Assessment of fungal contamination in moldy homes: comparison of different methods

Damp Buildings: Associated Fungi and How to Find Them

The number of buildings experiencing humidity problems and fungal growth appears to be increasing as energy-saving measures and changes in construction practices and climate become more common. Determining the cause of the problem and documenting the type and extent of fungal growth are complex processes involving both building physics and indoor mycology. New detection and identification methods have been introduced, and new fungal species have been added to the list of building-related fungi. However, the lack of standardised procedures and general knowledge hampers the effort to resolve the problems and advocate for an effective renovation plan. This review provides a framework for building inspections on current sampling methods and detection techniques for building-related fungi. The review also contains tables with fungal species that have been identified on commonly used building materials in Europe and North America (e.g., gypsum wallboard, oriented strand board (OSB), concrete and mineral wool). The most reported building-associated fungi across all materials are Penicillium chrysogenum and Aspergillus versicolor. Chaetomium globosum is common on all organic materials, whereas Aspergillus niger is common on all inorganic materials.

Mold in Paradise: A Review of Fungi Found in Libraries

Libraries contain a large amount of organic material, frequently stored with inadequate climate control; thus, mold growth represents a considerable threat to library buildings and their contents. In this essay, we review published papers that have isolated microscopic fungi from library books, shelving, walls, and other surfaces, as well as from air samples within library buildings. Our literature search found 54 published studies about mold in libraries, 53 of which identified fungi to genus and/or species. In 28 of the 53 studies, Aspergillus was the single most common genus isolated from libraries. Most of these studies used traditional culture and microscopic methods for identifying the fungi. Mold damage to books and archival holdings causes biodeterioration of valuable educational and cultural resources. Exposure to molds may also be correlated with negative health effects in both patrons and librarians, so there are legitimate concerns about the dangers of contact with high levels of fungal contamination. Microbiologists are frequently called upon to help librarians after flooding and other events that bring water into library settings. This review can help guide microbiologists to choose appropriate protocols for the isolation and identification of mold in libraries and be a resource for librarians who are not usually trained in building science to manage the threat molds can pose to library holdings.

Microbial Occupational Exposure Assessments in Sawmills—A Review

The composition of airborne microflora in sawmills may vary to a great degree depending on the kind of timber being processed and the technology of production being used. Cases of allergy alveolitis and asthma have been reported in woodworkers who were exposed to wood dust largely infected with microorganisms. The aim of this review article is to identify studies where the microbial occupational exposure assessment was performed in sawmills and the characteristics of the contamination found, as well as to identify which sampling methods and assays were applied. This study reports the search of available data published regarding microbial occupational exposure assessment in environmental samples from sawmills, following the Preferred Reporting Items for Systematic Reviews (PRISMA) methodology. The most used sampling method was air sampling, impaction being the most common method. Regarding analytical procedures for microbial characterization, morphological identification of fungi and bacteria was the most frequent approach. Screening for fungal susceptibility to azoles was performed in two studies and four studies applied molecular tools. Regarding microbial contamination, high fungal levels were frequent, as well as high bacteria levels. Fungal identification evidenced Penicillium as the most frequent genera followed by Aspergillus sp. Mycotoxins were not assessed in any of the analyzed studies. Microbial occupational exposure assessment in sawmills is crucial to allow this risk characterization and management.

Fungal populations in the bedroom dust of children in Havana, Cuba, and its relationship with environmental conditions

The study of the fungal community composition in house dust is useful to assess the accumulative exposure to fungi in indoor environments. The objective of this research was to characterize the fungal diversity of house dust and its association with the environmental conditions of bedrooms. For this, the dust was collected from 41 bedrooms of children between the ages of 8 and 9 with a family history of asthma, residents of Havana, Cuba. The fungal content of each sample was determined by two methods: plate culture with malt extract agar and by direct microscopy. An ecological analysis was carried out from the fungal diversity detected. To describe the factors associated with the fungi detected, bivariate logistic regression was used. Through direct microscopy, between 10 and 2311 fragments of hyphae and spores corresponding mainly to Cladosporium, Coprinus, Curvularia, Aspergillus/Penicillium, Xylariaceae, and Periconia were identified. Through the culture, 0-208 CFU were quantified, where Aspergillus, Cladosporium, and Penicillium predominated. The culturability evidenced the differences between the quantification determined by both methods. A positive relationship was found between the type of cleaning of the furniture, the presence of trees in front of the bedroom, indoor relative humidity, indoor temperature, the presence of air conditioning, and natural ventilation with specific spore types and genera. The use of two different identification methods allowed to detect a greater fungal diversity in the residences evaluated. Monitoring the exposure to these fungal allergens in childhood can help to prevent sensitization in the allergic child, the development of asthma, and other respiratory diseases.

Avoidance of allergens as an environmental method in the prevention of inhaled allergy symptoms

Asthma and other inhaled allergies are some of the most common paediatric diseases. The association of exposure to allergens with induction and exacerbation of symptoms has been proven. The majority of allergens are permanently or periodically suspended in the air, which leads to impaired quality of life for sensitive patients. Therefore, many methods of prevention and therapy of allergic diseases have been developed. The method of allergen exposure avoidance is often the first and the most significant measure. The present research has been conducted to evaluate, based on scientific data, which measures have the most reliable evidence of effectiveness. Environmental allergen avoidance methods, despite limited evidence supporting their clinical efficacy, are listed as the main therapeutic approaches in most recommendations. The significance of the holistic approach is also emphasised: only simultaneous introduction of several avoidance methods can bring possibly beneficial effects for the patient.

