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Jacek Dutkiewicz

Publications and source records attributed to Jacek Dutkiewicz.

At least 37 records · Page 2Linked to original sources

Exposure to airborne microorganisms, dust and endotoxin during flax scutching on farms.

Microbiological air sampling was performed on 5 flax farms located in eastern Poland. Air samples for determination of the concentrations of microorganisms, dust and endotoxin were collected in barns during machine scutching of flax stems by the farmers. The concentrations of mesophilic bacteria ranged from 203.5-698.8 x 10(3) cfu/m3, of Gram-negative bacteria from 27.2-123.4 x 10(3) cfu/m3, of thermophilic actinomycetes from 0.5-2.6 x 10(3) cfu/m3, and of fungi from 23.4-99.8 x 10(3) cfu/m3. The concentrations of total airborne microorganisms (bacteria + fungi) were within a range of 245.0-741.0 x 10(3) cfu/m3. The values of the respirable fraction of total airborne microflora on the examined farms were between 45.5-98.3%. Corynebacteria (irregular Gram-positive rods, mostly Corynebacterium spp.) were dominant at all sampling sites, forming 46.8-67.8% of the total airborne microflora. Among Gram-negative bacteria, the most numerous species was Pantoea agglomerans (synonyms: Erwinia herbicola, Enterobacter agglomerans), known to have strong endotoxic and allergenic properties. Among fungi, the allergenic species Alternaria alternata prevailed. Altogether, 25 species or genera of bacteria and 10 species or genera of fungi were identified in the farm air during flax scutching; of these, 11 and 6 species or genera respectively were reported as having allergenic and/or immunotoxic properties. The concentrations of airborne dust ranged within 43.7-648.1 mg/m3 (median 93.6 mg/m3), exceeding on all farms the Polish OEL value of 4 mg/m3. The concentrations of airborne endotoxin ranged within 16.9-172.1 microg/m3 (median 30.0 microg/m3), exceeding at all sampling sites the suggested OEL value of 0.2 microg/m). In conclusion, flax farmers performing machine scutching of flax could be exposed to large concentrations of airborne microorganisms, dust and endotoxin, posing a risk of work-related respiratory disease.

Agriculture↗

Studies on the occurrence of Gram-negative bacteria in ticks: Ixodes ricinus as a potential vector of Pasteurella.

A total of 372 Ixodes ricinus ticks (101 females, 122 males, and 149 nymphs) collected by flagging in 6 mixed woodlands of eastern Poland were examined by culture for the presence of internal Gram-negative bacteria other than Borrelia burgdorferi. Adult ticks were examined in pools of 2 specimens each and nymphs were examined in pools of 3-5 specimens each. Ticks were disinfected in 70 % ethanol and homogenized in 0.85% NaCl. The diluted homogenate was inoculated onto 3 kinds of agar media: buffered charcoal yeast extract (BCYE-alpha) for isolation of fastidious Gram-negative bacteria, eosin methylene blue agar (EMB) for isolation of enterobacteria, and tryptic soya agar for isolation of all other non-fastidious Gram-negative bacteria. The Gram-negative isolates were identified with the API Systems 20E and NE microtests. A total of 9 species of Gram-negative bacteria were identified, of which the commonest were strains determined as Pasteurella pneumotropica/haemolytica, which were isolated on BCYE-alpha agar from ticks collected in all 6 examined woodlands. The total number of these strains (49) exceeded the total number of all other strains of Gram-negative bacteria recovered from ticks (30). Of the total number of examined ticks, the minimum infection rate with Pasteurella pneumotropica/haemolytica was highest in females (18.8%), and slightly lower in males (12.3%) and nymphs (10%). Besides Pasteurella pneumotropica/haemolytica, the following species of Gram-negative bacteria were isolated from examined ticks: Pantoea agglomerans, Serratia marcescens, Serratia plymuthica on EMB agar and Aeromonas hydrophila, Burkholderia cepacia, Chromobacterium violaceum, Pseudomonas aeruginosa, and Stenotrophomonas maltophilia on tryptic soya agar. Minimal infection rates with these bacteria were low, ranging from 0.7-5.9%. Of the isolated bacteria, Chromobacterium violaceum, Pasteurella pneumotropica/haemolytica, Pseudomonas aeruginosa, and Serratia marcescens are potentially pathogenic for man and/or animals. In particular, the common occurrence of Pasteurella pneumotropica/haemolytica in Ixodes ricinus ticks poses a potential risk of pasteurellosis for humans and animals exposed to tick bites.

