Adverse Health Effects of Indoor Molds

Pre-exposure of peracetic acid enhances its subsequent combination with ultraviolet for the inactivation of fungal spores: Efficiency, mechanisms, and implications

Waterborne fungi pose a potential threat to water supply safety due to their high resistance to disinfectants. Peracetic acid, as a promising alternative disinfectant to chlorine, has attracted increasing attention in water treatment. In this study, the inactivation of two dominant fungal species (Aspergillus niger and Aspergillus flavus) by sequential application of peracetic acid and ultraviolet (PAA-UV/PAA) was reported for the first time. Results revealed that the pre-exposure of PAA could facilitate the subsequent process of UV/PAA combination and shorten the lag phase in fungi inactivation. After 10 min of PAA pre-exposure, PAA-UV/PAA achieved 3.03 and 2.40 log inactivation of Aspergillus niger and Aspergillus flavus, which were 2- and 4.3-fold higher than that of direct UV/PAA under the same UV and PAA doses. PAA-UV/PAA disinfection also exhibited a stronger regrowth inhibition for incompletely inactivated fungal spores than direct UV/PAA. The increase of pH (5.0-9.0) and humic acid concentration (1.0-5.0 mg L ^- 1) showed an inhibitory effect on PAA-UV/PAA inactivation, but PAA-UV/PAA was more adaptable in a wide pH range and the presence of humic acid compared to direct UV/PAA. The more severe cell membrane damage and higher reactive oxygen species level in PAA-UV/PAA were evidenced for the first time by flow cytometry. The increased hydroxyl radical generation and higher synergism were primarily responsible for inactivation improvement. This study enhances the further understanding of the PAA-UV/PAA process, and the findings are expected to promote the development of PAA as a promising disinfectant for effective fungi control.

Role of Lactic Acid Bacteria in Food Preservation and Safety

Fermentation of various food stuffs by lactic acid bacteria is one of the oldest forms of food biopreservation. Bacterial antagonism has been recognized for over a century, but in recent years, this phenomenon has received more scientific attention, particularly in the use of various strains of lactic acid bacteria (LAB). Certain strains of LAB demonstrated antimicrobial activity against foodborne pathogens, including bacteria, yeast and filamentous fungi. Furthermore, in recent years, many authors proved that lactic acid bacteria have the ability to neutralize mycotoxin produced by the last group. Antimicrobial activity of lactic acid bacteria is mainly based on the production of metabolites such as lactic acid, organic acids, hydroperoxide and bacteriocins. In addition, some research suggests other mechanisms of antimicrobial activity of LAB against pathogens as well as their toxic metabolites. These properties are very important because of the future possibility to exchange chemical and physical methods of preservation with a biological method based on the lactic acid bacteria and their metabolites. Biopreservation is defined as the extension of shelf life and the increase in food safety by use of controlled microorganisms or their metabolites. This biological method may determine the alternative for the usage of chemical preservatives. In this study, the possibilities of the use of lactic acid bacteria against foodborne pathogens is provided. Our aim is to yield knowledge about lactic acid fermentation and the activity of lactic acid bacteria against pathogenic microorganisms. In addition, we would like to introduce actual information about health aspects associated with the consumption of fermented products, including probiotics.

Prevalence of Aspergillus-Derived Mycotoxins (Ochratoxin, Aflatoxin, and Gliotoxin) and Their Distribution in the Urinalysis of ME/CFS Patients

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a known complex, multi-organ system disorder with a sudden or subacute onset. ME/CFS occurs most commonly among women between 30 and 50 years of age. The current diagnostic criteria of ME/CFS, as defined by the Centers for Disease Control and Prevention, includes: profound fatigue and post-exertional malaise (>6 mo) unrelieved by rest, persistent cognitive impairment or orthostatic intolerance, and chronic unrefreshing sleep. Despite reported associations between ME/CFS onset and exposure to infectious agents (viral, bacterial, or fungal), the pathophysiology of ME/CFS remains unknown. In this prevalence study, we investigated the rates of Aspergillus-derived toxin levels, Aflatoxin (AF), Ochratoxin A (OTA), and Gliotoxin (GT), in the urinalysis of 236 ME/CFS patients with a history of chronic exposure to mold (i.e., from water-damaged buildings). Among ME/CFS patients reporting chronic exposure to mold, we found evidence of exposure in 92.4 percent of patients, with OTA being the most prevalent mycotoxin. Mold distributions (OTA, AF, and GT) in the urinalysis all demonstrated right skewness, while the distribution of age of ME/CFS patients diagnosed showed no deviation from normality. This study aims to provide preliminary, epidemiological evidence among ME/CFS patients who were diagnosed in South Florida with a history of exposure to mycotoxins. Based on these findings, we proposed how future control studies should approach investigating the association between chronic mold exposure and the diagnosis of ME/CFS.

