Selected physiological effects of ultrafine particles in acute cardiovascular morbidity

Ultrafine particles: Sources, toxicity, and deposition dynamics in the human respiratory tract -- experimental and computational approaches

Ultrafine particles (UFPs ≤ 100 nm) pose significant health risks, including respiratory and cardiovascular diseases, and cancer. This review consolidates main sources, toxicity, and exposure assessment approaches to elucidate the deposition dynamics of UFPswithin the human respiratory tract. Key factors influencing the deposition fraction (DF) are highlighted. Our findings indicate that the DF surpasses 50% for particles ≤50 nm and reaches up to 70% for particles ≤30 nm, impacting both adults and children. Vulnerable populations, such as children and individuals with pre-existing health conditions, are disproportionately affected, yet research focusing on these groups remains scarce. Methodological deficiencies, including high costs, simplifying assumptions, and computational constraints, challenge prediction accuracy. Experimental methods struggle to capture temporal fluctuations, while computational models fail to account for complex phenomena. Addressing these gaps is crucial for refining public health regulations and advancing nanomedicine. An improved understanding of UFPs dynamics will enhance protective measures and nanomedicine applications, particularly in targeted drug delivery and diagnostics. This review emphasizes the need for innovative experimental and computational methods to study UFPs deposition dynamics, ultimately advancing our understanding of UFPs' impact on human health.

Investigation of the Mechanism of Oxidative Potential Increase in Atmospheric Particulate Matter during Photoaging: Important Role of Aromatic Nitrogenous Compounds

Particulate matter (PM) undergoing various aging processes in the atmosphere changes its toxicity. However, the mechanism of toxicity evolution is not fully clarified currently. This study demonstrates that photoaging promotes an increase in the oxidative potential (OP) of atmospheric PM by about 30%, and the increased OP is mainly attributed to the production of secondary organic compounds, while water-soluble metal ions contribute only 11%. The OP of nonextractable matters (NEMs) of atmospheric PM was mostly increased after photoaging, followed by water-soluble matters (WSMs). NEM can produce quinone-like functional groups and secondary persistent free radicals during photoaging, which are most likely to produce reactive oxygen species (ROS). For WSM, the conversion of low-oxidation humic-like substances (HULIS) to high-oxidation HULIS is the main reason for the increase in OP. Quinones, nitrophenols, and N-containing heterocycles are the OP contributors produced during the conversion process. Among them, quinones are the main secondary oxidizing active compounds, while nitro-phenolic compounds and N-containing heterocyclic compounds may play a catalyst-like role, facilitating the production of oxidizing active compounds and ROS in the newly converted high-oxidation HULIS. This study clarifies the secondary OP generation mechanism and provides new insights into the uncertainty of PM toxicity during atmospheric aging.

Short-term effects of ultrafine particles on heart rate variability: A systematic review and meta-analysis

An increasing number of epidemiological studies have examined the association between ultrafine particles (UFP) and imbalanced autonomic control of the heart, a potential mechanism linking particulate matter air pollution to cardiovascular disease. This study systematically reviews and meta-analyzes studies on short-term effects of UFP on autonomic function, as assessed by heart rate variability (HRV). We searched PubMed and Web of Science for articles published until June 30, 2022. We extracted quantitative measures of UFP effects on HRV with a maximum lag of 15 days from single-pollutant models. We assessed the risk of bias in the included studies regarding confounding, selection bias, exposure assessment, outcome measurement, missing data, and selective reporting. Random-effects models were applied to synthesize effect estimates on HRV of various time courses. Twelve studies with altogether 1,337 subjects were included in the meta-analysis. For an increase of 10,000 particles/cm³ in UFP assessed by central outdoor measurements, our meta-analysis showed immediate decreases in the standard deviation of the normal-to-normal intervals (SDNN) by 4.0% [95% confidence interval (CI): 7.1%, -0.9%] and root mean square of successive R-R interval differences (RMSSD) by 4.7% (95% CI: 9.1%, 0.0%) within 6 h after exposure. The immediate decreases in SDNN and RMSSD associated with UFP assessed by personal measurements were smaller and borderline significant. Elevated UFP were also associated with decreases in SDNN, low-frequency power, and the ratio of low-frequency to high-frequency power when pooling estimates of lags across hours to days. We did not find associations between HRV and concurrent-day UFP exposure (daily average of at least 18 h) or exposure at lags ≥ one day. Our study indicates that short-term exposure to ambient UFP is associated with decreased HRV, predominantly as an immediate response within hours. This finding highlights that UFP may contribute to the onset of cardiovascular events through autonomic dysregulation.

Cardiopulmonary benefits of respirator intervention against near road ambient particulate matters in healthy young adults: A randomized, blinded, crossover, multi-city study

Wearing a respirator is generally the most convenient individual intervention against ambient particulate matter (PM), and therefore there has been considerable research into its effectiveness. However, the effects of respirator intervention under different PM concentration settings have been insufficiently elucidated. We conducted a randomized, blinded, crossover intervention study in four representative cities in China in which 128 healthy university students spent 2-h walking along a busy road wearing either a real or a sham respirator and then spent the next 5-h indoors away from traffic pollution. Lung function, blood pressure, and heart rate variability were continuously measured throughout the visit. Linear mixed-effect models were fitted to evaluate the protective effects of respirator intervention on the cardiopulmonary indicators. Results showed that the beneficial effects of respirator intervention were only occasionally significant at specific time points or in specific cities or in selected parameters. Overall, respirator intervention was associated with reduced SBP (6.2 vs. 11.5 mmHg compared to baseline, p < 0.05) and increased LF (44 vs. 35 ms² compared to baseline, p < 0.05) over the 2-h walk, but no significant effects were found over the 7-h period. Respirators have significant effect modifications on the associations between PM_2.5/PM₁₀ and the cardiopulmonary indicators, but the directions of effects were inconsistent. The intercity difference in the effects of respirator intervention was found significant, with Taiyuan and Shanghai to be the two cities with lower personal PM concentrations but more pronounced benefits. In conclusion, reducing personal exposure to PM can have some beneficial effects in some scenarios. However, respirators may not provide sufficient protection from air pollution overall, and we should avoid over-reliance on respirators and accelerate efforts to reduce emissions of pollutants in the first place. Despite standardized procedures, we found inconsistency in results across cities, consistent with the previous literature.

The physics of respiratory particle generation, fate in the air, and inhalation

Given that breathing is one of the most fundamental physiological functions, there is an urgent need to broaden our understanding of the fluid dynamics that governs it. There would be many benefits from doing so, including a better assessment of respiratory health, a basis for more precise delivery of pharmaceutical drugs for treatment, and the understanding and potential minimization of respiratory infection transmission. We review the physics of particle generation in the respiratory tract, the fate of these particles in the air on exhalation and the physics of particle inhalation. The main focus is on evidence from experimental studies. We conclude that although there is qualitative understanding of the generation of particles in the respiratory tract, a basic quantitative knowledge of the characteristics of the particles emitted during respiratory activities and their fate after emission, and a theoretical understanding of particle deposition during inhalation, nevertheless the general understanding of the entire process is rudimentary, and many open questions remain.

Projecting Lifetime Health Outcomes and Costs Associated with the Ambient Fine Particulate Matter Exposure among Adult Women in Korea

We sought to estimate the lifetime healthcare costs and outcomes associated with the exposure to the escalated concentration of fine particulate matter (particle size < 2.5 μm, PM2.5) among adult Korean women. We adapted a previously developed Markov model, and a hypothetical cohort composed of Korean women was exposed to either a standard (15 μg/m3) or increased (25 μg/m3) concentration of PM2.5. The time horizon of the analysis was 60 years, and the cycle length was 1 year. The outcomes were presented as direct healthcare costs and quality-adjusted life years (QALYs), and costs were discounted annually at 5%. Deterministic and probabilistic sensitivity analyses were performed. The model estimated that when the exposure concentration was increased by 10 μg/m3, the lifetime healthcare cost increased by USD 9309, which is an 11.3% increase compared to the standard concentration group. Women exposed to a higher concentration of PM2.5 were predicted to live 30.64 QALYs, compared to 32.08 QALYs for women who were exposed to the standard concentration of PM2.5. The tendency of a higher cost and shorter QALYs at increased exposure was consistent across a broad range of sensitivity analyses. The negative impact of PM2.5 was higher on cost than on QALYs and accelerated as the exposure time increased, emphasizing the importance of early intervention.

Acute cardiovascular effects of traffic-related air pollution (TRAP) exposure in healthy adults: A randomized, blinded, crossover intervention study

Exposure to traffic-related air pollution (TRAP) may enhance the risk of cardiovascular disease. However, the short-term effects of TRAP components on the cardiovascular system are not well understood. We conducted a randomized, double-blinded, crossover intervention study in which 39 healthy university students spent 2 h next to a busy road. Participants wore a powered air-purifying respirator (PAPR) or an N95 mask. PAPRs were equipped with a filter for particulate matter (PM), a PM and volatile organic compounds (VOCs) filter or a sham filter. Participants were blinded to PAPR filter type and underwent randomized exposures four times, once for each intervention mode. Blood pressure (BP), heart rate (HR) and heart rate variability (HRV) were measured before, during and for 6 h after the roadside exposure. Linear mixed-effect models were used to evaluate the effects of the interventions relative to baseline controlling for other covariates. All HRV measures increased during and following exposure for all intervention modes. Some HRV measures (SDNN and rMSSD during exposure and SDNN after exposure) were marginally affected by PM filtration. Wearing the N95 mask affected VLF power and rMSSD responses to traffic exposure differently than the PAPR interventions. Both systolic and diastolic BP increased slightly during exposure, but then were generally lower than baseline after exposure for the sham and filter interventions. HR, which fell during exposure and mostly remained lower than baseline after exposure, was lower yet with all filter interventions compared to the sham mode following exposure. Therefore, short-term exposure to traffic acutely affects HRV, BP and HR, but N95 mask and PAPR interventions generally show little efficacy in reducing these effects. Removing the PM component of TRAP has some limited effects on HRV responses to exposure but exaggerates the traffic-related decrease in HR. HRV findings from N95 mask interventions need to be interpreted cautiously.

