Scholarly article on topic 'Fungal pollution of indoor environments and its management'

Fungal pollution of indoor environments and its management Academic research paper on "Earth and related environmental sciences"

Share paper
{Allergy / Infections / Toxicity / " Aspergillus " / " Trichoderma " / " Penicillium " / Mycotoxins / "HEPA filters" / Disinfectants}

Abstract of research paper on Earth and related environmental sciences, author of scientific article — A.A. Haleem Khan, S. Mohan Karuppayil

Abstract Indoor environments play important roles in human health. The health hazards posed by polluted indoor environments include allergy, infections and toxicity. Life style changes have resulted in a shift from open air environments to air tight, energy efficient, environments, in which people spend a substantial portion of their time. Most indoor air pollution comes from the hazardous non biological agents and biological agents. Fungi are ubiquitous in distribution and are a serious threat to public health in indoor environments. In this communication, we have reviewed the current status on biotic indoor air pollution, role of fungi as biological contaminants and their impact on human health.

Academic research paper on topic "Fungal pollution of indoor environments and its management"

Saudi Journal of Biological Sciences (2012) 19, 405-426

King Saud University Saudi Journal of Biological Sciences


Fungal pollution of indoor environments and its management

A.A. Haleem Khan *, S. Mohan Karuppayil 1

DST-FIST Sponsored School of Life Sciences, SRTM University, Nanded 431606, MS, India

Received 29 November 2011; revised 5 June 2012; accepted 6 June 2012 Available online 15 June 2012

Abstract Indoor environments play important roles in human health. The health hazards posed by polluted indoor environments include allergy, infections and toxicity. Life style changes have resulted in a shift from open air environments to air tight, energy efficient, environments, in which people spend a substantial portion of their time. Most indoor air pollution comes from the hazardous non biological agents and biological agents. Fungi are ubiquitous in distribution and are a serious threat to public health in indoor environments. In this communication, we have reviewed the current status on biotic indoor air pollution, role of fungi as biological contaminants and their impact on human health.

© 2012 King Saud University. Production and hosting by Elsevier B.V. All rights reserved.









HEPA filters;



1. Introduction......................................................................................................................................................406

1.1. Fungal pollution of indoor environments....................................................................................................406

1.2. Health hazards of indoor fungi..................................................................................................................414

1.3. Respiratory symptoms................................................................................................................................414

1.4. Hypersensitivity syndromes........................................................................................................................414

1.5. Respiratory infections................................................................................................................................414

1.6. Rheumatologic and other immune diseases ..................................................................................................414

1.7. Allergy......................................................................................................................................................415

1.8. Neuro psychiatric problems........................................................................................................................415

2. Fungal constituents of indoors............................................................................................................................415

2.1. Volatile fungal metabolites (VFM)..............................................................................................................415

2.2. (1-3)-b-D glucan........................................................................................................................................415

* Corresponding author. Mobile: 09848588901. E-mail addresses: (A.A. Haleem Khan), (S. Mohan Karuppayil).

1 Mobile: 09028528438. Peer review under responsibility of King Saud University.

1319-562X © 2012 King Saud University. Production and hosting by Elsevier B.V. All rights reserved. http://dx.doi.Org/10.1016/j.sjbs.2012.06.002

2.3. Ergosterol................................................................................................................................................415

2.4. Mycotoxins..............................................................................................................................................415

3. Factors influencing fungal colonization................................................................................................................416

4. Quantitation of fungi..........................................................................................................................................416

5. Sampling methods..............................................................................................................................................416

6. Practices contributing to indoor biotic pollution....................................................................................................417

7. Control and precautions....................................................................................................................................417



1. Introduction

All around the world, life style changes have resulted in a shift from open air environments to air tight,energy efficient environments at home and work places, where people spend a substantial portion of their time (Chao et al., 2003; Molhave, 2011). In these environments, improper maintenance, poor building design or occupant activities often result in a condition called as ''Sick Building Syndrome'' (SBS), where occupants experience adverse health effects that appear to link with the time spent in a building (Ebbehoj et al., 2002; Zeliger,

2003). The complaints may be localized to a particular room or widespread throughout a building and relief usually occurs soon after leaving the building (Bholah and Subratty, 2002; Bakke et al., 2008). Headaches, pressure on the head and throbbing, and feelings of tiredness are the most common signs of SBS.

Various abiotic agents like dust, particulate matter, wall coverings, synthetic paints, glue, polishes, and Voltile Organic Compounds (VOCs) may contribute to indoor pollution and cause SBS (Chao et al., 2002; Horner, 2003). Most of the air pollution comes from sources inside the building itself like, hair spray, perfume, room deodorizer, paints, thinners, home appliances, photo copiers, printers, computers, and air purifiers (Rossnagel, 2000; Wilson and Straus, 2002; Rylander,

2004). Use of disinfectants (linear alkyl benzene sulfonates) and fatty acid salts (soap) in cleaning agents (rug shampoo) can cause enhanced eye and air way irritation (Herbarth et al., 2003; Guo, 2011).

The release of gases from solvents used indoors, such as chlorine (used for drinking water disinfection), a-pinene, b-pinene (ingredients of synthetic paints and disinfectants) and formaldehyde (from building materials) can cause health problems (Hagmolen et al., 2007). Fiber glass or rock wool, floor coatings of linoleum, polyvinyl chloride, and use of gluteralde-hyde can cause throat and facial dermal symptoms (McDonnell and Burke, 2011). Odors associated with bioaerosols may lead to anhedonic responses (Hiipakka and Buffington, 2000; Hint-ikka, 2004). Cigarette smoke is another source of not only VOCs, but also of toxic chemicals, carcinogens, and dust particles that may affect the lungs (Roussel et al., 2008). VOCs may become a problem in buildings that are being renovated or constructed.

The increase in temperature and humidity also affects the release of VOCs (Reijula, 2004; Hatfield and Hartz, 2011). The outdoor air that enters a building can be a source of indoor air pollution. For example, outdoor air may contain pollutants from motor vehicle exhausts (Reynolds et al., 2001). Physical and design characteristics of buildings such

as lighting, ergonomics and noise may lead to chronic health effects. The nocturnal artificial lighting suppresses melatonin and may predispose people to breast and colon cancer (Li and Yang, 2004).

Bacteria, fungi, pollen, viruses, rat droppings, mites, insect body parts or bird droppings can be sources of biological contamination (Nevalainen andSeuri, 2005; Khan and Karuppayil, 2010). The indoor bacterium - Legionella causes both Legionnaire's Disease and Pontiac Fever (Nakayama and Morimoto, 2007). Common contributors to biological pollutants are water damage to homes during flooding or storm damage, leaks in plumbing, roofs or air conditioners, dehumidifiers, humidifiers, and bathrooms; and ice damming on building roofs allows water to seep through the roof sheathing (Cunningham et al., 2004; Mc Kernan et al., 2008). Humidifiers in the ventilation circuit provide place for proliferation of microorganisms (Farley and Franklin, 1992; Yamashita et al., 2005; Li et al., 2010).

An assessment of dust samples in schools and day care centers shows that dog, cat and mite allergens could cause severe health problems in children (Aydogdu and Asan, 2008). Allergens detected in mattresses, floor dust and curtains are found to increase the risk for asthma (Adgate et al., 2008). The design and operation of Heating, Ventilation and Air Conditioning systems (HVAC's) have an impact on the distribution of air borne infectious organisms (Mc Grath et al., 1999).

1.1. Fungal pollution of indoor environments

Fungi are ubiquitous in distribution and are a serious threat to public health in indoor environments (Samet and Spengler, 2003; Khan, 2009). Many fungi that are reported to cause allergy belong to Ascomycota, Basidiomycota or anamorphic fungi. There are many reports on fungi isolated from indoor environments (Table 1) (Portnoy, 2003; Khan et al., 2009). Fungi are able to grow on almost all natural and synthetic materials, especially if they are hygroscopic or wet. Inorganic materials get frequently colonized as they absorb dust and serve as good growth substrates for Aspergillus fumigatus and Aspergillus versicolor (Samet and Spengler, 2003). Wood is highly vulnerable to fungal attack. Cladosporium and Penicillium (Penicillium brevicompactum and Penicillium expansum) are reported to infest wooden building materials. Kiln dried wood surfaces are more susceptible to fungi (Sailer et al., 2010). Acylated wooden furnitures, wood polyethylene composites, plywood and modified wood products are susceptible to infestation by Aspergillus, Trichoderma and Penicillium (Thacker, 2004; Doherty et al., 2011).

Inner wall materials used in buildings, such as prefabricated gypsum board, highly favors the growth of Stachybotrys

Table 1 Studies on airborne fungi from the different countries.



Predominant Fungi

International Center for Chemical and Biological Sciences (ICCBS) building, Karachi

Soybean and cotton mills, Giza

Green houses



Cladosporium spp. Alternaria spp. Periconia spp. Curvularia spp. Stemophylium spp. Aspergillus spp. Pénicillium spp.

Aspergillus flavus, A. niger, A. parasiticus. Pénicillium nigricans, Alternaria alternata, Cladosporium cladosporoides

Aspergillus fumigatus Beauveria spp. Trichoderma spp. Pénicillium oslonii P. brevicompactum

Libraries and Archival settings Paper substrates, Genova

lasna Gora (Bright Hill) monastery library in Czestochowa

Hotel rooms in Asia and Europe



China,Taiwan, Malaysia,Thailand, Vietnam, lapan, Cambodia and Iran Europe

Spain, Italy, Sweden, France, Portugal, U. K, Norway, Denmark, Germany, Poland, Estonia and Iceland

Stachybotrys spp. Aspergillus niger, A. fumigatus Fusarium spp.

Cladosporium sphaerospermum, Pénicillium

purpurogenum, Aspergillus melleus,

Filamentous fungi

Acremonium striatum

Acremonium spp.

Alternaria spp.

Aspergillus flavus

Aspergillus niger

Aspergillus versicolor

Chaetomium elongation

Chaetomium spp.

Oidiodendron rhodogenum

Oidiodendron truncation

Pénicillium aurantiogriseum

Pénicillium verrucosum

Pénicillium spp.

Ulocladium spp.

Wallemia sebi


Candida famata Geotrichum candidum Rhodotorula glutinis

Aspergillus versicolor Stachybotrys chartarum Pénicillium spp.

Health concern


FTIR-ATR analysis for identification of fungi To check the degree of contamination of monastery library

Diagnosis and treatment or preventive measures for allergy and asthmatic individuals

Inhalation of toxigenic fungi and production of mycotoxins in the lungs of workers

Exposure of vegetable growers to (1—3 )-p-D-glucan, fungal spores and culturable fungi Indoor air quality in archives and libraries

Hasnain et al. (2012)

Abdel Hameed et al. (2012)

Hansen et al. (2012)

Pinheiro et al. (2011) Zotti et al. (2011) Harkawy et al. (2011)

Analysis of fungal DNA in 69 Norback and Cai (2011)

hotel rooms in 20 countries of Asia & Europe

(continued on next page)

Table 1 (continued)

Location Country Predominant Fungi

Child day care Sweden Aspergillus spp. Stachybotrys chartarum Pénicillium

centers, Uppsala spp.

House dust samples, Saudi Arabia Aspergillus spp. Cladosporium spp. Pénicillium spp.

Riyadh Acremonium spp. Botryodiplodia spp. Circenella spp.

Myrothecium spp. Syncepalastrum spp.

Campus of the Brazil Aspergillus spp. Pénicillium spp. Cladosporium spp.

University of Sao

Poultry farmhouse, France Aspergillus spp Scopulariopsis spp.


Air-Conditioning in Brazil Aspergillus spp. Pénicillium spp. Cladosporium spp.

Adult & Neonatal

Intensive treatment

units, Cuiaba city

Indoor environments Spain Aspergillus spp. Pénicillium spp. Cladosporium spp.

of Cave of Nerja Ascomycota

Bakery, Bucharest Romania Aspergillus spp. Pénicillium spp. Alternaria spp.

Fusarium spp. Ulocladium spp. Neurospora spp.

Trichoderma spp.

Building with wood France Serpula lacrymans Coniophora puteana, Trametes

decay, Plouzane versicolor Donkioporia expansa Phlebiopsis gigantea

Scleroderma verrucosum

Water damaged Belgium Trichoderma atroviride

building, Ghent

Dairy plant, Attica Greece Pénicillium spp. Cladosporium spp

Metro railway India Aspergillus flavus Aspergillus niger Pénicillium spp.

station, Kolkata

Health concern


To investigate relationship between building construction and indoor quality and exposure to fungi by qPCR To study the occurrence and distribution of indoor fungi

To determine possible correlations of bioaerosols (quantity of fungi)

To represent fungal contaminants in air of animal facilities

To evaluate fungi in A/C units of hospitals

To reduce allergen levels and protect allergic children

Study showed the presence of potential human pathogenic fungi

This study showed the risk factor for the acquisition of infection in ICU's

Cai et al. (2011)

Alwakeel and Nasser (2011)

Degobbi et al. (2011)

Nieguitsila et al. (2011) Simoes et al. (2011)

Fungal spores in Cave and seasonal behavior were studied Conventional and molecular methods were used to detect fungi

Capillary electrophoresis single-strand conformation polymorphism (CE-SSCP), denaturing high-performance liquid chromatography (DHPLC), PCR was used to detect fungi

To elucidate relationship between T. atroviride & Sick Building Syndrome

Microbiological methods and molecular typing techniques were used to detect the fungi in dairy plant

To evaluate prevalent airborne fungi in the indoor environment of railway station

Docampo et al. (2011 ) Cornea et al. (2011)

Maurice et al. (2011)

To investigate relation with SBS, the mucosal irritation potency of compounds by T. atroviride

Polizzi et al. (2011)

Beletsiotis et al. (2011)

Ghosh et al. (2011)

House dust samples, Saudi Arabia Aspergillus flavus Aspergillus fumigatus Aspergillus

Turubah, Taif penicilloides Aspergillus repens Pénicillium glabrum

Residential buildings, Lodz


Stachybotrys chartarum Aspergillus versicolor Pénicillium chrysogenum

Historic huts, Ross Island

Mogao Cave, Gansu province

Railway stations, Tokyo

Wine cellars, Graz

Antarctica Cladosporium cladosporoides Pseudeurotium

desertorum Geomyces spp. Antarctomyces psychro trophicus

China Pénicillium spp. Cladosporium spp. Aspergillus

spp. Alternaria spp.

Japan Pénicillium spp. Cladosporium spp. Aspergillus

Austria Pénicillium spp. Cladosporium spp. Aspergillus

Archives buildings, Cuba La Plata Houses of asthmatic patients Sari city

Cuba Argentina Pénicillium spp. Cladosporium spp.

