To assess whether school environments can adversely affect academic performance, we review scientific evidence relating indoor pollutants and thermal conditions, in schools or other indoor environments, to human performance or attendance. We critically review evidence for direct associations between these aspects of indoor environmental quality (IEQ) and performance or attendance. Secondarily, we summarize, without critique, evidence on indirect connections potentially linking IEQ to performance or attendance. Regarding direct associations, little strongly designed research was available. Persuasive evidence links higher indoor concentrations of nitrogen dioxide to reduced school attendance, and suggestive evidence links low ventilation rates to reduced performance. Regarding indirect associations, many studies link indoor dampness and microbiologic pollutants (primarily in homes) to asthma exacerbations and respiratory infections, which in turn have been related to reduced performance and attendance. Also, much evidence links poor IEQ (e.g., low ventilation rate, excess moisture, or formaldehyde) with adverse health effects in children and adults and documents dampness problems and inadequate ventilation as common in schools. Overall, evidence suggests that poor IEQ in schools is common and adversely influences the performance and attendance of students, primarily through health effects from indoor pollutants. Evidence is available to justify (1) immediate actions to assess and improve IEQ in schools and (2) focused research to guide IEQ improvements in schools.

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Do indoor pollutants and thermal conditions in schools influence student performance? A critical review of the literature

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.

/pdf/indoor-air-quality-ventilation-and-health-symptoms-in-1j21pntfmt.pdf

Indoor air quality, ventilation and health symptoms in schools: an analysis of existing information

Fungi of the genus Trichoderma are soilborne, green-spored ascomycetes that can be found all over the world. They have been studied with respect to various characteristics and applications and are known as successful colonizers of their habitats, efficiently fighting their competitors. Once established, they launch their potent degradative machinery for decomposition of the often heterogeneous substrate at hand. Therefore, distribution and phylogeny, defense mechanisms, beneficial as well as deleterious interaction with hosts, enzyme production and secretion, sexual development, and response to environmental conditions such as nutrients and light have been studied in great detail with many species of this genus, thus rendering Trichoderma one of the best studied fungi with the genome of three species currently available. Efficient biocontrol strains of the genus are being developed as promising biological fungicides, and their weaponry for this function also includes secondary metabolites with potential applications as novel antibiotics. The cellulases produced by Trichoderma reesei, the biotechnological workhorse of the genus, are important industrial products, especially with respect to production of second generation biofuels from cellulosic waste. Genetic engineering not only led to significant improvements in industrial processes but also to intriguing insights into the biology of these fungi and is now complemented by the availability of a sexual cycle in T. reesei/Hypocrea jecorina, which significantly facilitates both industrial and basic research. This review aims to give a broad overview on the qualities and versatility of the best studied Trichoderma species and to highlight intriguing findings as well as promising applications.

/pdf/biology-and-biotechnology-of-trichoderma-2kdws1fdv1.pdf

Biology and biotechnology of Trichoderma

The availability of immunotoxicity data for fungal toxins varies considerably for different toxins. The following is a comprehensive review of the most recent literature on the immunotoxicity of aflatoxins, fumonisins, gliotoxin, ochratoxins, patulin, and trichothecenes. Aflatoxin is an immunomodulating agent that acts primarily on cell-mediated immunity and phagocytic cell function. In addition to further characterization of aflatoxininduced immunotoxicity in various species, some recent studies have focused on ameliorating the effects of aflatoxin by supplementing or amending the diet. The immunomodulatory effects of ochratoxins have also been considered for many years. Notably, recent studies have examined immune function in the offspring of rats and mice exposed to ochratoxin pre- and perinatally. Fumonisin toxicity has been characterized relatively recently in comparison to aflatoxin and ochratoxin, and fumonisin-induced immunotoxicity is an area of active research. As these studies progress, they ma...

Immunomodulation by fungal toxins.