Sequential use of UV-LEDs irradiation and chlorine to disinfect waterborne fungal spores: Efficiency, mechanism and photoreactivation

In this work, sequential applications of light-emitting diodes (UV-LEDs) with two wavelengths and chlorine (Cl₂) were performed for fungal spores disinfection: UV-Cl₂, Cl₂-UV, UV/Cl₂-UV, UV-UV/Cl₂, Cl₂-UV/Cl₂-Cl₂. Overall comparisons of the sequential processes with respect to the inhibitory effect on photoreactivation were also evaluated. According to the evaluation of culturability and membrane permeability, inactivation of fungal spores by UV was not enhanced by prior or post exposure to Cl₂, but in the UV/Cl₂ process with pre or post UV treatment, the inactivation efficiency was greatly enhanced. Take P. polonicum for example, pre-treatments by UV₂₆₅ and UV₂₈₀ (40 mJ/cm²) caused the log count reduction (LCR) of 1.05 log and 0.95 log, then the followed UV₂₆₅/Cl₂ and UV₂₈₀/Cl₂ at the same UV fluence caused additional LCR of 1.80 log and 2.00 log. The permeabilization of P. polonicum was also accelerated in the processes of UV/Cl₂-UV and UV-UV/Cl₂, especially at the wavelength of 280 nm. In the sequential processes, especially those containing UV/Cl₂ or at the wavelength of 280 nm, could promote the formation of intracellular reactive oxygen species (ROS), thus leading to more severe damage to the spores as reflected in the culturability reduction, membrane permeability and inhibition of photoreactivation.

Efficacy of UV-LED based advanced disinfection processes in the inactivation of waterborne fungal spores: Kinetics, photoreactivation, mechanism and energy requirements

The contamination of fungi in water supply systems poses great risks to environment and human health. In this work, UV light-emitting diodes (UV-LEDs)-based advanced disinfection processes (ADPs) including UV-LEDs/hydrogen peroxide (H₂O₂), UV-LEDs/persulfate (PS) and UV-LEDs/peroxymonosulfate (PMS), were adopted for waterborne fungal spores inactivation. Overall comparisons of the UV-LEDs-based ADPs with respect to the control efficiency of photoreactivation and energy consumption were also evaluated. Results showed that culturability reduction of the fungal spores treated by UV-LEDs was not enhanced with the addition H₂O₂, PMS, and PS according to the results of heterotrophic plate counts and reaction rate constants; A. niger was expected to have higher UV resistance followed by T. harzianum and P. polonicum. However, UV-LEDs-ADPs inactivation, especially at the wavelengths of 280 and 265/280 nm, could accelerate the permeabilization of fungal spores as characterized by flow cytometry. Take P. polonicum for example, the percentage of membrane permeabilized spores was 98.0%, 98.7%, 97.6% and 82.6% after treatment by UV₂₈₀/H₂O₂, UV₂₈₀/PS, UV₂₈₀/PMS and UV₂₈₀ alone, respectively at the fluence of 100 mJ/cm². The direct attack of free radicals in the processes of UV-LEDs-ADPs further enhanced the membrane damage and lowered the photoreactivation level, thus improved the inactivation efficiency. UV-LEDs/H₂O₂ was considered as an effective process in the disinfection of fungal spores with the advantages of enhancing the damage of membrane, inhibiting photoreactivation and comparable energy consumption compared with UV-LEDs alone.

