Towards a risk evaluation of workers' exposure to handborne and airborne microbial species as exemplified with waste collection workers

Exposure to resistant fungi across working environments and time

Antifungal resistance has emerged as a significant health concern with increasing reports of resistant variants in previously susceptible species. At present, little is known about occupational exposure to antifungal-resistant fungi. This study aimed to investigate Danish workers' occupational exposure to airborne fungi resistant to first-line treatment drugs. A retrospective study was performed on a unique collection of personal exposure samples gathered over a twenty-year period from Danish working environments, in sectors including agriculture, animal handling, waste management, and healthcare. A total of 669 samples were cultivated at 37 °C and fungal colonies were identified using MALDI-TOF MS. Subsequently, identification was confirmed by amplicon sequencing the genes of calmodulin and beta-tubulin to unveil potential cryptic species. Infectious fungi (495 isolates from 23 species) were tested for resistance against Itraconazole, Voriconazole, Posaconazole, and Amphotericin B. Working environments were highly variable in the overall fungal exposure, and showed vastly different species compositions. Resistance was found in 30 isolates of the species Aspergillus fumigatus (4 of 251 isolates), A. nidulans (2 of 13), A. niger complex (19 of 131), A. versicolor (3 of 18), and A. lentulus (2 of 2). Sequence analysis revealed several cryptic species within the A. niger complex including A. tubingensis, A. luchuensis, and A. phoenicis. Among the resistant A. fumigatus isolates, two contained the well-described TR34/L98H mutation in the cyp51A gene and promoter region, while the remainder harbored silent mutations. The results indicate that the working environment significantly contributes to exposure to resistant fungi, with particularly biofuel plant workers experiencing high exposure. Differences in the prevalence of resistance across working environments may be linked to the underlying species composition.

Assessment of waste workers occupational risk to microbial agents and cytotoxic effects of mixed contaminants present in the air of waste truck cabin and ventilation filters

Workers in the waste-processing industry are potentially exposed to high concentrations of biological contaminants, leading to respiratory and digestive problems and skin irritations. However, few data on the exposure of waste collection truck (WCT) drivers are available. The goal was to document the microbial risk of the waste collection truck (WCT) workers while in the vehicle cab. Long-period sampling using the truck air filters (CAF) and short time ambient air sampling in the cab were used. The potential release of microbial particles from CAFs was also investigated since it could contribute to the microbial load of the cabin air. A combination of analytical methods also helped assess the complex mixture of the biological agents. Aspergillus sections Fumigati and Flavi, E. coli, Enterobacter spp. and Legionella spp. were detected in the CAF of trucks collecting three types of waste. The highest levels of bacteria and fungi were found in the CAF from organic WCT. The highest endotoxin concentrations in CAF were 300 EU/cm2. Most of the CAF showed cytotoxic effects on both lung cells and hepatocytes. Only one mycotoxin was detected in a CAF. The maximal concentrations in the ambient WCT air varied according to the type of waste collected. The highest proportion (84%) of the air samples without cytotoxic effects on the lungs cells was for the recyclable material WCTs. The results revealed the potential microbial risk to workers from a complex mixture of bio-contaminants in the cabs of vehicles collecting all types of waste. The sustained cytotoxic effect indicates the potential adverse health-related impact of mixed contaminants (biological and non-biological) for the workers. Overall, this study highlights the benefits of using complementary sampling strategy and combined analytical methods for a the assessment of the microbial risk in work environments and the need to implement protective measures for the workers.Implications: Exposure to microbial agents is a well-known occupational hazard in the waste management sector. No previous study had evaluated the cytotoxicity of ambient air and ventilation filters to document worker exposure to a combination of contaminants during waste collection. This research confirms the usefulness of ventilation filters for long-term characterization of exposure to infectious agents, azole-resistant fungi, coliform bacteria and mycotoxin. Overall, this study highlights the importance of using several sampling and analysis methods for a comprehensive assessment of microbial risk in work environments, as well as the need to implement appropriate protective measures for collection workers.

Measurement and prediction of the Aspergillus niger spore detachment from a vesicle unit subjected to air-blowing

Detachment of fungal spores from growing colonies results in human exposure. Thus far, the distribution of the binding forces of the spores in a fungal unit is unknown, so that precise prediction of the spores detachment is quite challenging. This investigation used centrifugal separation to measure the binding forces of the spores. Aspergillus niger (A. niger) colonies on a culture plate were placed in a centrifuge, the detached spores were counted, and this number was used to obtain the distribution of binding forces. Next, the air-blowing of an A. niger unit was modeled by computational fluid dynamics (CFD). A spore was judged to be detached if the air-imposed drag force was greater than the binding force. For model validation, the predicted spore detachment ratios were compared with the ratios measured in a wind tunnel test. The results revealed that the binding forces of the spores obeyed the log-normal distribution. The binding forces of the distal spores from colonies with a growth age of 66 h ranged from 0 nN to 4.0 nN and had a mean of 0.65 nN. The CFD modeling predicted the detachment ratios of the distal spores with good accuracy.

Cytotoxic and oxidative changes in individuals occupationally exposed to recyclable municipal solid waste

aste collectors are exposed to a wide variety of bacteria, endotoxins, fungi, allergens, particulate matter, irritating inhalants, and vehicle exhaust, making them more prone to development of chronic diseases. Although several studies described the impact of occupational exposure on the overall health of waste collectors, few investigations were conducted regarding cellular and molecular changes that may occur due to exposure. The aim of this study was to assess biomarkers of oxidative stress such as levels of reactive oxygen species (ROS), lipoperoxidation, total antioxidant capacity (TAC), apoptosis, butyrylcholinesterase (BChE) activity and mitochondrial function (MitoTrackerTM Green FM and MitoTrackerTM Red) using the peripheral blood from individuals occupationally exposed to recyclable solid waste in Southern Brazil. The study included 30 waste collectors and 30 control individuals, who did not perform activities with recognized exposure to biological and chemical substances. Waste collectors were found to exhibit in peripheral blood leukocytes (PBL) higher rates of apoptosis, increased production of ROS, and reduced mitochondrial membrane potential (MMP), associated with decreased total antioxidant capacity (TAC) and elevated activity of BChE in plasma. Therefore, evidence indicates that cytotoxicity, oxidative stress, and inflammatory responses may be involved in the multiplicity of adverse health outcomes related to contaminant exposure in waste collectors. It is thus necessary to implement and/or improve occupational health programs aimed at workers as well as mandatory inspections for the use of personal protective equipment.

Passive fungal spore release from fruit and vegetable solid waste

Food substrates in municipal solid wastes processing facilities and open dumpsites are a source for the release of fungal spores into air and can cause potential health and climate effects. Experiments were conducted in a laboratory scale flux chamber to measure the fungal growth and spore release from representative exposed cut fruit and vegetable substrates. The aerosolised spores were measured using an optical particle sizer. The results were compared to experiments conducted previously with a test species (Penicillium chrysogenum) on a synthetic media (czapek yeast extract agar). Significantly higher surface spore densities were observed for the fungi on the food substrates as compared to that on the synthetic media. The spore flux was high initially and then decreased on continued exposure to air. The spore emission flux normalised to the surface spore densities indicated that the emission from the food substrates was lower than the emissions from the synthetic media. A mathematical model was applied to the experimental data and the observed flux trends were explained in terms of the model parameters. A simple application of the data and the model to release from a municipal solid waste dumpsite was shown.

Exposure levels of dust, endotoxin, and microorganisms in the Danish recycling industry

INTRODUCTION

Recycling of domestic waste and a number of employees in the recycling industry is expected to increase. This study aims to quantify current exposure levels of inhalable dust, endotoxin, and microorganisms and to identify determinants of exposure among recycling workers.

