Evaluating the health significance of hazardous air pollutants using monitoring data

Elossaily G, Vellapandian C, Prajapati B. Investigating the Potential Impact of Air Pollution on Alzheimer's Disease and the Utility of Multidimensional Imaging for Early Detection

Pollution is ubiquitous, and much of it is anthropogenic in nature, which is a severe risk factor not only for respiratory infections or asthma sufferers but also for Alzheimer's disease, which has received a lot of attention recently. This Review aims to investigate the primary environmental risk factors and their profound impact on Alzheimer's disease. It underscores the pivotal role of multidimensional imaging in early disease identification and prevention. Conducting a comprehensive review, we delved into a plethora of literature sources available through esteemed databases, including Science Direct, Google Scholar, Scopus, Cochrane, and PubMed. Our search strategy incorporated keywords such as "Alzheimer Disease", "Alzheimer's", "Dementia", "Oxidative Stress", and "Phytotherapy" in conjunction with "Criteria Pollutants", "Imaging", "Pathology", and "Particulate Matter". Alzheimer's disease is not only a result of complex biological factors but is exacerbated by the infiltration of airborne particles and gases that surreptitiously breach the nasal defenses to traverse the brain, akin to a Trojan horse. Various imaging modalities and noninvasive techniques have been harnessed to identify disease progression in its incipient stages. However, each imaging approach possesses inherent limitations, prompting exploration of a unified technique under a single umbrella. Multidimensional imaging stands as the linchpin for detecting and forestalling the relentless march of Alzheimer's disease. Given the intricate etiology of the condition, identifying a prospective candidate for Alzheimer's disease may take decades, rendering the development of a multimodal imaging technique an imperative. This research underscores the pressing need to recognize the chronic ramifications of invisible particulate matter and to advance our understanding of the insidious environmental factors that contribute to Alzheimer's disease.

Multiple sclerosis in Iran: An epidemiological update with focus on air pollution debate

BACKGROUND

Multiple sclerosis (MS), as the most common neurologic disorder of the central nervous system, with growing incidence and prevalence worldwide and in the Middle East. This article aimed to find out the potential relationship between MS and air pollution in Iran.

METHODS

By assessing the published articles on MS and air pollution in Iran, the situation of MS as well as air/soil pollution in Iran was clarified. Then, studies on air pollution and its potential effect on Iranian MS patients were checked until 2020.

RESULTS

The MS prevalence is distributed across Iran Provinces with highest rates in Isfahan, located in the center of Iran. The higher rates of MS in Isfahan and Tehran (the Metropolitan) might be due to industrial pollution of these cities, but this hypothesis is not true for non-industrial provinces. Based on the published atlas of MS in Iran, it seems that there is a high-risk "belt" from northwest to southeast.

CONCLUSION

There are many risk factors of MS in Iran including age, gender, Vitamin D deficiency, smoking, and air pollution. The potential main risk factor of MS might be air pollution considering Isfahan and Tehran provinces. However, Chahar Mahal and Bakhtiary Province, with non-industrial nature, has the second highest MS rates which does not follow this hypothesis.

RELEVANCE FOR PATIENTS

By finding the air pollution as the main potential risk factor of MS in big provinces including Isfahan and Tehran, its effect of this factor can also be considered during diagnosis and treatment.

Emission and health risk assessment of volatile organic compounds in various processes of a petroleum refinery in the Pearl River Delta, China

