Measurement of dust-borne MRSA in pig farms using different approaches.

AIMS: To obtain knowledge about (i) how to sample airborne methicillin-resistant Staphylococcus aureus (MRSA) and dust in the pig farm environment including effects of sampler on (a) measured exposure, (b) MRSA survival and (c) spatial and temporal variation in exposure, and (ii) the association between exposure to MRSA, dust and optical density OD. METHODS AND RESULTS: Airborne dust was sampled on five pig farms using five active and one passive samplers. Staphylococcus aureus and MRSA (as a subset of S. aureus) were quantified using selective agar media and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. The Andersen sampler, electrostatic dust collectors (EDC), and Gesamtstaubprobenahme (GSP) and Institute of Occupational Medicine samplers with polycarbonate or Teflon filters were applicable for sampling airborne MRSA. The half-life of MRSA was not reduced by active sampling. A significant correlation was found between dust and S. aureus exposure within, but not between, farm section and farms. A significant spatial and temporal variation in dust and MRSA exposure was found within a stable. The dust sampling rate and the concentration of MRSA in the sampled dust decreased after 5 days of sampling. CONCLUSION: Sampling using the GSP can be performed for 1 h without affecting the following half-life of MRSA. Sampling for MRSA using the EDC should not exceed 3 days due to overloading and the die-off of MRSA. The measurement of OD may be used as a proxy measure for dust exposure. To obtain knowledge about potential exposure, samples should be taken repeatedly and in different areas within a stable section. SIGNIFICANCE AND IMPACT OF THE STUDY: Sampling method, sampling time and number of samples taken, but not force of airflow on the filter, influence the measured potential exposure to MRSA and dust.

Absorbable subcuticular staples versus suture for caesarean section closure: a randomised clinical trial.

OBJECTIVE: To compare outcomes of efficiency, safety, patient, and surgeon satisfaction between absorbable subcuticular staples and subcuticular suture for caesarean section skin closure. DESIGN: A prospective, randomised, non-blinded, parallel-group trial. SETTING: Mayo Clinic Family Birth Center in Rochester, MN, USA. POPULATION: At least 18 years old and 24 weeks' gestation, undergoing caesarean section. Exclusion criteria were body mass index >50, chorioamnionitis, intrauterine fetal death, and multifetal gestation. METHODS: Patients were stratified by prior caesarean section, body mass index, and surgeon level and randomised to absorbable subcuticular staples or subcuticular suture. Electronic medical records and surveys were used. MAIN OUTCOME MEASURES: Primary outcomes were total operating time, from incision start to close. Secondary outcomes included subcuticular skin closure time, patient and surgeon satisfaction, percutaneous injuries, pain (analgesic use), cosmesis, and wound complications. RESULTS: Of 220 randomised patients, 206 were included in the final analysis (103 per group). Baseline characteristics were similar. The primary outcome of total operative time was not significantly different between groups [54.0 (44.9-63.6) versus 58.0 (50.4-68.2) minutes, P = 0.053]. The subcuticular staple group had shorter subcuticular skin closure time [median 2.6 (1.8-4.0) versus 8.5 (6.2-10.5) minutes, P < 0.001]. There were no differences in analgesic use, wound complications, cosmesis or patient satisfaction. One needlestick injury occurred with suture. Surgeons were more likely to recommend (97% versus 85%, P = 0.004) and use (98% versus 82%, P < 0.001) absorbable subcuticular staples. CONCLUSION: For caesarean section skin closure, absorbable subcuticular staples did not result in significantly different total operative times compared with sutures. Analgesic use, wound complications, and cosmesis were comparable. Patient and surgeon satisfaction were high with both methods. TWEETABLE ABSTRACT: Absorbable subcuticular staples associated with a similar total operative time compared with suture.

Evaluation of air samplers and filter materials for collection and recovery of airborne norovirus.