METHODS

This cross-sectional study included 170 full-shift measurements from 88 production workers and 14 administrative workers from 12 recycling companies in Denmark. The companies recycle domestic waste (sorting, shredding, and extracting materials from waste). We collected inhalable dust with personal samplers that were analysed for endotoxin (n = 170) and microorganisms (n = 101). Exposure levels of inhalable dust, endotoxin, and microorganisms and potential determinants of exposure were explored by mixed-effects models.

RESULTS

The production workers were 7-fold or higher exposed to inhalable dust, endotoxin, bacteria, and fungi than the administrative workers. Among production workers recycling domestic waste, the geometric mean exposure level was 0.6 mg/m3 for inhalable dust, 10.7 endotoxin unit (EU)/m3 for endotoxin, 1.6 × 104 colony forming units (CFU)/m³ of bacteria, 4.4 × 104 CFU/m³ of fungi (25 °C), and 1.0 × 103 CFU/m³ of fungi (37 °C). Workers handling paper or cardboard had higher exposure levels than workers handling other waste fractions. The temperature did not affect exposure levels, although there was a tendency toward increased exposure to bacteria and fungi with higher temperatures. For inhalable dust and endotoxin, exposure levels during outdoor work were low compared to indoor work. For bacteria and fungi, indoor ventilation decreased exposure. The work task, waste fraction, temperature, location, mechanical ventilation, and the company size explained around half of the variance of levels of inhalable dust, endotoxin, bacteria, and fungi.

CONCLUSION

The production workers of the Danish recycling industry participating in this study had higher exposure levels of inhalable dust, endotoxin, bacteria, and fungi than the administrative workers. Exposure levels of inhalable dust and endotoxin among recycling workers in Denmark were generally below established or suggested occupational exposure limits (OEL). However, 43% to 58% of the individual measurements of bacteria and fungi were above the suggested OEL. The waste fraction was the most influential determinant for exposure, and the highest exposure levels were seen during handling paper or cardboard. Future studies should examine the relationship between exposure levels and health effects among workers recycling domestic waste.

Microbial contamination in grocery stores from Portugal and Spain - The neglected indoor environment to be tackled in the scope of the One Health approach

Microbial contamination in grocery shops (GS) should be evaluated since food commodities are commonly handled by workers and customers increasing the risk of food contamination and disease transmission. The aim of this study was to evaluate the microbial contamination in Portuguese and Spanish GS with a multi-approach protocol using passive (electrostatic dust cloths and surface swabs) sampling methods. The molecular detection of Aspergillus sections, mycotoxin analysis, screening of azole resistance as well as cytotoxicity measurement were conducted to better estimate the potential health risks of exposure and to identify possible relations between the risk factors studied. Fruits/vegetables sampling location was the one identified has being the most contaminated (bacteria and fungi) area in GS from both countries. Aspergillus section Fumigati and Fusarium species were observed in samples from Portuguese groceries with reduced susceptibilities to azoles commonly used in the clinical treatment of fungal infections. Fumonisin B2 was detected in Portuguese GS possible unveiling this emergent threat concerning occupational exposure and food safety. Overall, the results obtained raise concerns regarding human health and food safety and must be surveilled applying a One Health approach.

Dispersion characteristics of bioaerosols during treatment of rural solid waste in northwest China

In rural China, the release of bioaerosols containing pathogens from solid waste dumps poses a potential health risk to the local population. Here, we sampled bioaerosols from rural solid waste-treatment in four provinces of northwest China to investigate their emission and dispersion characteristics in order to provide a scientific basis for control and risk reduction of bioaerosols released from rural sanitation facilities. The airborne bioaerosol concentrations and particle size distributions were calculated using an Anderson six-stage airborne microbial sampler and counting with its internal Petri dish culture. High-throughput sequencing was used to characterize the microbial composition at different sampling sites and to explore possible influencing factors, while the health risk associated with exposure was estimated based on average daily dose-rate. The highest concentration point values of bacteria and fungi in bioaerosols near the solid waste were 63,617 ± 15,007 and 8044 ± 893 CFU/m³, respectively. Furthermore, the highest concentration point values of Enterobacteriaceae was 502 ± 35 CFU/m³. Most bioaerosols were coarse particles larger than 3.3 μm. Potentially pathogenic genera of winter-indicator species detected in the air were primarily Delftia, Rhodococcus and Aspergillus. The composition of solid waste and environmental conditions are important factors in determining the characteristics of bioaerosols. Local residents are exposed to bioaerosols mainly through inhalation. Children are at a particularly high risk of exposure through both inhalation and skin contact. The results of this study show that bioaerosols in the vicinity of rural solid waste dumps pose a health risk to the surrounding population. More suitable risk assessment criteria for rural areas should be established, and corresponding control and protection measures should be taken from three aspects: generation source and transmission pathway, as well as the recipient.

Airborne bacterial species in indoor air and association with physical factors

The aim of this study is to obtain knowledge about which cultivable bacterial species are present in indoor air in homes, and whether the concentration and diversity of airborne bacteria are associated with different factors. Measurements have been performed for one whole year inside different rooms in five homes and once in 52 homes. Within homes, a room-to-room variation for concentrations of airborne bacteria was found, but an overlap in bacterial species was found across rooms. Eleven species were found very commonly and included: Acinetobacter lowffii, Bacillus megaterium, B. pumilus, Kocuria carniphila, K. palustris, K. rhizophila, Micrococcus flavus, M. luteus, Moraxella osloensis and Paracoccus yeei. The concentrations of Gram-negative bacteria in general and the species P. yeei were significantly associated with the season with the highest concentrations in spring. The concentrations of P. yeei, K. rhizophila and B. pumilus were associated positively with relative humidity (RH), and concentrations of K. rhizophila were associated negatively with temperature and air change rate (ACR). Micrococcus flavus concentrations were associated negatively with ACR. Overall, this study identified species which are commonly present in indoor air in homes, and that the concentrations of some species were associated with the factors: season, ACR and RH.

Microbial Contamination of Bedding Material: One Health in Poultry Production

In poultry farms, the mixture of bedding material, chicken excrement, and feathers seems to play an important role in pathogen development which may contribute to a potential risk of zoonosis, spreading the disease through the food chain. The purpose of this study was to analyze microbial contamination in bedding material and other matrices as well as potential antimicrobial resistances in chicken production facilities, and also to identify the sampling techniques and assays used. This study evidences the available data published, following the PRISMA methodology. Among the environmental samples, surface swabs were frequently used as a passive sampling technique. Morphological identification was performed in all studies. From all the matrices, the bedding material was the most contaminated. Most studies focused on bacterial contamination, with Salmonella sp. and Campylobacter sp. being commonly reported and three studies evidenced fungal contamination, being Penicillium sp.- and Aspergillus sp.-dominant. Mycotoxin assessment was only performed in one study, being identified in all bedding samples. The screening for bacteria resistance evidenced bacteria multidrug resistance; however, fungal susceptibility to azoles was not assessed in any of the analyzed studies. Briefly, this review evidences the microbial contamination in poultry facilities, emphasizing animals' bedding as a potential source of contamination. Additionally, this study contributes to a sampling and analysis protocol proposal to assess the microbial contamination in this setting. Additionally, the knowledge gaps identified highlight the need of further research regarding microbial contamination and toxicological potential on animals' bedding in order to mitigate the exposure in poultry pavilions.

Research progress on distribution and exposure risk of microbial aerosols in animal houses

Environmental aerosols in animal houses are closely related to the productive performance and health level of animals living in the houses. Preferable housing environments can improve animal welfare and production efficiency, so it is necessary to monitor and study these environments. In recent years, there have been many large-scale outbreaks of respiratory diseases related to biological aerosols, especially the novel coronavirus that has been sweeping the world. This has attracted much attention to the mode of aerosol transmission. With the rapid development of large-scale and intensive breeding, microbial aerosols have gradually become the main factor of environmental pollution in animal houses. They not only lead to a large-scale outbreak of infectious diseases, but they also have a certain impact on the health of animals and employees in the houses and increase the difficulty of prevention and control of animal-borne diseases. This paper reviews the distribution, harm, and control measures of microbial aerosols in animal house environments in order to improve people's understanding of them.

