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Zhao Y, Liu S, Wang W, Li L, Zhang W, Ji X, Yang D, Guo X, Deng F. Associations of indoor airborne microbiome with lung function: evidence from a randomized, double-blind, crossover study of microbial intervention. ENVIRONMENTAL SCIENCE. PROCESSES & IMPACTS 2024. [PMID: 39355928 DOI: 10.1039/d4em00392f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/03/2024]
Abstract
Microorganisms constitute an essential component of the indoor ecosystem and may pose potential health risks after inhalation. However, evidence regarding the impact of indoor airborne microbiome on general respiratory health is scarce. Additionally, while air purification has been shown to be an effective strategy for controlling culturable bioaerosols, its impact on indoor airborne microbiome remains unclear. To determine the impact of indoor airborne microbial exposure on lung function, and whether and how air purification can modify indoor airborne microbiome, we conducted a randomized, double-blind, crossover study employing air purification intervention among 68 healthy young adults in Beijing, China. Indoor airborne bacteria and fungi were characterized using amplicon sequencing technology and quantified by qPCR. Our results indicated positive associations between indoor airborne microbial α-diversity and lung function indices; however, adverse effects from total microbial load were observed. Males were more susceptible to microbial exposure than females. Beneficial effects from richness in Actinobacteria, Bacteroidia, Oxyphotobacteria, Bacilli, Clostridia, Alphaproteobacteria, Gammaproteobacteria, Dothideomycetes, and Sordariomycetes, and detrimental effects from five Proteobacteria genera, including Dechloromonas, Hydrogenophaga, Klebsiella, Pseudomonas, and Tolumonas, were also identified. Air purification contributed to decreased fungal diversity and total fungal load, but not the overall microbial community structure. Our study demonstrates the significant role of indoor airborne microbiome in regulating human respiratory health and provides inspiration for improving health through manipulation of indoor microbiome. Meanwhile, our study also underscores the importance of balancing the potential benefits from decreased microbial load and the underlying risks from reduced microbial diversity while applying environmental microbial interventions.
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Affiliation(s)
- Yetong Zhao
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China.
| | - Shan Liu
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China.
| | - Wanzhou Wang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China.
| | - Luyi Li
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China.
| | - Wenlou Zhang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China.
| | - Xuezhao Ji
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China.
| | - Di Yang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China.
| | - Xinbiao Guo
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China.
| | - Furong Deng
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China.
- Center for Environment and Health, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing 100191, China
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Cecinato A, Romagnoli P, Cerasa M, Perilli M, Balducci C. Organic toxicants and emerging contaminants in hospital interiors before and during the SARS-CoV2 pandemic: alkanes and PAHs. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2024; 31:9713-9731. [PMID: 38194174 DOI: 10.1007/s11356-023-31735-7] [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: 01/26/2023] [Accepted: 12/19/2023] [Indexed: 01/10/2024]
Abstract
Indoor pollution and deposition dust (DD), in particular, are acquiring concern, due to long exposure time and importance of intake by humans through contact and ingestion. Hospitals look a special category of sites, owing to peculiar contaminants affecting them and to presence of people prone to adverse effects induced by toxicants. Four in-field campaigns aimed at understanding the chemical composition of DD were performed in five Italian hospitals. Measurements were performed before (autumn 2019), during (spring 2021), and after (winter 2022) the peak of SARS-CoV2 and when restrictions caused by pandemic were revoked (winter 2023). Parallel measurements were made outdoors (2022), as well as in a university and a dwelling. Targeted contaminants were n-alkanes and polycyclic aromatic hydrocarbons (PAHs), while iso- and anteiso-alkanes were analyzed to assess the impact of tobacco smoking. Total n-alkanes ranged from 3.9 ± 2.3 to 20.5 ± 4.2 mg/g, with higher percentages of short chain homologs in 2019. PAHs ranged from 0.24 ± 0.22 to 0.83 ± 0.50 mg/g, with light congeners (≤ 228 a.m.u.) always exceeding the heavy ones (≥ 252 a.m.u.). According to carbon preference indexes, alkanes originated overall from anthropogenic sources. Microorganisms resulted to affect a hospital, and tobacco smoke accounted for ~ 4-20‰ of DD mass. As for PAH sources, the diagnostic concentration ratios suggested the concourse of biological matter burning and vehicle emission. Benzo[a]pyrene equivalent carcinogenic and mutagenic potencies of depositions at hospitals ranged ~ 9-39 μg/g and ~ 15-76 μg/g, respectively, which seems of concern for health. DD composition in hospitals was different from that outside the premises, as well as that found at university and at dwelling.
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Affiliation(s)
- Angelo Cecinato
- National Research Council of Italy, Institute of Atmospheric Pollution Research (CNR-IIA), Via Salaria Km 29.3, P.O. Box 10, 00015, Monterotondo, RM, Italy.
| | - Paola Romagnoli
- National Research Council of Italy, Institute of Atmospheric Pollution Research (CNR-IIA), Via Salaria Km 29.3, P.O. Box 10, 00015, Monterotondo, RM, Italy
| | - Marina Cerasa
- National Research Council of Italy, Institute of Atmospheric Pollution Research (CNR-IIA), Via Salaria Km 29.3, P.O. Box 10, 00015, Monterotondo, RM, Italy
| | - Mattia Perilli
- National Research Council of Italy, Institute of Atmospheric Pollution Research (CNR-IIA), Via Salaria Km 29.3, P.O. Box 10, 00015, Monterotondo, RM, Italy
| | - Catia Balducci
- National Research Council of Italy, Institute of Atmospheric Pollution Research (CNR-IIA), Via Salaria Km 29.3, P.O. Box 10, 00015, Monterotondo, RM, Italy
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Burbank AJ, Hernandez ML, Jefferson A, Perry TT, Phipatanakul W, Poole J, Matsui EC. Environmental justice and allergic disease: A Work Group Report of the AAAAI Environmental Exposure and Respiratory Health Committee and the Diversity, Equity and Inclusion Committee. J Allergy Clin Immunol 2023; 151:656-670. [PMID: 36584926 PMCID: PMC9992350 DOI: 10.1016/j.jaci.2022.11.025] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/31/2022] [Accepted: 11/29/2022] [Indexed: 12/29/2022]
Abstract
Environmental justice is the concept that all people have the right to live in a healthy environment, to be protected against environmental hazards, and to participate in decisions affecting their communities. Communities of color and low-income populations live, work, and play in environments with disproportionate exposure to hazards associated with allergic disease. This unequal distribution of hazards has contributed to health disparities and is largely the result of systemic racism that promotes segregation of neighborhoods, disinvestment in predominantly racial/ethnic minority neighborhoods, and discriminatory housing, employment, and lending practices. The AAAAI Environmental Exposure and Respiratory Health Committee and Diversity, Equity and Inclusion Committee jointly developed this report to improve allergy/immunology specialists' awareness of environmental injustice, its roots in systemic racism, and its impact on health disparities in allergic disease. We present evidence supporting the relationship between exposure to environmental hazards, particularly at the neighborhood level, and the disproportionately high incidence and poor outcomes from allergic diseases in marginalized populations. Achieving environmental justice requires investment in at-risk communities to increase access to safe housing, clean air and water, employment opportunities, education, nutrition, and health care. Through policies that promote environmental justice, we can achieve greater health equity in allergic disease.
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Affiliation(s)
- Allison J Burbank
- Division of Pediatric Allergy and Immunology, University of North Carolina School of Medicine, Children's Research Institute, Chapel Hill, NC.
| | - Michelle L Hernandez
- Division of Pediatric Allergy and Immunology, University of North Carolina School of Medicine, Children's Research Institute, Chapel Hill, NC
| | - Akilah Jefferson
- University of Arkansas for Medical Sciences, Little Rock, Ark; Arkansas Children's Research Institute, Little Rock, Ark
| | - Tamara T Perry
- University of Arkansas for Medical Sciences, Little Rock, Ark; Arkansas Children's Research Institute, Little Rock, Ark
| | - Wanda Phipatanakul
- Division of Asthma, Allergy and Immunology, Boston Children's Hospital, Harvard Medical School, Boston, Mass
| | - Jill Poole
- Department of Internal Medicine, Division of Allergy and Immunology, University of Nebraska Medical Center, Omaha, Neb
| | - Elizabeth C Matsui
- Departments of Population Health and Pediatrics, Dell Medical School at University of Texas at Austin, Austin, Tex
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Amin H, Marshall IPG, Bertelsen RJ, Wouters IM, Schlünssen V, Sigsgaard T, Šantl-Temkiv T. Optimization of bacterial DNA and endotoxin extraction from settled airborne dust. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 857:159455. [PMID: 36252657 DOI: 10.1016/j.scitotenv.2022.159455] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 10/03/2022] [Accepted: 10/11/2022] [Indexed: 06/16/2023]
Abstract
Collecting and obtaining sufficient amount of airborne particles for multiple microbial component assessments can be challenging. A passive dust sampling device, the electrostatic dust fall collector (EDC) has been established for assessing airborne exposures including endotoxin and glucans. Recently, with advances in next-generation sequencing techniques, EDCs were used to collect microbial cells for DNA sequencing analysis to promote the study of airborne bacterial and fungal communities. However, low DNA yields have been problematic when employing passive sampling with EDC. To address this challenge, we attempted to increase the efficiency of extraction. We compared DNA extraction efficiency of bacterial components from EDCs captured on filters through filtration using five extraction techniques. By measuring the abundance, diversity and structure of bacterial communities using qPCR and amplicon sequencing targeting 16S rRNA genes, we found that two techniques outperformed the rest. Furthermore, we developed protocols to simultaneously extract both DNA and endotoxin from a single EDC cloth. Our technique promotes a high quality to price ratio and may be employed in large epidemiological studies addressing airborne bacterial exposure where a large number of samples is needed.
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Affiliation(s)
- Hesham Amin
- Department of Clinical Science, University of Bergen, Bergen, Norway.
| | - Ian P G Marshall
- Section for Microbiology, Department of Biology, Aarhus University, Aarhus, Denmark
| | - Randi J Bertelsen
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Inge M Wouters
- Institute for Risk Assessment Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands
| | - Vivi Schlünssen
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Torben Sigsgaard
- Department of Public Health, Environment, Work and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - Tina Šantl-Temkiv
- Section for Microbiology, Department of Biology, Aarhus University, Aarhus, Denmark
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Su B, Jadresin Milic R, McPherson P, Wu L. Thermal Performance of School Buildings: Impacts beyond Thermal Comfort. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19105811. [PMID: 35627345 PMCID: PMC9142073 DOI: 10.3390/ijerph19105811] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 05/08/2022] [Accepted: 05/09/2022] [Indexed: 02/04/2023]
Abstract
Based on field study data regarding the winter indoor thermal environment of three classrooms with different building envelopes, this study compared and evaluated these environments, not only related to students' thermal comfort but also to their health. The inadequacy of the conventional New Zealand school building for maintaining a comfortable and healthy winter indoor thermal environment has been identified. A classroom with thermal mass had 31%, 34% and 9% more time than a classroom without thermal mass when indoor temperatures met 16 °C 18 °C and 20 °C respectively and has 21.4% more time than the classroom without thermal mass when indoor relative humidity was in the optimal range of 40% to 60%, in a temperate climate with a mild and humid winter. Adding thermal mass to school building envelopes should be considered as a strategy to improve the winter indoor thermal environment in future school design and development. Adding thermal mass to a school building with sufficient insulation can not only increase winter indoor mean air temperature but can also reduce the fluctuation of indoor air temperatures. This can significantly reduce the incidence of very low indoor temperature and very high indoor relative humidity, and significantly improve the indoor thermal environment.
