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Bozzola E, Agostiniani R, Pacifici Noja L, Park J, Lauriola P, Nicoletti T, Taruscio D, Taruscio G, Mantovani A. The impact of indoor air pollution on children's health and well-being: the experts' consensus. Ital J Pediatr 2024; 50:69. [PMID: 38616250 PMCID: PMC11017701 DOI: 10.1186/s13052-024-01631-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 03/13/2024] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND Pollution of the indoor environment represents a concern for human health, mainly in case of prolonged exposure such as in the case of women, children, the elderly, and the chronically ill, who spend most of their time in closed environments. MAIN BODY The aim of the study is to organize a group of experts in order to evaluate the evidence and discuss the main risk factors concerning indoor air and the impact on human health as well as challenging factors regarding preventive strategies to reduce pollution. The experts highlighted the main risk factors concerning indoor air, including poor ventilation, climatic conditions, chemical substances, and socio-economic status. They discussed the impact on human health in terms of mortality and morbidity, as well as challenging factors regarding preventive strategies to reduce pollution. CONCLUSION The experts identified strategies that can be reinforced to reduce indoor pollution and prevent negative consequences on human health at national and local levels.
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Affiliation(s)
- Elena Bozzola
- Pediatric Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
| | | | | | - Jibin Park
- Saint Camillus International University of Health Sciences, Rome, Italy
| | - Paolo Lauriola
- Rete Italiana Medici Sentinella per l'Ambiente (RIMSA), ISDE/FNOMCeO, Rome, Italy
| | - Tiziana Nicoletti
- Association of the chronically ill and rare patients, Cittadinazattiva APS, Rome, Italy
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2
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Cowan K, Semmens EO, Lee JY, Walker ES, Smith PG, Fu L, Singleton R, Cox SM, Faiella J, Chassereau L, Lawrence L, Ying J, Baldner J, Garza M, Annett R, Chervinskiy SK, Snowden J. Bronchiolitis recovery and the use of High Efficiency Particulate Air (HEPA) Filters (The BREATHE Study): study protocol for a multi-center, parallel, double-blind, randomized controlled clinical trial. Trials 2024; 25:197. [PMID: 38504367 PMCID: PMC10953277 DOI: 10.1186/s13063-024-08012-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 02/23/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Acute viral bronchiolitis is the most common reason for hospitalization of infants in the USA. Infants hospitalized for bronchiolitis are at high risk for recurrent respiratory symptoms and wheeze in the subsequent year, and longer-term adverse respiratory outcomes such as persistent childhood asthma. There are no effective secondary prevention strategies. Multiple factors, including air pollutant exposure, contribute to risk of adverse respiratory outcomes in these infants. Improvement in indoor air quality following hospitalization for bronchiolitis may be a prevention opportunity to reduce symptom burden. Use of stand-alone high efficiency particulate air (HEPA) filtration units is a simple method to reduce particulate matter ≤ 2.5 µm in diameter (PM2.5), a common component of household air pollution that is strongly linked to health effects. METHODS BREATHE is a multi-center, parallel, double-blind, randomized controlled clinical trial. Two hundred twenty-eight children < 12 months of age hospitalized for the first time with bronchiolitis will participate. Children will be randomized 1:1 to receive a 24-week home intervention with filtration units containing HEPA and carbon filters (in the child's sleep space and a common room) or to a control group with units that do not contain HEPA and carbon filters. The primary objective is to determine if use of HEPA filtration units reduces respiratory symptom burden for 24 weeks compared to use of control units. Secondary objectives are to assess the efficacy of the HEPA intervention relative to control on (1) number of unscheduled healthcare visits for respiratory complaints, (2) child quality of life, and (3) average PM2.5 levels in the home. DISCUSSION We propose to test the use of HEPA filtration to improve indoor air quality as a strategy to reduce post-bronchiolitis respiratory symptom burden in at-risk infants with severe bronchiolitis. If the intervention proves successful, this trial will support use of HEPA filtration for children with bronchiolitis to reduce respiratory symptom burden following hospitalization. TRIAL REGISTRATION NCT05615870. Registered on November 14, 2022.
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Affiliation(s)
- Kelly Cowan
- Department of Pediatrics, Larner College of Medicine at the University of Vermont, 111 Colchester Ave, Smith 5, Burlington, VT, 05403, USA.
| | - Erin O Semmens
- School of Public and Community Health Sciences, University of Montana, 177 Skaggs, Missoula, MT, 59812-2016, USA
| | - Jeannette Y Lee
- University of Arkansas for Medical Sciences, 4301 West Markham, #781, Little Rock, AR, 72205, USA
| | - Ethan S Walker
- School of Public and Community Health Sciences, University of Montana, 177 Skaggs, Missoula, MT, 59812-2016, USA
| | - Paul G Smith
- School of Public and Community Health Sciences, University of Montana, 177 Skaggs, Missoula, MT, 59812-2016, USA
| | - Linda Fu
- National Institutes of Health Environmental Influences On Child, Health Outcomes (ECHO) Program, 11601, Landsdown Street, Rockville, MD, 20852, USA
| | - Rosalyn Singleton
- Alaska Native Tribal Health Consortium, AIP-CDC, 4055 Tudor Centre Drive, Anchorage, AK, 99508, USA
| | - Sara McClure Cox
- School of Public and Community Health Sciences, University of Montana, 177 Skaggs, Missoula, MT, 59812-2016, USA
| | - Jennifer Faiella
- School of Public and Community Health Sciences, University of Montana, 177 Skaggs, Missoula, MT, 59812-2016, USA
| | - Laurie Chassereau
- University of Vermont, Given C421, 89 Beaumont Ave, Burlington, VT, 05405, USA
| | - Lora Lawrence
- IDeA States Pediatric Network Data Coordination and Operations Center, 13 Children's Way, Slot 512-35, Little Rock, AR, 72202, USA
| | - Jun Ying
- Department of Family Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Mail Stop F496, Academic Office One L15-3407, 12631 E 17th Avenue, Aurora, CO, 80045, USA
| | - Jaime Baldner
- Department of Biomedical Informatics, University of Arkansas for Medical Sciences, 4301 W Markham Street, Little Rock, AR, 72205, USA
| | - Maryam Garza
- Department of Biomedical Informatics, University of Arkansas for Medical Sciences, 4301 W Markham Street, Little Rock, AR, 72205, USA
| | - Robert Annett
- University of New Mexico Health Sciences Center, Albuquerque, NM, 87106, USA
| | - Sheva K Chervinskiy
- Cook Children's Department of Immunology, 1500 Cooper St, Fort Worth, TX, 76104, USA
| | - Jessica Snowden
- IDeA States Pediatric Network Data Coordination and Operations Center, 13 Children's Way, Slot 512-35, Little Rock, AR, 72202, USA
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3
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Nassikas NJ, McCormack MC, Ewart G, Balmes JR, Bond TC, Brigham E, Cromar K, Goldstein AH, Hicks A, Hopke PK, Meyer B, Nazaroff WW, Paulin LM, Rice MB, Thurston GD, Turpin BJ, Vance ME, Weschler CJ, Zhang J, Kipen HM. Indoor Air Sources of Outdoor Air Pollution: Health Consequences, Policy, and Recommendations: An Official American Thoracic Society Workshop Report. Ann Am Thorac Soc 2024; 21:365-376. [PMID: 38426826 PMCID: PMC10913763 DOI: 10.1513/annalsats.202312-1067st] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024] Open
Abstract
Indoor sources of air pollution worsen indoor and outdoor air quality. Thus, identifying and reducing indoor pollutant sources would decrease both indoor and outdoor air pollution, benefit public health, and help address the climate crisis. As outdoor sources come under regulatory control, unregulated indoor sources become a rising percentage of the problem. This American Thoracic Society workshop was convened in 2022 to evaluate this increasing proportion of indoor contributions to outdoor air quality. The workshop was conducted by physicians and scientists, including atmospheric and aerosol scientists, environmental engineers, toxicologists, epidemiologists, regulatory policy experts, and pediatric and adult pulmonologists. Presentations and discussion sessions were centered on 1) the generation and migration of pollutants from indoors to outdoors, 2) the sources and circumstances representing the greatest threat, and 3) effective remedies to reduce the health burden of indoor sources of air pollution. The scope of the workshop was residential and commercial sources of indoor air pollution in the United States. Topics included wood burning, natural gas, cooking, evaporative volatile organic compounds, source apportionment, and regulatory policy. The workshop concluded that indoor sources of air pollution are significant contributors to outdoor air quality and that source control and filtration are the most effective measures to reduce indoor contributions to outdoor air. Interventions should prioritize environmental justice: Households of lower socioeconomic status have higher concentrations of indoor air pollutants from both indoor and outdoor sources. We identify research priorities, potential health benefits, and mitigation actions to consider (e.g., switching from natural gas to electric stoves and transitioning to scent-free consumer products). The workshop committee emphasizes the benefits of combustion-free homes and businesses and recommends economic, legislative, and education strategies aimed at achieving this goal.