Aspergillus Was the Dominant Genus Found during Diversity Tracking of Potentially Pathogenic Indoor Fungal Isolates

Viable airborne pathogenic fungi represent a potential health hazard when exposing vulnerable persons in quantities exceeding their resilience. In this study, 284 indoor fungal isolates from a strain collection of indoor fungi were screened for pathogenic potential through the ability to grow in neutral pH at 37 °C and 30 °C. The isolates were collected from 20 locations including 14 problematic and 6 non-problematic ordinary buildings. Out of the screened isolates, 170 isolates were unable to grow at 37 °C, whereas 67 isolates growing at pH 7.2 at 37 °C were considered as potential opportunistic pathogens. Forty-seven isolates growing at 30 °C but not at 37 °C were considered as less likely pathogens. Out of these categories, 33 and 33 strains, respectively, were identified to the species level. The problematic buildings included known opportunistic pathogens: Aspergillus calidoustus, Trichoderma longibrachiatum, Rhizopus arrhizus and Paecilomyces variotii, as well as less likely pathogens: Aspergillus versicolor, Chaetomium cochliodes, Chaetomium globosum and Chaetomium rectangulare. Opportunistic pathogens such as Aspergillus flavus, Aspergillus fumigatus, Aspergillus niger and Aspergillus tubingensis and less likely pathogens such as Aspergillus westerdijkiae, Chaetomium globosum and Dichotomopilus finlandicus were isolated both from ordinary and from problematic buildings. Aspergillus was the dominant, most diverse genus found during screening for potentially pathogenic isolates in the indoor strain collection. Studies on Aspergillus niger and Aspergillus calidodoustus revealed that tolerance to cleaning chemicals may contribute to the adaptation of Aspergillus species to indoor environments.

Microbial contamination and metabolite exposure assessment during waste and recyclable material collection

Waste workers are exposed to bioaerosols when handling, lifting and dumping garbage. Bioaerosol exposure has been linked to health problems such as asthma, airway irritant symptoms, infectious, gastrointestinal and skin diseases, and cancer. Our objective was to characterize the exposure of urban collectors and drivers to inhalable bioaerosols and to measured the cytotoxic effect of air samples in order to evaluate their health risk. Personal and ambient air sampling were conducted during the summer of 2019. Workers from 12 waste trucks collecting recyclables, organic waste or compost were evaluated. Bacteria and fungi were cultured, molecular biology methods were used to detect microbial indicators, cytotoxic assays were performed and endotoxins and mycotoxins were quantified. Domestic waste collectors were exposed to concentrations of bacteria and endotoxins above the recommended limits, and Aspergillus section Fumigati was detected at critical concentrations in their breathing zones. Cytotoxic effects were observed in many samples, demonstrating the potential health risk for these workers. This study establishes evidence that waste workers are exposed to microbial health risks during collection. It also demonstrates the relevance of cytotoxic assays in documenting the general toxic risk found in air samples. Our results also suggest that exposures differ depending on the type of waste, job title and discharge/unloading locations.

Development of an Indexed Score to Identify the Most Suitable Sampling Method to Assess Occupational Exposure to Fungi

The sampling approach is of utmost importance to obtain data regarding microbial viability and truly assess workers’ potential health effects. The purpose of this assessment is to create a score which will provide up-to-date information to identify the most suitable sampling method to assess occupational exposure to fungi. Data from a sampling campaign performed at Firefighters Headquarters (FFH) was analysed and a score was calculated from one (1) to three (3) for five (5) distinct sample parameters: (a) accuracy; (b) complexity of the field work; (c) cost; (d) complexity in laboratory work; and (e) time taken since the fieldwork until obtaining the fungal contamination characterization. The statistical analysis allowed us to conclude that settled dust and Andersen six-stage were the best sampling methods to perform the assessment of the occupational exposure to fungi at FFH, when considering the number of species. As for the final score, the results showed that surface swabs were the best sampling method. The results obtained for surface swabs highlights the low complexity of this processing combined with the fact that it is a low-cost sampling method. This study reinforces the need to use a wide array of sampling methods when assessing occupational exposure to fungal contamination to ensure an accurate risk characterization.

Microbial contamination in waste collection: Unveiling this Portuguese occupational exposure scenario

Previous studies anticipated that microorganisms and their metabolites in waste will increase as a consequence of a decreased collection frequency and due to differences in what kind of waste is bagged before collection leading to an increased exposure of workers handling the waste. This study aim was to investigate the microbial contamination present in the waste collection trucks (WCT) and in the support facilities (waste collection station - WCS). It was applied a multi-approach protocol using active (air sampling by impingement and impaction) and passive (surface swabs, electrostatic dust cloths and settled dust) sampling methods. The screening of azole-resistance, the investigation of mycotoxins and the assessment of the elicited biological responses in vitro were also carried out aiming recognizing the possible health effects of waste collection drivers. SARS-CoV-2 detection was also performed. In WCS only air samples had contamination in all the four sampling sites (canteen, operational removal core, operational removal center, and administrative service). Among all the analyzed matrices from the WCT a higher percentage of total bacterial counts and Gram-was detected in swabs (66.93%; 99.36%). In WCS the most common species were Penicillium sp. (43.98%) and Cladosporium sp. (24.68%), while on WCT Aspergillus sp. (4.18%) was also one of the most found. In the azole resistance screening Aspergillus genera was not observed in the azole-supplemented media. SARS-CoV-2 was not detected in any of the environmental samples collected, but Aspergillus section Fumigati was detected in 5 samples. Mycotoxins were not detected in EDC from WCS, while in WCT they were detected in filters (N = 1) and in settled dust samples (N = 16). In conclusion, our study reveals that a comprehensive sampling approach using active and passive sampling (e.g. settled dust sampling for a representative mycotoxin evaluation) and combined analytic methods (i.e., culture-based and molecular) is an important asset in microbial exposure assessments. Concerning the waste collection exposure scenario, the results of this study unveiled a complex exposure, particularly to fungi and their metabolites. Aspergillus section Fumigati highlight the significance of targeting this section in the waste management industry as an indicator of occupational health risk.

Six Feet under Microbiota: Microbiologic Contamination and Toxicity Profile in Three Urban Cemeteries from Lisbon, Portugal

Cemeteries are potential environmental reservoirs of pathogenic microorganisms from organic matter decomposition. This study aimed to characterize the microbial contamination in three cemeteries, and more specifically in grave diggers’ facilities. One active sampling method (impingement method) and several passive sampling methods (swabs, settled dust, settled dust filters and electrostatic dust cloths—EDC) were employed. The molecular detection of Aspergillus sections and SARS-CoV-2, as well as mycotoxin analysis, screening of azole resistance, and cytotoxicity measurement were also conducted. Total bacteria contamination was 80 CFU·m⁻² in settled dust samples, reached 849 CFU·m⁻² in EDC and 20,000 CFU·m⁻² in swabs, and ranged from 5000 to 10,000 CFU·m⁻² in filters. Gram-negative bacteria (VRBA) were only observed in in settled dust samples (2.00 × 10⁵ CFU·m⁻²). Regarding Aspergillus sp., the highest counts were obtained in DG18 (18.38%) and it was not observed in azole-supplemented SDA media. SARS-CoV-2 and the targeted Aspergillus sections were not detected. Mycophenolic acid was detected in one settled dust sample. Cytotoxic effects were observed for 94.4% filters and 5.6% EDC in A549 lung epithelial cells, and for 50.0% filters and 5.6% EDC in HepG2 cells. Future studies are needed in this occupational setting to implement more focused risk management measures.

