Microbial air quality at Szczawnica sanatorium, Poland.
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Department of Microbiology, University of Agriculture, Kraków, Poland.
Biohazard Laboratory, Department of Chemical and Aerosol Hazards, Central Institute for Labour Protection – National Research Institute, Warsaw, Poland
Corresponding author
Krzysztof Frączek   

Department of Microbiology, University of Agriculture, Mickiewicza Avenue 24/28, 30-059 Krakow, Poland
Ann Agric Environ Med. 2011;18(1):63-71
Nowadays, sanatorium treatment is undergoing a renaissance; however, data on air quality in such premises are scarce. The aim of this study was to characterize microbial air quality at the Szczawnica sanatorium in Southern Poland. The bioaerosol measurements were carried out using a 6-stage Andersen impactor over a period of one year in 3 naturally ventilated sanatorium premises (where different curative treatments took place) and in outdoor air. The indoor and outdoor concentrations of fungal aerosol were always below 1,600 cfu/m3. With regard to bacterial contamination, the highest concentrations (up to 6,223 cfu/m3 were usually noted when the patients were present and underwent curative procedures. Such concentrations crossed the Polish threshold limit values, which suggest that natural ventilation in this type of premises did not ensure the proper air quality; therefore a high-performance ventilation or air-conditioning system should be introduced to provide the clean air into the curative treatment rooms. Qualitative evaluation of bioaerosols revealed that the most prevalent indoors were Gram-positive cocci, mesophilic actinomycetes, and filamentous fungi. Analysis of microclimate parameters confirmed that ony relative humidity of the air influenced significantly the levels and composition of microbial aerosols. Hence, the constant control of this parameter should be scrupulously supervised at sanatorium premises.
Adhikari A, Reponen T, Grinshpun SA, Martuzevicius D, LeMasters G: Correlation of ambient inhalable bioaerosols with particulate matter and ozone: A two-year study. Environ Pollut 2006, 140, 16–28.
Alkiewicz J: Modern trends of inhaled therapy. Rev Fr Allergol 1999, 39, 72-73. 3. Amirav I: Aerosol therapy. Ital J Pediatr 2004, 30, 147–156.
Anderson K, Morris G, Kennedy H, Croall J, Michie J, Richardson MD, Gibson B: Aspergillosis in immunocompromised patients: associations with building hygiene, design and indoor air. Thorax 1996, 51, 256–261.
Anderson SD, Spring J, Moore B, Rodwell LT, Spalding N, Gonda I, Chan K, Walsh A, Clark AR: The effect of inhaling a dry powder of sodium chloride on the airways of asthmatic subjects. Eur Respir J 1997, 10, 2465–2473.
Araujo R, Cabral JP, Rodrigues AG: Air fi ltration systems and restrictive access conditions improve indoor air quality in clinical units: Penicillium as a general indicator of hospital indoor fungal levels. Am J Infect Control 2008, 36, 129–134.
Atlas RM: Handbook of Microbiological Media. CRC Press, Boca Raton 2004.
Beggs CB, Kerr KG, Noakes CJ, Hathway A, Sleigh A: The ventilation of multiple-bed hospital wards: review and analysis. Am J Infect Control 2008, 36, 250–259.
Bihari-Axelsson S, Axelsson R: The role of sanatoriums and health resorts in the Russian Federation. Health Policy 2002, 59, 25–36.
Bis H, Barabasz W, Grzyb J, Fraczek K: Occurrence of Actinomycetes in the air of sanatorium chambers at Bochnia and Wieliczka salt mines. Zeszyty Problemowe Postępów Nauk Rolniczych 2004, 501, 43–49 (in Polish).
Bis H, Grzyb J, Barabasz W, Frączek K: Prevalence of fungi – Micromycetes in the health resort chambers in Bochnia and Wieliczka salt mines. Acta Agraria Silvestria, Ser Agraria 2004, 42, 29–39 (in Polish).
Burkowska A, Donderski W: Airborne molds in the air of Ciechocinek spa. Pol J Nat Sci 2008, 23, 790–800.
Chervinskaya AV: Halotherapy of respiratory diseases. Physiother Balneol Rehabil 2003, 6, 8–15.
Chervinskaya AV: Respiratory hygiene in health resort medicine. In: Proceedings of the 35th Congress of the International Society of Medical Hydrology and Climatology, Istanbul, June 6–10, 2006, OP-2.P.86.
Chervinskaya AV, Zilber NA: Halotherapy for treatment of respiratory diseases. J Aerosol Med 1995, 8, 221–232.
Cienciała M, Smyk B, Bukowski Z, Kukliński P: Formation of the air microfl ora at allergological centers in Szczawnica and Kraków. Pol Balneol 1968, 13, 265–273 (in Polish).
Daviskas E, Anderson SD, Gonda I, Eberl S, Meikle S, Seale JP, Bautovich G: Inhalation of hypertonic saline aerosol enhances mucociliary clearance in asthmatic and healthy subjects. Eur Respir J 1996, 9, 725–732.