Mobile monitoring and spatial prediction of black carbon in Cairo, Egypt

This study harnesses the power of mobile data in developing a spatial model for predicting black carbon (BC) concentrations within one of the most heavily populated regions in the Middle East and North Africa MENA region, Greater Cairo Region (GCR) in Egypt. A mobile data collection campaign was conducted in GCR to collect BC measurements along specific travel routes. In total, 3,300 km were travelled across a widespread 525 km of routes. Reported average BC values were around 20 µg/m³, announcing an alarming order of magnitude value when compared to the maximum reported values in similar studies. A bi-directional stepwise land use regression (LUR) model was developed to select the best combination of explanatory variables and generate an exposure surface for BC, in addition to a number of machine learning models (random forest gradient boost, light gradient boost model (LightGBM), Keras neural network (NN)). Data from 7 air quality (AQ) stations were compared-in terms of mean square error (MSE) and mean absolute error (MAE)-with predictions from the LUR and the NN model. The NN model estimated higher BC concentrations in the downtown areas, while lower concentrations are estimated for the peripheral area at the east side of the city. Such results shed light on the credibility of the LUR models in generating a general spatial trend of BC concentrations while the superiority of NN in BC accuracy estimation (0.023 vs 0.241 in terms of MSE and 0.12 vs 0.389 in terms of MAE; of NN vs LUR respectively).

Short-term exposure to particulate matter on heart rate variability in humans: a systematic review of crossover and controlled studies

As an indicator of cardiac autonomic function, heart rate variability (HRV) has been proven to decrease after short-term exposure to particulate matters (PM) based on controlled animal studies. In this study, we conducted a systematic review to investigate short-term effects of exposure with different particle sizes on HRV in humans. Both crossover and controlled studies of human which were published prior to February 2020 were searched on four electronic databases. The HRV parameters included standard deviation of normal-to-normal intervals (SDNN), root mean square of successive normal-to-normal intervals (RMSSD), percent of normal-to-normal intervals that differ by more than 50 milliseconds (PNN50), low frequency (LF), high frequency (HF), and LF/HF. This review included 14 studies with 300 participants. The short-term effects of PM exposure on HRV in humans are inconclusive. For time-domain parameters, one study showed higher SDNN values with 2-h exposure to PM, whereas another one showed lower SDNN values. One study found RMSSD increased after PM exposure. One study found PNN50 decreased after PM exposure. For frequency-domain parameters, two studies showed LF increased with 2-h exposure to PM, and two studies showed an increase of LF/HF after PM exposure. Four studies showed lower HF values after PM exposure, whereas two studies showed higher HF values. Five studies did not find statistically significant results for any HRV parameters. We could not conclude that short-term exposure to PM can influence autonomic nervous function. The inconsistent changes of HRV in response to PM exposure may have complex mechanisms, which remains to be elucidated.

Calibration Method for Particulate Matter Low-Cost Sensors Used in Ambient Air Quality Monitoring and Research

Over the last decade, manufacturers have come forth with cost-effective sensors for measuring ambient and indoor particulate matter concentration. What these sensors make up for in cost efficiency, they lack in reliability of the measured data due to their sensitivities to temperature and relative humidity. These weaknesses are especially evident when it comes to portable or mobile measurement setups. In recent years many studies have been conducted to assess the possibilities and limitations of these sensors, however mostly restricted to stationary measurements. This study reviews the published literature until 2020 on cost-effective sensors, summarizes the recommendations of experts in the field based on their experiences, and outlines the quantile-mapping methodology to calibrate low-cost sensors in mobile applications. Compared to the commonly used linear regression method, quantile mapping retains the spatial characteristics of the measurements, although a common correction factor cannot be determined. We conclude that quantile mapping can be a useful calibration methodology for mobile measurements given a well-elaborated measurement plan assures providing the necessary data.

Monitoring of Particulate Matter Emissions from 3D Printing Activity in the Home Setting

Consumer-level 3D printers are becoming increasingly prevalent in home settings. However, research shows that printing with these desktop 3D printers can impact indoor air quality (IAQ). This study examined particulate matter (PM) emissions generated by 3D printers in an indoor domestic setting. Print filament type, brand, and color were investigated and shown to all have significant impacts on the PM emission profiles over time. For example, emission rates were observed to vary by up to 150-fold, depending on the brand of a specific filament being used. Various printer settings (e.g., fan speed, infill density, extruder temperature) were also investigated. This study identifies that high levels of PM are triggered by the filament heating process and that accessible, user-controlled print settings can be used to modulate the PM emission from the 3D printing process. Considering these findings, a low-cost home IAQ sensor was evaluated as a potential means to enable a home user to monitor PM emissions from their 3D printing activities. This sensing approach was demonstrated to detect the timepoint where the onset of PM emission from a 3D print occurs. Therefore, these low-cost sensors could serve to inform the user when PM levels in the home become elevated significantly on account of this activity and furthermore, can indicate the time at which PM levels return to baseline after the printing process and/or after adding ventilation. By deploying such sensors at home, domestic users of 3D printers can assess the impact of filament type, color, and brand that they utilize on PM emissions, as well as be informed of how their selected print settings can impact their PM exposure levels.

Short-term differences in cardiac function following controlled exposure to cookstove air pollution: The subclinical tests on volunteers exposed to smoke (STOVES) study

BACKGROUND

Exposure to household air pollution from solid fuel combustion for cooking and heating is an important risk factor for premature death and disability worldwide. Current evidence supports an association of ambient air pollution with cardiovascular disease but is limited for household air pollution and for cardiac function. Controlled exposure studies can complement evidence provided by field studies.

OBJECTIVES

To investigate effects of short-term, controlled exposures to emissions from five cookstoves on measures of cardiac function.

METHODS

Forty-eight healthy adults (46% female; 20-36 years) participated in six, 2-h exposures ('treatments'), including emissions from five cookstoves and a filtered-air control. Target fine particulate matter (PM2.5) exposure-concentrations per treatment were: control, 0 µg/m3; liquefied petroleum gas, 10 µg/m3; gasifier, 35 µg/m3; fan rocket, 100 µg/m3; rocket elbow, 250 µg/m3; and three stone fire, 500 µg/m3. Participants were treated in a set (pre-randomized) sequence as groups of 4 to minimize order bias and time-varying confounders. Heart rate variability (HRV) and cardiac repolarization metrics were calculated as 5-min means immediately and at 3 h following treatment, for analysis in linear mixed-effects models comparing cookstove to control.

RESULTS

Short-term differences in SDNN (standard deviation of duration of all NN intervals) and VLF (very-low frequency power) existed for several cookstoves compared to control. While all cookstoves compared to control followed a similar trend for SDNN, the greatest effect was seen immediately following three stone fire (β = -0.13 ms {%}; 95% confidence interval = -0.22, -0.03%), which reversed in direction at 3 h (0.03%; -0.06, 0.13%). VLF results were similar in direction and timing to SDNN; however, other HRV or cardiac repolarization results were not similar to those for SDNN.

DISCUSSION

We observed some evidence of short-term, effects on HRV immediately following cookstove treatments compared to control. Our results suggest that cookstoves with lower PM2.5 emissions are potentially capable of affecting cardiac function, similar to stoves emitting higher PM2.5 emissions.

Occupational exposure to unintentionally emitted nanoscale particles and risk of cancer: From lung to central nervous system - Results from three French case-control studies

OBJECTIVES

Nanoscale particles (1-100 nm) can be of natural origin, and either intentionally or unintentionally produced by human activities. Toxicological data have suggested a possible carcinogenic effect of such particles. The aim of this study was to estimate the association between occupational exposure to nanoscale particles and risk of lung cancer, pleural mesothelioma and brain tumors in adults.

METHODS

Three French population-based case-control studies were analyzed: 1) the ICARE study including 2029 lung cancer cases and 2591 controls; 2) the PNSM study including 371 pleural mesothelioma cases and 730 controls and 3) the CERENAT study including 257 brain tumor cases and 511 controls. Occupational exposure to unintentionally emitted nanoscale particles (UNPs) was retrospectively assessed by a job exposure matrix providing a probability and a frequency of exposure.

RESULTS

In adjusted analyses among men, significant associations between occupational exposure to UNPs and lung cancer (OR = 1.51; 95% CI: 1.22-1.86 and brain tumors (OR = 1.69; 95% CI: 1.17-2.44) were observed. No increased OR was observed for pleural mesothelioma (OR = 0.78; 95% CI: 0.46-1.33).

