Interprofessional Field Experiences in Occupational Safety and Health.

Field trips are beneficial to students, because they provide experiences outside of the traditional classroom. Incorporating field trips into graduate programs can increase students' exposures to real world experiences so that they can incorporate that knowledge as they complete their program. The purpose of the project was to collect and analyze graduate student feedback on 13 in-person interprofessional field trips focused on occupational safety and health. Data were collected through post-field trip structured discussions. Content analysis was used to determine themes. Five themes emerged from the data: Personal Value, Networking and Meeting, Health and Safety Planning and Policy, Environment, and Logistics and Planning. Field trips are valuable learning experiences for graduate students. The field trips in this study offered concrete experiences in occupational safety and health. Post-field trip, students provided feedback through structured discussions, which allowed for reflective observation. Overall, students found personal value in the field trips, observed health and safety procedures and policies in action, learned about various work environments, and provided input on the logistics and planning of field trips.

Assessment of indoor bioaerosol exposure using direct-reading versus traditional methods-potential application to home health care.

Home healthcare workers (HHCWs) can be occupationally exposed to bioaerosols in their clients' homes. However, choosing the appropriate method to measure bioaerosol exposures remains a challenge. Therefore, a systematic comparison of existing measurement approaches is essential. Bioaerosol measurements with a real-time, fluorescence-based Wideband Integrated Bioaerosol Sensor (WIBS) were compared to measurements with four traditional off-line methods (TOLMs). The TOLMS included optical microscopic counting of spore trap samples, microbial cultivation of impactor samples, qPCR, and next-generation sequencing (NGS) of filter samples. Measurements were conducted in an occupied apartment simulating the environments that HHCWs could encounter in their patients' homes. Descriptive statistics and Spearman's correlation test were computed to compare the real-time measurement with those of each TOLM. The results showed that the geometric mean number concentrations of the total fluorescent aerosol particles (TFAPs) detected with the WIBS were several orders of magnitude higher than those of total fungi or bacteria measured with the TOLMs. Among the TOLMs, concentrations obtained with qPCR and NGS were the closest to the WIBS detections. Correlations between the results obtained with the WIBS and TOLMs were not consistent. No correlation was found between the concentrations of fungi detected using microscopic counting and any of the WIBS fluorescent aerosol particle (FAP) types, either indoors or outdoors. In contrast, the total concentrations detected with microbial cultivation correlated with the WIBS TFAP results, both indoors and outdoors. Outdoors, the total concentration of culturable bacteria correlated with FAP-type AC. In addition, fungal and bacterial concentrations obtained with qPCR correlated with FAP types AB and AC. For a continuous, high-time resolution but broad scope, the real-time WIBS could be considered, whereas a TOLM would be the best choice for specific and more accurate microbial characterization. HHCWs' activities tend to re-aerosolize bioaerosols causing wide temporal variation in bioparticle concentrations. Thus, the advantage of using the real-time instrument is to capture those variations. This study lays a foundation for future exposure assessment studies targeting HHCWs.

Ciprofloxacin- and azithromycin-resistant bacteria in a wastewater treatment plant.

The occurrence of antibiotic-resistant bacteria (ARB) in wastewater treatment plants (WWTPs) has become an occupational and environmental concern. WWTPs are engineered systems that treat wastewater to meet public health standards before release into the environment. The residuals, as either effluent or solids, are then discharged or beneficially recycled into the environment. Since these wastes contain a diverse array of microorganisms, some of which are resistant to commonly used antibiotics, there is a potential for these organisms to spread in the environment via residual recycling and effluent discharge. Human infections with ARB are increasing, and it is not well known how the interaction between humans and the environment plays a role in this process. WWTP workers, who are on the front lines, may come into direct contact with materials containing these microbes. This study aimed to determine the number of ARB present in both air and sewage sludges in a WWTP using nonselective media supplemented with two antibiotics (ciprofloxacin and azithromycin). The densities of total heterotrophic bacteria, ciprofloxacin-resistant bacteria, and azithromycin-resistant bacteria were 7.82 × 105 - 4.7 × 109, 7.87 × 103 - 1.05 × 108, and 2.27 × 105 - 1.16 × 109 CFU/g, respectively. The prevalence [(concentration on medium with antibiotics/concentration on medium without antibiotics) × 100] of ciprofloxacin-resistant bacteria in treated sludge was twice as low as in digested sludge and approximately three times lower than in raw sludge. For azithromycin, the prevalence of resistant bacteria in treated sludge was about the same in digested and nearly twice lower than in raw sludge. Despite a marked reduction in the mean prevalence of resistant bacteria in dewatered treated sludge for both antibiotics, these differences were not significant. The highest prevalence of antibiotic resistance was observed for azithromycin. Similarly, the prevalence of airborne azithromycin-resistant bacteria inside the belt filter press room (BFPR) was nearly seven times higher than the prevalence of airborne ciprofloxacin-resistant bacteria. These concentrations of ARB were not negligible and may represent an exposure pathway for some workers in WWTPs.

