BACKGROUND:Fungal infections pose a significant threat to public health, with over 6.55 million cases and 2.55 million deaths annually. Exposure to fungal spores in indoor environments primarily occurs through inhalation or direct contact with surfaces. Monitoring is critical for early detection and prevention of outbreaks, yet routine airborne fungal testing is not universally mandated across healthcare settings. METHODS:A systematic review of peer-reviewed articles from four databases was conducted to identify current airborne fungal monitoring guidelines and best practices for sample collection, culture media, incubation conditions, and results interpretation. RESULTS:Eighteen articles met the inclusion criteria, and four studies discussed potential guidelines for acceptable airborne fungal levels in healthcare environments. Guidelines ranged from <1 CFU/m3 for HEPA-filtered environments to >1000 CFU/m3 for non-filtered areas. The most common fungi identified were Aspergillus, Penicillium, Alternaria, Cladosporium, and Rhizopus, with six WHO-listed critical fungal pathogens found. Impaction was the sole sampling method used, with most studies employing Sabouraud dextrose or malt extract agar with chloramphenicol, incubation for 2-7 days at 25-30 °C, and morphological identification. CONCLUSIONS:The need for globally recognized fungal monitoring standards is pressing. Without them, preventable fungal exposure will persist, risking severe, potentially fatal infections for patients and healthcare workers.

Exposure to airborne fungi has been linked with infections and the exacerbation of existing chronic conditions. Specific factors, such as seasonal variations and weather, can significantly influence fungal concentration. The environmental conditions in Las Vegas, Nevada play, a role in the distribution and concentration of airborne fungal spores. The objective of this study was to provide a comprehensive assessment of the estimated total fungal DNA concentration of airborne fungi in Las Vegas using polymerase chain reaction (PCR) across different seasons, weather patterns, and meteorologic factors. Environmental air samples collected for one year from 13 sites across Las Vegas were analyzed with a universal fungal PCR assay. Standards of known concentration were used to determine DNA copies in the samples. The estimated total fungal DNA concentration ranged from 346 to 4967 copies/m3. The mean estimated total fungal DNA concentration was 2276 copies/m3. There was a significant difference in the mean estimated total fungal DNA concentration between seasons (p = 0.026). There were no significant correlations between estimated total fungal DNA concentration and meteorologic factors. This study utilized a molecular detection method to measure outdoor fungal DNA concentrations. The methodology developed in this study can enhance indoor and outdoor air quality surveillance for public health assessment by providing rapid and quantitative results.

Airborne fungal spores are ubiquitous globally and are common allergens. Data comparing concentrations of spores between urban and natural desert environments are lacking. We continue to study fungal spore variability between Las Vegas and the Mojave Desert from 2020 - 2022.

The airborne pollen concentrations in the Las Vegas Valley are unique because of the subtropical and hot desert climate. Information on seasonal pollen trends is needed and is important for local allergy sufferers and tourists. This study aims to analyze yearly concentrations of pollen in the Las Vegas Valley and compare them to earlier years. Air samples were collected using a Burkard spore trap from January 1, 2019, to December 31, 2021, at the National Allergy Bureau site located at the University of Nevada, Las Vegas. Slides were analyzed by microscopy at 400X magnification to determine airborne pollen concentrations. Data for tree, weed, and grass pollen were compared using a one-way ANOVA and post-hoc testing. Three-year maximum grass and tree pollen concentrations peaked in March 2020, (73.7 grains/m3 and 18,803.1 grains/m3, respectively) and weed in April 2020, (299.5 grains/m3). Annual means of grass, tree, and weed were highest in 2020 (2.2, 357.8, 10.1 grains/m3, respectively) and were significantly different between the years (p = 0.001, p = 0.012, p < 0.000, respectively). Compared to the other years, grass and weed pollen concentrations were significantly lower in 2021 and tree concentrations were significantly higher in 2020. Tree and grass pollen concentrations peaked in 2020, possibly due to high precipitation in 2019. The three-year means of grass, tree, and weed pollen from 2019 – 2021 were considerably lower compared to those from 2016 – 2018. Continued monitoring is essential in understanding seasonal pollen trends and timely forecasts for the Las Vegas valley.

