Medical Journal of AustraliaVolume 215, Issue 1 p. 13-15.e1 Perspectives Dust diseases in modern Australia: a discussion of the new TSANZ position statement on respiratory surveillance Deborah H Yates, Corresponding Author Deborah H Yates d.yates@unsw.edu.au orcid.org/0000-0001-6419-6856 St Vincent’s Hospital, Sydney, NSW St Vincent’s Clinical School, UNSW, Sydney, NSW Correspondence d.yates@unsw.edu.auSearch for more papers by this authorJennifer L Perret, Jennifer L Perret Allergy and Lung Health Unit, University of Melbourne, Melbourne, VICSearch for more papers by this authorMargaret Davidson, Margaret Davidson Western Sydney University, Sydney, NSWSearch for more papers by this authorSusan E Miles, Susan E Miles Calvary Mater Newcastle, Newcastle, NSW University of Newcastle, Newcastle, NSWSearch for more papers by this authorAW Musk, AW Musk University of Western Australia, Perth, WASearch for more papers by this author Deborah H Yates, Corresponding Author Deborah H Yates d.yates@unsw.edu.au orcid.org/0000-0001-6419-6856 St Vincent’s Hospital, Sydney, NSW St Vincent’s Clinical School, UNSW, Sydney, NSW Correspondence d.yates@unsw.edu.auSearch for more papers by this authorJennifer L Perret, Jennifer L Perret Allergy and Lung Health Unit, University of Melbourne, Melbourne, VICSearch for more papers by this authorMargaret Davidson, Margaret Davidson Western Sydney University, Sydney, NSWSearch for more papers by this authorSusan E Miles, Susan E Miles Calvary Mater Newcastle, Newcastle, NSW University of Newcastle, Newcastle, NSWSearch for more papers by this authorAW Musk, AW Musk University of Western Australia, Perth, WASearch for more papers by this author First published: 30 May 2021 https://doi.org/10.5694/mja2.51097 Podcast with Deborah Yates available at mja.com.au/podcasts Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Volume215, Issue1July 2021Pages 13-15.e1 RelatedInformation

The exposure of people to opportunistic premise plumbing pathogens (OPPPs) such as Legionella, Mycobacterium and Pseudomonas in aerosolised water has been linked to opportunistic infections. Water mist systems (WMS) that are used to cool public places by flash evaporation of tiny water aerosols are gaining prominence in hot climatic regions of Australia. Their potential to be colonised by OPPPs has not been adequately studied. The public health impact of OPPPs is significant, as Legionella caused 63% of waterborne disease case hospitalisations in the United States associated with drinking water systems during 2013–2014, and the incidence of Mycobacterium avium over the same period was 647 cases per 100,000. As WMS are part of premise plumbing, they have structural characteristics that can promote biofilm formation, as well as the presence of free-living amoebae (FLA), low residual disinfection levels, elevated water temperatures and oligotrophic conditions, all of which can promote OPPP inhabitancy. This review highlights the potential public health risks of using WMS as a cooling intervention in public places and advocates for their regulation in places of public assembly and entertainment.

This protocol demonstrates a customized bioaerosol sampling method for viruses. In this system, anion exchange resin is coupled with liquid impingement-based air sampling devices for efficacious concentration of negatively-charged viruses from bioaerosols. Thus, the resin serves as an additional concentration step in the bioaerosol sampling workflow. Nucleic acid extraction of the viral particles is then performed directly from the anion exchange resin, with the resulting sample suitable for molecular analyses. Further, this protocol describes a custom-built bioaerosol chamber capable of generating virus-laden bioaerosols under a variety of environmental conditions and allowing for continuous monitoring of environmental variables such as temperature, humidity, wind speed, and aerosol mass concentration. The main advantage of using this protocol is increased sensitivity of viral detection, as assessed via direct comparison to an unmodified conventional liquid impinger. Other advantages include the potential to concentrate diverse negatively-charged viruses, the low cost of anion exchange resin (~$0.14 per sample), and ease of use. Disadvantages include the inability of this protocol to assess infectivity of resin-adsorbed viral particles, and potentially the need for the optimization of the liquid sampling buffer used within the impinger.

Dairy workers experience a high degree of bioaerosol exposure, composed of an array of biological and chemical constituents, which have been tied to adverse health effects. A better understanding of the variation in the magnitude and composition of exposures by task is needed to inform worker protection strategies. To characterize the levels and types of exposures, 115 dairy workers grouped into three task categories on nine farms in the high plains Western United States underwent personal monitoring for inhalable dust, endotoxin, 3-hydroxy fatty acids (3-OHFA), muramic acid, ergosterol, and ammonia through one work shift. Eighty-nine percent of dairy workers were exposed to endotoxin at concentrations exceeding the recommended exposure guidelines (adjusted for a long work shift). The proportion of workers with exposures exceeding recommended guidelines was lower for inhalable dust (12%), and ammonia (1%). Ergosterol exposures were only measurable on 28% of samples, primarily among medical workers and feed handlers. Milking parlor workers were exposed to significantly higher inhalable dust, endotoxin, 3-OHFA, ammonia, and muramic acid concentrations compared to workers performing other tasks. Development of large modern dairies has successfully made progress in reducing worker exposures and lung disease prevalence. However, exposure to endotoxin, dust, and ammonia continues to present a significant risk to worker health on North American dairies, especially for workers in milking parlors. This study was among the first to concurrently evaluate occupational exposure to assayable endotoxin (lipid A), 3-hydroxy fatty acids or 3-OHFA (a chemical measure of cell bound and noncell-bound endotoxins), muramic acid, ergosterol, and ammonia among workers on Western U.S. dairies. There remains a need for cost-effective, culturally acceptable intervention strategies integrated in OHS Risk Management and production systems to further optimize worker health and farm productivity.

