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Meyer S, Bay J, Franz AR, Ehrhardt H, Klein L, Petzinger J, Binder C, Kirschenhofer S, Stein A, Hüning B, Heep A, Cloppenburg E, Muyimbwa J, Ott T, Sandkötter J, Teig N, Wiegand S, Schroth M, Kick A, Wurm D, Gebauer C, Linnemann K, Kittel J, Wieg C, Kiechl-Kohlendorfer U, Schmidt S, Böttger R, Thomas W, Brevis Nunez F, Stockmann A, Kriebel T, Müller A, Klotz D, Morhart P, Nohr D, Biesalski HK, Giannopoulou EZ, Hilt S, Poryo M, Wagenpfeil S, Haiden N, Ruckes C, Ehrlich A, Gortner L. Early postnatal high-dose fat-soluble enteral vitamin A supplementation for moderate or severe bronchopulmonary dysplasia or death in extremely low birthweight infants (NeoVitaA): a multicentre, randomised, parallel-group, double-blind, placebo-controlled, investigator-initiated phase 3 trial. THE LANCET. RESPIRATORY MEDICINE 2024; 12:544-555. [PMID: 38643780 DOI: 10.1016/s2213-2600(24)00073-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 02/21/2024] [Accepted: 02/26/2024] [Indexed: 04/23/2024]
Abstract
BACKGROUND Vitamin A plays a key role in lung development, but there is no consensus regarding the optimal vitamin A dose and administration route in extremely low birthweight (ELBW) infants. We aimed to assess whether early postnatal additional high-dose fat-soluble enteral vitamin A supplementation versus placebo would lower the rate of moderate or severe bronchopulmonary dysplasia or death in ELBW infants receiving recommended basic enteral vitamin A supplementation. METHODS This prospective, multicentre, randomised, parallel-group, double-blind, placebo-controlled, investigator-initiated phase 3 trial conducted at 29 neonatal intensive care units in Austria and Germany assessed early high-dose enteral vitamin A supplementation (5000 international units [IU]/kg per day) or placebo (peanut oil) for 28 days in ELBW infants. Eligible infants had a birthweight of more than 400 g and less than 1000 g; gestational age at birth of 32+0 weeks postmenstrual age or younger; and the need for mechanical ventilation, non-invasive respiratory support, or supplemental oxygen within the first 72 h of postnatal age after admission to the neonatal intensive care unit. Participants were randomly assigned by block randomisation with variable block sizes (two and four). All participants received basic vitamin A supplementation (1000 IU/kg per day). The composite primary endpoint was moderate or severe bronchopulmonary dysplasia or death at 36 weeks postmenstrual age, analysed in the intention-to-treat population. This trial was registered with EudraCT, 2013-001998-24. FINDINGS Between March 2, 2015, and Feb 27, 2022, 3066 infants were screened for eligibility at the participating centres. 915 infants were included and randomly assigned to the high-dose vitamin A group (n=449) or the control group (n=466). Mean gestational age was 26·5 weeks (SD 2·0) and mean birthweight was 765 g (162). Moderate or severe bronchopulmonary dysplasia or death occurred in 171 (38%) of 449 infants in the high-dose vitamin A group versus 178 (38%) of 466 infants in the control group (adjusted odds ratio 0·99, 95% CI 0·73-1·55). The number of participants with at least one adverse event was similar between groups (256 [57%] of 449 in the high-dose vitamin A group and 281 [60%] of 466 in the control group). Serum retinol concentrations at baseline, at the end of intervention, and at 36 weeks postmenstrual age were similar in the two groups. INTERPRETATION Early postnatal high-dose fat-soluble enteral vitamin A supplementation in ELBW infants was safe, but did not change the rate of moderate or severe bronchopulmonary dysplasia or death and did not substantially increase serum retinol concentrations. FUNDING Deutsche Forschungsgemeinschaft and European Clinical Research Infrastructures Network (ECRIN).