CONCLUSION

This is the first study showing positive associations between occupational exposure to UNPs and increased risk of lung cancer and brain tumors. These preliminary results should encourage further epidemiological research.

Acute cardiovascular health effects in a panel study of personal exposure to traffic-related air pollutants and noise in Toronto, Canada

Urban populations are often simultaneously exposed to air pollution and environmental noise, which are independently associated with cardiovascular disease. Few studies have examined acute physiologic responses to both air and noise pollution using personal exposure measures. We conducted a repeated measures panel study of air pollution and noise in 46 non-smoking adults in Toronto, Canada. Data were analyzed using linear mixed-effects models and weighted cumulative exposure modeling of recent exposure. We examined acute changes in cardiovascular health effects of personal (ultrafine particles, black carbon) and regional (PM_2.5, NO₂, O₃, O_x) measurements of air pollution and the role of personal noise exposure as a confounder of these associations. We observed adverse changes in subclinical cardiovascular outcomes in response to both air pollution and noise, including changes in endothelial function and heart rate variability (HRV). Our findings show that personal noise exposures can confound associations for air pollutants, particularly with HRV, and that impacts of air pollution and noise on HRV occur soon after exposure. Thus, both noise and air pollution have a measurable impact on cardiovascular physiology. Noise should be considered alongside air pollution in future studies to elucidate the combined impacts of these exposures in urban environments.

The relationship between personal exposure and ambient PM2.5 and black carbon in Beijing

This study is part of the "Air Polluion Impacts on Cardiopulmonary disease in Beijing: an integrated study of Exposure Science, Toxicologenomics & Environmental Epidemiology (APIC-ESTEE)" project under the UK-China joint research programme "Atmospheric Pollution and Human Health in a Chinese Megacity (APHH-China)". The aim is to capture the spatio-temporal variability in people's exposure to fine particles (PM_2.5) and black carbon (BC) air pollution in Beijing, China. A total of 120 students were recruited for a panel study from ten universities in Haidian District in northwestern Beijing from December 2017 to June 2018. Real-time personal concentrations of PM_2.5 and BC were measured over a 24-h period with two research-grade portable personal exposure monitors. Personal microenvironments (MEs) were determined by applying an algorithm to the handheld GPS unit data. On average, the participants spent the most time indoors (79% in Residence and 16% in Workplace), and much less time travelling by Walking, Cycling, Bus and Metro. Similar patterns were observed across participant gender and body-mass index classifications. The participants were exposed to 33.8 ± 27.8 μg m^-3 PM_2.5 and to 1.9 ± 1.2 μg m^-3 BC over the 24-h monitoring period, on average 24.3 μg m^-3 (42%) and 0.8 μg m^-3 (28%) lower, respectively, than the concurrent fixed-site ambient measurements. Relative differences between personal and ambient BC concentrations showed greater variability across the MEs, highlighting significant contributions from Dining and travelling by Bus, which involve potential combustion of fuels. This study demonstrates the potential value of personal exposure monitoring in investigating air pollution related health effects, and in evaluating the effectiveness of pollution control and intervention measures.

A gradient boost approach for predicting near-road ultrafine particle concentrations using detailed traffic characterization

This study investigates the influence of meteorology, land use, built environment, and traffic characteristics on near-road ultrafine particle (UFP) concentrations. To achieve this objective, minute-level UFP concentrations were measured at various locations along a major arterial road in the Greater Toronto Area (GTA) between February and May 2019. Each location was visited five times, at least once in the morning, mid-day, and afternoon. Each visit lasted for 30 min, resulting in 2.5 h of minute-level data collected at each location. Local traffic information, including vehicle class and turning movements, were processed using computer vision techniques. The number of fast-food restaurants, cafes, trees, traffic signals, and building footprint, were found to have positive impacts on the mean UFP, while distance to the closest major road was negatively associated with UFP. We employed the Extreme Gradient Boosting (XGBoost) method to develop prediction models for UFP concentrations. The Shapley additive explanation (SHAP) measures were used to capture the influence of each feature on model output. The model results demonstrated that minute-level counts of local traffic from different directions had significant impacts on near-road UFP concentrations, model performance was robust under random cross-validation as coefficients of determination (R²) ranged from 0.63 to 0.69, but it revealed weaknesses when data at specific locations were eliminated from the training dataset. This result indicates that proper cross-validation techniques should be developed to better evaluate machine learning models for air quality predictions.

Spatial Correlation of Ultrafine Particle Number and Fine Particle Mass at Urban Scales: Implications for Health Assessment

The epidemiological evidence for ultrafine particles (UFP; particles with diameter <100 nm) causing chronic health effects independent of fine particulate matter (PM_2.5) mass is inconclusive. A prevailing view is that urban UFP and PM_2.5 mass have different spatial patterns, which should allow epidemiological studies to distinguish their independent, chronic health effects. We investigate intraurban spatial correlation of PM_2.5 and UFP exposures in Pittsburgh, Pennsylvania. Measurements and predictions of a land-use regression model indicate moderate spatial correlation between particle number concentrations (PNC; a proxy for UFP) and PM_2.5 (R² of 0.38 and 0.41, respectively). High-resolution (1-km) chemical transport model simulations predict stronger spatial correlation (R² ≈ 0.8). The finding of moderate to strong spatial correlation was initially surprising because secondary aerosol contributes the vast majority of PM_2.5 mass. However, intraurban spatial patterns of both PNC and PM_2.5 are driven by local emissions and both pollutants largely behave as passive tracers at time scales of 1 day or less required for transport across most urban environments. Although previous research has shown little temporal correlation between PNC and PM_2.5, our finding of moderate to strong spatial correlation may complicate epidemiological analyses to separate the chronic health effects of PNC from PM_2.5 mass.

Exposure to Submicron Particles and Estimation of the Dose Received by Children in School and Non-School Environments

In the present study, the daily dose in terms of submicron particle surface area received by children attending schools located in three different areas (rural, suburban, and urban), characterized by different outdoor concentrations, was evaluated. For this purpose, the exposure to submicron particle concentration levels of the children were measured through a direct exposure assessment approach. In particular, measurements of particle number and lung-deposited surface area concentrations at “personal scale” of 60 children were performed through a handheld particle counter to obtain exposure data in the different microenvironments they resided. Such data were combined with the time–activity pattern data, characteristics of each child, and inhalation rates (related to the activity performed) to obtain the total daily dose in terms of particle surface area. The highest daily dose was estimated for children attending the schools located in the urban and suburban areas (>1000 mm2), whereas the lowest value was estimated for children attending the school located in a rural area (646 mm2). Non-school indoor environments were recognized as the most influential in terms of children’s exposure and, thus, of received dose (>70%), whereas school environments contribute not significantly to the children daily dose, with dose fractions of 15–19% for schools located in urban and suburban areas and just 6% for the rural one. Therefore, the study clearly demonstrates that, whatever the school location, the children daily dose cannot be determined on the basis of the exposures in outdoor or school environments, but a direct assessment able to investigate the exposure of children during indoor environment is essential.

Design and methodology challenges of environment-wide association studies: A systematic review

Environment-wide association studies (EWAS) are an untargeted, agnostic, and hypothesis-generating approach to exploring environmental factors associated with health outcomes, akin to genome-wide association studies (GWAS). While design, methodology, and replicability standards for GWAS are established, EWAS pose many challenges. We systematically reviewed published literature on EWAS to categorize scope, impact, types of analytical approaches, and open challenges in designs and methodologies. The Web of Science and PubMed databases were searched through multiple queries to identify EWAS articles between January 2010 and December 2018, and a systematic review was conducted following the Preferred Reporting Item for Systematic Reviews and Meta-Analyses (PRISMA) reporting standard. Twenty-three articles met our inclusion criteria and were included. For each study, we categorized the data sources, the definitions of study outcomes, the sets of environmental variables, and the data engineering/analytical approaches, e.g. neighborhood definition, variable standardization, handling of multiple hypothesis testing, model selection, and validation. We identified limited exploitation of data sources, high heterogeneity in analytical approaches, and lack of replication. Despite of the promising utility of EWAS, further development of EWAS will require improved data sources, standardization of study designs, and rigorous testing of methodologies.

Ultrafine particles: Levels in ambient air during outdoor sport activities

Conducting aerobic activity on regular basis is recognised as one of the steps to maintain healthier lifestyle. The positive outcomes though can be outweighed if conducted in polluted atmosphere. Furthermore, the specific inhalation during exercising, which results in bypass of nasal filtration systems and deeper penetration into the respiratory system, might result in higher risks especially to pollutants such as ultrafine particles (UFP), which aerodynamic particle diameter are <100 nm. Thus, this work aims to evaluate UFP levels at sites used for conducting physical sport activities outdoors and to estimate the respective inhalation doses considering various scenarios and different physical activities. Monitoring of UFP was conducted during three weeks (May-June 2015) at four different sites (S1-S4) regularly used to conduct physical exercising. The results showed that UFP highly varied (medians 5.1-20.0 × 10³ # cm^-3) across the four sites, with the highest UFP obtained when exercising next to trafficked streets whereas S3 and S4 (a garden and city park) exhibited 2-4 times lower UFP. In view of the obtained UFP concentrations, the estimated inhalation doses ranged 1.73 × 10⁸-3.81 × 10⁸ # kg^-1 when conducting moderately intense sport activities and 1.93 × 10⁸-5.95 × 10⁸ # kg^-1 for highly intense ones. Highly intense activities (i.e. running) led to twice higher UFP exposure; children and youths (5-17 yrs old) experienced 203-267% higher doses. Considering the age- and gender- differences, estimated UFP doses of males were 1.1-2.8 times higher than of females. Finally, UFP inhalation doses estimated for walking (commuting to work and/or schools) were 1.6-7.5 times lower than when conducting sport activities. Thus to protect public health and to promote healthy and physically active lifestyle, strategies to minimize the negative impacts of air pollution should be developed and implemented.

