Abstract:
The increasing presence of moulds in workplaces poses significant occupational health risks, particularly in poorly
maintained structures. Insufficient attention is given to dealing with this emerging issue; therefore, it is imperative to
understand mould-related health effects and remediation strategies to ensure a safe and healthy work environment.
This case investigation aimed to establish an association between employee symptoms and moulds in a damp building.
An environmental assessment was undertaken to identify visible signs of water damage and identify mould species
in air and surface samples. Information on mould exposure, building-related symptoms and predisposing factors was
gathered through an online self-administered questionnaire. Serum samples were collected from the index cases and
controls to determine possible atopy and hypersensitivity reactions to moulds. The walkthrough revealed water-damaged
walls, visible mould growth and suboptimal maintenance of the plumbing system. Environmental mould species, including
Cladosporium, Aspergillus and Penicillium, were identified. The most common symptom reported was headache, followed
by a pressing sensation on the scalp, a lack of concentration and fatigue. Most of the workers were atopic, and specific
IgE tests yielded negative results for all workers except one positive for Alternaria alternata. Elevated sIgG antibody levels
were detected for Cladosporium and A alternata species, linking exposure to at least one mould species identified in the
work environment. This case highlights the importance of employing appropriate serological tools to investigate mould
exposure. Furthermore, it underscores the challenge of interpreting laboratory results without standardised reference
values, which may have an impact on accurate diagnosis and case management, in turn emphasising the need to
establish local IgG reference ranges. The investigation also raises awareness of effective case management to prevent
adverse health effects related to mould sensitisation in occupational settings.
