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Hey,.

Was perusing and found this article.

VERY exciting what is going on in Boston next week!!!!!!

Sharon

Clinical Rheumatology

Publisher: Springer-Verlag London Ltd

ISSN: 0770-3198 (Paper) 1434-9949 (Online)

DOI: 10.1007/s10067-003-0753-y

Issue: Volume 22, Number 6

Date: December 2003

Pages: 381 - 385

Original Article

Joint symptoms and diseases associated with moisture damage in a health

center

R. A. Luosujärvi1

(http://springerlink.metapress.com/app/home/contribution.asp?wasp=f62clce4kg0xtn\

d900ay & referrer=parent & backto=searcharticlesresults,4,15;

searcharticlesresults,1,1;#ContactOfAuthor1) , T. M. Husman2, M. Seuri3, M.

A. Pietikäinen4, P. Pollari5, J. Pelkonen6, H. T. Hujakka6, O. A.

Kaipiainen-Seppänen1 and K. Aho7 (1) Kuopio University Hospital, PO Box

1777,

70211 Kuopio, Finland (2) National Public Health Institute, Kuopio, Finland

(3) Kuopio Regional Institute of Occupational Health, Kuopio, Finland

(4) Health Care Unit of Kuopio, Kuopio, Finland (5) Kuopio Health

Center, Kuopio, Finland (6) Kuopio University, Kuopio, Finland (7)

National Public Health Institute, Helsinki, Finland

Received: 2 December 2002 Accepted: 29 April 2003 Published online: 14

October 2003

Abstract Rheumatic diseases do not usually cluster in time and space. It

has been proposed that environmental exposures may initiate autoimmune

responses. We describe a cluster of rheumatic diseases among a group of health

center employees who began to complain of symptoms typically related to moldy

houses, including mucocutaneous symptoms, nausea and fatigue, within a year of

moving into a new building. Dampness was found in the insulation space of the

concrete floor below ground level. Microbes indicating mold damage and

actinobacteria were found in the flooring material and in the outer wall

insulation.

The case histories of the personnel involved were examined. All 34 subjects

working at the health center had at least some rheumatic complaints. Two

fell ill with a typical rheumatoid factor (RF)-positive rheumatoid arthritis

(RA), and 10 had arthritis that did not conform to any definite arthritic

syndrome (three met the classification criteria for RA). Prior to moving into

the

problem building one subject had suffered reactive arthritis, which had then

recurred. Another employee had undiagnosed ankylosing spondylitis and later

developed psoriatic arthritis, and another developed undifferentiated

vasculitis. A total of 16 subjects developed joint pains, 11 of these after

beginning

work at the health center. Three subjects developed Raynauds symptom.

Fourteen cases had elevated levels of circulating immune complexes in 1998, 17

in

1999, but there were only three cases in 2001, when the health center had been

closed for 18 months. The high incidence of joint problems among these

employees suggests a common triggering factor for most of the cases. As some of

the symptoms had tended to subside while the health center was closed, the

underlying causes are probably related to the building itself and possibly to

the abnormal microbial growth in its structures.

Keywords Disease clusters - Rheumatic diseases

Abbreviations RF rheumatoid factor - RA rheumatoid arthritis - CFU

colony-forming units - CRP C-reactive protein - DMARD Disease-modifying

antirheumatic drug

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