Indoor airborne fungal spores and home characteristics in asthmatic children from Edirne region of Turkey

A Scoping Review on Fungus and Mycotoxin Studies in the Building's Environment: Mycotoxin Analysis by Mass Spectrometry

It has been well-established that mycotoxins are poisonous chemical metabolites secreted by certain molds. Some of them significantly affect the health of humans and livestock. Increasing attention is now being paid to uncovering and identifying mycotoxins' presence in the building's environment. However, the main challenge remains in suitable and reliable analytical methods for their identification and detection in infected structures. GC-MS and LC-MS/MS techniques have been used extensively for mycotoxin analysis, and advancement in these techniques enabled a more comprehensive range of mycotoxins to be detected. As such, this study aimed to address a brief overview of various phenomena of existing sample collection, preparation, and analysis to detect mycotoxins in the building's environment. This scoping review includes articles from 2010 to 2020 available from PubMed, Scopus, Cochrane, Wiley, Google Scholar, and ScienceDirect. Duplicate articles were removed, and exclusion criteria were applied to eliminate unrelated studies, resulting in 14 eligible articles. The present study provides an overview of mycotoxin analysis by GC-MS and LC-MS/MS in buildings. Many techniques are available for analyzing and detecting multiple mycotoxins using these methods. Future efforts would focus on rapid assays and tools enabling measuring a broader range of mycotoxins in a single matrix and lower detection limits. In addition, it would assist future findings on new techniques and mycotoxins that existed in the building's environment.

Jumping on the bed and associated increases of PM10, PM2.5, PM1, airborne endotoxin, bacteria, and fungi concentrations

Jumping on the bed is a favorite behavior of children; however, no study has investigated the increased air pollutants resulting from jumping on the bed. Therefore, we aimed to investigate the elevated concentrations of particulate matter (PM) and bioaerosols from jumping on the bed and making the bed. Simulation of jumping on the bed and making the bed was performed at sixty schoolchildren's houses in Taiwan. PM₁₀, PM_2.5, PM₁ (PM with aerodynamic diameter less than 10, 2.5, and 1 μm, respectively) and airborne bacteria, fungi and endotoxin concentrations were simultaneously measured over simulation and background periods. Our results show the increase of PM₁₀, PM_2.5, PM₁, airborne bacteria and fungi through the behavior of jumping on the bed (by 414 μg m-3, 353 μg m-3, 349 μg m-3, 6569 CFU m-3 and 978 CFU m-3, respectively). When making the bed, the PM₁₀, PM_2.5, PM₁, airborne bacteria and fungi also significantly increased by 4.69 μg m-3, 4.09 μg m-3, 4.15 μg m-3, 8569 CFU m-3, and 779 CFU m-3, respectively. Airborne endotoxin concentrations significantly increased by 21.76 EU m-3 following jumping on the bed and making the bed. Moreover, when jumping on the bed, higher PM_2.5 and PM₁ concentrations in houses with furry pets rather than no furry pets, and less airborne fungi in apartments than in townhouses were found. For making the bed, lower airborne fungi was found in houses using essential oils rather than no essential oils using. The airborne endotoxin concentrations were positively associated with furry pets and smokers in the homes and negatively correlated to the home with window opening with a statistical significance during the periods of jumping on the bed and making the bed. In conclusion, significant increases of PM and bioaerosols during jumping on the bed and making the bed may need to be concerned.

Sick Building Syndrome and Other Building-Related Illnesses

Sick building syndrome (SBS) and building-related illnesses are omnipresent in modern high-rise buildings. The SBS is a complex spectrum of ill health symptoms, such as mucous membrane irritation, asthma, neurotoxic effects, gastrointestinal disturbance, skin dryness, sensitivity to odours that may appear among occupants in office and public buildings, schools and hospitals. Studies on large office buildings from USA, UK, Sweden, Finland, Japan, Germany, Canada, China, India, Netherlands, Malaysia, Taiwan, and Thailand, substantiate the occurrence of SBS phenomena. The accumulated effects of a multitude of factors, such as the indoor environmental quality, building characteristics, building dampness, and activities of occupants attribute to SBS. A building occupant manifests at least one symptom of SBS, the onset of two or more symptoms at least twice, and rapid resolution of symptoms following moving away from the workstation or building may be defined as having SBS. Based on the peer-reviewed documentation, this chapter elaborates the magnitude of building-related health consequences due to measurable environmental causations, and the size of the population affected. The mechanisms and causative factors of SBS and illnesses include, for example, the oxidative stress resulting from indoor pollutants, VOCs, office work-related stressors, humidification, odours associated with moisture and bioaerosol exposure. Related regulatory standards and strategies for management of SBS and other illnesses are elaborated.

