Eckardt Johanning M.D. (1), Ray Biagini PhD (2), DeLon Hull PhD (2), Philip Morey PhD. (3), Bruce Jarvis, Prof.(4), Paul Landsbergis PhD (5).

1.Mount Sinai School of Medicine, Div. Environmental and Occupational Medicine/ENYOHP
2.National Institute for Occupational Safety and Health, Immune Chemistry Research Section, 
3.Clayton Environmental Consultants,
4.University of Maryland, Department of Chemistry
5.Cornell University Medical College

KEYWORDS:

Fungal bio-aerosols, Mycotoxins (Satratoxin), Epidemiology, Immunology, Stachybotrys chartarum (atra)

 ABSTRACT:

There is growing concern about adverse health effects of fungal bio-aerosols on occupants of water damaged buildings. Accidental, occupational exposure in nonagricultural setting has not been investigated using modern immunological laboratory tests.
 

The objective of this study was to evaluate health status of office workers after exposure to fungal bio-aerosol, esp. Stachybotrys chartarum (S. chartarum)- and its toxigenic metabolites (satratoxin) and to study laboratory parameters or bio-markers related to allergic or toxic human health effects.
 

Exposure characterization and quantification were performed using microscopical, 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 comprise 21 persons (mean age 37.5 years) without contact with the problem office site. Health complaints were surveyed with a 174 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 Stachybotrys 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 (CFS) 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 the regression analyses showed a significant association of 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 Stachybotrys chartarum and other atypical fungi was associated with reported disorders of the respiratory and central nervous system, reported disorders of the mucous membranes and a few parameters of the cellular and humoral immune system, suggesting a possible immune competency dysfunction.