Microbiomes of the Built Environment: Homes
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1 Microbiomes of the Built Environment: Homes Tiina Reponen, PhD, Professor Center for Health Related Exposure Assessment Department of Environmental Health University of Cincinnati Microbiomes of the Built Environment: From Research to Application October 17-18, 2016
2 What is different in homes? Prominent effect of outdoor environment on indoor fungi Presence of pets Sources of humidity: cooking, laundry Building materials How is mold exposure in homes affecting respiratory health?
3 SEASONAL VARIATION Snow cover CFU/m3 Lesson learned: Outdoor environment affects indoor fungi BACTERIA But not indoor bacteria. Reponen et al., Normal range criteria for indoor bacteria and fungal spores in subarctic climate. Indoor Air 2:26-31, 1992
4 EFFECT OF VENTILATION SYSTEM Lesson learned: - Filtration of supply air reduces outdoor-indoor transport of fungi. - Occupation affects indoor bacteria more than ventilation system. Reponen et al., Environ Internat.1989
5 Temporal variation Fungal spores Lesson learned: Pets do have an effect on indoor fungal concentration. Lehtonen, Reponen, Nevalainen: Everyday activities and variation of fungal spore concentrations in indoor air. Internat. Biodeter. & Biodegrad. 31:25-39, 1993.
6 Associations between Diversity versus Home Characteristics (based on next generation sequencing) BACTERIA Richness Evenness Shannon's Diversity Simpson's Diversity FUNGI Richness Evenness Shannon's Diversity Simpson's Diversity RH Age of home No of occupants Dog Cat Temperature Moldiness Kettleson et al. 2014
7 Cincinnati Childhood Allergy and Air Pollution Study - CCAAPS Longitudinal birth cohort study on the role of traffic pollution and bioaerosols in the development of children s allergy and asthma.
8 Microbial assessment in CCAAPS Qualitative: Quantitative Water damage Endotoxin (Dust, Inhalable and PM1) Visible mold B-glucan (Dust, Inhalable and PM1) Moldy odor Total spore count (air) qpcr assay of 36 fungi (dust) ERMI = Environmental Relative Moldiness Index qpcr assay of Streptomyces (dust)
9 EXPOSURE AT AGE 1 VS. RECURRENT WHEEZING AT AGE 1 n=574 upper respiratory condition lower respiratory condition recurrent wheeze siblings >=2 race (AfroAmerican) parental asthma mom's smoking visible mold High vs. no endotoxin glucan >134 ug/g Lesson learned: Age 1 wheezing 4 times higher in homes with visible mold aor (95%CI) Iossifova et al., Allergy 62: , 2007
10 Exposures at age 1 and 7 vs. asthma at age 7 (n=176) Asthma OR (p-value) YEAR 1 EXPOSURE BetaGlucan (µg/g) 1.17 (0.31) Endotoxin (EU/mg) 1.00 (0.99) ERMI high vs. low PCR-based assay 3.1 (0.04) Visible Mold YEAR 7 EXPOSURE Low vs. no 1.04 (0.89) Lesson learned: High vs. no 0.25 (0.19) Timing of mold exposure matters. BetaGlucan (µg/g) 0.79 (0.18) Endotoxin (EU/mg) 0.74 (0.13) ERMI 0.70 (0.89) Visible Mold Low vs. no 0.79 (0.63) High vs. no 1.14 (0.81) ERMI = Environmental Relative Moldiness Index (analysis of 36 fungal species by PCR)
11 Adjusted ORs (95% CIs) for Asthma Diagnosis Exposure at age 1 versus asthma at age 7 Age 1 ERMI: Multivariate model Predictor variables Sensitization to HDM HDM House Dust Mite ERMI (age 1) High vs. Low Parent asthma Yes vs. No + vs. - Air conditioning (age 1) Yes vs. No * 2.6 ( ) adjusted Odd's Ratio (95% confidence intervals) Reponen et al. Ann Allergy Asthma & Immunol, 2011 *
12 Beta-glucan concentration and load versus wheezing Lessons learned: - Concentration matters. - Microbial exposures can also be protective. Iossifova et al. Allergy 2007
13 Californian birth cohort CHAMACOS: Asthmatic children had lower fungal diversity in their home at age one. Lesson learned: Microbial diversity matters. n=13 n=28 unadjusted Odds Ratio (OR) 4.80, 95% CI is 1.04 to 22.1 DOI: /ina Dannemiller et al., Indoor Air (2014)
14 Size distribution of fungal particles Particle Concentration(#/cm 3 ) S. chartarum Fragments Spores A. versicolor Aerodynamic Size ( m) Cho et al. Atmos. Environ 39: , 2005
15 Lesson learned: Particle size matters. Smaller difference in CFU-count was observed Seo et al., 2014
16 Synergistic Effect of Age 1 Traffic Related Particles (TRAP) and Endotoxin at Age 3 wheeze (n=483) Prevalence of persistent wheeze Odds for Persistent wheeze TRAP/ endotoxin aor Lesson learned: Other, non-microbial exposures matter, too! High/high 5.9 ( ) High/low 1.4 ( ) Low/high 0.9 ( ) Low/low 1 TRAP: low high low high Adjusted for: tobacco exposure, visible mold, parental asthma, gender, lower respiratory condition, breast feeding. Ryan PH et al. Am J Respir Crit Care Med, 2009
17 Looking into the future Mold and dampness problems in buildings may increase due to: - Energy efficient tighter houses - Increased flooding
18 Extra
19 Visible mold and water damage index was strongly dose-related to respiratory effects in the first 3 years Visible mold categories: OUTCOMES AT AGE 1 OUTCOMES AT AGE 3 Mendell and Kumagai, 2016 [Epub ahead of print]
20 Mold exposure vs. Health Significant associations Age 1 Mold exposure Qualitative Age 1 Wheeze Quantitative (ERMI) Age 7 Mold exposure Age 3 Wheeze Qualitative Quantitative (ERMI) Age 7 Asthma Age 7 mold exposure was not associated with age 7 asthma
21 Association between Steptomyces exposure at age 7 and Exhaled Nitric Oxide (eno) at age 7 in asthmatic children (n=30) Parameter estimate = p<0.001 Johansson et al. Environ. Internat., 2013
22 CCAAPS: Exposure at age 7 vs. health at age 7 n=176 YEAR 7 EXPOSURE Any Asthma OR (p-value) Exhaled NO Parameter estimate (p-value) DUST BetaGlucan (µg/g) 0.79 (0.18) 0.01 (0.85) Endotoxin (EU/mg) 0.74 (0.13) (0.75) ERMI 1.00 (0.89) <0.01 (0.84) VISUAL OBSERVATION Visible Mold (1 vs 0) 0.79 (0.63) 0.31 (0.42) (2 vs 0) df= (0.81) 0.15 (0.26) AIR BetaGlucan (ng/m 3 ) Endotoxin (EU/m 3 ) Inhalable 0.72 (0.01) (0.58) PM (0.45) (0.55) Inhalable 0.80 (0.05) (0.35) PM (0.32) (<0.01) Spore Count #/m (0.15) 0.03 (0.55) Year7: significant associations were seen only with air results
23 FURTHER ASSESSMENT OF ERMI (n=289) Three species were found to be most significantly associated with asthma: - Aspergillus ochraceus - Aspergillus unguis - Penicillium variabile Reponen et al., JACI 2012
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