High-efficiency Particulate Arrestance Research Articles

Cytotoxicity and Characterization of Ultrafine Particles from Desktop Three-Dimensional Printers with Multiple Filaments.

Previous research has indicated that ultrafine particles (UFPs, particles less than 100 nm) emitted from desktop three-dimensional (3D) printers exhibit cytotoxicity. However, only a limited number of particles from different filaments and their combinations have been tested for cytotoxicity. This study quantified the emissions of UFPs from a commercially available filament extrusion desktop 3D printer using three different filaments, including acrylonitrile butadiene Styrene (ABS), thermoplastic polyurethane (TPU), and polyethylene terephthalate glycol (PETG). In this study, controlled experiments were conducted where the particles emitted were used to expose cells grown in an air-liquid interface (ALI) system. The ALI exposures were utilized for in vitro characterization of particle mixtures, including UFPs from a 3D printer. Additionally, a lactate dehydrogenase (LDH) assay was used to evaluate the cytotoxic effects of these UFPs. A549 cells were exposed at the ALI to UFPs generated by an operational 3D printer for an average of 45 and 90 min. Twenty-four hours post-exposure, the cells were analyzed for percent cytotoxicity in a 24-well ALI insert (LDH assay). UFP exposure resulted in diminished cell viability, as evidenced by significantly increased LDH levels. The findings demonstrate that ABS has the most significant particle emission. ABS was the only filament that showed a significant difference compared to the high efficiency particulate arrestance (HEPA) following 90 min of exposure (p-value < 0.05). Both ABS and PETG exhibited a significant difference compared to the HEPA control after 45 min of exposure. A preliminary analysis of potential exposure to these products in a typical environment advises caution when operating multiple printer and filament combinations in poorly ventilated spaces or without combined gas and particle filtration systems.

The Community Assessment of Freeway Exposure and Health Studies: Minimising Exposure to Traffic-related Air Pollution

People who live close to busy roads and highways are exposed to high levels of traffic-related air pollution. This puts them at risk of significant health difficulties such as high blood pressure, heart attacks and cancer. The Community Assessment of Freeway Exposure and Health Studies led by Dr Doug Brugge from the University of Connecticut represent community-engaged research into the biological impact of high exposure to pollution and importantly, possible solutions to this. This work has shown that high-efficiency particulate arrestance filters are one promising intervention for minimising exposure to pollution and thus improving health.

Effect of Reducing Ambient Traffic-Related Air Pollution on Blood Pressure: A Randomized Crossover Trial.

Exposure to traffic-related air pollution (TRAP) may contribute to increased prevalence of hypertension and elevated blood pressure (BP) for residents of near-highway neighborhoods. Relatively few studies have investigated the effects of reducing TRAP exposure on short-term changes in BP. We assessed whether reducing indoor TRAP concentrations by using stand-alone high-efficiency particulate arrestance (HEPA) filters and limiting infiltration through doors and windows effectively prevented acute (ie, over a span of hours) increases in BP. Using a 3-period crossover design, 77 participants were randomized to attend three 2-hour-long exposure sessions separated by 1-week washout periods. Each participant was exposed to high, medium, and low TRAP concentrations in a room near an interstate highway. Particle number concentrations, black carbon concentrations, and temperature were monitored continuously. Systolic BP (SBP), diastolic BP, and heart rate were measured every 10 minutes. Outcomes were analyzed with a linear mixed model. The primary outcome was the change in SBP from 20 minutes from the start of exposure. SBP increased with exposure duration, and the amount of increase was related to the magnitude of exposure. The mean change in SBP was 0.6 mm Hg for low exposure (mean particle number and black carbon concentrations, 2500 particles/cm3 and 149 ng/m3), 1.3 mm Hg for medium exposure (mean particle number and black carbon concentrations, 11 000 particles/cm3 and 409 ng/m3), and 2.8 mm Hg for high exposure (mean particle number and black carbon concentrations, 30 000 particles/cm3 and 826 ng/m3; linear trend P=0.019). There were no statistically significant differences in the secondary outcomes, diastolic BP, or heart rate. In conclusion, reducing indoor concentrations of TRAP was effective in preventing acute increases in SBP.

