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Methicillin-resistant Staphylococcus aureus (MRSA) is an increasing health concern across the globe and is often prevalent at long-term care facilities, such as nursing homes. However, we know little of whether nursing home staff is exposed to MRSA via air and surfaces. We investigated whether staff members at nursing homes are colonised with and exposed to culturable MRSA, and assessed staff members’ self-reported knowledge of MRSA and compliance with infection hygiene guidelines. Five nursing homes with MRSA positive residents were visited in Copenhagen, Denmark. Personal bioaerosol exposure samples and environmental samples from surfaces, sedimented dust and bioaerosols were examined for MRSA and methicillin-susceptible S. aureus (MSSA) to determine occupational exposure. Swabs were taken from staffs’ nose, throat, and hands to determine whether they were colonised with MRSA. An online questionnaire about MRSA and infection control was distributed. No staff members were colonised with MRSA, but MRSA was detected in the rooms of the colonised residents in two out of the five nursing homes. MRSA was observed in air (n =4 out of 42, ranging from 2.9–7.9 CFU/m3), sedimented dust (n = 1 out of 58, 1.1 × 103 CFU/m2/d), and on surfaces (n = 9 out of 113, 0.04–70.8 CFU/m2). The questionnaire revealed that half of the staff members worry about spreading MRSA to others. Identified aspects for improvement were improved availability and use of protective equipment, not transferring cleaning supplies (e.g., vacuum cleaners) between residents’ rooms and to reduce worry of MRSA, e.g., through education. [Figure not available: see fulltext.]

Ground level ozone arises primarily from traffic, it is a powerful oxidant and its primary target organ is the lung. Most epidemiological studies reporting the health effects of ozone have estimated individual exposure from measurements obtained from outdoor monitors but surrogates of personal exposure may not adequately reflect personal exposures. Also, the main focus has been on infants and children. Our purpose was to assess associations between urban background ozone and indoor residential ozone levels as well as to investigate the effects of indoor residential ozone on lung function in 51 elderly non-smokers. Indoor ozone was measured passively in homes, while urban background outdoor ozone was monitored continuously at a fixed monitoring station located on the roof of the 20-m high university H.C. Ørsteds campus building in a park area. Lung function was measured at baseline as well as on three consecutive occasions, for each subject. The mean residential ozone levels were 1.33 ppb, and mean outdoor urban background levels were 27 ppb. Outdoor urban background ozone levels were not consistently associated with residential ozone. No significant changes in lung function were detected in association with residential ozone among healthy participants. In this study, we were unable to detect significant changes in lung function in association with increased levels of residential ozone amongst healthy elderly non-smokers.

In the indoor environment, people are exposed to several fungal species. Evident dampness is associated with increased respiratory symptoms. To examine the immune responses associated with fungal exposure, mice are often exposed to a single species grown on an agar medium. The aim of this study was to develop an inhalation exposure system to be able to examine responses in mice exposed to mixed fungal species aerosolized from fungus-infested building materials. Indoor airborne fungi were sampled and cultivated on gypsum boards. Aerosols were characterized and compared with aerosols in homes. Aerosols containing107 CFU of fungi/m3 air were generated repeatedly from fungus-infested gypsum boards in a mouse exposure chamber. Aerosols contained Aspergillus nidulans, Aspergillus niger, Aspergillus ustus, Aspergillus versicolor, Chaetomium globosum, Cladosporium herbarum, Penicillium brevicompactum, Penicillium camemberti, Penicillium chrysogenum, Penicillium commune, Penicilliumglabrum, Penicillium olsonii, Penicillium rugulosum, Stachybotrys chartarum, and Wallemia sebi. They were all amongthe most abundant airborne species identified in 28 homes. Nine species from gypsum boards and 11 species in the homes areassociated with water damage. Most fungi were present as single spores, but chains and clusters of different species and fragments were also present. The variation in exposure level during the 60 min of aerosol generation was similar to the variation measured in homes. Through aerosolization of fungi from the indoor environment, cultured on gypsum boards, it was possible to generate realistic aerosols in terms of species composition, concentration, and particle sizes. The inhalation-exposure systemcan be used to study responses to indoor fungi associated with water damage and the importance of fungal species composition.

