Co-exposure to mycotoxins: the case of waste management workers

Introduction - Occupational exposures are characterized by being complex and associated to co-exposure to several contaminants by different exposure routes. Even if exposure occurs to only a chemical agent, it can have different exposure routes and can result in different health effects. The waste management setting is recognized by the presence of several chemical and biologic agents in the workplaces. Recently, it was reported occupational exposure to Aflatoxin B1 (AFB1) in one Portuguese waste management industry. However, data regarding to fungal burden showed that exposure to other mycotoxins should be expected. Aim of the study - The aim of the present work was to know if workers from this waste management industry were exposed to other mycotoxins besides AFB1.

Climate changes influence in occupational exposure to fungi and mycotoxins

Climate changes and their effects on fungal distribution and activity are aspects of concern regarding the human exposure to mycotoxins. An exhaustive search was made for papers available in scientific databases reposrting the influence that climate cchange has on fungi and mycotoxins. Also a review regarding fungal burden, collected between 2010 and 2015 in different settings, was done to support the discussion about future fungi and mycotoxins ocuupational exposure. A. flavus complex, E. graminerarum complex and F. verticilliodes were the most reported to be influenced by climate changes. We noted also that the analyzed Portuguese settings presented already an occupational problem due to their fungal burden. It will be important to know future climate changes to select what complexes/species and strains, and consequently the mycotoxins, we should consider as indicators of an occupational problem. In addition, epidemiologic studies are needed to increase knowledge about potential health effects related with the exposure to both risk factors.

Climate changes and mycotoxins: two risk factors associated!

Many species of fungi produce bioactive compounds called mycotoxins. These compounds are produced by filamentous fungi and can contaminate food, feeds and specific indoor environments resulting in high economic losses. Severe health problems and death have been related with mycotoxins exposure through the consumption of several food commodities. There are many factors involved in mycotoxin production by fungi but climate is the most important. Thus, when changes in the weather occur, mycotoxins production will be affected. We looked for articles that were available in scientific databases, written in English and that mention in the title and/or abstract the combined terms fungi and climate change and also mycotoxins and climate change.

Occupational exposure to mycotoxins: aspects to consider for the aggregate and cumulative risk assessment

Mycotoxins are an important group of naturally occurring substances known to contaminate a huge variety of agricultural products, feed and food commodities. The main concern is their widespread presence and toxic effects on humans and animals as they have been described as cytotoxic, nephrotoxic, hepatotoxic, teratogenic, immunosuppressive, mutagenic and/or carcinogenic. However, until now, risk assessments and regulations have usually been performed on individual mycotoxins despite humans and animals are being frequently exposed to a multitude of mycotoxins simultaneously. Moreover, even though some exposures through inhalation and dermal contact may potentially occur, only oral ingestion has been considered as the sole route of exposure in all the evaluations. However, more recent studies have also demonstrated airborne exposure to mycotoxins in different occupational settings with emphasis on agricultural professions. In these cases, skin contact with mold-infested substrates and inhalation of spore-borne toxins are the most important sources of exposure. Still, mycotoxins are not normally recongnize as na occupational hazard and exposure is different from the one ocurring by food intake. In this case, exposure is charaterized to be acute and simultaneous to other mycotoxins and also to fungi and dust. All these features increase the challenge implicated in the risk assessment process. Some topics will be presented and discussed in detailed such as: What occupational settings should be consider in this case; possible exposure routes; exposure characterization; how to assess exposure; co-exposure; aggregate exposure and cumulative risk assessment.

Occupational exposure to aflatoxin B1 and ochratoxin A: co-exposure in swine production

The most common scenario in occupational settings is the co-exposure to several risk factors. This aspect has to be considered in the risk assessment process because can alter the toxicity and the health effects when dealing with a co-exposure to two or more chemical agents. A study was developed aiming to elucidate if there is occupational co-exposure to aflatoxin B1 (AFB1) and ochratoxin (OTA) in Portuguese swine production. To assess occupational exposure to both mycotoxins, a biomarker of internal dose was used. The same blood samples from workers of seven swine farms and controls were consider to measure AFB1 and OTA. Twenty one workers (75%) showed detectable levels of AFB1 with values ranging from <1 ng/ml to 8.94 ng/ml and with significantly higher concentration when compared with controls. In the case of OTA, there wasn't found a statistical difference between workers and controls and the values for workers group ranged from 0.34 ng/ml to 3.12 ng/ml and 1.76 ng/ml to 3.42 ng/ml for control group. The results suggest that occupational exposure to AFB1 occurs. However, in the case of OTA results, seems that food consumption plays an important role in both groups exposure. The results claim attention for the possible implications on health of this co-exposure.