Degobbi C, Lopes F, Carvalho-Oliveira R, Muñoz JE, Saldiva P: Correlation of fungi and endotoxin with PM2.5 and meteorological parameters in atmosphere of Sao Paulo, Brazil. Atmos Environ 2011, 45, 2277–2283.
Doleżal M, Doleżal M, Żuława G: Microfl ora of subterranean chambers in Wieliczka Subterraneotherapy Centre. Biopollut Build Health 1983, 35, 55–65 (in Polish).
Domsch KH, Gams W, Traute-Heidi A: Compedium of Soil Fungi. Harcourt Brace Jovanovich Publishers, Academic Press, London 1980.
Donaldson SH, Bennett WD, Zeman KL, Knowles MR, Tarran R, Boucher RC: Mucus clearance and lung function in cystic fi brosis with hypertonic saline. N Engl J Med 2006, 354, 241–250.
Douwes J, Thorne P, Pearce N, Heederik D: Bioaerosol health effects and exposure assessment: progress and prospects. Ann Occup Hyg 2003, 47, 187–200.
Elkins MR, Robinson M, Rose BR, Harbour C, Moriarty CP, Marks GB, Belousova EG, Xuan W, Bye PT, National Hypertonic Saline in Cystic Fibrosis (NHSCF) Study Group: A controlled trial of long-term inhaled hypertonic saline in patients with cystic fi brosis. N Engl J Med 2006, 354, 229–240.
Fassatiowa O: Microscopic Fungi in Technical Microbiology. Scientifi c and Technical Publishing, Warsaw 1983 (in Polish). 25. Fiegel J, Clarke R, Edwards DA: Airborne infectious disease and the suppression of pulmonary bioaerosols. Drug Discov Today 2006, 11, 51–57.
Flannigan B, McCabe EM, McGarry F: Allergenic and toxigenic microorganisms in houses. J Appl Bacteriol 1991, 70 (Suppl.), 61–73.
Flannigan B, Samson RA, Miller JD (Eds): Microorganisms in Home and Indoor Work Environments. Taylor and Francis, New York 2001.
Frączek K, Grzyb J, Górny RL, Wlazło A: Biological aerosol in the premises of Szczawnica health resort. Ecol Tech 2008, 4, 150–154 (in Polish).
Garavello W, Romagnoli M, Sordo L, Gaini RM, Berardino C, Angrisano A: Hypersaline nasal irrigation in children with symptomatic seasonal allergic rhinitis: A randomized study. Pediatr Allergy Immunol 2003, 14, 140–143.
Gołofi t-Szymczak M, Górny RL: Bacterial and fungal aerosols in air-conditioned offi ce buildings in Warsaw, Poland – preliminary results (winter season). Int J Occup Saf Ergon 2010, 16, 407–418.
Górny RL: Aerozole biologiczne – rola normatywów higienicznych w ochronie środowiska i zdrowia. Med Środowiskowa 2010, 13, 41–51.
Górny RL, Dutkiewicz J: Bacterial and fungal aerosols in indoor environment in Central and Eastern European countries. Ann Agric Environ Med 2002, 9, 17–23.
Górny RL, Mainelis G, Grinshpun SA, Willeke K, Dutkiewicz J, Reponen T: Release of Streptomyces albus propagules from contaminated surfaces. Environ Res 2003, 91, 45–53.
Górny RL, Wlazło A, Krysińska-Traczyk E, Strzelczyk AB, Lis DO, Łudzeń-Izbińska B, Sokal JA: Microbial contamination of waterdamaged storerooms at libraries. Proc Indoor Air 2005, 2, 1464–1468.
Grinshpun SA, Reponen T, Willeke K: Aerosol characteristics of airborne actinomycetes and fungi. J Aerosol Sci 1997, 28, 667–668.
Hedman J, Hugg T, Sandell J, HaahtelaT: The effect of salt chamber treatment on bronchial hyperresponsiveness in asthmatics. Allergy 2006, 61, 605–610.
Helben J, Kolarzyk E: Natural environment advantages in pharmacological treatment stimulation. Prob Hyg Epidemiol 2005, 86, 22–26.
Institute of Medicine: Damp Indoor Spaces and Health. The National Academies Press, Washington 2004.
Jo W-K, Seo YJ: Indoor and outdoor bioaerosol levels at recreation facilities, elementary schools, and homes. Chemosphere 2005, 61, 1570–1579.
Jones AM, Harrison RM: The effects of meteorological actors on atmospheric bioaerosol concentrations – a review. Sci Total Environ 2004, 326, 151–180.
Kalogerakis N, Paschali D, Lekaditis V, Pantidou A, Eleftheriadis K, Lazaridis M: Indoor air quality – bioaerosol measurements in domestic and offi ce premises. J Aerosol Sci 2005, 36, 751–761.
Kleinheinz GT, Langolf BM, Englebert E: Characterization of airborne fungal levels after mold remediation. Microbiol Res 2006, 161, 367–376.