The process-specific emission of volatile organic compounds (VOCs) from a petroleum refinery in the Pearl River Delta, China was monitored to assess the health risk from VOCs to workers of this refinery. Over 60 VOCs were detected in the air samples collected from various sites in the refining, basic chemical, and wastewater treatment areas of the refinery using gas chromatography-mass spectrometry/flame ionization detection. The health risks of VOCs to the refinery workers were assessed using US Environmental Protection Agency (US EPA) and American Conference of Governmental Industrial Hygienists (ACGIH) methods. Monte Carlo simulation and sensitivity analysis were implemented to assess the uncertainty of the health risk estimation. The emission results showed that C5-C6 alkanes, including 2-methylpentane (17.6%), 2,3-dimethylbutane (15.4%) and 3-methylpentane (7.7%), were the major VOCs in the refining area. p-Diethylbenzene (9.3%), 2-methylpentane (8.1%) and m-diethylbenzene (6.8%) were dominant in the basic chemical area, and 2-methylpentane (20.9%), 2,3-dimethylbutane (11.4%) and 3-methylpentane (6.5%) were the most abundant in the wastewater treatment area. For the non-cancer risk estimated using the US EPA method, the total hazard ratio in the basic chemical area was the highest (3.1 × 10³), owing to the highest level of total concentration of VOCs. For the cancer risk, the total cancer risks were very high, ranging from 2.93 × 10^-3 (in the wastewater treatment area) to 1.1 × 10^-2 (in the basic chemical area), suggesting a definite risk. Using the ACGIH method, the total occupational exposure cancer risks of VOCs in the basic chemical area were the highest, being much higher than those of refining and wastewater treatment areas. Among the areas, the total occupational exposure risks in the basic chemical and refining areas were >1, which suggested a cancer threat to workers in these areas. Sensitivity analysis suggested that improving the accuracy of VOC concentrations themselves in future research would advance the health risk assessment.

Air toxics in Canada measured by the National Air Pollution Surveillance (NAPS) program and their relation to ambient air quality guidelines

This study reports ambient concentrations of 63 air toxics that were measured in Canada by the National Air Pollution Surveillance (NAPS) program over the period 2009-2013. Measured concentrations are compared with ambient air quality guidelines from Canadian jurisdictions, and compounds that exceeded guidelines are identified and discussed. Although this study does not assess risk or cumulative effects, air toxics that approached guidelines are also identified so that their potential contribution to ambient air toxics pollution can be considered. Eleven air toxics exceeded at least one guideline, and an additional 16 approached guidelines during the study period. Four compounds were measured using methods whose detection limits exceeded a guideline value, three of which could not be compared with guidelines, since they were not detected in any samples. The assessment of several metal(loid) concentrations is tentative, since they were measured only in fine particulate matter (PM) but compared with guidelines based on coarse or total PM. Improvements to sampling and analysis techniques for the latter compounds as well as for those whose methods are subject to known uncertainties would improve confidence in reported concentrations and their relation to applicable guidelines. Analysis of sampling strategies for all compounds found to exceed or approach guidelines would contribute to ensuring that their spatiotemporal coverage is adequate. Examination of the air toxics not measured by NAPS but having guidelines in Canadian jurisdictions or being included in other programs such as the U.S. National-Scale Air Toxics Assessment (NATA) would contribute to ensuring that the full suite of pollutants relevant to ambient air quality in Canada is subject to adequate study. The results of this study can be applied to evaluating the effectiveness of toxic substances management in Canada.

IMPLICATIONS

Recent measurements of 63 air toxics in Canada by the National Air Pollution Surveillance (NAPS) program showed that 11 compounds exceeded daily or annual ambient air quality guidelines and that an additional 16 compounds approached such guidelines within an order of magnitude. The results of this study can be applied to evaluating the effectiveness of toxic substances management in Canada and to identifying compounds that merit further investigation.

Air pollution, a rising environmental risk factor for cognition, neuroinflammation and neurodegeneration: The clinical impact on children and beyond

Air pollution (indoors and outdoors) is a major issue in public health as epidemiological studies have highlighted its numerous detrimental health consequences (notably, respiratory and cardiovascular pathological conditions). Over the past 15 years, air pollution has also been considered a potent environmental risk factor for neurological diseases and neuropathology. This review examines the impact of air pollution on children's brain development and the clinical, cognitive, brain structural and metabolic consequences. Long-term potential consequences for adults' brains and the effects on multiple sclerosis (MS) are also discussed. One challenge is to assess the effects of lifetime exposures to outdoor and indoor environmental pollutants, including occupational exposures: how much, for how long and what type. Diffuse neuroinflammation, damage to the neurovascular unit, and the production of autoantibodies to neural and tight-junction proteins are worrisome findings in children chronically exposed to concentrations above the current standards for ozone and fine particulate matter (PM2.5), and may constitute significant risk factors for the development of Alzheimer's disease later in life. Finally, data supporting the role of air pollution as a risk factor for MS are reviewed, focusing on the effects of PM10 and nitrogen oxides.