Animals↗

A farmer's occupational airborne contact dermatitis masqueraded by coexisting rosacea: delayed diagnosis and legal acknowledgement.

A rare case of coexistence of occupational airborne dermatitis with rosacea is presented in a 41-year-old female farmer. Her first dermatitis symptoms appeared at the age of 10 when she started helping her parents on the farm. Uncovered skin areas of the face, neck, décolleté, forearms and the hands gradually became involved. The dermatitis symptoms were provoked by agricultural dusts (especially of flax and dried herbs). For the subsequent 30 years, the work-related disease remained undiagnosed due to the lack of pre-employment and periodical health check in agriculture. She also suffered from protein contact dermatitis of the hands from cow epithelium. About 20 years after the onset of airborne dermatitis, rosacea developed, possibly secondary to the prolonged treatment. Diagnostic tests carried out at our department confirmed hypersensitivity to occupational allergens: type I allergy to storage mites, moulds, and cow epithelium. A cutaneous late-phase reaction on prick tests and serum precipitins to the bacterium Pantoea agglomerans (Erwinia herbicola) also were found. Among non-occupational hypersensitivities, type I allergy to house dust mites and contact allergy to methylchloroisothiazolinone/methylisothiazolinone (Kathon CG) was found. In connection with these results, the significance of agricultural dusts in farmers' airborne dermatitis is discussed. Also presented are the problems with obtaining acceptance from the State Sanitary Authority for qualification of this case as an occupational disease, which was due to the coexistence of the non-occupational rosacea. Discussed is also the problem of pre-employment exposure to occupational allergens among farmers' children, and the difficulties with delivering occupational health services to self-employed farmers.

Adult↗

[Prevalence of antibodies to Anaplasma phagocytophilum and Borrelia burgdorferi in forestry workers from the Lublin region].

Ticks are recently regarded as ones of the most important vectors of emerging diseases. One of these diseases is human granulocytic ehrlichiosis caused by obligatory intracellular microorganism recently named as Anaplasma phagocytophilum. 334 sera from forestry workers and 56 sera from blood donors (as a control group) were collected and examined for antibodies to A. phagocytophilum and B. burgdorferi. The antibodies were found statistically more frequently in sera from foresters compared to sera of the control group, both to A. phagocytophilum (19.8% vs. 5.4%, p < 0.001) and B. burgdorferi (32.0% vs. 7.1%, p < 0.01). Only 15 sera (4.5%) were found positive for both examined bacteria suggesting inhibition of coexistence although it was not statistically significant. No correlation was found between percentages of antibodies to A. phagocytophilum and to B. burgdorferi from different locations.

Anaplasma phagocytophilum↗

Release of Streptomyces albus propagules from contaminated surfaces.

The release of Streptomyces albus propagules from contaminated agar and ceiling tile surfaces was studied under controlled environmental conditions in a newly developed aerosolization chamber. The experiments revealed that both spores and cell fragments can be simultaneously released from the colonized surface by relatively gentle air currents of 0.3 ms(-1). A 100 x increase of the air velocity can result in a 50-fold increase in the number of released propagules. The aerosolization rate depends strongly on the type and roughness of the contaminated surface. Up to 90% of available actinomycete propagules can become airborne during the first 10 min of the release process. Application of vibration to the surface did not reveal any influence on the aerosolization process of S. albus propagules under the tested conditions. This study has shown that propagules in the fine particle size range can be released in large amounts from contaminated surfaces. Measurement of the number of S. albus fragments in the vicinity of a contaminated area, as an alternative to conventional air or surface sampling, appears to be a promising approach for quantitative exposure assessment.

Aerosols↗

Exposure to airborne Gram-negative bacteria, dust and endotoxin in paper factories.

