Allergens and Bacteria Webinar - EMLab

Allergens and Bacteria

Webinar

Will begin at 9:00 a.m. (PST)

Participants will be in listen only mode.

Download the PDF of this presentation (case sensitive):

http://www.emlab.com/m/media/CET-webinar-day2.pdf

Allergens

Bacteria

Risk Communication

Harriet Burge, Ph.D.






Copyright © 2007-2013 EMLab P&K. All rights reserved. 2

Continuing Education Units (CEUs)

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Seminar Agenda – Day 2

1. Allergens

2. Bacteria a. Overview of bacteria

b. Summary of some adverse health effects due to bacteria a. Legionella

b. Endotoxin

c. MRSA

d. Sewage

3. Sampling and analysis

4. Risk communication

Allergens

Participants will be in listen only mode.

Otherwise, the background noise makes

effective communication impossible.

Harriet Burge, Ph.D.


The Immune System

• Passive immunity Physical barriers (skin)

Low pH of our stomach

Coughing

• Active immunity

• Mediators Specific cell types

Antibodies

• Types Antigen exposure

Transfer from mother

Acquired


A Few Terms

• Antigen: A substance that stimulates an immune response, esp. production of antibodies.

• Antibody: One of a variety of proteins called immunoglobulins

– normally present in the body or produced in response to an antigen

– IgA, IgD, IgE, IgG, IgM

Source: http://en.wikipedia.org/wiki/Antigen


Internal Risk Factors For Infection

Poorly Developed or Impaired Immunity

• Age. Neonates and the elderly are at increased risk of

bacterial infections.

• Nutritional status. Malnutrition results in a depressed

immune system

• Genetic predisposition. The Human Genome Project

increased our ability to locate specific genes related to

infectious disease susceptibility ( Bentley, DR, 2000).

• Immunosuppression via disease or medications

• Lack of induced specific antibodies


Hypersensitivity Diseases

• Disease states caused by antigen exposure and subsequent sensitization

– Allergy

• Immunoglobulin E (IgE)

– Hypersensitivity pneumonitis

• Immunoglobulin G (IgG)


Allergy

• Allergy is an inappropriate over-reaction of our immune system.

• IgE antibodies are produced by B cells in response to allergen exposure

• IgE molecules attach to Mast cells.

• Mast cells release Histamine and other chemicals


Allergy

• Genetically controlled

• Sensitization thought to require repeated low-level exposures to allergens

• Allergens are complex proteins produced by many different organisms Dust mites, cockroaches

Cats, dogs, other pets

Rats, mice

Fungi

Plants

• Symptoms include upper respiratory (hay fever), lower respiratory (asthma), systemic (anaphylaxis), and skin (hives).


IgG

• IgG generally helps with antibody based protection against pathogens.

Allergens may also lead to high levels of IgG.

Sensitization is thought to require intense exposure to the allergen and may occur relatively quickly.

Sensitization may lead to flu-like symptoms.

Continued exposure can lead to hypersensitivity pneumonitis


Some Indoor Sources of Allergens

Organism Some allergens Some sources

within organism

Some exposure

sources

Dust mites Der f1, Der p1, Blo

t1, etc. Fecal material

Dust, especially

bedding

Cockroaches Bla g1, Bla a1 Skin secretions Dust, especially,

kitchens

Cats Fel d1, etc. Skin secretions Airborne,

accumulates in dust

Dogs Can f1 Skin secretions Airborne,

accumulates in dust

Rodents Rat r1, Mus m1 Urine Airborne,

accumulates in dust

Fungi Alt a1, Pen c1,

Asp v1, etc.

Digestive

enzymes

Airborne with spores,

accumulates in dust


Dust Mites

• Two most common house dust mites:

– American dust mite (Dermatophagoides

farinae)

– European dust mite (Dermatophagoides

pteronyssinus)

• Very small, invisible to the unaided eye.

• Live for approximately 3-4 months.

• Prefer warm, moist areas (mattresses,

pillows, carpeting and upholstery)

• Cause of asthma and allergy:

– Approximately 85% of asthmatics are allergic

to dust mite allergens

– Evidence exists for a causal relationship

between dust mite exposure and the

development of asthma


Cockroach

• Two most common indoor species of

cockroach in North America are:

– German cockroach (Blatella germanica)

– American cockroach (Periplaneta americana)

• Widely distributed in homes and schools

• Found throughout homes, including beds,

furniture, and carpets - highest levels are

typically found in kitchen

• Exposure is more likely in the bedroom

because the allergens are aerosolized when

getting into bed

• ~20% of homes with no evidence of

cockroach infestation have significant levels

in settled dust


Cat

• The household cat species is Felis

domestica

• Cats are pets in 27% of U.S. households

• Cat allergens are very sticky and can

remain airborne for long periods of time

• High levels are often found on walls and

other surfaces within homes

• Cat allergens are easily carried from

home to home, office, school, etc.

• The vast majority of homes contain cat

allergen, even if a cat has not lived there

• Cat allergen is produced in cat

sebaceous, salivary and anal glands


Dog

• The household dog species is Canis

familiaris

• Dogs are pets in 31% of U.S. households

• Dog allergens are associated with particles

smaller than 5µm, which are easily

aerosolized and can remain airborne for long

periods of time

• Carpeting, bedding, and upholstered

furniture are typical reservoirs for deposited

dog allergen

• Dog allergen is an important cause of

asthma

• There are over 100 million dogs and cats in

the U.S. and more than 15 million Americans

have allergic reactions to dog allergen


Rodent (Mouse and Rat)

• Two known sources of rodent allergen are:

– Rat (Rattus norvegicus)

– Mouse (Mus musculus)

• High concentrations of these allergens are

present in the rodent’s urine.

• May be an important cause of asthma and

allergic rhinitis.

• Exposure to rodent allergens have been

linked to increased asthma symptoms

among research animal lab workers.

• A major study on asthma among inner-city

children found that nearly 20% of

asthmatic children had been sensitized to

rats and 15% were sensitized to mice.


Mold

• Most molds produce potential

allergens

• Mold allergens are proteins. Two

commonly identified mold allergens

are Alt a1 and Asp f1

• Well documented evidence exists for

mold as a cause of allergic disease

(asthma, hay fever, upper respiratory

allergies, hypersensitivity pneumonitis)

• 30 to 35% of the population can have

allergic response to the environment.

1/3 of these (10% of the population)

may have fungal allergies


Sampling for Allergens

• Sample using a dust

cassette.

• Approximately 150mg or 1

teaspoon of dust is required

for the analysis

• Dust mite allergen analysis is

time sensitive and should be

sent using a cold pack or a

cooler to prevent the

increase of allergens in

transit


How Are Allergen Samples Analyzed?

• Allergens are analyzed by

ELISA (Enzyme-Linked

ImmunoSorbent Assay)

• ELISA is a highly sensitive

and specific test that uses

monoclonal antibodies that

latch on to the specific

allergens

• Results are expressed as

micrograms (µg) of allergen

per gram (g) of dust


How Do I Interpret the Results?

Critical levels for sensitization

Dust mite 2.0µg/g of dust

Cockroach (Bla g1) 0.2 units/g of dust

Cat 1-8µg/g of dust

Dog Sufficient evidence is

Mouse not yet available for

Rat establishing risk levels

for these allergens.

Critical levels for exacerbation

Dust mite 10.0µg/g of dust

Cat >8µg/g of dust

Cockroach (Bla g1) 1 to 2 units/g of dust


Dust Mite Control

• Keep humidity below 50%

• Vacuum regularly and discard bags immediately; Replace carpet with hard flooring if possible

• Wash bedding every week in hot water (54°C); Use allergen free mattress and pillow covers

• Minimize upholstered furniture and curtains or drapes

• Minimize dust and dust catchers


Pest control

• Keep kitchens clean and dry

• Use cockroach traps; if you see cockroaches, call an

exterminator

• Seal up openings for mouse/rat entry

• If you see mice or rats, call an exterminator


Allergen Chain of Custody


EMLab P&K’s IAQ Pocket Guide

• Sampling and regulatory guidelines for: fungi, asbestos, bacteria, and allergens

• Updated MoldRange™ data from over 350,000 spore trap samples

• Data interpretation guidelines

To order a complimentary Pocket Guide, complete the survey after the webinar.

The “Thank you” email (sent an hour after the webinar) will include a link to the survey to order your Pocket Guide.