Pesticide exposure and asthma morbidity in children residing in urban, multi-family housing.

BACKGROUND: Children are potentially more susceptible to the adverse effects of pesticides due to more sensitive organ systems and lower capacity to metabolize and eliminate chemicals compared to adults. The health risks are particularly concerning children with asthma, living in low-income neighborhoods in multi-family housing because of their impaired respiratory health, and factors associated with low-income, multi-family environments. OBJECTIVE: To assess the association between pesticide exposure and asthma morbidity among children 7-12 years residing in low-income, multi-family housing. METHODS: The concentrations of seven urinary pesticide biomarkers: 3,5,6-trichloro-2-pyridinol (TCPy), 2-isopropyl-4-methyl-6-hydroxypyrimidine, para-nitrophenol (PNP), 3-phenoxybenzoic acid (3-PBA), 4-fluoro-3-phenoxybenzoic acid, trans-3-(2,2-dichlorovinyl)-2,2-dimethyl-cyclopropane-1-carboxylic acid, and 2,4-dichlorophenoxyacetic acid (2,4-D) were measured. Children (n = 162) were followed for one year with three measures of pesticides biomarkers. Associations between individual biomarkers and asthma attack, asthma related health care utilization, and fraction of exhaled nitric oxide (FeNO), adjusting for demographic and household factors were examined with Generalized Estimating Equations (GEE). Weighted Quantile Sum (WQS) regression was used to examine the effect of pesticide mixture on asthma attacks and asthma-related health care utilization (HCU). RESULTS: In adjusted GEE models, positive non-significant associations were found between PNP and HCU (adjusted Odds Ratio(aOR):2.05 95% CI:0.76-5.52) and null associations for 3-PBA and HCU (aOR:1.07 95% CI: 0.88-1.29). Higher concentrations of PNP and 2,4-D were associated with significantly lower FeNO levels (PNP: -17.4%; 2,4-D:-19.74%). The mixture was positively associated with HCU in unadjusted (OR: 1.56 97.5% CI: 1.08-2.27) but not significant in adjusted models (aOR: 1.40 97.5% CI: .86-2.29). The non-specific pyrethroid biomarker 3-PBA at baseline contributed the greatest weight to the index (45%). SIGNIFICANCE: There were non-significant associations between pesticide biomarkers and respiratory outcomes in children with asthma. There was a suggestive association between urinary pesticide biomarkers and HCU. Further studies with larger sample sizes could help to confirm these findings. IMPACT STATEMENT: Pesticide exposure among children in the urban environment is ubiquitous and there is a dearth of information on the impact of low-level chronic exposure in vulnerable populations. This study suggested that pesticide exposure at concentrations below the national average may not affect asthma morbidity in children. However, different biomarkers of pesticides showed different effects, but the mixture suggested increasing pesticide exposure results in asthma related HCU. The results may show that children with asthma may be at risk for negative health outcomes due to pesticides and the need to further examine this relationship.

Assessing residential indoor and outdoor bioaerosol characteristics using the ultraviolet light-induced fluorescence-based wideband integrated bioaerosol sensor.