The impact of candle burning during All Saints' Day ceremonies on ambient alkyl-substituted benzene concentrations

Research findings concerning benzene, toluene, ethylobenzene, meta-, para- and ortho-xylene as well as styrene (BTEXS) emission at public cemeteries during All Saints' Day are presented here. Tests were carried out at town-located cemeteries in Opole and Grodków (southern Poland) and, as a benchmark, at the centres of those same towns. The purpose of the study was to estimate BTEXS emissions caused by the candle burning and, equally important to examine, whether emissions generated by the tested sources were similar to the BTEXS emissions generated by road transport. During the festive period, significant increases in benzene concentrations, by 200 % and 144 %, were noted at the cemeteries in Opole and Grodków, as well as in toluene, by 366 % and 342 %, respectively. Styrene concentrations also increased. It was demonstrated that the ratio of toluene to benzene concentrations from emissions caused by the burning candles are comparable to the ratio established for transportation emissions.

Hypospadias and maternal intake of phytoestrogens

Experimental data indicate that gestational exposures to estrogenic compounds impact risk of hypospadias. We examined whether risk of hypospadias (i.e., a congenital malformation in which the opening of the penile urethra occurs on the ventral side of the penis) was associated with maternal intake of phytoestrogens, given their potential impact on estrogen metabolism. The analysis included data on mothers of 1,250 hypospadias cases and 3,118 controls who delivered their infants from 1997 to 2005 and participated in the National Birth Defects Prevention Study, a multistate, population-based, case-control study. After adjustment for several covariates, high intakes of daidzein, genistein, glycetin, secoisolariciresinol, total isoflavones, total lignans, and total phytoestrogens were associated with reduced risks; odds ratios comparing intakes ≥90th percentile with intakes between the 11th and 89th percentiles ranged from 0.6 to 0.8. For example, the odds ratio for total phytoestrogen intake was 0.7 (95% confidence interval: 0.5, 1.0). This study represents the first large-scale analysis of phytoestrogen intake and hypospadias. The observed associations merit investigation in additional populations before firm conclusions can be reached.

An index for assessing demographic inequalities in cumulative environmental hazards with application to Los Angeles, California

Researchers in environmental justice contend that low-income communities and communities of color face greater impacts from environmental hazards. This is also of concern for policy makers. In this context, our paper has two principal objectives. First, we propose a method for creating an index capable of summarizing racial-ethnic and socioeconomic inequalities from the impact of cumulative environmental hazards. Second, we apply the index to Los Angeles County to illustrate the potential applications and complexities of its implementation. Individual environmental inequality indices are calculated based on unequal shares of environmental hazards for racial-ethnic groups and socioeconomic positions. The illustrated hazards include ambient concentrations of particulate matter, nitrogen dioxide, and estimates of cancer risk associated with modeled estimates for diesel particulate matter. The cumulative environmental hazard inequality index (CEHII) then combines individual environmental hazards, using either a multiplicative or an additive model. Significant but modest inequalities exist for both individual and cumulative environmental hazards in Los Angeles. The highest level of inequality among racial-ethnic and socioeconomic groups occurs when a multiplicative model is used to estimate cumulative hazard. The CEHII provides a generalized framework that incorporates environmental hazards and socioeconomic characteristics to assess inequalities in cumulative environmental risks.

Characterization of the chronic risk and hazard of hazardous air pollutants in the United States using ambient monitoring data

BACKGROUND

Ambient measurements of hazardous air pollutants (air toxics) have been used to validate model-predicted concentrations of air toxics but have not been used to perform risk screening at the national level.

OBJECTIVES

We used ambient concentrations of routinely measured air toxics to determine the relative importance of individual air toxics for chronic cancer and noncancer exposures.

