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Hurraß J, Heinzow B, Walser-Reichenbach S, Aurbach U, Becker S, Bellmann R, Bergmann KC, Cornely OA, Engelhart S, Fischer G, Gabrio T, Herr CEW, Joest M, Karagiannidis C, Klimek L, Köberle M, Kolk A, Lichtnecker H, Lob-Corzilius T, Mülleneisen N, Nowak D, Rabe U, Raulf M, Steinmann J, Steiß JO, Stemler J, Umpfenbach U, Valtanen K, Werchan B, Willinger B, Wiesmüller GA. [Medical clinical diagnostics for indoor mould exposure - Update 2023 (AWMF Register No. 161/001)]. Pneumologie 2024; 78:693-784. [PMID: 39424320 DOI: 10.1055/a-2194-6914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2024]
Abstract
This article is an abridged version of the updated AWMF mould guideline "Medical clinical diagnostics in case of indoor mould exposure - Update 2023", presented in July 2023 by the German Society of Hygiene, Environmental Medicine and Preventive Medicine (Gesellschaft für Hygiene, Umweltmedizin und Präventivmedizin, GHUP), in collaboration with German and Austrian scientific medical societies, and experts. Indoor mould growth is a potential health risk, even if a quantitative and/or causal relationship between the occurrence of individual mould species and health problems has yet to be established. There is no evidence for a causal relationship between moisture/mould damage and human diseases, mainly because of the ubiquitous presence of fungi and hitherto inadequate diagnostic methods. Sufficient evidence for an association between moisture/mould damage and the following health effects has been established for: allergic respiratory diseases, allergic rhinitis, allergic rhino-conjunctivitis, allergic bronchopulmonary aspergillosis (ABPA), other allergic bronchopulmonary mycosis (ABPM), aspergilloma, Aspergillus bronchitis, asthma (manifestation, progression, exacerbation), bronchitis (acute, chronic), community-acquired Aspergillus pneumonia, hypersensitivity pneumonitis (HP; extrinsic allergic alveolitis (EEA)), invasive Aspergillosis, mycoses, organic dust toxic syndrome (ODTS) [workplace exposure], promotion of respiratory infections, pulmonary aspergillosis (subacute, chronic), and rhinosinusitis (acute, chronically invasive, or granulomatous, allergic). In this context the sensitizing potential of moulds is obviously low compared to other environmental allergens. Recent studies show a comparatively low sensitization prevalence of 3-22,5 % in the general population across Europe. Limited or suspected evidence for an association exist with respect to atopic eczema (atopic dermatitis, neurodermatitis; manifestation), chronic obstructive pulmonary disease (COPD), mood disorders, mucous membrane irritation (MMI), odor effects, and sarcoidosis. (iv) Inadequate or insufficient evidence for an association exist for acute idiopathic pulmonary hemorrhage in infants, airborne transmitted mycotoxicosis, arthritis, autoimmune diseases, cancer, chronic fatigue syndrome (CFS), endocrinopathies, gastrointestinal effects, multiple chemical sensitivity (MCS), multiple sclerosis, neuropsychological effects, neurotoxic effects, renal effects, reproductive disorders, rheumatism, sick building syndrome (SBS), sudden infant death syndrome, teratogenicity, thyroid diseases, and urticaria.The risk of infection posed by moulds regularly occurring indoors is low for healthy persons; most species are in risk group 1 and a few in risk group 2 (Aspergillus fumigatus, A. flavus) of the German Biological Agents Act (Biostoffverordnung). Only moulds that are potentially able to form toxins can be triggers of toxic reactions. Whether or not toxin formation occurs in individual cases is determined by environmental and growth conditions, water activity, temperature and above all the growth substrates.In case of indoor moisture/mould damage, everyone can be affected by odor effects and/or mood disorders.However, this is not an acute health hazard. Predisposing factors for odor effects can include genetic and hormonal influences, imprinting, context and adaptation effects. Predisposing factors for mood disorders may include environmental concerns, anxiety, condition, and attribution, as well as various diseases. Risk groups to be protected particularly regarding infection risk are immunocompromised persons according to the classification of the German Commission for Hospital Hygiene and Infection Prevention (Kommission für Krankenhaushygiene und Infektionsprävention, KRINKO) at the Robert Koch-Institute (RKI), persons suffering from severe influenza, persons suffering from severe COVID-19, and persons with cystic fibrosis (mucoviscidosis); with regard to allergic risk, persons with cystic fibrosis (mucoviscidosis) and patients with bronchial asthma must be protected. The rational diagnostics include the medical history, physical examination, and conventional allergy diagnostics including provocation tests if necessary; sometimes cellular test systems are indicated. In the case of mould infections, the reader is referred to the specific guidelines. Regarding mycotoxins, there are currently no useful and validated test procedures for clinical diagnostics. From a preventive medical point of view, it is important that indoor mould infestation in relevant magnitudes cannot be tolerated for precautionary reasons.For evaluation of mould damage in the indoor environment and appropriate remedial procedures, the reader is referred to the mould guideline issued by the German Federal Environment Agency (Umweltbundesamt, UBA).
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Affiliation(s)
- Julia Hurraß
- Sachgebiet Hygiene in Gesundheitseinrichtungen, Abteilung Infektions- und Umwelthygiene, Gesundheitsamt der Stadt Köln
| | - Birger Heinzow
- Ehemals: Landesamt für soziale Dienste (LAsD) Schleswig-Holstein, Kiel
| | | | - Ute Aurbach
- Labor Dr. Wisplinghoff
- ZfMK - Zentrum für Umwelt, Hygiene und Mykologie, Köln
| | - Sven Becker
- Universitätsklinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum Tübingen
| | - Romuald Bellmann
- Universitätsklinik für Innere Medizin I, Medizinische Universität Innsbruck
| | | | - Oliver A Cornely
- Translational Research, CECAD Cluster of Excellence, Universität zu Köln
| | | | - Guido Fischer
- Landesgesundheitsamt Baden-Württemberg im Regierungspräsidium Stuttgart
| | - Thomas Gabrio
- Ehemals: Landesgesundheitsamt Baden-Württemberg im Regierungspräsidium Stuttgart
| | - Caroline E W Herr
- Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit München
- Ludwig-Maximilians-Universität München, apl. Prof. "Hygiene und Umweltmedizin"
| | - Marcus Joest
- Allergologisch-immunologisches Labor, Helios Lungen- und Allergiezentrum Bonn
| | - Christian Karagiannidis
- Fakultät für Gesundheit, Professur für Extrakorporale Lungenersatzverfahren, Universität Witten/Herdecke
- Lungenklinik Köln Merheim, Kliniken der Stadt Köln
| | | | - Martin Köberle
- Klinik und Poliklinik für Dermatologie und Allergologie am Biederstein, Technische Universität München
| | - Annette Kolk
- Institut für Arbeitsschutz der DGUV (IFA), Bereich Biostoffe, Sankt Augustin
| | | | | | | | - Dennis Nowak
- Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin, Mitglied Deutsches Zentrum für Lungenforschung, Klinikum der Universität München
| | - Uta Rabe
- Zentrum für Allergologie und Asthma, Johanniter-Krankenhaus Treuenbrietzen
| | - Monika Raulf
- Institut für Prävention und Arbeitsmedizin der Deutschen Gesetzlichen Unfallversicherung, Institut der Ruhr-Universität Bochum (IPA)
| | - Jörg Steinmann
- Institut für Klinikhygiene, Medizinische Mikrobiologie und Klinische Infektiologie, Paracelsus Medizinische Privatuniversität Klinikum Nürnberg
| | - Jens-Oliver Steiß
- Zentrum für Kinderheilkunde und Jugendmedizin, Universitätsklinikum Gießen und Marburg GmbH, Gießen
- Schwerpunktpraxis Allergologie und Kinder-Pneumologie Fulda
| | - Jannik Stemler
- Translational Research, CECAD Cluster of Excellence, Universität zu Köln
| | - Ulli Umpfenbach
- Arzt für Kinderheilkunde und Jugendmedizin, Kinderpneumologie, Umweltmedizin, klassische Homöopathie, Asthmatrainer, Neurodermitistrainer, Viersen
| | | | | | - Birgit Willinger
- Klinisches Institut für Labormedizin, Klinische Abteilung für Klinische Mikrobiologie - MedUni Wien
| | - Gerhard A Wiesmüller
- Labor Dr. Wisplinghoff
- ZfMK - Zentrum für Umwelt, Hygiene und Mykologie, Köln
- Institut für Arbeits-, Sozial- und Umweltmedizin, Uniklinik RWTH Aachen
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Iqbal MA, Siddiqua SA, Faruk MO, Md Towfiqul Islam AR, Salam MA. Systematic review and meta-analysis of the potential threats to respiratory health from microbial Bioaerosol exposures. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 341:122972. [PMID: 37984479 DOI: 10.1016/j.envpol.2023.122972] [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: 03/13/2023] [Revised: 10/16/2023] [Accepted: 11/14/2023] [Indexed: 11/22/2023]
Abstract
Infectious diseases are a part of everyday life, and acute respiratory diseases are the most common. Many agents carrying out respiratory infections are transmitted as bioaerosols through the air, usually, particulate matter containing living organisms. The purpose of the study is to conduct a systematic review and meta-analysis to assess the likelihood that people exposed to bioaerosols may experience severe respiratory diseases. Nine digital databases and bibliographies were assessed for papers conducted between January 1960 and April 2021. A total of 35 health and exposure studies were included from 825 studies for the systematic review, while only 17 contented the meta-inclusion analysis's criteria. This systematic review found higher bacterial bioaerosol concentrations in poultry farms, waste dumpsites, composting plants, and paper industries. The meta-analysis's Standard Mean Difference (SMD) measurement indicates a substantially positive association between bioaerosol exposure and respiratory disease outcomes in targeted populations. The value is 0.955 [95% CI, range 0.673-1.238; p < 0.001]. As per the Risk of Bias (ROB) findings, most of findings (30 out of 35 [85.71%]) were judged to have low ROB. From the random effect probit model, the total relative risk is 1.477 (95% CI, range 0.987-2.211), indicating a higher risk of respiratory diseases from bioaerosol exposure than the control groups. The total risk difference is 0.121 (95% CI, -0.0229 to 0.264), which means intervention groups may have a higher risk of respiratory diseases from continuous bioaerosol exposure than the control groups. The dose-response relationship revealed a strong positive linear coefficient correlation between bacterial & fungal bioaerosol exposure to respiratory health. Based on self-reported outcomes in those studies, The systematic review and meta-analysis stated that bioaerosol exposure had an effect on pulmonary health.
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Affiliation(s)
- Muhammad Anwar Iqbal
- Department of Environmental Science and Disaster Management, Noakhali Science and Technology University, Noakhali, 3814, Bangladesh
| | - Sadia Afrin Siddiqua
- Department of Animal Breeding and Genetics, Bangladesh Agricultural University, Mymensingh, 2202, Bangladesh
| | - Mohammad Omar Faruk
- Department of Statistics, Noakhali Science and Technology University, Noakhali, 3814, Bangladesh
| | | | - Mohammed Abdus Salam
- Department of Environmental Science and Disaster Management, Noakhali Science and Technology University, Noakhali, 3814, Bangladesh.
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Huang HC, Zou ML, Chen YH, Jiang CB, Wu CD, Lung SCC, Chien LC, Lo YC, Chao HJ. Effects of indoor air quality and home environmental characteristics on allergic diseases among preschool children in the Greater Taipei Area. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 897:165392. [PMID: 37423284 DOI: 10.1016/j.scitotenv.2023.165392] [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: 02/13/2023] [Revised: 06/11/2023] [Accepted: 07/06/2023] [Indexed: 07/11/2023]
Abstract
Indoor air quality and home environmental characteristics are potential factors associated with the onset and exacerbation of allergic diseases. Our study examined the effects of these factors on allergic diseases (i.e., asthma, allergic rhinitis, allergic conjunctivitis, and atopic dermatitis) among preschool children. We recruited a total of 120 preschool children from an ongoing birth cohort study in the Greater Taipei Area. A comprehensive environmental evaluation was conducted at each participant's residence and included measurements of indoor and outdoor air pollutants, fungal spores, endotoxins, and house dust mite allergens. A structured questionnaire was used to collect information on the allergic diseases and home environments of participants. Land-use characteristics and points of interest in the surrounding area of each home were analyzed. Other covariates were obtained from the cohort data. Multiple logistic regressions were used to examine the relationships between allergic diseases and covariates. We observed that all mean indoor air pollutant levels were below Taiwan's indoor air quality standards. After adjustment for covariates, the total number of fungal spores and the ozone, Der f 1, and endotoxin levels were significantly associated with increased risks of allergic diseases. Biological contaminants more significantly affected allergic diseases than other pollutants. Moreover, home environmental characteristics (e.g., living near power facilities and gas stations) were associated with an increased risk of allergic diseases. Regular and proper home sanitation is recommended to prevent the accumulation of indoor pollutants, especially biological contaminants. Living away from potential sources of pollution is also crucial for protecting the health of children.
