Concentrations and determinants of NO2 in homes of Ashford, UK and Barcelona and Menorca, Spain

Continuous measurement of the dynamics of residential indoor and outdoor NO2 and the contributions to human exposure

In residential environment, NO2 is an important air pollutant. Yet, the dynamics of indoor NO2 and source contributions to human exposure are not well understood. Here, we conducted a continuous NO2 measurement in and out of eight households in Guangzhou, China. Paired high time-resolution NO2 data sets indoors (kitchen, living room) and outdoors (balcony) were obtained with NO2 monitors. We summarized the indoor and outdoor NO2 levels, identified temporal variation patterns, analyzed indoor-outdoor relationships, and quantified source contributions to indoor NO2 exposure. Indoor NO2 were overall higher than outdoor NO2, and in most cases, the highest NO2 levels were observed in the kitchen. NO2 in the kitchen was characterized by multiple spikes associated with use of gas stoves, while NO2 in the living room was also elevated but the peaks were generally smaller. The indoor-outdoor correlations were stronger in winter than in summer, and were stronger in nighttime than daytime. The sources contributing to indoor NO2 were separated with a conceptual model. Overall, the outdoor NO2 source contributed 73%-76% of the NO2 in the kitchen, and 76%-85% in the living room. The source pattern was quite different: outdoor NO2 sources were present indoors all the time; by contrast, indoor NO2 sources were present sporadically but with a very high contribution. This has important implication to the exposure assessment that indoor NO2 sources lead to short-term high exposure, and deserves attention regarding acute health effects.

An assessment of spatial distribution and atmospheric concentrations of ozone, nitrogen dioxide, sulfur dioxide, benzene, toluene, ethylbenzene, and xylenes: ozone formation potential and health risk estimation in Bolu city of Turkey

Atmospheric pollutants including ozone, nitrogen dioxide, sulfur dioxide, and BTEX (benzene, toluene, ethylbenzene, and xylenes) compounds were evaluated concerning their spatial distribution, temporal variation, and health risk factor. Bolu plateau where sampling was performed has a densely populated city center, semi-rural areas, and forested areas. Additionally, the ozone formation potentials of BTEXs were calculated, and toluene was found to be the most important compound in ground level ozone formation. The spatial distribution of BTEXs and nitrogen dioxide pollution maps showed that their concentrations were higher around the major roads and city center, while rural-forested areas were found to be rich in ozone. BTEXs and nitrogen dioxide were found to have higher atmospheric concentrations in winter. That was mostly related to the source strength and low mixing height during that season. The average toluene to benzene ratios demonstrated that there was a significant influence of traffic emissions in the region. Although there was no significant change in sulfur dioxide concentrations in the summer and winter seasons of 2017, the differences in the spatial distribution showed that seasonal sources such as domestic heating and intensive outdoor barbecue cooking were effective in the atmospheric presence of this pollutant. The lifetime cancer risk through inhalation of benzene was found to be comparable with the limit value (1 × 10^-6) recommended by USEPA. On the other hand, hazard ratios for BTEXs were found at an acceptable level for different outdoor environments (villages, roadside, and city center) for both seasons.

Indoor Exposure to Selected Air Pollutants in the Home Environment: A Systematic Review

(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 (PM_2.5 and PM₁₀); nitrogen dioxide (NO₂); volatile organic compounds (VOCs) including benzene, toluene, xylenes and formaldehyde; and polycyclic aromatic hydrocarbons (PAHs) including naphthalene. Identified indoor PM_2.5 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 PM_2.5 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 PM_2.5, 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.

