Immunological aspects of humidifier fever

Molecular analysis of single room humidifier bacteriology

Portable, single-room humidifiers are commonly used in homes for comfort and health benefits, but also create habitats for microbiology. Currently there is no information on home humidifier microbiology aside from anecdotal evidence of infection with opportunistic pathogens and irritation from endotoxin exposure. To obtain a broader perspective on humidifier microbiology, DNAs were isolated from tap source waters, tank waters, and biofilm samples associated with 26 humidifiers of ultrasonic and boiling modes of operation in the Front Range of Colorado. Humidifiers sampled included units operated by individuals in their homes, display models continuously operated by a retail store, and new humidifiers operated in a controlled laboratory study. The V1V2 region of the rRNA gene was amplified and sequenced to determine the taxonomic composition of humidifier samples. Communities encountered were generally low in richness and diversity and were dominated by Sphingomonadales, Rhizobiales, and Burkholderiales of the Proteobacteria, and MLE1-12, a presumably non-photosynthetic representative of the cyanobacterial phylum. Very few sequences of potential health concern were detected. The bacteriology encountered in source waters sampled here was similar to that encountered in previous studies of municipal drinking waters. Source water bacteriology was found to have the greatest effect on tank water and biofilm bacteriology, an effect confirmed by a controlled study comparing ultrasonic and boiler humidifiers fed with tap vs. treated (deionized, reverse osmosis, 0.2 μm filtered) water over a period of two months.

Analysis of indoor air pollutants checklist using environmetric technique for health risk assessment of sick building complaint in nonindustrial workplace

Purpose

To analyze and characterize a multidisciplinary, integrated indoor air quality checklist for evaluating the health risk of building occupants in a nonindustrial workplace setting.

Design

A cross-sectional study based on a participatory occupational health program conducted by the National Institute of Occupational Safety and Health (Malaysia) and Universiti Putra Malaysia.

Method

A modified version of the indoor environmental checklist published by the Department of Occupational Health and Safety, based on the literature and discussion with occupational health and safety professionals, was used in the evaluation process. Summated scores were given according to the cluster analysis and principal component analysis in the characterization of risk. Environmetric techniques was used to classify the risk of variables in the checklist. Identification of the possible source of item pollutants was also evaluated from a semiquantitative approach.

Result

Hierarchical agglomerative cluster analysis resulted in the grouping of factorial components into three clusters (high complaint, moderate-high complaint, moderate complaint), which were further analyzed by discriminant analysis. From this, 15 major variables that influence indoor air quality were determined. Principal component analysis of each cluster revealed that the main factors influencing the high complaint group were fungal-related problems, chemical indoor dispersion, detergent, renovation, thermal comfort, and location of fresh air intake. The moderate-high complaint group showed significant high loading on ventilation, air filters, and smoking-related activities. The moderate complaint group showed high loading on dampness, odor, and thermal comfort.

Conclusion

This semiquantitative assessment, which graded risk from low to high based on the intensity of the problem, shows promising and reliable results. It should be used as an important tool in the preliminary assessment of indoor air quality and as a categorizing method for further IAQ investigations and complaints procedures.

Indoor particles and symptoms among office workers: results from a double-blind cross-over study

BACKGROUND

We studied the effects of removing small airborne particles in an office building without unusual contaminant sources or occupant complaints.

METHODS

We conducted a double-blind crossover study of enhanced particle filtration in an office building in the Midwest United States in 1993. We replaced standard particle filters, in separate ventilation systems on two floors, with highly efficient filters on alternate floors weekly over 4 weeks. Repeated-measures models were used to analyze data from weekly worker questionnaires and multiple environmental measurements.

RESULTS

Bioaerosol concentrations were low. Enhanced filtration reduced concentrations of the smallest airborne particles by 94%. This reduction was not associated with reduced symptoms among the 396 respondents, but three performance-related mental states improved; for example, the confusion scale decreased (-3.7%; 95% confidence limits (CL) = -6.5, -0.9). Most environmental dissatisfaction variables also improved; eg, "stuffy" air, -5.3% (95% CL = -10.3, -0.4). Cooler temperatures within the recommended comfort range were associated with remarkably large improvement in most outcomes; for example, chest tightness decreased -23.4% (95% CL = -38.1, -8.7) for every 1 degrees C decrease.

