Biomonitoring Human Exposure to Household Air Pollution and Association with Self-reported Health Symptoms - A Stove Intervention Study in Peru

Eye health risks associated with unclean fuel: a meta-analysis and systematic review

Purpose

This study comprehensively examined the correlation between unclean cooking fuels (UCF) and ocular health, covering diverse eye conditions such as cataracts, visual impairments, and ocular discomfort.

Methods

According to MOOSE and PRISMA guidelines, a meta-analysis and systematic review was conducted on 28 studies from 3 databases. Literature quality was assessed using the Newcastle-Ottawa Scale. Heterogeneity among articles was gaged with the I 2 statistic, sensitivity analysis used 'leave-one-out test', and publication bias was evaluated using Egger, Begg tests, and funnel plot analysis.

Results

The study evidenced a significant association between UCF exposure and cataracts [OR 2.29, 95% CI (1.24, 4.23)], visual impairments [OR 1.70, 95% CI (1.45, 2.00)], and eye diseases/symptoms [OR 2.03, 95% CI (1.25, 3.29)]. However, no correlation was found between UCF exposure and glaucoma or elevated intraocular pressure [OR 0.96, 95% CI (0.84, 1.10), n = 2]. Subgroup analysis revealed that UCF cooking had an impact on nuclear cataracts [OR 1.98, 95% CI (1.67, 2.33), n = 4]. But not on cortical cataracts [OR 1.25, 95% CI (0.98, 1.60), n = 3]. Additionally, UCF exposure was linked to severe visual impairments like night blindness [OR 2.03, 95% CI (1.00, 4.96)], blindness [OR 1.43, 95% CI (1.32, 1.55)], and specific ocular symptoms such as tearing while cooking (OR = 3.20), eye irritation (OR = 2.58), and red eyes (OR = 2.03).

Conclusion

UCF cooking had significant impact on ocular health, notably on eye symptoms, cataracts, and visual impairments. UCF exposure presented demographic inequalities in cataract prevalence, while eye symptoms can serve as a reliable self-assessment of UCF exposure.

The Association Between Solid Fuel Use and Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Hyperplasia in Sichuan, China: Cross-Sectional Study

Background

Benign prostatic hyperplasia (BPH) is a global age-related disease. It has been reported that over half of the Chinese male population aged 70 years or older are experiencing BPH. Solid fuel, which is the major source of household air pollution, has been reportedly associated with several adverse events, including sex hormone disorders. Due to the certain relationship between sex hormone levels and prostate disease, the relationship between solid fuel use and lower urinary tract symptoms (LUTSs) suggestive of BPH (LUTS/BPH) deserves further exploration.

Objective

This study mainly aimed to investigate the association between solid fuel use and LUTS/BPH.

Methods

The data used in this study were obtained from the West China Natural Population Cohort Study. Household energy sources were assessed using questionnaires. LUTS/BPH was evaluated based on participant self-reports. We performed propensity score matching (PSM) to reduce the influence of bias and unmeasured confounders. The odds ratio (OR) and 95% CI of LUTS/BPH for the solid fuel group compared with the clean fuel group were calculated. We also conducted stratified analyses based on BMI, metabolic syndrome, waist to hip ratio, drinking status, smoking status, and age.

Results

A total of 5463 participants were included in this study, including 399 solid fuel users and 5064 clean fuel users. After PSM, the solid fuel group included 354 participants, while the clean fuel group included 701 participants. Solid fuel use was positively correlated with LUTS/BPH before and after PSM (OR 1.68, 95% CI 1.31-2.15 and OR 1.81, 95% CI 1.35-2.44, respectively). In stratified analyses, the OR of the nonsmoking group was higher than that of the smoking group (OR 2.56, 95% CI 1.56-4.20 and OR 1.47, 95% CI 0.99-2.18, respectively). Similarly, the OR of the nondrinking group was higher than that of the drinking group (OR 2.70, 95% CI 1.46-4.99 and OR 1.48, 95% CI 1.01-2.17, respectively).

Conclusions

A positive correlation between solid fuel use and LUTS/BPH was observed. The results suggest that improving fuel structure for household cooking and other household needs can possibly help reduce the risk of LUTS/BPH.

The impact of air pollution and climate change on eye health: a global review

Climate change has important implications on human health, affecting almost every system in the body. Multiple studies have raised the possibility of climate change impacting eye health. In this review, we aimed to summarize current literature on the impact of air pollution and climate change on eye health. We performed a search in four different databases, including Medline, Scopus, Cochrane, and Web of Sciences databases. The search strategy combined terms regarding eye health and environmental/climate changes. The outcome of interest included all eye conditions. The search yielded 2,051 unique articles. After applying inclusion and exclusion criteria, 61 articles were included in this systematic review with data covering 2,620,030 participants. Most studies originated from China, India, South Korea, and USA. Climate change adversely affected different eye conditions, with ocular surface diseases (e.g., conjunctivitis and dry eye) being most affected. Moreover, higher particulate matter (PM) was the most widely assessed pollutant and was adversely associated with the majority of eye conditions, increasing the burden on patients and healthcare providers. We found a low frequency of publications related to the delivery of eye care and its impact on climate change in countries with high air pollution and climate change burden.