Municipal solid waste management: Dynamics, risk assessment, ecological influence, advancements, constraints and perspectives

Global energy consumption has been increasing in tandem with economic growth, putting pressure on the world's supply of renewable energy sources. Municipal Solid waste (MSW) has been reported contributing immensely to the improvement of a secure environment and renewable sources. Energy scarcity and conventional MSW disposal methods in developing countries lead towards many environmental and economic issues. Scientists have been able to experiment with various waste-to-energy conversion technologies in light of this situation. This communication highlights and reviews WtE technologies to convert MSW and other feedstocks into electricity, hydrogen gas, bioethanol along with other value added products like fertilizer(s), platform chemicals as an environmentally friendly products. This review comprehensively summarized the dynamics, risk assessment, ecological influence, advancements, constraints and perspectives altogether in field of municipal solid waste management and treatment. Stare-of-the-art information on ecological influence and risk assessment in handling and transportation of municipal solid waste has been provided. Advanced trends involved in remediation of emerging pollutants and resources obtained from municipal solid wastes have been uncovered. Lastly, this paper comprises constraints and perspectives for uncovering MSW based circular bioeconomy aspects.

Work clothes as a vector for microorganisms: Accumulation, transport, and resuspension of microorganisms as demonstrated for waste collection workers

Work clothes may act as a vector for the transport of microorganisms leading to second-hand exposure; however, this has not been studied in work environments. We investigated whether microorganisms accumulate on workers' clothes in environments with elevated microbial exposures, and whether they are transported with the clothes and subsequently resuspended to the air. To study this, we selected waste collection workers and potential transport of bacteria and fungi to waste truck cabs via clothes, and compared the microbial communities within truck cabs, in waste collection workers' personal exposure, and on clean T-shirts worn by the workers. Microbial communities were also investigated for the presence of potentially harmful microorganisms. Results showed that microorganisms accumulated in large quantities (GM = 3.69 × 10⁵ CFU/m²/h for bacteria, GM = 8.29 × 10⁴ CFU/m²/h for fungi) on workers' clothes. The concentrations and species composition of airborne fungi in the truck cabs correlated significantly with the accumulation and composition of fungi on clothes and correlated to concentrations (a trend) and species composition of their personal exposures. The same patterns were not found for bacteria, indicating that work clothes to a lesser degree act as a vector for bacteria under waste collection workers' working conditions compared to fungi. Several pathogenic or allergenic microorganisms were present, e.g.: Klebsiella oxytoca, K. pneumoniae, Proteus mirabilis, Providencia rettgeri, Pseudomonas aeruginosa, and Aspergillus fumigatus, A. glaucus, A. nidulans, A. niger, and various Penicillium species. The potential 'take-home' exposure to these microorganisms are of most concern for immunocompromised or atopic individuals or people with open wounds or cuts. In conclusion, the large accumulation of microorganisms on workers' clothes combined with the overlap between fungal species for the different sample types, and the presence of pathogenic and allergenic microorganisms forms the basis for encouragement of good clothing hygiene during and post working hours.

Accumulation of microorganisms on work clothes of workers collecting different types of waste - A feasibility study

Electrostatic dust cloths have previously been used to study microorganisms in settled dust by placing the cloths horizontally on surfaces (called Electrostatic Dust Collectors, EDC). In this study, we investigate whether the same cloths, henceforth called 'E-Cloths', can be used to study accumulation of microorganisms and endotoxin on workers' clothes. This was studied as current methods have limitations. It was examined for waste collection workers, as their work environment is associated with elevated exposure to microorganisms and endotoxin. Each worker received a kit with a T-shirt with an attached E-Cloth on the front, a instruction letter, and a questionnaire. Workers wore the T-shirts during the next two workdays. Unaffected by waste type collected, it was possible to measure the accumulation of bacteria, fungi, and endotoxin from the work environment on the E-Cloths. Geometric mean concentration of 9 × 10⁶ CFU bacteria/m², 1 × 10⁷ CFU fungi/m², and 4 × 10⁴ endotoxin units/m² were found. In total, 100 different bacterial and 25 fungal species were found. The genus Bacillus (with 18 species) and Brevibacterium aurantiacum were among the dominating bacteria. For fungi, Penicillium brevicompactum, P. commune, Penicillium italicum, and Aspergillus niger were most often found. Importantly, mainly environmental bacteria and fungi had accumulated on the E-Cloths and only few skin-related bacterial species were present, showing that accumulation had happened from the work exposure and not workers' skin. In conclusion, the T-shirts with an E-Cloth can be used as a self-administered method for measurement of accumulation of microorganisms and endotoxin from the work environment on waste collection workers' clothes.

Cytotoxicity of Aspergillus Section Fumigati Isolates Recovered from Protection Devices Used on Waste Sorting Industry

Safe working conditions must be guaranteed during waste sorting, which is crucial to maximizing recycling and reuse, in order to minimize workers’ exposure to chemical and biological hazards. This study determines the contribution of Aspergillus section Fumigati to the overall cytotoxicity of filtering respiratory protection devices (FRPD) and mechanic protection gloves (MPG) collected in 2019 from different workstations in one waste sorting industry in Portugal. The cytotoxicity of 133 Aspergillus section Fumigati isolates was determined as IC50 in human A549 epithelial lung cells and swine kidney cells, using the MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay. Aspergillus section Fumigati cytotoxicity results were compared with previous total cytotoxicity data from FRPD and MPG samples. A significant correlation was detected between the total cytotoxicity of samples and cytotoxicity of Aspergillus section Fumigati isolates in A549 cells (rS = −0.339, p = 0.030). The cytotoxicity of Aspergillus section Fumigati isolates explained 10.7% of the total cytotoxicity of the sample. On the basis of the comparison of cytotoxicity levels, it was possible to determine the contribution of Aspergillus section Fumigati isolates for the total cytotoxicity of protection devices used in the waste sorting industry. The results support in vitro toxicology as a relevant approach in risk assessments regarding cytotoxicity in passive sampling, and thus, useful in determining the contribution of relevant microbial contaminants to overall cytotoxicity. This approach can provide valuable answers in dose/response studies, and support innovations in risk characterization and their translation into occupational policies.

The air-borne antibiotic resistome: Occurrence, health risks, and future directions

Antibiotic resistance comprising of antibiotic resistant bacteria (ARB) and antibiotic resistance genes (ARGs) is an emerging problem causing global human health risks. Several reviews exist on antibiotic resistance in various environmental compartments excluding the air-borne resistome. An increasing body of recent evidence exists on the air-borne resistome comprising of antibiotic resistance in air-borne bioaerosols from various environmental compartments. However, a comprehensive review on the sources, dissemination, behavior, fate, and human exposure and health risks of the air-borne resistome is still lacking. Therefore, the current review uses the source-pathway-receptor-impact-mitigation framework to investigate the air-borne resistome. The nature and sources of antibiotic resistance in the air-borne resistome are discussed. The dissemination pathways, and environmental and anthropogenic drivers accounting for the transfer of antibiotic resistance from sources to the receptors are highlighted. The human exposure and health risks posed by air-borne resistome are presented. A health risk assessment and mitigation strategy is discussed. Finally, future research directions including key knowledge gaps are summarized.

