A systematic review of experimental animal studies on microbial bioaerosols: Dose-response data for the derivation of exposure limits

Beyond water and soil: Air emerges as a major reservoir of human pathogens

Assessing the risk of human pathogens in the environment is crucial for controlling the spread of diseases and safeguarding human health. However, conducting a thorough assessment of low-abundance pathogens in highly complex environmental microbial communities remains challenging. This study compiled a comprehensive catalog of 247 human-pathogenic bacterial taxa from global biosafety agencies and identified more than 78 million genome-specific markers (GSMs) from their 17,470 sequenced genomes. Subsequently, we analyzed these pathogens' types, abundance, and diversity within 474 shotgun metagenomic sequences obtained from diverse environmental sources. The results revealed that among the four habitats studied (air, water, soil, and sediment), the detection rate, diversity, and abundance of detectable pathogens in the air all exceeded those in the other three habitats. Air, sediment, and water environments exhibited identical dominant taxa, indicating that these human pathogens may have unique environmental vectors for their transmission or survival. Furthermore, we observed the impact of human activities on the environmental risk posed by these pathogens, where greater amounts of human activities significantly increased the abundance of human pathogenic bacteria, especially in water and air. These findings have remarkable implications for the environmental risk assessment of human pathogens, providing valuable insights into their presence and distribution across different habitats.

Potential airborne human pathogens: A relevant inhabitant in built environments but not considered in indoor air quality standards

Potential airborne human pathogens (PAHPs) may be a relevant component of the air microbiome in built environments. Despite that PAHPs can cause infections, particularly in immunosuppressed patients at medical centers, they are scarcely considered in standards of indoor air quality (IAQ) worldwide. Here, we reviewed the current information on microbial aerosols (bacteria, fungal and viruses) and PAHPs in different types of built environments (e.g., medical center, industrial and non-industrial), including the main factors involved in their dispersion, the methodologies used in their study and their associated biological risks. Our analysis identified the human occupancy and ventilation systems as the primary sources of dispersal of microbial aerosols indoors. We also observed temperature and relative humidity as relevant physicochemical factors regulating the dispersion and viability of some PAHPs. Our analysis revealed that some PAHPs can survive and coexist in different environments while other PAHPs are limited or specific for an environment. In relation to the methodologies (conventional or molecular) the nature of PAHPs and sampling type are pivotal. In this context, indoors air-borne viruses are the less studies because their small size, environmental lability, and absence of efficient sampling techniques and universal molecular markers for their study. Finally, it is noteworthy that PAHPs are not commonly considered and included in IAQ standards worldwide, and when they are included, the total abundance is the single parameter considered and biological risks is excluded. Therefore, we propose a revision, design and establishment of public health policies, regulations and IAQ standards, considering the interactions of diverse factors, such as nature of PAHPs, human occupancy and type of built environments where they develop.

Ventilation indices for evaluation of airborne infection risk control performance of air distribution

Air distribution is an effective engineering measure to fight against respiratory infectious diseases like COVID-19. Ventilation indices are widely used to indicate the airborne infection risk of respiratory infectious diseases due to the practical convenience. This study investigates the relationships between the ventilation indices and airborne infection risk to suggest the proper ventilation indices for the evaluation of airborne infection risk control performance of air distribution. Besides the commonly used ventilation indices of the age of air (AoA), air change effectiveness (ACE), and contaminant removal effectiveness (CRE), this study introduces two ventilation indices, i.e., the air utilization effectiveness (AUE) and contaminant dispersion index (CDI). CFD simulations of a hospital ward and a classroom served by different air distributions, including mixing ventilation, displacement ventilation, stratum ventilation and downward ventilation, are validated to calculate the ventilation indices and airborne infection risk. A three-step correlation analysis based on Spearman's rank correlation coefficient, Pearson correlation coefficient, and goodness of fit and a min-max normalization-based error analysis are developed to qualitatively and quantitatively test the validity of ventilation indices respectively. The results recommend the integrated index of AUE and CDI to indicate the overall airborne infection risk, and CDI to indicate the local airborne infection risk respectively regardless of the effects of air distribution, supply airflow rate, infectivity intensity, room configuration and occupant distribution. This study contributes to airborne transmission control of infectious respiratory diseases with air distribution.

