Viral infection does not explain DIA illness.
Epling C; Rose CS; Boguang Z; Kreiss K
Am J Ind Med 1997 Mar; 31(3):361-365
We appreciate the interest of Repsher et al.  in our study of febrile respiratory illness among construction workers building the Denver International Airport (DIA). Dr. Repsher and colleagues propose a viral etiology as the probable cause for endemic illness among DIA employees. However, such viral illness would not explain the prolonged nature of symptoms temporally associated with time working at DIA among the employees in our epidemiologic study. A majority (142) of the 149 employees meeting the case definition reported current respiratory or systemic symptoms at the time of the survey. The average duration of these symptoms was 7.3 months (range, ,1-30 months), differing substantially from the 1-2 weeks of symptoms attributed to viral illness [Jaremin, 1987] among Polish construction workers. Two important findings regarding DIA bioaerosol measurements were overlooked by Repsher et al., who suggest that indoor fungal levels were similar to outdoors. First, Penicillium was the predominant organism indoors but not outdoors at all sampling times, suggesting an indoor source for fungal growth and dissemination. Second, a worksimulated sample documented levels ranging to two orders of magnitude higher than outdoor levels, values that have been associated with both asthma and hypersensitivity pneumonitis. Recall bias is unlikely to account for the high case rates among indoor DIA workers due to the random selection of participants, the high response rates among all groups surveyed, and the elevated case rates among multiple trades and contractors. As the onsite medical clinic responded to worker allegations with this investigation, information meetings were held for contractors who in turn held weekly tool box meetings attended by all employees.We think it unlikely that differential information transfer existed among groups surveyed.
Construction-industry; Construction-workers; Respiratory-system-disorders; Pulmonary-system-disorders; Antibiotics; Particulate-dust; Dust-exposure; Dust-particles; Aerosol-particles; Mycotoxins
Dr. C. Epling, Division of Occupational and Environmental Medicine, Duke University, Box 3834, Durham, NC 27710
American Journal of Industrial Medicine