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People in Central Europe spend most of their time in private dwellings, offices, education centres or other public buildings. In these indoor places, they are exposed to a variety of gaseous or particulate pollutants that potentially exert adverse health effects. This work compiles current fields of action that are discussed in the public, among expert panels, and in the scientific community. These address ventilation in buildings, the impact of building product emissions and particulate matter sources on indoor air quality, the detection and prevention of mould as well as the assessment of indoor air quality using guidance values and the determination of the internal exposure by human biomonitoring. Indoor air quality appears as a dynamic field of action that has become more complex due to the interaction between new chemicals introduced into the indoor environment through a variety of products and the observed reduction of ventilation rates. Implications for human health have thus become less predictable.

Die von der Gesellschaft fur Hygiene, Umweltmedizin und Praventivmedizin (GHUP) federfuhrend erstellte Leitlinie „Medizinisch klinische Diagnostik bei Schimmelpilzexposition in Innenraumen“ ist Gegenstand des vorliegenden Abschnitts. Schimmelpilzwachstum im Innenraum ist als ein potenzielles Gesundheitsrisiko zu betrachten, auch ohne dass ein quantitativer und/oder kausaler Zusammenhang zwischen dem Vorkommen einzelner Arten und Gesundheitsbeschwerden gesichert werden kann. Abgesehen von der Allergischen Bronchopulmonalen Aspergillose (ABPA) und den durch Schimmelpilze kausal verursachten Mykosen, liegen lediglich ausreichende Evidenzen fur folgende Assoziationen von Feuchte-/Schimmelpilzschaden und unterschiedlichen Gesundheitseffekten vor: allergische Atemwegserkrankungen, Asthma (Manifestation, Progression, Exazerbation), allergische Rhinitis, Exogen Allergische Alveolitis, Begunstigung von Atemwegsinfekten/Bronchitis. Dabei ist das sensibilisierende Potenzial von Schimmelpilzen im Vergleich zu anderen Umweltallergenen deutlich geringer einzuschatzen. Aktuelle Studien zeigen europaweit eine vergleichsweise geringe Sensibilisierungspravalenz von 3–10 % gemessen an der Gesamtbevolkerung. Eingeschrankte oder vermutete Evidenz fur eine Assoziation liegt vor hinsichtlich „mucous membrane irritation“ und Atopischen Ekzems (Manifestation, Progression, Exazerbation). Inadaquate oder unzureichende Evidenz fur eine Assoziation liegt vor fur COPD, akute idiopathische pulmonale Hamorrhagie bei Kindern, Rheuma/Arthritis, Sarkoidose und Krebserkrankungen. Das Infektionsrisiko von den in Innenraumen regelmasig vorkommenden Schimmelpilzarten ist fur gesunde Personen gering, die meisten Arten sind in die Risikogruppe 1 und wenige in 2 (Aspergillus fumigatus, A. flavus) der Biostoffverordnung eingestuft. Nur Schimmelpilze, die potenziell in der Lage sind, Toxine zu bilden, kommen als Ausloser einer Intoxikation in Betracht. Ob im Einzelfall eine Toxinbildung im Innenraum stattfindet, entscheiden die Umgebungs- und Wachstumsbedingungen und hier vor allem das Substrat. Von Geruchswirkungen und/oder Befindlichkeitsstorungen kann bei Feuchte-/Schimmelpilzschaden im Innenraum grundsatzlich jeder betroffen sein. Hierbei handelt es sich nicht um eine Gesundheitsgefahrdung. Pradisponierende Faktoren fur Geruchswirkungen konnen genetische und hormonelle Einflusse, Pragung, Kontext und Adaptationseffekte sein. Pradisponierende Faktoren fur Befindlichkeitsstorungen konnen Umweltbesorgnisse, -angste, -konditionierungen und -attributionen sowie eine Vielzahl von Erkrankungen sein. Besonders zu schutzende Risikogruppen bezuglich eines Infektionsrisikos sind Personen unter Immunsuppression nach der Einteilung der Kommission fur Krankenhaushygiene und Infektionspravention (KRINKO) beim Robert Koch-Institut (RKI) und Personen mit Mukoviszidose (Zystischer Fibrose), bezuglich eines allergischen Risikos Personen mit Mukoviszidose (Zystischer Fibrose) und Personen mit Asthma bronchiale. Die rationale Diagnostik beinhaltet die Anamnese, eine korperliche Untersuchung, eine konventionelle Allergiediagnostik einschlieslich gegebenenfalls Provokationstests, vereinzelt sind auch zellulare Testsysteme indiziert. Zum Vorgehen bei Schimmelpilzinfektionen wird auf die angemeldete AWMF-Leitlinie Diagnose und Therapie invasiver Aspergillus-Infektionen verwiesen. Hinsichtlich Mykotoxine existieren zurzeit keine brauchbaren und validierten Testverfahren, die in der klinischen Diagnostik eingesetzt werden konnten. Praventivmedizinisch ist wichtig, dass Schimmelpilzbefall in relevantem Ausmas aus Vorsorgegrunden nicht toleriert werden darf. Zur Beurteilung des Schadensausmases und zum Vorgehen wird auf den „Schimmelpilzleitfaden“ des Umweltbundesamtes verwiesen.

