Assessment of indoor bioaerosol exposure using direct-reading versus traditional methods-potential application to home health care.

Home healthcare workers (HHCWs) can be occupationally exposed to bioaerosols in their clients' homes. However, choosing the appropriate method to measure bioaerosol exposures remains a challenge. Therefore, a systematic comparison of existing measurement approaches is essential. Bioaerosol measurements with a real-time, fluorescence-based Wideband Integrated Bioaerosol Sensor (WIBS) were compared to measurements with four traditional off-line methods (TOLMs). The TOLMS included optical microscopic counting of spore trap samples, microbial cultivation of impactor samples, qPCR, and next-generation sequencing (NGS) of filter samples. Measurements were conducted in an occupied apartment simulating the environments that HHCWs could encounter in their patients' homes. Descriptive statistics and Spearman's correlation test were computed to compare the real-time measurement with those of each TOLM. The results showed that the geometric mean number concentrations of the total fluorescent aerosol particles (TFAPs) detected with the WIBS were several orders of magnitude higher than those of total fungi or bacteria measured with the TOLMs. Among the TOLMs, concentrations obtained with qPCR and NGS were the closest to the WIBS detections. Correlations between the results obtained with the WIBS and TOLMs were not consistent. No correlation was found between the concentrations of fungi detected using microscopic counting and any of the WIBS fluorescent aerosol particle (FAP) types, either indoors or outdoors. In contrast, the total concentrations detected with microbial cultivation correlated with the WIBS TFAP results, both indoors and outdoors. Outdoors, the total concentration of culturable bacteria correlated with FAP-type AC. In addition, fungal and bacterial concentrations obtained with qPCR correlated with FAP types AB and AC. For a continuous, high-time resolution but broad scope, the real-time WIBS could be considered, whereas a TOLM would be the best choice for specific and more accurate microbial characterization. HHCWs' activities tend to re-aerosolize bioaerosols causing wide temporal variation in bioparticle concentrations. Thus, the advantage of using the real-time instrument is to capture those variations. This study lays a foundation for future exposure assessment studies targeting HHCWs.

Ciprofloxacin- and azithromycin-resistant bacteria in a wastewater treatment plant.

The occurrence of antibiotic-resistant bacteria (ARB) in wastewater treatment plants (WWTPs) has become an occupational and environmental concern. WWTPs are engineered systems that treat wastewater to meet public health standards before release into the environment. The residuals, as either effluent or solids, are then discharged or beneficially recycled into the environment. Since these wastes contain a diverse array of microorganisms, some of which are resistant to commonly used antibiotics, there is a potential for these organisms to spread in the environment via residual recycling and effluent discharge. Human infections with ARB are increasing, and it is not well known how the interaction between humans and the environment plays a role in this process. WWTP workers, who are on the front lines, may come into direct contact with materials containing these microbes. This study aimed to determine the number of ARB present in both air and sewage sludges in a WWTP using nonselective media supplemented with two antibiotics (ciprofloxacin and azithromycin). The densities of total heterotrophic bacteria, ciprofloxacin-resistant bacteria, and azithromycin-resistant bacteria were 7.82 × 105 - 4.7 × 109, 7.87 × 103 - 1.05 × 108, and 2.27 × 105 - 1.16 × 109 CFU/g, respectively. The prevalence [(concentration on medium with antibiotics/concentration on medium without antibiotics) × 100] of ciprofloxacin-resistant bacteria in treated sludge was twice as low as in digested sludge and approximately three times lower than in raw sludge. For azithromycin, the prevalence of resistant bacteria in treated sludge was about the same in digested and nearly twice lower than in raw sludge. Despite a marked reduction in the mean prevalence of resistant bacteria in dewatered treated sludge for both antibiotics, these differences were not significant. The highest prevalence of antibiotic resistance was observed for azithromycin. Similarly, the prevalence of airborne azithromycin-resistant bacteria inside the belt filter press room (BFPR) was nearly seven times higher than the prevalence of airborne ciprofloxacin-resistant bacteria. These concentrations of ARB were not negligible and may represent an exposure pathway for some workers in WWTPs.

Residential bacteria and fungi identified by high-throughput sequencing and childhood respiratory health.