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Eckert AJ, Semler O, Schnabel D, Köstner K, Wurm D, Bechtold-Dalla Pozza S, Schaaf K, Hörtenhuber T, Hammersen J, Holl RW. Bone Fractures in Children and Young Adults With Type 1 Diabetes: Age Distribution, Fracture Location, and the Role of Glycemic Control. J Bone Miner Res 2021; 36:2371-2380. [PMID: 34569646 DOI: 10.1002/jbmr.4451] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 09/03/2021] [Accepted: 09/24/2021] [Indexed: 12/16/2022]
Abstract
Type 1 diabetes (T1D) is a known risk factor for fractures, but the underlying pathophysiology is still not fully understood. This study aims to define age peaks and frequent fracture sites of children and young adults with T1D. Additionally, associations of fractures with metabolic and lifestyle factors as well as with additional complications in individuals with T1D were analyzed. A total of 750 individuals with T1D aged ≤25 years with fractures were matched to 3750 patients with T1D without fractures by demographics and insulin regimen. Hemoglobin A1c (HbA1c) values were compared using linear regression, and logistic regression was used to calculate odds ratios (OR) for fractures in individuals with acute complications and diseases. Median (Q1-Q3) age was 12.7 (9.9 to 14.9) years in individuals with fractures and 16.3 (12.6 to 17.8) years in the entire control group with 65% versus 53% males. Peak age for fractures was 7 to <15 years in males and 9 to <11 years in females, which is earlier than reported for the general population. HbA1c (%) was significantly higher in individuals with fractures than in controls (difference of estimated means: 0.26%; 95% confidence interval [CI] 0.07-0.46), especially in postpubertal females (0.68; 0.10-1.26). Significantly higher odds for fractures were observed in individuals with severe hypoglycemia (OR = 1.90; 95% CI 1.47-2.47), especially in prepubertal females (OR = 2.81; 1.21-6.52]) and postpubertal males (2.44; 1.11-5.38), celiac disease (2.02; 1.67-2.45), and with a history of smoking (1.38; 1.02-1.88). The age peak of fractures seems to be earlier in T1D than in the general population. Poor glycemic control is related to fractures, even before puberty. Associations of HbA1c and severe hypoglycemia with fractures highly depend on age and sex. © 2021 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
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Burgmaier K, Ariceta G, Bald M, Buescher AK, Burgmaier M, Erger F, Gessner M, Gokce I, König J, Kowalewska C, Massella L, Mastrangelo A, Mekahli D, Pape L, Patzer L, Potemkina A, Schalk G, Schild R, Shroff R, Szczepanska M, Taranta-Janusz K, Tkaczyk M, Weber LT, Wühl E, Wurm D, Wygoda S, Zagozdzon I, Dötsch J, Oh J, Schaefer F, Liebau MC. Severe neurological outcomes after very early bilateral nephrectomies in patients with autosomal recessive polycystic kidney disease (ARPKD). Sci Rep 2020; 10:16025. [PMID: 32994492 PMCID: PMC7525474 DOI: 10.1038/s41598-020-71956-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 08/24/2020] [Indexed: 11/23/2022] Open
Abstract
To test the association between bilateral nephrectomies in patients with autosomal recessive polycystic kidney disease (ARPKD) and long-term clinical outcome and to identify risk factors for severe outcomes, a dataset comprising 504 patients from the international registry study ARegPKD was analyzed for characteristics and complications of patients with very early (≤ 3 months; VEBNE) and early (4–15 months; EBNE) bilateral nephrectomies. Patients with very early dialysis (VED, onset ≤ 3 months) without bilateral nephrectomies and patients with total kidney volumes (TKV) comparable to VEBNE infants served as additional control groups. We identified 19 children with VEBNE, 9 with EBNE, 12 with VED and 11 in the TKV control group. VEBNE patients suffered more frequently from severe neurological complications in comparison to all control patients. Very early bilateral nephrectomies and documentation of severe hypotensive episodes were independent risk factors for severe neurological complications. Bilateral nephrectomies within the first 3 months of life are associated with a risk of severe neurological complications later in life. Our data support a very cautious indication of very early bilateral nephrectomies in ARPKD, especially in patients with residual kidney function, and emphasize the importance of avoiding severe hypotensive episodes in this at-risk cohort.
