indoor allergens · consultation: 2consultation: 2--3 hours3 hours investigation: 4-5 hours client...
TRANSCRIPT
Indoor AllergensMGH Pulmonary Grand Rounds
March 4, 2009
Jeffrey C. May, M.A., CIAQPMay Indoor Air Investigations LLC
Cambridge, MA
We have taken andanalyzed by
microscopy over25,000 air and dust
samples.
Since 1992MIAI has completed
more than 3000 buildinginspections, including
more than 1,000“sick buildinginvestigations.”
May Indoor Air Investigations LLC
© 2002 J. May
© 2002 J. May
May Indoor Air Investigations: two levels of serviceMay Indoor Air Investigations: two levels of service
Consultation: 2Consultation: 2--3 hours3 hoursInvestigation: 4Investigation: 4--5 hours5 hours
Client interviewClient interviewWalkthrough : exterior and interiorWalkthrough : exterior and interior
Sampling in relevant areasSampling in relevant areasReport with observations and recommendationsReport with observations and recommendations
Above: Aspergillusmildew on a chair leg.The yellow colonies
grew on many furnituresurfaces and in
carpeting in the slabhome. An infant
suffered serious, chronicrespiratory problems.
© 2002 J. May
© 2002 J. May
May Indoor Air Investigations
Below: Aspergillusmildew grew on the backof an easy chair becausethe fabric was in contactwith a cold, glass slidingdoor. The heat registerflapped the material andspores became airborne.
© 2002 J. May
Cladosporium Growing in a Window AC
May Indoor Air Investigations LLC
The thick coating of dust onthe AC coil below is typical ofmost poorly filtered systems.Clean fins can be seen at thebottom where there has been
low air flow.
Mold hyphaegrowing in the dustfrom the AC coil at
the left.© 2002 J. May
© 2002 J. May © 2002 J. May © 2002 J. MayMay Indoor Air Investigations.
White oxideWhite oxideonon
moldymoldyinsulationinsulation
near annear anA/C coilA/C coil
May Indoor Air Investigations LLC
© 2009 J. May
A/CA/CLinerLiner
SampledSampled
Mold spores fromMold spores from ““patpat”” sample of linersample of linerinsulation near A/C coilinsulation near A/C coil
Spores from Microfungi CauseSpores from Microfungi CauseAllergy and Asthma SymptomsAllergy and Asthma Symptoms
© 2009 J. May
May Indoor Air Investigations LLC
May Indoor Air Investigations© 2007 J. May
“Invisible” Aspergillus in the Office AirClient suffered
fromhypersensitivity
pneumonitis
that resolved afterremediation.
skin
skin
Office air samples
time
Allergenco sample of airAllergenco sample of air
May Indoor Air Investigations LLC
Burkard samples of airBurkard samples of air
Before hitting bed After hitting bed
© 2002 J. May
Andersen NAndersen N--6 sampler6 sampler
May Indoor Air Investigations LLC
Nutrient agar sampling only detectsNutrient agar sampling only detectsculturable spores; total sampling isculturable spores; total sampling is
preferablepreferable
MaskNo mask
Face masks remove particulates
The single-strap mask is inadequateA double strapped NIOSH
rated N95 mask can be useddiagnostically.but it does remove most pollen:
There are two samples in thephotomicrograph at the left. The
first was obtained with aBurkard sampler, the second
with a single-strap maskcovering the sampler intake.
pollen
May Indoor Air Investigations LLC© 2002 J. May
cat dander
spore
Cat Dander Particle and Penicillium Sporein Burkard Air Sample at 1000x
The particles are stained pink by acid fuchsin in this light micrograph. Inevery home with pets, many dander particles are in the air. The y are
probably epidermal and coated with sebaceous allergens.
© 2002 J. May May Indoor Air Investigations LLC
Pet Dander, Fur and HairRabbit
Skin
Dog
Cat
dog fur
cat fur
MayIndoor Air Investigations LLC
© 2002 J. May
rabbit fur
horse hair© 2007 J. May
J. May Home Inspections, Inc.J. May Home Inspections, Inc.
wing
Kera tingranules?
SEM of Cockatiel Feather withUnknown Particles (4000x)
Large numbers of theseparticles were in the airof the home. The clienthad hypersensitivitypneumonitis.
© 2002 J. May
May Indoor Air Investigations LLC
Bird Bioaerosol
From a quilt 1,000x
May Indoor Air Investigations LLC © 2007 J. May
May Indoor Air Investigations
Moth FecalAdhesive coating on spherule
surfaces, 30,000x
Missing surface spherules 8000x SEM
Low power light
50x SEMPellet Color Depends on Fiber Color
Spherule with“adhesive”
30,000x SEM
Surface of Wool Moth Fecal
WoolMothFecalPellets
© 2002 J. May
The tray of a furnace humidifier full of mineral clumps.Floating on the water surface is a large, white colony of
actinomycetes, a mold-like growth that can causehypersensitivity pneumonitis
© 2002 J. MayMay Indoor Air Investigations LLC
Actinomycetes in basement air1,000x
Pen/Asp spore chain
May Indoor Air Investigations LLC
skin scale
© 2007 J. May
The Species of Mites from Homes
A dust mite from culture.
A mite foraging in Stachybotrys .
A mite from fiberglass.
Dust mite fecal pellets fromthe cover of a fish tank.
May Indoor Air Investigations
A HDM colony at rest.
A mite egg from a basement door
covered with Aspergillus spores.
© 2002 J. May
Mite fecal from carpet 600x
Skin
May Indoor Air Investigations LLC© 2009 J. May
125-micron insect fecal full of pollenfrom a baseboard convector
MayIndoor Air Investigations LLC
pollen
© 2009 J. May
Insect fecal full of spores 600x
May Indoor Air Investigations LLC
Insect Fecalpollen
May Indoor Air Investigations LLC
pollen
About 500x, from feather pillow
63 -micron fecal full of Chaetomium spores
© 2007 J. May
A cross-section at 14x.
Below left:tops of fiber loopswith hyphae andcellulose strandsat 150x.
Below right:growing sporesand hyphae oncarpet fiber at2000x
May Indoor Air Investigations
SEM of a Smelly, Almost New Carpet
© 2002 J. May
Bacteria cluster from carpet 1,200x
Skin scale
MayIndoor Air Investigations LLC
© 2007 J. May
May Indoor Air Investigations
Wool Fiber1000x SEM
Wool Fiber2000x SEM
Missing cuticle revealscortex strands
Respirablewool cuticleparticulates
cuticleLight 400x
Skin scale
Wool fiber shedding cuticle
Light 400x
Wool cuticle and cortex particlesin an air sample
© 2002 J. May
Wool Bioaerosol (“dander”) Can Be an Irritant Evaporative FurnaceHumidifiers
May Indoor Air Investigations
The water in furnace humidifier trays is always contaminated withorganisms: bacteria, mold or actinomycetes. Most of the debris inthe tray, however, is minerals that form from evaporation of water.
© 2002 J. May
Two Basement Roomsin the Home of aTeenager with
Chronic AsthmaSymptoms
What the allergistdidn’t see!
At the left is theboy’s TV room.
Below is the laundry.
May Indoor Air Investigations LLC
© 2007 J. May
The tenants had only rented theapartment for one year. They
wondered what the “whitesmoke” was that billowed from
the carpeting when theyexercised on the floor. The
husband started having chronicsinus infections and the wife
became an asthmatic.
What the allergistdidn’t see!
May Indoor Air Investigations LLC
Mushrooms Growing Out of aBasement Carpet