We assessed and compared indoor and outdoor residential aerosol particles in a third-floor apartment from August through September 2020. The measurements were conducted using a direct-reading ultraviolet light-induced fluorescence (UV-LIF) wideband integrated bioaerosol spectrometer (WIBS). It measures individual particle light scattering and fluorescence from which particle properties can be derived. The number concentrations of total aerosol particles (TAP) and total fluorescent aerosol particles (TFAP) were significantly higher indoors. Daily and hourly TFAP mean concentrations followed the same trends as the TAP, both indoors and outdoors. The daily mean rank of the TFAP fraction (TFAP/TAP) was significantly higher indoors (23%) than outdoors (19%). Particles representing bacteria dominated indoors while particles representing fungi and pollen dominated outdoors. The mean volume-weighted median diameters for TFAP were 1.67 µm indoors and 2.09 µm outdoors. Higher TFAP fraction indoors was likely due to occupants' activities that generated or resuspended particles. This study contributes to understanding the characteristics of residential aerosol particles in situations when occupants spend most of their time indoors. Based on our findings, a large portion of all indoor aerosol particles could be biological (15-20%) and of respirable particle size (≥95%). Using a novel direct reading UV-LIF-based sensor can help quickly assess aerosol exposures relevant to human health.

Mental and Physical Stress Responses to Personal Ultrafine Particle Exposure in Adolescents.

Incidence rates of mental health disorders among adolescents is increasing, indicating a strong need for effective prevention efforts at a population level. The etiology of mental health disorders includes genetic, social, and environmental factors. Ultrafine particles (UFPs; particles less than 0.1 µm in diameter) have been shown to exert neurotoxic effects on the brain; however, epidemiologic evidence on the relationship between UFPs and childhood mental health outcomes is unclear. The objective of this study was to determine if exposure to UFPs was associated with symptoms of mental health in adolescents. Adolescents completed personal UFP monitoring for one week as well as a series of validated Patient-Reported Outcomes Measurement Information System (PROMIS) assessments to measure five domains of mental and physical stress symptoms. Multivariable linear regression models were used to estimate the association between PROMIS domain T-scores and median weekly personal UFP exposure with the inclusion of interactions to explore sex differences. We observed that median weekly UFP exposure was significantly associated with physical stress symptoms (ß: 5.92 per 10-fold increase in UFPs, 95% CI [0.72, 11.13]) but no other measured domains. Further, we did not find effect modification by sex on any of the PROMIS outcomes. The results of this study indicate UFPs are associated with physical symptoms of stress response among adolescents, potentially contributing to mental health disorders in this population.

Impact of Personal, Subhourly Exposure to Ultrafine Particles on Respiratory Health in Adolescents with Asthma.

Rationale: Ultrafine particle (UFP; particles <0.1 µm in diameter) concentrations exhibit high spatiotemporal variability; thus, individual-level exposures and health risks are difficult to estimate. Objectives: To determine the effects of recent UFP exposures on respiratory health outcomes in children and to determine if children with asthma are at increased risk. Methods: Personal sampling of UFPs was completed by adolescents in combination with repeated personal spirometry measurements and ecological momentary assessment of respiratory symptoms (wheeze, cough, and/or shortness of breath). We assessed the association between UFP exposures every 30 minutes up to 150 minutes before measuring forced expiratory volume in 1 second (FEV1), peak expiratory flow, and respiratory symptoms using mixed-effects models and interaction with asthma diagnosis. Results: Participants (N = 105; 43% with asthma) completed an average of 11 spirometry measurements and 16 symptom responses throughout sampling. After adjustments (maternal education, physical activity, season, and distance to nearest roadway), a 10-fold increase in UFP exposure was significantly associated with a 0.04-L decrease (95% confidence interval [CI], -0.07 to -0.001) in FEV1 90 minutes later. Asthma status modified this association in which participants with asthma had significantly lower FEV1 values in response to UFP exposures 30 minutes earlier than participants without asthma. We found a significant increase in the odds of reporting a respiratory symptom 30 minutes after increased UFP exposure (odds ratio, 1.8; 95% CI, 1.00 to 3.00). Conclusions: Greater UFP exposure conferred deleterious effects on lung function and respiratory symptoms within 90 minutes of exposure and was more pronounced among participants with asthma.

Direct-Read Fluorescence-Based Measurements of Bioaerosol Exposure in Home Healthcare.