Iran Aspergillus flavus A. fumigatus Cladosporium spp.

Pénicillium spp.

Newly built dwellings, Okayama Flood affected materials from homes. New Orleans Underground railway station, St. Petersburg Child care centers, Singapore

Japan USA



Alternaria spp Aspergillus spp. Aureobasidium spp. Cladosporium spp. Eurotium spp. Rhodotorula spp. Arthrinium, Ganoderma, Polythrincium, Torula, Aspergillus, Pénicillium, Cladosporium

Aspergillus, Pénicillium, Cladosporium, Acremonium

Aspergillus, Pénicillium, Geotrichum, Cladosporium

Xerophilic, yeast, thermophilic, thermotolerant, keratinophilic fungi were isolated

High performance liquid chromatography/tandem mass spectrometry of six toxic strains proved their ability to grow on building materials and produce mycotoxins

To confirm fungal presence in huts

Temporal, spatial distributions of airborne fungi in caves

Understand the distribution of airborne fungi Six stage Andersen-Cascade impactor was used for sampling of fungi and check the hygiene

To evaluate the microbial prevalence inside buildings To study the distribution of fungi in indoor and outdoor air of asthmatic patients houses

To explore the cause of sick building syndrome To examine the aerosolization of fungi in flood affected homes Indoor air of railway stations was examined for fungi over 4 months

Concentrations of culturable fungi were examined

Fungi identified were toxigenic, opportunists, pathogenic and antigenic

The study showed toxic risk in buildings under study

To restore and rejuvenate the flood affected areas Risk of mold allergic diseases for underground passengers was detected Information provided was useful to determine etiology of wheeze and rhinitis

Al-Humiany (2010)

Gutarowska et al. (2010)

Duncan et al. (2010)

Wang et al. (2010a.b)

Kawasaki et al. (2010) Haas et al. (2010)

Borrego et al. (2010) Hedayati et al. (2010)

Takigawa et al. (2009) Adhikari et al. (2009)

Bogomolova and Kirtsideli (2009)

Zuraimi et al. (2009)

(continued on next page)

Table 1 (continued)



Predominant Fungi

Hospitals, Zarqa

Noodle factory, Nantou Feedstuff-manufacturing factories, Seoul Indoors, Brisbane

Jordan Taiwan Korea


Aspergillus, Penicillium, Alternaria, Rhizopus Aspergillus, Penicillium, Cladosporium, Aspergillus, Penicillium, Cladosporium,

Aspergillus niger Penicillium, Cladosporium cladosporioides

Green waste windrow UK composting facility, Central England

Dust samples, Finland


Maternity hospitals, France

Aspergillus fumigatus

Aspergillus, Penicillium, Paecilomvces

Aspergillus, Alternaria, Penicillium, Cladosporium,

U.S. Lab module of International space station

Aspergillus flavus, Aspergillus niger, A. fumigatus, A. terreus, Penicillium chrysogenum, P. brevicompactum Fusarium solani Candida albicans

Moisture-damaged buildings, Leipzig


Aspergillus versicolor Penicillium expansion

Child day care centers, Edirne city

Office buildings, Helsinki



Acremonium, Alternaria, Arthrinium, Aspergillus, Bahusakala, Beauveria, Ceuthospora, Chaetomium, Cladosporium, Curvularia, Drechslera, Epicoccum, Eurotium, Fusarium, Mycotypha, Myrotechium, Paecilomvces, Penicillium, Pestalotiopsis, Phoma, Ramichloridium, Rhizopus, Scopulariopsis, Stachybotrys, Stemphylium, Torula, Trichoderma, Trichothecium, Ulocladium, Verticillium Aspergillus orchraceus Aspergillus glaucus Stachybotrys chart arum

Health concern


To investigate air quality and microbial quantity To evaluate the levels of microorganisms To investigate the distribution patterns of airborne fungi

To quantify the fungal fragments by Ultraviolet Aerodynamic particle sizer (UVASP) and Scanning fragmentation particle sizer (SMPS)

To study the particle size distribution of Aspergffli in compost operation To produce information of microbial concentrations using qPCR

To examine spectrum and levels of airborne fungi in newborn babies homes DNA based method mold-specific quantitative PCR (MSQPCR) was used to measure the molds in dust 2D-gel electrophoresis of spore proteins, Immunoblotting with patient sera to study indoor exposure to molds Purpose of this study was to determine the concentration, in terms of monthly and seasonal distribution and in relation to meteorological factors, of indoor and outdoor microfungi

Levels of fungi were measured and comparison was made in mold-damaged and control buildings

To assess level of airborne pathogens

To minimize the biological hazards

To evaluate potential health impacts

Purpose was to check the affect of mold on early childhood

Potential opportunists and moderate toxin producers were detected

Development of allergies were detected

Qudiesat et al. (2009) Tsai and Liu (2009) Kim et al. (2009)

Kanaani et al. (2009)

Deacon et al. (2009)

Kaarakainen et al. (2009)

Dassonville et al. (2008)

Vesper et al. (2008)

Bennorf et al. (2008)

Aydogdu and Asan (2008)

Salonen et al. (2007)

Indoor spaces of Austria

buildings, Styria

Coir factory Kerala India

Aureobasidium spp., Trichoderma spp., Rhizopus spp., Cladosporium spp., Alternaria spp., Aspergillus spp., Pénicillium spp., Aspergillus flavus, A. niger Cladosporium, Pénicillium citrinum

Hospitals, Childcare Korea centers. Elderly welfare facilities. Maternity

recuperation centers,



Various working Italy

environments in

hospitals, Genoa

Homes of patients Spain

with allergy to fungi,


Aspergillus spp., Pénicillium spp., Cladosporium spp.,

Aspergillus spp., Pénicillium spp.,

Cladosporium, Pénicillium, Aspergillus, Alternaria

Residential dwellings, Murdoch University, Perth

Pillows used for years in homes

Air conditioning units in operating theaters, Pune Coastal regions, Dammam, Jeddah, Jizan


Saudi Arabia

Cladosporium, Pénicillium, Aspergillus, Alternaria, Fusarium, Botrytis, Aureobasidium, Rhizopus, Epicoccum, Yeast, Nigrospora

Aspergillus fumigatus Aureobasidium pullulons Rhodotorula mucilaginosa

Aspergillus, Fusarium Pénicillium Rhizopus


Homes of children with allergy, Boston, Massachusetts Aerobiology Al-Khobar, Abha, Hofuf

Saudi Arabia

Aureobasidium, Aspergillus. Alternaria, Cladosporium, Pénicillium

Alternaria, Ulocladium, Drechslern Cladosporium,

To evaluate growth of indoor molds on fungal spores in the air

To study the prevalence of airborne fungal spores in indoor and outdoor environments Characteristics of airborne fungi were surveyed with six-stage cascade impactor

Haas et al. (2007) Nayar et al. (2007)

Kim and Kim (2007)

To assess the degree of fungal contamination in hospital environments To study the distribution of fungi inside and outside the homes of patients allergic to fungi

To investigate HEPA vacuuming of indoor particulates and fungi in residential environments To enumerate the fungal flora of used pillows and dust at homes

To find the fungal colonization of A/C units in O.T

Seasonal and diurnal variations of airborne fungi

Basidiomycetous spore concentrations To demonstrate the sensitization of fungi in children

Data were analyzed in relation to their allergenic capability and spore calendars were designed to correlate the patients symptoms

To demonstrate the effectiveness of air-handling systems Respiratory allergies were due to seasonal variability

To check the allergenicity of fungi isolated from pillows Post operative fungal infections from contaminated A/C units

To understand the development of allergic rhinitis and asthma

Perdelli et al. (2006) de Ana et al. (2006)

Cheong and Neumeister-Kemp (2005)

Woodcock et al. (2006) Kelkar et al. (2005) Hasnain et al. (2005)

Stark et al. (2005) Hasnain et al. (2005)

(continued on next page)

Table 1 (continued)



Predominant Fungi

Multi-storey hospital


Saw mill Palakkad, Kerala

Saudi Arabia India

Aspergillus flavus, Aspergillus fumigatus, Aspergillus niger, Aspergillus ochraceus, Aspergillus sydowii, Aspergillus ustus, Aspergillus versicolor, Eurotium (Asp.) spp

Cladosporium sphaerospermum, C. macrocarpum, C. cladosporioides, C. herbarum Aspergillus, Cladosporium, Penicillium, Nigrospora, Ganoderma

Residence with water leaks, California Water damaged and mold infested building materials, Lund

USA Sweden

Penicillium chrysogenum, P. crustosum P. aurantiogriseum

Aspergillus penicillioides, Stachybotrys chartarum, Chaetomium globosum

Dust from carpets Japan

with A/C and without A/C, Osaka

Operating theaters Germany

and hematological units of hospital, Grenoble

House dust, Australia


Cladosporium, Penicillium

Cladosporium, Penicillium, Aspergillus fumigatus

Cladosporium, Penicillium,

Water damaged Building, Cincinnati, Ohio

Penicillium, Aspergillus, Stachybotrys

Aerobiology Nagpur

Cladosporium, Penicillium, Aspergillus, Alternaria

Air samples from hospital, Taiwan Hematology ward, Lanarkshire

Republic of


Penicillium, Aspergillus,

Aspergillus versicolor, A. fumigatus, A. niger, Candida albicans, C. glabrata.C. parapsilosis

House dust, The Netherlands Aspergillus, Penicillium


Health concern


Monitoring Aspergillus species To assure new by qPCR during construction construction free from of a multi-storey hospital contamination of


To evaluate allergenicity to Cladosporium Concentration of airborne fungal spores in indoor and outdoor environments Evaluation of water leak buildings for mold damage Gas chromatography-mass spectrometry/solid phase microextraction (GC-MS/ SPME) to identify microbial volatile organic compounds (MVOCs) in water-damaged, mold-infested building materials

Fungal contamination in AC

Surveillance of environmental fungal contamination in hospital

Assess the influence of indoor levels of fungi on sensitization and asthma in adults Report the case of a worker with respiratory illness related to bioaerosol exposure in a water-damaged building with extensive fungal contamination Concentrations of airborne fungal spores in market environment

Quantitative evaluation of fungal exposure Air sampling and surveillance cultures for fungi were performed in a Scottish general hematology ward To evaluate the association between indoor storage of organic waste and levels of microbial agents in house dust

Morrison et al. (2004)

Hasnain et al. (2004) Jothish and Nayar (2004)

Morey et al. (2003) Wady et al. (2003)

Hamada and Fujita (2002) Faure et al. (2002)

Dharmage et al. (2001) Trout et al. (2001)

Kakde et al. (2001)

Wu et al. (2000) Richardson et al. (2000)

Wouters et al. (2000)




environments, Burdwan Dust from carpet, Erfurt, Hamburg

India India


Alternaría, Aspergillus, Cladosporium, Helminthosporium Curvularia, Rhizopu Alternaría, Aspergillus, Cladosporium, Drechslera, Curvularia, Fusarium

Alternaria, Aspergillus,Cladosporium, Pénicillium

Damp buildings, Denmark Pénicillium, Aspergillus, C.haetomium, Ulocladium,

Lyngby Stachybotrys,Cladosporium

Indoor Uganda Mycosphoerella Yeasts, Fusarium, Pénicillium,

environments Aspergillus, Alternaria,Cochliobolus

Aerobiology, Saudi Arabia Cladosporium spp.. Pénicillium spp.,Aspergillus

Riyadh spp.. Alternaría spp., Ulocladium spp., Drechslera

spp., Rhizopus spp..

Aerobiology, Saudi Arabia Alternaría, Aspergillus, Cladosporium, Pénicillium,

Riyadh Ulocladium, Drechslera, Fusarium, Rhizopus,


Indoor environments


Aspergillus, Pénicillium, Bipolaris, Cladosporium, Alternaría

Water damaged buildings


Stachybotrys chartarum, Aspergillus versicolor, Trichoderma spp.

Indoor atmosphere, Ismailia

Saw mills, Lucknow




Egypt India

Saudi Arabia

Hospital New Delhi India

Aspergillus flavus .Aureobasidium pullulans,Cladosporium cladsporioides Alternaría, Aspergillus, Curvularia, Drechslera, Epicoccum, Fusarium, Pénicillium

Alternaria Aspergillus, C.ercospora, C.haetomium, Cladosporium, Curvularia, Drechslera, Embellisia, Fusarium, Mucor, Pénicillium, Rhizopus, Scytalidium, Trichoderma, Torula, Ulocladium Aspergillus flavus, A. niger A. versicolor Cladosporium, Alternaria, Fusarium oxalicum, Pénicillium citrinum

To find out fungal flora and its impact

Comparative survey of airborne fungal spores

To compare exposure to mold spores in two German cities

To elucidate problems with fungal infestation in indoor environments To identify and enumerate the different airborne fungi To identify and quantify allergenic fungi and their seasonal fluctuations To identify and quantify allergenic fungi

Study provides information on the prevalence of allergenic fungi in indoor environments of Kuwait To verify the production of mycotoxins from A. versicolor, S. chartarwn, T. harzianwn, T. longibrachiatum and T. atroviride grown on artificially inoculated building materials Fungal spore population was studied

Fungi in different seasons in saw mill and their allergic potential were studied Fungi inhabiting household environments in the West, East and Central localities of Riyadh city were screened Fungal airspora of hospital

provide valuable information for the diagnosis and prophylaxis of allergic diseases

Jain (2000)

Chakraborty et al. (2000)

Koch et al. (2000)

Gravesen et al. (1999)

Ismail et al. (1999) Al-Suwaine et al. (1999)

Al-Suwaine et al. (1999)

Khan et al. (1999) Nielsen et al. (1998)

Wahid et al. (1996)

Tewary and Mishra (1996)

Bokhary and Parvez (1995)

Singh et al. (1994)

chartarum (Breum et al., 1999). Gypsum support fungal growth as it is hygroscopic. Paper and glue used in indoor surfaces are very good growth substrates for most of the indoor fungi. Fiber glass insulation and ceiling tiles support the growth of a number of fungi, among them frequently isolated were A. versicolor, Alternaría, Cladosporium, and Penicillium species (Erkara et al., 2008). Polyurethanes used in composites for insulation are attacked by Paecilomyces variotii, Tricho-derma harzianum and Penicillium species (Yazicioglu et al., 2004). Aspergillus and Penicillium grow superficially on painted surfaces, but Aureobasidium pullulans was found to deteriorate the paints (O'Neill, 1988; Shirakawa et al., 2002; Lugauskas et al., 2003). Acrylic painted surfaces are attacked by Alternaria, Cladosporium, and Aspergillus (Shirakawa et al., 2011). Air filters and ventilation ducts are also colonized by fungi (Noris et al., 2011).

