CRITICAL ANALYSIS

CRITICAL ANALYSIS

ACOEM POSITION STATEMENT/GUIDELINES

By a Mold Victim who is sick of the lies INTRODUCTION

When reports deliberately focus on only a few known effects of any dangerous substance, the results can be catastrophic for the American public.

The purpose of this critical analysis is to point out misleading information, theory flaws, and to establish a basis that this paper is methodologically flawed. This paper is exclusive of evidence that has been established about the toxic effects of fungi and their metabolites beyond the scope of what is being publicly promoted in a direct attempt to allay the American public’s real concern over a serious physical endangerment to their person, family, and pet(s) health. Due to the self-imposed restrictions of the ACOME statement/guidelines the report itself is of little value in determining the real effects of fungi in regard to Scientific Evidence, Empirical Evidence, Statistical and Practical Application Evidence, and Human Health effects.

The ACOEM report is regularly used as evidence in litigation cases. Reports used for such litigation by their very nature, should be continually updated and reflect full current knowledge. In this introduction several reports dealing with the serious effects of fungi are displayed for prominence.

The uninformed reader has been circumvented from the true facts as presented to the President of the United States of America. The first report verifies the dangers of airborne toxins by scientific and medical, government documentation which will be included in this report.

CDC/NIOSH

Guidance for Protecting Building Environments from Airborne Chemical, Biological, or Radiological Attacks, 2003 * Presented to The White House

HUMAN “Toxins” Toxin categories include bacterial (exotoxins and endotoxins), algae (blue-green algae and dinofiagellates), mycotoxins Trichothocenes and aflatoxins). Botulinum, and plant- and animal-derived toxins. Toxins form an extremely diverse category of materials and are typically most effectively introduced into the body by inhalation or an aerosol. They are much more toxic than chemical agents. Their persistency is determined by their stability in water and exposure to heat or direct solar radiation. Under normal circumstances toxins can be collected using appropriately selected particulate filters as described in the Recommendations section of this document.”

Treatment of Chemical and Biological Warfare Injuries: Insights Derived from the 1984 Iraqi Attack on Majnoon Island Authors: Kadivar H, Adams SC Source: Military Medicine, Vol. 156, No. 4, pages 171-177, 20 references, 1991 Abstract:

HUMAN-WARFARE-FUNGI POISON: Experiences gained during the Iraqi attack on Majnoon Island were reviewed. In March of 1984 chemical and biological weapons systems were employed in a massive attack against Iran. Majnoon Island was particularly heavily hit. Exposure to these weapons resulted in skin burns, ocular damage and pulmonary distress. The clinical presentation following exposure to a number of these agents was quite similar, which made identification of the specific agent very difficult. Agents in use during this attack included nitrogen-mustard (51752), lewisite (541253), tabun (77816), and tricothecene mycotoxins. Therapeutic methods used included decontamination, airway maintenance, fluid replacement, sedation, antibiotic therapy, tetanus prophylaxis, escharotomy, fasciotomy, gastric decompression, evacuation, debridement, and topical chemotherapy. Because medical treatment must be dispensed rapidly and proficiently under extremely adverse conditions, potential care givers must receive thorough advance training. A general treatment plan has to be instituted promptly, then modified as specific information becomes available. The authors note that a vital lesson learned from this particular attack is that the complications from toxic gas exposures is increased when temperatures are extremely high, 120 degrees-F. The administration of atropine and the need to wear protective suits increase the risk of heat stroke. *

Overwhelming evidence by the top scientists and health workers include extensive procedures to eliminate the health hazards presented to an under, or deliberately misinformed public. The extensive documentation of death and injury due to fungi and mycotoxins is so well documented as to make one question the entire premise of a report that deliberately ignores factual reports readily available from government agencies and health professionals on a wide-spread basis. If a report is so urgent and critical that it needs the attention of the President of the United States, why is this information being covered and withheld from the people most affected by it? Especially criminal is the inability for parents to properly access the danger to their children, many of whom have died as a result.

The condition(s) which allow growth of one fungi always welcome many other fungi and bacteria which greatly accelerate the harm done to the person inhaling the fungi. Slanted reports continuously attempt to hide the compounded effect of these multiple-growth organisms humans are exposed to at one time or in a continuous low-dose extended period of time. The end result is that physicians are faced with so many multiple, overlapping destructions of various parts of the human body as well as the neurodegenerative and cognitive effects which leave the sickened and weakened person with so many confusing symptoms that they are very difficult, if not impossible, to treat and return to physical and mental well-being.

Given the time, the studies/reports used to validate the ACOEM statement/guidelines will be reviewed. Anything from the studies/reports used by the ACOEM that is beneficial to this critical review will be included. This will include any part of these studies/reports not included that validate the premise of this critical review. The hypotheses being that if the reports/studies or any section of the reports/studies is credible enough for the ACOEM it is viable for this analysis.

The latest studies and studies prior to the ACOEM policy/statement/guidelines from various government agencies will be included that have been peer-reviewed and/or published by; government agencies, doctors, medical and chemical, poison experts representing government facilities, hospitals, educational facilities, and for the most part have been placed in the National Library of Medicine (with the exception of the latest updated reports) which will clearly reveal the misleading premise of the ACOEM policy/statement/guidelines.

Toxigenic mold activities produce metabolites that are either broad-spectrum antibiotics or mycotoxins that are cytotoxic. Indoor environmental exposure to these toxigenic molds leads to adverse health conditions with the main outcome measure of frequent neuroimmunologic and behavioral consequences Since mycotoxins, a byproduct of fungi are the most toxic (poisonous) substances known to man and are far more lethal than chemical poisons, a standard for human safety has been established in several industrial settings that should also qualify for home, office and schools regarding fungi/mycotoxin load. Since many contaminated homes, offices, and schools meet or exceed the standards set by OSHA and NIOSH it is reasonable that the major health issues created by the condition of prolific fungi are responsible for the associated complaints and developed underlying illnesses, both, well accepted, still being defined, and not well publicized. At present there are studies that state fungi and mycotoxins exposure in the “field” does have effect at much lower doses than previously though which may lead to NIOSH and OSHA having to set even lower levels than are presently verified as acceptable. Of special interest is Aspergillus as the only fungi monitored and regulated for feed for animal and human consumption world wide and monitored for human inhalation levels in industry in the U.S.A.

NIOSH AND OSHA PERMISSIBLE EXPOSURE LIMITS

Health Hazard Evaluation Report No. HETA-94-0033-2552, Ladish Malting Company, Jefferson, Wisconsin Authors: Knutti E, Kullman GJ, Source: Respiratory Disease Hazard Evaluations and Technical Assistance Program, NIOSH, U.S. Department of Health and Human Services, Morgantown, West Virginia, Report No. HETA-94-0033-2552, 31 pages, 36 references, 1996 Abstract:

HUMAN-FUNGI POISON; In response to a confidential request, worker exposures to mycotoxins during barley storage and malting operations at Ladish Malting Company (SIC-2083), Jefferson, Wisconsin were investigated. Medical and industrial hygiene surveys were conducted, and viable fungi were identified from all collected barley, malt, and dust samples. The most abundant genus cultured from the barley and dust samples was Fusarium. Barley samples also contained the tricothecene mycotoxins Deoxynivalenol (51481108) (DON) and 15-acetyl-deoxynivalenol (88337966). Settled dust samples also contained DON mycotoxin. Operations involved the blowing and sweeping of dust and caused the aerosolization of mycotoxin containing dust. Some personal breathing zone and area levels of airborne grain dust were high compared with the OSHA permissible exposure limit of 10mg/m3 and the NIOSH recommended exposure level of 4mg/m3. Respiratory protection was used by all workers; however, the type of protection used was inadequate for protection against some of the higher levels of dust and mycotoxin. Employee medical evaluations identified symptoms of eye irritation, tiredness, and throat irritation that appeared after the start of the work shift. The onset of at least one symptom within 24 hours of beginning work was reported by 62% of those surveyed. No significant increases in body temperature were identified in the workers. The authors conclude that the potential for the development of hypersensitivity or toxic syndrome exists in this facility. The authors recommend control measures to prevent such occurrences.