This article is an abridged version of the AWMF mould guideline “Medical clinical diagnostics of indoor mould exposure” presented in April 2016 by the German Society of Hygiene, Environmental Medicine and Preventive Medicine (Gesellschaft für Hygiene, Umweltmedizin und Präventivmedizin, GHUP), in collaboration with the above-mentioned scientific medical societies, German and Austrian societies, medical associations and experts. Indoor mould growth is a potential health risk, even if a quantitative and/or causal relationship between the occurrence of individual mould species and health problems has yet to be established. Apart from allergic bronchopulmonary aspergillosis (ABPA) and mould-caused mycoses, only sufficient evidence for an association between moisture/mould damage and the following health effects has been established: allergic respiratory disease, asthma (manifestation, progression and exacerbation), allergic rhinitis, hypersensitivity pneumonitis (extrinsic allergic alveolitis), and increased likelihood of respiratory infections/bronchitis. In this context the sensitizing potential of moulds is obviously low compared to other environmental allergens. Recent studies show a comparatively low sensitizing prevalence of 3–10% in the general population across Europe. Limited or suspected evidence for an association exist with respect to mucous membrane irritation and atopic eczema (manifestation, progression and exacerbation). Inadequate or insufficient evidence for an association exist for chronic obstructive pulmonary disease, acute idiopathic pulmonary hemorrhage in children, rheumatism/arthritis, sarcoidosis and cancer. The risk of infection posed by moulds regularly occurring indoors is low for healthy persons; most species are in risk group 1 and a few in risk group 2 (Aspergillus fumigatus, A. flavus) of the German Biological Agents Act (Biostoffverordnung). Only moulds that are potentially able to form toxins can be triggers of toxic reactions. Whether or not toxin formation occurs in individual cases is determined by environmental and growth conditions, above all the substrate. In the case of indoor moisture/mould damage, everyone can be affected by odour effects and/or mood disorders. However, this is not a health hazard. Predisposing factors for odour effects can include genetic and hormonal influences, imprinting, context and adaptation effects. Predisposing factors for mood disorders may include environmental concerns, anxiety, condition, and attribution, as well as various diseases. Risk groups to be protected particularly with regard to an infection risk are persons on immunosuppression according to the classification of the German Commission for Hospital Hygiene and Infection Prevention (Kommission für Krankenhaushygiene und Infektionsprävention, KRINKO) at the Robert Koch- Institute (RKI) and persons with cystic fibrosis (mucoviscidosis); with regard to an allergic risk, persons with cystic fibrosis (mucoviscidosis) and patients with bronchial asthma should be protected. The rational diagnostics include the medical history, physical examination, and conventional allergy diagnostics including provocation tests if necessary; sometimes cellular test systems are indicated. In the case of mould infections the reader is referred to the AWMF guideline “Diagnosis and Therapy of Invasive Aspergillus Infections”. With regard to mycotoxins, there are currently no useful and validated test procedures for clinical diagnostics. From a preventive medicine standpoint it is important that indoor mould infestation in relevant dimension cannot be tolerated for precautionary reasons. With regard to evaluating the extent of damage and selecting a remedial procedure, the reader is referred to the revised version of the mould guideline issued by the German Federal Environment Agency (Umweltbundesamt, UBA).