1.2. Health hazards of indoor fungi

Inhalation or ingestion is a principal route of exposure to fungal propagules. Products of mold growth such as Microbial volatile organic compounds (MVOC) or Microbial volatile break down products may contribute to symptoms of illness or discomfort independently on exposure to fungal biomass (Beezhold et al., 2008). The role of indoor fungi in irritative disorders i.e. primarily non-infective diseases such as allergy and asthma, has long been recognized. Bioaerosols of fungal origin, consisting of spores and hyphal fragments are readily respirable and are potent elicitors of bronchial irritation and allergy (Britton, 2003). At least 600 species of fungi are in contact with humans and less than 50 are frequently identified and described in epidemiologic studies on indoor environments (Phipatanakul, 2003; Khan et al., 2009).

1.3. Respiratory symptoms

Sinusitis similar to the common cold due to inflammation of para nasal sinuses is reported in homes with visible mold or water damage. Damp concrete floors increased the risk of irritated stuffy or running nose, and itching, burning or irritated eyes. A study showed association between nasal polyps and skin reactivity to Candida albicans in patients exposed to indoor pollution (Burge and Rogers, 2000). Exposure to air borne fungal spores is associated with persistent cough in infants whose mothers had asthma (Bush, 2008). Mucous membrane irritation syndrome is characterized by symptoms such as rhinorrhea (running nose), nasal congestion and sore throat, and irritation of nose and eyes. This syndrome is common not only in agricultural environments, but also found in people exposed to damp buildings (Lanier et al., 2010).

An allergen exposure increased the chances of allergic sensitization and was a risk factor for an early asthma onset as well as enhanced disease severity (Jaakkola et al., 2002; Dutkiewicz et al., 2002). In a study of the patients with a history of respiratory arrest, 91% had positive skin prick test for Alternaria alternata whereas that proportion was only 31% for the 99 matched control subjects with asthma and no history of respiratory arrest (Downs et al., 2001). Thus, sensitization to molds especially to A. alternata may be involved in severity of asthma in children and young adults.

1.4. Hypersensitivity syndromes

Various environmental antigens in the air have been found as elicitors of hypersensitivity, including fungi. Majority of the fungi that mediate hypersensitivity are due to occupational exposures. In non-industrial, non-agricultural settings, some case reports suggested that high airborne levels of fungal par-ticulates had caused hypersensitivity where patients exhibited pneumonia-like symptoms (Fung and Hughson, 2003). Hyper-sensitivity pneumonitis or extrinsic allergic alveolitis are a granulomatous lung disease due to exposure and sensitization to antigens inhaled. This disease can be acute or chronic. Exposure to buildings contaminated with fungi and mycotoxin (trichothecene) may develop hypersensitivity pneumonitis (Franks and Galvin, 2010).

Inhalation fevers or humidifier fever are a heterogeneous group of stimuli which result in influenza like syndrome. This is a potential problem of damp indoor environment (Cleri et al., 2007). Humidifier fever is an illness accompanied by respiratory tract symptoms and fatigue is common in industrial settings where workers are exposed to microorganisms growing in humidification systems (Gaffin and Phipatanakul,

2009). Organic dust toxic syndrome (ODTS) is a noninfectious illness after inhalation of heavy organic dust (mixture of fungi and bacteria) This occurs within few hours after exposure to dust and symptoms are similar to hypersensitivity pneumonitis but are not due to immune response. This problem is common in workers handling material contaminated with fungi (Jacobs and Andrews, 2003).

1.5. Respiratory infections

Exposure to a variety of fungi such as Aspergillus spp. and Fusarium spp. may result in serious respiratory infections in immunocompromised persons (Boyacioglu et al., 2007; Varani et al., 2009; Jain et al., 2010; Hedayati et al., 2010; Uztan et al.,

2010). People with impaired immune system who spend most of their time in indoor environments contaminated by fungi may develop serious fungal infections (Marcoux et al., 2009; Wang et al., 2010a,b). Chronic obstructive pulmonary disease, asthma, cystic fibrosis are disorders among persons potentially infected with Aspergillus (Baxter et al., 2011). In cystic fibrosis or asthma patients, Aspergillus spp. can develop allergic broncho pulmonary aspergillosis, invasive or semi-invasive pulmonary aspergillosis and pulmonary aspergilloma (Kawel et al., 2011).

1.6. Rheumatologic and other immune diseases

Rheumatic diseases are due to inflammation and stiffness in muscles, joints or fibrous tissue. These diseases are exacerbated by environmental conditions, which include dampness, fungi, and their products indoors (Breda et al., 2010). Systemic lupus erythematosus, rheumatoid arthritis, ankylosing spondylitis, Sjogren's syndrome and psoriatic arthritis are found in persons who work in water damaged buildings with microbial growth which include molds (Muise et al., 2010). The effect of inflammatory marker in blood of non smoking persons in homes with high (>4ng/m3) airborne concentrations of (1-3)-b-D glucan indicate mold exposure (Pedro-Botet et al., 2007; Kalyoncu, 2010).

1.7. Allergy

The major allergic diseases caused by fungi are allergic asthma, allergic rhinitis, allergic sinusitis, broncho pulmonary mycoses, and hypersensitivity pneumonitis (Pieckova and Wilkins, 2004). Concern regarding human exposure to fungi in indoor environments is mainly related to direct mucosal irritation and elicitation of an IgE-mediated hypersensitivity response that precipitates rhinitis and upper airways irritation, eye irritation, and sinusitis that characterize allergic syndrome (Jaakkola et al., 2002; Yike, 2011). The symptoms of allergy are not manifested until sensitization, in which an individual is repeatedly exposed to an allergen. During this process, antigen specific IgE is produced that attaches to receptors on mast cells which are concentrated on gastric and respiratory mucosa. The principal fungal allergens are either cell wall components (1-3)-b-D glucan or water soluble glycoproteins. These allergens become airborne when these materials are aerosolized (Katz et al., 1999).

A link between respiratory exposure to fungal material and seasonal allergy was first proposed in 1873 by Blackley who listed 106 fungi genera including members who elicited allergy (Blackely, 1873). Allergenic enzymes are produced upon germination of certain fungal spores and exposure to these compounds resulted from inhalation of germinable propagules, followed by germination on upper respiratory tract mucosa. Allergenic cross-reactivity is a consequence of correlated exposures because mites may occur together with fungi on water damaged indoor materials (Lander et al., 2001). In addition, mite fecal pellets often contain large numbers of intact and partially degraded fungal spores because these materials are a preferred food for many dust borne mite taxa ( Portnoy, 2003; Santilli and Rockwell, 2003; Khan et al., 2009). After exposure to fungal spores or mycelial particles, susceptible individuals may develop nasal allergy commonly called as -hay fever||or allergic rhinitis (Husman, 1996). The symptoms of fungi induced allergic rhinitis are usually indistinguishable from those caused by inhalation of pollen, dust, animal danders, and insect allergens (Savilahti et al., 2010).

1.8. Neuro psychiatric problems

People who inhabit moldy buildings were reported with cognitive defects and difficulties in concentration (Yates et al., 1986; Drappatz et al., 2007). S. chartarum and Aspergillus spp. were identified in air samples when occupants of buildings were checked for neuro psychological tests (such as Grooved peg-board test and Verbal learning test) (Otto et al., 1990).

2. Fungal constituents of indoors

2.1. Volatile fungal metabolites (VFM)

During exponential growth, many fungi release VFMs as products of secondary metabolism. These compounds comprise a great diversity of chemical structures including, ketones, aldehydes and alcohols (Wilkins et al., 2003). Cultural studies of some common household fungi suggest that the composition of VFM's remain stable over a range of growth media and conditions (Nilsson et al., 2004; Moularat et al., 2011). Determination of VFMs has been suggested as a

measure of fungal contamination monitoring in grain storage facilities (Weir, 2000). Limited evidence suggests whether exposure to low concentrations of VFMs may cause respiratory irritation independent of exposure to allergenic particulates ( Weinhold, 2007).

Volatile organic compounds may also cause indirect metabolic effects. A well-known example of this is the fungal degradation of urea formaldehyde foam insulation (Shinoj et al., 2011). Fungal colonization of this material results in the cleavage of urea from the polymer releasing formaldehyde, contributing to a decline in indoor air quality (Kreja and Seidel, 2002; Asan et al., 2010). VOCs may have strong and unpleasant odors and exposure to these VOCs has been linked to symptoms such as headache, nasal irritation, dizziness, fatigue and nausea (Burton et al., 2008). The gas chromatography -mass spectrometry (GC-MS) is used for chemical analysis of air samples to assess volatile organic compounds produced by fungi as suitable markers which correlate with fungal growth (Bornehag et al., 2005).

2.2. (1-3)-p-D glucan

This is a cell wall component of filamentous fungi and yeasts. In moisture damaged building materials, (1-3)-b-D glucan levels are found in the range of 2.5-210 ig/g (Rylander and Holt, 1998; Rylander et al., 1998; Wan et al., 1999). The mean concentrations of 1.55-2.22 ig/g (1-3)-b-D glucan in dust are positively related to the culturable fungi isolated from buildings (Wan and Li, 1999). (1-3)-b-D glucan may cause inflammatory air way reactions and also affect the immune system when inhaled (Rylander and Lin, 2000; Fogelmark et al., 2001). The biological activities of (1-3)-b-D glucan include host-mediated anti tumor activity, adjuvant effects, activation of neutrophils, eosinophils, macrophages and complement (Walinder et al., 2001). There is the increasing evidence that (1-3)-b-D glucan causes non-specific inflammatory reactions (Beijer et al., 2002; Rylander et al., 2010; Tercelj et al., 2011). The (1-3)-b-D glucan is responsible for bioaerosol-induced respiratory symptoms observed in both indoor and occupational environments (Srikanth et al., 2008; Douwes, 2003). (1-3)-b-D glucan levels are readily detected in house dust samples and the presence of textile floor coverings is strongly associated with increased levels of (1-3)-b-D glucan (Mork, 2002; Reponen et al., 2010; Rylander, 2010; Sykes et al., 2011).

2.3. Ergosterol

This is the most important sterol found in the cell membranes of fungi (Hyvarinen et al., 2006). The presence of ergosterol in the indoor environment indicates fungal contamination. The content of ergosterol in spores differs between different fungal species and cannot be considered as a good marker. < 62 ig/g of ergosterol in house dust indicates that the counts of fungi are very high (Park et al., 2008; Heinrich, 2011). Quantitative measure of ergosterol in fungal biomass in indoor environments by gas chromatography - mass spectrometry (GC-MS) provides a measure of total fungal matter (Cone, 1998).

2.4. Mycotoxins

These are non volatile, secondary metabolites of fungi. Routes of mycotoxin exposure include - inhalation, ingestion or skin

contact. The most well documented mycotoxins in indoor environments are aflatoxins, trichothecenes and ochratoxins (Kilburn, 2004; Zain, 2011). Humans may be exposed to these toxins by airborne or toxin containing spores in agricultural settings or moldy buildings (Vojdani et al., 2003a; Gottschalk et al., 2008). Aflatoxin B1 is the most thoroughly studied mycotoxin produced by Aspergillus flavus and Aspergillus parasiticus and is one of the most potent carcinogens (Thacker, 2004). A. flavus and A. parasiticus are not commonly found on building materials or in indoor environments (Etzel, 2001; Bhetariya et al., 2011).

Much of the information on the human health effects of inhalation exposure to mycotoxins comes from studies done in the work place. Human health effects attributed to inhalation of mycotoxins include: mucous membrane irritation, skin rash, nausea, immune system suppression, acute or chronic liver damage, acute or chronic central nervous system damage, endocrine effects and cancer (Olsen et al., 1988; Karunasena et al., 2010).The presence of fungi in a building does not necessarily mean that mycotoxins are present or they are in large quantities. Exposure to mycotoxins can occur by inhaling air borne particulates containing mycotoxins, including dust and fungal components (Vojdani et al., 2003b; Halios and Helmis, 2010).

Toxigenic fungi have been isolated from building materials and air samples in buildings with moisture problems, where the residents have suffered from nonspecific symptoms possibly related to mycotoxin production, such as cough, irritation of eyes, skin, respiratory tract, joint ache, headache and fatigue (Gottschalk et al., 2008; Bonetta et al., 2010). Few studies have established a casual relationship between mycotoxin exposure and building related illnesses (Kuo et al., 2008; Sen and Asan, 2009; Giulio et al., 2010; Asan et al., 2010). Even though some fungi can grow on almost any natural or synthetic construction material, mycotoxin production occurs preferentially on materials that allow these fungi to grow and provide the conditions for mycotoxin production (Soroka et al., 2008). Analysis of mycotoxins from contaminated materials, such as a dry wall, carpet or house dust can be done by GC-MS or liquid chromatography - mass spectrometry (LC-MS) (Chao et al., 2002).

3. Factors influencing fungal colonization

Moisture, nutrients and temperature are the most important factors that influence the growth of fungi on building materials (Rajasekar and Balasubramanian, 2011). Availability of water is expressed in terms of water activity (aw). The requirement for moisture depends on the fungal genus or species. Usually fungal growth is favored at aw of 0.95-0.99, while 0.65-0.90 and 0.88-0.99 are reported to be required for the growth of xerophilic fungi and yeasts (Leong et al., 2011). Nutrients in house dust and water favor fungal growth on building materials. Fiberglass, galvanized steel accumulated with dust or lubricant oil residues, allows the growth of fungi (Kennedy et al., 2004; Rene et al., 2010; Yau and Ng, 2011). The temperature in buildings of about 20-250 0C, promotes the growth of mesophilic fungi. However, the temperature below optimum level slows down the growth of fungi. pH range of 5-6.5 in building materials allows the best growth of most of the fungi (Vacher et al., 2010; Hoang et al., 2010). Sufficient light and oxygen are also critical for the growth of fungi in indoor

environments (Zadrazil et al., 1991; Airaksinen et al., 2004; Voisey, 2010). Separate collections of organic as well as nonorganic house hold waste is a common practice in many countries (Curtis et al.,2004, 2005). This often involves indoor storage of organic waste, including fruits, vegetables and food remain in apartment buildings in densely populated areas until they are disposed off. As a result, decomposition of organic waste may begin inside the waste bin and may act as a source of fungal spores inside the house (Husman, 1996).

