Estelle Levetin

Allergy diagnostic testing: an updated practice parameter.

I. Leonard Bernstein, MD; James T. Li, MD, PhD; David I. Bernstein, MD; Robert Hamilton, PhD, DABMLI; Sheldon L. Spector, MD; Ricardo Tan, MD; Scott Sicherer, MD; David B. K. Golden, MD; David A. Khan, MD; Richard A. Nicklas, MD; Jay M. Portnoy, MD; Joann Blessing-Moore, MD; Linda Cox, MD; David M. Lang, MD; John Oppenheimer, MD; Christopher C. Randolph, MD; Diane E. Schuller, MD; Stephen A. Tilles, MD; Dana V. Wallace, MD; Estelle Levetin, PhD; and Richard Weber, MD

Indoor air quality in schools: exposure to fungal allergens

This study examined indoor air quality within schools in Kansas City, Spokane, Santa Fe, and Orlando. Air sampling was undertaken with both Andersen Single Stage Samplers and Burkard Personal Air Samplers. The data show a wide range of indoor exposures ranging from less than 100 colony forming units (CFU/m3) for viable fungi and 100 spores/m3 for total spores in Spokane and Santa Fe to concentrations over 6000 CFU/m3 for viable fungi and 15 000 spores/m3 for total fungi in Orlando and Kansas City, respectively. In the majority of sites the indoor airspora reflected the outdoor taxa withCladosporium the most abundant genus identified; however, several indoor locations had elevated levels ofPenicillium andAspergillus indicating possible sources of indoor contamination. Airborne basidiospores and smut spores were also fairly abundant in the schools and were among the top five taxa identified. The data also indicated that the airborne concentrations vary significantly during the day and between classrooms within each school. Continued studies in schools are needed to fully assess both the exposure levels and the clinical significance to atopic children allergic to these spores.

An evaluation of two methods used for microscopic analysis of airborne fungal spore concentrations from the Burkard Spore Trap

The Burkard Volumetric Spore Trap is a common and efficient instrument used to collect outdoor air samples. In North America, two slide counting methods have been widely used by aerobiologists: the single longitudinal traverse method and the twelve transverse traverse method. The purpose of this study was to compare the two counting methods by assessing fungal spore concentrations of ascospores, basidiospores, smut teliospores, Cladosporium, Alternaria, Epicoccum, Curvularia, Drechslera, Pithomyces, other spores, and total spores at two metropolitan Tulsa, Oklahoma sites (Tulsa and Hectorville) during September 1996. Results showed that both methods were sensing parallel fluctuations in average daily spore concentration, although the twelve transverse traverse method usually resulted in higher concentrations. At the Tulsa site, the twelve transverse traverse method gave statistically higher concentrations than the single longitudinal traverse method except for Epicoccum, Pithomyces, smut teliospores, and other spores. At the Hectorville site, however, only Cladosporium and basidiospores showed that the twelve transverse traverse method was statistically higher than the single longitudinal traverse method. Comparison with concentrations obtained by counting the total slide surface of two slides indicated that neither method was equivalent to the total slide spore count, although the twelve transverse traverse method gave a lower absolute percent difference from the total slide surface concentration. While the twelve transverse traverse method gave slightly better approximations of the spore concentration, the increase in accuracy may not justify the extra effort required to analyze with this method.

Effectiveness of Germicidal UV Radiation for Reducing Fungal Contamination within Air-Handling Units

ABSTRACT Levels of fungi growing on insulation within air-handling units (AHUs) in an office building and levels of airborne fungi within AHUs were measured before the use of germicidal UV light and again after 4 months of operation. The fungal levels following UV operation were significantly lower than the levels in control AHUs.

Comparison of pollen sampling with a Burkard Spore Trap and a Tauber Trap in a warm temperate climate

Aerobiological data have been widely used by many scientists, including those that study modern flora as well as those wishing to reconstruct past vegetational associations. Burkard (Hirst-type) volumetric spore traps are widely used instruments for studying airborne pollen, while Tauber traps are typically used to analyze pollen deposition. The present study compared the pollen collected by these two methods in Tulsa, Oklahoma a warm temperate area with year-round pollen. There was a strong correlation between the pollen influx from the Tauber traps and cumulative sum of average daily airborne pollen concentrations recorded with the Burkard spore trap over the course of 12 months from 1 Feb 1997 through 1 Feb 1998. The correlation coefficient between all taxa over the 12 months was 0.914; while the correlation coefficient for the monthly totals was 0.972. The data showed that both methods reflected local anemophilous vegetation although variations occurred in the prevalence recorded by both samplers.

