advertising
-
1.
McLarnon NA: The ocular risks of human nail dust in podiatry. PhD thesis, Caledonian University, Glasgow, 2000, as cited in Burrow and McLarnon, Occup Environ Med 63: 713, 2006.
-
2.
Burrow JG & McLarnon NA: World at work: evidence based risk management of nail dust in chiropodists and podiatrists. Occup Environ Med 63: 713, 2006.
-
3.
Coggins MA , Hogan VJ & Kelly M et al.: Workplace exposure to bioaerosols in podiatry clinics. Ann Occup Hyg 56: 746, 2012.
-
4.
Harris-Roberts J , Bowen J & Sumner J et al.: Work-related symptoms in nail salon technicians. Occup Med (Lond) 61: 335, 2011.
-
5.
Hiipakka D & Samimi B: Exposure of acrylic fingernail sculptors to organic vapors and methacrylate dusts. Am Ind Hyg Assoc J 48: 230, 1987.
-
6.
Gupta AK , Versteeg SG & Shear NH: Onychomycosis in the 21st century: an update on diagnosis, epidemiology, and treatment. J Cutan Med Surg 21: 525, 2017.
-
7.
Lipner SR & Scher RK: Onychomycosis: clinical overview and diagnosis. J Am Acad Dermatol 80: 835, 2019.
-
8.
Gupta AK , Stec N & Summerbell RC et al.: Onychomycosis: a review. J Eur Acad Dermatol Venereol 34: 1972, 2020.
-
9.
Gupta AK & Paquet M: Improved efficacy in onychomycosis therapy. Clin Dermatol 31: 555, 2013.
-
10.
Sumikawa M , Egawa T & Honda I et al.: Effects of foot care intervention including nail drilling combined with topical antifungal application in diabetic patients with onychomycosis. J Dermatol 34: 456, 2007.
-
11.
Angelo T , Borgheti-Cardoso LN & Gelfuso GM et al.: Chemical and physical strategies in onychomycosis topical treatment: a review. Med Mycol 55: 461, 2017.
-
12.
Elkeeb R , AliKhan A & Elkeeb L et al.: Transungual drug delivery: current status. Int J Pharm 384: 1, 2010.
-
13.
Davies R , Ganderton MA & Savage MA: Human nail dust and precipitating antibodies to Trichophyton rubrum in chiropodists. Clin Allergy 13: 309, 1983.
-
14.
Tinley PD , Eddy K & Collier P: Contaminants in human nail dust: an occupational hazard in podiatry? J Foot Ankle Res 7: 15, 2014.
-
15.
Gupta AK , Drummond-Main C & Cooper EA et al.: Systematic review of nondermatophyte mold onychomycosis: diagnosis, clinical types, epidemiology, and treatment. J Am Acad Dermatol 66: 494, 2012.
-
16.
Hainsworth S , Hamblin JF & Vanniasinkam T: Isolation of dermatophytes (and other fungi) from human nail and skin dust produced by podiatric medical treatments in Australia. JAPMA 105: 111, 2015.
-
17.
Nowicka D , Nawrot U & Włodarczyk K et al.: Detection of dermatophytes in human nail and skin dust produced during podiatric treatments in people without typical clinical signs of mycoses. Mycoses 59: 379, 2016.
-
18.
Larato DC , Ruskin PF & Martin A et al.: Effect of a dental air turbine drill on the bacterial counts in air. J Prosthet Dent 16: 758, 1966.
-
19.
Donaldson CL , Carline T & Brown DM et al.: Toenail dust particles: a potential inhalation hazard to podiatrists? Ann Occup Hyg 46: 365, 2002.
-
20.
Gustafsson Å , Krais AM & Gorzsás A et al.: Isolation and characterization of a respirable particle fraction from residential house-dust. Environ Res 161: 284, 2018.
-
21.
Gutarowska B , Szulc J & Nowak A et al.: Dust at various workplaces—microbiological and toxicological threats. Int J Environ Res Public Health 15: 877, 2018.
-
22.
Borm PJA , Schins RPF & Albrecht C: Inhaled particles and lung cancer, part B: paradigms and risk assessment. Int J Cancer 110: 3, 2004.
