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Sarno G, Stanisci I, Maio S, Williams S, Ming KE, Diaz SG, Ponte EV, Lan LTT, Soronbaev T, Behera D, Tagliaferro S, Baldacci S, Viegi G. Issue 2 - "Update on adverse respiratory effects of indoor air pollution". Part 2): Indoor air pollution and respiratory diseases: Perspectives from Italy and some other GARD countries. Pulmonology 2023:S2531-0437(23)00083-1. [PMID: 37211526 DOI: 10.1016/j.pulmoe.2023.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 03/20/2023] [Indexed: 05/23/2023] Open
Abstract
OBJECTIVE to synthesize the Italian epidemiological contribution to knowledge on indoor pollution respiratory impact, and to analyze the perspective of some GARD countries on the health effects of indoor air pollution. RESULTS Italian epidemiological analytical studies confirmed a strong relationship between indoor air pollution and health in general population. Environmental tobacco smoke, biomass (wood/coal) fuel for cooking/heating and indoor allergens (house dust mites, cat and dog dander, mold/damp) are the most relevant indoor pollution sources and are related to respiratory and allergic symptoms/diseases in Italy and in other GARD countries such as Mexico, Brazil, Vietnam, India, Nepal and Kyrgyzstan. Community-based global health collaborations are working to improve prevention, diagnosis and care of respiratory diseases around the world, specially in low- and middle-income countries, through research and education. CONCLUSIONS in the last thirty years, the scientific evidence produced on respiratory health effects of indoor air pollution has been extensive, but the necessity to empower the synergies between scientific community and local administrations remains a challenge to address in order to implement effective interventions. Based on abundant evidence of indoor pollution health effect, WHO, scientific societies, patient organizations and other members of the health community should work together to pursue the GARD vision of "a world where all people breathe freely" and encourage policy makers to increase their engagement in advocacy for clean air.
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Affiliation(s)
- G Sarno
- CNR Institute of Clinical Physiology (IFC), Via Trieste, 41, 56126 Pisa, Italy
| | - I Stanisci
- CNR Institute of Clinical Physiology (IFC), Via Trieste, 41, 56126 Pisa, Italy
| | - S Maio
- CNR Institute of Clinical Physiology (IFC), Via Trieste, 41, 56126 Pisa, Italy
| | - S Williams
- International Primary Care Respiratory Group (IPCRG), 19 Armour Mews, Larbert FK5 4FF, Scotland, United Kingdom
| | - K E Ming
- International Primary Care Respiratory Group (IPCRG), 19 Armour Mews, Larbert FK5 4FF, Scotland, United Kingdom
| | - S G Diaz
- Universidad Autónoma de Nuevo León, Faculty of Medicine and University Hospital "Dr. José Eleuterio González", Regional Center of Allergy and Clinical Immunology, Av. Dr. José Eleuterio González 235, Mitras Centro, 64460 Monterrey, N.L., Mexico
| | - E V Ponte
- Faculdade de Medicina de Jundiaí - Department of Internal Medicine, R. Francisco Teles, 250, Vila Arens II, Jundiaí SP, 13202-550, Brazil
| | - L T T Lan
- University Medical Center, 217 Hong Bang, dist.5, Ho Chi Minh City 17000, Vietnam
| | - T Soronbaev
- Department of Respiratory Medicine, National Center for Cardiology and Internal Medicine, Togolok Moldo str., Bishkek 720040, Kyrgyzstan
| | - D Behera
- Department of Microbiology, National Institute of Tuberculosis and Respiratory Diseases (NITRD), Sri Aurobindo Marg Near Qutub Minar, Mehrauli, New Delhi 110030, India
| | - S Tagliaferro
- CNR Institute of Clinical Physiology (IFC), Via Trieste, 41, 56126 Pisa, Italy
| | - S Baldacci
- CNR Institute of Clinical Physiology (IFC), Via Trieste, 41, 56126 Pisa, Italy
| | - G Viegi
- CNR Institute of Clinical Physiology (IFC), Via Trieste, 41, 56126 Pisa, Italy.
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Paterson CA, Sharpe RA, Taylor T, Morrissey K. Indoor PM2.5, VOCs and asthma outcomes: A systematic review in adults and their home environments. ENVIRONMENTAL RESEARCH 2021; 202:111631. [PMID: 34224711 DOI: 10.1016/j.envres.2021.111631] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 06/25/2021] [Accepted: 06/29/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION As the amount of time people spend indoors increases globally, exposure to indoor air pollutants has become an important public health concern. Asthma is a complex disease caused and/or exacerbated by increased exposure to diverse chemical, physical and biological exposures from multiple indoor and outdoor sources. This review aims to investigate the relationship between increased indoor PM and VOC concentrations (i.e. objectively measured) and the risk of adult asthma in higher-income countries. METHODS Eleven databases were systematically searched on the February 1, 2019 and again on the February 2, 2020. Articles were limited to those published since 1990. Reference lists were independently screened by three reviewers and authors were contacted to identify relevant articles. Backwards and forward citation chasing was used to identify further studies. Data were extracted from included studies meeting our eligibility criteria by three reviewers and assessed for quality using the Newcastle-Ottawa scale designed for case-control and cohort studies. RESULTS Twelve studies were included in a narrative synthesis. We found insufficient evidence to determine the effect of PM2.5 on asthma in the indoor home environment. However, there was strong evidence to suggest that VOCs, especially aromatic compounds, and aliphatic compounds, were associated with increased asthma symptoms. DISCUSSION & CONCLUSION Although no single exposure appears to be responsible for the development of asthma or its associated symptoms, the use of everyday products may be associated with increased asthma symptoms. To prevent poor health outcomes among the general population, health professionals and industry must make a concerted effort to better inform the general population of the importance of appropriate use of and storage of chemicals within the home as well as better health messaging on product labelling.
