Airborne Fungal Colony-Forming Units in Outdoor and Indoor Environments in Yokohama,Japan

The fungal concentration and flora in indoor and outdoor air in Yokohama, Japan were analyzed with a Reuter centrifugal air sampler and dichloran 18% glycerol agar (DG18), and compared with the levels assessed with potato dextrose agar (PDA). The number of fungal colony-forming units (CFU) in outdoor air was < 13–2750/m³; Cladosporium spp. predominated, followed by Alternaria spp. and Penicillium spp. The fungal concentration in outdoor air peaked in September. The concentrations of fungi in outdoor air (n = 288) were significantly correlated with the maximum temperature of the day, minimum temperature of the day, average temperature of the day, average velocity of wind of the day, average temperature of the month, average relative humidity of the month and precipitation of the month. In indoor air, the fungal CFU was < 13–3750/m³. Cladosporium spp. predominated, followed by the xerophilic fungi such as the Aspergillus restrictus group, Wallemia sebi, the A. glaucus group, and Penicillium spp. The fungal concentration in indoor air peaked in October. The concentrations of fungi in indoor air (n = 288) were significantly correlated with the indoor temperature, indoor relative humidity and the outdoor climatic factors mentioned above, except for the average velocity of wind of the day. This revised version was published online in June 2006 with corrections to the Cover Date.     

Prediction of air temperature for thermal comfort of people in outdoor environments

Current thermal comfort indices do not take into account the effects of wind and body movement on the thermal resistance and vapor resistance of clothing. This may cause public health problem, e.g. cold-related mortality. Based on the energy balance equation and heat exchanges between a clothed body and the outdoor environment, a mathematical model was developed to determine the air temperature at which an average adult, wearing a specific outdoor clothing and engaging in a given activity, attains thermal comfort under outdoor environment condition. The results indicated low clothing insulation, less physical activity and high wind speed lead to high air temperature prediction for thermal comfort. More accurate air temperature prediction is able to prevent wearers from hypothermia under cold conditions.     

Indoor/outdoor concentrations of ozone and peroxyacetyl nitrate (PAN)

 Photochemical pollutants such as ozone and peroxyacetyl nitrate (PAN) could adversely affect human health, especially with relation to effects on lung function. For a realistic assessment of ambient concentrations, both outdoor and indoor measurements of ozone and PAN are required, because people stay indoors for most of the time. Indoor/outdoor concentration ratios, indoor half-life times and indoor chemistry including physicochemical reactions on surfaces are quite well known for ozone, but not for PAN. While ozone is removed very rapidly mainly by heterogeneous reactions on surfaces or by gasphase reactions with e.g. carpet emissions, no such processes are known for PAN at present. The main removal process for PAN is thermal decay. Indoor concentrations of ozone and PAN can be a significant fraction of those outdoors highly depending on the ventilation pattern. Our measurements in various kinds of non-air-conditioned rooms show maximal indoor concentrations between 80 and 100% of those outdoors for ozone and PAN, respectively. Average indoor/outdoor ratios were calculated of 0.5 for ozone and between 0.7 and 0.9 for PAN. The half-life times ranged between only a few minutes for ozone and 0.5 to 1 h for PAN. Received: 11 December 1996 / Accepted: 24 January 1997     

The physiological equivalent temperature – a universal index for the biometeorological assessment of the thermal environment

With considerably increased coverage of weather information in the news media in recent years in many countries, there is also more demand for data that are applicable and useful for everyday life. Both the perception of the thermal component of weather as well as the appropriate clothing for thermal comfort result from the integral effects of all meteorological parameters relevant for heat exchange between the body and its environment. Regulatory physiological processes can affect the relative importance of meteorological parameters, e.g. wind velocity becomes more important when the body is sweating. In order to take into account all these factors, it is necessary to use a heat-balance model of the human body. The physiological equivalent temperature (PET) is based on the Munich Energy-balance Model for Individuals (MEMI), which models the thermal conditions of the human body in a physiologically relevant way. PET is defined as the air temperature at which, in a typical indoor setting (without wind and solar radiation), the heat budget of the human body is balanced with the same core and skin temperature as under the complex outdoor conditions to be assessed. This way PET enables a layperson to compare the integral effects of complex thermal conditions outside with his or her own experience indoors. On hot summer days, for example, with direct solar irradiation the PET value may be more than 20 K higher than the air temperature, on a windy day in winter up to 15 K lower. Received: 14 December 1998 / Accepted: 26 May 1999     

