流行病學研究指出環境中真菌的暴露與人體多項症狀及疾病的產生有關，而大多數研究採用量測空氣或灰塵中活性真菌的濃度以評估環境中真菌暴露的情況，但何者為較合適的暴露指標，且能恰當反映與健康相關之風險值目前則尚無定論。此外，自不同環境介質分析而得之活性真菌濃度及其菌屬組成分佈是否具一定相關性之研究亦不足。故本研究之主要目的有二，(1)探討空氣及灰塵中之活性真菌濃度分佈之差異，並討論影響空氣或灰塵中活性真菌濃度之因子為何。(2)探討空氣及灰塵中活性真菌濃度與病態大樓症候群之相關性，以作為選擇環境暴露指標之參考。
本研究選取台灣地區10棟辦公大樓。使用衝擊式採樣器Burkard及真空吸塵器來採集配對之空氣樣本及灰塵樣本，共計有53對配對樣本。使用培養基在25℃下培養真菌5天後，在顯微鏡下進行菌落計數以計算活性真菌的濃度。此外，本研究同時調查了辦公大樓之一般基本特性以探討其是否會影響空氣及灰塵中活性真菌之濃度。此外，本研究並調查辦公大樓員工其病態大樓症候群相關症狀之盛行率以分析員工症狀與空氣或灰塵中活性真菌濃度之相關性，共計完成190名研究對象。
結果發現，空氣中活性真菌平均濃度為3256.5 CFU/m3，灰塵中則為53789.3 CFU/g dust。空氣中活性真菌濃度較高之真菌菌屬為Cladosporium、Non-sporing及Yeast，灰塵中則為Cladosporium、Yeast及Aspergillus。而空氣及灰塵中所出現真菌菌屬之種類相似，且兩者間並無統計上之顯著差異。在相關性探討方面，分別以空氣中之日平均值與週平均值與灰塵中活性真菌濃度作相關性分析，結果發現灰塵中活性真菌濃度與當日空氣中活性真菌濃度之相關性有統計上之顯著意義，其相關係數為-0.3。經比較空氣及灰塵中高、低濃度組之各項影響因子之分佈是否有顯著差異後發現，影響空氣中活性真菌濃度之可能因子為建築物的年齡及空調系統的種類，影響灰塵中活性真菌濃度之因子為建築物所在區域、人員密度及是否鋪設地毯。

在活性真菌濃度與病態大樓症候群之相關性方面，將活性真菌濃度依中位數濃度分為高低濃度組後，進行濃度與症狀之相關性探討。經校正年齡、性別、抽煙狀態及建築物所在區域等因子後，發現空氣中Penicillium之暴露可能會引起員工喘鳴症狀之發生，而Fusarium之暴露則與員工產生嘔吐或胃不適有關。灰塵中Yeast之暴露與緊張或神經質、記憶力或專注力不佳、頭暈目眩、覺得沮喪、喘不過氣及嘔吐或胃不適等症狀之發生有關。造成空氣及灰塵中活性真菌所引起之健康效應不同之原因可能為空氣及灰塵樣本中各真菌菌屬之濃度分佈不同所致。空氣中真菌之暴露則顯然與呼吸道相關症狀之表現較有關。本研究中發現灰塵中真菌暴露與病態大樓症候群中神經系統相關症狀之表現有關，但其暴露途徑及致病機制仍尚未釐清，此關係之探討應可為未來研究之優先重點。
綜合而言，本研究之結果比較出空氣及灰塵中活性真菌濃度分佈差異之處，並找出其各別之可能影響因子。相信此研究結果可提供未來研究有關真菌暴露估及環境控制之參考。此外，本研究尚發現與空氣及灰塵中活性真菌暴露有關之疾患症狀不同，顯示由不同環境介質分析而得之真菌濃度，對預測不同健康效應之適用性不同，故在探討與真菌有關之健康效應時，應謹慎選擇所選取之環境濃度來源。雖然目前文獻對於多項症狀之暴露途徑及致病機制仍尚未釐清，但本研究之發現相信對於未來研究在進行真菌暴露評估及選取反映健康風險之指標時具有其參考意義。

Epidemiological studies have demonstrated associations between fungal exposures and reporting respiratory symptoms, and measurements of airborne or dust concentrations have been utilized to estimate the levels of exposures. Yet, information remains limited regarding correlation between the fungal concentrations in air and dust, and no conclusion has been made as to which one might be the better indicator to reflect the health risk. Therefore, the study objectives include: (1) to investigate the difference between fungal concentration in air and dust, and (2) to estimate the association between fungal concentration and sick building syndromes.
This study was conducted in 10 office buildings in Taiwan. Burkard sampler and vacuum cleaner were employed to collect the air and dust samples respectively. There were 53 pair samples in total. Microscopic counting was performed after culturing, and fungal concentrations were calculated afterwards. Questionnaire of building characteristics and suspected health effects were also administered. There were 190 office workers in total.
The averaged concentrations of total fungi were 3256.5 CFU/m3 in air and 53789.3 CFU/g dust in dust, respectively. The fungal genera with higher concentrations were Cladosporium, Non-sporing and Yeast in air and Cladosporium, Yeast and Aspergillus in dust. There was no significant difference between the presence of fungal genera in the air and dust within the same environment. Spearman correlation analysis was performed to correlate the fungal concentrations in the air and dust using the daily-averaged or weekly-averaged levels respectively. The correlation coefficients were –0.3 with daily-averaged values with statistical significance. Factors associated with the levels of total fungal concentrations were building age and types of air conditioning system on air samples and building region, person density and use of carpet on dust samples.
We divided total fungal concentrations to two groups by medium to compare the difference of symptom prevalence between groups of corresponding buildings occupants. We find the significant relationship between airborne Penicillium exposure and reporting wheeze in office building workers. Airborne Fusarium concentration in the air was associated with reporting vomiting and nausea in workers. Yet, dustborne Yeast concentration was associated with depression, vomitting and nausea, lose of concentration and short of breath.
Different groups of health effects were found to be associated with airborne and dustborne exposure of fungi respectively. The association between air fungi exposure and respiratory related symptoms was observed. Yet, the fungal exposure from the dust was mostly related to the reporting of neuro symptoms. Results of this study provide recommendations for environmental control of fungi when different types of symptoms are concerned.

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蘇慧貞、江哲銘等 (2001)，"建築通風換氣與室內空氣品質及感染關係研究，工業技術研究院分包學術機構研究計畫"，工業技術研究院。