Biomonitoring of polycyclic aromatic hydrocarbons in Brazilian pregnant women: Urinary levels and health risk assessment

Over the years, humans have been continuously exposed to several compounds directly generated by industrial processes and/or present in consumed products. Polycyclic aromatic hydrocarbons (PAHs) are legacy pollutants ubiquitous in the environment and represent the main chemical pollutants in urban areas. Worldwide, studies that aim to understand the impacts of exposure to these chemicals have gained increasing prominence due to their potential toxicity profile, mainly concerning genotoxicity and carcinogenicity. Human biomonitoring (HB) is an analytical approach to monitoring population exposure to chemicals; however, these studies are still limited in Brazil. Thus, this work aimed to evaluate the exposure of Brazilian pregnant women to PAHs through HB studies. Besides, the risk characterization of this exposure was performed. For this purpose, urine samples from 358 Brazilian pregnant women were used to evaluate 11 hydroxylated metabolites of PAHs employing gas chromatography coupled to mass spectrometry. The 1OH-naphthol and 2OH-naphthol were detected in 100% of the samples and showed high levels, corresponding to 16.99 and 3.62 μg/g of creatinine, respectively. 2OH-fluorene (8.12 μg/g of creatinine) and 9OH-fluorene (1.26 μg/g of creatinine) were detected in 91% and 66% of the samples, respectively. Benzo(a)pyrene (BaP) metabolites were detected in more than 50% of the samples (0.58-1.26 μg/g of creatinine). A hazard index of 1.4 and a carcinogenic risk above 10-4 were found for BaP metabolites in the risk characterization. Therefore, our findings may indicate that exposure to PAHs poses a potential risk to pregnant women's health and a high probability of carcinogenic risk due to their exposure to BaP. Finally, this work shows the need for more in-depth studies to determine the sources of exposure and the implementation of health protection measures regarding the exposure of the Brazilian population to PAHs.

Investigating industrial PAH air pollution in relation to population exposure in major countries: A scoring approach

Polycyclic aromatic hydrocarbons (PAHs) are common air pollutants worldwide, associated with industrial processes. In the general population, both modeling and field studies revealed a positive correlation between air PAH concentrations and urinary PAH metabolite levels. Many countries lack population urinary data that correspond to local PAH air concentrations. Thus, we proposed a scoring-based approximate approach to investigating that correlation in selected countries, hypothesizing that PAH air concentrations in selected regions could represent the national air quality influenced by industrial emission and further correlate to PAH internal exposure in the general population. This research compiled 85 peer-reviewed journal articles and 9 official monitoring datasets/reports covering 34 countries, 16 of which with both atmospheric PAH data and human biomonitoring data. For the air pollution score (AirS), Egypt had the highest AirS at 0.94 and Pakistan was at the bottom of the score ranking at -1.95, as well as the median in the UK (AirS: 0.50). For the population exposure score (ExpS), China gained the top ExpS at 0.44 and Spain was with the lowest ExpS of -1.52, with the median value in Italy (ExpS: 0.43). Through the correlation analysis, atmospheric PAHs and their corresponding urinary metabolites provided a positive relationship to a diverse extent, indicating that the related urinary metabolites could reflect the population's exposure to specific atmospheric PAHs. The findings also revealed that in the 16 selected countries, AirS indexes were positively correlated with ExpS indexes, implying that higher PAH levels in the air may lead to elevated metabolite urinary levels in general populations. Furthermore, lowering PAH air concentrations could reduce population internal PAH exposure, implying that strict PAH air regulation or emission would reduce health risks for general populations. Notably, this study was an ideal theoretical research based on proposed assumptions to some extent. Further research should focus on understanding exposure pathways, protecting vulnerable populations, and improving the PAH database to optimize PAH pollution control.

Urinary PAHs metabolites in Karakoram Highway's heavy traffic vehicle (HTV) drivers: evidence of exposure and health risk

The current study features PAHs exposure on Karakoram Highway, a route of utmost importance in Pakistan. The drivers of heavy traffic vehicles (HTV) on Karakoram Highway spend long hours amid dense traffic and therefore, inevitably inhale huge amount of PAH carcinogens. The urinary metabolites of PAHs in such drivers (meeting selection criteria n = 48) and a control group (n = 49) were comparatively profiled. The higher urinary biomarkers among ninety-six percent HTV drivers were evident of PAHs exposure. We observed elevated concentrations of urinary benzo[a]pyrene metabolites (3-OH-BaP = 3.53 ± 0.62 ng g^-1 creatinine and 9-OH-BaP = 3.69 ± 0.74 ng g^-1 creatinine) in HTV driver's samples compared to controls (0.85 ± 0.08 and 0.31 ± 0.03 ng g^-1 creatinine, respectively). Interestingly, urinary benzo[a]pyrene metabolites were detected in almost similar amount among HTV drivers irrespective of their working hours. A distinct smoking effect was manifested with rising urinary levels of 1-hydroxypyrene, 2-hydroxyphenanthrene, and 3-hydroxybenzo[a]pyrene with corresponding increase in driving hours per day. These metabolites exhibited characteristic exposures to low molecular weight volatile PAHs that are commonly found in vehicular exhaust. The elevated PAH body burden was directly linked to the nature of their job and the route-long environmental pollution on Karakoram Highway. Additionally, the poor economic status and smoking also increased HTV driver's health vulnerability and significantly declined their health capacity. There was conclusive evidence that HTV drivers were exposed to PAHs during a ride on Karakoram Highway, back and forth, an aspect not reported earlier.