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Affiliation(s)
- Hsiao-Chun Huang
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Ming-Lun Zou
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Yi-Hua Chen
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan; Neuroscience Research Center, Taipei Medical University, Taipei, Taiwan
| | - Chuen-Bin Jiang
- Department of Pediatric Gastroenterology, Hepatology and Nutrition, MacKay Children's Hospital, Taipei, Taiwan; Department of Medicine, MacKay Medical College, New Taipei City, Taiwan
| | - Chih-Da Wu
- Department of Geomatics, National Cheng Kung University, Tainan, Taiwan; National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan; Innovation and Development Center of Sustainable Agriculture, National Chung Hsing University, Tainan, Taiwan
| | | | - Ling-Chu Chien
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan; Neuroscience Research Center, Taipei Medical University, Taipei, Taiwan
| | - Yu-Chun Lo
- Neuroscience Research Center, Taipei Medical University, Taipei, Taiwan; Program in Medical Neuroscience, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
| | - Hsing Jasmine Chao
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan; Neuroscience Research Center, Taipei Medical University, Taipei, Taiwan.
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Rimayi C, Park JH. Adjustment of Matrix Effects in Analysis of 36 Secondary Metabolites of Microbial and Plant Origin in Indoor Floor Dust Using Liquid Chromatography-Tandem Mass Spectrometry. BUILDINGS (BASEL, SWITZERLAND) 2023; 13:10.3390/buildings13051112. [PMID: 38650616 PMCID: PMC11034732 DOI: 10.3390/buildings13051112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
Exposure to microbial agents in water-damaged buildings is a major public health concern. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) has become a primary tool for testing environmental samples for microbial secondary metabolites (SMs); however, matrix effects can lead to inaccurate results in exposure assessment. Applying a universal internal standard (ISTD) and a matrix-matched calibration can adjust for matrix effects, as shown by our previous study. However, there are only few isotope-labeled internal standards for SMs available on the market. In this study, we determined the best-performing ISTDs among ten candidates (nine 13C-labeled isotopes and one unlabeled analogue) for each of 36 SMs. We analyzed school floor dust spiked with the 36 SMs to identify the best-performing ISTDs (initial experiment) and examined reproducibility with the selected ISTDs and the same spiked dust (validation 1). We also tested applicability for the selected ISTDs using spiked dust collected from different schools (validation 2). The three experiments showed that 26, 17, and 19 SMs had recoveries within the range 100 ± 40%. 13C-ochratoxin A and 13C-citrinin were most frequently selected as the best ISTDs for the 36 SMs, followed by deepoxy-deoxynivalenol, 13C-sterigmatocystin, and 13C-deoxynivalenol. Our study shows that using the identified, best-performing analogous ISTDs for those metabolites may improve testing accuracy for indoor dust and help better estimate exposure effects on potential health.
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Affiliation(s)
- Cornelius Rimayi
- Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV 26505, USA
| | - Ju-Hyeong Park
- Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV 26505, USA
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NIOSH Dampness and Mold Assessment Tool (DMAT): Documentation and Data Analysis of Dampness and Mold-Related Damage in Buildings and Its Application. BUILDINGS 2022; 12:1075-1092. [DOI: 10.3390/buildings12081075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Indoor dampness and mold are prevalent, and the exposure has been associated with various illnesses such as the exacerbation of existing asthma, asthma development, current asthma, ever-diagnosed asthma, bronchitis, respiratory infection, allergic rhinitis, dyspnea, wheezing, cough, upper respiratory symptoms, and eczema. However, assessing exposures or environments in damp and moldy buildings/rooms, especially by collecting and analyzing environmental samples for microbial agents, is complicated. Nonetheless, observational assessment (visual and olfactory inspection) has been demonstrated as an effective method for evaluating indoor dampness and mold. The National Institute for Occupational Safety and Health developed an observational assessment method called the Dampness and Mold Assessment Tool (DMAT). The DMAT uses a semi-quantitative approach to score the level of dampness and mold-related damage (mold odor, water damage/stains, visible mold, and wetness/dampness) by intensity or size for each of the room components (ceiling, walls, windows, floor, furnishings, ventilation system, pipes, and supplies and materials). Total or average room scores and factor-or component-specific scores can be calculated for data analysis. Because the DMAT uses a semi-quantitative scoring method, it better differentiates the level of damage compared to the binary (presence or absence of damage) approach. Thus, our DMAT provides useful information on identifying dampness and mold, tracking and comparing past and present damage by the scores, and prioritizing remediation to avoid potential adverse health effects in occupants. This protocol-type article describes the DMAT and demonstrates how to apply it to effectively manage indoor dampness and mold-related damage.
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Satoh K, Alshahni MM, Umeda Y, Komori A, Tamura T, Nishiyama Y, Yamazaki T, Makimura K. Seven years of progress in determining fungal diversity and characterization of fungi isolated from the Japanese Experiment Module KIBO, International Space Station. Microbiol Immunol 2021; 65:463-471. [PMID: 34251696 DOI: 10.1111/1348-0421.12931] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 06/19/2021] [Accepted: 07/09/2021] [Indexed: 11/29/2022]
Abstract
The International Space Station (ISS) is a closed facility that orbits the earth carrying not only its crew but also microorganisms. We have participated in microbiota analysis projects for the Japanese Experiment Module KIBO (ISS; operations nomenclature: Microbe-I, II, III, and IV) and were in charge of fungal screening. The interior of KIBO was sampled using swabs and microbe detection sheets (MDSs) for fungal detection. The dominant genera obtained by culture were Aspergillus and Penicillium. DNA analyses of the fungal biota using a clone library showed that KIBO was dominated by Malassezia, a fungal inhabitant of human skin. Three fungal species, Aspergillus sydowii, Penicillium palitans, and Rhodotorula mucilaginosa, which grew under microgravity in KIBO were observed under a field emission-scanning electron microscope on the ground. No novel phenotypic characteristics were noted. The results of antifungal susceptibility testing of all isolates did not differ significantly from previous reports of corresponding fungi. In Microbe-I (August 2009), MDSs were culture negative, while in the next stages the CFU of MDSs were 10 for Microbe-II (February 2011), 24 for Microbe-III (October 2012), and 151 for Microbe-IV (February 2015). These results indicated that fungi inside KIBO are increasing and expanding over time, and therefore continuous surveillance is crucial.
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Affiliation(s)
- Kazuo Satoh
- Medical Mycology, Space and Environmental Medicine, Graduate School of Medicine Teikyo University, Tokyo, Japan.,General Medical Education and Research Center, Teikyo University, Tokyo, Japan.,Teikyo University Institute of Medical Mycology, Tokyo, Japan
| | - Mohamed Mahdi Alshahni
- Medical Mycology, Space and Environmental Medicine, Graduate School of Medicine Teikyo University, Tokyo, Japan.,General Medical Education and Research Center, Teikyo University, Tokyo, Japan.,Teikyo University Institute of Medical Mycology, Tokyo, Japan
| | - Yoshiko Umeda
- Medical Mycology, Space and Environmental Medicine, Graduate School of Medicine Teikyo University, Tokyo, Japan
| | - Aya Komori
- Teikyo University Institute of Medical Mycology, Tokyo, Japan
| | - Takashi Tamura
- Teikyo University Institute of Medical Mycology, Tokyo, Japan
| | - Yayoi Nishiyama
- Teikyo University Institute of Medical Mycology, Tokyo, Japan
| | - Takashi Yamazaki
- Medical Mycology, Space and Environmental Medicine, Graduate School of Medicine Teikyo University, Tokyo, Japan.,General Medical Education and Research Center, Teikyo University, Tokyo, Japan.,Teikyo University Institute of Medical Mycology, Tokyo, Japan.,JEM Utilization Center, Human Spaceflight Technology Directorate, Japan Aerospace Exploration Agency (JAXA), Ibaraki, Japan
| | - Koichi Makimura
- Medical Mycology, Space and Environmental Medicine, Graduate School of Medicine Teikyo University, Tokyo, Japan.,General Medical Education and Research Center, Teikyo University, Tokyo, Japan.,Teikyo University Institute of Medical Mycology, Tokyo, Japan
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Ellie AS, Sun Y, Hou J, Wang P, Zhang Q, Sundell J. Prevalence of Childhood Asthma and Allergies and Their Associations with Perinatal Exposure to Home Environmental Factors: A Cross-Sectional Study in Tianjin, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084131. [PMID: 33919769 PMCID: PMC8070727 DOI: 10.3390/ijerph18084131] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 03/31/2021] [Accepted: 04/06/2021] [Indexed: 11/24/2022]
Abstract
Asthma, rhinitis, and eczema are becoming increasingly prevalent among children in China. Studies have shown that the perinatal period is critical and impacts children’s health. However, research on the associations between perinatal factors and childhood allergic diseases in China are few. We investigated 7366 children of ages 0–8 years old. The childhood asthma and allergies were surveyed by distributing questionnaires, modelled after Dampness in Buildings and Health (DBH) study in Sweden and had been validated. To determine the prevalence of the allergic conditions, explore for potential confounders, and analyze the associations between the allergies and the home environmental factors, chi-square test and binary logistic regression models (enter method) were employed. The prevalence of children’s doctor-diagnosed asthma, rhinitis, and eczema were 4.4%, 9.5%, and 39.1%, respectively. After adjusting for sociodemographic factors, the negative effect of dampness/humidity on children’s health became more obvious, with odd ratios (aORs) of up to 1.70 (95% confidence interval (CI): 1.12–2.57) for doctor-diagnosed asthma (DDA), 2.12 (95% CI: 1.38–3.25) for doctor-diagnosed rhinitis (DDR) and 1.79 (95% CI: 1.46–2.21) for doctor-diagnosed eczema (DDE). With parental smoking, aORs of up to 4.66 (95% CI: 1.99–10.92) for DDA and 1.74 (95%: 1.00–3.02) for DDE. Renovation exhibited aORs of up to 1.67 (95% CI: 1.13–2.47) for DDR. Although they showed no significant associations with some of the health outcomes, contact with animals, in general, were risk factors for the allergic conditions. Generally, the indoor environmental factors around the perinatal period were significant risk factors for the doctor-diagnosed allergic conditions discussed in this study.
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Affiliation(s)
| | - Yuexia Sun
- Correspondence: ; Tel.: +86-022-85356721
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Vornanen-Winqvist C, Järvi K, Andersson MA, Duchaine C, Létourneau V, Kedves O, Kredics L, Mikkola R, Kurnitski J, Salonen H. Exposure to indoor air contaminants in school buildings with and without reported indoor air quality problems. ENVIRONMENT INTERNATIONAL 2020; 141:105781. [PMID: 32417615 DOI: 10.1016/j.envint.2020.105781] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 04/17/2020] [Accepted: 04/30/2020] [Indexed: 06/11/2023]
Abstract
Reported indoor air quality (IAQ) complaints are common even in relatively new or renovated school buildings in Finland. However, detecting the causes for complaints with commonly used indoor air measurements is difficult. This study presents data on perceived and measured IAQ in six comprehensive school buildings in Finland. The aim of this study was to discover the possible differences of perceived and measured IAQ between schools with reported IAQ complaints and schools without reported IAQ complaints. The initial categorisation of schools with ('problematic schools') and without ('comparison schools') complaints was ensured via a validated indoor climate survey and a recently developed online questionnaire, which were completed by 186 teachers and 1268 students from the six schools. IAQ measurements of physical parameters, gaseous pollutants, particulate matter and bioaerosols were conducted in four problematic school buildings (26 classrooms) and two comparison school buildings (12 classrooms). Using air sampling as well as exhaust air filters and classroom settled dust to detect the presence of elevated concentrations of airborne cultivable microbes and pathogenic, toxigenic and mycoparasitic Trichoderma strains were the most indicative methods in distinguishing problematic schools from comparison schools. Other IAQ-related measurements did not detect clear differences between problematic and comparison schools, as the concentration levels were very low. The results indicate that the complaints reported by occupants could have been related to excess moisture or mould problems that had not been found or repaired. Ventilation pressure condition investigations and simultaneous exhaust and supply air filter dust culture should be addressed precisely in future studies.
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Affiliation(s)
| | - Kati Järvi
- Aalto University, Department of Civil Engineering, PO Box 12100, FI-00076 Aalto, Finland
| | - Maria A Andersson
- Aalto University, Department of Civil Engineering, PO Box 12100, FI-00076 Aalto, Finland
| | - Caroline Duchaine
- Université Laval, Département de Biochimie, de Microbiologie et de Bio-informatique, 2325, rue de l'Université, Québec G1V 0A6, Canada; Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, 2725, chemin Sainte-Foy, Québec G1V 4G5, Canada
| | - Valérie Létourneau
- Centre de Recherche de l'Institut Universitaire de Cardiologie et de Pneumologie de Québec, 2725, chemin Sainte-Foy, Québec G1V 4G5, Canada
| | - Orsolya Kedves
- University of Szeged, Faculty of Science and Informatics, Department of Microbiology, Közép fasor 52, H-6726 Szeged, Hungary
| | - László Kredics
- University of Szeged, Faculty of Science and Informatics, Department of Microbiology, Közép fasor 52, H-6726 Szeged, Hungary
| | - Raimo Mikkola
- Aalto University, Department of Civil Engineering, PO Box 12100, FI-00076 Aalto, Finland
| | - Jarek Kurnitski
- Aalto University, Department of Civil Engineering, PO Box 12100, FI-00076 Aalto, Finland; Tallinn University of Technology, Department of Civil Engineering and Architecture, Ehitajate tee 5, 19086 Tallinn, Estonia
| | - Heidi Salonen
- Aalto University, Department of Civil Engineering, PO Box 12100, FI-00076 Aalto, Finland
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Wang J, Pindus M, Janson C, Sigsgaard T, Kim JL, Holm M, Sommar J, Orru H, Gislason T, Johannessen A, Bertelsen RJ, Norbäck D. Dampness, mould, onset and remission of adult respiratory symptoms, asthma and rhinitis. Eur Respir J 2019; 53:13993003.01921-2018. [PMID: 30880288 DOI: 10.1183/13993003.01921-2018] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Accepted: 03/07/2019] [Indexed: 11/05/2022]
Abstract
STUDY QUESTION Is dampness and indoor mould associated with onset and remission of respiratory symptoms, asthma and rhinitis among adults? MATERIALS AND METHODS Associations between dampness, mould and mould odour at home and at work and respiratory health were investigated in a cohort of 11 506 adults from Iceland, Norway, Sweden, Denmark and Estonia. They answered a questionnaire at baseline and 10 years later, with questions on respiratory health, home and work environment. RESULTS Baseline water damage, floor dampness, mould and mould odour at home were associated with onset of respiratory symptoms and asthma (OR 1.23-2.24). Dampness at home during follow-up was associated with onset of respiratory symptoms, asthma and rhinitis (OR 1.21-1.52). Dampness at work during follow-up was associated with onset of respiratory symptoms, asthma and rhinitis (OR 1.31-1.50). Combined dampness at home and at work increased the risk of onset of respiratory symptoms and rhinitis. Dampness and mould at home and at work decreased remission of respiratory symptoms and rhinitis. THE ANSWER TO THE QUESTION Dampness and mould at home and at work can increase onset of respiratory symptoms, asthma and rhinitis, and decrease remission.