Outline for Bacteria

• Bacteria in the natural environment

• Nature and classification

• Overview of sampling and analytical methods for bacteria

• Health effects


Distribution and Role of the Bacteria in

the Natural Environment

• Ubiquity:

– “We live now in the ‘Age of Bacteria.’ Our planet has

always been in the Age of Bacteria, ever since the first

fossils — bacteria, of course — were entombed in rocks

more than 3 billion years ago. Bacteria are — and always

have been — the dominant forms of life on Earth”

— Steven J Gould

– All surfaces on earth and all water contain bacteria

– Approximately five nonillion (5x1030) bacteria on Earth,

forming much of the world's biomass.


• A teaspoon of soil may contain

100 million to 1 billion bacteria.

• Decomposers: can break down

pesticides and pollutants in soil

• Mutualists form partnerships

with plants. The most well-

known of these are the

nitrogen-fixing bacteria (ex.

Rhizobium)

• Plant pathogens: Xymomonas

and Erwinia species, and

species of Agrobacterium that

cause gall formation in plants

Soil

http://soils.usda.gov/sqi/concepts/soil_biology/images/PBUT_LR.JPG


• A million (106) bacterial cells in a milliliter of fresh water

• 5x108 in an 8 ounce glass of water

– Pseudomonas, Flavobacterium and Acinetobacter

Water


Air

• Over 2,000 different kinds

of bacteria may be present

in the air on any given day

(Gary Anderson).

• Bacteria are attracted to

bubbles in water; Bubbles

bursting at surface release

bacteria into the air.

• Bacteria may reproduce

within airborne droplets • Bacteria, globally

distributed in the

atmosphere, play a

large role in formation

of snow and rain.


Plant Surfaces

• In the air, water clumps

around bacteria forming

condensation nuclei,

leading to rainfall.

• Precipitation returns

bacteria to the ground and

onto leaf surfaces where

they multiply.

• Epiphytic bacteria can

increase water permeability

of leaf cuticles, increasing

the availability of water and

dissolved compounds.

• Bacteria multiply on the

surface of plants and are

aerosolized by wind and

rain action.


• There are at least ten times

as many bacteria as human

cells in the body

• In a 200-pound adult, these

organisms can weigh a

combined 2 to 6 pounds.

http://www.scientificamerican.com/arti

cle.cfm?id=microbiome-graphic-

explore-human-microbiome

• This interactive website

shows the kinds of bacteria

on/in different human parts.

The Mammalian Body

http://www.scientificamerican.com/article.cfm?id=microbiome-graphic-explore-human-microbiome











Biofilms: A Larger Structure

• In nature, most bacteria

are bound to surfaces in

biofilms

• Few microns to half a

meter (yes, meter) in

depth.

• Complex arrangement of

cells & extracellular

components including

networks of channels to

diffuse nutrients.

Source: wikipedia.org/wiki/Biofilm

• Shower biofilm


• Naming bacteria

• Morphology

– Macroscopic

– Microscopic

• Classification

• Physiology

Introduction To Bacteria


Bacterial Diversity

Source: http://en.wikipedia.org/wiki/Bacteria#Multicellularity


Naming Bacteria

Binomials:

– Genus: Escherichia

– Species: coli

– Genus: Staphylococcus

– Species: aureus


• DNA: loosely organized, no

membrane bound nucleus

• RNA: in cytoplasm

• Ribosomes: make protein

from amino acids under

instruction from RNA

• Plasma membrane:

lipid/protein layer with

selective permeability Source: http://en.wikipedia.org/wiki/File:Average_prokaryote_cell-_en.svg

• Cell wall:

– Peptidoglycan

– Lipopolysaccharide (Gram negative)

• Capsule (polysaccharides)

Bacterial Cell Structure


Size

– 0.1 to about 600 µm over a

single dimension

– Escherichia coli: 1.1 to 1.5

µm by 2.0 to 6.0 µm

– On surfaces, usually present

as colonies with a few or

millions of cells

– When airborne, usually on

rafts (e.g., skin scales) (>10

µm) or in droplet nuclei (one

or more bacteria surrounded

by dried mucous) (>2 µm).

Source: http://en.wikipedia.org/wiki/File:Relative_scale.svg

Morphology


Shape

– Cocci: Spherical

• Staphylococcus aureus

– Bacilli: Rod shaped

• Escherichia coli

• Pseudomonas

aeruginosa

– Spirilli: Spiral rods;

• Borrelia burgdorfii

• Helicobacter pylori

– Filamentous: long

branching strands

• Thermoactinomyces

vulgaris

Source: http://en.wikipedia.org/wiki/File:Bacterial_morphology_diagram.svg

Morphology


Practical Classification

Bacillus

Corynebacterium

Staphylococcus

Streptococcus

Streptomyces

Micropolyspora

E. Coli

Pseudomonas Neisseria Vibrio

Rods Cocci

Gram positive

Common

bacteria

Filaments Rods Cocci

Gram negative

Spirals


The Gram Stain

• Gram positive

– Cells with a peptidoglycan

outer wall

• Staphylococcus

• Bacillus

• Gram negative

– Cells with a

lipopolysaccharide outer

wall

• Pseudomonas

• “coliforms”


Acid Fast

• Cells with mycolic acid in

outer wall: retain a dye

when treated with acid.

All acid fast bacteria are

Gram positive.

– Mycobacterium

– Nocardia

– Some amoebal cysts


Physiology

• Professor Alan Parsons

and Dr. Richard Heal of

QinetiQ Ltd, claim to have

shown that physically

separated colonies of

bacteria can transmit

signals conferring

resistance to commonly

used antibiotics

• (volatile organic

compounds)?


• Psychrophiles: Grow

best at cold

temperatures. <10°C

• Mesophiles: Grow best

at medium temperatures.

All infectious bacteria are

mesophiles. 10-40°C

• Thermophiles: Grow

best at hot temperatures.

40-80°+C

Temperature Requirements


Oxygen Requirements

• Obligate Aerobes: strictly oxidative respiration and

require oxygen for survival.

• Facultative Anaerobes: fermentation in the absence of

O2, or respiration in its presence.

• Obligate Anaerobes: anaerobic fermentation; cannot

survive in the presence of oxygen.


• (volatile organic compounds)?

Volatile Organic Compounds (VOCs)


Sampling and Analysis

• Type of sample collection and choice of analytical

methods depends on:

– Hypothesis or goals (monitoring)

– Expected concentrations

– Agent(s) of concern

– Standards/guidelines


Types of Samples and Relevant

Hypotheses or Goals

• Water

– This water contains sewage organisms

– This water contains Legionella pneumophila

• Surface

– Potential pathogens are falling into wounds during surgery

– Residual contamination is present on these surfaces

• Bulk

– This slime contains Legionella pneumophila

– This humidifier water contains Thermophilic actinomycetes

• Air

– Exposure is occurring to this agent

– This activity produces aerosols containing this agent.


Analytical Methods: Bacteria

• Culture

• Microscopy

• Stains

• DNA methods

• Bioassays

• Immunoassays

• HPLC

• GCMS


Culture

• Requires organism to be alive; samples must be protected from extreme conditions, and from conditions that allow growth during transport.

• Recovers only organisms that can reproduce under the provided conditions

– Best to use broad spectrum medium such as R2A that allows damaged bacteria to recover

• Always underestimates concentrations and diversity

• Hypotheses:

– Potential pathogens are falling into wounds during surgery

– Legionella pneumophila is growing in this humidifier.


Microscopy

• Vital Staining

– Use of stain that differentiates living from dead bacteria

– All cells can be counted and % viable calculated

– Samples must be maintained to minimize growth and death during transport.

• Fluorescence staining

– Allows microscopic or flow cytometric counting of cells; fluorescent vital staining available

• Fluorescent antibody staining

– Allows counting of specific organisms

• Hypotheses:

– The bacterial aerosol has xx living and xx non-living organisms

– This treatment kills bacteria


Other Kinds of Staining

• Gram stain and Fluorescent gram stains

– This particular population consists of Gram negative bacteria (or not)

• Acid fast staining

– Mycobacterium cells are present in this tissue sample

• Acridine orange (a fluorescent stain)

– Total concentration of bacterial cells in this sample is xx

Mycobacterium tuberculosis (stained red) in tissue (blue).

Source: en.wikipedia.org/wiki/acid-fast


DNA Methods

• For identification

• For monitoring populations

– This specific strain of Legionella pneumophila is present in

this cooling tower

– Track composition of bacterial populations are present in

this aerosol

– The bacterial population in this biofilm is the same as or

different than the one in a different biofilm.


