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Norbäck D, Hashim JH, Hashim Z, Wieslander G. Fractional exhaled nitric oxide (FeNO) and respiratory symptoms in junior high school students in Penang, Malaysia: the role of household exposure. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024; 34:213-224. [PMID: 36335594 DOI: 10.1080/09603123.2022.2143482] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 10/31/2022] [Indexed: 06/16/2023]
Abstract
We studied associations between fractional exhaled nitric oxide (FeNO), health and household exposure among school children (N = 348) in Penang, Malaysia. Multiple logistic regression and linear mixed models were applied. Overall, 46.0% had elevated FeNO (>20 ppb) and 10.6% diagnosed asthma. Male gender (p = 0.002), parental asthma or allergy (p = 0.047), cat allergy (p = 0.009) and seafood allergy (p < 0.001), diagnosed asthma (p = 0.001), wheeze (p = 0.001), ocular symptoms (p = 0.001), rhinitis (p = 0.002) and respiratory infections (p = 0.004) were all associated with FeNO. Students exposed to ETS had lower FeNO (p = 0.05). Dampness and mould was associated with wheeze (p = 0.038), especially in wooden homes (interaction p = 0.042) and among students with elevated FeNO (interaction p = 0.024). Cat keeping increased rhinitis (p = 0.041) and respiratory infections (p = 0.008) and modified the dampness associations. In conclusion, FeNO can be associated with ocular and respiratory symptoms. Elevated FeNO, cat keeping and a wooden house can enhance the risk of wheeze when exposed to dampness and mould.
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Affiliation(s)
- Dan Norbäck
- Department of Medical Science, Occupational and Environmental Medicine, University Hospital, Uppsala, Sweden
| | - Jamal Hisham Hashim
- Department of Environmental Health and Occupational Safety, Universiti Selangor, Shah Alam, Malaysia
| | - Zailina Hashim
- Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Gunilla Wieslander
- Department of Medical Science, Occupational and Environmental Medicine, University Hospital, Uppsala, Sweden
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Takaoka M, Suzuki K, Norbäck D. Rhinitis in Japanese students - associations with window pane condensation, recent indoor painting, wooden home and dog allergen at school. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2023; 33:1502-1514. [PMID: 35881888 DOI: 10.1080/09603123.2022.2104225] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 07/18/2022] [Indexed: 06/15/2023]
Abstract
We studied risk factors for rhinitis in Japanese homes and schools. A questionnaire was sent to students in four schools (12-15 y age), 1048 (99.2%) participated. Crowdedness and furry pet allergens were measured in their classrooms. Household environment data was collected by a questionnaire. Risk factors were identified by multi-level logistic regression with mutual adjustment. The prevalence of current rhinitis was 60.3%, current rhinoconjunctivitis 24.4% and weekly rhinitis 29.5%. Window condensation (AORs1.69-1.90) and indoor painting (AORs1.72-1.76) at home were associated with rhinitis. The association between painting and rhinitis was stronger in girls (interaction p = 0.002) and in wooden homes (interaction p = 0.05). Dog allergen (Can f 1) in classroom air was associated with rhinitis (p = 0.04). In conclusion, window pane condensation and indoor painting can be household risk factors for rhinitis and dog allergen may be a risk factor in Japanese schools. Girls can be more sensitive to emissions from indoor paint than boys.
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Affiliation(s)
- Motoko Takaoka
- Department of Biosphere Sciences, School of Human Sciences, Kobe College, Nishinomiya, Japan
| | - Kyoko Suzuki
- Department of Biosphere Sciences, School of Human Sciences, Kobe College, Nishinomiya, Japan
| | - Dan Norbäck
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University and University Hospital, Uppsala, Sweden
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Fu X, Du B, Meng Y, Li Y, Zhu X, Ou Z, Zhang M, Wen H, Ma'pol A, Hashim JH, Hashim Z, Wieslander G, Chen Q, Jiang J, Wang J, Norbäck D, Xia Y, Chen Q, Sun Y. Associations between environmental characteristics, high-resolution indoor microbiome, metabolome and allergic and non-allergic rhinitis symptoms for junior high school students. ENVIRONMENTAL SCIENCE. PROCESSES & IMPACTS 2023; 25:791-804. [PMID: 36883483 DOI: 10.1039/d2em00480a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Rhinitis is one of the most prevalent chronic diseases globally. Microbiome exposure affects the occurrence of rhinitis. However, previous studies did not differentiate allergic rhinitis (AR) and non-allergic rhinitis (NAR) in the microbial association analysis. In this study, we investigate 347 students in 8 junior high schools, Terengganu, Malaysia, who were categorized as healthy (70.9%), AR (13.8%) and NAR (15.3%) based on a self-administered questionnaire and skin prick tests of pollen, pet, mould and house dust mite allergens. Classroom microbial and metabolite exposure in vacuumed dust was characterized by PacBio long-read amplicon sequencing, quantitative PCR and LC-MS-based untargeted metabolomics. Our findings indicate a similar microbial association pattern between AR and NAR. The richness in Gammaproteobacteria was negatively associated with AR and NAR symptoms, whereas total fungal richness was positively associated with AR and NAR symptoms (p < 0.05). Brasilonema bromeliae and Aeromonas enteropelogenes were negatively associated with AR and NAR, and Deinococcus was positively associated with AR and NAR (p < 0.01). Pipecolic acid was protectively associated with AR and NAR symptoms (OR = 0.06 and 0.13, p = 0.009 and 0.045). A neural network analysis showed that B. bromeliae was co-occurring with pipecolic acid, suggesting that the protective role of this species may be mediated by releasing pipecolic acid. Indoor relative humidity and the weight of vacuum dust were associated with AR and NAR, respectively (p < 0.05), but the health effects were mediated by two protective bacterial species, Aliinostoc morphoplasticum and Ilumatobacter fluminis. Overall, our study reported a similar microbial association pattern between AR and NAR and also revealed the complex interactions between microbial species, environmental characteristics, and rhinitis symptoms.
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Affiliation(s)
- Xi Fu
- Guangdong Provincial Engineering Research Center of Public Health Detection and Assessment, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, 510006, PR China.
| | - Bingqian Du
- Guangdong Provincial Engineering Research Center of Public Health Detection and Assessment, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, 510006, PR China.
| | - Yi Meng
- Guangdong Provincial Key Laboratory of Protein Function and Regulation in Agricultural Organisms, College of Life Sciences, South China Agricultural University, Guangzhou, Guangdong, 510642, PR China.
- Key Laboratory of Zoonosis of Ministry of Agriculture and Rural Affairs, South China Agricultural University, Guangzhou, Guangdong, 510642, PR China
- Guangdong Laboratory for Lingnan Modern Agriculture, South China Agricultural University, Guangzhou, Guangdong, 510642, China
| | - Yanling Li
- Guangdong Provincial Key Laboratory of Protein Function and Regulation in Agricultural Organisms, College of Life Sciences, South China Agricultural University, Guangzhou, Guangdong, 510642, PR China.
- Key Laboratory of Zoonosis of Ministry of Agriculture and Rural Affairs, South China Agricultural University, Guangzhou, Guangdong, 510642, PR China
- Guangdong Laboratory for Lingnan Modern Agriculture, South China Agricultural University, Guangzhou, Guangdong, 510642, China
| | - Xunhua Zhu
- Guangdong Provincial Key Laboratory of Protein Function and Regulation in Agricultural Organisms, College of Life Sciences, South China Agricultural University, Guangzhou, Guangdong, 510642, PR China.