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Affiliation(s)
- C A Paterson
- European Centre for Environment and Human Health, University of Exeter Medical School, University of Exeter, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall, TR1 3HD, UK.
| | - R A Sharpe
- Public Health, Cornwall Council, 1E, New County Hall, Truro, TR1 3AY, UK.
| | - T Taylor
- European Centre for Environment and Human Health, University of Exeter Medical School, University of Exeter, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall, TR1 3HD, UK.
| | - K Morrissey
- European Centre for Environment and Human Health, University of Exeter Medical School, University of Exeter, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall, TR1 3HD, UK.
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Zhang L, Ou C, Magana-Arachchi D, Vithanage M, Vanka KS, Palanisami T, Masakorala K, Wijesekara H, Yan Y, Bolan N, Kirkham MB. Indoor Particulate Matter in Urban Households: Sources, Pathways, Characteristics, Health Effects, and Exposure Mitigation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11055. [PMID: 34769574 PMCID: PMC8582694 DOI: 10.3390/ijerph182111055] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 10/14/2021] [Accepted: 10/15/2021] [Indexed: 02/07/2023]
Abstract
Particulate matter (PM) is a complex mixture of solid particles and liquid droplets suspended in the air with varying size, shape, and chemical composition which intensifies significant concern due to severe health effects. Based on the well-established human health effects of outdoor PM, health-based standards for outdoor air have been promoted (e.g., the National Ambient Air Quality Standards formulated by the U.S.). Due to the exchange of indoor and outdoor air, the chemical composition of indoor particulate matter is related to the sources and components of outdoor PM. However, PM in the indoor environment has the potential to exceed outdoor PM levels. Indoor PM includes particles of outdoor origin that drift indoors and particles that originate from indoor activities, which include cooking, fireplaces, smoking, fuel combustion for heating, human activities, and burning incense. Indoor PM can be enriched with inorganic and organic contaminants, including toxic heavy metals and carcinogenic volatile organic compounds. As a potential health hazard, indoor exposure to PM has received increased attention in recent years because people spend most of their time indoors. In addition, as the quantity, quality, and scope of the research have expanded, it is necessary to conduct a systematic review of indoor PM. This review discusses the sources, pathways, characteristics, health effects, and exposure mitigation of indoor PM. Practical solutions and steps to reduce exposure to indoor PM are also discussed.
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Affiliation(s)
- Ling Zhang
- Nantong Key Laboratory of Intelligent and New Energy Materials, Nantong University, Nantong 226019, China;
- School of Health, Jiangsu Food & Pharmaceutical Science College, Huai’an 223003, China
| | - Changjin Ou
- Nantong Key Laboratory of Intelligent and New Energy Materials, Nantong University, Nantong 226019, China;
| | - Dhammika Magana-Arachchi
- Molecular Microbiology and Human Diseases Project, National Institute of Fundamental Studies, Hantana Road, Kandy 20000, Sri Lanka; (D.M.-A.); (M.V.)
| | - Meththika Vithanage
- Molecular Microbiology and Human Diseases Project, National Institute of Fundamental Studies, Hantana Road, Kandy 20000, Sri Lanka; (D.M.-A.); (M.V.)
- Ecosphere Resilience Research Center, Faculty of Applied Sciences, University of Sri Jayewardenepura, Nugegoda 10250, Sri Lanka
| | - Kanth Swaroop Vanka
- Priority Research Centre for Healthy Lungs, Faculty of Health and Medicine, School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, NSW 2308, Australia;
| | - Thava Palanisami
- Global Innovative Centre for Advanced Nanomaterials (GICAN), Faculty of Engineering and Built Environment, The University of Newcastle, Callaghan, NSW 2308, Australia;
| | - Kanaji Masakorala
- Department of Botany, Faculty of Science, University of Ruhuna, Matara 80000, Sri Lanka;
| | - Hasintha Wijesekara
- Department of Natural Resources, Faculty of Applied Sciences, Sabaragamuwa University of Sri Lanka, Belihuloya 70140, Sri Lanka;
| | - Yubo Yan
- Jiangsu Engineering Laboratory for Environment Functional Materials, Huaiyin Normal University, Huai’an 223300, China
| | - Nanthi Bolan
- School of Agriculture and Environment, Institute of Agriculture, The University of Western Australia, Perth, WA 6001, Australia;
| | - M. B. Kirkham
- Department of Agronomy, Kansas State University, Manhattan, KS 66506, USA;
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Lee H, Chung SJ, Park JS, Kim S, Park DW, Sohn JW, Kim SH, Park CS, Yoon HJ. Impact of Grilling Meat or Fish at Home on Peak Expiratory Flow Rate in Adults With Asthma. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2020; 12:729-737. [PMID: 32400136 PMCID: PMC7225005 DOI: 10.4168/aair.2020.12.4.729] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Revised: 01/02/2020] [Accepted: 01/05/2020] [Indexed: 11/25/2022]
Abstract
Grilling, a common cooking method worldwide, can produce more toxic gases than other cooking methods. However, the impact of frequently grilling meat or fish at home on airflow limitation in adult asthma has not been well elucidated. We performed a prospective cohort study of 91 adult patients with asthma enrolled from 2 university hospitals. Of the patients, 39 (42.9%) grilled meat or fish at least once a week and 52 (57.1%) less than once a week. Patients who grilled at least once a week tended to have lower peak expiratory flow rate (PEFR) than those who grilled less than once a week (median, 345.5 L/min; 95% confidence interval [CI], 291.8–423.2 L/min vs. median, 375.1 L/min; 95% CI, 319.7–485.7 L/min; P = 0.059). Among patients with severe asthma who received step 4-5 treatment, PEFR was significantly lower in patients who grilled at least once a week compared with those who grilled less than once a week (median, 297.8 L/min; 95% CI, 211.3–357.7 L/min vs. median, 396.1 L/min; 95% CI, 355.0–489.6 L/min; P < 0.001). Our results suggest that the frequency of grilling meat or fish at home may affect PEFR in asthmatic patients, especially those with severe asthma who needed a high level of asthma treatment.