Multi-antibiotic resistant bacteria in landfill bioaerosols: Environmental conditions and biological risk assessment

Landfills, as well as other waste management facilities are well-known bioaerosols sources. These places may foment antibiotic-resistance in bacterial bioaerosol (A.R.B.) due to inadequate pharmaceutical waste disposal. This issue may foster the necessity of using last-generation antibiotics with extra costs in the health care system, and deaths. The aim of this study was to reveal the multi-antibiotic resistant bacterial bioaerosol emitted by a sanitary landfill and the surrounding area. We evaluated the influence of environmental conditions in the occurrence of A.R.B. and biological risk assessment. Antibiotic resistance found in the bacteria aerosols was compared with the AWaRE consumption classification. We used the BIOGAVAL method to assess the workers' occupational exposure to antibiotic-resistant bacterial bioaerosols in the landfill. This study confirmed the multi-antibiotic resistant in bacterial bioaerosol in a landfill and in the surrounding area. Obtained mean concentrations of bacterial bioaerosols, as well as antibiotic-resistant in bacterial bioaerosol (A.R.B.), were high, especially for fine particles that may be a threat for human health. Results suggest the possible risk of antibiotic-resistance interchange between pathogenic and non-pathogenic species in the landfill facilities, thus promoting antibiotic multi-resistance genes spreading into the environment.

Review of biological risks associated with the collection of municipal wastes

In many countries, the management of household waste has recently changed with an increased focus upon waste sorting resulting in lower collection frequency for some waste fractions. A consequence of this is the potential for increased growth of microorganisms in the waste before collection, which can lead to an increased exposure via inhalation for waste collection workers. Through a review of the literature, we aimed to evaluate risks caused by waste collecting workers' exposure to bioaerosols and to illuminate potential measures to reduce the exposure. Across countries and waste types, median exposure to fungi, bacteria, and endotoxin were typically around 10⁴ colony forming units (cfu)/m³, 10⁴ cfu/m³, and 10 EU/m³, respectively. However, some studies found 10-20+ times higher or lower median exposure levels. It was not clear how different types of waste influence the occupational exposure levels. Factors such as high loading, ventilation in and cleaning of drivers' cabs, increased collection frequency, waste in sealed sacks, and use of hand sanitizer reduce exposure. Incidences of gastrointestinal problems, irritation of the eye and skin and symptoms of organic dust toxic syndrome have been reported in workers engaged in waste collection. Several studies reported a correlation between bioaerosol exposure level and reduced lung function as either a short or a long term effect; exposure to fungi and endotoxin is often associated with an inflammatory response in exposed workers. However, a better understanding of the effect of specific microbial species on health outcomes is needed to proceed to more reliable risk assessments. Due to the increasing recycling effort and to the effects of global warming, exposure to biological agents in this working sector is expected to increase. Therefore, it is important to look ahead and plan future measures as well as improve methods to prevent long and short-term health effects.

Bacterial Quorum-Quenching Lactonase Hydrolyzes Fungal Mycotoxin and Reduces Pathogenicity of Penicillium expansum-Suggesting a Mechanism of Bacterial Antagonism

Penicillium expansum is a necrotrophic wound fungal pathogen that secrets virulence factors to kill host cells including cell wall degrading enzymes (CWDEs), proteases, and mycotoxins such as patulin. During the interaction between P. expansum and its fruit host, these virulence factors are strictly modulated by intrinsic regulators and extrinsic environmental factors. In recent years, there has been a rapid increase in research on the molecular mechanisms of pathogenicity in P. expansum; however, less is known regarding the bacteria–fungal communication in the fruit environment that may affect pathogenicity. Many bacterial species use quorum-sensing (QS), a population density-dependent regulatory mechanism, to modulate the secretion of quorum-sensing signaling molecules (QSMs) as a method to control pathogenicity. N-acyl homoserine lactones (AHLs) are Gram-negative QSMs. Therefore, QS is considered an antivirulence target, and enzymes degrading these QSMs, named quorum-quenching enzymes, have potential antimicrobial properties. Here, we demonstrate that a bacterial AHL lactonase can also efficiently degrade a fungal mycotoxin. The mycotoxin is a lactone, patulin secreted by fungi such as P. expansum. The bacterial lactonase hydrolyzed patulin at high catalytic efficiency, with a k_cat value of 0.724 ± 0.077 s⁻¹ and K_M value of 116 ± 33.98 μM. The calculated specific activity (k_cat/K_M) showed a value of 6.21 × 10³ s⁻¹M⁻¹. While the incubation of P. expansum spores with the purified lactonase did not inhibit spore germination, it inhibited colonization by the pathogen in apples. Furthermore, adding the purified enzyme to P. expansum culture before infecting apples resulted in reduced expression of genes involved in patulin biosynthesis and fungal cell wall biosynthesis. Some AHL-secreting bacteria also express AHL lactonase. Here, phylogenetic and structural analysis was used to identify putative lactonase in P. expansum. Furthermore, following recombinant expression and purification of the newly identified fungal enzyme, its activity with patulin was verified. These results indicate a possible role for patulin and lactonases in inter-kingdom communication between fungi and bacteria involved in fungal colonization and antagonism and suggest that QQ lactonases can be used as potential antifungal post-harvest treatment.

Cytotoxicity of filtering respiratory protective devices from the waste sorting industry: A comparative study between interior layer and exhalation valve

Filtering respiratory protection devices (FRPD) are mandatory for workers to wear in the Portuguese waste-sorting industry. Previous results regarding microbial contamination found on FRPD interior layer raised the question of whether microbial contamination from the exhalation valve would also have cytotoxicity effects. Since the FRPD exhalation valves are very close to workers' nose and mouth, they represent a source of exposure to bioburden by inhalation. This study aimed to evaluate the cytotoxicity of the microbial contamination present in the FRPD exhalation valves. For this purpose, the cytotoxicity effects were determined through the MTT assay in two different cell lines (human A549 epithelial lung cells, and swine kidney cells) and compared with previous results obtained with FRPD interior layers. The contamination present in the FRPD exhalation valves presented some cytotoxicity on epithelial lung cells, suggesting the inhalation route as a potential route of exposure through the use of FRPD in the waste-sorting industry. Half-maximal (50%) inhibitory concentration (IC50) values were lower for FRPD interior layer than exhalation valves in lung cells, with overall cytotoxicity lower in exhalation valves when compared to interior layer (z = -4.455, p = 0.000). Higher bacterial counts in TSA were correlated with lower IC50 values, thus, higher cytotoxicity effect in lung cells. No statistically significant differences were detected among different workplaces.

Bioaerosol Exposure and in vitro Activation of Toll-like Receptors in a Norwegian Waste Sorting Plant

Background

The global shift toward greener societies demands new technologies and work operations in the waste-management sector. However, progressive industrial methods do not necessarily consider workers’ health. This study characterized workers' exposure to bioaerosols and investigated the bioaerosols’ potential to engage the immune system in vitro.

Methods

Full shift personal aerosol sampling was conducted over three consecutive days. Dust load was analyzed by gravimetry, fungal and actinobacterial spores were analyzed by scanning electron microscopy, and endotoxin by limulus amebocyte lysate (LAL) assay. In vitro exposure of HEK cells to airborne dust samples was used to investigate the potential of inducing an inflammatory reaction.

Results

The total dust exposure level exceeded the recommended occupational exposure limit (OEL) of 5.0 mg/m³ in 3 out of 15 samples. The inhalable endotoxin level exceeded the recommended exposure level by a 7-fold, whereas the fungal spore level exceeded the recommended exposure level by an 11-fold. Actinobacterial spores were identified in 8 out of 14 samples. In vitro experiments revealed significant TLR2 activation in 9 out of 14 samples vs. significant TLR4 activation in all samples.

Conclusion

The present study showed that the dust samples contained potentially health-impairing endotoxin, fungi, and actinobacterial levels. Furthermore, the sampled dust contained microbial components capable of inducing TLR activation and thus have the potential to evoke an inflammatory response in exposed individuals.