Home healthcare workers (HHCWs) are subjected to variable working environments which increase their risk of being exposed to numerous occupational hazards. One of the potential occupational hazards within the industry includes exposure to bioaerosols. This study aimed to characterize concentrations of three types of bioaerosols utilizing a novel fluorescence-based direct-reading instrument during seven activities that HHCWs typically encounter in patients' homes. Bioaerosols were measured in an indoor residence throughout all seasons in Cincinnati, OH, USA. A fluorescence-based direct-reading instrument (InstaScope, DetectionTek, Boulder, CO, USA) was utilized for all data collection. Total particle counts and concentrations for each particle type, including fluorescent and non-fluorescent particles, were utilized to form the response variable, a normalized concentration calculated as a ratio of concentration during activity to the background concentration. Walking experiments produced a median concentration ratio of 52.45 and 2.77 for pollen and fungi, respectively. Fungi and bacteria produced the highest and lowest median concentration ratios of 17.81 and 1.90 for showering, respectively. Lastly, our current study showed that sleeping activity did not increase bioaerosol concentrations. We further conclude that utilizing direct-reading methods may save time and effort in bioaerosol-exposure assessment.

Residential bacteria and fungi identified by high-throughput sequencing and childhood respiratory health.

The objective of this study was to examine and compare environmental microbiota from dust and children's respiratory health outcomes at ages seven and twelve. At age seven, in-home visits were conducted for children enrolled in the Cincinnati Childhood Allergy and Air Pollution Study (CCAAPS). Floor dust was collected and analyzed for bacterial (16 S rRNA gene) and fungal (internal transcribed spacer region) microbiota. Respiratory outcomes, including physician-diagnosed asthma, wheeze, rhinitis, and aeroallergen sensitivity were assessed by physical examination and caregiver-report at ages seven and twelve. The associations between dust microbiota and respiratory outcomes were evaluated using Permanova, DESeq, and weighted quantile sum (WQS) regression models. Four types of WQS regression models were run to identify mixtures of fungi or bacteria that were associated with the absence or presence of health outcomes. For alpha or beta diversity of fungi and bacteria, no significant associations were found with respiratory health outcomes. DESeq identified specific bacterial and fungal indicator taxa that were higher or lower with the presence of different health outcomes. Most individual indicator fungal species were lower with asthma and wheeze and higher with aeroallergen positivity and rhinitis, whereas bacterial data was less consistent. WQS regression models demonstrated that a combination of species might influence health outcomes. Several heavily weighted species had a strong influence on the models, and therefore, created a microbial community that was associated with the absence or presence of asthma, wheeze, rhinitis, and aeroallergen+. Weights for specific species within WQS regression models supported indicator taxa findings. Health outcomes might be more influenced by the composition of a complex mixture of bacterial and fungal species in the indoor environment than by the absence or presence of individual species. This study demonstrates that WQS is a useful tool in evaluating mixtures in relation to potential health effects.

Personal exposure to average weekly ultrafine particles, lung function, and respiratory symptoms in asthmatic and non-asthmatic adolescents.

An increasing amount of evidence suggests ultrafine particles (UFPs) are linked to adverse health effects, especially in those with chronic conditions such as asthma, due to their small size and physicochemical characteristics. Toxicological and experimental studies have demonstrated these properties, and the mechanisms by which they deposit and translocate in the body result in increased toxicity in comparison to other air pollutants. However, current epidemiological literature is limited due to exposure misclassification and thus identifying health outcomes associated with UFPs. The objective of this study was to investigate the association between weekly personal UFP exposure with lung function and respiratory symptoms in 117 asthmatic and non-asthmatic adolescents between 13 and 17 years of age in the Cincinnati area. Between 2017 and 2019, participants collected weekly UFP concentrations by sampling for 3 h a day in their home, school, and during transit. In addition, pulmonary function was evaluated at the end of the sampling week, and respiratory symptoms were logged on a mobile phone application. Multivariable linear regression and zero-inflated Poisson (ZIP) models were used to estimate the association between personal UFP and respiratory outcomes. The average median weekly UFP exposure of all participants was 4340 particles/cm3 (p/cc). Results of fully adjusted regression models revealed a negative association between UFPs and percent predicted forced expiratory volume/forced vital capacity ratio (%FEV1/FVC) (ß:-0.03, 95% CI [-0.07, 0.02]). Prediction models estimated an association between UFPs and respiratory symptoms, which was greater in asthmatics compared to non-asthmatics. Our results indicate an interaction between asthma status and the likelihood of experiencing respiratory symptoms when exposed to UFPs, indicating an exacerbation of this chronic condition. More research is needed to determine the magnitude of the role UFPs play on respiratory health.

Exposure to traffic-related air pollution and bacterial diversity in the lower respiratory tract of children.

