Sauna-takers disease. Hypersensitivity pneumonitis due to contaminated water in a home sauna

Metzger, W. James

doi:10.1001/jama.236.19.2209

Cited by 36 publications

(24 citation statements)

References 9 publications

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“…A few studies from Sweden and Finland have reported allergic reactions directly caused by mold-contaminated water (9,41,43 in the growing epidemic of allergy and asthma observed in the human population (27,30,32,33,38). The evidence linking molds like the Aspergillus, Cladosporium, and Penicillium species with severe asthma was recently reviewed and found to be strong (14).…”

Section: Discussionmentioning

confidence: 99%

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Diversity and Significance of Mold Species in Norwegian Drinking Water

Hageskal

Knutsen

Gaustad

et al. 2006

Appl Environ Microbiol

155

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In order to determine the occurrence, distribution, and significance of mold species in groundwater-and surface water-derived drinking water in Norway, molds isolated from 273 water samples were identified. Samples of raw water, treated water, and water from private homes and hospital installations were analyzed by incubation of 100-ml membrane-filtered samples on dichloran-18% glycerol agar. The total count (number of CFU per 100 ml) of fungal species and the species diversity within each sample were determined. The identification of mold species was based on morphological and molecular methods. In total, 94 mold species belonging to 30 genera were identified. The mycobiota was dominated by species of Penicillium, Trichoderma, and Aspergillus, with some of them occurring throughout the drinking water system. Several of the same species as isolated from water may have the potential to cause allergic reactions or disease in humans. Other species are common contaminants of food and beverages, and some may cause unwanted changes in the taste or smell of water. The present results indicate that the mycobiota of water should be considered when the microbiological safety and quality of drinking water are assessed. In fact, molds in drinking water should possibly be included in the Norwegian water supply and drinking water regulations.

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Section: Discussionmentioning

confidence: 99%

“…In addition, studies have revealed species that may produce unwanted flavors and odors in water (10,46) and species of technical concern that have the ability to oxidize pipe surfaces in the water distribution network (19). Reports from Sweden and Finland have indicated allergic and respiratory health effects of fungi resident in water (9,41,43).…”

mentioning

confidence: 99%

Diversity and Significance of Mold Species in Norwegian Drinking Water

Hageskal

Knutsen

Gaustad

et al. 2006

Appl Environ Microbiol

155

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“…Dry saunas are maintained at elevated temperature, and due to the traffic of users, they are exposed to various microorganisms, which may be periodically removed by cleaning and disinfection (9).…”

Section: Introductionmentioning

confidence: 99%

Characterization of Bacterial Community Contaminating Floor of A Hot and Dry Sauna

Lee

Park

2012

J Bacteriol Virol

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The purpose of this study was to examine profile of bacteria contaminated in a dry sauna. Bacteria sampled from the floor of the dry sauna (75~80℃) were separated and identified by using a thermal gradient gel electrophoresis (TGGE) technique, and were cultivated using a defined medium at 50℃. Bacteria grown in the defined medium were identified based on 16S-rDNA sequence homology. The band number of DNA separated by TGGE was 15, indicating the species diversity of bacteria contaminating the dry sauna. Seven species of bacteria were successfully cultured on agar plate medium at 50℃, which represented a combination of thermophilic and thermoduric bacteria contaminating the dry sauna. The highest limit temperature for growth of the bacterial isolates was generally 50℃ when cultivated in a defined medium, but was raised to 60℃ when cultivated in a complex medium. Consequently, the bacteria grown at 50~60℃ are thermoduric or thermophilic, but others may not be.

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“…This is due, in part, to the fact that causal relationships between fungal occurrence and water quality remain uncertain. Nonetheless, waterborne fungi are likely associated with taste and odor problems, contamination in food and beverage preparation, and a variety of health-related effects (3,5,10,17). Uncertain ramifications of fungi in potable water have led to a limited number of investigations which show that fungi are present in a significant proportion of tap water samples; however, species abundance and diversity are extremely variable (6,11,13,16).…”

mentioning

confidence: 99%

Characterization of Fungal Biofilms within a Municipal Water Distribution System

2000

Appl Environ Microbiol

139

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Biofilms of a municipal water distribution system were characterized to assess the occurrence of fungi within surface matrixes. Densities of filamentous fungi ranged from 4.0 to 25.2 CFU cm ؊2 , whereas yeast densities ranged from 0 to 8.9 CFU cm ؊2 . Observations by scanning electron microscopy further suggested that spores, not hyphae or vegetative cells, comprised the primary source of viable propagules.The presence of fungi in drinking water and within biofilms of distribution systems has received limited attention. This is due, in part, to the fact that causal relationships between fungal occurrence and water quality remain uncertain. Nonetheless, waterborne fungi are likely associated with taste and odor problems, contamination in food and beverage preparation, and a variety of health-related effects (3,5,10,17). Uncertain ramifications of fungi in potable water have led to a limited number of investigations which show that fungi are present in a significant proportion of tap water samples; however, species abundance and diversity are extremely variable (6,11,13,16). This variation is often attributed to factors such as raw water source, water temperature patterns, treatment conditions, and maintenance of distribution systems (5). The nature and extent of fungi within distribution biofilms remain more obscure; only a single report has demonstrated conclusively that fungi are an integral biofilm component (12). Although it is assumed that contamination is attributable to spore deposition within the biofilm matrix, there is limited evidence to support this premise.Pipe surfaces were collected from the Springfield, Mo., water distribution system from March to July 1997. This municipal system serves approximately 100,000 people and consists of over 900 miles of water mains. Physical and chemical characteristics of this distribution system from January to July 1997 are reported in Table 1. Each sample consisted of a single pipe coupon (i.e., a longitudinal section of the inner pipe surface) obtained during routine maintenance and extension of 30-in. mains. During collection, each coupon was carefully rinsed with 2 liters of sterile distilled water and then placed in a sterile plastic bag. Coupons were immediately transported to the laboratory and rinsed again with 1 liter of sterile distilled water. The purpose of each rinse was to minimize the likelihood of contamination by airborne spores. Although each rinse was discarded, preliminary investigations of polyvinyl chloride (PVC) and iron coupons indicated that rinses did not remove biofilm deposition.Small biofilm fragments, each consisting of 0.5 cm 2 of surface matrix, were removed and plated on the following nonselective media: potato dextrose agar (Difco), Czapek solution agar (Difco), cornmeal agar (Difco), Sabouraud dextrose agar (Difco), and YMPG (10 g of dextrose, 5 g of neopeptone, 3 g of yeast extract, 3 g of malt extract, 10 g of agar, 1 liter distilled water). Four replicates of each medium were employed for each coupon to yield a total of 100 frag...

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Sauna-takers disease. Hypersensitivity pneumonitis due to contaminated water in a home sauna

Cited by 36 publications

References 9 publications

Diversity and Significance of Mold Species in Norwegian Drinking Water

Diversity and Significance of Mold Species in Norwegian Drinking Water

Characterization of Bacterial Community Contaminating Floor of A Hot and Dry Sauna

Characterization of Fungal Biofilms within a Municipal Water Distribution System

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