ArticlePDF AvailableLiterature Review

Abstract and Figures

Most investigations into the correlation between exposure to fungi and detrimental health effects focus on the 2-4 most prevalent genera in ambient air, both outdoors and indoors. Yet over 80 genera of fungi have been shown to have allergenic potential. Also, there is no agreement about threshold values for exposure to fungi. One of the fungal genera expected to be less prevalent in ambient air and known to cause allergy is Botrytis. In this review, we investigate the airborne exposure level and health effect of Botrytis, both at general exposure and in occupational settings. The surveyed papers show that Botrytis is found globally with different spore seasons depending on the region investigated. The levels of Botrytis in the percentage of all fungi have a calculated median of around 1.1% in the different environments, confirming that it is among the less prevalent fungi. Furthermore, a substantial proportion of patients and workers are allergic to Botrytis cinerea, and when B. cinerea was included in extended test panels additional allergic patients were found. Thus, B. cinerea is as important as the more prevalent mould genera Cladosporium and Alternaria and we suggest that it should be included in standard allergic tests panels.
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INTRODUCTION
Allergy and asthma induced by fungi have been known
for many years. In connection with allergy and asthma, the
typical fungal genera investigated are Cladosporium, Alter-
naria, Aspergillus and Penicillium, probably because they
are very often the most prevalent genera in ambient air.
However, the diversity of species can be rather high, both
within the 2–4 most prevalent genera and in less prevalent
genera. Lugauskas et al. [60] found, for example, 100 genera
containing 359 species when investigating the fungal com-
position indoors. Furthermore, many fungal species from at
least 80 genera, have been shown to have allergenic poten-
tial. One of these fungi present in ambient air is Botrytis ci-
nerea [13, 23, 56, 58]. Therefore, it is problematic to choose
only to investigate the most prevalent fungal genera.
Clarifying the causality between exposure and aller-
gy and respiratory symptoms is complicated by several
factors. For example, once an allergy is conrmed it is dif-
cult to work out where and when there has been exposure
to the allergen, e.g. at work or at home. Furthermore, there
does not seem to be any correlation between the ability to
induce allergy and a fungus’ proportional amount of the
total fungal spore level [7, 31, 32, 97]. Hence, it has still
not been claried how and at what exposure level fungi
cause illnesses in occupational settings, as well as at gen-
eral exposure [23, 26, 56, 84]. However, for non-specic
symptoms like coughing and irritation of nose and eyes,
Eduard et al. [28] found a correlation in Norwegian farm-
ers between these symptoms and exposure to total fungal
spore levels above 2 × 104 spores/m3, but they found no
correlation with wheezing and chest tightness.
However, a correlation between occupational asthma
and sensitisation to mould and ower-allergens has been
found for greenhouse workers. These greenhouse workers
have a higher prevalence of occupational asthma than the
EXPOSURE TO THE AIRBORNE MOULD BOTRYTIS AND ITS HEALTH EFFECTS
Claudia Würtz Jürgensen, Anne Mette Madsen
The National Research Centre for the Working Environment, Copenhagen, Denmark
Jürgensen CW, Madsen AM: Exposure to the airborne mould Botrytis and its health ef-
fects. Ann Agric Environ Med 2009, 16, 183–196.
Abstract: Most investigations into the correlation between exposure to fungi and detri-
mental health effects focus on the 2–4 most prevalent genera in ambient air, both outdoors
and indoors. Yet over 80 genera of fungi have been shown to have allergenic potential.
Also, there is no agreement about threshold values for exposure to fungi. One of the
fungal genera expected to be less prevalent in ambient air and known to cause allergy
is Botrytis. In this review, we investigate the airborne exposure level and health effect
of Botrytis, both at general exposure and in occupational settings. The surveyed papers
show that Botrytis is found globally with different spore seasons depending on the region
investigated. The levels of Botrytis in the percentage of all fungi have a calculated me-
dian of around 1.1% in the different environments, conrming that it is among the less
prevalent fungi. Furthermore, a substantial proportion of patients and workers are allergic
to Botrytis cinerea, and when B. cinerea was included in extended test panels additional
allergic patients were found. Thus, B. cinerea is as important as the more prevalent mould
genera Cladosporium and Alternaria and we suggest that it should be included in stand-
ard allergic tests panels.
Address for correspondence: Anne Mette Madsen, The National Research Centre for
the Working Environment, Lersø Parkallé 105, DK-2100 Copenhagen Ø, Denmark.
E-mail: amm@nrcwe.dk
Key words: allergy, Botrytis, fungi, indoor air, mould, occupational exposure,
outdoor air, season, spore calendar.
Received: 31 August 2009
Accepted: 16 November 2009
Ann Agric Environ Med 2009, 16, 183–196
REVIEW ARTICLES AAEM
- - - - -
184 Jürgensen CW, Madsen AM
general European population [67]. Interestingly, the preva-
lence of Botrytis ranks high in greenhouses [67, 79]. The
aim of this study is to review the exposure level and health
effects of airborne Botrytis, both at general exposure and
in occupational settings. Thus, we have made an effort to
compile and standardise literature data in order to obtain an
overview of the current knowledge of exposure levels and
health effects of Botrytis spp. and B. cinerea.
Sources of exposure to Botrytis cinerea
The mould B. cinerea has been isolated from numerous
places around the world, but the main occurrence is in hu-
mid, temperate and subtropical regions. It is considered to
be the most prevalent of the 25 species belonging to the
genus Botrytis. The fungus grows either parasitically or
saprophytically on a vast majority of plants, vegetables and
soft fruits, and can cause substantial crop losses, especially
in greenhouses, while other Botrytis species have narrower
host ranges [25, 29, 59].
B. cinerea is described as a hydrophilic fungus which
needs a minimum water activity of 0.9, a requirement
thought to be adequately met by host tissue [29, 30]. Like-
wise, the conidia of B. cinerea require freely accessible
water or a very high relative humidity to germinate [29].
The conidia of B. cinerea are mainly airborne and their
release is regulated by a hygroscopic mechanism after a
drop in humidity and air movements, such as rain splashes,
that can release large numbers [25, 29]. Thus, in a green-
house with geranium cuttings Hausbeck et al. [40] found
that any activity that resulted in air movement, such as
planting, irrigation, cleaning, fertilization and even spray-
ing fungicides, raised conidia levels substantially. Simi-
larly, a survey of the mycological ora of French wine
cellars by Simeray et al. [94] showed a large amount of
viable spores of B. cinerea after grape pressing activity in
one cellar compared to the other storage cellars. Likewise,
an investigation in Finland of the airborne fungi present in
water-damaged buildings before and after reconstruction
showed B. cinerea viable spores were only found during
demolition activity [82]. A higher prevalence of Botrytis
spp. indoors is also mentioned as a possible indicator of
excess water indoors in the BASE study of US ofce build-
ings [63]. Thus, in conjunction with its need for available
water, Botrytis may be thought of as an indicator fungus for
water damage in buildings.
Aus tria H
Aus tria L
Braz il
Croa tia
Den mark
Egy pt
Fin lan d
Greec e
Italy a
Italy b
Italy c
Italy d
Iran
Medi terrane an S ea*
Portu gal
Spa in
Sw eden
Tai wa n
US A
Ave rage , 2.3
Aus tralia a *
Aus tralia b *
Fran ce c*
Fran ce t*
Neth erla nds a
Neth erla nds b
Neth erla nds c
Netherlands d
Pol and c *
Pol and t*
Portu gal c
Portu gal t
Turke y med ian*
UK
Medi an, 1.2
Country
% of all airborne fungi
18
16
14
12
10
8
6
4
2
0
Figure 1. Prevalence of outdoor Botrytis in percent of all airborne fungi (black bars). More detailed information on the data can be found in Table 1.
