Mold and Fungal Contaminants - Detection and Prevention in the Built Environment

PO11​4

Wednesday, May 25, 2016, 10:00 AM - 12:00 PM

SR-114-0​1

Mold Remediation & Certification Laws in the United States: A Look at Where We Are & What We Need

E. Geltman and A. Hess, Hunter College, CUNY School of Public Health, New York, NY

Objective: Concern about mold in buildings and homes increased in the United States in the aftermath of Hurricane’s Katrina and Sandy. Mold is a known allergen and can cause a plethora of health issues, including mycotoxin poisoning and a range of respiratory ailments. As a naturally occurring irritant, there is great debate about the best means to safely remove mold. In order to protect the public against unscrupulous and unskilled contractors, a growing number of states enacted legislation requiring training, certification and other regulations of those in the business of mold remediation

Methods: In this study, we used principles of legal epidemiology to conduct policy surveillance to explore which states enacted mold remediation and certification laws. We used LEXIS/NEXIS and https://legiscan.com/ to evaluate the laws and regulations of all 50 states against sixteen preset codes using LawAtlas WorkBench. Coders crosschecked for consistency.

Results: Our review found that only a minority of states established mold remediation and certification laws and these vary in stringency and effectiveness. Some states (in the minority) are attempting to reduce consumer fraud in the mold removal industry and provide guidelines about how to both conduct proper mold removal and how to train those engaged in mold removal to protect both worker and building occupant safety. Moreover, penalties for violating laws in the few states that do provide guidelines are generally relatively insignificant; amounting to the regulatory equivalent of a parking ticket.

Conclusions: Overall the data shows a paucity of states establishing legal guidance and protection assuring that mold removal specialists are properly trained and/or licensed to protect the health of both removal workers and building occupants.

 

CS-114​-02

What Do Those Spore Trap Categories Mean?

H. Burge, EMLab PK, San Bruno, CA

Situation/Problem: Spore trap reports list counts for a variety of fungal spores. The categories listed are based on the analysts’ ability to recognize the spores by their morphology. Only a very few spores can be assigned to a genus and species on microscopic morphology alone (e.g., Epicoccum nigrum). Other spore types can be recognized to the genus level, but there may be hundreds of different species (e.g., Cladosporium). Other categories group spores of different (related) genera based on similar spore morphology (e.g., Drechslera/ Helminthosporium, Penicillium/Aspergillus). A fourth category unites all the spores of a particular large group that all produce spores in a similar way. Each of these groups includes hundreds of genera and thousands of species (e.g., Ascospores and Basidiospores). Finally, one of the groups often listed includes spores of completely unrelated fungi that happen to have spores of similar morphology (smuts, myxomycetes).

Resolution: So, given this lack of precision, of what use are these categories? They are generally used to compare populations of spore types indoors and outdoors. In fact, some reports list outdoor and indoor fungi. Note that ALL fungi are found in the natural outdoor environment, and none can grow exclusively indoors. Because of the lack of precision of listed spore categories, it is important to be familiar with the kinds of fungi included in each group, and to recognize that within each group there are those that often are found indoors, those that are occasionally found indoors, and those that have not been found in the indoor environment

Results: Understanding the complexity of these categories is important for interpreting spore trap data, especially when indoor/outdoor comparisons are being made. For example, high concentrations of ascospores both outdoors and in may indicate either penetration of the outdoor aerosol, or growth of an ascospore forming fungus indoors. A solution that the labs might provide would be to indicate whether or not the indoor and outdoor ascospores are similar or not. This would, of course, add expense to the analysis. Understanding the nature of spore trap categories will facilitate interpretation and direct investigators to, perhaps, reinvestigate sites where the complexity of the report categories could lead to errors of interpretation

Lessons learned: Spore trap categories reported by analytical laboratories rarely represent fungal species, but rather groups of species belonging to related families or even to completely unrelated classes of fungi. Understanding this complexity will aid in the interpretation of spore trap reports.

 

SR-1​14-03

Airborne Endotoxin and Asthma and Allergy in Elementary School Age Children: A Case-Control Study

Y. Yen, Kaohsiung Medical University, Kaohsiung, Taiwan

Objective: The objective of this study is to evaluate the association between the presence of asthma and allergy sensitization, and airborne endotoxin in homes of school age children in Kaohsiung City, Taiwan.