Spreading of SARS-CoV-2 via Heating, Ventilation, and Air Conditioning Systems—An Overview of Energy Perspective and Potential Solutions

Abstract The role of heating, ventilation, and air conditioning systems (HVAC) in spreading SARS-CoV-2 is a complex topic and has not been studied thoroughly. There are some existing strategies and technologies for health and high performance buildings; however, applications to other types of buildings come at large energy penalty: cost; design, regulations and standards changes, and varied public perception. In the present work, different factors and strategies are reviewed and discussed and suggested mitigations and solutions are provided including the required air flowrates with the presence of infectors with and without mask and disinfection techniques including ultraviolet (UV) light. Experimental and numerical research in open literature suggests that the airborne transmission of SARS-CoV-2 is sufficiently likely. However, in situ detailed experimental studies are still needed to understand the different scenarios of the virus spread. Displacement ventilation, underfloor air distribution, chilled beams, radiant ceiling panels, and laminar flow systems have varied effectiveness. High-efficiency particulate arrestance (HEPA) filters and UV light can clean viruses but at high energy cost. Suggested solutions to reduce the infection probability include recommended levels of ventilation and a combination of virus sampling technologies including cyclones, liquid impinger, filters, electrostatic precipitators, and water-based condensation.

Home Air Filtration for Traffic-Related Air Pollution: Study Design and Methods

Despite reducing indoor particulate matter (PM) pollution from traffic, it is not established that freestanding air filters in homes benefits cardiovascular health. We are launching a randomized crossover efficacy trial of high efficiency particulate arrestance (HEPA) filters in homes near a highway in Somerville, MA, USA. The approach is community-engaged research with active participation of community partners. Drawing on lessons from our pilot studies, we will focus on colder seasons when windows are less likely to be open and exclude participants with serious health problems or use of antihypertensive or anti-inflammatory medications. Over 3.5 years we will recruit 210 homes with 240 study participants aged 40-75. Each home will receive, in random order, two HEPA units either with or without (sham) filters for one month. Following a one-month wash out period, the filtration condition will be reversed. We will exclude smoking households and people who work at jobs with significant PM exposure. At baseline and at one-month intervals we will interview each participant for demographics, relevant behaviors and health symptoms. Blood pressure (central and peripheral) and blood draws taken at monthly intervals will be the primary health outcomes. Blood samples will be stored at -80 ᵒC and analyzed for inflammatory (IL-6) and coagulation (D-dimer) biomarkers. Secondary outcomes will be metabolome, asthma, allergy and cognitive function. We will monitor particle number concentration, PM2.5, PM size distribution and composition in a subset of homes for one week each during filtration and sham. Time activity will be self-reported monthly and we will measure time spent in the rooms with filters for a subset using custom Bluetooth technology. The results will provide evidence for or against use of air filters in homes to reduce health effects of traffic-related PM. We will investigate participant experience and reasons for compliance via interviews.

Reduction of personal PM2.5 exposure via indoor air filtration systems in Detroit: an intervention study.

The adverse health effects of fine particulate matter (PM < 2.5 μm in diameter [PM2.5]) air pollution are well-documented. There is a growing body of evidence that high-efficiency particulate arrestance (HEPA) filtration can reduce indoor PM2.5 concentrations and deliver some health benefits via the reduction of exposure to PM. However, few studies have tested the ability of portable air filtration systems to lower overall personal-level PM2.5 exposures. The Reducing Air Pollution in Detroit Intervention Study (RAPIDS) was designed to evaluate cardiovascular health benefits and personal PM2.5 exposure reductions via indoor portable air filtration systems among senior citizens in Detroit, Michigan. We evaluated the utility of two commercially available high-efficiency (HE: true-HEPA) and low-efficiency (LE: HEPA-type) indoor air filtration to reduce indoor PM2.5 concentrations and personal PM2.5 exposures for 40 participants in a double-blinded randomized crossover intervention. Each participant was subjected to three intervention scenarios: HE, LE, or no filter (control) of three consecutive days each, during which personal, indoor, and outdoor PM2.5 concentrations were measured daily. For mean indoor PM2.5 concentrations, we observed 60 and 52% reductions using HE and LE filters, respectively, relative to no filtration. Personal PM2.5 exposures were reduced by 53 and 31% using HE and LE filters, respectively, when compared with the control scenario. To our knowledge, this is the first indoor air filtration intervention study to examine the effectiveness of both HE and LE filters in reducing personal PM2.5 exposures.