Application of the Environmental Relative Moldiness Index in Indoor Marijuana Grow Operations

OBJECTIVES

Indoor marijuana grow operations (IMGOs) are increasing due to legalization of recreational and medicinal cannabis at the state level. However, the potential exposures of IMGO workers have not been well studied. Mold exposure has been identified as a major occupational health concern. Mold-specific quantitative polymerase chain reaction (MSQPCR) can provide quantitative exposure data for fungi at the species level. The purpose of this study was to characterize the airborne fungal burden using MSQPCR and to evaluate the applicability of an airborne Environmental Relative Moldiness Index (ERMI) in IMGOs.

METHODS

Air and dust samples were collected inside and outside the IMGOs and then analyzed via MSQPCR. These data were then used to calculate IMGO-specific ERMI scores. Culturable air samples were collected on agar plates and analyzed via microscopy. Differences were evaluated between indoor and outdoor concentrations, as well as between air and dust samples. The agreement between MSQPCR and culture-based methods was also evaluated.

RESULTS

Based on the geometric means for non-zero values of each fungal species across all IMGOs, the total airborne concentration was approximately 9100 spore equivalent (SE) m-3 with an interquartile range (IQR) of 222 SE m-3. The indoor/outdoor ratio of geometric means across all 36 species per IMGO ranged from 0.4 to 6.2. Significantly higher indoor concentrations of fungal species, including Aspergillus spp., were observed. An average airborne ERMI score of 7 (IQR = 7.6) indicated a relatively high burden of mold across a majority of operations. The ERMI scores were driven by the high concentrations of Group 1 species with a mean of 15.8 and an IQR of 13. There were 63 additional species identified in the culturable air samples not included in the ERMI.

CONCLUSIONS

High concentrations of airborne fungi were identified in IMGOs. Our evaluation of the ERMI based on MSQPCR as a rapid diagnostic and risk assessment tool for industrial hygienists in the IMGO setting is equivocal. ERMI did not identify all relevant fungal species associated with this specific occupational environment. We identified several issues with using the ERMI calculation. At this time, the catalog of fungal species needs to optimized for the occupational setting to ensure adequate coverage, especially for those species expected to be found in this burgeoning industry. Further research is necessary to elucidate the link between the ERMI score of airborne samples, worker exposure and health effects in grows to generate an acceptable index score for use in occupational exposure assessments.

The Myth of Mycotoxins and Mold Injury

In recent years, mold has been blamed for many symptoms or a constellation of symptoms. These symptoms are usually vague and subjective and difficult or impossible to measure or quantify. Moreover, there is no scientific evidence that mold has anything to do with these symptoms. In particular, the concept of toxic mold syndrome has permeated the public consciousness, and mycotoxins have falsely been associated with autoimmune diseases and a variety of other conditions. In fact, there is no evidence that the presence of mycotoxins in the air is enough to cause any disease known to man. Molds legitimately can cause allergies and can be a trigger for asthma. Certain specific molds such as Aspergillus can be a cause of hypersensitivity pneumonitis. In immunocompromised hosts, both dermatologic and systemic infections can result from various fungi and can be associated with significant morbidity or even mortality. However, the existence of toxic mold syndrome has been disproven, despite the numerous disreputable practices such as testing homes for mold spores, measuring "mycotoxins" in the urine, and testing patients for IgG to mold. In truth, none of these techniques have been validated, nor do they have any relevance to any clinical disease. All that these tests that are being performed by laboratories of disrepute does is to further propagate misinformation and inflict unnecessary and often exorbitant costs on patients desperate for a clinical diagnosis, right or wrong, for their constellation of maladies.

Molecular identification of fungi colonizing art objects in Thailand and their growth inhibition by local plant extracts

In this initial attempt to identify fungi predominantly colonizing art objects, mural paintings and a bas-relief, at 12 archaeological sites in the central and western parts of Thailand, 13 fungal isolates were identified using morphological technique and estimated for their prevalence frequency at each site. Five main genera of fungal community found were Aspergillus, Fusarium, Curvularia, Penicillium, and Neurospora. These fungi were further identified to species level by molecular method utilizing nucleotide sequence homology analysis of the conserved internal transcribed spacer (ITS) region. Environmental factors such as temperature, relative humidity, and the opening or closure of the temples did not have any influence upon the fungal type. From the area-based distribution, Aspergillus was found at all collection sites, while Fusarium was found in Bangkok, and Ratchaburi and Petchaburi provinces in the western part of the country. Curvularia was found mostly in Phra Nakhon Si Ayutthaya and Lopburi provinces, and in one temple in Petchaburi. From the phylogenetic relationship, these prevalent fungi were divided into three closely related groups: Aspergillus and Penicillium, Fusarium and Neurospora, and Curvularia. In addition, growth inhibition of the fungi by local plant extracts of betel leaves, custard apple leaves, mangosteen peel, and guava leaves at 10,000 ppm were investigated. Mangosteen peel extract gave the highest fungal growth inhibition for all the Curvularia tested, being 68.3%, 65.6%, and 60% for C. verruculosa, C. geniculata, and C. lunata, respectively. Guava leave extract also yielded highest growth inhibition of 64.4% for C. verruculosa. Both betel leave and custard apple leave extracts showed the highest inhibition towards A. fumigatus, at 65.1% and 61.8%, respectively. The results obtained here are basic information necessary for future applications in the biological prevention of art objects, and the design of appropriate measures for preventive conservation of Thai cultural heritage.

