Park J-H, Cox-Ganser J M, White S K, Laney A S, Caulfield S M, Turner W A, Sumner A D, Kreiss K
Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA.
Vermont Department of Health, Burlington, VT, USA.
Indoor Air. 2017 Jan;27(1):24-33. doi: 10.1111/ina.12278. Epub 2016 Jan 21.
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/m ) in dust were associated with FEV /FVC [coefficient = -2.8 per interquartile range change, P = 0.02], percent predicted FEF (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/m ) 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 FEV /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.
我们研究了患有结节病聚集病例和哮喘高发的建筑物居住者健康状况与微生物之间的关联。我们向员工发放了问卷并进行了肺功能测试，还收集了热泵排水管道存水弯处的地板灰尘和液体/污泥，对其中的各种微生物制剂进行了分析。在过去4周内，49%的参与者报告每周出现任何反映可能患有肉芽肿性疾病的症状（运动时呼吸急促、类似流感的酸痛，或发热和寒战）。在多变量回归分析中，灰尘中的嗜热放线菌（中位数 = 529 CFU/m）与第一秒用力呼气容积/用力肺活量（FEV₁/FVC）相关[每四分位间距变化的系数 = -2.8，P = 0.02]、预测的第一秒用力呼气流量百分比（FEF₂₅₋₇₅）（系数 = -12.9，P = 0.01）以及任何类似肉芽肿性疾病的症状[比值比（OR）= 3.1，95%置信区间（CI）= 1.45 - 6.73]。分枝杆菌（中位数 = 658 CFU/m）与哮喘症状呈正相关（OR = 1.5，95% CI = 0.97 - 2.43）。热泵中总细菌的综合评分（中位数 = 11.5）与哮喘呈负相关（0.8，0.71 - 1.00），与FEV₁/FVC呈正相关（系数 = 0.44，P = 0.095）。内毒素（中位数评分 = 12.0）与两种或更多种类似肉芽肿性疾病的症状呈负相关（OR = 0.8，95% CI = 0.67 - 0.98）以及与哮喘呈负相关（0.8，0.67 - 0.96）。灰尘或热泵存水弯处的真菌或（1→3）-β-D-葡聚糖与任何健康状况均无关联。在这座有水渍损坏的建筑物中，嗜热放线菌和非结核分枝杆菌可能在居住者的呼吸健康状况中发挥了作用。