Effect of Portable Air Filtration Systems on Personal Exposure to Fine Particulate Matter and Blood Pressure Among Residents in a Low-Income Senior Facility

Fine particulate matter (smaller than 2.5 μm) (PM2.5) air pollution is a major global risk factor for cardiovascular (CV) morbidity and mortality. Few studies have tested the benefits of portable air filtration systems in urban settings in the United States. To investigate the effectiveness of air filtration at reducing personal exposures to PM2.5 and mitigating related CV health effects among older adults in a typical US urban location. This randomized, double-blind crossover intervention study was conducted from October 21, 2014, through November 4, 2016, in a low-income senior residential building in Detroit, Michigan. Forty nonsmoking older adults were enrolled, with daily CV health outcome and PM2.5 exposure measurements. Participants were exposed to the following three 3-day scenarios separated by 1-week washout periods: unfiltered air (sham filtration), low-efficiency (LE) high-efficiency particulate arrestance (HEPA)-type filtered air, and high-efficiency (HE) true-HEPA filtered air using filtration systems in their bedroom and living room. The primary outcome was brachial blood pressure (BP). Secondary outcomes included aortic hemodynamics, pulse-wave velocity, and heart rate variability. Exposures to PM2.5 were measured in the participants' residences and by personal monitoring. The 40 participants had a mean (SD) age of 67 (8) years (62% men). Personal PM2.5 exposures were significantly reduced by air filtration from a mean (SD) of 15.5 (10.9) μg/m3 with sham filtration to 10.9 (7.4) μg/m3 with LE fitration and 7.4 (3.3) μg/m3 with HE filtration. Compared with sham filtration, any filtration for 3 days decreased brachial systolic and diastolic BP by 3.2 mm Hg (95% CI, -6.1 to -0.2 mm Hg) and 1.5 mm Hg (95% CI, -3.3 to 0.2 mm Hg), respectively. A continuous decrease occurred in systolic and diastolic BP during the 3-day period of LE filtration, with a mean of 3.4 mm Hg (95% CI, -6.8 to -0.1 mm Hg) and 2.2 mm Hg (95% CI, -4.2 to -0.3 mm Hg), respectively. For HE filtration, systolic and diastolic BP decreased by 2.9 mm Hg (95% CI, -6.2 to 0.5 mm Hg) and 0.8 mm Hg (95% CI, -2.8 to 1.2 mm Hg), respectively. Most secondary outcomes were not significantly improved. Results of this study showed that short-term use of portable air filtration systems reduced personal PM2.5 exposures and systolic BP among older adults living in a typical US urban location. The use of these relatively inexpensive systems is potentially cardioprotective against PM2.5 exposures and warrants further research. ClinicalTrials.gov identifier: NCT03334565.

A Mid-Infrared Fiber-Coupled QEPAS Nitric Oxide Sensor for Real-Time Engine Exhaust Monitoring

We report the development and application of a compact and sensitive mid-infrared nitric oxide (NO) sensor using off-beam quartz-enhanced photoacoustic spectroscopy (QEPAS). This QEPAS sensor exploits the strong absorption band of NO at $5.2~ \mu \text{m}$ using a distributed-feedback quantum cascade laser (QCL). The QCL was connected with the custom-designed photoacoustic gas cell with a mid-infrared multimode fiber to form a plug-and-play system. The selection of key sensor parameters, such as micro-resonator, laser modulation depth, and gas pressure, was discussed in detail about improving the detection sensitivity. With a minimum detection limit of 120 ppbv, our QEPAS NO sensor was deployed in real-time diesel-engine exhaust monitoring. We observed the influence of soot existing in the engine exhaust on the sensor performance, which was filtered by a high efficiency particulate arrestance material. Our sensor captured the varied NO concentrations between 126 and 187 ppmv in the exhaust at different engine rotational speeds.