A characterization of bioaerosols in biowaste pretreatment plants in relation to occupational health

Occupational exposure to microorganisms can be associated with adverse health outcomes. In this study, we assessed exposure to bioaerosols in two biowaste pretreatment plants in Denmark, which differed in location (city or countryside) and how they were built ('closed-off processes' or 'open processes'). Bioaerosol exposures were characterized by microbial concentrations in personal, stationary, sedimented dust, and hand samples, and their size distribution was assessed. Furthermore, species were identified by matrix-assisted laser desorption-ionisation time-of-flight mass spectrometry (MALDI-TOF MS), and inhalable dust, endotoxin, biofilm production, the total inflammatory potential, and fungicide resistance to four fungicides (amphotericin B, caspofungin acetate, itraconazole, voriconazole) were determined. Bacterial and fungal concentrations were on average (GM) in the order of 10⁴ cfu/m³, but ranged from 10² to 10⁸ cfu/m³. Several species which may cause health problems were identified. Personal endotoxin exposures were on average 28 EU/m³, but both personal and stationary samples ranged from 0.6 to 2035 EU/m³. Bioaerosols had the potential to form biofilms and to induce inflammation as measured in a human cell line. Exposures were higher in the plants that outdoor reference values. Higher exposures were found in the 'open process' plant, such as in microbial concentrations, species richness, endotoxin, biofilm production, and the total inflammatory potential. Six out of 28 tested Aspergillus fumigatus isolates were resistant to fungicides (amphotericin B and voriconazole). In conclusion, there is a high exposure to bioaerosols during work in biowaste pretreatment plants, however, results also suggests that how the plant is built and functions may affect the exposures.

Hazardous infectious waste collection and government aid distribution during COVID-19: A robust mathematical leader-follower model approach

The outbreak of COVID-19 has posed significant challenges to governments across the world. The increase in hazardous infectious waste (HIW) caused by the pandemic is associated with the risk of transmitting the virus. In this study, hazardous waste includes infectious waste generated both by individuals and by hospitals during the COVID-19 pandemic. To control the outbreak by maintaining social distance and home quarantine protocols, daily necessities and health supplies must be provided to the people affected. Governments play an essential role in the management of the crisis, creating an elaborate plan for collecting HIW and providing necessities and health supplies. This paper proposes a leader-follower approach for hazardous infectious waste collection and government aid distribution to control COVID-19. At the top level of the model, government policies are designed to support people by distributing daily necessities and health supplies, and to support contractors by waste collection. The lower level of the model is related to the operational decisions of contractors with limited capacities. Due to the potential risk of virus transmission via contaminated waste, the proposed model considers the complications imposed on contractors at the lower level. Applying a stochastic programming approach, four possible scenarios are examined, dependent of the severity of the outbreak. As a solution approach, the Benders decomposition method is combined with Karush-Kuhn-Tucker conditions. The results show that government support, in addition to much better management of citizen demand, can control the spread of the virus by implementing quarantine decisions.

Bioburden contamination and Staphylococcus aureus colonization associated with firefighter's ambulances

Ambulance vehicles are an essential part of emergency clinical services. Bioburden control in ambulances, through cleaning and disinfection, is crucial to minimize hospital-acquired infections, cross contamination and exposure of patients and ambulances' crew. In Portugal, firefighter crews are responsible, besides fire extinction, for first aid and urgent pre-hospital treatment. This study assessed the bioburden in Portuguese firefighters' ambulances with a multi-approach protocol using active and passive sampling methods. Fungal resistance profile and mycotoxins detection in ambulances' ambient, and S. aureus (SA) prevalence and resistance profile in ambulances' ambient and colonization in workers were also investigated. Toxigenic fungi with clinical relevance, namely Aspergillus section Fumigati, were found on ambulance's air in the hazardous dimension range. Interestingly, surface contamination was higher after cleaning in several sampling sites. Prevalence of S. aureus was 3% in environmental samples, of which 2% were methicillin-sensitive (MSSA) and 1% methicillin-resistant (MRSA). About 2.07 fungal species were able to grow in at least one azole, ranging from one (44% samples) to five (6% samples) species in each azole. Mycotoxins were detected in mops and electrostatic dust cloths. Colonization by S. aureus in the firefighter crew was observed with a high associated prevalence, namely 48%, with a 24% prevalence of MSSA (8/33) and 21% of MRSA (7/33). Additional studies are needed to determine the potential risk of infection transmission between different vehicle fleets and under varying conditions of use. This will strengthen the paramedic sector's mission to save lives without putting their own health and safety at risk.

Physiological Responses of Aspergillus niger Challenged with Itraconazole

Aspergillus niger is an opportunistic pathogen commonly found in a variety of indoor and outdoor environments. An environmental isolate of A. niger from a pig farm was resistant to itraconazole, and in-depth investigations were conducted to better understand cellular responses that occur during growth when this pathogen is exposed to an antifungal. Using a combination of cultivation techniques, antibiotic stress testing, and label-free proteomics, this study investigated the physiological and metabolic responses of A. niger to sublethal levels of antifungal stress. Challenging A. niger with itraconazole inhibited growth, and the MIC was estimated to be > 16 mg · liter^-1 Through the proteome analysis, 1,305 unique proteins were identified. During growth with 2 and 8 mg · liter^-1 itraconazole, a total of 91 and 50 proteins, respectively, were significantly differentially expressed. When challenged with itraconazole, A. niger exhibited decreased expression of peroxidative enzymes, increased expression of an ATP-binding cassette (ABC) transporter most likely involved as an azole efflux pump, and inhibited ergosterol synthesis; however, several ergosterol biosynthesis proteins increased in abundance. Furthermore, reduced expression of proteins involved in the production of ATP and reducing power from both the tricarboxylic acid (TCA) and glyoxylate cycles was observed. The mode of action of triazoles in A. niger therefore appears more complex than previously anticipated, and these observations may help highlight future targets for antifungal treatment.

Characteristics of microbial aerosol particles dispersed downwind from rural sanitation facilities: Size distribution, source tracking and exposure risk

Bioaerosols containing pathogens released from waste and wastewater treatment facilities pose potential health risks to workers on-site and residents downwind. In this study, sampling sites were set up at rural garbage stations (GS-1 and GS-2) and sewage treatment station (STS) to investigate the emission and diffusion characteristics of bioaerosols. High-throughput sequencing was utilized to assay the intestinal bacteria population, while the health risks associated with bioaerosols exposure were estimated based on average daily dose rates (DD). Traceability analysis was used to determine the percentages of intestinal bacteria from GS-1, GS-2 and STS. The recorded emission levels of bioaerosols in the air surrounding GS-1, GS-2, and STS were 5053, 6299, and 4795 CFU/m³, containing 1599, 2244, and 2233 CFU/m³ of intestinal bacteria, respectively. Most of the bioaerosols were coarse particles with size larger than 4.7 μm. Methylobacterium, Rhizobium, Pseudomonas, Enterobacteriaceae, and Brucella presented in the air were originally in rural waste and wastewater. STS and GS-2 were potential sources of intestinal bacteria. With increasing distance from the sources, the concentration of bioaerosols decreased gradually. On-site workers and residents were predominantly affected by bioaerosols through inhalation. The exposure risks via inhalation and skin contact for children were much higher than that for adults. The purpose of this study was to provide preliminary data for bioaerosols control and their risks reduction released from rural sanitation facilities.