Calculated average and median of the presented data (grey bars). *Numbers calculated from paper data. References for the presented data: Australia
a = [53], Australia b = [36], Austria H (high altitude) and L (low altitude) = [27], Brazil= [66], Croatia = [75], Denmark = [57], Egypt = [2], Finland =
[80], France c (country) and t (city) = [92], Greece = [32], Italy a = [76], Italy b = [22], Italy c (Cagliari) and d (Perugia) = [4], Iran = [41], Eastern Medi-
terranean Sea = [100], The Netherlands a and b = [97], The Netherlands c = [7], The Netherlands d = [8], Poland c (country) and t (city) = [51] average
of 2 years, Portugal c (country) and t (city) = [73], Spain = [43], Sweden = [70], Taiwan = [102], Turkey median* = [18], UK = [44], USA = [17].
- - - - -
Exposure to the airborne mould Botrytis and its health effects 185
Table 1. Outdoor prevalence of airborne Botrytis found in different environments and countries.
Species/
Specication of environment
Exposure
level
CFU/m3
%
positive
samples
%
of all
fungi
Sampling and
identication
method
Country,
number of samples
and sampling time
Ref.
B. cinerea
The roof of an ofce building in Perth 10 0.97* Andersen sampler,
MEA
Australia,
1 day,
November
[53]
6 different districts in Istanbul 1.5 m above
ground
0 -2.673
Med.
1.5*
Passive sedimentation
SMA plates, MEA,
CZD and PDA
Turkey,
November 2001–
September 2002
[18]
Botrytis, Botrytis sp. and Botrytis spp.
A roof 3.5 m above ground in a town park 0.3* 7-day Burkard spore
trap, microscopy
Australia,
1 sample, 2002
[36]
A roof 25 m above ground in Thessaloniki Annual av. 1118 0.64 Burkard spore trap,
microscopy
Greece,
1987–2001
[32]
Different regions of Croatia 1.5 m above
ground
Av. 0.026* 0.4* Passive sedimentation
SA-plates, CZ, MEA
and PSA
Croatia,
1 year,
1998
[75]
City of Turku 2.0 Andersen sampler Finland,
1982–1983
[80]
A balcony in the city of Oerebro 1.3 Passive sedimentation
plates, MSA
Sweden,
18 months,
1946–1947
[70]
A roof in Copenhagen 0.8 Biap Slit-sampler, V8
agar
Denmark,
1977–1979
[57]
Not specied 2.4 Passive sedimentation
plates
UK,
1951–1953
[44]
In the city of Rzeszów 12 m above ground,
2001
Peak day 418 2 Hirst type spore trap,
microscopy
Poland,
Spring 2001–2002
[51]
The countryside 12 m above ground, 2001 Peak day 726 3.6 Hirst type spore trap,
microscopy
Poland,
Spring 2001–2002
[51]
In the city of Rzeszów 12 m above ground,
2002
Peak day 213 1.1 Hirst type spore trap,
microscopy
Poland,
Spring 2001–2002
[51]
The countryside 12 m above ground, 2002 Peak day 475 2.5 Hirst type spore trap,
microscopy
Poland,
Spring 2001–2002
[51]
Based on data from different studies not
specied
2-20 – Europe [96]
The city of Leiden Seasonal total of
daily concentra-
tion 25665
2.7 Burkard sampler The Netherlands,
1980
[97]
The city of Groningen 8.6 Burkard sampler The Netherlands [97]
A roof in the city of Beatrixoord 8.6 Andersen sampler,
YMA
The Netherlands,
1981–1983
[7]
Gardens of 28 asthmatic patients
(17 in the city)
17 Andersen sampler,
YMA
The Netherlands,
1981–1982
[8]
Low altitude on a roof 20 m above ground Annual total
579
2.4 Jet spore sampler Austria,
1 year, 1989–1990
[27]
High altitude 1 m above ground Annual total 63 1.1 Jet spore sampler Austria,
1 year, 1989–1990
[27]
The city of Besançon 0.6 and
1.5
SAS sampler, MEA,
MESA and SDA
France,
1989–1990
[92]
The rural area of Emagny 0.2 and
0.7
SAS sampler, MEA,
MESA and SDA
France,
1989–1990
[92]
A roof 20 m above ground level in the city
of Porto
1.3 Burkard sampler,
microscopy
Portugal,
1 year,
2003
[72]
- - - - -
186 Jürgensen CW, Madsen AM
Species/
Specication of environment
Exposure
level
CFU/m3
%
positive
samples
%
of all
fungi
Sampling and
identication
method
Country,
number of samples
and sampling time
Ref.
Botrytis, Botrytis sp. and Botrytis spp.
A roof 20 m above ground level in the city
of Porto
1 Hirst Type Spore Trap,
microscopy
Portugal
3 years, 2005–2007
[73]
A farm 5 m above ground level in the rural
area of Amares
1 Hirst Type Spore Trap,
microscopy
Portugal
3 years, 2005–2007
[73]
A roof 8 m above ground in Madrid Annual total
625
0.29 Hirst Type Spore Trap Spain
2003
[43]
The city of Cagliari 2.9 Burkard type Hirst
trap collector
Italy
January–August 1990
[4]
The city of Perugia 0.6 Burkard type Hirst
trap collector
Italy
January–August 1990
[4]
Two squares in Milan 1 m above ground 0.77* Passive sedimentation
PDA plates
Italy
1 year, 1995–1996
[76]
A ship 3 m above sea level 0-1* Burkard Spore Trap The Eastern Mediter-
ranean Sea
5 days in July 2005
[100]
Surface train station in Cairo in the
breathing zone
0 AGI-30 sampler, MEA Egypt
May–July 1997
[2]
1-1.5 m above ground, homes of 90
asthmatic patients
0.47* Passive sedimentation
MEA plates
Iran
3 months, 2004
[41]
A roof 23 m above ground in the city of
Porto Alegre
1.22 Rotorod sampler®,
microscopy
Brazil
1 year, 2000–2001
[66]
1 m above ground outside homes in the
city of Tampa
5.9 Air-O-Cell cassettes,
microscopy
USA, 2 samples
Summer 2004
[17]
Shin-Jhuang and Shi-Men 14.1 0.22* Burkard sampler,
MEA
Taiwan
2003–2004
[102]
A city park in Shin-Jhuang 24.1 Burkard sampler,
MEA
Taiwan
2003–2004
[102]
The rural township of Shi-Men 5.7 Burkard sampler,
MEA
Taiwan
2003–2004
[102]
The homes of 40 mould sensitive asthmatic
children, Bronx
5.0 Burkard sampler,
DG-18
USA, 2 samples/home
1998–1999
[74]
The homes of 48 mould sensitive asthmatic
children, New York
6.3 Burkard sampler,
DG-18
USA, 2 samples/home
1998–1999
[74]
The homes of 44 mould sensitive asthmatic
children, Boston
4.5 Burkard sampler,
DG-18
USA
2 samples/homes
1998–1999
[74]
The homes of 54 mould sensitive asthmatic
children, Chicago
3.7 Burkard sampler,
DG-18
USA
2 samples/home
1998–1999
[74]
The homes of 95 mould sensitive asthmatic
children, Dallas
3.2 Burkard sampler,
DG-18
USA
2 samples/home
1998–1999
[74]
The homes of 81 mould sensitive asthmatic
children, Tucson
0.0 Burkard sample,
DG-18
USA
2 samples/home
1998–1999
[74]
The homes of 52 mould sensitive asthmatic
children, Seattle
25.0 Burkard sampler,
DG-18
USA
2 samples/home
1998–1999
[74]
Abbreviations used in the Tables: CM: Cornmeal agar, CZ: Czapek agar, CZD: Czapek-Dox agar, DG-18: Dichloran Glycerol agar, HS: not specied,
MEA: Malt Extract agar, MESA: Malt Extract Sucrose agar, MSA: Modied Sabouraud agar, PDA: Potato Dextrose agar, PSA: Potato Sucrose agar,
RBA: Rose Bengal agar, SA: Sabouraud agar, SDA: Sabouraud Dextrose agar, SMA: Sabouraud Maltose agar, YMA: Yeast Morphology agar. App.: ap-
proximately, Av.: values presented as averages or means in the papers, Med.: median, Ref.: reference. *Numbers followed by an * are values calculated
from the data presented in the papers or Figures.