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Affiliation(s)
- Bin Su
- School of Architecture, Unitec Institute of Technology, Auckland 0600, New Zealand; (R.J.M.); (P.M.)
- Correspondence:
| | - Renata Jadresin Milic
- School of Architecture, Unitec Institute of Technology, Auckland 0600, New Zealand; (R.J.M.); (P.M.)
| | - Peter McPherson
- School of Architecture, Unitec Institute of Technology, Auckland 0600, New Zealand; (R.J.M.); (P.M.)
| | - Lian Wu
- School of Healthcare and Social Practice, Unitec Institute of Technology, Auckland 0600, New Zealand;
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Nordberg ME, Täubel M, Heikkinen S, Jalkanen K, Köliö A, Stranger M, Leppänen H, Hyvärinen A, Huttunen K. Toxicological transcriptome of human airway constructs after exposure to indoor air particulate matter: In search of relevant pathways of moisture damage-associated health effects. ENVIRONMENT INTERNATIONAL 2022; 158:106997. [PMID: 34991257 DOI: 10.1016/j.envint.2021.106997] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 11/16/2021] [Accepted: 11/20/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Multiple health effects are associated with moisture damage in buildings. Studies explaining these associations and cell-level mechanisms behind the observed health effects are urgently called for. OBJECTIVES We focused on characterizing gene expression in human airway epithelium after exposure to indoor air particulate matter (PM) sampled from houses with and without moisture damage, alongside determination of general toxicological markers. METHODS We performed detailed technical building inspections in 25 residential houses and categorized them based on the detection of moisture damages and the probability of occupant exposure. PM sampling was complemented by microbiological and volatile organic compound assessment. We exposed human airway constructs to three dilutions (1:16, 1:8, 1:4) of collected PM from moisture-damaged (index) and non-moisture-damaged (reference) houses and imaged selected constructs with electron microscopy. We analyzed general toxicological markers and the RNA of exposed constructs was sequenced targeting genes associated with toxicological pathways. We did groupwise comparisons between index and reference houses and pairwise comparisons in matched index/reference houses. RESULTS In groupwise comparison, gene Cytochrome P450 Family 1 Subfamily A Member 1 (CYP1A1) was statistically significantly over-expressed in index houses at all dilutions of collected PM and Nuclear Factor Kappa B Subunit 1 (NFKB1) at dilution 1:4 of collected PM. In pairwise index/reference house comparison, several genes related to multiple toxicological pathways were activated, largest expression differences seen for CYP1A1. However, none of the genes was consistently expressed in all the matched pairs, and general toxicological markers did not differentiate index and reference houses. DISCUSSION The exposure to PM from index houses activated toxicology -related genes in airway constructs. Differential expression was not consistent among all the index/reference pairs, possibly due to compositional differences of bioactive particles. Our study highlights CYP1A1 and NFKB1 as potential targets in moisture damage -associated cellular responses.
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Affiliation(s)
- Maria-Elisa Nordberg
- Department of Environmental and Biological Sciences, University of Eastern Finland (UEF), Yliopistonranta 1, FI-70211 Kuopio, Finland.
| | - Martin Täubel
- Environmental Health Unit, Finnish Institute for Health and Welfare, Neulaniementie 4, FI-70701 Kuopio, Finland
| | - Sami Heikkinen
- School of Medicine, Institutes of Clinical Medicine and Biomedicine, University of Eastern Finland (UEF), Yliopistonranta 1, FI-70211 Kuopio, Finland
| | - Kaisa Jalkanen
- Environmental Health Unit, Finnish Institute for Health and Welfare, Neulaniementie 4, FI-70701 Kuopio, Finland
| | - Arto Köliö
- Renovatek Oy, Korkeakoulunkatu 1, FI-33720 Tampere, Finland
| | - Marianne Stranger
- Environmental Risk and Health Unit, VITO, Boeretang 200, 2400 Mol, Belgium
| | - Hanna Leppänen
- Environmental Health Unit, Finnish Institute for Health and Welfare, Neulaniementie 4, FI-70701 Kuopio, Finland
| | - Anne Hyvärinen
- Environmental Health Unit, Finnish Institute for Health and Welfare, Neulaniementie 4, FI-70701 Kuopio, Finland
| | - Kati Huttunen
- Department of Environmental and Biological Sciences, University of Eastern Finland (UEF), Yliopistonranta 1, FI-70211 Kuopio, Finland
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Vishnu Sreejith M, Aradhana KS, Varsha M, Cyrus MK, Aravindakumar CT, Aravind UK. ATR-FTIR and LC-Q-ToF-MS analysis of indoor dust from different micro-environments located in a tropical metropolitan area. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 783:147066. [PMID: 34088116 DOI: 10.1016/j.scitotenv.2021.147066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 04/02/2021] [Accepted: 04/06/2021] [Indexed: 06/12/2023]
Abstract
Indoor dust is an important matrix that exposes humans to a broad spectrum of chemicals. The information on the occurrence of contaminants of emerging concern (CECs), their metabolites, and re-emerging contaminants in indoor dust is rather limited. As the indoor environment is exposed to various chemicals from personal care products, furniture, building materials, machineries and cooking/cleaning products, there is a high chance of the presence of hazardous contaminants in indoor dust. In the present study, dust samples were collected from four different micro indoor environments (photocopying centres, residential houses, classrooms, and ATM cabins) located in an urban environment located in India's southwestern part. The collected samples were subjected to ATR - FTIR and LC-Q-ToF-MS analyses. The ATR - FTIR analysis indicated the presence of aldehydes, anhydrides, carboxylic acids, esters, sulphonic acids, and asbestos - a re-emerging contaminant. A total of 19 compounds were identified from the LC-Q-ToF-MS analysis. These compounds belonged to various classes such as plasticisers, plasticiser metabolites, photoinitiators, personal care products, pharmaceutical intermediates, surfactants, and pesticides. To the best of our knowledge, this is the first report regarding the presence of CECs in indoor environments in Kerala and also the suspected occurrence of pesticides (metaldehyde and ethofumesate) in classroom dust in India. Another important highlight of this work is the demonstration of ATR-FTIR as a complementary technique for LC-Q-ToF-MS in the analysis of indoor pollution while dealing with totally unknown pollutants. These results further highlight the occurrence of probable chemically modified metabolites in the tropical climatic conditions in a microenvironment.
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Affiliation(s)
- M Vishnu Sreejith
- Schoool of Environmental Sciences, Mahatma Gandhi University (MGU), Kottayam 686560, Kerala, India
| | - K S Aradhana
- School of Environmental Studies, Cochin University of Science & Technology (CUSAT), Kochi 682022, Kerala, India
| | - M Varsha
- School of Environmental Studies, Cochin University of Science & Technology (CUSAT), Kochi 682022, Kerala, India
| | - M K Cyrus
- Inter University Instrumentation Centre (IUIC), Mahatma Gandhi University (MGU), Kottayam 686560, Kerala, India
| | - C T Aravindakumar
- Schoool of Environmental Sciences, Mahatma Gandhi University (MGU), Kottayam 686560, Kerala, India; Inter University Instrumentation Centre (IUIC), Mahatma Gandhi University (MGU), Kottayam 686560, Kerala, India.
| | - Usha K Aravind
- School of Environmental Studies, Cochin University of Science & Technology (CUSAT), Kochi 682022, Kerala, India..
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Fakunle AG, Jafta N, Naidoo RN, Smit LAM. Association of indoor microbial aerosols with respiratory symptoms among under-five children: a systematic review and meta-analysis. Environ Health 2021; 20:77. [PMID: 34210330 PMCID: PMC8252236 DOI: 10.1186/s12940-021-00759-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 06/18/2021] [Indexed: 05/25/2023]
Abstract
BACKGROUND Despite the recognition of the importance of indoor microbial exposures on children's health, the role of different microbial agents in development and aggravation of respiratory symptoms and diseases is only poorly understood. This study aimed to assess whether exposure to microbial aerosols within the indoor environment are associated with respiratory symptoms among children under-5 years of age. METHODS A systematic literature search was conducted on PubMed, Web of Science, GreenFILE, ScienceDirect, EMBASE and Cochrane library through February 2020. Studies that investigated the exposure-response relationship between components of the indoor microbial communities and respiratory symptoms among under-five children were eligible for inclusion. A random-effect meta-analysis was applied to estimate pooled relative risk (RR) and 95% confidence interval (CI) for study specific high versus low microbial exposures. The potential effect of individual studies on the overall estimate was evaluated using leave-one-out analysis, while heterogeneity was evaluated by I2 statistics using RevMan 5.3. RESULTS Fifteen studies were eligible for inclusion in a meta-analysis. The pooled risk estimate suggested that increased microbial exposure was associated with an increased risk of respiratory symptoms [pooled relative risk (RR): 1.24 (1.09, 1.41), P = 0.001]. The association was strongest with exposure to a combination of Aspergillus, Penicillium, Cladosporium and Alternaria species [pooled RR: 1.73 (1.30, 2.31), P = 0.0002]. Stratified analysis revealed an increased risk of wheeze [pooled RR: 1.20 (1.05, 1.37), P = 0.007 and allergic rhinitis [RR: 1.18 (0.94, 1.98), P = 0.16] from any microbial exposure. CONCLUSIONS Microbial exposures are, in general, associated with risk of respiratory symptoms. Future studies are needed to study the indoor microbiome more comprehensively, and to investigate the mechanism of these associations.
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Affiliation(s)
- Adekunle Gregory Fakunle
- Discipline of Occupational and Environmental Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
- Department of Medicine, University of Ibadan, Ibadan, 200284 Nigeria
| | - Nkosana Jafta
- Discipline of Occupational and Environmental Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Rajen N. Naidoo
- Discipline of Occupational and Environmental Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Lidwien A. M. Smit
- Institute for Risk Assessment Sciences, Environmental Epidemiology Division (IRAS-EEPI), Utrecht University, Utrecht, The Netherlands
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Norbäck D, Hashim Z, Ali F, Hashim JH. Asthma symptoms and respiratory infections in Malaysian students-associations with ethnicity and chemical exposure at home and school. ENVIRONMENTAL RESEARCH 2021; 197:111061. [PMID: 33785322 DOI: 10.1016/j.envres.2021.111061] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 02/20/2021] [Accepted: 03/18/2021] [Indexed: 06/12/2023]
Abstract
Little is known on respiratory effects of indoor chemicals in the tropics. We investigated associations between asthma and respiratory infections in Malaysian students and chemical exposure at home and at school. Moreover, we investigated differences in home environment between the three main ethnic groups in Malaysia (Malay, Chinese, Indian). Totally, 462 students from 8 junior high schools in Johor Bahru participated (96% participation rate). The students answered a questionnaire on health and home environment. Climate, carbon dioxide (CO2), volatile organic compounds (VOC), formaldehyde and nitrogen dioxide (NO2) were measured inside and outside the schools. Multilevel logistic regression was applied to study associations between exposure and health. Totally 4.8% were smokers, 10.3% had wheeze, 9.3% current asthma, and had 18.8% any respiratory infection in the past 3 months. Malay students had more dampness or mould (p < 0.001), more environmental tobacco smoke (ETS) (p < 0.001) and more cats (p < 0.001) at home as compared to Chinese or Indian students. Wheeze was associated with ethnicity (p = 0.02; lower in Indian), atopy (p = 0.002), current smoking (p = 0.02) and recent indoor painting at home (p = 0.03). Current asthma was associated with ethnicity (p = 0.001; lower in Chinese) and para-dichlorobenzene in classroom air (p = 0.008). Respiratory infections were related to atopy (p = 0.002), ethylbenzene (p = 0.02) and para-dichlorobenzene (p = 0.01) in classroom air. Para-dichlorobenzene is used in Asia against insects. In conclusion, chemical emissions from recent indoor painting at home can increase the risk of wheeze. In schools, para-dichlorobenzene can increase the risk of current asthma and respiratory infections while ethylbenzene can increase the risk of respiratory infections.