Size-resolved particle oxidative potential in the office, laboratory, and home: Evidence for the importance of water-soluble transition metals

Particulate matter (PM) oxidative potential (OP) is an emerging health metric, but studies examining the OP of indoor PM are rare. This paper focuses on the relationships between respiratory exposure to OP and PM water-soluble composition in indoor environments. Size-resolved PM samples were collected between November 2015 and June 2016 from an office, home (including bedroom, living room, and storeroom), and laboratory using a MOUDI sampler. Particles from each source were segregated into eleven size bins, and the water-soluble metal content and dithiothreitol (DTT) loss rate were measured in each PM extract. The water-soluble OP (OP_ws) of indoor PM was highest in the office and lowest in the home, varying by factors of up to 1.2; these variations were attributed to differences in occupation density, occupant activity, and ventilation. In addition, the particulate Cu, Mn, and Fe concentrations were closely correlated with OP_ws in indoor particles; the transition metals may have acted as catalysts during oxidation processes, inducing ·OH formation through the concomitant consumption of DTT. The OP_ws particle size distributions featured single modes with peaks between 0.18 and 3.2 μm across all indoor sites, reflecting the dominant contribution of PM_3.2 to total PM levels and the enhanced oxidative activity of the PM_3.2 compared to PM_>3.2. Lung-deposition model calculations indicated that PM_3.2 dominated the pulmonary deposition of the OP_ws (>75%) due to both the high levels of metals content and the high deposition efficiency in the alveolar region. Therefore, because OP_ws has been directly linked to various health effects, special attention should be given to PM_3.2.

Identification of fungal candidates for asthma protection in a large population-based study

BACKGROUND

Exposure to molds has been related to asthma risk both positively and negatively, depending on the environmental setting. The pertinent results are based on generic markers or culturing methods although the majority of present fungi cannot be cultured under laboratory conditions. The aim of the present analysis was to assess environmental dust samples for asthma-protective fungal candidates with a comprehensive molecular technique covering also non-cultivable and non-viable fungi.

METHODS

Mattress dust samples of 844 children from the GABRIELA study were analyzed by polymerase chain reaction-single-strand conformation polymorphism (PCR-SSCP) of the fungus-specific internal transcribed spacer (ITS) region. Known asthma candidate species were tested for their associations with asthma, and further gel positions were sought to explain the above. As a second, data-driven, analysis, we tested the association of each individual gel position with asthma.

RESULTS

In the hypothesis-driven approach, Penicillium chrysogenum emerged with an odds ratio of 0.80 (95% confidence interval 0.66-0.96; p = 0.020). The effect size was changed by 39% toward the null when adjusting for the two bands 683 (DNA of Metschnikowia sp., Aureobasidium spp.) and 978 (DNA of Epicoccum spp., Galactomyces spp., uncultured Penicillium). The data-driven approach yielded an additional band (containing DNA of Pseudotaeniolina globosa) with reduced risk of asthma (OR = 0.80 [0.66-0.96], p = 0.012).

CONCLUSIONS

A large population-based study revealed several fungal taxa with inverse associations with childhood asthma. Molds produce a variety of bioactive compounds with detrimental but also beneficial immunoregulatory capacities, which renders them promising targets for further asthma research.

Comparison of methods for assessing temporal variation of growth of fungi on building materials

Fungal growth on indoor surfaces can decay building materials and release hazardous substances that affect indoor air quality. Despite the numerous methods available for growth determination, there is no commonly accepted standard. The goal of this study was to compare five different assay methods for the measurement of fungal growth: cultivation, MS-based determination of ergosterol, beta-N-acetylhexosaminidase activity, quantitative PCR and microscopic spore counting. Three fungal species (Aspergillus puulaauensis, Cladosporium montecillanum and Penicillium polonicum) were grown on three different building materials (two types of acoustic board and wood). Fungal load was determined at different time points. Results from all of the methods, except the spore count, showed good correlation between each other (r=0.6-0.8). Results obtained with the cultivation method had the highest variability among replicate samples (65 %), making it the least reproducible in repeated measurements. However, it also displayed the highest variability in incubation times (149 %), indicating its suitability for detecting transient changes in the physiological state of cells. Similar to the cultivation method, quantitative PCR correlated well with the other methods and had high variability in incubation times but had lower variability among replicate samples. Ergosterol and beta-N-acetylhexosaminidase enzyme activity seemed to be the methods least dependent on the physiological state of the cells. Varying growth dynamics were observed for different species over time with the different assay methods. Each one of the tests provides a different perspective on fungal quantification due to its specific responses to the various stages of fungal growth.

Microbial communities associated with house dust

House dust is a complex mixture of inorganic and organic material with microbes in abundance. Few microbial species are actually able to grow and proliferate in dust and only if enough moisture is provided. Hence, most of the microbial content originates from sources other than the dust itself. The most important sources of microbes in house dust are outdoor air and other outdoor material tracked into the buildings, occupants of the buildings including pets and microbial growth on moist construction materials. Based on numerous cultivation studies, Penicillium, Aspergillus, Cladosporium, and about 20 other fungal genera are the most commonly isolated genera from house dust. The cultivable bacterial flora is dominated by Gram-positive genera, such as Staplylococcus, Corynebacterium, and Lactococcus. Culture-independent studies have shown that both the fungal and the bacterial flora are far more diverse, with estimates of up to 500-1000 different species being present in house dust. Concentrations of microbes in house dust vary from nondetectable to 10(9) cells g(-1) dust, depending on the dust type, detection method, type of the indoor environment and season, among other factors. Microbial assemblages in different house dust types usually share the same core species; however, alterations in the composition are caused by differing sources of microbes for different dust types. For example, mattress dust is dominated by species originating from the user of the mattress, whereas floor dust reflects rather outdoor sources. Farming homes contain higher microbial load than urban homes and according to a recent study, temperate climate zones show higher dust microbial diversity than tropical zones.