AIMS: The aim of this study was to identify the most efficient sampling method for quantitative PCR-based detection of airborne human norovirus (NoV). METHODS AND RESULTS: A comparative experiment was conducted in an aerosol chamber using aerosolized murine norovirus (MNV) as a surrogate for NoV. Sampling was performed using a nylon (NY) filter in conjunction with four kinds of personal samplers: Gesamtstaubprobenahme sampler (GSP), Triplex-cyclone sampler (TC), 3-piece closed-faced Millipore cassette (3P) and a 2-stage NIOSH cyclone sampler (NIO). In addition, sampling was performed using the GSP sampler with four different filter types: NY, polycarbonate (PC), polytetrafluoroethylene (PTFE) and gelatine (GEL). The sampling efficiency of MNV was significantly influenced by both sampler and filter type. The GSP sampler was found to give significantly (P < 0·05) higher recovery of aerosolized MNV than 3P and NIO. A higher recovery was also found for GSP compared with TC, albeit not significantly. Finally, recovery of aerosolized MNV was significantly (P < 0·05) higher using NY than PC, PTFE and GEL filters. CONCLUSIONS: The GSP sampler combined with a nylon filter was found to be the best method for personal filter-based sampling of airborne NoV. SIGNIFICANCE AND IMPACT OF THE STUDY: The identification of a suitable NoV air sampler is an important step towards studying the association between exposure to airborne NoV and infection.

Whole-genome sequencing for identification of the source in hospital-acquired Legionnaires' disease.

Acquisition of Legionnaires' disease is a serious complication of hospitalization. Rapid determination of whether or not the infection is caused by strains of Legionella pneumophila in the hospital environment is crucial to avoid further cases. This study investigated the use of whole-genome sequencing to identify the source of infection in hospital-acquired Legionnaires' disease. Phylogenetic analyses showed close relatedness between one patient isolate and a strain found in hospital water, confirming suspicion of nosocomial infection. It was found that whole-genome sequencing can be a useful tool in the investigation of hospital-acquired Legionnaires' disease.

Assessment of airborne bacteria and noroviruses in air emission from a new highly-advanced hospital wastewater treatment plant.

Exposure to bioaerosols can pose a health risk to workers at wastewater treatment plants (WWTPs) and to habitants of their surroundings. The main objective of this study was to examine the presence of harmful microorganisms in the air emission from a new type of hospital WWTP employing advanced wastewater treatment technologies. Air particle measurements and sampling of inhalable bacteria, endotoxin and noroviruses (NoVs) were performed indoor at the WWTP and outside at the WWTP ventilation air exhaust, downwind of the air exhaust, and upwind of the WWTP. No significant differences were seen in particle and endotoxin concentrations between locations. Bacterial concentrations were comparable or significantly lower in the exhaust air than inside the WWTP and in the upwind reference. Bacterial isolates were identified using matrix-assisted laser desorption-ionization time-of-flight mass spectrometry. In total, 35 different bacterial genera and 64 bacterial species were identified in the air samples. Significantly higher genus and species richness was found with an Andersen Cascade Impactor compared with filter-based sampling. No pathogenic bacteria were found in the exhaust air. Streptomyces was the only bacterium found in the air both inside the WWTP and at the air emission, but not in the upwind reference. NoV genomes were detected in the air inside the WWTP and at the air exhaust, albeit in low concentrations. As only traces of NoV genomes could be detected in the exhaust air they are unlikely to pose a health risk to surroundings. Hence, we assess the risk of airborne exposure to pathogenic bacteria and NoVs from the WWTP air emission to surroundings to be negligible. However, as a slightly higher NoV concentration was detected inside the WWTP, we cannot exclude the possibility that exposure to airborne NoVs can pose a health risk to susceptible to workers inside the WWTP, although the risk may be low.

Allergy and respiratory health effects of dampness and dampness-related agents in schools and homes: a cross-sectional study in Danish pupils.