The objective of this study was to examine and compare environmental microbiota from dust and children's respiratory health outcomes at ages seven and twelve. At age seven, in-home visits were conducted for children enrolled in the Cincinnati Childhood Allergy and Air Pollution Study (CCAAPS). Floor dust was collected and analyzed for bacterial (16 S rRNA gene) and fungal (internal transcribed spacer region) microbiota. Respiratory outcomes, including physician-diagnosed asthma, wheeze, rhinitis, and aeroallergen sensitivity were assessed by physical examination and caregiver-report at ages seven and twelve. The associations between dust microbiota and respiratory outcomes were evaluated using Permanova, DESeq, and weighted quantile sum (WQS) regression models. Four types of WQS regression models were run to identify mixtures of fungi or bacteria that were associated with the absence or presence of health outcomes. For alpha or beta diversity of fungi and bacteria, no significant associations were found with respiratory health outcomes. DESeq identified specific bacterial and fungal indicator taxa that were higher or lower with the presence of different health outcomes. Most individual indicator fungal species were lower with asthma and wheeze and higher with aeroallergen positivity and rhinitis, whereas bacterial data was less consistent. WQS regression models demonstrated that a combination of species might influence health outcomes. Several heavily weighted species had a strong influence on the models, and therefore, created a microbial community that was associated with the absence or presence of asthma, wheeze, rhinitis, and aeroallergen+. Weights for specific species within WQS regression models supported indicator taxa findings. Health outcomes might be more influenced by the composition of a complex mixture of bacterial and fungal species in the indoor environment than by the absence or presence of individual species. This study demonstrates that WQS is a useful tool in evaluating mixtures in relation to potential health effects.

The mycobiomes and bacteriomes of sputum, saliva, and home dust.

Respiratory microbiome is an understudied area of research compared to other microbiomes of the human body. The respiratory tract is exposed to an array of environmental pollutants, including microbes. Yet, we know very little about the relationship between environmental and respiratory microbiome. The primary aim of our study was to compare the mycobiomes and bacteriomes between three sample types from the same participants, including home dust, saliva, and sputum. Samples were collected from 40 adolescents in a longitudinal cohort. We analyzed the samples using 16s bacterial rDNA and ITS fungal rDNA gene sequencing, as well as quantitative PCR with universal fungal and bacterial primers. Results showed that home dust had the greatest alpha diversity between the three sample types for both bacteria and fungi. Dust had the highest total fungal load and the lowest total bacterial load. Sputum had greater bacterial diversity than saliva, but saliva had greater fungal diversity than sputum. The distribution of major bacterial phyla differed between all sample types. However, the distribution of major fungal classes differed only between sputum and saliva. Future research should examine the biological significance of the taxa found in each sample type based on microbial ecology and associations with health effects.

Homemade facemasks: particle filtration, breathability, fit, and other performance characteristics.

Homemade cloth masks and other improvised face coverings have become widespread during the COVID-19 pandemic driven by severe shortages of personal protective equipment. In this study, various alternative (mostly common household) materials, which have not traditionally been used in respiratory protective devices, were tested for particle filtration performance and breathability. Most of these materials were found of some-but rather limited-utility in facemasks. At a breathing flow rate of 30 L min-1, 17 out of 19 tested materials demonstrated collection efficiency below 50%; at 85 L min-1, only one material featured particle collection efficiency above 50%. Pressure drop values were mostly below 4 mm w.g. (observed in 89% of cases for the two flow rates), which provides comfortable breathing. Only for one fabric material (silk) tested at 85 L min-1 did the pressure drop reach 11 mm w.g. Based on these results, a three-layer facemask prototype was designed and fabricated comprised of the best performing materials. Additional tests were conducted to examine possible particle detachment/shedding from the materials used in the newly developed facemask, but no such phenomenon was observed. The prototype was evaluated on 10 human subjects using the standard OSHA-approved quantitative fit testing protocol. The mask protection level, determined as an adopted fit factor, was found to lie between that of the two commercial surgical/medical masks tested for comparison. A 10-cycle washing of the mask prototype lowered its collection efficiency across the particle size range; however, washing did not substantially affect mask breathability. The study revealed that although homemade masks offer a certain level of protection to a wearer, one should not expect them to provide the same respiratory protection as high-end commercial surgical/medical masks or-by any means-NIOSH-certified N95 filtering facepieces.

¿Cómo afecta la frecuencia respiratoria el desempeño de una mascarilla respiratoria autofiltrante N95 y de una mascarilla quirúrgica contra sustitutos de partículas virales?