Use of unclean cooking fuels and visual impairment of older adults in India: A nationally representative population-based study

Despite widespread use of unclean cooking fuels (UCF) in India, evidence from nationally representative data on its association with visual impairment was lacking. We used a population-based nationwide survey of adults aged 45 years and older that included reported UCF and measured visual impairment. We estimated that 44.8% (95% CI: 42.6, 47.1) of older adults in India lived in households that used UCF. Age- and sex-adjusted prevalence of visual impairment was estimated to be 33.0% (95% CI: 31.0, 34.9) in the older population that did not use UCF and 9.0 percentage points (pp) (95% CI: 8.9, 9.1) higher among those who did. Among those who used UCF, age- and sex-adjusted prevalence of low distance vision was 4.3 pp (95% CI: 4.2, 4.4) higher, prevalence of low near vision was 8.0 pp (95% CI: 7.9, 8.1) higher, and prevalence of blindness was 1.0 pp (95% CI: 0.9, 1.0) higher. After controlling for a rich array of sociodemographic characteristics and state fixed effects, we estimated that use of UCF was associated with higher prevalence of visual impairment by 3.2 pp (95% CI: 1.4, 5.0), low distance vision by 1.8 pp (95% CI: 0.7, 2.9), and low near vision by 3.2 pp (95% CI: 1.3, 5.0). Doubly robust estimates of these differences were slightly larger. Blindness was not significantly partially associated with use of UCF (95% CI: -0.4, 0.6). We did not find support for the hypotheses that the visual impairment risk associated with use of UCF was even larger for females and in households without a separate kitchen or ventilation. The older population of India is highly reliant on UCF that is very strongly associated with visual impairment. Impaired vision should not be overlooked among the harms associated with UCF.

Effectiveness of a home-environmental intervention package and an early child development intervention on child health and development in high-altitude rural communities in the Peruvian Andes: a cluster-randomised controlled trial

BACKGROUND

Unsafe drinking water, poor sanitation and hygiene, exposure to household air pollution and low cognitive and socio-emotional stimulation are risk factors affecting children in low- and middle-income countries. We implemented an integrated home-environmental intervention package (IHIP), comprising a kitchen sink, hygiene education and a certified improved biomass cookstove, and an early child development (ECD) programme to improve children´s health and developmental outcomes in the rural high-altitude Andes of Peru.

METHODS

We conducted a one-year cluster-randomised controlled trial among 317 children < 36 months divided into 4 arms (IHIP + ECD, IHIP, ECD, and Control) and 40 clusters (10 clusters per arm). ECD status (socio-emotional, fine and gross motor, communication, cognitive skills, and an overall performance) measured with the Peruvian Infant Development Scale and the occurrence of self-reported child diarrhoea from caretakers were primary outcomes. Secondary outcomes included the occurrence of acute respiratory infections and the presence of thermo-tolerant faecal bacteria in drinking water. The trial was powered to compare each intervention against its control arm but it did not allow pairwise comparisons among the four arms. Primary analysis followed the intention-to-treat principle. For the statistical analysis, we employed generalised estimating equation models with robust standard errors and an independent correlation structure.

RESULTS

We obtained ECD information from 101 children who received the ECD intervention (individually and combined with IHIP) and 102 controls. Children who received the ECD intervention performed better in all the domains compared to controls. We found differences in the overall performance (64 vs. 39%, odd ratio (OR): 2.8; 95% confidence interval (CI): 1.6-4.9) and the cognitive domain (62 vs 46%, OR: 1.9; 95% CI: 1.1-3.5). Data analysis of child morbidity included 154 children who received the IHIP intervention (individually and combined with ECD) and 156 controls. We recorded 110,666 child-days of information on diarrhoea morbidity and observed 1.3 mean episodes per child-year in the children who received the IHIP intervention and 1.1 episodes in the controls. This corresponded to an incidence risk ratio of 1.2 (95% CI: 0.8-1.7).

CONCLUSIONS

Child stimulation improved developmental status in children, but there was no health benefit associated with the home-environmental intervention. Limited year-round access to running water at home and the possible contamination of drinking water after boiling were two potential factors linked to the lack of effect of the home-environmental intervention. Potential interactions between ECD and home-environmental interventions need to be further investigated.

TRIAL REGISTRATION

ISRCTN, ISRCTN-26548981. Registered 15 January 2018-Retrospectively registered, https://doi.org/10.1186/ISRCTN26548981 .

Effects of Polycyclic Aromatic Hydrocarbons on Lung Function in Children with Asthma: A Mediation Analysis

Studies investigating the association between urinary Polycyclic Aromatic Hydrocarbons (PAHs) and asthma in children provided inhomogeneous results. We aimed to use Mediation Analysis to discover whether a link between urinary PAHs and lung function exists and if it might be ascribed to a direct or a symptom-mediated (indirect) effect in children with asthma. This single-center prospective study was conducted in Palermo, Italy, between March and July 2017 and involved 50 children with persistent mild-moderate asthma, aged 6–11 years. At each time visit (day 0, 30, 60, and 90), physical examination, spirometry, and urine collection for detection of urinary cotinine and PAHs were performed. A symptom score was computed. The sum of individually calculated molar mass of nine PAH metabolites (ΣPAH), naphthalene metabolites (ΣPAHn) and phenanthrene metabolites (ΣPAHp) were calculated. Three children withdrew from the study due to technical problems (n = 1) and adverse events (n = 2). PAHs indirect effects on FEV1 (ΣPAH: −0.011, p = 0.04; ΣPAHn: −0.011, p = 0.04; ΣPAHp: −0.012, p < 0.001) and FVC (ΣPAH: −0.012, p = 0.02; ΣPAHn: −0.0126, p = 0.02; ΣPAHp: −0.013, p < 0.001) were statistically significant. In conclusion, PAHs exposures have significant indirect (symptom-mediated) effects on lung function, emphasizing the role of PAHs-induced respiratory morbidity in decreasing lung function in children with asthma.