Bioassays

• Limulus assay for endotoxin

– Depends on the horseshoe crab

– Quantitative only within each batch of lysate

– Internal controls essential for every assay

• This sample contains more endotoxin than the outdoor air


Immunoassays for Specific Bacteria

• There are immunoassays for surrogates of bacteria

considered possible biowarfare agents (e.g., Bacillus

globigii as a surrogate for Bacillus anthracis).

• Obviously it is possible since bacteria can stimulate an

antibody (immune system) response. Such methods

have not been widely used.


HPLC, GCMS

• Chemical methods used for measurement of bacterial

and other biological chemicals.

• HPLC: high pressure liquid chromatography

• GCMS: Gas chromatography Mass spectroscopy

• Fatty acid analysis used for identification of bacteria in

bulk samples


Overview of Health Effects of Bacteria

• Infection

• Allergy

• Toxicosis

• Symbiosis


Infection

Invasion by, and multiplication of, “pathogenic”

microorganisms in a bodily part or tissue, which may

produce subsequent tissue injury and progress to overt

disease through a variety of cellular or toxic mechanisms

Overwhelming communities of bacteria

Immune reactions leading to disease

Release of toxins that cause the symptoms of disease.


The Term “Pathogen”

• A pathogen is defined as:

– A microorganism able to cause infection

• Limited to infectious agents

— OR —

– A microorganism able to cause disease

• Includes humidifier fever, hypersensitivity pneumonitis,

allergy (rarely), toxicoses

• Obligate pathogens

– Only grow in the host; not recovered from the environment

• Environmental pathogens

– Pathogens that grow naturally in the environment but also

cause disease when they invade host tissue


Virulence

• Virulent infection: infection by an organism that can

infect anyone without specific antibodies.

• Virulence: a measure of how readily an organism can

infect a host.

– Highly virulent agents may cause infection following exposure

to a single organism. (e.g., Mycobacterium tuberculosis)

– Less virulent organisms may require higher doses before

infection occurs (e.g., Bacillus anthracis)

– Avirulent organisms may only infect those without a

functioning immune system (e.g, Pseudomonas aeruginosa)

• Opportunistic infection

– Caused by avirulent organisms


Risk Factors for Infection

• Immune status

– Lack of induced specific antibodies

– Age. Neonates and the elderly are at increased risk of bacterial infections.

– Nutritional status. Malnutrition results in a depressed immune system

– Genetic predisposition. The Human Genome Project increased our ability to locate specific genes related to infectious disease susceptibility ( Bentley DR 2000).

– Immunosuppression via disease or medications


Risk Factors for Infection: Exposure

• Amount of exposure

– Depends on virulence of the organism

– Depends on immune status of the host

• Exposure pathway

– Depends on the organism

• Mycobacterium tuberculosis: must be inhaled into lower airway

• GI tract agents must be ingested

• Exogenous: those that originate outside the body

– Food, water, air, surfaces, other people

– Ingestion, inhalation, other entry points.

• Endogenous: caused by bacteria within the body that cause disease when the body's resistance is lowered


Pathways To Infection

• Airborne infection – inhalation of microorganisms or spores suspended in air, on dust

particles, or in droplet nuclei (dried droplets).

• Droplet infection – inhalation of respiratory pathogens suspended for a brief time on

liquid particles exhaled by someone already infected.

• Direct contact – Touching an infected person or contaminated surface

• Endogenous infection – reactivation of organisms present in a dormant focus, as occurs

in tuberculosis, etc.

• Tunnel infection – subcutaneous infection of an artificial passage into the body that

has been kept open.


Respiratory Infections

• Respiratory infections involve the nose, throat, and all the airway passages plus the ears.

• Common respiratory infections

– Colds and flu (viral)

– Sinus infections and ear infections

– Bronchitis

– Pneumonia

• Modes of infection

– Airborne

– Droplets

– Direct contact

– Endogenous


URI and Ear Ache

• Upper respiratory tract infections (URI)

– Leading cause of time lost from work and school

– Bacteria account for up to 25 percent of URI (the rest are viral)

– Streptococcus, Haemophilus influenzae

• Otitis media

– Middle ear infection: most common bacterial infection in U.S. children.

– Streptococcus pneumoniae


Tuberculosis

• Tuberculosis (TB)

– Mycobacterium tuberculosis

– Affects 15 million people in the U.S. Fewer develop disease which depends on nutritional status, age, HIV, incarceration

– Major cause of death in many countries; in some cases virtually all of the population is infected and a large proportion develop disease

– Organism must be inhaled into the lower airway.

– Colonization occurs, causing development of antibodies detectable with skin test

– Active disease occurs when some change occurs in the immune system

– Treatment is long term and compliance is often poor

– Control requires prevention of exposure to patients with active disease


Legionnaires’ Disease

Legionella

• Gram negative bacteria

common in many

environments

• Approx. 50 species and 70

serogroups have been

described

• Legionella is the causative

agent of Legionellosis

(Legionnaires’ disease

and Pontiac fever)


Legionnaires’ Disease (cont’d)

Legionnaires’ Disease

Legionellosis takes two distinct forms:

1) Pontiac fever: respiratory illness without pneumonia, symptoms

resemble acute influenza (not a lower respiratory illness)

2) Legionnaires’ disease: symptoms include fever, chills, cough, muscle

aches, headache, tiredness, loss of appetite, loss of coordination (ataxia),

and occasionally diarrhea and vomiting.

• Community and Hospital Acquired

• Risk factors: Exposure, compromised immune function

– Transmission is not person to person

– Age: Highest risk in elderly >65; uncommon in people <50; very rare in people <20

– Smoking

– Pre-existing chronic obstructive pulmonary disease (COPD), diabetes


Infection and Transmission

• Infection occurs after inhaling water droplets that originated from a water source contaminated with Legionella.

• Manmade water sources include cooling towers, evaporative coolers, hot water systems, showers, whirlpool spas, architectural fountains, room-air humidifiers, ice-making machines, misting equipment.

• Environmental sources for Legionella are freshwater ponds, rivers and creeks.

• Legionella survives in the environment as intracellular parasites of freshwater protozoa.

• Legionella bacteria will grow in water at temperatures 20C to

50C (68F to 122F).

• Ideal growth conditions are in stagnant water (95F to 115F)




• Threshold limits for

potable water

especially in hospitals

and nursing homes

should be considerably

lower.

• Goal for “sensitive

locations” is a zero

count for Legionella

(detection limits are

typically around 100

cfu/liter)


Sampling for Legionella

• Wear Respiratory Protection: Wear appropriate

respiratory protection during the examination of water

systems if a significant potential exists for exposure to

high concentrations of contaminated aerosols (e.g.

operating spray humidifier).

• Swabs: Sampling of biofilm (slime) or on water outlets

(e.g. inside of shower heads). Use sterile swab and keep

moist.

• Air: Air samples collected on special culture plates with

an Andersen-type sampler rarely demonstrate the

presence of Legionella in the air. Not recommended.


Specific Guidelines for Legionella

Water samples:

• Non-potable water source (e.g. cooling towers, chillers, condensate pans, surface water in reservoirs, sprinklers): Collect 250 ml water from the bottom or side of the vessel or reservoir.

• Potable water source:

– Use 1 liter bottles containing thiosulfate to neutralize chlorine.

– Collect a 250-mL to 1-Liter “pre-flush" sample of the first water drawn from bottom drains and outlet valves of storage tanks, sumps, and water heaters as will as faucets and showerheads.

– Allow the water to run until the temperature stabilizes and collect a second "post-flush" sample when the water temperature is constant (after approx. 60 sec.).


Water Treatment

Water treatment options to eradicate Legionella

• Thermal Eradication

• Copper-Silver Ionization (ionization unit)-best long term treatment

• Chlorination

• Ozonation

• Chlorine Dioxide

• Ultraviolet Irradiation (point of delivery treatment)

Heat treatment:

70 to 80C (158 to 176F): Disinfection range

At 66C (151F): Legionellae die within 2 minutes

At 60C (140F): Legionellae die within 32 minutes

At 55C (131F): Legionellae die within 5 to 6 hours


Legionella – Thresholds

CFU of Legionella

per Liter Action

< 1000 System under control

1000 – 10,000 Review program operation. Conduct re-sampling.

Review of control measures and risk assessment

should be carried out to identify any remedial

actions.

> 10,000 Implement corrective action. The system should

immediately be re-sampled.