Exposure to ultrafine particles in children until 18 years of age: A systematic review

Airborne ultrafine particles (UFP) have been related to adverse health effects, but exposure in vulnerable population groups such as children is still not well understood. We aim to review the scientific literature regarding personal exposure to UFP in different microenvironments in populations until 18 years of age. The bibliographical search was carried out in July 2019 using the online database PubMed and was completed with references in articles found in the search. We selected the studies that used continuous counters and measured UFP levels in both specific microenvironment (houses, schools, transport, etc) and personal exposure. Finally, 32 studies fulfilled the criteria: of these, 10 analyzed personal exposure and 22 examined UFP levels in the microenvironment (especially in schools or nurseries (18/22)) and five in various microenvironments (including dwellings and means of transport, where exposure levels were higher). The characteristics of the microenvironments with the greatest levels of UFP were being close to heavy traffic or near cooking and cleaning activities. This review revealed the wide differences in exposure assessment methodologies that could lead to a lack of uniform and comparable information about the real UFP exposure in children.

Hematological effects of ultrafine carbon black on red blood cells and hemoglobin

The harmful effects of ultrafine particles (UFPs) in the atmosphere have caused widespread concern. Ultrafine carbon black (UFCB) is an important component of UFPs. In this study, we explored the impact of UFCB on the structure, the antioxidant defense system, and the ATPase activity of human red blood cells (hRBCs). It was found that UFCB decreased the activity of SOD (73.58%), CAT (89.79%), and GSH-Px (81.02%), leading to oxidative stress in hRBCs. UFCB had no destructive effect on the structure of hRBCs in 4 hours. ATPase activity increased (119.34%) and UFCB had weakly stimulated the cell membrane. On the molecular level, spectroscopic experiments showed that bovine hemoglobin (BHb) can bind to the UFCB by electrostatic force, leading to the shrinking of the BHb skeleton and increase in microenvironment polarity. This study demonstrates the negative hematological effect of UFCB on hemoglobin and hRBCs and reveals the potential risks in animals and humans.

Effects of Personal Exposures to Micro- and Nano-Particulate Matter, Black Carbon, Particle-Bound Polycyclic Aromatic Hydrocarbons, and Carbon Monoxide on Heart Rate Variability in a Panel of Healthy Older Subjects

As a non-invasive method, heart rate variability (HRV) has been widely used to study cardiovascular autonomous control. Environmental epidemiological studies indicated that the increase in an average concentration of particulate matter (PM) would result in a decrease in HRV, which was related to the increase of cardiovascular mortality in patients with myocardial infarction and the general population. With rapid economic and social development in Asia, how air pollutants, such as PM of different sizes and their components, affect the cardiovascular health of older people, still need to be further explored. The current study includes a 72 h personal exposure monitoring of seven healthy older people who lived in the Taipei metropolitan area. Mobile equipment, a portable electrocardiogram recorder, and the generalized additive mixed model (GAMM) were adopted to evaluate how HRV indices were affected by size-fractionated PM, particle-bound polycyclic aromatic hydrocarbons (p-PAHs), black carbon (BC), and carbon monoxide (CO). Other related confounding factors, such as age, sex, body mass index (BMI), temperature, relative humidity (RH), time, and monitoring week were controlled by fixed effects of the GAMM. Statistical analyses of multi-pollutant models showed that PM_2.5–10, PM₁, and nanoparticle (NP) could cause heart rate (HR), time-domain indices, and frequency-domain indices to rise; PM_1–2.5 and BC would cause the frequency-domain index to rise; p-PAHs would cause HR to rise, and CO would cause time-domain index and frequency-domain index to decline. In addition, the moving average time all fell after one hour and might appear at 8 h in HRVs’ largest percentage change caused by each pollutant, results of which suggested that size-fractionated PM, p-PAHs, BC, and CO exposures have delayed effects on HRVs. In conclusion, the results of the study showed that the increase in personal pollutant exposure would affect cardiac autonomic control function of healthy older residents in metropolitan areas, and the susceptibility of cardiovascular effects was higher than that of healthy young people. Since the small sample size would limit the generalizability of this study, more studies with larger scale are warranted to better understand the HRV effects of simultaneous PM and other pollution exposures for subpopulation groups.

Cardiovascular disease and long-term occupational exposure to ultrafine particles: A cohort study of airport workers

AIM

To investigate if ischemic heart disease (IHD) and cerebrovascular disease is associated with long-term occupational exposure to ultrafine particles (UFP) outdoors at an airport.

METHODS AND RESULTS

This is a register-based follow-up study based on a cohort comprising an exposed group of 6515 men employed in unskilled work at Copenhagen Airport and a reference group of 61,617 men in unskilled work in other firms in greater Copenhagen during 1990-2012. The exposure was assessed from information on proportion of time spent on the airport apron for each calendar year (apron-years) and the primary exposure measure was cumulated apron-years. The cohort was merged to the National Patient Register that includes data on all contacts to public and private hospitals in Denmark and the Register of Causes of Death. Risk estimates were provided by Poisson regression and adjusted for age, calendar year and educational level. We found no associations between cumulative apron-years and IHD (IRR, 1.00; 95%CI, 0.97-1.03) or cerebrovascular disease (IRR, 1.00; 0.98-1.02) when adjusted for confounders.

CONCLUSION

In this large cohort study, we found no association between outdoor occupational exposure to UFP and IHD and cerebrovascular disease.

Association between a urinary biomarker for exposure to PAH and blood level of the acute phase protein serum amyloid A in coke oven workers

BACKGROUND

Coke oven workers are exposed to both free and particle bound PAH. Through this exposure, the workers may be at increased risk of cardiovascular diseases. Systemic levels of acute phase response proteins have been linked to cardiovascular disease in epidemiological studies, suggesting it as a marker of these conditions. The aim of this study was to assess whether there was association between PAH exposure and the blood level of the acute phase inflammatory response marker serum amyloid A (SAA) in coke oven workers.

METHODS

A total of 87 male Polish coke oven workers from two different plants comprised the study population. Exposure was assessed by means of the individual post-shift urinary excretion of 1-hydroxypyrene, as internal dose of short-term PAH exposure, and by anti-benzo[a]pyrene diolepoxide (anti-B[a]PDE)-DNA), as a biomarker of long-term PAH exposure. Blood levels of acute phase proteins SAA and CRP were measured by immunoassay. C-reactive protein (CRP) levels were included to adjust for baseline levels of SAA.

RESULTS

Multiple linear regression showed that the major determinants of increased SAA levels were urinary 1-hydroxypyrene (beta = 0.56, p = 0.030) and serum CRP levels (beta = 7.08; p < 0.0001) whereas anti-B[a]PDE-DNA, the GSTM1 detoxifying genotype, diet, and smoking were not associated with SAA levels.

CONCLUSIONS

Urinary 1-hydroxypyrene as biomarker of short-term PAH exposure and serum levels of CRP were predictive of serum levels of SAA in coke oven workers. Our data suggest that exposure of coke oven workers to PAH can lead to increased systemic acute response and therefore potentially increased risk of cardiovascular disease.

Comparison of indoor air quality during sleep in smokers and non-smokers' bedrooms: A preliminary study

People spend one third of their life sleeping, but the bedroom, as a specific micro-environment, is often neglected when assessing human exposure to air pollutants. However, exposure during sleep may be significant in the long-term to the integrated individual exposure. This study aimed to assess the exposure during sleep, focusing on a multi-pollutant approach (comfort parameters, carbon dioxide - CO₂, carbon monoxide - CO, formaldehyde (CH₂O), total volatile organic compounds (VOCs), particulate matter - PM_2.5 and PM₁₀ - and ultrafine particles, particle number concentrations - PNC - and lung deposited surface area - LDSA). For that, the air quality during sleep (in real conditions) was monitored using real-time devices in 12 bedrooms of urban (Lisbon and Vila Franca de Xira) and rural (Ponte de Sor) areas of Portugal for one night. Volunteers were smokers and non-smokers. Considering the Portuguese legislation for indoor air quality (IAQ), 67% of the bedrooms registered CO₂ levels above the limit value, while CH₂O, VOC, PM₁₀ and PM_2.5 thresholds were exceeded in 30, 100, 36, and 45% of cases, respectively. Regarding ultrafine parameters, LDSA and PNC ranged from 7.3 to 95.2 μm²/cm³ and from 0.6 to 4.8 × 10³/cm³, respectively. Even with no smoking indoors, smokers' bedrooms were found to have significant higher levels of CO, CH₂O, PM_2.5, PM₁₀ and LDSA than non-smokers' bedrooms, showing the effect of thirdhand smoke, exhalation of pollutants after smoking and infiltration on the degradation of the air quality in the bedroom. A recent new model of real-time monitor was also used for a wide set of IAQ parameters. Its performance to measure PM_2.5 and CO₂ was assessed, showing its applicability in real conditions. Although often neglected, these micro-environments should be considered in the integrated individual exposure to air pollutants and further studied. MAIN FINDINGS OF THE WORK: Several pollutants (CO₂, PM, VOCs and CH₂O) exceeded the guidelines during sleep; smokers are exposed to higher levels of CO, CH₂O, PM, and LDSA than non-smokers while sleeping.