4. Quantitation of fungi

In non culture based methods, microscopic counting of spores or cells can determine fungi in the samples (Table 2). Light, epifluorescence and scanning electron microscopy are used for identification of fungi. The choice of microscope type depends on sample preparation. Light microscopy provides the basis for morphological identification (Moularat et al., 2008; Krause et al., 2003). Components or metabolites of fungi can also be used to quantitate fungi population in an environment. Extra cellular polysaccharides can be detected by specific assays for partial identification of fungal genera in indoor environments (Jovanovic et al., 2004). Polyclonal antibody based assays detect a broad range of fungal antigens but cannot detect the spores (Mitchell et al., 2007). Molecular methods for quantitation of fungi include the use of genus/species specific probes, Polymerase chain reaction (PCR) based methods, Restriction endonuclease analysis and Karyotyping (Dean et al., 2005). Mitochondrial DNA (mt DNA) can be used for restriction enzyme analysis and DNA finger printing for fungal identification.

5. Sampling methods

For isolation of fungi, surface and air sampling techniques are used (Asadi et al., 2011). Bulk sampling of materials such as settled dust, pieces of wall board, duct linings, carpets etc.

Table 2 Methods of quantitation of indoor fungi.

Method Assessment

Culture based

Air Sampling Impactor

Liquid impinger Air filtration

Non Culture based Air sampling Liquid impinger Air filtration

Organisms are collected on culture medium

Organisms are collected in collection fluid Organisms are collected on filter

Microscopy Simple microscopy Epifluorescence microscopy Electron microscopy Flow cytometry

Fluorescent in situ hybridization (FISH) Fluorechrome labeled nucleic acid probes Ergosterol or Fungal extracellular polysaccharides

GC-MS Specific enzyme immunoassays Volatile fungal metabolites (1-3)-b-glucan mycotoxins

are tested to determine the contamination with biological agents (O'Meara and Tovey, 2000; Reponen, 2011). Suction devices are used to collect samples of loose materials like carpet dust. Surface sampling is used to confirm the nature of the suspected microbial growth on environmental surfaces to measure the relative degree of contamination and identify the types of present fungi (Cabral, 2010). In this approach, samples are collected by pressing contact plate or adhesive tape onto a surface, suction device and wet swab. Therefore surface sampling can be of four types that is - contact sampling, agar contact sampling, adhesive tape sampling and surface wash sampling (Yamamoto et al., 2011). Adhesive tape sampling is an important method to examine the fungi in the specimens using a compound microscope. The samples provide the hyphal fragments and the reproductive structures which may help for identification (Ahlen et al., 2003; Aydogdu et al., 2010).

Air sampling for fungi can be done by three standard methods including: impactor, liquid impinger, and air filtration methods (Table 3).

In the impactor method, the air stream is passed through a slit into a culture medium and adhesive microscopic slide or tape strip is used to collect the sample (Zhen et al., 2009). Slit samplers, single stage impactor, multistage impactor, Burkard, rotorod, Andersen, SAS, casella, sierra marple impactor and centrifugal samplers are the common impactor samplers used. The air flow rate is about 2-180 L/min (Engelhart et al., 2007).

Liquid impingers collect the samples directly into the fluid and the microorganisms are retained in the liquid until they are cultivated on media or evaluated by techniques like biochemical or immuno assays (Jo, 2011). Shipe sampler, AGT-30, midget, multistage and micro impingers are common impinger devices. The air flow rate is 0.1-55 L/min and the sampling time ranges from minutes to hours. Centrifugal samplers such as RCS, aerojet cyclone are devices with 40-100 L/min air flow rate (Gralton et al., 2011).

Among the three standard methods, air filtration is used to collect the samples of indoor air in volume. In this method after sampling, the filters are agitated or sonicated in a solution (Bazaka et al., 2011). The solution is used for the cultivation of microbes or examination with analytical techniques. In air

filtration sampling, glass, cellulose ester, polycarbonate and Teflon filters are used. The air flow rate for this sampling is 1-1000 L/min (Muilenberg, 2003). Tilak air sampler is a modified Panzer's slide spore collector. The air is sucked through a projecting tube at the rate of 5 L/min and passes onto a transparent cello tape on the slowly rotating drum (Tilak, 1986; Fra-zer, 1998; Moularat and Robine, 2006).

Gravitational settling is a much earlier approach to collect the particles that settle passively on the open Petridish containing the growth medium (Bartlett et al., 2004; Cook et al., 2011). The choice of sampling technique and exposure assessment depends on the purpose of measurement. Air sampling as well as samples of settled dust, surface and contaminated material is used to monitor the environment (Gabrio et al., 2003; Jung et al., 2011).

6. Practices contributing to indoor biotic pollution

The habit of switching off Air Conditioning (A/C) units is a very common practice to save electricity during off business hours (Hsu et al., 2011). This may lead to condensation of water and rise in relative humidity and temperature favoring fungal growth. In rooms where the A/C units are switched off for long periods of time, frequent cleaning of the A/C filters or rooms is necessary (Yau et al., 2011). It is advised to keep the A/C units switched on continuously. To conserve energy, the temperature can be set or programed as per the manufacturer (Hibbett et al., 2011).

A/C filters need to be replaced or cleaned periodically since the filter can be clogged due to dust load and fungal infestation (Ruping et al., 2011). Potted plants kept in A/C rooms may be a risk factor for the residents since soil may act as a reservoir of fungi (Guieysse et al., 2008). Isolation of pathogenic fungi from soils of potted plants kept in A/C rooms is reported (Robbins et al., 1999; Haas et al., 2007). Places where carpets are furnished need periodic shampooing and vacuum cleaning is necessary since carpets can be home to dust borne fungi (Khan and Karuppayil, 2011).

7. Control and precautions

Spore infiltration from outside can be reduced by closing the outlets and using air conditioning for cooling. In one study, the use of window air conditioner with the vent closed showed effective exclusion of spores (Ayoko et al., 2004). The most effective way to manage fungi in a building is to remove the conditions that favor the establishment and growth of fungi (de Blay et al., 2000; Khan and Karuppayil, 2010).

Elimination of growth can be achieved by avoiding available moisture (Barnes et al., 2007). The steps to reduce moisture include, maintenance of indoor relative humidity to less than 50%, sealing the leaks to prevent water intrusion, increasing bathroom and kitchen ventilation, vent cloth dryers to be kept outside, to keep house plants that are watered regularly healthy, keeping the moisture sensitive materials dry, use of dehumidifier in the basement, etc. (Cole and Cook, 1998).

Carpets increase the fungal levels, hence frequent vacuum cleaning may reduce the spore levels (Ferguson et al., 2009). When a carpet is extensively contaminated cleaning may be difficult and it must be replaced with hardwood, tile or firm flooring materials (Ewers et al., 1994; Khan and Karuppayil,

Table 3 Commonly used air sampling methods for indoor


Method Sampler Air flow rate (L/min)

Impactor Slit

Single stage 2-180

Multi stage




Liquid impingers Shipe

AGT-30 0.1-55


Multi stage

Centrifugal RCS

Aerojet cyclone 40-100

2010). Washable wall papers and paneling can be treated with fungicidal compounds or antimicrobial products. Wall paper or paneling may be removed to reduce the severity of fungal contamination. Contaminated air ducts and filters may be cleaned to reduce fungal prevalence (Burr et al., 2007). Elimination of sources of indoor air borne pollutants can be achieved during the design phase of a new building, but it will be difficult in an existing building (Lange et al., 2004). The selection of building materials, finishes, furnishings and construction techniques are effective approaches to reduce the sources within a building (Menetrez et al., 2008).

To ensure clean air in the indoors - heating, ventilation and air conditioning system must drive out stale air and replenish it within a building (Gosden et al., 1998). Varying climatic regions demand different thermal performance and conditioning within a building ( Buckmaster, 2008). Diffusers and grills should be placed at opposite ends of buildings and be free from any obstructions that may result in the block of air flow into the building (Foarde and Menetrez, 2002). Effective air filtration ensures clean indoor air (Ahmad et al., 2001). Impingement, electronic and adsorption techniques are the three common air filtration technologies designed to get clean air (Escombe et al., 2009). Particulates are removed from the air by impingement and electronic air filters. Adsorptive type of filters eliminate unwanted gases present in the air (Garrison et al., 1993). Dry panel filters, Extended surface (dry) filters, High efficiency particulate air filters (HEPA), Bag filters and Charged media filters are different types of impingement and electronic filters (Hahn et al., 2002).

Regular cleaning prevents the accumulation of debris and particulate matter. Sometimes the cleaning products may also cause indoor air pollution, especially when the products are chemicals or solvent based (Myatt et al., 2008). Hence the use of non toxic cleaning solutions is recommended (Williams, 2004). The cleaning schedule should be during weekends or during periods when the building is not occupied. The maintenance of the HVAC system is very important, as poorly maintained HVAC systems may cause occupant discomfort and illnesses (Manuel, 2004; Gorny et al., 2007). In humidification systems, water drains and drip pans should not become stagnant to avoid air contamination.

Portable vacuum systems can be potential sources of airborne particulate matter (Oren et al., 2001). The smaller, more harmful particles may pass through them and be suspended in the air. Hence central vacuum systems which expel particulate matter to the exterior are the best alternatives (Buemi et al., 2000). A person may get sensitized to fungal spores while cleaning hence well fitted particulate mask with 1 im particle retention should be used (Gage-White, 1998). Use of mask can avoid fungal allergy during the handling of compost, vacuuming and cleaning (Warsco and Lindsey, 2003; Rengasamy et al., 2004).

There is a renewed interest in the use of germicidal treatment or irradiation to disinfect indoor environments for the control of infectious diseases in hospitals, other health care facilities and the public sector (Cardenas et al., 2008). It has been known for many years that UV light has various effects on fungi (Levetin et al., 2001). Only a few studies have specifically focused on the effects of germicidal UV light. Currently various manufacturers are marketing germicidal UV lamps for controlling contamination, including fungal contamination in

indoor environments, as well as Air Handling Units (AHU's) and ducts (Menzies et al., 1999; Alangaden, 2011).

Control of fungi in the indoor environments has traditionally focused on identifying the source of contamination control, use of filters, cleaning etc. Generally glutaraldehyde, formaldehyde and phenol derivatives such as cresol are used as disinfectants of the floors (Robertson et al., 1942; Weber et al., 1999). Glutaraldehyde shows high toxicity and its vapors irritate eyes, nose and throat (Samimi and Ross, 2003). Formaldehyde stimulates irritation of mucosa and is also reported as a carcinogen. Cresol is less toxic but extensive use may be harmful (Menetrez et al., 2007).

High toxicity and offensible odor of common disinfectants make their use restricted; there is a need for disinfectants which are harmless. There is considerable interest in plant extracts and molecules of natural origin (Khan and Karuppayil, 2010). Biologically active components from plants are reported to eliminate pathogenic microorganisms. A study on antimicrobial activity of vapors of aroma compounds was done to evaluate the practical applications in the indoor environment to reduce microbial count in air. Cinnamaldehyde vapors were reported as strong antimicrobials against air borne microbes (Sato et al., 2006). Essential oils and components of plants are good candidates for the inhibition of growth of environmental isolates. Plant extracts are generally assumed to be more acceptable and less hazardous than the synthetic disinfectants which have similar action (Burt, 2004; Khan and Karuppayil, 2010).


The authors thank Prof. Dr. Sarjerao Nimse, Hon. Vice chancellor of SRTM University for support.


Asadi, E., Costa, J.J., da Silva, M.G., 2011. Indoor air quality audit implementation in a hotel building in Portugal. Building and Environment 46 (8), 1617-1623.

Adgate, J.L., Ramachandran, G., Cho, S.J., Ryan, A.D., Grengs, J., 2008. Allergen levels in inner city homes: baseline concentrations and evaluation of intervention effectiveness. Journal of Exposure Analysis and Environmental Epidemiology 18, 430-440.

Ahlen, C., Mandal, L.H., Iversen, O.J., 2003. An in-field demonstration of the true relationship between skin infections and their sources in occupational living systems in the North Sea. Annals of Occupational Hygiene 47, 227-233.

Ahmad, I., Tansel, B., Mitrani, J.D., 2001. Effectiveness of HVAC Duct Cleaning Procedures in Improving Indoor Air Quality. Environmental Monitoring and Assessment 72 (3), 265-276.

Airaksinen, M., Pasanen, P., Kurnitski, J., Seppanen, O., 2004. Microbial contamination of indoor air due to leakages from crawl space. A field study. Indoor air 4, 55-64.

Alangaden, G.J., 2011. Nosocomial fungal infections: epidemiology, infection control, and prevention. Infectious Disease Clinics of North America 25 (1), 201-225.

Asan, A., Okten, S.S., Sen, B., 2010. Airborne and soilborne microfungi in the vicinity Hamitabat Thermic Power Plant in Kirklareli City (Turkey), their seasonal distributions and relations with climatological factors. Environmental Monitoring and Assessment 164 (1-4), 221-231.

Ayoko, G.A., Morawska, L., Kokot, S., Gilbert, D., 2004. Application of multicriteria decision making methods to air quality in the microenvironments of residential houses in Brisbane, Australia. Environmental Science Technology 38, 2609-2616.

Aydogdu, H., Asan, A., Otkun, M.T., 2010. Indoor and outdoor airborne bacteria in child day-care centers in Edirne City (Turkey), seasonal distribution and influence of meteorological factors. Environmental Monitoring and Assessment 164 (1-4), 53-66.

Aydogdu, H., Asan, A., 2008. Airborne fungi in child day care centers in Edirne City, Turkey. Environmental Monitoring and Assessment 147 (1-3), 423-444.

Al-Suwaine, A.S., Bahkali, A.H., Hasnain, S.M., 1999a. Seasonal incididence of airborne fungal allergens in Riyadh, Saudi Arabia. Mycopathologia 145 (1), 15-22.

Al-Suwaine, A.S., Hasnain, S.M., Bahkali, A.H., 1999b. Vaible airborne fungi in Riyadh, Saudi Arabia. Aerobiologia 15 (2), 121130.

Abdel Hameed, A.A., Ayesh, A.M., Abdel Razik Mohamed, M., Adel Malwa, H.F., 2012. Fungi and some mycotoxins producing species in the air of soybean and cotton mills: a case study. Atmospheric Pollution Research 3, 126-131.

Alwakeel, S.S., Nasser, L.A., 2011. Indoor terrestrial fungi in household dust samples in Riyadh, Saudi Arabia. Microbiology Journal 1 (1), 17-24.

Al-Humiany, A.A., 2010. Opportunistic pathogenic fungi of the house dust in Turuban. Kingdom of Saudi Arabia 4 (2), 122-126.

Adhikari, A., Jung, J., Reponen, T., Lewis, J.S., DeGrasse, E.C., Faye Grimsley, L., Chew, G.L., Grinshpun, S.A., 2009. Aerosol-ization of fungi, (1-3)-ß-glucan and endotoxin from flood-affected materials collected in New Orleans homes. Environmental Research 109, 215-224.