Methods: We conducted this study using a case-control study design from a general population of children by matching age and class exposure. Data collection of home visits included an interviewer administered questionnaire, air sampling of participants’ homes for endotoxin, bacteria and fungi, as well as temperature and relative humidity measurements. Airborne endotoxin was collected on filters with a sampling time of 24 hours. The houses of each case-control pair were visited within one week to ensure the similarity of the ambient environment. Questionnaires were administered to record housing characteristics. SAS statistical package (version 9.3) was used for data analyses.

Results: Endotoxin was detected in all air samples with a mean value of 1.45±1.67 EU/m3. In both the univariate and multivariate analyses, incense burning was consistently associated with increased concentrations of airborne endotoxin in the bedroom, while air fresheners and dehumidifiers were associated with decreased concentrations of airborne endotoxin. We observed that higher airborne endotoxin concentrations increased the risk of asthma/allergy. In addition, interquartile range increases of airborne endotoxin were significantly associated with asthma/allergy status (OR= 3.83).

Conclusions: Airborne endotoxin was significantly associated with asthma/allergy status. Reduced incense burning, and using air fresheners and dehumidifiers, may decrease airborne endotoxin in homes.

 

SR-11​4-04

IgE Antibodies to Fungi Among Asthmatic Children Living in Homes Damaged by Hurricane Sandy in New York City

A. Divjan, L. Acosta, and M. Perzanowski, Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY; M. Little, C. D’Andrea, and N. Clark, New York City Department of Health and Mental Hygiene, New York, NY; E. Sobek, Assured Bio Labs, LLC, Oak Ridge, TN; N. Soffer, Intralytix, Baltimore, MD; B. Green, Allergy and Clinical Immunology Branch, Health Effects Laboratory Division, CDC/NIOSH, Morgantown, WV

Objective: In New York City (NYC), domestic mold contamination has been a public health concern and the most common residential complaint following Hurricane Sandy (HS). The objective of this research was to determine the susceptibility of asthmatic children to adverse health effects from fungal exposures following catastrophic water damage.

Methods: Asthmatic children (n=58) living in homes damaged by HS were recruited (ages 6-15 years). Dust was collected from homes and serum from children 16-33 months after HS. Bedroom floor dust was analyzed by quantitative polymerase chain reaction for 36 fungi (Environmental Relative Moldiness Index panel) and compared to results from non-damaged homes (NYC Neighborhood Asthma and Allergy Study, n=347). IgE was measured by CAP (ThermoFisher, >0.1 IU/ml considered positive) to common fungi and those selected based on fungi detected in HS-damaged home dust.

Results: As compared to non-damaged homes, significantly (P<0.05) more Hurricane Sandy damaged homes had measurable Acremonium strictum, Aspergillus fumigatus, Aspergillus niger, Aspergillus penicillioides, Cladosporium cladosporioides, Epicoccum nigrum, Mucor amphibiorum, Penicillium purpurogenum, and Scopulariopsis brevicaulis. Nearly all homes (damaged and non-damaged) had detectable levels of Aureobasidium pullulans and Cladosporium herbarum. Many (50%) of the children in HS damaged homes had measureable IgE to at least one of the fungi tested, most commonly, Alternaria alternata (36%), Candida albicans (22%) Aureobasidium pullulans (19%), Aspergillus fumigatus (17%), Helminthosporium halodes (17%) and Mucor racemosus (17%).

Conclusions: Among asthmatic children living in NYC homes damaged by HS, sensitization to fungi was common, including to some species that were higher in HS-damaged homes. The ongoing analysis of fungal sensitization and effects on asthma morbidity will further characterize the impacts of Hurricane Sandy on this population.

 

SR-11​4-05

Aspergillus Section Petersonii Sect. Nov. Encompassing Indoor and Soil-borne Species with Predominant Tropical Distribution

Z. Jurjevic, EMSL Analytical, Inc., Cinnaminson, NJ; A. Kubátová, Department of Botany, Faculty of Science, Charles University in Prague, Prague, Czech Republic; M. Kolarík, Institute of Microbiology, Academy of Sciences of the Czech Republic, Prague, Czech Republic; V. Hubka, Department of Botany, Faculty of Science, Charles University in Prague, Prague, Czech Republic

Objective: During mold surveys, a number of Aspergillus strains were isolated from the environment which did not fit any known species or genus. Phenotypic examination of these isolates showed that they were very similar but differed in some growth characteristics. Multilocus DNA sequence data was obtained for the new isolates and some related species in the broader, more inclusive clade.

