Measured moisture in buildings and adverse health effects: A review.

It has not yet been possible to quantify dose-related health risks attributable to indoor dampness or mold (D/M), to support setting specific health-related limits for D/M. An overlooked target for assessing D/M is moisture in building materials, the critical factor allowing microbial growth. A search for studies of quantified building moisture and occupant health effects identified 3 eligible studies. Two studies assessed associations between measured wall moisture content and respiratory health in the UK. Both reported dose-related increases in asthma exacerbation with higher measured moisture, with 1 study reporting an adjusted odds ratio of 7.0 for night-time asthma symptoms with higher bedroom moisture. The third study assessed relationships between infrared camera-determined wall moisture and atopic dermatitis in South Korea, reporting an adjusted odds ratio of 14.5 for water-damaged homes and moderate or severe atopic dermatitis. Measuring building moisture has, despite extremely limited available findings, potential promise for detecting unhealthy D/M in homes and merits more research attention. Further research to validate these findings should include measured "water activity," which directly assesses moisture availability for microbial growth. Ultimately, evidence-based, health-related thresholds for building moisture, across specific materials and measurement devices, could better guide assessment and remediation of D/M in buildings.

Development of a method to relate the moisture content of a building material to its water activity.

Subjective indicators of building dampness consistently have been linked to health, but they are, at best, semi-quantitative, and objective and quantitative assessments of dampness are also needed to study dampness-related health effects. Investigators can readily and non-destructively measure the "moisture content" (MC) of building materials with hand-held moisture meters. However, MC does not indicate the amount of the water in a material that is available to microorganisms for growth, that is, the "water activity" (Aw ). Unfortunately, Aw has not been readily measurable in the field and is not relatable to MC unless previously determined experimentally, because for the same moisture meter reading, Aw can differ across materials as well as during moisture adsorption vs desorption. To determine the Aw s that correspond to MC levels, stable air relative humidities were generated in a glove box above saturated, aqueous salt solutions, and the Aw of gypsum board and the relative humidity of the chamber air were tracked until they reached equilibrium. Strong correlations were observed between meter readings and gravimetrically determined MC (r=.91-1.00), among readings with three moisture meters (r=.87-.98), and between meter readings and gypsum board Aw (r=.77-.99).

Higher measured moisture in California homes with qualitative evidence of dampness.

Relationships between measured moisture and qualitative dampness indicators (mold odor, visible mold, visible water damage, or peeling paint) were evaluated using data collected from California homes in a prospective birth cohort study when the infants were 6 or 12 months of age (737 home visits). For repeated visits, agreement between observation of the presence/absence of each qualitative indicator at both visits was high (71-87%, P < 0.0001). Among individual indicators, musty odor and visible mold were most strongly correlated with elevated moisture readings. Measured moisture differed significantly between repeated visits in opposite seasons (P < 0.0001), and dampness increased with the number of indicators in a home. Linear mixed-effect models showed that 10-unit increases in maximum measured moisture were associated with the presence of 0.5 additional dampness indicators (P < 0.001). Bedroom (BR) walls were damper than living room (LR) walls in the same homes (P < 0.0001), although both average and maximum readings were positively correlated across room type (r = 0.75 and 0.67, respectively, both P < 0.0001). Exterior walls were significantly damper than interior walls (P < 0.0001 in both LRs and BRs), but no differences were observed between maximum wall readings and measurements at either window corners or sites of suspected dampness.

Next-generation DNA sequencing reveals that low fungal diversity in house dust is associated with childhood asthma development.

UNLABELLED: Dampness and visible mold in homes are associated with asthma development, but causal mechanisms remain unclear. The goal of this research was to explore associations among measured dampness, fungal exposure, and childhood asthma development without the bias of culture-based microbial analysis. In the low-income, Latino CHAMACOS birth cohort, house dust was collected at age 12 months, and asthma status was determined at age 7 years.The current analysis included 13 asthma cases and 28 controls. Next-generation DNA sequencing methods quantified fungal taxa and diversity. Lower fungal diversity (number of fungal operational taxonomic units) was significantly associated with increased risk of asthma development: unadjusted odds ratio(OR) 4.80 (95% confidence interval (CI) 1.04­22.1). Control for potential confounders strengthened this relationship. Decreased diversity within the genus Cryptococcus was significantly associated with increased asthma risk (OR 21.0, 95% CI 2.16­204). No fungal taxon (species, genus, class) was significantly positively associated with asthma development, and one was significantly negatively associated. Elevated moisture was associated with increased fungal diversity, and moisture/mold indicators were associated with four fungal taxa. Next-generation DNA sequencing provided comprehensive estimates of fungal identity and diversity, demonstrating significant associations between low fungal diversity and childhood asthma development in this community. PRACTICAL IMPLICATIONS: Early life exposure to low fungal diversity in house dust was associated with increased risk for later asthma developmen tin this low-income, immigrant community. No individual fungal taxon (species, genus, or class) was associated with asthma development, although exposure to low diversity within the genus Cryptococcus was associated with asthma development. Future asthma development studies should incorporate fungal diversity measurements, in addition to measuring individual fungal taxa. These results represent a step toward identifying the aspect(s) of indoor microbial populations that are associated with asthma development and suggest that understanding the factors that control diversity in the indoor environment may lead to public health recommendations for asthma prevention in the future.