Bennorf, D., Muller, A., Bock, K., Manuwald, O., Herbarth, O., von Bergen, M., 2008. Identification of spore allergens from the indoor mould Aspergillus versicolor. Allergy 63, 454-460.

Bogomolova, E., Kirtsideli, I., 2009. Airborne fungi in four stations of the St. Petersburg Underground railway system. International Biodeterioration & Biodegradation 63, 156-160.

Borrego, S., Guiamet, P., de Saravia, S.G., Batistini, P., Garcia, M., Lavin, P., Perdomo, I., 2010. The quality of air at archives and the biodeterioration of photographs. International Biodeterioration & Biodegradation 64, 139-145.

Beletsiotis, E., Ghikas, D., Kalantzi, K., 2011. Incorporation of microbiological and molecular methods in HACCP monitoring scheme of molds and yeasts in a Greek dairy plant: a case study. Procedia Food Science 1, 1051-1059.

Bokhary, H.A., Parvez, S., 1995. Fungi inhabiting household environments in Riyadh, Saudi Arabia. Mycopathologia 130, 7987.

Bakke, J.V., Norback, D., Wieslander, G., Hollund, B.E., Florvaag, E., Haugen, E.N., Moen, B.E., 2008. Symptoms, complaints, ocular and nasal physiological signs in university staff in relation to indoor environment - temperature and gender interactions. Indoor Air 18, 131-143.

Barnes, C.S., Dowling, P., Van Osdol, T., Portnoy, J., 2007. Comparison of indoor fungal spore levels before and after professional home remediation. Annals of Allergy, Asthma Immunology 98, 262-268.

Bartlett, K.H., Kennedy, S.M., Brauer, M., Van Netten, C., Dill, B., 2004. Evalu ation and a predictive model of airborne fungal concentrations in school classrooms. Annals of Occupational Hygiene 48, 547-554.

Baxter, C.G., Jones, A.M., Webb, K., Denning, D.W., 2011. Homogenisation of cystic fibrosis sputum by sonication -- An essential step for Aspergillus PCR. Journal of Microbiological Methods 85 (1), 75-81.

Bholah, R., Subratty, A.H., 2002. Indoor biological contaminants and symptoms of sick building syndrome in office buildings in

Mauritius. International Journal of Environmental Health Research 12, 93-98.

Bhetariya, P.J., Madan, T., Basir, S.F., Varma, A., Usha, S.P., 2011. Allergens/Antigens, Toxins and Polyketides of Important Aspergillus Species. Indian Journal of Clinical Biochemistry 26 (2), 104119.

Beezhold, D.H., Green, B.J., Blachere, F.M., Schmechel, D., Weiss-man, D.N., Velickoff, D., Hogan, M.B., Wilson, N.W., 2008. Prevalence of allergic sensitization to indoor fungi in 70.West Virginia. Allergy and Asthma Proceedings 29, 29-34.

Blackely, C.H., 1873. Hay fever. Experimental research on the causes, treatment of Catarrhus Aestivus. Baillere Tindall Cox, London.

Bornehag, C.G., Sundell, J., Sigsgaard, T., 2005. Dampness in buildings and health (DBH): Report from an ongoing epidemio-logical investigation on the association between indoor environmental factors and health effects among children in Sweden. Indoor Air 14, 59-66.

Bonetta, S., Bonetta, S., Mosso, S., Sampo, S., Carraro, E., 2010. Assessment of microbiological indoor air quality in an Italian office building equipped with an HVAC system. Environmental Monitoring and Assessment 161 (1-4), 473-483.

Boyacioglu, H., Haliki, A., Ates, M., Guvensen, A., Abaci, O., 2007. The statistical investigation on airborne fungi and pollen grains of atmosphere in Izmir-Turkey. Environmental Monitoring and Assessment 135 (1-3), 327-334.

Beijer, L., Thorn, J., Rylander, R., 2002. Effects after inhalation of (1fi3)-ß-D-Glucan and relation to mould exposure in the home. Mediators of Inflammation 11, 149-153.

Breda, L., Nozzi, M., De Sanctis, S., Chiarelli, F., 2010. Laboratory tests in the diagnosis and follow-up of pediatric rheumatic diseases: an update. Seminars in Arthritis and Rheumatism 40 (1), 53-72.

Breum, N.O., Nielsen, B.H., Lyngbye, M., Midtgard, U., 1999. Dustiness of chopped straw as affected by lignosulfonate as a dust suppressant. Annals of Agricultural and Environmental Medicine 6, 133-140.

Britton, L.A., 2003. Microbiological threats to health in the home. Clinical Lab Science 16, 10-15.

Bazaka, K., Jacob, M.V., Crawford, R.J., Ivanova, E.P., 2011. Plasma-assisted surface modification of organic biopolymers to prevent bacterial attachment. Acta Biomaterialia 7 (5), 2015-2028.

Buckmaster, P., 2008. Successful mold growth remediation in HVAC systems. Occupational Health Safety 77, 28-30.

Buemi, M., Floccari, F., Netto, M., Allegra, A., Grasso, F., Mondio, G., Perillo, P., 2000. Environmental air pollution in an intensive care unit for nephrology and dialysis. Journal of Nephrology 13, 433-436.

Burge, H.A., Rogers, C.A., 2000. Outdoor allergens. Environmental Health Perspectives 108, 653-659.

Bush, R.K., 2008. Indoor allergens, environmental avoidance, and allergic respiratory disease. Allergy and Asthma Proceedings 29 (6), 575-579.

Burton, N.C., Adhikari, A., Iossifova, Y., Grinshpun, S.A., Reponen, T., 2008. Effect of gaseous chlorine dioxide on indoor microbial contaminants. Journal of the Air Waste Management Association 58, 647-656.

Burt, S.A., 2004. Essential oils: their antibacterial properties and potential applications in foods: a review. International Journal of Food Microbiology 94, 223-253.

Burr, M.L., Matthews, I.P., Arthur, R.A., Watson, H.L., Gregory, C.J., Dunstan, F.D., Palmer, S.R., 2007. Effects on patients with asthma of eradicating visible indoor mould: a randomised controlled trial. Thorax 62, 767-772.

Cabral, J.P.S., 2010. Can we use indoor fungi as bioindicators of indoor air quality? Historical perspectives and open questions. Science of the total environment 408 (20), 4285-4295.

Cook, A., Derbyshire, E., Plumlee, G., 2011. Impact of natural dusts on human health. Encyclopedia of Environmental Health, 178-186.

Cardenas, M.X., Cortes, J.A., Parra, C.M., 2008. Aspergillus spp. in risk areas of transplant patients in a university hospital. Revista Iberoamericana de Micologia 25, 232-236.

Chao, H.J., Schwartz, J., Milton, D.K., Burge, H.A., 2003. The work environment and workers health in four large office buildings. Environmental Health Perspectives 111, 1242-1248.

Cai, G., Malarstig, B., Kumlin, A., Johansson, I., Janson, C., Norback, D., 2011. Fungal DNA and pet allergen levels in Swedish day care centers and associations with building characteristics. Journal of Environmental Monitoring 13, 2018-2024.

Cheong, C.D., Neumeister-Kemp, H.G., 2005. Reducing airborne indoor fungi and fine particulates in carpeted Australian homes using intensive, high efficiency HEPA vacuuming. Journal of Environmental Health Research 4 (1), 3-16.

Chakraborty, S., Sen, S.K., Bhattacharya, K., 2000. Indoor and outdoor aeromycological survey in Burdwan, West Bengal, India. Aerobiologia 16 (2), 211-219.

Cleri, D.J., Ricketti, A.J., Vernaleo, J.R., 2007. Fever of Unknown Origin Due to Zoonoses. Infectious Disease Clinics of North America 21 (4), 963-996.

Cole, E.C., Cook, C.E., 1998. Characterization of infectious aerosols in health care facilities: an aid to effective engineering controls and preventive strategies. American Journal of Infection Control 26, 453-464.

Cone, J.E., 1998. Indoor environmental quality. The Western Journal of Medicine 169, 373-374.

Cornea, C.P., Ciuca, M., Voaides, C., Gagiu, V., Pop, A., 2011. Incidence of fungal contamination in a Romanian bakery: a molecular approach. Romanian Biotechnological Letters 16 (1), 5863-5871.

Cunningham, M.J., Roos, C., Gu, L., Spolek, G., 2004. Predicting psychrometric conditions in biocontaminant microenvironments with a microclimate heat and moisture transfer model description and field comparison. Indoor Air 14, 235-242.

Curtis, L., Cali, S., Conroy, L., Baker, K., Ou, C.H., Hershow, R., Norlock-Cruz, F., Scheff, P., 2005. Aspergillus surveillance project at a large tertiary-care hospital. Journal of Hospital Infection 59, 188-196.

Curtis, L., Allan, L., Stark, M., Rea, W., Vetter, M., 2004. Adverse health effects of Indoor Molds. Journal of Nutritional Environmental Medicine 14, 261-274.

Drappatz, J., Schiff, D., Kesari, S., Norden, A.D., Wen, P.Y., 2007. Medical Management of Brain Tumor Patients. Neurologic Clinics 25 (4), 1035-1071.

Dean, T.R., Roop, B., Betancourt, D., Menetrez, M.Y., 2005. A simple multiplex polymerase chain reaction assay for the identification of four environmentally relevant fungal contaminants. Journal of Microbiological Methods 61, 9-16.

de Blay, F., Casel, S., Colas, F., Spirlet, F., Pauli, G., 2000. Elimination of airborne allergens from the household environment. Revue des maladies respiratoires 17, 29-39.

Downs, S.H., Mitakakis, T.Z., Marks, G.B., Car, N.G., Belousova, E.G., Leuppi, J.D., Xuan, W., Downie, S.R., Tobias, A., Peat, J.K., 2001. Clinical importance of Alternaria exposure in children. American Journal of Respiratory and Critical Care Medicine 164, 455-459.

Doherty, W.O.S., Mousavioun, P., Fellows, C.M., 2011. Value-adding to cellulosic ethanol: Lignin polymers. Industrial Crops and products 33 (2), 259-276.

Douwes, J., 2003. (1-3)-b-D-glucans and respiratory health: a of the scientific evidence. Indoor Air 15, 160-169.

Dharmage, S., Bailey, M., Raven, J., Mitakakis, T., Cheng, A., Guest, D., Rolland, J., Forbes, A., Thien, F., Abramson, M., Walters, E.H., 2001. Current indoor allergen levels of fungi and cats, but not house dust mites, influence allergy and asthma in adults with high dust mite exposure. Am J Respir Crit Care Med 164, 65-71.

Dassonville, C., Demattei, C., Detaint, B., Barral, S., Bex-Capelle, V., Momas, I., 2008. Assessment and predictors determination of indoor airborne fungal concentrations in Paris newborn babies homes. Environmental Research 108, 80-85.

Deacon, L.J., Pankhurst, L.J., Drew, G.H., Hayes, E.T., Jackson, S., Longhurst, P.J., Longhurst, J.W.S., Liu, J., Pollard, S.J.T., Tyrrel,

5.F., 2009. Particle size distribution of airborne Aspergillus fumigatus spores emitted from compost using membrane filtration. Atmospheric Environment 43, 5698-5701.

Duncan, S.M., Farrell, R.L., Jordan, N., Jurgens, J.A., Blanchette, R.A., 2010. Monitoring and identification of airborne fungi at historic locations on Ross Island, Antarctica. Polar Science 4, 275283.

Docampo, S., Trigo, M.M., Recio, M., Melgar, M., Garcia-Sanchez, J., Cabezudo, B. Fungal spore content of the atmosphere of the Cave of Nerja (southern Spain): Diversity and origin. Science of the Total Environment, 409, pp.835-843.

Degobbi, C., Lopes, F.D.T.Q.S., Carvalho-Oliveira, R., Munoz, J.E., Saldiva, P.H.N., 2011. Correlation of fungi and endotoxin with Pm2.5 and meteorological parameters in atmosphere of Sao Paulo, Brazil. Atmospheric Environment 45, 2277-2283.

de Ana, S.G., Torres-Rodriguez, J.M., Ramirez, E.A., Garcia, S.M., Belmonte-Soler, J., 2006. Seasonal distribution of Alternaria, Aspergillus, Cladosporium and Penicillium species isolated in homes of fungal allergic patients. Journal of Investigational Allergology and Clinical Immunology 16 (6), 357-363.

Dutkiewicz, J., Skorska, C., Krysinska-Traczyk, E., Cholewa, G., Sitkowska, J., Milanowski, J., Gora, A., 2002. Precipitin response of potato processing workers to work-related microbial allergens. Annals of Agricultural and Environmental Medicine 9, 237-242.

Ebbehoj, N.E., Hansen, M.O., Sigsgaard, T., Larsen, L., 2002. Building-related symptoms and molds: a two-step intervention study. Indoor Air 12, 273-277.

Engelhart, S., Glasmacher, A., Simon, A., Exner, M., 2007. Air sampling of Aspergillus fumigatus and other thermotolerant fungi: Comparative performance of the Sartorius MD8 airport and the Merck MAS-100 portable bioaerosol sampler. International Journal of Hygiene and Environmental Health 210 (6), 733-739.

Erkara, I.P., Asan, A., Yilmaz, V., Pehlivan, S., Okten, S.S., 2008. Airborne Alternaria and Cladosporium species and relationship with meteorological conditions in Eskisehir City, Turkey. Environmental Monitoring and Assessment 144 (1-3), 31-41.

Escombe, A.R., Moore, D.A., Gilman, R.H., Navincopa, M., Ticona, E., Mitchell, B., Noakes, C., Martinez, C., Sheen, P., Ramirez, R., Quino, W., Gonzalez, A., Friedland, J.S., Evans, C.A., 2009. Upper-room ultraviolet light and negative air ionization to prevent tuberculosis transmission. PLoS Medicine

6, e43.

Etzel, R.A., 2001. Indoor air pollutants in homes and schools. Pediatric Clinics of North America 48, 1153-1165.

Ewers, L., Clark, S., Menrath, W., Succop, P., Bornschein, I.L., 1994. Clean up of lead in house hold carpet and floor dust. American Industrial Hygiene Association Journal 55, 650-657.

Fogelmark, B., Thorn, J., Rylander, R., 2001. Inhalation of (1-3)-ß-D-Glucan causes airway eosinophilia. Mediators of Inflammation 10, 13-19.

Foarde, K.K., Menetrez, M.Y., 2002. Evaluating the potential efficacy of three antifungal sealants of duct liner and galvanized steel as used in HVAC systems. Journal of Industrial Microbiology and Biotechnology 29, 38-43.

