Bacterial aerosols in an urban nursery school in Gliwice, Poland: a case study

Exposures to bioaerosols in the occupational environment are associated with a wide range of health effects with major public health impact, including infectious diseases, acute toxic effects, allergies and cancer. Respiratory symptoms and lung function impairment are the most widely studied and probably among the most important bioaerosol-associated health effects. In addition to these adverse health effects some protective effects of microbial exposure on atopy and atopic conditions has also been suggested. New industrial activities have emerged in recent years in which exposures to bioaerosols can be abundant, e.g. the waste recycling and composting industry, biotechnology industries producing highly purified enzymes and the detergent and food industries that make use of these enzymes. Dose-response relationships have not been established for most biological agents and knowledge about threshold values is sparse. Exposure limits are available for some contaminants, e.g. wood dust, subtilisins (bacterial enzymes) and flour dust. Exposure limits for bacterial endotoxin have been proposed. Risk assessment is seriously hampered by the lack of valid quantitative exposure assessment methods. Traditional culture methods to quantify microbial exposures have proven to be of limited use. Non-culture methods and assessment methods for microbial constituents [e.g. allergens, endotoxin, beta(1-->3)-glucans, fungal extracellular polysaccharides] appear more successful; however, experience with these methods is generally limited. Therefore, more research is needed to establish better exposure assessment tools and validate newly developed methods. Other important areas that require further research include: potential protective effects of microbial exposures on atopy and atopic diseases, inter-individual susceptibility for biological exposures, interactions of bioaerosols with non-biological agents and other potential health effects such as skin and neurological conditions and birth effects.

We reviewed the literature on Indoor Air Quality (IAQ), ventilation, and building-related health problems in schools and identified commonly reported building-related health symptoms involving schools until 1999. We collected existing data on ventilation rates, carbon dioxide (CO2) concentrations and symptom-relevant indoor air contaminants, and evaluated information on causal relationships between pollutant exposures and health symptoms. Reported ventilation and CO2 data strongly indicate that ventilation is inadequate in many classrooms, possibly leading to health symptoms. Adequate ventilation should be a major focus of design or remediation efforts. Total volatile organic compounds, formaldehyde (HCHO) and microbiological contaminants are reported. Low HCHO concentrations were unlikely to cause acute irritant symptoms (<0.05 ppm), but possibly increased risks for allergen sensitivities, chronic irritation, and cancer. Reported microbiological contaminants included allergens in deposited dust, fungi, and bacteria. Levels of specific allergens were sufficient to cause symptoms in allergic occupants. Measurements of airborne bacteria and airborne and surface fungal spores were reported in schoolrooms. Asthma and 'sick building syndrome' symptoms are commonly reported. The few studies investigating causal relationships between health symptoms and exposures to specific pollutants suggest that such symptoms in schools are related to exposures to volatile organic compounds (VOCs), molds and microbial VOCs, and allergens.

Polybrominated diphenyl ethers (PBDEs) are ubiquitous in the indoor environment, owing to their use in consumer products ranging from electronics to mattresses, furniture, and carpets. People are exposed to PBDEs through inhalation of indoor air and ingestion, and dermal absorption of dust particles present in the air. In this study, concentrations of PBDEs were determined in indoor air and house dust collected from homes in Albany, New York, USA. Based on the measured concentrations of PBDEs in indoor air and dust, we estimated daily exposure dose (DED) of PBDEs. In addition, we used previously published PBDE concentrations reported for breast milk from Massachusetts, USA [Johnson-Restrepo, B., Addink, R., Wong, C., Arcaro, K., Kannan, K., 2007. Polybrominated diphenyl ethers and organochlorine pesticides in human breast milk from Massachusetts. USA. J. Environ. Monitor. 9, 1205-1212] and foodstuffs collected from Texas and Florida, USA [Schecter, A., Päpke, O., Harris, T.R., Tung, K.C., Musumba, A., Olson, J., Birnbaum, L., 2006. Polybrominated diphenyl ether (PBDE) levels in an expanded market basket survey of U.S. food and estimated PBDE dietary intake by age and sex. Environ. Health Perspect. 114, 1515-1520, Johnson-Restrepo, B., Kannan, K., Addink, R., Adams, D.H., 2005b. Polybrominated diphenyl ethers and polychlorinated biphenyls in a marine foodweb of coastal Florida. Environ. Sci. Technol. 39, 8243-8250], in an estimation of dietary exposure to PBDEs. The exposure assessment was performed for five age groups: infants (<1yr), toddlers (1-5yr), children (6-11yr), teenagers (12-19yr), and adults (20yr). The dust ingestion and air inhalation factors that we used were the US Environmental Protection Agency's (EPA) exposure factors, while the daily food intake rates (g/day) were derived from the US Department of Agriculture's (USDA) food intake surveys. The total DED of PBDEs was calculated by summation of the exposures from diet, indoor air, and house dust. The average estimated DED of PBDEs was the highest for breastfed infants (86.4ng/kg-bw/day), contributed primarily (91%) from the consumption of breast milk. The average DED of PBDEs for toddlers, children, teenagers, and adults was respectively, 13.3, 5.3, 3.5, and 2.9ng/kg-bw/day. Ingestion and dermal absorption of house dust are the major pathways of PBDE exposure in toddlers, children, teenagers, and adults accounting for, on average, 56-77% of the total PBDE intake.