Evaluation of Hirst-type spore traps in outdoor Aspergillaceae monitoring during large demolition work in hospital

Our plain-English summary of Evaluation of Hirst-type spore traps in outdoor Aspergillaceae monitoring during large demolition work in hospital, by S.T. Loeffert, P. Vanhems, E. Tissot, et al (PloS One, 2018).

The study

• Authors: S.T. Loeffert, P. Vanhems, E. Tissot, C. Dananché, P. Cassier, T. Bénet, M. Perraud, M. Thibaudon, M.P. Gustin
• Journal: PloS One
• Published: 2018;13(1):e0191135
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Demolition can generate fungal spore suspensions in association with various adverse health effects, such as high risk of invasive aspergillosis in immunocompromised patients. One block of Edouard Herriot Hospital was entirely demolished. The aim of the present study was to evaluate Hirst-type spore traps utility in monitoring outdoor Aspergillaceae (Aspergillus spp. + Penicillium spp.) spores in part of Edouard Herriot Hospital (Lyon, France) undergoing major demolition. Three periods were scheduled in 2015: (A) Gutting of building and asbestos removal, (B) Demolition of floors, (C) Excavation and earthwork. Outdoor Aspergillaceae fungal load was monitored by cultivable (Air Ideal®, bioMérieux) and non-cultivable methods (Lanzoni VPPS-2000, Analyzair®, Bologna, Italy). Differences of Aspergillaceae recorded with Hirst-type spore traps were observed between Gerland and Edouard Herriot Hospital. Differences between Aspergillaceae were recorded between day time and night time at Gerland and Edouard Herriot Hospital. Daily paired differences between Aspergillaceae recorded with non-cultivable methodology at Edouard Herriot Hospital and in an area without demolition work were significant in Period A vs Period B (p = 10-4) and Period A vs Period C (p = 10-4). Weak correlation of daily Aspergillaceae recorded by both methods at Edouard Herriot Hospital was significant only for Period C (r = 0.26, p = 0.048, n = 58). Meteorological parameters and type of demolition works were found to heavily influenced Aspergillaceae dispersion. Non-cultivable methodology is a promising tool for outdoor Aspergillaceae scrutiny during major demolition work in hospital, helping infection control staff to rapidly implement control measures.

In plain English

This study measured airborne fungal spores, not asbestos. Asbestos appears only because the first of three demolition periods in 2015 at Edouard Herriot Hospital in Lyon, France, was gutting of the building and asbestos removal. No asbestos was measured. The authors tested whether Hirst-type spore traps could track outdoor Aspergillus and Penicillium spores (together, Aspergillaceae) during the gutting, floor demolition and excavation of a hospital block. Traps ran for 296 days at the hospital and at Gerland, a control area a few km away with no demolition. The authors also collected 511 culture-plate air samples at the hospital. The daily difference between the hospital and the control site was larger during floor demolition (median 13.5 spores per cubic meter per day) and excavation (median 8) than during gutting and asbestos removal (median 1). At the hospital, levels were higher by day than by night, and at night they were still higher than at the control site. Results from the two sampling methods were only weakly correlated, and only during excavation (r = 0.26). The authors concluded that the traps are a promising monitoring tool. They noted that the demolition periods coincided with seasons and that no baseline period without demolition was available.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Environmental air-monitoring study comparing a non-cultivable method (Hirst-type spore traps) with a cultivable method (agar impact sampler) at a demolition site and a control site
• Who was studied: Outdoor air at Edouard Herriot Hospital (850 beds), Lyon, France, and at the Gerland control area a few km away, February to December 2015 (42 weeks). There were 511 cultivable samples at the hospital and 296 days of spore-trap data at each site.
• Exposure: Airborne Aspergillaceae (Aspergillus spp. plus Penicillium spp.) spores during three demolition periods: (A) gutting of building and asbestos removal, (B) demolition of floors, (C) excavation and earthwork. Asbestos fibers were not measured.
• Main results:
  • With the cultivable method at the hospital, the highest median Aspergillaceae level was in Period C (excavation and earthwork): 30 CFU per cubic meter (IQR 80).
  • With the spore traps, the highest median at the hospital was in Period B (floor demolition): 23.5 spores per cubic meter per day (IQR 24.75). At Gerland the highest median was in Period A: 15 spores per cubic meter per day (IQR 35).
  • The daily paired difference between the hospital and Gerland had a median of 1 (IQR 24.3) in Period A, 13.5 (IQR 31.8) in Period B and 8 (IQR 13.5) in Period C. Period A differed from Period B and from Period C with p less than 0.0001. Period B differed from Period C with p = 0.032.
  • At the hospital, spore-trap levels were higher by day than by night: median 1.37 vs 1.09 spores per cubic meter per 2 hours, p = 0.007. At night, levels at the hospital were higher than at Gerland: 1.09 vs 0, p less than 0.0000001.
  • Daily levels from the two methods were weakly correlated only in Period C (r = 0.26, p = 0.0475, n = 109 days). There was no correlation in Periods A and B (p = 0.6 and p = 0.2).
  • With the cultivable method in Period A, a 10% rise in relative humidity multiplied the odds of Aspergillaceae presence by 1.25 (95% CI 1.02 to 1.54, p = 0.035). A 10 km/h fall in wind speed raised the odds by a factor of 2.04 (p less than 0.001).
• The authors' conclusion: The authors concluded that the non-cultivable spore-trap method is a promising tool for monitoring outdoor Aspergillaceae during major hospital demolition, helping infection control staff act quickly.
• Limitations the authors state:
  • The demolition periods coincided with seasons, which could have caused seasonality bias.
  • No baseline period without demolition work could be studied at the hospital.

Related studies

• Fungal weathering of asbestos in semi arid regions of India — S. Bhattacharya, P.J. John, et al. (2016)
• Demolition of high-rise public housing increases particulate matter air pollution in communities of high-risk asthmatics — S. Dorevitch, H. Demirtas, et al. (2006)
• Cell-growth and migration inhibition of human mesothelioma cells induced by 3-O-methylfunicone from Penicillium pinophilum and cisplatin — E. Buommino, A. De Filippis, et al. (2012)
• Fiber types, asbestos potency, and environmental causation: a peer review of published work and legal and regulatory scientific testimony — D. Egilman (2009)
• Ambient monitoring of asbestos in selected Italian living areas — A.F. Gualtieri, D. Mangano, et al. (2009)
• Exposure of UK industrial plumbers to asbestos, Part I: Monitoring of exposure using personal passive samplers — G. Burdett, D. Bard (2007)

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