- Key Laboratory of Zoonosis of Ministry of Agriculture and Rural Affairs, South China Agricultural University, Guangzhou, Guangdong, 510642, PR China
- Guangdong Laboratory for Lingnan Modern Agriculture, South China Agricultural University, Guangzhou, Guangdong, 510642, China
| | - Zheyuan Ou
- Guangdong Provincial Key Laboratory of Protein Function and Regulation in Agricultural Organisms, College of Life Sciences, South China Agricultural University, Guangzhou, Guangdong, 510642, PR China.
- Key Laboratory of Zoonosis of Ministry of Agriculture and Rural Affairs, South China Agricultural University, Guangzhou, Guangdong, 510642, PR China
- Guangdong Laboratory for Lingnan Modern Agriculture, South China Agricultural University, Guangzhou, Guangdong, 510642, China
| | - Mei Zhang
- Guangdong Provincial Key Laboratory of Protein Function and Regulation in Agricultural Organisms, College of Life Sciences, South China Agricultural University, Guangzhou, Guangdong, 510642, PR China.
- Key Laboratory of Zoonosis of Ministry of Agriculture and Rural Affairs, South China Agricultural University, Guangzhou, Guangdong, 510642, PR China
- Guangdong Laboratory for Lingnan Modern Agriculture, South China Agricultural University, Guangzhou, Guangdong, 510642, China
| | - Huarong Wen
- Baling Health Center, Dangyang, Hubei, 444100, PR China
| | - Aminnuddin Ma'pol
- Gombak District Health Office, Ministry of Health, Batu Caves, Selangor Darul Ehsan, Malaysia
| | | | - Zailina Hashim
- Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM, Serdang, Selangor, Malaysia
| | - Gunilla Wieslander
- Occupational and Environmental Medicine, Department of Medical Science, University Hospital, Uppsala University, 75237 Uppsala, Sweden
| | - Qingmei Chen
- Guangdong Provincial Key Laboratory of Protein Function and Regulation in Agricultural Organisms, College of Life Sciences, South China Agricultural University, Guangzhou, Guangdong, 510642, PR China.
- Key Laboratory of Zoonosis of Ministry of Agriculture and Rural Affairs, South China Agricultural University, Guangzhou, Guangdong, 510642, PR China
- Guangdong Laboratory for Lingnan Modern Agriculture, South China Agricultural University, Guangzhou, Guangdong, 510642, China
| | - Jun Jiang
- Guangdong Provincial Key Laboratory of Protein Function and Regulation in Agricultural Organisms, College of Life Sciences, South China Agricultural University, Guangzhou, Guangdong, 510642, PR China.
- Key Laboratory of Zoonosis of Ministry of Agriculture and Rural Affairs, South China Agricultural University, Guangzhou, Guangdong, 510642, PR China
- Guangdong Laboratory for Lingnan Modern Agriculture, South China Agricultural University, Guangzhou, Guangdong, 510642, China
| | - Juan Wang
- Occupational and Environmental Medicine, Department of Medical Science, University Hospital, Uppsala University, 75237 Uppsala, Sweden
| | - Dan Norbäck
- Occupational and Environmental Medicine, Department of Medical Science, University Hospital, Uppsala University, 75237 Uppsala, Sweden
| | - Yun Xia
- Guangdong Provincial Engineering Research Center of Public Health Detection and Assessment, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, 510006, PR China.
| | - Qingsong Chen
- Guangdong Provincial Engineering Research Center of Public Health Detection and Assessment, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, 510006, PR China.
| | - Yu Sun
- Guangdong Provincial Key Laboratory of Protein Function and Regulation in Agricultural Organisms, College of Life Sciences, South China Agricultural University, Guangzhou, Guangdong, 510642, PR China.
- Key Laboratory of Zoonosis of Ministry of Agriculture and Rural Affairs, South China Agricultural University, Guangzhou, Guangdong, 510642, PR China
- Guangdong Laboratory for Lingnan Modern Agriculture, South China Agricultural University, Guangzhou, Guangdong, 510642, China
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Hong G, Han YK, Yeo MK, Lee BG, Na YC. Development of analytical methods for the determination of 3-hydroxy fatty acids and muramic acid as bacterial markers in airborne particles and settled dust. J Chromatogr A 2023; 1688:463708. [PMID: 36528898 DOI: 10.1016/j.chroma.2022.463708] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 12/04/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022]
Abstract
Inhalation of airborne bacteria in indoor environments is known to be associated with respiratory diseases. Analytical methods for the determination of 3-hydroxy fatty acids (3-OHFAs) and muramic acid (MA) as chemical markers of gram-negative and gram-positive bacteria, respectively, were developed for airborne particle and dust samples in this study. 3-OHFAs as markers of endotoxin were released and esterified during the hydrolysis process under methanolic acid conditions, and their hydrolysates, i.e., 3-OHFA methyl esters, were cleaned up by solid-phase extraction using silica sorbent that provided more effective separation from interferents than polymeric sorbent through elution pattern. The SPE eluent was analyzed by GC-MS/MS measurement after the trimethylsilylation reaction. The recovery of the method ranged from 82.1 % to 103.2 %, with a limit of detection ranging from 0.5 to 1.1 ng/filter and good linearity (R2 > 0.991). For the analysis of MA, muramic acid methyl ester (MAME), a product formed during methanolic hydrolysis, was selected as a specific marker of peptidoglycan. It was the first proposed compound identified and confirmed with MS and MS/MS spectra using high-resolution measurement. In particular, the measurement of MAME providing 12.5 times greater sensitivity than MA with the application of the LC-MS/MS method is one of the notable findings of this study. The recovery by simple liquid extraction was 99.4 % following the removal of the hydrophobic matrix and neutralization with solvent reconstruction. The method displayed a LOD of 0.7 ng/filter and linearity (R2) of 0.997 through a simple pretreatment process. Both developed methods were applied and evaluated by determining 3-OHFAs and MA in airborne particles collected from multipurpose facilities and settled dust in the laboratory and office.
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Affiliation(s)
- Gieun Hong
- Western Seoul Center, Korea Basic Science Institute, 150 Bugahyeon-ro, Seodaemun-gu, Seoul 03759, Republic of Korea
| | - Yoon-Kyung Han
- Western Seoul Center, Korea Basic Science Institute, 150 Bugahyeon-ro, Seodaemun-gu, Seoul 03759, Republic of Korea
| | - Min-Kyeong Yeo
- Department of Applied Environmental Science, Graduate School Kyung Hee University, 1732 Deogyeong-daero, Giheung-gu, Yongin-si, Gyeonggi-do 17104, Republic of Korea; Department of Environmental Science and Engineering, College of Engineering, Kyung Hee University, 1732 Deogyeong-daero, Giheung-gu, Yongin-si, Gyeonggi-do 17104, Republic of Korea
| | - Bong Gu Lee
- Department of Applied Environmental Science, Graduate School Kyung Hee University, 1732 Deogyeong-daero, Giheung-gu, Yongin-si, Gyeonggi-do 17104, Republic of Korea
| | - Yun-Cheol Na
- Western Seoul Center, Korea Basic Science Institute, 150 Bugahyeon-ro, Seodaemun-gu, Seoul 03759, Republic of Korea.