Table 1. Outdoor prevalence of airborne Botrytis found in different environments and countries (continuation).
- - - - -
Exposure to the airborne mould Botrytis and its health effects 187
Botrytis prevalence in outdoor air
The majority of papers on the mycological ora of ambi-
ent air investigate the airborne fungi of cities and they of-
ten only identify fungi to genus level. This also holds true
for B. cinerea, and as a consequence we studied data from
papers concerning Botrytis, Botrytis sp., Botrytis spp. and
B. cinerea, hereafter referred to as Botrytis.
In Table 1 which shows the prevalence of Botrytis out-
doors, the few available data do not indicate an apparent
difference in the level of exposure between the city and the
countryside. Even though most data come from Europe,
studies show that airborne Botrytis can be found in many
places around the world (Tab. 1).
The outdoor occurrence of Botrytis in the percentage of
all fungi is shown in Figure 1 and ranges between 0%–17%,
with a median of 1.2%, conrming it to be a fungus with a
low prevalence in ambient air. The Netherlands stand out
by having a relatively high prevalence of Botrytis ranging
from 2.7%–17%.
When trying to estimate the exposure level of Botrytis
expressed in CFU/m3 it becomes clear that not only the
methods used vary, but also the way in which data is pre-
sented. Terms like annual total, seasonal total, daily con-
centration, daily average, average and peak day are used,
which make it difcult to compare data. However, an ap-
proximation of Botrytis CFU/m3 per day lies between 0.02
CFU/m3 and 726 CFU/m3 (Tab. 1), and an approximation
of an annual total lies between 63 CFU/m3–39,735 CFU/m3
(Tab. 1) [69]. In comparison, the outdoor concentration of
viable fungi as reviewed by the Robert Koch Institute [84]
can be around or below 100 CFU/m3 in wintertime, and
around or well above 2,000 CFU/m3 in summertime.
Botrytis prevalence in indoor air
The indoor/outdoor ratio of fungal spores is usually less
than 1 [31, 33, 56]. This seems not to be the case for Botrytis
in non-complaint homes compared with outdoor prevalenc-
es (Tab. 1 vs. Tab. 2). The annual total of Botrytis CFU/m3 at
Table 2. Indoor prevalence of airborne Botrytis in different non-complaint environments and countries.
Species/Specication of
environment
Exposure level
CFU/m3
% positive
samples
% of all fungi Sampling and
identication method
Country, number of
samples and sampling
time
Ref.
B. cinerea
1.5 m above ground, 6 dif-
ferent districts in Istanbul
0 -2.083 Med.
1.3*
Passive sedimentation
SMA plates, MEA,
CZD and PDA
Turkey,
November 2001–
September 2002
[18]
1.5 m above ground, 49
non-complaint urban and
suburban homes
0.28 Standard RCS centrifu-
gal sampler, MEA
Argentina,
1 day in 2002 and 2003
[6]
Auditoria app. 1 m above
ground
<1.0 RCS centrifugal Sam-
pler, RBA
Canada,
11 samples
[88]
Auditoria app. 1 m above
ground
0 Andersen N6 sampler,
RBA
Canada,
11 samples
[88]
Botrytis
39 schools 1 m above
ground
Av. 1-21 Andersen N6 sampler,
MEA
Canada,
1996–1997
[5]
Two underground stations
1 m above oor level
0.9* Passive sedimentation
PDA plates
Italy,
1 year,
1995–1996
[76]
In the breathing zone at a
Cairo underground station
2.44 AGI-30 sampler, MEA Egypt,
May–June 1997
[2]
1 m above ground low
altitude lounge
Annual total
490
3.4 Jet spore sampler Austria, 1 year,
1989–1990
[27]
1.5 m above ground low
altitude kitchen
Annual total
609
4.8 Jet spore sampler Austria, 1 year,
1989–1990
[27]
1.5 m above ground high
altitude station
Annual total
166
1.3 Jet spore sampler Austria, 1 year,
1989–1990
[27]
1 m above ground in 18
non-complaint homes,
rainy season
0 Air-O-Cell
cassettes,
microscopy
USA,
3 samples,
2004
[17]
9 non-complaint homes 11* Electrostatic dust
sampler (ALF-75),
MEA
Sweden [71]
For abbreviations see Table 1.
- - - - -
188 Jürgensen CW, Madsen AM
low alpine altitude lies between 490 CFU/m3–609 CFU/m3
indoors, and 579 CFU/m3 outdoors [27]. The correspond-
ing annual total at high alpine altitude in indoor air is 166
CFU/m3 while the outdoor value is 63 CFU/m3. At high
altitude, the indoor/outdoor ratio was also more than 1 for
the total fungi counts [27].
The CFU/mg dust for Botrytis could be up to 40 in non-
complaint homes and up to 600 in complaint homes [71].
The indoor prevalence of Botrytis in percent in non-com-
plaint environments and homes ranges between 0%–4.8%,
with a calculated median of 1.1% (Fig. 2).
The indoor prevalence of Botrytis in complaint environ-
ments and homes ranges from 0.9%–5.5%, with a calculat-
ed median of 2.0% (Tab. 3 and Fig. 3). This is higher than
the medians for both indoor non-complaint environments
and homes, as well as for outdoor air. Furthermore, Sharma
et al. [90] found an average of 112 CFU/m3 Botrytis sp. per
measurement in the homes of allergic patients in India, and
that the level of indoor Botrytis exposure was substantially
higher than outdoor exposure. Even though there are few
data for complaint environments and the methods used to
obtain data greatly differ, it is notable that there is a ten-
dency for a higher Botrytis level in complaint homes than
in non-complaint environments.
Botrytis prevalence in occupational settings
The indoor prevalence of Botrytis in different working
environments ranges between 0%–11.6%, with a calculated
median of 1.0% for indoor measurements and 0.4% for out-
door measurements (Fig. 4). As expected, Botrytis exposure
is relatively high in environments such as greenhouses, and
grain mills, and for one measurement, in a wine cellar dur-
ing grape pressing, although the outdoor value for the grain
mill was also rather high (Tab. 4). Surprisingly, the preva-
lence of Botrytis was low at an Indian fruit market. Most
interestingly, for Egypt, it is notable that for both a subway
station (Fig. 2) and a ourmill (Fig. 4), Botrytis was found
only indoors. This could be due to its requirement for high
water availability, implying that it in Egypt could be dened
as an indoor fungus. The approximate exposure to Botrytis
indoors in occupational settings ranges from below the de-
tection level to 125 CFU/m3 (Tab. 4).
Factors affecting the inammatory and allergenic
potential of Botrytis
B. cinerea is generally not described or shown as a my-
cotoxin-producing fungus [1, 61, 62, 89, 99], although one
study found that it had ciliostatic activity in a chicken tra-
chea bio-assay [77]. Like other fungi, B. cinerea contains
(1→3)-β-D-glucan and chitin in its cell wall. Studies have
shown that fungal (1→3)-β-D-glucan can elicit respiratory
inammation [11, 87, 91, 98]. Moreover, a recent study
indicates that chitin may also be involved in allergic reac-
tions upon frequent exposure [14].