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Affiliation(s)
- Hyun Lee
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Sung Jun Chung
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Jong Sook Park
- Allergy and Respiratory Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Sungroul Kim
- Department of Environmental Sciences, Soonchunhyang University, Asan, Korea
| | - Dong Won Park
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Jang Won Sohn
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Sang Heon Kim
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Choon Sik Park
- Allergy and Respiratory Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Ho Joo Yoon
- Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
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Richtwerte für Stickstoffdioxid (NO2) in der Innenraumluft. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2019; 62:664-676. [DOI: 10.1007/s00103-019-02891-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Drago G, Perrino C, Canepari S, Ruggieri S, L'Abbate L, Longo V, Colombo P, Frasca D, Balzan M, Cuttitta G, Scaccianoce G, Piva G, Bucchieri S, Melis M, Viegi G, Cibella F, Balzan M, Bilocca D, Borg C, Montefort S, Zammit C, Bucchieri S, Cibella F, Colombo P, Cuttitta G, Drago G, Ferrante G, L'Abbate L, Grutta SL, Longo V, Melis MR, Ruggieri S, Viegi G, Minardi R, Piva G, Ristagno R, Rizzo G, Scaccianoce G. Relationship between domestic smoking and metals and rare earth elements concentration in indoor PM 2.5. ENVIRONMENTAL RESEARCH 2018; 165:71-80. [PMID: 29674239 DOI: 10.1016/j.envres.2018.03.026] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2017] [Revised: 02/09/2018] [Accepted: 03/15/2018] [Indexed: 06/08/2023]
Abstract
Cigarette smoke is the main source of indoor chemical and toxic elements. Cadmium (Cd), Thallium (Tl), Lead (Pb) and Antimony (Sb) are important contributors to smoke-related health risks. Data on the association between Rare Earth Elements (REE) Cerium (Ce) and Lanthanum (La) and domestic smoking are scanty. To evaluate the relationship between cigarette smoke, indoor levels of PM2.5 and heavy metals, 73 children were investigated by parental questionnaire and skin prick tests. The houses of residence of 41 "cases" and 32 "controls" (children with and without respiratory symptoms, respectively) were evaluated by 48-h PM2.5 indoor/outdoor monitoring. PM2.5 mass concentration was determined by gravimetry; the extracted and mineralized fractions of elements (As, Cd, Ce, La, Mn, Pb, Sb, Sr, Tl) were evaluated by ICP-MS. PM2.5 and Ce, La, Cd, and Tl indoor concentrations were higher in smoker dwellings. When corrected for confounding factors, PM2.5, Ce, La, Cd, and Tl were associated with more likely presence of respiratory symptoms in adolescents. We found that: i) indoor smoking is associated with increased levels of PM2.5, Ce, La, Cd, and Tl and ii) the latter with increased presence of respiratory symptoms in children.
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Affiliation(s)
- Gaspare Drago
- National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, Palermo, Italy
| | - Cinzia Perrino
- National Research Council of Italy, Institute of Atmospheric Pollution Research, Rome, Italy
| | - Silvia Canepari
- Department of Chemistry, Sapienza University of Rome, Rome, Italy
| | - Silvia Ruggieri
- National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, Palermo, Italy
| | - Luca L'Abbate
- National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, Palermo, Italy
| | - Valeria Longo
- National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, Palermo, Italy
| | - Paolo Colombo
- National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, Palermo, Italy
| | - Daniele Frasca
- National Research Council of Italy, Institute of Atmospheric Pollution Research, Rome, Italy; Department of Chemistry, Sapienza University of Rome, Rome, Italy
| | - Martin Balzan
- Department of Respiratory Medicine, Mater Dei Hospital, Msida, Malta
| | - Giuseppina Cuttitta
- National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, Palermo, Italy
| | - Gianluca Scaccianoce
- Department of Energy, Information Engineering and Mathematical Models, University of Palermo, Palermo, Italy
| | | | - Salvatore Bucchieri
- National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, Palermo, Italy
| | - Mario Melis
- National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, Palermo, Italy
| | - Giovanni Viegi
- National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, Palermo, Italy
| | - Fabio Cibella
- National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, Palermo, Italy.