Little is known about the health effects of school-related indoor dampness and microbial exposures. In this study, we investigated dampness and dampness-related agents in both homes and schools and their association with allergy and respiratory health effects in 330 Danish pupils. Classroom dampness was identified based on technical inspection and bedroom dampness on parents' self-report. Classroom and bedroom dust was analyzed for seven microbial components. Skin prick testing determined atopic sensitization. Lung function was expressed as z-scores for forced expiratory volume in one-second (zFEV1 ), forced vital capacity (zFVC) and the ratio zFEV1 /zFVC using GLI-2012 prediction equations. The parents reported children's allergies, airway symptoms, and doctor-diagnosed asthma. High classroom dampness, but not bedroom dampness, was negatively associated with zFEV1 (ß-coef. -0.71; 95% CI -1.17 to -0.23) and zFVC (ß-coef. -0.52; 95% CI -0.98 to -0.06) and positively with wheezing (OR 8.09; 95% CI 1.49 to 43.97). No consistent findings were found between any individual microbial components or combination of microbial components and health outcomes. Among other indoor risk factors, environmental tobacco smoke (ETS) decreased zFEV1 (ß-coef. -0.22; 95% CI -0.42 to -0.02) and zFEV1 /zFVCratio (ß-coef. -0.26; 95% CI -0.44 to -0.07) and increased upper airway symptoms (OR 1.66; 95% CI 1.03-2.66). In conclusion, dampness in classrooms may have adverse respiratory health effects in pupils, but microbial agents responsible for this effect remain unknown.

Determinants of house dust, endotoxin, and ß-(1→3)-D-glucan in homes of Danish children.

Little is known about the geographic variation and determinants of bacterial endotoxin and ß-(1,3)-D-glucan in Danish house dust. In a population of 317 children, we: (i) described loads and concentrations of floor dust, endotoxin, and ß-(1→3)-D-glucan and (ii) their correlations and (iii) assessed their determinants; (iv) Finally, we compared our findings with previous European studies. Bedroom floor dust was analyzed for endotoxin content by the kinetic limulus amoebocyte lysate assay and for ß-(1→3)-D-glucan by the inhibition enzyme immunoassay. The parents answered questions regarding potential determinants. We found: geometric means (geometric standard deviations) 186 mg/m(2) (4.3) for dust; 5.46 × 10(3) EU/m(2) (8.0) and 31.1 × 10(3) EU/g (2.6) for endotoxin; and 142 µg/m(2) (14.3) and 0.71 × 10(3) µg/g (7.3) for ß-(1→3)-D-glucan. High correlations (r > 0.75) were found between floor dust and endotoxin and ß-(1→3)-D-glucan loads, while endotoxin and ß-(1→3)-D-glucan concentrations were moderately correlated (r = 0.36-0.41) with the dust load. Having a carpet was positively associated with dust load and with endotoxin and ß-(1→3)-D-glucan concentrations. Pet keeping, dwelling type, and dwelling location were determinants of endotoxin concentrations. No other determinants were associated with ß-(1→3)-D-glucan concentrations. Compared with other European studies, we found lower ß-(1→3)-D-glucan loads and concentrations but higher endotoxin loads and concentrations suggesting a geographically determined different composition of Danish floor dust compared with other European regions.

Effect of relative humidity on the aerosolization and total inflammatory potential of fungal particles from dust-inoculated gypsum boards.

The aim of this study was to investigate the effect of relative humidity (RH) on the aerosolization and total inflammatory potential (TIP) of microbial particles released from gypsum boards inoculated with dust samples from homes. After microbial colonization, the gypsum boards were incubated at either high or low RH. The aerosolized particles (0.54-19.8 µm), culturable fungi, ß-glucan and the TIP of the aerosolized particles were quantified. Despite the colonization of several fungal groups, Penicillium dominated the aerosolized fraction. Higher emission rates of particles and culturable fungi were found from low RH compared with high RH in both the inhalable and particulate matter <1 µm (PM1 ) fractions, and the TIP was accordingly higher. However, for the aerosolized fractions, the TIP or concentration ß-glucan relative to the number of fungi or particles present was higher from high RH compared with low RH. Despite the low number of culturable fungi in PM1 , this fraction showed a high TIP, and the concentration of ß-glucan correlated strongly with the TIP of this fraction. The individual particles of the aerosolized PM1 fraction were more inflammatory than the larger particles of the inhalable fraction, and ß-glucan may be an important contributor to the inflammatory potential of the aerosolized particles.