Assessment of toxigenic fungi in poultry feed

Introduction - Feed supplies the necessary nutrients for the growth of healthy animals, which are a part of the human diet. The presence of toxigenic fungi in animal feed such as Aspergillus spp. may contribute to 1) the loss of nutritional value of feedstuff, since fungi will assimilate the most readily available nutrients present in the feed, and 2) the development of mycotoxicoses and chronic conditions, which can raise economic issues due to animal disease and contamination of animal derived products. Aim of the study - The goal of this work was to evaluate the incidence of Aspergilli, particularly from the Circumdati, Flavi and Fumigati sections, through real-time quantitative PCR (qPCR) in 11 feed samples.

Fungi distribution in poultry feed

Feed can easily be contaminated and colonized by fungi that use up the nutrients for their own metabolism and growth, producing secondary metabolites such as mycotoxins that are not eliminated throughout the feed processing. The major problems associated with mycotoxin contaminated animal feed are metabolic disturbances resulting in poor animal productivity. In addition, handling contaminated animal feed can also raise health issues regarding workers exposure to fungi and mycotoxins. The scope of this work was to characterize fungal distribution in 11 poultry feed samples. Twenty grams of feed were suspended in 180 mL of distilled water and homogenized during 20 minutes at 200 rpm. The washed supernatant was plated in malt extract agar (MEA) and dichloran glycerol agar base (DG18) media for morphological identification of the mycobiota present. Using macro- and microscopic analysis of the colonies, fungal contamination was evident in 72.7% of the analyzed poultry feed samples. Fungal load ranged from 0 to 13140 CFU/g, and the most prevalent species/genera were F. graminearum complex (71.1%), Penicillium sp. (11.6%), Cladosporium sp. (8.8%), and Fusarium poae (3.6%). In addition to these species, we also isolated Aspergillus sections Circumdati, Nigri and Aspergilli, and Mucor and Rhizopus genus albeit at a lower abundance. The data obtained showed that, besides high fungal contamination, mycotoxins contamination is probably a reality, particularly in the final product since mycotoxins resist to all the processing operations including thermal treatment. Additionally, data claimed attention for the probable co-exposure to fungi and mycotoxins of the workers in feed industries.

Prevalence of Aspergillus section Fumigati in Portuguese slaughterhouses: a fungal and mycotoxin concern

Introduction - Within the Aspergillus genus, Aspergillus fumigatus species is one of the most ubiquitous saprophytic fungi and is considered the species with higher clinical relevance. The fungi belonging to the Fumigati section are the most common cause of invasive aspergillosis and a major source of infection related mortality in immunocompromised patients. One of the most abundant metabolites produced by Aspergillus fumigatus is the metabolite gliotoxin, which exhibits a diverse array of biologic effects on the immune system. Further, environments contaminated with A. fumigatus may be the cause or enhance respiratory problems in the workers of those specific settings. These species produce specific allergens and mycotoxins that could cause respiratory disorders. Aim of the study - The aim of the present work was to determine the prevalence of Aspergillus section Fumigati by cultural and molecular methods in poultry; swine and bovine; and large animal (bovine and horses) slaughterhouses.

Toxigenic fungi in coffee samples: a menace to public health

Introduction - Mycotoxin contamination was reported to occur in some food and commodities, such as coffee, particularly due to the presence of toxigenic fungi such as Aspergillus, Penicillium and Fusarium spp. Aspergilli are known to produce high levels of mycotoxins, such as ochratoxin and aflatoxin. Aspergillus ochraceus has been proposed as the major cause of ochratoxin A contamination in coffee beans. Aim of the study - The aim of this work was to evaluate the prevalence of Aspergillus sections Circumdati, Flavi and Fumigati in 28 green coffee samples to be used by Portuguese coffee industry, from Coffea arabica (Arabica coffee) and Coffea canephora (Robusta coffee) species from different origins.