• No concrete threshold and action limits for Legionella:

• The European Working Group for Legionella Infections

(EWGLI) published the following guidelines and action

limits for cooling towers:


Legionella – More Information

More information and literature can be found at:

• http://en.wikipedia.org/wiki/Legionnaire%27s_Disease

• http://www.cdc.gov/legionella/index.htm

• http://www.ewgli.org/

http://en.wikipedia.org/wiki/Legionnaire's_Disease

http://www.cdc.gov/legionella/index.htm

http://www.ewgli.org/


Inhalation Anthrax

• Mostly confined to

handlers of infected

animals

• Most of these develop

skin infection

• Inhalation infection rare

• Biowarfare problem


Gastrointestinal Infections

• GI infections involve the stomach, intestines, and colon

– Gastroenteritis: nausea, vomiting, diarrhea, abdominal

discomfort

– Diarrhea: abnormal fecal discharge with frequent and/or

fluid stool; usually resulting from disease of the small

intestine and resulting in fluid loss and dehydration

– Dysentery: inflammatory disorder accompanied by blood

and pus in the feces, abdominal pain, fever, and cramps;

usually results from disease of the large intestine.

– Enterocolitis: inflammatory disorder of both the small and

large intestine.


Common GI Infections

• Shiga toxin-producing E. coli (E. coli O157:H7 and other

serotypes)

• Salmonella species other than S. Typhi (salmonellosis)

• Shigella species (shigellosis)

• Campylobacter species

• Clostridum difficile and antibiotic-associated colitis


Shiga Toxin-producing E. Coli

(E. Coli O157:H7 and Other Serotypes)

• Estimated 20,000 cases of diarrheal disease each year.

• Most human infections transmitted by beef resulting from fecal

contamination of meat during slaughter. Undercooked hamburger

meat is a common problem. Other reported sources:

– Unchlorinated drinking water

– Unpasteurized apple cider

– Alfalfa sprouts

– Leaf lettuce

– Mesclun lettuce

– Radish sprouts

– Milk

• Infectious dose is low, possibly as low as 100 bacteria.

Therefore, prevention is difficult and person-to-person spread

may occur.


Salmonella Species Other Than

S. Typhi (Salmonellosis)

• Estimated 0.8 to 3.7 million cases each year.

• Human disease is usually associated with food products,

especially poultry and eggs. Other reported sources:

– Tomatoes

– Alfalfa sprouts

– Cantaloupe

– Freshly squeezed orange juice

– Keeping exotic pets, especially reptiles, of which up to

90% harbor Salmonella


Shigella Species (Shigellosis)

• Classic agents of dysentery

• At least 19,000 cases occur in the U.S. each year

• Shigella can contaminate food and water.

• Person-to-person transmission is the dominant mode of

transmission.

• As few as 10 to 100 Shigella organisms can cause

disease; therefore, shigellosis is highly communicable.

• Outbreaks of shigellosis occur in crowded, closed

environments such as nurseries, day care centers,

institutions, and cruise ships.


Campylobacter Species

• One of the most common infectious diseases worldwide

• More than 1 million cases occur each year in the U.S.

• Human disease is mostly food-borne but can result from

direct contact with animals, including household pets

(notably, puppies or kittens with diarrhea)

• Fecal-oral transmission occurs.

• Transmission from food handlers appears to be

uncommon.

• Disease can result from ingestion of as few as 500

bacilli.


Clostridum Difficile and Antibiotic-

associated Colitis

• Diarrhea is a relatively common complication of

antimicrobial therapy and is associated with Clostridium

difficile in about 10% to 30% of cases

• About 60% of adults in the U.S. have serum antibodies

to C. difficile

• Person-to-person transmission of C. difficile occurs, and

can be reduced by hand washing before and after

patient encounters and by use of disposable gloves

(followed by hand washing) during direct contact with

patients.


Sewage

• Because of its nature, GI tract disease is the most likely outcome of sewage exposure.

• Other diseases transmitted by sewage are not bacteria (Hepatitis, for example).

• Bacteria are used as indicators for sewage exposure.


What Are The Health Risks?

• Gastroenteritis: cramping stomach pains, diarrhea and

vomiting

• Weil's disease (leptospirosis) animal source bacterial

infection: a flu-like illness with persistent and severe headache;

damage to liver, kidneys and blood may occur and the condition

can be fatal (Leptospira)

• Hepatitis: inflammation of the liver, and jaundice (viral)

• Occupational asthma: attacks of breathlessness, chest

tightness and wheezing; produced by the inhalation of living or

dead organisms

• Infection of skin or eyes

• Rarely, allergic alveolitis: (inflammation of the lung) with

fever, breathlessness, dry cough, and aching muscles and joints


Who Is At Risk?

• Employees involved in sewer inspection and maintenance work

• Construction workers who repair or replace live sewers

• Water company employees who work with sewage treatment plants

• Agricultural and forestry workers who may be exposed to sewage sludge

• Sludge tanker drivers/operators and associated maintenance staff

• Plumbers

• Employees who clean and maintain the underside of railway carriages and empty aircraft sewage compartments and other types of portable lavatories.


How Do Sewage Micro-organisms Enter

The Body?

• Hand-to-mouth contact during eating, drinking and smoking,

• Wiping the face with contaminated hands or gloves, or by licking splashes from the skin.

• Skin contact, through cuts, scratches, or penetrating wounds, i.e. from discarded hypodermic needles.

• Aerosols landing on surfaces of the eyes, nose and mouth.

• By breathing them in, as either dust, aerosol or mist.


Aerosol Exposure

• Wastewater treatment

– Average concentrations of 17000 cfu/ml3 of mesophilic,

2100 cfu/ml3 of TSA-SB bacteria (bacteria associated with

certain waterborne virulence factors) in the water.

– In the aerosol of the fixed-film reactor 3000 cfu/m3

mesophilic and 730 cfu/m3 TSA-SB bacteria.


Coliforms

• Rod-shaped Gram-negative non-spore forming organisms that ferment lactose with the production of acid and gas when incubated at 35-37°C.

• Coliforms are abundant in the feces of warm-blooded animals, but can also be found in the aquatic environment, in soil and on vegetation

• TAXA – Citrobacter

– Enterobacter

– Escherichia

– Hafnia

– Klebsiella

– Serratia

– Yersinia


Water Quality Coliform Guidelines

• Culture based

– 200 colonies of fecal coliform bacteria /100ml for primary

contact recreation

– 1000 colonies of fecal coliform bacteria /100ml for

secondary contact recreation

• Swimming beaches:

– Geometric mean of 126 E.coli bacteria per 100 ml of water

(fresh water)


Enterococcus

• Higher correlation than fecal

coliforms with many human

pathogens

• In 2004, Enterococcus spp.

became the new federal

standard for water quality at

public beaches

• The acceptable level of

contamination is very low,

– Hawaii: 7 colony forming units

per 100 ml of water

– Geometric mean of 35 /100 ml

of water for five samples over

30 days and an instantaneous

(single sample) standard of 104

/ 100 ml of water (salt water).

Enterococcus infection in pulmonary tissue.

Source: wikipedia.org


• Remove all liquid and solid material as quickly as

possible.

• Residual organisms will stick to the dry surface and

eventually die (by orders of magnitude per hour).

• As a final precaution, soapy water with ~ 1/4 -1/2 cup

bleach/gallon can be used.

• Use skin protection especially over cuts and scrapes.

• Do not ever touch the face. Remember, the outside of

gloves are contaminated!

Sewage Spill Cleanup


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• Review your projects and reports as they

are made available

• Browse EMLab P&K's fungal library

• Contact your Project Manager with the

tap of the screen

More details at

http://www.emlab.com/mobile

https://play.google.com/store/apps/details?id=com.emlab.labservem

http://www.emlab.com/mobile


MRSA and Staphylococci – Overview

Staphylococcus aureus

• Gram-positive bacteria

• 0.5 – 1 m diameter

• Commonly found on the

skin and in the nose of

humans


MRSA – Resistance

• MRSA is a resistant variation of the common bacterium

Staphylococcus aureus. It has evolved an ability to

survive treatment with beta-lactam antibiotics, including

penicillin, methicillin, and cephalosporins

– Hospital acquired (HA)

– Community acquired (CA)


• Approximately one third of the world’s population has S.

aureus bacteria on their body at any given time

• About 1% of people carrying S. aureus have MRSA

(CDC estimated)

• Spread from one person to another through casual

contact or contaminated objects

• Estimated 94,000 cases of MRSA infections in the U.S.

per year and nearly 19,000 deaths.