Denning et al. [23] reviewed proteins approved as fungal
allergens, and many of them seem to be involved in spore
Arge nti na h om es
Ca n ad a Aud ito ria a <1
Ca n ad a A ud ito ria b
US A h om e s
Av era ge, 1.5
Au stri a lo u ng e L
Au stri a K itc he n L
Au stri a ski sta tio n H
Eg ypt su bw ay
Ital y su bw a y*
Tu rke y hom es*
Me di an , 1.1
0
1
2
3
4
5
6
Country
% of all airborne fungi
Iran*
USA *
Median , 2.0
Australi a
Netherlands d
Averag e, 2.6
0
1
2
3
4
5
6
Country
% of all fungi
Figure 3. Prevalence of Botrytis in percent of all fungi in indoor homes
of patients and complaint homes (black bars). More detailed description
of the data can be found in Table 3. Calculated average and median of the
presented data (grey bars). *Numbers calculated from paper data. Refer-
ences for the presented data: Australia = [31], Iran = [41], The Nether-
lands d = [8], USA = [85].
Figure 2. Prevalence of Botrytis in percent of all airborne fungi in in-
door non-complaint environments (black bars), i.e. neither occupants nor
investigators have reported health concerns. More detailed information
on the data can be found in Table 2. Calculated average and median of
the presented data (grey bars). *Numbers calculated from paper data.
References for the presented data: Argentina = [6], Austria lounge L and
kitchen L (low altitude) and ski station H (high altitude) = [27], Canada
auditoria a and b = [88], Egypt subway = [2], Italy subway = [76], Turkey
homes = [18], USA homes = [17].
- - - - -
Exposure to the airborne mould Botrytis and its health effects 189
Table 3. Indoor prevalence of airborne Botrytis in complaint and patients’ homes.
Species Specication
of environment
Exposure
level
CFU/m3
%
positive
samples
%
of all
fungi
Sampling
and identication
method
Country,
number of
samples and
sampling time
Ref.
Botrytis spp. Homes of asthmatic patients Total
for 21
months
104283
13.5Andersen sampler, YMA The Netherlands
21 months
1981–1982
[8]
Botrytis spp. Homes of 28 asthmatic
patients (17 in the city)
82 5.5 Andersen sampler, YMA The Netherlands
1981–1982
[8]
Botrytis Homes of 90 asthmatic
patients, city of Sari
100 0.9* Passive sedimentation plates,
MEA
Iran
2004
[41]
Botrytis 80 homes, most of them damp,
city of Latrobe Valley
1.1 Andersen sampler,
microscopy
Australia
1994–1995
[31]
Botrytis 44 homes of asthmatics, area
and city of East Moline
Av. 25 2.9* Andersen sampler USA [85]
B. cinerea Homes of 130 asthmatic
patientsa
27.7 Rodac Contact plates and
swabs, MEA
Belgium
1981–1992
[9]
B. cinerea Homes of 130 asthmatic
patients
<100 68.46 Reuter Centrifugal air
sampler, HS-RBA
Belgium
1981–1992
[9]
B. cinerea 83% homes with mould
damage, Vilnius
8.0 Slit sampler Krotov 818,
MEA, SDA, CZ and CM
Lithuania
1994–2000
[60]
B. cinerea 83% homes with mould
damage, Vilnius
1.7 Passive sedimentation plates,
MEA, SDA, CZ and CM
Lithuania
1994–2000
[60]
Botrytis Patients’ homesb4 Denmark [34]
Botrytis Patients’ homesb8 Denmark [34]
B. cinerea Homes of 175 allergic and
control children, Stockholm
2 Floor dust collected in
vacuum cleaners, V8 agar
Sweden
1988
[101]
Botrytis 9 damp homes 44* Electrostatic dust sampler
(ALF-75), MEA
Sweden
7 days
[71]
Botrytis sp. Homes of 90 allergic patients Av. 112 Andersen sampler, RBA India
6 samplings
2002–2003
[90]
Botrytis Homes of 44 mould sensitive
asthmatic children, Boston
4.5 Burkard sample, DG-18 USA 2 samples,
1998-1999
[74]
Botrytis Homes of 40 mould sensitive
asthmatic children, Bronx
5.0 Burkard sampler, DG-18 USA 2 samples,
1998–1999
[74]
Botrytis Homes of 54 mould sensitive
asthmatic children, Chicago
3.7 Burkard sampler, DG-18 USA 2 samples,
1998–1999
[74]
Botrytis Homes of 95 mould sensitive
asthmatic children, Dallas
0.0 Burkard sampler, DG-18 USA 2 samples,
1998–1999
[74]
Botrytis Homes of 48 mould sensitive
asthmatic children, New York
4.2 Burkard sampler, DG-18 USA 2 samples,
1998–1999
[74]
Botrytis Homes of 52 mould sensitive
asthmatic children, Seattle
21.2 Burkard sampler, DG-18 USA 2 samples,
1998–1999
[74]
Botrytis Homes of 81 mould sensitive
asthmatic children, Tucson
0.0 Burkard sampler, DG-18 USA 2 samples,
1998–1999
[74]
For abbreviations used in the table see Table 1. Value is for both indoor and outdoor occurrence combined. aSamples collected from walls and horizontal
surfaces. bUnspecied dust.
- - - - -
190 Jürgensen CW, Madsen AM
papers investigating allergy towards Botrytis is difcult:
those we found are presented in Table 5.
Allergy towards B. cinerea ranges between 1.3%–52%,
with a calculated median of 18.8%, compared to a calcu-
lated median of 40.5% of allergy to at least one fungal spe-
cies (Fig. 5 and Tab. 5).
Moreover, Immonen et al. [45] and Korhonen et al. [55]
found that allergy towards B. cinerea is the most prevalent
allergy, or is just as prevalent as allergy towards the typi-
cally investigated Alternaria, Cladosporium and Aspergil-
lus in young Finnish children newly diagnosed with asth-
ma and schoolchildren suspected of asthma (Tab. 5). This
is surprising considering that no airborne B. cinerea was
identied at the children’s school [45], and that B. cinerea
seems to have a low prevalence in ambient air in Finland
(Tab. 1).
In addition, Karlsson-Borgå et al. [49] and Koivikko
et al. [54], using Phadebas RAST, compared a standard
mould test panel with an extended mould panel in patients.
The extended mould panel included B. cinerea. In Swe-
den and Denmark, Karlsson-Borgå et al. [49] found 18%
additional mould allergic patients, and in the USA 75%.
B. cinerea allergy was the second most prevalent mould
allergy in Sweden and Denmark and the most prevalent in
the USA. Koivikko et al. [54] found an additional 3.3% of
mould allergic patients with the extended panel, and B. cin-
erea was the fourth most prevalent fungal allergy in the test
groups. Altogether, it seems that a substantial proportion
of test persons do have allergy towards B. cinerea (Tab. 5)
even though exposure to this mould in ambient air in most
places seems to be low.
Prevalence of allergy towards B. cinerea
in occupational settings
In certain occupational settings, such as in the produc-
tion of raspberries, wine and certain dessert wines, where
infestation with B. cinerea is necessary [19, 46, 83], or
greenhouses [79], exposure to B. cinerea can reach high
levels. Thus two cases from Austria of hypersensitivity
pneumonitis/allergic alveolitis caused by B. cinerea have
been reported in two farm workers working with noble rot
grapes [78]. In grape farm workers in South Africa only
1% had allergy towards B. cinerea (Tab. 5) though a rela-
tively high exposure could be expected. In the same group,
1.6% suffered from allergy towards at least one fungus in
a mould mix containing Altanaria alternata, C. herbarum
and Fusarium. Hence, even though the level of allergy to-
wards Botrytis was low it made up a high proportion of the
fungal allergies.
The prevalences of allergy towards B. cinerea in green-
house workers in the Netherlands are 4% for chrysanthe-
mum workers and 13.8% for bell pepper workers (Tab. 5).
The difference between the two types of greenhouse is in-
teresting since the data were obtained by the same research
group and using the same test extract. The greenhouse
germination and responses to oxidative stress thought to
be a consequence of contact with the human immune
response. Furthermore, Green et al. [35] compared the al-
lergenic properties of spores and germinated spores of 11
allergenic fungi including B. cinerea. The quantity of aller-
gens released increased signicantly after germination of
B. cinerea spores. In contrast, the quantity did not increase
for Cladosporium herbarum.