The characteristics of indoor and outdoor fungi and their relation with allergic respiratory diseases in the southern region of Turkey

Indoor and outdoor fungal exposure has been shown to be associated with the development of allergic respiratory diseases. The aim of the study was to investigate the types and concentrations of airborne fungi inside and outside homes and evaluate the association between fungal levels and allergic diseases in the southern region of Turkey. A total of 61 children admitted with respiratory complaints to the pediatric allergy clinic between September 2007 and November 2008 were included in this study. The air samples were obtained using the Air IDEAL volumetric air sampler longitudinally for 1 year. A comprehensive questionnaire was used for medical history and housing conditions. Skin prick test was performed to determine fungal sensitivity and spirometric indices were employed. The predominant indoor fungal species were Cladosporium (69.3 %), Penicillium (18.9 %), Aspergillus (6.5 %), and Alternaria (3.1 %). A strong correlation between indoor and outdoor fungal levels was detected for the Cladosporium species (p < 0.001, r = 0.72) throughout the year. Living in a detached home (p = 0.036) and the presence of cockroaches (p = 0.005) were associated with total indoor fungal levels. The presence of cockroaches (aOR 3.5; 95 % CI 0.95-13.10, p = 0.059) was also associated with fungal sensitization at the edge of significance. The statistical cutoff values of indoor and outdoor Cladosporium levels to predict symptomatic asthma were found to be >176 CFU/m(3) (p = 0.003, AUC 0.696; sensitivity 65.5 %; specificity 68.7 %) and >327 CFU/m(3) (p = 0.038; AUC 0.713; sensitivity 66.6 %; specificity 76.9 %), respectively. Children with respiratory symptoms are exposed to a considerable level of fungi inside and outside their homes. The prevention of fungal exposure may provide valuable intervention for respiratory diseases.

Aspergillus species in indoor environments and their possible occupational and public health hazards

The genus Aspergillus, which consists of a few hundred opportunistic mold species found in various climatic conditions, causes diseases including localized infections, fatal diseases, allergic responses, and inhaled conidia in humans. Herein, we present an overview of the most common diseases and allergic infections caused by Aspergillus species and their associated health hazards in various indoor environments worldwide.

Domestic exposure to fungal allergenic particles determined by halogen immunoassay using subject's serum versus particles carrying three non-fungal allergens determined by allergen-specific HIA

Studies that estimate indoor aeroallergen exposure typically measure a pre-selected limited range of allergens. In this study, inhalable aeroallergen particles were quantified using the halogen immunoassay (HIA) to determine the contribution of fungal and non-fungal aeroallergens to total allergen exposure. Bioaerosols from 39 homes of fungal-allergic subjects were sampled using inhalable fraction samplers and immunostained by HIA using resident subject's immunoglobulin E (IgE) to detect allergen-laden particles. Fungal aerosols as well as particles carrying mite, cat, and cockroach allergens were identified and enumerated by HIA. Reservoir dust-mite (Der p 1), cat (Fel d 1), and cockroach (Bla g 1) allergen concentrations were quantified by ELISA. Fungal particles that bound subject's IgE in the HIA were 1.7 (bedroom)- and 1.4 (living room)-fold more concentrated than Der p 1, Fel d 1, and Bla g 1 allergen particles combined. Predominant fungal conidia that bound IgE were derived from common environmental genera including Cladosporium and other fungi that produce amerospores. Airborne mite, cat, and cockroach allergen particle counts were not associated with reservoir concentrations determined by ELISA. This study demonstrates that inhalable fungal aerosols are the predominant aeroallergen sources in Sydney homes and should be considered in future exposure assessments.