MRSA and Staphylococci – Overview

(cont’d)


Staphylococci – Symptoms

Staphylococcus

• Folliculitis (hair roots)

• Impetigo (blisters)

• Skin abscesses

• Cellulites

• Necrolysis


S. aureus – Systemic Infections

• Staphylococci tend to infect skin but can travel through the bloodstream and involve almost any site in the body, particularly the heart and the bones

• May infect the respiratory tract, mainly in people with chronic lung disease or influenza and lead to staphylococcal pneumonia

• Other severe and life-threatening infections with staphylococci include infections of the heart and victims of severe burns


Hospital Acquired MRSA

• Most infections with MRSA occur in hospitals and

healthcare facilities (HA-MRSA) including:

– Surgical wound infections

– Urinary tract infections

– Blood stream infections and pneumonia


HA-MRSA – Risk Factors and Prevention

Risk factors for HA-MRSA:

• Current or recent hospitalization

• Residing in a long-term care facility

• Invasive devices

• Recent antibiotic use

Prevention:

• Ask hospital staff to wash their hands or use gloves

• Wash your own hands frequently

• Make sure invasive devices are kept sterile


Community Acquired MRSA

Community acquired MRSA recently gained much attention in the news media.

Risk factors:

• Young age (children)

• Participating in contact sports

• Sharing towels and athletic equipment

• Weakened immune system

• Living in crowded and/or unsanitary conditions

• Association with health care workers


Community Acquired MRSA

Prevention

• Washing hands frequently

• Keep personal items personal

• Keep wounds covered

• Shower after athletic games or practices

• Do not participate in athletic games or practices if you have infected wounds

• Sanitize items

• Get tested if you have a skin infection

• Use antibiotics appropriately


Diagnosis and Environmental Testing

Clinical testing

• Sample from an infected site or a nasal swab

• Clinical laboratory performs the testing

Environmental testing

• Collect swab samples from items that are frequently touched such as door knobs, keyboards, athletic equipment etc.

• Environmental laboratory can perform the testing for MRSA


Allergy

• IgE allergy

– Most patients with nasal polyposis and/or chronic

sinusitis possess bacteria-specific IgE, while subjects

with only allergic rhinitis do not;

– Multiple bacterial species isolated from chronically

infected sinuses are capable of inducing IgE-

mediated sensitization. (Calenoff et al 1993)

• IgG/cell mediated allergy

– Machining coolant aerosols?

– Thermophilic actinomycetes


Bacterial Toxicoses

General definitions

• Endotoxins: Toxic compounds

found in bacteria and other

pathogens.

• Exotoxins: Secreted in soluble

form.


Toxicoses: Endotoxin

Endotoxins

• Component of cell walls

of gram-negative

bacteria (E. coli,

Salmonella etc. )

• Lipopolysaccharide

(LPS) - Potent

stimulator of the

immune system

Detection with Limulus

Amebocyte Lysate


• Clinical effects described at 50 EU/m3 include:

– General symptoms of fever, shivering, joint pain and fatigue

(most common).

– Respiratory effects include dyspnea, chest tightness,

coughing, non-allergic asthma and reduction in lung function

• Higher sensitivity in people with pre-existing respiratory

disease.

• Relationship between endotoxin and Asthma is unclear:

Endotoxins may protect against allergic asthma but is a

risk factor for non-allergic asthma.

• Smoking, presence of furred pets and cleaning regime

are correlated with endotoxin levels.

Endotoxins (continued)


Endotoxins – Sampling

Sampling:

• Preferred sample type is air (endotoxin-free filter

cassettes)

• 250 – 1000 Liter sample volume for air

• Dust can also be used as sample type

• Metal working fluids, few milliliter sample


• Recommendation of ~100 EU/m3 as maximum exposure

limit. Background levels of >10 EU/m3 are of concern

and >30 EU/m3 should be avoided.

• Normal concentrations indoors: <1 EU/m3

• Higher concentrations may indicate water damage.

• Concentrations increase up to 100-fold in rooms of

smokers.

Endotoxins – Exposure Limits


Endotoxins – Control and Prevention

• Most serious illness occurs in industrial environments

where ventilation controls are the primary approach

• Controlling water reduces possibility of Gram-negative

bacteria (and endotoxin)

• Removal of contaminated materials and HEPA

vacuuming can reduce endotoxin levels

• Do not smoke


Toxicoses: Exotoxins

Toxin Toxic Dose

(mg) Host

Compared to

Strychnine

Botulinum

toxin 0.8x10-8 Mouse 3x106

Tetanus toxin 4x10-8 Mouse 1x106

Shiga toxin 2.3x10-6 Rabbit 1x106

Diphtheria

toxin 6x10-5 Guinea pig 2x103


"If we have not gotten our message across, then we ought to

assume that the fault is not with our receivers."

Baruch Fischhoff, Department of Engineering and Public Policy

Carnegie-Mellon University (1985)

Risk Communication

Risk Communication:

An interactive process of exchange of information and

opinion among individuals, groups, and institutions; often

involves multiple messages about the nature of risk or

expressing concerns, opinions, or reactions to risk

messages or to legal and institutional arrangements for

risk management.


Risk Communication (continued)

• Risk communication is sometimes an

important element of an investigation

• Important elements to successful

communication are establishing,

maintaining, and increasing trust and

credibility

• From Dr. Covello at Columbia Univ.

Center for Risk Commun.: Important

elements of trust and credibility are:

– Caring & empathy

– Openness & honesty

– Commitment & dedication

– Expertise & competence


Risks perceived:

• To be voluntary are more accepted than risks perceived to be imposed

• To be fairly distributed are more accepted than risks perceived to be

unfairly distributed.

• To be natural are more accepted than risks perceived to be manmade.

• To be statistical are more accepted than risks perceived to be

catastrophic.

• To be generated by a trusted source are more accepted than risks

perceived to be generated by an untrusted source.

• To be familiar are more accepted than risks perceived to be exotic.

• To affect adults are more accepted than risks perceived to affect

children.

Some Factors Influencing Risk

Perception (Fischhoff et al. 1981)


• The cardinal rule of risk communication is: first do no

harm.

• Gain a sense of the general attitude toward the situation

and tailor your presentation accordingly.

– Are they worried and in need of reassurance?

– Are they sanguine and in need of a warning?

– Are they angry and in need of calming?

Rules and Tips


• Review your remarks to gauge the probable impact that

your words will have on the situation and adjust them as

necessary; e.g.

• Are you using words, like “crisis,” “life-threatening,” or

“extremely”

• Can other, less dramatic words be substituted?

Rules and Tips (continued)


• Don’t speak unless you are comfortable doing so.

• Most communications mistakes are made by those who

are not prepared to speak but feel compelled to do so

anyway.

• If confronted with a demand for a quick answer, have the

confidence to say, “I would like to answer that question

later.”



• Informing clients (or the public) of the problem and

specific dangers, providing guidance on appropriate

responses, and easing concerns are achievable goals.

• If the risk is low, say: “The risk to the public is low.”

• Don’t elaborate with scientific jargon including statistics.



• Remember the rules for risk communication; don’t write

inflammatory statements.

• Write a straightforward factual account of your

interpretation of the data you have collected.

• Don’t make health inferences unless you are a qualified

health professional.

• If you don’t do remediation work, don’t recommend

remediation methods.

• Don’t fill the report with boilerplate

Communicating In Written Reports


A Few Risk Communication Resources

Web sites

Agency for Toxic Substances & Disease

Registry:

Primer on Health Risk Communication: http://www.atsdr.cdc.gov/HEC/primer.html

National Institute of Corrections:

Risk Communication Guidelines for

Public Officials:

http://nicic.org/Library/019092

Classes

The Centers for Disease Control offers

several classes

http://www.atsdr.cdc.gov/HEC/primer.html

http://nicic.org/Library/019092


Thank you for your time!

Questions about Allergens or Bacteria: [email protected]

All other questions: [email protected]

mailto:[email protected]

mailto:[email protected]

Appendix

EMLab P&K


Locations Nationwide to Serve You (Addresses on Following Slides)

WASHINGTON

OREGON

IDAHO

NEVADA

MONTANA

WYOMING

UTAH

ARIZONA

COLORADO

NEW

MEXICO

TEXAS

NORTH

DAKOTA

SOUTH

DAKOTA

NEBRASKA

KANSAS

OKLAHOMA

MINNESOTA

IOWA

MISSOURI

ARKANSAS

LOUISIANA

WISCONSIN

ILLINOIS INDIANA OHIO

KENTUCKY

TENNESSEE

GEORGIA

SOUTH

CAROLINA

NORTH

CAROLINA

VIRGINIA

NEW YORK

PENNSYLVANIA

MICHIGAN

MAINE

WEST

VIRGINIA

VERMONT

NEW

HAMPSHIRE

MARYLAND

DELAWARE

NEW JERSEY

CONNECTICUT

RHODE ISLAND

MASSACHUSETTS

HAWAII


EMLab P&K Locations Near You

MicroLabs in bold are

AIHA Accredited as

documented by the

Scope of Accreditation

Certificate.