Background There is growing public awareness regarding the risk associated with poor indoor air quality in the home and workplace. Because Americans spend approximately 22 hours every day indoors, susceptible individuals are at much greater risk of adverse health effects from chronic low levels of exposure to indoor air pollutants over time. Along with particulate matter, gases such as ozone, nitrogen dioxide, carbon monoxide, and sulfur dioxide; microbial and chemical volatile organic compounds; passive smoke; and outdoor ambient air are the most common types of air pollutants encountered indoors. Objective To provide the allergists with necessary information that will assist them in making useful recommendations to patients seeking advice regarding indoor environmental triggers beyond traditional perennial allergens. Methods Review of the literature pertaining to indoor exposure and health effects of gaseous and particular matter. Results Indoor pollutants act as respiratory irritants, toxicants, and adjuvants or carriers of allergens. Conclusion The allergist should be prepared to evaluate patient exposure to allergic and nonallergic triggers and understand how outdoor air pollution is affecting indoor environments. This requires being familiar with methodologies for monitoring and interpreting indoor air quality and interpreting results in the context of the patients exposure history and advising patients about rational environmental control interventions.

http://www.eila.univ-paris-diderot.fr/_media/enseignement/lea/cours/rech-documentaire/gbordet2/carding_protocole_2010.pdf

The health effects of nonindustrial indoor air pollution

The role of microfungi in the manufacture of bread, beer, and wine has been known and appreciated for centuries. Less well kncjwn is perhaps the industrial valtie ol manv common moulds used in the production of antibiotics, enzymes and steroids. Tlie increase in infections from fungi due to the extensive use of antibiotics and immunosuppressive agents is a problem under current discussion. Attention is also being focused on the very potent nephroand hepato-toxic metabohtes produced in common species such as Aspergilius and Penkillium which exude these mycotoxins into various animal foodstuffs for example, which il stored under moist conditions become contaminated with moulds. Due to the ubiquitous presence of fungi in nature and the escalating industrial exploitation of common moulds, attention must be paid to occupatiotial allergic problems as well as to allergen sources related to fungi, outside and especially inside the home,

https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1398-9995.1979.tb01562.x

Fungi as a Cause of Allergic Disease

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.

Microfungal contamination of damp buildings--examples of risk constructions and risk materials.

In this study, the ability to produce mycotoxins during growth on artificially infested building materials was investigated for Penicillium chrysogenum, Pen. polonicum, Pen. brevicompactum, Chaetomium spp., Aspergillus ustus, Asp. niger, Ulocladium spp., Alternaria spp., and Paecilomyces spp., all isolated from water-damaged building materials. Spores from the different isolates of the above mentioned species were inoculated on gypsum board with and without wallpaper and on chipboard with and without wallpaper. Fungal material was scraped off the materials, extracted, and analyzed using high performance liquid chromatography-diode array detection and thin layer chromatography. All six isolates of C. globosum produced the toxic chaetoglobosins A and C, at levels of up to 50 and 7 μg/cm2 respectively. The quantities of secondary metabolites produced by Penicillia were generally low, and no toxin production was detected from any of the five isolates of Pen. chrysogenum. Both isolates of Pen. polonicum produced 3-methoxy-viridicatin, verrucosidin, and verrucofortine. Two of five isolates of Pen. brevicompactum produced mycophenolic acid. From five out of six isolates of Alternaria spp., alternariol and alternariol monomethyl ether were detected. From Ulocladium spp., Paecilomyces spp., and Asp. ustus no known mycotoxins were detected, although the latter two are known mycotoxin producers. Asp. niger produced several naphtho-γ-pyrones and tetra-cyclic compounds. All investigated species, especially Asp. ustus and Asp. niger produced many unknown secondary metabolites on the building materials. Analyses of wallpaper and glass-fibre wallpaper naturally infested with Asp. versicolor revealed sterigmatocystin and 5-methoxysterigmatocystin. Analyses of naturally infested wallpaper showed that C. globosum produced the chaetoglobosins A and C, and Pen. chrysogenum produced the antibiotic meleagrin.

