Traffic-related air pollution. A pilot exposure assessment in Beirut, Lebanon

False positives and false negatives in benzene biological monitoring

Benzene is a commonly used industrial chemical that is a significant environmental pollutant. Occupational health specialists and industrial toxicologists are concerned with determining the exact amount of exposure to chemicals in the workplace. There are two main approaches to assess chemical exposure; air monitoring and biological monitoring. Air monitoring has limitations, which biological monitoring overcomes and could be used as a supplement to it. However, there are several factors that influence biological monitoring results. It would be possible to assess exposure more accurately if these factors were taken into account. This study aimed to review published papers for recognizing and discussing parameters that could affect benzene biological monitoring. Two types of effects can be distinguished: positive and negative effects. Factors causing positive effects will increase the metabolite concentration in urine more than expected. Furthermore, the parameters that decrease the urinary metabolite level were referred to as false negatives. From the papers, sixteen influential factors were extracted that might affect benzene biological monitoring results. Identified factors were clarified in terms of their nature and mechanism of action. It is also important to note that some factors influence the quantity and quality of the influence of other factors. As a result of this study, a decision-making protocol was developed for interpreting the final results of benzene biological monitoring.

Isotope Labeling Mass Spectrometry to Quantify Endogenous and Exogenous DNA Adducts and Metabolites of 1,3-Butadiene In Vivo

Human exposure to known carcinogen 1,3-butadiene (BD) is common due to its high concentrations in automobile exhaust, cigarette smoke, and forest fires, as well as its widespread use in the polymer industry. The adverse health effects of BD are mediated by epoxide metabolites such as 3,4-epoxy-1-butene (EB), which reacts with DNA to form 1-hydroxyl-3-buten-1-yl adducts on DNA nucleobases. EB-derived mercapturic acids (1- and 2-(N-acetyl-l-cysteine-S-yl)-1-hydroxybut-3-ene (MHBMA) and N-acetyl-S-(3,4-dihydroxybutyl)-l-cysteine (DHBMA)) and urinary N7-(1-hydroxyl-3-buten-1-yl) guanine DNA adducts (EB-GII) have been used as biomarkers of BD exposure and cancer risk in smokers and occupationally exposed workers. However, low but significant levels of MHBMA, DHBMA, and EB-GII have been reported in unexposed cultured cells, animals, and humans, suggesting that these metabolites and adducts may form endogenously and complicate risk assessment of butadiene exposure. In the present work, stable isotope labeling in combination with high-resolution mass spectrometry was employed to accurately quantify endogenous and exogenous butadiene metabolites and DNA adducts in vivo. Laboratory rats were exposed to 0.3, 0.5, or 3 ppm of BD-d6 by inhalation, and the amounts of endogenous (d0) and exogenous (d6) DNA adducts and metabolites were quantified in tissues and urine by isotope dilution capillary liquid chromatography/high resolution electrospray ionization tandem mass spectrometry (capLC-ESI-HRMS/MS). Our results reveal that EB-GII adducts and MHBMA originate exclusively from exogenous exposure to BD, while substantial amounts of DHBMA are formed endogenously. Urinary EB-GII concentrations were associated with genomic EB-GII levels in tissues of the same animals. Our findings confirm that EB-GII and MHBMA are specific biomarkers of exposure to BD, while endogenous DHBMA predominates at sub-ppm exposures to BD.

Poor regulation implications in a low and middle income country based on PAH source apportionment and cancer risk assessment

Ambient particle-bound polycyclic aromatic hydrocarbons (PAHs) were collected for one year at an urban background site, and spatially and temporally compared to yearly averages in three coastal cities in Lebanon. The samples were quantified using gas chromatography-mass spectrometry (GC-MS) and source apportioned with an optimized robust method using positive matrix factorization (PMF). Three major sources were found to contribute to PAH emissions at the urban background site, namely, traffic (48%), diesel generators (23%), and incineration (29%). The cancer risk was found higher than what was measured at the same site in previous years with an increase of 35%. Improper regulations of the sources (incineration, power plant, diesel generators and traffic) identified in the different sites resulted in PAH intraurban variability. It is essential to study the chemical components of particulate matter (PM) in order to assess toxicity. In particular, particle-bound PAHs and their oxidation products are known for their carcinogenicity as well as their persistence in the atmosphere, which facilitate their transport to new locations. In the absence of law enforcement, unregulated sources and their total contribution to ambient PAHs present a major health risk. This calls for the attention of development funding agencies and their need to implement sustainable "carbon-free" funding strategies in support of urban development of low and middle-income countries (LMICs).