Spirometry parameter alterations due to exposure to indoor air pollutants in rural homes in Bogotá, Colombia

The aim of this study was to determine the association between the concentrations of intradomiciliary PM_2.5, CO, and BC and alterations in respiratory function parameters in a population living in rural dwellings in Bogotá, Colombia. For this cross-sectional study, people were recruited from the rural areas of the localities of Usme and Sumapaz in Bogotá. In total, 68 participants were recruited by means of nonrandom sampling. Indoor air monitoring of PM_2.5, BC, and CO was carried out. Additionally, evaluations of pulmonary function were performed using spirometry. The variables of pulmonary function were included in a multiple linear regression by successive steps and adjusted by the main variables described as modifiers of spirometry parameters, which are age, height, sex, disability, and a history of tobacco use. Assumptions of multicollinearity and the randomization of variances in the residuals were evaluated. Negative associations were found between spirometry parameters and the concentrations of indoor air pollutants. For FEV1/FVC and theoretical FEV1, there was a statistically significant association with the concentration of carbon monoxide (p = 0.003 and 0.019, respectively). The environmental concentrations were higher in homes where biomass was used for cooking, but these differences were statistically significant only for BC and CO (p = 0.008 and 0.03, respectively). The concentrations of carbon monoxide in rural homes were associated with alterations in respiratory function parameters.

Measuring Environmental Exposure to Enteric Pathogens in Low-Income Settings: Review and Recommendations of an Interdisciplinary Working Group

Infections with enteric pathogens impose a heavy disease burden, especially among young children in low-income countries. Recent findings from randomized controlled trials of water, sanitation, and hygiene interventions have raised questions about current methods for assessing environmental exposure to enteric pathogens. Approaches for estimating sources and doses of exposure suffer from a number of shortcomings, including reliance on imperfect indicators of fecal contamination instead of actual pathogens and estimating exposure indirectly from imprecise measurements of pathogens in the environment and human interaction therewith. These shortcomings limit the potential for effective surveillance of exposures, identification of important sources and modes of transmission, and evaluation of the effectiveness of interventions. In this review, we summarize current and emerging approaches used to characterize enteric pathogen hazards in different environmental media as well as human interaction with those media (external measures of exposure), and review methods that measure human infection with enteric pathogens as a proxy for past exposure (internal measures of exposure). We draw from lessons learned in other areas of environmental health to highlight how external and internal measures of exposure can be used to more comprehensively assess exposure. We conclude by recommending strategies for advancing enteric pathogen exposure assessments.

Household Fuel Use and the Risk of Gastrointestinal Cancers: The Golestan Cohort Study

BACKGROUND

Three billion people burn nonclean fuels for household purposes. Limited evidence suggests a link between household fuel use and gastrointestinal (GI) cancers.

OBJECTIVES

We investigated the relationship between indoor burning of biomass, kerosene, and natural gas with the subsequent risk of GI cancers.

METHODS

During the period 2004-2008, a total of 50,045 Iranian individuals 40-75 years of age were recruited to this prospective population-based cohort. Upon enrollment, validated data were collected on demographics, lifestyle, and exposures, including detailed data on lifetime household use of different fuels and stoves. The participants were followed through August 2018 with < 1 % loss.

RESULTS

During the follow-up, 962 participants developed GI cancers. In comparison with using predominantly gas in the recent 20-y period, using predominantly biomass was associated with higher risks of esophageal [hazard ratio (HR): 1.89; 95% confidence interval (CI): 1.02, 3.50], and gastric HR: 1.83; 95% CI: 1.01, 3.31) cancers, whereas using predominantly kerosene was associated with higher risk of esophageal cancer (HR: 1.84; 95% CI: 1.10, 3.10). Lifetime duration of biomass burning for both cooking and house heating (exclusive biomass usage) using heating-stoves without chimney was associated with higher risk of GI cancers combined (10-y HR: 1.14; 95% CI: 1.07, 1.21), esophageal (10-y HR: 1.19; 95% CI: 1.08, 1.30), gastric (10-y HR: 1.11; 95% CI: 1.00, 1.23), and colon (10-y HR: 1.26; 95% CI: 1.03, 1.54) cancers. The risks of GI cancers combined, esophageal cancer, and gastric cancer were lower when biomass was burned using chimney-equipped heating-stoves (strata difference p -values = 0.001 , 0.003, and 0.094, respectively). Duration of exclusive kerosene burning using heating-stoves without chimney was associated with higher risk of GI cancers combined (10-y HR: 1.05; 95% CI: 1.00, 1.11), and esophageal cancer (10-y HR: 1.14; 95% CI: 1.04, 1.26).

DISCUSSION

Household burning of biomass or kerosene, especially without a chimney, was associated with higher risk of some digestive cancers. Using chimney-equipped stoves and replacing these fuels with natural gas may be useful interventions to reduce the burden of GI cancers worldwide. https://doi.org/10.1289/EHP5907.