Air samples for determination of the concentration of Gram-negative bacteria, dust and endotoxin were collected at 10 sites in 2 large pulp and paper mills (paper factories) located in northern Poland, of which one (plant "A") was an older type facility while the other (plant "B") was a modern, fully automated factory with an effective ventilatory system. In both factories paper was produced from wood chips derived mostly from Scots pine. The concentrations of Gram-negative bacteria in the air of examined factories were within a range of 11.0-310.0 cfu/m(3), being greatest in the old type factory "A" at the initial stages of production cycle comprising handling of chips and pulp production. The mean value for these sites (246.9 cfu/m(3)) was significantly greater (t-test, p < 0.01) compared to final stages of paper production in the same factory (mean 32.1 cfu/m(3)) and to corresponding stages of chip handling in the modern "B" factory (mean 94.4 cfu/m(3)). The values of the respirable fraction of airborne Gram-negative flora were at most sites within a range of 40.0-56.9%. The species of the family Enterobacteriaceacae, mostly belonging to the genera Enterobacter, Pantoea, Rahnella and Klebsiella, distinctly prevailed in the air of the examined factories. Altogether, 19 species or genera of Gram-negative bacteria were identified in the collected air samples, out of these 9 were reported as having allergenic, immunotoxic and/or infectious properties. The concentration of dust in the air of paper factories ranged from 0.13-3.9 mg/m(3) and never exceeded the safe level. The concentration of bacterial endotoxin in the air of paper factories varied within a fairly wide range of 0.0042-2.5 micro g/m(3). At 4 sites associated with initial chip handling and pulp production large concentrations of airborne endotoxin between 0.2-2.5 micro g/m(3) were found, significantly exceeding suggested safe levels. In conclusion, despite Gram-negative bacteria occur in the air of paper mills in relatively low concentrations which never exceeded the value of 1,000 cfu/m(3) proposed as safe level, they may exert adverse effects on exposed workers, as evidenced by high concentrations of airborne endotoxin and the presence of numerous potentially pathogenic species. Thus, these microorganisms pose a potential risk of respiratory disease for the workers of pulp and paper mills, in particular for those engaged in handling of wood chips and production of pulp.

Air Pollution, Indoor↗

Ixodes ricinus as a potential vector of Toxoplasma gondii.

The presence of Toxoplasma gondii DNA was detected by polymerase chain reaction (PCR) test in 2 out of 92 Ixodes ricinus ticks (2.8%) collected in the woodlands of eastern Poland. This suggests that ticks of this species may be involved in the spread of toxoplasmosis under natural conditions.

Animals↗

Toxoplasmosis in rabbits confirmed by strain isolation: a potential risk of infection among agricultural workers.

The presence of anti-Toxoplasma gondii IgG antibodies in a high titer of 1:8,000 was found in 2 out of 9 examined rabbits (22.2%), kept on a farm where cases of human toxoplasmosis were noted. A virulent Toxoplasma gondii strain was isolated in mice from the brain of a seropositive rabbit that showed clinical signs of disease: apathy, weight loss, skin lesions. The presence of T. gondii DNA in the peritoneal exudate of mice inoculated with the brain suspension of the dissected rabbit was confirmed by the positive results of PCR test. No toxoplasmas were found in mice inoculated with suspensions of other organs of the examined rabbit (liver, spleen, kidneys, lungs, heart, skeletal muscles). In the sections of the rabbit's brain the typical cysts of Toxoplasma gondii were found, filled with bradyzoites. On the basis of strain isolation and microscopic findings, toxoplasmosis of the central nervous system was diagnosed in the rabbit. The results of this study suggest that rabbits should be considered as a potential source of Toxoplasma infection among agricultural workers.

Agriculture↗

[Filamentous fungi and mycotoxins as potential occupational risk factors among farmers harvesting various crops].

The studies to determine the level of filamentous fungi and mycotoxins were carried out in samples of grain and grain dust during threshing of cereals by a combine harvester. High concentration of fungi was noted in grain and grain dust samples, it ranged from 5.0 to 520.0 cfu/g.10(3) and from 275.0 to 2825.0 cfu/g.10(3), respectively Allergizing and toxigenic fungi of Alternaria, Geotrichum, Cladosporium, Penicillium, Aspergillus and Fusarium species were observed in the study samples of grain and grain dust. In the samples of wheat grain, mycotoxins were also noted: moniliformin (MON), deoxynivalenol (DON) and ochratoxin A (OTA); their concentrations ranged from 0.025 to 0.088 microgram/g; 0.015-0.068 microgram/g; and from 0.0004 to 0.0008 microgram/g, respectively. The level of mycotoxins in the grain dust samples was within the range of 0.025-0.149 microgram/g-MON; 0.015-0.215 microgram/g-DON; 0.015-0.360 microgram/g-NIV; and 0.0004-0.0012 microgram/g-OTA. A significant correlation was observed between the occurrence of fungi of Fusarium species and the concentration of pathologic mycotoxins. The results confirm a considerable occupational risk among farmers engaged in grain threshing due to inhalation of pathogenic species of filamentous fungi and mycotoxins.