Due to concern with the health and environmental impacts of allergic pine pollen on an urban community in Las Vegas, Nevada, a computation fluid dynamics (CFD) modeling framework was established for investigating the dispersion and deposition of pollen emitted from inventoried pine trees. The framework employs a Eulerian–Lagrangian approach with mesh grids of < 10 m to simulate wind flows and track pollen particle movements around real-world building blocks. The initial assessment focused on a spring pollen episode and a low period following the episode. Model results highlighted that building structures constrained pollen transportation by reducing wind speeds, especially during the low period, and altered pollen distributions, creating hot spots and cold spots at the windward and leeward sides of buildings, respectively, on the pollen trajectories. The majority of pollen particles appear to deposit onto the ground or buildings 1–3 km downwind from the sources through gravitational settling. Multiple model validations are presented, while limitations and potential applications are discussed.

Contaminated surfaces are one of the ways that coronavirus disease 2019 (COVID-19) may be transmitted. SARS-CoV-2 can be detected on environmental surfaces; however, few environmental sampling studies have been conducted in nonclinical settings. The objective of this study was to detect SARS-CoV-2 RNA on environmental surfaces in public areas in Las Vegas, Nevada. In total, 300 surface samples were collected from high-touch surfaces from high-congregate public locations and from a public health facility (PHF) that was visited by COVID-19 patients. Environmental samples were analyzed with quantitative reverse-transcriptase polymerase chain reaction (RT-qPCR) using SARS-CoV-2 specific primers and probes for three target genes. Results showed that 31 out of 300 (10.3%) surface samples tested positive for SARS-CoV-2, 24 at the PHF and 7 in high-congregate public locations. Concentrations ranged from 102 to 106 viral particles per 3 ml sample on a wide variety of materials. The data also showed that the N gene assay had greater sensitivity compared to the S and ORF gene assays. Besides frequently touched surfaces, SARS-CoV-2 was detected in restrooms, on floors and surfaces in contact with floors, as well as in a mop water sample. The results of this study describe the extent and distribution of environmental SARS-CoV-2 contamination in public areas in Las Vegas, Nevada. A method using the N gene PCR assay was developed for SARS-CoV-2 environmental monitoring in public areas. Environmental monitoring with this method can determine the specific sites of surface contamination in the community and may be beneficial for prevention of COVID-19 indirect transmission, and evaluation and improvement of infection control practices in public areas, public health facilities, universities, and businesses.

In response to the airborne release of biothreat agents, surface sampling is often used to provide information on bioaerosol dispersal and deposition, to identify biocontaminant sources, and determine the effectiveness of decontamination. The objective of this project was to use aerosolization and deposition of dry spores to evaluate the efficiency of the cellulose sponge wipe and 37-mm cassette micro vacuum surface sampling methods for the collection of microorganisms from two contaminated surfaces, metal and concrete. Aerosolization trials were performed in a room-sized test chamber with known airborne concentrations of Bacillus atrophaeus spores serving as a surrogate for a bioterrorism agent. Following each aerosolization trial, the chamber heating, ventilation, air conditioning (HVAC) system was turned off to allow airborne spores to settle onto the test materials. Surface sampling was conducted and culture analysis was used to determine the concentration of B. atrophaeus on the surfaces. Results were compared with reference samples to determine the collection efficiency of the sampling methods. The sponge wipe sampling method was significantly more effective than the vacuum method for the collection of B. atrophaeus from both metal and concrete surfaces (P < 0.001). The collection efficiency of the sponge wipe method was 39.5% for metal and 26.5% for concrete, while the collection efficiency of the vacuum method was 7.6% for metal and 9.3% for concrete. The results of this study provided data on the collection efficiencies of two surface sampling methods for detection and enumeration of biocontaminants and can aid in selection of sampling methods.