Lessons from in-home air filtration intervention trials to reduce urban ultrafine particle number concentrations

BackgroundExposure to airborne ultrafine particle (UFP; <100 nm in aerodynamic diameter) is an emerging public health problem. Nevertheless, the benefit of using high efficiency particulate arrestance (HEPA) filtration to reduce UFP concentrations in homes is not yet clear. MethodsWe conducted a randomized crossover study of HEPA filtration without a washout period in 23 homes of low-income Puerto Ricans in Boston and Chelsea, MA (USA). Most participants were female, older adults who were overweight or obese. Particle number concentrations (PNC, a proxy for UFP) were measured indoors and outdoors at each home continuously for six weeks. Homes received both HEPA filtration and sham filtration for three weeks each in random order. ResultsMedian PNC under HEPA filtration was 50–85% lower compared to sham filtration in most homes, but we found no benefit in terms of reduced inflammation; associations between hsCRP, IL-6, or TNFRII in blood samples and associations with indoor PNC were inverse and not statistically significant. ConclusionsLimitations to our study design likely contributed to our findings. Limitations included carry-over effects, a population that may have been relatively unresponsive to UFP, reduction in PNC, even during sham filtration, that limited differences between HEPA and sham filtration, window opening by participants, and lack of fine-grained (room-specific) participant time-activity information. Our approach was similar to other recent HEPA intervention studies of particulate matter exposure and cardiovascular risk, suggesting that there may be a need to improve study designs.

Engineering intervention to reduce API dust exposure during milling operation

The health of workers in pharmaceutical industry is at risk as a result of inhalation of Active Pharmaceutical Ingredient (API) dusts generated during powder processing. A good number of workers are employed in powder processing areas where they are exposed to high concentrations of API dust. The work presented in this paper focuses on the efficiency of dust collection system in reducing API dust exposure from the working atmosphere near a powder milling machine. The dust was captured by creating suitable air stream at milling station which was further collected in a dust collector with HEPA (High-efficiency particulate arrestance) filter. The air stream was created by a blower, which was selected on the basis to get minimum air speed of minimum 0.5 m/s in the working zones of workers. It was observed that the dust collection system successfully collects the significant amount of respirable API dust from the working atmosphere and able to reduce the dust concentration up to 80%. Further, the respirable dust concentration reduced below occupational exposure limit (OEL) of the API after the installation of engineering control.

Solibacillus kalamii sp. nov., isolated from a high-efficiency particulate arrestance filter system used in the International Space Station.

A Gram-stain-positive, rod-shaped, endospore-forming, aerobic bacterial strain, designated ISSFR-015T, was isolated from a high-efficiency particulate arrestance filter in the International Space Station and was characterized by polyphasic taxonomy. A comparative analysis of the 16S rRNA gene sequence (1494 bp) of strain ISSFR-015T showed highest similarity to Solibacillus isronensis B3W22T (98.9 %), followed by Solibacillus silvestris HR3-23T (98.6 %) and Bacillus cecembensis PN5T (96.7 %). DNA-DNA hybridization analysis revealed that the DNA relatedness values of strain ISSFR-015T with other closely related species were in the range of 41-47 % [S. silvestrisMTCC 10789T (47 %), S. isronensis MTCC 7902T (41 %) and B. cecembensis MTCC 9127T (43 %)]. The DNA G+C content of strain ISSFR-015T was 45.4 mol%. The major fatty acids were iso-C15 : 0 (45.2 %) and C17 : 1ω10c (12.1 %). The polar lipid profile contained diphosphatidylglycerol, phosphatidylglycerol, phosphatidylethanolamine, phosphatidylserine and one unknown phospholipid. The isoprenoid quinones present in strain ISSFR-015T were MK-7 (86.8 %), MK-6 (11.6 %) and MK-8 (1.0 %). The peptidoglycan type of the cell wall was A4α l-Lys-d-Glu. Based on the phylogenetic analysis, strain ISSFR-015T belongs to the genus Solibacillus. The polyphasic taxonomic data, including low DNA-DNA hybridization values, and the chemotaxonomic analysis confirmed that strain ISSFR-015T represents a novel species, for which the name Solibacillus kalamii sp. nov. is proposed. The type strain for this proposed species is ISSFR-015T (=NRRL B-65388T=DSM 101595T).

