Fungi and fungal products in some Canadian houses

Indoor air quality in remote first nations communities in Ontario, Canada

A recent study of the health of Indigenous children in four First Nations Communities in remote northwestern Ontario found that 21% of children had been admitted to hospital for respiratory infections before age 2 years. Here we report a detailed analysis of the housing conditions in these communities. We employed a variety of statistical methods, including linear regression, mixed models, and logistic regression, to assess the correlations between housing conditions and loadings of biocontaminants (dust mite allergens, fungal glucan, and endotoxin) and indoor concentrations of PM2.5, CO2, benzene, and formaldehyde. The houses (n = 101) were crowded with an average of approximately 7 people. Approximately 27% of the homes had sustained CO2 concentrations above 1500 ppm. Most homes had more than one smoker. Commercial tobacco smoking and the use of non-electric heating (e.g., wood, oil) were associated with increased fine particle concentrations. Over 90% of the homes lacked working Heat Recovery Ventilators (HRVs), which was associated with increased fine particle concentrations and higher CO2. Of the 101 homes, 12 had mold damage sufficient to increase the relative risk of respiratory disease. This resulted from roof leaks, through walls or around the windows due to construction defects or lack of maintenance. A similar percentage had mold resulting from condensation on windows. Endotoxin loadings were much higher than any previous study in Canada. This work provides evidence for the need for more effort to repair existing houses and to ensure the HRVs are properly installed and maintained.

Fungal bioaerosols as an occupational hazard

PURPOSE OF REVIEW

Over the past 40 years, the circumstances where fungal bioaerosols are major issues have shifted because of changes in the industrial sector from mainly agriculture to operations, including composting, cannabis production and forestry in hot humid conditions. Changes in the design and operation of nonindustrial workplaces meant that mould and dampness became major issues that are just being reduced. This review attempts to frame that history offers a perspective on the current thinking on mechanisms and provide potentially useful sources of information for physicians and their patients.

RECENT FINDINGS

The major impact of fungal exposures is not only from their allergens but also from an array of Danger-Associated Molecular Pattern molecules, possibly the most important of which is the type of glucan found in moulds that grow in damp buildings, wood chips and crops, that is beta 1, 3 D glucan in triple helical form. Located in lung epithelia, the dectin receptor is exquisitely sensitive to this compound. Except in some agricultural workplaces, low molecular weight secondary metabolites often mischaracterized as mycotoxins play little, if any, role on population health.

SUMMARY

There has been a convergence in thinking between the allergy and industrial hygiene communities as well as government agencies on mould and occupational health. This has led to some useful strategies for better managing these issues as well as increasing consumer awareness.

Airborne fungi and human exposure in different areas of composting facilities

Airborne fungi can pose serious health concerns in humans; however, the area-specific abundance and composition of airborne fungal microbiota discharged from composting facilities remain unclear. In the present study, we collected air samples from composting, packaging, office, and downwind areas of four commercial composting facilities. The characteristics of airborne fungi, including pathogen/allergen-containing genera, and their corresponding human exposure in different areas of composting facilities were analyzed using high-throughput sequencing and ddPCR. High fungal concentrations and richness were detected in the air of the packaging area. In all four areas, Ascomycota, Basidiomycota, and Mucoromycota were observed to be the primary fungal phyla, with Cladosporium, Alternaria, and Aspergillus as the consistently dominant fungal genera. A large number of endemic airborne fungi were found in the composting and packaging areas, which also shared the most common airborne fungi as well as pathogen/allergen-containing genera. The packaging area contributed substantially to airborne fungi in the office and downwind areas. Area-specific human exposure to broad airborne fungal compositions was revealed, especially regarding the pathogen/allergen-containing genera. Current results provide valuable data for a comprehensive understanding of area-specific airborne fungi in composting facilities and highlight the importance of assessing the inhaled exposure to airborne fungi in evaluating their following health risks.

Fungal populations in the bedroom dust of children in Havana, Cuba, and its relationship with environmental conditions

The study of the fungal community composition in house dust is useful to assess the accumulative exposure to fungi in indoor environments. The objective of this research was to characterize the fungal diversity of house dust and its association with the environmental conditions of bedrooms. For this, the dust was collected from 41 bedrooms of children between the ages of 8 and 9 with a family history of asthma, residents of Havana, Cuba. The fungal content of each sample was determined by two methods: plate culture with malt extract agar and by direct microscopy. An ecological analysis was carried out from the fungal diversity detected. To describe the factors associated with the fungi detected, bivariate logistic regression was used. Through direct microscopy, between 10 and 2311 fragments of hyphae and spores corresponding mainly to Cladosporium, Coprinus, Curvularia, Aspergillus/Penicillium, Xylariaceae, and Periconia were identified. Through the culture, 0-208 CFU were quantified, where Aspergillus, Cladosporium, and Penicillium predominated. The culturability evidenced the differences between the quantification determined by both methods. A positive relationship was found between the type of cleaning of the furniture, the presence of trees in front of the bedroom, indoor relative humidity, indoor temperature, the presence of air conditioning, and natural ventilation with specific spore types and genera. The use of two different identification methods allowed to detect a greater fungal diversity in the residences evaluated. Monitoring the exposure to these fungal allergens in childhood can help to prevent sensitization in the allergic child, the development of asthma, and other respiratory diseases.

Opportunistic phaeohyphomycoses in wild saffron cod Eleginus gracilis from waterways of Norton Sound and Toksook Bay, Alaska, USA

These case reports describe locally invasive black pigmented mycotic infections of the skin and gills of saffron cod Eleginus gracilis associated with 8 different opportunistic ascomycete fungi: Alternaria sp., Cladosporium herbarum, Chaetomium globosum, Cadophora luteo-olivacea, Penicillium sp., Phoma herbarum, Pseudophacidium ledi and Valsa sordida. These fungi were isolated on conventional media, identified according to morphological structures and confirmed by genetic sequencing. Several of these fungi are primary plant pathogens as well as opportunistic human pathogens in immunocompromised individuals. Several have also been described as causing opportunistic infections of fish. This case material represents the first report of C. luteo-olivacea, C. globosum, P. ledi and V. sordida as likely opportunistic fish pathogens in Alaskan watersheds of Norton Sound and south in Toksook Bay and possibly elsewhere.

Biological Particles in the Indoor Environment

Airborne microorganisms are very difficult to assess accurately under field conditions owing to differences in the sample collection efficiency of the selected sampler and variations in DNA extraction efficiencies. Consequently, bioaerosol abundance and biodiversity can be underestimated, making it more difficult to link specific bioaerosol components to diseases and human health risk. Owing to the low biomass in air samples, it remains a challenge to obtain a representative microbiological sample to recover sufficient DNA for downstream analyses. Improved sampling methods are particularly crucial, especially for investigating viral communities, owing to the extremely low biomass of viral particles in the air compared with other environments. Without detailed information about sampling, characterization and enumeration techniques, interpretation of exposure level is very difficult. Despite this, bioaerosol research has been enhanced by molecular tools, especially next-generation sequencing approaches that have allowed faster and more detailed characterization of air samples.