Fungi and pollen exposure in the first months of life and risk of early childhood wheezing.

BACKGROUND: Many studies have found that the risk of childhood asthma varies by month of birth, but few have examined ambient aeroallergens as an explanatory factor. A study was undertaken to examine whether birth during seasons of elevated ambient fungal spore or pollen concentrations is associated with risk of early wheezing or blood levels of Th1 and Th2 type cells at 24 months of age. METHODS: 514 children were enrolled before birth and followed to 24 months of age. Early wheezing was determined from medical records, and Th1 and Th2 type cells were measured in peripheral blood using flow cytometry. Ambient aeroallergen concentrations were measured throughout the study period and discrete seasons of high spore and pollen concentrations were defined. RESULTS: A seasonal pattern was observed, with birth in autumn to winter (the spore season) associated with increased odds of early wheezing (adjusted odds ratio 3.1; 95% confidence interval 1.3 to 7.4). Increasing mean daily concentrations of basidiospores and ascospores in the first 3 months of life were associated with increased odds of wheeze, as were increasing mean daily concentrations of total and specific pollen types. Levels of Th1 cells at age 24 months were positively associated with mean spore concentrations and negatively associated with mean pollen concentrations in the first 3 months of life. CONCLUSIONS: Children with higher exposure to spores and pollen in the first 3 months of life are at increased risk of early wheezing. This association is independent of other seasonal factors including ambient levels of particulate matter of aerodynamic diameter

Utilisation d'une solution polyamphotère lors de lésions et brûlures chimiques oculaires cutanées et buccales. effet sur la douleur de la diphotérine®.

Polyamphoteric washing solutions (PWS) have been used for several years, mainly in industries, for cases of chemical ocular or cutaneous splashes by acid or alkali. We collected 37 cases reporting the use of PWS for ocular and cutaneous chemical splashes from several centres. Among the 37 cases, 55.26% resulted from occupational exposure. Among ocular exposures, initial clinical symptoms included pain (20 cases), blepharospasm (4 cases), hyperaemia (15 cases), palpebral oedema (2 cases) and blurred vision (7 cases). Among cutaneous exposures, 2 injuries were classified as deep, and 11 as superficial. Mean (SD) pain (VAS) before PWS was 6,29 +/- 2,74; mean (SD) pain after PWS was 1,47 +/- 1,73. Early application of PWS to the eye or skin reduces the intensity of pain that is associated with chemical damage. Early application of amphoteric solution appears to reduce the incidence of sequelae, provided its pre-hospital and hospital use is early. However, further studies are needed.

[Not Available]. / Épidémiologie descriptive de la brûlure dans un territoire de santé exemple du « territoire nord franche-comté ¼ durant l'année 2014.

This is an epidemiologic study of the need for Health Services for burns in the northern part of Franche Comté (north-east of France) along year 2014 (114 patients). Mean age was 26 years (8 month-81 years), one third of burns occurred in children below 15. Most burns take part in summer, around mealtime, in "school-free" days, at home and are scalds. Their surface is low (4,81%) and they are usually partial thickness ones. Patients are consulted in Emergency Department in 88,59% of the cases, and hospitalised thereafter in a Burns Unit (in Lyon more than Nancy or Metz) in 12,28%.

Public inquiries about indoor air quality in California.