We measured ultrafine particle concentrations in 56 Danish residences, estimated the daily integrated exposure of the occupants and apportioned this exposure to source events. The residential daily integrated particle number (PN) exposure in the homes was substantial and source events, especially candle burning, cooking, toasting and unknown activities, were responsible on average for ∼65% of the residential integrated exposure. Residents of another 60 homes were then asked to carry a backpack equipped with a GPS recorder and a portable monitor to measure real-time individual exposure over ~48 h. UFP exposure occurring in various microenvironments was estimated. The fractional contribution of each microenvironment to the daily integrated personal exposure corresponded to the fractions of the day the subjects spent in each microenvironment. The home environment accounted for 50% of the daily personal exposure, indoor environments other than home or vehicles contributed with ~40%, and being in transit or outdoors contributed 5% or less.

A series of 5 studies in a total of 300 middle-aged and elderly individuals have related exposure to indoor and outdoor ultrafine and fine particles for 5-48 h to effects on vascular and lung function with possible explanatory inflammation and oxidative stress biomarkers. The data consistently support detrimental effect of UFP from traffic on vascular function. Indoor UFP and PM2.5 might contribute to cardiovascular risk through endothelial damage and vascular dysfunction, respectively, whereas indoor UFP dominated by candle burning appears to have adverse lung effects. The biomarkers provided no mechanistic explanation.

Increased levels of oxidatively damaged DNA have been documented in studies of metal, metal oxide, carbon-based and ceramic engineered nanomaterials (ENMs). In particular, 8-oxo-7,8-dihydroguanine-2'-deoxyguanosine (8-oxodG) is widely assessed as a DNA nucleobase oxidation product, measured by chromatographic assays, antibody-based methods or the comet assay with DNA repair enzymes. However, spurious oxidation of DNA has been a problem in certain studies applying chromatographic assays, yielding high baseline levels of 8-oxodG. Antibody-based assays detect high 8-oxodG baseline levels, related to cross-reactivity with other molecules in cells. This review provides an overview of efforts to reliably detect oxidatively damaged DNA and a critical assessment of the published studies on DNA damage levels. Animal studies with high baseline levels of oxidatively damaged DNA are more likely to show positive associations between airway exposure to ENMs and oxidized DNA in lung tissue than studies showing acceptable baseline levels (odds ratio = 12.1, 95% confidence interval: 1.2-124). Nevertheless, reliable studies indicate that intratracheal instillation of nanosized carbon black is associated with increased levels of oxidatively damaged DNA in lung tissue. Oral exposure to nanosized carbon black, TiO2 , carbon nanotubes and ZnO is associated with elevated levels of oxidatively damaged DNA in tissues. These observations are supported by cell culture studies showing concentration-dependent associations between ENM exposure and oxidatively damaged DNA measured by the comet assay. Cell culture studies show relatively high variation in the ability of ENMs to oxidatively damage DNA; hence, it is currently impossible to group ENMs according to their DNA damaging potential. Environ. Mol. Mutagen., 2014. © 2014 Wiley Periodicals, Inc.

To explore associations of exposure to ambient and indoor air particulate and bio-aerosol pollutants with cardiovascular and respiratory disease markers, we utilized seven repeated measurements from 48 elderly subjects participating in a 4-week home air filtration study. Microvascular function (MVF), lung function, blood leukocyte counts, monocyte adhesion molecule expression, C-reactive protein, Clara cell protein (CC16) and surfactant protein-D (SPD) were examined in relation to exposure preceding each measurement. Exposure assessment included 48-h urban background monitoring of PM10, PM2.5 and particle number concentration (PNC), weekly measurements of PM2.5 in living- and bedroom, 24-h measurements of indoor PNC three times, and bio-aerosol components in settled dust on a 2-week basis. Statistically significant inverse associations included: MVF with outdoor PNC; granulocyte counts with PM2.5; CD31 expression with dust fungi; SPD with dust endotoxin. Significant positive associations included: MVF with dust bacteria; monocyte expression of CD11 with PM2.5 in the bedroom and dust bacteria and endotoxin, CD31 expression with dust serine protease; serum CC16 with dust NAGase. Multiple comparisons demand cautious interpretation of results, which suggest that outdoor PNC have adverse effects on MVF, and outdoor and indoor PM2.5 and bio-aerosols are associated with markers of inflammation and lung cell integrity.