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4
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Ebrahimifakhar A, Poursadegh M, Hu Y, Yuill DP, Luo Y. A systematic review and meta-analysis of field studies of portable air cleaners: Performance, user behavior, and by-product emissions. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 912:168786. [PMID: 38008326 DOI: 10.1016/j.scitotenv.2023.168786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 11/08/2023] [Accepted: 11/20/2023] [Indexed: 11/28/2023]
Abstract
Indoor air quality is important for the health of building occupants, and public interest in controlling indoor airborne pathogens increased dramatically with the COVID-19 pandemic. Pollutant concentrations can be controlled locally using portable air cleaners (sometimes called air purifiers), which allow occupants to apply air cleaning technology to meet their needs in the location and times that they find appropriate. This paper provides a systematic review of scientific literature that describes field studies of the effectiveness of portable air cleaners. Over 500 papers were considered, and 148 were reviewed in detail, to extract 35 specific research results (e.g., particulate removal performance) or characteristics (e.g., type of building). These were aggregated to provide an overview of results and approaches to this type of research, and to provide meta-analyses of the results. The review includes: descriptions of the geographical location of the research; rate of publications over time; types of buildings and occupants in the field study; types of air cleaner technology being tested; pollutants being measured; resulting pollutant removal effectiveness; patterns of usage and potential barriers to usage by occupants; and the potential for by-product emissions in some air cleaner technologies. An example result is that 83 of the 148 papers measured reductions in fine particulates (PM2.5) and found a mean reduction of 49 % with standard deviation of 20 %. The aggregated results were approximately normally distributed, ranging from finding no significant reduction up to a maximum above 90 % reduction. Sixteen of the 148 papers considered gaseous pollutants, such as volatile organic compounds, nitrogen dioxide, and ozone; 36 papers considered biological pollutants, such as bacteria, viruses, pollen, fungi, etc. An important challenge, common to several studies, is that occupants run the air cleaners for shorter periods and on low airflow rate settings, because of concerns about noise, drafts, and electricity cost, which significantly reduces air cleaning effectiveness.
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Affiliation(s)
- Amir Ebrahimifakhar
- Delos Labs, Delos, New York, NY 10014, USA; Durham School of Architectural Engineering and Construction, University of Nebraska - Lincoln, 1110 S. 67th Street, Omaha, NE 68182, USA.
| | - Mehrdad Poursadegh
- Durham School of Architectural Engineering and Construction, University of Nebraska - Lincoln, 1110 S. 67th Street, Omaha, NE 68182, USA.
| | - Yifeng Hu
- Durham School of Architectural Engineering and Construction, University of Nebraska - Lincoln, 1110 S. 67th Street, Omaha, NE 68182, USA; Buildings and Transportation Science Division, Oak Ridge National Laboratory, Oak Ridge, TN 37830, USA.
| | - David P Yuill
- Durham School of Architectural Engineering and Construction, University of Nebraska - Lincoln, 1110 S. 67th Street, Omaha, NE 68182, USA.
| | - Yu Luo
- Department of Applied Physics and Applied Mathematics, Columbia University, 500 W. 120th Street, New York, NY 10027, USA.
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5
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Gould CF, Davila L, Bejarano ML, Burke M, Jack DW, Schlesinger SB, Mora JR, Valarezo A. Exposure to Nitrogen Dioxide and Fine Particulate Matter When Cooking with Electricity Compared to Gas, a Randomized Crossover Study in Quito, Ecuador. ENVIRONMENTAL HEALTH PERSPECTIVES 2024; 132:17702. [PMID: 38261301 PMCID: PMC10805131 DOI: 10.1289/ehp13134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 12/11/2023] [Accepted: 01/02/2024] [Indexed: 01/24/2024]
Affiliation(s)
- Carlos F. Gould
- Doerr School of Sustainability, Stanford University, Stanford, California, USA
- Herbert Wertheim School of Public Health and Longevity Science, University of California, San Diego, California, USA
| | - Lissete Davila
- Institute for Energy and Materials, Universidad San Francisco de Quito, Quito, Ecuador
| | - M. Lorena Bejarano
- Institute for Energy and Materials, Universidad San Francisco de Quito, Quito, Ecuador
| | - Marshall Burke
- Doerr School of Sustainability, Stanford University, Stanford, California, USA
- Center on Food Security and the Environment, Stanford University, Palo Alto, California, USA
- National Bureau of Economic Research, Cambridge, Massachusetts, USA
| | - Darby W. Jack
- Department of Environmental Health Sciences, Columbia University, New York, New York, USA
| | | | - José R. Mora
- Department of Chemical Engineering, Universidad San Francisco de Quito, Quito, Ecuador
| | - Alfredo Valarezo
- Institute for Energy and Materials, Universidad San Francisco de Quito, Quito, Ecuador
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6
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Paulin LM, Samet JM, Rice MB. Gas Stoves and Respiratory Health: Decades of Data, but Not Enough Progress. Ann Am Thorac Soc 2023; 20:1697-1699. [PMID: 37703392 PMCID: PMC10704234 DOI: 10.1513/annalsats.202306-533vp] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 09/13/2023] [Indexed: 09/15/2023] Open
Affiliation(s)
- Laura M. Paulin
- Section of Pulmonary and Critical Care, Department of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| | | | - Mary B. Rice
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
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7
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Woollacott J, Alsufyani W, Beach RH, T. R. Morrison L, Bean de Hernández A, Rakic S, AlOmran M, Alsukait RF, Herbst CH, AlBalawi S. Effective options for addressing air quality– related environmental public health burdens in Saudi Arabia. Heliyon 2022; 8:e10335. [PMID: 36097490 PMCID: PMC9463589 DOI: 10.1016/j.heliyon.2022.e10335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 07/15/2022] [Accepted: 08/12/2022] [Indexed: 11/24/2022] Open
Abstract
Air pollution poses major disease burdens globally and accounts for approximately 10% of deaths annually through its contribution to a variety of respiratory, cardiovascular, and other diseases. The burden of disease is particularly acute in Saudi Arabia, where a mix of anthropogenic and natural sources of air pollution threatens public health. Addressing these burdens requires careful study of the costs and effectiveness of available technologies and policies for reducing emissions (mitigation) and avoiding exposure (adaptation). To help evaluate these options, we conduct a semi-systematic literature review of over 3,000 articles published since 2010 that were identified by searches of literature focused on pollution mitigation and pollution adaptation. We identify a wide variety of effective mitigation and adaptation technologies and find that cost-effectiveness information for policy design is highly variable in the case of mitigation, both within and across pollution source categories; or scarce, in the case of adaptation. While pollution control costs are well studied, policy costs differ; these may vary more by location because of factors such as technology operating conditions and behavioral responses to adaptation initiatives, limiting the generalizability of cost-effectiveness information. Moreover, potential cost advantages of multipollutant control policies are likely to depend on the existing mix of pollution sources and controls. While the policy literature generally favors more flexible compliance mechanisms that increase the cost of polluting to reflect its costs to society, important policy design factors include policy co-benefits, distributional concerns, and inter-regional harmonization. In addition to these key themes, we find that further study is needed both to improve the availability of cost information for adaptation interventions and to localize technology and policy cost estimates to the Saudi context. Literature review of environmental public health technology and policy options. Air pollution mitigation options have considerable cost variation. Air pollution adaptation options lack thorough cost effectiveness evaluation. Policy effectiveness will depend heavily on local conditions and design. Saudi Arabia requires a mix of mitigation and adaptation public health options.
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8
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Carson SW, Psoter K, Koehler K, Siklosi KR, Montemayor K, Toporek A, West NE, Lechtzin N, Hansel NN, Collaco JM, Merlo CA. Indoor air pollution exposure is associated with greater morbidity in cystic fibrosis. J Cyst Fibros 2022; 21:e129-e135. [PMID: 34531156 PMCID: PMC8918065 DOI: 10.1016/j.jcf.2021.08.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 08/10/2021] [Accepted: 08/22/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Exposure to higher levels of outdoor air pollution is associated with increased morbidity in individuals with cystic fibrosis. Limited information exist regarding the potential adverse effects of indoor air pollution on those with cystic fibrosis. METHODS Individuals with cystic fibrosis who were enrolled in the Twin and Sibling Study from 2000-2013, self-reported exposure to four known sources of indoor air pollution (secondhand smoke, forced hot air, wood stove and fireplace). Change in lung function, rates of hospitalizations and pulmonary exacerbations were followed over 4 years to compare outcomes in those who were exposed to those who were not exposed. RESULTS Of 1432 participants with data on secondhand smoke exposure, 362 (25.3%) were exposed. Of 765 individuals with data on forced hot air exposure, 491 (64.2%) were exposed. Of 1247 participants with data on wood stove exposure and 830 with data on fireplace exposure, 182 (14.6%) and 373 (44.9%) were exposed, respectively. In longitudinal analysis, pediatric individuals either exposed to secondhand smoke or to forced hot air had a 0.60% predicted/year decrease in FEV1% predicted (P=0.002) or a 0.46% predicted/year decrease in FEV1% predicted (P=0.048), respectively compared to individuals who were not exposed. Adults exposed to secondhand smoke had a 42% increased yearly risk of hospitalization compared to those who were not exposed (P=0.045). CONCLUSIONS Our questionnaire-based data suggest that exposure to sources of indoor air pollution increase morbidity in both the pediatric and adult cystic fibrosis populations. Future studies with quantitative indoor air quality assessments are needed.