Loading Rates of Dust and Bioburden in Dwellings in an Inland City of Southern Europe

Sampling campaigns indoors have shown that occupants exposed to contaminated air generally exhibit diverse health outcomes. This study intends to assess the deposition rates of total settleable dust and bioburden in the indoor air of dwellings onto quartz fiber filters and electrostatic dust collectors (EDCs), respectively. EDC extracts were inoculated onto malt extract agar (MEA) and dichloran glycerol (DG18) agar-based media used for fungal contamination characterization, while tryptic soy agar (TSA) was applied for total bacteria assessment, and violet red bile agar (VRBA) for Gram-negative bacteria. Azole-resistance screening and molecular detection by qPCR was also performed. Dust loading rates ranged from 0.111 to 3.52, averaging 0.675 μg cm−2 day−1. Bacterial counts ranged from undetectable to 16.3 colony-forming units (CFU) m−2 day−1 and to 2.95 CFU m−2 day−1 in TSA and VRBA, respectively. Fungal contamination ranged from 1.97 to 35.4 CFU m−2 day−1 in MEA, and from undetectable to 48.8 CFU m−2 day−1 in DG18. Penicillium sp. presented the highest prevalence in MEA media (36.2%) and Cladosporium sp. in DG18 (39.2%). It was possible to observe: (a) settleable dust loadings and fungal contamination higher in dwellings with pets; (b) fungal species considered indicators of harmful fungal contamination; (c) Aspergillus section Candidi identified in supplemented media with voriconazole and posaconazole; (d) specific housing typologies and (e) specific housing characteristics influencing the microbial contamination.

Occupational exposure to Aspergillus section Fumigati: Tackling the knowledge gap in Portugal

Aspergillus section Fumigati is one of the sections of the Aspergillus genus most often associated with respiratory symptoms. The azole-resistant clinical isolates in this section have been widely described worldwide. More recently, the environmental origin of azole resistance has been correlated with the development of fungal diseases and therapeutic failure. This paper presents a review of several studies performed in Portuguese occupational environments focusing on occupational exposure to this section and give guidance to exposure assessors and industrial hygienists to ensure an accurate exposure assessment. Future studies should tackle the limitations concerning the assessment of occupational exposure to the Fumigati section, in order to allow the implementation of adequate risk management measures. In the light of the results of previous studies, the following approach is proposed to ensure an accurate exposure assessment: a) a combination of active and passive sampling methods appropriate to each occupational environment; b) the use, in parallel, of culture-based methods and molecular tools to overcome the limitations of each method; c) evaluation of the mycobiota azole resistance profile; and d) consider the possible simultaneous presence of mycotoxins produced by this section when assessing workers occupational exposure. In sum, preventing the development of fungal strains resistant to azoles will only be achieved with a holistic approach. An adequate "One Health approach" can contribute positively to concerted actions in different sectors, by reducing the use of fungicides through the introduction of crops and agricultural practices that prevent fungal colonization, and by promoting the rational use of antifungal drugs in human and animal health.

A cohort study of cucumber greenhouse workers' exposure to microorganisms as measured using NGS and MALDI-TOF MS and biomarkers of systemic inflammation

Work in greenhouses entails exposure to airborne fungi and bacteria. The aims of this study are to obtain knowledge about whether exposure to fungal and bacterial genera and species during work in a cucumber greenhouse is affected by work tasks, and whether a cohort of greenhouse workers' serum levels of serum amyloid A (SAA) and C-reactive protein (CRP), biomarkers of systemic inflammation, are associated with this. Data on personal exposure to airborne fungal and bacterial species measured over 4 years as well as serum levels of SAA and CRP sampled over two years were analyzed. For data analysis, the main work tasks were grouped into three different groups, called 'grouped work task'. Microorganisms were identified using matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF MS) and next-generation sequencing (NGS). The 'daily exposure' of greenhouse workers' were as follows: 4.8 × 10⁴ CFU bacteria/m³, 1.4 × 10⁶ CFU fungi/m³, and 392 EU/m³ of endotoxin. Workers were exposed to many different microbial species including several species within the genera Acinetobacter, Bacillus, Microbacterium, Pseudomonas, Staphylococcus, and Streptomyces. The genera Ralstonia and Cladosporium were found in most samples. The exposure levels as well as the microbial composition were associated significantly with grouped work task and season with high exposures during tasks in close contact with mature and old plants and in the autumn. CRP and SAA levels were also associated with exposure level and grouped work tasks. The Shannon-Wiener indices were not different in the 3 'grouped work tasks'. Several specific species including e.g. Halomonas elongata, Stenotrophomonas maltophilia, Podosphaera fusca, and Wallemia spp. were found frequently or in high concentrations in the exposures associated with the highest levels of CRP and SAA. The microorganisms S. maltophilia, P. fusca, and Wallemia spp. were also found on the cucumber plant leaves. In conclusion, both exposure level and the species composition seem to have an effect on the serum levels of CRP and SAA of exposed workers. The greenhouse workers were exposed to only a few species characterized as human pathogens.

Culture Media and Sampling Collection Method for Aspergillus spp. Assessment: Tackling the Gap between Recommendations and the Scientific Evidence

Culturing is still the most widely used method for determining fungal growth. Thus, is important to identify the most suitable culture media to assess Aspergillus spp. The aim of this study was to analyze data obtained from previous studies, aiming at identifying the most suitable culture media (malt extract agar (MEA) or dichloran-glycerol agar (DG18) to assess Aspergillus spp. isolation and growth. This study was conducted by using environmental samples (n = 1153). Most of the active sampling methods (air samples) were impacted directly onto both culture media. As for passive sampling methods, fungi were extracted from environmental matrices inoculated onto both media. Overall, total Aspergillus counts were higher in MEA (n = 617, 53.5%) than in DG18 (n = 536, 46.5%). Regarding Aspergillus sections, significant associations were detected with the media (χ2 (7) = 241.118, p < 0.001), the sampling approach (p < 0.001, 95% CI = (0.3 × 10−4), and the indoor environment (p < 0.001, 95% CI = (0.3 × 10−4)). As such, sampling approach and the culture media should be accurately selected when dealing with Aspergillus spp. exposure assessment.

Cytotoxic effect of filtering respiratory protective devices from the waste sorting industry: is in vitro toxicology useful for risk characterization?

The use of Filtering Respiratory Protective Devices (FRPD) is mandatory in Portugal to protect workers from the waste industry of harmful exposures. Deleterious health effects of exposure to bioburden via inhalation and/or ingestion include respiratory symptoms and nephrotoxicity. Between January and February 2019, 118 FRPD samples were collected in one waste sorting industry and characterized regarding microbial contamination and cytotoxicity, defined as cell metabolic activity, through the MTT colorimetric assay (3-(4,5-dimethylthiazol-2-yl)-2,5- diphenyltetrazolium bromide). Cytotoxic effect was classified according to percentage of extinction values with respect to the control group, as follows: absent (≥90); low (80%-90%, +); medium (60%-79%, ++); and high (below 60%, +++). For 113 samples the MTT assay revealed a cytotoxic effect in A549 cells, of which 81 presented high cytotoxicity. In SK cells, a cytotoxic effect was observed in 56 samples, of which five displayed a high cytotoxic effect. Several moderate (p < 0.05) to strong (p < 0.01) correlations were found between higher bacterial and fungal counts both in interior layers (fungi and bacteria) and in exhalation valves (fungi) of FRPD samples and reduced cell metabolic activity of SK cells. On the basis of the obtained results for the cytotoxic effect of FRPD samples on two different cells lines, it was determined that A549 cells exhibited a cytotoxic effect for a higher number of FRPD, whereas the SK cells model correlated better with the other assessed parameters, namely, bacterial and fungal counts and conditions of FRPD use. Although the results are not conclusive on the most appropriate cell line to assess FRPD cytotoxicity, they reinforce the importance of in vitro toxicology in exposure assessments to determine the cytotoxicity of mixtures of contaminants, for better risk characterization and selection of appropriate risk management measures.