ResumenLa frecuencia respiratoria (respiraciones/min) difiere entre los individuos y dependiendo de los niveles de actividad física. Las partículas ingresan a las mascarillas respiratorias mediante dos vías principales de penetración: infiltración a través del sellado facial y penetración a través de filtros. Sin embargo, se desconoce la forma en que la frecuencia respiratoria afecta el desempeño general de las mascarillas autofiltrantes N95 (filtering facepiece respirators, FFR) y las mascarillas quirúrgicas (MQ) contra partículas virales y otras partículas submicrómicas de importancia para la salud. En un maniquí de respiración a cuatro flujos inspiratorios medios (FIM) (15, 30, 55 y 85 L/min) y cinco frecuencias respiratorias (10, 15, 20, 25 y 30 respiraciones/min) se probaron una FFR y una MQ. En los dispositivos de protección respiratoria probados se determinaron la penetración a través del filtro (Pfiltro) y la infiltración total hacia el interior (ITI) de partículas de aerosol de cloruro de sodio (NaCl) en tamaños que oscilaban entre 20 y 500 nm. Asimismo, se calcularon las proporciones de penetración de la "infiltración a través del sellado facial con respecto al filtro" (ISFF). Tanto el FIM como la frecuencia respiratoria mostraron efectos significativos (p < 0.05) en el Pfiltro y la ITI. El aumento de la frecuencia respiratoria incrementó la ITI para las FFR N95 mientras que en las MQ no se observaron tendencias claras. El aumento del FIM incrementó la Pfiltro y disminuyó la ITI, lo que dio lugar a una disminución de la proporción de la ISFF. La mayoría de las proporciones de la ISFF fueron >1, lo que sugiere que la infiltración a través del sellado facial fue la vía primaria de penetración de partículas a diversas frecuencias respiratorias. La frecuencia respiratoria es otro factor (además del FIM) que puede afectar significativamente el desempeño de las FFR N95: las frecuencias respiratorias más altas aumentan la ITI. En el caso de las MQ probadas no se observó ninguna tendencia consistente de aumento o disminución de la ITI relacionada con el FIM o la frecuencia respiratoria. Para ampliar potencialmente estos hallazgos más allá del maniquí/sistema respiratorio utilizado, se necesitan estudios futuros orientados a comprender plenamente el mecanismo que hace que la frecuencia respiratoria afecte el desempeño de los dispositivos de protección respiratoria en los sujetos humanos.

Eficacia de la mascarilla facial con filtro de partículas N95 y de la mascarilla quirúrgica durante la respiración humana: dos vías para la penetración de partículas.

RESUMENEl nivel de protección ofrecido por las mascarillas con filtro de partículas y las mascarillas se establece considerando el porcentaje de partículas ambientales que penetran dentro del dispositivo de protección. Existen dos vías de penetración: (1) la infiltración a través del sellado facial de la mascarilla y (2) a través del medio filtrante. El objetivo principal de este estudio fue diferenciar el aporte proveniente de cada una de estas dos vías para partículas cuyo tamaño oscila entre 0.03-1 µm en condiciones de respiración reales. Así, mientras se realizaban pruebas de ajuste convencionales, se evaluaron una mascarilla respiratoria autofiltrante N95 y una mascarilla quirúrgica usada comúnmente en entornos de atención médica en 25 sujetos (número coincidente con el último panel de pruebas de ajuste del Instituto Nacional de Seguridad y Salud Laborales). Asimismo, ambas mascarillas fueron evaluadas empleando maniquíes de respiración que imitaban de forma precisa los patrones de respiración registrados previamente en los sujetos evaluados. Posteriormente, se compararon los datos de penetración obtenidos en las evaluaciones realizadas con sujetos humanos y con maniquíes para determinar los diferentes tamaños de partículas, así como los patrones de respiración. Así se determinaron 5,250 valores de penetración específicos correspondientes al ejercicio y el tamaño de las partículas. Para cada valor se calcularon la tasa de infiltración a través del sellado facial de la mascarilla y la tasa de infiltración a través del filtro, con la finalidad de cuantificar los aportes relativos realizados por cada vía de penetración. El número de partículas que penetra mediante infiltración del sellado facial de la mascarilla autofiltrante/mascarilla quirúrgica probadas excedió ampliamente el número de aquellas que lo hacen a través del filtro. Para la mascarilla autofiltrante N95, el exceso fue (en promedio) de un orden de magnitud y se incrementó notablemente al aumentar el tamaño de las partículas (p < 0.001): ∼7 veces mayor para 0,04 µm, ∼10 veces para 0.1 µm y ∼20 veces para 1 µm. En el caso de la mascarilla quirúrgica, la tasa de infiltración a través del sellado facial de la misma con respecto al filtro osciló entre 4.8 y 5.8 y no se vio significativamente afectada por el tamaño de las partículas para la fracción del submicrómetro evaluado. El movimiento facial/corporal tuvo un efecto pronunciado en el aporte relativo de las dos vías de penetración. La intensidad de la respiración y las dimensiones faciales mostraron alguna influencia (aunque limitada). Considerando que la mayoría de las partículas que penetraron ingresaron a través del sellado facial, al desarrollar la mascarilla autofiltrante/mascarilla quirúrgica la prioridad debería ser realizar una adecuación que permitiera eliminar o minimizar la infiltración a través del sellado facial y no mejorar la eficiencia del medio de filtro.