Quantitative assessment of microbes from samples of indoor air and dust

Different types of house dust samples are widely used as surrogates of airborne inhalation exposure in studies assessing health effects of indoor microbes. Here we studied-in a quantitative assessment-the representativeness of different house dust samples of indoor air (IA) and investigated seasonality and reproducibility of indoor samples. Microbial exposure was measured five times over 1 year in four rural and five urban Finnish homes. Six sampling methods were used: button inhalable aerosol sampler (actively collected personal and indoor air sampling), settled dust, floor dust, mattress dust and vacuum cleaner dust bag dust; the latter three referred to herein as "reservoir dust samples". Using quantitative PCR, we quantified the fungal species Cladosporium herbarum, the fungal group Penicillium/Aspergillus/Paecilomyces variotii, total fungal DNA, and Gram-positive and Gram-negative bacteria. We observed significant differences in microbial levels between rural and urban homes, most pronounced for personal air samples. Fungal species and groups but not total fungal DNA in indoor air correlated moderately to well with reservoir dust and with personal air samples. For bacterial groups, the correlations between air and dust were generally lower. Samples of indoor air and settled dust reflected similarly seasonal variation in microbial levels and were also similar compositionally, as assessed by ratios of qPCR markers. In general, determinations from mattress dust and other reservoir samples were better reproducible in repeated assessments over time than from indoor air or settled dust. This study indicates that settled dust reflects the microbial composition of indoor air and responds similarly to environmental determinants. Reservoir dusts tend to predict better microbial levels in indoor air and are more reproducible. Sampling strategies in indoor studies need to be developed based on the study questions and may need to rely on more than one type of sample.

Microbial growth in building material samples and occupants' health in severely moisture-damaged homes

There is no commonly approved approach to detect and quantify the health-relevant microbial exposure in moisture-damaged buildings. In 39 single-family homes with severe moisture damage, we studied whether concentrations of viable microbes in building material samples are associated with health among 71 adults and 68 children, and assessed with symptoms questionnaires, exhaled NO, and peak expiratory flow (PEF) variability. Symptoms were grouped into three scores: upper respiratory symptoms, lower respiratory symptoms, and general symptoms. The homes were divided into three groups based on viable counts of fungi, actinomycetes, and total bacteria cultivated from building material samples. Highest group of actinomycete counts was associated with more general symptoms, worse perceived health, and higher daily PEF variability (aOR 12.51; 1.10-141.90 as compared to the lowest group) among adults, and with an increase in lower respiratory symptoms in children, but the confidence intervals were wide. We observed significant associations of fungal counts and total microbial score with worse perceived health in adults. No associations with exhaled NO were observed.

Variability of indoor fungal microbiome of green and non-green low-income homes in Cincinnati, Ohio

"Green" housing is designed to use low-impact materials, increase energy efficiency and improve occupant health. However, little is known about the indoor mycobiome of green homes. The current study is a subset of a multicenter study that aims to investigate the indoor environment of green homes and the respiratory health of asthmatic children. In the current study, the mycobiome in air, bed dust and floor dust was compared between green (study site) and non-green (control site), low-income homes in Cincinnati, Ohio. The samples were collected at baseline (within four months following renovation), and 12months after the baseline at the study site. Parallel sample collection was conducted in non-green control homes. Air samples were collected by PM2.5 samplers over 5-days. Bed and floor dust samples were vacuumed after the air sampling was completed. The DNA sample extracts were analyzed using ITS amplicon sequencing. Analysis indicated that there was no clear trend in the fungal communities between green and non-green homes. Instead, fungal community differences were greatest between sample types - air, bed, and floor. Microbial communities also changed substantially between sampling intervals in both green and non-green homes for all sample types, potentially indicating that there was very little stability in the mycobiomes. Research gaps remain regarding how indoor mycobiome fluctuates over time. Longer follow-up periods might elucidate the effect of green renovation on microbial load in buildings.

Monitoring of airborne fungal spore load in relation to meteorological factors, air pollutants and allergic symptoms in Farakka, an unexplored biozone of eastern India

Fungi are important components of atmosphere which play a major role in causing respiratory allergy upon inhalation. An airborne fungal spore survey was carried out in two outdoor environments in Farakka-an unexplored township covering the National Thermal Power Station, West Bengal, India for a period of 2 years (October 2013 to September 2015). A Burkard personal volumetric air sampler was used at 15 days interval to collect the total fungal spore load. A fungal spore calendar has been prepared depicting monthly average spore concentration in the air. The relationships between fungal spore concentration and different climatic factors were analysed statistically. Higher concentration levels of aerospora and pollutants were recorded during winter season. A detailed questionnaire was used to obtain medical history data of 523 local patients visiting the outpatients department of Farakka NTPC (National Thermal Power Station) hospital. A significant positive correlation was found between fungal spore concentration, atmospheric pollutants and allergic manifestation. The dominant fungal spores were isolated, sub-cultured and tested for allergenic potential by skin prick tests (SPTs) among subjects with clinical history of respiratory allergy, which evoked ˃45.0% skin reactivity upon individuals.

Metabolites of Trichoderma species isolated from damp building materials

Buildings that have been flooded often have high concentrations of Trichoderma spores in the air while drying. Inhaled spores and spore and mycelial fragments contain large amounts of fungal glucan and natural products that contribute to the symptoms associated with indoor mould exposures. In this study, we considered both small molecules and peptaibol profiles of T. atroviride, T. koningiopsis, T. citrinoviride, and T. harzianum strains obtained from damp buildings in eastern Canada. Twenty-residue peptaibols and sorbicillin-derived metabolites (1–6) including a new structure, (R)-vertinolide (1), were characterized from T. citrinoviride. Trichoderma koningiopsis produced several koninginins (7–10), trikoningin KA V, and the 11-residue lipopeptaibols trikoningin KB I and trikoningin KB II. Trichoderma atroviride biosynthesized a mixture of 19-residue trichorzianine-like peptaibols, whereas T. harzianum produced 18-residue trichokindin-like peptaibols and the 11-residue harzianin HB I that was subsequently identified from the studied T. citrinoviride strain. Two α-pyrones, 6-pentyl-pyran-2-one (11) and an oxidized analog (12), were produced by both T. atroviride and T. harzianum. Aside from exposure to low molecular weight natural products, inhalation of Trichoderma spores and mycelial fragments may result in exposure to membrane-disrupting peptaibols. This investigation contributes to a more comprehensive understanding of the biologically active natural products produced by fungi commonly found in damp buildings.

Quantification of the fungal fraction released from various preloaded fibrous filters during a simulated ventilation restart

This study aimed to demonstrate that particles, especially those associated with fungi, could be released from fibrous filters used in the air-handling unit (AHU) of heating, ventilation and air-conditioning (HVAC) systems during ventilation restarts. Quantification of the water retention capacity and SEM pictures of the filters was used to show the potential for fungal proliferation in unused or preloaded filters. Five fibrous filters with various particle collection efficiencies were studied: classes G4, M5, M6, F7, and combined F7 according to European standard EN779:2012. Filters were clogged with micronized rice particles containing the fungus Penicillium chrysogenum and then incubated for three weeks at 25°C and 90% relative humidity. The results indicated that the five clogged tested filters had various fungal growth capacities depending on their water retention capacity. Preloaded filters were subjected to a simulated ventilation restart in a controlled filtration device to quantify that the fraction of particles released was around 1% for the G4, 0.1% for the M5 and the M6, and 0.001% for the F7 and the combined F7 filter. The results indicate that the likelihood of fungal particle release by low efficiency filters is significantly higher than by high efficiency filters.