CDC

Health Hazard Evaluation Report No. HETA-95-0160-2571, Centers for Disease Control and Prevention, National Center for Environmental Health Authors: Kullman GJ, Sorenson W, Source: Respiratory Disease Hazard Evaluations and Technical Assistance Program, NIOSH, U.S. Department of Health and Human Services, Morgantown, West Virginia, Report No. HETA-95-0160-2571, 48 pages, 18 references, 1996 Abstract:

HUMAN HABITAT; In response to a request from the Centers for Disease Control and Prevention, National Center for Environmental Health, the presence of Stachybotrys-atra fungi and associated mycotoxins was assessed in 42 homes in the Cleveland, Ohio area to support an investigation of acute pulmonary hemorrhage (hemosiderosis) among infants in this area. Air, bulk, and surface samples were obtained from homes with cases of hemosiderosis and homes without such cases. Mean levels of total fungi were higher in homes with hemosiderosis cases compared to homes without such cases. Homes without hemosiderosis cases had higher levels of Aspergillus and Cladosporium fungi compared with homes with cases. In contrast, S-atra fungi were much more abundant in homes with cases of hemosiderosis. The mean concentration of S-atra in surface samples was significantly higher in homes with cases compared with those without. The authors conclude that homes with infants with hemosiderosis had higher concentrations of total fungi and Stachybotrys atra than homes without.

NIOSH

Elevated Airborne Concentrations of Fungi in Residential and Office Environments Authors: Reynolds SJ, Streifel AJ, McJilton CE, Source: American Industrial Hygiene Association Journal, Vol. 51, No. 11, pages 601-604, 19 references, 1990 Abstract: AIHAAP Entry Month: July, 1991 Year of Publication: 1990 Secondary Source ID: NIOSH /00197036

HUMAN HABITAT-FUNG: A review was presented of the general results obtained from six case studies conducted in response to health complaints related to exposure to indoor airborne fungi. The rationale for the sampling protocol was described with the concentrations and types of organisms detected. Six residential and office environments were tested to determine the airborne concentrations of fungi present there. Volumetric samples were collected using Andersen sieve samplers. Reference samples were taken outside of all buildings. Collections were also made of swab samples from surfaces and bulk samples of materials, such as carpeting and ceiling tiles. Gross colony morphology and microscopic examination was used to identify the predominant fungi present. The airborne concentrations of fungi detected inside each of the buildings significantly exceeded outdoor concentrations. It was determined that the contamination was caused by either water damage or buildup of dust. The movement of air through contaminated fans, the ventilation system, the fireplace, or human activity caused the fungi to become aerosolized from contaminated materials. The reduction of airborne concentrations of fungi by remedial means was demonstrated by air sampling taken at a later date.

Toxigenic fungi in a water-damaged building: An Intervention Study. Authors: SUDAKIN DL Author Address: Public Health General Preventive Med., Oregon Health Sci. Univ., 3181 SW Sam Jackson Park Road, CB-669, Portland, OR 97201-3098, USA. Source: AMERICAN JOURNAL OF INDUSTRIAL MEDICINE; 34 (2). 1998. 183-190. Abstract: Entry Month: September, 1998 Year of Publication: 1998 Secondary Source ID: BIOSIS /98/22568 BIOSIS COPYRIGHT: BIOL ABS. Behavioral Biology-Human Behavior, Respiratory System-General, Nervous System-General

HUMAN HABITAT-OFFICE-FUNGI POISON: In an investigation of health complaints among employees of a water-damaged office building, the environment showed evidence of fungal contamination with the isolation of Stachybotrys chartarum in one of five bulk samples tested for fungal growth. In response, a public health official recommended that employees be relocated from the building. Employees were subsequently moved to a different environment. A focused environmental investigation of microbial growth within the building followed, revealing moderate to high levels of fungi (Penicillium, Aspergillus versicolor) and bacteria in bulk and surface samples. S. chartarum was identified in one of 19 (5%) environmental samples using Czapek agar A health survey of building occupants revealed a high prevalence of multiple symptoms, with a predominance of neurobehavioral and upper respiratory tract complaints. The majority of symptoms were significantly less prevalent after relocation from the water-damaged environment. Th—.

DEPARTMENT OF ENVIRONMENTAL HEALTH

Measurements of Airborne aflatoxins during the Handling of 1979 Contaminated Corn, Toxnet, 1990 Authors: BURG WR, SHOTWELL OL, SALTZMAN BE Author Address: Dep. of Environmental Health, Univ. of Cincinnati, Cincinnati, Ohio 45267. Source: AM IND HYG ASSOC J; 43 (8). 1982. 580-586.

HUMAN-HIGH EXPOSURE EXAMPLE-FUNGI POISON; “The potential health hazard of aflatoxin (1402682) contaminated corn grain dusts to agricultural workers was investigated. The average aflatoxin level in all three farm areas was 42.7 parts per billion while the average aflatoxin level from airborne dust samples collected at the grain elevator was 172.8ppb (settled dust average, 222ppb). The author concluded that farmers, truckers, and grain handlers may experience significant exposure to aflatoxin contaminated dust in regions where the Aspergillus-flavus mold thrives, particularly in the southern regions of the United States. They recommend the use of respiratory protection when handling corn know to be contaminated with aflatoxin.”

Exposure to airborne microbes during the repair of moldy buildings. Authors: RAUTIALA S, REPONEN T, HYVARINEN A, NEVALAINEN A, HUSMAN T, VEHVILAINEN A, KALLIOKOSKI P, Author Address: Department Environmental Sciences, University Kuopio, P.O. Box 1627, FIN-70211, Kuopio, Finland. Source: AMERICAN INDUSTRIAL HYGIENE ASSOCIATION JOURNAL; 57 (3). 1996. 279-284. Abstract: BIOSIS COPYRIGHT: BIOL ABS. Entry Month: June, 1996 Public Health-Public Health Administration and Statistics Public Health: Environmental Health-Occupational Health Public Health: Epidemiology-Communicable Diseases Public Health: Disease Vectors-Inanimate Public Health: Microbiology Year of Publication: 1996 Secondary Source ID: BIOSIS /96/12825

HUMAN HABITAT-REMEDIATION-FUNGI; Concentrations of airborne microbes, studied during the repair of seven moldy buildings, showed that concentrations of airborne fungi increased during the repair work. This was especially true during the demolition of moldy building materials, even though the total dust levels remained low. Concentrations of viable fungi sampled with a six-stage cascade impactor were 103 - > 1.9oncentrations of fungal propagules, as determined by the Camnea method (i.e., air filtration method with epifluorescence microscopic counting of acridine-stained organisms) showed 105 - 106 counts/m3 during the demolition. Penicillium was the main genus throughout. Concentrations of viable total bacteria also increased, but this change proved less noticeable than that of the fungi. However, rather high concentrations of viable actinomycetes up to 104 cfu/m3 were detected during the demolition. Results show that construction workers are exposed to high concentrations of microbes, perhaps causi ----.

NIOSH

Fungal Spores; Hazardous to Health? Division of Respiratory disease Studies, National Institute for Occupation and Health, 1999 Authors: SORENSON WG NOTE: ACOME Expert # 1. Author Address: Immunology Section, NIOSH, 1095 Willowdale Road, Morgantown, WV, 26505, USA. Source: ENVIRONMENTAL HEALTH PERSPECTIVES; 107 (SUPPL. 3). 1999. 469-472.

HUMAN DISABILITIES AND DISEASES; “–INHALATION OF FUNGAL SPORES INCLUDE: TOXIC PNEUMONITIS, HYPER PNEUMONITIS, TREMORS, CHRONIC FATIGUE SYNDROME, KIDNEY FAILURE, AND CANCER..”