Comparison of sampling methods for the assessment of indoor microbial exposure.

UNLABELLED: Indoor microbial exposure has been related to allergy and respiratory disorders. However, the lack of standardized sampling methodology is problematic when investigating dose-response relationships between exposure and health effects. In this study, different sampling methods were compared regarding their assessment of microbial exposures, including culturable fungi and bacteria, endotoxin, as well as the total inflammatory potential (TIP) of dust samples from Danish homes. The Gesamtstaubprobenahme (GSP) filter sampler and BioSampler were used for sampling of airborne dust, whereas the dust fall collector (DFC), the electrostatic dust fall collector (EDC), and vacuum cleaner were used for sampling of settled dust. The GSP assessed significantly higher microbial levels than the BioSampler, yet measurements from both samplers correlated significantly. Considerably higher levels of fungi, endotoxin, and TIP were found in the EDC compared with the DFC, and regarding fungi, the EDC correlated more strongly and significantly with vacuumed dust than the DFC. Fungi in EDC and vacuum dust correlated most strongly with airborne dust, and in particular, the measurements from the EDC associated well with those from GSP. Settled dust from the EDC was most representative of airborne dust and may thus be considered as a surrogate for the assessment of indoor airborne microbial exposure. PRACTICAL IMPLICATIONS: Significant discrepancies between sampling methods regarding indoor microbial exposures have been revealed. This study thus facilitates comparison between methods and may therefore be used as a frame of reference when studying the literature or when conducting further studies on indoor microbial exposure. Results also imply that the relatively simple EDC method for the collection of settled dust may be used as an alternative to otherwise tedious and time-consuming airborne dust sampling.

Airborne endotoxin associated with particles of different sizes and affected by water content in handled straw.

High exposures to endotoxin are observed in environments where organic materials are handled and lower exposures are found in e.g. indoor air. Inhaled endotoxin contributes significantly to the induction of airway inflammation and dysfunction. The size of an inhaled particle influences the deposition in the airways and the following health symptoms. The objective is to characterise the distribution of endotoxin on airborne particles of different sizes in straw storage halls with high exposure and in other environments with lower exposure levels to endotoxin. Furthermore we have studied the influence of water content of handled straw on the size distribution of endotoxin containing particles. Total, inhalable, thoracic and respirable endotoxin and particles have each been quantified in aerosols from boiler rooms and straw storage halls at 24 power plants, including 21 biofuel plants. Inhalable, thoracic and respirable endotoxin have been quantified in aerosols from offices and outdoor air. The endotoxin concentration was higher in airborne thoracic dust than in airborne 'total dust'. The median respirable fraction in the straw storage halls, boiler rooms at biofuel plants, boiler rooms at conventional plants, offices and outdoors was respectively 42%, 9%, 19%, 24% and 34%. Thoracic endotoxin per number of thoracic particles was higher than respirable endotoxin per number of respirable particles at the biofuel plants. In straw storage halls the fraction of endotoxin of respirable size was highest on the days with lowest water content in the received straw. Furthermore the exposures to all endotoxin fractions were highest on days with the lowest water content in the received straw. In conclusion the highest exposures and concentrations of endotoxin occur or tend to occur from thoracic dust. A high variation in endotoxin concentrations and in fractions of respirable or thoracic size is found in the different working areas. This is important in the risk assessment and makes attempts to influence the endotoxin exposure a possibility. Water content in straw affected the concentration, exposure level and size distribution of airborne endotoxin.

Exposure to dust and endotoxin of employees in cucumber and tomato nurseries.