AERMOD modeling of ambient manganese for residents living near a ferromanganese refinery in Marietta, OH, USA.

Elevated exposure to ambient manganese (Mn) is associated with adverse health outcomes. In Marietta, Ohio, the primary source of ambient Mn exposure is from the longest operating ferromanganese refinery in North America. In this study, the US EPA air dispersion model, AERMOD, was used to estimate ambient air Mn levels near the refinery for the years 2008-2013. Modeled air Mn concentrations for 2009-2010 were compared to concentrations obtained from a stationary air sampler. Census block population data were used to estimate population sizes exposed to an annual average air Mn > 50 ng/m3, the US EPA guideline for chronic exposure, for each year. Associations between modeled air Mn, measured soil Mn, and measured indoor dust Mn in the modeled area were also examined. Median modeled air Mn concentrations ranged from 6.3 to 43 ng/m3 across the years. From 12,000-56,000 individuals, including over 2000 children aged 0-14 years, were exposed to respirable annual average ambient air Mn levels exceeding 50 ng/m3 in five of the six years. For 2009-2010, the median modeled air Mn concentration at the stationary site was 20 ng/m3, compared to 18 ng/m3 measured with the stationary air sampler. All model performance measures for monthly modeled concentrations compared to measured concentrations were within acceptable limits. The study shows that AERMOD modeling of ambient air Mn is a viable method for estimating exposure from refinery emissions and that the Marietta area population was at times exposed to Mn levels that exceeded US EPA guidelines.

HEPA filtration improves asthma control in children exposed to traffic-related airborne particles.

Traffic-related airborne particles are associated with asthma morbidity. The aim of this study was to assess the impact of a high-efficiency particulate air (HEPA) filtration on the concentrations of traffic particles and the resultant effect on children with asthma. Forty-three children with asthma were enrolled in this double-blind, placebo-controlled crossover design. A HEPA air cleaner or a placebo "dummy" was placed in participants' homes for four weeks, interrupted by a one-month washout period, before crossing over to the other treatment arm for four weeks. Air sampling and health outcomes, including asthma control (ACQ) and quality of life (AQLQ) measures, were completed prior to and at the end of each treatment arm. Indoor concentrations of traffic particles were significantly reduced with the HEPA treatment but not with the "dummy" treatment. In participants with poorly controlled asthma and lower quality of life at baseline, ACQ and AQLQ scores were significantly improved (1.3 to 0.9, P = .003 and 4.9 to 5.5, P = .02, respectively) following the HEPA treatment. In this study, HEPA filtration is associated with improved clinical outcomes and quality of life measures in children with uncontrolled asthma.

Predicting Indoor Concentrations of Black Carbon in Residential Environments.