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Morava E, Tiemes V, Thiel C, Seta N, de Lonlay P, de Klerk H, Mulder M, Rubio-Gozalbo E, Visser G, van Hasselt P, Horovitz DDG, de Souza CFM, Schwartz IVD, Green A, Al-Owain M, Uziel G, Sigaudy S, Chabrol B, van Spronsen FJ, Steinert M, Komini E, Wurm D, Bevot A, Ayadi A, Huijben K, Dercksen M, Witters P, Jaeken J, Matthijs G, Lefeber DJ, Wevers RA. Erratum to: ALG6-CDG: a recognizable phenotype with epilepsy, proximal muscle weakness, ataxia and behavioral and limb anomalies. J Inherit Metab Dis 2016; 39:759. [PMID: 27498540 DOI: 10.1007/s10545-016-9967-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Morava E, Tiemes V, Thiel C, Seta N, de Lonlay P, de Klerk H, Mulder M, Rubio-Gozalbo E, Visser G, van Hasselt P, Horovitz DDG, de Souza CFM, Schwartz IVD, Green A, Al-Owain M, Uziel G, Sigaudy S, Chabrol B, van Spronsen FJ, Steinert M, Komini E, Wurm D, Bevot A, Ayadi A, Huijben K, Dercksen M, Witters P, Jaeken J, Matthijs G, Lefeber DJ, Wevers RA. ALG6-CDG: a recognizable phenotype with epilepsy, proximal muscle weakness, ataxia and behavioral and limb anomalies. J Inherit Metab Dis 2016; 39:713-723. [PMID: 27287710 DOI: 10.1007/s10545-016-9945-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 03/17/2016] [Accepted: 05/04/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Alpha-1,3-glucosyltransferase congenital disorder of glycosylation (ALG6-CDG) is a congenital disorder of glycosylation. The original patients were described with hypotonia, developmental disability, epilepsy, and increased bleeding tendency. METHODS Based on Euroglycan database registration, we approached referring clinicians and collected comprehensive data on 41 patients. RESULTS We found hypotonia and developmental delay in all ALG6-CDG patients and epilepsy, ataxia, proximal muscle weakness, and, in the majority of cases, failure to thrive. Nine patients developed intractable seizures. Coagulation anomalies were present in <50 % of cases, without spontaneous bleedings. Facial dysmorphism was rare, but seven patients showed missing phalanges and brachydactyly. Cyclic behavioral change, with autistic features and depressive episodes, was one of the most significant complaints. Eleven children died before the age of 4 years due to protein losing enteropathy (PLE), sepsis, or seizures. The oldest patient was a 40 year-old Dutch woman. The most common pathogenic protein alterations were p.A333V and p.I299Del, without any clear genotype-phenotype correlation. DISCUSSION ALG6-CDG has been now described in 89 patients, making it the second most common type of CDG. It has a recognizable phenotype and a primary neurologic presentation.
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Kuchler F, Fierlinger P, Wurm D. A novel approach to measure the electric dipole moment of the isotope 129-Xe. EPJ WEB OF CONFERENCES 2014. [DOI: 10.1051/epjconf/20146605011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Wurm D, Kruse S, Mink D, Möller J. Wunschsektio und neonatales Outcome im Jahre 2009 an einem Perinatalzentrum. KLINISCHE PADIATRIE 2010. [DOI: 10.1055/s-0030-1261499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Wurm D, Geipel M, Gortner L. THC-Konsum in der Schwangerschaft und mögliche Folgen für die fetale ZNS-Entwicklung – eine Kasuistik. Z Geburtshilfe Neonatol 2008. [DOI: 10.1055/s-2008-1078963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Gottschling S, Meyer S, Dill-Mueller D, Wurm D, Gortner L. Outbreak Report of Airborne Caterpillar Dermatitis in a Kindergarten. Dermatology 2007; 215:5-9. [PMID: 17587833 DOI: 10.1159/000102027] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2006] [Accepted: 01/04/2007] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The oak processionary caterpillar is found in several European countries. The larva of Thaumetopoea processionea Lepidoptera from the third to sixth larval instar develops poisonous hair (setae), filled with an urticating toxin that could lead to serious dermatitis, conjunctivitis and pulmonary problems (summarized as lepidopterism) on contact. OBJECTIVES To determine the incidence of caterpillar dermatitis in a kindergarten population with three infested oak trees located in its enclosure. METHODS We made a survey by the use of a questionnaire that was handed out to all parents with children regularly visiting that kindergarten. RESULTS Twenty-four out of 47 (51%) questionnaires were returned and 10/24 (42%) children showing symptoms of lepidopterism were reported: 8/10 (80%) dermatitis, 5/10 (50%) pruritus, 5/10 (50%) respiratory distress, 4/10 (40%) malaise and/or fever and 1/10 (10%) conjunctivitis. Seven out of 10 visited a physician but the correct diagnosis was not posed in any case. Four out of 7 received medication (topical and/or systemic antihistaminics and/or steroids). CONCLUSIONS Lepidopterism, an airborne disease caused by the setae of the processionary caterpillar, is a growing public health problem because of the increasing numbers of outbreaks, and it is still underestimated. Children seem to suffer more often from general symptoms and airway affection than adults.