Paving the way of systems biology and precision medicine in allergic diseases: the MeDALL success story: Mechanisms of the Development of ALLergy; EU FP7-CP-IP; Project No: 261357; 2010-2015

MeDALL (Mechanisms of the Development of ALLergy; EU FP7-CP-IP; Project No: 261357; 2010-2015) has proposed an innovative approach to develop early indicators for the prediction, diagnosis, prevention and targets for therapy. MeDALL has linked epidemiological, clinical and basic research using a stepwise, large-scale and integrative approach: MeDALL data of precisely phenotyped children followed in 14 birth cohorts spread across Europe were combined with systems biology (omics, IgE measurement using microarrays) and environmental data. Multimorbidity in the same child is more common than expected by chance alone, suggesting that these diseases share causal mechanisms irrespective of IgE sensitization. IgE sensitization should be considered differently in monosensitized and polysensitized individuals. Allergic multimorbidities and IgE polysensitization are often associated with the persistence or severity of allergic diseases. Environmental exposures are relevant for the development of allergy-related diseases. To complement the population-based studies in children, MeDALL included mechanistic experimental animal studies and in vitro studies in humans. The integration of multimorbidities and polysensitization has resulted in a new classification framework of allergic diseases that could help to improve the understanding of genetic and epigenetic mechanisms of allergy as well as to better manage allergic diseases. Ethics and gender were considered. MeDALL has deployed translational activities within the EU agenda.

Indoor concentrations of nitrogen dioxide and sulfur dioxide from burning solid fuels for cooking and heating in Yunnan Province, China

The Chinese national pollution census has indicated that the domestic burning of solid fuels is an important contributor to nitrogen dioxide (NO2 ) and sulfur dioxide (SO2 ) emissions in China. To characterize indoor NO2 and SO2 air concentrations in relation to solid fuel use and stove ventilation in the rural counties of Xuanwei and Fuyuan, in Yunnan Province, China, which have among the highest lung cancer rates in the nation, a total of 163 participants in 30 selected villages were enrolled. Indoor 24-h NO2 and SO2 samples were collected in each household over two consecutive days. Compared to smoky coal, smokeless coal use was associated with higher NO2 concentrations [geometric mean (GM) = 132 μg/m(3) for smokeless coal and 111 μg/m(3) for smoky coal, P = 0.065] and SO2 [limit of detection = 24 μg/m(3) ; percentage detected (%Detect) = 86% for smokeless coal and 40% for smoky coal, P < 0.001]. Among smoky coal users, significant variation of NO2 and SO2 air concentrations was observed across different stove designs and smoky coal sources in both counties. Model construction indicated that the measurements of both pollutants were influenced by stove design. This exposure assessment study has identified high levels of NO2 and SO2 as a result of burning solid fuels for cooking and heating.

A cross sectional analysis of behaviors related to operating gas stoves and pneumonia in U.S. children under the age of 5

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.

Interaction between gas cooking and GSTM1 null genotype in bronchial responsiveness: results from the European Community Respiratory Health Survey

Background

Increased bronchial responsiveness is characteristic of asthma. Gas cooking, which is a major indoor source of the highly oxidant nitrogen dioxide, has been associated with respiratory symptoms and reduced lung function. However, little is known about the effect of gas cooking on bronchial responsiveness and on how this relationship may be modified by variants in the genes GSTM1, GSTT1 and GSTP1, which influence antioxidant defences.

Methods

The study was performed in subjects with forced expiratory volume in one second at least 70% of predicted who took part in the multicentre European Community Respiratory Health Survey, had bronchial responsiveness assessed by methacholine challenge and had been genotyped for GSTM1, GSTT1 and GSTP1-rs1695. Information on the use of gas for cooking was obtained from interviewer-led questionnaires. Effect modification by genotype on the association between the use of gas for cooking and bronchial responsiveness was assessed within each participating country, and estimates combined using meta-analysis.

Results

Overall, gas cooking, as compared with cooking with electricity, was not associated with bronchial responsiveness (β=−0.08, 95% CI −0.40 to 0.25, p=0.648). However, GSTM1 significantly modified this effect (β for interaction=−0.75, 95% CI −1.16 to −0.33, p=4×10⁻⁴), with GSTM1 null subjects showing more responsiveness if they cooked with gas. No effect modification by GSTT1 or GSTP1-rs1695 genotypes was observed.

Conclusions

Increased bronchial responsiveness was associated with gas cooking among subjects with the GSTM1 null genotype. This may reflect the oxidant effects on the bronchi of exposure to nitrogen dioxide.