Visualization of the structural changes in plywood and gypsum board during the growth of Chaetomium globosum and Stachybotrys chartarum

Fungal growth in indoor environments is associated with many negative health effects. Many studies focus on brown- and white-rot fungi and their effect on wood, but there is none that reveals the influence of soft-rot fungi, such as Stachybotrys spp. and Chaetomium spp., on the structure of building materials such as plywood and gypsum wallboard. This study focuses on using micro-computed tomography (microCT) to investigate changes of the structure of plywood and gypsum wallboard during fungal degradation by S. chartarum and C. globosum. Changes in the materials as a result of dampness and fungal growth were determined by measuring porosity and pore shape via microCT. The results show that the composition of the building material influenced the level of penetration by fungi as shown by scanning electron microscopy (SEM). Plywood appeared to be the most affected, with the penetration of moisture and fungi throughout the whole thickness of the sample. Conversely, fungi grew only on the top cardboard in the gypsum wallboard and they did not have significant influence on the gypsum wallboard structure. The majority of the observed changes in gypsum wallboard occurred due to moisture. This paper suggests that the mycelium distribution within building materials and the structural changes, caused by dampness and fungal growth, depend on the type of the material.

Microbial communities associated with house dust

House dust is a complex mixture of inorganic and organic material with microbes in abundance. Few microbial species are actually able to grow and proliferate in dust and only if enough moisture is provided. Hence, most of the microbial content originates from sources other than the dust itself. The most important sources of microbes in house dust are outdoor air and other outdoor material tracked into the buildings, occupants of the buildings including pets and microbial growth on moist construction materials. Based on numerous cultivation studies, Penicillium, Aspergillus, Cladosporium, and about 20 other fungal genera are the most commonly isolated genera from house dust. The cultivable bacterial flora is dominated by Gram-positive genera, such as Staplylococcus, Corynebacterium, and Lactococcus. Culture-independent studies have shown that both the fungal and the bacterial flora are far more diverse, with estimates of up to 500-1000 different species being present in house dust. Concentrations of microbes in house dust vary from nondetectable to 10(9) cells g(-1) dust, depending on the dust type, detection method, type of the indoor environment and season, among other factors. Microbial assemblages in different house dust types usually share the same core species; however, alterations in the composition are caused by differing sources of microbes for different dust types. For example, mattress dust is dominated by species originating from the user of the mattress, whereas floor dust reflects rather outdoor sources. Farming homes contain higher microbial load than urban homes and according to a recent study, temperate climate zones show higher dust microbial diversity than tropical zones.

The Canadian Healthy Infant Longitudinal Development (CHILD) birth cohort study: assessment of environmental exposures

The Canadian Healthy Infant Longitudinal Development birth cohort was designed to elucidate interactions between environment and genetics underlying development of asthma and allergy. Over 3600 pregnant mothers were recruited from the general population in four provinces with diverse environments. The child is followed to age 5 years, with prospective characterization of diverse exposures during this critical period. Key exposure domains include indoor and outdoor air pollutants, inhalation, ingestion and dermal uptake of chemicals, mold, dampness, biological allergens, pets and pests, housing structure, and living behavior, together with infections, nutrition, psychosocial environment, and medications. Assessments of early life exposures are focused on those linked to inflammatory responses driven by the acquired and innate immune systems. Mothers complete extensive environmental questionnaires including time-activity behavior at recruitment and when the child is 3, 6, 12, 24, 30, 36, 48, and 60 months old. House dust collected during a thorough home assessment at 3-4 months, and biological specimens obtained for multiple exposure-related measurements, are archived for analyses. Geo-locations of homes and daycares and land-use regression for estimating traffic-related air pollution complement time-activity-behavior data to provide comprehensive individual exposure profiles. Several analytical frameworks are proposed to address the many interacting exposure variables and potential issues of co-linearity in this complex data set.

Indoor fungi: companions and contaminants

This review discusses the role of fungi and fungal products in indoor environments, especially as agents of human exposure. Fungi are present everywhere, and knowledge for indoor environments is extensive on their occurrence and ecology, concentrations, and determinants. Problems of dampness and mold have dominated the discussion on indoor fungi. However, the role of fungi in human health is still not well understood. In this review, we take a look back to integrate what cultivation-based research has taught us alongside more recent work with cultivation-independent techniques. We attempt to summarize what is known today and to point out where more data is needed for risk assessment associated with indoor fungal exposures. New data have demonstrated qualitative and quantitative richness of fungal material inside and outside buildings. Research on mycotoxins shows that just as microbes are everywhere in our indoor environments, so too are their metabolic products. Assessment of fungal exposures is notoriously challenging due to the numerous factors that contribute to the variation of fungal concentrations in indoor environments. We also may have to acknowledge and incorporate into our understanding the complexity of interactions between multiple biological agents in assessing their effects on human health and well-being.

Evaluation of ergosterol content in the air of various environments

The aim of the study was to compare the content of ergosterol in different microorganisms (bacteria, yeasts and moulds) isolated from the air as well as in six species of moulds in their different morphological forms-live mycelium, dead mycelium, and spores. Evaluation of the level of mould contamination of the air in various places using culture method and ergosterol determination was also performed. The analysis of ergosterol was carried out by gas chromatography equipped with flame ionisation detector. For evaluation of the results, analysis of variance and multiple comparison test were used. The quantity of ergosterol in the spores of various species of mould was in the range 1.9-9.4 pg/spore. The presence of yeasts and bacteria in the air does not significantly affect ergosterol concentration, in view of the low content of that sterol in their cells (max. 0.009 pg/cell for bacteria and 0.39 pg/cell for yeast). An ergosterol concentration above 1 ng per m³ can be considered an indicator of excessive mould contamination of indoor air. Based on determination of ergosterol in the air of mouldy rooms the result obtained may be compared with the culture method, due to the 1,000 times higher concentration of ergosterol in the mycelium compared with spores. However, in the analysis of outdoor air, in view of the presence of mould mainly in the form of spores and the degradation of ergosterol by UV radiation, analysis of that compound may indicate a lower level of contamination compared with the culture method.

Determinants, reproducibility, and seasonal variation of ergosterol levels in house dust

This study aimed to clarify the determinants that affect the concentrations of ergosterol and viable fungi in house dust and to examine the seasonal variation and reproducibility of ergosterol concentrations indoors. In studying the determinants, dust samples from living room floors and vacuum cleaner dust bags were collected from 107 farming and 105 non-farming homes. Ergosterol levels were determined with gas chromatography-mass spectrometry,and the dust bag dust was cultivated for enumeration of fungal genera. Lifestyle and environmental factors, for example using of the fireplace, and visible mold observations in homes, explained 20–26% of the variation of fungal concentrations. For the reproducibility study, samples were collected from five urban homes in four different seasons. The reproducibility of ergosterol determinations within a sample was excellent (ICC = 89.8) for floor dust and moderate (ICC = 63.8) for dust bag dust, but poor when sampling the same home throughout a year (ICC = 31.3 and 12.6, respectively) due to large temporal variation in ergosterol concentrations. In conclusion, environmental characteristics only partially predicted the variation of fungal concentrations. Based on these studies, we recommend repeated sampling of dust over time if one seeks to adequately describe overall fungal levels and exposure in a home.