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Affiliation(s)
- Sara W. Carson
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD
| | - Kevin Psoter
- Department of Pediatrics, Division of General Pediatrics, Johns Hopkins University, Baltimore, MD
| | - Kirsten Koehler
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Karen R. Siklosi
- Department of Pediatrics, Division of Pulmonology, Johns Hopkins University, Baltimore, MD
| | - Kristina Montemayor
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD
| | - Alexandra Toporek
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD
| | - Natalie E. West
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD
| | - Noah Lechtzin
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD
| | - Nadia N. Hansel
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD
| | - Joseph M. Collaco
- Department of Pediatrics, Division of Pulmonology, Johns Hopkins University, Baltimore, MD
| | - Christian A Merlo
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, MD,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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Meng X, Cao S, Li S, Yan M, Guo Q, Gong J, Liu Q, Zhang JJ, Duan X. Household environmental factors and children's respiratory health: comparison of two cross-sectional studies over 25 years in Wuhan, China. J Thorac Dis 2021; 13:4589-4600. [PMID: 34422384 PMCID: PMC8339747 DOI: 10.21037/jtd-20-2170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 04/05/2021] [Indexed: 11/24/2022]
Abstract
Background Over the recent decades, residential lifestyle and household environment have changed substantially with rapid development of industrialization and urbanization in China. Whether the prevalence of respiratory diseases changed is still lack of evidence. The objective of this study is to assess potential changes in children’s respiratory disease prevalence and associated household environmental factors in Wuhan over a 25-year time interval. Methods Two cross-sectional studies in the Period 1 (1993 to 1996) and Period 2 (2017 to 2018) were compared in this research. Elementary school children in period 1 (N=2,517) and in period 2 (N=3,152) were recruited in Wuhan, China. The respiratory health condition, home environmental factors, and family socioeconomic status of each subject were acquired through questionnaire survey using the same protocols in both periods. We used the Chi-square test to analyze the difference of household environmental factors (focused on three indoor air quality determinants) and children’s respiratory health condition between two periods. Logistic regression models were used to assess the impacts of household environmental determinants on children’s respiratory diseases and symptoms between the two studies, by adjusting a set of covariates. Results The three indoor air quality determinants have reduced substantially in prevalence from period 1 to period 2: environment tobacco smoke (ETS) from 86.6% to 45.9%, household coal use from 47.6% to 4.9%, and kitchen smoke from 58.9% to 7.3%. The prevalence of certain respiratory symptoms in children significantly decreased, such as cough with colds (51.1% to 41.6%) and phlegm with colds (22.3% to 17.7%). The prevalence of asthma was 2.5% and 2.4% and that of bronchitis was 27.1% and 29.8% in both periods. Coal use was a risk factor for asthma in period 1 (OR =2.34, 95% CI: 1.30–4.23), while it was not significantly associated with prevalence of asthma in period 2 (OR =0.60, 95% CI: 0.08–4.51). Conclusions Household indoor air quality determinants and respiratory health condition of children in Wuhan has been improved over the last 25 years. At present, kitchen smoke is an important factor affecting the prevalence of wheeze whatever child has a cold or not and reducing exposure to ETS could be beneficial to protect children to be less likely to develop bronchitis.
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Affiliation(s)
- Xin Meng
- School of Energy and Environmental Engineering, Beijing Key Laboratory of Resource-oriented Treatment of Industrial Pollutants, University of Science and Technology Beijing, Beijing, China.,Beijing Innovation Center for Engineering Science and Advanced Technology, State Key Joint Laboratory for Environmental Simulation and Pollution Control, College of Environmental Sciences and Engineering, And Center for Environment and Health, Peking University, Beijing, China
| | - Suzhen Cao
- School of Energy and Environmental Engineering, Beijing Key Laboratory of Resource-oriented Treatment of Industrial Pollutants, University of Science and Technology Beijing, Beijing, China
| | - Sai Li
- School of Energy and Environmental Engineering, Beijing Key Laboratory of Resource-oriented Treatment of Industrial Pollutants, University of Science and Technology Beijing, Beijing, China
| | - Meilin Yan
- Beijing Innovation Center for Engineering Science and Advanced Technology, State Key Joint Laboratory for Environmental Simulation and Pollution Control, College of Environmental Sciences and Engineering, And Center for Environment and Health, Peking University, Beijing, China
| | - Qian Guo
- School of Energy and Environmental Engineering, Beijing Key Laboratory of Resource-oriented Treatment of Industrial Pollutants, University of Science and Technology Beijing, Beijing, China
| | - Jicheng Gong
- Beijing Innovation Center for Engineering Science and Advanced Technology, State Key Joint Laboratory for Environmental Simulation and Pollution Control, College of Environmental Sciences and Engineering, And Center for Environment and Health, Peking University, Beijing, China
| | - Qin Liu
- School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Junfeng Jim Zhang
- Global Health Research Center, Duke Kunshan University, Kunshan, China.,Nicholas School of the Environment and Duke Global Health Institute, Duke University, Durham, USA.,Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xiaoli Duan
- School of Energy and Environmental Engineering, Beijing Key Laboratory of Resource-oriented Treatment of Industrial Pollutants, University of Science and Technology Beijing, Beijing, China
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10
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Fong WCG, Grevatt S, Potter S, Tidbury T, Kadalayil L, Bennett K, Larsson M, Nicolas F, Kurukulaaratchy R, Arshad SH. The Efficacy of the Dyson Air Purifier in Improving Asthma Control: Protocol for a Single-Center, Investigator-Led, Randomized, Double-Blind, Placebo-Controlled Trial. JMIR Res Protoc 2021; 10:e28624. [PMID: 34313599 PMCID: PMC8367098 DOI: 10.2196/28624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 05/19/2021] [Accepted: 05/19/2021] [Indexed: 11/13/2022] Open
Abstract
Background Indoor air quality has been shown to influence asthma control and outcomes. Air purifiers and high-efficiency particulate air filtration devices can improve indoor air quality by reducing the indoor levels of air pollution and allergens. However, the influence of this improved indoor air quality on asthma control remains unclear; hence, randomized controlled trials are needed to further elucidate this phenomenon. Objective This study aims to investigate the effect of reducing the levels of allergens and pollutants in the bedroom and living room through the use of Dyson air purifiers (Dyson Pure Cool) on asthma control. Methods This is an 18-month long, investigator-led, randomized, double-blinded, placebo-controlled, single-center trial. Subjects will be randomized in a 1:1 ratio to active or placebo Dyson filters. The primary outcome is the change in the scores of Asthma Control Questionnaire 6 and Asthma-specific Quality of Life Questionnaire from baseline. Secondary outcomes include changes in lung function (forced expiratory volume in one second, forced expiratory volume in one second/forced vital capacity ratio, and midexpiratory flows), peak expiratory flow measurements, airway hyperresponsiveness (assessed by methacholine bronchial challenge), fractional exhaled nitric oxide, and indoor air pollutant levels. The sample size will be 50 subjects, and all subjects will have a confirmed diagnosis of mild persistent to moderate persistent asthma along with an Asthma Control Questionnaire 6 score of >1.5. Results This study was approved by the West Midlands Research Ethics Committee (18/WM/0277). The study results will be published in peer-reviewed scientific journals; presented at relevant scientific conferences; and shared in plain English with participants in our newsletters, in our clinics, and via the David Hide Asthma and Allergy Research Centre website. Our trial began in September 2019 and is expected to end in August 2021. Conclusions This is a double-blinded, placebo-controlled, randomized, investigator-led study to investigate the efficacy of a novel air purifier in improving asthma control in adults. The trial period of 18 months will facilitate the collection of robust data and will therefore generate clear signals. However, this extended trial duration may lead to patient withdrawal. Furthermore, this trial is conducted at a single center and in a location with a homogenous cohort of people, which may affect translatability. Nonetheless, it is hoped that the findings of this trial may help further inform clinicians regarding the utility of this novel device as an adjunct in asthma care. Trial Registration ClinicalTrials.gov NCT04729530; https://clinicaltrials.gov/ct2/show/NCT04729530 International Registered Report Identifier (IRRID) DERR1-10.2196/28624
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Affiliation(s)
- Wei Chern Gavin Fong
- David Hide Asthma and Allergy Research Centre, Newport, United Kingdom.,School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Susan Grevatt
- David Hide Asthma and Allergy Research Centre, Newport, United Kingdom
| | - Stephen Potter
- David Hide Asthma and Allergy Research Centre, Newport, United Kingdom
| | - Tracey Tidbury
- David Hide Asthma and Allergy Research Centre, Newport, United Kingdom
| | - Latha Kadalayil
- David Hide Asthma and Allergy Research Centre, Newport, United Kingdom.,School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Kaisha Bennett
- David Hide Asthma and Allergy Research Centre, Newport, United Kingdom
| | - Maria Larsson
- David Hide Asthma and Allergy Research Centre, Newport, United Kingdom
| | - Frédéric Nicolas
- Dyson Technology Limited, Tetbury Hill, Malmesbury, Wiltshire, United Kingdom
| | - Ramesh Kurukulaaratchy
- David Hide Asthma and Allergy Research Centre, Newport, United Kingdom.,School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Syed Hasan Arshad
- David Hide Asthma and Allergy Research Centre, Newport, United Kingdom.,School of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
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11
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Raju S, Siddharthan T, McCormack MC. Indoor Air Pollution and Respiratory Health. Clin Chest Med 2021; 41:825-843. [PMID: 33153698 DOI: 10.1016/j.ccm.2020.08.014] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Worldwide, more than 4 million deaths annually are attributed to indoor air pollution. This largely preventable exposure represents a key target for reducing morbidity and mortality worldwide. Significant respiratory health effects are observed, ranging from attenuated lung growth and development in childhood to accelerated lung function decline and is determined by chronic obstructive pulmonary disease later in life. Personal exposure to household air pollutants include household characteristics, combustion of solid fuels, cooking practices, and household pest allergens. This review outlines important sources of indoor air pollution, their respiratory health effects, and strategies to reduce household pollution and improve lung health across the globe.