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Wurm D, Hänsgen A, Kim YJ, Lindinger A, Baghai A, Gortner L. Early fatal course in siblings with CDG-Ia (caused by two novel mutations in the PMM2 gene): clinical, molecular and autopsy findings. Eur J Pediatr 2007; 166:377-8. [PMID: 16941129 DOI: 10.1007/s00431-006-0240-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2006] [Accepted: 06/26/2006] [Indexed: 10/24/2022]
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Wurm D, Reith W, Lindinger A, Meyer S, Gortner L. Neurogenes pulmonales Ödem (NPE) bei einem 13-jährigen Mädchen mit AV-Malformation der hinteren Schädelgrube. Z Geburtshilfe Neonatol 2007. [DOI: 10.1055/s-2007-983231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Meyer S, Wurm D, Baghai A, Limbach HG, Polcher T, Gortner L. Vasopressin as a pressor adjunct in various forms of severe hypotensive shock. Z Geburtshilfe Neonatol 2006. [DOI: 10.1055/s-2006-946249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Wurm D, Limbach HG, Gortner L. Rekombinanter aktivierter Faktor VIIa (rFVIIa) bei akuten lebensbedrohlichen Blutungen –3 Fälle. Z Geburtshilfe Neonatol 2006. [DOI: 10.1055/s-2006-946231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Wurm D, Hamacher J, Beier R, Löffler G, Limbach HG, Gortner L. Kryptogene organisierende Pneumonie (COP) bei einem 3-jährigen Mädchen mit akuter lymphoblastischer Leukämie. Z Geburtshilfe Neonatol 2006. [DOI: 10.1055/s-2006-946171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Meyer S, Steiner M, Wurm D, Nunold H, Gortner L. Alcohol intoxication in children and adolescents requiring emergency hospital admission in 20 major children's hospitals in Germany between 2000–2002. Z Geburtshilfe Neonatol 2006. [DOI: 10.1055/s-2006-946257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Meyer S, Baghai A, Löffler G, Wurm D, Gottschling S, Gortner L. Arginine-Vasopressin in severe septic vs. non-septic shock in extremely low birth weight infants with acute renal failure. Z Geburtshilfe Neonatol 2006. [DOI: 10.1055/s-2006-946052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Meyer S, Wurm D, Baghai A, Limbach HG, Polcher T, Gortner L. Vasopressin as a pressor adjunct in various forms of severe hypotensive shock. Z Geburtshilfe Neonatol 2006. [DOI: 10.1055/s-2006-943334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Wurm D, Limbach HG, Gortner L. Rekombinanter aktivierter Faktor VIIa (rFVIIa) bei akuten lebensbedrohlichen Blutungen –3 Fälle. Z Geburtshilfe Neonatol 2006. [DOI: 10.1055/s-2006-943316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Meyer S, Steiner M, Wurm D, Nunold H, Gortner L. Alcohol intoxication in children and adolescents requiring emergency hospital admission in 20 major children's hospitals in Germany between 2000–2002. Z Geburtshilfe Neonatol 2006. [DOI: 10.1055/s-2006-943342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Wurm D, Hamacher J, Beier R, Löffler G, Limbach HG, Gortner L. Kryptogene organisierende Pneumonie (COP) bei einem 3-jährigen Mädchen mit akuter lymphoblastischer Leukämie. Z Geburtshilfe Neonatol 2006. [DOI: 10.1055/s-2006-943256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Meyer S, Baghai A, Löffler G, Wurm D, Gottschling S, Gortner L. Arginine-Vasopressin in severe septic vs. non-septic shock in extremely low birth weight infants with acute renal failure. Z Geburtshilfe Neonatol 2006. [DOI: 10.1055/s-2006-943137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Meyer S, Gottschling S, Baghai A, Wurm D, Gortner L. Arginine-vasopressin in catecholamine-refractory septic versus non-septic shock in extremely low birth weight infants with acute renal injury. CRITICAL CARE : THE OFFICIAL JOURNAL OF THE CRITICAL CARE FORUM 2006; 10:R71. [PMID: 16677425 PMCID: PMC1550969 DOI: 10.1186/cc4917] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2006] [Revised: 04/06/2006] [Accepted: 04/12/2006] [Indexed: 11/10/2022]
Abstract
