Abstract
Fungi and their toxic metabolites have been pinpointed as possible causes of sick building syndrome, an illness associated with poor indoor ventilation. Certain risk groups, such as hospitalized patients, the elderly and young children, tend to be more susceptible. Substantial effort has been devoted to establishing optimal fungal monitoring techniques and identification protocols. This overview screens the available monitoring and identification methods which may provide qualitative or quantitative information about the presence of particular fungi or their secondary metabolites/ mycotoxins and evaluation of their effect on the potential improvement in the associated health symptomology and the establishment of the pathophysiological mechanism involved in this process. Certain target locations, where mycological contamination is more likely to occur and certain risk groups that are in need of stricter environmental inspection and more refined fungal monitoring and identification protocols, are addressed. In assessing the impact of environmental inspection, there is no gold standard for the expected response rate in terms of fungal load reduction and its significance. This lack of standards and the limitations in associating specific fungal contamination with health effects may be related to the determination of indoor fungal load. This could be the result of either reporting biases of dampness or the choice of method used to monitor fungal load. Refined fungal monitoring and identification protocols are suggested for the more specific targeting of fungal isolates, their identification and quantification.
Highlights
There is a growing body of evidence in Europe implicating a correlation between dampness and mold in buildings and increased risk of adverse health effects to building occupants [1,2]
Detection and subsequent enumeration and identification of airborne fungal particulates collected on growth media depends on whether the spores and hyphal fragments are viable and whether the media used can support their growth into colonies
In Bloom et al.'s [85] study, high-performance liquid chromatography (HPLC) and mass spectrometry (MS), especially tandem MS involving multiple steps of MS selection with some form of fragmentation between stages (MSMS), providing high analytical specificity, and gas chromatography (GC) proved to be complementary tools for detecting some of the most potent mycotoxins produced by molds that are frequently encountered in damp indoor environments
Summary
There is a growing body of evidence in Europe implicating a correlation between dampness and mold in buildings and increased risk of adverse health effects to building occupants [1,2]. Other groups at risk, such as the elderly [9] and young children [10,11], have been noted for their susceptibility to the harmful effects of indoor air and fungi Both direct fungal infection (mycosis) [7] and toxigenic effects of fungal mycotoxins have been reported [12,13,14,15,16]. This rising epidemiological phenomenon requires preventive activities, and mitigation of the contaminated sources These include the ability to define and quantify the mycological load and harmful sources, i.e., the types of fungi and their toxins, to determine their reduction upon treatment and to translate the fungal risk base into an environmental health policy that will include guidelines for monitoring fungal load and the associated health burden. The integration of better validated screening criteria and occupants’ subjective evaluations is indicated as a means of assessing the impact of, monitoring and mitigating mycological load
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