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Affiliation(s)
- Sarath Raju
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Johns Hopkins School of Medicine, 1830 East Monument Street Fifth Floor, Baltimore, MD, 21287, USA.
| | - Trishul Siddharthan
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Johns Hopkins School of Medicine, 1830 East Monument Street Fifth Floor, Baltimore, MD, 21287, USA
| | - Meredith C McCormack
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University, Johns Hopkins School of Medicine, 1830 East Monument Street Fifth Floor, Baltimore, MD, 21287, USA
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12
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Indoor Exposure to Selected Air Pollutants in the Home Environment: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17238972. [PMID: 33276576 PMCID: PMC7729884 DOI: 10.3390/ijerph17238972] [Citation(s) in RCA: 118] [Impact Index Per Article: 29.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 11/22/2020] [Accepted: 11/27/2020] [Indexed: 11/17/2022]
Abstract
(1) Background: There is increasing awareness that the quality of the indoor environment affects our health and well-being. Indoor air quality (IAQ) in particular has an impact on multiple health outcomes, including respiratory and cardiovascular illness, allergic symptoms, cancers, and premature mortality. (2) Methods: We carried out a global systematic literature review on indoor exposure to selected air pollutants associated with adverse health effects, and related household characteristics, seasonal influences and occupancy patterns. We screened records from six bibliographic databases: ABI/INFORM, Environment Abstracts, Pollution Abstracts, PubMed, ProQuest Biological and Health Professional, and Scopus. (3) Results: Information on indoor exposure levels and determinants, emission sources, and associated health effects was extracted from 141 studies from 29 countries. The most-studied pollutants were particulate matter (PM2.5 and PM10); nitrogen dioxide (NO2); volatile organic compounds (VOCs) including benzene, toluene, xylenes and formaldehyde; and polycyclic aromatic hydrocarbons (PAHs) including naphthalene. Identified indoor PM2.5 sources include smoking, cooking, heating, use of incense, candles, and insecticides, while cleaning, housework, presence of pets and movement of people were the main sources of coarse particles. Outdoor air is a major PM2.5 source in rooms with natural ventilation in roadside households. Major sources of NO2 indoors are unvented gas heaters and cookers. Predictors of indoor NO2 are ventilation, season, and outdoor NO2 levels. VOCs are emitted from a wide range of indoor and outdoor sources, including smoking, solvent use, renovations, and household products. Formaldehyde levels are higher in newer houses and in the presence of new furniture, while PAH levels are higher in smoking households. High indoor particulate matter, NO2 and VOC levels were typically associated with respiratory symptoms, particularly asthma symptoms in children. (4) Conclusions: Household characteristics and occupant activities play a large role in indoor exposure, particularly cigarette smoking for PM2.5, gas appliances for NO2, and household products for VOCs and PAHs. Home location near high-traffic-density roads, redecoration, and small house size contribute to high indoor air pollution. In most studies, air exchange rates are negatively associated with indoor air pollution. These findings can inform interventions aiming to improve IAQ in residential properties in a variety of settings.
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Carlsten C, Salvi S, Wong GWK, Chung KF. Personal strategies to minimise effects of air pollution on respiratory health: advice for providers, patients and the public. Eur Respir J 2020; 55:1902056. [PMID: 32241830 PMCID: PMC7270362 DOI: 10.1183/13993003.02056-2019] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 02/24/2020] [Indexed: 11/11/2022]
Abstract
As global awareness of air pollution rises, so does the imperative to provide evidence-based recommendations for strategies to mitigate its impact. While public policy has a central role in reducing air pollution, exposure can also be reduced by personal choices. Qualified evidence supports limiting physical exertion outdoors on high air pollution days and near air pollution sources, reducing near-roadway exposure while commuting, utilising air quality alert systems to plan activities, and wearing facemasks in prescribed circumstances. Other strategies include avoiding cooking with solid fuels, ventilating and isolating cooking areas, and using portable air cleaners fitted with high-efficiency particulate air filters. We detail recommendations to assist providers and public health officials when advising patients and the public regarding personal-level strategies to mitigate risk imposed by air pollution, while recognising that well-designed prospective studies are urgently needed to better establish and validate interventions that benefit respiratory health in this context.
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Affiliation(s)
- Christopher Carlsten
- Air Pollution Exposure Laboratory, Dept of Medicine, University of British Columbia, Vancouver, BC, Canada
| | | | - Gary W K Wong
- Dept of Pediatrics and School of Public Health, Chinese University of Hong Kong, Shatin, Hong Kong
| | - Kian Fan Chung
- Faculty of Medicine, National Heart and Lung Institute, Imperial College London, Royal Brompton and Harefield NHS Foundation Trust, London, UK
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Conrad L, Perzanowski MS. The Role of Environmental Controls in Managing Asthma in Lower-Income Urban Communities. Clin Rev Allergy Immunol 2020; 57:391-402. [PMID: 30903438 DOI: 10.1007/s12016-019-08727-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Children living in lower-income urban communities are at much greater risk of developing asthma, going to the emergency department for an asthma attack and being hospitalized for asthma than children living in upper- and middle-income communities. For many asthmatic children living in urban communities, especially those with greater morbidity, the allergic pathway is important in the etiology of the disease. The stages of developing allergic disease can be divided into the onset of allergic sensitization, development of allergic disease and subsequent exacerbations, and it is useful to consider the relevance of interventions at each of these stages. Indoor allergens and environmental exposures are a major contributor to allergic disease, particularly among lower socioeconomic status, urban, minority communities. These exposures include allergens, environmental tobacco smoke, combustion by-products, and mold, all of which can play an important role in asthma progression as well as morbidity. These exposures are often not found in isolation and thus these concomitant exposures need to be considered when conducting environmental interventions. There have been numerous studies looking at both primary and tertiary prevention strategies and the impact on allergic sensitization and asthma with varied results. While the outcomes of these studies have been mixed, what has emerged is the need for tertiary interventions to be targeted to the individual and to reduce all relevant exposures to which an asthmatic child is exposed and sensitized. In addition, effective intervention strategies must also consider other social determinants of asthma morbidity impacting low socioeconomic, urban communities.
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Affiliation(s)
- Laura Conrad
- Division of Pulmonology, Department of Pediatrics, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Matthew S Perzanowski
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, 722 West 168th Street, 11th floor, New York, NY, 10032, USA.
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Permaul P, Gaffin JM, Petty CR, Baxi SN, Lai PS, Sheehan WJ, Camargo CA, Gold DR, Phipatanakul W. Obesity may enhance the adverse effects of NO 2 exposure in urban schools on asthma symptoms in children. J Allergy Clin Immunol 2020; 146:813-820.e2. [PMID: 32197971 DOI: 10.1016/j.jaci.2020.03.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 02/26/2020] [Accepted: 03/09/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Sparse data address the effects of nitrogen dioxide (NO2) exposure in inner-city schools on obese students with asthma. OBJECTIVE We sought to evaluate relationships between classroom NO2 exposure and asthma symptoms and morbidity by body mass index (BMI) category. METHODS The School Inner-City Asthma Study enrolled students aged 4 to 13 years with asthma from 37 inner-city schools. Students had baseline determination of BMI percentile. Asthma symptoms, morbidity, pulmonary inflammation, and lung function were monitored throughout the subsequent academic year. Classroom NO2 data, linked to enrolled students, were collected twice per year. We determined the relationship between classroom NO2 levels and asthma outcomes by BMI stratification. RESULTS A total of 271 predominantly black (35%) or Hispanic students (35%) were included in analyses. Fifty percent were normal weight (5-84th BMI percentile), 15% overweight (≥85-94th BMI percentile), and 35% obese (≥95th BMI percentile). For each 10-parts per billion increase in NO2, obese students had a significant increase in the odds of having an asthma symptom day (odds ratio [OR], 1.86; 95% CI, 1.15-3.02) and in days caregiver changed plans (OR, 4.24; 95% CI, 2.33-7.70), which was significantly different than normal weight students who exhibited no relationship between NO2 exposure and symptom days (OR, 0.90; 95% CI, 0.57-1.42; pairwise interaction P = .03) and change in caregiver plans (OR, 1.37; 95% CI, 0.67-2.82; pairwise interaction P = .02). Relationships between NO2 levels and lung function and fractional exhaled nitric oxide did not differ by BMI category. If we applied a conservative Holm-Bonferroni correction for 16 comparisons (obese vs normal weight and overweight vs normal weight for 8 outcomes), these findings would not meet statistical significance (all P > .003). CONCLUSIONS Obese BMI status appears to increase susceptibility to classroom NO2 exposure effects on asthma symptoms in inner-city children. Environmental interventions targeting indoor school NO2 levels may improve asthma health for obese children. Although our findings would not remain statistically significant after adjustment for multiple comparisons, the large effect sizes warrant future study of the interaction of obesity and pollution in pediatric asthma.
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Affiliation(s)
- Perdita Permaul
- Division of Pediatric Pulmonology, Allergy and Immunology, New York-Presbyterian/Weill Cornell Medicine, New York, NY; Weill Cornell Medical College, New York, NY
| | - Jonathan M Gaffin
- Division of Pulmonary Medicine, Boston Children's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass
| | - Carter R Petty
- Clinical Research Center, Boston Children's Hospital, Boston, Mass
| | - Sachin N Baxi
- Division of Allergy and Immunology, Boston Children's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass
| | - Peggy S Lai
- Harvard Medical School, Boston, Mass; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Mass; Division of Pulmonary and Critical Care, Massachusetts General Hospital, Boston, Mass
| | - William J Sheehan
- Division of Allergy and Immunology, Children's National Health System, Washington, DC; George Washington University School of Medicine, Washington, DC
| | - Carlos A Camargo
- Harvard Medical School, Boston, Mass; Department of Emergency Medicine, Massachusetts General Hospital, Boston, Mass
| | - Diane R Gold
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Mass; Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Mass
| | - Wanda Phipatanakul
- Division of Allergy and Immunology, Boston Children's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass.