Studies concerning the metabolites produced by Stachybotrys atra, Pencillium islandicum, penicillium viridicatum and aspergillus-versicolor. PubMed, 1977 Ann Nutr Aliment. 1977;31(4-6):663-84. Pohland AE.

HUMAN DEATH-FUNGI POISON; “Over the past ten years it has become quite apparent that mycotoxins, or toxins produced by fungi, are responsible for a wide variety of human and animal illnesses and, in many cases, deaths.”

IAQ and human toxicosis: empirical evidence and theory, Concordia, 2001 ACOEM Expert # 56, #57. Author: Ammann, H. M. Year 2001 Source In "Bioaerosols, Fungi and Mycotoxins: Health Effects, Assessment, Prevention and Control", Edited by Johanning, E., Boyd Printing, Albany, New York Citation: Ammann, H. M., (2001), "IAQ and human toxicosis: empirical evidence and theory", In "Bioaerosols, Fungi and Mycotoxins: Health Effects, Assessment, Prevention and Control", Edited by Johanning, E., Boyd Printing, Albany, New York. HUMAN EXPOSURE-IMMUNE SYSTEM-FUNGI POISON; “Studies of injury, illness and death occurring in mold-exposed animals and people in the field, observe that the illness called mycotoxicosis results from more complex exposures than can be observed in laboratory experiments with pure mold toxins. Response in field exposures occurs at lower exposure concentrations than those from controlled experiments.

Changes in the immune system, often reflected as increased susceptibility to infectious illness, are a common finding of low level exposure to toxigenic molds that inhibit protein synthesis. Changes in the immune system are extremely complex, but changes in the endocrine and nervous system accompany them and may reflect changes in the central neuroendocrine-immune control system.

Prudent public health practice recognizes the potency of the toxic agents produced by toxigenic molds, and seeks to protect occupants of buildings once moisture incursion with resultant microbial growth has been discovered.”

USDA-1977

HUMAN EXPOSURE-DISEASE-FUNGI POISON; “A healthy individual is more able to fight the toxins than a one that starts out malnourished or diseased. The very young and very old have weakened immune systems that are less able to fight the effects of toxicoses. In general female animals, and to a degree female humans, seem to be more susceptible to the effects of mycotoxicosis. Hosts exposed to harsh living conditions of neglect or squalor have an added burden on their systems. Very high doses of aflatoxin attack the host quicker than lower doses. A very short time of exposure (a single dose) allows the host time to fight the infection where a continued exposure tends to have cumulative effects. Areas that lack the means to regulate and monitor the presence of mycotoxins in genera, and aflatoxin in particular, leave the inhabitants open to unknown poisonings that can continue over long periods of time unchecked. Aspergillus species produce toxins that exhibit a wide range of toxicities, with the most significant effects being long term.

The toxins produced by Penicillium species can be placed in two general groups; those that affect the liver and kidney function, and those that are neurotoxic. The penicillium toxins that affect liver or kidney function are asymptomatic or cause generalized debility in humans or animals while the neurotoxins are characterized by sustained trembling.

The main human disease associated with F. moniliforme is esophageal cancer. -Alternaria toxins-that have been grown or corn or rice and fed to rats, chicks, turkey poults, and ducklings have been shown to be quite toxic.”

1: ScientificWorldJournal. 2003 Nov 13;3:1128-37. The neurological significance of abnormal natural killer cell activity in chronic toxigenic mold exposures. Anyanwu E, Campbell AW, Jones J, Ehiri JE, Akpan AI. Neurosciences Research, Cahers Inc., Conroe, TX, USA. ebereanyanwu@msn.com PMID: 14625399 [PubMed - in process] HUMAN HABITAT-NEUROIMMUNOLOGIC-BEHAVIORAL-DISEASE-FUNGI PRODUCE; Toxigenic mold activities produce metabolites that are either broad-spectrum antibiotics or mycotoxins that are cytotoxic. Indoor environmental exposure to these toxigenic molds leads to adverse health conditions with the main outcome measure of frequent neuroimmunologic and behavioral consequences. One of the immune system disorders found in patients presenting with toxigenic mold exposure is an abnormal natural killer cell activity. This paper presents an overview of the neurological significance of abnormal natural killer cell (NKC) activity in chronic toxigenic mold exposure. A comprehensive review of the literature was carried out to evaluate and assess the conditions under which the immune system could be dysfunctionally interfered with leading to abnormal NKC activity and the involvement of mycotoxins in these processes. The functions, mechanism, the factors that influence NKC activities, and the roles of mycotoxins in NKCs were cited wherever necessary. The major presentations are headache, general debilitating pains, nose bleeding, fevers with body temperatures up to 40 degrees C (104 degrees F), cough, memory loss, depression, mood swings, sleep disturbances, anxiety, chronic fatigue, vertigo/dizziness, and in some cases, seizures. Although sleep is commonly considered a restorative process that is important for the proper functioning of the immune system, it could be disturbed by mycotoxins. Most likely, mycotoxins exert some rigorous effects on the circadian rhythmic processes resulting in sleep deprivation to which an acute and transient increase in NKC activity is observed. Depression, psychological stress, tissue injuries, malignancies, carcinogenesis, chronic fatigue syndrome, and experimental allergic encephalomyelitis could be induced at very low physiological concentrations by mycotoxin-induced NKC activity. In the light of this review, it is concluded that chronic exposures to toxigenic mold could lead to abnormal NKC activity with a wide range of neurological consequences, some of which were headache, general debilitating pains, fever, cough, memory loss, depression, mood swings, sleep disturbances, anxiety, chronic fatigue, and seizures.

Immunol Allergy Clin North Am. 2003 Aug;23(3):519-31. Assessment of the indoor environment: evaluation of mold growth indoors. Horner WE. Publication Types: Review Review, Tutorial PMID: 14524389 [PubMed - indexed for MEDLINE] Air Quality Sciences, 1337 Capital Circle, Atlanta, GA 30067, USA. NOTE: ACOEM Expert #2. HUMAN HABITAT-NONATOPIC: Much attention has been focused on indoor molds; resulting in modest amounts of new research. There is strong evidence of respiratory effects. Although mechanisms are disputed, some of the effect (but not all) is likely to be allergy related. There is some evidence that atopic individuals may be more affected, but many nonatopic individuals also are affected. This area needs more general research and specific research on exposure measures (such as what fungal components should be measured) and on health-effect mechanisms. It is worthwhile to emphasize the practical knowledge that is readily available. Buildings should be designed, built, operated, and occupied so that the buildings stay dry. When this situation does not occur, the environmental and clinical aspects that are observed by competent professionals should both be considered when determining causal relationships.

Appl Environ Microbiol. 2002 Apr;68(4):1743-53. Profiles of airborne fungi in buildings and outdoor environments in the United States. Shelton BG, Kirkland KH, Flanders WD, Morris GK. PathCon Laboratories, Norcross, Georgia 30092, USA. PMID: 11916692 [PubMed - indexed for MEDLINE] HUMAN-INDOOR-OUTDOOR AIR SAMPLES; We examined 12,026 fungal air samples (9,619 indoor samples and 2,407 outdoor samples) from 1,717 buildings located across the United States; these samples were collected during indoor air quality investigations performed from 1996 to 1998. For all buildings, both indoor and outdoor air samples were collected with an Andersen N6 sampler. The culturable airborne fungal concentrations in indoor air were lower than those in outdoor air. The fungal levels were highest in the fall and summer and lowest in the winter and spring. Geographically, the highest fungal levels were found in the Southwest, Far West, and Southeast. The most common culturable airborne fungi, both indoors and outdoors and in all seasons and regions, were Cladosporium, Penicillium, nonsporulating fungi, and Aspergillus. Stachybotrys chartarum was identified in the indoor air in 6% of the buildings studied and in the outdoor air of 1% of the buildings studied. This study provides industrial hygienists, allergists, and other public health practitioners with comparative information on common culturable airborne fungi in the United States. This is the largest study of airborne indoor and outdoor fungal species and concentrations conducted with a standardized protocol to date.