Revealing the air pollution burden associated with internal Migration in Peru

This study aims to quantify changes in outdoor (ambient) air pollution exposure from different migration patterns within Peru and quantify its effect on premature mortality. Data on ambient fine particulate matter (PM2.5) was obtained from the National Aeronautics and Space Administration (NASA). Census data was used to calculate rates of within-country migration at the district level. We calculated differences in PM2.5 exposure between "current" (2016-2017) and "origin" (2012) districts for each migration patterns. Using an exposure-response relationship for PM2.5 extracted from a meta-analysis, and mortality rates from the Peruvian Ministry of Health, we quantified premature mortality attributable to each migration pattern. Changes in outdoor PM2.5 exposure were observed between 2012 and 2016 with highest levels of PM2.5 in the Department of Lima. A strong spatial autocorrelation of outdoor PM2.5 values (Moran's I = 0.847, p-value=0.001) was observed. In Greater Lima, rural-to-urban and urban-to-urban migrants experienced 10-fold increases in outdoor PM2.5 exposure in comparison with non-migrants. Changes in outdoor PM2.5 exposure due to migration drove 137.1 (95%CI: 93.2, 179.4) premature deaths related to air pollution, with rural-urban producing the highest risk of mortality from exposure to higher levels of ambient air pollution. Our results demonstrate that the rural-urban and urban-urban migrant groups have higher rates of air pollution-related deaths.

Household air pollution profiles associated with persistent childhood cough in urban Uganda

BACKGROUND

Most household air pollution (HAP) interventions in developing countries of sub-Saharan Africa have focused on a single source, such as replacing polluting cooking sources with cleaner burning cooking stoves. Such interventions, however, have resulted in insufficient reductions in HAP levels and respiratory health risks in children. In this study we determined how multiple HAP combustion sources and exposure-mitigation factors in the home environment influence child respiratory health alone and in combination.

METHODS

We carried out a case-control study to determine associations between multiple indicators of HAP and persistent cough among children (<15 years of age) seeking care at three primary-care clinics in Kampala, Uganda. HAP indicators included self-report of combustion sources inside the home (e.g., stove type, fuel type, and smoking); housing characteristics and cooking practices that mitigate HAP exposure (e.g., use of windows, location of cooking, location of children during cooking) and perceptions of neighborhood air quality. To explore joint associations between indicators of HAP, we applied a Bayesian clustering technique (Bayesian profile regression) to identify HAP indicator profiles most strongly associated with persistent cough in children.

RESULTS

Most HAP indicators demonstrated significant positive bivariate associations with persistent cough among children, including fuel-type (kerosene), the number of hours burning solid fuels, use of polluting fuels (kerosene or candles) for lighting the home, tobacco smoking indoors, cooking indoors, cooking with children indoors, lack of windows in the cooking area, and not opening windows while cooking. Bayesian cluster analysis revealed 11 clusters of HAP indicator profiles. Compared to a reference cluster that was representative of the underlying study population cough prevalence, three clusters with profiles characterized by highly adverse HAP indicators resulted in ORs of 1.72 (95% credible interval: 1.15, 2.60), 4.74 (2.88, 8.0), and 8.6 (3.9, 23.9). Conversely, at least two clusters of HAP indicator-profiles were protective compared to the reference cluster, despite the fact that these protective HAP indicator profiles used solid fuels for cooking in combination with an unimproved stove (cooking was performed predominantly outdoors in these protective clusters).

CONCLUSIONS

In addition to cooking fuel and type of cook stove, multiple HAP indicators were strongly associated with persistent cough in children. Bayesian profile regression revealed that the combination of HAP sources and HAP exposure-mitigating factors was driving risk of adverse cough associations in children, rather than any single HAP source at the home.

Reductions in urinary metabolites of exposure to household air pollution in pregnant, rural Guatemalan women provided liquefied petroleum gas stoves

BACKGROUND

Household air pollution from solid fuels is a leading risk factor for morbidity and mortality worldwide. Pregnant women's exposure to polycyclic aromatic hydrocarbons (PAHs) and volatile organic compounds (VOCs), two components of solid-fuel smoke, is associated with adverse birth outcomes. Even with improved solid-fuel stoves, exposure to PAHs and VOCs remains high. Therefore, cleaner cooking fuels need to be prioritized.

OBJECTIVE

We aimed to quantify exposure reduction to PAHs and VOCs among pregnant women in rural Guatemala with a liquefied petroleum gas (LPG) stove intervention.

MATERIALS AND METHODS

Urine from pregnant women (N = 50) was collected twice: at <20 weeks gestation, when women cooked exclusively with wood, and 6-8 weeks after receiving an LPG stove. Metabolites of four PAHs and eight VOCs were analyzed. Concurrent with urine collection, personal 48-h PM2.5 exposure was measured.

RESULTS

Women cooking exclusively with wood were exposed to high levels of particulate matter (PM2.5), which was reduced by 57% with the LPG stove. Urinary concentrations of total PAH metabolites (-37%), PMA (benzene metabolite; -49%), and CNEMA (acrylonitrile metabolite; -51%) were reduced. However, recent use of a wood-fired sauna bath led to large increases in excretion of urinary toxicant metabolites (+66-135%).

CONCLUSIONS

This is the first study to report PAH and VOC reductions from an LPG stove intervention introduced during pregnancy. However, other sources of air pollution minimized the gains seen from using an LPG stove. Thus, all sources of air pollution must be addressed in concert to reduce exposures to levels that protect health.