Faure, O., Fricker-Hidalgo, H., Lebeau, B., Mallaret, M.R., Ambro-ise-Thomas, P., Grillot, R., 2002. Eight-year surveillance of environmental fungal contamination in hospital operating rooms and haematological units. Journal of Hospital Infection 50, 155160.

Ferguson, A., Bursac, Z., Coleman, S., Johnson, W., 2009. Comparisons of computercontrolled chamber measurements for soil-skin

adherence from aluminum an carpet surfaces. Environmental Research 109 (3), 207-214.

Farley, R.D., Franklin, D.H., 1992. Development of a humidifier for patient ventilation using a semi-permeable tube to minimize system condensate. Journal of Biomedical Engineering 14 (5), 426-430.

Frazer, L.N., 1998. One stop mycology. Mycological Research 102 (1), 103-128.

Franks, T.J., Galvin, J.R., 2010. Hypersensitivity pneumonitis: essential radiologic and pathologic findings. Surgical Pathology Clinics 3 (1), 187-198.

Fung, F., Hughson, W.G., 2003. Health effects of indoor fungal bioaerosol exposure. Applied Occupational and Environmental Hygiene 18, 535-544.

Gabrio, T., Dill, I., Fischer, G., Grun, L., Rabe, R., Samson, R., Seidl, H P., Szewzyk, R., Trautmann, C., Warscheid, T., 2003. Strategies and targets for establishing a multicenter trail: Identification of indoor felevant moulds. Mycoses 46, 32-36.

Gage-White, L., 1998. Practical environmental modifications for the inhalant allergy patient. Otolaryngologic Clinics of North America 31, 83-90.

Gaffin, J.M., Phipatanakul, W., 2009. The role of indoor allergens in the development of asthma. Current Opinion in Allergy and Clinical Immunology 9, 128-135.

Garrison, R.A., Robertson, L.D., Koehn, R.D., Wynn, S.R., 1993. Effect of heatingventilation-air conditioning system sanitation on airborne fungal populations in residential environments. Annals of Allergy, Asthma and Immunology 71, 546-556.

Guieysse, B., Hort, C., Platel, V., Munoz, R., Ondarts, M., Revah, S., 2008. Biological treatment of indoor air for VOC removal: Potential and challenges. Biotechnology Advances 26 (5), 398-410.

Ghosh, D., Dhar, P., Das, A.K., Uddin, N., 2011. Identification and distribution of aeromycoflora in the indoor environment of Shyam bazaar metro-railway station, Kolkata, India. African Journal of Microbiology Research 5 (31), 5569-5574.

Gutarowska, B., Sulyok, M., Krska, R., 2010. A study of the toxicity of moulds isolated from dwellings. Indoor and Built Environment 19 (6), 668-675.

Gravesen, S., Nielsen, P.A., Iversn, R., Nielsen, K.F., 1999. Microf-ungal contamination of damp buildings-examples of risk constructions and risk materials. Environmental Health Perspectives 107 (3), 505-508.

Gralton, J., Tovey, E., McLaws, M.L., Rawlinson, W.D., 2011. The role of particle size in aerosolised pathogen transmission: a review. Journal of Infection 62 (1), 1-13.

Guo, H., 2011. Source apportionment of Volatile organic compounds in Hong Kong homes. Building and Environment 46 (11), 22802286.

Giulio, M.D., Grande, R., Campli, E.D., Bartolomeo, S.D., Luigina Cellini, L., 2010. Indoor air quality in university environments. Environmental Monitoring and Assessment 170 (1-4), 509-517.

Gottschalk, C., Bauer, J., Meyer, K., 2008. Detection of satratoxin g and h in indoor air from water-damaged building. Mycopathologia 166 (2), 103-107.

Gosden, P.E., MacGowan, A.P., Bannister, G.C., 1998. Importance of air quality and related factors in the prevention of infection in orthopaedic implant surgery. Journal of Hospital Infection 39, 173-180.

Gorny, R.L., Mainelis, G., Wlazlo, A., Niesler, A., Lis, D.O., Marzec, S., Siwinska, E., Ludzen-Izbinska, B., Harkawy, A., Kasznia-Kocot, J., 2007. Viability of fungal amd actinomycetal spores after microwave radiation of building materials. Annals of Agricultural and Environmental Medicine 14, 313-324.

Hagmolen, W., van den Berg, N.J., van der Palen, J., van Aalderen, W.M., Bindels, P.J., 2007. Residential exposure to mould and dampness is associated with adverse respiratory health. Clinical Experimental Allergy 37, 1827-1832.

Hahn, T., Cummings, K., Michalek, A.M., Lipman, B., Segel, B., McCarthy, P., 2002. Efficacy of High efficiency particulate air

filtration in preventing aspergillosis in immunocompromised patients with hematologic malignancies. Infection Control and Hospital Epidemiology 23, 525-531.

Haas, D., Habib, J., Galler, H., Buzina, W., Schlacher, R., Marth, E., Reinthaler, F.F., 2007. Assessment of indoor air in Austrian apartments with and without visible mold growth. Atmospheric Environment 41 (25), 5192-5201.

Hibbett, D.S., Ohman, A., Glotzer, D., Nuhn, M., Kirk, P., Nilsson, R.H., 2011. Progress in molecular and morphological taxon discovery in Fungi and options for formal classification of environmental sequences. Fungal Biology Reviews 25 (1), 38-47.

Hsu, N.Y., Chen, P.Y., Chang, H.W., Su, H.J., 2011. Changes in profiles of airborne fungi in flooded homes in southern Taiwan after Typhoon Morakot. Science of the Total Environment 409 (9), 1677-1682.

Hatfield, M.L., Hartz, K.E.H., 2011. Secondary organic aerosol from biogenic Volatile organic compounds mixtures. Atmospheric Environment 45 (13), 2211-2219.

Hoang, CP., Kinney, K.A., Corsi, R.L., Szaniszlo, P.J., 2010. Resistance of green building materials to fungal growth. International Biodeterioration Biodegradation 64 (2), 104-113.

Heinrich, J., 2011. Influence of indoor factors in dwellings on the development of childhood asthma. International Journal of Hygiene and Environmental Health 214 (1), 1-25.

Herbarth, O., Schlink, U., Muller, A., Richter, M., 2003. Spatiotemporal distribution of airborne mould spores in apartments. Myco-logical Research 107, 1361-1371.

Hasnain, S.M., Fatima, K., Al-Frayh, A., Al-Sedalry, S.T., 2005a. One year pollen and spore calendars of Saudi Arabia Al-Khobar, Abha and Hofuf. Aerobiologia 23 (3-4), 241-247.

Hasnain, S.M., Fatima, K., Al-Frayh, A.S., Al-Sedalry, S.T., 2005b. Pevalence of airborne basidiospores in three coastal cities of Saudi Arabia. Aerobiologia 21 (2), 139-145.

Hasnain, S.M., Al-Frayh, A.S., Al-Suwaine, A., Gad-El-Rab, M.O., Fatima, K., Al-Sedalry, S.T., 2004. Cladosporium and respiaratory allergy: Diagnostic implications in Saudi Arabia. Mycopathologia 157 (2), 171-179.

Hamada, N., Fujita, T., 2002. Effect of air-conditioner on fungal contamination. Atmospheric Environment 36, 5443-5448.

Haas, D., Galler, H., Habib, J., Melkes, A., Schlacher, R., Buzina, W., Friedl, H., Marth, E., Reithaler, F.F., 2010. Concentrations of viable aaaairborne fungal spores and trichloroanisole in wine cellars. International Journal of Food Microbiology 144, 126-132.

Harkawy, A., Gorny, R.L., Ogierman, L., Wlazlo, A., Lawniczek-Walczyk, A., Niesler, A., 2011. Bioaerosol assessment in naturally ventilated historically library building with restricted personnel access. Annals of Agricultural and Environmental Medicine 18 (2), 323-329.

Hasnain, S.M., Akhter, T., Waqar, M.A., 2012. Airborne and allergenic fungal spores of the Karachi environment and their correlation with meteorological factors. Journal of Environmental Monitoring 14, 1006-1013.

Hansen, V.M., Meyling, N.V., Winding, A., Eilenberg, J., Madsen, A.M., 2012. Factors affecting vegetable growers exposure to fungal bioaerosols and airborne dust. The Annals of Occupation Hygine 56 (2), 170-181.

Hedayati, M.T., Mayahi, S., Denning, D.W., 2010. A study on Aspergillus species in houses of asthmatic patients from Sari City, Iran and a brief review of the health effects of exposure to indoor Aspergillus. Environmental Monitoring and Assessment 168 (1-4), 481-487.

Halios, C.H., Helmis, C.G., 2010. Temporal evolution of the main processes that control indoor pollution in an office microenvironment: a case study. Environmental Monitoring and Assessment 167, 199-217.

Hiipakka, D.W., Buffington, J.R., 2000. Resolution of sick building syndrome in a highsecurity facility. Applied Occupational and Environmental Hygiene 15, 635-643.

Hintikka, E.L., 2004. The role of Stachybotrys in the phenomenon known as sick building syndrome. Advances in Applied Microbiology 55, 155-173.

Horner, W.E., 2003. Assessment of the indoor environment: evaluation of mold growth indoors. Immunology and Allergy Clinics of North America 23, 519-531.

Husman, T., 1996. Health effects of indoor-air microorganisms. Scandinavian Journal of Work, Environment Health 22, 5-13.

Hyvarinen, A., Sebastian, A., Pekkanen, J., Larsson, L., Korppi, M., Putus, T., Nevalainen, A., 2006. Characterizing microbial exposure with ergosterol, 3-hydroxy fatty acids, and viable microbes in house dust: determinants and association with childhood asthma. Archives of Environmental and Occupational Health 61, 149-157.

Ismail, M.A., Chebon, S.K., Hakamya, R., 1999. Preliminary surveys of outdoor and indoor aeromycobiota in Uganda. Aerobiologia 148 (1), 41-51.

Jaakkola, M.S., Laitinen, S., Piipari, R., Uitti, J., Nordman, H., Haapala, A.M., Jaakkola, J.J., 2002. Immunoglobulin G antibodies against indoor dampness-related microbes and adult-onset asthma: a population-based incident case-control study. Clinical and Experimental Immunology 129, 107-112.

Jo, W.K., 2011. Bioaerosols in Apartment Buildings. Encyclopedia of Environmental Health, 323-330.

Jung, JH., Lee, J.E., Bae, G.N., 2011. Real-time measurement of UV-inactivated Escherichia coli bacterial particles by electrospray-assisted UVAPS spectrometry. Science of the Total Environment 409 (17), 3249-3255.

Jacobs, R.L., Andrews, C.P., 2003. Hypersensitivity pneumonia-nonspecific interstitial pneumonia/fibrosis histopathologic presentation: a study in diagnosis and long-term management. Annals of Allergy, Asthma Immunology 90, 265-270.

Jothish, P.S., Nayar, T.S., 2004. Airborne fungal spores in a saw mill environment in Palakkad District, Kerala, India. Aerobiologia 20 (1), 75-81.

Jain, A.K., 2000. Survey of bioaerosol in different indoor working environments in central India. Aerobiologia 16 (2), 221-225.

Jain, S., nag, V., Marak, R.S.K., prasad, N., Dhole, T., 2010. Incidence of mycobacteria and fungi in clinically suspected urinary tract infection of immunocompromised patients - A tertiary care hospital study. International Journal of Infectious Diseases 14 (1), e206-e207.

Jovanovic, S., Felder-Kennel, A., Gabrio, T., Kouros, B., Link, B., Maisner, V., Piechotowski, I., Schick, K.H., Schrimpf, M., Weidner, U., Zollner, I., Schwenk, M., 2004. Indoor fungi levels in homes of children with and without allergy history. International Journal of Hygiene and Environmental Health 207, 369-378.

Kawasaki, T., Kyotani, T., Ushiogi, T., Izumi, Y., Lee, H., Hayakawa, T., 2010. Distribution and Identification of airborne fungi in railway stations in Tokyo, Japan. Journal of Occupation Health 52, 186-193.

Kanaani, H., Hargeeaves, M., Ritovski, Z., Morawska, L., 2009. Fungal spore fragmentation as afunction of airflow rates and fungal generation methods. Atmospheric Environment 43, 37253735.

Kim, K., Kim, H., Kim, D., Nakajima, J., Higuchi, T., 2009. Distribution characteristics of airborne bacteria and fungi in the feedstuff-manufacturing factories. Journal of Hazardous Materials 169, 1054-1060.

Kaarakainen, P., Rintala, H., Vesalainen, A., Hyvarinen, A., Nevalainen, A., Meklin, T., 2009. Microbial content of house dust samples determined with qPCR. Science of the Total Environment 407, 4673-4680.

Kim, K.Y., Kim, C.N., 2007. Airborne microbiological characteristics in public buildings of Korea. Building and Environment 45 (2), 2188-2196.

Kelkar, U., Bal, A.M., Kulkarni, S., 2005. Fungal contamination of air conditioning units in operating theatres in India. Journal of Hospital Infection 60, 81-84.

Koch, A., Heilemann, K.J., Bishof, Heinrich, J., Wichmann, H.E., 2000. Indoor viable mold spores-a comparison between two cities, Erfurt (eastern Germany) and Hamburg (waestern Germany). Allergy 55, 176-180.

Khan, Z.U., Khan, M.A.Y., Chandy, R., Sharma, P.N., 1999. Aspergilli and other moulds in the air of Kuwait. Mycopathologia 146 (1), 25-32.

Kakde, D.B., Kakde, H.U., Saoji, A.A., 2001. Seasonal variation of fungal propagules in afruit market environment, Nagpur (India). Aerobiologia 17 (2), 177-182.

Kalyoncu, F., 2010. Relationship between airborne fungal allergens and meteorological factors in Manisa City, Turkey. Environmental Monitoring and Assessment 165 (1-4), 553-558.

Karunasena, E., Larranaga, M.D., Simoni, J.S., Douglas, D.R., Straus, D.C., 2010. Building-associated neurological damage modeled in human cells: a mechanism of neurotoxic effects by exposure to mycotoxins in the indoor environment. Mycopathologia 170 (6), 377-390.

Katz, Y., Verleger, H., Barr, J., Rachmiel, M., Kiviti, S., Kuttin, E.S., 1999. Indoor survey of moulds and prevalence of mould atopy in Israel. Clinical and Experimental Allergy 29, 186-192.

Kawel, N., Schorer, G., Desbiolles, L., Seifert, B., Marincek, B., Boehm, T., 2011. Discrimination between invasive pulmonary aspergillosis and pulmonary lymphoma using CT. European Journal of Radiology 77 (3), 417-425.

Kuo, N.W., Chiang, H.S., Chiang, C.M., 2008. Development and application of an integrated indoor air quality audit to an international hotel building in Taiwan. Environmental Monitoring and Assessment 147 (1-3), 139-147.

