Bioaerosol lung damage in a worker with repeated exposure to fungi in a water-damaged building

There has been increased concern over health effects related to potential e xposure of building occupants to bioaerosols. We report the case of a worke r with a respiratory illness related to bioaerosol exposure in a water-dama ged building with extensive fungal contamination. We performed environmenta l tests to evaluate potential exposure to fungi, and we used mycotoxin-spec ific IgG antibody in serologic studies in the attempt to evaluate exposure to mycotoxins. Extensive fungal contamination was documented in many areas of the building. Penicillium, Aspergillus, and Stachybotrys species were th e most predominant fungi found in air sampling. Our serologic test was not useful in differentiating workers who were probably occupationally exposed to mycotoxins from those who were not; however, it did yield evidence that individuals may make specific Ige antibodies to macrocyclic tricothecene my cotoxins. Further research is needed concerning heath effects related to bi oaerosol exposures, particularly regarding markers of exposure to specific fungi that may produce mycotoxins. In the absence of clinical tools specifi c for evaluation of mycotoxin-related illness, a systematic clinical approa ch for evaluating persons with suspected building-related respiratory illne ss is warranted.