Identification and concentration of airborne basidiospores

Abstract Although clinical investigations have shown that basidiospores are allergenic, very little information exists on the airborne concentration or identification of these spores. The atmosphere in Tulsa, Oklahoma has been monitored for the presence of basidiospores using Burkard Volumetric Spore Traps. The concentration of total basidiospores shows that they are a significant component of the Tulsa atmosphere during certain periods. Overall spores of 18 genera have been identified from the atmosphere; the morphology of these spores is described. Field studies have shown that fruiting bodies of all these genera are common within the city. In addition other basidiospores present in the atmosphere include those identifiable only to the family level as well as many morphologically indistinct hyaline basidiospores.

Correlation of environmental factors with asthma and rhinitis symptoms in Tulsa, OK

BACKGROUND Airborne allergens, pollutants, and climatic changes are known to influence the symptoms of asthma patients. OBJECTIVE To correlate airborne fungal spore and pollen concentrations, meteorological data, and airborne pollutants with asthma and rhinitis symptoms to develop predictive models for asthma severity. METHODS Patients from the Tulsa community participated in this study from September 1 to October 31, 2000, by filling out daily symptom diaries and measuring morning and evening peak expiratory flow rates. Air samples were collected using a volumetric spore trap. Meteorological variables and maximum and average pollutants were also included in the analysis. Linear regression analyses were performed for all environmental variables and symptom scores. Forward stepwise multiple regression analyses were performed to determine sets of variables that could be used to predict the conditions of increased symptom severity. RESULTS Twenty-four patients participated in this study. The predominant spore types included Cladosporium, ascospores, and basidiospores. The predominant pollen type was Ambrosia. September was unusually hot and dry in Tulsa, but 161 mm of precipitation fell in October, primarily during the last 11 days. Two periods of peak symptoms occurred during the study, the first during the peak week of Ambrosia and the second after a 22 degrees C drop in temperature over 6 days. Numerous environmental variables showed significant correlations with symptom scores; however, there was no single predictive model for all symptoms. CONCLUSIONS Ambrosia pollen and other environmental variables, including ozone levels, were significantly correlated with asthma and rhinitis symptoms.

Multi-year study of Ganoderma aerobiology

Ganoderma basidiospores are dominant members ofthe airspora in many regions of the world and areconsidered important airborne allergens. Theaerobiology of Ganoderma spores in the Tulsa,Oklahoma area was examined using Burkard VolumetricSpore Traps from 1987–1996. Ganodermaspores were present in the atmosphere on more than95% of the days from June through October with peakconcentrations generally occurring from late August tomid-October. The data showed marked interannualvariation, with seasonal totals in 1994 and 1995significantly higher than other years. Stepwisebackward multiple regression showed that cumulativeseason total was significantly related to Junetemperature and May through August precipitation(R2 = 0.97, p < 0.01).

Studies on airborne basidiospores.

SummaryBasidiomycetes are well known to produce abundant airborne spores which have been implicated in both asthma and allergic rhinitis. The atmosphere in Tulsa has been monitored with Burkard Volumetric Spore Traps to determine the concentration, seasonal occurrence, and identity of airborne basidiospores. During 1987 basidiospores were present in the atmosphere during most of the year with peaks in June and September. Spores from 18 genera were identified from the atmosphere withCoprinus andAgaricus being the most abundant spores in the spring. These genera continued to be prominent during the late summer and fall whenGanoderma spores were also abundant. Field studies conducted in conjunction with air sampling have shown that basidiomycete fruiting bodies were also most prevalent during the spring and fall.

Effect of sampling height on the concentration of airborne fungal spores

BACKGROUND Spores of many fungal species have been documented as important aeroallergens. Airborne fungal spores are commonly collected from the outdoor air at the rooftop level of high buildings; however, human exposure usually occurs nearer to the ground. It is necessary to estimate the concentration of airborne fungal spores at the human breathing level to evaluate the actual human exposure to outdoor aeroallergens. OBJECTIVE To compare the concentration of airborne fungal spores at human respiration level (1.5 m above the ground) and at roof level (12 m height). METHODS Air samples were collected using 2 Burkard volumetric 7-day recording spore traps from July 1 to October 31, 2005. One sampler was located on the roof of a building at the University of Tulsa at 12 m above ground, and the second sampler was placed in the courtyard of the building at 1.5 m. Burkard slides were analyzed for fungal spores by light microscopy at a magnification of 1,000, and the results were statistically analyzed to compare the concentration of airborne fungal spores at the 2 levels. RESULTS The ground sampler had significantly higher concentration of basidiospores, Penicillium/Aspergillus-type spores, and smut spores than the roof sampler. By contrast, the rooftop sampler registered significantly higher concentration of Alternaria, ascospores, and other spores. CONCLUSIONS Ground level had significantly higher concentration of some important fungal aeroallergens but lower concentrations of others, suggesting that sampling height is one of the many variables that influence bioaerosol levels.