PRACTICAL IMPLICATIONS

Indoor allergen exposure assessment studies have primarily focused on a limited range of allergen sources in samples derived from reservoir dust samples. Using an innovative immunodiagnostic approach, this study demonstrates that fungal bioaerosols are the dominant source of aeroallergen exposure in the domestic environment, providing unique insight into domestic aeroallergen exposure.

Fungal pollution of indoor environments and its management

Indoor environments play important roles in human health. The health hazards posed by polluted indoor environments include allergy, infections and toxicity. Life style changes have resulted in a shift from open air environments to air tight, energy efficient, environments, in which people spend a substantial portion of their time. Most indoor air pollution comes from the hazardous non biological agents and biological agents. Fungi are ubiquitous in distribution and are a serious threat to public health in indoor environments. In this communication, we have reviewed the current status on biotic indoor air pollution, role of fungi as biological contaminants and their impact on human health.

Fungal pollution of indoor environments and its management

Indoor environments play important roles in human health. The health hazards posed by polluted indoor environments include allergy, infections and toxicity. Life style changes have resulted in a shift from open air environments to air tight, energy efficient, environments, in which people spend a substantial portion of their time. Most indoor air pollution comes from the hazardous non biological agents and biological agents. Fungi are ubiquitous in distribution and are a serious threat to public health in indoor environments. In this communication, we have reviewed the current status on biotic indoor air pollution, role of fungi as biological contaminants and their impact on human health.

A study on Aspergillus species in houses of asthmatic patients from Sari City, Iran and a brief review of the health effects of exposure to indoor Aspergillus

To study the distribution of Aspergillus spp. in outdoor and indoor air of asthmatic patients' houses, as well as a review on the health effects of exposure to indoor Aspergillus. Open plates containing malt extract agar media were used to isolate fungi from the indoor (n = 360) and outdoor (n = 180) air of 90 asthmatic patients' houses living in Sari City, Iran. Plates were incubated at room temperature for 7-14 days. Cultured Aspergillus spp. were identified by standard mycological techniques. All culture plates grew fungi, a testament to the ubiquitous nature of fungal exposure. Cladosporium spp. (29.2%), Aspergillus spp. (19.0%), and Penicillium spp. (18.3%) were most common inside the houses while Cladosporium spp. (44.5%), Aspergillus spp. (12.4%), and Alternaria spp. (11.1%) were most common outside the houses. Aspergillus flavus (30.1%) and A. fumigatus (23.1%) are the most commonly isolated species in indoor air. Aspergillus flavus (44.5%) and A. fumigatus (42.6%) were the most prevalent Aspergillus spp. outside. The most colony numbers of Aspergillus were isolated from kitchens (30.4%) and the least from bedrooms (21.1%). Aspergillus flavus was the most prevalent species in all sampled rooms except in the kitchen where A. fumigatus was the most common. Aspergillus flavus is the most prevalent species among the Aspergillus spp. in the indoor and outdoor of a warm climate area. In these areas, A. flavus can be a major source of allergen in the air. Therefore, minimizing indoor fungal exposure could play an important role in reducing allergic symptoms in susceptible persons.

Fungal flora in indoor and outdoor air of different residential houses in Tekirdag City (Turkey): seasonal distribution and relationship with climatic factors

This study was investigated the density and monthly distribution of indoor and outdoor microfungi in six different residential houses in Tekirdag City through the exposure of Petri dishes containing Rose-Bengal Streptomycin Agar media. Samples were collected in 1-month intervals over a period of 12 months between March, 2001, and February, 2002. We used 432 Petri dishes and counted a total of 4,205 microfungi colonies, 1,790 from indoor air and 2,415 from outdoor air. As a result, 42 species belonging to 12 genera were identified. The most frequent fungal genera were Penicillium (28.61%), Cladosporium (16.08%) and Alternaria (15.98%). While Penicillium (40.61%) and Cladosporium (15.92%) were the dominant genera of indoor air, Alternaria (20.62%) and Penicillium (19.71%) were isolated most frequently from outdoor air (Table 3). Alternaria citri (10.15%) and Penicillium brevicompactum (10.15%) were found to be the most frequent among the 42 identified species. While P. brevicompactum (19.55%) and Aspergillus niger (6.37%) were the most frequent indoor species, A. citri (13.37%) and Cladosporium cladosporioides (8.20%) were the most frequent outdoor species. Linear Regression Analysis was applied to determine whether or not there was a relationship between the number of colonies of isolated fungal genera and meteorological factors during the research period. Correlations between the presence of Aspergillus and temperature, relative humidity, duration of sunny periods and agents of air pollution such as SO(2) and PM were statistically significant. No significant correlations, however, were found between other fungal genera and environmental variables.