People in Central Europe spend most of their time in private dwellings, offices, education centres or other public buildings. In these indoor places, they are exposed to a variety of gaseous or particulate pollutants that potentially exert adverse health effects. This work compiles current fields of action that are discussed in the public, among expert panels, and in the scientific community. These address ventilation in buildings, the impact of building product emissions and particulate matter sources on indoor air quality, the detection and prevention of mould as well as the assessment of indoor air quality using guidance values and the determination of the internal exposure by human biomonitoring. Indoor air quality appears as a dynamic field of action that has become more complex due to the interaction between new chemicals introduced into the indoor environment through a variety of products and the observed reduction of ventilation rates. Implications for human health have thus become less predictable.

To determine the exchange of nitrogen and carbon between ectomycorrhiza and host plant, young beech (Fagus sylvatica) trees from natural regeneration in intact soil cores were labelled for one growing season in a greenhouse with 13CO2 and 15NO3 15NH4. The specific enrichments of 15N and 13C were higher in ectomycorrhizas (EMs) than in any other tissue. The enrichments of 13C and 15N were also higher in the fine-root segments directly connected with the EM (mainly second-order roots) than that in bulk fine or coarse roots. A strict, positive correlation was found between the specific 15N enrichment in EM and the attached second-order roots. This finding indicates that strong N accumulators provide more N to their host than low N accumulators. A significant correlation was also found for the specific 13C enrichment in EM and the attached second-order roots. However, the specific enrichments for 15N and 13C in EM were unrelated showing that under long-term conditions, C and N exchange between host and EMs are uncoupled. These findings suggest that EM-mediated N flux to the plant is not the main control on carbon flux to the fungus, probably because EMs provide many different services to their hosts in addition to N provision in their natural assemblages.

We labeled tree saplings of beech and ash with 15 N and 13 C in a greenhouse. Carbon (C) was applied as 13 CO 2 to plants and nitrogen (N) was added as 15 NH 4 15 NO 3 to the soil. We hypothesized that C will be transferred from plants to the rhizosphere, subsequently in beech to ectomycorrhiza (EM), in ash to arbuscular mycorrhiza (AM) and finally to soil animals. We expected the C signal to be more effectively transferred to soil animals in EM as compared to AM systems since EM forms more extensive extramatrical mycelia as compared to AM. For 15 N we hypothesized that it will be taken up by both saprotrophic microorganisms and mycorrhizal fungi and then channeled to soil animals. After five month, δ 13 C and δ 15 N signatures of soil animals, EM and fine roots of beech and ash were measured. Litter and soil were hardly enriched in 15 N whereas fine roots of beech and ash were highly enriched suggesting that nitrogen in 15 NH 4 15 NO 3 was predominantly taken up by plants and mycorrhizal fungi but little by saprotrophic microorganisms. Roots of beech and ash were highly enriched in 13 C with maximum values in EM proving that 13 C was translocated into roots and mycorrhizal fungi. Soil animals were a priori assigned to primary decomposers, secondary decomposers and predators. Generally, signatures of soil animals did not significantly vary between beech and ash and therefore were pooled. Primary decomposers had low δ 13 C and δ 15 N signatures similar to litter and soil confirming that rhizosphere C and microbial N are of limited importance for primary decomposer taxa. δ 13 C and δ 15 N signatures of secondary decomposers were higher than those of primary decomposers and spanned a large gradient indicating that certain secondary decomposers rely on root derived C and microbial N, however, none of the secondary decomposers had signatures pointing to exclusive feeding on EM. Unexpectedly, δ 13 C and δ 15 N signatures were highest in predators suggesting that they heavily preyed on secondary decomposer species such as the litter dwelling Collembola species Lepidocyrtus cyaneus and species not captured by the heat extraction procedure used for capturing prey taxa, presumably predominantly root associated nematodes. Overall, the results highlight that in particular higher trophic levels rely on carbon originating from other resources than litter with these resources channeled to dominant predators via litter dwelling Collembola species.

