Comment in: • J Occup Environ Med. 1998 Sep;40(9):761-4. Building-associated pulmonary disease from exposure to Stachybotrys chartarum and Aspergillus versicolor.

1998

CardiovascularEndocrine (ADH/ACTH/MSH)GastrointestinalImmune/InnateNeurologicalRespiratory/Sinus

Indoor Mold (Stachybotrys, Aspergillus, etc.)MycotoxinsWater-Damaged Buildings (WDB)

Abstract

-7 POPULARVETENSKAPLIG SAMMANFATTNING - 8 ABBREVIATIONS -10 INTRODUCTION -13 INDOOR AIR QUALITY AND HEALTH -13 MICROORGANISMS IN WATER DAMAGED INDOOR ENVIRONMENTS -15 EXPOSURE ASSESSMENT METHODS FOR MOLD -16 MOLDS AND THEIR BIOLOGICALLY ACTIVE METABOLITES - 18 DETECTION OF MYCOTOXINS -26 Mass Spectrometty -27 GC-MS -29 HPLC-MS -31 MS detection of mycotoxins - 33 AIMS OF THE STUDY -35 MATERIAL AND METHODS - 37 SAMPLES -37 SAMPLING AND CULTIVATION - 38 MICROSCOPY -38 QPCR -39 CHEMICAL EXPERIMENTS -39 Extraction -39 Purification and hj'drolysis -40 Derivati^ation (for GC-MS) - 41 GC-MS -42 HPLC-MS -45 SUMMARY OF RESULTS - 49 MASS SPECTROMETRY - 49 OVERVIEW OF ALL ANALYZED SAMPLES -50 ADDITIONAL COMMENTS - 52 DISCUSSION -53 MOLD IN BUILDINGS - GUIDELINES AND REGULATIONS - 53 THIS STUDY IN CONTEXT - 56 CONCLUSIONS -59 ACKNOWLEDGEMENTS -61 REFERENCES -63 PAPERSI-IV -81

Key Biomarkers

Abnormal autonomic nervous system testsAbnormal brain SPECT imagingAbnormal pulmonary function testsAbnormal T and B cell subsetsAutoantibodies against CNS and PNS myelinAutoantibodies against smooth muscle (ASM)Decreased diffusing capacity of the lungElevated antinuclear autoantibodies (ANA)Neural autoantibodies (myelin basic protein, ganglioside GM1, sulfatide)Satratoxins G and HTrichothecenes

Symptom Clusters

Airway bleedingAltered neurophysiological functionAsthma and airway obstructionBalance disorders and ataxiaCognitive dysfunction consistent with mild traumatic brain injuryDepression and mood disturbanceDizzinessExecutive function impairmentInterstitial lung diseaseMemory impairment and concentration deficitsPeripheral neuropathyRhinorrhea and sinus involvementTremors and muscle weaknessVisuospatial learning and memory deficits