Thermal resistance parameters of the air environment at various altitudes

 The thermal properties of atmospheric air surrounding the human body at various altitudes are characterized with a system of parameters. This system comprises resistance of the air to convective heat transfer h _c ^–1, °C (W/m²)⁻¹ and to water vapour transfer h _D ^–1, s/m. The concept of ’evaporative resistance’h _e ^–1, hPa (W/m²)⁻¹) following the similarity of the processes is introduced. In obtaining the altitude dependencies of investigated paramters, a respective heat transfer equation expressing the rate of heat exchange at the boundary body surface – ambient air is applied. The use of the body thermal state of the established altitude dependencies is discussed. The concept of ’thermal stability’ related to the evaporative resistance parameter h _e ^–1 is introduced. This parameter is assumed as: (1) an indicator of the human body thermal stability and (2) distributor and predictor of environmental influence on the body thermal state. Received: 5 January 1996 / Accepted 5 November 1996     

Thermoregulation by rhesus monkeys at different absolute humidities

The effect of relative humidity on thermoregulation has been well examined. Because the same relative humidity represents very different absolute humidities at different ambient temperatures, the present study was designed to examine the interaction of temperature and absolute humidity on the thermal balance of rhesus monkeys, Macaca mulatta. Thermal balance was examined in six unacclimated, unanesthetized, female rhesus monkeys at ambient temperatures of 25, 30, 35, and 40 °C and absolute humidities of 6, 22, and 40 torr. Monkeys were capable of achieving thermal balance under all conditions except at 40 °C with 40 torr absolute humidity, where experiments were stopped after rectal temperature exceeded 40.5 °C. At 40 °C, monkeys increased evaporative heat loss through both respiration and sweating; the slope of the relationship between evaporative heat loss and core temperature was attenuated by increases in absolute humidity. In contrast, absolute humidity had no direct effect on metabolic rate. The rise in body temperature under the conditions of high heat/high humidity was therefore most attributable to humidity-dependent decreases in evaporative heat loss.Abbreviations E_tot total evaporative heat loss - HR heart rate - K thermal conductance - M metabolic rate - RQ respiratory quotient - T_c core temperature - T_sk mean skin temperature - VCO₂ carbon dioxide production - VO₂ oxygen consumptionCommunicated by G. Heldmaier     

Airborne bacteria and fungal spores in the indoor environment. A case study in Singapore

The concentration of airborne fungal spores and bacteria as related to room temperature, humidity and occupancy levels within a library building in Singapore was determined. Measurement of indoor air quality with respect to microorganisms is of particular importance in tropical environments due to the extensive use of air‐conditioning systems and the potential implications for human health. This study has revealed a number of interesting relationships between the concentrations of fungal spores and bacteria in relation to both environmental and human factors. The levels of fungal spores measured in the indoor environment were approximately fifty times lower than those measured outside, probably because of the lowered humidity caused by air‐conditioning in the indoor environment. The variation in fungal spore concentration in the outdoor environment is likely to be due to the diurnal periodicity of spore release and the response to environmental factors such as light temperature and humidity. The indoor concentration of fungal spores in air was not clearly correlated to concentrations measured in air outside of the library building and remained relatively constant, unaffected by the difference in the numbers of occupants in the library. In contrast, the indoor concentrations of bacteria in air were approximately ten times higher than those measured outdoors, indicating a signficant internal source of bacteria. The elevated levels of indoor bacteria were primarily attributed to the number of library occupants. Increased human shedding of skin cells, ejection of microorganisms and particulates from the respiratory tract, and the transport of bacteria on suspended dust particles from floor surfaces probably accounts for the strong positive correlation between occupancy levels and the concentration of bacteria in internal air.     