Mold allergy: Fungal airborne spores in the homes of allergic and non-allergic subjects. Authors: FADDA ME, COSENTINO S, ATZORI C, DEPLANO M, CARDIA P, PALMAS F Author Address: Ricercatori del Dipartimento di Biologia Sperimentale, Univesita degli Studi di Cagliari. Source: FOLIA ALLERGOL IMMUNOL CLIN; 37 (6). 1990. 335-342. Entry Month: March, 1992 Year of Publication: 1990 Secondary Source ID: BIOSIS/92/03758 Abstract: BIOSIS COPYRIGHT: BIOL ABS.

HUMAN HABITAT-SKIN TESTS-FUNGI: A survey was carried out to compare the incidence of fungal spores in the homes of patients with allergic manifestations and positive skin tests for fungi with spore assessment in the homes of non-allergic subjects. Particularly, the spores which have been more frequently found to give skin-positive reactions in the allergic patients were considered. Cladosporium and Penicillium were the most frequent fungi recovered from both groups of homes, whereas spore counts of yeasts, Alternaria, Aureobasidium, Aspergillus and Fusarium, were significantly higher in allergic patients homes. This survey confirms that spore assessments in the air of residential buildings can have direct application in determining the exposure to the various spore types and therefore in the management of allergic patients. Moreover, this kind of study permits to compare the environmental findings with the skin reaction of the patients to extracts of several of the fungal species isolated.

NOTE; THIS STUDY HAS SOME VERY IMPORTANT INFORMATION; (could cortisone treatment cause vulnerability in humans?)

Pathogenic potential of fungal insecticides. Authors: Pore RS, Goodman N, Larsh HW, Source: Am. Rev. Respirat. Disease; 101(4): 627-8 1970; (REF:22) Abstract: HAPAB Entry Month: December, 1973 Year of Publication: 1970 Secondary Source ID: HAPAB /71/00719

HUMAN-INSECTICIDES MADE FROM FUNGI-CORTISONE: A study to explore the pathogenic potential for man of Beauveria bassiana (agent of white muscardine in numerous insects) and other fungi-insecticides has been made. B. bassiana spores were introduced into cultures of mouse peritoneal macrophages maintained by a slightly modified Howard (1965) method. In cultures maintained at 35 C, the spores germinated and in the mouse-derived macrophages formed budding hyphal bodies resembling those observed in the pathogenic process of the fungus in the hemocoels of infected insects. Similar growth occurred in cultures of HeLa cells. Neither in HeLa nor in mouse macrophage cultures held at 37 C, would the spores of B. bassiana germinate. The hyphal bodies of the fungus are considered the pathogenic phase. B. bassiana showed collagenase and elastase activity to a decided degree, as did Trichophyton rubrum and T. mentagrophytes. Entomophthora coronata showed good collagenase production regardless of inoculation route, B. bassiana failed to produce progressive infection in normal mice. Although Aspergillus flavus is pathogenic for mice and rats, cortisone treatment was needed to predispose rats to infection by the respiratory route. Normal animals and man usually resist infection by ,opportunistic' fungi. Application of fungi for insecticidal purposes might lead to more than ,moderate' exposure. At present, several lb of spores/acre are required for insect control. Victims of chronic pulmonary disease have altered resistance. Many fungi are allergenic, a factor that should be taken into account in evaluating fungi for insecticidal use. B. bassiana has been reported as causing intense allergic response in man. Mixtures of bacterial and fungal insecticides have been proposed and are being investigated but they constitute a problem for human health. Many variables, dealing with fungi and hosts, remain to be studied before fungal insecticides can come into use for insect control. 1970

The insurance industry’s inability to financially provide for the remediation for all the damaged structures without additional expenses of medical complications has been well documented in Claim’s Magazine and in the measures taken to protect themselves from future litigation and liability concerning fungal infestation in personal and business properties in and of itself is a form of “evidence,” and has been utilized to avoid the financially catastrophic ramifications of dealing with fungi contamination. Since some reports estimate between 600,000 and 800,000 homes, businesses, and public buildings have fungal infestation, this problem is not going away.

The blue ink is the report by the ACOEM and to highlight the experts used in their report. In all instances if the documentation used by ACOEM could not be provided in this paper, it is noted. Due to the use of specific experts by ACOEM, whenever possible, published, peer-reviewed studies, documents, reviews, tutorials, case history(s), etc., by the same experts will be used. The black ink is the critical analysis and peer-reviewed, published documentation. Red ink is an immediate notice that the study pertains to Human(s) or has critical information. Green ink is used for primate, animal, and rodent studies.

CHAPTER ONE -- PARAGRAPH ONE

“Human Health Effects Associated with Molds in the Indoor Environment”

PARAGRAPH 1, sentence 1 and 2.

“In recent years, the growth of molds in home, school, and office environments has been cited as the cause of a wide variety of human ailments and disabilities. So-called "toxic mold" has become a prominent topic in the lay press and is increasingly the basis for litigation when individuals, families, or building occupants believe they have been harmed by exposure to indoor molds.”

A) The red flag “toxic Mold” is a coin-phrase misused and is designed to be inflammatory.

B) Any “Evidence Based Statements” that starts out with a statement concerning a “basis for litigation” should be immediately suspect for having a bias, pro or con.

PARAGRAPH 1, sentence 3.

“This evidence-based statement from the American College of Occupational and Environmental Medicine (ACOEM) discusses the state of scientific knowledge as to the nature of fungal-related illnesses while emphasizing the possible relationships to indoor environments.”

A) “discusses the state of scientific knowledge,” is misleading. This critical review is to provide a wider scope and extensive “scientific knowledge” that the ACOEM does not provide or address in the very limited and slanted view included in the ACOEM’s “state of scientific knowledge”.

B) The proof that the American College of Occupational and Environmental Medicine is exploring all “Scientific Knowledge” is yet to be proved and is disclaimed in sentence 5 of this paragraph. (See Paragraph 1, sentence 5)

C) The general attitude of this paper in the first paragraph give the impression of prejudice due to the phrasing of the sentences, i.e.; “So-called “toxic mold,” and, ”while emphasizing the possible relationships to indoor environments.”

SAMPLE STUDIES THAT VERIFY INDOOR ENVIRONMENTS AND “TOXIC MOLD”

Whenever possible experts used by ACOEM will be used for valid proof of this critical review. See Introduction for some of the more stunning statements concerning fungi and human health effects. At the end of this “critical review” is the majority of verification studies done by Experts used by ACOEM.

NIOSH

Health Hazard Evaluation Report No. HETA-83-327-1402, Weatherwax Golf Course, Middletown, Ohio Authors: Liss GM ,Moseley CL Source: Hazard Evaluation and Technical Assistance Branch, NIOSH, U.S. Department of Health and Human Services, Cincinnati, Ohio, Report No. HETA-83-327-1402, 18 pages, 10 references, 1984 Abstract:

HUMAN-FUNGI; In response to a request from the City Health Department of Middletown, Ohio, an investigation was begun into an outbreak of acute respiratory illness in workers at the Weatherwax Golf Course (SIC-7992). Workers had experienced an outbreak of acute respiratory illness following the unloading of a truck filled with wood chips. Five employees experienced fever, chills, weakness, cough, chest tightness, and headaches, while six employees were not ill. Chips in the front of the truck may have been stored there for about a year. The fungi growing from the wood chips included species of Thermoactinomyces, Aspergillus, Mucor and Candida. Workers who were ill had worked unloading the front part of the truck. Symptoms began to appear approximately 13 hours after the work had been performed. The affected workers were well within 3 days. No diagnostically meaningful serological responses were identified. The authors conclude that the outbreak may have been pulmonary mycotoxicosis brought on by a toxic reaction to the inhalation of large amounts of fungi. Several recommendations were made to avoid this problem in the future.