-
23.
Iliadi A , Koletsi D & Eliades T et al.: Particulate production and composite dust during routine dental procedures. A systematic review with meta-analyses. Materials (Basel) 13: 2513, 2020.
-
24.
Delfino RJ , Sioutas C & Malik S: Potential role of ultrafine particles in associations between airborne particle mass and cardiovascular health. Environ Health Perspect 113: 934, 2005.
-
25.
Choudat D , Triem S & Weill B et al.: Respiratory symptoms, lung function, and pneumoconiosis among self-employed dental technicians. Br J Ind Med 50: 443, 1993.
-
26.
Abramson C & Wilton J: Nail dust aerosols from onychomycotic toenails. Part II. Clinical and serologic aspects. 1984. JAPMA 82: 116, 1992.
-
27.
Li Z , Lu G & Meng G: Pathogenic fungal infection in the lung. Front Immunol 10: 1524, 2019.
-
28.
Richardson M , Bowyer P & Sabino R: The human lung and Aspergillus: you are what you breathe in? Med Mycol 57 (suppl 2) : S145, 2019.
-
29.
Brown GD , Denning DW & Gow NAR et al.: Hidden killers: human fungal infections. Sci Transl Med 4: 165rv13, 2012.
-
30.
Knutsen AP , Bush RK & Demain JG et al.: Fungi and allergic lower respiratory tract diseases. J Allergy Clin Immunol 129: 280, 2012.
-
31.
Woodfolk JA , Wheatley LM & Piyasena RV et al.: Trichophyton antigens associated with IgE antibodies and delayed type hypersensitivity. Sequence homology to two families of serine proteinases. J Biol Chem 273: 29489, 1998.
-
32.
Porter PC , Ongeri V & Luong A et al.: Seeking common pathophysiology in asthma, atopy and sinusitis. Trends Immunol 32: 43, 2011.
-
33.
Agarwal R , Dhooria S & Aggarwal AN et al.: Guidelines for diagnosis and management of bronchial asthma: joint ICS/NCCP (I) recommendations. Lung India 32 (suppl 1) : S3, 2015.
-
34.
Woolnough K , Fairs A & Pashley CH et al.: Allergic fungal airway disease: pathophysiologic and diagnostic considerations. Curr Opin Pulm Med 21: 39, 2015.
-
35.
Agarwal R , Sehgal IS & Dhooria S et al.: Challenging cases in fungal asthma. Med Mycol 57 (suppl 2) : S110, 2019.
-
36.
Denning DW , Pashley C & Hartl D et al.: Fungal allergy in asthma—state of the art and research needs. Clin Transl Allergy 4: 14, 2014.
-
37.
Chowdhary A , Agarwal K & Kathuria S et al.: Allergic bronchopulmonary mycosis due to fungi other than Aspergillus: a global overview. Crit Rev Microbiol 40: 30, 2014.
-
38.
Fahy JV & Dickey BF: Airway mucus function and dysfunction. N Engl J Med 363: 2233, 2010.
-
39.
Ibrahim-Granet O , Philippe B & Boleti H et al.: Phagocytosis and intracellular fate of Aspergillus fumigatus conidia in alveolar macrophages. Infect Immun 71: 891, 2003.
-
40.
Verma A , Wüthrich M & Deepe G et al.: Adaptive immunity to fungi. Cold Spring Harb Perspect Med 5: a019612, 2014.
-
41.
Kao C , Hanania NA & Parulekar AD: The impact of fungal allergic sensitization on asthma. Curr Opin Pulm Med 27: 3, 2021.
-
42.
Shoham S & Levitz SM: The immune response to fungal infections. Br J Haematol 129: 569, 2005.
-
43.
Wambre E , Bajzik V & DeLong JH et al.: A phenotypically and functionally distinct human TH2 cell subpopulation is associated with allergic disorders. Sci Transl Med 9: eeam9171, 2017.
-
44.
Boonpiyathad T , Sözener ZC & Satitsuksanoa P et al.: Immunologic mechanisms in asthma. Semin Immunol 46: 101333, 2019.
-
45.
Kita H: ILC2s and fungal allergy. Allergol Int 64: 219, 2015.
-
46.