Black carbon (BC) is a descriptive term that refers to light-absorbing particulate matter (PM) produced by incomplete combustion and is often used as a surrogate for traffic-related air pollution. Exposure to BC has been linked to adverse health effects. Penetration of ambient BC is typically the primary source of indoor BC in the developed world. Other sources of indoor BC include biomass and kerosene stoves, lit candles, and charring food during cooking. Home characteristics can influence the levels of indoor BC. As people spend most of their time indoors, human exposure to BC can be associated to a large extent with indoor environments. At the same time, due to the cost of environmental monitoring, it is often not feasible to directly measure BC inside multiple individual homes in large-scale population-based studies. Thus, a predictive model for indoor BC is needed to support risk assessment in public health. In this study, home characteristics and occupant activities that potentially modify indoor levels of BC were documented in 23 homes, and indoor and outdoor BC concentrations were measured twice. The homes were located in the Cincinnati-Kentucky-Indiana tristate region and measurements occurred from September 2015 through August 2017. A linear mixed-effect model was developed to predict BC concentration in residential environments. The measured outdoor BC concentrations and the documented home characteristics were utilized as predictors of indoor BC concentrations. After the model was developed, a leave-one-out cross-validation algorithm was deployed to assess the predictive accuracy of the output. The following home characteristics and occupant activities significantly modified the concentration of indoor BC: outdoor BC, lit candles and electrostatic or high efficiency particulate air (HEPA) filters in heating, ventilation and air conditioning (HVAC) systems. Predicted indoor BC concentrations explained 78% of the variability in the measured indoor BC concentrations. The data show that outdoor BC combined with home characteristics can be used to predict indoor BC levels with reasonable accuracy.

Pilot study on the efficiency of water-only decontamination for firefighters' turnout gear.

Firefighters are exposed to toxic environments upon entering burning structures. Many structures contain synthetic materials which release toxic chemicals when on fire. These chemicals can enter the body through multiple routes of exposure, including inhalation and skin absorption. Thus, according to the fire departments included in this study, firefighters now conduct on-site decontamination procedures to remove hazardous chemicals, including polycyclic aromatic hydrocarbons (PAHs) from the surface of firefighter turnout gear. Several methods are being practiced at the local level, including decontamination with soap and water, and decontamination with water alone. The water-only decontamination method requires less time and supplies yet has not been investigated as a suitable method for removing polycyclic aromatic hydrocarbons from turnout gear. Therefore, we evaluated the efficiency of this method by measuring PAH concentration levels before and after water-only decontamination. The calculated efficiency displays the percentage of PAHs removed (or not removed) at post-decontamination in relation to the initial sample collected at pre-decontamination. The turnout gear was sampled after live residential structure fires. Firefighter turnout gear was worn throughout Attack, Overhaul Search and Rescue, and Rescue from Fire operations. All firefighters came to a central location for sampling after completing their job responsibilities. Water only decontamination did not appear to be effective, resulting in an overall 42% increase in PAH contamination. The unexpected increase may have been due to disparate pre- and post-decontamination sampling sites on turnout gear.

Ten questions concerning the implications of carpet on indoor chemistry and microbiology.

Carpet and rugs currently represent about half of the United States flooring market and offer many benefits as a flooring type. How carpets influence our exposure to both microorganisms and chemicals in indoor environments has important health implications but is not well understood. The goal of this manuscript is to consolidate what is known about how carpet impacts indoor chemistry and microbiology, as well as to identify the important research gaps that remain. After describing the current use of carpet indoors, questions focus on five specific areas: 1) indoor chemistry, 2) indoor microbiology, 3) resuspension and exposure, 4) current practices and future needs, and 5) sustainability. Overall, it is clear that carpet can influence our exposures to particles and volatile compounds in the indoor environment by acting as a direct source, as a reservoir of environmental contaminants, and as a surface supporting chemical and biological transformations. However, the health implications of these processes are not well known, nor how cleaning practices could be optimized to minimize potential negative impacts. Current standards and recommendations focus largely on carpets as a primary source of chemicals and on limiting moisture that would support microbial growth. Future research should consider enhancing knowledge related to the impact of carpet in the indoor environment and how we might improve the design and maintenance of this common material to reduce our exposure to harmful contaminants while retaining the benefits to consumers.

Effectiveness of a portable air cleaner in removing aerosol particles in homes close to highways.

Outdoor traffic-related airborne particles can infiltrate a building and adversely affect the indoor air quality. Limited information is available on the effectiveness of high efficiency particulate air (HEPA) filtration of traffic-related particles. Here, we investigated the effectiveness of portable HEPA air cleaners in reducing indoor concentrations of traffic-related and other aerosols, including black carbon (BC), PM2.5 , ultraviolet absorbing particulate matter (UVPM) (a marker of tobacco smoke), and fungal spores. This intervention study consisted of a placebo-controlled cross-over design, in which a HEPA cleaner and a placebo "dummy" were placed in homes for 4-weeks each, with 48-hour air sampling conducted prior to and during the end of each treatment period. The concentrations measured for BC, PM2.5 , UVPM, and fungal spores were significantly reduced following HEPA filtration, but not following the dummy period. The indoor fraction of BC/PM2.5 was significantly reduced due to the HEPA cleaner, indicating that black carbon was particularly impacted by HEPA filtration. This study demonstrates that HEPA air purification can result in a significant reduction of traffic-related and other aerosols in diverse residential settings.