BACKGROUND: Exposure to particulate matter has been shown to increase the adhesion of bacteria to human airway epithelial cells. However, the impact of traffic-related air pollution (TRAP) on the respiratory microbiome is unknown. METHODS: Forty children were recruited through the Cincinnati Childhood Allergy and Air Pollution Study, a longitudinal cohort followed from birth through early adolescence. Saliva and induced sputum were collected at age 14 years. Exposure to TRAP was characterized from birth through the time of sample collection using a previously validated land-use regression model. Sequencing of the bacterial 16S and ITS fungal rRNA genes was performed on sputum and saliva samples. The relative abundance of bacterial taxa and diversity indices were compared in children with exposure to high and low TRAP. We also used multiple linear regression to assess the effect of TRAP exposure, gender, asthma status, and socioeconomic status on the alpha diversity of bacteria in sputum. RESULTS: We observed higher bacterial alpha diversity indices in sputum than in saliva. The diversity indices for bacteria were greater in the high TRAP exposure group than the low exposure group. These differences remained after adjusting for asthma status, gender, and mother's education. No differences were observed in the fungal microbiome between TRAP exposure groups. CONCLUSION: Our findings indicate that exposure to TRAP in early childhood and adolescence may be associated with greater bacterial diversity in the lower respiratory tract. Asthma status does not appear to confound the observed differences in diversity. These results demonstrate that there may be a TRAP-exposure related change in the lower respiratory microbiota that is independent of asthma status.

AERMOD modeling of ambient manganese for residents living near a ferromanganese refinery in Marietta, OH, USA.

Elevated exposure to ambient manganese (Mn) is associated with adverse health outcomes. In Marietta, Ohio, the primary source of ambient Mn exposure is from the longest operating ferromanganese refinery in North America. In this study, the US EPA air dispersion model, AERMOD, was used to estimate ambient air Mn levels near the refinery for the years 2008-2013. Modeled air Mn concentrations for 2009-2010 were compared to concentrations obtained from a stationary air sampler. Census block population data were used to estimate population sizes exposed to an annual average air Mn > 50 ng/m3, the US EPA guideline for chronic exposure, for each year. Associations between modeled air Mn, measured soil Mn, and measured indoor dust Mn in the modeled area were also examined. Median modeled air Mn concentrations ranged from 6.3 to 43 ng/m3 across the years. From 12,000-56,000 individuals, including over 2000 children aged 0-14 years, were exposed to respirable annual average ambient air Mn levels exceeding 50 ng/m3 in five of the six years. For 2009-2010, the median modeled air Mn concentration at the stationary site was 20 ng/m3, compared to 18 ng/m3 measured with the stationary air sampler. All model performance measures for monthly modeled concentrations compared to measured concentrations were within acceptable limits. The study shows that AERMOD modeling of ambient air Mn is a viable method for estimating exposure from refinery emissions and that the Marietta area population was at times exposed to Mn levels that exceeded US EPA guidelines.

Homemade facemasks: particle filtration, breathability, fit, and other performance characteristics.

Homemade cloth masks and other improvised face coverings have become widespread during the COVID-19 pandemic driven by severe shortages of personal protective equipment. In this study, various alternative (mostly common household) materials, which have not traditionally been used in respiratory protective devices, were tested for particle filtration performance and breathability. Most of these materials were found of some-but rather limited-utility in facemasks. At a breathing flow rate of 30 L min-1, 17 out of 19 tested materials demonstrated collection efficiency below 50%; at 85 L min-1, only one material featured particle collection efficiency above 50%. Pressure drop values were mostly below 4 mm w.g. (observed in 89% of cases for the two flow rates), which provides comfortable breathing. Only for one fabric material (silk) tested at 85 L min-1 did the pressure drop reach 11 mm w.g. Based on these results, a three-layer facemask prototype was designed and fabricated comprised of the best performing materials. Additional tests were conducted to examine possible particle detachment/shedding from the materials used in the newly developed facemask, but no such phenomenon was observed. The prototype was evaluated on 10 human subjects using the standard OSHA-approved quantitative fit testing protocol. The mask protection level, determined as an adopted fit factor, was found to lie between that of the two commercial surgical/medical masks tested for comparison. A 10-cycle washing of the mask prototype lowered its collection efficiency across the particle size range; however, washing did not substantially affect mask breathability. The study revealed that although homemade masks offer a certain level of protection to a wearer, one should not expect them to provide the same respiratory protection as high-end commercial surgical/medical masks or-by any means-NIOSH-certified N95 filtering facepieces.