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Prasad V, Abdullah M, Nordin F, Subha ST. Prevalence, causes and treatments of allergic rhinitis in Malaysia: a literature review. THE EGYPTIAN JOURNAL OF OTOLARYNGOLOGY 2022. [DOI: 10.1186/s43163-022-00361-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
AbstractRecently, allergic rhinitis (AR) cases have been surging rapidly in many developing countries. However, the prevalence, risk factors and treatment modalities for AR within the Malaysian population have not been thoroughly evaluated. The present study aimed to provide a complete review of literature on allergic rhinitis in Malaysia. Available data indicated that the prevalence of AR varied across different age groups and regions in Malaysia, but there is an increasing trend among the younger population. The key contributing factor is exposure and sensitization towards several airborne allergens, mainly house dust mites, cat fur and fungi, with possible genetic predispositions. In addition, variations in the symptom severity may be associated with racial orientations. For management of the disease, standard prescriptions of conventional drugs (antihistamines, intranasal corticosteroids and nasal decongestants) remain as the treatment of choice. A small proportion of the native residents tend to resort to alternative approaches of self-healing through aromatherapy and natural food consumption such as tiger’s milk mushroom and Tualang honey. In conclusion, the increase in the cases of AR in Malaysia is due to environmental and genetic factors which requires proper medical intervention as treatment strategies. The utilization of holistic approaches requires further studies and clear understanding prior to their integration into the standard of care. There are still many gaps in the knowledge and management of allergic rhinitis which demands further attention from the research community.
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Fu X, Ou Z, Sun Y. Indoor microbiome and allergic diseases: From theoretical advances to prevention strategies. ECO-ENVIRONMENT & HEALTH (ONLINE) 2022; 1:133-146. [PMID: 38075599 PMCID: PMC10702906 DOI: 10.1016/j.eehl.2022.09.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 09/06/2022] [Accepted: 09/12/2022] [Indexed: 12/20/2023]
Abstract
The prevalence of allergic diseases, such as asthma, rhinitis, eczema, and sick building syndrome (SBS), has increased drastically in the past few decades. Current medications can only relieve the symptoms but not cure these diseases whose development is suggested to be greatly impacted by the indoor microbiome. However, no study comprehensively summarizes the progress and general rules in the field, impeding subsequent translational application. To close knowledge gaps between theoretical research and practical application, we conducted a comprehensive literature review to summarize the epidemiological, environmental, and molecular evidence of indoor microbiome studies. Epidemiological evidence shows that the potential protective indoor microorganisms for asthma are mainly from the phyla Actinobacteria and Proteobacteria, and the risk microorganisms are mainly from Bacilli, Clostridia, and Bacteroidia. Due to extremely high microbial diversity and geographic variation, different health-associated species/genera are detected in different regions. Compared with indoor microbial composition, indoor metabolites show more consistent associations with health, including microbial volatile organic compounds (MVOCs), lipopolysaccharides (LPS), indole derivatives, and flavonoids. Therefore, indoor metabolites could be a better indicator than indoor microbial taxa for environmental assessments and health outcome prediction. The interaction between the indoor microbiome and environmental characteristics (surrounding greenness, relative humidity, building confinement, and CO2 concentration) and immunology effects of indoor microorganisms (inflammatory cytokines and pattern recognition receptors) are briefly reviewed to provide new insights for disease prevention and treatment. Widely used tools in indoor microbiome studies are introduced to facilitate standard practice and the precise identification of health-related targets.
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Affiliation(s)
- Xi Fu
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou 510006, China
- Guangdong Provincial Engineering Research Center of Public Health Detection and Assessment, Guangdong Pharmaceutical University, Guangzhou 510006, China
| | - Zheyuan Ou
- Guangdong Provincial Key Laboratory of Protein Function and Regulation in Agricultural Organisms, College of Life Sciences, South China Agricultural University, Guangzhou 510642, China
- Guangdong Laboratory for Lingnan Modern Agriculture, Guangzhou 510642, China
| | - Yu Sun
- Guangdong Provincial Key Laboratory of Protein Function and Regulation in Agricultural Organisms, College of Life Sciences, South China Agricultural University, Guangzhou 510642, China
- Guangdong Laboratory for Lingnan Modern Agriculture, Guangzhou 510642, China
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Fu X, Ou Z, Zhang M, Meng Y, Li Y, Chen Q, Jiang J, Zhang X, Norbäck D, Zhao Z, Sun Y. Classroom microbiome, functional pathways and sick-building syndrome (SBS) in urban and rural schools - Potential roles of indoor microbial amino acids and vitamin metabolites. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 795:148879. [PMID: 34328924 DOI: 10.1016/j.scitotenv.2021.148879] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 06/24/2021] [Accepted: 07/02/2021] [Indexed: 06/13/2023]
Abstract
Sick building symptoms (SBS) are defined as non-specific symptoms related to indoor exposures, including mucosal symptoms in eye, nose, throat, and skin, and general symptoms as headache and tiredness. Indoor microbial composition is associated with SBS symptoms, but the impact of microbial functional genes and potential metabolic products has not been characterized. We conducted a shotgun microbial metagenomic sequencing for vacuum dust collected in urban and rural schools in Shanxi province, China. SBS symptoms in students were surveyed, and microbial taxa and functional pathways related to the symptoms were identified using a multi-level linear regression model. SBS symptoms were common in students, and the prevalence of ocular and throat symptoms, headache, and tiredness was higher in urban than in rural areas (p < 0.05). A significant higher microbial α-diversity was found in rural areas than in urban areas (Chao1, p = 0.001; ACE, p = 0.002). Also, significant variation in microbial taxonomic and functional composition (β-diversity) was observed between urban and rural areas (p < 0.005). Five potential risk Actinobacteria species were associated with SBS symptoms (p < 0.01); students in the classrooms with a higher abundance of an unclassified Geodermatophilaceae, Geodermatophilus, Fridmanniella luteola, Microlunatus phosphovorus and Mycetocola reported more nasal and throat symptoms and tiredness. Students with a higher abundance of an unclassified flavobacteriaceae reported fewer throat symptoms and tiredness. The abundance of microbial metabolic pathways related to the synthesis of B vitamins (biotin and folate), gamma-aminobutyric acid (GABA), short-chain fatty acids (SCFAs), and peptidoglycan and were protectively (negatively) associated with SBS symptoms (FDR < 0.05). The result is consistent with human microbiota studies, which reported that these microbial products are extensively involved in immunological processes and anti-inflammatory effects. This is the first study to report the functional potential of the indoor microbiome and the occurrence of SBS, providing new insights into the potential etiologic mechanisms in chronic inflammatory diseases.