Indoor humidity levels and associations with reported symptoms in office buildings

Moderate indoor relative humidity (RH) levels (i.e., 40%-60%) may minimize transmission and viability of some viruses, maximize human immune function, and minimize health risks from mold, yet uncertainties exist about typical RH levels in offices globally and about the potential independent impacts of RH levels on workers' health. To examine this, we leveraged one year of indoor RH measurements (which study participants could view in real time) in 43 office buildings in China, India, Mexico, Thailand, the United Kingdom, and the United States, and corresponding self-report symptom data from 227 office workers in a subset of 32 buildings. In the buildings in this study, 42% of measurements during 9:00 - 17:00 on weekdays were less than 40% RH and 7% exceeded 60% RH. Indoor RH levels tended to be lower in less tropical regions, in winter months, when outdoor RH or temperature was low, and late in the workday. Furthermore, we also found statistically significant evidence that higher indoor RH levels across the range of 14%-70% RH were associated with lower odds of reporting dryness or irritation of the throat and skin among females and unusual fatigue among males in models adjusted for indoor temperature, country, and day of year.

The aggregation of Aspergillus spores and the impact on their inactivation by chlorine-based disinfectants

The formation of fungal biofilm goes through some different states, including monodisperse state, aggregated state, germinated state, hyphal and biofilm. The aggregation of spores is a primary step of fungal biofilm development in aquatic systems. Previous studies on the inactivation of fungi were mostly performed in the monodisperse state of fungal spores and biofilm state, however, the inactivation of aggregated fungal spores is still unclear. In this study, the aggregated characteristics of fungal spores (Aspergillus fumigatus and Aspergillus flavus) at different pH values were firstly studied, and the inactivation efficiency of fungal spores at different aggregation degree by chlorine-based disinfectants was also clarified. The results showed that the aggregation degree of Aspergillus fumigatus was the highest at pH 9.0 while it was the lowest at pH 5.0. Aggregation between fungal spores was mainly mediated by occasional adhesin-adhesin interactions and electrostatic interactions. Compared with monodisperse spores, fungal spores were more resistant to chlorine-based disinfectants with the increase of spore aggregation degree. The inactivation rate constants of Aspergillus fumigatus at 30% and 63% aggregation degree were 1.5- and 4-folds lower than that of monodisperse spores, respectively. The lower proportion of membrane damage and higher intracellular reactive oxygen species level for aggregated spores than monodisperse spores was observed according to the flow cytometric results after chlorine-based disinfectants treatment. The reasons for the lower inactivation efficiency of aggregated spores are as following: the protection of outer layer spores and signals between aggregates lead to the increase of resistance for aggregated spores. This study is meaningful for the control of the fungal spores at different states in water.

Biological contaminants in the indoor air environment and their impacts on human health

Indoor air environment contains a complex mixture of biological contaminants such as bacteria, fungi, viruses, algae, insects, and their by-products such as endotoxins, mycotoxins, volatile organic compounds, etc. Biological contaminants have been categorized according to whether they are allergenic, infectious, capable of inducing toxic or inflammatory responses in human beings. At present, there is a lack of awareness about biological contamination in the indoor environment and their potential sources for the spreading of various infections. Therefore, this review article examines the association of biological contaminants with human health, and it will also provide in-depth knowledge of various biological contaminants present in different places such as residential areas, hospitals, offices, schools, etc. Moreover, qualitative and quantitative data of bio-contaminants in various indoor environments such as schools, hospitals, residential houses, etc. have also been derived from the recent literature survey.

Inactivation of fungal spores in water using ozone: Kinetics, influencing factors and mechanisms

Fungal contamination of drinking water sources is increasingly threatening the environment and human health. In this study, the inactivation of three genera of dominant fungi in drinking water sources using ozone was first reported. The inactivation of the fungal spores by ozone could be divided into two distinct stages: first a rapid reduction in survival, and then the inactivation at a slower rate. The secondary stage inactivation fitted the Chick-Watson model well, and there was no significant difference in the second-order inactivation rate constants of the three fungal spores (0.199-0.209 L mg^-1 min^-1). The inactivation rate constants of fungal spores by molecular ozone were much lower than those of viruses, which were equivalent to that of Cryptosporidium. The increase in pH and temperature showed a positive effect on the inactivation rate. Damage to cell membranes, leakage of intracellular compounds, and changes of reactive oxygen species and esterase activity in the spores were detected after inactivation. The results indicated that ozone inactivated fungal spores by firstly destroying cell walls and membranes and then causing the release of intracellular compounds. The fungicidal efficiency of ozone was superior to those of chlorine and chlorine dioxide. In addition, the inactivation efficiency of ozone on fungal spores in real water matrices was reduced to 50.7-91.2% of the efficiency in phosphate buffer. In conclusion, ozone showed high efficiency in the inactivation of fungal spores and could be used as an alternative disinfectant for fungal contamination in drinking water sources.