Khan, A.A.H., Karuppayil, S.M., Chary, M., Kunwar, I.K., Wagh-ray, S., 2009. Isolation, identification and testing of allergenicity of fungi from air-conditioned indoor environments. Aerobiologia 25, 119-123.

Khan, A.A.H., 2009. Studies on Indoor Fungi and Their Control (Thesis), Department of Biotechnology, School of Life Sciences, Swami Ramanand Teerth Marathwada University, Nanded.

Khan, A.A.H., Karuppayil, S.M., 2010. Potential natural disinfectants for indoor environments. International Journal of Clinical Aromatherapy 7, 1-5.

Khan, A.A.H., Karuppayil, S.M., 2011. Practices contributing to biotic pollution in Airconditioned indoor environments. Aerobio-logia 27, 85-89.

Kennedy, S.M., Copes, R., Bartlett, K.H., Brauer, M., 2004. Point-of-sale glass bottle recycling: indoor airborne exposures and symptoms among employees. Occupational and Environmental Medicine 61, 628-635.

Kilburn, K.H., 2004. Role of molds and mycotoxins in being sick in buildings: neurobehavioral and pulmonary impairment. Advances in Applied Microbiology 55, 339-359.

Krause, J.D., Hammad, Y.Y., Ball, L.B., 2003. Application of a fluorometric method for the detection of mold in indoor environments. Applied Occupational and Environmental Hygiene 18, 499503.

Kreja, L., Seidel, H.J., 2002. Evaluation of the genotoxic potential of some microbial volatile organic compounds (MVOC) with the comet assay, the micronucleus assay and the HPRT gene mutation assay. Mutation Research 513, 143-150.

Lander, F., Meyer, H.W., Norn, S., 2001. Serum IgE specific to indoor moulds, measured by basophil histamine release, is associated with building-related symptoms in damp buildings. Inflammation Research 50, 227-231.

Lange, J H., Thomulka, K.W., Mastrangelo, G., Fedeli, U., Quezada, N.V., 2004. Airborne mold concentrations during remediation of an apartment building. Bulletin of Environmental Contamination and Toxicology 73, 487-489.

Levetin, E., Shaughnessy, R., Rogers, C.A., Scheir, R., 2001. Effectiveness of germicidal UV radiation for reducing fungal contamination within air-handling units. Applied and Environmental Microbiology 67, 3712-3715.

Leong, S.L., Pettersson, O.V., Rice, T., Hocking, A.D., Schnurer, J., 2011. The extreme xerophilic mould Xeromyces bisporus -Growth and competition at various water activities. International Journal of Food Microbiology 145 (1), 57-63.

Lanier, C., Richard, E., Heutte, N., Picquet, R., Bouchart, V., Garon, D., 2010. Airborne molds and mycotoxins associated with handling of corn silage and oilseed cakes in agricultural environment. Atmospheric Environment 44 (16), 1980-1986.

Li, D.W., Yang, C.S., 2004. Fungal contamination as a major contributor to sick building syndrome. Advances in Applied Microbiology 55, 31-112.

Li, A., Liu, Z., Zhu, X., Liu, Y., Wangb, Q., 2010. The effect of air-conditioning parameters and deposition dust on microbial growth in supply air ducts. Energy and Buildings 42, 449-454.

Lugauskas, A., Levinskaite, L., Peciulyte, D., 2003. Micromycetes as deterioration agents of polymeric materials. International Biodete-rioration Biodegradation 52 (4), 233-242.

Manuel, J., 2004. HVAC officemate. Environmental Health Perspectives 112, A346.

Marcoux, D., Jafarian, F., Joncas, V., Buteau, C., Victor Kokta, V., Albert Moghrabi, A., 2009. Deep cutaneous fungal infections in immunocompromised children. Journal of the American Academy of Dermatology 61 (5), 857-864.

Molhave, L., 2011. Sick building syndrome. Encyclopedia of Environmental Health, 61-67.

McDonnell, G., Burke, P., 2011. Disinfection: is it time to reconsider Spaulding? Journal of Hospital Infection 78 (3), 163-170.

Moularat, S., Hulin, M., Robine, E., Annesi-Maesano, I., Caillaud, D., 2011. Airborne fungal volatile organic compounds in rural and urban dwellings: detection of mould contamination in 94 homes determined by visual inspection and airborne fungal volatile organic compounds method. Science of the Total Environment 409 (11), 2005-2009.

Muilenberg, M.L., 2003. Sampling devices. Immunology and Allergy Clinics of North America 23 (3), 337-355.

Moularat, S., Robine, E., 2006. Mesure des mycotoxines aeroportees. Revue Francaise d'Allergologie et d'Immunologie Clinique 46 (3), 180-183.

Menzies, D., Pasztor, J., Rand, T., Bourbeau, J., 1999. Germicidal ultraviolet irradiation in air conditioning systems: effect on office worker health and wellbeing: a pilot study. Occupational and Environmental Medicine 56, 397-402.

Menetrez, M.Y., Foarde, K.K., Webber, T.D., Dean, T.R., Betan-court, D.A., 2007. Testing antimicrobial cleaner efficacy on gypsum wallboard contaminated with Stachybotrys chartarum. Environmental science and pollution research international 14, 523-528.

Menetrez, M.Y., Foarde, K.K., Webber, T.D., Dean, T.R., Betan-court, D.A., 2008. Testing antimicrobial paint efficacy on gypsum wallboard contaminated with Stachybotrys chartarum. Journal of Occupational and Environmental Hygiene 5, 63-66.

Moularat, S., Robine, E., Ramalho, O., Oturan, M.A., 2008. Detection of fungal development in closed spaces through the determination of specific chemical targets. Chemosphere 72, 224-232.

Mc Grath, J.J., Wong, W.C., Cooley, J.D., Straus, D.C., 1999. Continually measured fungal profiles in sick building syndrome. Current Microbiology 38, 33-36.

Mc Kernan, L.T., Wallingford, K.M., Hein, M.J., Burge, H., Rogers, C.A., Herrick, R., 2008. Monitoring microbial populations on wide-body commercial passenger aircraft. Annals of Occupational Hygiene 52, 139-149.

Mitchell, C.S., Zhang, J., Sigsgaard, T., Jantunen, M., Lioy, P.J., Samson, R., Karol, M.H., 2007. Current state of the science. Health effects and indoor environmental quality. Environmental Health Perspectives 115, 958-964.

Maurice, S., Floch, G.L., Bras-Quere, M.L., Barbier, G., 2011. Improved molecular methods to characterize Serpula lachymans and other Basidiomycetes involved in wood decay. Journal of Microbiological Methods 84, 208-215.

Morey, PR., Hull, M.C., Andrew, M. E1 Nino water leaks identify rooms with concealed mould growth and degraded indoor air quality. International Biodeterioration & Biodegradation, 52, pp. 197-202.

Morrison, J., Yang, C., Lin, K.T., Haugland, R.A., Neely, A.N., Vesper, S.J., 2004. Monitoring Aspergillus species by quantitative PCR during construction of a multi-storey hospital building. Journal of Hospital Infection 57, 85-87.

Mork, L., 2002. Breaking the mold. Occupational Health Safety 71, 80.

Muise, B., Seo, D.C., Blair, E.E., Applegate, T., 2010. Mold spore penetration through wall service outlets: a pilot study. Environmental Monitoring and Assessment 163 (1-4), 95-104.

Myatt, T.A., Minegishi, T., Allen, J.G., Macintosh, D.L., 2008. Control of asthma triggers in indoor air with air cleaners: a modeling analysis. Environmental health 7, 43.

Nakayama, K., Morimoto, K., 2007. Relationship between, lifestyle, mold and sick building syndromes in newly built dwellings in Japan. International Journal of Immunopathology Pharmacology 20, 35-43.

Nayar, T.S., Mohan, T.K., Jothish, P.S., 2007. Status of airborne spores and pollen in a coir factory in Kerala, India. Aerobiologia 23 (2), 131-143.

Nielsen, K.F., Thrane, U., Larsen, T.O., Nielsen, P.A., Gravesen, S., 1998. Production of mycotoxins on artificially inoculated building materials. International Biodeterioration & Biodegradation 42, 916.

Nieguitsila, A., Arne, P., Durand, B., Deville, M., Benoit-Valiergue, H., Chermette, R., Cottenot-Latouche, S., Guillot, J., 2011. Relative efficiencies of two air sampling methods and three culture conditions for the assessment of airborne culturable fungi in a poultry farmhouse in France. Environmental Research 11, 248253.

Norback, D., Cai, G., 2011. Fungal DNA in hotel rooms in Europe and Asia-associations with latiyude, precipitation, building data, room characteristics and hotel ranking. Journal of Environmental Monitoring 13, 2903-2895.

Nevalainen, A., Seuri, M., 2005. Of microbes and men. Indoor Air 15, 58-64.

Nilsson, A., Kihlstrom, E., Lagesson, V., Wessen, B., Szponar, B., Larsson, L., Tagesson, C., 2004. Microorganisms and volatile organic compounds in airborne dust from damp residences. Indoor Air 14, 74-82.

Noris, F., Siegel, J.A., Kinney, K.A., 2011. Evaluation of HVAC filters as a sampling mechanism for indoor microbial communities. Atmospheric Environment 45 (2), 338-346.

O'Neill, T.B., 1988. Succession and interrelationships of microorganisms on painted surfaces. International Biodeterioration 24 (4-5), 373-379.

Olsen, J.H., Dragsted, L., Autrup, H., 1988. Cancer risk and occupational exposure to aflatoxins in Denmark. British Journal of Cancer 58, 392-396.

O'Meara, T., Tovey, E., 2000. Monitoring personal allergen exposure. Clinical Reviews in Allergy and Immunology 18, 341-395.

Oren, I., Haddad, N., Finkelstein, R., Rowe, J.M., 2001. Invasive pulmonary aspergillosis in neutropenic patients during hospital construction: before and after chemoprophylaxis and institution of HEPA filters. American Journal of Hematology 66, 257-262.

Otto, D., Molhave, L., Rose, G., Hundell, H.K., House, D., 1990. Neurobehavioral and sensory irritant effects of controlled exposure to a complex mixture of volatile organic compounds. Neurotox-icology and Teratology 12, 649-652.

Park, J.H., Cox-Ganser, J.M., Kreiss, K., White, S.K., Rao, C.Y., 2008. Hydrophilic fungi and ergosterol associated with respiratory illness in a water-damaged building. Environmental Health Perspectives 116, 45-50.

Pedro-Botet, M.L., Sanchez, I., Sabria, M., Sopena, N., Mateu, L., Garcia-Nunez, M., Rey- Joly, C., 2007. Impact of copper and silver

ionization on fungal colonization of the water supply in health care centers: implications for immunocompromised patients. Clinical Infectious Diseases 45, 84-86.

Pieckova, E., Wilkins, K., 2004. Airway toxicity of house dust and its fungal composition. Annals of Agricultural and Environmental Medicine 11, 67-73.

Pinheiro, A.C., Macedo, M.F., Jurado, Saiz-Jimenez, C., Viegas, C., Brandao, J., Rosado, L., 2011. Mould and yeast identification in archival settings: Preliminary results on the use of traditional methods and molecular biology options in Portuguese archives. International Biodeterioration & Biodegradation 65 (4), 619-627.

Perdelli, F., Cristina, M.L., Sartini, M., Spagnolo, A.M., Dallera, M., Ottria, G., Lombardi, R., Orlando, P., 2006. Fungal contamination in hospital environments. Infection Control and Hospital Epidemiology 27 (1), 44-47.

Phipatanakul, W., 2003. Environmental indoor allergens. Pediatric Annals 32, 40-48.

Polizzi, V., Adams, A., Picco, A.M., Adriaens, E., Lenoir, J., Van Peteghem, C., De Saeger, De Kimpe, N., 2011. Influence of environmental conditions on production of volatiles by Tricho-derma atroviride in relation with sick building syndrome. Building and Environment 46, 945-954.

Portnoy, J.M., 2003. Evaluation of indoor mold exposure is what allergists do best. Annals of Allergy, Asthma Immunology 90, 175.

Qudiesat, K., Abu-Elteen, K., Elkarmi, A., Hamad, M., Abussaud, M., 2009. Assesssment of airborne pathogens in healthcare settings. African Journal of Microbiology 3 (2), 066-076.

Reijula, K., 2004. Moisture-problem buildings with molds causing work-related diseases. Advances in Applied Microbiology 55, 175189.

Rene, E., Montes, M., Veiga, M.C., Kennes, C., 2010. Biotreatment of gas-phase VOC mixtures from fiberglass and composite manufacturing industry. Journal of Biotechnology 150 (1), 218-219.

Ruping, M.J.G.T., Gerlach, S., Fischer, G., Lass-Florl, C., Hellmich, M., Vehreschild, J.J., Cornely, O.A., 2011. Environmental and clinical epidemiology of Aspergillus terreus: data from a prospective surveillance study. Journal of Hospital Infection 78 (3), 226230.

Rajasekar, A., Balasubramanian, R., 2011. Assessment of airborne bacteria and fungi in food courts. Building and Environment 46 (10), 2081-2087.

Reponen, T., 2011. Methodologies for Assessing Bioaerosol Exposures. Encyclopedia of Environmental Health, 722-730.

Rengasamy, A., Zhuang, Z., BerryAnn, R., 2004. Respiratory protection against bioaerosols: literature review and research needs. American Journal of Infection Control 32 (6), 345-354.

Reynolds, S.J., Black, D.W., Borin, S.S., Breuer, G., Burmeister, L.F., Fuortes, L.J., Smith, T.F., Stein, M.A., Subramanian, P., Thorne, P.S., Whitten, P., 2001. Indoor environmental quality in six commercial office buildings in the Midwest United States. Applied Occupational and Environmental Hygiene 16, 1065-1077.

Robertson, O.H., Bigg, E., Puck, T.T., Miller, B.F., 1942. The bactericidal action of propylene glycol vapor on microorganisms suspended in air. Journal of Experimental Medicine 75 (6), 593610.

Roussel, S., Reboux, G., Bellanger, A.P., Sornin, S., Grenouillet, F., Dalphin, J.C., Piarroux, R., Millon, L., 2008. Characteristics of dwellings contaminated by moulds. Journal of Environmental Monitoring 10, 724-729.

Rossnagel, B., 2000. IAQ priorities for mold, yeast, bacteria spores. Occupational Health Safety 69, 58-60.

Richardson, M.D., Rennie, S., Marshall, I., Morgan, M.G., Murphy, J.A., Shankland, G.S., Watson, W.H., Soutar, R.L., 2000. Fungal surveillance of an open haematology ward. Journal of Hospital Infection 45, 288-292.