Agricultural Workers' Diseases↗

[Incidence of tick-borne encephalitis virus and Borrelia burgdorferi infections in farmers of the Lublin province].

The objective of the study was to evaluate the incidence of tick-borne encephalitis virus and Borrelia burgdorferi infections in farmers of the Lublin province. The study involved sero-epidemiological examinations of 242 farmers (the study group) and 50 healthy urban blood donors (the control group). In both tick-transmitted diseases, the frequency of sero-positive reactions was significantly higher in farmers than in controls. Serological examinations for the detection of tick-borne encephalitis showed 17.3% of positive results among farmers, and only 6.0% (p < 0.05) in the control group. The presence of specific antibodies IgG against Borrelia burgdorferi was observed in 15.3% of the farmers versus 4.0% (p < 0.05) in controls. In the IgM class, 14.0% of farmers showed positive reactions to B. burgdorferi, while in the control group no sero-positive reactions were noted (p < 0.01). The results of the study indicate that farmers are at increased risk of infection with zoonotic tick-transmitted diseases.

Adult↗

Exposure to bioaerosols in a municipal sewage treatment plant.

Microbiological air sampling was performed in a medium-size sewage treatment plant processing municipal wastewater from a city located in eastern Poland. Air samples for determination of the concentrations of viable mesophilic bacteria, Gram-negative bacteria, thermophilic actinomycetes, fungi and endotoxin were collected at 12 sites associated with various phases of sewage treatment process. The concentrations of total mesophilic bacteria (both Gram-positive and Gram-negative) were within a range of 2.4-70.7 x 10(2) cfu/m(3). Gram-positive coryneform bacteria and cocci were dominant, forming respectively 56.6 % and 24.0 % of the total count. The concentrations of Gram-negative bacteria, thermophilic actinomycetes, and fungi were respectively within ranges of 0.2-5.7 x 10(2) cfu/m(3), 0-0.5 x 10(2) cfu/m(3), and 0.24-1.4 x 10(2) cfu/m(3). Among Gram-negative bacteria, commonly occurred Enterobacter cloacae (17.3 % of the total count), followed by Acinetobacter calcoaceticus (16.2 %), Pseudomonas spp. (14.0 %) and Stenotrophomonas maltophilia (11.1 %). Among thermophilic actinomycetes prevailed Thermoactinomyces thalpophilus (47.2 %) and Thermoactinomyces vulgaris (22.2 %), while among fungi, Geotrichum candidum (32.2 %), Penicillium spp. (20 %), Cladosporium lignicola (12.2 %), and Alternaria alternata (10.4 %). Altogether, 20 potentially pathogenic species or genera of bacteria and fungi were identified in the air samples taken in the examined plant. The values of the respirable fraction of airborne microflora varied within a fairly wide range and were between 24.1-100 %. The concentrations of airborne endotoxin were in the range of 0.104-5.2 ng/m(3). In conclusion, the concentrations of microorganisms and endotoxin in the examined municipal sewage treatment plant were low and did not exceed proposed occupational exposure limit values. A moderate risk for the workers may be associated with the presence of potentially pathogenic microbial species having allergenic and/or immunotoxic properties.

Actinobacteria↗

Prevalence of antibodies to Coxiella burnetii among farming population in eastern Poland.

The presence of blood serum antibodies to Coxiella burnetii phase I antigen, indicative of chronic Q fever or convalescence, was found by indirect immuno-fluorescent test in 16 out of 90 examined farmers (17.8 %) living in the Lublin region (eastern Poland) and in none of 30 examined urban blood donors living in the city of Lublin (p < 0.05). In both groups no antibodies to C. burnetii phase II antigen, indicative of acute Q fever, were detected. The frequency of antibodies among farmers was greater in females than in males (26.1 % versus 9.1 %, p < 0.05) and was significantly dependent on age ( xi(2) = 146.42, p < 0.000001) being greatest in the subgroup of farmers aged 41-55 (38.5 %) while no positive reactions were found in young and elderly farmers (respectively, equal to or below 25 and above 56 years). The results suggest that the examined agricultural region could be in the past an epidemic area of Q fever, probably before 15-30 years.