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16
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Zhou S, Young CJ, VandenBoer TC, Kowal SF, Kahan TF. Time-Resolved Measurements of Nitric Oxide, Nitrogen Dioxide, and Nitrous Acid in an Occupied New York Home. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2018; 52:8355-8364. [PMID: 29973042 DOI: 10.1021/acs.est.8b01792] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Indoor oxidizing capacity in occupied residences is poorly understood. We made simultaneous continuous time-resolved measurements of ozone (O3), nitric oxide (NO), nitrogen dioxide (NO2), and nitrous acid (HONO) for two months in an occupied detached home with gas appliances in Syracuse, NY. Indoor NO and HONO mixing ratios were higher than those outdoors, whereas O3 was much lower (sub-ppbv) indoors. Cooking led to peak NO, NO2, and HONO levels 20-100 times greater than background levels; HONO mixing ratios of up to 50 ppbv were measured. Our results suggest that many reported NO2 levels may have a large positive bias due to HONO interference. Nitrous acid, NO2, and NO were removed from indoor air more rapidly than CO2, indicative of reactive removal processes or surface uptake. We measured spectral irradiance from sunlight entering the residence through glass doors; hydroxyl radical (OH) production rates of (0.8-10) × 107 molecules cm-3 s-1 were calculated in sunlit areas due to HONO photolysis, in some cases exceeding rates expected from ozone-alkene reactions. Steady-state nitrate radical (NO3) mixing ratios indoors were predicted to be lower than 1.65 × 104 molecules cm-3. This work will help constrain the temporal nature of oxidant concentrations in occupied residences and will improve indoor chemistry models.
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Affiliation(s)
- Shan Zhou
- Department of Chemistry , Syracuse University , Syracuse , New York 13244 , United States
| | - Cora J Young
- Department of Chemistry , York University , Toronto , Ontario M3J 1P3 , Canada
| | - Trevor C VandenBoer
- Department of Chemistry , York University , Toronto , Ontario M3J 1P3 , Canada
| | - Shawn F Kowal
- Department of Chemistry , Syracuse University , Syracuse , New York 13244 , United States
| | - Tara F Kahan
- Department of Chemistry , Syracuse University , Syracuse , New York 13244 , United States
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17
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Underhill LJ, Fabian MP, Vermeer K, Sandel M, Adamkiewicz G, Leibler JH, Levy JI. Modeling the resiliency of energy-efficient retrofits in low-income multifamily housing. INDOOR AIR 2018; 28:459-468. [PMID: 29280511 PMCID: PMC6386461 DOI: 10.1111/ina.12446] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Accepted: 12/15/2017] [Indexed: 05/15/2023]
Abstract
Residential energy efficiency and ventilation retrofits (eg, building weatherization, local exhaust ventilation, HVAC filtration) can influence indoor air quality (IAQ) and occupant health, but these measures' impact varies by occupant activity. In this study, we used the multizone airflow and IAQ analysis program CONTAM to simulate the impacts of energy retrofits on indoor concentrations of PM2.5 and NO2 in a low-income multifamily housing complex in Boston, Massachusetts (USA). We evaluated the differential impact of residential activities, such as low- and high-emission cooking, cigarette smoking, and window opening, on IAQ across two seasons. We found that a comprehensive package of energy and ventilation retrofits was resilient to a range of occupant activities, while less holistic approaches without ventilation improvements led to increases in indoor PM2.5 or NO2 for some populations. In general, homes with simulated concentration increases included those with heavy cooking and no local exhaust ventilation, and smoking homes without HVAC filtration. Our analytical framework can be used to identify energy-efficient home interventions with indoor retrofit resiliency (ie, those that provide IAQ benefits regardless of occupant activity), as well as less resilient retrofits that can be coupled with behavioral interventions (eg, smoking cessation) to provide cost-effective, widespread benefits.
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Affiliation(s)
- Lindsay Jeanne Underhill
- Department of Environmental Health, Boston University School of Public Health, 715 Albany Street, Boston, MA 02118, USA
| | - Maria Patricia Fabian
- Department of Environmental Health, Boston University School of Public Health, 715 Albany Street, Boston, MA 02118, USA
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, 401 Park Drive, Boston, MA 02115, USA
| | - Kimberly Vermeer
- Urban Habitat Initiatives Inc., 328A Tremont Street, Boston, MA 02116, USA
| | - Megan Sandel
- Department of Pediatrics, Boston Medical University School of Medicine, 88 E. Newton St Vose Hall, Boston MA 02118, USA
| | - Gary Adamkiewicz
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, 401 Park Drive, Boston, MA 02115, USA
| | - Jessica H. Leibler
- Department of Environmental Health, Boston University School of Public Health, 715 Albany Street, Boston, MA 02118, USA
| | - Jonathan Ian Levy
- Department of Environmental Health, Boston University School of Public Health, 715 Albany Street, Boston, MA 02118, USA
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, 401 Park Drive, Boston, MA 02115, USA
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18
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Naja AS, Permaul P, Phipatanakul W. Taming Asthma in School-Aged Children: A Comprehensive Review. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2018; 6:726-735. [PMID: 29747980 PMCID: PMC5953205 DOI: 10.1016/j.jaip.2018.01.023] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 01/23/2018] [Accepted: 01/24/2018] [Indexed: 12/14/2022]
Abstract
Asthma is the most common chronic disease of childhood and the leading cause of childhood morbidity as measured by school absences, emergency department visits, and hospitalizations. Multiple factors play a role in the development, treatment and prevention of childhood asthma including racial/ethnic and socioeconomic disparities, both the home and school environments, and medication use. The goals of this review are to summarize these aspects of asthma in school-aged children and to present an updated review of medications as it relates to treatment strategies that will help in the care of these children. We conclude that phenotypic heterogeneity and appropriate environmental assessments and interventions are important considerations in the management of childhood asthma.
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Affiliation(s)
- Ahmad Salaheddine Naja
- Division of Allergy and Immunology, Boston Children's Hospital, Boston, Mass; Lebanese American University, Beirut, Lebanon
| | - Perdita Permaul
- Harvard Medical School, Boston, Mass; Division of Pediatric Allergy and Immunology, Massachusetts General Hospital for Children, Boston, Mass
| | - Wanda Phipatanakul
- Division of Allergy and Immunology, Boston Children's Hospital, Boston, Mass; Harvard Medical School, Boston, Mass.
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19
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Paulin LM, Williams D'AL, Peng R, Diette GB, McCormack MC, Breysse P, Hansel NN. 24-h Nitrogen dioxide concentration is associated with cooking behaviors and an increase in rescue medication use in children with asthma. ENVIRONMENTAL RESEARCH 2017; 159:118-123. [PMID: 28797886 PMCID: PMC5623630 DOI: 10.1016/j.envres.2017.07.052] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 07/24/2017] [Accepted: 07/31/2017] [Indexed: 05/06/2023]
Abstract
Exposure to nitrogen dioxide (NO2), a byproduct of combustion, is associated with poor asthma control in children. We sought to determine whether gas-fueled kitchen appliance use is associated with 24-h indoor NO2 concentrations and whether these concentrations are associated with asthma morbidity in children. Children aged 5-12 years old with asthma were eligible. Mean 24-h NO2 concentration was measured in the kitchen over a four-day sampling period and gas stove use was captured in time activity diaries. The relationship between stove and oven use and daily NO2 concentration was analyzed. Longitudinal analysis assessed the effect of daily NO2 exposure on symptoms, inhaler use, and lung function. Multivariate models were adjusted for age, sex, season, and maternal education. Thirty children contributed 126 participant days of sampling. Mean indoor 24-h NO2 concentration was 58(48)ppb with a median (range) of 45(12-276)ppb. All homes had gas stoves and furnaces. Each hour of kitchen appliance use was associated with an 18ppb increase in 24-h NO2 concentration. In longitudinal multivariate analysis, each ten-fold increase in previous-day NO2 was associated with increased nighttime inhaler use (OR = 4.9, p = 0.04). There were no associations between NO2 and lung function or asthma symptoms. Higher previous-day 24-h concentration of NO2 is associated with increased nighttime inhaler use in children with asthma.