Simultaneously enhance the inactivation and inhibit the photoreactivation of fungal spores by the combination of UV-LEDs and chlorine: Kinetics and mechanisms

Waterborne fungi have been recognized as an emerging environmental contaminant in recent years. This work was to investigate the inactivation efficiency and mechanisms of ultraviolet light-emitting diodes (UV-LEDs)/chlorine (Cl₂) (265, 280 and 265/280 nm combination) and LPUV/Cl₂ (254 nm) treatments for three fungal species compared with individual disinfection processes. Control of photoreactivation for fungal species inactivated by UV-LEDs/Cl₂ and LPUV/Cl₂ was also evaluated. The results revealed that the combined UV-LEDs/Cl₂ and LPUV/Cl₂ processes, especially UV-LEDs/Cl₂, exhibited better inactivation performance compared to UV alone and Cl₂ alone based on the inactivation rate constants, and an evident synergistic effect was observed. For example, the inactivation rates for Penicillium polonicum in the processes of UV₂₆₅/Cl₂, UV₂₈₀/Cl₂, UV_265/280/Cl₂ and LPUV/Cl₂ was 0.142, 0.168, 0.174 and 0.106 cm²/mJ, respectively, which were all approximately 1.5-fold higher than that of UV alone. The synergistic effect of fungal spores inactivation by UV-LEDs/Cl₂ and LPUV/Cl₂ was due to the high level production of intracellular reactive oxygen species and the reaction of potential extracellular free radicals. Resistance of the tested fungal spores was as follows: Trichoderma harzianum < Penicillium polonicum < Aspergillus niger. In addition, the joint effect of DNA and other cellular damage resulted in the inhibition of photoreactivation of fungal spores inactivated by UV-LEDs/Cl₂ and LPUV/Cl₂ compared with that of fungal spore inactivated by UV alone. This study may provide reference for controlling the dissemination of waterborne fungi utilizing combined UV-LEDs and free chlorine processes.

Influence of Nonthermal Atmospheric Plasma-Activated Water on the Structural, Optical, and Biological Properties of Aspergillus brasiliensis Spores

Plasma-activated water (PAW) has emerged as a platform for sterilizing fungal pathogens. In this study, we investigated the influence of PAW on black melanized spores of Aspergillus brasiliensis to explore the mechanism of fungal spore inactivation. PAW was prepared by activating deionized water with a nonthermal atmospheric pressure air plasma jet (soft plasma jet). The concentrations of H2O2 and NOx in the PAW treated by the soft plasma jet for 3 min were 50 μM and 1.8 mM, respectively, and the pH of the PAW was 3.10. The reactive oxygen and nitrogen species (RONS) in the PAW increased with longer plasma activation time. After being treated for 30 min in the PAW with a plasma activation time of 3 min, the spore viability dramatically dropped to 15%. The viabilities of 0.3% H2O2- and 0.3% HNO3-treated spores were 22% and 42%, respectively. The breakage of the spore cell wall by the PAW was revealed in scanning electron microscope images and flow cytometry measurements. Disruption of cell wall integrity provides a path for intracellular components to escape and RONS of the PAW can attack intracellular components directly. Degradation of high molecular genomic DNA was also observed by agarose gel electrophoresis. These results suggest that long-lived reactive species generated in the PAW play an important role in the inactivation of melanized fungal spores. Consequently, PAW produced by a soft plasma jet can be applied to sterilize bioprotective walled fungal spores in a relatively large volume.

