title: Hypersensitivity pneumonitis: a sentinel event investigation in a wet building.
abstract: Hypersensitivity pneumonitis (HP) as a sentinel event implies a remediable exposure and an exposed cohort that require evaluation. A patient with HP convincingly related to her building led to a questionnaire survey in follow-up. Building coworkers demonstrated substantially higher symptom rates than did controls in five other buildings, although no further cases of disease were identified. It is likely that moisture sources in the building included an oversized cooling system and below-grade moisture, but the building met all applicable regulations and standards. Screening investigations for disease are not mandated by law and are often not conducted, in part because cost coverage is unclear. The absence of regulatory or professional standards that adequately address moisture in the built environment forces occupational health professionals to rely on disease documentation strategies to justify intervention.
authors.affiliation: Department of Neurology, Universität Muenster, Germany.
authors.forename: B M
authors.initials: BM
authors.lastname: Weltermann
authors.forename: M
authors.initials: M
authors.lastname: Hodgson
authors.forename: E
authors.initials: E
authors.lastname: Storey
authors.forename: A C
authors.initials: AC
authors.lastname: DeGraff
authors.forename: A
authors.initials: A
authors.lastname: Bracker
authors.forename: S
authors.initials: S
authors.lastname: Groseclose
authors.forename: S R
authors.initials: SR
authors.lastname: Cole
authors.forename: M
authors.initials: M
authors.lastname: Cartter
authors.forename: D
authors.initials: D
authors.lastname: Phillips
mesh_terms: D000542:Alveolitis, Extrinsic Allergic / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology*; D018571:Sentinel Surveillance; D018877:Sick Building Syndrome / Q000453:epidemiology*; D014867:Water
chemical_list: D014867:Water