Sources and Temporal Variations of Coarse Particulate Matter (PM) in Central Tehran, Iran

In this study, we used the positive matrix factorization (PMF) model to evaluate the sources of ambient coarse particulate matter (PM) and their temporal variations in two sampling sites, i.e., a school dormitory and a retirement home, located in central Tehran. 24-h ambient PM samples were collected using low-volume air samplers from May 2012 to June 2013. The collected filters were analyzed for their chemical components, including water-soluble ions, metals, and trace elements, which were used as the input to the PMF model. Our results indicated annual averages of 45.7 ± 3.8 µg/m3 and 36.2. ± 4.0 µg/m3 for coarse PM at the School dormitory and Tohid retirement home, respectively. Moreover, higher ambient coarse PM mass concentrations were observed in the warm season (53.3 ± 5.8 µg/m3 for school dormitory and 43.1 ± 6.1 µg/m3 for Tohid retirement home) as opposed to the cold season (41.4 ± 4.7 µg/m3 for school dormitory and 28.7 ± 4.6 µg/m3 for Tohid retirement home). Our PMF analysis also identified road dust, soil, and industry, and atmospherically processed coarse PM as the three sources of ambient coarse PM in central Tehran. Road dust, soil, and industry were the major sources of ambient coarse PM, contributing respectively to 74 ± 9% and 19 ± 2% of the total coarse PM mass concentration, while atmospherically aged aerosols had a rather minimal contribution of 7 ± 1% to total coarse PM mass concentration. The temporal trends of the resolved factors also revealed higher contributions of road dust to total ambient coarse PM during warm season as opposed to cold season, due to the increased resuspension rate from road surfaces as a result of higher wind speeds, and temperatures, combined with lower relative humidity. Similarly, higher resuspension rate of mechanically originated particulates resulted in higher warm-season time contributions of the soil factor. Results of this study clearly revealed the key role of road dust and non-tail pipe emissions on ambient coarse PM mass concentrations in crowded areas of central Tehran, and have important implications on the potential health impacts that can be caused by these difficult to mitigate sources of coarse PM.

Acute exposure to e-cigarettes causes inflammation and pulmonary endothelial oxidative stress in nonsmoking, healthy young subjects

The effects of e-cigarette (e-cig) aerosol inhalation by nonsmokers have not been examined to date. The present study was designed to evaluate the acute response to aerosol inhalation of non-nicotinized e-cigarettes in terms of oxidative stress and indices of endothelial activation in human pulmonary microvascular endothelial cells (HPMVEC). Ten smoking-naïve healthy subjects (mean age ± SD = 28.7 ± 5.5 yr) were subjected to an e-cig challenge, following which their serum was monitored for markers of inflammation [C-reactive protein (CRP) and soluble intercellular adhesion molecule (sICAM)] and nitric oxide metabolites (NOx). The oxidative stress and inflammation burden of the circulating serum on the vascular network was also assessed by measuring reactive oxygen species (ROS) production and induction of ICAM-1 expression on HPMVEC. Our results show that serum indices of oxidative stress and inflammation increased significantly (P < 0.05 as compared with baseline), reaching a peak at approximately 1-2 h post-e-cig aerosol inhalation and returning to baseline levels at 6 h. The circulatory burden of the serum (ICAM-1 and ROS) increased significantly at 2 h and returned to baseline values 6 h post-e-cig challenge. ROS production by HPMVEC was found to occur via activation of the NADPH oxidase 2 (NOX2) pathways. These findings suggest that even in the absence of nicotine, acute e-cig aerosol inhalation leads to a transient increase in oxidative stress and inflammation. This can adversely affect the vascular endothelial network by promoting oxidative stress and immune cell adhesion. Thus e-cig inhalation has the potential to drive the onset of vascular pathologies.

Ambient air pollution is associated with cardiac repolarization abnormalities in healthy adults

BACKGROUND

Ambient air pollution has been associated with acute cardiovascular events; however, the underlying mechanisms remain incompletely understood. We aimed to examine the impacts of ambient air pollutants on cardiac ventricular repolarization in a highly polluted urban region.

METHODS

Seventy-three healthy non-smoking young adults (66% female, mean age of 23.3 ± 5.4 years) were followed with four repeated 24-h electrocardiogram recordings in 2014-2016 in Beijing, China. Continuous concentrations of ambient particulates in size fractions of 5-560 nm diameter, black carbon (BC), nitrogen dioxide (NO₂), carbon monoxide (CO), sulfur dioxide (SO₂), and ozone (O₃) were measured at a fixed-location air pollution monitoring station. Generalized linear mixed models, with adjustment for individual risk factors, time-varying factors and meteorological parameters, were used to evaluate the effects of air pollution on 5-min segments of heart rate-corrected QT interval (QTc), an index of cardiac ventricular repolarization.

RESULTS

During the study period, the mean levels of number concentrations of particulates in size range of 5-560 nm (PNC_5-560) were 20,711 particles/cm³. Significant increases in QTc of 0.56% (95% CI: 0.27, 0.84) to 1.76% (95% CI: 0.73, 2.79) were associated with interquartile range increases in PNC_50-560 at prior 1-5 moving average days. Significant increases in QTc were also associated with increases in exposures to traffic-related air pollutants (BC, NO₂ and CO), a combustion pollutant SO₂, and the secondary pollutant O₃. The associations were stronger in participants who were male, overweight, with abdominal obesity, and with higher levels of high-sensitivity C-reactive protein.

CONCLUSIONS

Our findings suggest that exposures to higher levels of ambient particulates in small size fractions and traffic pollutants were associated with cardiac repolarization abnormalities in healthy adults, and the cardio-metabolic risks may modify the adverse cardiac effects attributable to air pollution.

Quantifying high-resolution spatial variations and local source impacts of urban ultrafine particle concentrations

To quantify the fine-scale spatial variations and local source impacts of urban ultrafine particle (UFP) concentrations, we conducted 3-6 weeks of continuous measurements of particle number (a proxy for UFP) and other air pollutant (CO, NO₂, and PM_2.5) concentrations at 32 sites in Pittsburgh, Pennsylvania during the winters of 2017 and 2018. Sites were selected to span a range of urban land use attributes, including urban background, near local and arterial roads, traffic intersections, urban street canyon, near-highway, near large industrial source, and restaurant density. The spatial variations in urban particle number concentrations varied by about a factor of three. Particle number concentrations are 2-3 times more spatially heterogeneous than PM_2.5 mass. The observed order of spatial heterogeneity is UFP > NO₂ > CO > PM_2.5. On average, particle number concentrations near local roads with a cluster of restaurants and near arterial roads are roughly two times higher than the urban background. Particle number concentrations in the urban street canyon, downwind of a major highway, and near large industrial sources are 2-4 times higher than background concentrations. While traffic is known as an important contributor to particle number concentrations, restaurants and industrial emissions also contribute significantly to spatial variations in Pittsburgh. Particle size distribution measurements using a mobile laboratory show that the local spatial variations in particle number concentrations are dictated by concentrations of particles smaller than 50 nm. A large fraction of urban residents (e.g., ~50%) in Pittsburgh live near local sources and are therefore exposed to 50%-300% higher particle number concentrations than urban background location. These locally emitted particles may have greater health effects than background particles.

Effects of the exposure to ultrafine particles on heart rate in a healthy population

The correlation amongst exposure to ultrafine particle concentrations and heart rate in a large healthy population was investigated. The study was conducted by continuously monitoring for seven days fifty volunteers in terms of exposure to particle concentrations, heart rate and physical activity performed through portable monitors. Data were analyzed adopting a linear mixed model able to manage the obtained repeated measures and to recognize a general trend resulting from the subject-specific patterns. Results show that the short-term exposure to ultrafine particle concentrations is positively associated with the heart rate for the different physical activities of the subject investigated (laying down, sitting, standing positions). In particular, a logarithmic correlation was recognized with a sharper increase of about 4-6 bpm for a variation of the particle number concentration of 2 × 10⁴ part/cm³ and a slighter effect for further increases of about 0.1-0.2 × 10^-4 bpm/(part/cm). CAPSULE: A positive correlation can be associated between the exposure to ultrafine particles and the heart rate.

Occupational Exposure to Fine Particles and Ultrafine Particles in a Steelmaking Foundry

Several studies have shown an increased mortality rate for different types of tumors, respiratory disease and cardiovascular morbidity associated with foundry work. Airborne particles were investigated in a steelmaking foundry using an electric low-pressure impactor (ELPI+™), a Philips Aerasense Nanotracer and traditional sampling equipment. Determination of metallic elements in the collected particles was carried out by inductively coupled plasma mass spectrometry. The median of ultrafine particle (UFP) concentration was between 4.91 × 103 and 2.33 × 105 part/cm3 (max. 9.48 × 106 part/cm3). Background levels ranged from 1.97 × 104 to 3.83 × 104 part/cm3. Alveolar and deposited tracheobronchial surface area doses ranged from 1.3 × 102 to 8.7 × 103 mm2, and 2.6 × 101 to 1.3 × 103 mm2, respectively. Resulting inhalable and respirable fraction and metallic elements were below limit values set by Italian legislation. A variable concentration of metallic elements was detected in the different fractions of UFPs in relation to the sampling site, the emission source and the size range. This data could be useful in order to increase the knowledge about occupational exposure to fine and ultrafine particles and to design studies aimed to investigate early biological effects associated with the exposure to particulate matter in the foundry industries.