Characterization and exposure assessment to urban air toxics across Middle Eastern and North African countries: a review

Middle East and North African (MENA) countries over the decades are experiencing rapid industrial and infrastructural growth combined with being the global hub of oil and gas industries. These economic transformations are associated with release of air pollutants including urban air toxics (UAT) through industrial, traffic, and constructional activities into ambient urban environments. UAT concentrations levels may exacerbate in most MENA countries considering high number of vehicular traffic populations and petrochemical industries which are one of the main sources of this pollutant. Therefore, the main objective of the study is to review major findings of UAT levels in urban areas across thirteen (13) MENA countries. The study characterizes various measured UAT, assesses their concentrations in ambient environment, and identifies their major sources of emissions by reviewing more than 100 relevant UAT papers across the selected MENA countries. It was found that benzene, heavy metals, formaldehyde, and dioxin-like compounds are the most reported UAT. The study concluded that road traffic, fuel stations, and petrochemical industries were identified as the main sources of ambient UAT levels. It was further reported that most of the studies were based on short-term ambient environment with limited studies in indoor environments. Therefore, it is highly recommended that future research should focus on innovative health impact assessment and epidemiological studies from exposure to UAT levels. Also embarking on sustainable mitigation approaches through urban greenery, eco-industrial estates infrastructural developments, and renewable energy shares will reduce UAT levels and improve human health.

Cross-sectional study of in-vehicle exposure to ultrafine particles and black carbon inside Lebanese taxicabs

Taxi drivers' exposure to traffic-related air pollutants inside their vehicles has been reported in different countries but not yet in Lebanon. Thus, we conducted a cross-sectional study on 20 Lebanese taxi drivers to (1) assess their exposure to ultrafine particles (UFP) and black carbon (BC) inside their vehicles and (2) identify determinants of this exposure. UFP and BC were measured using Diffusion Size Classifier Miniature^® and microAeth^® Model AE51, respectively, for 5 hours. Data on characteristics of vehicles and trips were collected by face-to-face interviews. Associations between pollutant levels and their determinants were analyzed by multiple linear regression. The mean of UFP count (35.2 ± 17.6 x 10³ particles cm^-3 ) and BC (5.2 ± 1.9 μg m^-3 ) concentrations in-taxis was higher in the morning measurements compared with those in the afternoon measurements. UFP count increased in-taxis by 60% for every 10 minutes spent in blocked traffic and by 84% starting from two trips with smokers compared to trips without smokers. Conversely, UFP count decreased by 30% for every 10 minutes under both air-conditioning and air recirculation mode with windows closed. BC was not affected by any of these factors. Our findings suggest easy ways to reduce UFP exposure inside vehicles for all commuters.

Urinary Mercapturic Acids to Assess Exposure to Benzene and Other Volatile Organic Compounds in Coke Oven Workers

Coke production was classified as carcinogenic to humans by the International Agency for Research on Cancer. Besides polycyclic aromatic hydrocarbons, coke oven workers may be exposed to benzene and other volatile organic compounds (VOCs). The aim of this study was to assess the exposure to several VOCs in 49 coke oven workers and 49 individuals living in the same area by determining urinary mercapturic acids. Active tobacco smoking was an exclusion criterion for both groups. Mercapturic acids were investigated by a validated isotopic dilution LC-MS/MS method. Linear models were built to correct for different confounding variables. Urinary levels of N-acetyl-S-phenyl-L-cysteine (SPMA) (metabolite of benzene), N-acetyl-S-(2-hydroxy-1/2-phenylethyl)-L-cysteine (PHEMA) (metabolite of styrene), N-acetyl-S-(2-cyanoethyl)-L-cysteine (CEMA) (metabolite of acrylonitrile), N-acetyl-S-[1-(hydroxymethyl)-2-propen-1-yl)-L-cysteine and N-acetyl-S-(2-hydroxy-3-buten-1-yl)-L-cysteine (MHBMA) (metabolites of 1,3-butadiene) were 2-10 fold higher in workers than in controls (p < 0.05). For SPMA, in particular, median levels were 0.02 and 0.31 µg/g creatinine in workers and controls, respectively. Among workers, coke makers were more exposed to PHEMA and SPMA than foremen and engine operators. The comparison with biological limit values shows that the exposure of workers was within 20% of the limit values for all biomarkers, moreover three subjects exceeded the restrictive occupational limit value recently proposed by the European Chemicals Agency (ECHA) for SPMA.