Hadebe S & Brombacher F: Environment and host-genetic determinants in early development of allergic asthma: contribution of fungi. Front Immunol 10: 2696, 2019.
-
47.
Bacher P , Heinrich F & Stervbo U et al.: Regulatory T cell specificity directs tolerance versus allergy against aeroantigens in humans. Cell 167: 1067, 2016.
-
48.
Knutsen AP & Slavin RG: Allergic bronchopulmonary aspergillosis in asthma and cystic fibrosis. Clin Dev Immunol 2011: 843763, 2011.
-
49.
Bacher P & Scheffold A: The effect of regulatory T cells on tolerance to airborne allergens and allergen immunotherapy. J Allergy Clin Immunol 142: 1697, 2018.
-
50.
Renz H , Blümer N & Virna S et al.: The immunological basis of the hygiene hypothesis. Chem Immunol Allergy 91: 30, 2006.
-
51.
Allard JB , Rinaldi L & Wargo MJ et al.: Th2 allergic immune response to inhaled fungal antigens is modulated by TLR-4-independent bacterial products. Eur J Immunol 39: 776, 2009.
-
52.
Allard JB , Poynter ME & Marr KA et al.: Aspergillus fumigatus generates an enhanced Th2-biased immune response in mice with defective cystic fibrosis transmembrane conductance regulator. J Immunol 177: 5186, 2006.
-
53.
Pamer EG: Immune responses to commensal and environmental microbes. Nat Immunol 8: 1173, 2007.
-
54.
Kiss A , Montes M & Susarla S et al.: A new mechanism regulating the initiation of allergic airway inflammation. J Allergy Clin Immunol 120: 334, 2007.
-
55.
Shendell DG , Graber JM & Milich LJ et al.: Assessing acute symptoms related to occupational exposures among nail salon technicians. J Occup Environ Med 60: 343, 2018.
-
56.
Konda A , Prakash A & Moss GA et al.: Aerosol filtration efficiency of common fabrics used in respiratory cloth masks. ACS Nano 14: 6339, 2020.
-
57.
Harvey C: Comparison of the effectiveness of nail dust extractors. JAPMA 83: 669, 1993.
-
58.
Blair J , Burrow J & Millar N et al.: Efficiency and effectiveness of dust extraction systems of podiatric nail drills. Br J Podiatr Med 2: 53, 1999.
-
59.
McLarnon N , Burrow G & Maclaren W et al.: The use of an air filtration system in podiatry clinics. Int J Environ Health Res 13: 215, 2003.
-
60.
McLarnon NA , Edwards G & Burrow JG et al.: The efficiency of an air filtration system in the hospital ward. Int J Environ Health Res 16: 313, 2006.
-
61.
Graudenz GS , Degobbi C & Saldiva PH: SARS-CoV-2. Long distance airborne transmission and its public health implications. Clinics (Sao Paulo) 75: e2343, 2020.
-
62.
Dumont IJ: Diagnosis and prevalence of onychomycosis in diabetic neuropathic patients: an observational study. JAPMA 99: 135, 2009.
Fungal Lung
The Risk of Fungal Exposure to Nail Care Professionals
Search for other papers by Aditya K. Gupta in
Current site
Google Scholar
PubMed
Search for other papers by Emma M. Quinlan in
Current site
Google Scholar
PubMed
Foot and nail care specialists spend a great portion of their day using nail drills to reduce nail thickness and smooth foot calluses. This process generates a large amount of dust, some of which is small enough to breathe in and deposit into the deepest regions of the respiratory tract, potentially causing health problems. Foot and nail dust often contains fungi, from both fungus-infected and healthy-appearing nails. Although the majority of healthy individuals can tolerate inhaled fungi, the immune systems of older, immunocompromised, and allergy-prone individuals often react using the inflammatory T helper cell type 2 pathway, leading to mucus overproduction, bronchoconstriction, and, in severe cases, lung tissue damage. To protect vulnerable podiatry professionals, wearing a surgical mask, using a water spray suppression system on nail drills, installing air filtration systems, and considering drilling technique can help reduce exposure to nail dust.
Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
Mediprobe Research Inc, London, Ontario, Canada.
advertising