| | - Martin Balzan
- Department of Respiratory Medicine, Mater Dei Hospital, Msida, Malta
| | - David Bilocca
- Department of Respiratory Medicine, Mater Dei Hospital, Msida, Malta
| | - Charles Borg
- Department of Respiratory Medicine, Mater Dei Hospital, Msida, Malta
| | - Stephen Montefort
- Department of Respiratory Medicine, Mater Dei Hospital, Msida, Malta
| | | | - Salvatore Bucchieri
- National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, Palermo, Italy
| | - Fabio Cibella
- National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, Palermo, Italy
| | - Paolo Colombo
- National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, Palermo, Italy
| | - Giuseppina Cuttitta
- National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, Palermo, Italy
| | - Gaspare Drago
- National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, Palermo, Italy
| | - Giuliana Ferrante
- National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, Palermo, Italy
| | - Luca L'Abbate
- National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, Palermo, Italy
| | - Stefania La Grutta
- National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, Palermo, Italy
| | - Valeria Longo
- National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, Palermo, Italy
| | - Mario R Melis
- National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, Palermo, Italy
| | - Silvia Ruggieri
- National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, Palermo, Italy
| | - Giovanni Viegi
- National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, Palermo, Italy
| | - Remo Minardi
- ASP Caltanissetta - Health District of Gela, Italy
| | | | | | - Gianfranco Rizzo
- Department of Energy, Information Engineering and Mathematical Models, University of Palermo, Palermo, Italy
| | - Gianluca Scaccianoce
- Department of Energy, Information Engineering and Mathematical Models, University of Palermo, Palermo, Italy
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Ooi SS, Mak JW, Chen DKF, Ambu S. The correlation of Acanthamoeba from the ventilation system with other environmental parameters in commercial buildings as possible indicator for indoor air quality. INDUSTRIAL HEALTH 2017; 55:35-45. [PMID: 27476379 PMCID: PMC5285312 DOI: 10.2486/indhealth.2015-0218] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The free-living protozoan Acanthamoeba is an opportunistic pathogen that is ubiquitous in our environment. However, its role in affecting indoor air quality and ill-health of indoor occupants is relatively unknown. The present study investigated the presence of Acanthamoeba from the ventilation system and its correlation with other indoor air quality parameters, used in the industry code of practice and its potential as an indicator for indoor air quality. Indoor air quality assessments were carried out in nine commercial buildings with approval from the building management, and the parameters assessed were as recommended by the Department of Occupational Safety and Health. The presence of Acanthamoeba was determined through dust swabs from the ventilation system and indoor furniture. Logistic regression was performed to study the correlation between assessed parameters and occupants’ complaints. A total of 107 sampling points were assessed and 40.2% of the supplying air diffuser and blowing fan and 15% of the furniture were positive for cysts. There was a significant correlation between Acanthamoeba detected from the ventilation system with ambient total fungus count (r=0.327; p=0.01) and respirable particulates (r=0.276; p=0.01). Occupants’ sick building syndrome experience also correlated with the presence of Acanthamoeba in the ventilation system (r=0.361; p=0.01) and those detected on the furniture (r=0.290; p=0.01). Logistic regression showed that there was a five-fold probability of sick building syndrome among occupants when Acanthamoeba was detected in the ventilation system.
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Affiliation(s)
- Soo Shen Ooi
- School of Postgraduate Studies, Institute for Research, Development and Innovation (IRDI), International Medical University, Malaysia
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Park DW, Kim SH, Yoon HJ. The impact of indoor air pollution on asthma. ALLERGY ASTHMA & RESPIRATORY DISEASE 2017. [DOI: 10.4168/aard.2017.5.6.312] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Dong Won Park
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Sang-Heon Kim
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Ho Joo Yoon
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
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[Seasonality in asthma: Impact and treatments]. Presse Med 2016; 45:1005-1018. [PMID: 27039335 DOI: 10.1016/j.lpm.2016.01.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 01/18/2016] [Accepted: 01/25/2016] [Indexed: 12/12/2022] Open
Abstract
The role of seasons should be taken into account in the management of asthma. The environment varies between seasons and it is well documented that asthma is modulated by environment. Viruses cause asthma exacerbations peak, in winter, in adults while the peak is present in September in children. Allergens are probably a less powerful source of asthma exacerbation than viruses but pollen involvement in spring and summer and dust mites in autumn are indisputable. Air pollutants, present in summer during the hottest periods, are also highly involved in asthma exacerbations. Indoor air pollution, in winter, is also implicated in asthma disease. All these environmental factors are synergistic and increase the risk of asthma exacerbation. Therapies should be adapted to each season depending on environmental factors potentially involved in the asthma disease.
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Vardoulakis S, Dimitroulopoulou C, Thornes J, Lai KM, Taylor J, Myers I, Heaviside C, Mavrogianni A, Shrubsole C, Chalabi Z, Davies M, Wilkinson P. Impact of climate change on the domestic indoor environment and associated health risks in the UK. ENVIRONMENT INTERNATIONAL 2015; 85:299-313. [PMID: 26453820 DOI: 10.1016/j.envint.2015.09.010] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Revised: 07/30/2015] [Accepted: 09/07/2015] [Indexed: 05/25/2023]
Abstract
There is growing evidence that projected climate change has the potential to significantly affect public health. In the UK, much of this impact is likely to arise by amplifying existing risks related to heat exposure, flooding, and chemical and biological contamination in buildings. Identifying the health effects of climate change on the indoor environment, and risks and opportunities related to climate change adaptation and mitigation, can help protect public health. We explored a range of health risks in the domestic indoor environment related to climate change, as well as the potential health benefits and unintended harmful effects of climate change mitigation and adaptation policies in the UK housing sector. We reviewed relevant scientific literature, focusing on housing-related health effects in the UK likely to arise through either direct or indirect mechanisms of climate change or mitigation and adaptation measures in the built environment. We considered the following categories of effect: (i) indoor temperatures, (ii) indoor air quality, (iii) indoor allergens and infections, and (iv) flood damage and water contamination. Climate change may exacerbate health risks and inequalities across these categories and in a variety of ways, if adequate adaptation measures are not taken. Certain changes to the indoor environment can affect indoor air quality or promote the growth and propagation of pathogenic organisms. Measures aimed at reducing greenhouse gas emissions have the potential for ancillary public health benefits including reductions in health burdens related heat and cold, indoor exposure to air pollution derived from outdoor sources, and mould growth. However, increasing airtightness of dwellings in pursuit of energy efficiency could also have negative effects by increasing concentrations of pollutants (such as PM2.5, CO and radon) derived from indoor or ground sources, and biological contamination. These effects can largely be ameliorated by mechanical ventilation with heat recovery (MVHR) and air filtration, where such solution is feasible and when the system is properly installed, operated and maintained. Groups at high risk of these adverse health effects include the elderly (especially those living on their own), individuals with pre-existing illnesses, people living in overcrowded accommodation, and the socioeconomically deprived. A better understanding of how current and emerging building infrastructure design, construction, and materials may affect health in the context of climate change and mitigation and adaptation measures is needed in the UK and other high income countries. Long-term, energy efficient building design interventions, ensuring adequate ventilation, need to be promoted.