Prenatal and postnatal exposure to DDT by breast milk analysis in Canary Islands

INTRODUCTION

The use of p,p'-dichlorodiphenyltrichloroethane (DDT) has been banned since the late 1970s due to its toxicity. However, its long half-life makes it persistent in the environment and, consequently, almost everyone has DDT residues in the body. Human milk constitutes an ideal non-conventional matrix to investigate environmental chronic exposure to organochlorine compounds (OCs) residues. The study aimed to identify potential population risk factors of exposure to DDT due to the proximity to countries where it is still used.

METHODS

Seventy-two consecutive lactating women were prospectively included in Tenerife, Canary Islands (Spain). A validated questionnaire was used to obtain socioeconomic, demographics data, and daily habits during pregnancy. DDT levels in breast milk were measured by gas chromatography with-electron capture detector (GC-ECD). Anthropometrics measurements in newborns were obtained.

RESULTS

Thirty-four out of 72 (47.2%) of the analysed milk samples presented detectable levels of DDT (mean: 0.92 ng/g), ranging between 0.08 to 16.96 ng/g. The socio-demographic variables did not significantly differ between detectable DDT and non-detectable DDT groups. We found positive association between DDT levels and vegetables (OR (95%CI): 1.23 (1.01-1.50)) and poultry meat (OR (95%CI): 2.05 (1.16-3.60)) consumption, and also between the presence of DDT in breast milk and gestational age (OR (95%CI): 0.59 (0.40-0.90)).

CONCLUSIONS

DDT is present in breast milk of women at the time of delivery. Residual levels and the spread from countries still using DDT explain DDT detection from vegetables and from animal origin food. The presence of this compound in breast milk represents a pre- and postnatal exposure hazard for foetuses and infants due to chronic bioaccumulation and poor elimination, with possible deleterious effects on health. This data should be used to raise awareness of the risks of OCs exposure and to help establish health policies in order to avoid its use worldwide and thus, to prevent its propagation.

Using PM2.5 concentrations to estimate the health burden from solid fuel combustion, with application to Irish and Scottish homes

BACKGROUND

This study estimates the potential population health burden from exposure to combustion-derived particulate air pollution in domestic settings in Ireland and Scotland.

METHODS

The study focused on solid fuel combustion used for heating and the use of gas for cooking. PM2.5 (particulate matter with an aerodynamic diameter < 2.5 μm) was used as the pollutant mixture indicator. Measured PM2.5 concentrations in homes using solid fuels were adjusted for other sources of PM2.5 by subtracting PM2.5 concentrations in homes using gas for cooking but not solid fuel heating. Health burden was estimated for exposure indoors 6 pm - midnight, or all day (24-hour), by combining estimated attributable annual PM2.5 exposures with (i) selected epidemiological functions linking PM2.5 with mortality and morbidity (involving some re-scaling from PM10 to PM2.5, and adjustments 'translating' from concentrations to exposures) and (ii) on the current population exposed and background rates of morbidity and mortality.

RESULTS

PM2.5 concentrations in coal and wood burning homes were similar to homes using gas for cooking, used here as a baseline (mean 24-hr PM2.5 concentrations 8.6 μg/m3) and so health impacts were not calculated. Concentrations of PM2.5 in homes using peat were higher (24-hr mean 15.6 μg/m3); however, health impacts were calculated for the exposed population in Ireland only; the proportion exposed in Scotland was very small. The assessment for winter evening exposure (estimated annual average increase of 2.11 μg/m3 over baseline) estimated 21 additional annual cases of all-cause mortality, 55 of chronic bronchitis, and 30,100 and 38,000 annual lower respiratory symptom days (including cough) and restricted activity days respectively.

CONCLUSION

New methods for estimating the potential health burden of combustion-generated pollution from solid fuels in Irish and Scottish homes are provided. The methodology involves several approximations and uncertainties but is consistent with a wider movement towards quantifying risks in PM2.5 irrespective of source. Results show an effect of indoor smoke from using peat (but not wood or coal) for heating and cooking; but they do not suggest that this is a major public health issue.