Mold inhalation causes innate immune activation, neural, cognitive and emotional dysfunction

Individuals living or working in moldy buildings complain of a variety of health problems including pain, fatigue, increased anxiety, depression, and cognitive deficits. The ability of mold to cause such symptoms is controversial since no published research has examined the effects of controlled mold exposure on brain function or proposed a plausible mechanism of action. Patient symptoms following mold exposure are indistinguishable from those caused by innate immune activation following bacterial or viral exposure. We tested the hypothesis that repeated, quantified doses of both toxic and nontoxic mold stimuli would cause innate immune activation with concomitant neural effects and cognitive, emotional, and behavioral symptoms. We intranasally administered either 1) intact, toxic Stachybotrys spores; 2) extracted, nontoxic Stachybotrys spores; or 3) saline vehicle to mice. As predicted, intact spores increased interleukin-1β immunoreactivity in the hippocampus. Both spore types decreased neurogenesis and caused striking contextual memory deficits in young mice, while decreasing pain thresholds and enhancing auditory-cued memory in older mice. Nontoxic spores also increased anxiety-like behavior. Levels of hippocampal immune activation correlated with decreased neurogenesis, contextual memory deficits, and/or enhanced auditory-cued fear memory. Innate-immune activation may explain how both toxic mold and nontoxic mold skeletal elements caused cognitive and emotional dysfunction.

Moist and Mold Exposure is Associated With High Prevalence of Neurological Symptoms and MCS in a Finnish Hospital Workers Cohort

Background

Indoor air dampness microbiota (DM) is a big health hazard. Sufficient evidence exists that exposure to DM causes new asthma or exacerbation, dyspnea, infections of upper airways and allergic alveolitis. Less convincing evidence has yet been published for extrapulmonary manifestations of dampness and mold hypersensitivity syndrome ).

Methods

We investigated the prevalence of extrapulmonary in addition to respiratory symptoms with a questionnaire in a cohort of nurses and midwives (n = 90) exposed to DM in a Helsinki Obstetric Hospital. The corresponding prevalence was compared with an unexposed cohort (n = 45). Particular interest was put on neurological symptoms and multiple chemical sensitivity.

Results

The results show that respiratory symptoms were more common among participants of the study vs. control cohort, that is, 80 vs 29%, respectively (risk ratio [RR]: 2.56, p < 0.001). Symptoms of the central or peripheral nervous system were also more common in study vs. control cohort: 81 vs 11% (RR: 6.63, p < 0.001). Fatigue was reported in 77 vs. 24%, (RR: 3.05, p < 0.001) and multiple chemical sensitivity in 40 vs. 9%, (RR: 3.44, p = 0.01), the so-called “brain fog”, was prevalent in 62 vs 11% (RR: 4.94, p < 0.001), arrhythmias were reported in 57 vs. 2.4% (RR: 19.75, p < 0.001) and musculoskeletal pain in 51 vs 22% (RR: 2.02, p = 0.02) among participants of the study vs. control cohort, respectively.

Conclusion

The results indicate that the exposure to DM is associated with a plethora of extrapulmonary symptoms. Presented data corroborate our recent reports on the health effects of moist and mold exposure in a workplace.

Indoor Temperatures in Low Cost Housing in Johannesburg, South Africa

Ambient and indoor temperature affects thermal comfort and human health. In a changing climate with a predicted change in temperature extremes, understanding indoor temperatures, both hot and cold, of different housing types is important. This study aimed to assess the hourly, daily and monthly variation in indoor temperatures in different housing types, namely formal houses, informal houses, flats, government-built low-cost houses and old, apartheid era low-cost housing, in five impoverished urban communities in Johannesburg, South Africa. During the cross-sectional survey of the Health, Environment and Development study data loggers were installed in 100 homes (20 per suburb) from February to May 2014. Indoor temperature and relative humidity were recorded on an hourly basis. Ambient outdoor temperatures were obtained from the nearest weather station. Indoor and outdoor temperature and relative humidity levels were compared; and an inter-comparison between the different housing types were also made. Apparent temperature was calculated to assess indoor thermal comfort. Data from 59 retrieved loggers showed a significant difference in monthly mean indoor temperature between the five different housing types (p < 0.0001). Low cost government-built houses and informal settlement houses had the greatest variation in temperature and experienced temperatures between 4 and 5 °C warmer than outdoor temperatures. Housing types occupied by poor communities experienced indoor temperature fluctuations often greater than that observed for ambient temperatures. Families living in government-built low-cost and informally-constructed homes are the most at risk for indoor temperature extremes. These types of housing should be prioritised for interventions aimed at assisting families to cope with extreme temperatures, gaining optimal thermal comfort and preventing temperature-related health effects.