Home environment and health: Domestic risk factors for rhinitis, throat symptoms and non-respiratory symptoms among adults across China

Few studies exist from China on associations between home environment and adult health. We studied associations between home environment factors (other than dampness and mould) and rhinitis, throat and dermal symptoms and headache and fatigue among young parents in six cities across China (N = 36,541). They were recruited as parents from day care centers selected randomly and answered a questionnaire on medical symptoms and the home environment. Odds ratios (OR) were calculated by multilevel logistic regression adjusting for gender, atopy, smoking, home size and dampness/mould. Overall, 4.8% had skin symptoms 3.1% rhinitis, 2.8% eye, 4.1% throat symptoms, 3.0% headache and 13.9% had fatigue (all as weekly symptoms). Redecoration was associated with rhinitis, eye and skin symptoms, headache and fatigue. New furniture was associated with eye, throat and skin symptoms and fatigue. Gas cooking was associated with eye and throat symptoms, headache and fatigue. Biomass cooking was associated with eye and throat symptoms and headache. Burning incense was associated with eye, throat and skin symptoms, headache and fatigue. Presence of cockroaches and mosquitos or flies was associated with all six symptoms. Rats or mice were associated with eye and dermal symptoms. Cat keeping was associated with eye symptoms while dog keepers had less fatigue. Living near major roads was associated with rhinitis, eye, throat and skin symptoms and fatigue. Daily cleaning, a mechanical ventilation system in the kitchen or in the bathroom, living in older buildings and living in less urbanized areas were protective factors. In conclusion, urbanization, traffic exhaust, indoor emissions from redecoration and new furniture, gas cooking and air pollution from burning incense and biomass may cause dermal and mucosal symptoms, headache and fatigue among adults in China. Indoor animals (cats, mice/rats, cockroaches) were other risk factors. Daily cleaning, mechanical ventilation and living in older buildings can be protective.

The impact on T-regulatory cell related immune responses in rural women exposed to polycyclic aromatic hydrocarbons (PAHs) in household air pollution in Gansu, China: A pilot investigation

Previous studies found associations between impairments of immune functions and exposure to polycyclic aromatic hydrocarbons (PAHs) in ambient air pollution in the U. S. and China. However, the results remain inconclusive due to the limitations of these studies. In this study, we aimed to examine the direction and magnitude of immune changes related to PAH exposure from household air pollution among rural women living in Gansu, China. Healthy village women (n = 34) were recruited and enrolled in the study. Questionnaires were administered. Blood and urine samples were collected and analyzed during non-heating (September 2017, "summer") and heating (January 2018, "winter") seasons. Urinary 1-hydroxypyrene (1-OHP) was quantified as the biomarker of PAH exposure. To evaluate Treg cell related immune functions, we examined immunoglobulin E (IgE), percent of T-regulatory (Treg) cells, and gene expression of following: forkhead box transcription factor 3 (Foxp3), transforming growth factor-β (TGF-β), interleukin 10 (IL-10), and interleukin 35 (IL-35), composed of interleukin-12 alpha (IL-12α) and Epstein-Barr-virus-induced gene 3 (EBi3). Urinary 8-hydroxy-2-deoxyguanosine (8-OHdG) was measured to evaluate oxidative DNA damage. The results showed that the concentration of 1-OHP increased from 0.90 to 17.4 μmol mol-Cr ^-1 from summer to winter (p < 0.001). Meanwhile, average percent of Treg cells decreased from 5.01% to 1.15% (p < 0.001); IgE and mRNA expressions of Foxp3, TGF-β, IL-10, IL-12α and EBi3 all significantly decreased (p < 0.001); Urinary 8-OHdG increased from 12.7 to 30.3 ng mg-Cr ^-1 (p < 0.001). The changes in 8-OHdG, Foxp3 and TGF-β were significantly associated with the increase of 1-OHP. The results suggested that we observed a substantial increase of PAH exposure in winter, which was significantly associated with the repression on Treg cell function and oxidative DNA damage. Exposure to PAHs in household air pollution possibly induced immune impairments among rural women in northwest China.

Cytotoxic and genotoxic effects in mechanics occupationally exposed to diesel engine exhaust

Diesel engine exhaust (DEE), which is the product of diesel combustion, is considered carcinogenic in humans. It comprises toxic gases, polycyclic aromatic hydrocarbons (PAHs) and particulate matter which can reach the pulmonary parenchyma and trigger various diseases, including cancer. The aim of the present study was to evaluate the potential cytotoxic and genotoxic effects of DEE exposure on peripheral blood and buccal epithelial cells in mechanics occupationally exposed to DEE. We recruited 120 exposed mechanics and 100 non-exposed control individuals. Significant differences were observed between the two groups in terms of percentage of tail DNA and damage index (DI) in the alkaline comet assay; levels of biomarkers by cytokinesis-block micronucleus cytome (CBMN-Cyt) assay; frequency of micronucleus (MN), nucleoplasmic bridge (NPB), nuclear bud (NBUD) and apoptotic cells (APOP) and levels of biomarkers for micronucleus, karyorrhexis (KRX), karyolysis (KRL) and condensed chromatin (CC) by the buccal micronucleus cytome (BM-Cyt) assay. A significant and positive correlation was found between the frequency of MN in lymphocytes and buccal cells in the exposed group. Also, there was a significant correlation between age and percentage of tail DNA and DI in the comet assay, APOP and MN in the CBMN-Cyt assay and NBUD and MN in the BM-Cyt assay. Additionally, we found a positive and significant correlation of MN frequency in lymphocytes and buccal cells and age and MN frequency in lymphocytes with the time of service (years). Regarding lifestyle-related factors, a significant correlation was observed between meat and vitamin consumption and NBUD formation on CBMN-Cyt and between meat consumption and MN formation on CBMN-Cyt. Of the BM-Cyt biomarkers, there was a correlation between alcohol consumption and NBUD formation and between binucleated cell (BN), pyknosis (PYC), CC and KRL occurrence and family cancer history. These results are the first data in Colombia on the cytotoxic and genotoxic effects induced by continuous exposure to DEE and thus showed the usefulness of biomarkers of the comet, CBMN-Cyt and BM-Cyt assays for human biomonitoring and evaluation of cancer risk in the exposed populations.