In recent years, renewable portfolio standards (RPS), which require a certain percentage of electricity sold to consumers to come from renewable resources, have been established by many state governments to mitigate emissions of greenhouse gases and air pollutants in the United States. Nevada’s RPS set a target of 50% of electricity to come from renewable sources by 2030. By coupling the U.S. Environmental Protection Agency’s AVoided Emissions and geneRation Tool (AVERT) and CO–Benefits Risk Assessment (COBRA) model, this study assesses potential emission reductions from fossil fuels owing to this requirement and regional health benefits via improved air quality, as well as how these benefits vary spatially under high and low projected electricity demands in 2030. Successful implementation of the RPS could produce health benefits equivalent to USD 3–8 million per year for Nevada residents and up to USD 164 million per year for the entire U.S. Nevada is ranked only 6th among states benefiting from the policy, while California and Washington obtain the most health benefits. There is also inequity among Nevada counties, partly caused by the county population and proximity to major fossil fuel power plants. Lowering electricity demands by 5% in Nevada would lead to a ~10% increase in health benefits. These findings should empower public support of RPS policies and energy conservation to reduce air pollution and public health inequity for the region.

Airborne fungal spores are common allergens present in urban and surrounding environments. Data comparing the abundance of airborne fungi are lacking, especially in desert climates. This study aims to compare fungal spore concentrations between Las Vegas and the surrounding Mojave Desert from 2016-2020. Air samples were collected using a Burkard spore trap from January 1, 2016, to December 31, 2020, at air monitoring sites in Las Vegas and in the Mojave Desert. Samples were analyzed by microscopy at 1,000X magnification. Spore concentration data were converted to log10, and an independent samples t-test was utilized to compare the data from the two sites. Maximum fungal spore concentrations (spores/m3) from the Mojave Desert and Las Vegas between 2016-2020 were; 5,479 and 9,077 (2016); 9,123 and 14,296 (2017); 5,332 and 2,624 (2018); 5,378 and 3,236 (2019); 17,360 and 5,705 (2020), respectively. Average airborne fungal spore concentrations were significantly higher in Las Vegas compared to the Mojave Desert for 2016-2019 (p < 0.001), with 2020 not statistically different (p = 0.076). Airborne fungal spore concentrations in the Mojave Desert and Las Vegas followed similar trends across the five-year period studied but were statistically different from 2016-2019. Concentrations in Las Vegas were typically higher on average compared to those in the Mojave Desert. This may be due to urban green spaces and development in Las Vegas, resulting in a more favorable environment for fungi than the naturally occurring desert ecosystem found in the Mojave Desert.

Healthcare-associated infections (HAIs) are infections that patients acquire while receiving medical treatment in a healthcare facility. During ambulatory transport, the patient may be exposed to pathogens transmitted from emergency medical service (EMS) personnel or EMS surfaces.The aim of this study was to determine whether organisms commonly associated with HAIs have been detected on surfaces in the patient-care compartment of ambulances. Five electronic databases - PubMed, Scopus, Web of Science, Embase and Google Scholar were used to search for articles using inclusion and exclusion criteria following the PRISMA checklist. Inclusion criteria consisted of articles published in English, between 2009 and 2020, had positive samples collected from the patient-care compartment of a ground ambulance, and reported sample collection methods of either swab sampling and/or Replicate Organism Detection and Counting (RODAC) contact plates. Studies not meeting these criteria were excluded from this review. From a total of 1376 articles identified, 16 were included in the review. Organisms associated with HAIs were commonly detected in the patient-care compartment of ambulances across a variety of different surfaces, including blood pressure cuffs, oxygen apparatuses, and areas of patient stretchers. A high prevalence of pathogenic bacteria in ambulances suggests that standard protocols related to cleaning compliance may not be effective. The primary recommendation is that designated subject matter experts in infection prevention should be incorporated as liaisons in the pre-hospital setting, acting as a link between the pre-hospital (e.g., ambulance transport) and hospital environments.