Importance of size-selective particle measuring for assessing occupational exposures: a case study “from field to fork”

Sampling the total air concentration of particulate matter (PM) only provides a basic estimate of exposure that normally not allows correlating with the observed health effects. Therefore is of great importance to recognize the particles size distribution and, particularly, the exposure to fine particles (≤ 2.5 μm). This particles dimension corresponds to the respirable fraction, the one that can implicate local and systemic effects due to particle deposition and clearance from the lungs and transport within the organism. This study intended to describe occupational exposure to PM2.5 in three units related with swine production and consumption, namely: feed production, swine production and swine slaughterhouse. A size-selective particle measuring in five to six workplaces of each unit was performed. Measurements of PM were done using a portable direct-reading hand-held equipment (Lighthouse, model 3016 IAQ). Data showed slaughterhouse unit with higher values, with values ranging from 0.030 to 0.142 mg/m3 (0.073 + 0.043), being the cutting room the workplace with higher values. In feed production unit, values were between 0.026 and 0.033 mg/m3 (0.028 + 0.003) with the warehouse of pharmacy products as the workplace with higher values. Finally, in swine unit values ranged from 0.006 to 0.048 mg/m3 (0.023 + 0.017) with the batteries area presenting the higher values. PM can be rich in fungi and bacteria and their metabolites, such as endotoxins and mycotoxins. Previous publications already showed high contamination in these occupational settings and particles can have an important role in exposure since can easily act as carrier of these agents. Data acquired allow not only a better prediction of particle penetration into respiratory regions of the respiratory tract, but also a better estimation of PM health effects. Moreover, data permit to identify the workplaces where investment should be made to prevent and reduce exposure.

Fungal contamination in coffee samples: a public health concern

Introduction - Fungi are natural coffee contaminants and under certain environmental conditions have the potential to produce toxins. Many studies revealed that the important toxigenic fungal genera (Aspergillus and Penicillium) are natural coffee contaminants, and are present from the field to storage. Aspergilli from the Circumdati and Nigri sections are known to produce high levels of ochratoxin A, a mycotoxin known as nephrotoxic for animals and humans. This work aimed to evaluate fungal distribution and also the prevalence of Aspergillus sections Fumigati, Flavi, Nigri and Circumdati from Coffea arabica (Arabica coffee) and Coffea canephora (Robusta coffee) green samples.

Assessment of genotoxicity of aflatoxin M1 and B1 contaminated milks after in vitro human digestion

Introduction - Milk is considered a complete food from the nutritional point of view. Milk can be exposed to various types of contamination, such as mycotoxins. These metabolites are naturally occurring toxic compounds produced by fungi. Several studies on milk samples have reported the presence of aflatoxin B1 (AFB1) and M1 (AFM1), due to the high incidence in samples intended for human consumption, carcinogenicity proven AFB1 and resistance of the contaminants to the process of digestion, making those available for intestinal absorption. Considering these aspects, the objective of this study was to evaluate the genotoxicity of milk samples contaminated by AFB1 and AFM1 before and after the action of lactic acid bacteria using Caco-2 intestinal human cells.

Bibliotecas na saúde… e a saúde nas bibliotecas?

