Bacteria in a water‐damaged building: associations of actinomycetes and non‐tuberculous mycobacteria with respiratory health in occupants

We examined microbial correlates of health outcomes in building occupants with a sarcoidosis cluster and excess asthma. We offered employees a questionnaire and pulmonary function testing and collected floor dust and liquid/sludge from drain tubing traps of heat pumps that were analyzed for various microbial agents. Forty‐nine percent of participants reported any symptom reflecting possible granulomatous disease (shortness of breath on exertion, flu‐like achiness, or fever and chills) weekly in the last 4 weeks. In multivariate regressions, thermophilic actinomycetes (median = 529 CFU/m²) in dust were associated with FEV₁/FVC coefficient = ?2.8 per interquartile range change, P = 0.02], percent predicted FEF_25–75% (coefficient = ?12.9, P = 0.01), and any granulomatous disease‐like symptom odds ratio (OR) = 3.1, 95% confidence interval (CI) = 1.45?6.73]. Mycobacteria (median = 658 CFU/m²) were positively associated with asthma symptoms (OR = 1.5, 95% CI = 0.97?2.43). Composite score (median = 11.5) of total bacteria from heat pumps was negatively associated with asthma (0.8, 0.71?1.00) and positively associated with FEV₁/FVC (coefficient = 0.44, P = 0.095). Endotoxin (median score = 12.0) was negatively associated with two or more granulomatous disease‐like symptoms (OR = 0.8, 95% CI = 0.67?0.98) and asthma (0.8, 0.67?0.96). Fungi or (1→3)‐β‐D‐glucan in dust or heat pump traps was not associated with any health outcomes. Thermophilic actinomycetes and non‐tuberculous mycobacteria may have played a role in the occupants' respiratory outcomes in this water‐damaged building.