Exposure assessment in one central hospital: a multi-approach protocol to achieve an accurate risk characterization

Carla Viegas, Beatriz Almeida, Ana Monteiro, Inês Paciência, João Rufo, Lívia Aguiar, Bruna Lage, Lídia Maria Diogo Gonçalves, Liliana Aranha Caetano, Elisabete Carolino, Anita Quintal Gomes, Magdalena Twarużek, Robert Kosicki, Jan Grajewski, João Paulo Teixeira, Susana Viegas, Cristiana Pereira

Research output: Contribution to journalArticle

Abstract

The bioburden in a Hospital building originates not only from patients, visitors and staff, but is also disseminated by several indoor hospital characteristics and outdoor environmental sources. This study intends to assess the exposure to bioburden in one central Hospital with a multi-approach protocol using active and passive sampling methods. The microbial contamination was also characterized through molecular tools for toxigenic species, antifungal resistance and mycotoxins and endotoxins profile. Two cytotoxicity assays (MTT and resazurin) were conducted with two cell lines (Calu-3 and THP-1), and in vitro pro-inflammatory potential was assessed in THP-1 cell line. Out of the 15 sampling locations 33.3% did not comply with Portuguese legislation regarding bacterial contamination, whereas concerning fungal contamination 60% presented I/O > 1. Toxigenic fungal species were observed in 27% of the sampled rooms (4 out of 15) and qPCR analysis successfully amplified DNA from the Aspergillus sections Flavi and Fumigati, although mycotoxins were not detected. Growth of distinct fungal species was observed on Sabouraud dextrose agar with triazole drugs, such as Aspergillus section Versicolores on 1 mg/L VORI. The highest concentrations of endotoxins were found in settled dust samples and ranged from 5.72 to 23.0 EU.mg-1. While a considerable cytotoxic effect (cell viability < 30%) was observed in one HVAC filter sample with Calu-3 cell line, it was not observed with THP-1 cell line. In air samples a medium cytotoxic effect (61-68% cell viability) was observed in 3 out of 15 samples. The cytokine responses produced a more potent average cell response (46.8 ± 12.3 ρg/mL IL-1β; 90.8 ± 58.5 ρg/mL TNF-α) on passive samples than air samples (25.5 ± 5.2 ρg/mL IL-1β and of 19.4 ± 5.2 ρg/mL TNF-α). A multi-approach regarding parameters to assess, sampling and analysis methods should be followed to characterize the biorburden in the Hospital indoor environment. This study supports the importance of considering exposure to complex mixtures in indoor environments.

Original languageEnglish
Article number108947
Pages (from-to)108947
JournalEnvironmental Research
DOIs
Publication statusE-pub ahead of print - 18 Nov 2019

Fingerprint Dive into the research topics of 'Exposure assessment in one central hospital: a multi-approach protocol to achieve an accurate risk characterization'. Together they form a unique fingerprint.

Cite this