NIOSH

Health Hazard Evaluation Report No. HETA-93-1110-2575, Martin County Courthouse and Constitutional Office Building, Stuart, Florida Authors: Weber AM, Martinez KF Source: Hazard Evaluation and Technical Assistance Branch, NIOSH, U.S. Department of Health and Human Services, Cincinnati, Ohio, Report No. HETA-93-1110-2575, 27 pages, 15 references, 1996 Abstract:

HUMAN HABITAT-COURTHOUSE-FUNGI & POISON: In response to a request from the Martin County Board of County Commissioners, an investigation was begun into possible exposure to toxicogenic fungi during the renovation of microbiological contaminated areas of the Martin County Courthouse Complex (SIC-9211) in Stuart, Florida. Severe contamination was present, consisting predominantly of Aspergillus, Penicillium, and Stachybotrys. Due to occupant health complaints the Courthouse complex was not occupied. Prior to beginning remediation efforts, an initial environmental assessment had been made in September of 1993, by NIOSH investigators. Follow up site visits were conducted in October and November. After completion, a final visit was made in June of 1994. Containment areas with dedicated supply and exhaust ventilation systems were used in the remediation activities. While containment areas reduced the dissemination of spores, potentially toxicogenic fungal spores were identified on 56% of the filter samples collected outside the containment areas. The authors conclude that workers were exposed to a potential health hazard during removal of the microbiologically contaminated building materials. The authors note that workers performing renovations in buildings contaminated with fungi may unknowingly put themselves and other occupants of the buildings at risk for exposure.

NIOSH

Health Hazard Evaluation Report No. HETA-97-0048-2641, Cowlitz County Health Department, Longview, Washington Authors: Boudreau Y, Perkner J Source: Hazard Evaluations and Technical Assistance Branch, NIOSH, U.S. Department of Healt and Human Services, Cincinnati, Ohio, Report No. HETA-97-0048-2641, 19 pages, 43 references, 1997 Abstract: (EVACUATION OF BUILDING)

HUMAN HABITAT-FUNGI POISON; In response to a request from the Service Employees International Union, a health hazard evaluation was performed at the former Cowlitz County Health Department Building (CCHDB) (SIC-9431) in Longview, Washington. Concern was voiced over employee reports of upper respiratory problems, aches and pains in joints and muscles, and skin rashes, perhaps related to toxins and molds in the building. After an inspection by the Washington State Department of Health revealed the presence of fungi including Stachybotrys, Aspergillus, and Penicillium, the building was evacuated. Twenty nine of the 341 current employees and eight former employees participated in medical interviews and responded to a symptoms questionnaire. Employees reported a decrease in all symptoms after leaving the CCHDB. There was a statistically significant decreased prevalence in most symptoms after leaving the old building. The authors recommend that the new building be inspected once renovations are complete. Employees should see their personal physician for health concerns and should inform that person of any problems they feel may be work related.

NIOSH

Elevated Airborne Concentrations of Fungi in Residential and Office Environments Authors: Reynolds SJ, Streifel AJ, McJilton CE Source: American Industrial Hygiene Association Journal, Vol. 51, No. 11, pages 601-604, 19 references, 1990 Entry Month: July, 1991 DCN-192469 Year of Publication: 1990 Secondary Source ID: NIOSH/00197036 Abstract:

HUMAN HABITAT-ACTIVITY-FUNGI: A review was presented of the general results obtained from six case studies conducted in response to health complaints related to exposure to indoor airborne fungi. The rationale for the sampling protocol was described with the concentrations and types of organisms detected. Six residential and office environments were tested to determine the airborne concentrations of fungi present there. Volumetric samples were collected using Andersen sieve samplers. Reference samples were taken outside of all buildings. Collections were also made of swab samples from surfaces and bulk samples of materials, such as carpeting and ceiling tiles. Gross colony morphology and microscopic examination was used to identify the predominant fungi present. The airborne concentrations of fungi detected inside each of the buildings significantly exceeded outdoor concentrations. It was determined that the contamination was caused by either water damage or buildup of dust. The movement of air through contaminated fans, the ventilation system, the fireplace, or human activity caused the fungi to become aerosolized from contaminated materials. The reduction of airborne concentrations of fungi by remedial means was demonstrated by air sampling taken at a later date.

Laboratory experiments on Membrane Filter Sampling of Airbourne Mycotoxins Produced by Stachybotrys atra Corda, Toxnet, 1993, 21 references Authors: PASANEN A-L, NIKULIN M, TUOMAINEN M, BERG S, PARIKKA P, HINTIKKA E-L Author Address: Univ. Kuopio, Dep. Environ. Sci., P.O. Box 1627, SF-70211 Kuopio, Finland. Source: ATMOS ENVIRON PART A GEN TOP; 27 (1). 1993. 9-13.

HUMAN HABITAT; ”Sixty-six air samples were collected on the filters,. Only one of the 27 air samples collected in methanol was toxic in both the cell culture and rabbit skin tests. All samples collected on a cellulose-nitrate filter were negative in the biological tests, whereas less than half of the samples on a polycarbonate filter and more than half of the samples on a polycarbonate filter were toxic. Twenty-five percent of the air samples collect from contaminated grain and 42% of the samples collected from contaminated wallpaper were toxic. None of the air samples collected from contaminated hay and straw were toxic, even when the original material was toxic.”

NIOSH

Trichothecene mycotoxins in the dust of ventilation systems of office buildings, Toxnet, 1994 Smoragiewicz W ; Cossette B ; Boutard A ; Krzystyniak K International Archives of Occupational and Environmental Health, Vol. 65, No. 2, pages 113-117, 25 references, 1993 [NIOSH]

HUMAN HABITAT; “–reportedly affected by the “sick buildings syndrome”, were analyzed. The dust samples contained at least four trichothecenes; T-2 toxin, diacetoxyscirpenol, roridene A and T-2 tetraol. Screening of dust samples from air ventilation systems of reportedly affected buildings provided direct evidence of trichothecene mycotoxins, with the detection limit estimated at 0.4-4 ng/mg dust.”

Trichothecene Mycotoxins in Aerosolized Conidia of Stachybotrys atra, Toxnet, 1987, 24 references.

HUMAN HABITAT; “A dose depended inhibition of protein synthesis in rat alveolar macrophages was noted within 1 hour–was greatly inhibited by Satratoxin-H and the spore extracts. Each filter contained one or more of the specific trichothecenes.–Trichothecene mycotoxins are acutely toxic to a variety of mammalian species, strongly inhibit protein, DNA, and RNA synthesis in eucaryotic cells, and are immunotoxic in rats and mice. -- Demonstrates the possibility for pulmonary exposure of workers to these toxins contained in moldy hay, contaminated ductwork, and carpets heavily contaminated by S-atra.

Correlation between the prevalence of certain fungi and sick building syndrome. Authors: COOLEY JD, WONG WC, JUMPER CA, STRAUS DC, Author Address: Dep. Microbiol. Immunol., Texas Tech Univ. Health Sci. Center, Lubbock, TX 79430, USA. Source: OCCUPATIONAL AND ENVIRONMENTAL MEDICINE; 55 (9). 1998. 579-584.Entry Month: November, 1998Year of Publication: 1998 Secondary Source ID: BIOSIS/98/30276

Abstract: BIOSIS COPYRIGHT: BIOL ABS. Objective-

HUMAN HABITAT-SCHOOLS-FUNGI; To examine the role of fungi in the production of sick building syndrome. Methods-A 22 month study in the United States of 48 schools (in which there had been concerns about health and indoor air quality (IAQ)). Building indoor air and surface samples, as well as outdoor air samples were taken at all sites to look for the presence of fungi or their viable propagules. Results-Five fungal genera were consistently found in the outdoor air and comprised over 95% of the outdoor fungi. These genera were Cladosporium (81.5%), Penicillium (5.2%), Chrysosporium (4.9%), Alternaria (2.8%), and Aspergillus (1.1%). At 20 schools, there were significantly more colony forming units per cubic metre (CFU/m3) (p<0.0001) of propagules of Penicillium species in the air samples from complaint areas when compared with the outdoor air samples and the indoor air samples from noncomplaint areas. At five schools, there were more, although not significant (p=0.10), Penicillium propag—.