Adaptive Architecture and the Prevention of Infections in Hospitals

Abstract Researches has shown that climate change may spark global epidemics. The objectives of hospital design consistent with a high standard of sustainable architecture must not only be the tropicalization of buildings but also a system to confront the impact of infectious diseases which arise from climate change. Infection control is the discipline concerned with preventing nosocomial or healthcare-associated infection. Infection control addresses factors related to the spread of infections within the hospital building, including prevention, monitoring and management measures. As the application of new technologies such as the Heating, ventilation and air conditioning system (HVAC) with high-efficiency particulate arrestance (HEPA) has application range within stamina, the study suggests the need to adopt an integrated adaptive hospital design strategy to prevent infection.

Comparison of MERV 16 and HEPA filters for cab filtration of underground mining equipment.

Significant strides have been made in optimizing the design of filtration and pressurization systems used on the enclosed cabs of mobile mining equipment to reduce respirable dust and provide the best air quality to the equipment operators. Considering all of the advances made in this area, one aspect that still needed to be evaluated was a comparison of the efficiencies of the different filters used in these systems. As high-efficiency particulate arrestance (HEPA) filters provide the highest filtering efficiency, the general assumption would be that they would also provide the greatest level of protection to workers. Researchers for the U.S. National Institute for Occupational Safety and Health (NIOSH) speculated, based upon a previous laboratory study, that filters with minimum efficiency reporting value, or MERV rating, of 16 may be a more appropriate choice than HEPA filters in most cases for the mining industry. A study was therefore performed comparing HEPA and MERV 16 filters on two kinds of underground limestone mining equipment, a roof bolter and a face drill, to evaluate this theory. Testing showed that, at the 95-percent confidence level, there was no statistical difference between the efficiencies of the two types of filters on the two kinds of mining equipment. As the MERV 16 filters were less restrictive, provided greater airflow and cab pressurization, cost less and required less-frequent replacement than the HEPA filters, the MERV 16 filters were concluded to be the optimal choice for both the roof bolter and the face drill in this comparative-analysis case study. Another key finding of this study is the substantial improvement in the effectiveness of filtration and pressurization systems when using a final filter design.

Method for a homogeneous distribution of pollens in an environmental exposure chamber.

A variety of different environmental exposure chambers (EECs) have been used to evaluate treatments for allergic rhinitis. To describe and test a system for a homogenous distribution of grass pollen, Phleum Pratense, in an EEC to be used for controlled pollen exposure studies in allergic participants. A chamber made of stainless steel with completely rounded corners, seating four individuals at a time, was used. Room pressure, temperature, humidity and the air change rate were kept constant throughout the study period. A rotating pipette dispensed a uniform supply of pollen into a turntable's v-shaped grooves. A stainless steel capillary tube sucked the pollens into a venturi throat at which time the pollens were mixed with a high-pressure airstream of compressed high-efficiency particulate arrestance filtered air and then transported to a spreading plate inside the EEC. To achieve uniform concentrations in the EEC, the turntable's rotating speed was continuously adjusted using information from video-coupled feedback and feed forward mechanisms. Pollen levels were detected using standard volumetric air samplers and laser particle counters. The target pollen exposure level was 1000 pollens/m(3) . Twenty-one participants were exposed to pollens in the EEC twice for 210 min. Participants evaluated their symptoms every 30 min using a total nasal symptom score (TNSS) consisting of blocked nose, runny nose, nasal itching and sneezing. Across fifteen study days, the average pollen level was 982 pollens/m(3) (SD, 102 pollens/m(3) ). On average, participants experienced a 10% difference in overall pollen levels between their two visits to the EEC. The mean TNSSs rose throughout the exposure period, with a low at baseline of 0.43 (SD, 0.68) to a high of 4.71 (SD, 2.43) just before exiting the EEC. This EEC provides a reproducible, precise and homogenous distribution of pollens making it suitable for single-centre allergy clinical trials.