Arizona - Phoenix

1501 West Knudsen Drive

Phoenix, AZ 85027

phone: 800.651.4802

fax: 623.780.7695

AIHA EMLAP# 102297

California - San Bruno

1150 Bayhill Drive, Suite 100

San Bruno CA 94066

phone: 866.888.6653

fax: 650.829.5852

AIHA EMLAP# 102856

New Jersey - Cherry Hill

1936 Olney Avenue

Cherry Hill, NJ 08003

phone: 866.871.1984

fax: 856.489.4085

AIHA EMLAP #103005

M I C R O L A B S

L A B O R A T O R I E S

California - San Diego

9089 Clairemont Mesa Blvd.

Suite 106

San Diego, CA 92123

Phone: 866.465.6653

Colorado - Denver

4955 Yarrow Street

Arvada, CO 80002

phone: 800.651.4802

Florida - Ft. Lauderdale

6301 NW 5th Way

Suite 2850

Ft. Lauderdale, FL 33309

phone: 877.711.8400

Illinois - Chicago

655 W. Grand Ave.

Suite 205

Elmhurst, IL 60126

phone: 866.871.1984

Nevada - Las Vegas

6000 S. Eastern Ave.

Suite 5E

Las Vegas, NV 89119

phone: 866.888.6653

Texas - Houston

6310 Rothway St.

Houston, Texas 77040

phone: 800.651.4802

California - Glendale

1010 N. Central Ave.

Suite 420

Glendale, CA 91202

phone: 866.465.6653

California - Irvine

17461 Derian Ave

Suite 100

Irvine, CA 92614

Phone: 866.465.6653

California - Sacramento

880 Riverside Parkway

West Sacramento, CA 95605

phone: 866.888.6653

Virginia - Fairfax

3929 Old Lee Highway

Unit 91C

Fairfax, Virginia 22030

phone: 866.871.1984

Washington - Seattle

19515 North Creek

Parkway N, Suite 100

Bothell, WA 98011

phone: 866.888.6653

For the most current list of locations, please visit us at www.emlabpk.com

Contact individual laboratories for service capabilities and scopes of accreditation.

http://www.emlab.com/s/main/locations.html


TestAmerica Locations


For your convenience, you can drop off samples for EMLab P&K at these locations.

CALIFORNIA - Pleasanton

1220 Quarry Ln.

Pleasanton, CA 94566

phone: (925) 484-1919

CALIFORNIA - San Bernardino

202 E. Airport Road

Suite 140

San Bernardino, CA 92408

Phone: (909) 370-4707

CALIFORNIA – W. Sacramento

880 Riverside Pkwy

West Sacramento, CA 95605

phone: (916) 373-5600

CONNECTICUT

128 Long Hill Cross Rd.

Shelton, CT 06484

phone: (203) 929-8140

FLORIDA - Jacksonville

8933 Western Way, Suite 1

Jacksonville, FL 32256

phone: (904) 519-9551

FLORIDA - Orlando

8010 Sunport Drive, Suite 116

Orlando, FL 32809

phone: (407) 851-2560

FLORIDA - Pensacola

3355 McLemore Dr.

Pensacola, FL 32514

phone: (850) 474-1001

FLORIDA - Tallahassee

2846 Industrial Plaza Dr.

Tallahassee, FL 32301

phone: (850) 878-3994

FLORIDA - Tampa

6712 Benjamin Rd., Suite 100

Tampa, FL 33634

phone: (813) 885-7427

GEORGIA - Atlanta

6500 McDonough Drive, Suite C-10

Norcross, GA 30093

phone: (678) 966-9991

GEORGIA - Savannah

5102 LaRoche Avenue

Savannah, GA 31404

phone: (912) 354-7858

HAWAII - Honolulu

99-193 Aiea Heights Dr.

Suite 121

Aiea, HI 96701

phone: (808) 486-5227

ILLINOIS - Chicago

2417 Bond Street

University Park, IL 60484

phone: (708) 534-5200

ILLINOIS - Elmhurst

655 W. Grand Ave., Suite 205

Elmhurst, IL 60126

phone: (630) 758-0262

INDIANA - Indianapolis

Stutz Business Center

212 W. 10th Street, Ste A-205

Indianapolis, IN 46202

Phone: (317) 264-9686

INDIANA - Valparaiso

2400 Cumberland Drive

Valparaiso, IN 46383

phone: (219) 464-2389

IOWA - Cedar Falls

704 Enterprise Drive

Cedar Falls, IA 50613

phone: (319) 277-2401

IOWA - Davenport

736 Federal St., Suite 2202

Davenport, IA 52803

phone: (563) 323-7944

LOUISIANA - Baton Rouge

6113 Benefit Dr.

Baton Rouge, LA 70809

phone: (225) 755-8200

MARYLAND - Baltimore

5710 Executive Drive, Suite 106

Baltimore, MD 21228

phone: (410) 869-0085

MASSACHUSETTS - Boston

240 Bear Hill Rd., Suite 104

Waltham, MA 02451

phone: (781) 466-6900

MASSACHUSETTS - Westfield

53 Southampton Road

Westfield, MA 01085

phone: (413) 572-4000

MICHIGAN - Brighton

10448 Citation Drive, Suite 200

Brighton, MI 48116

Phone: (810) 229-2763

MINNESOTA - Minneapolis

7204 West 27th Street, Suite 114

St. Louis Park, MN 55426

phone: (800) 593-8519

ALABAMA - Mobile

900 Lakeside Drive

Mobile, AL 36693

phone: (251) 666-6633

ALASKA - Anchorage

2000 W. International Airport

Rd., Suite A10

Anchorage, AK 99502

phone: (907) 563-9200

ARIZONA - Phoenix

4625 E. Cotton Center Blvd.,

Suite 189

Phoenix, AZ 85040

phone: (602) 437-3340

ARIZONA - Tucson

1870 W. Prince Road, Suite 59

Tucson, AZ 85705

phone: (520) 807-3801

CALIFORNIA – Costa Mesa

3585 Cadillac Ave, Suite A

Costa Mesa, CA 92626

phone: (714) 258-8610



TestAmerica Locations (cont’d)

NEW YORK - Albany

25 Kraft Ave.

Albany, NY 12205

phone: (518) 438-8140

NEW YORK - Buffalo

10 Hazelwood Drive, Ste. 106

Amherst, NY 14228

phone: (716) 691-2600

NEW YORK - New York City

47-32 32nd Place, Suite 1141

Long Island City, NY 11101

Phone: (347) 507-0579

NEW YORK - Syracuse

118 Boss Rd.

Syracuse, NY 13211

phone: (315) 431-0171

NORTH CAROLINA - Charlotte

I-85 South Bldg.

2858 Queen City Dr., Suite B

Charlotte, NC 28208

phone: (704) 392-1164

NORTH CAROLINA - Raleigh

101-F Woodwinds Industrial Court

Cary, NC 27511

phone: (919) 380-9919


For your convenience, you can drop off samples for EMLab P&K at these locations.