The detection of aerosolized viruses can serve as an important surveillance and control tool in agriculture, human health, and environmental settings. Here, we adapted an anion exchange resin-based method, initially developed to concentrate negatively charged viruses from water, to liquid impingement-based bioaerosol sampling. In this method, aerosolized viruses are collected in a 20 ml liquid sample contained within widely used impingers, BioSamplers (SKC Inc., Eighty Four, PA), and further concentrated via adsorption to an anion exchange resin that is suspended within this liquid. Viral nucleic acids are then extracted from the resin to facilitate molecular analyses through a reduction in the effective sample volume. For this study, various quantities of two negatively charged viruses, type A and type B influenza viruses (FluMist Quadrivalent vaccine) and the male-specific (F+) RNA coliphage MS2 (MS2), were nebulized into a custom-built bioaerosolization chamber, and sampled using BioSamplers with and without anion exchange resin. Compared to direct testing of the BioSampler liquid, detection was improved by 6.77× and 3.33× for type A and type B influenza viruses, respectively, by using the anion exchange resin. For MS2, the anion exchange resin method allowed for an average improvement in detection of 8.26×.

Renewable energy production may offer advantages to human health by way of less pollution and fewer climate-change associated ill-health effects. Limited data suggests that renewable energy will also offer benefits to workers in the form of reduced occupational injury, illness and deaths. However, studies of worker safety and health in the industry are limited. The Mountain and Plains Education and Research Center (MAP ERC) Energy Summit held in April 2011 explored issues concerning worker health and safety in the renewable energy industry. The limited information on hazards of working in the renewable energy industry emphasizes the need for further research. Two basic approaches to guiding both prevention and future research should include: (1) applying lessons learned from other fields of occupational safety and health, particularly the extractive energy industry; and (2) utilizing knowledge of occupational hazards of specific materials and processes used in the renewable energy industry.

Objective: Organic dust inhalation has been associated with adverse respiratory responses among agricultural workers. We evaluated factors that may confer increased susceptibility to these health effects. Methods: We quantified personal work shift exposures to inhalable dust, endotoxin, and its 3-hydroxy fatty acid constituents, and evaluated changes in pulmonary function among 137 grain elevator, cattle feedlot, dairy, and corn farm workers. Results: Increased dust exposure was associated with work shift reductions in lung function. Although interpretation is limited because of small samples, a suggestion of stronger exposure-response relationships was observed among smokers, as well as workers reporting pesticide/herbicide application, asthma, or allergies, and those with genetic polymorphisms (TLR4) (P interaction <= 0.05). Conclusions: A better understanding of factors leading to increased susceptibility of adverse respiratory outcomes is needed to optimize exposure reduction strategies and develop more comprehensive wellness programs.

Background and Aims: Organic dust inhalation has been associated with adverse respiratory responses among agricultural workers. Susceptibility to the adverse health effects resulting from these agricultural exposures may be related to: constituents of the dust, e.g. endotoxin; intrinsic factors, e.g. genetic traits; and extrinsic factors, e.g. smoking and work-related behaviors. Methods: This study quantified breathing-zone personal work shift exposures to inhalable dust, endotoxin, and its 3-hydroxy fatty acid (3-OHFA) constituents, and evaluated pulmonary function before and after the work shift among 136 cattle feedlot, dairy, grain elevator, and corn farm workers. General linear models were used to assess the multivariable relationships between dust exposures and lung function (forced vital capacity, FVC; forced expiratory volume in 1 second, FEV1; and the FEV1/FVC ratio). Genotyping of SNPs in two polymorphisms in the TLR4 gene (TLR4 299 and 399) was performed. Results: Geometric mean dust levels were similar among feedlot (1.53mg/m3; n=59), dairy (1.45mg/m3; n=15), and farm (1.58mg/m3; n=9) employees and elevated among grain elevator operators (2.03mg/m3; n=53). Endotoxin concentrations were similar across all facility types. Increased dust exposure was associated with work shift decrements in FVC and FEV1. These relationships were stronger among current smokers and those reporting application of pesticides/herbicides at work or home (interactions between dust and smoking and between dust and pesticide use, p•0.05); however, no evidence of increased susceptibility was observed among those living on a farm. Interactions between dust/endotoxin exposures and genetic mutations were observed (p<0.05), although the small number of participants with genetic mutations limits interpretation. Further analyses will identify additional factors that may confer increased susceptibility to the adverse pulmonary effects (crossshift and pre-shift) of agricultural exposures. Conclusions: A better understanding of factors leading to increased susceptibility for the development of adverse respiratory outcomes is needed to optimize prevention strategies among agricultural workers.

The major immediate-early proteins of human cytomegalovirus (HCMV) play a pivotal role in controlling viral and cellular gene expression during productive infection. As well as negatively autoregulating its own promoter, the HCMV 86-kDa major immediate early protein (IE86) activates viral early gene expression and is known to be a promiscuous transcriptional regulator of cellular genes. IE86 appears to act as a multimodal transcription factor. It is able to bind directly to target promoters to activate transcription but is also able to bridge between upstream binding factors such as CREB/ATF and the basal transcription complex as well as interacting directly with general transcription factors such as TATA-binding protein and TFIIB. We now show that IE86 is also able to interact directly with histone acetyltransferases during infection. At least one of these factors is the histone acetyltransferase CBP-associated factor (P/CAF). Furthermore, we show that this interaction results in synergistic transactivation by IE86 of IE86-responsive promoters. Recruitment of such chromatin-remodeling factors to target promoters by IE86 may help explain the ability of this viral protein to act as a promiscuous transactivator of cellular genes.