ß-Glucan exacerbates allergic asthma independent of fungal sensitization and promotes steroid-resistant TH2/TH17 responses.

BACKGROUND: Allergic sensitization to fungi has been associated with asthma severity. As a result, it has been largely assumed that the contribution of fungi to allergic disease is mediated through their potent antigenicity. OBJECTIVE: We sought to determine the mechanism by which fungi affect asthma development and severity. METHODS: We integrated epidemiologic and experimental asthma models to explore the effect of fungal exposure on asthma development and severity. RESULTS: We report that fungal exposure enhances allergen-driven TH2 responses, promoting severe allergic asthma. This effect is independent of fungal sensitization and can be reconstituted with ß-glucan and abrogated by neutralization of IL-17A. Furthermore, this severe asthma is resistant to steroids and characterized by mixed TH2 and TH17 responses, including IL-13+IL-17+CD4+ double-producing effector T cells. Steroid resistance is dependent on fungus-induced TH17 responses because steroid sensitivity was restored in IL-17rc-/- mice. Similarly, in children with asthma, fungal exposure was associated with increased serum IL-17A levels and asthma severity. CONCLUSION: Our data demonstrate that fungi are potent immunomodulators and have powerful effects on asthma independent of their potential to act as antigens. Furthermore, our results provide a strong rationale for combination treatment strategies targeting IL-17A for this subgroup of fungus-exposed patients with difficult-to-treat asthma.

Assessing the accuracy of commercially available gas sensors for the measurement of ambient ozone and nitrogen dioxide.

The objective of the National Institute for Occupational Safety and Health (NIOSH) accuracy criterion is to ensure that measurements from monitoring devices are within ±25% of the true concentration of the analyte with 95% certainty. To determine whether NO2 and O3 sensors meet this criterion, three commercially available units (Cairclip O3/NO2, Aeroqual NO2, and Aeroqual O3 sensors) were co-located three times with validated instruments (NOx chemiluminescence [NO2mon] and photometric O3 analyzers [O3mon]) at an outdoor monitoring station. As cofactors of sensor performance such as temperature (T) and relative humidity (RH) potentially influence the response of NO2 and O3 sensors, corrections for cofactors were made by using T, RH, and the sensor measurements to predict measurements made by NO2mon and O3mon during the first co-location period (training dataset). The developed models were tested in the merged data obtained from the second and third co-location periods (testing dataset). In the training and testing datasets, the mean NO2 as measured by NO2mon was 4.6 ppb (range = 0.4-35 ppb) and 9.4 ppb (range = 1-37 ppb), respectively. The mean O3 in the training and testing datasets as measured by O3mon was 38.8 ppb (range = 1-65 ppb) and 35.7 ppb (range = 1-61 ppb), respectively. None of the sensor measurements in the training dataset were within the NIOSH accuracy criterion (mean error ≥25%). After correcting for cofactors of sensor performance, the accuracy of the Cairclip O3/NO2 and the Aeroqual O3 sensors considerably improved when tested with the testing dataset (mean error = -1% and 14%, respectively). However, the Aeroqual NO2 sensor had an error that was not within ±25%. Raw measurements from the tested sensors may be unsuitable for assessing workers' exposure to NO2 and O3. Corrections for cofactors of Cairclip O3/NO2 and Aeroqual O3 sensor performance are required for more accurate occupational exposure assessment.

Fungal Microbiomes Associated with Green and Non-Green Building Materials.

Water-damaged buildings can lead to fungal growth and occupant health problems. Green building materials, derived from renewable sources, are increasingly utilized in construction and renovations. However, the question as to what fungi will grow on these green compared to non-green materials, after they get wet, has not been adequately studied. By determining what fungi grow on each type of material, the potential health risks can be more adequately assessed. In this study, we inoculated green and non-green pieces of ceiling tile, composite board, drywall, and flooring with indoor dust containing a complex mixture of naturally occurring fungi. The materials were saturated with water and incubated for two months in a controlled environment. The resulting fungal microbiomes were evaluated using ITS amplicon sequencing. Overall, the richness and diversity of the mycobiomes on each pair of green and non-green pieces were not significantly different. However, different genera dominated on each type of material. For example, Aspergillus spp. had the highest relative abundance on green and non-green ceiling tiles and green composite boards, but Peniophora spp. dominated the non-green composite board. In contrast, Penicillium spp. dominated green and non-green flooring samples. Green gypsum board was dominated by Phialophora spp. and Stachybotrys spp., but non-green gypsum board by Myrothecium spp. These data suggest that water-damaged green and non-green building materials can result in mycobiomes that are dominated by fungal genera whose member species pose different potentials for health risks.