METHODS

We compiled 3-year averages for ambient measurement of air toxics collected at monitoring locations in the United States from 2003 through 2005. We then used national distributions of risk-weighted concentrations to identify the air toxics of most concern.

RESULTS

Concentrations of benzene, carbon tetrachloride, arsenic, 1,3-butadiene, and acetaldehyde were above the 10(-6) cancer risk level at most sites nationally with a high degree of confidence. Concentrations of tetrachloroethylene, ethylene oxide, acrylonitrile, and 1,4-dichlorobenzene were also often greater than the 10(-6) cancer risk level, but we have less confidence in the estimated risk associated with these pollutants. Formaldehyde and chromium VI concentrations were either above or below the 10(-6) cancer risk level, depending on the choice of agency-recommended 10(-6) level. The method detection limits of eight additional pollutants were too high to rule out that concentrations were above the 10(-6) cancer risk level. Concentrations of 52 compounds compared with chronic noncancer benchmarks indicated that only acrolein concentrations were greater than the noncancer reference concentration at most monitoring sites.

CONCLUSIONS

Most pollutants with national site-level averages greater than health benchmarks were also pollutants of concern identified in modeled national-scale risk assessments. Current monitoring networks need more sensitive ambient measurement techniques to better characterize the air toxics problem in the United States.

Use of residential wood heating in a context of climate change: a population survey in Québec (Canada)

Background

Wood heating is recommended in several countries as a climate change (CC) adaptation measure, mainly to increase the autonomy of households during power outages due to extreme climatic events. The aim of this study was to examine various perceptions and individual characteristics associated with wood heating through a survey about CC adaptations.

Methods

A telephone survey (n = 2,545) of adults living in the southern part of the province of Québec (Canada) was conducted in the early fall season of 2005. The questionnaire used closed questions and measured the respondents' beliefs and current adaptations about CC. Calibration weighting was used to adjust the data analysis for the respondent's age and language under stratified sampling based on health regions.

Results

More than three out of four respondents had access to a single source of energy at home, which was mainly electricity; 22.2% combined two sources or more; 18.5% heated with wood occasionally or daily during the winter. The prevalence of wood heating was higher in the peripheral regions than in the more urban regions, where there was a higher proportion of respondents living in apartments. The prevalence was also higher with participants completely disagreeing (38.5%) with the eventual prohibition of wood heating when there is smog in winter, compared to respondents somewhat disagreeing (24.2%) or agreeing (somewhat: 17.5%; completely: 10.4%) with the adoption of this strategy. It appears that the perception of living in a region susceptible to winter smog, smog warnings in the media, or the belief in the human contribution to CC, did not influence significantly wood heating practices.

Conclusion

Increased residential wood heating could very well become a maladaptation to climate change, given its known consequences on winter smog and respiratory health. It would thus be appropriate to implement a long-term national program on improved and controlled residential wood heating. This would constitute a "no-regrets" adaptation to climate change, while reducing air pollution and its associated health impacts.

Ambient air pollution: health hazards to children

Ambient (outdoor) air pollution is now recognized as an important problem, both nationally and worldwide. Our scientific understanding of the spectrum of health effects of air pollution has increased, and numerous studies are finding important health effects from air pollution at levels once considered safe. Children and infants are among the most susceptible to many of the air pollutants. In addition to associations between air pollution and respiratory symptoms, asthma exacerbations, and asthma hospitalizations, recent studies have found links between air pollution and preterm birth, infant mortality, deficits in lung growth, and possibly, development of asthma. This policy statement summarizes the recent literature linking ambient air pollution to adverse health outcomes in children and includes a perspective on the current regulatory process. The statement provides advice to pediatricians on how to integrate issues regarding air quality and health into patient education and children's environmental health advocacy and concludes with recommendations to the government on promotion of effective air-pollution policies to ensure protection of children's health.