Likewise, Kauffman et al. [52] looked at the allergen ex-
pression of B. cinerea during different phases of growth in
Sabouraud-2% glucose medium at 20°C. They found that
the binding of IgE and IgG by culture ltrate was maximal
in the early phase of growth. Thus, the allergenic potential
of Botrytis seems to be affected by its state of growth and
germination ability.
Prevalence of allergy towards B. cinerea
A survey of the standard skin prick tests from 29 allergy
centres in Europe shows that routine testing is mainly car-
ried out for one to two fungi. The fungi in question are
Alternaria and Cladosporium, sometimes combined with
each other, or Aspergillus and Candida, and at 2 centres a
mould-mix is tested. Some of the centres in southern Eu-
rope test for more than 2 fungal species simultaneously in-
cluding Fusarium and Penicillium, in addition to the gen-
era mentioned above. B. cinerea is only tested routinely at
the centres in Kraków and Montpellier [42]. Hence, nding
Figure 4. Indoor and outdoor prevalence of Botrytis in percent of all fungi
found for different occupational settings. More detailed description of the
data can be found in Tables 1–4. Indoor prevalence (black bars), outdoor
prevalence (oa) of an indoor – outdoor pair (bars with squares in a line),
outdoor prevalence (grey bars) and the calculated average and median
from the presented data (bars with grey stripes). *Numbers calculated
from paper data. References for the presented data: Flour mill and Flour
mill oa = [3], Fruit market A and B = [48], Grain mill and Grain mill
oa = [22], Greenhouse = [68], Ofce building and Ofce building oa =
[53], Production places = [95], Sawmills = [93], Schools = [45], Slaughter
house = [39], Swine houses = [15], Wine storage cellars = [15].
Occupational setting
% of all fungi
0
2
4
6
8
10
12
14
Flour mill
Flour mill oa
Fruit market A oa
Fruit market B oa
Grain mill*
Grain mill oa*
Greenhouse*
Office building oa*
Office building*
Production places
Sawmills*
Schools
Slaughter house < 1
Swine houses
Wine storage cellars*
Average indoor, 2.6
Average outdoor, 2.6
Median indoor, 1.0
Median outdoor, 0.4
- - - - -
Exposure to the airborne mould Botrytis and its health effects 191
Table 4. Prevalence of airborne Botrytis in different working environments and countries.
Environ-
ment
category
Specication of environment Exposure
level
CFU/m3
%
positive
samples
%
of all
fungi
Sampling and
identication method
Country, number
of samples and
sampling time
Ref.
Botrytis
Outdoor 1.5 m above ground,
outside a grain mill
Av. 60 11.6* Orthogonal impact Micro-
ow active sampler, SDA
Italy
8 samples
[22]
Indoor 1.5 m above ground,
different areas in a grain mill
Av. 5–75 3.2* Orthogonal impact Micro-
ow active sampler, SDA
Italy
8 samples
[22]
Indoor Greenhouses, ower and
ornamental plant growers
10.2* Personal sampler,
microbiology laboratory
Spain [68]
Indoor 1.5 m above ground,
our mill store
0.9 AGI-30 sampler, MEA Egypt, 8 samplings,
2004–2005
[3]
Outdoor 1.5 m above ground,
our mill store
0 AGI-30 sampler, MEA Egypt, 8 samplings,
2004–2005
[3]
Indoor 1.2 m above ground,
twelve sawmills
0–46 Av. 1.3
0.5–5.5*
Med. 0.6
SAS sampler, MEA and
MESA
France
8 samples
[93]
Indoor 1,5 m above oor,
swine breeding houses
0.12 Andersen sampler, MEA Taiwan
2 days, 1995
[15]
Outdoor 1 m above ground, fruit market 0.2 Rotorod sampler,
microscopy
India, 8 days interval
1 year, 1993–1994
[48]
B. cinerea
Outdoor 0.5–1 m above ground,
fruit market
0.4 Passive sedimentation
plates, PDA, CZ and RBA
India
15 days interval
1 year, 1993–1994
[48]
Indoor 0.8–1 m above ground,
ofce building in Perth
0–5 Av.
2.1*
1.1* Andersen sampler, MEA Australia
2 samples
[53]
Indoor 1.2 m above oor level,
in nine wine storage cellars
8–125 Av. 7.6
0.8–61*
Med. 1.2
One-stage volumetric sieve
sampler (SAS Compact),
MESA
France
2 samples,
1997
[94]
Indoor Production places (meat, our,
sweets and dairy)
1.01 Passive sedimentation
plates, MEA
Turkey, 16 samples,
1995–1996
[95]
Indoor Four schools in the city of Turku 0 Andersen sampler, 2%
MEA and DG18
Finland, 15–19 sam-
ples, 1999
[45]
Botrytis sp./spp.
Indoor 1.7 m above ground,
slaughterhouse
< 1% Andersen impactor and
SKC Biosampler impinger,
MEA or saline solution
Austria
48 samples
June–November 2002
[39]
Indoor 1.5 m above ground, greenhouses 32.4 Polypropylene air
monitoring cassettes,
DG-18 and MEA
Spain [79]
B. cinerea
Indoor Greenhouses 48 PDA surface contact plates Italy
1987–1988
[21]
Outdoor 40 cm above the beds, strawberry
farm, until the rst day of harvest
0–2.0 × 10³ Burkard sampler,
microscopy
Spain, October 2001–
13 February 2002
[10]
Outdoor 40 cm above the beds, strawberry
farm, until the rst day of harvest
0–2.8 × 103Burkard sampler,
microscopy
Spain, October 2002–
6 February 2003
[10]
Outdoor 40 cm above the beds, strawberry
farm, during harvest
0–2.6 × 104Burkard sampler,
microscopy
Spain, 13 February–
20 May 2002
[10]
Outdoor 40 cm above the beds, strawberry
farm, during harvest
0–1.3 × 105Burkard sampler,
microscopy
Spain,
6 February–
19 May 2003
[10]
Outdoor 1.5 m above ground,
5 ha vineyard
Av./day
100–1000*
Hirst type spore trap,
microscopy
Spain
June–September 1994
[24]
For abbreviations used in the table see Table 1.
- - - - -
192 Jürgensen CW, Madsen AM
workers prevalences of allergy to Botrytis are compara-
ble to the values found in atopic and suspected atopic test
persons in the Netherlands. However, patients suspected of
mould allergy in the Netherlands had a higher prevalence
of allergy to Botrytis (Tab. 5).
Combining the information that a substantial part of
patients and workers are allergic to B. cinerea, and that
extending the Phadebas RAST test panel detected new pa-
tients, makes it desirable to include B. cinerea in a stand-
ard allergy test. Furthermore, taking into account that test
persons in the surveyed papers are rarely allergic to only
one fungal species, using an extended fungi test panel as
standard might assist in identifying a higher proportion of
mould allergic patients.
Seasonal variations in Botrytis exposure
Diagnosing and treating allergy in patients is dependent
on both diagnostic tools and patient history. For that rea-
son, knowledge of allergen exposure is important to doc-
tors and patients [64]. Even though the amount of spores
present does not seem to inuence a fungus’ ability to cause
allergy, the amount does seem important when an allergy
is established. Hence, Malling [64] reviewed a study of
asthma patients that showed a correlation between asthma
symptoms and Cladosporium spore counts. Furthermore,
a study into autumnal asthma showed a better correlation
between symptoms and fungal spore counts than between
symptoms and ragweed pollen [64].