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Affiliation(s)
- Dan Norbäck
- Uppsala University, Department of Medical Science, Occupational and Environmental Medicine, University Hospital, 75185, Uppsala, Sweden.
| | - Zailina Hashim
- Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400, UPM, Serdang, Selangor, Malaysia
| | - Faridah Ali
- Primary Care Unit, Johor State Health Department, 80100, Johor Bahru, Malaysia
| | - Jamal Hisham Hashim
- Faculty of Health Sciences, Universiti Selangor, 40000, Shah Alam, Malaysia; Department of Community Health, National University of Malaysia, 56000, Kuala Lumpur, Malaysia
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Indoor Microbial Exposures and Chronic Lung Disease: From Microbial Toxins to the Microbiome. Clin Chest Med 2021; 41:777-796. [PMID: 33153695 DOI: 10.1016/j.ccm.2020.08.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Effects of environmental microbial exposures on human health have long been of interest. Microbes were historically assumed to be harmful, but data have suggested that microbial exposures can modulate the immune system. We focus on the effects of indoor environmental microbial exposure on chronic lung diseases. We found contradictory data in bacterial studies using endotoxin as a surrogate for bacterial exposure. Contradictory data also exist in studies of fungal exposure. Many factors may modulate the effect of environmental microbial exposures on lung health, including coexposures. Future studies need to clarify which method of assessing environmental microbial exposures is most relevant.
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Bioreactivity, Guttation and Agents Influencing Surface Tension of Water Emitted by Actively Growing Indoor Mould Isolates. Microorganisms 2020; 8:microorganisms8121940. [PMID: 33297485 PMCID: PMC7762365 DOI: 10.3390/microorganisms8121940] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 12/03/2020] [Accepted: 12/04/2020] [Indexed: 02/07/2023] Open
Abstract
The secretion of metabolites in guttation droplets by indoor moulds is not well documented. This study demonstrates the guttation of metabolites by actively growing common indoor moulds. Old and fresh biomasses of indoor isolates of Aspergillus versicolor, Chaetomium globosum, Penicillium expansum, Trichoderma atroviride, T. trixiae, Rhizopus sp. and Stachybotrys sp. were compared. Metabolic activity indicated by viability staining and guttation of liquid droplets detected in young (<3 weeks old) biomass were absent in old (>6 months old) cultures consisting of dehydrated hyphae and dormant conidia. Fresh (<3 weeks old) biomasses were toxic more than 10 times towards mammalian cell lines (PK-15 and MNA) compared to the old dormant, dry biomasses, when calculated per biomass wet weight and per conidial particle. Surfactant activity was emitted in exudates from fresh biomass of T. atroviride, Rhizopus sp. and Stachybotrys sp. Surfactant activity was also provoked by fresh conidia from T. atroviride and Stachybotrys sp. strains. Water repealing substances were emitted by cultures of P. expansum, T. atroviride and C. globosum strains. The metabolic state of the indoor fungal growth may influence emission of liquid soluble bioreactive metabolites into the indoor air.
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Howard EJ, Vesper SJ, Guthrie BJ, Petty CR, Ramdin VA, Sheehan WJ, Gaffin JM, Permaul P, Lai PS, Bartnikas LM, Cunningham A, Hauptman M, Gold DR, Baxi SN, Phipatanakul W. Asthma Prevalence and Mold Levels in US Northeastern Schools. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2020; 9:1312-1318. [PMID: 33091637 DOI: 10.1016/j.jaip.2020.10.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 10/01/2020] [Accepted: 10/01/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND Asthma is among the most common chronic diseases of children in the United States (US). Mold exposures have been linked to asthma development and exacerbation. In homes, mold exposures have been quantified using the Environmental Relative Moldiness Index (ERMI), and higher home ERMI values have been linked to occupant asthma. OBJECTIVE In this analysis of the School Inner-City Asthma Study (SICAS), we aimed to evaluate the ERMI's applicability to measuring mold in schools compared with homes and to examine the prevalence of asthma in relationship to students' demographics and the physical characteristics of school buildings. METHODS Northeastern US schools (n = 32) and homes (n = 33) were selected, and the 36 ERMI molds were quantified in a dust sample from each classroom (n = 114) or home. School building characteristics data were collected from SICAS. Asthma prevalence and student demographics data were obtained from government websites. Linear regression and mixed models were fit to assess the association of the current asthma prevalence and physical characteristics of the school, make-up of the student body, and the ERMI metric. RESULTS Levels of outdoor group 2 molds were significantly (P < .01) greater in schools compared with homes. The presence of air-conditioning in school buildings correlated significantly (P = .02) with lower asthma prevalence. CONCLUSION The prevalence of asthma in student bodies is associated with many factors in schools and homes.
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Affiliation(s)
- Evin J Howard
- Bouvé College of Health Sciences, School of Nursing, Northeastern University, Boston, Mass
| | - Stephen J Vesper
- US Environmental Protection Agency, Center for Environmental Measurement and Modeling, Cincinnati, Ohio
| | - Barbara J Guthrie
- Bouvé College of Health Sciences, School of Nursing, Northeastern University, Boston, Mass
| | - Carter R Petty
- Institutional Centers for Clinical and Translational Research, Boston Children's Hospital, Boston, Mass
| | - Valeria A Ramdin
- Bouvé College of Health Sciences, School of Nursing, Northeastern University, Boston, Mass
| | - William J Sheehan
- Division of Allergy and Immunology, Boston Children's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass
| | - Jonathan M Gaffin
- Harvard Medical School, Boston, Mass; Division of Pulmonary Medicine, Boston Children's Hospital, Boston, Mass
| | - Perdita Permaul
- Division of Pediatric Pulmonology, Allergy and Immunology, New York-Presbyterian Hospital, Weill Cornell Medical College, New York, NY
| | - Peggy S Lai
- Harvard Medical School, Boston, Mass; Division of Pulmonary and Critical Care, Massachusetts General Hospital, Boston, Mass
| | - Lisa M Bartnikas
- Division of Allergy and Immunology, Boston Children's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass
| | - Amparito Cunningham
- Division of Allergy and Immunology, Boston Children's Hospital, Boston, Mass
| | - Marissa Hauptman
- Harvard Medical School, Boston, Mass; Division of General Pediatrics, Boston Children's Hospital, Boston, Mass; Region 1 New England Pediatric Environmental Health Specialty Unit, Boston, Mass
| | - Diane R Gold
- Harvard Medical School, Boston, Mass; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Mass; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Mass
| | - Sachin N Baxi
- Division of Allergy and Immunology, Boston Children's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass
| | - Wanda Phipatanakul
- Division of Allergy and Immunology, Boston Children's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass.
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13
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Savelieva K, Elovainio M, Lampi J, Ung-Lanki S, Pekkanen J. Psychosocial factors and indoor environmental quality in respiratory symptom reports of pupils: a cross-sectional study in Finnish schools. BMJ Open 2020; 10:e036873. [PMID: 32958485 PMCID: PMC7507850 DOI: 10.1136/bmjopen-2020-036873] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES Poor indoor environmental quality (IEQ) in schools is related to higher respiratory symptoms of pupils, but little is known about the importance of other factors. This study examined the associations between different psychosocial factors and other pupils' individual and allergic characteristics, beyond school IEQ, and reporting of respiratory symptoms in pupil-administered and parent-administered questionnaires. SETTING All primary and secondary schools in two areas of Helsinki, Finland. PARTICIPANTS Primary school pupils (grade 3-6, n=8775, 99 school buildings) and secondary school pupils (grade 7-9, n=3410, 30 school buildings) reported their respiratory symptoms, as well as psychosocial factors and individual characteristics. Parents of primary school pupils (grade 1-6, n=3540, 88 school buildings) also filled in questionnaires, but the response rate was low (20% in 2017 and 13% in 2018). MAIN OUTCOME MEASURE Respiratory symptoms were reported in relation to the school environment and in general (without such relation) by pupils or parents. RESULTS Worry about IEQ and low school satisfaction, and asthma and hay fever were related to higher reporting of respiratory symptoms in three samples. The variance between schools in respiratory symptoms was low (intraclass correlation=0.6%-2.4%). Psychosocial factors, especially worry about school's IEQ, explained more of the variance between schools in symptoms than IEQ among secondary school pupils and parents, but not among primary school pupils for symptoms in general. Worry about IEQ also modified the associations between IEQ and respiratory symptoms, but only in parental reports. CONCLUSION In addition to IEQ, psychosocial factors and pupils' individual and allergic characteristics were related to higher reporting of respiratory symptoms in all three samples. Psychosocial factors explained more variance between schools than IEQ, although it was 2.4% at most. Other factors beyond IEQ should be considered when interpreting symptom reporting in indoor air questionnaires.
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Affiliation(s)
- Kateryna Savelieva
- Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Marko Elovainio
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Jussi Lampi
- Department of Health Security, Environmental Health Unit, Finnish Institute for Health and Welfare, Kuopio, Pohjois-Savo, Finland
| | - Sari Ung-Lanki
- Department of Health Security, Environmental Health Unit, Finnish Institute for Health and Welfare, Kuopio, Pohjois-Savo, Finland
| | - Juha Pekkanen
- Department of Public Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Health Security, Environmental Health Unit, Finnish Institute for Health and Welfare, Kuopio, Pohjois-Savo, Finland
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14
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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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15
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Cai J, Li B, Yu W, Yao Y, Wang L, Li B, Wang Y, Du C, Xiong J. Associations of household dampness with asthma, allergies, and airway diseases among preschoolers in two cross-sectional studies in Chongqing, China: Repeated surveys in 2010 and 2019. ENVIRONMENT INTERNATIONAL 2020; 140:105752. [PMID: 32371306 DOI: 10.1016/j.envint.2020.105752] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 04/12/2020] [Accepted: 04/18/2020] [Indexed: 06/11/2023]
Abstract
Many studies have investigated the associations between household damp indicators, and allergies and respiratory diseases in childhood. However, the findings are rather inconsistent. In 2010, we conducted a cross-sectional study of preschoolers aged three-six years in three urban districts of Chongqing, China. In 2019, we repeated this cross-sectional study with preschoolers of the same ages and districts. Here, we selected data for 2935 and 2717 preschoolers who did not change residences since birth in the 2010 and 2019 studies, respectively. We investigated associations of household damp indicators with asthma, allergic rhinitis, pneumonia, eczema, wheeze, and rhinitis in childhood in the two studies. The proportions of residences with household damp indicators and the prevalence of the studied diseases (except for allergic rhinitis) were significantly lower in 2019 than in 2010. In the two-level (district-child) logistic regression analyses, household damp exposures that showed by different indicators were significantly associated with the increased odds of lifetime-ever asthma (range of adjusted odds ratio (AOR): 1.69-3.50 in 2019; 1.13-1.90 in 2010), allergic rhinitis (1.14-2.39; 0.67-1.61), pneumonia (1.09-1.64; 1.21-1.59), eczema (0.96-1.83; 0.99-1.56), wheeze (1.64-2.79; 1.18-1.91), rhinitis (1.43-2.71; 1.08-1.58), and current (in the past 12 months before the survey) eczema (0.46-2.08; 0.99-1.48), wheeze (0.97-2.86; 1.26-2.07) and rhinitis (1.34-2.25; 1.09-1.56) in most cases. The increased odds ratios (ORs) of most diseases had exposure-response relationships with the cumulative number (n) of household damp indicators in the current and early residences. Our results indicated household damp exposure could be a risk factor for childhood allergic and respiratory diseases, although the magnitudes of these effects could be different in different studies.
