Rhinitis, Ocular, Throat and Dermal Symptoms, Headache and Tiredness among Students in Schools from Johor Bahru, Malaysia: Associations with Fungal DNA and Mycotoxins in Classroom Dust

PLoS One. 2016 Feb 1;11(2):e0147996. doi: 10.1371/journal.pone.0147996. eCollection 2016.

Abstract

There are few studies on rhinitis and sick building syndrome (SBS) among students in tropical countries. We studied associations between levels of five fungal DNA sequences, two mycotoxins (sterigmatocystin and verrucarol) and cat allergen (Fel d 1) levels in schools and rhinitis and other weekly SBS symptoms in the students. Fungal DNA was measured by quantitative PCR and cat allergen by ELISA. Pupils (N = 462) from eight randomly selected schools in Johor Bahru, Malaysia participated (96%). Dust samples were collected by cotton swabs and Petri dishes exposed for one week. None of the schools had a mechanical ventilation system, but all classrooms had openable windows that were kept open during lectures and indoor CO2 levels were low (mean 492 ppm; range 380-690 ppm). Weekly nasal symptoms (rhinitis) (18.8%), ocular (11.6%), throat (11.1%), dermal symptoms, headache (20.6%) and tiredness (22.1%) were common. Total fungal DNA in swab samples was associated with rhinitis (p = 0.02), ocular symptoms (p = 0.009) and tiredness (p = 0.001). There were positive associations between Aspergillus versicolor DNA in Petri dish samples, ocular symptoms (p = 0.02) and tiredness (p = 0.001). The level of the mycotoxin verrucarol (produced by Stachybotrys chartarum) in swab samples was positively associated with tiredness (p = 0.04). Streptomyces DNA in swab samples (p = 0.03) and Petri dish samples (p = 0.03) were negatively associated with tiredness. In conclusion, total fungal contamination, measured as total fungal DNA) in the classrooms, Aspergillus versicolor and verrucarol can be risk factors for rhinitis and SBS symptoms among students in the tropical country Malaysia.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Allergens / adverse effects
  • Animals
  • Cats
  • DNA, Fungal / analysis*
  • Dust / analysis*
  • Eye / pathology*
  • Fatigue / complications*
  • Female
  • Headache / complications*
  • Humans
  • Malaysia / epidemiology
  • Male
  • Models, Theoretical
  • Mycotoxins / analysis*
  • Pharynx / pathology*
  • Prevalence
  • Rhinitis / complications*
  • Schools
  • Skin / pathology
  • Students

Substances

  • Allergens
  • DNA, Fungal
  • Dust
  • Mycotoxins

Grants and funding

This study was supported by grants from the Swedish Council for Environmental and Agricultural Science and Spatial Planning (FORMAS) (grant nr 244-2008-68), the Swedish Asthma and Allergy Association’s Research Foundation and (grant nr 2013020-K), Swedish International Development Agency (SIDA) (grant 348-2004-5596), Swedish Research Council (VR)/grant nr 348-2013-6762), and the Swedish Foundation for Health Care Sciences and Allergy research. The corresponding author was the recipient of all funding. The funders supported the project financially. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. IVL Swedish Environmental Research Institute Ltd provided support in the form of salaries for authors [EB], but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of these authors are articulated in the ‘author contributions’ section. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.