Reponen, T., Singh, U., Schaffer, C., Vesper, S., Johansson, E., Adhikari, A., Grinshpun, S.A., Indugula, R., Ryan, P., Levin, L., LeMasters, G., 2010. Visually observed mold and moldy odor

versus quantitatively measured microbial exposure in homes. Science of the Total Environment 408, 5565-5574.

Rylander, R., Lin, R.-H., 2000. (1-3)-b-D-Glucan - relationship to indoor air-related symptoms, allergy and asthma. Toxicology 152, 47-52.

Rylander, R., 2004. Microbial cell wall agents and sick building syndrome. Advances in Applied Microbiology 55, 139-154.

Rylander, R., Holt, P.G., 1998. (1fi3)-b-D-Glucan and endotoxins modulate immune response to inhaled allergen. Mediators of Inflammation 7, 105-110.

Rylander, R., Norrhall, M., Engdahl, U., Tunser, A., Holt, P.G., 1998. Airways inflammation, atopy, and (1 fi 3)-b-D-Glucan exposures in two schools. American Journal of Respiratory and Critical Care Medicine 158, 1685-1687.

Rylander, R., 2010. Organic dust induced pulmonary disease - the role of mould derived b-glucan. Annals of Agricultural and Environmental Medicine 17, 9-13.

Rylander, R., Reeslev, M., Hulander, T., 2010. Airborne enzyme measurements to detect indoor mould exposure. Journal of Environmental Monitoring 12, 2161-2164.

Robbins, C.A., Swenson, L.J., Nealley, M.L., Gots, R.E., Kelman,

B.J., 1999. Health effects of mycotoxins in indoor air: a critical. Applied Occupational and Environmental Hygiene 15, 773-784.

Sailer, M.F., van Nieuwenhuijzen, E.J., Knol, W., 2010. Forming of a functional biofilm on wood surfaces. Ecological Engineering 36 (2), 163-167.

Samet, J.M., Spengler, J.D., 2003. Indoor environments and health: Moving into the 21st century. American Journal of Public Health 93 (9), 1489-1493.

Santilli, J., Rockwell, W., 2003. Fungal contamination of elementary schools: a new environmental hazard. Annals of Allergy, Asthma Immunology 90 (2), 203-208.

Sato, K., Krist, S., Buchbauer, G., 2006. Antibacterial effect of trans-Cinnamaldehyde, (-)- perillaldehyde, (-)-citronellal, Citral, Eugenol and Carvacrol on Air borne microbes using an air washer. Biological Pharmaceutical Bulletin 29, 2292-2294.

Savilahti, E., Kolho, K. L., Westerholm-Ormio, M., M Verkasalo, M., 2010. Clinics of coeliac disease in children in the 2000s Acta Psdiatrica/Acta Psdiatrica, 99, pp. 1026-1030.

Shinoj, S., Visvanathan, R., Panigrahi, S., Kochubabu, M., 2011. Oil palm fiber (OPF) and its composites: a review. Industrial Crops and Products 33 (1), 7-22.

Samimi, B.S., Ross, K., 2003. Extent of fungal growth on fiberglass duct liners with and without biocides under challenging environmental conditions. Applied Occupational and Environmental Hygiene 18, 193-199.

Shirakawa, M.A., Loh, K., John, V.M., Silva, M.E.S., Gaylarde,

C.C., 2011. Biodeterioration of painted mortar surfaces in tropical urban and coastal situations: comparison of four paint formulations. International Biodeterioration Biodegradation 65 (5), 669674.

Shirakawa, M.A., Gaylarde, C.C., Gaylarde, P.M., John, V., Gambale, W., 2002. Fungal colonization and succession on newly painted buildings and the effect of biocide. FEMS Microbiology Ecology 39 (2), 165-173.

Sykes, P., Morris, R.H.K., Allen, J.A., Wildsmith, J.D., Jones, K.P., 2011. Workers' exposure to dust, endotoxin and b-(1-3) glucan at four large-scale composting facilities. Waste Management 31, 423430.

Simoes, S.A., Junior, D.P.L., Hahn, R.C., 2011. Fungal microbiota in air-conditioning installed in both adult and neonatal intensive treatmentunits and their impact in two university hospitals of the central western region, Mato Grosso, Brazil. Mycopathologia 172, 109-116.

Salonen, H., Lappalainen, S., Lindroos, O., Harju, R., Reijula, K., 2007. Fungi and bacteria in mould-damaged and non-damaged office environments in asubarctic climate. Atmospheric Environment 41, 6797-6807.

Stark, P.C., Celedon, J.C., Chew, G.L., Ryan, L.M., Burge, H.A., Muilenberg, M.L., Gold, D.R., 2005. Fungal levels in the home and allergic rhinitis by 5 years of age. Environmental Health Perspectives 113 (10), 1405-1409.

Singh, A., Gangal, S.V., Singh, A.E., 1994. Airborne fungal spores in the hospitals of metropolitan Delhi. Aerobiologia 10 (1), 11-21.

Sen, B., Asan, A., 2009. Fungal flora in indoor and outdoor air of different residential houses in Tekirdag City (Turkey): seasonal distribution and relationship with climatic factors. Environmental Monitoring and Assessment 151 (1-4), 209-219.

Soroka, P.M., Cyprowski, M., Stanczyk, I.S., 2008. Occupational exposure to mycotoxins in various branches of industry. Medycyna pracy 59, 333-345.

Srikanth, P., Sudharsanam, S., Steinberg, R., 2008. Bio-aerosols in indoor environment: composition, health effects and analysis. Indian Journal of Medical Microbiology 26, 302-312.

Thacker, P.D., 2004. Airborne mycotoxins discovered in moldy buildings. Environmental Science Technology 38 (15), 282A.

Tilak, S.T., 1986. Aerobiological investigations. Department of Ocean Development technical publication No. 3, pp. 175-177.

Tercelj, M., Salobir, B., Harlander, M., Rylander, R., 2011. Fungal exposure in homes of patients with sarcoidosis - an environmental exposure study. Environmental Health 10 (8), 1-5.

Tewary, R., Mishra, J.K., 1996. Allergic potential of some Aspergilli on saw mill workers in Lucknow, India. Aerobiologia 12 (4), 229-232.

Trout, D., Bernstein, J., Martinez, K., Biagini, R., Wallingford, K., 2001. Bioaerosol lung damage in a worker with repeated exposure to fungi in a water-damaged building. Environmental Health Perspectives 109, 641-644.

Tsai, M., Liu, H., 2009. Exposure to culturable airborne bioaerosols during noodle manufacturing in central Taiwan. Science of the Total Environment 407, 1536-1546.

Takigawa, T., Wang, B., Sakano, N., Wang, D., Ogino, K., Kishi, R., 2009. A longitudinal study of environmental risk factors for subjective symptoms associated with sick building syndrome in new dwellings. Science of the Total Environment 407, 5223-5228.

Uztan, A.H., Ates, M., Abaci, O., Gulbahar, O., Erdem, N., Ciftci, O., Boyacioglu, H., 2010. Determination of potential allergenic fungal flora and its clinical reflection in suburban elementary schools in Izmir. Environmental Monitoring and Assessment 168 (1-4), 691-702.

Vacher, S., Hernandez, C., Bartschi, C., Poussereau, N., 2010. Impact of paint and wall-paper on mould growth on plasterboards and aluminum. Building and Environment 45 (4), 916-921.

Vesper, S.J., Wong, W., Kuo, C.M., Pierson, D.L., 2008. Mold species in dust from the International space station identified and quantified by mold-specific quantitative PCR. Research in Microbiology 159, 432-435.

Voisey, C.R., 2010. Intercalary growth in hyphae of filamentous fungi. Fungal Biology Reviews 24 (3-4), 123-131.

Varani, S., Stanzani, M., Paolucci, M., Melchionda, F., Castellani, G., Nardi, L., Landini, M.P., Baccarani, M., Pession, A., Sambri, V., 2009. Diagnosis of bloodstream infections in immunocompromised patients by real-time PCR. Journal of Infection 58 (5), 346-351.

Vojdani, A., Kashanian, A., Vojdani, E., Campbell, A.W., 2003a. Saliva secretory IgA antibodies against molds and mycotoxins in patients exposed to toxigenic fungi. Immunopharmacology and Immunotoxicology 25, 595-614.

Vojdani, A., Campbell, A.W., Kashanian, A., Vojdani, E., 2003b. Antibodies against molds and mycotoxins following exposure to toxigenic fungi in a water-damaged building. Archives of Environmental Health 58, 324-336.

Wan, G.H., Li, C.S., 1999. Indoor endotoxin and glucan in association with airway inflammation and systemic symptoms. Archives of Environmental Health 54, 172-179.

Wan, G H., Li, C.S., Guo, S.P., Rylander, R., Lin, R.H., 1999. An airborne mold-derived product, (1-3)-ß-D-Glucan, potentiates airway allergic responses. European Journal of Immunology 29, 2491-2497.

Wang, C.C., Fang, G.C., Kuo, C.H., 2010a. Bioaerosols as contributors to poor air quality in Taichung City, Taiwan. Environmental Monitoring and Assessment 166 (1-4), 1-9.

Wang, W., Ma, X., Ma, Y., Mao, L., Wu, F., Ma, X., An, L., Feng, H., 2010b. Seasonal dynamics of airborne fungi in different caves of the Mogao Grottoes, Dunhuang, China. International Biodeteri-oration & Biodegradation 64, 461-466.

Woodcock, A.A., Steel, N., Moore, C.B., Howard, S.J., Custovic, A., Denning, D.W., 2006. Fungal contamination of bedding. Allergy 61 (1), 140-142.

Wu, P., Su, H.J., Ho, H., 2000. A comparison of sampling media for environmental viable fungi collected in hospital environment. Environmental Research Section A 82, 253-257.

Wady, L., Bunte, A., Pehrson, C., Larsson, L., 2003. Use of gas chromatography-mass spectrometry/solid phase microextraction for the identification of MVOCs from moldy building materials. Journal of Microbiological Methods 52, 325-332.

Wouters, I.M., Douwes, J., Doekes, G., Thorne, P.S., Brunekreef, B., Heederik, D.J.J., 2000. Increased levels of markers of microbial exposure in homes with indoor storage of organic household waste. Applied and Environmental Microbiology 66 (2), 627-631.

Wahid, O.A.A., Moustafa, A.W.F., Moustafa, A.M., 1996. Fungal population in the atmosphere of Ismailia City. Aerobiologia 12 (4), 249-255.

Walinder, R., Norback, D., Wessen, B., Venge, P., 2001. Nasal lavage biomarkers: effects of water damage and microbial growth in an office building. Archives of Environmental Health 56, 30-36.

Warsco, K., Lindsey, P.F., 2003. Proactive approaches for mold-free interior environments. Archives of Environmental Health 58 (8), 512-522.

Weinhold, B., 2007. A spreading concern: inhalational health effects of mold. Environmental Health Perspectives 115, A300-A305.

Weir, E., 2000. Indoor moulds and human health. Canadian Medical Association Journal 162, 1469.

Weber, D.J., Barbee, S.L., Sobsey, M.D., Rutala, W.A., 1999. The effect of blood on the antiviral activity of sodium hypochlorite, a phenolic, and a quaternary ammonium compound. Infection Control and Hospital Epidemiology 20 (12), 821-827.

Wilkins, K., Nielsen, K.F., Din, S.U., 2003. Patterns of volatile metabolites and nonvolatile trichothecenes produced by isolates of Stachybotrys, Fusarium, Trichoderma, Trichothecium and Mem-noniella. Environmental science and pollution research international 10 (3), 162-166.

Williams, D., 2004. An IAQ overview. Increasing ventilation is a fundamental method to reduce concentrations of several substances of concern. Occupational Health Safety 73, 66-96.

Wilson, S.C., Straus, D.C., 2002. The presence of fungi associated with sick building syndrome in North American zoological institutions. Journal of Zoo and Wildlife 33, 322-327.

Yates, A., Gray, F.B., Misiaszek, J.I., Wolman, W., 1986. Air ions: Past problems and future directions. Environment International 12 (1-4), 99-108.

Yazicioglu, M., Asan, A., Ones, U., Vatansever, U., Sen, B., Ture, M., Bostancioglu, M., Pala, O., 2004. Indoor airborne fungal spores and home characteristics in asthmatic children from Edirne region of Turkey. Allergologia et immunopathologia 32, 197-203.

Yike, I., 2011. Fungal Proteases and Their Pathophysiological Effects. Mycopathologia 171 (5), 299-323.

Yamamoto, N., Schmechel, D., Chen, B.T., Lindsley, W.G., Peccia, J., 2011. Comparison of quantitative airborne fungi measurements by active and passive sampling methods. Journal of Aerosol Science 42 (8), 499-507.

Yau, Y.H., Chandrasegaran, D., Badarudin, A., 2011. The ventilation of multiple-bed hospital wards in the tropics: a review. Building and Environment 46 (5), 1125-1132.

Yamashita, K., Nishiyama, T., Yokoyama, T., Abe, H., Manabe, M., 2005. A comparison of the rate of bacterial contamination for

prefilled disposable and reusable oxygen humidifiers. Journal of Critical Care 20 (2), 172-175.

Yau, Y.H., Ng, W.K., 2011. A comparison study on energy savings and fungus growth control using heat recovery devices in a modern tropical operating theatre. Energy Conversion and Management 52 (4), 1850-1860.

Zadrazil, F., Galletti, G.C., Piccaglia, R., Chiavari, G., Francioso, O., 1991. Influence of oxygen and carbon dioxide on cell wall degradation by white-rot fungi. Animal Feed Science and Technology 32 (1-3), 137-142.

Zeliger, H.I., 2003. Toxic effects of chemical mixtures. Archives of Environmental Health: An International Journal 58 (1), 23-29.

Zhen, S., Li, K., Yin, L., Yao, M., Zhang, H., Chen, L., Zhou, M., Chen, X., 2009. A comparison of the efficiencies of a portable BioStage impactor and a Reuter centrifugal sampler (RCS) High Flow for measuring airborne bacteria and fungi concentrations. Journal of Aerosol Science 40 (6), 503-513. Zain, M.E., 2011. Impact of mycotoxins on humans and animals.

Journal of Saudi Chemical Society 15 (2), 129-144. Zotti, M., Ferroni, A., Calvini, P., 2011. Mycological and FTIR analysis of biotic foxing on paper substrates. International Biodeterioration & Biodegradtion 65 (4), 569-578. Zuraimi, M.S., Fang, L., Tan, T.K., Chew, F.T., Tham, K.W., 2009. Airborne fungi in low and high allergic prevalence child care centers. Atmospheric Environment 43, 2391-2400.