Luke Curtis

Indoor air quality in a middle school, Part II: Development of emission factors for particulate matter and bioaerosols.

A middle school (grades 6 to 8) in a residential section of Springfield, Illinois, with no known air quality problems, was selected for a baseline indoor air quality survey. The study was designed to measure and evaluate air quality at the middle school with the objective of providing a benchmark for comparisons with measurements in schools with potential air quality problems. The focus of this article is on the development of emission factors for particulate matter and bioaerosols. The school was characterized as having no health complaints and good maintenance schedules. Four indoor locations including the cafeteria, a science classroom, an art classroom, the lobby outside the main office, and one outdoor location were sampled for various environmental comfort and pollutant parameters for one week in February 1997. Integrated samples (eight-hour sampling time) for respirable and total particulate matter, and short-term measurements (two-minute samples, three times per day) for bioaerosols were collected on three consecutive days at each of the sampling sites. Continuous measurements of carbon dioxide were logged at all locations for five days. Continuous measurements of respirable particulate matter were also collected in the lobby area. A linear relationship between occupancy and corresponding carbon dioxide and particle concentrations was seen. A completely mixed space, one compartment mass balance model with estimated CO2 generation rates and actual CO2 and particulate matter concentrations was used to model ventilation and pollutant emission rates. Emission factors for occupancy were represented by the slope of emission rate versus occupancy scatter plots. The following particle and bioaerosol emission factors were derived from the indoor measurements: total particles: 1.28 mg/hr/person-hr; respirable particles: 0.154 g/hr/person-hr; total fungi: 167 CFU/hr/person-min; thermophilic fungi: 35.8 CFU/hr/person-min; mesophilic fungi: 119 CFU/hr/person-min; total bacteria: 227 CFU/hr/person-min; gram-negative bacteria: 69.5 CFU/hr/person-min; gram-positive bacteria: 191 CFU/hr/person-min; Aspergillus: 17.0 CFU/hr/person-min; Penicillium: 161 CFU/hr/person-min; and yeasts: 16.4 CFU/hr/person-min.

Environmental Allergens and Asthma Morbidity in Low-Income Children

Asthma morbidity is high in inner-city children in the United States, which may be related in part to increased allergens in poorly maintained housing. This study examined asthma morbidity in relation to mold, cockroach, dust mite, and cat allergens in the homes of 61 low-income Chicago children with asthma. Children exposed to higher levels of Penicillium in the bedroom had more frequent asthma symptoms, whereas those exposed to higher levels of cockroach allergen in the bedroom had a higher number of asthma symptoms. Respiratory infections confounded the association of cockroach allergen with number of asthma symptoms.

Adverse Health Effects of Indoor Moulds

Purpose: It has long been known that eating moldy food is hazardous, and airborne Aspergillus and other fungi can cause life‐threatening illnesses in immunocompromised patients. However, the possible health risks of indoor mold exposure in immunocompetent humans are controversial. This literature review examines the health effects of indoor airborne exposure to mold.Design: Literature review.Materials and Methods: This review was conducted by searching PubMed and other medical databases, as well as reading recent conference reports.Results: Many studies link exposure to damp or moldy indoor conditions to increased incidence and/or severity of respiratory problems such as asthma, wheezing and rhinosinusitis. Stachybotrys produces trichothecenes and other mycotoxins, which can inhibit protein synthesis and induce hemorrhaging disorders. Indoor mold exposure can alter immunological factors and produce allergic reactions. Several studies have indicated that indoor mold exposure can alter brain blood flow, aut...

Effect of ozone and aeroallergens on the respiratory health of asthmatics.

Abstract The effect of ambient air pollutants, pollens, and mold spores on respiratory health was studied in an area with low concentrations of chemical pollutants and abundant aeroallergens. A panel of 40 asthmatic subjects living near East Moline, Illinois, recorded peak expiratory flow rates (PEFRs), respiratory symptoms, frequency of asthma attacks, and asthma medication use between April and October 1994. Daily outdoor concentrations of pollutants and aeroallergens were measured, and indoor levels of bioaerosols were measured on several occasions in each participants home. Ozone was associated with increased morning and evening symptom scores and decreased evening PEFR, and these associations remained significant with adjustment for weather and aeroallergens. The association between ozone and asthma medication use was increased in magnitude and significance with adjustment for weather and aeroallergens; however, the association between ozone and morning PEFR became nonsignificant with weather and aeroallergen adjustment. Significant associations were also found between pollen concentration and decreased evening PEFR, as well as between increased morning and evening symptom scores and asthma medication use. In addition, associations were noted between total spore concentration and increased morning PEFR and decreased morning and evening symptom scores. The inverse associations found with mold spore concentrations were not consistent with the results of other studies; however, the associations between ozone and pollen concentration were consistent with previous studies. When results were stratified by a number of independent risk factors, no differences were noted relative to allergic status or presence of dampness or flooding in the home; however, the associations with outdoor ozone and pollens were seen mainly among participants with low levels of exposure to indoor bioaerosols (< 1,800 spores/m3) or with no environmental tobacco smoke exposure.