Eficacia de la mascarilla facial con filtro de partículas N95 y de la mascarilla quirúrgica durante la respiración humana: dos vías para la penetración de partículas.

RESUMENEl nivel de protección ofrecido por las mascarillas con filtro de partículas y las mascarillas se establece considerando el porcentaje de partículas ambientales que penetran dentro del dispositivo de protección. Existen dos vías de penetración: (1) la infiltración a través del sellado facial de la mascarilla y (2) a través del medio filtrante. El objetivo principal de este estudio fue diferenciar el aporte proveniente de cada una de estas dos vías para partículas cuyo tamaño oscila entre 0.03-1 µm en condiciones de respiración reales. Así, mientras se realizaban pruebas de ajuste convencionales, se evaluaron una mascarilla respiratoria autofiltrante N95 y una mascarilla quirúrgica usada comúnmente en entornos de atención médica en 25 sujetos (número coincidente con el último panel de pruebas de ajuste del Instituto Nacional de Seguridad y Salud Laborales). Asimismo, ambas mascarillas fueron evaluadas empleando maniquíes de respiración que imitaban de forma precisa los patrones de respiración registrados previamente en los sujetos evaluados. Posteriormente, se compararon los datos de penetración obtenidos en las evaluaciones realizadas con sujetos humanos y con maniquíes para determinar los diferentes tamaños de partículas, así como los patrones de respiración. Así se determinaron 5,250 valores de penetración específicos correspondientes al ejercicio y el tamaño de las partículas. Para cada valor se calcularon la tasa de infiltración a través del sellado facial de la mascarilla y la tasa de infiltración a través del filtro, con la finalidad de cuantificar los aportes relativos realizados por cada vía de penetración. El número de partículas que penetra mediante infiltración del sellado facial de la mascarilla autofiltrante/mascarilla quirúrgica probadas excedió ampliamente el número de aquellas que lo hacen a través del filtro. Para la mascarilla autofiltrante N95, el exceso fue (en promedio) de un orden de magnitud y se incrementó notablemente al aumentar el tamaño de las partículas (p < 0.001): ∼7 veces mayor para 0,04 µm, ∼10 veces para 0.1 µm y ∼20 veces para 1 µm. En el caso de la mascarilla quirúrgica, la tasa de infiltración a través del sellado facial de la misma con respecto al filtro osciló entre 4.8 y 5.8 y no se vio significativamente afectada por el tamaño de las partículas para la fracción del submicrómetro evaluado. El movimiento facial/corporal tuvo un efecto pronunciado en el aporte relativo de las dos vías de penetración. La intensidad de la respiración y las dimensiones faciales mostraron alguna influencia (aunque limitada). Considerando que la mayoría de las partículas que penetraron ingresaron a través del sellado facial, al desarrollar la mascarilla autofiltrante/mascarilla quirúrgica la prioridad debería ser realizar una adecuación que permitiera eliminar o minimizar la infiltración a través del sellado facial y no mejorar la eficiencia del medio de filtro.

¿Cómo afecta la frecuencia respiratoria el desempeño de una mascarilla respiratoria autofiltrante N95 y de una mascarilla quirúrgica contra sustitutos de partículas virales?