Microfungal contamination of damp buildings--examples of risk constructions and risk materials. Gravesen S, Nielsen PA, Iversen R, Nielsen KF. Energy and Indoor Climate Division, Danish Building Research Institute, Horsholm, Denmark. PMID: 10347000 [PubMed - indexed for MEDLINE] HOUSING MATERIALS-FUNGI POISONS: To elucidate problems with microfungal infestation in indoor environments, a multidisciplinary collaborative pilot study, supported by a grant from the Danish Ministry of Housing and Urban Affairs, was performed on 72 mold-infected building materials from 23 buildings. Water leakage through roofs, rising damp, and defective plumbing installations were the main reasons for water damage with subsequent infestation of molds. From a score system assessing the bioavailability of the building materials, products most vulnerable to mold attacks were water damaged, aged organic materials containing cellulose, such as wooden materials, jute, wallpaper, and cardboard. The microfungal genera most frequently encountered were Penicillium (68%), Aspergillus (56%), Chaetomium (22%), Ulocladium, (21%), Stachybotrys (19%) and Cladosporium (15%). Penicillium chrysogenum, Aspergillus versicolor, and Stachybotrys chartarum were the most frequently occurring species. Under field conditions, several trichothecenes were detected in each of three commonly used building materials, heavily contaminated with S. chartarum. Under experimental conditions, four out of five isolates of S. chartarum produced satratoxin H and G when growing on new and old, very humid gypsum boards. A. versicolor produced the carcinogenic mycotoxin sterigmatocystin and 5-methoxysterigmatocystin under the same conditions.

Aspergillosis in immunocompromised pediatric patients: Associations with building hygiene, design, and indoor air. Authors: ANDERSON K MORRIS G KENNEDY H CROALL J MICHIE J RICHARDSON MD GIBSON B Author Address: Department Respiratory Medicine, Western Infirmary, Glasgow G11 6NT, UK. Source: THORAX; 51 (3). 1996. 256-261. Abstract: BIOSIS COPYRIGHT: BIOL ABS. Entry Month: June, 1996 Year of Publication: 1996 Secondary Source ID:BIOSIS/96/14024 (Six children in 1 year, 1 hospital ward)

HUMAN-HOSPITAL; Background: Nosocomial aspergillosis is a well known complication of immunosuppression in cancer patients and those undergoing transplantation and has usually been associated with major building construction or demolition. An observational study is reported of the hospital environment associated with an outbreak of aspergillosis in a pediatric oncology ward. Methods: All cases of aspergillosis were identified from the hospital records and categorized as definite or probable according to the extent of supportive clinical and laboratory findings. All relevant aspects of building ventilation, air filtration, and aerosol generation considered relevant were examined and air samples for fungi were taken in triplicate at 25 sites using a slit sampler with appropriate culture media. Results: Six cases of aspergillosis were identified over one year out of the 148 patients who attended the unit - the only part of the hospital where cases were found.

Pathogenic molds (including Aspergillus species) in hospital water distribution systems: a 3-year prospective study and clinical implications for patients with hematologic malignancies. Anaissie EJ, Stratton SL, Dignani MC, Lee CK, Summerbell RC, Rex JH, Monson TP, Walsh TJ . myeloma Institute for Research and Treatment, University of Arkansas for Medical Sciences, Little Rock 72205, USA. PMID: 12468437 [PubMed - indexed for MEDLINE] HUMAN-HOSPITAL-CANCER PATIENTS-FUNGI; The incidence of mold infections in patients with hematologic malignancies continues to increase despite the widespread use of air filtration systems, suggesting the presence of other hospital sources for these molds. Water sources are known to harbor pathogenic molds. We examined samples from water, water surfaces, air, and other environment sources from a bone marrow transplantation unit with optimal air precautions. Molds (Aspergillus species, others) were recovered in 70% of 398 water samples, in 22% of 1311 swabs from plumbing structures and environmental surfaces, and in 83% of 274 indoor air samples. Microscopic examination of the water plumbing lines revealed hyphal forms compatible with molds. Four findings suggest that indoor airborne molds were aerosolized from the water: (1) higher mean airborne concentrations of molds in bathrooms (16.1 colony-forming units [CFU]/m(3)) than in patient rooms (7 CFU/m(3)) and hallways (8.6 CFU/m(3); P =.00005); (2) a strong type and rank correlation between molds isolated from hospital water and those recovered from indoor hospital; (3) lack of seasonal correlation between the airborne mold concentration in outdoor and indoor air; and (4) molecular relatedness between a clinical strain and a water-related strain (previously reported). Hospital water distribution systems may serve as a potential indoor reservoir of Aspergillus and other molds leading to aerosolization of fungal spores and potential exposure for patients. Clin Infect Dis. 2001 Dec 1;33(11):1871-8. Epub 2001 Oct 24.

Fusariosis associated with pathogenic fusarium species colonization of a hospital water system: a new paradigm for the epidemiology of opportunistic mold infections. Anaissie EJ, Kuchar RT, Rex JH, Francesconi A, Kasai M, Muller FM, Lozano-Chiu M, Summerbell RC, Dignani MC, Chanock SJ, Walsh TJ. Myeloma and Transplantation Research Center, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA. PMID: 11692299 [PubMed - indexed for MEDLINE] (8 patients) HOSPITAL-FUNGI; We sought the reservoir of Fusarium species in a hospital with cases of known fusarial infections. Cultures of samples from patients and the environment were performed and evaluated for relatedness by use of molecular methods. Fusarium species was recovered from 162 (57%) of 283 water system samples. Of 92 sink drains tested, 72 (88%) yielded Fusarium solani; 12 (16%) of 71 sink faucet aerators and 2 (8%) of 26 shower heads yielded Fusarium oxysporum. Fusarium solani was isolated from the hospital water tank. Aerosolization of Fusarium species was documented after running the showers. Molecular biotyping revealed multiple distinct genotypes among the isolates from the environment and patients. Eight of 20 patients with F. solani infections had isolates with a molecular match with either an environmental isolate (n=2) or another patient isolate (n=6). The time interval between the 2 matched patient-environment isolates pairs was 5 and 11 months, and 2, 4, and 5.5 years for the 3 patient-patient isolate pairs. The water distribution system of a hospital was identified as a reservoir of Fusarium species.

An indoor mycoaerological investigation at home of allergic patients

Authors: DI BERARDINO L ANGRISANO A BAIO G COMPOSTELLA R Author Address: Div. di Pediatrica, Ospedale di Bollate, Mich. Source: FOLIA ALLERGOL IMMUNOL CLIN; 36 (6). 1990. 431-436.

HUMAN HABITAT-IgE mediated respiratory-FUNGI; The etiopathogenetic role of molds in the respiratory allergic syndromes is now well accepted. To better define the correlation between fungi and allergic diseases we investigated over a period of one year, by gravimetric method, the presence of six genera of moulds (Alternaria, Aspergillus, Candida, Penicillium, Mucor and Cladosporium) inside the house of 20 children affected with an IgE mediated respiratory disease (rhinitis and/or asthma) and skin-test positive to one or more of the six genera of fungi. We evaluated that total aspecific mycoallergenic burden and the global distribution of each mold genus over the period of study. Cladosporium and Penicillium make up the 88% of identified colonies and are constantly present in considerable concentration, with a decrease during winter months for Cladosporium and an increase from November to April for Penicillium. Alternaria was detected particularly in September and October; Aspergillus is constantly present in low co (NEED REST OF REPORT) Medical Subject Headings (MeSH): Entry Month: February, 1991 Year of Publication: 1990 Secondary Source ID: BIOSIS/91/01090.