Settleable Dust and Bioburden in Portuguese Dwellings

Monitoring campaigns in several buildings have shown that occupants exposed to contaminated indoor air generally exhibit diverse health symptoms. This study intends to assess settleable dust loading rates and bioburden in Portuguese dwellings by passive sampling onto quartz fiber filters and electrostatic dust cloths (EDCs), respectively. Settled dust collected by EDCs was analyzed by culture-based methods (including azole-resistance screening) and qPCR, targeting four different toxigenic Aspergillus sections (Flavi, Fumigati, Circumdati, and Nidulantes). Dust loading rates and bioburden showed higher variability in the summer season. In both seasons, Penicillium sp. was the one with the highest prevalence (59.1% winter; 58.1% summer), followed by Aspergillus sp. in winter (13.0%). Fungal contamination increased in the winter period, while bacterial counts decreased. Aspergillus sections Circumdati and Nidulantes, detected in voriconazole supplemented media, and Aspergillus sections Fumigati and Nidulantes, detected by molecular tools, were found in the winter samples. This study reinforces the importance of applying: (a) Passive sampling methods in campaigns in dwellings; (b) two different culture media (MEA and DG18) to assess fungi; (c) in parallel, molecular tools targeting the most suitable indicators of fungal contamination; and (d) azole resistance screening to unveil azole resistance detection in fungal species.

Aspergillus spp. presence on mechanical protection gloves from the waste sorting industry

The organic material present on waste sorting units serve as a substrate for different microorganisms, increasing workers' exposure to Aspergillus spp. This study intends to assess the Aspergillus spp. contamination on Mechanical Protection Gloves (MPG) from different workstations and understand the role of MPG in workers' exposure to these genera. Sixty-seven used MPG were collected from different workstations and extracts were seeded on malt extract agar (MEA) supplemented with chloramphenicol (0.05%) and dichloran glycerol (DG18). The same extracts were used for the molecular detection of fungal species/strains, with reported toxigenic potential, namely Aspergillus sections (Circumdati, Flavi, Fumigati, and Nidulantes). Among Aspergillus spp., the sections with the highest prevalence on MEA were Nigri (88.29%) and Fumigati (8.63%), whereas on DG18 were Nigri (31.79%) and Circumdati (30.77%). Aspergillus section Circumdati was detected in 22 MPG samples by RT-PCR (32.84%), Fumigati in 59 samples (88.06%), Nidulantes in 61 samples (91.05%), and Flavi in 6 samples (8.96%). It was showed that, even with daily replacement, MPG presented Aspergillus spp. contamination. Thus, a more regular replacement of MPG and the adoption of complementary hygienic procedures by workers are critical to guarantee workers' protection in this occupational environment.

Assessment of the microbial contamination of mechanical protection gloves used on waste sorting industry: A contribution for the risk characterization

In Portugal, mechanical protection gloves (MPG) are of mandatory use and during their use sweat is released and, consequently, the humidity of the material increases leading to conditions favorable to the growth of microorganisms. However, no studies have been conducted in MPG to assess the bioburden. This study intended to determine the bioburden present in MPG and their biological effects, and to discuss the possibility to use MPG as a passive method to assess occupational exposure to microbial contamination. Fungal burden was characterized through molecular tools for fungal toxigenic species, and antifungal resistance and mycotoxins profiles were determined. Cell viability was determined in swine kidney (SK) monolayer and hepatocellular carcinoma (Hep G2) cell lines. All MPG samples presented Gram-negative bacteria. The fungal contamination ranged from 0 CFU.m^-2 in both MEA and DG18, to 5.09 × 10⁶ and 2.75 × 10⁶ and the most commonly fungi found was Aspergillus spp. (50.46%). Azole resistant Aspergillus sections were found in azole supplemented media. Aspergillus sections (Circumdati, Flavi, Fumigati and Versicolores) were detected by molecular tools in 66 out of 67 samples. The most reported mycotoxin was mycophenolic acid (89.6%). HepG2 cells appear to be more sensitive to MPG contamination, with high cytotoxicity (IC50 < 0.05 mm2/ml) observed for 18 out of 57 gloves. MPG can be used in passive sampling to assess occupational exposure to bioburden in waste sorting industries and contribute for risk characterization. Some contaminants of MPG had cytotoxic potential and affected the biology of hepatic cells more than renal cells.

Assessment of Children’s Potential Exposure to Bioburden in Indoor Environments

The exposure to particles and bioaerosols has been associated with the increase in health effects in children. The objective of this study was to assess the indoor exposure to bioburden in the indoor microenvironments more frequented by children. Air particulate matter (PM) and settled dust were sampled in 33 dwellings and four schools with a medium volume sampler and with a passive method using electrostatic dust collectors (EDC), respectively. Settled dust collected by EDC was analyzed by culture-based methods (including azole resistance profile) and using qPCR. Results showed that the PM2.5 and PM10 concentrations in classrooms (31.15 μg/m3 and 57.83 μg/m3, respectively) were higher than in homes (15.26 μg/m3 and 18.95 μg/m3, respectively) and highly exceeded the limit values established by the Portuguese legislation for indoor air quality. The fungal species most commonly found in bedrooms was Penicillium sp. (91.79%), whereas, in living rooms, it was Rhizopus sp. (37.95%). Aspergillus sections with toxigenic potential were found in bedrooms and living rooms and were able to grow on VOR. Although not correlated with PM, EDC provided information regarding the bioburden. Future studies, applying EDC coupled with PM assessment, should be implemented to allow for a long-term integrated sample of organic dust.

Liver and kidney serum profile abnormalities in workers exposed to aflatoxin B1 in urban solid waste management centers

Many workers are exposed to health problems arising from molds, fungi, and their toxins during waste processing. Aflatoxin B₁ (AFB₁) level in airborne and settled dust, aflatoxin B₁-albumin (AFB₁-Alb) adduct in serum, liver and kidney biochemical tests, and body redox change of workers in municipal dry waste-processing sites were investigated. The surface, personal, and area air dust and the blood of workers' samples were collected from the plastic and bread waste-sorting sections in three recycling municipal dry waste sites. Digestion (only for serum samples), passed through SPE cartridge, elution, and collection with methanol, immune-affinity column clean-up, and HPLC system equipped with post-column derivatization method and fluorescence detection were performed for determination of AFB₁ and AFB₁-Alb levels in the samples. The mean level of dust and AFB₁ in the personal and area air, and in the settled dust and the AFB₁-Alb in the serum of workers in the bread waste sorting, was higher than plastic waste-sorting samples, in all of the sites. The differences in the biochemical profiles of subjects exposed to aflatoxin B₁ as compared to the control group especially in liver and kidney function parameters as well as antioxidant factors of the serum were significant. The workers in handling of municipal waste may be exposed to potentially hazardous levels of aflatoxin B₁. The adverse effects of AFB₁ on the kidney and liver may be caused by changes in the redox system.

Methods for Bioaerosol Characterization: Limits and Perspectives for Human Health Risk Assessment in Organic Waste Treatment

Bioaerosol characterization represents a major challenge for the risk assessment and management of exposed people. One of the most important bioaerosol sources is the organic waste collection and treatment. This work analyzed and discussed the literature with the purpose of investigating the main techniques used nowadays for bioaerosol monitoring during organic waste treatment. The discussion includes an overview on the most efficient sampling, DNA extraction, and analysis methods, including both the cultural and the bio-molecular approach. Generally, an exhaustive biological risk assessment is not applied due to the organic waste heterogeneity, treatment complexity, and unknown aerosolized emission rate. However, the application of bio-molecular methods allows a better bioaerosol characterization, and it is desirable to be associated with standardized cultural methods. Risk assessment for organic waste workers generally includes the evaluation of the potential exposition to pathogens and opportunistic pathogens or to other microorganisms as biomarkers. In most cases, Saccharopolyspora rectivirgula, Legionella spp., Aspergillus spp., and Mycobacterium spp. are included. Future perspectives are focused on identifying common composting biomarkers, on investigating the causality process between chronic bioaerosol exposure and disease onset, and finally, on defining common exposure limits.