Work-related respiratory symptoms, including dyspnoea, cough, fever, tiredness
and malaise, were recorded in two customs offi cers employed in 2 depositories of
confi scated cigarettes, of which one showed signs of dampness. Microbiological sampling
of the air and the cigarettes stored in a damp depository revealed the presence of
potentially pathogenic fungi and bacteria and the biochemical markers of bacterial lipopolysaccharide
and fungal biomass. The Penicillium species (P. simplicissimum, P. infl
atum, P. commune) dominated in the damp depository, while in the other one Aspergillus
fumigatus was prevalent. The patients under study did not show a specifi c sensitization
to microbial allergens in the precipitin test, the test for inhibition of leukocyte migration
and the bronchial provocation challenge, except for a weak reaction to fungal allergens
in the test for inhibition of leukocyte migration. Moreover, one patient responded with
subjective symptoms after exposure to inhalation of increased doses of Penicillium simplicissimum
antigen. Both cases were diagnosed as a specifi c form of organic dust toxic
syndrome (ODTS). It is hypothesized that the symptoms were evoked most probably by
the non-specifi c action of low molecular fungal metabolites, such as mycotoxins or VOCs
(volatile organic compounds), with the possible contribution of bacterial endotoxin. However,
as there is no a direct proof to support this presumption, and the effects of nicotine
and other tobacco constituents cannot be excluded, further studies are needed to elucidate
etiopathogenesis of the disorders associated with the exposure to stored tobacco.