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Affiliation(s)
- Jiao Cai
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing, China; National Centre for International Research of Low-carbon and Green Buildings (Ministry of Science and Technology), Chongqing University, Chongqing, China
| | - Baizhan Li
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing, China; National Centre for International Research of Low-carbon and Green Buildings (Ministry of Science and Technology), Chongqing University, Chongqing, China.
| | - Wei Yu
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing, China; National Centre for International Research of Low-carbon and Green Buildings (Ministry of Science and Technology), Chongqing University, Chongqing, China
| | - Yinghui Yao
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing, China; National Centre for International Research of Low-carbon and Green Buildings (Ministry of Science and Technology), Chongqing University, Chongqing, China
| | - Lexiang Wang
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing, China; National Centre for International Research of Low-carbon and Green Buildings (Ministry of Science and Technology), Chongqing University, Chongqing, China
| | - Bicheng Li
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing, China; National Centre for International Research of Low-carbon and Green Buildings (Ministry of Science and Technology), Chongqing University, Chongqing, China
| | - Yujue Wang
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing, China; National Centre for International Research of Low-carbon and Green Buildings (Ministry of Science and Technology), Chongqing University, Chongqing, China
| | - Chenqiu Du
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing, China; National Centre for International Research of Low-carbon and Green Buildings (Ministry of Science and Technology), Chongqing University, Chongqing, China
| | - Jie Xiong
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing, China; National Centre for International Research of Low-carbon and Green Buildings (Ministry of Science and Technology), Chongqing University, Chongqing, China
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16
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Juel Holst G, Pørneki A, Lindgreen J, Thuesen B, Bønløkke J, Hyvärinen A, Elholm G, Østergaard K, Loft S, Brooks C, Douwes J, Linneberg A, Sigsgaard T. Household dampness and microbial exposure related to allergy and respiratory health in Danish adults. Eur Clin Respir J 2020; 7:1706235. [PMID: 32128077 PMCID: PMC7034447 DOI: 10.1080/20018525.2019.1706235] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 12/11/2019] [Indexed: 11/03/2022] Open
Abstract
Background: Indoor dampness has consistently been associated with respiratory symptoms and exacerbations. The causal mechanisms may involve increased microbial exposures. However, the evidence regarding the influence of indoor microbial exposures under damp- and non-damp conditions on the risk of asthma and allergy has been inconclusive. Objective: The aim of this study was to investigate the association between dampness and microbial exposure with allergy and respiratory health in Danish adults using a cross-sectional design. Methods: From 1,866 participants of the Health2006 cohort, we selected three non-overlapping groups: 196 at random, 107 with confirmed atopy, and 99 without atopy. Bedroom dust was sampled using electrostatic dust fall collectors and analysed for endotoxin, β-(1,3)-D-glucan, 19 microbial species or groups, and total fungal load. Household moisture-related problems and asthma were self-reported by questionnaire. Atopy was determined by skin-prick-testing and lung function was measured by spirometry. Results: Household moisture damage was positively associated with asthma outcomes, although this was statistically significant only in atopics for self-reported asthma (odds ratio (OR) 3.52; 95%CI 1.01-12.7). Mould odor was positively associated with wheezing (OR 6.05; 95%CI 1.19-30.7) in atopics. Inconsistent associations were found for individual microbial exposures and health outcomes. Inverse associations were observed between microbial diversity and rhinitis in the random sample and both doctor-diagnosed and self-reported asthma in non-atopics. Conclusions: In conclusion, our findings suggest that household moisture damage may increase the risk of asthma and wheeze with mould odor in atopics. In addition, asthma and allergy may be affected by the indoor microbial composition in urban domestic environments. Further studies are needed to identify and understand the causal agents and underlying mechanisms behind the potential effects of environmental microbial exposure on human health.
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Affiliation(s)
- G Juel Holst
- Section of Environment, Occupation and Health, Aarhus University, Aarhus, Denmark
| | | | | | - B Thuesen
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region of Denmark, Denmark
| | - J Bønløkke
- Department of Occupational and Environmental Medicine, Danish Ramazzini Centre, Aalborg University Hospital, Aalborg, Denmark
| | - A Hyvärinen
- Environment and Health Unit, National Institute for Health and Welfare - THL, Kuopio, Finland
| | - G Elholm
- Section of Environment, Occupation and Health, Aarhus University, Aarhus, Denmark
| | - K Østergaard
- Section of Environment, Occupation and Health, Aarhus University, Aarhus, Denmark
| | - S Loft
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - C Brooks
- Centre for Public Health Research, Massey University, Wellington, New Zealand
| | - J Douwes
- Centre for Public Health Research, Massey University, Wellington, New Zealand
| | - A Linneberg
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region of Denmark, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - T Sigsgaard
- Section of Environment, Occupation and Health, Aarhus University, Aarhus, Denmark
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17
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Savelieva K, Marttila T, Lampi J, Ung-Lanki S, Elovainio M, Pekkanen J. Associations between indoor environmental quality in schools and symptom reporting in pupil-administered questionnaires. Environ Health 2019; 18:115. [PMID: 31881894 PMCID: PMC6935098 DOI: 10.1186/s12940-019-0555-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 12/18/2019] [Indexed: 05/29/2023]
Abstract
BACKGROUND The associations between indoor environmental quality (IEQ) in homes and symptom reporting of children have been extensively studied, but only few large-scale studies have been done in schools. We examined associations between expert-assessed IEQ in schools and pupils' reporting of different symptoms, and whether associations were stronger if participants relate symptoms to the school environment. METHODS The questionnaire survey was done in all primary and secondary schools in two areas of Helsinki, Finland. Primary school pupils (grade 3-6, n = 8775, 99 school-buildings) and secondary school pupils (grade 7-9, n = 3410, 30 school-buildings) reported their symptoms. Symptoms were combined into respiratory, lower respiratory, eye, skin, and general symptom groups. Surveys were also done among the parents of the primary school pupils (grade 1-6, n = 3540, 88 school buildings), but results are reported only in the supplement due to the low response rate (20% in 2017 and 13% in 2018). The associations between IEQ and symptoms were analyzed using multilevel logistic regression analysis. RESULTS Several of the IEQ indicators were highly correlated and indicators were therefore mainly analyzed by combining them into a summary score and into latent classes. Dose-response associations were found between IEQ problems and higher reporting of respiratory and general symptoms among both primary and secondary school pupils. Some associations were also observed with lower respiratory and skin symptoms, but not with eye symptoms. The associations were somewhat stronger with symptoms related to the school environment compared to symptoms reported without such relation: for a unit change in IEQ summary score and respiratory symptoms in primary schools, odds ratios were 1.07 (95% CI 1.02-1.06) and 1.04 (95% CI 1.04-1.10), and in secondary schools 1.09 (95% CI 1.01-1.09) and 1.05 (95% CI 1.02-1.17), respectively. CONCLUSIONS Expert-assessed IEQ problems in schools were associated with increased reporting of especially respiratory and general symptoms. The associations were only somewhat stronger in magnitude for symptoms reported in relation to the school environment compared to symptoms reported without such relation.
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Affiliation(s)
- Kateryna Savelieva
- Department of Public Health, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland
| | - Tero Marttila
- Unit of Civil Engineering, Faculty of Built Environment, Tampere University, 33014 Tampere, Finland
| | - Jussi Lampi
- Department of Health Security, Environmental Health, National Institute for Health and Welfare, 70701 Kuopio, Finland
| | - Sari Ung-Lanki
- Department of Health Security, Environmental Health, National Institute for Health and Welfare, 70701 Kuopio, Finland
| | - Marko Elovainio
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland
| | - Juha Pekkanen
- Department of Public Health, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland
- Department of Health Security, Environmental Health, National Institute for Health and Welfare, 70701 Kuopio, Finland
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18
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Fisk WJ, Chan WR, Johnson AL. Does dampness and mold in schools affect health? Results of a meta-analysis. INDOOR AIR 2019; 29:895-902. [PMID: 31310034 DOI: 10.1111/ina.12588] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 07/03/2019] [Accepted: 07/10/2019] [Indexed: 06/10/2023]
Abstract
This paper provides meta-analyses of the published findings relating the respiratory health of occupants of schools with visible dampness, water damage, visible mold, and/or mold odor. Random effects models were used to develop central estimates and confidence limits for the associations of respiratory health effects with school dampness and mold. Eleven studies, all with cross-sectional designs, were included in the meta-analyses; however, analyses for some health outcomes were based on as few as four studies. Analyses were performed using data from adults and children combined, using only data from children, and using data from adults and children after excluding two studies. The central estimates of odds ratios from the meta-analyses were consistently above unity. The evidence of adverse health effects was strongest for cough and wheeze, which had confidence limits excluding unity in some or all analyses. The odds ratios of 1.32 for cough and 1.68 for wheeze suggest moderate increases in health risk. Studies not included in the meta-analyses provide additional evidence that dampness and mold in schools are associated with adverse health outcomes. These meta-analyses and the published literature not included in the meta-analyses suggest that dampness and mold in schools are associated with adverse respiratory health effects.
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Affiliation(s)
- William J Fisk
- Indoor Environment Group, Lawrence Berkeley National Laboratory, Berkeley, CA
| | - Wanyu R Chan
- Indoor Environment Group, Lawrence Berkeley National Laboratory, Berkeley, CA
| | - Alexandra L Johnson
- Indoor Environment Group, Lawrence Berkeley National Laboratory, Berkeley, CA
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19
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Luo Y, Yang M, Guo M, Zhong X, Hu Y. Huang Qin Hua Shi decoction for high-temperature- and high-humidity-induced cognitive-behavioral disorder in rats is associated with deactivation of the hypothalamic-pituitary-adrenal axis. J Int Med Res 2019; 47:5752-5766. [PMID: 31547741 PMCID: PMC6862911 DOI: 10.1177/0300060519875369] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Objective To investigate the effects of Huang Qin Hua Shi (HQ) decoction on the hypothalamic–pituitary–adrenal (HPA) axis in rats under high-temperature (hT)- and high-humidity (hH)-induced stress. Methods Male rats were randomized into four groups: rats without stress; rats induced with hT (35 ± 1°C) and hH (85 ± 5% humidity); rats induced with hT and hH and treated with HQ decoction; and rats induced with hT and hH and treated with mifepristone. After 3 weeks, rats underwent the Morris water maze and open-field test. Rat hypothalami were analyzed pathologically using hematoxylin and eosin staining and glucocorticoid receptor (GR) mRNA expression was evaluated by in situ hybridization. Serum levels of corticotropin-releasing hormone (CRH), adrenocorticotropic hormone (ACTH), and corticosteroid (CORT) were assessed by enzyme-linked immunosorbent assay. Results The administration of mifepristone or HQ in stressed rats significantly improved their performance in the Morris water maze test and increased the central-to-peripheral ratio and incidence of deep rearing in the open-field test. Mifepristone and HQ also reversed histological changes in the hypothalami of stressed rats. Compared with control rats, GR mRNA expression in the hypothalamus and serum CRH, ACTH, and CORT were significantly elevated in rats stressed with hT and hH, and these changes were attenuated by mifepristone and HQ. Conclusion HQ decoction protects against hT- and hH-induced cognitive-behavioral disorder and its therapeutic effect is associated with decreased HPA axis activity.