Pooling birth cohorts in allergy and asthma: European Union-funded initiatives - a MeDALL, CHICOS, ENRIECO, and GA²LEN joint paper

Long-term birth cohort studies are essential to understanding the life course and childhood predictors of allergy and the complex interplay between genes and the environment (including lifestyle and socioeconomic determinants). Over 100 cohorts focusing on asthma and allergy have been initiated in the world over the past 30 years. Since 2004, several research initiatives funded under the EU Framework Program for Research and Technological Development FP6-FP7 have attempted to identify, compare, and evaluate pooling data from existing European birth cohorts (GA(2)LEN: Global Allergy and European Network, FP6; ENRIECO: Environmental Health Risks in European Birth Cohorts, FP7; CHICOS: Developing a Child Cohort Research Strategy for Europe, FP7; MeDALL: Mechanisms of the Development of ALLergy, FP7). However, there is a general lack of knowledge about these initiatives and their potentials. The aim of this paper is to review current and past EU-funded projects in order to make a summary of their goals and achievements and to suggest future research needs of these European birth cohort networks.

Urban air pollutants are significant risk factors for asthma and pneumonia in children: the influence of location on the measurement of pollutants

BACKGROUND

Air pollution is associated with a substantial burden on human health; however, the most important pollutants may vary with location. Proper monitoring is necessary to determine the effect of these pollutants on respiratory health.

OBJECTIVES

This study was designed to evaluate the role of outdoor, indoor and personal exposure to combustion-related pollutants NO(2) and O(3) on respiratory health of children in a non-affluent urban area of São Paulo, Brazil.

METHODS

Levels of NO(2) and O(3) were continuously measured in outdoor and indoor air, as well as personal exposure, for 30 days using passive measurement monitors. Respiratory health was assessed with a Brazilian version of the ISAAC questionnaire.

RESULTS

Complete data were available from 64 children, aged 6-10 years. Respiratory morbidity was high, with 43 (67.2%) reporting having had wheezing at any time, 27 (42.2%) wheezing in the last month, 17 (26.6%) asthma at any time and 21 (32.8%) pneumonia at any time. Correlations between levels of NO(2) and O(3) measured in the three locations evaluated were poor. Levels of NO(2) in indoor air and personal exposure to O(3) were independently associated with asthma (both cases P=.02), pneumonia (O(3), P=.02) and wheezing at any time (both cases P<.01). No associations were seen between outdoor NO(2) and O(3) and respiratory health.

CONCLUSIONS

Exposure to higher levels of NO(2) and O(3) was associated with increased risk for asthma and pneumonia in children. Nonetheless, the place where the pollutants are measured influences the results. The measurements taken in indoor and personal exposure were the most accurate.

Contribution of solid fuel, gas combustion, or tobacco smoke to indoor air pollutant concentrations in Irish and Scottish homes

  There are limited data describing pollutant levels inside homes that burn solid fuel within developed country settings with most studies describing test conditions or the effect of interventions. This study recruited homes in Ireland and Scotland where open combustion processes take place. Open combustion was classified as coal, peat, or wood fuel burning, use of a gas cooker or stove, or where there is at least one resident smoker. Twenty-four-hour data on airborne concentrations of particulate matter<2.5 μm in size (PM2.5), carbon monoxide (CO), endotoxin in inhalable dust and carbon dioxide (CO2), together with 2-3 week averaged concentrations of nitrogen dioxide (NO2) were collected in 100 houses during the winter and spring of 2009-2010. The geometric mean of the 24-h time-weighted-average (TWA) PM2.5 concentration was highest in homes with resident smokers (99 μg/m3--much higher than the WHO 24-h guidance value of 25 μg/m3). Lower geometric mean 24-h TWA levels were found in homes that burned coal (7 μg/m3) or wood (6 μg/m3) and in homes with gas cookers (7 μg/m3). In peat-burning homes, the average 24-h PM2.5 level recorded was 11 μg/m3. Airborne endotoxin, CO, CO2, and NO2 concentrations were generally within indoor air quality guidance levels.