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Affiliation(s)
- Juan Wang
- Dept of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden.,These authors contributed equally to this work
| | - Mihkel Pindus
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia.,These authors contributed equally to this work
| | - Christer Janson
- Dept of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Torben Sigsgaard
- Dept of Public Health, Section for Environment, Occupation and Health, Aarhus University, Danish Ramazzini Centre, Aarhus, Denmark
| | - Jeong-Lim Kim
- Occupational and Environmental Medicine, Gothenburg University, Gothenburg, Sweden
| | - Mathias Holm
- Occupational and Environmental Medicine, Gothenburg University, Gothenburg, Sweden
| | - Johan Sommar
- Occupational and Environmental Medicine, Dept of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Hans Orru
- Institute of Family Medicine and Public Health, University of Tartu, Tartu, Estonia.,Occupational and Environmental Medicine, Dept of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | | | - Ane Johannessen
- Centre for International Health, Dept of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Dept of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
| | - Randi J Bertelsen
- Centre for International Health, Dept of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Dept of Occupational Medicine, Haukeland University Hospital, Bergen, Norway.,Dept of Clinical Science, University of Bergen, Bergen, Norway
| | - Dan Norbäck
- Dept of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden
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10
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Yen YC, Yang CY, Mena KD, Cheng YT, Yuan CS, Chen PS. Jumping on the bed and associated increases of PM 10, PM 2.5, PM 1, airborne endotoxin, bacteria, and fungi concentrations. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2019; 245:799-809. [PMID: 30502709 DOI: 10.1016/j.envpol.2018.11.053] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 11/16/2018] [Accepted: 11/17/2018] [Indexed: 06/09/2023]
Abstract
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, PM2.5, 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, PM2.5, 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, PM2.5, 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 PM2.5 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.
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Affiliation(s)
- Yu-Chuan Yen
- Department of Public Health, College of Health Science, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Chun-Yuh Yang
- Department of Public Health, College of Health Science, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Kristina Dawn Mena
- Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, University of Texas Health Science Center at Houston, TX, United States
| | - Yu-Ting Cheng
- Research Center for Environmental Changes, Academia Sinica, Taipei, Taiwan
| | - Chung-Shin Yuan
- Institute of Environmental Engineering, College of Engineering, National Sun Yat-Sen University, Kaohsiung, Taiwan
| | - Pei-Shih Chen
- Department of Public Health, College of Health Science, Kaohsiung Medical University, Kaohsiung City, Taiwan; Institute of Environmental Engineering, College of Engineering, National Sun Yat-Sen University, Kaohsiung, Taiwan; Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan.
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11
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Cummings KJ, Johns DO, Mazurek JM, Hearl FJ, Weissman DN. NIOSH's Respiratory Health Division: 50 years of science and service. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2019; 74:15-29. [PMID: 30501580 PMCID: PMC6490691 DOI: 10.1080/19338244.2018.1532387] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
The year 2017 marked the 50th anniversary of NIOSH's Respiratory Health Division (RHD). RHD began in 1967 as the Appalachian Laboratory for Occupational Respiratory Diseases (ALFORD), with a focus on coal workers' pneumoconiosis. ALFORD became part of NIOSH in 1971 and added activities to address work-related respiratory disease more generally. Health hazard evaluations played an important role in understanding novel respiratory hazards such as nylon flock, diacetyl, and indium-tin oxide. Epidemiologic and laboratory studies addressed many respiratory hazards, including coal mine dust, silica, asbestos, cotton dust, beryllium, diesel exhaust, and dampness and mold. Surveillance activities tracked the burden of diseases and enhanced the quality of spirometry and chest radiography used to screen workers. RHD's efforts to improve scientific understanding, inform strategies for prevention, and disseminate knowledge remain important now and for the future.
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Affiliation(s)
- Kristin J. Cummings
- Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - Doug O. Johns
- Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - Jacek M. Mazurek
- Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - Frank J. Hearl
- Office of the Director, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Washington, DC, USA
| | - David N. Weissman
- Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
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12
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Jaderson M, Park JH. Evaluation of Matrix Effects in Quantifying Microbial Secondary Metabolites in Indoor Dust Using Ultraperformance Liquid Chromatograph-Tandem Mass Spectrometer. Saf Health Work 2018; 10:196-204. [PMID: 31297282 PMCID: PMC6598797 DOI: 10.1016/j.shaw.2018.12.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 11/30/2018] [Accepted: 12/14/2018] [Indexed: 11/25/2022] Open
Abstract
Background Liquid chromatography-tandem mass spectrometry (LC-MSMS) for simultaneous analysis of multiple microbial secondary metabolites (MSMs) is potentially subject to interference by matrix components. Methods We examined potential matrix effects (MEs) in analyses of 31 MSMs using ultraperformance LC-MSMS. Twenty-one dust aliquots from three buildings (seven aliquots/building) were spiked with seven concentrations of each of the MSMs (6.2 pg/μl-900 pg/μl) and then extracted. Another set of 21 aliquots were first extracted and then, the extract was spiked with the same concentrations. We added deepoxy-deoxynivalenol (DOM) to all aliquots as a universal internal standard. Ten microliters of the extract was injected into the ultraperformance LC-MSMS. ME was calculated by subtracting the percentage of the response of analyte in spiked extract to that in neat standard from 100. Spiked extract results were used to create a matrix-matched calibration (MMC) curve for estimating MSM concentration in dust spiked before extraction. Results Analysis of variance was used to examine effects of compound (MSM), building and concentration on response. MEs (range: 63.4%-99.97%) significantly differed by MSM (p < 0.01) and building (p < 0.05). Mean percent recoveries adjusted with DOM and the MMC method were 246.3% (SD = 226.0) and 86.3% (SD = 70.7), respectively. Conclusion We found that dust MEs resulted in substantial underestimation in quantifying MSMs and that DOM was not an optimal universal internal standard for the adjustment but that the MMC method resulted in more accurate and precise recovery compared with DOM. More research on adjustment methods for dust MEs in the simultaneous analyses of multiple MSMs using LC-MSMS is warranted.
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Affiliation(s)
- Mukhtar Jaderson
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - Ju-Hyeong Park
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA
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13
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Green BJ, Couch JR, Lemons AR, Burton NC, Victory KR, Nayak AP, Beezhold DH. Microbial hazards during harvesting and processing at an outdoor United States cannabis farm. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2018; 15:430-440. [PMID: 29370578 PMCID: PMC6314012 DOI: 10.1080/15459624.2018.1432863] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Cannabis cultivation is an emerging industry within the United States. Organic dust derived in part from naturally occurring microorganisms is known to cause byssinosis in the hemp industry. In this pilot study, bacteria and fungi encountered by workers at an outdoor cannabis farm that utilized organic practices were elucidated by 16 S ribosomal RNA (rRNA) and Internal Transcribed Spacer (ITS) region sequencing, respectively. Area (n = 14) and personal air samples (n = 12) were collected during harvesting and processing activities. 16 S rRNA and ITS regions of extracted bacterial and fungal genomic DNA were amplified and sequenced using Sanger sequencing. Bacterial sequencing resolved 1,077 sequences that were clustered into 639 operational taxonomic units (OTUs) and predominantly placed in the phylum, Actinobacteria (46%). Personal air samples revealed higher bacterial and Actinobacteria diversity compared to outdoor area samples collected within the facility (p < 0.05). A high degree of dissimilarity between bacteria was identified within and between samples. Fungal sequences (n = 985) were identified and predominantly clustered in the phylum Ascomycota (53%). Of the 216 fungal OTUs elucidated, the cannabis plant pathogenic species, Botrytis cinerea, was the most prevalent and accounted for 34% of all fungal sequences. The relative abundance of B. cinerea was highest in personal air samples (59%) compared to area samples collected in the drying room (19%), greenhouse (18%), and outdoor environment (6%). There was 49% sample similarity between fungi identified within personal air samples, but higher dissimilarity coefficients were observed within and between greenhouse, drying room, and outdoor area air samples. The results of this pilot study suggest that the cannabis farm workers are potentially exposed to Actinobacteria as well as the cannabis plant pathogen, B. cinerea during harvesting, bud-stripping, and hand-trimming processes.
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Affiliation(s)
- Brett J. Green
- Allergy and Clinical Immunology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
- Corresponding author: Brett J. Green, Allergy and Clinical Immunology Branch, Health Effects Laboratory Branch, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, 1095 Willowdale Road, Morgantown, WV 26505,
| | - James R. Couch
- Hazard Evaluations and Technical Assistance Branch, Division of Surveillance, Hazard Evaluations and Field Studies, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, OH, USA
| | - Angela R. Lemons
- Allergy and Clinical Immunology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - Nancy C. Burton
- Hazard Evaluations and Technical Assistance Branch, Division of Surveillance, Hazard Evaluations and Field Studies, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, OH, USA
| | - Kerton R. Victory
- Office of the Director, Emergency Preparedness and Response Office, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ajay P. Nayak
- Allergy and Clinical Immunology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - Donald H. Beezhold
- Office of the Director, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
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14
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Park JH, Cho SJ, White SK, Cox-Ganser JM. Changes in respiratory and non-respiratory symptoms in occupants of a large office building over a period of moisture damage remediation attempts. PLoS One 2018; 13:e0191165. [PMID: 29324816 PMCID: PMC5764347 DOI: 10.1371/journal.pone.0191165] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 12/31/2017] [Indexed: 11/18/2022] Open
Abstract
There is limited information on the natural history of building occupants’ health in relation to attempts to remediate moisture damage. We examined changes in respiratory and non-respiratory symptoms in 1,175 office building occupants over seven years with multiple remediation attempts. During each of four surveys, we categorized participants using a severity score: 0 = asymptomatic; 1 = mild, symptomatic in the last 12 months, but not frequently in the last 4 weeks; 2 = severe, symptomatic at least once weekly in the last 4 weeks. Building-related symptoms were defined as improving away from the building. We used random intercept models adjusted for demographics, smoking, building tenure, and microbial exposures to estimate temporal changes in the odds of building-related symptoms or severity scores independent of the effect of microbial exposures. Trend analyses of combined mild/severe symptoms showed no changes in the odds of respiratory symptoms but significant improvement in non-respiratory symptoms over time. Separate analyses showed increases in the odds of severe respiratory symptoms (odds ratio/year = 1.15‒1.16, p-values<0.05) and severity scores (0.02/year, p-values<0.05) for wheezing and shortness of breath on exertion, due to worsening of participants in the mild symptom group. For non-respiratory symptoms, we found no changes in the odds of severe symptoms but improvement in severity scores (-0.04‒-0.01/year, p-values<0.05) and the odds for mild fever and chills, excessive fatigue, headache, and throat symptoms (0.65–0.79/year, p-values<0.05). Our study suggests that after the onset of respiratory and severe non-respiratory symptoms associated with dampness/mold, remediation efforts might not be effective in improving occupants’ health.
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Affiliation(s)
- Ju-Hyeong Park
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia, United States of America
- * E-mail:
| | - Sook Ja Cho
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia, United States of America
| | - Sandra K. White
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia, United States of America
| | - Jean M. Cox-Ganser
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia, United States of America
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15
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Vesper S, Cox-Ganser JM, Wymer L, Park JH. Quantification of mold contamination in multi-level buildings using the Environmental Relative Moldiness Index. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2018; 15:38-43. [PMID: 29053934 PMCID: PMC6117826 DOI: 10.1080/15459624.2017.1376069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The goal of this study was to evaluate the possible use of the Environmental Relative Moldiness Index (ERMI) to quantify mold contamination in multi-level, office buildings. Settled-dust samples were collected in multi-level, office buildings and the ERMI value for each sample determined. In the first study, a comparison was made between two identical four-story buildings. There were health complaints in one building but none in the other building. In the second study, mold contamination was evaluated on levels 6-19 of an office building with a history of water problems and health complaints. In the first study, the average ERMI value in the building with health complaints was 5.33 which was significantly greater than the average ERMI value, 0.55, in the non-complaint building. In the second study, the average ERMI values ranged from a low of -0.58 on level 8 to a high of 5.66 on level 17, one of the top five ranked levels for medical symptoms or medication use. The mold populations of ten (six Group 1 and four Group 2) of the 36-ERMI molds were in significantly greater concentrations in the higher compared to lower ERMI environments. The ERMI metric may be useful in the quantification of water-damage and mold growth in multi-level buildings.