Krikštaponis A: Diversity of Fungi Species in Occupational and Residential Environments and Their Biological Peculiarities (Toxicity, Pathogenicity, Proteolytic, Lipolytic, and Cellulolytic Activity). Ph.D. thesis. Institute of Botany, Vilnius 2000.
Lee J-H, Jo W-K: Characteristics of indoor and outdoor bioaerosols at Korean apartment buildings. Environ Res 2006, 101, 11–17.
Lee T, Grinshpun SA, Martuzevicius D, Adhikari A, Crawford CM, Reponen T: Culturability and concentration of indoor and outdoor airborne fungi in six single-family homes. Atmos Environ 2006, 40, 2902–2910.
Leung M, Chan AHS: Control and management of hospital indoor air quality. Med Sci Monit 2006, 12, 17–23.
Lis DO, Pastuszka JS, Górny RL: The prevalence of bacterial and fungal aerosol in homes, offi ces and ambient air of Upper Silesia. Preliminary results. Roczn PZH 1997, 48, 59–68 (in Polish).
Macher J (Ed.): Bioaerosols: Assessment and Control. American Conference of Governmental Industrial Hygienists, Cincinnati 1999.
Mancinelli RL, Shulls WA: Airborne bacteria in an urban environment. Appl Environ Microbiol 1978, 35, 1095–1101.
Marcinowska K: Characteristic, Occurrence and Importance of Actinomycetales in Nature. Microorganisms’ Activity in Various Environments. Academy of Agriculture, Kraków 2002 (in Polish).
Martins-Diniz JN, Da Silva RAM, Mendes-Gianini E: Monitoring of airborne species in a hospital unit. Rev Saude Publica 2005, 39, 1–7.
McCorkle RG: The patient and the sanatorium. Chest 1935, 1, 17–18.
Nourian AA, Badali H, Khodaverdi M, Hamzehei H, Mohseni S: Airborne mycofl ora of Zanjan – Iran. Int J Agric Biol 2007, 9, 628–630.
Nunes ZG, Martins AS, Altoe AL, Nishikawa MM, Leite MO, Aguiar PFL, Fracalanzza SE: Indoor air microbiological evaluation of offi ces, hospitals, industries, and shopping centers. Mem Inst Oswaldo Cruz 2005, 100, 351–357.
O’Gorman CM, Fuller HT: Prevalence of culturable airborne spores of selected allergenic and pathogenic fungi in outdoor air. Atmos Environ 2008, 42, 4355–4368.
Pastuszka JS, Paw U KT, Lis D, Wlazło A, Ulfi g K: Bacterial and fungal aerosol in indoor environment in Upper Silesia, Poland. Atmos Environ 2000, 34, 3833–3842.
Prunk A, Azman J, Frkovic V, Skrobonja A, Muzur A: Physician Albin Eder and his contribution to the development of health resorts in the Northern Adriatic area. Publ Health 2008, 122, 1131–1133.
Raper KB, Fennel DI: The Genus Aspergillus. Williams and Wilkins Co., Baltimore 1965.
Reponen TA, Gazenko SV, Grinshpun SA, Willeke K, Cole EC: Characteristics of airborne actinomycete spores. Appl Environ Microbiol 1998, 64, 3807–3812.
Roberts K, Hathway A, Fletcher LA, Beggs CB, Elliott MW, Sleigh PA: Bioaerosol production on a respiratory ward. Indoor Built Environ 2006, 15, 35–40.
Samson RA, Hoekstra ES, Frisvad JC: Introduction to Food– and Airborne Fungi. 7th Ed. Centraalbureau voor Schimmelcultures, Utrecht 2004.
Szczegielniak J, Migała M: Meaning of microclimate of caves in a health resort medical care. Ann Univ Mariae Curie Sklodowska Med 2003, 243, 219–223 (in Polish).
Tsai FC, Macher JM, Hung YY: Biodiversity and concentrations of airborne fungi in large US offi ce buildings from the BASE study. Atmos Environ 2007, 41, 5181–5191.
Wanner H, Verhoeff A, Colombi A, Flannigan B, Gravesen S, Mouilleseaux A, Nevalainen A, Papadakis J, Seidel K: Indoor Air Quality and its Impact on Man: Report No. 12: Biological Particles in Indoor Environments. ECSC-EEC-EAEC, Brussels-Luxembourg 1993.
Wlazło A, Górny RL, Złotowska R, Ławniczek A, ŁudzieńIzbińska B, Harkawy AS, Anczyk E: Workers exposure to selected biological agents in libraries of Upper Silesia. Med Pr 2008, 59, 159–170 (in Polish).
World Health Organization: WHO Guidelines for Indoor Air Quality: Dampness and Mould. WHO Regional Offi ce for Europe, Copenhagen 2009.
Zhilina LP, Dobrodceeva LK: Features of the physical state of schoolchildren before and after a stay at a sanatorium. Human Physiol 2005, 31, 142–144.
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