To identify the indoor air quality issues about which Californians most often sought advice from a health department or a public information agency and to evaluate how well these agencies met the public's needs, members of the California Interagency Working Group (IWG) on Indoor Air Quality kept records of inquiries they received over a 30-month period from mid-1985 through 1987. Members of the IWG answered calls from residents of a least 49 of California's 58 counties. IWG members received more public inquiries about residences than about offices, educational institutions, commercial buildings, or medical facilities. However, each call about a residence probably represented fewer people at risk of exposure to a real or a potential problem than did calls about other types of buildings. Homeowners themselves asked the majority of the questions about residences, whereas a large number of the inquiries about office buildings were made, not by affected office workers, but by building managers, contractors, consultants, or company health and safety officers. The leading topics of concern in the residences were asbestos, chemical and biological contamination, and radon. In offices, chemical contamination, the ventilation system, biological contamination, asbestos, and tobacco smoke were the most frequently mentioned sources of problems. Callers often reported experiencing headaches, allergy symptoms, nose or throat irritation, and respiratory tract problems in connection with their complaints. IWG members directed a third of the calls elsewhere, of which half were referred to consultants or testing laboratories. The IWG's experience in the State of California could help other health departments prepare to face the public's increasing concern about indoor air pollution.

Effectiveness of in-room air filtration and dilution ventilation for tuberculosis infection control.

Tuberculosis (TB) is a public health problem that may pose substantial risks to health care workers and others. TB infection occurs by inhalation of airborne bacteria emitted by persons with active disease. We experimentally evaluated the effectiveness of in-room air filtration systems, specifically portable air filters (PAFs) and ceiling-mounted air filters (CMAFs), in conjunction with dilution ventilation, for controlling TB exposure in high-risk settings. For each experiment, a test aerosol was continuously generated and released into a full-sized room. With the in-room air filter and room ventilation system operating, time-averaged airborne particle concentrations were measured at several points. The effectiveness of in-room air filtration plus ventilation was determined by comparing particle concentrations with and without device operation. The four PAFs and three CMAFs we evaluated reduced room-average particle concentrations, typically by 30% to 90%, relative to a baseline scenario with two air-changes per hour of ventilation (outside air) only. Increasing the rate of air flow recirculating through the filter and/or air flow from the ventilation did not always increase effectiveness. Concentrations were generally higher near the emission source than elsewhere in the room. Both the air flow configuration of the filter and its placement within the room were important, influencing room air flow patterns and the spatial distribution of concentrations. Air filters containing efficient, but non-high efficiency particulate air (HEPA) filter media were as effective as air filters containing HEPA filter media.

A two-year study of microbiological indoor air quality in a new apartment.

Concentrations and types of bacteria and fungi in the air and on surfaces were measured in a new, one-bedroom apartment before occupancy and at 3-mo intervals thereafter for 2 y. Air samples were collected with a single-stage impactor at two locations in the kitchen, living room, bedroom, bathroom, and outdoors. Even though damp surfaces supported large populations of bacteria and yeasts, the air concentrations in the kitchen and bathroom were similar to those in other rooms. No changes in concentrations or types of microbiological contamination were observed between the first and second years of occupancy, but elevated outdoor humidity, lower air temperature, and winds from the northeast were associated with higher bacterial and fungal air concentrations. The median air concentrations of bacteria were 98 cfu/m3 (95% confidence interval 26-372 cfu/m3) indoors and 101 cfu/m3 (28-364 cfu/m3) outdoors. The median air concentrations of fungi were 198 cfu/m3 (58-673 cfu/m3) indoors and 362 cfu/m3 (113-1158 cfu/m3) outdoors. This information established useful baseline data against which measurements in neighboring complaint residences could be compared.

Concentrations of airborne culturable bacteria in 100 large US office buildings from the BASE study.