PRACTICAL IMPLICATIONS

This study shows that levels of ergosterol and viable fungi in house dust are related to visible mold observations. Only 20% of the variation in fungal levels can be explained with questionnaires, and therefore, environmental samples need to be taken in addition. Reproducibility of ergosterol determination was excellent for floor dust, and thus, ergosterol measurements from floor dust samples could be suitable for assessing the fungal load in building investigations. The temporal variation needs to be taken into account when describing the ergosterol concentration of urban homes.

Assessment of fungal contamination in waste sorting and incineration-case study in Portugal

Organic waste is a rich substrate for microbial growth, and because of that, workers from waste industry are at higher risk of exposure to bioaerosols. This study aimed to assess fungal contamination in two plants handling solid waste management. Air samples from the two plants were collected through an impaction method. Surface samples were also collected by swabbing surfaces of the same indoor sites. All collected samples were incubated at 27°C for 5 to 7 d. After lab processing and incubation of collected samples, quantitative and qualitative results were obtained with identification of the isolated fungal species. Air samples were also subjected to molecular methods by real-time polymerase chain reaction (RT PCR) using an impinger method to measure DNA of Aspergillus flavus complex and Stachybotrys chartarum. Assessment of particulate matter (PM) was also conducted with portable direct-reading equipment. Particles concentration measurement was performed at five different sizes (PM0.5; PM1; PM2.5; PM5; PM10). With respect to the waste sorting plant, three species more frequently isolated in air and surfaces were A. niger (73.9%; 66.1%), A. fumigatus (16%; 13.8%), and A. flavus (8.7%; 14.2%). In the incineration plant, the most prevalent species detected in air samples were Penicillium sp. (62.9%), A. fumigatus (18%), and A. flavus (6%), while the most frequently isolated in surface samples were Penicillium sp. (57.5%), A. fumigatus (22.3%) and A. niger (12.8%). Stachybotrys chartarum and other toxinogenic strains from A. flavus complex were not detected. The most common PM sizes obtained were the PM10 and PM5 (inhalable fraction). Since waste is the main internal fungal source in the analyzed settings, preventive and protective measures need to be maintained to avoid worker exposure to fungi and their metabolites.

Fungal contamination in two Portuguese wastewater treatment plants

The presence of filamentous fungi was detected in wastewater and air collected at wastewater treatment plants (WWTP) from several European countries. The aim of the present study was to assess fungal contamination in two WWTP operating in Lisbon. In addition, particulate matter (PM) contamination data was analyzed. To apply conventional methods, air samples from the two plants were collected through impaction using an air sampler with a velocity air rate of 140 L/min. Surfaces samples were collected by swabbing the surfaces of the same indoor sites. All collected samples were incubated at 27°C for 5 to 7 d. After lab processing and incubation of collected samples, quantitative and qualitative results were obtained with identification of the isolated fungal species. For molecular methods, air samples of 250 L were also collected using the impinger method at 300 L/min airflow rate. Samples were collected into 10 ml sterile phosphate-buffered saline with 0.05% Triton X-100, and the collection liquid was subsequently used for DNA extraction. Molecular identification of Aspergillus fumigatus and Stachybotrys chartarum was achieved by real-time polymerase chain reaction (RT-PCR) using the Rotor-Gene 6000 qPCR Detection System (Corbett). Assessment of PM was also conducted with portable direct-reading equipment (Lighthouse, model 3016 IAQ). Particles concentration measurement was performed at five different sizes: PM0.5, PM1, PM2.5, PM5, and PM10. Sixteen different fungal species were detected in indoor air in a total of 5400 isolates in both plants. Penicillium sp. was the most frequently isolated fungal genus (58.9%), followed by Aspergillus sp. (21.2%) and Acremonium sp. (8.2%), in the total underground area. In a partially underground plant, Penicillium sp. (39.5%) was also the most frequently isolated, also followed by Aspergillus sp. (38.7%) and Acremonium sp. (9.7%). Using RT-PCR, only A. fumigatus was detected in air samples collected, and only from partial underground plant. Stachybotrys chartarum was not detected in any of the samples analyzed. The distribution of particle sizes showed the same tendency in both plants; however, the partially underground plant presented higher levels of contamination, except for PM2.5. Fungal contamination assessment is crucial to evaluating the potential health risks to exposed workers in these settings. In order to achieve an evaluation of potential health risks to exposed workers, it is essential to combine conventional and molecular methods for fungal detection. Protective measures to minimize worker exposure to fungi need to be adopted since wastewater is the predominant internal fungal source in this setting.

[Characterization of air mycobiota in two repositories of the National Archives of the Republic of Cuba]

BACKGROUND

The high relative humidity and temperatures in tropical countries create favorable conditions for development of fungi that are not only a risk to human health but they can also colonize documentary support.

AIMS

To study the concentration of the airborne fungi in two repositories of the National Archives of the Republic of Cuba, the mycobiota deposited on different photographic supports and maps preserved in these repositories, and to determine the taxonomic characterization of the fungi isolated.

METHODS

The air sampling was performed using a sedimentation method, and the supports (6 pictures and 7 maps) were analyzed using moistened sterile swabs.

RESULTS

The Cladosporium genus was predominant, followed by Aspergillus and Penicillium genera. Filamentous fungi were isolated in all the photos and maps, and yeasts were only isolated from a photographic supports and a map. We identified several species of Aspergillus and Penicillium genera, but Aspergillus niger and Aspergillus flavus predominated. Candida and Rhodotorula were the yeast genera isolated.

CONCLUSIONS

The fungal concentration of the air demonstrated that the environments were not contaminated. From the 26 species of filamentous fungi isolated only 5 were detected in the indoor air of the repositories and on one or more of the document supports analyzed (representing a 19.3%). This shows that there is a low ecological relationship between the fungi detected in the indoor air and those that were isolated from the supports studied.

Dominant microbial volatile organic compounds in 23 US homes

Associating Microbial Volatile Organic Compounds (MVOCs) with the species producing them may open the path to more rapid and reliable chemical methods to detect mold problems, especially for mold hidden in wall cavities or small enclosed spaces. This study associated the dominant MVOCs in a convenience sample of 23 homes with the mold species present. Three semi-quantitative predictors of mold growth ("MOW scores") were assessed in the homes through a comparison of basement to main floor areas. MVOC samples were collected and analyzed by GC/MS. Aerotek N-6 samplers were co-located with the MVOC samplers to collect bioaerosols. Concentration and prevalence data for 19 definitive MVOCs were compared with the bioaerosol data. Mold predictor scores were elevated in basement locations as compared with main floor areas. Of the 23 mold genera identified, the predominant genera (ranked occurrences) were Cladosporium, Penicillium, Basidiomycetes, and Aspergilli. The MVOCs 2-octen-1-ol, 3-octenone, 2-heptanone, 1-octen-3-ol, and 1-butanol showed the highest average concentrations (11-37 μg m(-3)), but no single MVOC was significantly elevated in basement locations as compared with main floor living areas in these non-problematic homes. Using a less conservative one-tail test of significance, average 2-octen-1-ol concentrations in basements were higher (p<0.040), and both 3-octenone and 1-octen-3-ol were elevated (p<0.095). Differences in MVOC occurrence were greatest between homes, with MVOCs found in basement locations typically detected in living areas at similar concentrations and frequencies. Based on these findings, the C(8) MVOCs show promise as gross indicators of fungal growth related to the most frequently found mold genera.