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Affiliation(s)
- Sotiris Vardoulakis
- Environmental Change Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, Oxon OX11 0RQ, UK; Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK; Division of Environmental Health and Risk Management, School of Geography, Earth and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
| | - Chrysanthi Dimitroulopoulou
- Environmental Change Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, Oxon OX11 0RQ, UK.
| | - John Thornes
- Environmental Change Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, Oxon OX11 0RQ, UK; Division of Environmental Health and Risk Management, School of Geography, Earth and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
| | - Ka-Man Lai
- Department of Biology, Hong Kong Baptist University, Kowloon Tong, Hong Kong, China.
| | - Jonathon Taylor
- UCL Institute for Environmental Design and Engineering, The Bartlett School of Environment Energy and Resources, University College London, 14 Upper Woburn Place, London WCIH ONN, UK.
| | - Isabella Myers
- Public Health England Toxicology Unit, Department of Medicine, Imperial College London, London W12 0NN, UK.
| | - Clare Heaviside
- Environmental Change Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Chilton, Oxon OX11 0RQ, UK; Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK; Division of Environmental Health and Risk Management, School of Geography, Earth and Environmental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
| | - Anna Mavrogianni
- UCL Institute for Environmental Design and Engineering, The Bartlett School of Environment Energy and Resources, University College London, 14 Upper Woburn Place, London WCIH ONN, UK.
| | - Clive Shrubsole
- UCL Institute for Environmental Design and Engineering, The Bartlett School of Environment Energy and Resources, University College London, 14 Upper Woburn Place, London WCIH ONN, UK.
| | - Zaid Chalabi
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK.
| | - Michael Davies
- UCL Institute for Environmental Design and Engineering, The Bartlett School of Environment Energy and Resources, University College London, 14 Upper Woburn Place, London WCIH ONN, UK.
| | - Paul Wilkinson
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK.
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12
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Cibella F, Cuttitta G, Della Maggiore R, Ruggieri S, Panunzi S, De Gaetano A, Bucchieri S, Drago G, Melis MR, La Grutta S, Viegi G. Effect of indoor nitrogen dioxide on lung function in urban environment. ENVIRONMENTAL RESEARCH 2015; 138:8-16. [PMID: 25682253 DOI: 10.1016/j.envres.2015.01.023] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 01/28/2015] [Accepted: 01/29/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND High levels of indoor NO2 are associated with increased asthma symptoms and decreased expiratory peak flows in children. We investigated the association of exposure to domestic indoor NO2, objectively measured in winter and spring, with respiratory symptoms and lung function in a sample of adolescents from a southern Mediterranean area. METHODS From a large school population sample (n=2150) participating in an epidemiological survey in the urban area of the City of Palermo (southern Italy), a sub-sample of 303 adolescents was selected which furnished an enriched sample for cases of current asthma. All subjects were evaluated by a health questionnaire, skin prick tests and spirometry. One-week indoor NO2 monitoring of their homes was performed by diffusive sampling during spring and again during winter. RESULTS We found that about 25% of subjects were exposed to indoor NO2 levels higher than the 40µg/m(3) World Health Organization limit, during both spring and winter. Moreover, subjects exposed to the highest indoor NO2 concentrations had increased frequency of current asthma (p=0.005), wheeze episodes in the last 12 months (p<0.001), chronic phlegm (p=0.013), and rhinoconjunctivitis (p=0.008). Finally, subjects with a personal history of wheeze ever had poorer respiratory function (FEF25-75%, p=0.01) when exposed to higher indoor NO2 concentrations. CONCLUSIONS Home exposure to high indoor NO2 levels frequently occurs in adolescents living in a southern Mediterranean urban area and is significantly associated with the risks for increased frequency of both respiratory symptoms and reduced lung function.
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Affiliation(s)
- Fabio Cibella
- National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, Palermo, Italy.
| | - Giuseppina Cuttitta
- National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, Palermo, Italy
| | - Roberto Della Maggiore
- National Research Council of Italy, Institute of Information Science and Technologies, Pisa, Italy
| | - Silvia Ruggieri
- National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, Palermo, Italy
| | - Simona Panunzi
- National Research Council of Italy, Institute for System Analysis and Computer Science "Antonio Ruberti", Roma, Italy
| | - Andrea De Gaetano
- National Research Council of Italy, Institute for System Analysis and Computer Science "Antonio Ruberti", Roma, Italy
| | - Salvatore Bucchieri
- National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, Palermo, Italy
| | - Gaspare Drago
- National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, Palermo, Italy
| | - Mario R Melis
- National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, Palermo, Italy
| | - Stefania La Grutta
- National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, Palermo, Italy
| | - Giovanni Viegi
- National Research Council of Italy, Institute of Biomedicine and Molecular Immunology, Palermo, Italy
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13
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Balmes JR, Cisternas M, Quinlan PJ, Trupin L, Lurmann FW, Katz PP, Blanc PD. Annual average ambient particulate matter exposure estimates, measured home particulate matter, and hair nicotine are associated with respiratory outcomes in adults with asthma. ENVIRONMENTAL RESEARCH 2014; 129:1-10. [PMID: 24528996 PMCID: PMC4169238 DOI: 10.1016/j.envres.2013.12.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Revised: 12/18/2013] [Accepted: 12/19/2013] [Indexed: 05/19/2023]
Abstract