Em arquivos e bibliotecas a presença de fungos é considerada nefasta pelas suas implicações na conservação e leitura de documentos históricos e pela sua associação a problemas de saúde sentidos pelos funcionários e utentes que frequentam estes locais. De acordo com alguns autores, os problemas de saúde mais reportados por funcionários em Bibliotecas e Arquivos são dermatite, rinite, alergias e asma. Embora revestida de inegável importância, existem poucos estudos internacionais sobre a temática e, em Portugal, a contaminação fúngica em ambiente arquivístico e em bibliotecas é ainda muito pouco conhecida. O estudo realizado em quatro Arquivos Portugueses teve como objectivo conhecer a contaminação fúngica, contribuindo para a análise da qualidade do ar interior desses espaços e sua comparação com estudos internacionais. Para isso foram recolhidas amostras de ar e de superfícies e estas foram analisadas por métodos clássicos de cultura e, quando necessário, por métodos de biologia molecular. A avaliação foi feita quantitativa e qualitativamente, considerando os requisitos legais em vigor. No que respeita à análise do ar, o número de unidades formadoras de colónias (UFC)/m3 nunca excedeu as 500 (limite legislado), tendo sido verificada contaminação interior em todos os locais estudados. Comparativamente aos estudos realizados anteriormente em contextos semelhantes foram encontrados níveis elevados de contaminação por leveduras nas amostras de ar analisadas em Arquivos Portugueses. Não foi identificado nenhum fungo patogénico neste estudo, mas em quase todas as amostras estavam presentes fungos potencialmente toxinogénicos. Dentro do grupo dos Aspergillus, o A.versicolor mostrou predominância, tendo este fungo reconhecidas capacidades de emissão de micotoxinas em ambiente de interior. A inclusão de amostras de superfície revelou-se vital para conhecer todo o espectro fúngico existente em cada um dos locais estudados, incluindo a detecção de Stachybotrys chartarum e a do fungo potencialmente queratinofílico, Chrysosporium carmichaelli. Tanto para a saúde como para a conservação, o recente estudo realizado em quatro arquivos permitiu retirar importantes conclusões e reforçar a necessidade de vigilância, sendo também útil para a definição de padrões de qualidade no campo do património cultural.

Professional exposure to fungal pathogens: an update to exposure conditions and exposure measurement

In many occupational settings an exposure to fungi occurs. Fungal exposure may occur for instance in the form of dermatocytes, yeasts or mold. Associated to the fungi themselves an exposure to cell wall components like ß(1 ? 3)-D-glucans, to mycotoxins or to microbial volatile compounds can occur. Health hazards may differ across species because fungi may produce different allergens and mycotoxins, and some species can infect humans. Occupational settings are often characterized by special exposure conditions with respect to duration, frequency and especially to the level of exposure resulting at least sometimes to high or very high fungal exposure. Because of these special conditions occupational settings are suitable for epidemiologic studies. However, the knowledge about occupational exposure to fungi and associated compounds like mycotoxins is still fragmentary and not well disseminated. An indication for a high fungal exposure is for instance the handling of dry natural products like grain, hay or herbal plants with a high specific surface and the tendency to release dust during handling. The fungal components often form the determinative part of such dusts and might be a vehicle to respiratory airways. The authors will present results of exposure measurements of occupational settings and exposure conditions which are only rarely investigated.

Exposure and risk assessment in occupational exposure to fungi: aspects to consider in highly contaminated settings

Although a clear correlation between levels of fungi in the air and health impacts has not been shown in epidemiological studies, fungi must be regarded as potential occupational health hazards. Fungi can have an impact on human health in four different ways: (1) they can infect humans, (2) they may act as allergens, (3) they can be toxigenic, or (4) they may cause inflammatory reactions. Fungi of concern in occupational hygiene are mostly non-pathogenic or facultative pathogenic (opportunistic) species, but are relevant as allergens and mycotoxins producers. It is known that the exclusive use of conventional methods for fungal quantification (fungal culture) may underestimate the results due to different reasons. The incubation temperature chosen will not be the most suitable for every fungal species, resulting in the inhibition of some species and the favouring of others. Differences in fungi growth rates may also result in data underestimation, since the fungal species with higher growth rates may inhibit others species’ growth. Finally, underestimated data can result from non-viable fungal particles that may have been collected or fungal species that do not grow in the culture media used, although these species may have clinical relevance in the context. Due to these constraints occupational exposure assessment, in setings with high fungal contamination levels, should follow these steps: Apply conventional methods to obtain fungal load information (air and surfaces) regarding the most critical scenario previously selected; Guideline comparation aplying or legal requirements or suggested limits by scientific and/or technical organizations. We should also compare our results with others from the same setting (if there is any); Select the most suitable indicators for each setting and apply conventional-culture methods and also molecular tools. These methodology will ensure a more real characterization of fungal burden in each setting and, consequently, permits to identify further measures regarding assessment of fungal metabolites, and also a more adequate workers health surveillance. The methodology applied to characterize fungal burden in several occupational environments, focused in Aspergillus spp. prevalence, will be present and discussed.