Performance of two respiratory protective devices used by home-attending health care workers (a pilot study).

OBJECTIVES: This pilot study aimed at determining the Workplace Protection Factor (WPF) for respiratory protective devices widely used by health care workers to reduce exposure to potentially hazardous aerosols when attending patients in their homes. Two devices were tested, an N95 filtering facepiece respirator (FFR) and a surgical mask (SM). METHODS: Three home-attending health care workers were recruited, medically cleared and fit tested. At the workplace, the aerosol concentrations outside (Cout) and inside (Cin) of the tested respiratory protective device worn by a subject were measured using two simultaneously operating P-Trak condensation particle counters within the particle size range of approximately 20-1,000 nm. Real-time and integrated (time-weighted average, TWA) values of WPF = Cout/Cin were determined. RESULTS: This pilot study demonstrated that the WPF of the tested N95 FFR consistently exceeded that of the SM. The WPFTWA(C) values calculated for the entire test time (based on the TWA aerosol concentration values) ranged from 29 to 40 and 2 to 9, respectively. In all cases, the N95 FFR provided protection above the Occupational Safety and Health Administration's (OSHA) assigned protection factor of 10, whereas the SM often offered little or essentially no protection against the measured sub-micrometer aerosol particles. For both devices, the protection level was found to depend on activity. For example, the WPFTWA(C) for one subject wearing the N95 FFR was 56 during normal activity but fell almost 70% during tracheal suctioning. It is explicable considering that different procedures implemented by health care workers in homes generate particles of different sizes and require different body movements; both factors are anticipated to affect the WPF. CONCLUSIONS: Wearing an N95-certified respirator helps significantly reduce the aerosol inhalation exposure of home-attending health care workers. An SM offers much lower protection. The WPF depends on several factors, including, but not limited to, the health care worker's activity and/or body movements; the WPF varies from one worker to another.

Evaluation of personal inhalable aerosol samplers with different filters for use during anthrax responses.

Risk of inhalation exposure to viable Bacillus anthracis (B. anthracis) spores has primarily been assessed using short-term, stationary sampling methods which may not accurately characterize the concentration of inhalable-sized spores reaching a person's breathing zone. While a variety of aerosol sampling methods have been utilized during previous anthrax responses, no consensus has yet been established for personal air sampling. The goal of this study was to determine the best sampler-filter combination(s) for the collection and extraction of B. anthracis spores. The study was designed to (1) evaluate the performance of four filter types (one mixed cellulose ester, MCE (pore size = 3 µm), two polytetrafluoroethylene, PTFE (1 and 3 µm), and one polycarbonate, PC (3 µm)); and (2) evaluate the best performing filters in two commercially available inhalable aerosol samplers (IOM and Button). Bacillus thuringiensis kurstaki [Bt(k)], a simulant for B. anthracis, served as the aerosol challenge. The filters were assessed based on criteria such as ability to maintain low pressure drop over an extended sampling period, filter integrity under various environmental conditions, spore collection and extraction efficiencies, ease of loading and unloading the filters into the samplers, cost, and availability. Three of the four tested collection filters-except MCE-were found suitable for efficient collection and recovery of Bt(k) spores sampled from dry and humid as well as dusty and clean air environments for up to 8 hr. The PC (3 µm) filter was identified as the best performing filter in this study. The PTFE (3 µm) demonstrated a comparable performance, but it is more expensive. Slightly higher concentrations were measured with the IOM inhalable sampler which is the preferred sampler's performance criterion when detecting a highly pathogenic agent with no established "safe" inhalation exposure level. Additional studies are needed to address the effects of environmental conditions and spore concentration. The data obtained in this investigation are crucial for future efforts on the development and optimization of a method for assessing inhalation exposure to B. anthracis.

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

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

Application of the Environmental Relative Moldiness Index in Finland.

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.