Occupational allergic rhinitis in a laboratory worker due to mould contamination in a water-damaged hospital building

Mould exposure from water-damaged buildings and indoor dampness has been associated with allergies, infections and irritation, however, the immune mechanisms are complex. Occupational rhinitis is referred to as an inflammatory disease of the nose characterised by intermittent or persistent symptoms (nasal congestion, sneezing, rhinorrhoea, itching) and/or variable airflow limitation and/or hypersecretion attributable to a particular work environment and not to stimuli encountered outside the workplace. The purpose of this case report is to highlight the challenges in evaluating the relationship between mould exposure in water-damaged buildings and suspected allergic rhinitis. The case report is one of probable occupational rhinitis caused by sensitisation to Alternaria alternata and Aspergillus sp. The 52-year-old patient experienced recurring nasal polyps and sinus infection and underwent several operations. Patient serum tests to the mould mixture and specific moulds using the UniCAP system (Pharmacia, Sweden) revealed moderate to elevated IgE levels for various mould allergens. Paint scrapings and swab samples collected from her work environment revealed the presence of Aspergillus sp and Alternaria amongst other moulds, which she was sensitised to. Her condition improved after the building was repaired.