Occupational rhinitis in damp and moldy workplaces

Background: Numerous studies confirm the association between exposure to indoor air dampness and molds and different health outcomes. Of these, upper respiratory tract problems are the most commonly reported work-related symptoms in damp indoor environments. The aim of this study was to describe a clinically investigated patient series with occupational rhinitis induced by molds. Methods: Nasal provocation test (NPT) with commercial fungal allergens was performed in 369 patients during 1995-2004 at the Finnish Institute of Occupational Health. Of these, 60 (16%) were positive. In addition to positive NPT, the diagnosis of occupational rhinitis was based on verified exposure to molds, work-related nasal symptoms, and clinical investigations. We wanted to review the patient files of these 60 patients retrospectively, and 56 patients gave their informed consent. Results: The mean age of the patients was 43.7 years (SD +/- 9.5). Fifty (89.3%) patients were women. In 23% of the patients, IgE-mediated allergy to molds could be established. Atopy significantly increased IgE sensitization to molds (OR, 10.3 [95% CI, 2.0-52.5]). The most common mold to induce occupational rhinitis was Aspergillus fumigatus. Exposure time was over 5 years in 63% of the patients. Association between the IgE sensitization to molds and exposure level was statistically significant (Fisher's exact test, p = 0.046). Conclusion: This is the first clinically investigated series on occupational rhinitis in relation to a moldy environment. Based on our findings, we conclude that molds growing in conjunction with moisture damages can induce occupational rhinitis. IgE-mediated allergy to molds was not common. Atopy and significant-exposure level increased IgE sensitization to molds. zri00508