Estimating Lung Deposition of Fungal Spores Using Actual Airborne Spore Concentrations and Physiological Data

Exposure to bioaerosols has been implicated in adverse respiratory symptoms, infectious diseases, and bioterrorism. Although these particles have been measured within residential and occupational settings in multiple studies, the deposition of bioaerosol particles within the human respiratory system has been only minimally explored. This paper uses real-world environmental measurement data of total fungal spores using Air-o-Cell cassettes in 16 different apartments and residents' physiological data in those apartments to predict respiratory deposition of the spores. The airborne spore concentrations were measured during the spring, summer, and fall. The respiratory deposition of five most prevalent spore genera-Ascospores, Aspergillus, Basidiospores, Cladosporium, and Myxomycetes-was predicted using three empirical models: the Multiple Path Particle Dosimetry model, using both the Yeh and age-specific versions, and the Bioaerosol Adaptation of the International Committee on Radiological Protection's Lung deposition model. The predicted total deposited number of spores was highest for Ascospores and Cladosporium. While the majority of spores deposit were in the extrathoracic region, there is a significant deposition for both Aspergillus and Cladosporium in the alveolar region, potentially leading to the development of aspergillosis or allergic asthma. Although the dose-response relationship is unknown, the estimate of the actual spore deposition could be the first step in determining such a relationship.

Impact of negative pressure system on microbiological air quality in a Central Sterile Supply Department

OBJECTIVE

Guidelines recommend that the cleaning area in a Central Sterile Supply Department (CSSD) maintain a negative pressure of the environmental air, but how much this system can impact the contamination of the air by bioaerosols in the area is not known. The objective of this study was to assess the impact of negative pressure on CSSD by evaluating the microbiological air quality of this sector.

METHODS

Microbiological air samples were collected in two CSSD in the same hospital: one with and one without a negative air pressure system. Outdoor air samples were collected as a comparative control. Andersen six-stage air sampler was used to obtain the microbiological air samples.

RESULTS

The concentration of bioaerosols in the CSSD without negative pressure was 273.15 and 206.71 CFU/m3 , while in the CSSD with negative pressure the concentration of bioaerosols was 116.96 CFU/m3 and 131.10 CFU/m3 . The number of isolated colonies in the negative pressure CSSD was significantly lower (P = .01541).

CONCLUSION

The findings showed that the negative pressure system in the CSSD cleaning area contributed to the quantitative reduction in bioaerosols. However, the concentration of bioaerosols was lower than that established in the guideline for indoor air quality of many countries. Therefore, it cannot be concluded that CSSDs which do not have a negative pressure system in their cleaning area offer occupational risk.

Workplace Biological Risk Assessment: Review of Existing and Description of a Comprehensive Approach

Biological risks potentially affect workers in multiple occupational sectors through their exposure to pathogenic agents. These risks must be carefully assessed to prevent adverse health effects. This article identifies and critically analyzes approaches that manage the qualitative evaluation of biological risk (EvBR) as part of occupational health and safety prevention, for which no standard method yet exists. Bibliographic and computing references were searched to identify qualitative EvBR approaches, which were then analyzed based on defined criteria, such as the risks studied and the type of assessment. Approaches proposing the most representative types of assessment were analyzed. EvBR approaches in an occupational setting were identified in 32 sources. “Workstation analysis” combined with “assessment by risk level” were the most common approaches. The predominant risk descriptors (RDs) were defined in a characterized and quantifiable way, and a variety of hazard levels and exposure indices were created. Overall, the risk was determined by summing or multiplying the hazard level and exposure indicators. The results confirmed that no methodological consensus currently exists regarding the EvBR and no approach has yet been described that integrates all the parameters to allow for a full assessment of biological risk. Based on the detailed analysis of the existing data, the present paper proposes a general approach.

