Indoor environment assessment of special wards of educational hospitals for the detection of fungal contamination sources: A multi-center study (2019-2021)

Background and Purpose: The hospital environment was reported as a real habitat for different microorganisms, especially mold fungi. On the other hand, these opportunistic fungi were considered hospital-acquired mold infections in patients with weak immune status. Therefore, this multi-center study aimed to evaluate 23 hospitals in 18 provinces of Iran for fungal contamination sources.Materials and Methods: In total, 43 opened Petri plates and 213 surface samples were collected throughout different wards of 23 hospitals. All collected samples were inoculated into Sabouraud Dextrose Agar containing Chloramphenicol (SC), and the plates were then incubated at 27-30ºC for 7-14 days.Results: A total of 210 fungal colonies from equipment (162, 77.1%) and air (48,22.9%) were identified. The most predominant isolated genus was Aspergillus (47.5%),followed by Rhizopus (14.2%), Mucor (11.7%), and Cladosporium (9.2%). Aspergillus(39.5%), Cladosporium (16.6%), as well as Penicillium and Sterile hyphae (10.4% each), were the most isolates from the air samples. Moreover, intensive care units (38.5%) and operating rooms (21.9%) had the highest number of isolated fungal colonies. Out of 256 collected samples from equipment and air, 163 (63.7%) were positive for fungal growth.The rate of fungal contamination in instrument and air samples was 128/213 (60.1%) and 35/43 (81.2%), respectively. Among the isolated species of Aspergillus, A. flavus complex (38/96, 39.6%), A. niger complex (31/96, 32.3%), and A. fumigatus complex (15/96, 15.6%) were the commonest species.Conclusion: According to our findings, in addition to air, equipment and instrument should be considered among the significant sources of fungal contamination in the indoor environment of hospitals. Airborne fungi, Hospital, Indoor air, Equipment, Sources of fungal contamination in the indoor environment of hospitals

Novel Methods for Sampling, Characterization and Analysis of Airborne Street Particles in a Health Perspective

Over the last decades, there has been much attention on air quality, especially in urban environments. A significant factor effecting the air quality in the urban environment is airborne particulate matter (PM). Long-term exposure to PM causes increased risk for heart disease, decreased lung function, exacerbation of asthma, and lung cancer. Therefore, many countries have implemented exposure limits to the concentration of ambient PM in the urban environments. The toxicity of PM is dependent on several factors such as chemical composition, shape, adsorbed materials, and particle sizes (usually divided in ultrafine, fine and coarse particles). However, the relationship between different PM properties and developing health hazards are not clear. Therefore, further studies to investigate different properties of PM may contribute to understanding the influence of PM on human health.  In the present work, different novel methods to investigate sampled airborne PM and to investigate potential health effects have been used to increase the knowledge regarding street and wear particles. In study I, a sampling plan involving collecting one filter from Tapered Element Oscillating Microbalance (TEOM) monitoring stations used for Environmental monitoring each month for 20 months were developed. Particles on the filters were extracted into a suspension. TEOM particles were then studied with respect to constituents and variables that reflect their toxicity. The constituent and toxicity was found to be spatial and seasonal dependent. As a follow-up, in study II, TEOM filters from three geographical different cities were collected once a month for a year. The variation in particle mass measured with TEOM monitor, cadmium and lead contents, as well as endotoxin levels between locations and time points over the year was studied. The correlation between studied variables and biological effect was investigated. The results show that the concentration of metals and endotoxin in TEOM particles have no relationship to particle mass, while endotoxin levels coincided with pro-inflammatory response. These studies show that results from analyzing different variables on obtained particles from TEOM filters in combination with information about the ambient particle concentration, could be helpful in the evaluation of differences in the risk of breathing air at various locations.  The dominant road traffic particle sources are wear particles from the road and tyre interface, and from vehicle brake pads. The particle concentrations are highest in cities with high traffic amounts and a high frequency of braking. There are a few cell studies that have investigated the toxicological and biological effect of these wear particles, but there is a lack of knowledge regarding their effect on tissue level. Furthermore, the knowledge about importance of rock materials in pavement is deficient. To mitigate these knowledge gaps, the effect of different wear particles from pavement and brake pad were tested using a model with isolated perfused rat lungs in study III. The wear particles from the pavement showed a significant decrease of tidal volume compared to unexposed controls. The largest effect were found with quartzite stone material. Wear particles from brakes instead showed a larger effect on released proinflammatory cytokines. The study shows that the toxic effect on lungs exposed to airborne particles can be investigated using repetitive measurements of tidal volume. Furthermore, the study shows that the choice of rock material in road pavements has the potential to affect the toxicity of road wear particles. This should be considered in environments where the concentrations and exposures are high. The brake particles showed a different effect than stone particles, indicating the need to differentiate wear particles from different sources in relation to health effects. In summary, the present work have investigated different aspects of airborne particles collected from streets as well as generated wear particles. These indicate different important aspects of the particles that may be of importance to better understand their health effects.