Assessment of multi-contaminant exposure in a cancer treatment center: a 2-year monitoring of molds, mycotoxins, endotoxins, and glucans in bioaerosols

Indoor air quality in health care facilities is a major public health concern, particularly for immunocompromised patients who may be exposed to microbiological contaminants such as molds, mycotoxins, endotoxins, and (1,3)-ß-D-glucans. Over 2 years, bioaerosols were collected on a monthly basis in a cancer treatment center (Centre F. Baclesse, Normandy, France), characterized from areas where there was no any particular air treatment. Results showed the complexity of mycoflora in bioaerosols with more than 100 fungal species identified. A list of major strains in hospital environments could be put forward due to the frequency, the concentration level, and/or the capacity to produce mycotoxins in vitro: Aspergillus fumigatus, Aspergillus melleus, Aspergillus niger, Aspergillus versicolor, Cladosporium herbarum, Purpureocillium lilacinum, and Penicillium brevicompactum. The mean levels of viable airborne fungal particles were less than 30.530 CFU per m³ of air and were correlated to the total number of 0.30 to 20 μm particles. Seasonal variations were observed with fungal particle peaks during the summer and autumn. Statistical analysis showed that airborne fungal particle levels depended on the relative humidity level which could be a useful indicator of fungal contamination. Finally, the exposure to airborne mycotoxins was very low (only 3 positive samples), and no mutagenic activity was found in bioaerosols. Nevertheless, some fungal strains such as Aspergillus versicolor or Penicillium brevicompactum showed toxigenic potential in vitro.

Contaminants in human nail dust: an occupational hazard in podiatry?

Background

There has been limited literature indicating that podiatrists’ health may be at risk from exposure to human nail dust. Previous studies carried out in the UK have shown that large amounts of dust become airborne during the human nail drilling procedure and are present in the air up to 10 hours after a clinical session. This increases the risk of Respiratory Tract (RT) infection for the practitioner.

Methods

This study used a nasal swabbing technique and fungal culture to determine whether podiatrists (n = 50) had the same microbes present in their nasal cavities as non-podiatry health professional control group (n = 45). All swabs were cultured, counted and identified for each subject. Survey data of use and type of nail drill, type of mask used and frequency of change over a two week period.

Results

The results showed podiatrists had a greater range of microbes in their nasal cavities although the controls had greater overall numbers of organisms. The known pathogen and common mould, Aspergillus fumigatus was ost commonly found fungus within the podiatric group with 44% of the group having the fungus present. All nail drills used by the podiatrists had some form of dust extraction (except one). Of concern was 17% (n = 8) of the podiatrists did not use a mask at all whilst drilling and seemed unaware of any infection control issues. Simple disposable masks were the most frequently worn with only half being changed after each patient further increasing the cross infection risk

Conclusion

The high levels of Aspergilus contamination is a significant finding in the podiatry group as this fungus is small enough to enter the tissue of the nasal cavity and as a small particle will stay airborne in the room for up to 16 hours. Aspergilus has been shown to cause brain and soft tissue tumours in extreme cases. The high levels of upper respiratory track problems reported in the literature may well be caused by this fungal agent. The non use and use of inappropriate masks by podiatrists is clearly an occupational hazard to their health and well being.

A review of the mechanism of injury and treatment approaches for illness resulting from exposure to water-damaged buildings, mold, and mycotoxins

Physicians are increasingly being asked to diagnose and treat people made ill by exposure to water-damaged environments, mold, and mycotoxins. In addition to avoidance of further exposure to these environments and to items contaminated by these environments, a number of approaches have been used to help persons affected by exposure to restore their health. Illness results from a combination of factors present in water-damaged indoor environments including, mold spores and hyphal fragments, mycotoxins, bacteria, bacterial endotoxins, and cell wall components as well as other factors. Mechanisms of illness include inflammation, oxidative stress, toxicity, infection, allergy, and irritant effects of exposure. This paper reviews the scientific literature as it relates to commonly used treatments such as glutathione, antioxidants, antifungals, and sequestering agents such as Cholestyramine, charcoal, clay and chlorella, antioxidants, probiotics, and induced sweating.