In-vehicle airborne fine and ultra-fine particulate matter exposure: The impact of leading vehicle emissions

Airborne particulate matter (PM) concentrations inside vehicle cabins are often extremely high compared to background levels. The present study was motivated by the fact that in the last few decades, the implementation of new emission standards has led to the reduction of vehicle particle emissions. This study addresses for the first time the relationship between leading vehicle (LV) emissions and in-cabin PM exposure levels in the immediately following vehicle (henceforth called the study vehicle - SV), with particular emphasis on the role of the LV's emission reduction technologies (e.g., diesel particulate filter-DPF) as an effective risk management measure. The study was performed using an instrumented study vehicle (always to be considered as the following vehicle) on a 26-km fixed route where 10 repeated tests were conducted during 60-minute trips. On-line monitoring of the fine 0.3-1 μm and 1-2.5 μm (PM_0.3-1 and PM_1-2.5) and ultra-fine particle (UFP) concentrations was performed inside the SV's car cabin with fixed ventilation settings (i.e., windows closed, air conditioning off, and recirculation fan off). Simultaneously, the license plate numbers of the LVs along the route were recorded to retrieve information pertaining to their fuel type and Euro emission standard category. The results clearly showed that the in-cabin PM levels were significantly affected by the LV's Euro emission standard. Regarding petrol-fuelled LVs, the median in-cabin particle exposure levels were statistically lower (e.g., -34% for PM_0.3-1) when following vehicles with stricter emission standards (in particular, Euro 6) than when following a low-emission standard vehicle (i.e., Euro 0-2). Concerning diesel-fuelled LVs, a strong and significant decrease in the in-cabin median exposure levels (up to -62%, -44%, and -48% for UFPs, PM_0.3-1, and PM_1-2.5, respectively) was observed for recent-emission standards LVs (i.e., Euro 5-6) with respect to older-emission standard LVs (i.e., Euro 0-4). A specific analysis revealed that the in-cabin median exposure concentrations of PM were highly and significantly reduced by DPF-equipped LVs. For UFPs, this resulted in a 47% reduction compared to diesel-fuelled (non-DPF) LVs. For PM_0.3-1, an approximate 80% reduction was observed compared to both petrol-fuelled and diesel-fuelled (non-DPF) LVs. For PM_1-2.5, an approximate 38% reduction was observed compared to petrol-fuelled LVs and a 46% reduction compared to non-DPF LVs.

Exposure to Ambient Ultrafine Particles and Nitrogen Dioxide and Incident Hypertension and Diabetes

BACKGROUND

Previous studies reported that long-term exposure to traffic-related air pollution may increase the incidence of hypertension and diabetes. However, little is known about the associations of ultrafine particles (≤0.1 μm in diameter) with these two conditions.

METHODS

We conducted a population-based cohort study to investigate the associations between exposures to ultrafine particles and nitrogen dioxide (NO2) and the incidence of diabetes and hypertension. Our study population included all Canadian-born residents aged 30 to 100 years who lived in the City of Toronto, Canada, from 1996 to 2012. Outcomes were ascertained using validated province-wide databases. We estimated annual concentrations of ultrafine particles and NO2 using land-use regression models and assigned these estimates to participants' annual postal code addresses during the follow-up period. Using random-effects Cox proportional hazards models, we calculated hazard ratios (HRs) and 95% confidence intervals (CIs) for ultrafine particles and NO2, adjusted for individual- and neighborhood-level covariates. We considered both single- and multipollutant models.

RESULTS

Each interquartile change in exposure to ultrafine particles was associated with increased risk of incident hypertension (HR = 1.03; 95% CI = 1.02, 1.04) and diabetes (HR = 1.06; 95% CI = 1.05, 1.08) after adjusting for all covariates. These results remained unaltered with further control for fine particulate matter (≤2.5 μm; PM2.5) and NO2. Similarly, NO2 was positively associated with incident diabetes (HR = 1.06; 95% CI = 1.05, 1.07) after controlling for ultrafine particles and PM2.5.

CONCLUSIONS

Exposure to traffic-related air pollution including ultrafine particles and NO2 may increase the risk for incident hypertension and diabetes. See video abstract at, http://links.lww.com/EDE/B337.

Associations of Long-Term Exposure to Ultrafine Particles and Nitrogen Dioxide With Increased Incidence of Congestive Heart Failure and Acute Myocardial Infarction

Although long-term exposure to traffic-related air pollutants such as nitrogen dioxide has been linked to cardiovascular disease (CVD) mortality, little is known about the association between ultrafine particles (UFPs), defined as particles less than or equal to 0.1 μm in diameter, and incidence of major CVD events. We conducted a population-based cohort study to assess the associations of chronic exposure to UFPs and nitrogen dioxide with incident congestive heart failure (CHF) and acute myocardial infarction. Our study population comprised all long-term Canadian residents aged 30-100 years who lived in Toronto, Ontario, Canada, during the years 1996-2012. We estimated annual concentrations of UFPs and nitrogen dioxide by means of land-use regression models and assigned these estimates to participants' postal-code addresses in each year during the follow-up period. We estimated hazard ratios for the associations of UFPs and nitrogen dioxide with incident CVD using random-effects Cox proportional hazards models. We controlled for smoking and obesity using an indirect adjustment method. Our cohorts comprised approximately 1.1 million individuals at baseline. In single-pollutant models, each interquartile-range increase in UFP exposure was associated with increased incidence of CHF (hazard ratio for an interquartile-range increase (HRIQR) = 1.03, 95% confidence interval (CI): 1.02, 1.05) and acute myocardial infarction (HRIQR = 1.05, 95% CI: 1.02, 1.07). Adjustment for fine particles and nitrogen dioxide did not materially change these estimated associations. Exposure to nitrogen dioxide was also independently associated with higher CHF incidence (HRIQR = 1.04, 95% CI: 1.03, 1.06).

Submicron particle number doses in the human respiratory tract: implications for urban traffic and background environments

The deposition of ambient submicron particles in the different parts of the human respiratory tract (HRT) was, for the first time, estimated for males and females from different age classes (children-adults-seniors) of urban population in the city of Thessaloniki, northern Greece, during the cold and the warm period of the year. Outdoor daily and hourly particle number doses in the different regions of the HRT, i.e., the extra-thoracic (ET), tracheobronchial (TB), and the acinar (AC) regions, were calculated by employing the Multiple-Path Particle Dosimetry (MPPD) model. Because of the absence of information being available for the hygroscopic properties of particles, three different particle hygroscopicity scenarios were considered: (i) non-hygroscopic (i.e., raw model estimations), (ii) nearly hydrophobic, and (iii) hygroscopic particles. When hygroscopic properties were considered, we found a remarkable reduction (up to ~ 55%) in the estimated total particle number doses in comparison to the non-hygroscopic particle scenario. Furthermore, we found that the size distribution pattern of the particle doses within the different parts of the HRT was strongly affected by particles' hygroscopic properties with the non-hygroscopic particle scenario significantly overestimating the particle doses in the sub-100-nm range, while underestimating the doses of larger particles. On the contrary, the deposition density appeared to be negligibly affected by the particles' hygroscopic properties, implying the existence of a possible threshold in the number of particles deposited per airway surface area. Similarly, the lobar particle number deposition fraction was unaffected by the hygroscopic properties of particles, as well as the ambient particle size distribution and the individuals' physiological parameters. The total particle number deposition doses estimated here are within the range of the corresponding values reported for other urban environments. It is hoped that our findings could contribute to better understanding of submicron particle exposure and add to the development of more sufficient methods to evaluate the related health impacts.

Influence of ship emissions on NOx, SO2, O3 and PM concentrations in a North-Sea harbor in France

The influence of in-port ship emissions on gases and PM₁₀ concentrations has been estimated in the port city of Calais, northern France, one of the busiest harbor in Europe, with numerous rotations of ferries or roll-on/roll-off cargo in average per day. NO_x, SO₂, O₃ and PM₁₀ concentrations were continuously measured over a three-month period, as well as real-time particle size distribution. A rural site located at Cape Gris-Nez, 20km from Calais, was considered to deduce intrinsic contribution of ship emissions at the harbor city. The average concentrations of the studied species as well as the pattern of the conditional bivariate probability function at the two sites evidenced that in-port shipping, especially during the maneuvering operations, has an important influence on the NO_x and SO₂ concentrations. The impact of shipping in the harbor of Calais on average concentrations was estimated to 51% for SO₂, 35% for NO, 15% for NO₂ and 2% for PM₁₀ in the studied period. Concentration peaks of SO₂ and NOx associated with an O₃ depletion appeared synchronized with departures and arrivals of ferries. For winds blowing from the harbor, when compared to the background level, the number of particles appeared 10 times higher, with the highest differences in the 30-67nm and the 109-167nm size ranges. The average impact of in-port ships on PM₁₀ concentrations was estimated to +28.9μg/m³ and concerned mainly the PM₁ size fraction (40%). Punctually, PM₁₀ can potentially reach a concentration value close to 100μg/m³.