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Affiliation(s)
- Stephen Vesper
- National Exposure Research Laboratory (NERL), United States Environmental Protection Agency (US EPA), Cincinnati, Ohio
| | - Jean M. Cox-Ganser
- National Institute for Occupational Safety and Health (NIOSH), Morgantown, West Virginia
| | - Larry Wymer
- National Exposure Research Laboratory (NERL), United States Environmental Protection Agency (US EPA), Cincinnati, Ohio
| | - Ju-Hyeong Park
- National Institute for Occupational Safety and Health (NIOSH), Morgantown, West Virginia
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16
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Lemons AR, Hogan MB, Gault RA, Holland K, Sobek E, Olsen-Wilson KA, Park Y, Park JH, Gu JK, Kashon ML, Green BJ. Microbial rRNA sequencing analysis of evaporative cooler indoor environments located in the Great Basin Desert region of the United States. ENVIRONMENTAL SCIENCE. PROCESSES & IMPACTS 2017; 19:101-110. [PMID: 28091681 PMCID: PMC5450635 DOI: 10.1039/c6em00413j] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Recent studies conducted in the Great Basin Desert region of the United States have shown that skin test reactivity to fungal and dust mite allergens are increased in children with asthma or allergy living in homes with evaporative coolers (EC). The objective of this study was to determine if the increased humidity previously reported in EC homes leads to varying microbial populations compared to homes with air conditioners (AC). Children with physician-diagnosed allergic rhinitis living in EC or AC environments were recruited into the study. Air samples were collected from the child's bedroom for genomic DNA extraction and metagenomic analysis of bacteria and fungi using the Illumina MiSeq sequencing platform. The analysis of bacterial populations revealed no major differences between EC and AC sampling environments. The fungal populations observed in EC homes differed from AC homes. The most prevalent species discovered in AC environments belonged to the genera Cryptococcus (20%) and Aspergillus (20%). In contrast, the most common fungi identified in EC homes belonged to the order Pleosporales and included Alternaria alternata (32%) and Phoma spp. (22%). The variations in fungal populations provide preliminary evidence of the microbial burden children may be exposed to within EC environments in this region.
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Affiliation(s)
- Angela R Lemons
- Allergy and Clinical Immunology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, 1095 Willowdale Road, Morgantown, WV 26505, USA.
| | - Mary Beth Hogan
- Department of Pediatrics, Pediatrics Center, University of Nevada School of Medicine, Las Vegas, NV, USA
| | - Ruth A Gault
- Department of Microbiology and Immunology, Center for Molecular Medicine, University of Nevada School of Medicine, Reno, NV, USA
| | - Kathleen Holland
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | | | - Kimberly A Olsen-Wilson
- Department of Pediatrics, Center for Molecular Medicine, University of Nevada School of Medicine, Reno, NV, USA
| | - Yeonmi Park
- Field Studies Branch, Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - Ju-Hyeong Park
- Field Studies Branch, Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - Ja Kook Gu
- Biostatistics and Epidemiology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - Michael L Kashon
- Biostatistics and Epidemiology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - Brett J Green
- Allergy and Clinical Immunology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, 1095 Willowdale Road, Morgantown, WV 26505, USA.
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17
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Heutte N, André V, Dubos Arvis C, Bouchart V, Lemarié F, Legendre P, Votier E, Louis MY, Madelaine S, Séguin V, Gente S, Vérité P, Garon D. Assessment of multi-contaminant exposure in a cancer treatment center: a 2-year monitoring of molds, mycotoxins, endotoxins, and glucans in bioaerosols. ENVIRONMENTAL MONITORING AND ASSESSMENT 2017; 189:31. [PMID: 28012082 DOI: 10.1007/s10661-016-5751-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Accepted: 12/13/2016] [Indexed: 06/06/2023]
Abstract
Indoor air quality in health care facilities is a major public health concern, particularly for immunocompromised patients who may be exposed to microbiological contaminants such as molds, mycotoxins, endotoxins, and (1,3)-ß-D-glucans. Over 2 years, bioaerosols were collected on a monthly basis in a cancer treatment center (Centre F. Baclesse, Normandy, France), characterized from areas where there was no any particular air treatment. Results showed the complexity of mycoflora in bioaerosols with more than 100 fungal species identified. A list of major strains in hospital environments could be put forward due to the frequency, the concentration level, and/or the capacity to produce mycotoxins in vitro: Aspergillus fumigatus, Aspergillus melleus, Aspergillus niger, Aspergillus versicolor, Cladosporium herbarum, Purpureocillium lilacinum, and Penicillium brevicompactum. The mean levels of viable airborne fungal particles were less than 30.530 CFU per m3 of air and were correlated to the total number of 0.30 to 20 μm particles. Seasonal variations were observed with fungal particle peaks during the summer and autumn. Statistical analysis showed that airborne fungal particle levels depended on the relative humidity level which could be a useful indicator of fungal contamination. Finally, the exposure to airborne mycotoxins was very low (only 3 positive samples), and no mutagenic activity was found in bioaerosols. Nevertheless, some fungal strains such as Aspergillus versicolor or Penicillium brevicompactum showed toxigenic potential in vitro.
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Affiliation(s)
- Natacha Heutte
- CETAPS EA 3832, Normandie Université, UNIROUEN, 76821, Mont Saint Aignan cedex, France
- Centre de Lutte Contre le Cancer François Baclesse, 14076, Caen cedex 05, France
| | - Véronique André
- ABTE EA 4651, Normandie Université, UNICAEN, UNIROUEN, 14000, Caen, France
| | | | | | - Françoise Lemarié
- Centre de Lutte Contre le Cancer François Baclesse, 14076, Caen cedex 05, France
| | | | - Edwige Votier
- ABTE EA 4651, Normandie Université, UNICAEN, UNIROUEN, 14000, Caen, France
| | - Marie-Yolande Louis
- Centre de Lutte Contre le Cancer François Baclesse, 14076, Caen cedex 05, France
| | - Stéphane Madelaine
- Centre de Lutte Contre le Cancer François Baclesse, 14076, Caen cedex 05, France
| | - Virginie Séguin
- ABTE EA 4651, Normandie Université, UNICAEN, UNIROUEN, 14000, Caen, France
| | - Stéphanie Gente
- ABTE EA 4651, Normandie Université, UNICAEN, UNIROUEN, 14000, Caen, France
| | - Philippe Vérité
- ABTE EA 4651, Normandie Université, UNICAEN, UNIROUEN, 14000, Caen, France
| | - David Garon
- ABTE EA 4651, Normandie Université, UNICAEN, UNIROUEN, 14000, Caen, France.
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18
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Park JH, Cox-Ganser JM, White SK, Laney AS, Caulfield SM, Turner WA, Sumner AD, Kreiss K. Bacteria in a water-damaged building: associations of actinomycetes and non-tuberculous mycobacteria with respiratory health in occupants. INDOOR AIR 2017; 27:24-33. [PMID: 26717439 PMCID: PMC5035226 DOI: 10.1111/ina.12278] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 12/23/2015] [Indexed: 05/31/2023]
Abstract
We examined microbial correlates of health outcomes in building occupants with a sarcoidosis cluster and excess asthma. We offered employees a questionnaire and pulmonary function testing and collected floor dust and liquid/sludge from drain tubing traps of heat pumps that were analyzed for various microbial agents. Forty-nine percent of participants reported any symptom reflecting possible granulomatous disease (shortness of breath on exertion, flu-like achiness, or fever and chills) weekly in the last 4 weeks. In multivariate regressions, thermophilic actinomycetes (median = 529 CFU/m2 ) in dust were associated with FEV1 /FVC [coefficient = -2.8 per interquartile range change, P = 0.02], percent predicted FEF25-75% (coefficient = -12.9, P = 0.01), and any granulomatous disease-like symptom [odds ratio (OR) = 3.1, 95% confidence interval (CI) = 1.45-6.73]. Mycobacteria (median = 658 CFU/m2 ) were positively associated with asthma symptoms (OR = 1.5, 95% CI = 0.97-2.43). Composite score (median = 11.5) of total bacteria from heat pumps was negatively associated with asthma (0.8, 0.71-1.00) and positively associated with FEV1 /FVC (coefficient = 0.44, P = 0.095). Endotoxin (median score = 12.0) was negatively associated with two or more granulomatous disease-like symptoms (OR = 0.8, 95% CI = 0.67-0.98) and asthma (0.8, 0.67-0.96). Fungi or (1→3)-β-D-glucan in dust or heat pump traps was not associated with any health outcomes. Thermophilic actinomycetes and non-tuberculous mycobacteria may have played a role in the occupants' respiratory outcomes in this water-damaged building.
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Affiliation(s)
- J-H Park
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - J M Cox-Ganser
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - S K White
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - A S Laney
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA
- Vermont Department of Health, Burlington, VT, USA
| | - S M Caulfield
- Turner Building Science & Design, LLC, Harrison, ME, USA
| | - W A Turner
- Turner Building Science & Design, LLC, Harrison, ME, USA
| | - A D Sumner
- Vermont Department of Health, Burlington, VT, USA
- University of Vermont Health Network Occupational Medicine, Berlin, VT, USA
| | - K Kreiss
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, WV, USA
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Biyeyeme Bi Mve MJ, Cloutier Y, Lacombe N, Lavoie J, Debia M, Marchand G. Comparison of methods to evaluate the fungal biomass in heating, ventilation, and air-conditioning (HVAC) dust. ENVIRONMENTAL MONITORING AND ASSESSMENT 2016; 189:8. [PMID: 27924457 DOI: 10.1007/s10661-016-5682-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 11/07/2016] [Indexed: 06/06/2023]
Abstract
Heating, ventilation, and air-conditioning (HVAC) systems contain dust that can be contaminated with fungal spores (molds), which may have harmful effects on the respiratory health of the occupants of a building. HVAC cleaning is often based on visual inspection of the quantity of dust, without taking the mold content into account. The purpose of this study is to propose a method to estimate fungal contamination of dust in HVAC systems. Comparisons of different analytical methods were carried out on dust deposited in a controlled-atmosphere exposure chamber. Sixty samples were analyzed using four methods: culture, direct microscopic spore count (DMSC), β-N-acetylhexosaminidase (NAHA) dosing and qPCR. For each method, the limit of detection, replicability, and repeatability were assessed. The Pearson correlation coefficients between the methods were also evaluated. Depending on the analytical method, mean spore concentrations per 100 cm2 of dust ranged from 10,000 to 682,000. Limits of detection varied from 120 to 217,000 spores/100 cm2. Replicability and repeatability were between 1 and 15%. Pearson correlation coefficients varied from -0.217 to 0.83. The 18S qPCR showed the best sensitivity and precision, as well as the best correlation with the culture method. PCR targets only molds, and a total count of fungal DNA is obtained. Among the methods, mold DNA amplification by qPCR is the method suggested for estimating the fungal content found in dust of HVAC systems.
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Affiliation(s)
- Marie-Jeanne Biyeyeme Bi Mve
- Institut de recherche Robert-Sauvé en santé et sécurité du travail, 505 Boul. de Maisonneuve Ouest, Montréal, H3A3C2, Canada
- Département de santé environnementale et santé au travail, École de santé publique, Université de Montréal, Pavillon Marguerite d'Youville, 2375 Chemin de la côte Ste-Catherine, Montréal, H3T 1A8, Canada
| | - Yves Cloutier
- Institut de recherche Robert-Sauvé en santé et sécurité du travail, 505 Boul. de Maisonneuve Ouest, Montréal, H3A3C2, Canada
| | - Nancy Lacombe
- Institut de recherche Robert-Sauvé en santé et sécurité du travail, 505 Boul. de Maisonneuve Ouest, Montréal, H3A3C2, Canada
| | - Jacques Lavoie
- Institut de recherche Robert-Sauvé en santé et sécurité du travail, 505 Boul. de Maisonneuve Ouest, Montréal, H3A3C2, Canada
- Département de santé environnementale et santé au travail, École de santé publique, Université de Montréal, Pavillon Marguerite d'Youville, 2375 Chemin de la côte Ste-Catherine, Montréal, H3T 1A8, Canada
| | - Maximilien Debia
- Département de santé environnementale et santé au travail, École de santé publique, Université de Montréal, Pavillon Marguerite d'Youville, 2375 Chemin de la côte Ste-Catherine, Montréal, H3T 1A8, Canada
| | - Geneviève Marchand
- Institut de recherche Robert-Sauvé en santé et sécurité du travail, 505 Boul. de Maisonneuve Ouest, Montréal, H3A3C2, Canada.
- Département de santé environnementale et santé au travail, École de santé publique, Université de Montréal, Pavillon Marguerite d'Youville, 2375 Chemin de la côte Ste-Catherine, Montréal, H3T 1A8, Canada.