Exposure to ambient air particles is associated with elevated levels of DNA strand breaks (SBs) and endonuclease III, formamidopyrimidine DNA glycosylase (FPG) and oxoguanine DNA glycosylase-sensitive sites in cell cultures, animals and humans. In both animals and cell cultures, increases in SB and in oxidatively damaged DNA are seen after exposure to a range of engineered nanomaterials (ENMs), including carbon black, carbon nanotubes, fullerene C60, ZnO, silver and gold. Exposure to TiO2 has generated mixed data with regard to SB and oxidatively damaged DNA in cell cultures. Nanosilica does not seem to be associated with generation of FPG-sensitive sites in cell cultures, while large differences in SB generation between studies have been noted. Single-dose airway exposure to nanosized carbon black and multi-walled carbon nanotubes in animal models seems to be associated with elevated DNA damage levels in lung tissue in comparison to similar exposure toTiO2 and fullerene C60. Oral exposure has been associated with augmented DNA damage levels in cells of internal organs, although the doses have been typically very high. Intraveneous and intraperitoneal injection of ENMs have shown contradictory results dependent on the type of ENM and dose in each set of experiments. In conclusion, the exposure to both combustion-derived particles and ENMs is associated with increased levels of DNA damage in the comet assay. Particle size, composition and crystal structure of ENM are considered important determinants of toxicity, whereas their combined contributions to genotoxicity in the comet assay are yet to be thoroughly investigated.

Exposure to airborne particulate matter in homes is associated with the risk of cardiovascular diseases and respiratory problems. Due to the extended time people spend at home, reducing the particle concentration in homes may be a means to reduce the risk of cardiovascular diseases and respiratory problems. Use of particle filtration units (PFU's) might be an effective way for rapid removal of indoor PM.In a randomised cross-over design, the custom built PFU's ran for two weeks in each of two modes: with or without the inclusion of a HEPA filter.We assessed the association between the concentration levels of particulate matter and building characteristics; and the use of PFU as a way to effectively reduce the levels of PM2.5 indoors.The results obtained from the study have shown that a small room area, wooden floor material, or the use of gas for cooking is strongly associated with high PM2.5 mass concentrations. Furthermore, the winter period and a location farther from a trafficked street were associated with increased PM2.5 mass. Overall, the use of PFU led to a decrease in the concentrations of PM2.5 of 54.5% (median value).We assessed the PFU particle-removal efficiency by using the amount of infiltrated air, size of the controlled room and filtration effectiveness.

BACKGROUND: Exposure to ambient air particulate matter (PM) has been linked to decline in pulmonary function and cardiovascular events possibly through inflammation. Little is known about individual exposure to ultrafine particles (UFP) inside and outside modern homes and associated health-related effects.METHODS: Associations between vascular and lung function, inflammation markers and exposure in terms of particle number concentration (PNC; d = 10-300 nm) were studied in a cross-sectional design with personal and home indoor monitoring in the Western Copenhagen Area, Denmark. During 48-h, PNC and PM2.5 were monitored in living rooms of 60 homes with 81 non-smoking subjects (30-75 years old), 59 of whom carried personal monitors both when at home and away from home. We measured lung function in terms of the FEV1/FVC ratio, microvascular function (MVF) and pulse amplitude by digital artery tonometry, blood pressure and biomarkers of inflammation including C-reactive protein, and leukocyte counts with subdivision in neutrophils, eosinophils, monocytes, and lymphocytes in blood.RESULTS: PNC from personal and stationary home monitoring showed weak correlation (r = 0.15, p = 0.24). Personal UFP exposure away from home was significantly inversely associated with MVF (1.3% decline per interquartile range, 95% confidence interval: 0.1-2.5%) and pulse amplitude and positively associated with leukocyte and neutrophil counts. The leukocyte and neutrophil counts were also positively and pulse amplitude negatively associated with total personal PNC. Indoor PNC and PM2.5 showed positive association with blood pressure and inverse association with eosinophil counts.CONCLUSIONS: The inverse association between personal exposure away from home and MVF is consistent with adverse health effects of UFP from sources outside the home and might be related to increased inflammation indicated by leukocyte counts, whereas UFP from sources in the home could have less

Background: Exposure to ambient air particulate matter (PM) has been linked to decline in pulmonary function and cardiovascular events possibly through inflammation. Little is known about individual exposure to ultrafine particles (UFP) inside and outside modern homes and associated health-related effects. Methods: Associations between vascular and lung function, inflammation markers and exposure in terms of particle number concentration (PNC; d = 10-300 nm) were studied in a cross-sectional design with personal and home indoor monitoring in the Western Copenhagen Area, Denmark. During 48-h, PNC and PM2.5 were monitored in living rooms of 60 homes with 81 non-smoking subjects (30-75 years old), 59 of whom carried personal monitors both when at home and away from home. We measured lung function in terms of the FEV1/FVC ratio, microvascular function (MVF) and pulse amplitude by digital artery tonometry, blood pressure and biomarkers of inflammation including C-reactive protein, and leukocyte counts with subdivision in neutrophils, eosinophils, monocytes, and lymphocytes in blood. Results: PNC from personal and stationary home monitoring showed weak correlation (r = 0.15, p = 0.24). Personal UFP exposure away from home was significantly inversely associated with MVF (1.3% decline per interquartile range, 95% confidence interval: 0.1-2.5%) and pulse amplitude and positively associated with leukocyte and neutrophil counts. The leukocyte and neutrophil counts were also positively and pulse amplitude negatively associated with total personal PNC. Indoor PNC and PM2.5 showed positive association with blood pressure and inverse association with eosinophil counts. Conclusions: The inverse association between personal exposure away from home and MVF is consistent with adverse health effects of UFP from sources outside the home and might be related to increased inflammation indicated by leukocyte counts, whereas UFP from sources in the home could have less effect.

