Sick building syndrome: Association of symptoms with serum IgE specific to fungi H. W. Meyer 1 , F. O. Larsen 2 , H. H. Jacobi 3 , L. K. Poulsen 3 , P. Clementsen 4 , S. Gravesen 5 , F. Gyntelberg 1 and S. Norn 2 1 Department of Occupational and Environmental Medicine, Rigshospitalet, Copenhagen University Hospital, Tagensvej 20, DK-2200 Copenhagen N, Denmark 2 Department of Pharmacology, University of Copenhagen, The Panum Institute, Blegdamsvej 3, DK-2200 Copenhagen N, Denmark, Fax +45 35 32 76 10 3 Allergy Unit, National University Hospital, Tagensvej 20, DK-2200 Copenhagen N, Denmark 4 Department of Pulmonary Medicine and Department of Gynaecology, Gentofte University Hospital, Niels Andersens Vej 65, DK-2900 Hellerup, Denmark 5 The Danish Building Research Institute, Dr. Neergaardsvej 15, DK-2970 Hørsholm, Denmark Introduction Since the mid-eighties, reports of adverse health effects such as sick building syndrome (SBS) in buildings with moisture and mould have been published [1–3]. However, until now no studies have demonstrated a solid cause-relationship between mould growth and sick building related symptoms. Using the histamine-release test (HRT) we previously examined the staff of two municipal schools and of an indoor swimmingbath. We found IgE-specific to fungi from the buildings, both in serum and bound to basophils. The staff members reported SBS symptoms, but no history of type I allergic disease [4]. In this study we have examined whether the presence in serum of IgE specific to fungi, verified by HRT, was associated with sick building related symptoms. Materials and methods In a municipal school in Copenhagen a questionnaire survey, carried out in May 1995, revealed a high occurrence of sick building related symptoms among staff members. The mucous membrane/facial skin symptoms (MMS) were: nasal congestion, irritation of eyes, nose, throat and facial skin. The CNS symptoms were: fatigue, headache and lack of concentration. Sixty-seven individuals with either presence (35 persons) or absence (32 persons) of nasal congestion were invited to participate in our study. Fifty of them (30 women) participated in the clinical investigation carried out in November 1995, giving a response rate of 75%. Twenty-eight participants (56%) suffered from nasal congestion daily or several times a week. Eleven of the participants (22%) had none of the sick building-related symptoms. The 17 non- participants did not differ from participants with respect to symptom prevalence. Penicillium chrysogenum (Pc) (synonym P. notatum) was found in the school and was cultivated according to [5]. Pc is a heavily sporulating mould, which frequently attacks different damp building materials of organic origin [6]. The presence in serum of IgE specific to Pc was examined by HRT, based on the passive sensitisation of basophils [5, 7]. After sensitisation, the cells were exposed to intact freeze-dried spores of Pc, and histamine release was determined [5]. Skin prick test (ALK  , Hørsholm, Denmark) and specific IgE (Magic Lite, ALK  ) directed against Pc were included. For skin prick test a diameter  3 mm was considered a positive reaction. In the Magic Lite a class 1 was considered a positive result. Statistics Fisher’s Exact Test with two-tailed p-value was used for testing association between symptoms and the result of HRT. Results and discussion Fifteen participants (30%) had serum IgE specific to Pc in the HRT. All the individuals showed negative response to Pc in both skin prick tests and in Magic Lite. The lack of response could be due to the lack of relevant epitopes in the allergen preparation or on the paramagnetic particles, in contrast to the use of intact fungal spores in the HRT. The standard allergens, against which the participants most frequently had a positive skin reaction, were timothy-grass (16%), birch (10%) and dog (8%). The participants presenting these type-I responses showed no IgE specific to Pc in HRT. The prevalence of self-reported asthma and hayfever did not differ between participants with and without IgE specific to Pc. In addition, the frequency of serum IgE specific to Pc did not differ in relation to either smoking habits or gender. The associations between the presence of serum IgE specific to Pc, verified by HRT, and the subsequent answers to the questionnaire were analysed: 1) nasal congestion, Inflamm. res. 47, Supplement 1 (1998) S9–S10  Birkha ¨user Verlag, Basel, 1998 1023-3830/98/0100S9-02 $ 1.50+0.20/0 Inflammation Research Correspondence to: S. Norn 