Childhood cancer incidence rates and hazardous air pollutants in California: an exploratory analysis

Hazardous air pollutants (HAPs) are compounds shown to cause cancer or other adverse health effects. We analyzed population-based childhood cancer incidence rates in California (USA) from 1988 to 1994, by HAP exposure scores, for all California census tracts. For each census tract, we calculated exposure scores by combining cancer potency factors with outdoor HAP concentrations modeled by the U.S. Environmental Protection Agency. We evaluated the relationship between childhood cancer rates and exposure scores for 25 potentially carcinogenic HAPs emitted from mobile, area, and point sources and from all sources combined. Our study period saw 7,143 newly diagnosed cancer cases in California; of these, 6,989 (97.8%) could be assigned to census tracts and included in our analysis. Using Poisson regression, we estimated rate ratios (RRs) adjusted for age, race/ethnicity, and sex. We found little evidence for elevated cancer RRs for all sites or for gliomas among children living in high-ranking combined-source exposure areas. We found elevated RRs and a significant trend with increasing exposure level for childhood leukemia in tracts ranked highest for exposure to the combined group of 25 HAPs (RR = 1.21; 95% confidence interval, 1.03, 1.42) and in tracts ranked highest for point-source HAP exposure (RR = 1.32; 95% confidence interval, 1.11, 1.57). Our findings suggest an association between increased childhood leukemia rates and high HAP exposure, but studies involving more comprehensive exposure assessment and individual-level exposure data will be important for elucidating this relationship.

Hazardous air pollutants and asthma

Asthma has a high prevalence in the United States, and persons with asthma may be at added risk from the adverse effects of hazardous air pollutants (HAPs). Complex mixtures (fine particulate matter and tobacco smoke) have been associated with respiratory symptoms and hospital admissions for asthma. The toxic ingredients of these mixtures are HAPs, but whether ambient HAP exposures can induce asthma remains unclear. Certain HAPs are occupational asthmagens, whereas others may act as adjuncts during sensitization. HAPs may exacerbate asthma because, once sensitized, individuals can respond to remarkably low concentrations, and irritants lower the bronchoconstrictive threshold to respiratory antigens. Adverse responses after ambient exposures to complex mixtures often occur at concentrations below those producing effects in controlled human exposures to a single compound. In addition, certain HAPs that have been associated with asthma in occupational settings may interact with criteria pollutants in ambient air to exacerbate asthma. Based on these observations and past experience with 188 HAPs, a list of 19 compounds that could have the highest impact on the induction or exacerbation of asthma was developed. Nine additional compounds were identified that might exacerbate asthma based on their irritancy, respirability, or ability to react with biological macromolecules. Although the ambient levels of these 28 compounds are largely unknown, estimated exposures from emissions inventories and limited air monitoring suggest that aldehydes (especially acrolein and formaldehyde) and metals (especially nickel and chromium compounds) may have possible health risk indices sufficient for additional attention. Recommendations for research are presented regarding exposure monitoring and evaluation of biologic mechanisms controlling how these substances induce and exacerbate asthma.

Addressing community concerns about asthma and air toxics

People with asthma who live near or downwind from a source of toxic emissions commonly express concerns about the possible impact of hazardous air pollution on their health, especially when these emissions are visible or odorous. Citizens frequently turn to their local and state health departments for answers, but health departments face many challenges in addressing these concerns. These challenges include a lack of asthma statistics at the local level, limited exposure information, and a paucity of scientific knowledge about the contributions of hazardous air pollutants to asthma induction or exacerbation. Health agencies are creatively developing methods to address these challenges while working toward improving asthma surveillance data at the state and local levels. Recent community health investigations suggest that hazardous air pollutants that are occupational asthmagens or associated with odors may deserve more attention. In seeking to address community concerns about hazardous air pollution and asthma, community health investigations may also help to fill gaps in our scientific knowledge and identify areas for further research or environmental intervention. The solutions to community problems associated with environmental contamination and asthma, however, require sustained, coordinated efforts by public and private groups and citizens. Public health agencies can make a unique contribution to this effort, but additional resources and support will be required to develop information systems and epidemiologic capacity at the state and local levels.