Effects of fungal species, cultivation time, growth substrate, and air exposure velocity on the fluorescence properties of airborne fungal spores

Real-time bioaerosol monitoring is possible with fluorescence based instruments. This study provides information on major factors that can affect the fluorescence properties of airborne fungal spores. Two fluorescence-based bioaerosol detectors, BioScout, and ultraviolet aerodynamic particle sizer (UVAPS), were used to study fluorescent particle fractions (FPFs) of released spores of three fungal species (Aspergillus versicolor, Cladosporium cladosporioides, and Penicillium brevicompactum). Two culture media (agar and gypsum board), three ages of the culture (one week, one month, and four months), and three aerosolization air velocities (5, 15, and 27 m/s) were tested. The results showed that the FPF values for spores released from gypsum were typically lower than for those released from agar indicating that poor nutrient substrate produces spores with lower amounts of fluorescent compounds. The results also showed higher FPF values with lower air velocities in aerosolization. This indicates that easily released fully developed spores have more fluorescent compounds compared to forcibly extracted non-matured spores. The FPFs typically were lower with older samples. The FPF results between the two instruments were similar, except with four-month-old samples. The results can be utilized in field measurements of fungal spores to estimate actual concentrations and compare different instruments with fluorescence-based devices as well as in instrument calibration and testing in laboratory conditions.

PRACTICAL IMPLICATIONS

Fluorescence-based instruments are the only choice for real-time detection of fungal spores at the moment. In general, all fluorescence-based bioaerosol instruments are tested against known bacterial and fungal spores in laboratory conditions. This study showed that fungal species, growth substrate, age of culture, and air current exposure rate have an effect on detection efficiency of fungal spores in the fluorescence-based instruments. Therefore, these factors should be considered in the instrument calibration process. The results are also important when interpreting results of fluorescence-based field measurements of fungal spores.

Biological air contamination in elderly care centers: geria project

Indoor air quality (IAQ) affects health particularly in susceptible individuals such as the elderly. It has been estimated that the older population spends approximately 19-20 h/d indoors, and the majority of the elderly spend all of their time indoors in elderly care centers (ECC). Older individuals may be particularly at risk of exposure to detrimental effects from pollutants, even at low concentrations, due to common and multiple underlying chronic diseases that increase susceptibility. This study, aimed to assess the impact of indoor biological agents in 22 ECC located in Porto, was conducted during summer and winter from November 2011 to August 2013 at a total of 141 areas within dining rooms, drawing rooms, medical offices, and bedrooms (including the bedridden). Air sampling was carried out with a microbiological air sampler (Merck MAS-100) and using tryptic soy agar for bacteria and malt extract agar for fungi. The results obtained were compared with the recently revised Portuguese standards. In winter, mean fungi concentration exceeded reference values, while bacteria concentrations were within the new standards in both seasons. The main fungi species found indoors were Cladosporium (73%) in summer and Penicillium (67%) in winter. Aspergillus fumigatus, Aspergillus niger, and Aspergillus flavus, known potential pathogenic/toxigenic species, were also identified. Although the overall rate and mean values of bacteria and fungi found in ECC indoor air met Portuguese legislation, some concern is raised by the presence of pathogenic microorganisms. Simple measures, like opening windows and doors to promote air exchange and renewal, may improve effectiveness in enhancing IAQ.

Indoor fungal contamination: health risks and measurement methods in hospitals, homes and workplaces

Indoor fungal contamination has been associated with a wide range of adverse health effects, including infectious diseases, toxic effects and allergies. The diversity of fungi contributes to the complex role that they play in indoor environments and human diseases. Molds have a major impact on public health, and can cause different consequences in hospitals, homes and workplaces. This review presents the methods used to assess fungal contamination in these various environments, and discusses advantages and disadvantages for each method in consideration with different health risks. Air, dust and surface sampling strategies are compared, as well as the limits of various methods are used to detect and quantify fungal particles and fungal compounds. In addition to conventional microscopic and culture approaches, more recent chemical, immunoassay and polymerase chain reaction (PCR)-based methods are described. This article also identifies common needs for future multidisciplinary research and development projects in this field, with specific interests on viable fungi and fungal fragment detections. The determination of fungal load and the detection of species in environmental samples greatly depend on the strategy of sampling and analysis. Quantitative PCR was found useful to identify associations between specific fungi and common diseases. The next-generation sequencing methods may afford new perspectives in this area.

Mould routine identification in the clinical laboratory by matrix-assisted laser desorption ionization time-of-flight mass spectrometry

Background

MALDI-TOF MS recently emerged as a valuable identification tool for bacteria and yeasts and revolutionized the daily clinical laboratory routine. But it has not been established for routine mould identification. This study aimed to validate a standardized procedure for MALDI-TOF MS-based mould identification in clinical laboratory.

Materials and Methods

First, pre-extraction and extraction procedures were optimized. With this standardized procedure, a 143 mould strains reference spectra library was built. Then, the mould isolates cultured from sequential clinical samples were prospectively subjected to this MALDI-TOF MS based-identification assay. MALDI-TOF MS-based identification was considered correct if it was concordant with the phenotypic identification; otherwise, the gold standard was DNA sequence comparison-based identification.

Results

The optimized procedure comprised a culture on sabouraud-gentamicin-chloramphenicol agar followed by a chemical extraction of the fungal colonies with formic acid and acetonitril. The identification was done using a reference database built with references from at least four culture replicates. For five months, 197 clinical isolates were analyzed; 20 were excluded because they were not identified at the species level. MALDI-TOF MS-based approach correctly identified 87% (154/177) of the isolates analyzed in a routine clinical laboratory activity. It failed in 12% (21/177), whose species were not represented in the reference library. MALDI-TOF MS-based identification was correct in 154 out of the remaining 156 isolates. One Beauveria bassiana was not identified and one Rhizopus oryzae was misidentified as Mucor circinelloides.

Conclusions

This work's seminal finding is that a standardized procedure can also be used for MALDI-TOF MS-based identification of a wide array of clinically relevant mould species. It thus makes it possible to identify moulds in the routine clinical laboratory setting and opens new avenues for the development of an integrated MALDI-TOF MS-based solution for the identification of any clinically relevant microorganism.