Seasonal variations of indoor microbial exposures and their relation to temperature, relative humidity, and air exchange rate

Indoor microbial exposure has been related to adverse pulmonary health effects. Exposure assessment is not standardized, and various factors may affect the measured exposure. The aim of this study was to investigate the seasonal variation of selected microbial exposures and their associations with temperature, relative humidity, and air exchange rates in Danish homes. Airborne inhalable dust was sampled in five Danish homes throughout the four seasons of 1 year (indoors, n = 127; outdoors, n = 37). Measurements included culturable fungi and bacteria, endotoxin, N-acetyl-beta-d-glucosaminidase, total inflammatory potential, particles (0.75 to 15 μm), temperature, relative humidity, and air exchange rates. Significant seasonal variation was found for all indoor microbial exposures, excluding endotoxin. Indoor fungi peaked in summer (median, 235 CFU/m(3)) and were lowest in winter (median, 26 CFU/m(3)). Indoor bacteria peaked in spring (median, 2,165 CFU/m(3)) and were lowest in summer (median, 240 CFU/m(3)). Concentrations of fungi were predominately higher outdoors than indoors, whereas bacteria, endotoxin, and inhalable dust concentrations were highest indoors. Bacteria and endotoxin correlated with the mass of inhalable dust and number of particles. Temperature and air exchange rates were positively associated with fungi and N-acetyl-beta-d-glucosaminidase and negatively with bacteria and the total inflammatory potential. Although temperature, relative humidity, and air exchange rates were significantly associated with several indoor microbial exposures, they could not fully explain the observed seasonal variations when tested in a mixed statistical model. In conclusion, the season significantly affects indoor microbial exposures, which are influenced by temperature, relative humidity, and air exchange rates.

Airborne fungal volatile organic compounds in rural and urban dwellings: detection of mould contamination in 94 homes determined by visual inspection and airborne fungal volatile organic compounds method

Moulds can both degrade the materials and structures they colonise and contribute to the appearance of symptoms and diseases in the inhabitants of contaminated dwellings. Only few data have compared the levels of contamination in urban and rural environments and the results are not consistent. The aim of this study was to use a fungal contamination index, based on the detection of specific Microbial Volatile Organic Compounds (MVOC), to determine the exposure to moulds of individuals living in urban and rural dwellings. For this purpose, 94 dwellings (47 in an urban setting in Clermont-Ferrand and 47 in rural areas of the Auvergne region, France) were studied. By demonstrating marked disparities between the proportion of visible contamination (19%) and that of active, visible and/or hidden contamination (59%) and the fact that almost all visible contamination was identified by MVOC, we were able to show that use of the index seemed relevant to confirm the actual presence of fungal contamination in a dwelling. Furthermore, it was possible to demonstrate a relationship between moulds and the presence of water on surfaces (condensation, infiltrations, water damage, etc.). A higher proportion of positive fungal contamination index in rural homes was observed compared to the proportion in urban ones (68% versus 49%; p<0.05).

Molds and mycotoxins in indoor environments--a survey in water-damaged buildings

Mycotoxins are toxic, secondary metabolites frequently produced by molds in water-damaged indoor environments. We studied the prevalence of selected, potent mycotoxins and levels of fungal biomass in samples collected from water-damaged indoor environments in Sweden during a 1-year period. One hundred samples of building materials, 18 samples of settled dust, and 37 samples of cultured dust were analyzed for: (a) mycoflora by microscopy and culture; (b) fungal chemical marker ergosterol and hydrolysis products of macrocyclic trichothecenes and trichodermin (verrucarol and trichodermol) by gas chromatography-tandem mass spectrometry; and (c) sterigmatocystin, gliotoxin, aflatoxin B(1), and satratoxin G and H by high performance liquid chromatography-tandem mass spectrometry. Sixty-six percent of the analyzed building materials samples, 11% of the settled dust samples, and 51% of the cultured dust samples were positive for at least one of the studied mycotoxins. In addition, except in the case of gliotoxin, mycotoxin-positive building material samples contained 2-6 times more ergosterol than mycotoxin-negative samples. We show that (a) molds growing on a range of different materials indoors in water-damaged buildings generally produce mycotoxins, and (b) mycotoxin-containing particles in mold-contaminated environments may settle on surfaces above floor level. The mass spectrometry methods used in this study are valuable tools in further research to survey mycotoxin exposure and investigate potential links with health effects.

Detection of fungal development in closed spaces through the determination of specific chemical targets

In addition to the biodegradation problems encountered in buildings, exposure of their occupants to moulds is responsible for numerous diseases: infections (invasive nosocomial aspergillosis), immediate or delayed allergies, food-borne infections and different types of irritation. In this context, the aim of our work has been to determine specific chemical tracers for fungal development on construction materials. More generally, by detecting a specific chemical fingerprint of fungal development, our objective was to propose a microbiological alert system which could control systems and/or procedures for the microbiological treatment of indoor areas. We therefore characterized the chemical emissions from six types of construction material contaminated artificially by moulds. Chemical fingerprints were established for 19 compounds arising specifically from fungal metabolism: 2-ethylhexanoic acid methyl ester, 1-octen-3-ol, 3-heptanol, 3-methyl-1-butanol, 2-methyl-1-butanol, 1,3-octadiene, 2-(5H)-furanone, 2-heptene, alpha-pinene, 2-methylisoborneol, 4-heptanone, 2-methylfuran, 3-methylfuran, dimethyldisulfide, methoxybenzene, a terpenoid and three sesquiterpenes. Determining the origin of these compounds and their specific links with a growth substrate or fungal species made it possible to judge the pertinence of choosing these compounds as tracers. Thus the detecting specific volatile organic compounds emitted as from the second day of fungal growth demonstrated that this approach had the advantage of detecting fungal development both reliably and rapidly before any visible signs of contamination could be detected.

Microbial volatile organic compounds in the air of moldy and mold-free indoor environments

A single-blinded study was performed to analyze whether indoor environments with and without mold infestation differ significantly in microbial volatile organic compounds (MVOC) concentrations. Air sampling for MVOC was performed in 40 dwellings with evident mold damage and in 44 dwellings, where mold damage was excluded after a thorough investigation. The characteristics of the dwellings, climatic parameters, airborne particles and air exchange rates (AER) were recorded. The parameters mold status, characteristics of the interiors and measured climatic parameters were included in the multiple regression model. The results show no significant association between most of the analyzed MVOC and the mold status. Only the compounds 2-methyl-1-butanol and 1-octen-3-ol indicated a statistically significant, but weak association with the mold status. However, the concentrations of the so-called MVOC were mainly influenced by other indoor factors. 2-Methylfuran and 3-methylfuran, often used as main indicators for mold damage, had a highly significant correlation with the smoking status. These compounds were also significantly correlated with the humidity and the AER. The compounds 3-methyl-1-butanol, 2-hexanone, 3-heptanone and dimethyl disulfide were weakly correlated with the recorded parameters, the humidity being the strongest influencing factor. Only 2-methyl-1-butanol and 1-octen-3-ol showed a statistically significant association with the mold status; however, only a small portion (10% in this case) of the total variability could be explained by the predictor mold status; they do not qualify as indicator compounds, because such minor correlations lead to a too excessive part of incorrect classifications, meaning that the diagnostic sensitivity and specificity of these compounds are too low.