Estimated individual inhaled dose of fine particles and indicators of lung function: A pilot study among Chinese young adults

Fine particle (PM_2.5)-related lung damage has been reported in most studies regarding environmental or personal PM_2.5 concentrations. To assess effects of personal PM_2.5 exposures on lung function, we recruited 20 postgraduate students and estimated the individual doses of inhaled PM_2.5 based on their microenvironmetal PM_2.5 concentrations, time-activity patterns and refereed inhalation rates. During the period of seven consecutive days in each of the four seasons, we repeatedly measured the daily lung function parameters and airway inflammation makers such as fractional exhaled nitric oxide (FeNO) as well as systemic inflammation markers including interleukin-1β on the final day. The high individual dose (median (IQR)) of inhaled PM_2.5 was 957 (948) μg/day. We observed a maximum FeNO increase (9.1% (95%CI: 2.2-15.5)) at lag 0 day, a maximum decrease of maximum voluntary ventilation (11.8% (95% CI: 4.6-19.0)) at lag 5 day and a maximum interleukin-1β increase (103% (95% CI: 47-159)) at lag 2 day for an interquartile range increase in the individual dose of inhaled PM_2.5 during the four seasons. Short-term exposure to PM_2.5 assessed by the individual dose of inhaled PM_2.5 was associated with higher airway and systemic inflammation and reduced lung function. Further studies are needed to understand better underlying mechanisms of lung damage following acute exposure to PM_2.5.

Estimated effects of air pollution and space-time-activity on cardiopulmonary outcomes in healthy adults: A repeated measures study

BACKGROUND

Exposure to air pollution is known to affect both short and long-term outcomes of the cardiopulmonary system; however, findings on short-term outcomes have been inconsistent and often from isolated and long-term rather than coexisting and short-term exposures, and among susceptible/unhealthy rather than healthy populations.

AIMS

We aimed to investigate separately the annual, daily and daily space-time-activity-weighted effect of ambient air pollution, as well as confounding or modification by other environmental (including noise) or space-time-activity (including total daily physical activity) exposures, on cardiopulmonary outcomes in healthy adults.

METHODS

Participants (N=57: 54% female) had indicators of cardiopulmonary outcomes [blood pressure (BP), pulse (HR) and heart rate variability (HRV {SDNN}), and lung function (spirometry {FEV₁, FVC, SUM})] measured on four different mornings (at least five days apart) in a clinical setting between 2011 and 2014. Spatiotemporal ESCAPE-LUR models were used to estimate daily and annual air pollution exposures (including PM₁₀, PM_Coarse, but not Ozone {derived from closest station}) at participant residential and occupational addresses. Participants' time-activity diaries indicated time spent at either address to allow daily space-time-activity-weighted estimates, and capture total daily physical activity (total-PA {as metabolic-equivalents-of-task, METs}), in the three days preceding health measurements. Multivariate-adjusted linear mixed-effects models (using either annual or daily estimates) were adjusted for possible environmental confounders or mediators including levels of ambient noise and greenness. Causal mediation analysis was also performed separately considering these factors as well as total-PA. All presented models are controlled by age, height, sex and season.

RESULTS

An increase in 5μg/m³ of daily space-time-activity-weighted PM_Coarse exposure was statistically significantly associated with a 4.1% reduction in total heart rate variability (SDNN; p=0.01), and remained robust after adjusting for suspected confounders [except for occupational-address noise (β=-2.7, p=0.20)]. An increase in 10ppb of annual mean Ozone concentration at the residential address was statistically significantly associated with an increase in diastolic BP of 6.4mmHg (p<0.01), which lost statistical significance when substituted with daily space-time-activity-weighted estimates. As for pulmonary function, an increase in 10μg/m³ of annual mean PM₁₀ concentration at the residential address was significantly associated with a 0.3% reduction in FVC (p<0.01) and a 0.5% reduction in SUM (p<0.04), for which again significance was lost when substituted for daily space-time-activity-weighted estimates These associations with pulmonary function remained robust after adjusting for suspected confounders, including annual Ozone, as well as total-PA and bioaerosol (pollen and fungal spore) levels (but not residential-neighborhood greenness {β=-0.22, p=0.09; β=-0.34, p=0.15, respectively}). Multilevel mediation analysis indicated that the proportion mediated as a direct effect on cardiopulmonary outcomes by suspected confounders (including total-PA, residential-neighborhood greenness, and occupational-address noise level) from primary exposures (including PM₁₀, PM_Coarse, and O₃) was not statistically significant.

CONCLUSION

Our findings suggest that increased daily space-time-activity-weighted PM_Coarse exposure levels significantly adversely affect cardiac autonomic modulation (as reduced total HRV) among healthy adults. Additionally, increased annual levels at the residential address of Ozone and PM₁₀ significantly increase diastolic blood pressure and reduce lung function, respectively, among healthy adults. These associations typically remained robust when adjusting for suspected confounders. Occupational-address noise and residential-neighborhood greenness levels, however, were seen as mediators of cardiovascular and pulmonary outcomes, respectively. Total daily physical activity was not seen as a mediator of any of the studied outcomes, which supports the promotion of active mobility within cities.

Impacts of exposure to black carbon, elemental carbon, and ultrafine particles from indoor and outdoor sources on blood pressure in adults: A review of epidemiological evidence

INTRODUCTION

Ambient particulate air pollution is known to have detrimental effects on cardiovascular health but less is known about the specific effects of black carbon or elemental carbon (BC/EC) and ultrafine particles (UFP).

METHODS

We present a narrative review of the epidemiological evidence related to the impact of exposure to BC/EC and UFP on blood pressure in adults. We searched PubMed and EMBASE in September 2017, using a predefined search strategy. Abstracts were screened using predefined inclusion criteria. Data collection was completed using a standard data extraction form. We focused on main effect estimates for associations between short (≤7 days) and long-term exposures to BC/EC and UFP and systolic (SBP) and diastolic blood pressure (DBP). Effect estimates were rescaled to enable direct comparisons between studies.

RESULTS

Thirty publications were included in the review: 19 studies examined outdoor exposure to BC/EC, 11 examined outdoor UFP, three studies examined indoor BC and one study examined indoor UFP. In general, existing evidence supports a positive association between BC/EC and blood pressure. Evidence for outdoor UFP exposures were less clear as effect estimates were small in magnitude and confidence intervals often included the null.

CONCLUSIONS

Existing evidence supports a positive association between BC/EC and blood pressure in adults, whereas UFPs do not appear to have a meaningful impact on blood pressure.

The influence of lifestyle on airborne particle surface area doses received by different Western populations

In the present study, the daily dose in terms of particle surface area received by citizens living in five cities in Western countries, characterized by different lifestyle, culture, climate and built-up environment, was evaluated and compared. For this purpose, the exposure to sub-micron particle concentration levels of the population living in Barcelona (Spain), Cassino (Italy), Guilford (United Kingdom), Lund (Sweden), and Brisbane (Australia) was measured through a direct exposure assessment approach. In particular, measurements of the exposure at a personal scale were performed by volunteers (15 per each population) that used a personal particle counter for different days in order to obtain exposure data in microenvironments/activities they resided/performed. Non-smoking volunteers performing non-industrial jobs were considered in the study. Particle concentration data allowed obtaining the exposure of the population living in each city. Such data were combined in a Monte Carlo method with the time activity pattern data characteristics of each population and inhalation rate to obtain the most probable daily dose in term of particle surface area as a function of the population gender, age, and nationality. The highest daily dose was estimated for citizens living in Cassino and Guilford (>1000 mm²), whereas the lowest value was recognized for Lund citizens (around 100 mm²). Indoor air quality, and in particular cooking and eating activities, was recognized as the main influencing factor in terms of exposure (and thus dose) of the population: then confirming that lifestyle (e.g. time spent in cooking activities) strongly affect the daily dose of the population. On the contrary, a minor or negligible contribution of the outdoor microenvironments was documented.

Low-dose combined exposure of nanoparticles and heavy metal compared with PM2.5 in human myocardial AC16 cells

The co-exposure toxicity mechanism of ultrafine particles and pollutants on human cardiovascular system are still unclear. In this study, the combined effects of silica nanoparticles (SiNPs) and/or carbon black nanoparticles (CBNPs) with Pb(AC)₂ compared with particulate matter (PM)_2.5 were investigated in human myocardial cells (AC16). Our study detected three different combinations of SiNPs and Pb(AC)₂, CBNPs and Pb(AC)₂, and SiNPs and CBNPs compared with PM_2.5 at low-dose exposure. Using PM_2.5 as positive control, our results suggested that the combination of SiNPs and Pb(AC)₂/CBNPs could increase the production of reactive oxygen species (ROS), lactate dehydrogenase leakage (LDH), and malondialdehyde (MDA) and decrease the activities of superoxide dismutase (SOD) and glutathione (GSH); induce inflammation by the upregulation of protein CRP and TNF-α, and apoptosis by the upregulation of protein caspase-3, caspase-9, and Bax while the downregulation of protein Bcl-2; and trigger G2/M phase arrest by the upregulation of protein Chk2 and downregulation of protein Cdc2 and cyclin B1. In addition, the combination of CBNPs and Pb(AC)₂ induced a significant increase in MDA and reduced the activities of ROS, LDH, SOD, and GSH, with G1/S phase arrest via upregulation of Chk1 and downregulation of CDK6 and cyclin D1. Our data suggested that the additive interaction and synergistic interaction are the major interaction in co-exposure system, and PM_2.5 could trigger more severe oxidative stress, G2/M arrest, and apoptosis than either co-exposure or single exposure.