BACKGROUND While exposure to outdoor particulate matter (PM) has been associated with poor asthma outcomes, few studies have investigated the combined effects of outdoor and indoor PM (including secondhand tobacco smoke). OBJECTIVE To examine the associations between PM and asthma outcomes. METHODS We analyzed data from a cohort of adults with asthma and rhinitis (n=302; 82% both conditions; 13% asthma only; 5% rhinitis alone) including measures of home PM, tobacco smoke exposure (hair nicotine and self-report), ambient PM from regional monitoring, distance to roadway, and season (wet or dry). The outcomes of interest were frequent respiratory symptoms and forced expiratory volume in 1 second (FEV1) below the lower limit of normal (NHANES reference values). Multivariable regression analyses examined the associations (Odds Ratio [OR] and 95% Confidence Interval [95%CI]) between exposures and these outcomes, adjusted by sociodemographic characteristics. RESULTS In adjusted analyses of each exposure, the highest tertile of home PM and season of interview were associated with increased odds for more frequent respiratory symptoms (OR=1.64 95%CI: [1.00, 2.69] and OR=1.66 95%CI: [1.09, 2.51]). The highest tertile of hair nicotine was significantly associated with FEV1 below the lower limit of normal (OR=1.80 95%CI: [1.00, 3.25]). In a model including home PM, ambient PM, hair nicotine, and season, only two associations remained strong: hair nicotine with FEV1 below the lower limit of normal and season of measurement (dry, April-October) with increased respiratory symptoms (OR=1.85 95%CI: [1.00, 3.41] and OR=1.54 95%CI: [1.0, 2.37]). When that model was stratified by sex, the highest tertiles of ambient PM and hair nicotine were associated with FEV1 below the lower limit of normal among women (OR=2.23 95%CI: [1.08, 4.61] and OR=2.90 95%CI: [1.32, 6.38]), but not men. The highest tertile of hair nicotine was also associated with increased respiratory symptoms in women but not men (OR=2.38 95%CI: [1.26, 4.49]). When stratified by age, the middle quartile of ambient PM and the highest hair nicotine tertile were associated with increased respiratory symptoms (OR=2.07 95%CI: [1.01, 4.24] and OR=2.55 95%CI: [1.21, 5.36]) in those under 55 but not in the older stratum. CONCLUSIONS Exposure to PM from both home and ambient sources is associated with increased symptoms and lower lung function in adults with asthma, although these associations vary by type of PM, the respiratory outcome studied, sex and age.
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Affiliation(s)
- John R Balmes
- Department of Medicine, University of California, San Francisco, CA, USA; School of Public Health, University of California, Berkeley, USA.
| | | | - Patricia J Quinlan
- Department of Medicine, University of California, San Francisco, CA, USA
| | - Laura Trupin
- Department of Medicine, University of California, San Francisco, CA, USA
| | | | - Patricia P Katz
- Department of Medicine, University of California, San Francisco, CA, USA
| | - Paul D Blanc
- Department of Medicine, University of California, San Francisco, CA, USA
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14
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Mendes A, Pereira C, Mendes D, Aguiar L, Neves P, Silva S, Batterman S, Teixeira JP. Indoor air quality and thermal comfort-results of a pilot study in elderly care centers in Portugal. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2013; 76:333-44. [PMID: 23514075 PMCID: PMC4269561 DOI: 10.1080/15287394.2013.757213] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
The age of the European population is rising and percentage of adults aged 65 years and older is projected to increase from 16% in 2000 to 20% in 2020. It has been estimated that older subjects spend approximately 19 to 20 h/d indoors. Older individuals may be particularly at risk for detrimental effects from pollutants, even at low concentrations, due to reduced immunological defenses and multiple underlying chronic diseases. Six Porto, Portugal, urban area elderly care centers (ECC), housing a total of 425 older persons, were studied to assess indoor air quality (IAQ) and thermal comfort (TC) in two seasons. This study presents the IAQ and TC results in 36 rooms and constitutes part of a wider and ongoing study. The study areas were all naturally ventilated, and indoor concentrations in winter were within Portuguese reference values. However, 42% of the participants were dissatisfied with indoor thermal conditions, rating it "slightly cool." In summer, the index rate of dissatisfied individuals was lower (8%). Significant differences were found between seasons in predicted percent of dissatisfied people (PPD) and predicted mean vote (PMV) indices. Fungal concentrations frequently exceeded reference levels (>500 colony-forming units [CFU]/m(3)). In addition, other pollutants occasionally exceeded reference levels. To our knowledge, this is the first study in Portugal to assess effects of indoor air contaminants on the health status and quality of life in older subjects living in ECC. Although IAQ and TC parameters were mostly within reference values, the results suggest a need to improve the balance between IAQ and TC in ECC, a critical environment housing a susceptible population.
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Affiliation(s)
- Ana Mendes
- Environmental Health Department, Portuguese National Health Institute Doutor Ricardo Jorge, Porto, Portugal.
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15
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Indoor air particles in office buildings with suspected indoor air problems in the Helsinki area. Int J Occup Med Environ Health 2013; 26:155-64. [DOI: 10.2478/s13382-013-0091-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2012] [Accepted: 11/26/2012] [Indexed: 11/21/2022] Open
Abstract
Abstract
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16
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Pegas PN, Alves CA, Nunes T, Bate-Epey EF, Evtyugina M, Pio CA. Could houseplants improve indoor air quality in schools? JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2012; 75:1371-1380. [PMID: 23095155 DOI: 10.1080/15287394.2012.721169] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Previous studies performed by the National Aeronautics Space Administration (NASA) indicated that plants and associated soil microorganisms may be used to reduce indoor pollutant levels. This study investigated the ability of plants to improve indoor air quality in schools. A 9-wk intensive monitoring campaign of indoor and outdoor air pollution was carried out in 2011 in a primary school of Aveiro, Portugal. Measurements included temperature, carbon dioxide (CO₂), carbon monoxide (CO), concentrations of volatile organic compounds (VOC), carbonyls, and particulate matter (PM₁₀) without and with plants in a classroom. PM₁₀ samples were analyzed for the water-soluble inorganic ions, as well for carbonaceous fractions. After 6 potted plants were hung from the ceiling, the mean CO₂ concentration decreased from 2004 to 1121 ppm. The total VOC average concentrations in the indoor air during periods of occupancy without and with the presence of potted plants were, respectively, 933 and 249 μg/m³. The daily PM₁₀ levels in the classroom during the occupancy periods were always higher than those outdoors. The presence of potted plants likely favored a decrease of approximately 30% in PM₁₀ concentrations. Our findings corroborate the results of NASA studies suggesting that plants might improve indoor air and make interior breathing spaces healthier.