A Review of Mycotoxins in Indoor Air Authors: ,Hendry KM Cole EC , Source: Journal of Toxicology and Environmental Health, Vol. 38, No. 2, pages 183-198, 48 references, 1993 Abstract: HUMAN HABITAT-FUNGI POISONS; A review of the sources and health effects of mycotoxins that have been found in indoor air was presented. Discussions were presented on the origins and health effects of classes of mycotoxins that have been identified in dust. These included aflatoxins, trichothecenes, zearalenone (17924924), and secalonic-acid-D (35287695). Exposure sources for mycotoxins have included agricultural products such as cereal grains, nuts, and rice, and components of homes and buildings such as heating, ventilation, and air conditioning systems, and burning wood chips. Another source of mycotoxins has been commercial facilities involved in the processing of contaminated materials such as grains or nuts and livestock feed. Fungal growth has been identified in wood drying kilns and two cases of cancer in laboratory workers with repeated exposure to mycotoxins have been reported. Factors conducive to the growth of fungi and the relationship between such growth and the subsequent production of mycotoxins was reviewed. The use of viable and particulate impactors, high volume filtration samplers, or liquid impingers have been recommended by the American Conference of Governmental Industrial Hygienists for the sampling of airborne mycotoxins. The use of thin layer chromatography, high performance liquid chromatography, and a chicken embryo bioassay for the analysis of mycotoxins was discussed. Epidemiological studies on the association between exposures to mycotoxins and the development of human disease were reviewed. Needs for future research in this area were outlined.

NIOSH

Trichothecene Mycotoxins in the Dust of Ventilation Systems in Office Buildings Authors: Smoragiewicz W.

Cossette B, Boutard A, Krzystyniak K Source: International Archives of Occupational and Environmental Health, Vol. 65, No. 2, pages 113-117, 25 references, 1993 Abstract:

HUMAN HABITAT-OFFICE-FUNGI POISON; The presence of trichothecene mycotoxins in dust samples from office buildings suspected of having sick building syndrome was studied. Dust samples were obtained from the ventilation systems or drapes, carpets, and ceiling fiberboards of office spaces from three buildings whose technical and medical records indicated the presence of sick building syndrome and analyzed using thin layer chromatography (TLC) and high performance liquid chromatography (HPLC). TLC proved superior to HPLC for the detection of trichothecene mycotoxins. Dust samples obtained from the ventilation system of one of the buildings had mycotoxins identified as T-2-toxin (21259201), diacetoxyscirpenol (2270408), roridine-A (14729294), and T-2-tetraol (34114993) as well as a fifth mycotoxin that produced a trichothecene specific colored reaction. The dusts obtained from the office spaces of the other two buildings contained six trichothecenes which included two unknown mycotoxins. The authors conclude that the TLC method described is useful for the detection and identification of trichothecene mycotoxins in dust samples.

Relationship of airborne microorganisms with the lung function and leukocyte levels of workers with a history of humidifier fever. Authors: KATEMAN E, HEEDERIK D, PAL TM, SMEETS M, SMID T, SPITTELER M, Author Address: Univ. Wageningen, Dep. Environ. Trop. Health, PO Box 238, 6700 AE Wageningen, Neth. Source: SCAND J WORK ENVIRON HEALTH; 16 (6). 1990. 428-433. Medical Subject Headings Entry Month: May, 1991 Year of Publication: 1990 Secondary Source ID: BIOSIS/91/09345 Abstract: BIOSIS COPYRIGHT: BIOL ABS.

HUMAN HABITAT-PLANT-FUNGI ET.AL.; An influenza-like illness appeared recently among workers in a plant processing synthetic yarn. A humidifier, a cold-water spraying system, was the suspected cause. Lung function changes over the day and week and changes in blood leucocytes were studied among the workers from the suspected department and two reference populations. Exposure to colony-forming units of bacteria and fungi and to endotoxins was also monitored. The workers from the suspected department had statistically significantly lower lung functions on the first workday of the week than the referents. Their blood leucocytes were also raised statistically significantly. The exposure to fungi, bacteria, and endotoxins differed significantly between the various departments, but the measured levels were low. It was concluded that the observed effects were suggestive of a "Monday morning fever" type of reaction and that adverse effects occurred at exposure levels lower than those found to date in the literature —.

“Filamentous fungi from walls of “mouldy” dwellings and schools-Penicillium, Aspergillus versicolor, Tiraboschi, A. Flavus Link, Cladosporium sphacrospermum, etc.

HUMAN: “All frequently isolated strains produced secondary metabolites. There are some toxic fungal metabolites in the indoor air not only with the ability to destroy ciliary movement in the upper airways in vitro but, probably, during long-lasting exposure to cause general intoxication of macroorganism via lung tissue.”

1: Inhal Toxicol. 2003 Jan;15(1):23-38. Roponen M, Toivola M, Alm S, Nevalainen A, Jussila J, Hirvonen MR.Department of Environmental Health, National Public Health Institute, PO Box 95, SF-70701 Kuopio, Finland. Inflammatory and cytotoxic potential of the airborne particle material assessed by nasal lavage and cell exposure methods. HUMAN Exposure to bioaerosols in moisture-damaged indoor environments has been shown to be a potential health risk. The aim of the present study was to evaluate the inflammatory and cytotoxic potential of airborne particle material using both the nasal lavage (NAL) method and a cell exposure study. A 24-h sample collection for airborne particles was performed using personal sampling and microenvironmental measurements in homes and an 8-h sample collection in the working places of the studied subjects. At the end of the sampling period, the production of nitric oxide, tumor necrosis factor alpha, interleukin (IL)-1 beta, IL-4, and IL-6 was analyzed in the NAL samples of the subjects. The same mediators, excluding IL-4, were measured in the cell culture medium of mouse RAW264.7 macrophages, which were exposed to the pooled filter extracts representing personal, home, and workplace exposure of each individual during the 24 h before the NAL. Samplings were repeated after 2 wk. The subjects were divided into groups of "low exposure" and "high exposure" according to the concentrations of viable fungi, viable bacteria, or total microbial amount in the pooled extract. Cytokine levels in the NAL samples of subjects with high microbial exposure were slightly increased compared to the corresponding values of the subjects with low exposure. Filter samples collected from the subjects with high microbial exposure induced a significant increase in the production of cytokines in the RAW264.7 macrophages, as compared to those from the subjects with low exposure. The within-subject variation was low in all of the cytokine measurements, but the correlation between the studied methods was poor. In conclusion, both of the methods discriminate at the group level between subjects with high and low microbial exposure. Sampling of airborne particle material and exposure of the mammalian cells to the obtained samples seems to be highly applicable in the environmental monitoring, whereas examination of the exposed subjects directly, for example by using the NAL method, is essential when association between exposure and health effects is evaluated. PMID: 12476358 [PubMed - indexed for MEDLINE]

NIOSH

Mycotoxins as Potential Occupational Hazards Authors: Sorenson WG Source: Developments in Industrial Microbiology, Vol. 31, pages 205-211, 48 references, 1990 Abstract: Entry Month: August, 1992 Year of Publication: 1990 Secondary Source ID: NIOSH /00204894.

HUMAN-FUNGI & POISON: A review was provided to examine the exposure of workers to fungi and the various effects such exposures have on human health. Fungi were noted to affect humans through direct infections, allergy and hypersensitivity and by the production of toxic metabolites. Farmer's lung disease was described as a hypersensitivity reaction which occurs in the lung in response to inhaled thermophilic actinomycetes and certain fungi. Organic dust toxic syndrome was noted to be a new syndrome, possibly associated with the presence of fungi and/or mycotoxins. It was noted that various fungi produce numerous volatile compounds, some of which can be very hazardous. Studies have indicated the inhalation of aflatoxin contaminated dust by chemical engineers working with contaminated peanut dust and biochemists working to purify aflatoxins by preparative thin layer chromatography. Mortality for total cancer and respiratory cancer was shown to be higher than expected among peanut-oil press workers. Airborne dust around combine harvesters of cereal in England has been revealed to consist predominantly of fungus spores and hyphael fragments with spore concentrations as high as 200 million spores/cubic meter. Relatively little information was noted available in the literature pertaining to the effects of specific mycotoxins on the cells and tissues of the lung. A additional studies are needed to determine whether exposure to fungus spores may constitute a significant health risk by virtue of their mycotoxins as well as by their ability to stimulate adverse immunologic response.

