title: Respiratory disorders in two workers of customs depositories occupationally exposed to mouldy tobacco.
abstract: Work-related respiratory symptoms, including dyspnoea, cough, fever, tiredness and malaise, were recorded in two customs officers employed in 2 depositories of confiscated cigarettes, of which one showed signs of dampness. Microbiological sampling of the air and the cigarettes stored in a damp depository revealed the presence of potentially pathogenic fungi and bacteria and the biochemical markers of bacterial lipopolysaccharide and fungal biomass. The Penicillium species (P. simplicissimum, P. inflatum, P. commune) dominated in the damp depository, while in the other one Aspergillus fumigatus was prevalent. The patients under study did not show a specific sensitization to microbial allergens in the precipitin test, the test for inhibition of leukocyte migration and the bronchial provocation challenge, except for a weak reaction to fungal allergens in the test for inhibition of leukocyte migration. Moreover, one patient responded with subjective symptoms after exposure to inhalation of increased doses of Penicillium simplicissimum antigen. Both cases were diagnosed as a specific form of organic dust toxic syndrome (ODTS). It is hypothesized that the symptoms were evoked most probably by the non-specific action of low molecular fungal metabolites, such as mycotoxins or VOCs (volatile organic compounds), with the possible contribution of bacterial endotoxin. However, as there is no a direct proof to support this presumption, and the effects of nicotine and other tobacco constituents cannot be excluded, further studies are needed to elucidate etiopathogenesis of the disorders associated with the exposure to stored tobacco.
authors.affiliation: Department of Pneumonology, Oncology and Allergology, Medical University of Lublin, Jaczewskiego 8, Lublin, Poland. b.mack@wp.pl
authors.forename: Barbara
authors.initials: B
authors.lastname: Mackiewicz
authors.forename: Czesława
authors.initials: C
authors.lastname: Skórska
authors.forename: Ewa
authors.initials: E
authors.lastname: Krysińska-Traczyk
authors.forename: Lennart
authors.initials: L
authors.lastname: Larsson
authors.forename: Bogumiła
authors.initials: B
authors.lastname: Szponar
authors.forename: Janusz
authors.initials: J
authors.lastname: Milanowski
authors.forename: Elzbieta
authors.initials: E
authors.lastname: Czekajska-Chehab
authors.forename: Jolanta
authors.initials: J
authors.lastname: Sitkowska
authors.forename: Grazyna
authors.initials: G
authors.lastname: Cholewa
authors.forename: Jolanta
authors.initials: J
authors.lastname: Szymańska
authors.forename: Jacek
authors.initials: J
authors.lastname: Dutkiewicz
mesh_terms: D000328:Adult; D000391:Air Microbiology; D001230:Aspergillus / Q000254:growth & development / Q000302:isolation & purification; D015169:Colony Count, Microbial; D004391:Dust; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000175:diagnosis / Q000453:epidemiology*; D016273:Occupational Exposure / Q000009:adverse effects*; D010407:Penicillium / Q000254:growth & development / Q000302:isolation & purification; D012140:Respiratory Tract Diseases / Q000175:diagnosis / Q000453:epidemiology*; D014026:Nicotiana / Q000382:microbiology*
chemical_list: D004391:Dust