Fungal pollution of indoor environments and its management

Indoor environments play important roles in human health. The health hazards posed by polluted indoor environments include allergy, infections and toxicity. Life style changes have resulted in a shift from open air environments to air tight, energy efficient, environments, in which people spend a substantial portion of their time. Most indoor air pollution comes from the hazardous non biological agents and biological agents. Fungi are ubiquitous in distribution and are a serious threat to public health in indoor environments. In this communication, we have reviewed the current status on biotic indoor air pollution, role of fungi as biological contaminants and their impact on human health.

Fungal spore content of the atmosphere of the Cave of Nerja (southern Spain): diversity and origin

Fungal spores are of great interest in aerobiology and allergy due to their high incidence in both outdoor and indoor environments and their widely recognized ability to cause respiratory diseases and other pathologies. In this work, we study the spore content of the atmosphere of the Cave of Nerja, a karstic cavity and an important tourist attraction situated on the eastern coast of Malaga (southern Spain), which receives more than half a million visitors every year. This study was carried out over an uninterrupted period of 4 years (2002-2005) with the aid of two Hirst-type volumetric pollen traps (Lanzoni VPPS 2000) situated in different halls of the cave. In the atmosphere of the Cave of Nerja, 72 different spore types were detected during the studied period and daily mean concentrations of up to 282,195 spores/m(3) were reached. Thirty-five of the spore types detected are included within Ascomycota and Basidiomycota (19 and 16 types, respectively). Of the remaining spore types, 32 were categorized within the group of so-called imperfect fungi, while Oomycota and Myxomycota were represented by 2 and 3 spore types, respectively. Aspergillus/Penicillium was the most abundant spore type with a yearly mean percentage that represented 50% of the total, followed by Cladosporium. Finally, the origin of the fungal spores found inside the cave is discussed on the basis of the indoor/outdoor concentrations and the seasonal behaviour observed.

Boar spermatozoa as a biosensor for detecting toxic substances in indoor dust and aerosols

The presence, quantity and origins of potentially toxic airborne substances were searched in moisture damaged indoor environments, where building related ill health symptoms were suspected and reference sites with no health complaints. Boar spermatozoa were used as the toxicity sensor. Indoor aerosols and dusts were collected from kindergartens, schools, offices and residences (n=25) by electrostatic filtering, vacuuming, wiping from elevated surfaces and from the interior of personal computers. Toxicity was measured from the ethanol or methanol extracts of the dusts and aerosols. EC(50) was expressed as the lowest concentration of the airborne substance that inhibited motility of >50% of the exposed sperm cells compared to vehicle control, within 30 min, 1 day or 3-4 days of exposure. Remarkably toxic aerosols (EC(50) <or=6 μg ml(-1)) were found from 11 sites, all of these were sites with known or suspected for building related ill health. Toxic microbial cultures were obtained from subsamples of the toxic aerosols/dusts. From these cereulide, amylosin, valinomycin and a novel indoor toxin, stephacidin B were identified and toxicities measured. Airborn dispersal of valinomycin from Streptomyces griseus cultures was evaluated using a flow-through chamber. Significant amounts of valinomycin (LC-MS assay) and toxicity (boar sperm motility assay) were carried by air and were after 14 days mainly recovered from the interior surfaces of the flow chamber.

The treatment of patients with mycotoxin-induced disease

Twenty-eight incapacitated individuals (average 43 years old, 7 males, 21 females, range 12-70) exposed to molds and mycotoxins were studied and treated with a protocol of cleaning up or changing their environment to be mold free. Injections of the optimum dose of antigens were given as part of the treatment protocol as was oral and intravenous (i.v.) antioxidants; heat depuration (sauna); physical therapy with massage and exercise under environmentally controlled conditions; oxygen therapy at 4-8 L/min for 2 hours with a special wood-grade cellophane reservoir and a glass oxygen container. Many patients were sensitive to plastics; therefore, exposures to these were kept to a minimum. Autogenous lymphocytic factor was given as an immune modulator. Of 28 patients, 27 did well and returned to work. One patient improved but did not return to work during the period of study.

