Moulds: a Public Health Problem in Belgium
Nicole Nolard, Ph. D.
This paper is a summary of highlights recorded from 15 years’ experience of surveys in home environments of patients with respiratory disorders linked with allergy, mainly asthma. Actually, after the 1st oil crisis, in the 1970’s, people began to renovate their house with the aim of best insulating every part from cellar to attic and we registered a continuing increase in complaints correlated with the presence of fungi, not only in damp houses but also in renovated and even new houses. Each survey responded to a specific case with different situation standards (house/flat; city / country, underprivileged / luxurious; pets / no pets) Moreover, taking into account the evolution of the sampling methods, a standard methodology was rather difficult to elaborate. Under these circumstances, in 1982, a scheme was set up in our laboratory at the Institute of Public Health, which belongs to the Belgian Ministry of Health, for environmental control in homes. It includes:
a visit to the home
a standardized home environment form,
the sampling of air, surfaces, furniture, wall paper, mattress and carpet dust for fungal moulds
the isolation, purification and placing in our collection of fungal strains for immunological testing (more than 2000 strains are stored either freeze dried or under liquid nitrogen in the IHEM collection),
the creation of a serum bank containing not only the serum of the allergic patient but also the sera of people living in the same surroundings,
the standardisation of a mini-method for preparing fungal extracts from selected strain,
finally, the immunological analysis from allergic patients, from subjects exposed to the same environment but not symptomatic and from a pool of test sera. Prick tests and antibody research (IgE and IgG) are carried out, or are in the process of being carried out, with our own extracts and have confirmed the role, in greater and greater numbers, of moulds as pneumoallergens in the home. Our objective is to present in this article a synthesis of our work at the Institute and to inform about the interest of environmental surveys.