Exposure to bioaerosols in occupational settings is associated with a range of adverse health effects. The aim of this study was to investigate the exposure levels to dust and endotoxin of people working in two cucumber nurseries and two tomato nurseries. Exposure was measured for greenhouse workers (n = 70) mainly working on harvesting cucumbers and tomatoes and clearing the plants after the harvest season. The people were exposed to between 0.2 and 15 mg inhalable dust m(-3) (median = 1.6 mg m(-3)) and between 0.5 and 400 ng inhalable endotoxin m(-3) (median = 32 ng m(-3)). The exposure to 'total dust' and endotoxin measured by stationary samplers (n = 30) in the greenhouses was low. Endotoxin was present in relatively high concentrations on cucumber leaves compared with leaves on pot plants. The Danish occupational exposure limit (OEL) for total organic dust is 3 mg m(-3) and 36% and 17% of the cucumber and tomato workers, respectively, were exposed to >3.0 mg inhalable dust m(-3). There is no OEL for endotoxin, but 'no effect levels' at approximately 15 ng m(-3) have been found. The majority of subjects (65%) were exposed to >15 ng m(-3). Significantly higher exposure was found for employees in cucumber nurseries than for employees in tomato nurseries. Clearing tomato plants after the harvest season caused a higher exposure to endotoxin than tomato harvesting. In conclusion, people working in cucumber and tomato nurseries were often exposed to high levels of inhalable dust and endotoxin. Cucumber harvest workers were exposed to significantly more dust and endotoxin than tomato harvest workers. The dust and endotoxin aerosolized during the working processes were only transported to other areas in the greenhouses to a very low degree. Cucumber and tomato leaves were identified as endotoxin reservoirs.

Sampling of high amounts of bioaerosols using a high-volume electrostatic field sampler.

For studies of the biological effects of bioaerosols, large samples are necessary. To be able to sample enough material and to cover the variations in aerosol content during and between working days, a long sampling time is necessary. Recently, a high-volume transportable electrostatic field sampler for collection of fine particles has been described. The aim of this study was to investigate whether this sampler can be used for collection of high amounts of authentic bioaerosols that can subsequently be used for biological analysis. The investigation was carried out at a biofuel plant in a straw storage room and in a boiler room over two seasons. The sampled dust was quantified in terms of mass and characterized regarding microbial components and compared with dust sampled by Gravikon and GSP samplers. For the electrostatic field sampler, a prefilter was used to remove large objects. The prefilter was characterized for particle penetration and this testing indicated that the prefilter did not remove particles up to 10 mum, and therefore respirable dust was sampled by the electrostatic field sampler. Using the electrostatic field sampler in the straw storage and in the boiler room, 330 and 315 mg dust (net recovery of the lyophilized dust) was sampled during a period of 7 days, respectively. The sampling rates of the electrostatic field samplers were between 1.34 and 1.96 mg dust per hour, the value for the Gravikon was between 0.083 and 0.108 mg dust per hour and the values for the GSP samplers were between 0.0031 and 0.032 mg dust per hour. The standard deviations of replica samplings and the following microbial analysis using the electrostatic field sampler and GSP samplers were at the same levels. The exposure to dust in the straw storage was 7.7 mg m(-3) when measured by the electrostatic field sampler and 11.8 mg m(-3) when measured by the GSP inhalable dust sampler. The quantity (amount per mg dust) of total fungi, Aspergillus fumigatus, total bacteria, endotoxin and mesophilic actinomycetes sampled by the electrostatic field samplers and the Gravikon samplers varied within the same season by a factor smaller than four. The quantities of some microbial components were higher in the dust collected with all samplers in March than in August. In conclusion, by using the electrostatic field sampler, it was possible to sample replicas of large authentic aerosol samples that can be used, e.g. biological analysis.

Inflammatory potency of dust from the indoor environment and correlation to content of NAGase and fungi.

The aim of this study was to analyse the contribution of microbial factors to the inflammatory potency of dust (PD). Floor dust was sampled three times from 12 rooms in two schools. The potency of floor dust was measured as interleukin-8 secretion from the lung epithelial cell line A549 after exposure to dust. Measurements of endotoxin, NAGase activity and cultivable fungi in the dust were made. For endotoxin a difference was found between sampling days and for NAGase a difference was found between the schools. The carpeted staff rooms of the two schools had a significantly higher amount of dust/m(2) and endotoxin/m(2), and the PD/m(2) and NAGase activity/m(2) were also higher than in the classrooms with smooth flooring. The PD/m(2) correlated with all fungal parameters except total cultivable fungi. NAGase/m(2) correlated with PD, endotoxin and cultivable Cladosporium sp. per area, and was nearly significantly correlated to total cultivable fungi and Penicillium spp. Therefore; microbiological activity especially from fungi may contribute to the inflammatory potency of floor dust. Carpet flooring may act as a "sink" for microorganisms resulting in a higher inflammatory potency of floor dust, which may reflect building-related symptoms in occupants.