Part B: Revisions to the COMFA outdoor thermal comfort model for application to subjects performing physical activity

This study assessed the performance of the COMFA outdoor thermal comfort model on subjects performing moderate to vigorous physical activity. Field tests were conducted on 27 subjects performing 30 min of steady-state activity (walking, running, and cycling) in an outdoor environment. The predicted COMFA budgets were compared to the actual thermal sensation (ATS) votes provided by participants during each 5-min interval. The results revealed a normal distribution in the subjects’ ATS votes, with 82% of votes received in categories 0 (neutral) to +2 (warm). The ATS votes were significantly dependent upon sex, air temperature, short and long-wave radiation, wind speed, and metabolic activity rate. There was a significant positive correlation between the ATS and predicted budgets (Spearman’s rho = 0.574, P < 0.01). However, the predicted budgets did not display a normal distribution, and the model produced erroneous estimates of the heat and moisture exchange between the human body and the ambient environment in 6% of the cases.     

Air movement preferences observed in office buildings

Office workers’ preferences for air movement have been extracted from a database of indoor environmental quality surveys performed in over 200 buildings. Dissatisfaction with the amount of air motion is very common, with too little air movement cited far more commonly than too much air movement. Workers were also surveyed in a detailed two-season study of a single naturally ventilated building. About one-half the building’s population wanted more air movement and only 4% wanted less. This same ratio applied when the air movement in workspaces was higher than 0.2 m/s, the de facto draft limit in the current ASHRAE and ISO thermal environment standards. Preference for “less air motion” exceeded that for “more” only at thermal sensations of −2 (cool) or colder. These results raise questions about the consequences of the ASHRAE and ISO standards’ restrictions on air movement, especially for neutral and warm conditions.     

Redefining physiological responses of moose (Alces alces) to warm environmental conditions

We tested the concept that moose (Alces alces) begin to show signs of thermal stress at ambient air temperatures as low as 14 °C. We determined the response of Alaskan female moose to environmental conditions from May through September by measuring core body temperature, heart rate, respiration rate, rate of heat loss from exhaled air, skin temperature, and fecal and salivary glucocorticoids. Seasonal and daily patterns in moose body temperature did not passively follow the same patterns as environmental variables. We used large changes in body temperature (≥1.25 °C in 24hr) to indicate days of physiological tolerance to thermal stressors. Thermal tolerance correlated with high ambient air temperatures from the prior day and with seasonal peaks in solar radiation (June), ambient air temperature and vapor pressure (July). At midday (12:00hr), moose exhibited daily minima of body temperature, heart rate and skin temperature (difference between the ear artery and pinna) that coincided with daily maxima in respiration rate and the rate of heat lost through respiration. Salivary cortisol measured in moose during the morning was positively related to the change in air temperature during the hour prior to sample collection, while fecal glucocorticoid levels increased with increasing solar radiation during the prior day. Our results suggest that free-ranging moose do not have a static threshold of ambient air temperature at which they become heat stressed during the warm season. In early summer, body temperature of moose is influenced by the interaction of ambient temperature during the prior day with the seasonal peak of solar radiation. In late summer, moose body temperature is influenced by the interaction between ambient temperature and vapor pressure. Thermal tolerance of moose depends on the intensity and duration of daily weather parameters and the ability of the animal to use physiological and behavioral responses to dissipate heat loads.     

Comparisons of urban and rural bioclimatological conditions in the case of a Central-European city

This paper examines the influence of a medium-sized city (Szeged, Hungary) on the bioclimatological conditions of human beings. With the help of suitable indices for the available data set, differences in the annual and diurnal variation of human bioclimatic characteristics between an urban and rural environment are evaluated over a 3-year period. These indices are the thermohygrometric index (THI, defined by air temperature and relative humidity), the relative strain index (RSI, defined by air temperature and vapour pressure) and the number of ”beergarden days” (defined by air temperature at 2100 hours). In urban and rural areas, ”hot” THI conditions characterize 6% and 1% of the year, ”comfortable” conditions 30% and 20%, ”cool” conditions 10% and 12%, and ”cold” conditions 54% and 66% respectively. Over longer periods (e.g. one, month) RSI remains below the threshold value for strong heat stress in the city. The monthly frequencies of beergarden days show that these days appears from May until October and the city has almost twice as many pleasant evenings as the rural areas. Consequently, the city favourably modifies the main climatological elements within the general climate of its region; periods likely to be comfortable are therefore found more frequently in the city than in rural areas. Received: 24 November 1998 / Revised: 14 June 1999 / Accepted: 4 August 1999     

Thermodynamic State of the System “Human Body–Closed Medium” during a 240-Day Isolation in a Hermetic Chamber