ResumenLa frecuencia respiratoria (respiraciones/min) difiere entre los individuos y dependiendo de los niveles de actividad física. Las partículas ingresan a las mascarillas respiratorias mediante dos vías principales de penetración: infiltración a través del sellado facial y penetración a través de filtros. Sin embargo, se desconoce la forma en que la frecuencia respiratoria afecta el desempeño general de las mascarillas autofiltrantes N95 (filtering facepiece respirators, FFR) y las mascarillas quirúrgicas (MQ) contra partículas virales y otras partículas submicrómicas de importancia para la salud. En un maniquí de respiración a cuatro flujos inspiratorios medios (FIM) (15, 30, 55 y 85 L/min) y cinco frecuencias respiratorias (10, 15, 20, 25 y 30 respiraciones/min) se probaron una FFR y una MQ. En los dispositivos de protección respiratoria probados se determinaron la penetración a través del filtro (Pfiltro) y la infiltración total hacia el interior (ITI) de partículas de aerosol de cloruro de sodio (NaCl) en tamaños que oscilaban entre 20 y 500 nm. Asimismo, se calcularon las proporciones de penetración de la "infiltración a través del sellado facial con respecto al filtro" (ISFF). Tanto el FIM como la frecuencia respiratoria mostraron efectos significativos (p < 0.05) en el Pfiltro y la ITI. El aumento de la frecuencia respiratoria incrementó la ITI para las FFR N95 mientras que en las MQ no se observaron tendencias claras. El aumento del FIM incrementó la Pfiltro y disminuyó la ITI, lo que dio lugar a una disminución de la proporción de la ISFF. La mayoría de las proporciones de la ISFF fueron >1, lo que sugiere que la infiltración a través del sellado facial fue la vía primaria de penetración de partículas a diversas frecuencias respiratorias. La frecuencia respiratoria es otro factor (además del FIM) que puede afectar significativamente el desempeño de las FFR N95: las frecuencias respiratorias más altas aumentan la ITI. En el caso de las MQ probadas no se observó ninguna tendencia consistente de aumento o disminución de la ITI relacionada con el FIM o la frecuencia respiratoria. Para ampliar potencialmente estos hallazgos más allá del maniquí/sistema respiratorio utilizado, se necesitan estudios futuros orientados a comprender plenamente el mecanismo que hace que la frecuencia respiratoria afecte el desempeño de los dispositivos de protección respiratoria en los sujetos humanos.

Associations of observed home dampness and mold with the fungal and bacterial dust microbiomes.

The objective of this analysis was to examine and compare quantitative metrics of observed dampness and mold, including visible mold and moisture damage, and fungal and bacterial microbiomes. In-home visits were conducted at age 7 for children enrolled in the Cincinnati Childhood Allergy and Air Pollution Study. Trained study staff evaluated the primary residence and measured total areas of visible moisture and mold damage in the home. Floor dust was collected and archived. Archived dust samples collected from each home (n = 178) were extracted and analyzed using bacterial (16S rRNA gene) and fungal (internal transcribed spacer region) sequencing. Fungi were also divided into moisture requirement categories of xerophiles, mesophiles, and hydrophiles. Data analyses used Spearman's correlation, Kruskal-Wallis, Permanova, DESeq, and negative binomial regression models. Comparing high moisture or mold damage to no damage, five fungal species and two bacterial species had higher concentrations (absolute abundance) and six fungal species and three bacterial species had lower concentrations. Hydrophilic and mesophilic fungi showed significant dose-related increases with increasing moisture damage and mold damage, respectively. When comparing alpha or beta diversity of fungi and bacteria across mold and moisture damage levels, no significant associations or differences were found. Mold and moisture damage did not affect diversity of fungal and bacterial microbiomes. Instead, both kinds of damage were associated with changes in species composition of both bacterial and fungal microbiomes, indicating that fungal and bacterial communities in the home might be influenced by one another as well as by mold or moisture in the home.

The mycobiomes and bacteriomes of sputum, saliva, and home dust.

Respiratory microbiome is an understudied area of research compared to other microbiomes of the human body. The respiratory tract is exposed to an array of environmental pollutants, including microbes. Yet, we know very little about the relationship between environmental and respiratory microbiome. The primary aim of our study was to compare the mycobiomes and bacteriomes between three sample types from the same participants, including home dust, saliva, and sputum. Samples were collected from 40 adolescents in a longitudinal cohort. We analyzed the samples using 16s bacterial rDNA and ITS fungal rDNA gene sequencing, as well as quantitative PCR with universal fungal and bacterial primers. Results showed that home dust had the greatest alpha diversity between the three sample types for both bacteria and fungi. Dust had the highest total fungal load and the lowest total bacterial load. Sputum had greater bacterial diversity than saliva, but saliva had greater fungal diversity than sputum. The distribution of major bacterial phyla differed between all sample types. However, the distribution of major fungal classes differed only between sputum and saliva. Future research should examine the biological significance of the taxa found in each sample type based on microbial ecology and associations with health effects.

Quantitative and semiquantitative estimates of mold exposure in infancy and childhood respiratory health.