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Cox-Ganser JM. Indoor dampness and mould health effects - ongoing questions on microbial exposures and allergic versus nonallergic mechanisms. Clin Exp Allergy 2016; 45:1478-82. [PMID: 26372722 DOI: 10.1111/cea.12601] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- J M Cox-Ganser
- Division of Respiratory Disease Studies, National Institute for Occupational Health, Morgantown, WV, USA
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21
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Cho SJ, Cox-Ganser JM, Park JH. Observational scores of dampness and mold associated with measurements of microbial agents and moisture in three public schools. INDOOR AIR 2016; 26:168-78. [PMID: 25650175 PMCID: PMC4526443 DOI: 10.1111/ina.12191] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Accepted: 01/27/2015] [Indexed: 05/06/2023]
Abstract
We examined associations between observational dampness scores and measurements of microbial agents and moisture in three public schools. A dampness score was created for each room from 4-point-scale scores (0-3) of water damage, water stains, visible mold, moldy odor, and wetness for each of 8 room components (ceiling, walls, windows, floor, ventilation, furniture, floor trench, and pipes), when present. We created mixed microbial exposure indices (MMEIs) for each of 121 rooms by summing decile ranks of 8 analytes (total culturable fungi; total, Gram-negative, and Gram-positive culturable bacteria; ergosterol; (1→3)-β-D-glucan; muramic acid; and endotoxin) in floor dust. We found significant (P ≤ 0.01) linear associations between the dampness score and culturable bacteria (total, Gram-positive, and Gram-negative) and the MMEIs. Rooms with dampness scores greater than 0.25 (median) had significantly (P < 0.05) higher levels of most microbial agents, MMEIs, and relative moisture content than those with lower scores (≤0.25). Rooms with reported recent water leaks had significantly (P < 0.05) higher dampness scores than those with historical or no reported water leaks. This study suggests that observational assessment of dampness and mold using a standardized form may be valuable for identifying and documenting water damage and associated microbial contamination.
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Affiliation(s)
- S J Cho
- Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - J M Cox-Ganser
- Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - J-H Park
- Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Morgantown, WV, USA
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22
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Saito R, Park JH, LeBouf R, Green BJ, Park Y. Measurement of macrocyclic trichothecene in floor dust of water-damaged buildings using gas chromatography/tandem mass spectrometry-dust matrix effects. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2016; 13:442-450. [PMID: 26853932 PMCID: PMC5497306 DOI: 10.1080/15459624.2016.1143951] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Gas chromatography-tandem mass spectrometry (GC-MS/MS) was used to detect fungal secondary metabolites. Detection of verrucarol, the hydrolysis product of Stachybotrys chartarum macrocyclic trichothecene (MCT), was confounded by matrix effects associated with heterogeneous indoor environmental samples. In this study, we examined the role of dust matrix effects associated with GC-MS/MS to better quantify verrucarol in dust as a measure of total MCT. The efficiency of the internal standard (ISTD, 1,12-dodecanediol), and application of a matrix-matched standard correction method in measuring MCT in floor dust of water-damaged buildings was additionally examined. Compared to verrucarol, ISTD had substantially higher matrix effects in the dust extracts. The results of the ISTD evaluation showed that without ISTD adjustment, there was a 280% ion enhancement in the dust extracts compared to neat solvent. The recovery of verrucarol was 94% when the matrix-matched standard curve without the ISTD was used. Using traditional calibration curves with ISTD adjustment, none of the 21 dust samples collected from water damaged buildings were detectable. In contrast, when the matrix-matched calibration curves without ISTD adjustment were used, 38% of samples were detectable. The study results suggest that floor dust of water-damaged buildings may contain MCT. However, the measured levels of MCT in dust using the GC-MS/MS method could be significantly under- or overestimated, depending on the matrix effects, the inappropriate ISTD, or combination of the two. Our study further shows that the routine application of matrix-matched calibration may prove useful in obtaining accurate measurements of MCT in dust derived from damp indoor environments, while no isotopically labeled verrucarol is available.
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Affiliation(s)
- Rena Saito
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia
- Occupational Health Sciences, University of Texas Health Science Center at Tyler, Tyler, Texas
| | - Ju-Hyeong Park
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia
| | - Ryan LeBouf
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia
| | - Brett J. Green
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia
| | - Yeonmi Park
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia
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Karunanayake CP, Hagel L, Rennie DC, Lawson JA, Dosman JA, Pahwa P, the Saskatchewan Rural Health Study. Prevalence and Risk Factors of Respiratory Symptoms in Rural Population. J Agromedicine 2015; 20:310-7. [DOI: 10.1080/1059924x.2015.1042613] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Lim FL, Hashim Z, Than LTL, Md Said S, Hisham Hashim J, Norbäck D. Asthma, Airway Symptoms and Rhinitis in Office Workers in Malaysia: Associations with House Dust Mite (HDM) Allergy, Cat Allergy and Levels of House Dust Mite Allergens in Office Dust. PLoS One 2015; 10:e0124905. [PMID: 25923543 PMCID: PMC4414577 DOI: 10.1371/journal.pone.0124905] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2014] [Accepted: 03/08/2015] [Indexed: 11/18/2022] Open
Abstract
A prevalence study was conducted among office workers in Malaysia (N= 695). The aim of this study was to examine associations between asthma, airway symptoms, rhinitis and house dust mites (HDM) and cat allergy and HDM levels in office dust. Medical data was collected by a questionnaire. Skin prick tests were performed for HDM allergens (Dermatophagoides pteronyssinus, Dermatophagoides farinae) and cat allergen Felis domesticus. Indoor temperature and relative air humidity (RH) were measured in the offices and vacuumed dust samples were analyzed for HDM allergens. The prevalence of D. pteronyssinus, D. farinae and cat allergy were 50.3%, 49.0% and 25.5% respectively. Totally 9.6% had doctor-diagnosed asthma, 15.5% had current wheeze and 53.0% had current rhinitis. The Der p 1 (from D. pteronyssinus) and Der f 1 (from D. farinae) allergens levels in dust were 556 ng/g and 658 ng/g respectively. Statistical analysis was conducted by multilevel logistic regression, adjusting for age, gender, current smoking, HDM or cat allergy, home dampness and recent indoor painting at home. Office workers with HDM allergy had more wheeze (p= 0.035), any airway symptoms (p= 0.032), doctor-diagnosed asthma (p= 0.005), current asthma (p= 0.007), current rhinitis (p= 0.021) and rhinoconjuctivitis (p< 0.001). Cat allergy was associated with wheeze (p= 0.021), wheeze when not having a cold (p= 0.033), any airway symptoms (p= 0.034), doctor-diagnosed asthma (p= 0.010), current asthma (p= 0.020) and nasal allergy medication (p= 0.042). Der f 1 level in dust was associated with daytime breathlessness (p= 0.033) especially among those with HDM allergy. Der f 1 levels were correlated with indoor temperature (p< 0.001) and inversely correlated with RH (p< 0.001). In conclusion, HDM and cat allergies were common and independently associated with asthma, airway symptoms and rhinitis. Der f 1 allergen can be a risk factor for daytime breathlessness.
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Affiliation(s)
- Fang Lee Lim
- Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM, Serdang, Selangor, Malaysia
| | - Zailina Hashim
- Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM, Serdang, Selangor, Malaysia
- * E-mail:
| | - Leslie Thian Lung Than
- Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM, Serdang, Selangor, Malaysia
| | - Salmiah Md Said
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM, Serdang, Selangor, Malaysia
| | - Jamal Hisham Hashim
- United Nations University-International Institute for Global Health (UNU-IIGH), Kuala Lumpur, Malaysia
- Department of Community Health, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Dan Norbäck
- Uppsala University, Department of Medical Science, Occupational and Environmental Medicine, University Hospital, Uppsala, Sweden
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Johansson E, Reponen T, Meller J, Vesper S, Yadav J. Association of Streptomyces community composition determined by PCR-denaturing gradient gel electrophoresis with indoor mold status. ENVIRONMENTAL MONITORING AND ASSESSMENT 2014; 186:8773-83. [PMID: 25331035 PMCID: PMC4255558 DOI: 10.1007/s10661-014-4071-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Accepted: 09/01/2014] [Indexed: 05/31/2023]
Abstract
Both Streptomyces species and mold species have previously been isolated from moisture-damaged building materials; however, an association between these two groups of microorganisms in indoor environments is not clear. In this study, we used a culture-independent method, PCR-denaturing gradient gel electrophoresis (PCR-DGGE), to investigate the composition of the Streptomyces community in house dust. Twenty-three dust samples each from two sets of homes categorized as high-mold and low-mold based on mold-specific quantitative PCR analysis were used in the study. Taxonomic identification of prominent bands was performed by cloning and sequencing. Associations between DGGE amplicon band intensities and home mold status were assessed using univariate analyses as well as multivariate recursive partitioning (decision trees) to test the predictive value of combinations of bands intensities. In the final classification tree, a combination of two bands was significantly associated with mold status of the home (p = 0.001). The sequence corresponding to one of the bands in the final decision tree matched a group of Streptomyces species that included Streptomyces coelicolor and Streptomyces sampsonii, both of which have been isolated from moisture-damaged buildings previously. The closest match for the majority of sequences corresponding to a second band consisted of a group of Streptomyces species that included Streptomyces hygroscopicus, an important producer of antibiotics and immunosuppressors. Taken together, the study showed that DGGE can be a useful tool for identifying bacterial species that may be more prevalent in mold-damaged buildings.
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Affiliation(s)
- Elisabet Johansson
- Department of Environmental Health, University of Cincinnati College of Medicine, P.O. Box 670056, 160 Panzeca Way, Cincinnati, OH, 45267-0056, USA,
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26
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Pollutions à l’intérieur des espaces clos : sources, niveaux et impact sanitaire. Volet 1 : contaminants biologiques. ARCH MAL PROF ENVIRO 2014. [DOI: 10.1016/j.admp.2014.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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27
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Kreiss K. Dampness and mould in schools and respiratory symptoms. Occup Environ Med 2013; 70:679-80. [PMID: 23940192 DOI: 10.1136/oemed-2013-101641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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28
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Cho SJ, Cox-Ganser JM, Kreiss K, Park JH. Evaluation of individual-based and group-based exposure estimation of microbial agents in health effects associated with a damp building. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2013; 23:409-415. [PMID: 22968350 DOI: 10.1038/jes.2012.89] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2012] [Accepted: 06/13/2012] [Indexed: 06/01/2023]
Abstract
We evaluated attenuation in linear associations between microbial exposure and respiratory symptoms occurring when individual measurements of microbial agents were used for estimating employees' exposure compared with group means. Symptoms, which improved when away from the building (building-related, BR), and measurements of culturable fungi, ergosterol, and endotoxin in floor dust were obtained between 2001 and 2007 from four cross-sectional studies on occupants of a water-damaged building. We compared odds ratios from longitudinal health effect models using individual measurements at employees' workstations with those using floor (group) means. Estimated odds for BR respiratory symptoms in group-based analyses increased by 2 to 5 times compared with those from individual-based analyses for culturable fungi and ergosterol, although they were less precise. For endotoxin, we found substantially increased and significant odds in group-based analyses, while we found no associations in individual-based analyses for various symptoms. Our study suggested that the building floor was useful in constructing exposure groups for microbial agents in this water-damaged building for epidemiologic analysis. Our study showed that group-average exposure estimation provides less attenuated associations between exposures to microbial agents and health in damp indoor environments where measurement error and intrinsic temporal variability are often large.
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Affiliation(s)
- Sook Ja Cho
- Field Studies Branch, Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
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Akpinar-Elci M, White SK, Siegel PD, Park JH, Visotcky A, Kreiss K, Cox-Ganser JM. Markers of upper airway inflammation associated with microbial exposure and symptoms in occupants of a water-damaged building. Am J Ind Med 2013; 56:522-30. [PMID: 23390064 DOI: 10.1002/ajim.22165] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2013] [Indexed: 11/12/2022]
Abstract
BACKGROUND Water damage in buildings has been associated with reports of upper airway inflammation among occupants. METHODS This survey included a questionnaire, allergen skin testing, nasal nitric oxide, and nasal lavage on 153 participants. We conducted exposure assessments of 297 workstations and analyzed collected dust for fungi, endotoxin, and (1 → 3)-β-D-glucan to create floor-specific averages. RESULTS Males had higher levels of nasal inflammatory markers, and females reported more symptoms. ECP, IL-8, and MPO were significantly associated with nasal symptoms, flu-like achiness, or chills. Fungi and glucan were positively associated with blowing out thick mucus. Endotoxin was significantly associated with ECP in overall models, and with ECP, IL-8, MPO, and neutrophils among non-atopic females. CONCLUSIONS In this study, we documented an association between endotoxin and nasal inflammatory markers among office workers. The results of our study suggest that a non-allergic response may contribute to symptoms occurring among occupants in this water-damaged building.