Relationships between Exposure to Bioaerosols, Moldy Surface and Symptoms in French Mold-Damaged Homes

Air quality in homes is a major concern in Europe, where people spend most of their time indoors. According to the World Health Organization, numerous houses are subject to dampness that can lead to mold growth, with associated health and economic consequences. Our goal was to characterize the human exposure to bioaerosols in French mold-damaged houses but also to study the effects of these bioaerosols as suffered by the inhabitants of these houses. A global approach including both field study and laboratory experimentation was used to investigate 48 mold-damaged homes. Among a wide fungal diversity, 101 viable species, Aspergillus versicolor, Penicillium chrysogenum and P. crustosum were observed as recurrent species and could be used as microbial indicators of indoor air quality. Statistical analyses highlighted a relationship between the concentrations of these recurrent molds and the levels of surface contamination by molds in homes. Fever, cough, dyspnea, flu-like symptoms were observed with several fungal strains (A. versicolor, P. chrysogenum and P. crustosum) or in relation to moldy odor. Relationships between particles of 2 to 15 µm diameter and headaches and dizziness were also observed. In our study, we identified a cutaneous effect (itching) in relationship to the airborne concentration of A. versicolor.

The Dose of Fungal Aerosol Inhaled by Workers in a Waste-Sorting Plant in Poland: A Case Study

Bioaerosol monitoring is a rapidly emerging area in the context of work environments because microbial pollution is a key element of indoor air pollution and plays an important role in certain infectious diseases and allergies. However, as yet, relatively little is known about inhaled doses of microorganisms in workplaces. Today, the important issue of social concern is due to waste management, transport, sorting, and processing of wastes and their environmental impact and effects on public health. In fact, waste management activities can have numerous adverse effects on human wellbeing. Health effects are generally linked to exposure (EX), defined as the concentration of a contaminant and the length of time a person is exposed to this concentration. Dose is an effective tool for evaluating the quantity of a contaminant that actually crosses the body’s boundaries and influences the goal tissue. This document presents an analysis of the fungal waste-sorting plant EX dose (FWSPED) inhaled by workers in a waste-sorting plant (WSP) in Poland in March 2019. The main purpose of this research was to assess FWSPED inhaled by workers in two cabins at the WSP: the preliminary manual sorting cabin (PSP) and the purification manual sorting cabin (quality control; QSP). It was found that the FWSPED inhaled by workers was 193 CFU/kg in the PSP and 185 CFU/kg in the QSP. Fungal particles were quantitatively evaluated and qualitatively identified by the GEN III Biolog system. During the research, it was found that isolates belonging to the Aspergilus flavus and Penicillum chrysogenum strains were detected most frequently in the WSP. The total elimination of many anthropogenic sources is not possible, but the important findings of this research can be used to develop realistic management policies and methods to improve the biological air quality of WSPs for effective protection of WSP workers.

Respiratory Health Effects of Exposure to Ambient Particulate Matter and Bioaerosols

Researchers have been studying the respiratory health effects of ambient air pollution for more than 70 years. While air pollution as a whole can include gaseous, solid, and liquid constituents, this article focuses only on the solid and liquid fractions, termed particulate matter (PM). Although PM may contain anthropogenic, geogenic, and/or biogenic fractions, in this article, particles that originate from microbial, fungal, animal, or plant sources are distinguished from PM as bioaerosols. Many advances have been made toward understanding which particle and exposure characteristics most influence deposition and clearance processes in the respiratory tract. These characteristics include particle size, shape, charge, and composition as well as the exposure concentration and dose rate. Exposure to particles has been directly associated with the exacerbation and, under certain circumstances, onset of respiratory disease. The circumstances of exposure leading to disease are dependent on stressors such as human activity level and changing particle composition in the environment. Historically, researchers assumed that bioaerosols were too large to be inhaled into the deep lung, and thus, not applicable for study in conjunction with PM2.5 (the 2.5-μm and below size fraction that can reach the deep lung); however, this concept is beginning to be challenged. While there is extensive research on the health effects of PM and bioaerosols independent of each other, only limited work has been performed on their coexposure. Studying these two particle types as dual stressors to the respiratory system may aid in more thoroughly understanding the etiology of respiratory injury and disease. © 2020 American Physiological Society. Compr Physiol 10:1-20, 2020.