PRACTICAL IMPLICATIONS

The assumption that mold infestations might be detected by microbial VOC emissions must be considered with great reservation. The major part of the total variability of the measured MVOC concentrations originates from not known influencing factors and/or from factors not directly associated with the mold status of the dwellings (confounders). More specific and sensitive markers for the assessment of the mold status should be found, if the screening for mold infestations should be performed by volatile organic compounds.

Evolution of the Environmental Contamination by Thermophilic Fungi in a Turkey Confinement House in France

Fungal species constitute a major part of environmental contaminants in facilities where animals are housed. The present investigation was aimed at describing the relative abundances of fungal species and their concentrations in a turkey confinement house in France. Fungal cultures from poultry feed, litter, and air were undertaken every week throughout the 16-wk period of breeding. The incubation temperature of 40 degrees C was selected to isolate thermophilic fungal species (especially Aspergillus spp. and Candida albicans) that are potentially pathogenic for birds. The 2 species Aspergillus fumigatus and Aspergillus flavus were recovered at a mean of 10.5 and 37.0 cfu/m(3) of air sampled, respectively. Individual samplings yielded concentrations of up to 150.0 cfu/m(3) for A. flavus in the first weeks of the investigation. Other fungal species were recovered at a mean of 18.9 cfu/m(3) (maximum 36.3 cfu/m(3)) in the air. The yeast C. albicans was first detected at wk 4 from litter samples and at wk 7 from poultry feed. Densities of C. albicans remained very high in litter samples (63.2 cfu/g) even after new litter was added at wk 10. To analyze the genetic polymorphism of A. fumigatus, the most pathogenic mold in birds, a total number of 198 isolates (134 from air, 34 from litter, and 30 from feed samples) were genotyped using 2 polymorphic microsatellite markers. More than half (42 out of 73, 57.5%) of the genotypes were detected only once. This finding suggests that the contamination of the breeding environment is not due to a single source and confirms the very high genetic diversity of environmental A. fumigatus isolates. As during the study period, no outbreak of fungal infections occurred; the levels of fungal contaminations reported here do not seem sufficient, at least alone, to trigger fungal infections.

What the primary care pediatrician should know about syndromes associated with exposures to mycotoxins

Disease associated with exposure to mycotoxins is known as the "Great Masquerader" of the 21st century because of its complex natural history involving different tissues and resembling different diseases at each stage in its evolution. It can present with a variety of nonspecific clinical signs and symptoms such as rash, conjunctivitis, epistaxis, apnea, cough, wheezing, nausea, and vomiting. Some cases of vomiting illness, bone marrow failure, acute pulmonary hemorrhage, and recurrent apnea and/or "pneumonia" are associated with exposure to mycotoxins. Familiarity with the symptoms of exposure to the major classes of mycotoxins enables the clinician to ask pertinent questions about possible fungal exposures and to remove the infant or child from the source of exposure, which could be contaminated food(s), clothing and furniture, or the indoor air of the home. Failure to prevent recurrent exposure often results in recurrent illness. A variety of other conditions, including hepatocellular and esophageal cancer and neural tube defects, are associated with consumption of foods contaminated with mycotoxins. Awareness of the short- and long-term consequences of exposures to these natural toxins helps pediatricians to serve as better advocates for children and families.

Phospholipids from some common fungi associated with damp building materials

Methods for the analysis of fungal biomass in contaminated building materials have been limited to methods that use viable propagules as well as indicators of total biomass such as fungal glucan and ergosterol. Because of large differences in the survival times of spores, and limitations imposed by the use of agar media to assess fungal cells for the former approach, no quantitative information and poor qualitative information is obtained. The use of the biochemical indicators provides reliable quantitative information but no qualitative data. Analysis of phospholipids of various bacteria and, recently, of fungi common in outdoor air has provided both qualitative and quantitative data on their distributions in various substrates including in outdoor air samples. In this report, we provide new data on the signature lipids of some fungi common on moldy building materials. Using the LC/MS/MS analysis described, an estimate can be made of the fresh weight of fungal cells and the relative abundance of the common genera of fungi typically found on moldy materials.

A comparison of airborne ergosterol, glucan and Air-O-Cell data in relation to physical assessments of mold damage and some other parameters

We report here a comparison of long duration air samples in 110 homes where the material collected on open faced filter cassettes was analyzed for beta 1,3-d glucan, ergosterol, cholesterol and endotoxin. These data were then compared to careful estimates of visible mold and Air-O-Cell data. All the values found except cholesterol were of a similar magnitude to values reported in the limited number of studies available. Glucan was measured with a factor G based assay of the Limulus Amebocyte Lysate followed by size exclusion chromatography. This showed that the majority of airborne glucan found in these houses was fungal in origin arising from both yeasts and intact spores, as well as hyphal and spore fragments. Hyphal and spore fragments together represented 16% of the intact spore counts but over a broad range. Correlations between airborne glucan were strong for ergosterol and visible mold. However, airborne ergosterol was more highly correlated to visible mold than glucan. Endotoxin and Air-O-Cell measurements were poorly or not related to the other measures in the study. This study provides confidence that long duration air samples of the toxin glucan and ergosterol are related to building damage.

PRACTICAL IMPLICATIONS

Some studies of damp buildings have shown a relationship between extent of water/mold damage and symptoms. This study compared long duration air samples for glucan and ergosterol to extent of visible mold in houses measuring also the nature of the glucans present. Both measures were highly correlated to extent of visible mold damage in the houses; ergosterol was somewhat superior. Spore counts or prevalence of Asp/Pen in Air-O-Cell samples was not related to extent of visible mold damage but the observation of hyphal fragments was more likely when mold damage was present. This indicates that rigorous assessment of mold damage is a useful measure.

Indoor air microbiological evaluation of offices, hospitals, industries, and shopping centers

In this study it was compared the MAS-100 and the Andersen air samplers' performances and a similar trend in both instruments was observed. It was also evaluated the microbial contamination levels in 3060 samples of offices, hospitals, industries, and shopping centers, in the period of 1998 to 2002, in Rio de Janeiro city. Considering each environment, 94.3 to 99.4% of the samples were the allowed limit in Brazil (750 CFU/m3). The industries' results showed more important similarity among fungi and total heterotrophs distributions, with the majority of the results between zero and 100 CFU/m3. The offices' results showed dispersion around 300 CFU/m3. The hospitals' results presented the same trend, with an average of 200 CFU/m3. Shopping centers' environments showed an average of 300 CFU/m3 for fungi, but presented a larger dispersion pattern for the total heterotrophs, with the highest average (1000 CFU/m3). It was also investigated the correlation of the sampling period with the number of airborne microorganisms and with the environmental parameters (temperature and air humidity) through the principal components analysis. All indoor air samples distributions were very similar. The temperature and air humidity had no significant influence on the samples dispersion patterns.