Risk Assessment on Benzene Exposure among Gasoline Station Workers

Benzene is a human carcinogen presented in gasoline (1% by volume). It is also found in vehicle exhaust. The aim of this study was to assess the health risk of inhalation exposure to benzene among gasoline station workers. The ambient benzene concentration was measured by personal sampling from 150 gasoline station workers (137 fueling workers and 13 cashiers). Additional data of working characteristics were collected by interviews and on-site observations. All workers were non-smokers and passive smoking was limited. Risk assessment of inhalation exposure was determined using the United State Environmental Protection Agency (USEPA), and showed a high risk of adverse health effect (Hazard Quotients (HQ) >1) in 51.33% of workers. The cancer risk was increased from 1.35 × 10⁻⁸ to 1.52 × 10⁻⁴, and 70.67% of the workers had a lifetime cancer risk (>Inhalation Unit Risk (IUR): 2.2 × 10⁻⁶). A significantly higher risk was found in fueling workers compared to cashiers, and in workers at gasoline stations in inner-city zones (suburban and urban), compared to rural zones. All risk estimations were based upon a single measurement in an eight hour working period, which was assumed to be the average shift length for all working days in a year (250 days). The increased health risk suggests that there should be health surveillance for workers in order to protect them from exposure to benzene. In addition to benzene, the volatile organic compounds (VOCs) present in gasoline may influence health outcomes.

Individual exposure level following indoor and outdoor air pollution exposure in Dakar (Senegal)

The consequences of indoor and outdoor air pollution on human health are of great concern nowadays. In this study, we firstly evaluated indoor and outdoor air pollution levels (CO, CO₂, NO, NO₂, PM₁₀) at an urban site in Dakar city center and at a rural site. Then, the individual exposure levels to selected pollutants and the variations in the levels of biomarkers of exposure were investigated in different groups of persons (bus drivers, traders working along the main roads and housemaids). Benzene exposure levels were higher for housemaids than for bus drivers and traders. High indoor exposure to benzene is probably due to cooking habits (cooking with charcoal), local practices (burning of incense), the use of cleaning products or solvent products which are important emitters of this compound. These results are confirmed by the values of S-PMA, which were higher in housemaids group compared to the others. Urinary 1-HOP levels were significantly higher for urban site housemaids compared to semirural district ones. Moreover, urinary levels of DNA oxidative stress damage (8-OHdG) and inflammatory (interleukin-6 and -8) biomarkers were higher in urban subjects in comparison to rural ones. The air quality measurement campaign showed that the bus interior was more polluted with PM₁₀, CO, CO₂ and NO than the market and urban or rural households. However, the interior of households showed higher concentration of VOCs than outdoor sites confirming previous observations of higher indoor individual exposure level to specific classes of pollutants.

Impact of the implementation of Lisbon low emission zone on air quality

Air pollution is an increasing concern due to the negative impacts on human health, environment, and patrimony. The implementation of a Low Emission Zone (LEZ) is an important air quality policy action to reduce air pollutant emissions. This study aims to assess the air quality improvements in Lisbon with the LEZ implementation, analysing its impact on the air pollutant concentrations. The analysis performed from 2009 to 2016 showed an improvement in air quality. In the Zone 1, the reduction of PM₁₀ and NO₂ annual average concentrations were 29% and 12%, respectively, while, in the Zone 2, the reduction of PM₁₀ and NO₂ annual average concentrations were 23% and 22%, respectively. The background pollution analysis showed the LEZ effect on the lowest levels of ambient air pollution to which the population is chronically exposed. The achieved reductions of PM₁₀ and NO₂ levels were 30.5% and 9.4% in Zone 1, and 22.5% and 12.9% in the Zone 2, respectively. Concluding, this study evidenced an air quality improvement mainly for PM₁₀ and NO₂; however, insignificant reductions were observed for NO_x and PM_2.5. Therefore, stricter restriction standards should be defined, combining with other air quality policy decisions to reduce the population exposure to air pollutants.