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Affiliation(s)
| | - Sandra K. White
- Division of Respiratory Disease Studies; National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention; Morgantown, WV
| | - Paul D. Siegel
- Health Effects Laboratory Division; National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention; Morgantown, WV
| | - Ju-Hyeong Park
- Division of Respiratory Disease Studies; National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention; Morgantown, WV
| | - Alexis Visotcky
- Division of Respiratory Disease Studies; National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention; Morgantown, WV
| | - Kathleen Kreiss
- Division of Respiratory Disease Studies; National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention; Morgantown, WV
| | - Jean M. Cox-Ganser
- Division of Respiratory Disease Studies; National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention; Morgantown, WV
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Young SH, Wolfarth MG, Roberts JR, Kashon ML, Antonini JM. Adjuvant effect of zymosan after pulmonary treatment in a mouse ovalbumin allergy model. Exp Lung Res 2013; 39:48-57. [PMID: 23282019 DOI: 10.3109/01902148.2012.749960] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
An association has been observed between indoor mold contamination and lung allergy and asthma. This relationship is not fully understood. 1→3-β-Glucan is the major cell wall component of fungi and a good marker of fungi exposure. The objective was to evaluate the adjuvant effect of zymosan, a crude yeast cell wall preparation of 1→3-β-glucan, during ovalbumin (OVA) sensitization in an allergy model. BALB/c mice were sensitized by pharyngeal aspiration with saline, 50 μg of OVA, or OVA with 1, 10, 50, or 75 μg of zymosan on days 0, 7, and 14. One week after sensitization, each sensitized animal group was challenged with an aspiration dose of 50 μg of OVA once a week for 2 weeks. At 1 day after the last aspiration, bronchoalveolar lavage fluid and blood was collected, and markers of lung allergy and inflammation were assessed. An adjuvant effect of zymosan on OVA allergy during sensitization was observed as indicated by significant elevations in lung eosinophils, serum OVA-specific IgE, and lung IL-5 in the groups sensitized with zymosan and OVA. Pulmonary treatment with zymosan also amplified lung inflammation. Elevations were observed in lung neutrophils, TNF-α, and parameters of lung injury in the groups primed with both zymosan and OVA. In nearly all parameters, a non-linear dose-response relationship was observed in the groups primed with OVA and zymosan. The optimum adjuvant dose of zymosan was 10 μg. This study demonstrated an adjuvant effect of zymosan when exposures occurred during the sensitization phase in an OVA-induced allergy model in BALB/c mice.
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Affiliation(s)
- Shih-Houng Young
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
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31
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Park JH, Kreiss K, Cox-Ganser JM. Rhinosinusitis and mold as risk factors for asthma symptoms in occupants of a water-damaged building. INDOOR AIR 2012; 22:396-404. [PMID: 22385263 DOI: 10.1111/j.1600-0668.2012.00775.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
UNLABELLED Mold exposure in damp buildings is associated with both nasal symptoms and asthma development, but the progression of building-related (BR) rhinosinusitis symptoms to asthma is unstudied. We examined the risk of developing BR-asthma symptoms in relation to prior BR-rhinosinusitis symptoms and microbial exposure among occupants of a damp building. We conducted four cross-sectional health and environmental surveys among occupants of a 20-story water-damaged office building. We defined BR-rhinosinusitis symptom (N=131) and comparison (N=361) groups from participants' first questionnaire responses. We compared the odds for the development of BR-asthma symptoms between these two groups over the subsequent surveys, using logistic regression models adjusted for demographics, smoking, building tenure, and first-survey exposures to fungi, endotoxin, and ergosterol. The BR-rhinosinusitis symptom group had higher odds for developing BR-asthma symptoms [odds ratio (OR)=2.2; 95% confidence interval (CI)=1.3-3.6] in any subsequent survey compared to those without BR-rhinosinusitis symptoms. The BR-rhinosinusitis symptom group with higher fungal exposure within the building had an OR of 7.4 (95% CI=2.8-19.9) for developing BR-asthma symptoms, compared to the lower fungal exposure group without BR-rhinosinusitis symptoms. Our findings suggest that rhinosinusitis associated with occupancy of water-damaged buildings may be a sentinel for increased risk for asthma onset in such buildings. PRACTICAL IMPLICATIONS Exposure to mold is associated with the development of asthma in damp building occupants, and rhinitis is known to be a risk factor for asthma. However, there is little information about the degree of risk for the progression of rhinosinusitis to asthma owing to mold exposures in damp buildings. Our study of damp building occupants demonstrates that building-related (BR) rhinosinusitis symptoms were a risk factor for the development of BR asthma symptoms and that exposure to mold (fungi) or other dampness-related agents augments risk for the development of BR asthma symptoms among those with BR rhinosinusitis symptoms. Our findings suggest that occurrence of BR upper respiratory illness in water-damaged buildings may presage future endemic asthma.
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Affiliation(s)
- J-H Park
- National Institute for Occupational Safety and Health, Division of Respiratory Disease Studies, Morgantown, WV 26505-5820, USA.
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Predictors of respiratory symptoms in a rural Canadian population: A longitudinal study of respiratory health. Can Respir J 2012; 18:149-53. [PMID: 21766078 DOI: 10.1155/2011/838703] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Predictors of new and long-term respiratory symptoms for rural residents are not well defined. OBJECTIVE To identify early predictors of respiratory symptoms in a rural community population. METHODS The study population consisted of 871 adults living in the rural community of Humboldt, Saskatchewan, who participated in two cross-sectional respiratory studies conducted in 1993 and 2003. Questionnaire information obtained at both time points included respiratory symptoms (cough, phlegm and wheeze), history of allergy, smoking, and information regarding home and farm environments. Transitional modelling, in which measurement in a longitudinal sequence is described as a function of previous outcomes, was used to predict later outcomes of cough, phlegm and wheeze. Asymptomatic individuals in 1993 were assessed to determine factors associated with the development of symptoms during the study period. RESULTS The prevalences of cough, phlegm and wheeze in 1993 were 16.1%, 18.1% and 25.5%, respectively. Change in symptoms over time was significant for cough, phlegm and wheeze. The adjusted ORs (95% CI) from separate transitional models for each respiratory outcome in 1993 that predicted the same symptom in 2003 were 6.32 (4.02 to 9.95) for cough, 14.36 (9.01 to 22.89) for phlegm and 6.40 (4.40 to 9.32) for wheeze. For asymptomatic individuals in 1993, home dampness, allergic reaction to inhaled allergens and cigarette smoking were major risk factors associated with respiratory symptoms that were reported in 2003. CONCLUSION The presence of previous respiratory symptoms, allergies and environmental exposures can predict the occurrence of future respiratory symptoms in adults.
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Keall MD, Crane J, Baker MG, Wickens K, Howden-Chapman P, Cunningham M. A measure for quantifying the impact of housing quality on respiratory health: a cross-sectional study. Environ Health 2012; 11:33. [PMID: 22583775 PMCID: PMC3410778 DOI: 10.1186/1476-069x-11-33] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2011] [Accepted: 05/14/2012] [Indexed: 05/22/2023]
Abstract
BACKGROUND Damp and mould in homes have been established as risk factors for respiratory health. There is a need for a relatively straightforward assessment of the home that quantifies this risk. METHODS Using data from 891 New Zealand houses, the utility of a Respiratory Hazard Index quantifying key attributes related to damp and mould was tested by studying its associations with self-reported respiratory symptoms. RESULTS A dose-response relationship was found whereby each unit increase in the Respiratory Hazard Index was associated with an 11% increase in the odds of at least one episode of wheezing/whistling in the chest over the last 12 months (relative odds of 1.11 with a 95% CI 1.04%-1.20%). An 11% increase in the odds of an asthma attack over the last 12 months was estimated (relative odds of 1.11 with a 95% CI 1.01%-1.22%). These estimates were adjusted for household crowding levels, age, sex and smoking status. There was suggestive evidence of more steeply increasing odds of respiratory symptoms with increasing levels of the Respiratory Hazard Index for children aged under 7. In the worst performing houses according to the Index, a 33% reduction in the number of people experiencing respiratory symptoms (relative risk 0.67 with 95% CI 0.53 to 0.85) could be expected if people were housed in the best performing houses. CONCLUSIONS This study showed that increased evidence of housing conditions supporting dampness and mould was associated with increased odds of respiratory symptoms. A valid housing assessment tool can provide a rational basis for investment in improved housing quality to improve respiratory health.
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Affiliation(s)
- Michael D Keall
- He Kainga Oranga/Housing and Health Research Programme, Department of Public Health, University of Otago, PO Box 7343, Wellington South, New Zealand
| | - Julian Crane
- Wellington Asthma Research Group, Department of Medicine, University of Otago, Wellington, New Zealand
| | - Michael G Baker
- He Kainga Oranga/Housing and Health Research Programme, Department of Public Health, University of Otago, PO Box 7343, Wellington South, New Zealand
| | - Kristin Wickens
- Wellington Asthma Research Group, Department of Medicine, University of Otago, Wellington, New Zealand
| | - Philippa Howden-Chapman
- He Kainga Oranga/Housing and Health Research Programme, Department of Public Health, University of Otago, PO Box 7343, Wellington South, New Zealand
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Rittenour WR, Park JH, Cox-Ganser JM, Beezhold DH, Green BJ. Comparison of DNA extraction methodologies used for assessing fungal diversity via ITS sequencing. JOURNAL OF ENVIRONMENTAL MONITORING : JEM 2012; 14:766-74. [PMID: 22230933 PMCID: PMC4685454 DOI: 10.1039/c2em10779a] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Traditional methods of assessing fungal exposure have been confounded by a number of limiting variables. The recent utilization of molecular methods such as internal transcribed spacer (ITS) sequencing of ribosomal RNA genes has provided improved insight into the diversity of fungal bioaerosols in indoor, outdoor and occupational environments. However, ITS analyses may also be confounded by a number of methodological limitations. In this study, we have optimized this technology for use in occupational or environmental studies. Three commonly used DNA extraction methodologies (UltraClean Soil kit, High Pure PCR Template kit, and EluQuik/DNeasy kit) were compared in terms of sensitivity and susceptibility to PCR inhibitors in dust for three common fungal bioaerosols, Aspergillus versicolor, Rhizopus microsporus and Wallemia sebi. Environmental dust samples were then studied using each extraction methodology and results were compared to viable culture data. The extraction methods differed in terms of their ability to efficiently extract DNA from particular species of fungi (e.g. Aspergillus versicolor). In addition, the ability to remove PCR inhibitors from dust samples was most effective using the soil DNA extraction kit. The species composition varied greatly between ITS clone libraries generated with the different DNA extraction kits. However, compared to viable culture data, ITS clone libraries included additional fungal species that are incapable of growth on solid culture medium. Collectively, our data indicated that DNA extraction methodologies used in ITS sequencing studies of occupational or environmental dust samples can greatly influence the fungal species that are detected.
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Affiliation(s)
- William R. Rittenour
- Allergy and Clinical Immunology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, 1095 Willowdale Rd., Morgantown, West Virginia, USA. ; Tel: +1 304-285-5721 ext 7
| | - Ju-Hyeong Park
- Field Studies Branch, Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - Jean M. Cox-Ganser
- Field Studies Branch, Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - Donald H. Beezhold
- Allergy and Clinical Immunology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, 1095 Willowdale Rd., Morgantown, West Virginia, USA. ; Tel: +1 304-285-5721 ext 7
| | - Brett J. Green
- Allergy and Clinical Immunology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, 1095 Willowdale Rd., Morgantown, West Virginia, USA. ; Tel: +1 304-285-5721 ext 7
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Simoni M, Cai GH, Norback D, Annesi-Maesano I, Lavaud F, Sigsgaard T, Wieslander G, Nystad W, Canciani M, Viegi G, Sestini P. Total viable molds and fungal DNA in classrooms and association with respiratory health and pulmonary function of European schoolchildren. Pediatr Allergy Immunol 2011; 22:843-52. [PMID: 22122789 DOI: 10.1111/j.1399-3038.2011.01208.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Indoor molds are associated with adverse respiratory effects in children. Although schools are important exposure sources of molds, objective measurements were more often taken in homes. Our aim was to assess indoor molds in schools and related effects on schoolchildren health. The Health Effects of the School Environment study (HESE) included 21 schools (46 classrooms) in Italy, Denmark, Sweden, Norway, and France and 654 schoolchildren (mean age 10 yr). Information on schoolchildren was collected by standardized questionnaires. Measurements of total viable molds (VM, colony-forming units, cfu/m(3)) and total/specific fungal DNA (cell equivalents, CE/g dust) were taken inside all classrooms in the cold season during normal activities, using the same standardized methodology. Pulmonary function tests were performed on 244 pupils. VM (mean, 320,cfu/m(3)) and total fungal DNA (geometric mean, 2.2 × 10(5) ± 2.1 CE/g dust) were detectable in all classrooms. The levels were significantly higher in buildings with mold/dampness problems. VM, but not fungal DNA, were inversely related to ventilation rate. VM exceeded the maximum standard of 300 cfu/m(3) in 33% of the classrooms. In the past 12 months, dry cough at night (34%) and rhinitis (32%) were the mostly reported. Children exposed to VM levels ≥ 300 cfu/m(3), compared with those exposed to lower levels, showed higher risk for past year dry cough at night (odds ratio, OR: 3.10, 95% confidence interval, CI: 1.61-5.98) and rhinitis (OR: 2.86, 95% CI: 1.65-4.95), as well as for persistent cough (OR: 3.79, 95% CI: 2.40-5.60). Aspergillus/Penicillium DNA was significantly positively associated with wheeze, and Aspergillus versicolor DNA with wheeze, rhinitis, and cough. There were significant inverse associations of Aspergillus versicolor DNA with forced vitality capacity (FVC) and Streptomyces DNA with both FEV(1) and FVC. In conclusion, indoor VM and fungal DNA were commonly found in monitored European schools and adversely related to respiratory health. Schools should be routinely tested through both culturable and non-culturable methods for global indoor molds' evaluation.
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Affiliation(s)
- Marzia Simoni
- Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa, Italy.