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Affiliation(s)
- Laura M Paulin
- Johns Hopkins Pulmonary/Critical Care, Baltimore, MD, United States.
| | - D 'Ann L Williams
- Maryland Department of Health and Mental Hygiene, Baltimore, MD, United States
| | - Roger Peng
- Johns Hopkins Bloomberg School of Public Health, Balitmore, MD, United States
| | - Gregory B Diette
- Johns Hopkins Pulmonary/Critical Care, Baltimore, MD, United States
| | | | - Patrick Breysse
- Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Nadia N Hansel
- Johns Hopkins Pulmonary/Critical Care, Baltimore, MD, United States
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20
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Gold DR, Adamkiewicz G, Arshad SH, Celedón JC, Chapman MD, Chew GL, Cook DN, Custovic A, Gehring U, Gern JE, Johnson CC, Kennedy S, Koutrakis P, Leaderer B, Mitchell H, Litonjua AA, Mueller GA, O'Connor GT, Ownby D, Phipatanakul W, Persky V, Perzanowski MS, Ramsey CD, Salo PM, Schwaninger JM, Sordillo JE, Spira A, Suglia SF, Togias A, Zeldin DC, Matsui EC. NIAID, NIEHS, NHLBI, and MCAN Workshop Report: The indoor environment and childhood asthma-implications for home environmental intervention in asthma prevention and management. J Allergy Clin Immunol 2017; 140:933-949. [PMID: 28502823 PMCID: PMC5632590 DOI: 10.1016/j.jaci.2017.04.024] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 04/14/2017] [Indexed: 01/19/2023]
Abstract
Environmental exposures have been recognized as critical in the initiation and exacerbation of asthma, one of the most common chronic childhood diseases. The National Institute of Allergy and Infectious Diseases; National Institute of Environmental Health Sciences; National Heart, Lung, and Blood Institute; and Merck Childhood Asthma Network sponsored a joint workshop to discuss the current state of science with respect to the indoor environment and its effects on the development and morbidity of childhood asthma. The workshop included US and international experts with backgrounds in allergy/allergens, immunology, asthma, environmental health, environmental exposures and pollutants, epidemiology, public health, and bioinformatics. Workshop participants provided new insights into the biologic properties of indoor exposures, indoor exposure assessment, and exposure reduction techniques. This informed a primary focus of the workshop: to critically review trials and research relevant to the prevention or control of asthma through environmental intervention. The participants identified important limitations and gaps in scientific methodologies and knowledge and proposed and prioritized areas for future research. The group reviewed socioeconomic and structural challenges to changing environmental exposure and offered recommendations for creative study design to overcome these challenges in trials to improve asthma management. The recommendations of this workshop can serve as guidance for future research in the study of the indoor environment and on environmental interventions as they pertain to the prevention and management of asthma and airway allergies.
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Affiliation(s)
- Diane R Gold
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Mass; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Mass.
| | - Gary Adamkiewicz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Mass
| | - Syed Hasan Arshad
- David Hide Asthma and Allergy Research Centre, Isle of Wight, and Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Juan C Celedón
- Division of Pulmonary Medicine, Allergy and Immunology, Children's Hospital of Pittsburgh of the University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, Pa
| | | | - Ginger L Chew
- Centers for Disease Control and Prevention (CDC), National Center for Environmental Health, Division of Environmental Hazards and Health Effects | Air Pollution and Respiratory Health Branch, Atlanta, Ga
| | - Donald N Cook
- Immunity, Inflammation and Disease Laboratory, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC
| | - Adnan Custovic
- Section of Paediatrics and MRC and Asthma UK Centre in Allergic Mechanisms of Asthma, Imperial College London, London, United Kingdom
| | - Ulrike Gehring
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - James E Gern
- Departments of Pediatrics and Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wis
| | - Christine C Johnson
- Department of Public Health Sciences, Henry Ford Hospital & Health System, Detroit, Mich
| | - Suzanne Kennedy
- Department of Pediatrics, NC Children's Hospital, University of North Carolina, Chapel Hill, NC
| | - Petros Koutrakis
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Mass
| | - Brian Leaderer
- Yale School of Public Health, Yale School of Medicine, Yale School of Forestry and Environmental Studies, Center for Perinatal, Pediatric and Environmental Epidemiology (CPPEE), New Haven, Conn
| | | | - Augusto A Litonjua
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Mass
| | - Geoffrey A Mueller
- Genome Integrity and Structural Biology Laboratory, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC
| | - George T O'Connor
- Pulmonary Center, Boston University School of Medicine, Boston, Mass
| | - Dennis Ownby
- Division of Allergy-Immunology and Rheumatology, Department of Pediatrics, Augusta University, Augusta, Ga
| | - Wanda Phipatanakul
- Asthma, Allergy and Immunology, Boston Children's Hospital, Harvard Medical School, Boston, Mass
| | - Victoria Persky
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, Ill
| | - Matthew S Perzanowski
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY
| | - Clare D Ramsey
- Departments of Medicine and Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Päivi M Salo
- Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC
| | - Julie M Schwaninger
- Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, Md
| | - Joanne E Sordillo
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Mass
| | - Avrum Spira
- Division of Computational Biomedicine, Department of Medicine, Boston University School of Medicine, Boston, Mass
| | - Shakira F Suglia
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Ga
| | - Alkis Togias
- Division of Allergy, Immunology, and Transplantation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, Md
| | - Darryl C Zeldin
- Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC
| | - Elizabeth C Matsui
- Division of Pediatric Allergy/Immunology, Johns Hopkins University, Baltimore, Md
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21
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Abtahi M, Koolivand A, Dobaradaran S, Yaghmaeian K, Mohseni-Bandpei A, Khaloo SS, Jorfi S, Saeedi R. National and sub-national age-sex specific and cause-specific mortality and disability-adjusted life years (DALYs) attributable to household air pollution from solid cookfuel use (HAP) in Iran, 1990-2013. ENVIRONMENTAL RESEARCH 2017; 156:87-96. [PMID: 28340488 DOI: 10.1016/j.envres.2017.03.026] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 02/15/2017] [Accepted: 03/14/2017] [Indexed: 05/15/2023]
Abstract
National and sub-national mortality, years of life lost due to premature mortality (YLLs), years lived with disability (YLDs) and disability-adjusted life years (DALYs) for household air pollution from solid cookfuel use (HAP) in Iran, 1990-2013 were estimated based on the Global Burden of Disease Study 2013 (GBD 2013). The burden of disease attributable to HAP was quantified by the comparative risk assessment method using four inputs: (1) exposure to HAP, (2) the theoretical minimum risk exposure level (TMREL), (3) exposure-response relationships of related causes (4) disease burden of related causes. All across the country, solid fuel use decreased from 5.26% in 1990 to 0.15% in 2013. The drastic reduction of solid fuel use leaded to DALYs attributable to HAP fell by 97.8% (95% uncertainty interval 97.7-98.0%) from 87,433 (51072-144303) in 1990 to 1889 (1016-3247) in 2013. Proportion of YLLs in DALYs from HAP decreased from 95.7% in 1990 to 86.6% in 2013. Contribution of causes in the attributable DALYs was variable during the study period and in 2013 was in the following order: ischemic heart disease for 43.4%, chronic obstructive pulmonary disease for 24.7%, hemorrhagic stroke for 9.7%, lower respiratory infections for 9.3%, ischemic stroke for 7.8%, lung cancer for 3.4% and cataract for 1.8%. Based on the Gini coefficient, the spatial inequality of the disease burden from HAP increased during the study period. The remained burden of disease was relatively scarce and it mainly occurred in seven southern provinces. Further reduction of the disease burden from HAP as well as compensation of the increasing spatial inequality in Iran could be attained through an especial plan for providing cleaner fuels in the southern provinces.
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Affiliation(s)
- Mehrnoosh Abtahi
- Department of Environmental Health Engineering, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Koolivand
- Department of Environmental Health Engineering, Faculty of Health, Arak University of Medical Sciences, Arak, Iran
| | - Sina Dobaradaran
- The Persian Gulf Marine Biotechnology Research Center, Bushehr University of Medical Sciences, Bushehr, Iran; Department of Environmental Health Engineering, Faculty of Health, Bushehr University of Medical Sciences, Bushehr, Iran; Systems Environmental Health, Oil, Gas and Energy Research Center, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Kamyar Yaghmaeian
- Department of Environmental Health Engineering, School of Public Health and Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Anoushiravan Mohseni-Bandpei
- Department of Environmental Health Engineering, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shokooh Sadat Khaloo
- School of Health, Safety and Environment, Shahid Beheshti University of Medical Sciences, P.O. Box 16858-116, Tehran, Iran
| | - Sahand Jorfi
- Environmental Technology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; Department of Environmental Health Engineering, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Reza Saeedi
- Department of Health Sciences, School of Health, Safety and Environment, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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22
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Abstract
Indoor environmental exposures, particularly allergens and pollutants, are major contributors to asthma morbidity in children; environmental control practices aimed at reducing these exposures are an integral component of asthma management. Some individually tailored environmental control practices that have been shown to reduce asthma symptoms and exacerbations are similar in efficacy and cost to controller medications. As a part of developing tailored strategies regarding environmental control measures, an environmental history can be obtained to evaluate the key indoor environmental exposures that are known to trigger asthma symptoms and exacerbations, including both indoor pollutants and allergens. An environmental history includes questions regarding the presence of pets or pests or evidence of pests in the home, as well as knowledge regarding whether the climatic characteristics in the community favor dust mites. In addition, the history focuses on sources of indoor air pollution, including the presence of smokers who live in the home or care for children and the use of gas stoves and appliances in the home. Serum allergen-specific immunoglobulin E antibody tests can be performed or the patient can be referred for allergy skin testing to identify indoor allergens that are most likely to be clinically relevant. Environmental control strategies are tailored to each potentially relevant indoor exposure and are based on knowledge of the sources and underlying characteristics of the exposure. Strategies include source removal, source control, and mitigation strategies, such as high-efficiency particulate air purifiers and allergen-proof mattress and pillow encasements, as well as education, which can be delivered by primary care pediatricians, allergists, pediatric pulmonologists, other health care workers, or community health workers trained in asthma environmental control and asthma education.