OHIO - Cincinnati

11416 Reading Road

Cincinnati, OH 45241

phone: (513) 733-5700

OHIO - Dayton

4738 Gateway Circle

Dayton, OH 45440

Phone: (937) 294-6856

OHIO - North Canton

4101 Shuffel Street NW

North Canton, OH 44720

phone: (330) 497-9396

OREGON - Portland

9405 SW Nimbus Avenue

Beaverton, OR 97008

phone: (503) 906-9200

PENNSYLVANIA - King of Prussia

1008 W. Ninth Ave.

King of Prussia, PA 19406

phone: (610) 337-9992

PENNSYLVANIA - Pittsburgh

301 Alpha Drive

Pittsburgh, PA 15238

phone: (412) 963-7058

SOUTH CAROLINA - Charleston

1436-A North Point Lane

Mt. Pleasant, SC 29464

phone: (843) 849-6550

TENNESSEE - Knoxville

5815 Middlebrook Pike

Knoxville, TN 37921

phone: (865) 291-3000

TENNESSEE - Nashville

2960 Foster Creighton Dr.

Nashville, TN 37204

phone: (615) 726-0177

TEXAS - Austin

14050 Summit Dr., Ste. A100

Austin, TX 78728

phone: (512) 244-0855

TEXAS - Beaumont

4400 Lawndale Ave.

Groves, TX 77619

phone: (409) 540-5302

TEXAS - Corpus Christi

1733 N. Padre Island Drive

Corpus Christi, TX 78408

phone: (361) 289-2673

MISSOURI - Eureka

1699 West Fifth Street, #200

Eureka, MO 63025

Phone: (314) 302-8354

MISSOURI - Kansas City

601 NW 39th Street

Blue Springs, MO 64015

phone: (800) 276-1286

MISSOURI - St. Louis

13715 Rider Trail North

Earth City, MO 63045

phone: (314) 298-8566

NEW JERSEY - Edison

777 New Durham Road

Edison, NJ 08817

phone: (732) 549-3900

NEW JERSEY - South Jersey

520 Fellowship Rd., Suite A-106

Mt. Laurel, NJ 08054

phone: (856) 222-1990

TEXAS - San Antonio

404 E. Ramsey, Suite 208

San Antonio, TX 78216

phone: (210) 344-9751

VERMONT - Burlington

30 Community Drive, Suite 11

South Burlington, VT 05403

phone: (802) 660-1990

VIRGINIA - Virginia Beach

5135 Cleveland Street

Virginia Beach, VA 23462

phone: (757) 671-1291

WASHINGTON - Richland

2800 George Washington Way

Richland, WA 99354

phone: (509) 375-3131

WASHINGTON - Spokane

11922 E. 1st Ave.

Spokane, WA 99206

phone: (509) 924-9200

WASHINGTON - Tacoma

5755 8th Street East

Tacoma, WA 98424

phone: (253) 922-2310



EMLab P&K Products

Authorized Distributor for:

Buy equipment and supplies for sampling

allergens, asbestos, bacteria, mold, fungi, and more

Shop online at www.emlabpk.com/store

http://www.emlabpk.com/store


Accreditation: A formalized recognition that a facility meets the AIHA, or other accrediting authorities, policy requirements to carry out defined

tasks or specific types of tests. See also Certification.

Accredited Laboratory: A testing laboratory that has been evaluated and granted accreditation covering a specified measurement or task, usually

for a specific property or analyze, and for a specified period of time.

Accuracy: The degree of agreement between an observed value and an accepted reference value or statistically defined criteria. Accuracy includes

a combination of precision and bias. See Precision and Bias.

Agar: Musilagenous substance (galactan) extracted from some algae used to grow fungi and bacteria.

Aliquot: See Subsample.

Analysis: A qualitative or quantitative determination of a substance or material.

Analytical Method: A standardized set of procedures required to prepare a sample for analysis and analyze a sample to obtain a qualitative or

quantitative determination. See also Standard Operating Procedure (SOP).

Approved Signatory: A person who is recognized by the laboratory as competent to adopt SOP’s, approve change control documents and other

internal QC documents, verify the integrity of results, and introduce policies related to Quality Assurance.

Audit Trail: A process of documentation that allows for the tracking of a sample through the laboratory, including the time, date, and identification of

the individual(s) responsible for performing an action during the receiving, log-in, sample preparation, and analysis of a sample. See also Sample

Tracking.

Autoclave: A device that sterilizes using pressurized steam for a prescribed time period. Generally autoclaves run at 121º C and 15 PSI.

Autoclaving allows for sterilization at lower temperatures than dry heat.

Bacterium (pl. bacteria): Heterogenous group of unicellular prokaryotic organisms.

Bacteriology: The scientific study of bacteria.

Bias: A systematic error manifested as a consistent positive or negative deviation from the known true value.

EMLab P&K General Glossary


Bioaerosol: Airborne particles that are either alive or originate from living organisms. Bioaerosols include microorganisms (i.e. culturable, non-

culturable, and dead microorganisms) and fragments, toxins, and particulate waste products from all varieties of living things.

Biohazard: An object that contains infectious or dangerous organisms, or any object that contains an inordinate amount of organisms.

Blank: An unexposed sampling media or reagent(s), not taken to the field or shipped, but carried through the complete sample preparation and

analytical procedure. The blank is used to assess possible background contamination from the analytical process.

Blind Sample: A sample submitted for analysis with a composition and identity known to the submitter, but unknown to the analyst, and used to

evaluate proficiency in the execution of the measurement process.

Bulk Sample: Any non-liquid, solid matrix submitted for analysis that cannot be categorized as a soil, dust, or spore trap. Some examples of bulks

include carpet, drywall, carpet backing, particleboard, wood, etc. Ideally bulks samples should be reported as a surface area instead of a unit of

mass.

Calibration: To determine, by measurement or comparison with a standard, the correct setting on a meter or other instrument. See Calibration

curve.

Calibration Curve: A graphical relationship between the known values for a series of calibration standards and instrument responses. The levels of

the calibration standards should bracket the range of measurements.

Certification: Procedure by which a third party gives written assurance that the process of testing and evaluating against specifications designed to

document, verify and recognize the competence of a person, organization, or other entity to perform a function or service conforms to specified

requirements. See Accreditation.

Certified Reference Material (CRM): A reference material that has one or more of its property values established by a technically valid procedure,

and is accompanied by or traceable to a certificate or other documentation issued by a certifying body. See Reference material.

Chain of Custody: An unbroken trail of records that documents the location of samples, associated data, and records. See also Audit Trail.

Change Control (CC): The process by which changes are made to any controlled document that defines procedures, processes, products, etc. The

process involves formally updating all associated documents and officially removing and archiving all the non-updated versions of the document.

Client: Any person or organization that engages the services of the laboratory.

EMLab P&K General Glossary (continued)


Communications: Transmission of information by any means including verbal, mail, and electronic.

Computer Records: Files containing data that can be retrieved when needed and documentation of alterations to data. Computer records should

not allow unauthorized access to data or the undocumented amendment of data.

Conclusion: A determination based on the analysis and interpretation of data collected from the testing of a hypothesis. See also Hypothesis

Testing.

Contamination: The introduction of non-indigenous organisms or substances into an environment, or the introduction of organisms or substances

into a previously sterile environment.

Control Chart: A graph of some measurement plotted over time or sequence of sampling, together with control limit(s) and, usually, a central line

and warning limit(s).

Corrective Action: A process that addresses a Work Out of Specification, Client Contact, or Continuous Improvement event that is rated as

significant by the management team and requires a change to the way a process or the work is performed, or an adaptation to the Quality Control

System associated with the step or process.

Culturable Air Analysis: A technique that assesses the amount of viable organisms present in the air. The technique allows for the differentiation

of Penicillium and Aspergillus species, and permits further speciation when required. The technique misses fungi that are not viable, do not

compete well, or do not germinate on the selected medium.

Direct Examination (Surface) Analysis: A technique that assesses whether mold is growing on a surface, and if there is mold growth, what

organisms are present. A direct exam also notes if there is skewing of the distribution of mold types. The technique shows exactly what is found on

the surface and can differentiate between growth and normal fallout. The technique cannot differentiate between certain spore types, does not

assess the airborne levels of spores, or give any information about the viability of organisms.

Document Control: A system of protecting the integrity of processes and systems in the laboratory by uniquely identifying and monitoring the

alteration to documents within the laboratory. New documents and revisions or changes to documents are signed for authorization by a designated

signatory before implementation in the laboratory. See also Approved Signatory.

Duplicate Analyses: The analyses or measurements of the variable of interest performed identically on two sub-samples of the same sample. The

results from duplicate analyses are used to evaluate analytical or measurement precision but not the precision of sampling, preservation or storage

internal to the laboratory.



Duplicate Samples: Two samples taken from and representative of the same population and carried through all steps of the sampling and

analytical procedures in an identical manner. Duplicate samples are used to assess variance of the total method including sampling and analysis.

Dust Sample: A sample matrix generally collected using a vacuum device and a cassette, or other collection device, containing a filter or filtering

matrix. Typically dust samples are reported per unit of area vacuumed or per unit mass.

Endotoxins: Toxins that are confined inside the microorganisms and released only when microorganisms are broken down or die.

Environmental Microbiology: The area of microbiology that focuses on the biology, physiology, ecology and sampling and analysis of

microorganisms inhabiting or affecting air, water, soil and other natural or man-made substances and/or systems in a variety of work environments,

and that may contribute to adverse health effects.