PRACTICAL IMPLICATIONS

Little is known about indoor air quality (IAQ) in homes that burn solid or fossil-derived fuels in economically developed countries. Recent legislative changes have moved to improve IAQ at work and in enclosed public places, but there remains a real need to begin the process of quantifying the health burden that arises from indoor air pollution within domestic environments. This study demonstrates that homes in Scotland and Ireland that burn solid fuels or gas for heating and cooking have concentrations of air pollutants generally within guideline levels. Homes where combustion of cigarettes takes place have much poorer air quality.

Outdoor, but not indoor, nitrogen dioxide exposure is associated with persistent cough during the first year of life

BACKGROUND AND AIMS

Because their lungs and immune system are not completely developed, children are more susceptible to respiratory disease and more vulnerable to ambient pollution. We assessed the relation between prenatal and postnatal nitrogen dioxide (NO(2)) levels and the development of lower respiratory tract infections (LRTI), wheezing and persistent cough during the first year of life.

METHODS

The study population consisted of 352 children from a birth cohort in Valencia, Spain. Prenatal exposure to NO(2), a marker of traffic related air pollution was measured at 93 sampling sites spread over the study area during four different sampling periods of 7 days each. It was modeled for each residential address through land use regression using the empirical measurements and data from geographic information systems. Postnatal exposure was measured once inside and outside each home using passive samplers for a period of 14 days. Outcomes studied were any episode of LRTI during the child's first year of life diagnosed by a doctor (bronchitis, bronchiolitis or pneumonia), wheezing (defined as whistling sounds coming from the chest), and persistent cough (more than three consecutive weeks). Outcomes and potential confounders were obtained from structured questionnaires. Multiple logistic regression was used to identify associations.

RESULTS

The cumulative incidence (CI) at first year of life was 30.4% for LRTI (23.0% bronchiolitis, 11.9% bronchitis and 1.4% pneumonia), 26.1% for wheezing and 6.3% for persistent cough. The adjusted odds ratio (95% confidence interval) per 10μg/m(3) increment in postnatal outdoor NO(2) concentration was 1.40 (1.02-1.92) for persistent cough. We also found some pattern of association with LRTI, bronchiolitis, bronchitis, wheezing and persistent cough in different prenatal periods, although it was not statistically significant.

CONCLUSIONS

Our results indicate that exposure to outdoor, but not indoor, NO(2) during the first year of life increases the risk of persistent cough.

MeDALL (Mechanisms of the Development of ALLergy): an integrated approach from phenotypes to systems medicine

The origin of the epidemic of IgE-associated (allergic) diseases is unclear. MeDALL (Mechanisms of the Development of ALLergy), an FP7 European Union project (No. 264357), aims to generate novel knowledge on the mechanisms of initiation of allergy and to propose early diagnosis, prevention, and targets for therapy. A novel phenotype definition and an integrative translational approach are needed to understand how a network of molecular and environmental factors can lead to complex allergic diseases. A novel, stepwise, large-scale, and integrative approach will be led by a network of complementary experts in allergy, epidemiology, allergen biochemistry, immunology, molecular biology, epigenetics, functional genomics, bioinformatics, computational and systems biology. The following steps are proposed: (i) Identification of 'classical' and 'novel' phenotypes in existing birth cohorts; (ii) Building discovery of the relevant mechanisms in IgE-associated allergic diseases in existing longitudinal birth cohorts and Karelian children; (iii) Validation and redefinition of classical and novel phenotypes of IgE-associated allergic diseases; and (iv) Translational integration of systems biology outcomes into health care, including societal aspects. MeDALL will lead to: (i) A better understanding of allergic phenotypes, thus expanding current knowledge of the genomic and environmental determinants of allergic diseases in an integrative way; (ii) Novel diagnostic tools for the early diagnosis of allergy, targets for the development of novel treatment modalities, and prevention of allergic diseases; (iii) Improving the health of European citizens as well as increasing the competitiveness and boosting the innovative capacity of Europe, while addressing global health issues and ethical issues.