Concentrations and diversity of microbes from four local bioaerosol emission sources in Finland

Microbial particles can readily be released into the air from different types of man-made sources such as waste operations. Microbiological emissions from different biological sources and their dispersion may be an issue of concern for area planning and for nearby residents. This study was designed to determine the concentrations and diversity of microbiological emissions from four different man-made source environments: waste center with composting windrows, sewage treatment plant, farming environment, and cattle manure spreading. Samples of airborne particles were collected onto polyvinyl chloride filters at three distances along the prevailing downwind direction, from each source environment during a period of approximately 1 week. These samples were analyzed for 13 species or assay groups of fungi, bacterial genus Streptomyces, and Gram-positive and -negative bacteria using quantitative polymerase chain reaction (PCR). Samples for determining the concentrations of viable fungi and bacteria were collected from all environments using a six-stage impactor. The results show that there were variations in the microbial diversity between the source environments. Specifically, composting was a major source for the fungal genera Aspergillus and Penicillium, particularly for Aspergillus fumigatus, and for the bacterial genus Streptomyces. Although the microbial concentrations in the sewage treatment plant area were significantly higher than those at 50 or 200 m distance from the plant area, in the farming environment or cattle manure spreading area, no significant difference was observed between different distances from the source. In summary, elevated concentrations of microbes that differ from background can only be detected within a few hundred meters from the source. This finding, reported earlier for culturable bacteria and fungi, could thus be confirmed using molecular methods that cover both culturable and nonculturable microbial material.

Indoor environment and children's health: recent developments in chemical, biological, physical and social aspects

Much research is being carried out into indoor exposure to harmful agents. This review focused on the impact on children's health, taking a broad approach to the indoor environment and including chemical, microbial, physical and social aspects. Papers published from 2006 onwards were reviewed, with regards to scientific context. Most of publications dealt with chemical exposure. Apart from the ongoing issue of combustion by-products, most of these papers concerned semi volatile organic compounds (such as phthalates). These may be associated with neurotoxic, reprotoxic or respiratory effects and may, therefore, be of particular interest so far as children are concerned. In a lesser extent, volatile organic compounds (such as aldehydes) that have mainly respiratory effects are still studied. Assessing exposure to metals is still of concern, with increasing interest in bioaccessibility. Most of the papers on microbial exposure focused on respiratory tract infections, especially asthma linked to allergens and bio-aerosols. Physical exposure includes noise and electromagnetic fields, and articles dealt with the auditory and non auditory effects of noise. Articles on radiofrequency electromagnetic fields mainly concerned questions about non-thermal effects and papers on extremely low-frequency magnetic fields focused on the characterization of exposure. The impact of the indoor environment on children's health cannot be assessed merely by considering the effect of these different types of exposure: this review highlights new findings and also discusses the interactions between agents in indoor environments and also with social aspects.

Allergens in household dust and serological indicators of atopy and sensitization in Detroit children with history-based evidence of asthma

BACKGROUND

Home exposure to allergens is an important factor in the development of sensitization and subsequent exacerbations of allergic asthma. We investigated linkages among allergen exposure, immunological measurements, and asthma by examining (1) reservoir dust allergen levels in homes, (2) associations between presence of allergens in homes and sensitization status of resident children, and (3) associations between asthma status and total IgE, atopy (by Phadiatop), and positive allergen-specific tests.

METHODS

The study protocol was approved by Institutional Review Boards (IRBs) of the University of North Carolina Chapel Hill; Westat, Inc.; and the US Environmental Protection Agency Human Research Protocol Office. Data were collected from questionnaires, serum analyses, and household vacuum dust. Children (n = 205) were predominately African American (AA) (85.4%) and 51.6% were asthmatic. Sera from 185 children and home dust samples (n = 141) were analyzed for total and specific IgE antibodies to allergens from cat and dog dander, cockroach, dust mites, mice, rats, and molds.

RESULTS

Sixty percent of the homes had detectable levels of three or more dust allergens. The proportions of children with positive allergen-specific IgE tests were dust mite (32%), dog (28%), cat (23%), cockroach (18%), mouse (5%), rat (4%), and molds (24-36%). Children testing positive to a single allergen also had positive responses to other allergens. Those children with positive serum tests for cat, dog, and dust mite lived in homes with detectable levels of cat (51%), dog (90%), and dust mite (Der f 1) (92%) allergens. Correlations between children's specific IgE levels and dust levels were linearly related for dog (p < .04), but not for cat (p = .12) or dust mite (Der f 1) (p = .21). Odds ratios (95% CI) for the associations between asthma and serum-specific IgE were over 1.0 for cat, dog, dust mite (Der f 1), cockroach, and four types of molds. House dust allergen exposure levels, however, exhibited no differences between asthmatic and non-asthmatic homes.

CONCLUSIONS

Both the co-occurrence of multiple allergens in dust and the high frequency of multiple allergen sensitizations indicate that a broad-based intervention aimed at reducing multiple allergens (pets, pests, and molds) would be more successful than any approach that aimed at reducing one type of allergen.

Associations between fungal species and water-damaged building materials

Fungal growth in damp or water-damaged buildings worldwide is an increasing problem, which has adverse effects on both the occupants and the buildings. Air sampling alone in moldy buildings does not reveal the full diversity of fungal species growing on building materials. One aim of this study was to estimate the qualitative and quantitative diversity of fungi growing on damp or water-damaged building materials. Another was to determine if associations exist between the most commonly found fungal species and different types of materials. More than 5,300 surface samples were taken by means of V8 contact plates from materials with visible fungal growth. Fungal identifications and information on building material components were analyzed using multivariate statistic methods to determine associations between fungi and material components. The results confirmed that Penicillium chrysogenum and Aspergillus versicolor are the most common fungal species in water-damaged buildings. The results also showed Chaetomium spp., Acremonium spp., and Ulocladium spp. to be very common on damp building materials. Analyses show that associated mycobiotas exist on different building materials. Associations were found between (i) Acremonium spp., Penicillium chrysogenum, Stachybotrys spp., Ulocladium spp., and gypsum and wallpaper, (ii) Arthrinium phaeospermum, Aureobasidium pullulans, Cladosporium herbarum, Trichoderma spp., yeasts, and different types of wood and plywood, and (iii) Aspergillus fumigatus, Aspergillus melleus, Aspergillus niger, Aspergillus ochraceus, Chaetomium spp., Mucor racemosus, Mucor spinosus, and concrete and other floor-related materials. These results can be used to develop new and resistant building materials and relevant allergen extracts and to help focus research on relevant mycotoxins, microbial volatile organic compounds (MVOCs), and microparticles released into the indoor environment.