Exposure to airborne microbial components in autumn and spring during work at Danish biofuel plants.

Exposure to microbial components can cause respiratory problems. The exposure levels to microbial components at biofuel plants are not known. Therefore, exposure to inhalable airborne fungi, bacteria, actinomycetes, endotoxin and NAGase was measured using personal and stationary samplers at five Danish biofuel plants in autumn and spring. The personal exposure levels to endotoxin (median=55 EU m-3), thermophilic actinomycetes (median=1.3x10(4) colony forming units (cfu) m-3), total bacteria (median=48x10(4) cells m-3) and total fungi (median=21x10(4) spores m-3) were, in general, high at the five biofuel plants. At straw reception areas, higher exposure to most microbial components was found in spring than in autumn. Endotoxin was found in higher concentrations at straw plants than at wood-chip plants, while the opposite was measured for Aspergillus fumigatus. Some tasks were associated with exposures to microorganisms and endotoxins at much higher levels than the suggested occupational exposure limits. For example, people working with a straw shredder for at least 30 min during a working day were exposed to a median endotoxin exposure of 23,775 endotoxin units (EU) m-3. People working with estimating the water content in wood chips and repairing the chips cranes for at least 30 min during a working day were exposed to a median value of A. fumigatus of 6.7x10(4) cfu m-3 and a median value of fungi of 70x10(4) spores m-3. Consequently, this working environment may cause respiratory disorders in the people working at the plant. Differences in exposure levels were seen between the plants and this may partly be due to differences of the process equipment, tasks and the biofuel handled.

Characterization of microbial particle release from biomass and building material surfaces for inhalation exposure risk assessment.

A conceptual approach including measurements of materials at rest (step 1), measurements using a large rotating drum (step 2) or a Particle-FLEC (step 2) and measurements at a workplace (step 4) has been used to characterize the release of microbial components (bacteria, fungi, actinomycetes, endotoxin or enzymes) and particles from straw, wood chips or fungal cultures of different ages on gypsum boards. Repeated agitation or handling periods were included in step 2 and step 4. There was a low similarity between the amount of microbial components measured in step 1 and the aerosolized amount (step 2) from gypsum boards, wood chips and straw. Ratios between some microbial components measured at the workplace (step 4) and measured in step 2, showed similarities. Less than 1.3% of the total amount of microorganisms and endotoxin becomes airborne during 5 min of agitation of straw or wood chips. Most microbial components were released at higher rates during the first agitation period than during the following periods. However, differences were seen between different microbial components, and endotoxin from straw was released at the same rate in two successive agitation periods. Fungal particles smaller than spores were released from fungal colonized gypsum boards at amounts that were up to 30 times higher in the first agitation period compared with that in the following period, while fungal spores were released at amounts that were five times as high in the first period compared with that in the following period. In addition to differences between microbial components, the release patterns of microbial components were different for wood chips and straw. The time for maximum particle release to half particle release was longer for straw than for wood chips. The observation that some components, e.g. endotoxin, are released at the same rate in two successive handling steps, and that others (e.g. fungi) are mainly released initially, shows that the exposure period to different components from the same material differs in duration. The observed differences in the release patterns of different components and the differences between materials are important when preventive steps are to be taken, and it stresses the importance of applying a relevant sampling time and period in exposure assessments.

Microbial dustiness and particle release of different biofuels.