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Affiliation(s)
- Xi Fu
- Guangdong Provincial Key Laboratory of Protein Function and Regulation in Agricultural Organisms, College of Life Sciences, South China Agricultural University, Guangzhou, Guangdong 510642, PR China
| | - Zheyuan Ou
- Guangdong Provincial Key Laboratory of Protein Function and Regulation in Agricultural Organisms, College of Life Sciences, South China Agricultural University, Guangzhou, Guangdong 510642, PR China; Key Laboratory of Zoonosis of Ministry of Agriculture and Rural Affairs, South China Agricultural University, Guangzhou, Guangdong 510642, PR China; Guangdong Laboratory for Lingnan Modern Agriculture, South China Agricultural University, Guangzhou, Guangdong 510642, PR China
| | - Mei Zhang
- Guangdong Provincial Key Laboratory of Protein Function and Regulation in Agricultural Organisms, College of Life Sciences, South China Agricultural University, Guangzhou, Guangdong 510642, PR China; Key Laboratory of Zoonosis of Ministry of Agriculture and Rural Affairs, South China Agricultural University, Guangzhou, Guangdong 510642, PR China; Guangdong Laboratory for Lingnan Modern Agriculture, South China Agricultural University, Guangzhou, Guangdong 510642, PR China
| | - Yi Meng
- Guangdong Provincial Key Laboratory of Protein Function and Regulation in Agricultural Organisms, College of Life Sciences, South China Agricultural University, Guangzhou, Guangdong 510642, PR China; Key Laboratory of Zoonosis of Ministry of Agriculture and Rural Affairs, South China Agricultural University, Guangzhou, Guangdong 510642, PR China; Guangdong Laboratory for Lingnan Modern Agriculture, South China Agricultural University, Guangzhou, Guangdong 510642, PR China
| | - Yanling Li
- Guangdong Provincial Key Laboratory of Protein Function and Regulation in Agricultural Organisms, College of Life Sciences, South China Agricultural University, Guangzhou, Guangdong 510642, PR China; Key Laboratory of Zoonosis of Ministry of Agriculture and Rural Affairs, South China Agricultural University, Guangzhou, Guangdong 510642, PR China; Guangdong Laboratory for Lingnan Modern Agriculture, South China Agricultural University, Guangzhou, Guangdong 510642, PR China
| | - Qingmei Chen
- Guangdong Provincial Key Laboratory of Protein Function and Regulation in Agricultural Organisms, College of Life Sciences, South China Agricultural University, Guangzhou, Guangdong 510642, PR China; Key Laboratory of Zoonosis of Ministry of Agriculture and Rural Affairs, South China Agricultural University, Guangzhou, Guangdong 510642, PR China; Guangdong Laboratory for Lingnan Modern Agriculture, South China Agricultural University, Guangzhou, Guangdong 510642, PR China
| | - Jun Jiang
- Guangdong Provincial Key Laboratory of Protein Function and Regulation in Agricultural Organisms, College of Life Sciences, South China Agricultural University, Guangzhou, Guangdong 510642, PR China; Key Laboratory of Zoonosis of Ministry of Agriculture and Rural Affairs, South China Agricultural University, Guangzhou, Guangdong 510642, PR China; Guangdong Laboratory for Lingnan Modern Agriculture, South China Agricultural University, Guangzhou, Guangdong 510642, PR China
| | - Xin Zhang
- Institute of Environmental Science, Shanxi University, Taiyuan, PR China
| | - Dan Norbäck
- Occupational and Environmental Medicine, Dept. of Medical Science, University Hospital, Uppsala University, 75237 Uppsala, Sweden
| | - Zhuohui Zhao
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai 200030, China; Key Laboratory of Public Health Safety of the Ministry of Education, NHC Key Laboratory of Health Technology Assessment (Fudan University), Shanghai Typhoon Institute/CMA, Shanghai Key Laboratory of Meteorology and Health, Shanghai 200030, China.
| | - Yu Sun
- Guangdong Provincial Key Laboratory of Protein Function and Regulation in Agricultural Organisms, College of Life Sciences, South China Agricultural University, Guangzhou, Guangdong 510642, PR China; Key Laboratory of Zoonosis of Ministry of Agriculture and Rural Affairs, South China Agricultural University, Guangzhou, Guangdong 510642, PR China; Guangdong Laboratory for Lingnan Modern Agriculture, South China Agricultural University, Guangzhou, Guangdong 510642, PR China.
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Yang Q, Wang J, Norbäck D. The home environment in a nationwide sample of multi-family buildings in Sweden: associations with ocular, nasal, throat and dermal symptoms, headache, and fatigue among adults. INDOOR AIR 2021; 31:1402-1416. [PMID: 33682978 DOI: 10.1111/ina.12787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 12/17/2020] [Indexed: 06/12/2023]
Abstract
Risk factors at home for ocular, nasal, throat and dermal symptoms, headache, and fatigue were studied in a nationwide questionnaire survey in Sweden, the BETSI study in 2006. Totally, 5775 adults from a stratified random sample of multi-family buildings participated. Associations between home environment factors and weekly symptoms were analyzed by multi-level logistic regression. In total, 8.3% had ocular symptoms; 11.9% nasal symptoms; 7.1% throat symptoms; 11.9% dermal symptoms; 8.5% headache and 23.1% fatigue. Subjects in colder climate zones had more mucosal and throat symptoms but less fatigue and ocular symptoms. Rented apartments had poorer indoor environment than self-owned apartments. Those living in buildings constructed from 1961 to 1985 had most symptoms. Building dampness, mold and mold odor were risk factors, especially headache and ocular symptoms. Lack of mechanical ventilation system was another risk factor, especially for headache. Environmental tobacco smoke (ETS), electric radiators, and crowdedness were other risk factors. Oiled wooden floors, recent indoor painting, and new floor materials were negatively associated with symptoms. In conclusion, building dampness, mold, poor ventilation conditions, crowdedness, ETS, and emissions from electric radiators in apartments in Sweden can increase the risk of ocular, nasal, throat and dermal symptoms, headache, and fatigue.
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Affiliation(s)
- Qin Yang
- College of Civil Engineering, Guizhou University, Guiyang, China
- Department of Medical Sciences, Uppsala University and University Hospital, Uppsala, Sweden
| | - Juan Wang
- Department of Medical Sciences, Uppsala University and University Hospital, Uppsala, Sweden
| | - Dan Norbäck
- Department of Medical Sciences, Uppsala University and University Hospital, Uppsala, Sweden
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Chang YC, Lee TJ, Huang CC, Chang PH, Chen YW, Fu CH. The Role of Phadiatop Tests and Total Immunoglobulin E Levels in Screening Aeroallergens: A Hospital-Based Cohort Study. J Asthma Allergy 2021; 14:135-140. [PMID: 33628036 PMCID: PMC7898199 DOI: 10.2147/jaa.s292710] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 01/28/2021] [Indexed: 11/23/2022] Open
Abstract
Background Screening for the existence of aeroallergens in patients with possible allergic rhinitis using venous blood samples has become more popular, with advantages of increased convenience and less consumption of time. Objective The aim of this study was to investigate the sensitivities and specificities of Phadiatop tests and total immunoglobulin E (IgE) levels in both adults and children. Methods This study was conducted prospectively in a tertiary center. The process of recruitment took place from Jan 2015 to Dec 2019, and patients with clinical symptoms that suggested persistent allergic rhinitis were recruited and their serum samples collected. The results of the total IgE and Phadiatop tests as well as the positive items in the ImmunoCAP assay were recorded and analyzed. Results A total of 9174 cases with complete data were enrolled, including 576 children and 8598 adults. A positive result in the ImmunoCAP assay was considered a positive atopic status towards aeroallergens. While using the total IgE levels to predict positive aeroallergens, the sensitivities and specificities were 65.7% and 85.7%, respectively, for adults and 86.3% and 77.4%, respectively, for children. When we used Phadiatop tests for allergy screening, the sensitivities and specificities was 94.5% and 98.2%, respectively, for the adult group and 98.5% and 96.8%, respectively, for the pediatric group. Conclusion The Phadiatop test had better diagnostic power for aeroallergen detection than the serum total IgE levels, or even the dual test, for both the adult and pediatric groups in this hospital-based study. We suggest that the Phadiatop test is more cost-effective in aeroallergen screening for patients with suspected atopic airway diseases.