Temperature, humidity, and CO₂ concentration in the atmosphere of a closed object were studied by the method of daily monitoring. The analysis of the results of monitoring was performed using a system with variation of body temperature (T) parameters of healthy subjects. Experimental data were obtained by the method of autothermotopometry in the state of rest (including rhythmic changes in these parameters during the morning–evening cycle) using medical thermometers. Four healthy volunteer subjects were tested. They were confined for 240 days to a simulator of the main unit of the Mir space station. Technogenic parameters of surrounding medium were ranked in accordance with a four-point scale of the degree of physiological impact (neutral–threshold–negative–significantly negative). The first stage of the two-factor analysis included the valuation of the state of the closed system medium (temperature–concentration of CO₂). The second stage of the two-factor analysis included the evaluation of technogenic (i.e., attributed to surrounding medium) and physiological (i.e., attributed to human body) parameters of the system human body–closed medium. It was shown that, among eight parameters of thermal homeostasis (THS), a statistically significant correlation with technogenic parameters was observed for the parameter of deep body T (with CO₂) and two T-gradients of human body (external longitudinal and internal radial) (with air T and CO₂). According to the degree of strain of the body thermoregulation system in subjects, an increase in air T (above >23°) and a separate increase in the concentration of CO₂ (above 0.4%) were found to be intermediate between threshold and negative physiological impacts. Combined application of the two factors distinctly potentiated a negative effect of surrounding medium on human body, the effect of carbon dioxide being more significant. Experimental evidence was obtained that factors of the closed environmental medium (falling within the normal range) exerted an unfavorable effect on the thermal balance of human body. This raises the problem of the revision of standards of basic physical parameters of surrounding medium in hermetic objects of various purposes.     

Profiles of Airborne Fungi in Buildings and Outdoor Environments in the United States

We examined 12,026 fungal air samples (9,619 indoor samples and 2,407 outdoor samples) from 1,717 buildings located across the United States; these samples were collected during indoor air quality investigations performed from 1996 to 1998. For all buildings, both indoor and outdoor air samples were collected with an Andersen N6 sampler. The culturable airborne fungal concentrations in indoor air were lower than those in outdoor air. The fungal levels were highest in the fall and summer and lowest in the winter and spring. Geographically, the highest fungal levels were found in the Southwest, Far West, and Southeast. The most common culturable airborne fungi, both indoors and outdoors and in all seasons and regions, were Cladosporium, Penicillium, nonsporulating fungi, and Aspergillus. Stachybotrys chartarum was identified in the indoor air in 6% of the buildings studied and in the outdoor air of 1% of the buildings studied. This study provides industrial hygienists, allergists, and other public health practitioners with comparative information on common culturable airborne fungi in the United States. This is the largest study of airborne indoor and outdoor fungal species and concentrations conducted with a standardized protocol to date.     

Profiles of airborne fungi in buildings and outdoor environments in the United States

We examined 12,026 fungal air samples (9,619 indoor samples and 2,407 outdoor samples) from 1,717 buildings located across the United States; these samples were collected during indoor air quality investigations performed from 1996 to 1998. For all buildings, both indoor and outdoor air samples were collected with an Andersen N6 sampler. The culturable airborne fungal concentrations in indoor air were lower than those in outdoor air. The fungal levels were highest in the fall and summer and lowest in the winter and spring. Geographically, the highest fungal levels were found in the Southwest, Far West, and Southeast. The most common culturable airborne fungi, both indoors and outdoors and in all seasons and regions, were Cladosporium, Penicillium, nonsporulating fungi, and Aspergillus. Stachybotrys chartarum was identified in the indoor air in 6% of the buildings studied and in the outdoor air of 1% of the buildings studied. This study provides industrial hygienists, allergists, and other public health practitioners with comparative information on common culturable airborne fungi in the United States. This is the largest study of airborne indoor and outdoor fungal species and concentrations conducted with a standardized protocol to date.     

Evaporative water loss in seven species of fossorial rodents: Does effect of degree of fossoriality and sociality exist?