Monthly variation in masses, metals and endotoxin content as well as pro-inflammatory response of airborne particles collected by TEOM monitors

Particle exposure has been linked to an increased incidence of cardiovascular disease. Furthermore, particle exposure has been shown to have a chronic inhibitory effect on lung development in young people and may result in increased respiratory problems in adults or children with respiratory-related diseases. In today’s urban environments, particle levels are mainly monitored gravimetrically; however, other factors such as particle size, shape and surface reactivity have recently been noted as highly important in relation to possible health outcomes. Here, particles from TEOM monitor filters placed in three different cities were studied. The purpose of the study was to investigate whether there are variations in particle masses, cadmium and lead contents, as well as endotoxin levels between locations and time points over the year and if this can be correlated to the particles ability to induce a pro-inflammatory response in vitro. Results showed that it is possible to detect variations at different locations and at different time points over the year and that cadmium, lead and endotoxin levels did not coincide with the increased total particle masses while endotoxin levels coincided with pro-inflammatory responses in vitro. The present study shows that filter analysis is a useful complement to gravimetric or particle-counting measurements in studies of particle-related health effects and will give useful information regarding future air quality measurements.Funding agencies: Linkoping University</p

Use of TEOM monitors for continuous long-term sampling of ambient particles for analysis of constituents and biological effects

Many countries have implemented exposure limits for the concentration of ambient particular matter and do therefore have to monitor their concentration. This could be performed with TEOM monitors (Tapered Element Oscillating Microbalance-monitors) that contain a filter on which particles are collected. These filters are regularly exchanged for new ones. The aim of this study was to test the feasibility of collecting used filters from monitors at different locations and establishing a method to extract particles and then study them with respect to their ability to generate oxidants, their endotoxin content, and ability to activate inflammatory cells. Filters from nine geographically spread locations in Sweden were collected during a 21-month period by local technicians who then sent them to the laboratory where they were extracted and analyzed. The procedure to let local technicians perform the filter exchange and send used TEOM filters to the laboratory worked well. A method was established in which pyrogen-free water was used to extract particles that then were aliquoted and stored for later analysis. Particulate matter (PM10) from different locations showed both a considerable seasonal and spatial-dependent difference with respect to oxidative potential (oxidize glutathione), endotoxin content, and ability to activate blood monocytes to release interleukin-1β. This study shows that, instead of discarding TEOM filters, they can be collected and extracted so that particles that have been sampled in a standardized way could be analyzed with respect to variables that reflect their toxicity. This could be done at a low cost. In combination with information about the ambient particle concentration, such information could be helpful in the evaluation of differences in the risk of breathing air at various locations

Isolation of keratinophilic fungi from the soil of islands of Greater Tunb, Abu-Musa and Sirri, Persian Gulf, Iran