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Affiliation(s)
- Yong Luo
- Graduate College, Naval Medical University, Shanghai, China.,Traditional Chinese Medicine (TCM) Department, the General Hospital of Western Theater Command PLA, Chengdu, China
| | - Min Yang
- Traditional Chinese Medicine (TCM) Department, the General Hospital of Western Theater Command PLA, Chengdu, China
| | - Mingyang Guo
- Traditional Chinese Medicine (TCM) Department, the General Hospital of Western Theater Command PLA, Chengdu, China
| | - Xiaolong Zhong
- Traditional Chinese Medicine (TCM) Department, the General Hospital of Western Theater Command PLA, Chengdu, China
| | - Yonghe Hu
- Traditional Chinese Medicine (TCM) Department, the General Hospital of Western Theater Command PLA, Chengdu, China
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20
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School exposure and asthma. Ann Allergy Asthma Immunol 2019; 120:482-487. [PMID: 29407419 DOI: 10.1016/j.anai.2018.01.028] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 01/18/2018] [Accepted: 01/22/2018] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To provide a comprehensive overview of common school exposures and the association between school exposures and pediatric asthma morbidity. DATA SOURCES A comprehensive literature review was performed using PubMed. STUDY SELECTIONS Full-length, peer-reviewed studies published in English were considered for review. In vivo, in vitro, and animal studies were excluded. Studies of school exposure to cockroach, mouse, dust mite, dog, cat, molds, pollution, and endotoxin associated with asthma and asthma morbidity were considered. RESULTS The current literature establishes an association between school exposure and pediatric asthma morbidity. There is a need for ongoing research to evaluate the effects of school-based environmental interventions on asthma morbidity. CONCLUSION It is evident that the indoor school environment is a significant reservoir of allergens, molds, pollutants, and endotoxin and that there is an association between school exposure and pediatric asthma morbidity. School-based interventions have the potential for substantial individual, community, and public health benefit. It is important that researchers continue to study the health effects associated with school exposures and assess cost-effectiveness of multifaceted school-based interventions.
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21
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Huttunen K, Wlodarczyk AJ, Tirkkonen J, Mikkonen S, Täubel M, Krop E, Jacobs J, Pekkanen J, Heederik D, Zock JP, Hyvärinen A, Hirvonen MR, Adams R, Jones T, Zimmermann R, BéruBé K. Oxidative capacity and hemolytic activity of settled dust from moisture-damaged schools. INDOOR AIR 2019; 29:299-307. [PMID: 30575131 DOI: 10.1111/ina.12527] [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: 03/19/2018] [Revised: 10/19/2018] [Accepted: 12/17/2018] [Indexed: 06/09/2023]
Abstract
Exposure to moisture-damaged indoor environments is associated with adverse respiratory health effects, but responsible factors remain unidentified. In order to explore possible mechanisms behind these effects, the oxidative capacity and hemolytic activity of settled dust samples (n = 25) collected from moisture-damaged and non-damaged schools in Spain, the Netherlands, and Finland were evaluated and matched against the microbial content of the sample. Oxidative capacity was determined with plasmid scission assay and hemolytic activity by assessing the damage to isolated human red blood cells. The microbial content of the samples was measured with quantitative PCR assays for selected microbial groups and by analyzing the cell wall markers ergosterol, muramic acid, endotoxins, and glucans. The moisture observations in the schools were associated with some of the microbial components in the dust, and microbial determinants grouped together increased the oxidative capacity. Oxidative capacity was also affected by particle concentration and country of origin. Two out of 14 studied dust samples from moisture-damaged schools demonstrated some hemolytic activity. The results indicate that the microbial component connected with moisture damage is associated with increased oxidative stress and that hemolysis should be studied further as one possible mechanism contributing to the adverse health effects of moisture-damaged buildings.
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Affiliation(s)
- Kati Huttunen
- Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland
- School of Biosciences, Cardiff University, Cardiff, UK
- Helmholtz Virtual Institute of Complex Molecular Systems in Environmental Health (HICE), Neuherberg, Germany
| | - Anna J Wlodarczyk
- School of Biosciences, Cardiff University, Cardiff, UK
- Helmholtz Virtual Institute of Complex Molecular Systems in Environmental Health (HICE), Neuherberg, Germany
| | - Jenni Tirkkonen
- Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland
| | - Santtu Mikkonen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Martin Täubel
- Environmental Health Unit, Department of Health Security, National Institute for Health and Welfare, Kuopio, Finland
| | - Esmeralda Krop
- Division Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - José Jacobs
- Division Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Juha Pekkanen
- Environmental Health Unit, Department of Health Security, National Institute for Health and Welfare, Kuopio, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Dick Heederik
- Division Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Jan-Paul Zock
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Anne Hyvärinen
- Environmental Health Unit, Department of Health Security, National Institute for Health and Welfare, Kuopio, Finland
| | - Maija-Riitta Hirvonen
- Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland
- Helmholtz Virtual Institute of Complex Molecular Systems in Environmental Health (HICE), Neuherberg, Germany
| | - Rachel Adams
- Cardiff School of Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | - Tim Jones
- School of Earth & Ocean Sciences, Cardiff University, Cardiff, UK
| | - Ralf Zimmermann
- Helmholtz Virtual Institute of Complex Molecular Systems in Environmental Health (HICE), Neuherberg, Germany
- Joint Mass Spectrometry Centre, Institute of Chemistry, Analytical Chemistry, University of Rostock, Rostock, Germany
| | - Kelly BéruBé
- School of Biosciences, Cardiff University, Cardiff, UK
- Helmholtz Virtual Institute of Complex Molecular Systems in Environmental Health (HICE), Neuherberg, Germany
- Cardiff Institute for Tissue Engineering & Repair (CITER), Cardiff University, Cardiff, Wales, UK
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Online Questionnaire as a Tool to Assess Symptoms and Perceived Indoor Air Quality in a School Environment. ATMOSPHERE 2018. [DOI: 10.3390/atmos9070270] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
School environments are a complex entirety where various different exposure factors are related that contribute to the indoor air quality (IAQ) and may affect occupants’ health and well-being. Indoor air questionnaires are useful for collecting information about the occupants’ experiences and perceptions of the indoor air and for evaluating the results of the measures taken. A common way to implement health questionnaires is to ask the respondents to describe symptoms at certain time points, such as weeks or months. The aim of our study was to develop a short and easy online questionnaire to assess symptoms and perceived IAQ. We also aimed to test the usability of the questionnaire in school buildings and assess the differences between the online measurement data (CO2, T, and RH) and the IAQ complaints and symptoms reported by the pupils. A total of 105 teachers and 1268 pupils in 36 classrooms at six schools answered the questionnaires over a two-week period. The participants completed the questionnaire always after the lesson in the studied classroom. We received 719 answers from the teachers and 6322 answers from the pupils. The results demonstrated that the teachers reported more IAQ problems and symptoms than the pupils did. Differences between classrooms were observed in both the IAQ problem and reference schools. The most common significant differences (p-value > 0.05) between the classrooms were among humidity, too cold air, and stuffy air, and among symptoms, dry/sore throat, tiredness, headache, and skin symptoms. Maximum values of CO2 measurements and the highest prevalence of stuffy air were relatively consistent. The testing process demonstrated that such a questionnaire was suitable for adults and children aged at least 12 years. The results of our study suggest that a quick and easy online questionnaire that is completed within a short period may be useful for gathering valuable knowledge about perceived IAQ. It could be used in combination with other indoor environment investigations to produce detailed results and restorative measures.
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An international comparison of risk factors between two regions with distinct differences in asthma prevalence. Allergol Immunopathol (Madr) 2018; 46:341-353. [PMID: 29588089 DOI: 10.1016/j.aller.2018.01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 12/13/2017] [Accepted: 01/03/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND PURPOSE Investigation of the geographic variation in asthma prevalence can improve our understanding of asthma etiology and management. The purpose of our investigation was to compare the prevalence of asthma and wheeze among adolescents living in two distinct international regions and to investigate reasons for observed differences. METHODS A cross-sectional survey of 13-14 year olds was completed in Saskatoon, Canada (n=1200) and Skopje, Republic of Macedonia (n=3026), as part of the International Study of Asthma and Allergies in Childhood (ISAAC) Phase 3 study. Surveys were self-completed by students following the ISAAC protocol. Multiple logistic regression models were used to investigate associations with reports of asthma and current wheeze. A mediation analysis was then completed. RESULTS Asthma prevalence was much higher in Saskatoon than Skopje (21.3% vs. 1.7%) as was the prevalence of current wheeze (28.2% vs. 8.8%). Higher paracetamol (acetaminophen) use was a consistent risk factor for asthma and wheeze in both locations and showed dose-response relationships. In both countries, paracetamol use and physical activity mediated some of the association for both asthma and wheeze. In Saskatoon, among those with current wheeze, 42.6% reported ever having a diagnosis of asthma compared to 10.2% among Skopje adolescents. CONCLUSIONS The results suggest that the variation in risk factors between the two locations may explain some of the differences in the prevalence of asthma and wheeze between these two study sites. However, diagnostic labeling patterns should not be ruled out as another potential explanatory factor.
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An Official American Thoracic Society Workshop Report: Presentations and Discussion of the Sixth Jack Pepys Workshop on Asthma in the Workplace. Ann Am Thorac Soc 2018; 14:1361-1372. [PMID: 28862493 DOI: 10.1513/annalsats.201706-508st] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
The Sixth Jack Pepys Workshop on Asthma in the Workplace focused on six key themes regarding the recognition and assessment of work-related asthma and airway diseases: (1) cleaning agents and disinfectants (including in swimming pools) as irritants and sensitizers: how to evaluate types of bronchial reactions and reduce risks; (2) population-based studies of occupational obstructive diseases: use of databanks, advantages and pitfalls, what strategies to deal with biases and confounding?; (3) damp environments, dilapidated buildings, recycling processes, and molds, an increasing problem: mechanisms, how to assess causality and diagnosis; (4) diagnosis of occupational asthma and rhinitis: how useful are recombinant allergens (component-resolved diagnosis), metabolomics, and other new tests?; (5) how does exposure to gas, dust, and fumes enhance sensitization and asthma?; and (6) how to determine probability of occupational causality in chronic obstructive pulmonary disease: epidemiological and clinical, confirmation, and compensation aspects. A summary of the presentations and discussion is provided in this proceedings document. Increased knowledge has been gained in each topic over the past few years, but there remain aspects of controversy and uncertainty requiring further research.
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Abstract
There are possibly millions of mold species on earth. The vast majority of these mold spores live in harmony with humans, rarely causing disease. The rare species that does cause disease does so by triggering allergies or asthma, or may be involved in hypersensitivity diseases such as allergic bronchopulmonary aspergillosis or allergic fungal sinusitis. Other hypersensitivity diseases include those related to occupational or domiciliary exposures to certain mold species, as in the case of Pigeon Breeder's disease, Farmer's lung, or humidifier fever. The final proven category of fungal diseases is through infection, as in the case of onchomycosis or coccidiomycosis. These diseases can be treated using anti-fungal agents. Molds and fungi can also be particularly important in infections that occur in immunocompromised patients. Systemic candidiasis does not occur unless the individual is immunodeficient. Previous reports of "toxic mold syndrome" or "toxic black mold" have been shown to be no more than media hype and mass hysteria, partly stemming from the misinterpreted concept of the "sick building syndrome." There is no scientific evidence that exposure to visible black mold in apartments and buildings can lead to the vague and subjective symptoms of memory loss, inability to focus, fatigue, and headaches that were reported by people who erroneously believed that they were suffering from "mycotoxicosis." Similarly, a causal relationship between cases of infant pulmonary hemorrhage and exposure to "black mold" has never been proven. Finally, there is no evidence of a link between autoimmune disease and mold exposure.