In terrestrial endotherms, evaporation is a significant mechanism of water loss in hot environments. Although water is passively lost by evaporation, individuals can regulate it at different levels. Inhabiting a relatively stable environment characterized by mild ambient temperature (T_a) and high humidity can ensure a balanced water budget. Many fossorial rodents are well adapted to live in such conditions. In this study, evaporative water loss (EWL) of fossorial rodent species with different degree of adaptations to underground life (from strictly subterranean to those with regular surface activity) was evaluated. By measuring EWL, the specific contribution of either evaporative or non-evaporative components of heat loss can be determined. With the exception of the silvery mole-rat (Heliophobius argenteocinereus), in all tested rodents EWL is relatively stable below and within the thermoneutral zone (TNZ). As T_as increase above TNZ, EWL increases as does total thermal conductance, but conductance increases several times more than EWL. In addition, non-evaporative routes seem to be more important than evaporative heat loss in the analyzed species. No clear pattern of EWL in relation to a species degree of fossoriality or sociality was detected. In this context, atmosphere of burrows could affect EWL, since the high humidity found inside tunnels can establish limits on evaporation to favor water rather than thermal balance.     

Outdoor thermal comfort study in a sub-tropical climate: a longitudinal study based in Hong Kong

This paper presents the findings of an outdoor thermal comfort study conducted in Hong Kong using longitudinal experiments—an alternative approach to conventional transverse surveys. In a longitudinal experiment, the thermal sensations of a relatively small number of subjects over different environmental conditions are followed and evaluated. This allows an exploration of the effects of changing climatic conditions on thermal sensation, and thus can provide information that is not possible to acquire through the conventional transverse survey. The paper addresses the effects of changing wind and solar radiation conditions on thermal sensation. It examines the use of predicted mean vote (PMV) in the outdoor context and illustrates the use of an alternative thermal index—physiological equivalent temperature (PET). The paper supports the conventional assumption that thermal neutrality corresponds to thermal comfort. Finally, predictive formulas for estimating outdoor thermal sensation are presented as functions of air temperature, wind speed, solar radiation intensity and absolute humidity. According to the formulas, for a person in light clothing sitting under shade on a typical summer day in Hong Kong where the air temperature is about 28°C and relative humidity about 80%, a wind speed of about 1.6 m/s is needed to achieve neutral thermal sensation.     

Thermoregulation in a large bird,the emu (Dromaius novaehollandiae)

The emu is a large, flightless bird native to Australia. Its habitats range from the high snow country to the arid interior of the continent. Our experiments show that the emu maintains a constant body temperature within the ambient temperature range-5 to 45°C. The males regulate their body temperature about 0.5°C lower than the females. With falling ambient temperature the emu regulates its body temperature initially by reducing conductance and then by increasing heat production. At-5°C the cost of maintaining thermal balance is 2.6 times basal metabolic rate. By sitting down and reducing heat loss from the legs the cost of homeothermy at-5°C is reduced to 1.5 times basal metabolic rate. At high ambient temperatures the emu utilises cutaneous evaporative water loss in addition to panting. At 45°C evaporation is equal to 160% of heat production. Panting accounts for 70% of total evaporation at 45°C. The cost of utilising cutaneous evaporation for the other 30% appears to be an increase in dry conductance.Abbreviations A _r Effective radiating surface area - BMR basal metabolic rate - C _dry dry conductance - CEWL cutaneous evaporative water loss - EHL evaporative heat loss - EWL evaporative water loss - FECO₂ fractional concentration of CO₂ in excurrent air - FF_H2O water content of chamber excurrent air - FEO₂ fractional concentration of O₂ in chamber excurrent air - FICO₂ fractional concentration of CO₂ in incurrent air - FIO₂ fractional concentration of O₂ in chamber incurrent air - MHP metabolic heat production - MR metabolic rate - REWL respiratory evaporative water loss - RH relative humidity - RQ respiratory quotient ; - SA surface area - SEM standard error of the mean - SNK Student-Newman-Keuls multiple range test - STPD standard temperature and pressure dry - T _a ambient temperature(s) - T _b body temperature(s) - T _e surface temperature(s) - flow rate of air into the chamber - carbon dioxide production - oxygen consumption - vapour pressure of water     

Characterization of metal(loid)s in indoor and outdoor PM2.5 of an office in winter period