Background and Purpose: Keratinophilic fungi are among the important groups of fungi living in the soil. This study aimed to isolate and identify keratinophilic fungi from the soil of three Iranian islands, namely Greater Tunb, Abu Musa, and Sirri, located in the Persian Gulf using morphological and molecular (polymerase chain reaction) methods. Materials and Methods: In this study, a total of 60 soil samples were collected from the three islands of Greater Tunb, Abu Musa, and Sirri. The samples were analyzed for the presence of the keratinophilic fungi using a hair baiting technique. Furthermore, the identification of keratinophilic fungi was accomplished through the employment of molecular and sequencing techniques. Results: A total of 130 fungal isolates, including 11 genera with 24 species, were collected. Accordingly, Chrysosporium tropicum (24;18.5%), C. keratinophilum (17; 13.1%),&nbsp; Chrysosporium&nbsp; species (15; 11.5%), Aspergillus&nbsp; species ( 8;6.1%), Aspergillus flavus (8; 6.1%), Penicillium&nbsp; species (8;6.1%), Alternaria spp ( 6; 4.6%), Phoma&nbsp; species (5;&nbsp; 3.8%), Aphanoascus verrucosus (4;3.1%), Fusarium chlamydosporum (4; 3.1%), Aspergillus trreus (4;3.1%), Acremonium&nbsp; species (4; 3.1%), and other fungi( 23; 17.8 %) isolates were identified . All isolates of keratinophilic fungi were isolated from the soils with the pH range of 7-9. Conclusion: The results of this study contributed towards a better conceptualization of the incidence pattern of keratinophilic fungi in the regions of Iran. Given that no study has investigated this issue, the findings of the present study can be beneficial for the management of public health surveillance, physicians, and epidemiologists.&nbsp;&nbsp

Exposure of metals and PAH through local foods and risk of cancer in a historically contaminated glasswork area

Background Production of crystal glass and colored art glassware have been going on in the south-eastern part of Sweden since the 1700s, at over 100 glassworks and smaller glass blowing facilities, resulting in environmental contamination with mainly arsenic (As), cadmium (Cd), lead (Pb) and polycyclic hydrocarbons (PAH). High levels of metals have been found in soil, and moderately elevated levels in vegetables, mushrooms and berries collected around the glassworks sites compared with reference areas. Food in general, is the major exposure source to metals, such as Cd and Pb, and PAHs. Exposure to these toxic metals and PAH has been associated with a variety of adverse health effects in humans including cancer. Objective The aim of the present study was to evaluate the occurrence of cancer in a cohort from the contaminated glasswork area in relation to long-term dietary intake of locally produced foods, while taking into account residential, occupational and life styles factors. Methods The study population was extracted from a population cohort of 34,266 individuals who, at some time between the years 1979–2004, lived within a 2 km radius of a glassworks or glass landfill. Register information on cancer incidence and questionnaire information on consumption of local foods (reflecting 30 years general eating habits), life-time residence in the area, life style factors and occupational exposure was collected. Furthermore, blood (n = 660) and urine (n = 400) samples were collected in a subsample of the population to explore associations between local food consumption frequencies, biomarker concentrations in blood (Cd, Pb, As) and urine (PAH metabolite 1-OHPy) as well as environmental and lifestyle factors. The concurrent exposure to persistent organic pollutants (POPs) from food was also considered. A case-control study was performed for evaluation of associations between intakes of local food and risk of cancer. Results Despite high environmental levels of Cd, Pb and As at glasswork sites and landfills, current metal exposure in the population living in the surrounding areas was similar or only moderately higher in our study population compared to the general population. Reported high consumption of certain local foods was associated with higher Cd and Pb, but not As, concentrations in blood, and 1-OHPy in urine. An increased risk of cancer was associated with smoking, family history of cancer, obesity, and residence in glasswork area before age 5 years. Also, a long-term high consumption of local foods (reflecting 30 years general eating habits), i.e. fish and meat (game, chicken, lamb), was associated with increased risk of various cancer forms. Conclusions The associations between consumption of local food and different types of cancer may reflect a higher contaminant exposure in the past, and thus, if consumption of local food contributes to the risk of acquiring cancer, that contribution is probably lower today than before. Furthermore, it cannot be ruled out that other contaminants in the food contribute to the increased cancer risks observed.Funding agencies: Swedish Environmental Protection Agency; Medical Research Council of Southeast Sweden; Kamprad Family Foundation, Sweden; Occupational and Environmental Medicine, Linkoping University Hospital, Sweden</p