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Affiliation(s)
- Yun-Chen Chang
- Department of Otolaryngology-Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan City, 333, Taiwan
| | - Ta-Jen Lee
- Department of Otolaryngology-Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan City, 333, Taiwan
| | - Chi-Che Huang
- Department of Otolaryngology-Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan City, 333, Taiwan.,Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan City, 333, Taiwan
| | - Po-Hung Chang
- Department of Otolaryngology-Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan City, 333, Taiwan.,Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan City, 333, Taiwan
| | - Yi-Wei Chen
- Department of Otolaryngology-Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan City, 333, Taiwan
| | - Chia-Hsiang Fu
- Department of Otolaryngology-Head and Neck Surgery, Linkou Chang Gung Memorial Hospital, Taoyuan City, 333, Taiwan.,Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan City, 333, Taiwan
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10
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Indoor Microbial Exposures and Chronic Lung Disease: From Microbial Toxins to the Microbiome. Clin Chest Med 2021; 41:777-796. [PMID: 33153695 DOI: 10.1016/j.ccm.2020.08.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Effects of environmental microbial exposures on human health have long been of interest. Microbes were historically assumed to be harmful, but data have suggested that microbial exposures can modulate the immune system. We focus on the effects of indoor environmental microbial exposure on chronic lung diseases. We found contradictory data in bacterial studies using endotoxin as a surrogate for bacterial exposure. Contradictory data also exist in studies of fungal exposure. Many factors may modulate the effect of environmental microbial exposures on lung health, including coexposures. Future studies need to clarify which method of assessing environmental microbial exposures is most relevant.
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11
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Impact of Air Pollution and Weather on Dry Eye. J Clin Med 2020; 9:jcm9113740. [PMID: 33233863 PMCID: PMC7699870 DOI: 10.3390/jcm9113740] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 11/16/2020] [Accepted: 11/19/2020] [Indexed: 01/05/2023] Open
Abstract
Air pollution has broad effects on human health involving many organ systems. The ocular surface is an excellent model with which to study the effects of air pollution on human health as it is in constant contact with the environment, and it is directly accessible, facilitating disease monitoring. Effects of air pollutants on the ocular surface typically manifest as dry eye (DE) symptoms and signs. In this review, we break down air pollution into particulate matter (organic and inorganic) and gaseous compounds and summarize the literature regarding effects of various exposures on DE. Additionally, we examine the effects of weather (relative humidity, temperature) on DE symptoms and signs. To do so, we conducted a PubMed search using key terms to summarize the existing literature on the effects of air pollution and weather on DE. While we tried to focus on the effect of specific exposures on specific aspects of DE, environmental conditions are often studied concomitantly, and thus, there are unavoidable interactions between our variables of interest. Overall, we found that air pollution and weather conditions have differential adverse effects on DE symptoms and signs. We discuss these findings and potential mitigation strategies, such as air purifiers, air humidifiers, and plants, that may be instituted as treatments at an individual level to address environmental contributors to DE.
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12
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A Systematic Review of Air Quality Sensors, Guidelines, and Measurement Studies for Indoor Air Quality Management. SUSTAINABILITY 2020. [DOI: 10.3390/su12219045] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The existence of indoor air pollutants—such as ozone, carbon monoxide, carbon dioxide, sulfur dioxide, nitrogen dioxide, particulate matter, and total volatile organic compounds—is evidently a critical issue for human health. Over the past decade, various international agencies have continually refined and updated the quantitative air quality guidelines and standards in order to meet the requirements for indoor air quality management. This paper first provides a systematic review of the existing air quality guidelines and standards implemented by different agencies, which include the Ambient Air Quality Standards (NAAQS); the World Health Organization (WHO); the Occupational Safety and Health Administration (OSHA); the American Conference of Governmental Industrial Hygienists (ACGIH); the American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE); the National Institute for Occupational Safety and Health (NIOSH); and the California ambient air quality standards (CAAQS). It then adds to this by providing a state-of-art review of the existing low-cost air quality sensor (LCAQS) technologies, and analyzes the corresponding specifications, such as the typical detection range, measurement tolerance or repeatability, data resolution, response time, supply current, and market price. Finally, it briefly reviews a sequence (array) of field measurement studies, which focuses on the technical measurement characteristics and their data analysis approaches.
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13
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Liu Z, Niu H, Rong R, Cao G, He BJ, Deng Q. An experiment and numerical study of resuspension of fungal spore particles from HVAC ducts. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 708:134742. [PMID: 31806338 DOI: 10.1016/j.scitotenv.2019.134742] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 09/26/2019] [Accepted: 09/28/2019] [Indexed: 06/10/2023]
Abstract
Fungal spore resuspension on the surfaces of the heating, ventilation and air-conditioning (HVAC) ducts have been verified as one of the most important factors causing indoor biological pollution. To effectively control indoor bioaerosols pollution, it is essential to understand the resuspension characteristics of fungal spores in HVAC ducts. Therefore, this study aims to investigate the movement behavior of particles and further the variation of particle resuspension with HVAC operation mode. Based on the experimental and numerical study, this study specifically investigated the micro-movement behavior of particles and impact of particle size (1, 4, 7 and 10 μm), air temperature (9, 15 and 30 °C), relative humidity (20, 50 and 80%), duct surface roughness (0.5 and 50 μm) and air velocity (0.3, 0.9, 1.5 and 2.5 m/s) on the short-term resuspension of particle in horizontal HVAC ducts. Results indicate that spore particles were dominantly rolling off rather than sliding or being lifted into the air. Compared with larger particles, smaller ones were more sensitive to the wall roughness. The resuspension rate of spores was mainly affected by airflow velocity and particle size, where the resuspension rate of particles increased by up to six times with the increase of airflow velocity from 0.9 to 2.5 m/s. In comparison, either air temperature or relative humidity made negligible difference to particle resuspension rate. Overall, this study provides the knowledge of fungal spore resuspension in HVAC ducts, laying the foundation for effectively controlling the indoor biological pollution.
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Affiliation(s)
- Zhijian Liu
- Department of Power Engineering, North China Electric Power University, Baoding, Hebei 071003, PR China.
| | - Haotian Niu
- Department of Power Engineering, North China Electric Power University, Baoding, Hebei 071003, PR China
| | - Rui Rong
- Department of Power Engineering, North China Electric Power University, Baoding, Hebei 071003, PR China
| | - Guoqing Cao
- Institute of Building Environment and Energy, China Academy of Building Research, Beijing 100013, PR China
| | - Bao-Jie He
- Faculty of Built Environment, University of New South Wales, NSW 2052, Australia.