UNLABELLED: This paper presents summary statistics of airborne culturable bacteria from the US Environmental Protection Agency Building Assessment Survey and Evaluation (BASE) study. Air samples were collected with single-stage, multiple-hole, agar impactors in 100 large office buildings in 1994-1998 to obtain normative data on indoor environmental quality. Bacterial concentrations were compared by incubation temperature, location, season, and climate zone. Forty-one percent of the samples were below the 2- or 5-min detection limits (18 or 7 CFU/m3, respectively) but less than 1% were overgrown. Mesophilic bacteria (30 degrees C) accounted for >95% of culturable bacteria, both indoors and outdoors. Average concentrations were higher outdoors, except for Gram-positive cocci, which were the only group that were significantly higher indoors (39 vs. 24 CFU/m3), and Gram-negative cocci, for which both concentrations were low and the difference were not significant. Outdoor concentrations of culturable bacteria were somewhat higher in winter (194 vs.165 CFU/m3), and the two dominant outdoor groups were unknown bacteria and Gram-positive rods. Conversely, indoor concentrations were significantly higher in summer (116 vs. 87 CFU/m3), consisting primarily of unknown bacteria and Gram-positive cocci. Bacterial concentrations were within the ranges reported in previous studies of non-problem buildings, and the extreme aggregated indoor concentrations (e.g. the 90th percentile, 175 CFU/m3) of these 100 representative buildings may serve as upper bounds to develop interpretation guidelines for office environments and similar non-manufacturing workplaces in various climate zones. PRACTICAL IMPLICATIONS: The Building Assessment Survey and Evaluation (BASE) study was one of the most comprehensive investigations of indoor environmental quality in which a standardized protocol was used to measure bioaerosols in 100 typical US office buildings. The information on the indoor and outdoor concentrations of airborne bacteria in different climate zones during the heating and cooling seasons has expanded the baseline data available for interpretation of measurements from building investigations. With suggested refinements, the BASE protocol may serve as a guide for future studies of bioaerosol concentrations, building characteristics, and occupant perceptions of the indoor environment.

Concentrations of cat and dust-mite allergens in dust samples from 92 large US office buildings from the BASE Study.

UNLABELLED: The concentrations of cat (Fel d1) and dust-mite (Der f1 and Der p1) allergens were measured in 92 large office buildings in the US Environmental Protection Agency's Building Assessment Survey and Evaluation (BASE) Study (251 dust samples; one to four samples per building). Fel d1 was detected in almost all buildings and samples (91 buildings, 99%; 235 samples, 94%; range: <0.01-19 microg/g; median: 0.3 microg/g). Cat allergen exceeded 1 microg/g (a lower symptom threshold) in 56 samples (22%) from 45 buildings, but exceeded 8 microg/g (a sensitization threshold) in only two samples (1%) from two buildings. Der f1 or Der p1 was found in approximately half of all buildings and samples (63 and 70% of buildings; 45 and 51% of samples; range: <0.01-53 microg/g and <0.01-25 microg/g; median: <0.02 and 0.03 microg/g, respectively). Mite allergen exceeded 2 microg/g (a sensitization threshold) in seven samples (3%) from five buildings and exceeded 10 microg/g (a symptom threshold) in three samples (1%) from three buildings. Fel d1 concentration was significantly higher in samples collected in summer (June to September, 48 buildings), but cat allergen was not correlated with either mite allergen. Der f1, but not Der p1, concentration tended to be higher in samples collected in winter (December to April, 44 buildings), and the two mite allergens were significantly correlated only in winter. Cat and mite allergens were detected in 78% of representative US office buildings, but the concentrations seldom exceeded levels associated with sensitization or symptom provocation. PRACTICAL IMPLICATIONS: The information on the concentrations of cat and dust-mite allergens in representative large US offices has expanded the baseline data available for interpretation of measurements from other building investigations. With suggested refinements, the BASE protocol for measurement of allergen concentrations in dust samples may serve as a guide to future studies of building characteristics, bioaerosol concentrations, and occupant perceptions of the indoor environment.

Positive-hole correction of multiple-jet impactors for collecting viable microorganisms.

Multiple-jet impactors, typically with 200 or 400 holes, are used widely for collecting aerosols of living bacteria and fungi. In this type of impactor, the air jets impinge directly onto nutrient agar in a petri dish which is incubated after sampling until collected cells multiply into colonies. The observed number of colonies can be adjusted for the probability that more than one viable particle was collected through a sampling hole and merged with other microorganisms at an impaction site to produce a single colony. A "positive-hole" correction table has been published for a 400-hole impactor, but none has been produced previously for the 200-hole impactor. The expected number of sampled particles required to fill each of 1 through 200 and 1 through 400 impaction sites and the standard deviations of these values were calculated from probability theory. The results were compared with a Monte Carlo simulation. By using correction tables (which include the standard deviation of an expected value) an investigator can report the most probable viable particle count and a 95% confidence interval (mean +/- 2 standard deviations). The range of collected particles that could have produced an observed number of colonies increases as the number of collected particles increases, and investigators should acknowledge the uncertainty associated with adjusted counts. It is advisable to use an impactor with the greatest practical number of sampling holes because this decreases the likelihood that multiple particles are deposited at the impaction sites.(ABSTRACT TRUNCATED AT 250 WORDS)

Evaluation of a procedure to isolate culturable microorganisms from carpet dust.