Methods: Fungal isolates were collected mainly from homes and offices. To describe the species, we used phenotypes from 14 day Czapek yeast extract agar, CYA with 20 % sucrose, malt extract agar, oatmeal agar, potato dextrose agar, dichloran-glycerol agar, Czapek yeast autolysate agar with 5% NaCl, and creatine agar. Cultures were incubated in darkness at 25 °C. Additional CYA cultures were incubated at different temperatures to determine the cardinal growth temperatures of the new species (20, 30, 35 and 37°C) for 14 d. This was followed by multilocus DNA sequencing of beta-tubulin (BT2), calmodulin (CF), nuclear internal transcribed spacer region (ITS), RNA polymerase II (RPB2), and phylogenetic analysis (Maximum Likelihood and Bayesian Inference analysis).

Results: Based on molecular and morphological analysis the new species are described as A. asclerogenus and A. petersonii. Aspergillus arenarius is reduced to synonymy with A. peyronelii. In addition, three new sections Petersonii, Robusti and Tanneri in the subgenus Circumdati are proposed.

Conclusions: Aspergillus is a diverse genus encompassing approximately 350 species with high economic impact for humans. The current classification into four subgenera and 20 sections resolves the placement of the vast majority of species with only a few exceptions. The subgenus Circumdati comprises important producers of mycotoxins, bioactive exometabolites, and biotechnologically important enzymes and organic acids. Some species are used in food fermentations, and some may cause food spoilage or human infections. Our phenotypical and phylogenetic data resolved the position of species with ambiguous taxonomic placement and supported the proposal of three new sections in the subg. Circumdati, sect. Petersonii, Robusti and Tanneri.

 

SR-114-​06

The Influence of Children Jumping on the Bed on Airborne Endotoxin and PM10/ PM2.5/ PM1 Concentration Profile

Y. Yen, Kaohsiung Medical University, Kaohsiung, Taiwan

Objective: The purpose of the present study is to detect the concentrations of airborne endotoxin, PM1, PM2.5, and PM10 through the behavior of jumping on the bed and making the bed as well as the background period to understand the influences of those behaviors.

Methods: 60 schoolchildren’s houses in Kaohsiung city in Taiwan were evaluated. PM10/ PM2.5/ PM1 concentration was simultaneously monitored over the first five minutes to obtain background concentration profiles. Then, a common cane was used to tap the bed for about one minute, followed by keeping motionless in 7 to 10 minutes to let PM settle down. Then, we made children’s bed by raising bed sheets for about one minute, followed by keeping motionless in 7 to 10 minutes. This evaluation was conducted by the same person for consistency of the beating strength, beating frequency, and beating location. We collect airborne endotoxin on 1μm pore size and 37mm diameter of Teflon filters in the plastic cassettes by using a sampling pump operating at 20 L/m for 25minutes when we performed the action of jumping on the bed and making the bed.

Results: This is the first study to detect the concentrations of airborne endotoxin, PM1, PM2.5, and PM10 through the behavior of jumping on the bed and making the bed. When jumping on the bed and making the bed, the airborne endotoxin concentrations is higher more than eighteen times of background, and the PM concentrations of jumping on the bed is higher more than ten times of background concentrations, and making the bed is higher nearly double than background. And also indicated that the largest ratio of PM in background was PM1 (PM1, PM1-2.5 and PM2.5-10 accounted for 0.916, 0.009 and 0.075, respectively). When jumping on the bed and making the bed, the ratio of PM1 and PM1-2.5 were decreased, specifically, the ratio of PM1 were decreased more than PM1-2.5 (the ratio of PM1 when jumping on the bed wa​​​s 0.905, and when making the bed was 0.895). However, the ratio of PM2.5-10 were increased when jumping on the bed and making the bed (the ratio of PM2.5-10 was 0.090 and 0.097, respectively).

Conclusions: In conclusion, jumping on the bed and making bed significantly increased airborne endotoxin and PM concentration. These actions may increase the risk of respiratory symptoms, especially for asthma children.​