Introduction The aim of this study was to assess the efficacy of arginine-vasopressin (AVP) as a rescue therapy in catecholamine-refractory septic and non-septic shock in extremely low birth weight (ELBW) infants with acute renal injury. Methods Prospective assessment of AVP therapy in three ELBW infants with catecholamine-refractory septic shock and acute renal injury (mean birth weight 600 ± 30 g) and three ELBW infants with non-septic shock and acute renal injury (mean birth weight 770 ± 110 g) at a University hospital. The main outcome measures were restoration of blood pressure with adequate organ perfusion and survival at discharge. Results In all three ELBW infants with catecholamine-resistant septic shock, systemic arterial blood pressure increased substantively with restoration of urine output after AVP administration (dosage, 0.035 to 0.36 U/kg/h; length, 70 ± 21 hours). In the three ELBW infants with non-septic shock, only a transient stabilization in mean arterial pressure with restoration of urine output was observed after AVP therapy (dosage, 0.01 to 0.36 U/kg/h; length, 30 ± 16 hours). The mortality rate was 1/3 in the sepsis group versus 3/3 in the non-septic group. Conclusion AVP may be a promising rescue therapy in catecholamine-resistant shock in ELBW infants with acute renal injury. Larger prospective clinical trials are warranted to assess the efficacy and safety of AVP as a pressor adjunct in septic versus non-septic shock in ELBW infants.
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Wurm D, Lindinger A, Marquardt T, Löffler G, Gortner L. CDG Typ Ia als Ursache eines „mirror syndrome“. Z Geburtshilfe Neonatol 2005. [DOI: 10.1055/s-2005-871501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Zaharescu T, Podina C, Wurm D. Effect of metallic oxides on thermal stability of ethylene-propylene terpolymer. J Appl Polym Sci 2001. [DOI: 10.1002/app.2062] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Schleibinger HW, Wurm D, Möritz M, Böck R, Rüden H. [Sick building syndrome and HVAC system: MVOC from air filters]. ZENTRALBLATT FUR HYGIENE UND UMWELTMEDIZIN = INTERNATIONAL JOURNAL OF HYGIENE AND ENVIRONMENTAL MEDICINE 1997; 200:137-51. [PMID: 9636985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Growth and emissions of volatile metabolites of microorganisms on air filters are suspected to contribute to health complaints in ventilated rooms. To prove the microbiological production of volatile organic compounds (MVOC), concentrations of aldehydes and ketones were determined in two large HVAC systems. The in situ derivated aldehydes and ketones (as 2,4-dinitrophenyl-hydrazones) were analysed by HPLC and UV detection. The detection limit of each compound was 1 ppb (margin of error < 10%). Field measurements were carried out before and after the prefilters and the main filters, respectively, to investigate whether aldehydes and ketones increase in concentration after filters of HVAC systems. First results show that the compounds formaldehyde, acetaldehyde and acetone could be detected before and after the filters. The concentrations of these VOC after the filters were significantly increased--as a mean over twenty measurements--, especially as far as filters made of glass fibre are concerned. However the found concentrations were low and mostly comparable to outdoor findings. In simultaneous laboratory experiments pieces of used filter material of one HVAC system and unused filter pieces (for blank values) were examined in small incubation chambers to investigate the possible production of MVOC. For the incubation a temperature of 20 degrees C and a relative humidity of 95% was chosen. In these experiments an almost identical spectrum of compounds (formaldehyde and acetone) was found as in the field measurements. The concentrations of these compounds were higher in the chambers with the used filter pieces. The concentration of acetone ranged up to almost 12 mg/m3.--As our field experiments correspond with our laboratory experiments, we assume that the microbial production of volatile organic compounds in HVAC systems under operating conditions is possible.
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