Nanomaterials Versus Ambient Ultrafine Particles: An Opportunity to Exchange Toxicology Knowledge

BACKGROUND

A rich body of literature exists that has demonstrated adverse human health effects following exposure to ambient air particulate matter (PM), and there is strong support for an important role of ultrafine (nanosized) particles. At present, relatively few human health or epidemiology data exist for engineered nanomaterials (NMs) despite clear parallels in their physicochemical properties and biological actions in in vitro models.

OBJECTIVES

NMs are available with a range of physicochemical characteristics, which allows a more systematic toxicological analysis. Therefore, the study of ultrafine particles (UFP, <100 nm in diameter) provides an opportunity to identify plausible health effects for NMs, and the study of NMs provides an opportunity to facilitate the understanding of the mechanism of toxicity of UFP.

METHODS

A workshop of experts systematically analyzed the available information and identified 19 key lessons that can facilitate knowledge exchange between these discipline areas.

DISCUSSION

Key lessons range from the availability of specific techniques and standard protocols for physicochemical characterization and toxicology assessment to understanding and defining dose and the molecular mechanisms of toxicity. This review identifies a number of key areas in which additional research prioritization would facilitate both research fields simultaneously.

CONCLUSION

There is now an opportunity to apply knowledge from NM toxicology and use it to better inform PM health risk research and vice versa. https://doi.org/10.1289/EHP424.

Ultrafine particles and black carbon personal exposures in asthmatic and non-asthmatic children at school age

Traffic-related air pollution (TRAP) exposure during childhood is associated with asthma; however, the contribution of the different TRAP pollutants in each microenvironment (home, school, transportation, others) in asthmatic and non-asthmatic children is unknown. Daily (24-h) personal black carbon (BC), ultrafine particle (UFP), and alveolar lung-deposited surface area (LDSA) individual exposure measurements were obtained from 100 children (29 past and 21 current asthmatics, 50 non-asthmatics) aged 9±0.7 years from the INMA-Sabadell cohort (Catalonia, Spain). Time spent in each microenvironment was derived by the geolocation provided by the smartphone and a new spatiotemporal map-matching algorithm. Asthmatics and non-asthmatics spent the same amount of time at home (60% and 61%, respectively), at school (20% and 23%), on transportation (8% and 7%), and in other microenvironments (7% and 5%). The highest concentrations of all TRAPs were attributed to transportation. No differences in TRAP concentrations were found overall or by type of microenvironment between asthmatics and non-asthmatics, nor when considering past and current asthmatics, separately. In conclusion, asthmatic and non-asthmatic children had a similar time-activity pattern and similar average exposures to BC, UFP, and LDSA concentrations. This suggests that interventions should be tailored to general population, rather than to subgroups defined by disease.

Long-term exposure to ambient ultrafine particles and respiratory disease incidence in in Toronto, Canada: a cohort study

BACKGROUND

Little is known about the long-term health effects of ambient ultrafine particles (<0.1 μm) (UFPs) including their association with respiratory disease incidence. In this study, we examined the relationship between long-term exposure to ambient UFPs and the incidence of lung cancer, adult-onset asthma, and chronic obstructive pulmonary disease (COPD).

METHODS

Our study cohort included approximately 1.1 million adults who resided in Toronto, Canada and who were followed for disease incidence between 1996 and 2012. UFP exposures were assigned to residential locations using a land use regression model. Random-effect Cox proportional hazard models were used to estimate hazard ratios (HRs) describing the association between ambient UFPs and respiratory disease incidence adjusting for ambient fine particulate air pollution (PM_2.5), NO₂, and other individual/neighbourhood-level covariates.

RESULTS

In total, 74,543 incident cases of COPD, 87,141 cases of asthma, and 12,908 cases of lung cancer were observed during follow-up period. In single pollutant models, each interquartile increase in ambient UFPs was associated with incident COPD (HR = 1.06, 95% CI: 1.05, 1.09) but not asthma (HR = 1.00, 95% CI: 1.00, 1.01) or lung cancer (HR = 1.00, 95% CI: 0.97, 1.03). Additional adjustment for NO₂ attenuated the association between UFPs and COPD and the HR was no longer elevated (HR = 1.01, 95% CI: 0.98, 1.03). PM_2.5 and NO₂ were each associated with increased incidence of all three outcomes but risk estimates for lung cancer were sensitive to indirect adjustment for smoking and body mass index.

CONCLUSIONS

In general, we did not observe clear evidence of positive associations between long-term exposure to ambient UFPs and respiratory disease incidence independent of other air pollutants. Further replication is required as few studies have evaluated these relationships.

Copenhagen Airport Cohort: air pollution, manual baggage handling and health

PURPOSE

Copenhagen Airport Cohort 1990-2012 presents a unique data source for studies of health effects of occupational exposure to air pollution (ultrafine particles) and manual baggage handling among airport employees. We describe the extent of information in the cohort and in the follow-up based on data linkage to the comprehensive Danish nationwide health registers. In the cohort, all information is linked to the personal identification number that also is used in Denmark Statistics demographic and socioeconomic databases and in the nationwide health registers.

PARTICIPANTS

The cohort covers 69 175 men in unskilled positions. The exposed cohort includes men in unskilled jobs employed at Copenhagen Airport in the period 1990-2012 either as baggage handlers or in other outdoor work. The reference cohort includes men in unskilled jobs working in the greater Copenhagen area.

FINDINGS TO DATE

The cohort includes environmental Global Positioning System (GPS) measurements in Copenhagen Airport, information on job function/task for each calendar year of employment between 1990 and 2012, exposure to air pollution at residence, average weight of baggage lifted per day and lifestyle. By linkage to registers, we retrieved socioeconomic and demographic data and data on healthcare contacts, drug subscriptions, incident cancer and mortality.

FUTURE PLANS

The size of the cohort and the completeness of the register-based follow-up allow a more accurate assessment of the possible health risks of occupational exposure to ultrafine particles and manual baggage handling at airports than in previous studies. We plan to follow the cohort for the incidence of ischaemic heart diseases, cerebrovascular disease, lung and bladder cancer, asthma and chronic obstructive pulmonary disease, and further for associations between heavy manual baggage handling and musculoskeletal disorders.

TRIAL REGISTRATION

number 2012-41-0199.

Electronic cigarettes: age-specific generation-resolved pulmonary doses

Particle size-number distributions of aerosol from e-cigarettes (0 and 14 mg mL^-1 nicotine) were compared with conventional cigarettes. Results were used to provide age-specific (9-21 years) dosimetry estimates applying the MMPD model. After a 2-s puff, total number doses (D _Tot ) were highest for 9 years of age (6.01 × 10¹⁰-1.31 × 10¹¹ particles) and lowest for 18 years of age (4.69 × 10¹⁰-1.06 × 10¹¹ particles). Such doses represented about 19-45 and 25-100% of the relevant daily doses of not smoking individuals, respectively, in tracheobronchial (TB) and alveolar (A) regions. D _Tot for the e-cigarettes were about double that for conventional cigarette. Deposition densities and daily volume of e-cigarette liquid deposited per unit surface area were maximum at lobar bronchi, highest for 9 years and lowest for 21 years age.

Genome-wide transcriptional analysis of cardiovascular-related genes and pathways induced by PM2.5 in human myocardial cells

Air pollution has been a major environment-related health threat. Most of the studies on PM_2.5 toxicity have verified on the cardiovascular system and endothelial cells. However, researches on PM_2.5-induced myocardial-related toxicity are limited. This study aims to fully understand the toxic effects of PM_2.5 on human myocardial cell (AC16) and explore its molecular mechanism based on microarray analysis and bioinformatics analysis. Microarray data analysis manifested that PM_2.5-induced toxicity affected expression of 472 genes compared with the control group, including 166 upregulated genes and 306 downregulated genes in human myocardial (AC16) cells. GO analysis showed that cellular processes such as immune response, cell maturation, embryonic heart tube morphogenesis, cellular response to electrical stimulus, skeletal muscle tissue regeneration, and negative regulation of signal transduction were upregulated, while regulation of transcription (DNA-dependent), rhythmic process, protein destabilization apoptotic process, and innate immune response were downregulated. The pathway analysis indicates that cell signaling pathways such as cytokine-cytokine receptor interaction, NF-κB signaling pathway, chemokine signaling pathway, endocrine and other factor-regulated calcium reabsorption, HTLV-I infection, and cell adhesion molecules (CAMs) were upregulated, while the TGF-β signaling pathway was downregulated. In addition, Signal-net showed that the TUBA4A, ADRBK2, BRIX1, SMC4, EIF5B, PRMT1, ATG4B, and NDC80 genes were significantly decreased, while the expression of the KRT6B gene was markedly increased compared with the control group. All the genes were verified by qRT-PCR. This study had provided new bioinformatics evidences in PM_2.5-induced myocardial tissue toxicity which is necessary for further cardiovascular system toxicity studies.