Production of mycotoxins on artificially and naturally infested building materials.

Background. In the Danish Town Hall Study" it has previously been shown that the sick building syndrome is a widespread phenomenon. This has given rise to speculations as to whether biologically active components in dust or whether absorbed organic gases and vapours in the indoor climate may be partly responsible for the sick building syndrome. Therefore, we wished to study whether qualitative conditions in dust, of a physical, chemical, and biological nature, are related to the prevalence of symptoms of the sick building syndrome. Material and methods. The study included 12 town halls in the Copenhagen area. A total of 870 persons participated, 584 women and 286 men. All the participants filled out a questionnaire regarding health and working conditions, and dust samples were collected with a special vacuum cleaner in the working environment of the participants, after which the contents of inorganic and organic particles as well as of human source fragments the (hair, nails, skin) and various fibres were determined. Results. There was a significant correlation (P<0.05) between the prevalence of gram-negative bacteria in the indoor climate dust, and general symptoms (fatigue, heavy-headedness, headache, dizziness, concentration problems) (corr.coeff.=0.73), as well as symptoms from the mucous membranes of the upper respiratory tract (corr.coeff.=0.76). Also, there was a significant relation between the prevalence of particles in the dust and the prevalence of symptoms from the mucous membranes (corr.coeff.=0.81). There was a strong and significant correlation between the total amount of volatile organic components (TVOC) and lack of concentration (corr.coeff. =0.85) and feeling heavy-headed (corr.coeff.=0.72). Macromolecular dust (potentially allergenetic material) was significantly correlated to the prevalence of headache and general malaise/dizziness (corr.coeff.=0.66), while the ability of the dust to liberate histamine was significantly related to the prevalence of general malaise, dizziness (corr.coeff.=0.65) and lack of concentration (corr.coeff. =0.58). Further analyses including a number of potential confounders did not change the results of the above analyses.

Conclusion. The results of this study support the hypothesis that qualitative properties of dust are important to the sick building syndrome. The study was based on relatively few buildings, but nevertheless strong correlations were found. In perspective, epidemiological intervention studies should be carried out to investigate whether minimizing the amount of both dust and bacteria in the indoor climate affect the prevalence of sick building syndrome.

Dust and the Sick Building Syndrome

The release and transport of fungal spores from water-damaged building materials is a key factor for understanding the exposure to particles of fungal origin as a possible cause of adverse health effects associated to growth of fungi indoors. In this study, the release of spores from nine species of typical indoor fungi has been measured under controlled conditions. The fungi were cultivated for a period of 4-6 weeks on sterilized wet wallpapered gypsum boards at a relative humidity (RH) of approximately 97%. A specially designed small chamber (P-FLEC) was placed on the gypsum board. The release of fungal spores was induced by well-defined jets of air impacting from rotating nozzles. The spores and other particles released from the surface were transported by the air flowing from the chamber through a top outlet to a particle counter and sizer. For two of the fungi (Penicillium chrysogenum and Trichoderma harzianum), the number of spores produced on the gypsum board and subsequently released was quantified. Also the relationship between air velocities from 0.3 to 3 m/s over the surface and spore release has been measured. The method was found to give very reproducible results for each fungal isolate, whereas the spore release is very different for different fungi under identical conditions. Also, the relationship between air velocity and spore release depends on the fungus. For some fungi a significant number of particles smaller than the spore size were released. The method applied in the study may also be useful for field studies and for generation of spores for exposure studies.

S. Gravesen

Papers

Fungi as a Cause of Allergic Disease

Microfungal contamination of damp buildings--examples of risk constructions and risk materials.

Production of mycotoxins on artificially and naturally infested building materials.

Dust and the Sick Building Syndrome

Determination of fungal spore release from wet building materials