Associations between inhaled doses of PM2.5-bound polycyclic aromatic hydrocarbons and fractional exhaled nitric oxide

Exposure to fine particulate matter (PM_2.5) is linked to various respiratory outcomes. However, the associations of concentrations of PM_2.5-bound polycyclic aromatic hydrocarbons (PM_2.5-bound PAHs) with airway inflammatory indices remains unclear. To assess effects of short-term exposure to PM_2.5-bound PAHs on fractional exhaled nitric oxide (FeNO), we conducted a pilot study with repeated measures. We recruited 20 postgraduate students in Wuhan city, China, and repeatedly measured outdoor and indoor (including dormitories, offices and laboratories) PM_2.5-bound PAHs concentrations, urinary monohydroxy polycyclic aromatic hydrocarbons (OH-PAHs) and FeNO levels in the four seasons. Subsequently, we estimated inhaled doses of PM_2.5-bound PAHs based on the micro-environmental PM_2.5-bound PAHs concentrations, time-activity patterns and referred inhalation rates. We assessed the association of inhaled doses of PM_2.5-bound PAHs with FeNO using linear mixed-effects regression models. We found the positive associations of urinary ∑OH-PAHs levels with inhaled doses of indoor PM_2.5-bound PAHs (including dormitories and offices) (all p < 0.05). A one-unit increase in inhaled doses of PM_2.5-bound PAHs or in urinary concentrations of ∑OH-PAHs was corresponded to a maximum FeNO increase of 13.5% (95% CI: 5.4, 22.2) at lag2 day or of 6.8% (95% CI: 3.4, 10.2) at lag1 day. Inhaled doses of PM_2.5-bound PAHs or urinary OH-PAHs was positively related to increased FeNO, they may be accepted as a short-term biomarker of exposure to PAHs in air. Exposure to PM_2.5-bound PAHs in indoor air may contribute more to the body burden of PAHs than outdoor air, and exhibited stronger effect on increased FeNO rather than urinary OH-PAHs.

Combined seven miRNAs for early hepatocellular carcinoma detection with chronic low-dose exposure to microcystin-LR in mice

Aberrant miRNA expression has been detected in various tumor tissues, which may be considered as a marker for early cancer diagnosis. One miRNA has multiple downstream target genes, which can be regulated by multiple upstream other miRNAs. Hence, this dynamic regulation is likely characterized by volatility, and thus, finding the appropriate time point for tests becomes essential for the use of miRNAs as an early marker of tumor diagnosis. In this study, we established a chronic liver cancer progression model in mice by using low doses of the harmful substance microcystin-LR (MC-LR). On the basis of miRNAs microarray assay, we further tested seven miRNAs that showed characteristic expression changes in pre-hepatocarcinogenesis. Our results showed that the levels of four miRNAs (miR-122-5p, miR-125-5p, miR-199a-5p, and miR-503-5p) decreased dramatically, whereas those of two miRNAs (miR-222-5p and miR-590-5p) increased significantly in the early stages, which were all accompanied by an increase in atypia of hepatocytes. MiR-490-5p was a sensitive molecular, suitable only for evaluation of pathological changes in young mice. Therefore the combination the seven of miRNAs for a set may prove to be an effective method in healthy assessment of environmental toxicants for detection of hepatocarcinogenesis caused by hazardous materials.

Differential exposure and acute health impacts of inhaled solid-fuel emissions from rudimentary and advanced cookstoves in female CD-1 mice

BACKGROUND

There is an urgent need to provide access to cleaner end user energy technologies for the nearly 40% of the world's population who currently depend on rudimentary cooking and heating systems. Advanced cookstoves (CS) are designed to cut emissions and solid-fuel consumption, thus reducing adverse human health and environmental impacts.

STUDY PREMISE

We hypothesized that, compared to a traditional (Tier 0) three-stone (3-S) fire, acute inhalation of solid-fuel emissions from advanced natural-draft (ND; Tier 2) or forced-draft (FD; Tier 3) stoves would reduce exposure biomarkers and lessen pulmonary and innate immune system health effects in exposed mice.

RESULTS

Across two simulated cooking cycles (duration ~ 3h), emitted particulate mass concentrations were reduced 80% and 62% by FD and ND stoves, respectively, compared to the 3-S fire; with corresponding decreases in particles visible within murine alveolar macrophages. Emitted carbon monoxide was reduced ~ 90% and ~ 60%, respectively. Only 3-S-fire-exposed mice had increased carboxyhemoglobin levels. Emitted volatile organic compounds were FD ≪ 3-S-fire ≤ ND stove; increased expression of genes involved in xenobiotic metabolism (COX-2, NQO1, CYP1a1) was detected only in ND- and 3-S-fire-exposed mice. Diminished macrophage phagocytosis was observed in the ND group. Lung glutathione was significantly depleted across all CS groups, however the FD group had the most severe, ongoing oxidative stress.

