Biomedical subjects

Donald K Milton

Publications and source records attributed to Donald K Milton.

28 records · Page 2Linked to original sources

PubMed2003

Fungal levels in the home and lower respiratory tract illnesses in the first year of life.

The association between home dampness and lower respiratory symptoms in children has been well documented. Whether fungal exposures contribute to this association is uncertain. In a prospective birth cohort of 499 children of parents with asthma/allergies, we examined in-home fungal concentrations as predictors of lower respiratory illnesses (LRI) (croup, pneumonia, bronchitis, and bronchiolitis) in the first year. In multivariate analyses, we found a significant increased relative risk (RR) between LRI and high levels (more than the 90th percentile) of airborne Penicillium (RR = 1.73, 95% confidence interval [CI], 1.23, 2.43), dust-borne Cladosporium (RR = 1.52; CI, 1.02, 2.25), Zygomycetes (RR = 1.96; CI, 1.35, 2.83), and Alternaria (RR = 1.51; CI, 1.00, 2.28), after controlling for sex, presence of water damage or visible mold/mildew, born in winter, breastfeeding, and being exposed to other children through siblings. In a multivariate analysis, the RR of LRI was elevated in households with any fungal level at more than the 90th percentile (RR = 1.86; CI, 1.21, 2.88). Exposure to high fungal levels increased the risk of LRI in infancy, even for infants with nonwheezing LRI. Actual mechanisms remain unknown, but fungi and their components (glucans, mycotoxins, and proteins) may increase the risk of LRI by acting as irritants or through increasing susceptibility to infection.

Air Microbiology↗

PubMed2003

Airborne rhinovirus detection and effect of ultraviolet irradiation on detection by a semi-nested RT-PCR assay.

BACKGROUND: Rhinovirus, the most common cause of upper respiratory tract infections, has been implicated in asthma exacerbations and possibly asthma deaths. Although the method of transmission of rhinoviruses is disputed, several studies have demonstrated that aerosol transmission is a likely method of transmission among adults. As a first step in studies of possible airborne rhinovirus transmission, we developed methods to detect aerosolized rhinovirus by extending existing technology for detecting infectious agents in nasal specimens. METHODS: We aerosolized rhinovirus in a small aerosol chamber. Experiments were conducted with decreasing concentrations of rhinovirus. To determine the effect of UV irradiation on detection of rhinoviral aerosols, we also conducted experiments in which we exposed aerosols to a UV dose of 684 mJ/m2. Aerosols were collected on Teflon filters and rhinovirus recovered in Qiagen AVL buffer using the Qiagen QIAamp Viral RNA Kit (Qiagen Corp., Valencia, California) followed by semi-nested RT-PCR and detection by gel electrophoresis. RESULTS: We obtained positive results from filter samples that had collected at least 1.3 TCID50 of aerosolized rhinovirus. Ultraviolet irradiation of airborne virus at doses much greater than those used in upper-room UV germicidal irradiation applications did not inhibit subsequent detection with the RT-PCR assay. CONCLUSION: The air sampling and extraction methodology developed in this study should be applicable to the detection of rhinovirus and other airborne viruses in the indoor air of offices and schools. This method, however, cannot distinguish UV inactivated virus from infectious viral particles.

Air Microbiology↗

PubMed2003

The work environment and workers' health in four large office buildings.

We conducted a 1-year epidemiologic study in Boston, Massachusetts, beginning May 1997, to examine the associations between environmental factors and office workers' health. We recruited 98 subjects (81 females and 17 males) in 21 offices in four office buildings. We conducted environmental sampling every 6 weeks and concurrently administered detailed questionnaires to collect information on work-related symptoms, psychosocial factors, and perceptions of the office environments. In multivariate analyses, eye irritation was positively correlated with floor dust [odds ratio (OR) = 1.46; 95% confidence intervals (CI), 1.14-1.86] and reported lack of office cleanliness (OR = 1.52; 95% CI, 1.11-2.08). Nonspecific symptoms were positively associated with unidentified chair fungi (OR = 1.87; 95% CI, 1.11-3.15) and several self-reported conditions, including a history of asthma (OR = 3.15; 95% CI, 1.26-7.87), more people in offices (OR = 1.71; 95% CI, 1.16-2.51), lack of office cleanliness (OR = 2.85; 95% CI, 1.72-4.73), and low job satisfaction (OR = 1.72; 95% CI, 1.06-2.81). Upper respiratory symptoms were positively associated with total fungal concentrations recovered from chair dust (OR = 1.35; 95% CI, 1.07-1.70) and the following self-reported conditions: more people in offices (OR = 1.45; 95% CI, 1.01-2.08), lack of office cleanliness (OR = 1.62; 95% CI, 1.15-2.30), and jobs frequently requiring hard work (OR = 1.43; 95% CI, 1.05-1.95). This study emphasizes the importance of maintaining a clean, uncrowded workspace and the importance of chair fungi as a correlate for health effects.