CONCLUSIONS

Benefits of enhanced filtration require assessment in buildings with higher particulate contaminant levels in studies controlling for temperature effects. Benefits from lower indoor temperatures need confirmation.

Health effects of exposure to endotoxins and organic dust in poultry slaughter-house workers

Twenty-three dust-exposed shacklers in the hanging departments of four poultry slaughter-house plants were examined immediately before work on a Monday morning with a standardized interview, pulmonary function tests (VC and FEV1), and blood sampling for analysis of complement factors. The examinations were repeated immediately after work the same day. Further, the individual breathing zone levels of both total dust and endotoxins were monitored during the whole work-shift. Moreover, spot samples of airborne bacteria and fungi were collected. The mean level of total dust was 6.3 mg/m3 (range 0.4-15.3 mg/m3) and of endotoxins 0.40 micrograms/m3 (range 0.02-1.50 micrograms/m3). Total levels of 4 x 10(5)-4 x 10(6) cfu/m3 of airborne bacteria, mainly coagulase-negative staphylococcal strains, but only 500-4000 cfu/m3 of fungi were found in the hanging departments. An over-shift increase in respiratory symptoms was found, but none of the workers had experienced any symptoms indicating extrinsic allergic alveolitis (EAA) or organic dust toxic syndrome (ODTS). Further, mean over-shift decreases of VC (3.1%) and FEV1 (4.1%) were found, indicating a harmful effect on the bronchi. There were, however, no associations between these over-shift decreases and the individual time-weighted average breathing zone levels of either total dust or of endotoxins. No over-shift change in serum complement factors was observed.

Precipitating antibodies and positive skin tests in workers exposed to airborne antigens from a contaminated humidification system

Precipitating antibodies and positive skin tests to antigens from a contaminated humidification system in a synthetic carpet yarn plant were tested in a group of exposed (n = 66) and non-exposed (n = 45) workers. The first investigation was carried out in 1979 shortly before hygienic actions to reduce exposure had been taken. In 1981 and 1985 they were repeated. The significant difference between the positive skin reactions and of positive serology (4 or more lines), observed in 1979 between the exposed and non-exposed population, was not found in 1981 and 1985. In 1979 the differences were the most pronounced in the non-smoking individuals. However, even in that category the significant difference disappeared in 1981 and 1985. A positive skin test in 1979 did not increase the chance of having a positive skin test during repeat investigations. In serology this was only the case when the positive criterion was lowered to three or more lines. This study demonstrates that, in the absence of a quantitative analysis of airborne antigens, skin tests and serology may be helpful in obtaining an estimation of antigenic contamination of the air and subsequent sensitization on a group level. However, these tests are less appropriate when used in an individual health surveillance program at this type of nonspecific antigen exposure.

Determination of endotoxins by gas chromatography: evaluation of electron-capture and negative-ion chemical-ionization mass spectrometric detection of halogenated derivatives of beta-hydroxymyristic acid

The sensitivity and selectivity of gas chromatography for analysing several halogenated ester derivatives of beta-hydroxymyristic acid were studied using both selected-ion monitoring detection with negative-ion chemical-ionization mass spectrometry and electron-capture detection. Six different derivatization methods were compared with respect to yield, chemical stability and formation of by-products. Procedures for removal of excess reagents using disposable silica columns and thin-layer chromatography were elaborated. The 3-O-pentafluorobenzoyl-methyl ester was the preferred derivative since it provided high sensitivity and had the molecular ion as the base peak in the mass spectrum. The detection limit was 0.5 pg with electron-capture detection and 0.3 pg with the mass spectrometric system. Using beta-hydroxymyristic acid as a chemical marker it was possible to detect Escherichia coli endotoxin in aqueous solution at a level of 1 ng/ml.