PREVALENCE OF DIABETES IN GREATER BEIRUT AREA: WORSENING OVER TIME

OBJECTIVE

The Middle East North Africa region has one of the highest rates of diabetes, both in prevalence and in rate of increase. The aim of this study was to examine the prevalence and associated risk factors of type 2 diabetes mellitus (T2D) in the adult population of Beirut.

METHODS

A random sample of 501 men and women aged 18 to 79 years was examined in a cross-sectional manner. The sample was then divided into 3 groups based on T2D self-report, glycosylated hemoglobin (HbA1c), and fasting glucose (no diabetes [ND], at risk for diabetes [RD], and probable diabetes [PD]). These were compared to determine the various associated risks.

RESULTS

The sample consisted of 64.3% women, with an average age of 45.4 ± 15 years, and a mean body mass index (BMI) of 29.4 ± 5.9 kg/m². The subjects were predominantly from a low socio-economic status, and more than half smoked either cigarettes or a waterpipe. The percentages of the 3 groups were as follows: 41.7%, 40.3%, and 18.0% for ND, RD, and PD, respectively. Out of 90 subjects diagnosed with PD, 26 did not know they had diabetes. Independent, positively associated risk factors were age, BMI, heart rate, hypertension, triglyceride, and high-density lipoprotein cholesterol.

CONCLUSION

The prevalence of T2D was high in this study and seems to be increasing compared to prior diabetes reports. Overall, the whole sample had a high prevalence of cardiovascular risk factors such as smoking, obesity, and physical inactivity. However, subjects with diabetes had significantly more components of the metabolic syndrome.

ABBREVIATIONS

ADA = American Diabetes Association CRP = C-reactive protein DD = definite diabetes FPG = fasting plasma glucose HbA1c = glycosylated hemoglobin MENA = Middle-East North Africa ND = no diabetes PD = probable diabetes RD = at risk of diabetes T2D = type 2 diabetes mellitus TSH = thyroid-stimulating hormone.

Quantitative cancer risk assessment and local mortality burden for ambient air pollution in an eastern Mediterranean City

Health risks posed by ambient air pollutants to the urban Lebanese population have not been well characterized. The aim of this study is to assess cancer risk and mortality burden of non-methane hydrocarbons (NMHCs) and particulates (PM) based on two field-sampling campaigns conducted during summer and winter seasons in Beirut. Seventy NMHCs were analyzed by TD-GC-FID. PM_2.5 elemental carbon (EC) components were examined using a Lab OC-EC aerosol Analyzer, and polycyclic aromatic hydrocarbons were analyzed by GC-MS. The US EPA fraction-based approach was used to assess non-cancer hazard and cancer risk for the hydrocarbon mixture, and the UK Committee on Medical Effects of Air Pollutants (COMEAP) guidelines were followed to determine the PM_2.5 attributable mortality burden. The average cumulative cancer risk exceeded the US EPA acceptable level (10^-6) by 40-fold in the summer and 30-fold in the winter. Benzene was found to be the highest contributor to cancer risk (39-43%), followed by 1,3-butadiene (25-29%), both originating from traffic gasoline evaporation and combustion. The EC attributable average mortality fraction was 7.8-10%, while the average attributable number of deaths (AD) and years of life lost (YLL) were found to be 257-327 and 3086-3923, respectively. Our findings provide a baseline for future air monitoring programs, and for interventions aiming at reducing cancer risk in this population.

A retrospective analysis of 254 acute stroke cases admitted to two university hospitals in Beirut: classification and associated factors

Lebanon is a developing country where the prevalence of stroke subtypes and their correlation with risk factors have not been studied, even though stroke management is an ongoing major national healthcare challenge. In a retrospective study conducted in two university hospitals, data were collected on all stroke cases admitted in 2012 and 2013. Ischemic strokes were then classified according to a modified TOAST classification. A total of 254 inpatients (mean age 68.41 years ±13.34, 55.1% males) was included in the study; of these, 15% had had a hemorrhagic stroke and was therefore excluded. Conversely to findings from studies in other Arab and Asian countries, where small vessel disease is the most frequent subtype, our study showed a predominance of large artery atherosclerosis (53.5%) which, in comparison with other subtypes, was found to be associated with dyslipidemia (OR= 3.82, 95% CI= [1.76-8.28]; p=0.001). Cardioembolic stroke and small vessel disease were found to be positively associated with aging and living in Beirut, respectively. Larger studies are needed to explain these findings.