A comparison of the few papers that look into the distribu-
tion of Botrytis throughout the year shows a mixed picture,
but indicate an all-year presence for the temperate climate
in Europe with an approximate season starting in April and
lasting until November, peaking in August–September [8,
27, 44, 50, 51, 69, 96]. In contrast, a 15-year study in Thes-
saloniki (Greece) showed a low nearly even distribution
over the year with a slight decrease in December and Janu-
ary [32]. In Porto Alegre (Brazil), Botrytis was only found
in autumn and winter [66] and in Porto (Portugal) a 1-year
study found a seasonal distribution from April–December,
where Botrytis peaked from July–December, with a low
in November [72]. In Canada, Bartlett et al. [5] found low
exposure to Botrytis at schools in winter (November–Feb-
ruary) and spring (April–June), with a major increase in the
autumn season (September–November).
The distribution of B. cinerea during the day was inves-
tigated by Blanco et al. [10] during two seasons in a straw-
berry eld in Spain. They found a diurnal pattern where
the conidial concentration increased from 08:00 and de-
creased towards 15:00 while peaking between 09:00–11:00
in the rst season. In the second season, conidial concen-
tration increased from 06:00 and decreased towards 17:00,
while peaking between 12:00–14:00. Similarly, Jarvis [46]
studied the dispersal of B. cinerea conidia in a raspberry
eld in Scotland and found a diurnal pattern for B. cinerea
spore dispersal in response to changes in relative humid-
ity. Thus, Botrytis increased from 07:00 and decreased
towards 18:00, while peaking between 09:00–13:00 and
15:00–17:00. However, this pattern was not followed
during rainfall at night and days with otherwise unsuit-
able conditions for spore dispersal, at those times Botrytis
was also dispersed. In a vineyard in Switzerland Corbaz
[19] similarly showed a diurnal dispersal pattern for Bot-
rytis spores. Thus, spore dispersal also increased between
06:00–09:00, but in contrast peaked between 09:00–20:00,
while decreasing towards 24:00. Consequently, Botrytis
allergic patients should ventilate their rooms in the very
early morning hours and in the late evening hours, while
avoiding ventilation during rainfall and windy weather.
DISCUSSION
The quality of fungal test extracts for detecting fungal al-
lergy varies greatly, and the range of available test extracts
is low compared to the number of fungi with allergenic po-
tential [13, 56, 84]. Hence, Malling et al. [65] investigated
test extracts of C. herbarum from three different manufac-
turers and at different concentrations. They found that with-
in the same test group the percentage of positive skin prick
test reactions ranged from 10%–60%. Hence, the level of
allergy towards fungi in general and among them B. cinerea
may well be underestimated. Thus, with the limitations of
Figure 5. Prevalence of allergy towards B. cinerea# in test persons (black
bars). More detailed information on the data can be found in Table 5.
Average and median of allergy towards at least one fungus in test per-
sons calculated from the paper data presented in Table 5 (bars with grey
stripes), and the calculated average and median of the presented data of
allergy towards B. cinerea (grey bars). # In references (Ref.) [70], [42],
[12] and [20] only Botrytis was investigated and in ref. [8] Botrytis spp.
Ref. for the presented data: Denmark and Sweden = [49], Finland a = [45],
Finland b = [55], France = [42] and [12], The Netherlands and Germany =
[8], The Netherlands Group a and b = [7], The Netherlands c and d = [97],
The Netherlands e = [38], The Netherlands f = [37], USA Group a and b
= [20], USA c = [16], USA d = [49], South Africa = [47], Sweden = [70].
France
Netherlands c
Netherlands f
Average Botrytis, 21.7
Median Botrytis, 18.8
Average mould, 34.4
Denmark & Sweden *
Finland a*
Finland b*
Finland c
Netherlands & Germany*
Netherlands Group a
Netherlands Group b
Netherlands d
Netherlands e
USA Group a*
USA Group b*
USA c*
USA d*
South Africa*
Sweden*
Median mould, 40.5
0
10
20
30
40
50
60
Country
% allergic subjects
- - - - -
Exposure to the airborne mould Botrytis and its health effects 193
Table 5. Levels of allergy towards Botrytis cinerea found in the surveyed papers.
Specications of test persons Number of
persons
% positive
SPT
Botrytis
% positive
RAST
Botrytis
% positive
allergy
fungib
Allergy test extract Country and
Year
Ref.
Suspected asthmatic, allergic or
rhinitis patients
404 2.7 Stallergènes SA, Fresnes France [12,
42]
Suspected and asthmatic school
children
144 1.3* 4 ALK panel, Denmark Finland [45]
Newly diagnosed asthmatic
children
114 2.6* < 5 Possibly ALK panel Finland [55]
Suspected mould allergic
children with asthma
121 24 40.5 Extended Phadebas RAST,
Pharmacia
Turku, Finland [54]
Subgroup of allergic rhinitis
patients with suspected mould
allergy
39 28.2* 44 ImmunoCap (modied
RAST), Pharmacia
Chicago, USA [20]
Randomly selected patients
suspected of allergic rhinitis
32 18.8* 44 ImmunoCap (modied
RAST), Pharmacia
Chicago, USA [20]
Allergic fungal sinusitis patients 10 50* 100 MMP, Bayer USA [16]
Suspected mould allergic
patients
21 52* 66* Extended Phadebas RAST,
Pharmacia
USA [49]
Suspected mould allergic
patients
34 47* 77* Extended Phadebas RAST,
Pharmacia
Denmark and
Sweden
[49]
Patients 150 50* Mould extract after
Feinberg
Sweden [70]
Suspected allergic patients 692 4.9 Extract from cultivated
mould mycelium
Groningen, The
Netherlands
[97]
Suspected mould allergic
patients
180 24 Extract from cultivated
mould mycelium
Leiden, The
Netherlands
[97]
Suspected asthmatic and/or
allergic patients
68 7.3aDiephuis Laboratories
Groningen, Netherlands
Beatrixoord, The
Netherlands,
1981–1983
[7]
Suspected asthmatic and/or
allergic patients
692 (833) 4.9a(4.6) Diephuis Laboratories
Groningen, Netherlands
Beatrixoord, The
Netherlands,
1981–1983
[7]
Mould allergic asthmatic
patients
28 7.1* 100 Diephuis Laboratories
Groningen, Netherlands
The Netherlands
and Germany,
1981–1982
[8]
Chrysanthemum greenhouse
workers
104 4 NI ALK Abelló, Netherlands The Netherlands,
2000
[38]
Predatory mite allergic workers
in Bell pepper greenhouses
109 13.8 NI ALK Abelló, Netherlands The Netherlands,
1999–2000
[37]
Table grape farm workers 190 1* NI ALK South Africa [47]
Abbreviations used in the table: NF = not found, NI = not investigated, SPT = Skin-prick test, RAST = radioallergosorbent test. a results from an intra-
cutaneous skin test, b positive skin prick test or radioallergosorbent test to at least one of the fungi of a test-panel in the entire test group. In ref. [70],
[42], [12] and [20] only Botrytis was investigated and in ref. [8] Botrytis spp.
current knowledge, about 20%–30% of atopic individuals
are estimated to suffer from respiratory allergy towards
fungi, while the same is true for about 6% of the general
population [56, 84]. In that respect, a substantial amount of
test persons are allergic towards B. cinerea, especially when
considering that the surveyed papers show that Botrytis in
most instances is a genus with a low airborne prevalence
(Tables 1–4) compared to e.g. Alternaria, Cladosporium,
Aspergillus, yeasts, basidiospores and sterile mycelia.
This study shows that Botrytis spp. can be sampled us-
ing different methods (Tables 1–4). However, we have
described a relatively low airborne prevalence of Botrytis.
This may be due to the sampling methods applied [84] be-
cause the viability of fungal spores during sampling might
be inuenced by e.g. mechanical forces and/or transient
declines in water activity of the sampling media. For exam-
ple, Saldanha et al. [88] recovered B. cinerea with a Reuter
Centrifugal Sampler (RCS) but not with an Andersen sam-
pler. The rst sampler is signicantly better at sampling
fungi dened as having a high water activity requirement
than fungi dened as xerotolerant compared to the An-
dersen sampler and vice versa [88]. On the other hand, this
- - - - -
194 Jürgensen CW, Madsen AM
review shows that Botrytis has often been sampled using
an Andersen sampler. This difference could be due, for ex-
ample, to the different sampling times used in the surveyed
papers as sampling durations range from 1 minute to 1 day
(Tables 1–4).