Neonatal abstinence syndrome (NAS) is a postnatal withdrawal syndrome among neonates born to mothers with drug dependence disorders. NAS poses a significant public health challenge nationally, with a six-fold increase in incidence (1.2 to 6.7 per 1000 hospital births/year) from 2000–2016. Besides national data, it is critical to quantify NAS at the state-level to identify target areas for prevention. The objectives of this study were to ascertain statewide burden, including county and regional distribution of NAS in Nevada during 2016–2018, and to investigate potential factors associated with NAS. This study utilized hospital administrative data, and a total of 100,845 inpatient pediatric discharges were examined to identify NAS cases. Statistical analyses included estimation of crude incidence rates per 1000 hospital births and multilevel logistic regression modeling. NAS incidence in Nevada decreased slightly from 8.6 to 7.7 per 1000 hospital births between 2016 and 2018, but the overall incidence of 8 was substantially higher than earlier estimates (4.8/1000 hospital births) reported for 2013. Incidence was disproportionately higher among white newborns (12, 95% CI 11.0,13.0) and Medicaid enrollees (13.2, 95% CI 11.0,15.0). Southern Nevada had the highest incidence rate of 8.2 per 1000 hospital births. Nearly 75% of NAS cases were residents of Clark County. Incidence rates of NAS parallel the growing opioid prescription rates in Nevada and highlight the need for adopting opioid control prescribing practices to combat this drug epidemic. These findings might help in designing and evaluating state- and system-level interventions introduced to combat the opioid epidemic.

Weed pollen grains are common allergens in the desert region of Southern Nevada. This study aims to compare annual weed pollen between the Las Vegas Area and a rural site in Jean, Nevada, in the Mojave Desert. Air samples were collected using a Burkard spore trap from January 1, 2017, to December 31, 2019, at the National Allergy Bureau site in Las Vegas and a site in Jean. Samples were analyzed via microscopy at 400x magnification. Data were compared using an independent samples t-test. The Las Vegas site had an annual mean of 19, 7, and 10 weed pollen grains/m3 from 2017-2019, respectively. The Jean site had an annual mean of 60, 5, and 15 grains/m3 from 2017-2019, respectively. The Jean site showed significantly higher weed pollen concentration than the Las Vegas site in 2017 (P≤0.001). There was no significant difference between the sites in 2018 (P<0.132) or 2019 (P<0.213). The maximum weed pollen concentration at both sites occurred in 2017; with Las Vegas at 488 grains/m3 in March and 1745 grains/m3 in April for the Jean site. Variability between the sites was significant only for 2017, with more weed pollen at the Jean site. The spring of 2017 showed the highest concentrations of weed pollen for both sites. Highest concentrations were observed in spring, an observation unique to this region. There were similar average weed pollen concentrations between the two sites for 2018 and 2019, suggesting that weed pollen in urban environments is similar to the surrounding desert environment.

In Las Vegas, the airborne pollen pattern is unique because of a distinctive subtropical, hot desert climate. Knowledge of seasonal pollen concentrations is important for local allergy sufferers and tourists. The goal of this study is to compare annual patterns for grass, tree and weed pollen in Las Vegas. Air samples were collected using a Burkard spore trap from January 1, 2015, to December 31, 2018 at the National Allergy Bureau site located at the University of Nevada, Las Vegas. Slides were analyzed by microscopy at 400X magnification to determine airborne pollen concentrations. Data for tree, weed and grass pollen were compared using a one-way ANOVA and post-hoc testing. Monthly mean concentrations of grass and tree pollen were highest in March, 2017, with concentrations of 28 grains/m3 and 3848 grains/m3, respectively (maximum concentrations, 282 and 16,045 grains/m3, respectively). Weed pollen concentrations were highest in April, 2017 (mean, 89 grains/m3; maximum, 325 grains/m3). The annual tree pollen mean concentrations showed a decreasing trend, but were not statistically significantly different between the years (P =0.082). Significant differences were observed for the annual weed pollen mean concentrations in 2017 compared with all other years, and for grass pollen in 2018 compared with all other years. After a peak in 2017, total tree pollen concentrations showed a decrease in 2018. Weed and grass pollen also showed an increase in 2017 compared to the other years. Continued monitoring is needed to determine the annual pollen trends to provide timely forecasts for the community.