Knowledge about the influence of living roots on decomposition processes in soil is scarce but is needed to understand carbon dynamics in soil. We investigated the effect of dominant deciduous tree species of the Central European forest vegetation, European beech ( Fagus sylvatica L.) and European ash ( Fraxinus excelsior L.), on soil biota and carbon dynamics differentiating between root- and leaf litter-mediated effects. The influence of beech and ash seedlings on carbon and nitrogen flow was investigated using leaf litter enriched in 13 C and 15 N in double split-root rhizotrons planted with beech and ash seedlings as well as a mixture of both tree species and a control without plants. Stable isotope and compound-specific fatty acid analysis ( 13 C-PLFA) were used to follow the incorporation of stable isotopes into microorganisms, soil animals and plants. Further, the bacterial community composition was analyzed using pyrosequencing of 16S rRNA gene amplicons. Although beech root biomass was significantly lower than that of ash only beech significantly decreased soil carbon and nitrogen concentrations after 475 days of incubation. In addition, beech significantly decreased microbial carbon use efficiency as indicated by higher specific respiration. Low soil pH probably increased specific respiration of bacteria suggesting that rhizodeposits of beech roots induced increased microbial respiration and therefore carbon loss from soil. Compared to beech δ 13 C and δ 15 N signatures of gamasid mites in ash rhizotrons were significantly higher indicating higher amounts of litter-derived carbon and nitrogen to reach higher trophic levels. Similar δ 13 C signatures of bacteria and fine roots indicate that mainly bacteria incorporated root-derived carbon in beech rhizotrons. The results suggest that beech and ash differentially impact soil processes with beech more strongly affecting the belowground system via root exudates and associated changes in rhizosphere microorganisms and carbon dynamics than ash.

Through their leaf litter and throughfall water, tree species can have a pronounced influence on soil chemistry. However, there is little knowledge of species-specific root effects on greenhouse gas fluxes between forest soils and the atmosphere. By growing saplings of beech (Fagus sylvatica) and ash (Fraxinus excelsior) in monoculture or mixture at defined atmospheric and soil conditions in rhizotrons, we tested four hypotheses related to potential root-induced tree species effects on the uptake of CH4 and the emission of N2O and CO2 from the soil. This design excluded putative effects of leaf litter mineralisation on trace gas fluxes. Gas fluxes were measured biweekly using the closed chamber technique; the CO2 derived from root respiration was estimated, and the concentration of organic acids in the rhizosphere solution was analysed. Rhizotrons planted with ash took up significantly more CH4 and emitted less N2O than control rhizotrons without plants. CH4 and N2O fluxes from beech rhizotrons did not differ from the root-free control but were significantly smaller (CH4) or higher (N2O) than the fluxes from the ash treatment. While root respiration of ash was higher than of beech, root-induced soil respiration was higher in the rhizosphere of beech roots. The concentration of organic acids tended to be higher in the rhizosphere of beech and also the composition was different from that of ash. We conclude that tree species identity may substantially alter the soil source/sink strength for greenhouse gases through root-related processes.

In April 2016, the German Society of Hygiene, Environmental Medicine and Preventative Medicine (Gesellschaft fur Hygiene, Umweltmedizin und Praventivmedizin (GHUP)) together with other scientific medical societies, German and Austrian medical societies, physician unions and experts has provided an AWMF (Association of the Scientific Medical Societies) guideline 'Medical diagnostics for indoor mold exposure'. This guideline shall help physicians to advise and treat patients exposed indoors to mold. Indoor mold growth is a potential health risk, even without a quantitative and/or causal association between the occurrence of individual mold species and health effects. Apart from the allergic bronchopulmonary aspergillosis (ABPA) and the mycoses caused by mold, there is only sufficient evidence for the following associations between moisture/mold damages and different health effects: Allergic respiratory diseases, asthma (manifestation, progression, exacerbation), allergic rhinitis, exogenous allergic alveolitis and respiratory tract infections/bronchitis. In comparison to other environmental allergens, the sensitizing potential of molds is estimated to be low. Recent studies show a prevalence of sensitization of 3-10% in the total population of Europe. The evidence for associations to mucous membrane irritation and atopic eczema (manifestation, progression, exacerbation) is classified as limited or suspected. Inadequate or insufficient evidence for an association is given for COPD, acute idiopathic pulmonary hemorrhage in children, rheumatism/arthritis, sarcoidosis, and cancer. The risk of infections from indoor molds is low for healthy individuals. Only molds that are capable to form toxins can cause intoxications. The environmental and growth conditions and especially the substrate determine whether toxin formation occurs, but indoor air concentrations are always very low. In the case of indoor moisture/mold damages, everyone can be affected by odor effects and/or impairment of well-being. Predisposing factors for odor effects can be given by genetic and hormonal influences, imprinting, context and adaptation effects. Predisposing factors for impairment of well-being are environmental concerns, anxieties, conditioning and attributions as well as a variety of diseases. Risk groups that must be protected are patients with immunosuppression and with mucoviscidosis (cystic fibrosis) with regard to infections and individuals with mucoviscidosis and asthma with regard to allergies. If an association between mold exposure and health effects is suspected, the medical diagnosis includes medical history, physical examination, conventional allergy diagnosis, and if indicated, provocation tests. For the treatment of mold infections, it is referred to the AWMF guidelines for diagnosis and treatment of invasive Aspergillus infections. Regarding mycotoxins, there are currently no validated test methods that could be used in clinical diagnostics. From the perspective of preventive medicine, it is important that mold damages cannot be tolerated in indoor environments.

