Navigating the complexities of mould exposure in damp buildings : a case report on challenges and potential solutions

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.