While an exact cause(s) of spondylitis is unknown, a recent study investigated an interesting situation. Rheumatic diseases do not usually cluster in time and space – that said, researcher R. Luosujarvi and colleagues from the Kuopio University Hospital in Kuopio, Finland, describe a cluster of rheumatic diseases among a group of health center employees who began to complain of symptoms typically related to moldy houses.

Working Conditions
Dampness was found in the insulation space of the concrete floor below ground level. They discovered microbes in the flooring and in the outer wall insulation, which indicated mold damage and actinobacteria.

Health Concerns
Reported symptoms included mucocutaneous problems, nausea and fatigue, within a year of moving into a new building.

They examined the case histories of the personnel involved:

• All 34 subjects working at the health center had at least some rheumatic complaints.
  
• Two fell ill with a typical rheumatoid factor (RF)-positive rheumatoid arthritis (RA)
  
• 10 had arthritis that did not conform to any definite arthritic syndrome (three met the classification criteria for RA).
  
• Prior to moving into the problem building, one subject had suffered reactive arthritis, which had then recurred.
  
• Another employee had undiagnosed ankylosing spondylitis and later developed psoriatic arthritis, and another developed undifferentiated vasculitis.
  
• 16 subjects developed joint pains, 11 of these after beginning work at the health center.
  
• Three subjects developed Raynaud's symptom.
  
• Fourteen cases had elevated levels of circulating immune complexes in 1998, 17 in 1999, but there were only three cases in 2001, when the health center had been closed for 18 months.

Is there a connection?
The high incidence of joint problems among these employees suggests a common triggering factor for most of the cases, the researchers believe. Furthermore, since some of the symptoms had tended to subside while the health center was closed, the underlying causes are probably related to the building itself and possibly to the abnormal microbial growth in its structures.

Source -- Joint symptoms and diseases associated with moisture damage in a health center. Clin Rheumatol. 2003 Dec; 22(6);381-5. Luosujarvi RA, Husman TM, Seuri M, Pietikainen MA, Pollari P, Pelkonen J, Hujakka HT, Kaipiainen-Seppanen OA, Aho K.