EMLab P&K Accreditation Program (EMLAP): This AIHA program is intended for the accreditation of environmental microbiology laboratories.

Environmental Microbiology Proficiency Analytical Testing (EMPAT): Required proficiency testing program in the core business of an EMLab

P&K .

Equipment: All physical items (including software and instruments) in a facility used in the process of analytical testing.

Equipment Log: A chronological record of preventive and emergency maintenance performed on an analytical instrument. The logs include a

record of calls, service technician summaries, records of calibration by the manufacturer, and other information as required by these policies.

Facility: A permanent, temporary or mobile operation established for the purpose of performing laboratory testing.

Field Blank: An analyte-free matrix (i.e. spore trap cassette, media plate, tape, etc.) carried to the sampling site, kept sealed or un-exposed

throughout the sampling process, returned to the laboratory, treated as a sample, and carried through all steps of the analysis.

Fungus (pl. fungi): Eukaryotic organisms without plastids, nutrition absorptive, never phagotrophic, lacking an amoeboid pseudopodial phase.

Hardcopy: Information or data recorded on a paper form or other physical document. See also Computer Records and Single Strike Out

Hypothesis Testing: The process of developing a tentative explanation that accounts for a set or facts that is either proved or disproved by

subsequent investigation.



Incubation period: The time between inoculation and the development of visible symptoms

Industrial Hygiene Experience: A person’s history of onsite evaluation of a variety of occupational environments to include inspection, monitoring,

laboratory analysis and control recommendations regarding actual or potential occupational exposure to conditions likely to result in adverse health

effects.

Instrument: A device used for observation or measurement that yields test results.

Intra-analyst Comparisons: A method for measuring and improving analyst precision, and to a certain extent accuracy, by having multiple analysts

analyze one sample. Raw counts are statistically analyzed to determine the degree of variance in counting amongst analysts.

Internal Quality Control: Routine activities and checks, such as periodic calibrations, duplicate analyses, and intra-analyst comparisons, that are

performed during routine internal procedures to control the accuracy and precision of measurements.

Laboratory: A place within a permanent, mobile or temporary facility used for the purpose of analysis.

Laboratory Assessment: An onsite evaluation of a laboratory for the purpose of conducting a technical systems audit to assess compliance with

AIHA accreditation requirements.

Laboratory Accreditation Committee (LAC): A group of qualified individuals responsible for carrying out the technical business of an AIHA

Laboratory Accreditation Program (LAP). Each individual LAP will have an LAC.

Laboratory Quality Assurance Committee (LQAC): General term referring to one or more committee(s) associated with any analytical program.

Laboratory Quality Assurance Program (LQAP): General term referring to any AIHA program or programs established to maintain the highest

possible standards of performance for analysts and/or laboratories analyzing samples and evaluating exposures to hazardous agents.

Lot: A set of samples submitted together for laboratory analysis that can be treated as one or more batches. Lot may also refer to a batch of

sampling media or reagents manufactured at the same time.



Macrofungi: See also Mushroom.

Matrix: The component or substrate (e.g., spore trap, air or bulk) that contains the analyte of interest.

Method Detection Limit (MDL): The minimum concentration of an analyte that, in a given matrix and with a specific method, has a 99 percent

probability of being identified, qualitatively or quantitatively measured, and reported to be greater than zero.

Method Performance: A general term used to document the characteristics of a method. These characteristics usually include method detection

limits, linearity, precision, accuracy and bias and uncertainty of measurement. See Acceptance limits.

Microfungus: A fungus whose morphological features are visible by high magnification compound microscope. e.g. Cladosporium, Aspergillus etc.

Mold: A microfungus having a well-marked mycelium or spore mass; a subset of fungi.

Mushroom: A fleshy basidioma, usually stalked and with a cap (pileus) beneath which gills or fleshy tubes are covered or lined with the hymenium.

Mycology: The scientific study of fungi.

Mycotoxins: Secondary metabolites (toxin) produced by fungi.

Policy: An organization’s written statement of commitment to implement a management program element.

Precision: The degree to which a set of observations or measurements of the same property, usually obtained under similar conditions, conform to

themselves. Precision is often expressed as standard deviation, variance or range, in either absolute or relative terms.

Preventive Action: A planned activity to identify, recognize and control potential sources of nonconformance.

Procedure: A written set of instructions that describes how to implement a policy requirement, or how to carry out a specific task

Proficiency Testing: Refers to any proficiency analytical testing program(s), such as the programs established under the



Quality: A characteristic of a high standard of service including reliability and traceability.

Quality Assurance: An integrated system of activities involving planning, quality control, quality assessment, reporting, and quality improvement to

ensure a product or service meets defined standards of quality within a stated level of confidence.

Quality Assurance Coordinator: See Quality manager.

Quality Control (QC): Technical activities whose purpose is to measure and control the quality of a product or service so that it meets the needs of

users. The aim is to provide quality that is satisfactory, adequate, dependable and economical.

Quality Manager: The manager of the quality system. The quality manager is independent of the analyst (for a specific sample set) and reports

directly to the highest level of management.

Quality Manual: A document stating the quality policy, quality system and internal quality control procedures of the laboratory.

Quality System: See Quality assurance.

Record Control: The procedures used to identify, collect, index, access, file, store, maintain, and dispose of quality and technical documents.

Reporting Limits: The maximum or minimum levels, or quantities of a target analyze, that can be quantified with the certainty required by the data

user.

Reference Material: A material or substance, one or more properties of which are sufficiently homogeneous and well established to be used to

monitor instrument and method performance. AIHA PAT samples may be used as reference materials.

Relevant Degree: A program of collegiate study that is appropriate to the applicable accreditation program.

Reproducibility: The extent to which a method, test or experiment yields the same or similar results when performed on sub-samples of the same

sample by different analysts or laboratories.

Revision Number: A system of tracking new editions to a document or form. See also Document Control.

Root Cause Analysis (RCA): A process used to identify the cause of a problem or error. The process involves identifying all of the portions of a

problem and through the process of elimination, narrowing the field down until a cause can be agreed upon by consensus.



Sample Log: A document where sample identification, date received, client, etc., are noted when samples arrive at the laboratory. The log is part of

the sample tracking system. See Sample tracking.

Sample Tracking: A document system of following a sample from receipt at the laboratory, through sample processing and analysis, to final

reporting. The system includes unique numbering, or bar coding labels, and the use of a Sample Log.

Sporulation: Process by which spores are produced.

Standard Operating Procedure (SOP): A written document that details the procedures of an operation; an analysis or action whose techniques

and procedures are thoroughly prescribed, and which are accepted as the procedure for performing certain routine or repetitive tasks.

Standard Reference Material: A certified reference material produced by the U.S. National Institute of Standards and Technology (NIST) and

characterized for absolute content independent of analytical method. It is accompanied by a certificate that reports the results of the characterization

and describes the intended use of the material.

Standardization: The process of establishing the quantitative relationship between a known mass of target material (for example, the measurement

system or instrument response). See Calibration and Calibration curve. The term may also refer to activities that establish provisions for common

and repeated use of accreditation policies to achieve an optimum level of conformity.

Stock Solution: A concentrated solution of analyte(s) or reagent(s) prepared and verified by prescribed procedure(s), and used for preparing

calibration standards. See Calibration standard.

Subsample: A representative portion of a sample; a subsample may be taken from any location or a field sample; in analytical chemistry, an

“aliquot.”

Suspension: A temporary removal of the accredited status of a laboratory when it is found to be out of compliance with specific program

requirements.



Taxonomy: The science of classification.

Technical Systems Audit: A thorough, systematic, onsite, qualitative evaluation of facilities, equipment, personnel, training, procedures, record

keeping, data validation, data management and reporting aspects of a total quality system.

Test: A technical operation that consists of determining one or more elements in a sample according to a specified procedure.

Test Method: Specified technical procedure for performing a test.

Traceability: The process of documenting the value of a reference material or standard as related to NIST standards or equivalent through an

unbroken chain of comparisons with stated uncertainties.

Training: A series of documented tasks related to learning

Uncertainty of Measurement: Result of the evaluation aimed at characterizing the range within which the true value of a test result is estimated to

lie, generally within a given likelihood.

Validation: The process of confirming specified method performance criteria.

Verification: Confirmation by examination and provision of evidence that specified requirements have been met.

Work Out of Specification (WOOS): Work or processes that fall outside of the specifications of the internal Quality Control or deemed by the

personnel performing the task as not meeting the requirements of normal operation.



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