Estratégias analíticas com cromatografia e espectrometria de massas para biomonitorização da exposição ao benzeno pela determinação do ácido S-fenilmercaptúrico urinário

Resumo Introdução: o benzeno é uma substância de reconhecida toxicidade e sua biomonitorização torna-se fundamental para a prevenção de danos à saúde humana, principalmente em situações de exposição ocupacional. Dentre os biomarcadores de exposição, o ácido S-fenilmercaptúrico é considerado o único específico, mas, devido a suas baixas concentrações na urina, é requerido o uso de técnicas analíticas sensíveis capazes de quantificar traços. Objetivo: revisar metodologias baseadas na cromatografia e na espectrometria de massas para a determinação do ácido S-fenilmercaptúrico. Método: revisão da literatura sobre a determinação do ácido S-fenilmercaptúrico urinário por técnicas de cromatografia e espectrometria de massas, nas principais bases de dados científicas, considerando o período entre 1951 e 2015. Resultados: 120 documentos serviram como base teórica para a construção desta revisão. A técnica analítica mais empregada foi o acoplamento da cromatografia a líquido com a espectrometria de massas. Contudo, os métodos diferem quanto ao preparo das amostras. Conclusão: o alto custo de aquisição e a manutenção de equipamentos são fatores limitantes para a difusão dos sistemas de cromatografia e espectrometria de massas. No entanto, sua elevada sensibilidade e seletividade faz com que essas técnicas, acopladas, possibilitem elucidar situações de exposição ocupacional e ambiental a poluentes, como o benzeno.

Investigation of outdoor BTEX: Concentration, variations, sources, spatial distribution, and risk assessment

The aim of this study was to measure BTEX (benzene, toluene, ethylbenzene, and xylenes) concentrations in the ambient air of Tehran, the capital of Iran, and investigate their seasonal variations, probable sources, spatial mapping, and risk assessment. The concentrations of BTEX were measured using a continuous monitoring device installed in seven stations around the city. Spatial mapping procedure was conducted using the inverse distance weighting (IDW) method. Monte Carlo simulation was used to assess the carcinogenic and noncarcinogenic risks imposed by BTEX. The highest and lowest annual mean concentrations of toluene and ethylbenzene were recorded as 16.25 and 3.63 μg m(-3), respectively. The maximum (6.434) and minimum (3.209) toluene/benzene (T/B) ratio was observed in summer and winter, respectively. The spatial distribution of BTEX pollution indicated that the highest concentrations were found along the major roads because of heavy traffic. Spearman's rank correlation coefficients and concentration ratios showed that BTEX were produced by the multiemission sources. The mean of inhalation lifetime cancer risk (LTCR) for benzene was 3.93 × 10(-7), which is lower than the limits recommended by the United States Environmental Protection Agency (US EPA) and the World Health Organization (WHO). The hazard quotient (HQ), noncarcinogenic risk index, for all BTEX compounds was <1. The obtained results showed no threat of BTEX concentrations to human health. However, as the concentrations of BTEX will increase due to the rapid growth of vehicles and industrial activities, much effort is required to control and manage the levels of these compounds in the future.

Association between occupational exposure to benzene and chromosomal alterations in lymphocytes of Brazilian petrochemical workers removed from exposure

We aimed to investigate the association between chronic exposure to benzene and genotoxicity in the lymphocytes of workers removed from exposure. The study included 20 workers with hematological disorders who had previously worked in the petrochemical industry of Salvador, Bahia, Brazil; 16 workers without occupational exposure to benzene served as the control group. Chromosomal analysis was performed on lymphocytes from peripheral blood, to assess chromosomal breaks and gaps and to identify aneuploidy. The Kruskal-Wallis test was used to compare the mean values between two groups, and Student's t test for comparison of two independent means. The frequency of gaps was statistically higher in and the exposed group than in the controls (2.13 ± 2.86 vs. 0.97 ± 1.27, p = 0.001). The frequency of chromosomal breaks was significantly higher among cases (0.21 ± 0.58) than among controls (0.12 ± 0.4) (p = 0.0002). An association was observed between chromosomal gaps and breaks and occupational exposure to benzene. Our study showed that even when removed from exposure for several years, workers still demonstrated genotoxic damage. Studies are still needed to clarify the long-term genotoxic potential of benzene after removal from exposure.