| | - Qihong Deng
- School of Energy Science and Engineering, Central South University, Changsha 410083, China
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14
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Microbial Agents in the Indoor Environment: Associations with Health. CURRENT TOPICS IN ENVIRONMENTAL HEALTH AND PREVENTIVE MEDICINE 2020. [PMCID: PMC7122805 DOI: 10.1007/978-981-32-9182-9_9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
There is international consensus that damp buildings and indoor mould can increase the risk of asthma, rhinitis, bronchitis and respiratory tract infections but we do not know which types of microbial agents that are causing the observed adverse health effects. Microbial indoor exposure is a broader concept than microbial growth in buildings. Other sources of indoor microbial exposure include the outdoor environment, humans (crowdedness) and furry pet keeping. Microbial exposure can have different health effects depending on the dose, different exposure route, genetic disposition and the timing of exposure. Microbial stimulation linked to large microbial diversity in early life can protect against disease development, especially for allergic asthma and atopy. Protective effects are more often reported for bacterial exposure and adverse health effects are more often linked to mould exposure. There are many studies on health associations for indoor exposure to endotoxin, mainly from homes. The risk of getting atopic asthma may be less if you are exposed to endotoxin in childhood but the risk of non-atopic asthma may increase if exposed to endotoxin especially in adulthood. Moreover, genetic disposition modifies health effects of endotoxin. Epidemiological studies on muramic acid (from gram-positive bacteria) or ergosterol (from mould) are few. Studies on health effects of indoor exposure to beta-1-3-glucan (from mould) have conflicting results (positive as well as negative associations). Epidemiological studies on health effects of indoor exposure to mycotoxins are very few. Some studies have reported health associations for MVOC, but it is unclear to what extent MVOC has microbial sources in indoor environments. Many studies have reported health associations for fungal DNA, especially as a risk factor for childhood asthma at home. Since most studies on health effects of indoor exposure to mould, bacteria and microbial agents are cross-sectional, it is difficult to draw conclusions on causality. More prospective studies on indoor microbial exposure are needed and studies should include other indoor environments than homes, such as day care centers, schools, hospitals and offices.
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15
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Norback D, Li T, Bai X, Li C, Zhao Z, Zhang X. Onset and remission of rhinitis among students in relation to the home and school environment-A cohort study from Northern China. INDOOR AIR 2019; 29:527-538. [PMID: 30985976 DOI: 10.1111/ina.12559] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 03/05/2019] [Accepted: 04/10/2019] [Indexed: 06/09/2023]
Abstract
Few prospective studies exist on indoor and outdoor air pollution in relation to adolescent rhinitis. We studied associations between onset and remission of rhinitis among junior high school students in relation to the home and school environment. A 2-year questionnaire cohort study was performed among 1325 students (11-15 years) in eight schools in Taiyuan, Northern China. Climate and air pollution were measured by direct reading instruments and passive samplers inside and outside the schools at baseline. Associations were calculated by multilevel logistic regression. Two-year onset of rhinitis and weekly rhinitis were 26.7% and 13.1%, respectively. RH (P < 0.001), CO2 (P < 0.01) and PM10 (P < 0.01) in the classrooms, PM10 (P < 0.01) and NO2 (P < 0.05) outside the schools, and redecoration (OR = 2.25) and dampness/indoor mold at home (OR = 2.04) were associated with onset of weekly rhinitis. RH (P < 0.05) and CO2 (P < 0.05) in the classroom and dampness/indoor mold (OR = 0.67) and environmental tobacco smoke (ETS) at home (OR = 0.63) reduced remission of rhinitis. In conclusion, dampness/mold and chemical emissions from new materials at home can increase onset of rhinitis and ETS and dampness/mold can reduce the remission. PM10 , RH, CO2 , and NO2 at school can increase the onset, and RH and CO2 can reduce the remission of rhinitis.
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Affiliation(s)
- Dan Norback
- Institute of Environmental Science, Shanxi University, Taiyuan, China
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden
| | - Tian Li
- Institute of Environmental Science, Shanxi University, Taiyuan, China
| | - Xu Bai
- Institute of Environmental Science, Shanxi University, Taiyuan, China
| | - Chenghuan Li
- Institute of Environmental Science, Shanxi University, Taiyuan, China
| | - Zhuohui Zhao
- School of Public Health, Fudan University, Shanghai, China
| | - Xin Zhang
- Institute of Environmental Science, Shanxi University, Taiyuan, China
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16
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Unterwurzacher V, Pogner C, Berger H, Strauss J, Strauss-Goller S, Gorfer M. Validation of a quantitative PCR based detection system for indoor mold exposure assessment in bioaerosols. ENVIRONMENTAL SCIENCE. PROCESSES & IMPACTS 2018; 20:1454-1468. [PMID: 30225499 DOI: 10.1039/c8em00253c] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Determination and assessment of airborne fungal particles is complex and results of different sampling and analytical strategies are hard to compare due to limitations of each of the techniques. Here, an indoor mold detection system based on quantitative polymerase chain reaction (qPCR) is described and validated for its reliability and stability to identify airborne fungal particles collected. Data obtained from testing the system with fungal DNA, spore suspensions and bioaerosols indicated a need for spiking and normalization of measurements due to material loss and assay specific bias. Considering the loss of material during sample processing, detection limits defined for suspensions of Tritirachium oryzae spores were roughly 18 spores per sample. Detection of fungal spore mixtures nebulized under controlled conditions in a bioaerosol chamber showed generally 2-3 times higher normalized values measured with the molecular system compared to cultivation. Data obtained from a mold infested indoor sampling site and its corresponding outdoor reference measurement showed good correlations between qPCR and high-throughput sequencing (rho = 0.83, p < 0.01), if Cladosporium species were excluded. Taking necessary data normalization into account, the described qPCR detection system shows great potential to complement commonly used culture based approaches with the aim to improve the precision of indoor mold assessments. In contrast to already available qPCR assays that detect certain molds on a species level, this system covers a broad range of relevant fungal communities, serving as a promising alternative to high-throughput sequencing to identify indoor molds.
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Affiliation(s)
- Verena Unterwurzacher
- Center for Health and Bioresources, Austrian Institute of Technology - AIT, Tulln, Austria.
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17
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Chong SN, Chew FT. Epidemiology of allergic rhinitis and associated risk factors in Asia. World Allergy Organ J 2018; 11:17. [PMID: 30128063 PMCID: PMC6091170 DOI: 10.1186/s40413-018-0198-z] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 07/11/2018] [Indexed: 12/22/2022] Open
Abstract
This review article aims to present the epidemiology and associated risk factors of allergic rhinitis (AR) in Asia. AR-related literature published on Asia was systematically reviewed and the associated risk factors were investigated. The prevalence of AR in Asia varied considerably depending on the geographical location, study design and population involved. Several risk factors were observed to have strong association with disease presentation across multiple studies. Among these, family income, family size, daily personal computer usage time, personal and parental education attainment, and stress level have shown some level of biological gradient influence when multiple risk levels were analyzed. This suggests that AR manifestation and presentation possibly might be strongly affected by various personal and family factors. These findings are beneficial as they may provide insights into modifiable factors that may influence AR presentation. In addition, these results indicate that strategies to reduce personal and family-related risk factors have to be developed in order to alleviate the odds of AR expression.
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Affiliation(s)
- Sher Ney Chong
- Department of Biological Sciences, Faculty of Science, Allergy and Molecular Immunology Laboratory, Lee Hiok Kwee Functional Genomics Laboratories, National University of Singapore, Block S2, Level 5, Science Drive 4, Lower Kent Ridge Rd, Singapore, 117543 Singapore
| | - Fook Tim Chew
- Department of Biological Sciences, Faculty of Science, Allergy and Molecular Immunology Laboratory, Lee Hiok Kwee Functional Genomics Laboratories, National University of Singapore, Block S2, Level 5, Science Drive 4, Lower Kent Ridge Rd, Singapore, 117543 Singapore
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Abstract
There are possibly millions of mold species on earth. The vast majority of these mold spores live in harmony with humans, rarely causing disease. The rare species that does cause disease does so by triggering allergies or asthma, or may be involved in hypersensitivity diseases such as allergic bronchopulmonary aspergillosis or allergic fungal sinusitis. Other hypersensitivity diseases include those related to occupational or domiciliary exposures to certain mold species, as in the case of Pigeon Breeder's disease, Farmer's lung, or humidifier fever. The final proven category of fungal diseases is through infection, as in the case of onchomycosis or coccidiomycosis. These diseases can be treated using anti-fungal agents. Molds and fungi can also be particularly important in infections that occur in immunocompromised patients. Systemic candidiasis does not occur unless the individual is immunodeficient. Previous reports of "toxic mold syndrome" or "toxic black mold" have been shown to be no more than media hype and mass hysteria, partly stemming from the misinterpreted concept of the "sick building syndrome." There is no scientific evidence that exposure to visible black mold in apartments and buildings can lead to the vague and subjective symptoms of memory loss, inability to focus, fatigue, and headaches that were reported by people who erroneously believed that they were suffering from "mycotoxicosis." Similarly, a causal relationship between cases of infant pulmonary hemorrhage and exposure to "black mold" has never been proven. Finally, there is no evidence of a link between autoimmune disease and mold exposure.