Bioaerosol Concentrations in the Quad Cities 1 Year after the 1993 Mississippi River Floods

Bioaerosol measurements were made in 45 Quad Cities, Illinois houses following the 1993 floods of the Mississip pi and Rock Rivers. Least squares log transformed means for fungal concentrations (in cfu m-3) were 1,449 in basements, 1,174 in living rooms, 1,234 in kitchens, 1,464 in first floor bedrooms, 1,197 in second floor bedrooms, and 2,590 outside. Mean least squares log transformed bacterial concentrations were 887 cfu m-3 in basements, 878 cfu m-3 in living rooms and 697 cfu m-3 outdoors. Levels of fungi and bacteria were not notably elevated in the basements or other rooms of the formerly flooded houses. Levels of fungi and bacteria indoors were significantly less in houses with dehumidifiers and in homes with natural gas odors. Air-conditioning during warm periods significantly reduced airborne concentra tions of fungi.

Fungal exposure endocrinopathy in sinusitis with growth hormone deficiency: Dennis-Robertson syndrome:

A retrospective study was carried out on 79 patients with a history of mold exposure, fatigue, and chronic rhinosinusitis (CRS) to determine whether there is a causal relationship between fungal exposure and chronic sinusitis, fatigue, and anterior hypopituitarism, especially growth hormone deficiency (GHD). Of the patients, 94% had a history of CRS, endoscopically and/or computed tomography (CT) confirmed; 100% had chronic fatigue and 100% had either significant history of indoor mold exposure and/or positive mold plate testing as measured by settle plates, with an average colony count of 21 (0-4 normal). A total of 62 had positive mold plate testing and 17 had positive history of mold exposure. Of 75, 73 (97.3%) had positive serum immunoglobulin G (IgG)-specific antibodies to fungal antigens. Out of 8, 7 were positive for urinary trichothecenes. Resting levels of insulin-like growth factor 1 (IGF-1) averaged 123 ng/mL (range 43-285, normal 88-249 ng/mL). Despite normal resting levels of IGF-1, significant deficiency of serum human growth hormone (GH) was confirmed by insulin tolerance test (ITT) in 40 of 50 tested. In all, 51% (40/79) were GH deficient. Primary or secondary hypothyroidism in T3 and/or T4 was seen in 81% (64/79) patients; 75% (59/79) had adrenocorticotrophic hormone (ACTH) deficiency. Fungal exposure endocrinopathy likely represents the major cause of GHD, affecting approximately 4.8 million people compared to approximately known 60,000 cases from all other causes. A literature review indicates a possible mechanism of GHD in fungal exposure is that the fungal glucan receptors in the lenticulostellate cells of the anterior pituitary bind to fungal cells wall glucans and activate the innate immune system, which activates macrophages that destroy the fungus and lenticulostellate tissue. Treatment of patients included normal saline nasal irrigations, antifungal and antibiotic nasal sprays, appropriate use of oral antibiotics and antifungals, facial steamer with CitriDrops. Thymate and/or Intramax vitamin supplements, hormone replacement, and reduction of indoor mold levels. Resolution of rhinosinusitis was seen in 93% (41 of 45) of the patients who achieved a mold count by settling plates of 0-4 colonies. Thirty patients were unable to lower their mold counts below four colonies and had various degrees of mucosal disease and fatigue remaining. Fatigue was improved in all 37 patients who received GH and cortisol and/or thyroid hormone, which were deficient. Fatigue was partially relieved in 7 of the 37 who did not achieve mold counts of fewer than four colonies.

Dust‐mite‐allergen concentrations in asthmatics' bedrooms in the Quad Cities (Illinois, USA) after the Mississippi River floods of 1993

This study aimed to measure allergens from Dermatophagoides farinae and D. pteronyssinus and to examine possible relationships of these mite allergens with flooding and other housing factors. A total of 313 dust samples were collected from the bedrooms of 57 asthmatics in 45 homes in the Quad Cities (Illinois, USA) and analyzed by ELISA for the presence of the D. farinae and D. pteronyssinus allergens. Twenty of these homes had some flooding in the last 12 months due to the Mississippi River floods of 1993 and/or other factors. The log‐transformed least‐squares means of allergens collected were 28 ng/m2 for the D. farinae allergen and 26 ng/m2 for the D. pteronyssinus allergen. D. farinae allergen levels were significantly higher in homes located in the valley, in homes during the summer months, in homes with furred or feathered pets, in homes which had not been flooded in the last year, and in homes where rugs had been steam‐cleaned in the last 12 months. D. pteronyssinus allergen levels were significantly higher in homes located in the valley, in homes during April and July‐September, in homes with furred or feathered pets, and in homes with no dehumidifier.