Investigation of an Accidental Radiological Release in an Underground Disposal Facility.

A radioactive release took place at the Waste Isolation Pilot Plant near Carlsbad, New Mexico, on 14 February 2014. An alarm from a Continuous Air Monitor caused a switch from unfiltered to filtered air exiting the facility through High-Efficiency Particulate Arrestance filters. The activity measured on the filters demonstrated first order decay, indicating that the release was a single release. The facility was reentered in April 2014 and photographic evidence pointed to a single breached 55-gallon drum that originated at Los Alamos as the source of the release. Data were collected and analyzed to verify the source and cause of the release.

One Health approach to controlling a Q fever outbreak on an Australian goat farm.

A recent outbreak of Q fever was linked to an intensive goat and sheep dairy farm in Victoria, Australia, 2012-2014. Seventeen employees and one family member were confirmed with Q fever over a 28-month period, including two culture-positive cases. The outbreak investigation and management involved a One Health approach with representation from human, animal, environmental and public health. Seroprevalence in non-pregnant milking goats was 15% [95% confidence interval (CI) 7-27]; active infection was confirmed by positive quantitative PCR on several animal specimens. Genotyping of Coxiella burnetii DNA obtained from goat and human specimens was identical by two typing methods. A number of farming practices probably contributed to the outbreak, with similar precipitating factors to the Netherlands outbreak, 2007-2012. Compared to workers in a high-efficiency particulate arrestance (HEPA) filtered factory, administrative staff in an unfiltered adjoining office and those regularly handling goats and kids had 5·49 (95% CI 1·29-23·4) and 5·65 (95% CI 1·09-29·3) times the risk of infection, respectively; suggesting factory workers were protected from windborne spread of organisms. Reduction in the incidence of human cases was achieved through an intensive human vaccination programme plus environmental and biosecurity interventions. Subsequent non-occupational acquisition of Q fever in the spouse of an employee, indicates that infection remains endemic in the goat herd, and remains a challenge to manage without source control.

A Randomized Cross-over Air Filtration Intervention Trial for Reducing Cardiovascular Health Risks in Residents of Public Housing near a Highway.

Exposure to traffic-generated ultrafine particles (UFP; particles <100 nm) is likely a risk factor for cardiovascular disease. We conducted a trial of high-efficiency particulate arrestance (HEPA) filtration in public housing near a highway. Twenty residents in 19 apartments living <200 m from the highway participated in a randomized, double-blind crossover trial. A HEPA filter unit and a particle counter (measuring particle number concentration (PNC), a proxy for UFP) were installed in living rooms. Participants were exposed to filtered air for 21 days and unfiltered air for 21 days. Blood samples were collected and blood pressure measured at days 0, 21 and 42 after a 12-hour fasting period. Plasma was analyzed for high sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6), tumor necrosis factor alpha-receptor II (TNF-RII) and fibrinogen. PNC reductions ranging from 21% to 68% were recorded in 15 of the apartments. We observed no significant differences in blood pressure or three of the four biomarkers (hsCRP, fibrinogen, and TNF-RII) measured in participants after 21-day exposure to HEPA-filtered air compared to measurements after 21-day exposure to sham-filtered air. In contrast, IL-6 concentrations were significantly higher following HEPA filtration (0.668 pg/mL; CI = 0.465–0.959) compared to sham filtration. Likewise, PNC adjusted for time activity were associated with increasing IL-6 in 14- and 21-day moving averages, and PNC was associated with decreasing blood pressure in Lags 0, 1 and 2, and in a 3-day moving average. These negative associations were unexpected and could be due to a combination of factors including exposure misclassification, unsuccessful randomization (i.e., IL-6 and use of anti-inflammatory medicines), or uncontrolled confounding. Studies with greater reduction in UFP levels and larger sample sizes are needed. There also needs to be more complete assessment of resident time activity and of outdoor vs. indoor source contributions to UFP exposure. HEPA filtration remains a promising, but not fully realized intervention.