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19
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Norbäck D, Hashim JH, Hashim Z, Ali F. Volatile organic compounds (VOC), formaldehyde and nitrogen dioxide (NO 2) in schools in Johor Bahru, Malaysia: Associations with rhinitis, ocular, throat and dermal symptoms, headache and fatigue. THE SCIENCE OF THE TOTAL ENVIRONMENT 2017; 592:153-160. [PMID: 28319702 DOI: 10.1016/j.scitotenv.2017.02.215] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Revised: 02/24/2017] [Accepted: 02/27/2017] [Indexed: 06/06/2023]
Abstract
This paper studied associations between volatile organic compounds (VOC), formaldehyde, nitrogen dioxide (NO2) and carbon dioxide (CO2) in schools in Malaysia and rhinitis, ocular, nasal and dermal symptoms, headache and fatigue among students. Pupils from eight randomly selected junior high schools in Johor Bahru, Malaysia (N=462), participated (96%). VOC, formaldehyde and NO2 were measured by diffusion sampling (one week) and VOC also by pumped air sampling during class. Associations were calculated by multi-level logistic regression adjusting for personal factors, the home environment and microbial compounds in the school dust. The prevalence of weekly rhinitis, ocular, throat and dermal symptoms were 18.8%, 11.6%, 15.6%, and 11.1%, respectively. Totally 20.6% had weekly headache and 22.1% fatigue. Indoor CO2 were low (range 380-690 ppm). Indoor median NO2 and formaldehyde concentrations over one week were 23μg/m3 and 2.0μg/m3, respectively. Median indoor concentration of toluene, ethylbenzene, xylene, and limonene over one week were 12.3, 1.6, 78.4 and 3.4μg/m3, respectively. For benzaldehyde, the mean indoor concentration was 2.0μg/m3 (median<1μg/m3). Median indoor levels during class of benzene and cyclohexane were 4.6 and 3.7μg/m3, respectively. NO2 was associated with ocular symptoms (p<0.001) and fatigue (p=0.01). Formaldehyde was associated with ocular (p=0.004), throat symptoms (p=0.006) and fatigue (p=0.001). Xylene was associated with fatigue (p<0.001) and benzaldehyde was associated with headache (p=0.03). In conclusion, xylene, benzaldehyde, formaldehyde and NO2 in schools can be risk factors for ocular and throat symptoms and fatigue among students in Malaysia. The indoor and outdoor levels of benzene were often higher than the EU standard of 5μg/m3.
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Affiliation(s)
- Dan Norbäck
- Uppsala University, Dept. of Medical Science, Occupational and Environmental Medicine, University Hospital, 75185 Uppsala, Sweden.
| | - Jamal Hisham Hashim
- United Nations University-International Institute for Global Health, 56000 Kuala Lumpur, Malaysia; Department of Community Health, National University of Malaysia, 56000 Kuala Lumpur, Malaysia
| | - Zailina Hashim
- Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, University Putra Malaysia (UPM), 43400 Serdang, Selagor, Malaysia
| | - Faridah Ali
- Johor State Health Department, Johor Bahru, Malaysia
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20
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Li Z, Wen Q, Zhang R. Sources, health effects and control strategies of indoor fine particulate matter (PM 2.5): A review. THE SCIENCE OF THE TOTAL ENVIRONMENT 2017; 586:610-622. [PMID: 28216030 DOI: 10.1016/j.scitotenv.2017.02.029] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 02/04/2017] [Accepted: 02/04/2017] [Indexed: 05/21/2023]
Abstract
Indoor air quality is directly influenced by indoor PM2.5. Short-term and long-term exposure of PM2.5 in the micro environment would severely detriment the health of both humans and animals. The researches both at home and abroad dating from 2000 were analyzed and summarized mainly in the following 3 sections: source apportionment, health effects and control methods. Health effects were illustrated in both epidemiology and toxicology. The epidemiology was explicated in morbidity and mortality, the toxicology was illuminated in inflammatory reaction, oxidative stress, genotoxicity, mutagenicity and carcinogenicity. Control methods were showed in two aspects (sources and means of transmission), of which each was resolved by corresponding control strategy. Abundant investigations indicated that comprehensive control strategies were needed for sources decrement and health burden mitigation of indoor PM2.5. Based on the increasingly wide research of indoor PM2.5, the concept of indoors was essentially expanded, and on the basis of the summary of all the aspects mentioned above, both the scope and depth of indoor PM2.5 research were found insufficiently. Meantime, the potential direction of development in indoor PM2.5 research were projected, in hope of contributing to further relevant study of engineers in ambient environment and building environment.
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Affiliation(s)
- Zhisheng Li
- School of Civil and Transportation Engineering, Guangdong University of Technology, NO. 100 Outer ring Road, Guangzhou, Guangdong, China
| | - Qingmei Wen
- School of Civil and Transportation Engineering, Guangdong University of Technology, NO. 100 Outer ring Road, Guangzhou, Guangdong, China.
| | - Ruilin Zhang
- School of Electro-mechanical Engineering, Guangdong University of Technology, NO. 100 Outer ring Road, Guangzhou, Guangdong, China
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21
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Salin JT, Salkinoja-Salonen M, Salin PJ, Nelo K, Holma T, Ohtonen P, Syrjälä H. Building-related symptoms are linked to the in vitro toxicity of indoor dust and airborne microbial propagules in schools: A cross-sectional study. ENVIRONMENTAL RESEARCH 2017; 154:234-239. [PMID: 28107741 DOI: 10.1016/j.envres.2017.01.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 01/10/2017] [Accepted: 01/12/2017] [Indexed: 06/06/2023]
Abstract
INTRODUCTION Indoor microbial toxicity is suspected to cause some building-related symptoms, but supporting epidemiological data are lacking. OBJECTIVE We examined whether the in vitro toxicity of indoor samples from school buildings was associated with work-related health symptoms (building-related symptoms, BRS). METHODS Administrators of the Helsinki City Real Estate Department selected 15 schools for the study, and a questionnaire on symptoms connected to work was sent to the teachers in the selected schools for voluntary completion. The cellular toxicity of classroom samples was determined by testing substances extracted from wiped indoor dust and by testing microbial biomass that was cultured on fallout plates. Boar sperm cells were used as indicator cells, and motility loss was the indicator for toxic effects. The effects were expressed as the half maximal effective concentration (EC50) at which >50% of the exposed boar sperm cells were immobile compared to vehicle control. RESULTS Completed symptom questionnaires were received from 232 teachers [median age, 43 years; 190 (82.3%) women] with a median time of 6 years working at their school. Samples from their classrooms were available and were assessed for cellular toxicity. The Poisson regression model showed that the impact of extracts of surface-wiped school classroom dust on teacher work-related BRS was 2.8-fold (95% CI: 1.6-4.9) higher in classrooms with a toxic threshold EC50 of 6µgml-1 versus classrooms with insignificant EC50 values (EC50 >50µgml-1); P<0.001. The number of symptoms that were alleviated during vacation was higher in school classrooms with high sperm toxicity compared to less toxic sites; the RR was 1.9 (95% CI: 1.1-3.3, P=0.03) for wiped dust extracts. CONCLUSIONS Teachers working in classrooms where the samples showed high sperm toxicity had more BRS. The boar sperm cell motility inhibition assay appears promising as a tool for demonstrating the presence of indoor substances associated with BRS.