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Cho SJ, Park JH, Kreiss K, Cox-Ganser JM. Levels of microbial agents in floor dust during remediation of a water-damaged office building. INDOOR AIR 2011; 21:417-426. [PMID: 21545528 DOI: 10.1111/j.1600-0668.2011.00722.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
UNLABELLED We examined the effects of remediation on loads of culturable fungi in floor dust collected from a large water-damaged office building during four cross-sectional surveys (2002, 2004, 2005, and 2007, respectively). We created a binary remediation variable for each year for each sampled workstation using information on remediation associated with water damage obtained from building management and used generalized linear mixed-effects models. We found significantly lower levels of culturable total and hydrophilic fungi at remediated workstations than at non-remediated workstations in 2004 and 2005 after completion of major remediation. The remediation effect, however, disappeared in 2007. The fraction of hydrophilic to total fungal concentrations was lowest in 2004, increased in 2005, and was highest in 2007. Our results indicate that the 2003 remediation lowered dust indices of dampness temporarily, but remediation was incomplete, consistent with a building assessment report of water infiltration. This study demonstrates the utility of longitudinal evaluation of microbial indices during remediation of water damage in this building, in which elimination of sources of moisture was not fully addressed. Our findings indicate that the fraction of hydrophilic fungi derived from concentrations of fungal species may be a useful index for assessing the long-term effectiveness of remediation. PRACTICAL IMPLICATIONS This study demonstrates the utility of longitudinal evaluation of microbial indices during remediation of water damage in this building, in which elimination of sources of moisture was incomplete. Our findings indicate that the fraction of hydrophilic fungi derived from concentrations of fungal species may be a useful index for assessing the long-term effectiveness of remediation.
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Affiliation(s)
- S J Cho
- Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Morgantown, WV 26505, USA
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Täubel M, Sulyok M, Vishwanath V, Bloom E, Turunen M, Järvi K, Kauhanen E, Krska R, Hyvärinen A, Larsson L, Nevalainen A. Co-occurrence of toxic bacterial and fungal secondary metabolites in moisture-damaged indoor environments. INDOOR AIR 2011; 21:368-375. [PMID: 21585551 DOI: 10.1111/j.1600-0668.2011.00721.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
UNLABELLED Toxic microbial secondary metabolites have been proposed to be related to adverse health effects observed in moisture-damaged buildings. Initial steps in assessing the actual risk include the characterization of the exposure. In our study, we applied a multi-analyte tandem mass spectrometry-based methodology on sample materials of severely moisture-damaged homes, aiming to qualitatively and quantitatively describe the variety of microbial metabolites occurring in building materials and different dust sample types. From 69 indoor samples, all were positive for at least one of the 186 analytes targeted and as many as 33 different microbial metabolites were found. For the first time, the presence of toxic bacterial metabolites and their co-occurrence with mycotoxins were shown for indoor samples. The bacterial compounds monactin, nonactin, staurosporin and valinomycin were exclusively detected in building materials from moist structures, while chloramphenicol was particularly prevalent in house dusts, including settled airborne dust. These bacterial metabolites are highly bioactive compounds produced by Streptomyces spp., a group of microbes that is considered a moisture damage indicator in indoor environments. We show that toxic bacterial metabolites need to be considered as being part of very complex and diverse microbial exposures in 'moldy' buildings. PRACTICAL IMPLICATIONS Bacterial toxins co-occur with mycotoxins in moisture-damaged indoor environments. These compounds are measurable also in settled airborne dust, indicating that inhalation exposure takes place. In attempts to characterize exposures to microbial metabolites not only mycotoxins but also bacterial metabolites have to be targeted by the analytical methods applied. We recommend including analysis of samples of outdoor air in the course of future indoor assessments, in an effort to better understand the outdoor contribution to the indoor presence of microbial toxins. There is a need for a sound risk assessment concerning the exposure to indoor microbial toxins at concentrations detectable in moisture-damaged indoor environments.
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Affiliation(s)
- M Täubel
- Department of Environmental Health, National Institute for Health and Welfare, Kuopio, Finland.
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Johansson E, Vesper S, Levin L, LeMasters G, Grinshpun S, Reponen T. Streptomycetes in house dust: associations with housing characteristics and endotoxin. INDOOR AIR 2011; 21:300-10. [PMID: 21204988 PMCID: PMC3097268 DOI: 10.1111/j.1600-0668.2010.00702.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
In addition to mold, indoor bioaerosols also contain bacterial components that may have implications for human health. Endotoxin is a cell wall component in Gram-negative bacteria present at varying levels indoors that has been found to have respiratory health implications. Streptomyces is a large genus of Gram-positive bacteria, and some species have been shown to produce inflammatory reactions in vitro and in vivo. The aim of this study was to determine predictors of streptomycetes levels in house dust and to compare the variation in streptomycetes levels with that in endotoxin levels. Dust was collected by floor vacuuming from 178 homes in the Cincinnati metropolitan area. Streptomycetes levels were measured by quantitative PCR, and endotoxin was assayed by the Limulus amebocyte lysate method. Associations between home characteristics and bacterial contaminants, expressed as concentration and load, were investigated through multiple regression analyses. The presence of two or more dogs was a strong predictor of both streptomycetes and endotoxin levels. Season of dust collection and levels of outdoor molds were predictors of streptomycetes but not endotoxin levels. In contrast, number of inhabitants was a significant predictor of endotoxin load only. Neither streptomycetes nor endotoxin levels were associated with metrics of moisture damage.
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Affiliation(s)
- Elisabet Johansson
- Department of Environmental Health, University of Cincinnati, Box 670056, Cincinnati, OH 45267-0056, USA
| | - Stephen Vesper
- US Environmental Protection Agency, 26 W. M. L. King Drive, Cincinnati, OH 45268, USA
| | - Linda Levin
- Department of Environmental Health, University of Cincinnati, Box 670056, Cincinnati, OH 45267-0056, USA
| | - Grace LeMasters
- Department of Environmental Health, University of Cincinnati, Box 670056, Cincinnati, OH 45267-0056, USA
| | - Sergey Grinshpun
- Department of Environmental Health, University of Cincinnati, Box 670056, Cincinnati, OH 45267-0056, USA
| | - Tiina Reponen
- Department of Environmental Health, University of Cincinnati, Box 670056, Cincinnati, OH 45267-0056, USA
- Corresponding author: Tiina Reponen, University of Cincinnati, Department of Environmental Health, P.O. Box 670056 (3223 Eden Avenue), Cincinnati, OH, 45267-0056, USA, Tel. 513-558-0571; Fax 513-5582263;
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Mendy A, Gasana J, Vieira ER, Forno E, Patel J, Kadam P, Ramirez G. Endotoxin exposure and childhood wheeze and asthma: a meta-analysis of observational studies. J Asthma 2011; 48:685-93. [PMID: 21732750 DOI: 10.3109/02770903.2011.594140] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Exposure to endotoxin has been widely investigated as a potential factor for asthma and associated symptoms in children with different results. To clarify a potential relationship, we performed the present meta-analysis to integrate the results of studies examining the association of endotoxin exposure with wheeze and asthma in children. METHODS A search for relevant studies and reviews was conducted in MEDLINE, Highwire, CINAHL, and The Cochrane Library databases. Adjusted odds ratio (OR) with corresponding 95% confidence interval (CI) for endotoxin exposure and wheeze or asthma were retrieved and pooled to generate summary effect estimates in STATA 11.1. RESULTS Nineteen studies were included in the meta-analysis. The summary estimates suggested that endotoxin was positively associated with wheeze in infants and toddlers (meta-OR: 1.48, 95% CI: 1.10-1.98), but negatively related to asthma in school-aged children (meta-OR: 0.82, 95% CI: 0.69-0.97 for endotoxin concentration and 0.68, 95% CI: 0.50-0.93 for endotoxin load). CONCLUSIONS Based on the studies evaluated, endotoxin is a risk factor for wheeze in younger children, but a protective factor for asthma in older children. Thus, this study supports the "hygiene hypothesis."
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Affiliation(s)
- Angelico Mendy
- Robert Stempel School of Public Health, Florida International University, Miami, FL 33199, USA
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Mendell MJ, Mirer AG, Cheung K, Tong M, Douwes J. Respiratory and allergic health effects of dampness, mold, and dampness-related agents: a review of the epidemiologic evidence. ENVIRONMENTAL HEALTH PERSPECTIVES 2011; 119:748-56. [PMID: 21269928 PMCID: PMC3114807 DOI: 10.1289/ehp.1002410] [Citation(s) in RCA: 487] [Impact Index Per Article: 37.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2010] [Accepted: 01/26/2011] [Indexed: 05/02/2023]
Abstract
OBJECTIVES Many studies have shown consistent associations between evident indoor dampness or mold and respiratory or allergic health effects, but causal links remain unclear. Findings on measured microbiologic factors have received little review. We conducted an updated, comprehensive review on these topics. DATA SOURCES We reviewed eligible peer-reviewed epidemiologic studies or quantitative meta-analyses, up to late 2009, on dampness, mold, or other microbiologic agents and respiratory or allergic effects. DATA EXTRACTION We evaluated evidence for causation or association between qualitative/subjective assessments of dampness or mold (considered together) and specific health outcomes. We separately considered evidence for associations between specific quantitative measurements of microbiologic factors and each health outcome. DATA SYNTHESIS Evidence from epidemiologic studies and meta-analyses showed indoor dampness or mold to be associated consistently with increased asthma development and exacerbation, current and ever diagnosis of asthma, dyspnea, wheeze, cough, respiratory infections, bronchitis, allergic rhinitis, eczema, and upper respiratory tract symptoms. Associations were found in allergic and nonallergic individuals. Evidence strongly suggested causation of asthma exacerbation in children. Suggestive evidence was available for only a few specific measured microbiologic factors and was in part equivocal, suggesting both adverse and protective associations with health. CONCLUSIONS Evident dampness or mold had consistent positive associations with multiple allergic and respiratory effects. Measured microbiologic agents in dust had limited suggestive associations, including both positive and negative associations for some agents. Thus, prevention and remediation of indoor dampness and mold are likely to reduce health risks, but current evidence does not support measuring specific indoor microbiologic factors to guide health-protective actions.
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Affiliation(s)
- Mark J Mendell
- Indoor Air Quality Section, Environmental Health Laboratory Branch, California Department of Public Health, Richmond, California 94804, USA.
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Iossifova YY, Cox-Ganser JM, Park JH, White SK, Kreiss K. Lack of respiratory improvement following remediation of a water-damaged office building. Am J Ind Med 2011; 54:269-77. [PMID: 21413053 DOI: 10.1002/ajim.20910] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2010] [Indexed: 11/09/2022]
Abstract
BACKGROUND Damp buildings are commonly remediated without removing employees or ongoing medical surveillance. METHODS We examined paired pulmonary function and questionnaire data from 2002 and 2005 for 97 employees in a water-damaged building during ongoing but incomplete remediation. RESULTS We observed no overall improvement in respiratory health, as reflected in symptom scores, overall medication use, spirometry abnormalities, or sick leave. Four employees went from borderline bronchial hyperresponsiveness to bronchial hyperresponsiveness; six developed abnormal spirometry; three more reported post-occupancy current asthma, and four hypersensitivity pneumonitis. The number of participants without lower respiratory symptoms decreased from 27 in 2002 to 20 in 2005. Respiratory cases relocated in the building had a decrease in medication use and sick leave in 2005. CONCLUSIONS During dampness remediation, relocation may be health protective and prevent incident building-related respiratory cases. Without relocation of entire workforces, medical surveillance is advisable for secondary prevention of existing building-related disease.
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Affiliation(s)
- Yulia Y Iossifova
- Epidemic Intelligence Service, Office of Workforce and Career Development, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Shogren ES, Park JH. Pre-sampling contamination of filters used in measurements of airborne (1 → 3)-β-D-glucan based on glucan-specific Limulus amebocyte lysate assay. ACTA ACUST UNITED AC 2011; 13:1082-7. [PMID: 21359295 DOI: 10.1039/c0em00495b] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Air sampling for (1 → 3)-β-D-glucan may be a good method for assessing inhalation exposure to airborne fungi. Pre-sampling contamination of filter media used for sampling (1 → 3)-β-D-glucan may lead to substantial exposure measurement errors. Using the Limulus amebocyte lysate assay, we tested for pre-sampling levels of (1 → 3)-β-D-glucan on three types of filters-mixed cellulose ester (MCE)[1 brand], glass fiber (GF)[1 brand], and polycarbonate (PC)[5 brands]. Levels of (1 → 3)-β-D-glucan on MCE filters exceeded 4586.1 pg per filter. Levels on GF filters averaged 135.3 (± 28.9) pg per filter (range = 94.8-160.4 pg per filter) and levels on PC filters averaged 152.4 (± 236.1) pg per filter (range = non-detectable-1760.7 pg per filter). Efforts to clean MCE and GF filters were unfeasible or unsuccessful. Sonicating PC filters for two hours in ethanol, followed by a wash in pyrogen-free water, effectively eliminated measured levels of (1 → 3)-β-D-glucan on four brands of PC filters, as compared to untreated PC filters. This pretreatment process did not appear to physically damage the PC filters. Air sampling results highlighted the potentially problematic contamination of untreated PC filters. Ensuring that sampling media are free of (1 → 3)-β-D-glucan before sampling is crucial to accurately measure levels of (1 → 3)-β-D-glucan exposure, especially in environments where levels of (1 → 3)-β-D-glucan are low.