The characterization of indoor (a naturally ventilated office) and outdoor (adjacent courtyard) metals in PM_2.5 during a winter period in Xi'an, China were carried out. The results indicated that the average mass concentrations of PM_2.5 in indoor and outdoor environments all exceeded the daily average limit of 75 µg m^–3 set by the Chinese government. The dominant metals in PM_2.5 were Ca, Al, Zn, Mg, Fe, and Pb in both indoor and outdoor air. Concentration of As was much higher than the standard of 6 ng m^–3 issued by the government. Enrichment factor analysis showed that anthropogenic emissions might be the primary sources of As, Cd, Pb, and Zn, while crust was the main origin of Co. A majority of indoor-to-outdoor concentration ratios of metal were lower than 1 indicating mostly the contribution of outdoor sources rather than indoor ones. As and Cr in both indoor and outdoor air posed the highest noncarcinogenic and carcinogenic risks, respectively. The noncarcinogenic and carcinogenic risks were 2.74 and 2.54 × 10^?4 indoor and 4.04 and 3.87 × 10^?4 outdoor, which suggested that possible adverse health effects should be of concern.     

Heat and PAHs Emissions in Indoor Kitchen Air and Its Impact on Kidney Dysfunctions among Kitchen Workers in Lucknow,North India

Indoor air quality and heat exposure have become an important occupational health and safety concern in several workplaces including kitchens of hotels. This study investigated the heat, particulate matter (PM), total volatile organic compounds (TVOCs) and polycyclic aromatic hydrocarbons (PAHs) emissions in indoor air of commercial kitchen and its association with kidney dysfunctions among kitchen workers. A cross sectional study was conducted on 94 kitchen workers employed at commercial kitchen in Lucknow city, North India. A questionnaire-based survey was conducted to collect the personal and occupational history of the kitchen workers. The urine analysis for specific gravity and microalbuminuria was conducted among the study subjects. Indoor air temperature, humidity, wet/ dry bulb temperature and humidex heat stress was monitored during cooking activities at the kitchen. Particulate matter (PM) for 1 and 2.5 microns were monitored in kitchen during working hours using Hazdust. PAH_S in indoor air was analysed using UHPLC. Urinary hydroxy-PAHs in kitchen workers were measured using GC/MS-MS. Higher indoor air temperature, relative humidity, PM₁ and PM_2.5 (p<0.001) was observed in the kitchen due to cooking process. Indoor air PAHs identified are Napthalene, fluorine, acenaphthene, phenanthrene, pyrene, chrysene and indeno [1,2,3-cd) pyrene. Concentrations of all PAHs identified in kitchen were above the permissible OSHA norms for indoor air. Specific gravity of urine was significantly higher among the kitchen workers (p<0.001) as compared to the control group. Also, the prevalence of microalbuminuria was higher (p<0.001) among kitchen workers. Urinary PAH metabolites detected among kitchen workers were 1-NAP, 9-HF, 3-HF, 9-PHN and 1-OHP. Continuous heat exposure in kitchens due to cooking can alter kidney functions viz., high specific gravity of urine in kitchen workers. Exposure to PM, VOCs and PAHs in indoor air and presence of urinary PAHs metabolites may lead to inflammation, which can cause microalbuminuria in kitchen workers, as observed in the present study.     

In-Field Ambient Fine Particle Monitoring of an Outdoor Wood Boiler: Public Health Concerns

Outdoor wood boilers (OWBs) are detached wood-fired units that heat water used for domestic consumption and heating. The increasing use of OWBs has prompted regulatory concern because of escalating public complaints. Few field studies of OWB ambient emissions have been conducted, limiting efforts to assess this air quality problem. A screening level evaluation was conducted to characterize ambient fine particle (PM_2.5) levels nearby an OWB device and to overview operating and design factors that could influence PM_2.5 levels. High hourly (186 μ g/m³ 4.3 h mean, 665 μg/m³ 95th percentile) and peak continuous (8,880 μg/m³ 15 s avg) PM_2.5 concentrations were found within 50–150 ft of an OWB relative to background levels throughout the course of nearly routine operating conditions. Values were highest during air intake within 1 h of fuel loading (416 μg/m³ 1 h mean) compared to air-starved 22–24 h after loading (115 μg/m³ 3.3 h mean). OWB features that could affect PM_2.5 levels include exemption from federal wood stove standards, poor combustion design, large firebox capacity, trash burning use, low stack height, and four-season utility. In view of cardiac and respiratory health risks associated with transient exposure to ambient PM_2.5 at levels well below those reported here, this pilot study contributes to the risk assessment field by identifying an emerging problem of potential public health significance.