CONCLUSIONS

These results are consistent with reports associating exposure to solid fuel stove emissions with modulation of the innate immune system and increased susceptibility to infection. Lower respiratory infections continue to be a leading cause of death in low-income economies. Notably, 3-S-fire-exposed mice were the only group to develop acute lung injury, possibly because they inhaled the highest concentrations of hazardous air toxicants (e.g., 1,3-butadiene, toluene, benzene, acrolein) in association with the greatest number of particles, and particles with the highest % organic carbon. However, no Tier 0-3 ranked CS group was without some untoward health effect indicating that access to still cleaner, ideally renewable, energy technologies for cooking and heating is warranted.

Ordered Mesoporous NiCo2O4 Nanospheres as a Novel Electrocatalyst Platform for 1-Naphthol and 2-Naphthol Individual Sensing Application

The novel ordered mesoporous NiCo₂O₄ (meso-NiCo₂O₄) nanospheres were synthesized by the nanocasting strategy followed by a calcination process for 2-naphthol (2-NAP) and 1-naphthol (1-NAP) individual sensing application. The as-obtained meso-NiCo₂O₄ material possesses mesoporous structure in spinel crystalline type with a larger specific surface area than other structures. The meso-NiCo₂O₄-modified carbon paste electrode exhibited excellent electrocatalytic performance for NAP detection by amperometry measurement. The fabricated sensor of 2-NAP and 1-NAP has a wide linear detection range (0.02-300 and 0.02-20 μM) with high sensitivity (1.822 and 1.510 μA μM^-1 cm^-2) and low limit of detection (0.007 and 0.007 μM), respectively. In addition, the NAP sensors possess excellent reproducibility, stability, and selectivity.

Individual and cumulative impacts of fire emissions and tobacco consumption on wildland firefighters' total exposure to polycyclic aromatic hydrocarbons

There is limited information about wildland firefighters' exposure to polycyclic aromatic hydrocarbons (PAHs), being scarce studies that included the impact of tobacco consumption. Thus, this work evaluated the individual and cumulative impacts of firefighting activities and smoking on wildland firefighters' total exposure to PAHs. Six urinary PAH metabolites (1-hydroxynaphthalene (1OHNaph), 1-hydroxyacenaphthene (1OHAce), 2-hydroxyfluorene (2OHFlu), 1-hydroxyphenanthrene (1OHPhen), 1-hydroxypyrene (1OHPy), and 3-hydroxybenzo[a]pyrene (3OHB[a]P)) were quantified by high-performance liquid chromatography with fluorescence detection. Firefighters from three fire stations were characterized and organized in three groups: non-smoking and non-exposed to fire emissions (NSNExp), smoking non-exposed (SNExp), and smoking exposed (SExp) individuals. 1OHNaph+1OHAce were the most predominant OH-PAHs (66-91% ∑OH-PAHs), followed by 2OHFlu (2.8-28%), 1OHPhen (1.3-7%), and 1OHPy (1.4-6%). 3OHB[a]P, the carcinogenicity PAH biomarker, was not detected. Regular consumption of tobacco increased 76-412% ∑OH-PAHs. Fire combat activities promoted significant increments of 158-551% ∑OH-PAHs. 2OHFlu was the most affected compound by firefighting activities (111-1068%), while 1OHNaph+1OHAce presented the more pronounced increments due to tobacco consumption (22-339%); 1OHPhen (76-176%) and 1OHPy (20-220%) were the least influenced ones. OH-PAH levels of SExp firefighters were significantly higher than in other groups, suggesting that these subjects may be more vulnerable to develop and/or aggravate diseases related with PAHs exposure.

Ancient water bottle use and polycyclic aromatic hydrocarbon (PAH) exposure among California Indians: a prehistoric health risk assessment

BACKGROUND

Polycyclic aromatic hydrocarbons (PAHs) are the main toxic compounds in natural bitumen, a fossil material used by modern and ancient societies around the world. The adverse health effects of PAHs on modern humans are well established, but their health impacts on past populations are unclear. It has previously been suggested that a prehistoric health decline among the native people living on the California Channel Islands may have been related to PAH exposure. Here, we assess the potential health risks of PAH exposure from the use and manufacture of bitumen-coated water bottles by ancient California Indian societies.

METHODS

We replicated prehistoric bitumen-coated water bottles with traditional materials and techniques of California Indians, based on ethnographic and archaeological evidence. In order to estimate PAH exposure related to water bottle manufacture and use, we conducted controlled experiments to measure PAH contamination 1) in air during the manufacturing process and 2) in water and olive oil stored in a completed bottle for varying periods of time. Samples were analyzed with gas chromatography/mass spectrometry (GC/MS) for concentrations of the 16 PAHs identified by the US Environmental Protection Agency (EPA) as priority pollutants.

RESULTS

Eight PAHs were detected in concentrations of 1-10 μg/m³ in air during bottle production and 50-900 ng/L in water after 2 months of storage, ranging from two-ring (naphthalene and methylnaphthalene) to four-ring (fluoranthene) molecules. All 16 PAHs analyzed were detected in olive oil after 2 days (2 to 35 μg/kg), 2 weeks (3 to 66 μg/kg), and 2 months (5 to 140 μg/kg) of storage.

CONCLUSIONS

For ancient California Indians, water stored in bitumen-coated water bottles was not a significant source of PAH exposure, but production of such bottles could have resulted in harmful airborne PAH exposure.