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Affiliation(s)
- P N Pegas
- Centre for Environmental and Marine Studies-CESAM, Department of Environment, University of Aveiro, 3810-193, Aveiro, Portugal.
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17
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Do indoor environments influence asthma and asthma-related symptoms among adults in homes?: a review of the literature. J Formos Med Assoc 2011; 110:555-63. [PMID: 21930065 DOI: 10.1016/j.jfma.2011.07.003] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2011] [Revised: 05/16/2011] [Accepted: 06/08/2011] [Indexed: 11/21/2022] Open
Abstract
This review summarizes the results of epidemiological studies focusing on the detrimental effects of home environmental factors on asthma morbidity in adults. We reviewed the literature on indoor air quality (IAQ), physical and sociodemographic factors, and asthma morbidity in homes, and identified commonly reported asthma, allergic, and respiratory symptoms involving the home environment. Reported IAQ and asthma morbidity data strongly indicated positive associations between indoor air pollution and adverse health effects in most studies. Indoor factors most consistently associated with asthma and asthma-related symptoms in adults included fuel combustion, mold growth, and environmental tobacco smoke. Environmental exposure may increase an adult's risk of developing asthma and also may increase the risk of asthma exacerbations. Evaluation of present IAQ levels, exposure characteristics, and the role of exposure to these factors in relation to asthma morbidity is important for improving our understanding, identifying the burden, and for developing and implementing interventions aimed at reducing asthma morbidity.
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18
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Latza U, Gerdes S, Baur X. Effects of nitrogen dioxide on human health: systematic review of experimental and epidemiological studies conducted between 2002 and 2006. Int J Hyg Environ Health 2008; 212:271-87. [PMID: 18771952 DOI: 10.1016/j.ijheh.2008.06.003] [Citation(s) in RCA: 141] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2008] [Revised: 06/19/2008] [Accepted: 06/24/2008] [Indexed: 11/29/2022]
Abstract
In order to assess health effects in humans caused by environmental nitrogen dioxide (NO(2)) a systematic review of studies in humans was conducted. MEDLINE database was searched for epidemiological studies and experiments on adverse effects of NO(2) published between 2002 and 2006. The evidence with regard to NO(2) exposure limits was assessed using the Scottish Intercollegiate Guidelines Network (SIGN) grading system and the modified three star system. Of the 214 articles retrieved 112 fulfilled the inclusion criteria. There was limited evidence that short-term exposure to a 1-h mean value below 200 microg NO(2)/m(3) is associated with adverse health effects provided by only one study on mortality in patients with severe asthma (*2+). The effect remained after adjusting for other air pollutants. There was moderate evidence that short-term exposure below a 24-h mean value of 50 microg NO(2)/m(3) at monitor stations increases hospital admissions and mortality (**2+). Evidence was also moderate when the search was restricted to susceptible populations (children, adolescents, elderly, and asthmatics). There was moderate evidence that long-term exposure to an annual mean below 40 microg NO(2)/m(3) was associated with adverse health effects (respiratory symptoms/diseases, hospital admissions, mortality, and otitis media) provided by generally consistent findings in five well-conducted cohort and case-control studies with some shortcomings in the study quality (**2+). Evidence was also moderate when the search was restricted to studies in susceptible populations (children and adolescents) and for the combination with other air pollutants. The most frequent reasons for decreased study quality were potential misclassification of exposure and selection bias. None of the high-quality observational studies evaluated was informative for the key questions due to the choice of the dose parameter (e.g., 1-week mean) and exposure levels above the limit values. Inclusion of study designs unlisted in the SIGN grading system did not bring additional evidence regarding exposures below the current air quality limit values for NO(2). As several recent studies reported adverse health effects below the current exposure limits for NO(2) particularly among susceptible populations regarding long-term exposure further research is needed. Apart from high-quality epidemiological studies on causality and the interaction of NO(2) with other air pollutants there is a need for double-blinded randomized cross-over studies among susceptible populations for further evaluation of the short-term exposure limits.
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Affiliation(s)
- Ute Latza
- Institute for Occupational Medicine and Maritime Medicine (ZfAM), University of Hamburg, Hamburg State Department for Social Affairs, Family, Health, and Consumer Protection, Hamburg, Germany.
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19
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Bernstein JA, Alexis N, Bacchus H, Bernstein IL, Fritz P, Horner E, Li N, Mason S, Nel A, Oullette J, Reijula K, Reponen T, Seltzer J, Smith A, Tarlo SM. The health effects of nonindustrial indoor air pollution. J Allergy Clin Immunol 2008; 121:585-91. [DOI: 10.1016/j.jaci.2007.10.045] [Citation(s) in RCA: 294] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2007] [Revised: 10/15/2007] [Accepted: 10/19/2007] [Indexed: 10/22/2022]
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20
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Koenig JQ, Mar TF, Allen RW, Jansen K, Lumley T, Sullivan JH, Trenga CA, Larson T, Liu LJS. Pulmonary effects of indoor- and outdoor-generated particles in children with asthma. ENVIRONMENTAL HEALTH PERSPECTIVES 2005; 113:499-503. [PMID: 15811822 PMCID: PMC1278493 DOI: 10.1289/ehp.7511] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2004] [Accepted: 01/10/2005] [Indexed: 05/03/2023]
Abstract
Most particulate matter (PM) health effects studies use outdoor (ambient) PM as a surrogate for personal exposure. However, people spend most of their time indoors exposed to a combination of indoor-generated particles and ambient particles that have infiltrated. Thus, it is important to investigate the differential health effects of indoor- and ambient-generated particles. We combined our recently adapted recursive model and a predictive model for estimating infiltration efficiency to separate personal exposure (E) to PM2.5 (PM with aerodynamic diameter < or = 2.5 microm) into its indoor-generated (Eig) and ambient-generated (Eag) components for 19 children with asthma. We then compared Eig and Eag to changes in exhaled nitric oxide (eNO), a marker of airway inflammation. Based on the recursive model with a sample size of eight children, Eag was marginally associated with increases in eNO [5.6 ppb per 10-microg/m3 increase in PM2.5; 95% confidence interval (CI), -0.6 to 11.9; p = 0.08]. Eig was not associated with eNO (-0.19 ppb change per 10 microg/m3). Our predictive model allowed us to estimate Eag and Eig for all 19 children. For those combined estimates, only Eag was significantly associated with an increase in eNO (Eag: 5.0 ppb per 10-microg/m3 increase in PM2.5; 95% CI, 0.3 to 9.7; p = 0.04; Eig: 3.3 ppb per 10-microg/m3 increase in PM2.5; 95% CI, -1.1 to 7.7; p = 0.15). Effects were seen only in children who were not using corticosteroid therapy. We conclude that the ambient-generated component of PM2.5 exposure is consistently associated with increases in eNO and the indoor-generated component is less strongly associated with eNO.