Tree pollens are significant allergens that predominantly occur between February and May. Data are lacking in annual variations of tree pollen in Las Vegas. The objective of this study is to compare airborne tree pollen concentrations in Las Vegas from 2015-2018. Air samples were collected using a Burkard 7-day recording volumetric spore sampler located at a National Allergy Bureau certified sampling site in Las Vegas. Samples were analyzed with a compound light microscope at 400x magnification. Data were compared with a one-way ANOVA. From 2015-2018, mulberry had the greatest annual mean (1,349 grains/m3 ± 143) when compared to all other tree pollen, peaking at 16,218 grains/m3 in March 2018. Cedar pollen reached higher concentrations in 2015 in comparison to all of the other years (P = 0.000). Oak pollen was higher in 2015 when compared to 2016 and 2018 (P = 0.001). Olive concentrations reached a maximum of 855 grains/m3 in 2015. Ash concentrations reached a maximum of 610 grains/m3 in 2018. The mean concentrations of olive and ash were not significantly different between years (P =1.00). An increasing trend in annual total tree pollen since 2016 was observed. Mulberry was by far the predominant tree pollen from 2015-2018. Variations were observed in all airborne tree pollens monitored from year to year. The total tree pollen concentrations have shown a steady increase, possibly due to shorter winters and warmer springs. Further monitoring is needed to determine seasonal trends in tree pollen concentrations and provide timely forecasts for the community.

Despite being recognized as an important part of particulate matter (PM) air pollution and health risk, bioaerosols have not been quantified as extensively as other PM components for establishing PM standards and management strategies. The challenge lies partly in the lack of practical measurement methods. This study evaluated a filter-based, direct-staining fluorescence microscopy (DS-FM) method that may be adapted to routine air quality monitoring for bioaerosol concentration and size distribution. Through testing with bioaerosol standards made of bacterial cells and fungal spores, the method is shown to have precision, accuracy, detection limit, and dynamic range suitable for most ambient environments. DS-FM was demonstrated with PM samples from an arid urban location in Las Vegas, Nevada during the spring allergy season. Detectable bioaerosols ranged from 0.37 to 16 mu m in geometric diameter and averaged 0.27 +/- 0.23 cm(-3) in number concentration with about 2/3 and 1/3 in the fine (<= 2.5 mu m) and coarse (> 2.5 mu m) mode, respectively. The bioaerosol mass, estimated from the size distribution and an assumed density, was mainly in the coarse mode and accounted for 17 +/- 11% of PM10, 20 +/- 13% of PM10-2.5, and 4 +/- 3% of PM2.5 mass. Rain and high wind speeds appeared to elevate bioaerosol levels. Other advantages of DS-FM include low sample consumption and short turnaround times; a large amount of data can be generated by incorporating the measurement into current long-term air quality networks. Suggestions for using the data to inform bioaerosol origins, contributions, and public health impacts are discussed.

Background. Traditional undergraduate college students in the United States are in the age range that experiences the highest rate of sexually transmitted infections (STIs) and are vulnerable to contracting STIs. Increasing condom use among college students is a prevention strategy to reduce the spread of STIs. Aim. The purpose of this systematic review of the literature was to identify behavioral interventions that increased condom use behaviors and/or intentions among college students. Method. The Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines were followed in systematically searching, extracting, appraising, and synthesizing the evidence. A quality assessment was also conducted with the tool provided by the Effective Public Health Practice Project. Results. The initial search yielded 715 records. After critical appraisal, seven articles remained for review. Discussion. Four of the interventions were developed using the three constructs of the information, motivation, and behavioral skills model, and all four found significant increases in condom use or condom use intentions. Additionally, interventions that included modules to increase self-efficacy for condom use, taught participants where to get condoms and how to negotiate condom use with partners, or elicited positive associations (feels) toward condoms saw increased condom use or intention to use condoms.