Adult↗

PubMed2002

A study of indoor carbon dioxide levels and sick leave among office workers.

BACKGROUND: A previous observational study detected a strong positive relationship between sick leave absences and carbon dioxide (CO2) concentrations in office buildings in the Boston area. The authors speculated that the observed association was due to a causal effect associated with low dilution ventilation, perhaps increased airborne transmission of respiratory infections. This study was undertaken to explore this association. METHODS: We conducted an intervention study of indoor CO2 levels and sick leave among hourly office workers employed by a large corporation. Outdoor air supply rates were adjusted periodically to increase the range of CO2 concentrations. We recorded indoor CO2 concentrations every 10 minutes and calculated a CO2 concentration differential as a measure of outdoor air supply per person by subtracting the 1-3 a.m. average CO2 concentration from the same-day 9 a.m. - 5 a.m. average concentration. The metric of CO2 differential was used as a surrogate for the concentration of exhaled breath and for potential exposure to human source airborne respiratory pathogens. RESULTS: The weekly mean, workday, CO2 concentration differential ranged from 37 to 250 ppm with a peak CO2 concentration above background of 312 ppm as compared with the American Society of Heating, Refrigeration and Air-conditioning Engineers (ASHRAE) recommended maximum differential of 700 ppm. We determined the frequency of sick leave among 294 hourly workers scheduled to work approximately 49,804.2 days in the study areas using company records. We found no association between sick leave and CO2 differential CONCLUSIONS: The CO2 differential was in the range of very low values, as compared with the ASHRAE recommended maximum differential of 700 ppm. Although no effect was found, this study was unable to test whether higher CO2 differentials may be associated with increased sick leave.

Adult↗

PubMed2002

Airborne fungi and endotoxin concentrations in different areas within textile plants in Taiwan: a 3-year study.

Bioaerosols have been found in many occupational environments, including animal feeding houses, poultry slaughter houses, and cotton textile plants. This study was undertaken to examine a group of bioaerosols, the endotoxins, fungi, and bacteria, inside two textile factories over 3 years in Taiwan, where temperature and humidity are usually high year-round. Airborne dust was collected with filter cassettes attached to personal pumps and analyzed by the Kinetic Limulus Assay with Resistant-parallel-line Estimation. For fungi and bacteria determination, samples were collected using duplicated single-stage impactors, and organisms were counted after incubation. Endotoxin was the major contamination inside textile plants. Indoor levels were substantially higher than outdoor concentrations by 63- to 278-fold. The average values of fungi inside and outside the plants were not significantly different. Airborne bacteria levels were higher inside the plants as compared to outside. The carding sites, using only cotton, had extremely high endotoxin levels, greater than those at sites using synthetic fibers. Cotton, may be a major source of endotoxin contamination. In conclusion, the early stage of textile processing seems to generate high endotoxin and bacteria contamination. Priorities should be given to occupational hygiene programs for workers at various sites in textile plants.

Aerosols↗

PubMed2002

Dustborne fungi in large office buildings.

Fungi are ubiquitous in our daily environments. However, their effects on office workers' health are of great interest to many environmental health researchers. Dust has been considered an important reservoir of indoor fungi from which aerosolization and exposure could occur. We have examined the characteristics of dustborne fungal populations recovered from floors and chairs in office buildings. We investigated twenty-one offices in four office buildings in Boston, MA over a year beginning May 1997. We conducted intensive environmental sampling every six weeks to measure culturable dustborne fungi from floors and chairs, surface dust levels and water activity in carpeting. Carbon dioxide, temperature, and relative humidity were monitored continuously. Concentrations of total dustborne fungi recovered from floors were positively related to carbon dioxide (beta = 0.00064; p-value = 0.0002) and temperatures between 20 and 22.5 degrees C (p-value = 0.0026). Also, total fungal concentrations in floors gradually increased over the year (p-value = 0.0028). Total fungi recovered from chairs varied significantly by season (p-value < 0.0001), highest in September and lowest in March, and were positively correlated with dust loads in floors (beta = 0.25; p-value < 0.0001). We used principal component analysis (PCA) to reduce various observed fungal species to fewer factors. Six groups (PCA factors) were obtained for dustborne fungi recovered from both floors and chairs. The models of the first PCA factors for both floors and chairs were similar to those for total fungal concentrations. The results of this study provide essential information to further evaluate the effects of dustborne fungi on office workers' health.

Air Microbiology↗

PubMed2002

A longitudinal analysis of wheezing in young children: the independent effects of early life exposure to house dust endotoxin, allergens, and pets.

