Reboux G, Bellanger A-P, Roussel S, Grenouillet F, Millon L
Laboratoire de parasitologie-mycologie, CHU Jean-Minjoz, 2, boulevard Fleming, 25030 Besançon, France.
Rev Mal Respir. 2010 Feb;27(2):169-79. doi: 10.1016/j.rmr.2009.09.003. Epub 2010 Jan 25.
In industrialized countries the population spends 90% of its time in enclosed spaces. Since 1973, energy consumption for heating decreased on average by 36% per dwelling. Low-quality insulation, a fall in temperature and inadequate ventilation translated into high humidity in dwellings, which led to proliferation of moulds.
The allergenic, toxic and infectious effects of moulds on human health are documented. However, the potential dose/effect relationship between measured concentrations of indoor moulds and respiratory disorders often remains difficult to assess accurately. In several cases, fungi were demonstrated only as a promoter of health disorders. In a few cases (hypersensitivity pneumonitis, invasive fungal infections), the pathogenesis is without doubt due to environmental fungal exposure in a limited number of patients. On the other hand, the role of fungi was suspected but not proven for some well-defined pathologies, and some ill-defined health disorders, affecting large numbers of patients, such as the Sick Building Syndrome, rhinitis, sinusitis and conjunctivitis, as well as asthma and exacerbations of bronchitis. Eighteen fungal species, suspected of playing a role in public health, have been listed by the French Superior Council of Public Health. For each species, the proliferation conditions, type of substrates contaminated and heath effects reported in the literature are described.
The lack of standardization of measurements of concentrations of fungal species, the interactions with chemical compounds (formaldehydes), organic compounds (mycotoxins, endotoxins) and between species, makes the analysis of indoor fungal contamination complicated. The time has come to establish clearly a relationship between exposure to fungi and health disorders, rather than continuing to investigate factors related to the level of indoor fungal contamination.
在工业化国家，人们90%的时间都在封闭空间内度过。自1973年以来，每户家庭用于取暖的能源消耗平均下降了36%。劣质的保温材料、温度降低以及通风不足导致住宅内湿度较高，进而引发霉菌大量繁殖。
霉菌对人体健康的致敏、毒性和感染作用已有文献记载。然而，室内霉菌测量浓度与呼吸系统疾病之间潜在的剂量/效应关系往往仍难以准确评估。在一些案例中，真菌仅被证明是健康问题的诱因。在少数情况下（过敏性肺炎、侵袭性真菌感染），发病机制无疑是由于少数患者接触了环境中的真菌。另一方面，对于一些明确的病症以及一些影响大量患者的不明健康问题，如病态建筑综合征、鼻炎、鼻窦炎、结膜炎以及哮喘和支气管炎加重等，真菌的作用受到怀疑但尚未得到证实。法国公共卫生高级委员会列出了18种疑似对公众健康有影响的真菌物种。文献中描述了每种真菌的繁殖条件、受污染底物类型以及健康影响。
真菌物种浓度测量缺乏标准化，以及真菌与化学化合物（甲醛）、有机化合物（霉菌毒素、内毒素）之间的相互作用和物种间的相互作用，使得室内真菌污染分析变得复杂。现在是时候明确建立真菌暴露与健康问题之间的关系了，而不是继续研究与室内真菌污染水平相关的因素。