Airborne fungi in child day care centers in Edirne City, Turkey

The purpose of this study was to determine the concentration, in terms of monthly and seasonal distribution and in relation to meteorological factors, of indoor and outdoor microfungi at selected sites in several child day care centers in the city of Edirne, Turkey. Samples were collected at one month intervals over a period of 12 months between January-December 2004, by exposing petri plates containing Peptone Dextrose Agar with Rose-Bengal and Streptomycin medium to the air for 10-15 min. A total of 2,071 microfungal colonies were counted on 192 petri plates. Thirty microfungal genera (Acremonium, Alternaria, Arthrinium, Aspergillus, Bahusakala, Beauveria, Ceuthospora, Chaetomium, Cladosporium, Curvularia, Drechslera, Epicoccum, Eurotium, Fusarium, Mycotypha, Myrotechium, Paecilomyces, Penicillium, Pestalotiopsis, Phoma, Ramichloridium, Rhizopus, Scopulariopsis, Stachybotrys, Stemphylium, Torula, Trichoderma, Trichothecium, Ulocladium, Verticillium) and 75 microfungal species were isolated from the air indoor and outdoor of the day care centers. The dominant microfungal genera were Cladosporium, Penicillium and Alternaria (44.11%, 18.94%, 14.67% of the total respectively), while the genus with the most species richness was Penicillium (26 species). Alternaria, Cladosporium, Penicillium and non-sporulating microfungi were found every month. Cladosporium was the dominant genus in both indoor and outdoor air. Although the predominant genus was the same in both indoor and outdoor air, Cladosporium was followed by Penicillium, Alternaria and Aspergillus genera in indoor air and by Alternaria, Penicillium and Aspergillus genera in outdoor air. While a positive correlation was found between the concentration of monthly outdoor microfungi and monthly average temperature, a negative correlation was found between the concentration of monthly outdoor microfungi and monthly average wind velocity. Also, some relationships were found between the monthly concentrations of the most predominant microfungal genera (Cladosporium, Penicillium and Alternaria) and various meteorological factors.

Effect of indoor mold concentrations on daily symptom severity of children with asthma and/or rhinitis monosensitized to molds

Little is known about the contribution of indoor molds to the symptoms of asthma and/or rhinitis in children monosensitized to molds. We aimed to investigate the effect of indoor mold spore concentrations on daily symptoms of asthma and/or rhinitis in children monosensitized to molds. Nineteen children with asthma and/or rhinitis sensitized only to molds recorded their daily symptoms and peak expiratory flow (PEF) values to the diaries, from February 2005 to January 2006. In this study period, indoor mold concentrations were measured monthly from the living rooms/bedrooms. The median indoor mold concentration was 37.5 CFU/m(3). Most commonly recovered indoor molds were Cladosporium (26.4%), Penicillium (24.7%), and Aspergillus (7%). Significant correlation was not found between indoor mold concentrations and daily rhinitis score (r = -0.021, p = 0.932), daily asthma score (r = 0.155, p = 0.554), daily morning PEF (r = -0.056, p = 0.475), and evening PEF (r = -0.057, p = 0.471). The effect of indoor molds is not evident on the symptoms of our patients with asthma and/or rhinitis monosensitized to molds.

Fungi and indoor conditions in asthma patients

This study was carried out with 127 asthmatic patients and 127 controls, which aimed to compare and evaluate the environmental conditions in the homes of asthmatic patients and the control group. Air samples were obtained by using an air sampler and the mean mould colony counts were established. Aspergillus and Penicillium were the most common isolated species. No significant difference was observed with regard to various house conditions and the mean mould colony counts between the houses of patients and controls. The mould colony counts were found to be lower in houses with wooden parquet flooring. The odds ratio for stone floors vs. wood floors was 2.3 (95% CI 1.08-4.98) for mould growth.