A pilot study to investigate the effects of combined dehumidification and HEPA filtration on dew point and airborne mold spore counts in day care centers

Meteorological factors such as relative humidity directly correlate with airborne fungal levels outdoors and indoors. While dehumidification alone is effective at reducing moisture necessary for mold growth, it is inadequate as a single intervention as it does not remove viable and non-viable fungal spores that are potentially allergenic. The purpose of this pilot study was to investigate whether dehumidification in combination with high-efficiency particulate arrestance (HEPA) filtration is effective at reducing airborne mold spore levels in day care centers. Two day care centers within a 2-mile radius of each other were selected. Day care center A was 2 years old with eight rooms while day care center B was 15 years old with six rooms. A high efficiency Santa Fe dehumidification unit equipped with a HEPA filter was installed in half the rooms (intervention) of each day care facility. Electronic HOBO data loggers continuously measured outdoor and indoor room dew point and temperature every 2 h throughout the study. Dew point and airborne fungal spore measurements from selected rooms with controlled air conditions were analyzed by comparing baseline measurements to those obtained at subsequent time periods over 1 year. Regression models accounted for correlations between measurements in the same room over time. Intervention resulted in a lowered average dew point from baseline by 8.8 degrees C compared with a decrease of 7.1 degrees C in non-intervention rooms across all time periods in both facilities (P<0.001). Fungal analyses demonstrated lower baseline (P=0.06) and follow-up means in intervention rooms (P<0.05), however the change from baseline to end of follow-up differed between intervention and non-intervention rooms in the two facilities. Log transformation was applied to approximate normality of fungal measurements. Dehumidification with HEPA filtration was effective at controlling indoor dew point in both facilities and at reducing airborne culturable fungal spore levels in one of the two facilities. These preliminary results provide a scientific rationale for using this intervention in future studies designed to investigate the impact of indoor mold exposure on health outcomes. Poor indoor air quality is a recognized cause or contributing factor to health effects. Dampness and humidity have been linked to upper and lower respiratory symptoms in children and adults. This study indicates that reducing indoor relative humidity and airborne mold spore levels using high-efficiency dehumidification units equipped with HEPA filtration is feasible even in work facilities such as day care centers where traffic in and out of the building is difficult to regulate. Clinicians should emphasize to their patients the importance of dehumidification and HEPA filtration to improve indoor air quality in the home and workplace.

Mold colonization during use of preservative-treated and untreated air filters, including HEPA filters from hospitals and commercial locations over an 8-year period (1996–2003)

High efficiency particulate arrestance (HEPA; 99.97% efficient at 0.3 microm) filters, filters with ASHRAE particulate arrestance rating of 90-95% at 1 mum (90-95% filters), and lower efficiency cellulosic-polyester filters from air conditioning systems in hospitals and commercial buildings were removed from the systems and examined microscopically for mold colonization. Cellulosic-type filters from systems with water entrainment problems typically were colonized, or became colonized upon incubation in moisture chambers. Species of Acremonium, Aspergillus, and Cladosporium were most common. With air filters of all types, treatment of filter media with an antimicrobial preservative tended to reduce or delay colonization. Mold colonization of HEPA and 90-95% filters was observed most often on the load surfaces, but two untreated HEPA filters were permeated with fungi, one with Aspergillus flavus, the other with Cladosporium sp. Air filters in heating, ventilating, and air conditioning (HVAC) systems, particularly those with chronic or periodic exposure to moisture, may serve as point sources for indoor molds.