What is more, Rotem and Aust [86] investigated the vi-
ability of spores and spore aggregates. They found the vi-
ability of B. cinerea was the most vulnerable of the fungal
species investigated to the detrimental effects of exposure
to darkness under high temperature, UV-radiation and sun-
light.
Another possible factor affecting the measured airborne
exposure level of Botrytis could be the sampling height,
which varies from a few centimetres to several metres above
ground (Tables 1–4). For example, Rantio-Lethimäki et al.
[81] compared spore counts sampled at 15 meters height
and at ground level. They found that Botrytis spores had
the highest ground/ roof ratio of the genera studied and that
its spore season was 100 days longer at ground level. This
could explain the differences in outdoor exposure levels
seen for the Netherlands which ranges from 2.7%–17%
(Tab. 1).
Tables 1–4 show Botrytis can be cultivated and identi-
ed on different agar media, though they may not all be
optimal media. Indeed, cultivation and identication of
fungi is very complicated and often requires spores to be
viable and able to germinate, grow and sporulate; there-
fore, the choice of sampling method, sampling duration,
identication method and media affects which fungi can
be identied and thus correlated with a following study of
health symptoms. With reference to the above reasons, the
airborne exposure level of Botrytis may well be underes-
timated.
An alternative route to exposure to airborne Botrytis
might be oral exposure, thus resulting in higher exposure.
As mentioned above, Botrytis is frequently isolated from
fruits and vegetables [61, 89, 99], also after surface dis-
infection [89, 99]. Hence, exposure may occur from fruits
with no visible Botrytis growth.
CONCLUSION
In conclusion, Botrytis is found globally with differ-
ent spore seasons and has low prevalence in ambient air
indoors and outdoors. However, the prevalence in indoor
complaint homes tends to be higher. The dispersal of spores
follows a diurnal pattern where the spore level increases in
the early morning hours, decreasing towards the late af-
ternoon. The exposure to Botrytis may also increase dur-
ing rainfall at night. Thus, Botrytis allergic patients should
ventilate their rooms in the late evening, at night, or in the
very early morning hours, except during rainfall.
Furthermore, a substantial amount of patients and work-
ers are allergic to B. cinerea, thus it seems to be as impor-
tant as more prevalent mould genera such as Cladosporium
and Alternaria when investigating allergy towards fungi.
Even though the degree of sensibility varies between dif-
ferent geographical groups and test groups, we suggest that
B. cinerea should be included in standard tests. Further-
more, given the low airborne prevalence of Botrytis and
other fungi capable of inducing allergy, it is clear that when
investigating the correlation between exposure and health
effect it is not adequate to only look at the 2–4 most preva-
lent genera. Although the scientic community agrees that
the methods applied to assess fungal exposure to date are
a compromise, it would be advisable to agree on what ap-
proach should be used to make data comparable.
Acknowledgement
We wish to acknowledge the collaboration and invaluable dis-
cussions with our colleagues. We are especially grateful to our co-
worker Kira Tendal.
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... In addition to plant physiological damage and crop losses, some MC pathogens impose a direct health hazard to patients that consume infected inflorescences. For example, B. cinerea, which is one of the most common pathogens of MC, is a known allergen and can lead to harsh reactions in humans [11]. Furthermore, air samples from the lungs of workers from MC farms have contained a significantly higher than normal concentration of microorganisms, especially different kinds of Ascomycota, of which B. cinerea was the most common [12]. ...
... One of the main difficulties in managing diseases caused by this fungus is that many classes of fungicides fail to control pathogen outbreaks, due to their genetic plasticity and resistance mechanisms [27]. Furthermore, B. cinerea, which has been shown from this study to be a common pathogen of MC in Israel, is a known allergen, and can lead to detrimental effects in humans [11]. ...
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The use of and research on medical cannabis (MC) is becoming more common, yet there are still many challenges regarding plant diseases of this crop. For example, there is a lack of formal and professional knowledge regarding fungi that infect MC plants, and practical and effective methods for managing the casual agents of disease are limited. The purpose of this study was to identify foliar, stem, and soilborne pathogens affecting MC under commercial cultivation in Israel. The predominant major foliage pathogens were identified as Alternaria alternata and Botrytis cinerea, while the common stem and soilborne pathogens were identified as Fusarium oxysporum and F. solani. Other important fungi that were isolated from foliage were those producing various mycotoxins that can directly harm patients, such as Aspergillus spp. and Penicillium spp. The sampling and characterization of potential pathogenic fungi were conducted from infected MC plant parts that exhibited various disease symptoms. Koch postulates were conducted by inoculating healthy MC tissues and intact plants with fungi isolated from infected commercially cultivated symptomatic plants. In this study, we report on the major and most common plant pathogens of MC found in Israel, and determine the seasonal outbreak of each fungus.
... B. cinerea, also known as grey mould or Botrytis rot, has the ability to thrive in different environments from tropical to cold regions, and infects more than 200 different plant hosts [40], but can also be harmful to humans. Recently, in addition to its allergenic effects [41], Hashimoto et al. [42] reported the first case of pulmonary Botrytis sp. infection in an apparently healthy individual. ...
... They carried out this field study from December 2005 to November 2011 at 14 sites, mostly in Southern France, and found out that the presence of B. cinerea in precipitation was promoted by acidic substances, in addition to the fact that snowfall and rainfall were equal in their deposition capacity, and that high humidity and colder temperatures favoured its contribution. In fact, as we also noticed, the Botrytis genus is more abundant in spring, when several days of cloudy and rainy weather, and cool nights, create an ideal environment for Botrytis spore germination, infection, and disease development [40,41,44]. Note that the Botrytis RA reached higher values in winter and spring (Figure 6a), when T and RH were characterized by lower and higher mean values, respectively, than in summer (Table 1). ...
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The atmosphere represents an underexplored temporary habitat for airborne microbial communities such as eukaryotes, whose taxonomic structure changes across different locations and/or regions as a function of both survival conditions and sources. A preliminary dataset on the seasonal dependence of the airborne eukaryotic community biodiversity, detected in PM10 samples collected from July 2018 to June 2019 at a coastal site representative of the Central Mediterranean, is provided in this study. Viridiplantae and Fungi were the most abundant eukaryotic kingdoms. Streptophyta was the prevailing Viridiplantae phylum, whilst Ascomycota and Basidiomycota were the prevailing Fungi phyla. Brassica and Panicum were the most abundant Streptophyta genera in winter and summer, respectively, whereas Olea was the most abundant genus in spring and autumn. With regards to Fungi, Botrytis and Colletotrichum were the most abundant Ascomycota genera, reaching the highest abundance in spring and summer, respectively, while Cryptococcus and Ustilago were the most abundant Basidiomycota genera, and reached the highest abundance in winter and spring, respectively. The genus community structure in the PM10 samples varied day-by-day, and mainly along with the seasons. The impact of long-range transported air masses on the same structure was also proven. Nevertheless, rather few genera were significantly correlated with meteorological parameters and PM10 mass concentrations. The PCoA plots and non-parametric Spearman’s rank-order correlation coefficients showed that the strongest correlations generally occurred between parameters reaching high abundances/values in the same season or PM10 sample. Moreover, the screening of potential pathogenic fungi allowed us to detect seven potential pathogenic genera in our PM10 samples. We also found that, with the exception of Panicum and Physcomitrella, all of the most abundant and pervasive identified Streptophyta genera could serve as potential sources of aeroallergens in the studied area.
