitoxin. Food Chem Toxicol 27:361–368

    Article  PubMed  Google Scholar 

  • Pope AM, Patterson R, Burge H (ed) (1993) Indoor allergens. National Academy Press, Washington D.C., pp 131–151

    Google Scholar 

  • Rowlands DT, Wiener D, Bolton TA, Muus CJ (1991) Cells of the immune system. In: Henry JB (ed) Clinical diagnosis and management by laboratory methods, 18th edn. W.B. Saunders, Philadelphia, pp 795–808

    Google Scholar 

  • Ruotsalainen R, Jaakkola N, Jaakkola JJK (1995) Dampness and molds in day-care centers as an occupational problem. Int Arch Occup Environ Health 66:369–374

    PubMed  Google Scholar 

  • Rylander R, Fogelmark B (1994) Inflammatory responses by inhalation of endotoxin and (1-3)-β-D-glucan. Am J Ind Med 25:103–101

    PubMed  Google Scholar 

  • Rylander R, Jacobs RR (eds) (1994) Organic dusts. Exposure, effects and prevention. Lewis, Boca Raton, FL.

    Google Scholar 

  • Sarkisov AK (1947) Veterinariya 24, 25

    PubMed  Google Scholar 

  • Smith JE, Anderson JG, Lewis CW, Murad YM (1992) Cytotoxic fungal spores in the indoor atmosphere of the damp domestic environment. FEMS Microbiol Lett 100:337–344

    Article  Google Scholar 

  • Smoragiewics W, Cossette B, Boutard A, Krzystyniak K (1993) Trichothecene mycotoxins in the dust of ventilation systems in office buildings. Int Arch Occup Environ Health 65:113–117

    PubMed  Google Scholar 

  • Sorenson WG (1990) Mycotoxins as potential occupational hazards. Dev Indust Microbiol 31:205–211

    Google Scholar 

  • Sorenson WG, Frazier DG, Jarvis BB, Simpson J, Robinson V (1987) Trichothecene mycotoxins in aerosolized conidia of Stachybotrys atra. Appl Environ Microbiol 53:1370–1375

    PubMed  Google Scholar 

  • Spielberg HL (1989) Biological role of different antibody classes. Int Arch Allergy Appl Immunol (Suppl 1) 90:22–27

    PubMed  Google Scholar 

  • Tutelyan VA, Dadiani KR, Voitko NE (1992) Changes in serological indicators of immune status of workers in contact with mycotoxin-contaminated foodstuffs (in Russian). Gigiena Truda i Professional'nye Zabolevaniya 8:18–20

    Google Scholar 

  • Ueno Y (1983) Trichothecenes—chemical, biological and toxicological aspects. Development in Food Science 4. Elsevier, Amsterdam, pp 135–194

    Google Scholar 

  • Van der Zee JS, van Swieten P, Aalberse RD (1989) Serologic aspects of IgG4 antibodies. J Immunol 137:3566–3671

    Google Scholar 

  • WHO (1990) Selected mycotoxins: ochratoxins, trichothecenes, ergotamine Environmental Health Criteria 105. World Health Organization, Geneva, Switzerland, pp 71–163

    Google Scholar 

  • Yarom R, Sherman Y, More R, Ginsberg I, Borinski R, Yagen B (1984) T-2 toxin effect on bacterial infection and leukocyte functions. Toxicol Appl Pharmacol 75:60–68

    Article  PubMed  Google Scholar 

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Johanning, E., Biagini, R., Hull, D. et al. Health and immunologv study following exposure to toxigenic fungi (Stachybotrys chartarum) in a water-damaged office environment. Int. Arch Occup Environ Heath 68, 207–218 (1996). https://doi.org/10.1007/BF00381430

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  • DOI: https://doi.org/10.1007/BF00381430

Key words

  • Fungal bio-aerosols
  • Mycotoxins (satratoxins)
  • Epidemiology
  • Immunology
  • Stachbotrys chartarum (atra)