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Casas L, Tischer C, Täubel M. Pediatric Asthma and the Indoor Microbial Environment. Curr Environ Health Rep 2018; 3:238-49. [PMID: 27230430 DOI: 10.1007/s40572-016-0095-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
The global increase in the prevalence of asthma has been related to several risk factors; many of them linked to the "westernization" process and the characteristics of the indoor microbial environment during early life may play an important role. Living in moisture damaged homes contributes to the exacerbation and development of asthma. However, living in homes with a rich variety and high levels of microbes (e.g., traditional farming environments) may confer protection. While the results of previous research are rather consistent when it comes to observation/report of indoor moisture damage or when comparing farming versus non-farming homes, when actual measures targeting indoor microbial exposure are included, the picture becomes less clear and the associations appear inconsistent. This may partly be due to limitations of sampling and measurement techniques that make comparisons difficult and provide an incomplete picture of the indoor microbial environment and in particular also human exposure. In this regard, new generation sequencing techniques represent a potential revolution in better understanding the impact of the indoor microbiome on human health.
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Affiliation(s)
- Lidia Casas
- Department of Public Health and Primary Care, Centre for Environment and Health, KU Leuven, Herestraat 49, 3000, Leuven, Belgium. .,ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Dr Aiguader 88, 08003, Barcelona, Spain. .,University Pompeu Fabra (UPF), Barcelona, Spain. .,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
| | - Christina Tischer
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Dr Aiguader 88, 08003, Barcelona, Spain.,University Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Martin Täubel
- Living Environment and Health Unit, National Institute for Health and Welfare, Neulaniementie 4, 70210, Kuopio, Finland
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Permaul P, Phipatanakul W. School Environmental Intervention Programs. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2018; 6:22-29. [PMID: 29310758 PMCID: PMC5773264 DOI: 10.1016/j.jaip.2017.10.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Revised: 09/29/2017] [Accepted: 10/03/2017] [Indexed: 12/30/2022]
Abstract
Exposure to indoor allergens and pollutants plays a significant part in the development of asthma and its associated morbidity. Inner-city children with asthma are disproportionately affected by these exposures with increased asthma morbidity. Although years of previous research have linked exposures in the urban home environment with significant childhood asthma disease, many of these allergens are also present in inner-city school environments. Therefore, evaluation of the school environment of patients with asthma is also essential. School-based environmental interventions may offer benefit for this problem and has the potential to help many children with asthma at once in a cost-effective manner. It is important that environmental health researchers continue to assess which interventions are most practical and result in the greatest measurable improvements.
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Affiliation(s)
- Perdita Permaul
- Division of Pediatric Allergy and Immunology, Massachusetts General Hospital for Children, Boston, Mass; Harvard Medical School, Boston, Mass
| | - Wanda Phipatanakul
- Harvard Medical School, Boston, Mass; Division of Allergy and Immunology, Boston Children's Hospital, Boston, Mass.
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28
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Jayaprakash B, Adams RI, Kirjavainen P, Karvonen A, Vepsäläinen A, Valkonen M, Järvi K, Sulyok M, Pekkanen J, Hyvärinen A, Täubel M. Indoor microbiota in severely moisture damaged homes and the impact of interventions. MICROBIOME 2017; 5:138. [PMID: 29029638 PMCID: PMC5640920 DOI: 10.1186/s40168-017-0356-5] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 09/27/2017] [Indexed: 05/22/2023]
Abstract
BACKGROUND The limited understanding of microbial characteristics in moisture-damaged buildings impedes efforts to clarify which adverse health effects in the occupants are associated with the damage and to develop effective building intervention strategies. The objectives of this current study were (i) to characterize fungal and bacterial microbiota in house dust of severely moisture-damaged residences, (ii) to identify microbial taxa associated with moisture damage renovations, and (iii) to test whether the associations between the identified taxa and moisture damage are replicable in another cohort of homes. We applied bacterial 16S rRNA gene and fungal ITS amplicon sequencing complemented with quantitative PCR and chemical-analytical approaches to samples of house dust, and also performed traditional cultivation of bacteria and fungi from building material samples. RESULTS Active microbial growth on building materials had significant though small influence on the house dust bacterial and fungal communities. Moisture damage interventions-including actual renovation of damaged homes and cases where families moved to another home-had only a subtle effect on bacterial community structure, seen as shifts in abundance weighted bacterial profiles after intervention. While bacterial and fungal species richness were reduced in homes that were renovated, they were not reduced for families that moved houses. Using different discriminant analysis tools, we were able identify taxa that were significantly reduced in relative abundance during renovation of moisture damage. For bacteria, the majority of candidates belonged to different families within the Actinomycetales order. Results for fungi were overall less consistent. A replication study in approximately 400 homes highlighted some of the identified taxa, confirming associations with observations of moisture damage and mold. CONCLUSIONS The present study is one of the first studies to analyze changes in microbiota due to moisture damage interventions using high-throughput sequencing. Our results suggest that effects of moisture damage and moisture damage interventions may appear as changes in the abundance of individual, less common, and especially bacterial taxa, rather than in overall community structure.
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Affiliation(s)
| | - Rachel I. Adams
- Plant and Microbial Biology, University of California, Berkeley, California USA
- California Department of Public Health, Richmond, California USA
| | - Pirkka Kirjavainen
- Environmental Health Unit, National Institute for Health and Welfare, Kuopio, Finland
| | - Anne Karvonen
- Environmental Health Unit, National Institute for Health and Welfare, Kuopio, Finland
| | - Asko Vepsäläinen
- Environmental Health Unit, National Institute for Health and Welfare, Kuopio, Finland
| | - Maria Valkonen
- Environmental Health Unit, National Institute for Health and Welfare, Kuopio, Finland
| | - Kati Järvi
- School of Engineering, Aalto University, Espoo, Finland
| | - Michael Sulyok
- Department for Agrobiotechnology (IFA-Tulln), University of Natural Resources and Life Sciences, (BOKU), Vienna, Tulln Austria
| | - Juha Pekkanen
- Environmental Health Unit, National Institute for Health and Welfare, Kuopio, Finland
- Department of Public Health, Helsinki University, Helsinki, Finland
| | - Anne Hyvärinen
- Environmental Health Unit, National Institute for Health and Welfare, Kuopio, Finland
| | - Martin Täubel
- Environmental Health Unit, National Institute for Health and Welfare, Kuopio, Finland
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29
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Vilén LK, Atosuo J, Lilius EM. The Response of Phagocytes to Indoor Air Toxicity. Front Immunol 2017; 8:887. [PMID: 28804487 PMCID: PMC5532390 DOI: 10.3389/fimmu.2017.00887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 07/11/2017] [Indexed: 11/25/2022] Open
Abstract
This perspective presents a viewpoint on potential methods assessing toxicity of indoor air. Until recently, the major techniques to document moldy environment have been microbial isolation using conventional culture techniques for fungi and bacteria as well as in some instances polymerase chain reaction to detect microbial genetic components. However, it has become increasingly evident that bacterial and fungal toxins, their metabolic products, and volatile organic substances emitted from corrupted constructions are the major health risks. Here, we illustrate how phagocytes, especially neutrophils can be used as a toxicological probe. Neutrophils can be used either in vitro as probe cells, directly exposed to the toxic agent studied, or they can act as in vivo indicators of the whole biological system exposed to the agent. There are two convenient methods assessing the responses, one is to measure chemiluminescence emission from activated phagocytes and the other is to measure quantitatively by flow cytometry the expression of complement and immunoglobulin receptors on the phagocyte surface.
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Affiliation(s)
- Liisa K Vilén
- Department of Biochemistry, University of Turku, Turku, Finland
| | - Janne Atosuo
- Department of Biochemistry, University of Turku, Turku, Finland
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30
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Salin JT, Salkinoja-Salonen M, Salin PJ, Nelo K, Holma T, Ohtonen P, Syrjälä H. Building-related symptoms are linked to the in vitro toxicity of indoor dust and airborne microbial propagules in schools: A cross-sectional study. ENVIRONMENTAL RESEARCH 2017; 154:234-239. [PMID: 28107741 DOI: 10.1016/j.envres.2017.01.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 01/10/2017] [Accepted: 01/12/2017] [Indexed: 06/06/2023]
Abstract
INTRODUCTION Indoor microbial toxicity is suspected to cause some building-related symptoms, but supporting epidemiological data are lacking. OBJECTIVE We examined whether the in vitro toxicity of indoor samples from school buildings was associated with work-related health symptoms (building-related symptoms, BRS). METHODS Administrators of the Helsinki City Real Estate Department selected 15 schools for the study, and a questionnaire on symptoms connected to work was sent to the teachers in the selected schools for voluntary completion. The cellular toxicity of classroom samples was determined by testing substances extracted from wiped indoor dust and by testing microbial biomass that was cultured on fallout plates. Boar sperm cells were used as indicator cells, and motility loss was the indicator for toxic effects. The effects were expressed as the half maximal effective concentration (EC50) at which >50% of the exposed boar sperm cells were immobile compared to vehicle control. RESULTS Completed symptom questionnaires were received from 232 teachers [median age, 43 years; 190 (82.3%) women] with a median time of 6 years working at their school. Samples from their classrooms were available and were assessed for cellular toxicity. The Poisson regression model showed that the impact of extracts of surface-wiped school classroom dust on teacher work-related BRS was 2.8-fold (95% CI: 1.6-4.9) higher in classrooms with a toxic threshold EC50 of 6µgml-1 versus classrooms with insignificant EC50 values (EC50 >50µgml-1); P<0.001. The number of symptoms that were alleviated during vacation was higher in school classrooms with high sperm toxicity compared to less toxic sites; the RR was 1.9 (95% CI: 1.1-3.3, P=0.03) for wiped dust extracts. CONCLUSIONS Teachers working in classrooms where the samples showed high sperm toxicity had more BRS. The boar sperm cell motility inhibition assay appears promising as a tool for demonstrating the presence of indoor substances associated with BRS.
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Affiliation(s)
- J T Salin
- Department of Infection Control, Oulu University Hospital, Finland
| | - M Salkinoja-Salonen
- Department of Food and Environmental Sciences, FI 00014 University of Helsinki, Finland; Department of Electrical Engineering and Automation, Aalto University, Espoo, Finland
| | - P J Salin
- Oulu University Hospital, Inspector Sec Oy Laboratories, Oulu, Finland; Department of Food and Environmental Sciences, FI 00014 University of Helsinki, Finland
| | - K Nelo
- Oulu University Hospital, Inspector Sec Oy Laboratories, Oulu, Finland
| | - T Holma
- Department of Otorhinolaryngology and Head and Neck Surgery, Oulu University Hospital, Finland; PEDEGO Research Unit, University of Oulu, Finland; Medical Research Center Oulu, Finland
| | - P Ohtonen
- Division of Operative Care and Medical Research Center, Finland
| | - H Syrjälä
- Department of Infection Control, Oulu University Hospital, Finland.