Bioaerosols associated with composting facilities. Authors: MILLNER PD, OLENCHOCK SA, EPSTEIN E, RYLANDER R, HAINES J, WALKER J, OOI BL, HORNE E, MARITATO M, Author Address: US Dep. Agric., Agric. Res. Serv., Soil Microbial Systems Lab., Beltsville, MD, USA.Source: COMPOST SCIENCE & UTILIZATION; 2 (4). 1994. 8-57. Abstract:BIOSIS COPYRIGHT: BIOL ABS. Entry Month: May, 1995Year of Publication: 1994 Secondary Source ID: BIOSIS/95/106148.

HUMAN-FUNGI, ETC.: Composting is one of the major treatment processes used to transform wastes into agriculturally useful products. The potential health risks associated with exposure to biological aerosols (hereafter referred to as bioaerosols) generated from the processing and handling of composted organic materials are a major concern in jurisdictions evaluating existing compost installations or planning new ones. Bioaerosols of concern during composting are like those from other organic dusts and they consist of microorganisms (actinomycetes, bacteria and fungi), arthropods, protozoa and organic constituents of microbial and plant origin. Major concerns are the fungus Aspergillus fumigatus (AF), cell walls of gram-negative bacteria (endotoxins), beta-1,3 glucans from the cell walls of fungi and mycotoxins. These biological materials are found in aerosols generated from a wide variety of organic wastes including grass clippings, wood chips, food and household wastes, agricultural waste. *

ACOME EXPERT #1. Solomon WR,

The report used by ACOEM is in a book which costs over $360.00 and not in PubMed. Here are reports from from Solomon WR on related subjects.

1B) 1: Appl Environ Microbiol. 1980 Apr;39(4):840-4. Microbial prevalence in domestic humidifiers. Burge HA, Solomon WR, Boise JR.PMID: 7377779 [PubMed - indexed for MEDLINE]

HUMAN HABITAT-MICHIGAN HOMES: The prevalence of viable thermophilic bacteria and actinomycetes and mesophilic fungi was examined in 145 samples from 110 domestic humidifiers. A total of 72 and 43% of furnace and console humidifier samples, respectively, contained viable thermophilic bacteria, whereas 60 and 72% of these samples produced mesophilic fungal growth. Thermophilic actinomycetes were recovered from seven humidifier samples. Efforts to detect thermophilic actinomycete antigens in 15 humidifier fluid samples were not successful. Antifoulants added to humidifier fluid reservoirs had no apparent effect on microbial frequency. Airborne microbial recoveries did not reflect patterns of humidifier contamination with respect to either kinds or numbers of microorganisms in 20 homes in which volumetric air samples were obtained during humidifier operation.

1C) 1: Monaldi Arch Chest Dis. 1998 Feb;53(1):43-9. b) J Allergy Clin Immunol. 1978 Jul;62(1):56-60. Airborne Aspergillus fumigatus levels outside and within a large clinical center. Solomon WR, Burge HP, Boise JR. PMID: 350933 [PubMed - indexed for MEDLINE] HUMAN HABITAT-HOSPITAL; Most considerations of Aspergillus fumigatus prevalence have implied that patterns of occurrence observed within London hospitals are generally applicable. Since prevalence data are almost nonexistent elsewhere, this assumption remains untested. To provide a comparison relevant to North America, we have monitored thermotolerant fungi outside as well as at two sites within the University Hospital, Ann Arbor, Michigan, during one year. Collections were made with paired Andersen samplers and malt agar for 30- to 40-min periods in a hallway adjacent to 6W, a general medical ward (47 days), and 2W, a lower level service and supply area (40 days); in addition, 10-min outdoor samples (44 days) were taken on an unobstructed hospital rooftop (out). Recoveries were analyzed after 3 and 7 days of 37 degrees C aerobic incubation. Virtually complete suppression of Cladosporium form species at 37 degrees left a mycoflora with A. fumigatus, A. niger, Paecilomyces spp., Mucor spp., and yeast/bacteria predominating. Although the proportions of samples yielding A. fumigatus were 76% for 6W, 57% for 2W, and 56% (out), levels exceeded 40 isolates/m3 only twice and were over 10 isolates/m3 on only 10 of 131 total samples. For 6W, 2W and out, respectively, means were 4.78, 1.97, and 6.25 isolates/m3; medians were 1.20, 1.05 and 1.75/m3 without annual trends indoors and with only a limited outdoor summer increase. Our data fail entirely to show the fall-winter abundance observed in the London report and suggest substantially lower indoor exposure levels of A. fumigatus than those noted in London.

Pathogenic fungi in human dwellings. Authors: STAIB F ,Author Address: Brentanostr. 26, D-1000 Berlin 41, Ger. Source: MYCOSES; 35 (11-12). 1992. 289-292. Abstract: BIOSIS COPYRIGHT: BIOL ABS. Entry Month: July, 1993 Year of Publication: 1992 Secondary Source ID: BIOSIS /93/16604

HUMAN-INDOOR AIR-FUNGI: Airborne invasive fungal infections in various risk groups of people suffering from immunodeficiencies are an increasing problem for modern medicine. Because of the acute and rapid course of invasive infections, prevention is of principal significance. Such prevention mainly concerns the control of fungal spores in indoor air. In this connection the immediate environment offering ecological niches for growth and morphogenesis of infective particles of Aspergillus spp., Mucoraceae, Cryptococcus neoformans and some other yeast-like fungi is of main interest. The current problems of indoor air mycology, i.e. the epidemiology and ecology of pathogenic fungi in indoor air, can only be recognized and interpreted by centres routinely performing mycological diagnosis for all the various risk groups of patients. Models of specific surveillance of the most important fungal pathogens (e.g. Aspergillus spp. and Cryptococcus neoformans) in indoor air will be outlined and discussed.

1D) J Allergy Clin Immunol. 1976 Jan;57(1):46-55. A volumetric study of winter fungus prevalence in the air of midwestern homes. Solomon WR. PMID: 942733 [PubMed - indexed for MEDLINE] HUMAN HABITAT-MICHIGAN HOUSES; Volumetric recoveries of airborne, mesophilic microfungi were made during winter months at three specific points in 150 single-family dwellings in southeastern Michigan. Mean levels of total isolates/m3 comprised a range of from less than 10 to over 20,000, although concurrent outdoor levels never exceeded 230/m3. Form species of Penicillium, Aspergillus, Cladosporium, and Rhodotorula as well as non-pigmented yeasts were the types encountered most widely indoors. Certain homes showed high recoveries of other types, including Cephalosporium, Sporobolomyces, Verticillium, and Sporothrix form species. A positive association between indoor fungus prevalence and bedroom relative humidity was strongly suggested, and high levels were observed in well-humidified homes despite the presence of electrostatic air cleaners. The data indicate characteristic patterns of (winter) air spora in specific homes and suggest that humidifying devices may serve as dispersion sources in addition to their permissive role in facilitating fungus growth.

1E) Mycopathologia. 1977 Jul 29;61(1):27-33. Comparative recoveries of airborne fungus spores by viable and non-viable modes of volumetric collection. Burge HP, Boise JR, PMID: 895829 [PubMed - indexed for MEDLINE] Rutherford JA, Solomon WR. The suitability of viable and non-viable volumetric collectors as prevalence indicators for potentially allergenic airborne fungi was studied during 124 paired exposures of the Burkard (Hirst) spore trap and a modified, wind-oriented Andersen sampler. Overall, viable recoveries of several Cladosporium form species varied directly with microscopic spore counts (p less than or equal to 0.0001). Ho