Fungal spores are biological particles that are ubiquitous in the outdoor air. Spores of several very common fungal species are known allergens, with the potential to cause respiratory illnesses by exacerbating asthma and allergic rhinitis. The National Allergy Bureau typically has one monitoring station established per city to determine fungal spore counts for an entire metropolitan area. However, variations in fungal spore concentrations could occur among different locations. The objective of this study was to measure and compare airborne fungal spore concentrations in five locations in Las Vegas for the year 2015 to determine if there are differences among microenvironments in the city. Twenty-four-hour or 7-day air samples were collected from five sites across the Las Vegas Valley. Samples were analyzed with a light microscope for fungal spores and counts were converted to concentrations of spores per volume of air. Mixed-model methods were used to evaluate mean differences. Results showed that smuts (basidiomycetes) were the dominant spore type for all five sites during the spring season. Cladosporium species were responsible for the second most dominant spore type with the highest concentrations occurring during the summer and fall months. Results obtained from the five stations established in Las Vegas show that there are important variations among the sites regarding fungal spore concentrations. The data suggest that more sites and additional monitoring of outdoor allergens are needed to provide information necessary to inform the community of outdoor air quality conditions and their potential effects on public health. This study presents new outdoor fungal spore data for the southwest region of the USA, focused in the Las Vegas Valley.

In Southern Nevada, Olea and Morus pollen are major outdoor allergens that trigger seasonal allergic diseases. The objective of this study is to examine 2016 data to compare airborne Morus and Olea pollen concentrations at five stations in the metropolitan area of Las Vegas and one in the Mojave Desert, to determine any differences between microenvironments. Air samples were collected using a Burkard spore trap and analyzed by light microscopy. The data were log transformed and a mixed-model analysis was used to compare each site by location, month, and mean pollen concentrations. At site 1, the peak concentration for Morus occurred in March (8810 grains/m3) and the largest monthly mean was observed at this site (3051 grains/m3). Several differences in Morus concentrations among sites 1 vs 2 and 4, 3 vs 2, and 5 vs 2 were detected in March. Olea pollen peaked at site 1 (474 grains/m3) and the largest monthly mean for Olea was also seen at site 1 (87 grains/m3) in April. There was a seasonal mean difference seen between sites 1 vs 2 for Olea. Concentrations at the Mojave sites were much lower or non-existent compared to the other five sites. Las Vegas and Mojave Desert Morus and Olea pollen concentrations differed among several sites examined during the peak pollen months in 2016. The results at the Mojave site suggest pollen transport is limited to the metropolitan area. Our findings indicate that multiple monitoring stations are needed to adequately inform the public of outdoor allergens.

This study compared airborne mold concentrations in Las Vegas with the surrounding desert to determine seasonal variability between the urban and rural desert environments. Air samples were collected using a Burkard spore trap from January 1st to December 31st 2015, at a National Allergy Bureau (NAB) site in Las Vegas and a site in the Mojave Desert, located approximately 32 miles south of Las Vegas. Microscope slides were prepared and analyzed by light microscopy. Las Vegas had an annual mean of 374±280 spores/m3 compared to 350±265 spores/m3 at the Mojave site (p<0.01). The peak concentrations occurred in June (1917 spores/m3) in Las Vegas and in March (1789 spores/m3) for the Mojave site. There were differences observed between Cladosporium and smut concentrations. At the Mojave site, the peak was in July with 1151 spores/m3, while the peak was in June for Las Vegas (696 spores/m3). The smut concentrations for both sites had the highest concentrations in June, with lower concentration is Las Vegas (599 grains/m3) compared to the Mojave desert (1439 grains/m3). Mold concentrations in Las Vegas and the Mojave Desert show similar overall patterns. For both locations, Cladosporium and smuts had higher counts during the warmer months (March-September), which is consistent with expected trends for airborne molds. Although the Mojave location had a slightly lower mean concentration than Las Vegas, both Cladosporium and smut levels were higher in the Mojave site. Higher variation in the types of molds was observed at the Las Vegas site.