Airborne microorganisms, endotoxin, and (1→3)-β-D-glucan exposure in greenhouses and assessment of respiratory symptoms among workers

OBJECTIVES

Greenhouse operations are an important sector of the horticulture industry, also known as the Green Industry. The objectives of this study were (i) to investigate exposure levels to airborne culturable fungi, bacteria (total culturable bacteria and actinomycetes), endotoxin, and (1→3)-β-D-glucan in three Midwest greenhouses during summer and winter using multiple exposure assessment methods; (ii) characterize the load of microorganisms on greenhouse floors and determine potential microbial source strengths of the floors for aerosolizing microbial biocontaminants, and (iii) to estimate the prevalence of rhinitis, wheezing, asthma, and other respiratory symptoms/conditions among greenhouse workers.

METHODS

Stationary inhalable aerosol samples were collected from each greenhouse using Button Inhalable Aerosol Samplers. Control samples were collected from offices and nearby outdoor locations. A microbial source strength tester was used to examine the aerosolization potential of microbial contaminants from greenhouse floors. Additionally, surface samples were collected by sterile cotton swabs. Temperature, relative humidity, and wind velocity were recorded. Airborne culturable fungi, bacteria, and actinomycetes were analyzed in the extracts from field samples by cultivation in nutrient agar media. Endotoxin and (1→3)-β-D-glucan in the extracts from field samples were analyzed by specific kinetic chromogenic Limulus amebocyte lysate assays. The prevalence of respiratory symptoms among greenhouse workers (n = 35) and control subjects (office workers; n = 14) was estimated with a standardized questionnaire.

RESULTS AND CONCLUSIONS

The collected data indicate that workers employed in Midwest greenhouses may be exposed to elevated levels of inhalable culturable microorganisms (fungi and bacteria collectively on the order of 10(2)-10(5) CFU m(-3)), endotoxin (10(1)-10(3) EU m(-3)), and (1→3)-β-D-glucan (10(1)-10(2) ng m(-3)). Seasonal variations were observed for some bioaerosol components. The prevalence of self-reported respiratory symptoms was generally higher among greenhouse workers compared to controls; however, the differences were not statistically significant, likely due to the relatively low statistical power of the study.

Exposure matrices of endotoxin, (1→3)-β-d-glucan, fungi, and dust mite allergens in flood-affected homes of New Orleans

This study examined: (i) biocontaminant levels in flooded homes of New Orleans two years after the flooding; (ii) seasonal changes in biocontaminant levels, and (iii) correlations between biocontaminant levels obtained by different environmental monitoring methods. Endotoxin, (1→3)-β-d-glucan, fungal spores, and dust mite allergens were measured in 35 homes during summer and winter. A combination of dust sampling, aerosolization-based microbial source assessment, and long-term inhalable bioaerosol sampling aided in understanding exposure matrices. On average, endotoxin found in the aerosolized fraction accounted for <2% of that measured in the floor dust, suggesting that vacuuming could overestimate inhalation exposures. In contrast, the (1→3)-β-d-glucan levels in the floor dust and aerosolized fractions were mostly comparable, and 25% of the homes showed aerosolizable levels even higher than the dust-borne levels. The seasonal patterns for endotoxin in dust and the aerosolizable fraction were different from those found for (1→3)-β-d-glucan, reflecting the temperature and humidity effects on bacterial and fungal contamination. While the concentration of airborne endotoxin followed the same seasonal trend as endotoxin aerosolized from surfaces, no significant seasonal difference was identified for the concentrations of airborne (1→3)-β-d-glucan and fungal spores. This was attributed to the difference in the particle size; smaller endotoxin-containing particles can remain airborne for longer time than larger fungal spores or (1→3)-β-d-glucan-containing particles. It is also possible that fungal aerosolization in home environments did not reach its full potential. Detectable dust mite allergens were found only in dust samples, and more commonly in occupied homes. Levels of endotoxin, (1→3)-β-d-glucan, and fungi in air had decreased during the two-year period following the flooding as compared to immediate measurements; however, the dust-borne endotoxin and (1→3)-β-d-glucan levels remained elevated. No conclusive correlations were found between the three environmental monitoring methods. The findings support the use of multiple methods when assessing exposure to microbial contaminants.

Traditional mould analysis compared to a DNA-based method of mould analysis

Traditional environmental mould analysis is based on microscopic observations and counting of mould structures collected from the air on a sticky surface or culturing of moulds on growth media for identification and quantification. These approaches have significant limitations. A DNA-based method of mould analysis called mould specific quantitative PCR (MSQPCR) was created for more than 100 moulds. Based on a national sampling and analysis by MSQPCR of dust in US homes, a scale for comparing the mould burden in homes was created called the Environmental Relative Mouldiness Index (ERMI).