Ergosterol as an indicator of mould growth on building materials

Ergosterol was used as a specific indicator of fungal biomass to determine and assess mould growth on damp building material. The samples were saponified, cleaned up on a silica gel column and the sterols silylated and analysed by gas chromatography and mass spectrometry in MS/MS mode. Ninety-one samples of building materials from damp rooms were analysed including plaster, plaster/paint, paint, wood-chip wallpaper and paper wall covering. The concentrations of ergosterol ranged from 0.1 to 130 microg/g dry mass and depended on carbon content of the material. The highest concentrations were determined for wallpaper, the lowest for plaster and intermediate ones for paint. Based on ergosterol content and inspection of the room during sampling a rough classification of mould infestation is presented. The applicability of the ergosterol method was further tested in two case studies on the spatial distribution of fungi on damp walls and irregular distributions were found. With few exceptions the concentration of ergosterol in building materials was found to be a suitable indicator to estimate fungal biomass.

Ergosterol as a measure of living fungal biomass: persistence in environmental samples after fungal death

The membrane lipid ergosterol is found almost exclusively in fungi, and is frequently used by environmental microbiologists as an indicator of living fungal biomass, based on the assumption that ergosterol is labile, and therefore rapidly degraded after the death of fungal hyphae. We studied the degradation of ergosterol in environmental samples without living fungi. Under the conditions used in this study, ergosterol was very stable both when added as a pure compound and when associated with dead fungi. The decrease of ergosterol was at most 34% during 2 months when protected from sunlight. Presence of a natural bacterial assemblage did not enhance degradation over this time period, as compared to sterile controls. However, photochemical degradation was significant, and led to a 43% decrease of in ergosterol content during 24 h. These results suggest that ergosterol should be used cautiously as a biomarker for living fungi.

Sampling devices

A number of commonly used samplers are presented in this article. Many samplers have not been discussed because they are used for specific purposes or are considered research tools. Air sampling for microbes may seem like a simple proposal, yet to develop and implement a well-thought out plan that answers questions or hypotheses with a high level of reliability is often a difficult and expensive undertaking. Sampler selection is only one step in this process. The information given in this article, along with the other resources listed, should aid in setting up a useful bioaerosol sampling plan.

Pathogenesis of indoor fungal diseases*

Mold growth within homes and other buildings has been associated to varying degrees with human health problems. These problems vary from allergenic disease to toxicosis. Case definitions for mold exposure have not been adequately defined to allow for a pathognomonic diagnosis of mold-caused disease following indoor exposure. Some important factors that may contribute to the pathogenesis of indoor mold induced disease include beta (1,3)-D-glucans, outer cell wall fungal hydrophobins, 1,8-dihydroxynaphthalene melanin, fungal volatile organic compounds, mycotoxins, and stachylysin. The information in this contribution was presented as the ISHAM Presidential address as a means to clarify some of the confusing surrounding indoor mold-related health issues.

Residential characteristics predict changes in Der p 1, Fel d 1 and ergosterol but not fungi over time

BACKGROUND

Allergen and fungal exposures are important risk factors for asthma. We conducted a longitudinal analysis of allergen levels in Melbourne homes between 1996 and 1998 to examine the effects of changing residential characteristics on allergen and fungal levels. We also examined the changes in levels of indoor allergens.

METHODS

The subjects were participants in the European Community Respiratory Health Survey (ECRHS) in Melbourne. In 1996, 485 subjects participated in a follow-up study, which involved both home and laboratory visits. Dust and air samples were collected from participants' bedrooms and a validated residential questionnaire was administered. In 1998, 360 participants underwent further follow-up. House dust mite (Der p 1) and cat allergens (Fel d 1) and ergosterol were measured in dust.

RESULTS

We observed moderate within home correlations between 1996 and 1998 in floor Der p 1 (intraclass correlation ICC=0.48), bed Der p 1 (ICC=0.61), Fel d 1 (kappa=0.53) and ergosterol (ICC=0.28) levels. We found that the floor Der p 1 levels decreased from 1996 to 1998 in the homes of participants who moved to an attached home, moved their bedrooms to the first floor, removed fitted carpet or central heating. Replacing or vacuuming the mattress more than twice per year reduced levels of Der p 1 in the bed. Ergosterol levels were reduced by removing visible mould and fitted carpet.

CONCLUSIONS

These findings provide evidence to support current advice with regard to allergen avoidance in patients with dust mite and fungal allergies.

Mycotoxin production by indoor molds

Fungal growth in buildings starts at a water activity (a(w)) near 0.8, but significant quantities of mycotoxins are not produced unless a(w) reaches 0.95. Stachybotrys generates particularly high quantities of many chemically distinct metabolites in water-damaged buildings. These metabolites are carried by spores, and can be detected in air samples at high spore concentrations. Very little attention has been paid to major metabolites of Stachybotrys called spirocyclic drimanes, and the precise structures of the most abundant of these compounds are unknown. Species of Aspergillus and Penicillium prevalent in the indoor environment produce relatively low concentrations of mycotoxins, with the exception of sterigmatocystins that can represent up to 1% of the biomass of A. versicolor at a(w)'s close to 1. The worst-case scenario for homeowners is produced by consecutive episodes of water damage that promote fungal growth and mycotoxin synthesis, followed by drier conditions that facilitate the liberation of spores and hyphal fragments.

Indoor mold, toxigenic fungi, and Stachybotrys chartarum: infectious disease perspective

Damp buildings often have a moldy smell or obvious mold growth; some molds are human pathogens. This has caused concern regarding health effects of moldy indoor environments and has resulted in many studies of moisture- and mold-damaged buildings. Recently, there have been reports of severe illness as a result of indoor mold exposure, particularly due to Stachybotrys chartarum. While many authors describe a direct relationship between fungal contamination and illness, close examination of the literature reveals a confusing picture. Here, we review the evidence regarding indoor mold exposure and mycotoxicosis, with an emphasis on S. chartarum. We also examine possible end-organ effects, including pulmonary, immunologic, neurologic, and oncologic disorders. We discuss the Cleveland infant idiopathic pulmonary hemorrhage reports in detail, since they provided important impetus for concerns about Stachybotrys. Some valid concerns exist regarding the relationship between indoor mold exposure and human disease. Review of the literature reveals certain fungus-disease associations in humans, including ergotism (Claviceps species), alimentary toxic aleukia (Fusarium), and liver disease (Aspergillys). While many papers suggest a similar relationship between Stachybotrys and human disease, the studies nearly uniformly suffer from significant methodological flaws, making their findings inconclusive. As a result, we have not found well-substantiated supportive evidence of serious illness due to Stachybotrys exposure in the contemporary environment. To address issues of indoor mold-related illness, there is an urgent need for studies using objective markers of illness, relevant animal models, proper epidemiologic techniques, and examination of confounding factors.

Volatile metabolites from actinomycetes

Twenty-six Streptomyces spp. were screened for their volatile production capacity on yeast starch agar. The volatile organic compounds (VOCs) were concentrated on a porous polymer throughout an 8-day growth period. VOCs were analyzed by gas chromatography with flame ionization detection and identified or characterized by gas chromatography-mass spectrometry. A total of 120 VOCs were characterized by retention index and mass spectra. Fifty-three compounds were characterized as terpenoid compounds, among which 18 could be identified. Among the VOCs were alkanes, alkenes, alcohols, esters, ketones, sulfur compounds, and isoprenoid compounds. Among the most frequently produced compounds were isoprene, acetone, 1-butanol, 2-methyl-1-propanol, 3-methyl-3-buten-1-ol, 3-methyl-1-butanol, 2-methyl-1-butanol, cyclopentanone, dimethyl disulfide, dimethyl trisulfide, 2-phenylethanol, and geosmin. The relationship between the excretion of geosmin and the production of spores was examined for one isolate. A good correlation between headspace geosmin and the number of spores was observed, suggesting that VOCs could be used to indicate the activity of these microorganisms in heterogeneous substrates.