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Dėdelė A, Miškinytė A. Seasonal variation of indoor and outdoor air quality of nitrogen dioxide in homes with gas and electric stoves. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2016; 23:17784-17792. [PMID: 27250086 DOI: 10.1007/s11356-016-6978-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 05/25/2016] [Indexed: 06/05/2023]
Abstract
Indoor air pollution significantly influences personal exposure to air pollution and increases health risks. Nitrogen dioxide (NO2) is one of the major air pollutants, and therefore it is important to properly determine indoor concentration of this pollutant considering the fact that people spend most of their time inside. The aim of this study was to assess indoor and outdoor concentration of NO2 during each season; for this purpose, passive sampling was applied. We analyzed homes with gas and electric stoves to determine and compare the concentrations of NO2 in kitchen, living room, and bedroom microenvironments (MEs). The accuracy of passive sampling was evaluated by comparing the sampling results with the data from air quality monitoring stations. The highest indoor concentration of NO2 was observed in kitchen ME during the winter period, the median concentration being 28.4 μg m(-3). Indoor NO2 levels in homes with gas stoves were higher than outdoor levels during all seasons. The concentration of NO2 was by 2.5 times higher in kitchen MEs with gas stoves than with electric stoves. This study showed that the concentration of NO2 in indoor MEs mainly depended on the stove type used in the kitchen. Homes with gas stoves had significantly higher levels of NO2 in all indoor MEs compared with homes where electric stoves were used.
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Affiliation(s)
- Audrius Dėdelė
- Department of Environmental Sciences, Vytautas Magnus University, Vileikos Street 8, 44404, Kaunas, Lithuania.
| | - Auksė Miškinytė
- Department of Environmental Sciences, Vytautas Magnus University, Vileikos Street 8, 44404, Kaunas, Lithuania
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24
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Abstract
Chronic Obstructive Pulmonary Disease (COPD) affects 12-16 million people in the United States and is the third-leading cause of death. In developed countries, smoking is the greatest risk factor for the development of COPD, but other exposures also contribute to the development and progression of the disease. Several studies suggest, though are not definitive, that outdoor air pollution exposure is linked to the prevalence and incidence of COPD. Among individuals with COPD, outdoor air pollutants are associated with loss of lung function and increased respiratory symptoms. In addition, outdoor air pollutants are also associated with COPD exacerbations and mortality. There is much less evidence for the impact of indoor air on COPD, especially in developed countries in residences without biomass exposure. The limited existing data suggests that indoor particulate matter and nitrogen dioxide concentrations are linked to increased respiratory symptoms among patients with COPD. In addition, with the projected increases in temperature and extreme weather events in the context of climate change there has been increased attention to the effects of heat exposure. Extremes of temperature-both heat and cold-have been associated with increased respiratory morbidity in COPD. Some studies also suggest that temperature may modify the effect of pollution exposure and though results are not conclusive, understanding factors that may modify susceptibility to air pollution in patients with COPD is of utmost importance.
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Affiliation(s)
- Nadia N. Hansel
- Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Environmental Health Sciences, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Meredith C. McCormack
- Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Environmental Health Sciences, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Victor Kim
- Temple University, Philadelphia, Pennsylvania, USA
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25
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Colton MD, Laurent JGC, MacNaughton P, Kane J, Bennett-Fripp M, Spengler J, Adamkiewicz G. Health Benefits of Green Public Housing: Associations With Asthma Morbidity and Building-Related Symptoms. Am J Public Health 2015; 105:2482-9. [PMID: 26469661 DOI: 10.2105/ajph.2015.302793] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVES We examined associations of several health outcomes with green and conventional low-income housing, where the prevalence of morbidities and environmental pollutants is elevated. METHODS We used questionnaires and a visual inspection to compare sick building syndrome (SBS) symptoms and asthma-related morbidity among residents in multifamily units in Boston, Massachusetts, between March 2012 and May 2013. Follow-up was approximately 1 year later. RESULTS Adults living in green units reported 1.35 (95% confidence interval [CI] = 0.66, 2.05) fewer SBS symptoms than those living in conventional (control) homes (P < .001). Furthermore, asthmatic children living in green homes experienced substantially lower risk of asthma symptoms (odds ratio [OR] = 0.34; 95% CI = 0.12, 1.00), asthma attacks (OR = 0.31; 95% CI = 0.11, 0.88), hospital visits (OR = 0.24; 95% CI = 0.06, 0.88), and asthma-related school absences (OR = 0.21; 95% CI = 0.06, 0.74) than children living in conventional public housing. CONCLUSIONS Participants living in green homes had improved health outcomes, which remained consistent over the study period. Green housing may provide a significant value in resource-poor settings where green construction or renovation could simultaneously reduce harmful indoor exposures, promote resident health, and reduce operational costs.
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Affiliation(s)
- Meryl D Colton
- Meryl D. Colton, Jose Guillermo Cedeno Laurent, Piers MacNaughton, John Spengler, and Gary Adamkiewicz are with the Department of Environmental Health, Harvard T. H. Chan School of Public Health, Harvard University, Boston, MA. John Kane is with the Boston Housing Authority. Mae Bennett-Fripp is with the Committee for Boston Public Housing
| | - Jose Guillermo Cedeno Laurent
- Meryl D. Colton, Jose Guillermo Cedeno Laurent, Piers MacNaughton, John Spengler, and Gary Adamkiewicz are with the Department of Environmental Health, Harvard T. H. Chan School of Public Health, Harvard University, Boston, MA. John Kane is with the Boston Housing Authority. Mae Bennett-Fripp is with the Committee for Boston Public Housing
| | - Piers MacNaughton
- Meryl D. Colton, Jose Guillermo Cedeno Laurent, Piers MacNaughton, John Spengler, and Gary Adamkiewicz are with the Department of Environmental Health, Harvard T. H. Chan School of Public Health, Harvard University, Boston, MA. John Kane is with the Boston Housing Authority. Mae Bennett-Fripp is with the Committee for Boston Public Housing
| | - John Kane
- Meryl D. Colton, Jose Guillermo Cedeno Laurent, Piers MacNaughton, John Spengler, and Gary Adamkiewicz are with the Department of Environmental Health, Harvard T. H. Chan School of Public Health, Harvard University, Boston, MA. John Kane is with the Boston Housing Authority. Mae Bennett-Fripp is with the Committee for Boston Public Housing
| | - Mae Bennett-Fripp
- Meryl D. Colton, Jose Guillermo Cedeno Laurent, Piers MacNaughton, John Spengler, and Gary Adamkiewicz are with the Department of Environmental Health, Harvard T. H. Chan School of Public Health, Harvard University, Boston, MA. John Kane is with the Boston Housing Authority. Mae Bennett-Fripp is with the Committee for Boston Public Housing
| | - John Spengler
- Meryl D. Colton, Jose Guillermo Cedeno Laurent, Piers MacNaughton, John Spengler, and Gary Adamkiewicz are with the Department of Environmental Health, Harvard T. H. Chan School of Public Health, Harvard University, Boston, MA. John Kane is with the Boston Housing Authority. Mae Bennett-Fripp is with the Committee for Boston Public Housing
| | - Gary Adamkiewicz
- Meryl D. Colton, Jose Guillermo Cedeno Laurent, Piers MacNaughton, John Spengler, and Gary Adamkiewicz are with the Department of Environmental Health, Harvard T. H. Chan School of Public Health, Harvard University, Boston, MA. John Kane is with the Boston Housing Authority. Mae Bennett-Fripp is with the Committee for Boston Public Housing
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26
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Yoo JY, Park CJ, Kim KY, Son YS, Kang CM, Wolfson JM, Jung IH, Lee SJ, Koutrakis P. Development of an activated carbon filter to remove NO2 and HONO in indoor air. JOURNAL OF HAZARDOUS MATERIALS 2015; 289:184-189. [PMID: 25725340 DOI: 10.1016/j.jhazmat.2015.02.038] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Revised: 01/14/2015] [Accepted: 02/13/2015] [Indexed: 06/04/2023]
Abstract
To obtain the optimum removal efficiency of NO2 and HONO by coated activated carbon (ACs), the influencing factors, including the loading rate, metal and non-metal precursors, and mixture ratios, were investigated. The NOx removal efficiency (RE) for K, with the same loading (1.0 wt.%), was generally higher than for those loaded with Cu or Mn. The RE of NO2 was also higher when KOH was used as the K precursor, compared to other K precursors (KI, KNO3, and KMnO4). In addition, the REs by the ACs loaded with K were approximately 38-55% higher than those by uncoated ACs. Overall, the REs (above 95%) of HONO and NOx with 3% KOH were the highest of the coated AC filters that were tested. Additionally, the REs of NOx and HONO using a mixing ratio of 6 (2.5% PABA (p-aminobenzoic acid)+6% H3PO4):4 (3% KOH) were the highest of all the coatings tested (both metal and non-metal). The results of this study show that AC loaded with various coatings has the potential to effectively reduce NO2 and HONO levels in indoor air.