Exposure to organic dust originating from biofuels can cause adverse health effects. In the present study we have assessed the dustiness in terms of microbial components and particles of various biofuels by using a rotating drum as a dust generator. Microbial components from straw, wood chips, wood pellets and wood briquettes were quantified by several methods. Excellent correlations (r >/= 0.85, P < 0.0001) were found: between lipopolysaccharide (LPS) (as determined by 3-hydroxy fatty acid analysis) and endotoxin (as determined by a Limulus test), cultivable bacteria, total number of bacteria and muramic acid; between endotoxin and cultivable bacteria, total number of bacteria and muramic acid; between total number of bacteria and muramic acid; between cultivable fungi and total number of fungi. Straw was dustier than the other biofuels in terms of actinomycetes, bacteria, muramic acid, endotoxin, LPS, particle mass and number of particles. One of the wood chips studied and the straws had comparatively high dustiness in terms of fungi, while both wood pellets and wood briquettes had comparatively low dustiness in terms of all microbial components. An initially high particle generation rate of straw and wood chips decreased over time whereas the particle generation rate of wood briquettes and wood pellets increased during a 5 min rotation period. Particles of non-microbial origin may be the determining factor for the health risk in handling briquettes and pellets. Straw dust contained significantly more microorganisms per particle than did wood chip dust, probably because bacteria were most abundant in straw dust. The concentrations of endotoxin and fungi were high in wood and straw dust; dust from one of the straws contained 3610 EU/mg and dust from one of the chips contained 7.3 x 10(6) fungal spores/mg. An exposure to 3 mg of straw or wood chips dust/m(3) (the Swedish and Danish OEL of unspecific inhalable dust) could cause exposures to endotoxin and fungi higher than levels were health symptoms are seen to develop. The very different levels of dustiness in terms of particles and microbial components of different biofuels shows that dustiness is an important health-relevant factor to consider when choosing among biofuels and when designing worksites for handling of biofuels.

Fos-like immunoreactivity increases in the lumbar spinal cord following a chronic constriction injury to the sciatic nerve of rat.

A chronic constriction injury (CCI), transection injury, or sham injury to the sciatic nerve was induced in 30 rats. Rats were then sacrificed at 1, 3, 5, 10, and 20 days following injury, and the number of cells immunohistochemically labeled for Fos-like immunoreactivity (Fos-LI) was determined in random sections from the lumbar 4 and 5 (L4 and L5) spinal segments. Non-parametric statistics (Wilcoxon) were used to compare the number of labeled cells ipsilateral to the injury to the number of labeled cells on the contralateral side. At 1 and 5 days following injury, in all treatment groups, significantly more labeled cells (P < 0.05) were observed ipsilaterally. In addition, at 3 and 10 days following injury, the CCI groups exhibited significantly more labeled cells ipsilaterally. The significant increases for the CCI groups ranged from 161% to 360%. Generally, increases were greater for the CCI groups. These results indicate that Fos-LI increases to a greater extent and for a longer duration following the CCI than following either a transection or sham injury.

[Deliveries in Denmark in 1991]. / Fødsler i Danmark 1991.

PIP: In 1991 in Denmark, there were 64,645 children born: 64,349 were born live while 296 were stillborn. In 1990, 63,731 children were born, 914 fewer than in 1991. In 1991 the number of births was 26.5% over the level of 1983, the annual rate increasing 3.4% since 1989. The number of live-born children increased by 3382 from 1991 to 1992 corresponding to rate of 5%. In 1991 the rate of perinatal mortality was 8.0/1000 born. The perinatal mortality of children weighing less than 1000 g was 7.5/1000 born in 1982, compared to 6.0/1000 in 1991. In 1989 the counties of Roskilde, Ribe, Viborg, and Nordjylland had a perinatal mortality over 10/1000; in 1990 only Ribe county had a rate over 10/1000; however, in 1991 the counties of Bornholm and Ribe had a rate over 10/1000. Until 1989 women in the 20-24 age group gave birth to more children than women in the 30-34 age group, but in 1991, 20.4% of children (13,208) were born to women aged 20-24 and 25.4% (16,409) to women aged 30-34. Most (42% or 27,160) were born to women aged 25-29. In 1991, 200 children were born with an extremely low birth weight (up to 999 g), the same number as in 1989. About half of these babies died during the perinatal period, and 15% died in the course of the first year of life. Consequently, infant mortality is significantly dependent on birth weight and it is the lowest for children with a birth weight between 3000 and 5000 g.^ieng