Bioaerosols: prevalence and health effects in the indoor environment.

Assessing the role of bioaerosols in residence-related symptoms involves (1) determining that symptoms are related to the residence by medical examination and careful questioning, (2) connecting reported symptoms with known or hypothesized effects of bioaerosols, (3) examining the residence for bioaerosol risk factors such as overcrowding/poor ventilation, inappropriate outdoor air intrusion, and dampness/standing water, (4) and finally, if no obvious risk factors are present, air sampling. Air sampling should always be a last resort and should use a reliable volumetric method. Particulate samplers, such as the Burkard personal spore trap, are inexpensive alternatives to viable particle samplers and will provide data on most organisms implicated in hypersensitivity diseases. Interpretation of residential bioaerosol sample data requires both qualitative and quantitative comparison with adjacent outdoor air and examination of aerosol changes related to domestic activities. Recommendations that should lead to a decrease in indoor bioaerosols include the use of air conditioning to allow limitation of outdoor aerosols, prevention of dampness or moisture intrusion, and discouraging the use of humidifying devices other than steam. Bioaerosol assessment in the workplace is often more complex than for residences. Because the symptomatic subjects are not in charge of the environment, such situations often lead to difficult employee/management relations and occasionally to litigation. It is essential that each step in workplace bioaerosol assessment be defensible and that the best possible methods are used. The approach is similar to the approach used for residences, but on a larger scale. Symptom assessment must include stress and ergonomic factors. Air sampling, if this is necessary, must usually be extensive with controls for ventilation rates, occupancy, and spatial variation.