BACKGROUND: It has been postulated that exposure to bacterial endotoxins and animals early in life might confer protection against the development of asthma and allergies. OBJECTIVE: We investigated the longitudinal effects of exposure to house dust endotoxin (HDE), allergen levels, and the presence of a dog in the home on wheezing in young children over a 4-year period. METHODS: Two hundred twenty-six children younger than 5 years were followed for 4 years. Endotoxin and allergen levels were measured from house dust collected at baseline. Longitudinal associations were investigated by using a proportional hazards technique that allowed for multiple outcomes per subject. RESULTS: Exposure to high concentrations of HDE of greater than the median level was associated with an increased risk for wheezing over the period of observation (multivariate relative risk, 1.52; 95 % CI, 1.07-2.14), but this risk rapidly decreased over time (P for trend =.005). Exposure to cockroach allergen was associated with increased risk for wheezing, whereas exposure to cat allergen and the presence of a dog in the home were both associated with decreased risk for wheezing. The risks associated with cockroach allergen, cat allergen, and dog did not change over the period of observation. CONCLUSION: The negative associations between exposures to dogs and cat allergen and wheeze appear to be independent of the effects of endotoxin and suggest that separate mechanisms might mediate the effects of HDE exposure and pet exposure on the developing immune system.

Air Pollution, Indoor↗

PubMed2002

Populations and determinants of airborne fungi in large office buildings.

Bioaerosol concentrations in office environments and their roles in causing building-related symptoms have drawn much attention in recent years. Most bioaerosol studies have been cross-sectional. We conducted a longitudinal study to examine the characteristics of airborne fungal populations and correlations with other environmental parameters in office environments. We investigated four office buildings in Boston, Massachusetts, during 1 year beginning May 1997, recruiting 21 offices with open workstations. We conducted intensive bioaerosol sampling every 6 weeks resulting in 10 sets of measurement events at each workstation, and recorded relative humidity, temperature, and CO2 concentrations continuously. We used principal component analysis (PCA) to identify groups of culturable fungal taxa that covaried in air. Four major groupings (PCA factors) were derived where the fungal taxa in the same groupings shared similar ecological requirements. Total airborne fungal concentrations varied significantly by season (highest in summer, lowest in winter) and were positively correlated with relative humidity and negatively related to CO2 concentrations. The first and second PCA factors had similar correlations with environmental variables compared with total fungi. The results of this study provide essential information on the variability within airborne fungal populations in office environments over time. These data also provide background against which cross-sectional data can be compared to facilitate interpretation. More studies are needed to correlate airborne fungi and occupants' health, controlling for seasonal effects and other important environmental factors.

Air Pollution, Indoor↗

PubMed2002

Improving the health of workers in indoor environments: priority research needs for a national occupational research agenda.

Indoor nonindustrial work environments were designated a priority research area through the nationwide stakeholder process that created the National Occupational Research Agenda. A multidisciplinary research team used member consensus and quantitative estimates, with extensive external review, to develop a specific research agenda. The team outlined the following priority research topics: building-influenced communicable respiratory infections, building-related asthma/allergic diseases, and nonspecific building-related symptoms; indoor environmental science; and methods for increasing implementation of healthful building practices. Available data suggest that improving building environments may result in health benefits for more than 15 million of the 89 million US indoor workers, with estimated economic benefits of $5 to $75 billion annually. Research on these topics, requiring new collaborations and resources, offers enormous potential health and economic returns.

Air Pollutants, Occupational↗

PubMedDate not supplied

Comparison of endotoxin assays using agricultural dusts.

Endotoxins from gram-negative bacteria pose a significant respiratory hazard. Establishing dose-response relationships is problematic because there are no standard procedures for sampling and analysis. The goal of this study was to compare endotoxin analyses in six laboratories using Limulus-based assays for analysis of organic dusts from three agricultural environments: chicken barns, swine barns, and corn processing facilities. For each dust generation experiment 14 side-by-side air samples were collected on 37-mm glass fiber filters at flows of 1.8 L/min. Each laboratory was randomly allocated two filters from each of seven experiments per dust type. Three laboratories used the QCL-1000 endpoint assay, and three used the kinetic-QCL method. To eliminate variability among different lots, a single lot of Limulus amebocyte lysate for endpoint assays and one similar lot for kinetic assays was provided. Precision of assays performed within labs was very good, with pooled coefficients of variation for replicate samples ranging from 1 to 11% over all labs and all dust types. There were significant differences between laboratories for all three dust types (p < 0.01). The pattern of differences between labs varied by dust type. For chicken dust, labs using the endpoint method reported higher results than those using kinetic methods. For swine and corn dusts, labs using the kinetic method reported the highest endotoxin values. For chicken dust, results from all labs except A and B were highly correlated (r = 0.86-1.00). For swine dust, only labs B and E, and C and D were correlated. For corn, A, B, and D were significantly correlated with most other labs. In conclusion, statistical differences in performance between laboratories were apparent and may be related to the extraction and analytical methods. The results of this study will be useful for standardization of sampling and analysis of airborne endotoxin in agriculture.

Agriculture↗