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Affiliation(s)
- J T Salin
- Department of Infection Control, Oulu University Hospital, Finland
| | - M Salkinoja-Salonen
- Department of Food and Environmental Sciences, FI 00014 University of Helsinki, Finland; Department of Electrical Engineering and Automation, Aalto University, Espoo, Finland
| | - P J Salin
- Oulu University Hospital, Inspector Sec Oy Laboratories, Oulu, Finland; Department of Food and Environmental Sciences, FI 00014 University of Helsinki, Finland
| | - K Nelo
- Oulu University Hospital, Inspector Sec Oy Laboratories, Oulu, Finland
| | - T Holma
- Department of Otorhinolaryngology and Head and Neck Surgery, Oulu University Hospital, Finland; PEDEGO Research Unit, University of Oulu, Finland; Medical Research Center Oulu, Finland
| | - P Ohtonen
- Division of Operative Care and Medical Research Center, Finland
| | - H Syrjälä
- Department of Infection Control, Oulu University Hospital, Finland.
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Norbäck D, Hashim JH, Hashim Z, Sooria V, Ismail SA, Wieslander G. Ocular symptoms and tear film break up time (BUT) among junior high school students in Penang, Malaysia - Associations with fungal DNA in school dust. Int J Hyg Environ Health 2017; 220:697-703. [PMID: 28254266 DOI: 10.1016/j.ijheh.2017.01.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 01/29/2017] [Accepted: 01/30/2017] [Indexed: 12/29/2022]
Abstract
BACKGROUND There are few studies on ocular effects of indoor mould exposure in schools, especially in the tropics OBJECTIVE: To study associations between eye symptoms and tear film break up time (BUT) in students and demographic data and fungal DNA in schools. METHODS A school environment study was performed among randomly selected students in eight randomly selected secondary schools in Penang, Malaysia. Information on eye symptoms and demographic data was collected by a standardised questionnaire. BUT was measured by two methods, self-reported BUT (SBUT) and by the non-invasive Tearscope (NIBUT). Dust was collected by vacuuming in 32 classrooms and analysed for five fungal DNA sequences. Geometric mean (GM) for total fungal DNA was 7.31*104 target copies per gram dust and for Aspergillus/Penicillium DNA 3.34*104 target copies per gram dust. Linear mixed models and 3-level multiple logistic regression were applied adjusting for demographic factors. RESULTS A total of 368 students (58%) participated and 17.4% reported weekly eye symptoms the last 3 months. The median SBUT and TBUT were 15 and 12s, respectively. Students wearing glasses (OR 2.41, p=0.01) and with a history of atopy (OR=2.67; p=0.008) had more eye symptoms. Girls had less eye symptoms than boys (OR=0.34; p=0.006) Indoor carbon dioxide in the classrooms was low (range 380-720ppm), temperature was 25-30°C and relative air humidity 70-88%. Total fungal DNA in vacuumed dust was associated with shorter SBUT (4s shorter per 105 target copies per gram dust; p=0.04) and NIBUT (4s shorter per 105 target copies per gram dust; p<0.001). Aspergillus/Penicillium DNA was associated with shorter NIBUT (5s shorter per 105 target copies per gram dust; p=0.01). CONCLUSION Fungal contamination in schools in a tropical country can be a risk factor for impaired tear film stability among students.
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Affiliation(s)
- Dan Norbäck
- Uppsala University, Department of Medical Science, Occupational and Environmental Medicine, University Hospital, 75185 Uppsala, Sweden.
| | - Jamal Hisham Hashim
- United Nations University-International Institute for Global Health, 56000 Kuala Lumpur, Malaysia; Department of Community Health, National University of Malaysia, 56000 Kuala Lumpur, Malaysia
| | - Zailina Hashim
- Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 UPM, Serdang, Selangor, Malaysia
| | - Vinoshini Sooria
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 UPM, Serdang, Selangor, Malaysia
| | - Syazwan Aizat Ismail
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 UPM, Serdang, Selangor, Malaysia; Environmental Health, Allied Health Science College Sg Buloh, Ministry of Health Malaysia, 47000 Sungai Buloh; Selangor, Malaysia
| | - Gunilla Wieslander
- Uppsala University, Department of Medical Science, Occupational and Environmental Medicine, University Hospital, 75185 Uppsala, Sweden
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Chen YY, Sung FC, Chen ML, Mao IF, Lu CY. Indoor Air Quality in the Metro System in North Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13121200. [PMID: 27918460 PMCID: PMC5201341 DOI: 10.3390/ijerph13121200] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 11/28/2016] [Accepted: 11/29/2016] [Indexed: 12/16/2022]
Abstract
Indoor air pollution is an increasing health concern, especially in enclosed environments such as underground subway stations because of increased global usage by urban populations. This study measured the indoor air quality of underground platforms at 10 metro stations of the Taipei Rapid Transit system (TRTS) in Taiwan, including humidity, temperature, carbon monoxide (CO), carbon dioxide (CO2), formaldehyde (HCHO), total volatile organic compounds (TVOCs), ozone (O3), airborne particulate matter (PM10 and PM2.5), bacteria and fungi. Results showed that the CO2, CO and HCHO levels met the stipulated standards as regulated by Taiwan’s Indoor Air Quality Management Act (TIAQMA). However, elevated PM10 and PM2.5 levels were measured at most stations. TVOCs and bacterial concentrations at some stations measured in summer were higher than the regulated standards stipulated by Taiwan’s Environmental Protection Administration. Further studies should be conducted to reduce particulate matters, TVOCs and bacteria in the air of subway stations.
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Affiliation(s)
- Ying-Yi Chen
- Institute of Environmental and Occupational Health Sciences, School of Medicine, National Yang Ming University, Taipei 11221, Taiwan.
| | - Fung-Chang Sung
- Management Office for Health Data, China Medical University Hospital, Taichung 40402, Taiwan.
- Department of Health Services Administration, College of Public Health, China Medical University, Taichung 40402, Taiwan.
| | - Mei-Lien Chen
- Institute of Environmental and Occupational Health Sciences, School of Medicine, National Yang Ming University, Taipei 11221, Taiwan.
| | - I-Fang Mao
- Department of Occupational Safety and Health, Chung Shan Medical University, Taichung 40201, Taiwan.
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung 40201, Taiwan.
| | - Chung-Yen Lu
- Department of Sport and Health Management, Da-Yeh University, No.168, University Rd., Dacun, Changhua 51591, Taiwan.
- School of Post-Baccalaureate Chinese Medicine, China Medical University, Taichung 40402, Taiwan.
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