BACKGROUND: Previous epidemiologic studies of dampness and mold relied on metrics that did not fully assess exposure-response relationships. Our objective was to examine quantitative metrics of dampness and mold during infancy and respiratory health outcomes during childhood. METHODS: In-home visits were conducted before age 1 for children in the Cincinnati Childhood Allergy and Air Pollution Study. Respiratory outcomes included age 3 wheeze and age 7 asthma and wheeze. The associations between home exposure and respiratory outcomes were evaluated for 779 children using logistic regression adjusting for household income, neighborhood socioeconomic status, and the presence of pests. RESULTS: Children residing in homes with ≥0.29 m2 of moisture damage were significantly more likely to have wheezing at age 3 and persistent wheeze through age 7 (adjusted odds ratio [aOR] = 2.2; 95% confidence interval [CI] = 1.0, 4.3 and aOR = 3.2; CI = 1.3, 7.5, respectively). Additionally, homes having ≥0.19 m2 of mold damage were associated with wheezing at age 3 and early transient wheeze assessed at age 7 (aOR = 2.9; CI = 1.3, 6.4 and aOR = 3.5; CI = 1.5, 8.2, respectively). Mold damage <0.19 m2 and moisture damage <0.29 m2 were not associated with health outcomes. Mold and moisture damage were also not associated with asthma. CONCLUSION: Our data indicate that only the highest categories analyzed for mold (≥0.19 m2) and moisture damage (≥0.29 m2) in homes at age 1 were significantly associated with wheeze at ages 3 and 7; however, data below these levels were too sparse to assess the shape of the relationship or explore potential health-relevant thresholds.

Birth outcomes associated with maternal exposure to metals from informal electronic waste recycling in Guiyu, China.

BACKGROUND: Informal electronic waste (e-waste) recycling is a rapidly growing industry. Informal e-waste recycling creates a mixture of chemicals that can be harmful to humans, especially vulnerable populations like pregnant women and young children. OBJECTIVES: We aimed to analyze the associations between birth outcomes and living in a community with a history of informal e-waste recycling. METHODS: The e-waste Recycling Exposure and Community Health (e-REACH) Study enrolled pregnant women in Guiyu, an informal e-waste recycling site (n = 314), and an unexposed control site (Haojiang) (n = 320) at delivery. We analyzed maternal whole blood samples for lead (Pb), cadmium (Cd), chromium (Cr), and manganese (Mn). We captured data in newborns on birth weight, birth length, head circumference, body mass index (BMI), and Ponderal Index (PI). We compared the birth outcomes between sites after adjustment for covariates, and examined the associations with individual and the mixture of metals. RESULTS: The neonates from Guiyu had smaller head circumference (adj ß -1.96 cm, 95% CI -2.39, -1.52), BMI (adj ß -0.77 kg/m2, 95% CI -1.03, -0.51), and PI (adj ß -2.01 kg/m3, 95% CI -2.54, -1.47). Birth weights were lower in Guiyu compared to Haojiang, but the difference was not significant (ß -51, 95% CI -132, 29). Cumulative exposure to metals was related to lower head circumference, BMI, and PI, but not related to birth weight. DISCUSSION: We observed slight and statistically significant differences in the head size, BMI, and PI of neonates, but not birth weight, from Guiyu when compared to neonates from Haojiang. Cumulative metal exposure may partially account for the findings.

HEPA filtration improves asthma control in children exposed to traffic-related airborne particles.

Traffic-related airborne particles are associated with asthma morbidity. The aim of this study was to assess the impact of a high-efficiency particulate air (HEPA) filtration on the concentrations of traffic particles and the resultant effect on children with asthma. Forty-three children with asthma were enrolled in this double-blind, placebo-controlled crossover design. A HEPA air cleaner or a placebo "dummy" was placed in participants' homes for four weeks, interrupted by a one-month washout period, before crossing over to the other treatment arm for four weeks. Air sampling and health outcomes, including asthma control (ACQ) and quality of life (AQLQ) measures, were completed prior to and at the end of each treatment arm. Indoor concentrations of traffic particles were significantly reduced with the HEPA treatment but not with the "dummy" treatment. In participants with poorly controlled asthma and lower quality of life at baseline, ACQ and AQLQ scores were significantly improved (1.3 to 0.9, P = .003 and 4.9 to 5.5, P = .02, respectively) following the HEPA treatment. In this study, HEPA filtration is associated with improved clinical outcomes and quality of life measures in children with uncontrolled asthma.