Microbial Cell Wall Constituents in Indoor Air and their Relation to Disease

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Abstract
This presentation reviews the relation between damp buildings, mold growth and symptoms and disease among persons living or working in such buildings. Epidemiological studies on these relationships date back to 1924 and at present there are almost 30 large‐scale investigations. There is an almost general concordance between studies on the relation between damp buildings and symptoms of the airways. Most of the studies show also a relation between symptoms and reported or measured mold growth. The symptoms reported are remarkably similar in the different studies: nose or throat irritation, wheezing, dry cough and fatigue. It is suggested that this symptom profile reflects a non‐specific airways inflammation and that antigen‐mediated allergy is rare. Regarding agents capable of inducing airways inflammation, data on bacterial endotoxin demonstrate a causal relationship, whereas information on another microbial wall agent ‐ (1→3)‐β‐D‐glucan ‐ is suggestive but not conclusive of a causal relationship. From a practical point of view, dampness and previous mold growth represent conditions in buildings where renovation should be undertaken, particularly if there are symptoms of airways inflammation among the occupants.

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