Microbial content of house dust samples determined with qPCR

This study was designed to produce information about microbial concentrations using qPCR and their variation in different seasons and home environments with analyses of two types of house dust samples. Also the correlations between the two types of samples and the reproducibility of the parallel subsamples were studied. Two types of vacuumed house dust samples, rug dust and vacuum cleaner bag dust, were collected in 5 normal urban homes in four different seasons (N=20+20). From all dust samples, five parallel subsamples were subjected to qPCR analyses of 17 microbial species or assay groups of microbes. The highest fungal concentrations were found for the Penicillium/Aspergillus/Paecilomyces variotii group, and for the species Aspergillus penicillioides, Aureobasidium pullulans, Cladosporium cladosporioides and Cladosporium herbarum. These species/groups were present in almost all samples. The two types of dust samples gave similar results for most microbial species or groups analyzed, but in general, concentrations were slightly higher in rug dust than in dust from vacuum cleaner bag. Microbial concentrations varied significantly between different seasons and hence the similarity of samples within home was mainly low. The concentrations varied significantly also between different home environments. The reproducibility of the parallel subsamples was good or moderate for most of the analyzed species or assay groups. However, further studies are needed to fully understand the factors causing variation in these methods. Nevertheless, in order to show actual differences in fungal concentrations between urban homes with no known microbial sources, all dust samples to be compared should be taken during the same season.

The effects of human activities on exposure to particulate matter and bioaerosols in residential homes

Indoor and outdoor airborne particle mass, protein, endotoxin and (1 --> 3)-beta-D-glucan in three size fractions (PM2.5, PM10, and TSP) were measured in ten single-family homes, along with quantifying household activities in the sampling room. Correlations between human activity levels and elevations in the indoor concentrations of particles and biomarkers were evaluated using four approaches for distinguishing activity levels: diurnal differences, the number of occupants, self-estimated occupancy, and activity strength. The concentrations of particles, protein, endotoxin and (1 --> 3)-beta-D-glucan in all three size fractions (PM < 2.5 microm, PM10-2.5, and PM >10 microm) were found, in most cases, to be significantly elevated during the day, and with higher activity levels in the room. The coarser fractions of particle mass and bioaerosols were more strongly correlated with human activity levels. Activity strength was the most statistically robust measure for relating human activities to indoor bioaerosol levels. While self-estimated activity and analysis of diurnal differences both offer reasonable (but not perfect) alternatives to activity strength, the number of occupants appears to be a weaker indicator for homes.

Aerosolization of fungi, (1-->3)-beta-D glucan, and endotoxin from flood-affected materials collected in New Orleans homes

Standing water and sediments remaining on flood-affected materials were the breeding ground for many microorganisms in flooded homes following Hurricane Katrina. The purpose of this laboratory study was to examine the aerosolization of culturable and total fungi, (1-->3)-beta-D glucan, and endotoxin from eight flood-affected floor and bedding materials collected in New Orleans homes, following Hurricane Katrina. Aerosolization was examined using the Fungal Spore Source Strength Tester (FSSST) connected to a BioSampler. Dust samples were collected by vacuuming. A two-stage cyclone sampler was used for size-selective analysis of aerosolized glucan and endotoxin. On average, levels of culturable fungi ranged from undetectable (lower limit=8.3 x 10(4)) to 2.6 x 10(5) CFU/m(2); total fungi ranged from 2.07 x 10(5) to 1.6 x 10(6) spores/m(2); (1-->3)-beta-D glucan and endotoxin were 2.0 x 10(3) - 2.9 x 10(4) ng/m(2) and 7.0 x 10(2) - 9.3 x 10(4) EU/m(2), respectively. The results showed that 5-15 min sampling is sufficient for detecting aerosolizable biocontaminants with the FSSST. Smaller particle size fractions (<1.0 and <1.8 microm) have levels of glucan and endotoxin comparable to larger (>1.8 microm) fractions, which raises additional exposure concerns. Vacuuming was found to overestimate inhalation exposure risks by a factor of approximately 10(2) for (1-->3)-beta-D glucan and by 10(3)-10(4) for endotoxin as detected by the FSSST. The information generated from this study is important with respect to restoration and rejuvenation of the flood-affected areas in New Orleans. We believe the findings will be significant during similar disasters in other regions of the world including major coastal floods from tsunamis.

Evaluation of quantitative PCR and culture methods for detection of house dust fungi and streptomycetes in relation to moisture damage of the house

AIMS

Microbial concentrations in vacuumed house dust samples (n = 71) were analysed by culture and quantitative polymerase chain reaction (qPCR) methods and their association with extent of moisture damage in the house was studied.

METHODS AND RESULTS

Microbial concentrations measured by qPCR correlated with concentrations obtained by culture method, but were orders of magnitude higher. qPCR also had better sensitivity. Concentrations of several microbes in house dust, determined with qPCR, were associated with the extent of moisture damage in the house. This association was strongest for Penicillium brevicompactum, one of the fungi detected in highest concentrations by qPCR. Furthermore, house dust concentrations of Wallemia sebi, Trichoderma viride, Cladosporium sphaerospermum, Eurotium amstelodami and the combined assay group for Penicillium spp., Aspergillus spp. and Paecilomyces variotii were significantly associated with the extent of the moisture damage.

CONCLUSION

These species or assay groups could probably be used as indicators of moisture damage in the house.

SIGNIFICANCE AND IMPACT OF THE STUDY

This finding indicates the benefits of the qPCR method, which is sensitive enough to reveal the differences in microbial concentrations of house dust between moisture-damaged and undamaged houses.

Diversity and seasonal dynamics of bacterial community in indoor environment

Background

We spend most of our lives in indoor environments and are exposed to microbes present in these environments. Hence, knowledge about this exposure is important for understanding how it impacts on human health. However, the bacterial flora in indoor environments has been only fragmentarily explored and mostly using culture methods. The application of molecular methods previously utilised in other environments has resulted in a substantial increase in our awareness of microbial diversity.