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The quality of the indoor microclimate in museums is a problem of great interest to the contemporary society, given that it is in close connection with the health and comfort of visitors and employees, as well as with the integrity of the exhibits. Taking into account the fact that museums are places that have a special role in the community’s life and therefore attract a very large number of visitors of all ages, a very important issue is to determine the degree of safety that the indoor microclimate presents. Thus, the quality of the indoor microclimate was investigated inside an iconic museum in Romania, dating back to the 19th century, because pollutants from external or internal sources of the building, generated secondary, often anthropogenic, as a tendency to defend/adapt to climate change (CC), contribute to both local and regional pollution, but also lead to challenges in identifying links between air quality (AQ) and and climate change (CC). The methodology used was based on monitoring the main parameters of the microclimate (temperature, relative humidity and CO2) over a period of between October 2020 and March 2021, 21 weeks, as well as on determining the microbiological contamination of the air and some indoor exhibits located in three different areas of the museum. At the same time, the study aims to identify cheap, easy to implement and non-invasive solutions for removing fungi identified on exhibits for long-term preservation and reducing the risk of various pathologies in humans following prolonged exposure. The results obtained show that the indoor microclimate in the old heritage building favours the development of fungi, which have a high degree of contamination of the air (over 800 CFU/m3) and of the exhibits, representing a potential risk for the health of the visitors and museum workers. Thus, six species of yeast and five different fungi genera were identified in the air, while on the exhibits were individualised six fungi genera, a species of yeast and a bacterium. The most viable solution for cleaning materials, prolonging their lifespan and reducing the risk of disease in humans was represented by the use of essential oils (EO). Three essential oils (lavender, mint and lemon) were applied on an exhibit with five different microorganism genera, and it was observed that they have the ability to inhibit the spores from moulds and bacteria, being a very good alternative to the usual chemical treatments that are used in the cultural heritage field.
... B. cinerea has an international distribution and is located frequently in soil [25] . cinerea [26,27] . ...
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In India, the prevalence of allergic responses and bronchial asthma is on the rise, which is a major public health concern. Increased exposure to an allergen, a substance that causes a reaction, can cause allergy sensitization in genetically vulnerable people. Continued exposure to allergens can raise the risk of allergic diseases which can further progress into life threating respiratory diseases. Allergic reactions to a variety of indoor and outdoor allergens play a key role in severe breathing disorders such as asthma and chronic obstructive pulmonary disease (COPD). There are distinctive kinds of allergens like animal proteins and animal dander, pollen, food, fungi, mould, Insects, Bird droppings and many others. The common allergens that cause respiratory difficulties have been identified after an honest effort. A modest retrospective analysis of 160 patients was done. Their medical history was gathered in order to determine whether or not they had been exposed to allergies in the past. All of the study participants were given a Skin prick test (SPT) with a variety of allergens, and their allergy status was evaluated based on the results. Most allergens, such as dust mites, pollen grains, and pigeon droppings, have been discovered to cause severe respiratory allergies, which can lead to life-threatening respiratory complications.
... 82 Although present in the outdoor air most of the year at low concentrations, the median sensitization rate was found to be high (18.8%) in Danish patient workers. 83 Epicoccum is a dry spore, and in Italy, it peaks in September. 84 Despite relatively low outdoor concentrations, high sensitization rates have been observed, particularly in patients admitted in intensive care unit for acute asthma attack. ...
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Background: Fungal spores are the predominant biological particulates in outdoor air. However, in contrast to pollens or outdoor air pollution, little is known about their respiratory health risks. Objectives: The objectives were to conduct the first review of epidemiological studies on the short and long-term effects of outdoor mould exposure on respiratory health in children and adults. Methods: Health outcomes included asthma, lung function and rhinitis. Cross-sectional and longitudinal epidemiological studies using quantitative measures of outdoor mould exposure (optical microscopy, culture-based methods) were selected, providing that important confounding factors including temporal trends or meteorological factors were accounted for. A systematic literature search was performed up to June 2020, leading to the selection of 37 publications. Results: Most studies were longitudinal and investigated short-term effects. There is evidence of an association between outdoor fungal exposure and an increase in asthma exacerbation among children for total spores, two phyla (Ascomycetes, Basidiomycetes), and two taxa (Cladosporium, Alternaria). A few studies also suggested an association for Coprinus, Ganoderma, Aspergillus-Penicillium, Botrytis and Epicoccum in children, but this needs to be confirmed. Some studies reported mould associations with rhinitis, lung function, and among adults but these were few in number or inconsistent. Discussion: Further ecological studies in different regions that measure exposure to all taxa over several years are required to better understand their impact on rhinitis, asthma exacerbations and lung function. Larger panel studies are necessary to identify threshold effects in susceptible individuals. Finally, further research should assess the long-term effects of outdoor mould.
... This may apply to staff working in museum rooms, at exhibitions, and in places where fungi of the Botrytis family have good conditions to thrive. In such cases, systemic symptoms such as weight loss and/or a recurrent cough, shortness of breath etc. appear [50][51][52]. Botrytis in immunocompromised people, such as patients with the hepatitis C virus, AIDS, and organ transplant patients, can cause local infections, causing pathologies of the eye, brain, heart, peritoneum, or onychomycosis. It is highly resistant to conventional and most modern antifungal agents when its concentration is elevated or the body's resistance is low [53,54]. ...
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... Botrytis spp. is slightly less pathogenic in humans and if inhaled can enter the body triggering, in the case of prolonged exposure, characteristic pathologies in the respiratory system, asthma attacks and the development of hypersensitivity pneumonitis. The clinical picture of the infection includes altered general condition and limited ability to mobilize the chest, dyspnea, dry cough and wheezing [82][83][84]. ...
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... Its impact on human activities is, consequently, of acknowledged significance but its direct impact on human health is also gaining recognition. B. cinerea could be as important in causing allergies as fungi of the genera Cladosporium and Alternaria [3,4]. ...
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... Botrytis spores in the air could potentially cause respiratory allergies in humans (Jürgensen & Madsen 2009). ...
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Environmental Study in Subway Metro Stations in Cairo, Egypt: Abdel Hameed A. AWAD, Air Pollution Department, National Research Centre —Airborne viable and non-viable measurements were carried out in two different metro stations, one located in a tunnel and the other on the surface. The concentrations of airborne total viable bacteria (incubated at 37°C and 22°C), staphylococci, suspended dust and oxidants (ozone) were higher in the air of the tunnel station than those recorded at the surface station. In contrast, spore forming bacteria, Candida spp, fungi and actinomycetes were found at slightly higher levels in the surface station than in the tunnel station. A statistically significant difference (p
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The aim of this study was identification of fungi in indoor and outdoor of asthmatic patients' home environment. Opened plates (containing of Malt extract agar media) were used for isolation of fungi in the air of indoor (n=360) and outdoor (n=180) of 90 asthmatic patients' home living in the city of Sari at the level of breathing height. Plates were incubated in room temperature for 7-14 days. Then grown fungi were identified by standard mycological techniques. A total of 1876 colonies with 31 and 1692 colonies with 27 genera of fungi were identified from indoor and outdoor of asthmatic patients' home respectively. The most common fungi isolated were Cladosporium, Aspergillus and Penicillium. Stachibotyris, Oedocephalum, and Stemphillium showed the least frequencies among the isolated fungi. Cladosporium, Aspergillus, Penicillium, and Alternaria as the most common allergenic moulds had the most frequencies in indoor air of the houses of asthmatic patients. Copyright © 2005, Iranian Journal of Allergy, Asthma and Immunology. All rights reserved.
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The relationship of grower activities to concentrations of airborne conidia of Botrytis cinerea among geranium (Pelargonium hortorum) cuttings was studied within a commercial-propagation greenhouse. Hourly concentrations of conidia of B. cinerea were estimated for selected time periods of the 1986 and 1987 growing seasons with a Burkard recording spore trap in two propagation areas. Conidia of B. cinerea were present in the greenhouse throughout the propagation cycle
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