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Casas L, Espinosa A, Pekkanen J, Asikainen A, Borràs-Santos A, Jacobs J, Krop EJM, Täubel M, Hyvärinen A, Heederik D, Zock JP. School attendance and daily respiratory symptoms in children: influence of moisture damage. INDOOR AIR 2017; 27:303-310. [PMID: 27224645 DOI: 10.1111/ina.12311] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 05/20/2016] [Indexed: 06/05/2023]
Abstract
We investigated the effect of weekends and school holidays on the daily frequency and severity of respiratory and other symptoms among children attending schools with (index) or without (reference) moisture damage in Spain, the Netherlands, and Finland. Throughout 1 year, parents of 419 children with a respiratory condition attending index (n=15) or reference (n=10) primary schools completed three symptom diaries. We assessed associations between lower respiratory tract, upper respiratory tract or allergy, and other symptom scores and school day, weekend, or summer holiday using mixed regression models stratified by country and moisture damage. We evaluated interactions between moisture damage and type of day. We combined country-specific estimates (incidence rate ratios [IRRs] and 95% confidence interval [CI]) in meta-analyses. Symptom scores were lower during weekends and holiday. Lower respiratory tract symptoms were statistically significantly less common during holiday with strongest effect in index schools (IRR=0.7; CI=0.6-0.8). Reporting of other symptoms was more reduced during holiday in index (IRR=0.6; CI=0.4-0.9) than in reference (IRR=0.95; CI=0.8-1.2) schools (interaction P<.01). In conclusion, symptoms were less frequent and/or severe during summer holiday and weekends. This pattern was stronger among children attending moisture-damaged schools, suggesting potential improvement in moisture damage-related symptoms during school breaks.
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Affiliation(s)
- L Casas
- Department of Public Health and Primary Care-Centre for Environment and Health, KU Leuven, Leuven, Belgium
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- University Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - A Espinosa
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- University Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - J Pekkanen
- Department Health Protection, National Institute for Health and Welfare, Kuopio, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - A Asikainen
- Department Health Protection, National Institute for Health and Welfare, Kuopio, Finland
| | - A Borràs-Santos
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- University Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- CIBER Respiratorio (CIBERES), Madrid, Spain
| | - J Jacobs
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - E J M Krop
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - M Täubel
- Department Health Protection, National Institute for Health and Welfare, Kuopio, Finland
| | - A Hyvärinen
- Department Health Protection, National Institute for Health and Welfare, Kuopio, Finland
| | - D Heederik
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - J-P Zock
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- University Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
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32
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Beridze V, Abuladze L, Partenadze N, Bakhtadze T, Lawson J, Zejda JE. Childhood asthma in Batumi, Georgia: Prevalence and environmental correlates. J Asthma 2017; 55:43-49. [PMID: 27901622 DOI: 10.1080/02770903.2016.1247169] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE A relative lack of data for Eastern Europe and unknown epidemiology of childhood asthma in Batumi (Georgia) justified a study aimed at determining the prevalence of physician-diagnosed asthma and related respiratory conditions, a comparison of the prevalence of these conditions between urban and rural children, and identification of their environmental correlates. METHODS Subjects of the cross-sectional population-based study were 3238 urban and 2081 rural children aged 5-17 years whose respiratory status was assessed using the ISAAC questionnaire. RESULTS The overall prevalence of asthma was larger in rural children than in urban children (2.8% vs. 1.8%, respectively; p = 0.01). Spastic bronchitis occurred with similar frequency in urban (7.8%) and rural children (6.5%). Compared with urban children, rural subjects had dry cough at night (13.1 vs 8.2%, p < 0.001) and attacks of dyspnea (4.7 vs 2.4%, p < 0.001) more often. The prevalence of other symptoms did not differ significantly between urban and rural subjects. Results of multivariate analyses showed that both asthma and spastic bronchitis were associated (p < 0.05) with parental history of asthma, dampness in the house, and poor financial standing of the family. In addition, asthma was related to coal/wood-based heating whereas spastic bronchitis was associated with passive smoking and lower parental education. CONCLUSIONS The findings show a low prevalence of ever-diagnosed asthma in the examined population. Nosological tradition and similar correlates of asthma and spastic bronchitis suggest that some cases of asthma might be included in the diagnostic category of spastic bronchitis.
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Affiliation(s)
- Vakhtang Beridze
- a Faculty of Natural Sciences and Health Care, Shota Rustaveli State University , Batumi , Georgia
| | - Lia Abuladze
- b Maternity and Child Health Center , Batumi , Georgia
| | | | - Tamar Bakhtadze
- a Faculty of Natural Sciences and Health Care, Shota Rustaveli State University , Batumi , Georgia
| | - Joshua Lawson
- c Canadian Centre for Health and Safety in Agriculture, College of Medicine, University of Saskatchewan , Saskatoon , Canada
| | - Jan E Zejda
- d Department of Epidemiology , School of Medicine in Katowice, Medical University of Silesia , Katowice , Poland
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Korpelainen H, Pietiläinen M. Diversity of indoor fungi as revealed by DNA metabarcoding. Genome 2017; 60:55-64. [DOI: 10.1139/gen-2015-0191] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
In the present study, we conducted DNA metabarcoding (the nuclear ITS2 region) for indoor fungal samples originating from two nursery schools with a suspected mould problem (sampling before and after renovation), from two university buildings, and from an old farmhouse. Good-quality sequences were obtained, and the results showed that DNA metabarcoding provides high resolution in fungal identification. The pooled proportions of sequences representing filamentous ascomycetes, filamentous basidiomycetes, yeasts, and other fungi equalled 62.3%, 8.0%, 28.3%, and 1.4%, respectively, and the total number of fungal genera found during the study was 585. When comparing fungal diversities and taxonomic composition between different types of buildings, no obvious pattern was detected. The average pairwise values of SørensenChao indices that were used to compare similarities for taxon composition between samples among the samples from the two university buildings, two nurseries, and farmhouse equaled 0.693, 0.736, 0.852, 0.928, and 0.981, respectively, while the mean similarity index for all samples was 0.864. We discovered that making explicit conclusions on the relationship between the indoor air quality and mycoflora is complicated by the lack of appropriate indicators for air quality and by the occurrence of wide spatial and temporal changes in diversity and compositions among samples.
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Affiliation(s)
- Helena Korpelainen
- Department of Agricultural Sciences, P.O. Box 27 (Latokartanonkaari 5), FI-00014 University of Helsinki, Finland
- Department of Agricultural Sciences, P.O. Box 27 (Latokartanonkaari 5), FI-00014 University of Helsinki, Finland
| | - Maria Pietiläinen
- Department of Agricultural Sciences, P.O. Box 27 (Latokartanonkaari 5), FI-00014 University of Helsinki, Finland
- Department of Agricultural Sciences, P.O. Box 27 (Latokartanonkaari 5), FI-00014 University of Helsinki, Finland
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34
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Recent advances in environmental controls outside the home setting. Curr Opin Allergy Clin Immunol 2016; 16:135-41. [PMID: 26859366 DOI: 10.1097/aci.0000000000000250] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE OF REVIEW It has been well studied that aeroallergen, mold, and airborne pollutant exposure in the inner-city home environment is associated with significant childhood asthma morbidity. Although the home environment has been extensively studied, the school environment is less well understood. RECENT FINDINGS In this article, we discuss the relationship between environmental exposures within the school and daycare environment and pediatric asthma morbidity and novel environmental interventions designed to help mitigate pediatric asthma morbidity. SUMMARY Studies assessing environmental exposures outside the home environment and interventions to mitigate these exposures have the potential to reduce pediatric asthma morbidity. Further study in this area should focus on the complex cost benefit analyses of environmental interventions outside the home setting, while controlling for the home environment.
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Holst GJ, Høst A, Doekes G, Meyer HW, Madsen AM, Plesner KB, Sigsgaard T. Allergy and respiratory health effects of dampness and dampness-related agents in schools and homes: a cross-sectional study in Danish pupils. INDOOR AIR 2016; 26:880-891. [PMID: 26643593 DOI: 10.1111/ina.12275] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 11/24/2015] [Indexed: 05/16/2023]
Affiliation(s)
- G. J. Holst
- Section of Environment, Occupation and Health; Aarhus University; Aarhus C Denmark
| | - A. Høst
- H.C. Andersen Children's Hospital; Odense University Hospital; Odense Denmark
| | - G. Doekes
- Institute for Risk Assessment Sciences; Utrecht University; Utrecht The Netherlands
| | - H. W. Meyer
- Department of Occupational and Environmental Medicine; Copenhagen University Hospital; Bispebjerg Denmark
| | - A. M. Madsen
- National Research Centre for the Working Environment; Copenhagen Denmark
| | - K. B. Plesner
- Department of Anaesthesiology and Intensive Care; Odense University Hospital; Odense Denmark
| | - T. Sigsgaard
- Section of Environment, Occupation and Health; Aarhus University; Aarhus C Denmark
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Rosbach J, Krop E, Vonk M, van Ginkel J, Meliefste C, de Wind S, Gehring U, Brunekreef B. Classroom ventilation and indoor air quality-results from the FRESH intervention study. INDOOR AIR 2016; 26:538-545. [PMID: 26171647 DOI: 10.1111/ina.12231] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 07/03/2015] [Indexed: 06/04/2023]
Abstract
Inadequate ventilation of classrooms may lead to increased concentrations of pollutants generated indoors in schools. The FRESH study, on the effects of increased classroom ventilation on indoor air quality, was performed in 18 naturally ventilated classrooms of 17 primary schools in the Netherlands during the heating seasons of 2010-2012. In 12 classrooms, ventilation was increased to targeted CO2 concentrations of 800 or 1200 ppm, using a temporary CO2 controlled mechanical ventilation system. Six classrooms were included as controls. In each classroom, data on endotoxin, β(1,3)-glucans, and particles with diameters of <10 μm (PM10 ) and <2.5 μm (PM2.5 ) and nitrogen dioxide (NO2 ) were collected during three consecutive weeks. Associations between the intervention and these measured indoor air pollution levels were assessed using mixed models, with random classroom effects. The intervention lowered endotoxin and β(1,3)-glucan levels and PM10 concentrations significantly. PM10 for instance was reduced by 25 μg/m³ (95% confidence interval 13-38 μg/m³) from 54 μg/m³ at maximum ventilation rate. No significant differences were found between the two ventilation settings. Concentrations of PM2.5 and NO2 were not affected by the intervention. Our results provide evidence that increasing classroom ventilation is effective in decreasing the concentrations of some indoor-generated pollutants.
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Affiliation(s)
- J Rosbach
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
- Department of Environmental Health, Municipal Health Services Groningen, Groningen, the Netherlands
| | - E Krop
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - M Vonk
- Department of Environmental Health, Municipal Health Services Groningen, Groningen, the Netherlands
| | - J van Ginkel
- Department of Environmental Health, Municipal Health Services IJsselland, Zwolle, the Netherlands
| | - C Meliefste
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - S de Wind
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - U Gehring
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - B Brunekreef
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
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Huttunen K, Tirkkonen J, Täubel M, Krop E, Mikkonen S, Pekkanen J, Heederik D, Zock JP, Hyvärinen A, Hirvonen MR. Inflammatory potential in relation to the microbial content of settled dust samples collected from moisture-damaged and reference schools: results of HITEA study. INDOOR AIR 2016; 26:380-390. [PMID: 25967114 DOI: 10.1111/ina.12223] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 05/07/2015] [Indexed: 06/04/2023]
Abstract
Aiming to identify factors causing the adverse health effects associated with moisture-damaged indoor environments, we analyzed immunotoxicological potential of settled dust from moisture-damaged and reference schools in relation to their microbiological composition. Mouse RAW264.7 macrophages were exposed to settled dust samples (n = 25) collected from moisture-damaged and reference schools in Spain, the Netherlands, and Finland. After exposure, we analyzed production of inflammatory markers [nitric oxide (NO), tumor necrosis factor-α (TNF-)α, interleukin (IL)-6, and macrophage inflammatory protein (MIP)2] as well as mitochondrial activity, viability, apoptosis, and cell cycle arrest. Furthermore, particle counts, concentration of selected microbial groups as well as chemical markers such as ergosterol, 3-hydroxy fatty acids, muramic acid, endotoxins, and glucans were measured as markers of exposure. Dust from moisture-damaged schools in Spain and the Netherlands induced stronger immunotoxicological responses compared to samples from reference schools; the responses to Finnish samples were generally lower with no difference between the schools. In multivariate analysis, IL-6 and apoptosis responses were most strongly associated with moisture status of the school. The measured responses correlated with several microbial markers and numbers of particles, but the most important predictor of the immunotoxicological potential of settled dust was muramic acid concentration, a marker of Gram-positive bacteria.