Results

The composition and dynamics of indoor dust bacterial flora were investigated in two buildings over a period of one year. Four samples were taken in each building, corresponding to the four seasons, and 16S rDNA libraries were constructed. A total of 893 clones were analysed and 283 distinct operational taxonomic units (OTUs) detected among them using 97% sequence similarity as the criterion. All libraries were dominated by Gram-positive sequences, with the most abundant phylum being Firmicutes. Four OTUs having high similarity to Corynebacterium-, Propionibacterium-, Streptococcus- and Staphylococcus- sequences were present in all samples. The most abundant of the Gram-negative OTUs were members of the family Sphingomonadaceae, followed by Oxalobacteraceae, Comamonadaceae, Neisseriaceae and Rhizobiaceae.

The relative abundance of alpha- and betaproteobacteria increased slightly towards summer at the expense of firmicutes. The proportion of firmicutes and gammaproteobacteria of the total diversity was highest in winter and that of actinobacteria, alpha- and betaproteobacteria in spring or summer, whereas the diversity of bacteroidetes peaked in fall. A statistical comparison of the libraries revealed that the bacterial flora of the two buildings differed during all seasons except spring, but differences between seasons within one building were not that clear, indicating that differences between the buildings were greater than the differences between seasons.

Conclusion

This work demonstrated that the bacterial flora of indoor dust is complex and dominated by Gram-positive species. The dominant phylotypes most probably originated from users of the building. Seasonal variation was observed as proportional changes of the phyla and at the species level. The microflora of the two buildings investigated differed statistically and differences between the buildings were more pronounced than differences between seasons.

Verifying interpretive criteria for bioaerosol data using (bootstrap) Monte Carlo techniques

A number of interpretive descriptors have been proposed for bioaerosol data due to the lack of health-based numerical standards, but very few have been verified as to their ability to describe a suspect indoor environment. Culturable and nonculturable (spore trap) sampling using the bootstrap version of Monte Carlo simulation (BMC) at several sites during 2003-2006 served as a source of indoor and outdoor data to test various criteria with regard to their variability in characterizing an indoor or outdoor environment. The purpose was to gain some insight for the reliability of some of the interpretive criteria in use as well as to demonstrate the utility of BMC methods as a generalized technique for validation of various interpretive criteria for bioaerosols. The ratio of nonphylloplane (NP) fungi (total of Aspergillus and Penicillium) to phylloplane (P) fungi (total of Cladosporium, Alternaria, and Epicoccum), or NP/P, is a descriptor that has been used to identify "dominance" of nonphylloplane fungi (NP/P > 1.0), assumed to be indicative of a problematic indoor environment. However, BMC analysis of spore trap and culturable bioaerosol data using the NP/P ratio identified frequent dominance by nonphylloplane fungi in outdoor air. Similarly, the NP/P descriptor indicated dominance of nonphylloplane fungi in buildings with visible mold growth and/or known water intrusion with a frequency often in the range of 0.5 Fixed numerical criteria for spore trap data of 900 and 1300 spores/m(3) for total spores and 750 Aspergillus/Penicillium spores/m(3) exhibited similar variability, as did ratios of nonphylloplane to total fungi, phylloplane to total fungi, and indoor/outdoor ratios for total fungal spores. Analysis of bioaerosol data by BMC indicates that numerical levels or descriptors based on dominance of certain fungi are unreliable as criteria for characterizing a given environment. The utility of BMC analysis lies in its generalized application to test mathematically the validity of any given descriptor or criterion for bioaerosols, which can be an important tool in quantifying the uncertainty in interpreting bioaerosol data.

Analysis of fungal flora in indoor dust by ribosomal DNA sequence analysis, quantitative PCR, and culture

In recent years increasing attention has been given to the potential health effects of fungal exposure in indoor environments. We used large-scale sequencing of the fungal internal transcribed spacer region (ITS) of nuclear ribosomal DNA to describe the mycoflora of two office buildings over the four seasons. DNA sequencing was complemented by cultivation, ergosterol determination, and quantitative PCR analyses. Sequences of 1,339 clones were clustered into 394 nonredundant fungal operational taxonomical units containing sequences from 18 fungal subclasses. The observed flora differed markedly from that recovered by cultivation, the major differences being the near absence of several typical indoor mold genera such as Penicillium and Aspergillus spp. and a high prevalence of basidiomycetes in clone libraries. A total of 55% of the total diversity constituted of unidentifiable ITS sequences, some of which may represent novel fungal species. Dominant species were Cladosporium cladosporioides and C. herbarum, Cryptococcus victoriae, Leptosphaerulina americana and L. chartarum, Aureobasidium pullulans, Thekopsora areolata, Phaeococcomyces nigricans, Macrophoma sp., and several Malassezia species. Seasonal differences were observed for community composition, with ascomycetous molds and basidiomycetous yeasts predominating in the winter and spring and Agaricomycetidae basidiomycetes predominating in the fall. The comparison of methods suggested that the cloning, cultivation, and quantitative PCR methods complemented each other, generating a more comprehensive picture of fungal flora than any of the methods would give alone. The current restrictions of the methods are discussed.

Biomechanics of conidial dispersal in the toxic mold Stachybotrys chartarum

Conidial dispersal in Stachybotrys chartarum in response to low-velocity airflow was studied using a microflow apparatus. The maximum rate of spore release occurred during the first 5 min of airflow, followed by a dramatic reduction in dispersal that left more than 99% of the conidia attached to their conidiophores. Micromanipulation of undisturbed colonies showed that micronewton (microN) forces were needed to dislodge spore clusters from their supporting conidiophores. Calculations show that airspeeds that normally prevail in the indoor environment disturb colonies with forces that are 1000-fold lower, in the nanonewton (nN) range. Low-velocity airflow does not, therefore, cause sufficient disturbance to disperse a large proportion of the conidia of S. chartarum.