Endotoxins are lipopolysaccharides found in the outer membrane of most Gram-negative bacteria and cyanobacteria. Worker exposure to endotoxins has been shown in a number of work situations and is associated with both respiratory and systemic pathologies. The lack of an occupational exposure limit is mainly due to the absence of a standard protocol at the international level for sampling and analyzing airborne endotoxins. The bibliographic review in this article takes an exhaustive look at the current knowledge on measuring airborne endotoxins. It shows that, despite several reference documents at the international level, the methods used to measure endotoxin exposure differ considerably from one laboratory to another. Standardization is necessary to reduce interlaboratory variability and, ultimately, to improve the use of interstudy data. The bibliographic review presents the current status of standardization for airborne endotoxin measurement methods in the workplace and summarizes areas for further research. This article is both a reference document for all operators wishing to use such methods and a working document to build international consensus around the measurement of airborne endotoxins.

During the summer of 2012, a major Legionella pneumophila serogroup 1 outbreak occurred in Quebec City, Canada, which caused 182 declared cases of Legionnaire's disease and included 13 fatalities. Legionella pneumophila serogroup 1 isolates from 23 patients as well as from 32 cooling towers located in the vicinity of the outbreak were recovered for analysis. In addition, 6 isolates from the 1996 Quebec City outbreak and 4 isolates from patients unrelated to both outbreaks were added to allow comparison. We characterized the isolates using pulsed-field gel electrophoresis, sequence-based typing, and whole genome sequencing. The comparison of patients-isolated strains to cooling tower isolates allowed the identification of the tower that was the source of the outbreak. Legionella pneumophila strain Quebec 2012 was identified as a ST-62 by sequence-based typing methodology. Two new Legionellaceae plasmids were found only in the epidemic strain. The LVH type IV secretion system was found in the 2012 outbreak isolates but not in the ones from the 1996 outbreak and only in half of the contemporary human isolates. The epidemic strains replicated more efficiently and were more cytotoxic to human macrophages than the environmental strains tested. At least four Icm/Dot effectors in the epidemic strains were absent in the environmental strains suggesting that some effectors could impact the intracellular replication in human macrophages. Sequence-based typing and pulsed-field gel electrophoresis combined with whole genome sequencing allowed the identification and the analysis of the causative strain including its likely environmental source.

Both the processing of solid waste and the composting of organic matter generate airborne biological contaminants. For this type of environment, some authors have proposed Threshold Limit Values (TLV) of 10,000 Colony Forming Units per cubic meter (CFU/m³) of air for total bacteria, and 1,000 CFU/m³ of air for Gram-negative bacteria. Endotoxins produced by Gram-negative bacteria can cause fever and respiratory problems. Diarrhea and gastrointestinal problems can also be caused by Gram-negative bacteria. Other researchers have found Aspergillus fumigatus, which is considered an opportunistic pathogenic fungus, in the nose and throat of people exposed to compost. The objectives of this study were to evaluate the microbiological content of indoor and outdoor air, to detect concentrations of total and Gram-negative bacteria exceeding their proposed TLV, and to suggest corrective measures based on the technical and scientific literature. Air sampling was carried out twice in one day using Andersen samplers. The culture media used were trypticase soya agar for total bacteria, MacConkey for Gram-negative bacteria, and Sabouraud dextrose agar for the fungi. In at least one sample from each work station, the air concentrations of total bacteria exceeded 10,000 CFU/m³. The air concentrations of Gram-negative bacteria were above 1,000 CFU/m³ of air at six of the nine work stations. Indoor concentrations of fungi exceeded outdoor concentrations at eight of the nine work stations studied. To reduce exposure to biological contaminants, it is suggested that ventilation be modified in the separating area, and protective and hygienic measures be initiated at the other work stations.

Composting is a natural dynamic biological process used to valorise putrescible organic matter. The composting process can involve vigorous movements of waste material piles, which release high concentrations of bioaerosols into the surrounding environment. There is a lack of knowledge concerning the dispersal of airborne microorganisms emitted by composting plants (CP) as well as the potential occupational exposure of composting workers. The aim of this study was to investigate the workers exposure to bioaerosols during working activities in three different types of composting facilities (domestic, manure, carcass) using two different quantification methods (cultivation and qPCR) for bacteria and moulds concentrations. As expected, even if there are differences between all CP frameworks, independently of the type of the raw compost used, the production of bioaerosols increases significantly during handling activities. Important concentrations of mesophilic moulds and mesophilic bacteria were noted in the working areas with a respective maximal concentration of 2.3 × 105 CFU/m3 and 1.6 × 105 CFU/m3. A. fumigatus and thermophilic Actinomycetes were also detected in all working areas for the 3 CP. This study emphases the risks for workers to being in contact with aerosolized pathogens such as Mycobacterium and Legionella and more specifically, L. pneumophila. The presence of high concentration of these bacteria in CP suggests a potential occupational health risk. This study may lead to recommendations for the creation of limits for occupational exposure. There is a need for identifying the standards exposure limits to bioaerosols in CP and efficient recommendation for a better protection of workers' health.