Indoor air pollutants in homes and schools

Exposure to the four indoor air pollutants mentioned in this article may cause illnesses and fatalities in children. It is important for pediatricians to be aware of each of them and to remove children from environments contaminated with these pollutants. Guidance about monitoring the indoor air and interpreting the results is difficult to find. A chart of proposed guidelines may help the pediatrician faced with an indoor air problem (Table 1).

Volatile metabolites from mold growth on building materials and synthetic media

Mold species which were isolated from damp buildings were grown on sterile building materials and some synthetic media in order to study the microbial volatile organic compounds produced. Patterns of the microbial volatile organic compounds (MVOC) were very media dependent but media which favor terpene biosynthesis may give patterns unique enough for identification of dominant indoor molds.

Mycotoxins in crude building materials from water-damaged buildings

We analyzed 79 bulk samples of moldy interior finishes from Finnish buildings with moisture problems for 17 mycotoxins, as well as for fungi that could be isolated using one medium and one set of growth conditions. We found the aflatoxin precursor, sterigmatocystin, in 24% of the samples and trichothecenes in 19% of the samples. Trichothecenes found included satratoxin G or H in five samples; diacetoxyscirpenol in five samples; and 3-acetyl-deoxynivalenol, deoxynivalenol, verrucarol, or T-2-tetraol in an additional five samples. Citrinine was found in three samples. Aspergillus versicolor was present in most sterigmatocystin-containing samples, and Stachybotrys spp. were present in the samples where satratoxins were found. In many cases, however, the presence of fungi thought to produce the mycotoxins was not correlated with the presence of the expected compounds. However, when mycotoxins were found, some toxigenic fungi usually were present, even if the species originally responsible for producing the mycotoxin was not isolated. We conclude that the identification and enumeration of fungal species present in bulk materials are important to verify the severity of mold damage but that chemical analyses are necessary if the goal is to establish the presence of mycotoxins in moldy materials.

Sick building syndrome. III. Stachybotrys chartarum

Increasingly, physicians are being asked to evaluate patients with putative environmentally associated illnesses. These can include a variety of problems, including infectious illnesses (Legionnaire's disease), chemical exposure in the workplace, and sick building syndromes. The latter has been an issue particularly in asthma because of the association of mold and increased bronchial responsiveness. Recently, attention has been focused on the mold Stachybotrys in human disease. Stachybotrys was first identified more than 60 years ago following an epidemic of stomatitis, rhinitis, conjunctivitis, pancytopenia, neurologic disorders, and death in horses. Since then, Stachybotrys has been identified in several outbreaks of disease in animals. It has also attracted attention as a possible agent in idiopathic pulmonary hemorrhage in infants. Stachybotrys is a relatively uncommon fungus but has been isolated from a variety of sources, including contaminated grains, tobacco, indoor air, insulator foams, and water-damaged buildings with high humidity. This fungus is particularly important because it is one of a series of fungi that produces trichothecenes mycotoxins; these mycotoxins are biologically active and can produce a variety of physiological and pathologic changes in humans and animals, including modulation of inflammation and altered alveolar surfactant phospholipid concentrations. The presence of Stachybotrys in a building does not necessarily imply a cause-and-effect relationship with illness, but should alert physicians and healthcare professionals to do more vigorous environmental testing. Guidelines are presented herein for intervention measures in the maintenance of heating, ventilation, and air-conditioning systems.

Indoor viable mold spores--a comparison between two cities, Erfurt (eastern Germany) and Hamburg (western Germany)

BACKGROUND

In eastern Germany, the prevalence of allergies is lower than in western Germany for both children and adults. Several reasons for this fact have been discussed, although it is still not completely understood. One purpose of the epidemiologic study "Indoor and genetic factors in asthma and allergy" (INGA) is to compare exposure to mold spores in two German cities. Therefore, 405 homes in Erfurt (east) and Hamburg (west) were visited twice by trained investigators between June 1995 and May 1997.

METHODS

Samples of settled dust were taken by vacuuming from the carpet in the living room. Sieved house dust was diluted and plated on DG18 agar. The analyses were carried out in duplicate in the same laboratory.

RESULTS

No significant difference could be shown for the total and for single genera (Alternaria, Aspergillus, Cladosporium, and Penicillium) in concentration of spores of viable fungi in settled house dust between Erfurt and Hamburg. Seasonal variation of the mold picture, with highest values in August, could be identified both indoors and outdoors.

CONCLUSIONS

Because outdoor concentration is the main influence on indoor concentration of mold spores from June to October, we recommend sampling from November to May to evaluate exposure to indoor mold spores.

Prevalence and residential determinants of fungi within homes in Melbourne, Australia

BACKGROUND

Recent epidemiological studies suggest that the adverse respiratory health effects caused by the inhalation of fungal propagules are substantial. Knowledge of the prevalence and environmental determinants of indoor fungal levels is essential in designing effective avoidance measures.

AIM

To investigate the prevalence of fungi and the influence of residential characteristics on levels of fungi within homes in Melbourne, Australia.

METHODS

Floor dust and air samples were collected from bedrooms in 485 houses over 1 year. The dust was analysed for ergosterol, a marker of cumulative fungal biomass exposure. Total and genera-specific fungal propagules were identified in air samples. Details of the relevant residential characteristics were documented using a questionnaire. Independent predictors (P < 0.05) of ergosterol and total fungal propagules were identified by multiple linear regression.

RESULTS

Fifty-five percent of the houses had viable fungal propagules exceeding 500 CFU/m3. Cladosporium and Penicillium were identified as the most prevalent and abundant fungal genera in indoor air. The median ergosterol level in bedroom floor was 3.8 microg/g of dust. Multivariate analysis showed that total fungal propagules in indoor air were lower in bedrooms with a ceiling fan, without visible mould, and those that were more frequently vacuumed, had a solid fuel fire, had windows closed at the time of the sampling or lacked pets. The presence of more than one cat had the greatest effect on total fungal propagules. Ergosterol levels were significantly lower in homes without old fitted carpets, visible mould or pets and those with frequent airing and regular use of an extractor fan in the kitchen. Old wall-to-wall carpets had the greatest effect on ergosterol.

CONCLUSIONS

High indoor fungal exposures were associated with infrequent ventilation or vacuuming, presence of pets, visible mould and old carpets.

Isolation of Stachybotrys from the lung of a child with pulmonary hemosiderosis

Recently, Stachybotrys atra, a toxigenic fungus, has been implicated as a potential cause of pulmonary hemorrhage/hemosiderosis in infants living in water-damaged homes. Although epidemiologic evidence supports this association, neither the organism nor its toxic products has ever been recovered from humans. We report the first case in which Stachybotrys was isolated from the bronchoalveolar lavage fluid of a child with pulmonary hemorrhage. Stachybotrys was also recovered from his water-damaged home. The patient recovered completely after his immediate removal from the environment and subsequent cleaning of his home. This case provides further evidence that this fungus is capable of causing pulmonary hemorrhage in children.