Particle number (PN) concentrations (10-300 nm in size) were continuously measured over a period of ~45 h in 56 residences of nonsmokers in Copenhagen, Denmark. The highest concentrations were measured when occupants were present and awake (geometric mean, GM: 22.3 × 10(3) cm(-3)), the lowest when the homes were vacant (GM: 6.1 × 10(3) cm(-3)) or the occupants were asleep (GM: 5.1 × 10(3) cm(-3)). Diary entries regarding occupancy and particle related activities were used to identify source events and apportion the daily integrated exposure among sources. Source events clearly resulted in increased PN concentrations and decreased average particle diameter. For a given event, elevated particle concentrations persisted for several hours after the emission of fresh particles ceased. The residential daily integrated PN exposure in the 56 homes ranged between 37 × 10(3) and 6.0 × 10(6) particles per cm(3)·h/day (GM: 3.3 × 10(5) cm(-3)·h/day). On average, ~90% of this exposure occurred outside of the period from midnight to 6 a.m. Source events, especially candle burning, cooking, toasting, and unknown activities, were responsible on average for ~65% of the residential integrated exposure (51% without the unknown activities). Candle burning occurred in half of the homes where, on average, it was responsible for almost 60% of the integrated exposure.

Exposure to particulate air pollution increases respiratory and cardiovascular morbidity and mortality, especially in elderly, possibly through inflammation and vascular dysfunction.

Oxidatively damaged DNA may be important in carcinogenesis. 8-Oxo-7,8-dihydroguanine (8-oxoGua) is an abundant and mutagenic lesion excised by oxoguanine DNA glycosylase 1 (OGG1) and measurable in urine or plasma by chromatographic methods with electrochemical or mass spectrometric detectors, reflecting the rate of damage in steady state. A common genetic OGG1 variant may affect the activity and was associated with increased levels of oxidized purines in leukocytes without apparent effect on 8-oxoGua excretion or major change in cancer risk. 8-OxoGua excretion has been associated with exposure to air pollution, toxic metals, tobacco smoke and low plasma antioxidant levels, whereas fruit and vegetable intake or dietary interventions showed no association. In rodent studies some types of feed may be source of 8-oxoGua in collected urine. Of cancer therapies, cisplatin increased 8-oxoGua excretion, whereas radiotherapy only showed such effects in experimental animals. Case-control studies found high excretion of 8-oxoGua in relation to cancer, dementia and celiac disease but not hemochromatosis, although associations could be a consequence rather than reflecting causality of disease. One prospective study found increased risk of developing lung cancer among non-smokers associated with high excretion of 8-oxoGua. Urinary excretion of 8-oxoGua is a promising biomarker of oxidatively damaged DNA.

Hsp70 has the ability to enhance the recovery of stressed cells by its ability to catalyze the reassembly of damaged proteins. Such a chaperoning function is essential for the Hsp70-mediated protection against anoxic stress that causes protein denaturation. We have studied induction of both transcription and translation of Hsp70 during recovery from chemical anoxia and the role of the extracellular signal regulated kinase ERK2 in this induction of Hsp70. 10 mM azide for 30 minutes (chemical anoxia) significantly inhibited the activity of ERK2 (measured as phospho-ERK) but the ERK-2 activity is rapidly increased in a MEK-independen manner, when azide is washed out of the cells. Chemical anoxia and overnight recovery induced Hsp70 expression (analyzed by Western blotting) and this was inhibited by actinomycin D as well as by cycloheximide showing that induction of both translation and transcription was involved. Inhibition of the MAP kinase p38, which was transiently activated during chemical anoxia, had no effect on the increase in Hsp70 expression whereas an inhibitor of reactive oxygen species and inhibition of the phosphatase PP1 and PP2a inhibited the increase in Hsp70 expression. Inhibition of ERK2 by the MEK inhibitor PD98059 resulted in strong inhibition of Hsp70 protein expression and simultaneous stimulation of hsp70 transcription.