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Affiliation(s)
- K Huttunen
- Department of Environmental Science, University of Eastern Finland, Kuopio, Finland
- School of Bioscience, Cardiff University, Cardiff, UK
| | - J Tirkkonen
- Department of Environmental Science, University of Eastern Finland, Kuopio, Finland
| | - M Täubel
- Living Environment and Health Unit, National Institute for Health and Welfare, Kuopio, Finland
| | - E Krop
- Division Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - S Mikkonen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - J Pekkanen
- Living Environment and Health Unit, National Institute for Health and Welfare, Kuopio, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - D Heederik
- Division Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - J-P Zock
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - A Hyvärinen
- Living Environment and Health Unit, National Institute for Health and Welfare, Kuopio, Finland
| | - M-R Hirvonen
- Department of Environmental Science, University of Eastern Finland, Kuopio, Finland
- Living Environment and Health Unit, National Institute for Health and Welfare, Kuopio, Finland
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Abstract
A gathering body of evidence has repeatedly revealed associations between indoor fungi and initiation, promotion, and exacerbation of allergic respiratory disease. The relationship between the exposure and outcome are complicated by the difficulties in measuring both exposure and outcome, the multifactorial nature of the disease, and the wide range of potential confounders. New technologies are becoming available that may enable better measurement of exposure and tighter case definitions so as to build more confidence in the associations discovered. The growing strength of the evidence base will aid the design of future public health interventions and generate new hypotheses on the cause of the rapid increase in allergic respiratory disease prevalence.
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Application of the Environmental Relative Moldiness Index in Finland. Appl Environ Microbiol 2015; 82:578-84. [PMID: 26546428 PMCID: PMC4711148 DOI: 10.1128/aem.02785-15] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 11/04/2015] [Indexed: 11/24/2022] Open
Abstract
The environmental relative moldiness index (ERMI) metric was previously developed to quantify mold contamination in U.S. homes. This study determined the applicability of the ERMI for quantifying mold and moisture damage in Finnish residences. Homes of the LUKAS2 birth cohort in Finland were visually inspected for moisture damage and mold, and vacuumed floor dust samples were collected. An ERMI analysis including 36 mold-specific quantitative PCR assays was performed on the dust samples (n = 144), and the ERMI metric was analyzed against inspection-based observations of moisture damage and mold. Our results show that the ERMI was significantly associated with certain observations of visible mold in Finnish homes but not with moisture damage. Several mold species occurred more frequently and at higher levels in Finnish than in U.S. homes. Modification of the ERMI toward Finnish conditions, using a subsample of LUKAS2 homes with and without moisture damage, resulted in a simplified metric based on 10 mold species. The Finnish ERMI (FERMI) performed substantially better in quantifying moisture and mold damage in Finnish homes, showing significant associations with various observations of visible mold, strongest when the damage was located in the child's main living area, as well as with mold odor and moisture damage. As shown in Finland, the ERMI as such is not equally well usable in different climates and geographic regions but may be remodeled to account for local outdoor and indoor fungal conditions as well as for moisture damage characteristics in a given country.
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Normand AC, Ranque S, Cassagne C, Gaudart J, Sallah K, Charpin DA, Piarroux R. Comparison of Air Impaction and Electrostatic Dust Collector Sampling Methods to Assess Airborne Fungal Contamination in Public Buildings. ANNALS OF OCCUPATIONAL HYGIENE 2015; 60:161-75. [DOI: 10.1093/annhyg/mev075] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Accepted: 09/23/2015] [Indexed: 12/30/2022]
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Hauptman M, Phipatanakul W. The school environment and asthma in childhood. Asthma Res Pract 2015; 1:12. [PMID: 26523228 PMCID: PMC4627718 DOI: 10.1186/s40733-015-0010-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Accepted: 09/18/2015] [Indexed: 01/25/2023] Open
Abstract
In this article, we discuss the relationship between environmental exposures within the school environment and pediatric asthma morbidity. This article will conclude by reviewing novel school based asthma education and therapeutic programs and environmental interventions designed to help mitigate pediatric asthma morbidity.
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Affiliation(s)
- Marissa Hauptman
- Division of General Pediatrics, Boston Children’s Hospital, Boston, MA USA
- Division of Allergy and Immunology, Boston Children’s Hospital, Boston, MA USA
- Harvard Medical School, Boston, MA USA
- Region 1 New England Pediatric Environmental Health Specialty Unit, Boston, MA USA
- Boston Children’s Hospital, 300 Longwood Ave., Boston, MA 02115 USA
| | - Wanda Phipatanakul
- Division of Allergy and Immunology, Boston Children’s Hospital, Boston, MA USA
- Harvard Medical School, Boston, MA USA
- Boston Children’s Hospital, 300 Longwood Ave., Boston, MA 02115 USA
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42
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Nevalainen A, Täubel M, Hyvärinen A. Indoor fungi: companions and contaminants. INDOOR AIR 2015; 25:125-56. [PMID: 25601374 DOI: 10.1111/ina.12182] [Citation(s) in RCA: 119] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Accepted: 12/20/2014] [Indexed: 05/21/2023]
Abstract
This review discusses the role of fungi and fungal products in indoor environments, especially as agents of human exposure. Fungi are present everywhere, and knowledge for indoor environments is extensive on their occurrence and ecology, concentrations, and determinants. Problems of dampness and mold have dominated the discussion on indoor fungi. However, the role of fungi in human health is still not well understood. In this review, we take a look back to integrate what cultivation-based research has taught us alongside more recent work with cultivation-independent techniques. We attempt to summarize what is known today and to point out where more data is needed for risk assessment associated with indoor fungal exposures. New data have demonstrated qualitative and quantitative richness of fungal material inside and outside buildings. Research on mycotoxins shows that just as microbes are everywhere in our indoor environments, so too are their metabolic products. Assessment of fungal exposures is notoriously challenging due to the numerous factors that contribute to the variation of fungal concentrations in indoor environments. We also may have to acknowledge and incorporate into our understanding the complexity of interactions between multiple biological agents in assessing their effects on human health and well-being.
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Affiliation(s)
- A Nevalainen
- Institute for Health and Welfare, Kuopio, Finland
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Rocchi S, Reboux G, Frossard V, Scherer E, Valot B, Laboissière A, Zaros C, Vacheyrou M, Gillet F, Roussel S, Raherison C, Millon L. Microbiological characterization of 3193 French dwellings of Elfe cohort children. THE SCIENCE OF THE TOTAL ENVIRONMENT 2015; 505:1026-1035. [PMID: 25461103 DOI: 10.1016/j.scitotenv.2014.10.086] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Revised: 10/03/2014] [Accepted: 10/24/2014] [Indexed: 06/04/2023]
Abstract
Although exposure to indoor microorganisms in early life has already been associated with respiratory illness or allergy protection, only a few studies have performed standardized samplings and specific microbial analysis. Moreover, most do not target the different groups of microorganisms involved in respiratory diseases (fungi, bacteria, dust mites). In our study, ten specific qPCR targets (6 fungal species, 1 family and 2 genera of bacteria, 1 house dust mite) were used to analyze the microorganism composition of electrostatic dust fall collector (EDC) from 3193 dwellings of the Elfe French cohort study. Multivariate analyses allowed us to show that the microbial composition of dwellings, assessed with simultaneous analysis of 10 microorganisms, can be characterized by four entities: three bacteria, house dust mite Dermatophagoïdes pteronyssinus, fungi Alternaria alternata, and five other molds. Some dwellings' intrinsic characteristics (occupational ratio, type of dwelling and presence of pets) clearly influence microorganism distribution, and six different profiles of dwellings, characterized by their composition in microorganisms, have been described across France. The use of these clusters seems promising in the evaluation of allergic risk. Allergic respiratory diseases will develop in the near future in some children of the Elfe cohort and will indicate to what extent our approach can be predictive of respiratory disease.
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Affiliation(s)
- S Rocchi
- Chrono-Environnement Research Team UMR/CNRS-6249-Franche-Comté University, Besançon, France; Department of Parasitology and Mycology, University Hospital, Besançon, France
| | - G Reboux
- Chrono-Environnement Research Team UMR/CNRS-6249-Franche-Comté University, Besançon, France; Department of Parasitology and Mycology, University Hospital, Besançon, France.
| | - V Frossard
- Chrono-Environnement Research Team UMR/CNRS-6249-Franche-Comté University, Besançon, France
| | - E Scherer
- Chrono-Environnement Research Team UMR/CNRS-6249-Franche-Comté University, Besançon, France; Department of Parasitology and Mycology, University Hospital, Besançon, France
| | - B Valot
- Chrono-Environnement Research Team UMR/CNRS-6249-Franche-Comté University, Besançon, France
| | - A Laboissière
- Chrono-Environnement Research Team UMR/CNRS-6249-Franche-Comté University, Besançon, France; Department of Parasitology and Mycology, University Hospital, Besançon, France
| | - C Zaros
- Elfe Consortium, INED, INSERM, EFS, 133 boulevard Davout, Paris, France
| | - M Vacheyrou
- Chrono-Environnement Research Team UMR/CNRS-6249-Franche-Comté University, Besançon, France
| | - F Gillet
- Chrono-Environnement Research Team UMR/CNRS-6249-Franche-Comté University, Besançon, France
| | - S Roussel
- Chrono-Environnement Research Team UMR/CNRS-6249-Franche-Comté University, Besançon, France; Department of Parasitology and Mycology, University Hospital, Besançon, France
| | - C Raherison
- Department of Pneumology, University Hospital, Bordeaux, France; Occupational Health Environment Research Team, EA 3672, ISPED, Bordeaux 2 University, France
| | - L Millon
- Chrono-Environnement Research Team UMR/CNRS-6249-Franche-Comté University, Besançon, France; Department of Parasitology and Mycology, University Hospital, Besançon, France
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Huffaker M, Phipatanakul W. Introducing an environmental assessment and intervention program in inner-city schools. J Allergy Clin Immunol 2014; 134:1232-1237. [PMID: 25441649 DOI: 10.1016/j.jaci.2014.09.010] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Revised: 09/14/2014] [Accepted: 09/15/2014] [Indexed: 10/24/2022]
Abstract
Home-based environmental interventions have demonstrated clinical benefit for children with asthma. Although much is known about school-based exposures, few studies have comprehensively examined the role the school environment plays in asthma and how effectively changing the environment might reduce morbidity when adjusting for exposures in the home. This review summarizes the importance and common challenges of school-based environmental assessment and intervention studies linked to health effects. We focus on the key components of study development and the challenges and benefits to implementation.
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Affiliation(s)
- Michelle Huffaker
- Brigham and Women's Hospital, Boston, Mass; Boston Children's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass
| | - Wanda Phipatanakul
- Boston Children's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass.
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