Assessment of the aerosolization potential for fungal spores in moldy homes.

UNLABELLED: The airborne fungal concentration measured with air samplers during specific time intervals may not adequately represent the indoor air quality because of the sporadic nature of spore release from sources. The conventional source evaluation (e.g. swab and tape sampling) characterizes the mold source but does not relate to the fraction of spores that can be aerosolized from a contaminated material. As an alternative to these methods, we have recently developed and laboratory-tested a novel Fungal Spore Source Strength Tester (FSSST). It allows assessing the potential of aerosolization of fungal spores from contaminated surfaces under the most favorable release conditions. In this study, the FSSST was used to characterize the release of spores from four building materials in mold-problem homes. The spores of different species were efficiently aerosolized by the FSSST, exhibiting a total spore release rate ranging approximately from 10(2) to 10(3) cm2/min. For all tested materials, <2% of the spores on the contaminated surface were released during the tests. The airborne spore concentration estimated from the release rate data was found in most cases to be significantly greater than the concentration actually measured in these environments with simultaneous air sampling. The results suggest that the FSSST can be used for the assessment of maximum potential exposure to airborne spores released from identified sources in homes. PRACTICAL IMPLICATIONS: A recently developed FSSST was found to be suitable to measure the aerosolization potential of indoor fungal sources at the most favorable release conditions. The FSSST generates the data that allows assessing the strength of mold sources in homes with respect to their maximum ability to contaminate indoor air with fungi. The novel approach bridges two conventional methods, the air sampling and the direct source evaluation (e.g. swab sampling), thus providing a better representation of the airborne fungal exposure than these methods individually. The device prototype can be used for evaluating the effectiveness of environmental interventions by taking samples before and after the intervention. As a broader application, the FSSST can be utilized for assessing the release of various hazardous biological and non-biological particles from contaminated surfaces.

Prior stimulant treatment in adolescents with bipolar disorder: association with age at onset.

OBJECTIVES: To compare demographic and clinical characteristics between bipolar adolescents with and without a history of stimulant treatment, we hypothesized that adolescents treated with stimulants would have an earlier age at onset of bipolar disorder, independent of co-occurring attention-deficit-hyperactivity disorder (ADHD). METHOD: Thirty-four adolescents hospitalized with mania were assessed using the Washington University at St Louis Kiddie Schedule for Affective Disorders and Schizophrenia (WASH-U-KSADS). We systematically evaluated age at onset of bipolar disorder and pharmacological treatment history. RESULTS: Bipolar adolescents with a history of stimulant exposure prior to the onset of bipolar disorder had an earlier age at onset of bipolar disorder than those without prior stimulant exposure. Additionally, bipolar adolescents treated with at least two stimulant medications had a younger age at onset compared with those who were treated with one stimulant. There was no difference in age at onset of bipolar disorder between bipolar adolescents with and without ADHD. CONCLUSIONS: Our results suggest that stimulant treatment, independent of ADHD, is associated with younger age at onset of bipolar disorder. A behavioral sensitization model is proposed to explain our findings. There are several limitations to our study including the small sample size, the retrospective assessment of stimulant exposure and age at onset of bipolar disorder, and the inclusion of only hospitalized patients, who may be more likely to present with a severe illness. Nonetheless, future prospective longitudinal investigations that systematically assess the effects of stimulant medications in children with or at genetic risk for bipolar disorder are warranted.