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Affiliation(s)
- Elizabeth S Shogren
- National Institute for Occupational Safety and Health, Morgantown, West Virginia 26505, USA
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Reponen T, Singh U, Schaffer C, Vesper S, Johansson E, Adhikari A, Grinshpun SA, Indugula R, Ryan P, Levin L, Lemasters G. Visually observed mold and moldy odor versus quantitatively measured microbial exposure in homes. THE SCIENCE OF THE TOTAL ENVIRONMENT 2010; 408:5565-74. [PMID: 20810150 PMCID: PMC2972663 DOI: 10.1016/j.scitotenv.2010.07.090] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2010] [Revised: 07/28/2010] [Accepted: 07/30/2010] [Indexed: 04/14/2023]
Abstract
The main study objective was to compare different methods for assessing mold exposure in conjunction with an epidemiologic study on the development of children's asthma. Homes of 184 children were assessed for mold by visual observations and dust sampling at child's age 1 (Year 1). Similar assessment supplemented with air sampling was conducted in Year 7. Samples were analyzed for endotoxin, (1-3)-β-D-glucan, and fungal spores. The Mold Specific Quantitative Polymerase Chain Reaction assay was used to analyze 36 mold species in dust samples, and the Environmental Relative Moldiness Index (ERMI) was calculated. Homes were categorized based on three criteria: 1) visible mold damage, 2) moldy odor, and 3) ERMI. Even for homes where families had not moved, Year 7 endotoxin and (1-3)-β-d-glucan exposures were significantly higher than those in Year 1 (p<0.001), whereas no difference was seen for ERMI (p=0.78). Microbial concentrations were not consistently associated with visible mold damage categories, but were consistently higher in homes with moldy odor and in homes that had high ERMI. Low correlations between results in air and dust samples indicate different types or durations of potential microbial exposures from dust vs. air. Future analysis will indicate which, if any, of the assessment methods is associated with the development of asthma.
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Affiliation(s)
- Tiina Reponen
- University of Cincinnati, Department of Environmental Health, Cincinnati, OH 45267-0056, USA.
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Rylander R, Reeslev M, Hulander T. Airborne enzyme measurements to detect indoor mould exposure. ACTA ACUST UNITED AC 2010; 12:2161-4. [PMID: 20936239 DOI: 10.1039/c0em00336k] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Mould in buildings constitutes a threat to health. Present methods to determine the moulds comprise counting of spores or determination of viable moulds which give imprecise measures of total mould cell biomass. Analysis of ergosterol and β-glucan as markers of mould cell biomass is expensive and cumbersome. To evaluate if airborne enzyme activity was related to mould in buildings air samples were taken using an impinger technique or cellulose filters in 386 rooms in 141 buildings. The samples were analysed for the activity of N-acetylhexosaminidase (NAHA) and expressed as enzyme units per m(3) (EU per m(3)). The highest value found in a building was used for the classification of the building and was related to the results from the subsequent technical inspection. In buildings without mould damage, the NAHA activity was generally below 20 EU per m(3). In buildings with mould damage, almost all the buildings had activities above 20 EU per m(3) (specificity 85%). At 30 EU per m(3) the specificity was 100%. Measurements of airborne enzyme activity have a high sensitivity and specificity to identify buildings with mould problems. The method can be used in the investigations of building related symptoms or for home exposure characteristics when investigating diseases such as asthma that can be related to mould exposure.
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Affiliation(s)
- Ragnar Rylander
- BioFact Environmental Health Research Centre, Bjorkasv 21, 44391, Lerum, Sweden.
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Lundin JI, Checkoway H. Endotoxin and cancer. CIENCIA & SAUDE COLETIVA 2010; 15:2787-98. [PMID: 20922287 DOI: 10.1590/s1413-81232010000600016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2008] [Accepted: 05/07/2009] [Indexed: 11/22/2022] Open
Abstract
Exposure to endotoxin, a component of gram-negative bacterial cell walls, is widespread in many industrial settings and in the ambient environment. Heavy-exposure environments include livestock farms, cotton textile facilities, and saw mills. In this article, we review epidemiologic, clinical trial, and experimental studies pertinent to the hypothesis that endotoxin prevents cancer. Since the 1970s, epidemiologic studies of cotton textile and other endotoxin-exposed occupational groups have consistently demonstrated reduced lung cancer risks. Experimental animal toxicology research and some limited therapeutic trials in cancer patients offer additional support for an anticarcinogenic potential. The underlying biological mechanisms of anticarcinogenesis are not entirely understood but are thought to involve the recruitment and activation of immune cells and proinflammatory mediators (e.g., tumor necrosis factor α and interleukin-1 and -6). In view of the current state of knowledge, it would be premature to recommend endotoxin as a cancer-chemopreventive agent. However, further epidemiologic and experimental investigations that can clarify further dose-effect and exposure-timing relations could have substantial public health and basic biomedical benefits.
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Affiliation(s)
- Jessica I Lundin
- Department of Environmental and Occupational Health Sciences, University of Washington, School of Public Health, Office E-179E, Box 357234, 1959 NE Pacific St., Seattle, WA 98195, USA. jlundin2@.u.washington.edu
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Huttunen K, Kauhanen E, Meklin T, Vepsäläinen A, Hirvonen MR, Hyvärinen A, Nevalainen A. The effect of ozonization on furniture dust: microbial content and immunotoxicity in vitro. THE SCIENCE OF THE TOTAL ENVIRONMENT 2010; 408:2305-2311. [PMID: 20227106 DOI: 10.1016/j.scitotenv.2010.02.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2008] [Revised: 02/08/2010] [Accepted: 02/15/2010] [Indexed: 05/28/2023]
Abstract
Moisture and mold problems in buildings contaminate also the furniture and other movable property. If cleaning of the contaminated furniture is neglected, it may continue to cause problems to the occupants even after the moisture-damage repairs. The aim of this study was to determine the effectiveness of high-efficiency ozone treatment in cleaning of the furniture from moisture-damaged buildings. In addition, the effectiveness of two cleaning methods was compared. Samples were vacuumed from the padded areas before and after the treatment. The microbial flora and concentrations in the dust sample were determined by quantitative cultivation and QPCR-methods. The immunotoxic potential of the dust samples was analyzed by measuring effects on cell viability and production of inflammatory mediators in vitro. Concentrations of viable microbes decreased significantly in most of the samples after cleaning. Cleaning with combined steam wash and ozonisation was more effective method than ozonising alone, but the difference was not statistically significant. Detection of fungal species with PCR showed a slight but nonsignificant decrease in concentrations after the cleaning. The immunotoxic potential of the collected dust decreased significantly in most of the samples. However, in a small subgroup of samples, increased concentrations of microbes and immunotoxicological activity were detected. This study shows that a transportable cleaning unit with high-efficiency ozonising is in most cases effective in decreasing the concentrations of viable microbes and immunotoxicological activity of the furniture dust. However, the method does not destroy or remove all fungal material present in the dust, as detected with QPCR analysis, and in some cases the cleaning procedure may increase the microbial concentrations and immunotoxicity of the dust.
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Affiliation(s)
- Kati Huttunen
- Department of Environmental Health, National Institute for Health and Welfare, P.O. Box 95, FI-70701 Kuopio, Finland.
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Thrasher JD, Crawley S. The biocontaminants and complexity of damp indoor spaces: more than what meets the eyes. Toxicol Ind Health 2009; 25:583-615. [DOI: 10.1177/0748233709348386] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Nine types of biocontaminants in damp indoor environments from microbial growth are discussed: (1) indicator molds; (2) Gram negative and positive bacteria; (3) microbial particulates; (4) mycotoxins; (5) volatile organic compounds, both microbial (MVOCs) and non-microbial (VOCs); (6) proteins; (7) galactomannans; (8) 1-3-β-D-glucans (glucans) and (9) lipopolysaccharides (LPS — endotoxins). When mold species exceed those outdoors contamination is deduced. Gram negative bacterial endotoxins, LPS in indoor environments, synergize with mycotoxins. The gram positive Bacillus species, Actinomycetes (Streptomyces, Nocardia and Mycobacterium), produce exotoxins. The Actinomycetes are associated with hypersensitivity pneumonitis, lung and invasive infections. Mycobacterial mycobacterium infections not from M. tuberculosis are increasing in immunocompetent individuals. In animal models, LPS enhance the toxicity of roridin A, satratoxins G and aflatoxin B1 to damage the olfactory epithelium, tract and bulbs (roridin A, satratoxin G) and liver (aflatoxin B1). Aflatoxin B1 and probably trichothecenes are transported along the olfactory tract to the temporal lobe. Co-cultured Streptomyces californicus and Stachybotrys chartarum produce a cytotoxin similar to doxorubicin and actinomycin D (chemotherapeutic agents). Trichothecenes, aflatoxins, gliotoxin and other mycotoxins are found in dust, bulk samples, air and ventilation systems of infested buildings. Macrocyclic trichothecenes are present in airborne particles <2 μm. Trichothecenes and stachylysin are present in the sera of individuals exposed to S. chartarum in contaminated indoor environments. Haemolysins are produced by S. chartarum, Memnoniella echinata and several species of Aspergillus and Penicillium. Galactomannans, glucans and LPS are upper and lower respiratory tract irritants. Gliotoxin, an immunosuppressive mycotoxin, was identified in the lung secretions and sera of cancer patients with aspergillosis produced by A. fumigatus, A. terreus, A. niger and A. flavus.
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Lundin JI, Checkoway H. Endotoxin and cancer. ENVIRONMENTAL HEALTH PERSPECTIVES 2009; 117:1344-50. [PMID: 19750096 PMCID: PMC2737008 DOI: 10.1289/ehp.0800439] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2008] [Accepted: 05/07/2009] [Indexed: 05/21/2023]
Abstract
OBJECTIVE Exposure to endotoxin, a component of gram-negative bacterial cell walls, is widespread in many industrial settings and in the ambient environment. Heavy-exposure environments include livestock farms, cotton textile facilities, and saw mills. Concentrations are highly variable in non-occupational indoor and outdoor environments. Endotoxin is a potent inflammagen with recognized health effects, including fever, shaking chills, septic shock, toxic pneumonitis, and respiratory symptoms. Somewhat paradoxically, given the putative role of inflammation in carcinogenesis, various lines of evidence suggest that endotoxin may prevent cancer initiation or limit tumor growth. The hypothesis that components of bacteria may retard cancer progression dates back to William B. Coley's therapeutic experiments ("bacterial vaccine") in the 1890s. DATA SOURCES In this article, we review epidemiologic, clinical trial, and experimental studies pertinent to the hypothesis that endotoxin prevents cancer. Since the 1970s, epidemiologic studies of cotton textile and other endotoxin-exposed occupational groups have consistently demonstrated reduced lung cancer risks. Experimental animal toxicology research and some limited therapeutic trials in cancer patients offer additional support for an anticarcinogenic potential. The underlying biological mechanisms of anticarcinogenesis are not entirely understood but are thought to involve the recruitment and activation of immune cells and proinflammatory mediators (e.g., tumor necrosis factor alpha and interleukin-1 and -6). CONCLUSIONS In view of the current state of knowledge, it would be premature to recommend endotoxin as a cancer-chemopreventive agent. Nonetheless, further epidemiologic and experimental investigations that can clarify further dose-effect and exposure-timing relations could have substantial public health and basic biomedical benefits.
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Affiliation(s)
- Jessica I. Lundin
- Address correspondence to J.I. Lundin, Department of Environmental and Occupational Health Sciences, University of Washington, School of Public Health, Office E-179E, Box 357234, 1959 NE Pacific St., Seattle, WA 98195 USA. Telephone: (206) 221-5619. Fax: (206) 685-3990. E-mail:
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Kankkunen P, Rintahaka J, Aalto A, Leino M, Majuri ML, Alenius H, Wolff H, Matikainen S. Trichothecene Mycotoxins Activate Inflammatory Response in Human Macrophages. THE JOURNAL OF IMMUNOLOGY 2009; 182:6418-25. [DOI: 10.4049/jimmunol.0803309] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Takeda M, Saijo Y, Yuasa M, Kanazawa A, Araki A, Kishi R. Relationship between sick building syndrome and indoor environmental factors in newly built Japanese dwellings. Int Arch Occup Environ Health 2009; 82:583-93. [PMID: 19205722 DOI: 10.1007/s00420-009-0395-8] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2007] [Accepted: 01/18/2009] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Indoor air contaminants and dampness in dwellings have become important environmental health issues. The aim of this study is to clarify which factors are related to sick building syndrome (SBS) in newly built dwellings at Hokkaido, Japan, through a comprehensive evaluation of the indoor environment and validated sick building symptom questionnaires. METHODS The symptoms of 343 residents in 104 detached houses were surveyed by standardized questionnaires, and the concentrations of formaldehyde, acetaldehyde, volatile organic compounds (VOCs), airborne fungi, and dust mite allergen in their living rooms were measured. By summing the presence or absence of the five dampness indicators (condensations, mold growth, moldy odor, high air humidity of the bathroom, water leakage), a dampness index was calculated. RESULTS SBS symptoms were found in 21.6% of surveyed individuals. In a fully adjusted multivariate logistic regression analysis, the dampness index [odds ratio (OR) = 1.50; 95% confidence interval (CI): 1.06-1.11], log formaldehyde (OR = 23.79, 95% CI: 2.49-277.65), and log alpha-pinene (OR = 2.87, 95% CI: 1.36-6.03) had significantly higher ORs for SBS symptoms. However, other VOCs, airborne fungi, and dust mite allergen did not have significantly higher ORs. CONCLUSION Dampness, formaldehyde, and alpha-pinene were significantly related to SBS symptoms in newly built dwellings. We should, therefore, take measures to reduce the chemicals and dampness in dwellings.
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Affiliation(s)
- Makoto Takeda
- Department of Public Health Science, Graduated School of Medicine, Hokkaido University, N15, W7, Kita-ku, Sapporo, 060-8638, Japan
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