title: Bacteria in a water-damaged building: associations of actinomycetes and non-tuberculous mycobacteria with respiratory health in occupants.
abstract: We examined microbial correlates of health outcomes in building occupants with a sarcoidosis cluster and excess asthma. We offered employees a questionnaire and pulmonary function testing and collected floor dust and liquid/sludge from drain tubing traps of heat pumps that were analyzed for various microbial agents. Forty-nine percent of participants reported any symptom reflecting possible granulomatous disease (shortness of breath on exertion, flu-like achiness, or fever and chills) weekly in the last 4 weeks. In multivariate regressions, thermophilic actinomycetes (median = 529 CFU/m2) in dust were associated with FEV1/FVC [coefficient = -2.8 per interquartile range change, P = 0.02], percent predicted FEF25-75%(coefficient = -12.9, P = 0.01), and any granulomatous disease-like symptom [odds ratio (OR) = 3.1, 95% confidence interval (CI) = 1.45-6.73]. Mycobacteria (median = 658 CFU/m2) were positively associated with asthma symptoms (OR = 1.5, 95% CI = 0.97-2.43). Composite score (median = 11.5) of total bacteria from heat pumps was negatively associated with asthma (0.8, 0.71-1.00) and positively associated with FEV1/FVC (coefficient = 0.44, P = 0.095). Endotoxin (median score = 12.0) was negatively associated with two or more granulomatous disease-like symptoms (OR = 0.8, 95% CI = 0.67-0.98) and asthma (0.8, 0.67-0.96). Fungi or (1→3)-β-D-glucan in dust or heat pump traps was not associated with any health outcomes. Thermophilic actinomycetes and non-tuberculous mycobacteria may have played a role in the occupants' respiratory outcomes in this water-damaged building.
authors.affiliation: Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA.
authors.forename: J-H
authors.initials: JH
authors.lastname: Park
authors.affiliation: Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA.
authors.forename: J M
authors.initials: JM
authors.lastname: Cox-Ganser
authors.affiliation: Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA.
authors.forename: S K
authors.initials: SK
authors.lastname: White
authors.affiliation: Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA.|Vermont Department of Health, Burlington, VT, USA.
authors.forename: A S
authors.initials: AS
authors.lastname: Laney
authors.affiliation: Turner Building Science & Design, LLC, Harrison, ME, USA.
authors.forename: S M
authors.initials: SM
authors.lastname: Caulfield
authors.affiliation: Turner Building Science & Design, LLC, Harrison, ME, USA.
authors.forename: W A
authors.initials: WA
authors.lastname: Turner
authors.affiliation: Vermont Department of Health, Burlington, VT, USA.|University of Vermont Health Network Occupational Medicine, Berlin, VT, USA.
authors.forename: A D
authors.initials: AD
authors.lastname: Sumner
authors.affiliation: Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA.
authors.forename: K
authors.initials: K
authors.lastname: Kreiss
mesh_terms: D039903:Actinobacteria / Q000302:isolation & purification*; D000328:Adult; D001249:Asthma / Q000382:microbiology; D003252:Construction Materials / Q000382:microbiology; D004391:Dust / Q000032:analysis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009170:Nontuberculous Mycobacteria / Q000302:isolation & purification*; D009784:Occupational Diseases / Q000382:microbiology*; D016273:Occupational Exposure / Q000032:analysis*; D012044:Regression Analysis; D012141:Respiratory Tract Infections / Q000382:microbiology*; D017565:Sarcoidosis, Pulmonary / Q000382:microbiology; D014871:Water Microbiology
chemical_list: D004391:Dust
keywords: Actinobacteria; Actinomycetes; Bacteria; Fungi; Non-tuberculous mycobacteria; Office buildings