Building-Related Illnesses

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Abstract
As occupational and environmental physicians, we disagree with Menzies and Bourbeau's assessment of building-related illnesses with respect to fungal and bacterial contamination (Nov. 20 issue).1 In a growing number of investigations we are encountering problems in office workers associated with moisture- and water-related microbial contamination resulting in fungal growth and marked bioaerosol exposure. Building materials made of cellulose are particularly susceptible to fungal growth. The clinically important information with respect to exposure is not necessarily the absolute quantity of colony-forming units, but the fact that fungal species are atypical and that the concentrations are higher than in the outside air, used as a normal reference. In well-documented clinical case evaluations and epidemiologic studies, we and other authors have found clear evidence of an association of mucous membrane irritation, allergy, asthma, and inflammatory effects with allergenic or toxigenic fungal bioaerosol exposures.2-6