Background At Holi festivals, originally celebrated in India but more recently all over the world, people throw coloured powder (Holi powder, Holi colour, Gulal powder) at each other. Adverse health effects, i.e. skin and ocular irritations as well as respiratory problems may be the consequences. The aim of this study was to uncover some of the underlying mechanisms. Methods We analysed four different Holi colours regarding particle size using an Electric field cell counting system. In addition, we incubated native human cells with different Holi colours and determined their potential to induce a pro-inflammatory response by quantifying the resulting cytokine production by means of ELISA (Enzyme Linked Immunosorbent Assay) and the resulting leukocyte oxidative burst by flow cytometric analysis. Moreover, we performed the XTT (2,3-Bis-(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide) and Propidium iodide cytotoxicity tests and we measured the endotoxin content of the Holi colour samples by means of the Limulus Amebocyte Lysate test (LAL test). Results We show here that all tested Holi colours consist to more than 40 % of particles with an aerodynamic diameter smaller than 10 μm, so called PM10 particles (PM, particulate matter). Two of the analysed Holi powders contained even more than 75 % of PM10 particles. Furthermore we demonstrate in cell culture experiments that Holi colours can induce the production of the pro-inflammatory cytokines TNF-α (Tumor necrosis factor-α), IL-6 (Interleukine-6) and IL-1β (Interleukine-1β). Three out of the four analysed colours induced a significantly higher cytokine response in human PBMCs (Peripheral Blood Mononuclear Cells) and whole blood than corn starch, which is often used as carrier substance for Holi colours. Moreover we show that corn starch and two Holi colours contain endotoxin and that certain Holi colours display concentration dependent cytotoxic effects in higher concentration. Furthermore we reveal that in principle Holi colours and corn starch are able to generate an oxidative burst in human granulocytes and monocytes. In Holi colour 1 we detected a fungal contamination. Conclusions Some of the observed unwanted health effects of Holi colours might be explained by the high content of PM10 particles in conjunction with the possible induction of a pro-inflammatory response and an oxidative leukocyte burst.

We tested the hypothesis that carbon productivity of beech (Fagus sylvatica) controls ectomycorrhizal colonization, diversity and community structures. Carbon productivity was limited by long-term shading or by girdling. The trees were grown in compost soil to avoid nutrient deficiencies. Despite severe limitation in photosynthesis and biomass production by shading, the concentrations of carbohydrates in roots were unaffected by the light level. Shade-acclimated plants were only 10% and sun-acclimated plants were 74% colonized by ectomycorrhiza. EM diversity was higher on roots with high than at roots with low mycorrhizal colonization. Evenness was unaffected by any treatment. Low mycorrhizal colonization had no negative effects on plant mineral nutrition. In girdled plants mycorrhizal colonization and diversity were retained although 14 C-leaf feeding showed almost complete disruption of carbon transport from leaves to roots. Carbohydrate storage pools in roots decreased upon girdling. Our results show that plant carbon productivity was the reason for and not the result of high ectomycorrhizal diversity. We suggest that ectomycorrhiza can be supplied by two carbon routes: recent photosynthate and stored carbohydrates. Storage pools may be important for ectomycorrhizal survival when photoassimilates were unavailable, probably feeding preferentially less carbon demanding EM species as shifts in community composition were found.