Asthma Morbidity in Adult Chicago Public Housing Residents

Background. Residents of public housing can experience socioeconomic disadvantages, inadequate access to health care, and particularly substandard indoor air quality due to inadequate building maintenance. Objective. This study investigates demographic, medical management, severity, and household factors associated with asthma-related emergency department visits and hospitalizations. Methods. A total of 103 adult participants with asthma from four Chicago housing developments completed surveys and underwent household inspections. Results. Using stepwise multivariate logistic regression, we identified independent predictors of asthma-related emergency department visits: asthma controller medication use, not keeping an asthma-related doctors appointment, and frequent nocturnal wheeze episodes. Using stepwise multivariate logistic regression, we identified independent predictors of asthma-related hospitalizations: peeling paint, plaster, or wallpaper, environmental tobacco smoke, written action plan for an asthma-related doctor or emergency department visit, and frequent nocturnal wheeze episodes. Conclusions. In multivariate models, factors related to clinical severity and asthma management were related to both emergency department visits and hospitalizations while household conditions were related only to hospitalizations. Interventions to address both asthma management and household environmental triggers may be needed to reduce asthma morbidity in low-income populations.

Bundling or multiple interventions needed to control nosocomial infections

benefits of using it are that it prevents ‘‘spotting’’ on glassware (caused by droplets of water drying and leaving behind dissolved limescale minerals), and can also improve drying performance as there is less water remaining to be dried [1]. A 21-year-old man who is a soldier come to our burn unit. Some rinse aid was poured out to his foot while he was working in the dishwashing unit. While he was working he sweat, sometimes his foot wet and thereafter feeled burning on his foot. At the evening he noticed the wounds on his left foot. There were multiple wounds on his left foot (Fig. 1). Two of them were full thickness necrotic areas, one of them was 1.5 cm 3 cm and the other 1 cm 4 cm diameters. We thought that rinse aid molecules combined with the patient’s sweat or water and a chemical reaction occurred and caused skin burns. Cutaneous chemical burns represent a small, but significant, proportion of burns with reported incidences of up to 10.7%. Such burns are commonly small in size, and the most common burn areas are the face and limbs [2]. Chemical burns occurring in an industrial setting, have dropped, whilst the number of domestic chemical burns has increased by over three times [3]. To the best of our knowledge, this type of burn injury has not been reported. Prevention of such injuries is, most important and in order to draw attention to a possible injury, warnings indicating injury mechanism should be placed on the package of the rinse aids. We hope this report would be beneficial in terms of protecting the people from unexpected injuries.

Neural autoantibodies in patients with neurological symptoms and histories of chemical/mold exposures

A number of studies have linked exposures to industrial and household chemicals and biological toxins to increased risk of autoimmunity in general and elevated levels of autoantibodies to neural antigens specifically. Elevated neural autoantibodies are biomarkers for many diseases such as multiple sclerosis and Parkinson’s disease. Our study reports levels of six types of neural autoantibodies in a group of 24 toxicant-exposed patients. The patients were exposed to a variety of toxicants including contaminated drinking water (four patients), building water/mold damage (eight patients), pesticides (four patients), and other assorted toxic chemicals (eight patients). Levels of all six neural autoantibodies were significantly elevated in most patients and in the patient group at large, with mean antibody levels for the 24 chemically exposed patients (relative to a healthy control population), in descending order: 475% for tau proteins, 391% for microtubule associated proteins-2, 334% for neurofilament proteins (NFP), 302% for myelin basic protein, 299% for glial fibrillary acidic proteins, and 225% for tubulin. Tau protein autoantibodies were significantly elevated in the patient groups with peripheral neuropathy, muscle and joint pain, asthma, and chemical sensitivity. Autoantibodies to tubulin were significantly higher in the chemical sensitivity and asthma patients, autoantibodies to NFP were significantly higher in the patients with sleep apnea, whereas S-100B autoantibodies were significantly increased in patients with muscle/joint pain, asthma, and apnea/insomnia. In patients exposed to environmental toxicants, measurements of autoantibodies may be useful for prevention, diagnosis, and treatment. This study adds to the scientific literature the ability of a broad spectrum of environmental triggers adversely affecting the nervous system through the process of autoimmunity, which may explain the increasing incidence of neurodegenerative diseases.