Epidemics of mold poisoning past and present

Molds are ubiquitous throughout the biosphere of planet earth and cause infectious, allergic, and toxic diseases. Toxic diseases arise from exposure to mycotoxins produced by molds. Throughout history, there have been a number of toxic epidemics associated with exposure to mycotoxins. Acute epidemics of ergotism are caused by consumption of grain infested by fungi of the genus Claviceps, which produce the bioactive amine ergotamine that mimics the neurotransmitters norepinephrine, serotonin, and dopamine. Acute aflatoxin outbreaks have occurred from ingestion of corn stored in damp conditions that potentiate growth of the molds of the species Aspergillus. Contemporary construction methods that use cellulose substrates such as fiber board and indoor moisture have caused an outbreak of contaminated buildings with Stachybotrys chartarum, with the extent of health effects still a subject of debate and ongoing research. This article reviews several of the more prominent epidemics and discusses the nature of the toxins. Two diseases that were leading causes of childhood mortality in England in the 1970s and vanished with changing dietary habits, putrid malignant fever, and slow nervous fever were most likely toxic mold epidemics.

Acrebol, a novel toxic peptaibol produced by an Acremonium exuviarum indoor isolate

AIMS

To identify a toxin and its producer isolated from woody material in a building where the occupants experienced serious ill health symptoms.

METHODS AND RESULTS

Hyphal extracts of an indoor fungus, identified as the cycloheximide-tolerant species Acremonium exuviarum, inhibited motility of boar spermatozoa (EC(50) 5 +/- 2 microg of crude solids ml(-1)) and caused cytolysis of murine neuroblastoma cells (MNA) and feline fetal lung cells (FL). The responsible substances were purified and identified as two structurally similar, heat-stable, novel, toxic peptaibols, 1726 Da and 1740 Da, respectively, with amino acid sequences of Acetyl-Phe-Iva/Val-Gln-Aib-Ile-Thr-Leu-Aib-Pro-Aib-Gln-Pro-Aib-(X-X-X)-SerOH and Acetyl-Phe-Iva/Val-Gln-Aib-Ile-Thr-Leu-Val-Pro-Aib-Gln-Pro-Aib-(X-X-X)-SerOH. Purified acrebol inhibited motility of boar sperm, depleted ATP half-content in 1 day (EC(50) of 0.1 microg ml(-1), 60 nmol l(-1)) depolarised the mitochondria after 2 days, but did not affect the cellular content in NADH. This indicates mitochondrial toxicity. Plate-grown biomass of A. exuviarum BMB4 contained 0.1-1% (w/w) of acrebol, depending on the culture medium.

CONCLUSIONS

Acrebol paralysed the energy generation of mammalian cells suggesting that mitochondria were its target of action.

SIGNIFICANCE AND IMPACT OF THE STUDY

Acremonium exuviarum, as an indoor fungus, is potentially hazardous to health because of the toxic peptaibols that it produces.

Seasonal fine and coarse culturable fungal constituents and concentrations from indoor and outdoor air samples taken from an arid environment

This study was undertaken to determine the normal indoor and outdoor airborne culturable fungal constituents and concentrations of an arid environment. Air samples were taken with two-stage, ambient, culturable sampler systems and analyzed for nine specific fungal genera from 50 homes as a repeated measure during each season of the year. These homes had no previous histories of indoor air quality issues. This study detected seasonal differences for the arid environment between different culturable fungal concentrations across the two size ranges. The highest concentrations were during fall, in the outdoor fine-size range. The lowest concentrations were the indoor coarse concentrations in the spring. From this study it can be concluded that Cladosporium spp. had the highest concentrations during fall in an arid environment. The overall findings suggest that Cladosporium had concentrations greater than the other genera evaluated, specifically, the fall outdoor fine concentrations. Seasonality was found to be a key factor in determining the variability of fungal constituents and concentrations within the arid indoor and outdoor environments. The fine-size range was 12 times and 6 times greater than the coarse-size range for indoor and outdoor samples, respectively, which accounted for the majority of fungal organisms. In addition, the results from this study in an arid climate differ from those conducted in a moister climate.