Adolescent↗

Health effects of exposure to thyme dust in a group of thyme growing farmers.

Medical examinations were performed in a group of 47 thyme farmers from eastern Poland while threshing thyme (Thymus vulgaris). As a reference group 63 urban dwellers were examined not exposed to organic dusts. The examinations included an interview concerning the occurrence of respiratory disorders and work-related symptoms, physical examination, lung function tests, skin prick tests with four microbial allergens and agar-gel precipitation tests with 12 antigens. 63.8% of thyme handling farmers reported occurrence of work-related symptoms while threshing thyme. The most common complaints were: blocking of the nose (reported by 18 farmers--38.3%), dry cough (14 persons--29.8%) and general weakness (13 persons--27.7%). The mean spirometric values in the farmers group were within a normal range and did not show a significant post-work decline. The farmers showed positive skin reactions to microbial antigens in the range of 4.3-14.9%, and a frequency of positive precipitin reactions 0-56.5%. The reference group responded to most allergens with a significantly lower frequency of positive results compared to the examined group. In conclusion, thyme farmers engaged in threshing this herb represent a group of elevated professional risk because of high incidence of work-related symptoms and common occurrence of positive skin and precipitin reactions to bacterial and fungal allergens associated with organic dust.

Adult↗

Health effects of inhalation exposure to organic dust in hops farmers.

Medical examinations were performed in a group of 23 hops farmers exposed to organic dust from hop (Humulus lupulus). The examinations took place in individual farms during harvesting, sorting and transporting of hop cones. As a reference group, 50 urban dwellers not exposed to organic dust were examined. There were conducted physical examinations, interviews concerning the occurrence of respiratory disorders and work-related symptoms, lung function tests, determination of cytokines concentrations, and allergological tests comprising skin prick test with 4 microbial antigens associated with organic dust, precipitin test with 12 microbial antigens, and a test for inhibition of leukocyte migration. Five farmers (21.7%) reported occurrence of work-related symptoms, including dry cough and dyspnoea. Eight farmers (34.8%) reported symptoms of chronic bronchitis. Mean spirometric values were within normal ranges. The farmers showed positive responses in precipitin test and test for inhibition of leukocyte migration to antigens of environmental microbes, mainly to the antigen of Gram-negative bacterium Pantoea agglomerans. The results showed a potential risk of occupational respiratory diseases in the population of hops farmers.

Adult↗

[The prevalence of anti-Toxoplasma gondii antibodies among abattoir workers in Lublin].

Abattoir workers are occupationally exposed to Toxoplasma gondii by the contact with raw meat. One hundred and seven abattoir workers from the Meat Factory in Lublin were examined for the presence of anti-Toxoplasma antibodies. Sixty-one blood donors were also tested as the reference group. Sera from workers and referents were tested by direct agglutination with 2-mercaptoethanol (DA-2ME), and also by ELFA IgG and ELFA IgM tests (Vidas Toxo IgM, Vidas Toxo IgG, bioMerieux, France). In the workers group, out of 107 tested sera, 70 were found positive (65.4%). The highest percentage of seropositive results was found in the Cured Meat Division--76.2%. In the Meat Production Division 66.6% of seropositive results were found, and in the Slaughter Division--46.1%. Three persons with the presence of IgM antibodies were found in the Cured Meat Division. In the reference group, 34 out of 61 sera (55.7%) were positive. The difference in seropositivity between Cured Meat Division workers and reference group was statistically significant (p < 0.05). The high percentage of seropositive reactions among the workers of Cured Meat Division and the presence of persons in early stage of invasion suggest an increased risk of exposure to T. gondii in this section.

Abattoirs↗

[Evaluation of occurrence of spirochetes Borrelia burgdorferi sensu lato in Ixodes ricinus ticks in selected areas of the Lublin region by polymerase chain reaction method (PCR)].