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Affiliation(s)
- Jane Q Koenig
- Department of Environmental Health and Occupational Sciences, University of Washington, Seattle, Washington 98195, USA.
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21
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Simoni M, Scognamiglio A, Carrozzi L, Baldacci S, Angino A, Pistelli F, Di Pede F, Viegi G. Indoor exposures and acute respiratory effects in two general population samples from a rural and an urban area in Italy. JOURNAL OF EXPOSURE ANALYSIS AND ENVIRONMENTAL EPIDEMIOLOGY 2004; 14 Suppl 1:S144-52. [PMID: 15118755 DOI: 10.1038/sj.jea.7500368] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
A study of indoor air exposures and acute respiratory effects in adults was conducted in the Po Delta (rural) and Pisa (urban) areas of Italy. Indoor exposures were monitored for nitrogen dioxide (NO(2)) and particulate matter <2.5 microm (PM(2.5)) for 1 week during the winter or summer in a total of 421 houses (2/3 in Pisa). Information on house characteristics, subjects' daily activity pattern and presence of acute respiratory symptoms was collected by a standardized questionnaire. Peak expiratory flow (PEF) maneuvers were performed by adult subjects four times daily; maximum amplitude and diurnal variation were taken into account. Indices of NO(2) and PM(2.5) exposures were computed as the product of weekly mean pollutant concentration by the time of daily exposure. Mean levels of pollutants were significantly higher in winter than in summer, regardless of the area. The relationship between exposure indices and acute respiratory symptoms was investigated only in winter. In spite of a slightly lower indoor level in the urban than in the rural area in winter (NO(2): 15 vs. 22 ppb; PM(2.5): 67 vs. 76 microg/m(3)), prevalence rates of acute respiratory symptoms were significantly higher in the urban than in the rural area. Acute respiratory illnesses with fever were significantly associated with indices of NO(2) (odds ratio (OR)=1.66; 95% CI=1.08-2.57) and PM(2.5) exposures (OR=1.62; 95% CI=1.04-2.51), while bronchitic/asthmatic symptoms were associated only with PM(2.5) (OR=1.39; 95% CI=1.17-1.66). PEF variability was positively related only to PM(2.5) exposure index (OR=1.38; 95% CI=1.24-1.54, for maximum amplitude; OR=1.37; 95% CI=1.23-1.53, for diurnal variation). In conclusion, indoor pollution exposures were associated with the presence of acute respiratory symptoms and mild lung function impairment in a rural and an urban area of Northern-Central Italy.
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Affiliation(s)
- Marzia Simoni
- Pulmonary Environmental Epidemiological Unit, CNR Institute of Clinical Physiology, Pisa, Italy
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22
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Archer AJ, Cramton JLH, Pfau JC, Colasurdo G, Holian A. Airway responsiveness after acute exposure to urban particulate matter 1648 in a DO11.10 murine model. Am J Physiol Lung Cell Mol Physiol 2003; 286:L337-43. [PMID: 14660482 DOI: 10.1152/ajplung.00202.2003] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Enhanced airway responsiveness (AR) is a well-established characteristic of asthma that epidemiological evidence has linked with inhalation of ambient particulate matter (PM). To determine whether acute exposure to urban particulate matter PM1648 can exacerbate airway responsiveness and alter the early inflammatory state, a unique murine model was created using DO11.10 mice, transgenic for a T cell receptor recognizing ovalbumin(323-339). Because these mice are sensitive to ovalbumin, immunization procedures involving adjuvant or long aerosolization procedures are not necessary and, therefore, allow for the study of an acute AR response to particulate and antigen in young animals. AR was assessed by barometric whole body plethysmography and measured by enhanced pause (Penh). PM1648 and ovalbumin were administered intranasally 72 and 4 h before to AR assessment, respectively. A dose-response relationship between PM1648 and Penh was determined, and doses at or above 500 microg had Penh values significantly higher than saline controls. Penh values of control particle titanium dioxide (TiO(2)) were similar to saline controls demonstrating no nonspecific particulate effect on AR. Lung lavage at time of AR assessment showed no significant inflammation due to particulate exposure or ovalbumin alone; however, PM1648/ovalbumin and TiO(2)/ovalbumin combinations resulted in significant neutrophilia. In addition, treatment with polymyxin B to remove surface-bound endotoxin did not significantly affect Penh levels. These results indicate that PM1648 specifically increases AR in a dose-dependent manner and that this exacerbation is not a direct response to increased neutrophil concentration, particle-bound endotoxin or nonspecific particle effects.
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Affiliation(s)
- Amy J Archer
- Center for Environmental Health Sciences, Department of Pharmaceutical Sciences, University of Montana, Missoula, MT 59812, USA
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