Particulate Matter Exposure in a Police Station Located near a Highway

People living or working near roadways have experienced an increase in cardiovascular or respiratory diseases due to vehicle emissions. Very few studies have focused on the PM exposure of highway police officers, particularly for the number concentration and size distribution of ultrafine particles (UFP). This study evaluated exposure concentrations of particulate matter (PM) in the Sinying police station near a highway located in Tainan, Taiwan, under different traffic volumes, traffic types, and shift times. We focused on periods when the wind blew from the highway toward the police station and when the wind speed was greater than or equal to 0.5 m/s. PM2.5, UFP, and PM-PAHs concentrations in the police station and an upwind reference station were measured. Results indicate that PM2.5, UFP, and PM-PAHs concentrations in the police station can be on average 1.13, 2.17, and 5.81 times more than the upwind reference station concentrations, respectively. The highest exposure level for PM2.5 and UFP was observed during the 12:00 PM–4:00 PM shift while the highest PAHs concentration was found in the 4:00 AM–8:00 AM shift. Thus, special attention needs to be given to protect police officers from exposure to high PM concentration.

1,3-Butadiene exposure and metabolism among Japanese American, Native Hawaiian, and White smokers

BACKGROUND

We hypothesize that the differences in lung cancer risk in Native Hawaiians, whites, and Japanese Americans may, in part, be due to variation in the metabolism of 1,3-butadiene, one of the most abundant carcinogens in cigarette smoke.

METHODS

We measured two biomarkers of 1,3-butadiene exposure, monohydroxybutyl mercapturic acid (MHBMA) and dihydroxybutyl mercapturic acid (DHBMA), in overnight urine samples among 584 Native Hawaiians, Japanese Americans, and white smokers in Hawaii. These values were normalized to creatinine levels. Ethnic-specific geometric means were compared adjusting for age at urine collection, sex, body mass index, and nicotine equivalents (a marker of total nicotine uptake).

RESULTS

We found that mean urinary MHBMA differed by race/ethnicity (P = 0.0002). The values were highest in whites and lowest in Japanese Americans. This difference was only observed in individuals with the GSTT1-null genotype (P = 0.0001). No difference across race/ethnicity was found among those with at least one copy of the GSTT1 gene (P ≥ 0.72). Mean urinary DHBMA did not differ across racial/ethnic groups.

CONCLUSIONS

The difference in urinary MHBMA excretion levels from cigarette smoking across three ethnic groups is, in part, explained by the GSTT1 genotype. Mean urinary MHBMA levels are higher in whites among GSTT1-null smokers.

IMPACT

The overall higher excretion levels of MHBMA in whites and lower levels of MHBMA in Japanese Americans are consistent with the higher lung cancer risk in the former. However, the excretion levels of MHBMA in Native Hawaiians are not consistent with their disease risk and thus unlikely to explain their high risk of lung cancer.

Genotoxic and epigenotoxic effects of fine particulate matter from rural and urban sites in Lebanon on human bronchial epithelial cells

Assessment of air pollution by particulate matter (PM) is strongly required in Lebanon in the absence of an air quality law including updated air quality standards. Using two different PM2.5-0.3 samples collected at an urban and a rural site, we examined genotoxic/epigenotoxic effects of PM exposure within a human bronchial epithelial cell line (BEAS-2B). Inorganic and organic contents evidence the major contribution of traffic and generating sets in the PM2.5-0.3 composition. Urban PM2.5-0.3 sample increased the phosphorylation of H2AX, the telomerase activity and the miR-21 up-regulation in BEAS-2B cells in a dose-dependent manner. Furthermore, urban PM2.5-0.3 induced a significant increase in CYP1A1, CYP1B1 and AhRR genes expression. The variable concentrations of transition metals and organic compounds detected in the collected PM2.5-0.3 samples might be the active agents leading to a cumulative DNA damage, critical for carcinogenesis.