Details of a method to isolate culturable bacteria and fungi from carpet dust were evaluated to isolate the greatest numbers of these agents. Four broad groups were evaluated: mesophilic and thermophilic bacteria and moderately hydrophilic and xerophilic fungi. Features studied included: 1) mixing time; 2) addition of glass beads; 3) length of time dust settled before suspensions were plated; 4) relative concentrations of microorganisms in the fibrous and fine dust fractions; and 5) storage temperature and period. The findings are preliminary because of the small number of samples, but a votexing time of at least 2 min with glass beads gave the best results in terms of the highest estimate of the concentration of culturable bacteria or fungi. Microorganisms were retrievable-from the upper portion of a suspending liquid for at least 30 min with little detectable change in concentration. Both bacteria and fungi were more abundant in the fine than the fibrous dust fraction. No significant losses were observed for samples stored up to 25 days at 5 degrees C or 25 degrees C. This procedure optimized measurement of total concentration, but may not identify the range of genera and species in dust if microorganisms present in small numbers and as single units are underrepresented relative to those in clusters and aggregates.

Review of methods to collect settled dust and isolate culturable microorganisms.

Examination of settled dust is often included in investigations of indoor environments to identify the types and concentrations of particles to which building occupants may be exposed. Fungi and bacteria are among the many components in dust that have been studied. Isolation by culture is an established method that is used widely to quantify and identify microorganisms in environmental samples. However, no standard procedures for culturing fungi or bacteria from dust have been adopted widely to ensure the validity of comparing findings from different studies. This paper reviews methods various researchers have used to study surface particles and to isolate culturable microorganisms from dust. Factors that were found to differ included the method of sample collection, the ways dust was prepared for inoculation onto growth media, and the culture media chosen for specific categories of agents. The need for reference methods in environmental microbiology for use in the assessment of indoor environmental quality is discussed.

Personal size-separating impactor for sampling microbiological aerosols.

A commercially-available personal impactor was altered to sample viable microorganisms onto a semisolid, moist, gelatin medium rather than onto a stainless steel or filter surface. The Marple personal cascade impactor is an eight-stage sampler with predicted cut-offs of 20, 15, 10, 6, 3.5, 2, 1, and 0.61 microns for stages one to eight, at a flow rate of 2 L/min. The possibility was examined that using trays containing a small amount of gelatin medium in place of the thin, flat filters of the original design would alter the impactor's performance. A polydisperse aerosol of di-2-ethylhexyl phthalate (DEHP or DOP) was sampled directly into an aerodynamic particle sizer and through a stage of the personal impactor. The aerosol particles penetrating the tested stage were sized and counted, and the counts compared with those in the total aerosol. With a Mylar medium filter as the collecting substrate, the measured particle cut-offs (D50) for stages four to seven were 5.2, 3.4, 1.4, and 1.0 microns. With a tray containing gelatin as the collecting substrate, the D50 were 5.9, 4.0, 1.6, and 1.0 microns. The size separation of the personal sampler for ambient bacterial and fungal aerosols compared well with that of the Andersen microbiological impactor. The use of a moist collecting surface, compared to a dry surface, can be expected to enhance recovery of viable airborne microorganisms sensitive to dehydration.

Reuter centrifugal air sampler: measurement of effective airflow rate and collection efficiency.

Incorrect calculation of effective air sampling rate and disregard of differences in collection efficiency among samplers can lead to false conclusions about the usefulness of samplers for measuring concentrations of airborne microorganisms.

Personal air samplers for measuring occupational exposures to biological hazards.

Microbiological air samplers, designed to be worn as personal samplers, were evaluated for studying occupational exposures to aerosols of infectious and allergenic materials. Gelatin filter media, an impinger sampler, and spiral and cascade impactors were tested for collection efficiency for small (less than or equal to 2 microns) latex spheres and for recovery of bacterial aerosols. Only 20% of an aerosol of 0.8 micron latex particles passed through the impinger uncollected, while recovery of bacteria equalled or exceeded collection in an all-glass impinger. Gelatin filters matched the collection efficiency of membrane filters, but were unsatisfactory for the isolation of bacteria sensitive to dehydration. The spiral sampler and the cascade impactor provide information on the size distribution of collected particles, although, at present, collection efficiencies for very small particles are too low for rigorously quantitative studies. Methods of collection, and sampling strategies for biological aerosols are similar to those used for measuring exposures of workers to chemical and mineral aerosols; however, preparation of samples and identification of isolates may have to be referred to experts in the fields of bacteriology, virology, and mycology.