During the period 2001-2002, 1098 Ixodes ricinus ticks were collected at forest sampling sites and the degree of their infection with Borrelia burgdorferi spirochetes was determined by means of polimerase chain reaction (PCR). The presence of Borrelia burgdorferi genetic material was noted in 69 cases (6.3%). It was confirmed that the frequency of infection of adult forms of ticks (males and females) was nearly twice as high as nymphs. The highest degree of infection was observed in females--9.5%. The degree of infection among males and nymphs was smaller--5.9% and 4.4% respectively in individual provinces. The percentage of infected females ranged from 7.9% in the Zamość Province to 13.6% in the Włodawa Province. In males, the percentage of infected ticks remained within the range from 3.1% in the Lublin Province to 13.3% in the Lubartów Province.

Animals↗

[Biologic factors hazardous to health: classification and criteria of exposure assessment].

Occupational biohazards include not only factors that have long been known (viruses, bacteria, fungi, parasites), but also agents exerting allergic and toxic effects, which are directly responsible for the development of various diseases in many occupational groups. Numerous agents of this group (allergens, microbial toxins, pollen allergens and allergens of animal origin) are components of bioacrosols--potential hazards inducing occupational respiratory diseases among farmers and people involved in other occupations. Contrary to the majority of chemical and physical factors, neither commonly approved criteria for assessing exposure to biological factors, nor threshold values and methodological recommendations are as yet available. The lack of these criteria renders it difficult to implement in Poland and in other countries Directive 2000/54/EC on the protection of workers against the risk of occupational exposure to biohazards, issued by the European Community. The Institute of Rural Medicine in Lublin has drafted the proposals for threshold limit values of occupational exposure to bioaerosols associated with plant and animal dusts, including: mesophilic bacteria, Gram-negative bacteria, thermophilic actinomycetes, fungi and bacterial endotoxins. These proposals could be considered as a starting point for developing appropriate facultative standards that would facilitate the practical implementation of the aforesaid Directive. Meantime it is essential to be strict in following the binding concentration limits of the plant and animal dusts in the air.

Aerosols↗

Bacterial and fungal aerosols in indoor environment in Central and Eastern European countries.

Studies of indoor bioaerosols conducted in Central and Eastern European countries, as a result of the scarcity of funding, mostly do not attain the level presented by similar studies in Northern America and Western Europe. For socio-economic reasons, most of the intense studies on indoor bioaerosols in Central and Eastern European countries were carried out in industrial facilities and have contributed significantly to occupational health science. In contrast, until recently, insufficient of studies have been conducted on bioaerosols of residential and communal premises (dwellings, offices, schools, etc.) and no network for monitoring the microbiological quality of air in such premises exists. In Poland, in the mid-1990s complex bioaerosol investigations were carried out by the Bioaerosol Group at the Institute of Occupational Medicine and Environmental Health in Sosnowiec. The concentrations of airborne bacteria and fungi in dwellings without mold problems were between 88-4297 cfu/m(3) and 0-1997 cfu/m(3), while in moldy homes they were 178-4751 cfu/m(3) and 49-16,968 cfu/m(3), respectively. As many as 167 microbial species were isolated from the air of examined dwellings. Most frequently occurred Gram-positive cocci (Micrococcus/ Kocuria spp., Staphylococcus spp.), endospore-forming bacilli (Bacillus spp.), Gram-negative bacteria (Pseudomonadaceae, Aeromonas spp.), filamentous fungi (Penicillium spp., Aspergillus spp.), and yeasts. Notable studies of indoor bioaerosols have also been performed in the other Central and Eastern European countries: Lithuania, Latvia, Estonia, Russian Federation, Ukraine, Czech Republic, Slovakia, Bulgaria and Hungary, are reviewed in this article. The lack of reference limit values for bioaerosols seriously hinders interpretation of results obtained in various countries. The following residential limit values (RLV) for dwellings and communal premises are proposed for the concentration of airborne bacteria, fungi and bacterial endotoxin: 5 x 10(3) cfu/m(3), 5 x 10(3) cfu/m(3) and 5 ng/m(3) (50 EU), respectively. The proposed values of occupational exposure limit (OEL) for industrial settings contaminated by organic dust are 100 x (3) cfu/m(3), 50 x (3) cfu/m(3) and 200 ng/m(3) (2000 EU), respectively. It is also proposed that the presence in indoor air of microorganisms from risk groups 3 and 4 of European Community Directive 2000/54/EC (e.g., Mycobacterium tuberculosis, Bacillus anthracis, Coxiella burnetii), independently of the concentration, should always be inadmissible and result in preventive actions.

Aerosols↗