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Affiliation(s)
- Jun Young Yoo
- Air Development Group, Coway R&D Center, Seoul National University Research Park, 56-39, Nakseongdaero 15-gil, Gwanak-gu, Seoul 151-919, South Korea
| | - Chan Jung Park
- Development Division, Coway R&D Center, Seoul National University Research Park, 56-39, Nakseongdaero 15-gil, Gwanak-gu, Seoul 151-919, South Korea
| | - Ki Yeong Kim
- R&D Center, 3AC Co., Ltd., 1521-3, Sicheong-ro, Bongdam-eup, Hwaseong-si, Gyeonggi-do 445-902, South Korea
| | - Youn-Suk Son
- Research Division for Industry & Environment, Korea Atomic Energy Research Institute, Jeongeup-si, Jeollabuk-do 580-185, South Korea.
| | - Choong-Min Kang
- Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard School of Public Health, 401 Park Drive, Landmark Center West Room 417, Boston, Massachusetts 02115, United States
| | - Jack M Wolfson
- Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard School of Public Health, 401 Park Drive, Landmark Center West Room 417, Boston, Massachusetts 02115, United States
| | - In-Ha Jung
- Research Division for Industry & Environment, Korea Atomic Energy Research Institute, Jeongeup-si, Jeollabuk-do 580-185, South Korea
| | - Sung-Joo Lee
- Research Division for Industry & Environment, Korea Atomic Energy Research Institute, Jeongeup-si, Jeollabuk-do 580-185, South Korea
| | - Petros Koutrakis
- Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard School of Public Health, 401 Park Drive, Landmark Center West Room 417, Boston, Massachusetts 02115, United States
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27
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Willand N, Ridley I, Maller C. Towards explaining the health impacts of residential energy efficiency interventions - A realist review. Part 1: Pathways. Soc Sci Med 2015; 133:191-201. [PMID: 25687402 DOI: 10.1016/j.socscimed.2015.02.005] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This paper is Part 1 of a realist review that tries to explain the impacts of residential energy efficiency interventions (REEIs) on householder health. According to recent systematic reviews residential energy efficiency interventions may benefit health. It is argued that home energy improvement are complex interventions and that a better understanding of the latent mechanisms and contextual issues that may shape the outcome of interventions is needed for effective intervention design. This realist review synthesises the results of 28 energy efficiency improvement programmes. This first part provides a review of the explanatory factors of the three key pathways, namely warmth in the home, affordability of fuel and psycho-social factors, and the pitfall of inadequate indoor air quality. The review revealed that REEIs improved winter warmth and lowered relative humidity with benefits for cardiovascular and respiratory health. In addition, residential energy efficiency improvements consolidated the meaning of the home as a safe haven, strengthened the householder's perceived autonomy and enhanced social status. Although satisfaction with the home proved to be an important explanation for positive mental health outcomes, financial considerations seemed to have played a secondary role. Evidence for negative impacts was rare but the risk should not be dismissed. Comprehensive refurbishments were not necessarily more effective than thermal retrofits or upgrades. A common protocol for the quantitative and qualitative evaluation of interventions would facilitate the synthesis of future studies. Householder and contextual influences are addressed in Part 2.
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Affiliation(s)
- Nicola Willand
- School of Property, Construction and Project Management, Royal Melbourne Institute of Technology (RMIT) University, 124 La Trobe Street, Melbourne, GPO Box 2476V, Melbourne, VIC, 3001, Australia.
| | - Ian Ridley
- School of Property, Construction and Project Management, Royal Melbourne Institute of Technology (RMIT) University, 124 La Trobe Street, Melbourne, GPO Box 2476V, Melbourne, VIC, 3001, Australia.
| | - Cecily Maller
- Centre for Urban Research, School of Global, Urban and Social Studies, College of Design & Social Context, Royal Melbourne Institute of Technology (RMIT) University, 124 La Trobe Street, Melbourne, GPO Box 2476V, Melbourne, VIC, 3001, Australia.
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28
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Coker ES, Smit E, Harding AK, Molitor J, Kile ML. A cross sectional analysis of behaviors related to operating gas stoves and pneumonia in U.S. children under the age of 5. BMC Public Health 2015; 15:77. [PMID: 25648867 PMCID: PMC4321321 DOI: 10.1186/s12889-015-1425-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 01/15/2015] [Indexed: 01/31/2023] Open
Abstract
Background Poorly ventilated combustion stoves and pollutants emitted from combustion stoves increase the risk of acute lower respiratory illnesses (ALRI) in children living in developing countries but few studies have examined these issues in developed countries. Our objective is to investigate behaviors related to gas stove use, namely using them for heat and without ventilation, on the odds of pneumonia and cough in U.S. children. Methods The National Health and Nutrition Examination Survey (1988–1994) was used to identify children < 5 years who lived in homes with a gas stove and whose parents provided information on their behaviors when operating their gas stoves and data on pneumonia (N = 3,289) and cough (N = 3,127). Multivariate logistic regression models were used to examine the association between each respiratory outcome and using a gas stove for heat or without ventilation, as well as, the joint effect of both behaviors. Results The adjusted odds of parental-reported pneumonia (adjusted odds ratio [aOR] = 2.08, 95% confidence interval [CI]: 1.08, 4.03) and cough (aOR = 1.66, 95% CI: 1.14, 2.43) were higher among children who lived in homes where gas stoves were used for heat compared to those who lived in homes where gas stoves were only used for cooking. The odds of pneumonia (aOR = 1.76, 95% CI: 1.04, 2.98), but not cough (aOR = 1.23, 95% CI: 0.87, 1.75), was higher among those children whose parents did not report using ventilation when operating gas stoves compared to those who did use ventilation. When considering the joint association of both stove operating conditions, only children whose parents reported using gas stoves for heat without ventilation had significantly higher odds of pneumonia (aOR = 3.06, 95% CI: 1.32, 7.09) and coughing (aOR = 2.07, 95% CI: 1.29, 3.30) after adjusting for other risk factors. Conclusions Using gas stoves for heat without ventilation was associated with higher odds of pneumonia and cough among U.S. children less than five years old who live in homes with a gas stove. More research is needed to determine if emissions from gas stoves ventilation infrastructure, or modifiable behaviors contribute to respiratory infections in children.
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Affiliation(s)
- Eric S Coker
- College of Public Health and Human Sciences, Oregon State University, Milam Hall, Corvallis, OR, 97331, USA.
| | - Ellen Smit
- College of Public Health and Human Sciences, Oregon State University, Milam Hall, Corvallis, OR, 97331, USA.
| | - Anna K Harding
- College of Public Health and Human Sciences, Oregon State University, Milam Hall, Corvallis, OR, 97331, USA.
| | - John Molitor
- College of Public Health and Human Sciences, Oregon State University, Milam Hall, Corvallis, OR, 97331, USA.
| | - Molly L Kile
- College of Public Health and Human Sciences, Oregon State University, Milam Hall, Corvallis, OR, 97331, USA.
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29
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Yang HJ, Kim SH, Jang AS, Kim SH, Song WJ, Kim TB, Ye YM, Yoo Y, Yu J, Yoon JS, Jee HM, Suh DI, Kim CW. Guideline for the prevention and management of particulate matter/yellow dust-induced adverse health effects on the patients with bronchial asthma. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2015. [DOI: 10.5124/jkma.2015.58.11.1034] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Hyeon-Jong Yang
- Department of Pediatrics, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Sang-Heon Kim
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - An-Soo Jang
- Department of Internal Medicine, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Sang-Hoon Kim
- Department of Internal Medicine, Eulji University School of Medicine, Seoul, Korea
| | - Woo-Jung Song
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Tae-Bum Kim
- Department of Allergy and Clinical Immunology, University of Ulsan College of Medicine, Seoul, Korea
| | - Young-Min Ye
- Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Korea
| | - Young Yoo
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
| | - Jinho Yu
- Department of Pediatrics, University of Ulsan College of Medicine, Seoul, Korea
| | - Jong-Seo Yoon
- Department of Pediatrics, the Catholic University of Korea College of Medicine, Seoul, Korea
| | - Hye Mi Jee
- Department of Pediatrics, CHA University School of Medicine, Seongnam, Korea
| | - Dong In Suh
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Cheol-Woo Kim
- Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea
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30
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Kanchongkittiphon W, Gaffin JM, Phipatanakul W. The indoor environment and inner-city childhood asthma. Asian Pac J Allergy Immunol 2014; 32:103-10. [PMID: 25003723 PMCID: PMC4110514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Accepted: 03/21/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVE Exposure to indoor pollutants and allergens has been speculated to cause asthma symptoms and exacerbations and influence the risk of developing asthma. The aim of this article is to review the medical literature regarding the role of the indoor environment on inner-city childhood asthma. DATA SOURCES A literature search was performed in PubMed. Studies focusing on inner-city indoor allergen, childhood asthma, and environmental controls were included. RESULTS The prevalence of asthma in children is increasing especially in inner-city area. Exposure to high levels of indoor allergens and pollutants has been related to asthma development. Studies have shown that mouse, cockroach, pets, dust mite, mold, tobacco smoke, endotoxin and nitrogen dioxide are the important exposures. Recent studies have shown that indoor environmental control is beneficial in reducing asthma morbidity and development. CONCLUSIONS Inner-city children are exposed to various indoor allergens and pollutants that may lead to asthma development and exacerbation of existing asthma. Multifaceted environmental controls are beneficial in improving asthma symptom and maybe a viable prevention strategy. Further prospective studies of environmental intervention are needed to further identify effective strategies to improve and prevent asthma symptoms in inner-city children.
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Affiliation(s)
- Watcharoot Kanchongkittiphon
- Division of Allergy and Immunology, Boston Children’s Hospital, Boston, MA, U.S
- Harvard Medical School, Boston, MA, U.S
- Department of Pediatrics, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Jonathan M. Gaffin
- Harvard Medical School, Boston, MA, U.S
- Division of Respiratory Diseases, Boston Children’s Hospital, Boston, MA, U.S
| | - Wanda Phipatanakul
- Division of Allergy and Immunology, Boston Children’s Hospital, Boston, MA, U.S
- Harvard Medical School, Boston, MA, U.S
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31
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Seltenrich N. Take care in the kitchen: avoiding cooking-related pollutants. ENVIRONMENTAL HEALTH PERSPECTIVES 2014; 122:A154-9. [PMID: 24892412 PMCID: PMC4050506 DOI: 10.1289/ehp.122-a154] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
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