||There's a Fungus Among Us
by Clare Coppa
Indoor air pollution is an important health consideration when
spending long hours in enclosed buildings. Aspergillus, a common
fungus found in dust, clings to hair and piggybacks on clothes.
It becomes airborne through movement and is inhaled regularly
without a problem, but is linked to allergic reactions or asthma
in weakened individuals. In those with suppressed immune systems,
such as AIDS or organ-transplant patients, inhalation can be deadly.
The subject was studied by ASTM members S. Kay Obendorf, Ph.D.
and Betsy L. Dart, M.S., in Retention of Aspergillus Niger Spores
on Textiles published in ASTM STP 1386, Performance of Protective Clothing: Issues and Priorities for
the 21st Century (Vol. 7; 2000). Their results imply that increased
regulation of textiles in hospital isolation units could save
Fungal spores are carried into hospital isolation units by staff
or visitors. In excess of 90% of the cases where someone with
immunosuppression would get a pulmonary infection, it would be
fatal, said Dart, a consultant for Arthur D. Little, Inc., Mass.,
who has an M.S. in Fiber Science from Cornell University, N.Y.
Its likely that Aspergillus is transmitted but overlooked, regardless
of the HEPA-filtration and regular air-sampling in isolation rooms,
she said. The problem is that by the nature of the airflow design
in the room, particulates coming off clothing are diluted very
quickly. In-room air sampling devices would probably indicate
much lower contamination levels than would be found in the microenvironment
that youd be experiencing very close to the person with the soiled
It is a hospital policy and facility issue, said Obendorf, an
associate dean of research and facilities at Cornell and professor,
Department of Textiles and Apparel. Its a management thing.
Its understanding the phenomena and managing that phenomena versus
developing clothing that wont hold spores.
Less than seven percent of bone-marrow units restrict visitors
interaction with patients, according to a national survey, and
less than 25% require cover-gowns. Careful monitoring of hospital-laundered
garments in units could remove the fungal spores, Obendorf said.
As you notice in the paper, laundering and dry-cleaning removed
these spores very easily.
In June, 1992, the immune system of Darts five-year old daughter
Dalia was chemically suppressed to avoid rejection of a bone marrow
transplant for leukemia. Tragically, by Aug. 3, the child died
of pulmonary Aspergillosis. During the ordeal, Betsy noticed that
handwashing was strictly enforced in her daughters hospital isolation
unit, and toys and surfaces were carefully wiped, but that visitors
clothes were not covered.
Dart explored the subject in her Masters of Science thesis, Redispersion
of Aspergillus Spores From Textiles Relative to Hospital Infection
Control, (Cornell University, Ithaca, N.Y.; Aug. 1998). The thesis
became the basis for the Dart/ Obendorf study.
For instance, Dart explained, if you were sitting in a rocking
chair and you had your child in your lap and you moved your arm
creating some friction and some air flow, you could have this
local high-density pollution and it would never be picked up by
the air sampling.
Clothing billows, added Obendorf. Youve got the situation
where it doesnt take very many spores. And theres no effective
Professor Thad Godish, Ph.D., author of Sick Buildings, and director
of indoor air quality research at Ball State University, Ind.,
wrote on his Web site that Aspergillus is a health concern. Godish
interestingly pointed out that the tenacious fungus is believed
to have been responsible for the deaths that have been ascribed
to King Tuts curse. A concentrated inhalation of Aspergillus
by raiders of the tomb may have caused their demise, the Canadian
Medical Journal concurred. Although the sarcophagus was sealed
in 1352 BC, fungal spores are capable of surviving for long periods
outside a host. When opened Nov. 26, 1922, a black fungus was
found in the interior.
A. fumigatus commonly found growing in compost and not uncommonly
found in building dust is of particular concern to immune-compromised
individuals who it readily infects and causes a life-threatening
disease of the lungs, Godish also wrote. (Dart and Obendorf used
the less pathogenic Aspergillus niger to avoid risk of exposure
during their study.)
Having received enthusiastic feedback to the study, their next
step is to share their research with hospital policy makers. Were
trying to get the word out to get people not to overlook this
route of cross-contamination, Obendorf said. //
Copyright 2001, ASTM