Nitrogen dioxide and household fuel use in the Pakistan

More than half the world's population use biomass fuels as a household energy source and, hence, face significant exposure to a number of air pollutants. In Pakistan about 90% of rural households and 22% of urban households use biomass fuels. In order to assess the levels of NO(2) in the residential micro-environment, two sampling campaigns were carried out at different times of the year (summer and winter) at an urban and two rural sites during 2005 and 2007. Rural site I used biomass fuels while natural gas was utilized at rural site II and the urban site. In winter NO(2) concentrations at all three sites were higher in the kitchens than living rooms and outdoors. ANOVA showed that, although, there was a significant difference among NO(2) concentrations in the kitchens, living rooms and courtyards, at all the three sites, there was no significant different between kitchens using biomass fuels and natural gas. During the summer NO(2) levels fell sharply at both rural sites (from 256 μg/m(3) and 242 μg/m(3) to 51 μg/m(3) and 81 μg/m(3)). However at the urban site the mean levels were slightly higher in summer (234 μg/m(3)) than in winter (218 μg/m(3)). The considerable seasonal variation at the rural sites was due to a shift of indoor kitchens to open outdoor kitchens at rural site I and more ventilation at rural site II during summer. There was no significant difference between kitchens using biomass (site I) or natural gas (site II), however the kitchens at rural site II and urban site showed a significant difference. Overall fuel selection showed no significant effect on NO(2) levels. However the NO(2) concentrations may pose a significant threat to the health of people, especially women and children.

Indoor and outdoor concentrations and determinants of NO2 in a cohort of 1-year-old children in Valencia, Spain

Nitrogen dioxide (NO2) is produced from the exhausts of vehicles and gas appliances and is known to pose certain health risks. In this study, we characterize the exposure to this substance during the first year of life, which is an important period of development. To this end, we used passive samplers to measure indoor and outdoor NO2 levels for 2 weeks in the homes of 352 children. To compensate for the fact that NO2 levels were measured only once in each home, a correction factor was calculated to assign each child an outdoor NO2 exposure value for the first year of life. The outdoor NO2 concentrations were 26.1 microg/m(3) while those measured indoors averaged 18.0 microg/m(3). A multivariate linear regression analysis showed that the main determinants of outdoor NO2 levels were the degree of urbanization and the frequency of vehicle traffic at the location of the residence while for indoor NO2 levels the principal determinants were the type of cooking range and water heater present in the home, the season of the year, and both the country of origin and educational level of the mother.

PRACTICAL IMPLICATIONS

Exposure to NO2 has been related to respiratory and other health problems among children. Precise identification of the main sources of both indoor and outdoor NO2 should shed light on appropriate intervention periods and methods. Our results indicate that while population density and traffic-related variables are the main determinants of outdoor NO2 levels, the use of gas appliances have the greatest impact on indoor levels. Strategies should thus be developed to reduce such exposure, especially with regard to reducing emissions from vehicle traffic.

Long-term exposure to indoor air pollution and wheezing symptoms in infants

Long-term exposure to air pollution is suspected to cause recurrent wheeze in infants. The few previous studies have had ambiguous results. The objective of this study was to estimate the impact of measured long-term exposure to indoor air pollution on wheezing symptoms in infants. We monitored wheezing symptoms in diaries for a birth cohort of 411 infants. We measured long-term exposure to nitrogen oxides (NO(x)), NO(2), formaldehyde, PM(2.5) and black smoke in the infants' bedrooms and analyzed risk associations during the first 18 months of life by logistic regression with the dichotomous end-point 'any symptom-day' (yes/no) and by standard linear regression with the end-point 'number of symptom-days'. The results showed no systematic association between risk for wheezing symptoms and the levels of these air pollutants with various indoor and outdoor sources. In conclusion, we found no evidence of an association between long-term exposure to indoor air pollution and wheezing symptoms in infants, suggesting that indoor air pollution is not causally related to the underlying disease. Practical Implications Nitrogen oxides, formaldehyde and fine particles were measured in the air in infants' bedrooms. The results showed no evidence of an association between long-term exposure and wheezing symptoms in the COPSAC birth cohort.

Sources of indoor air pollution and respiratory health in preschool children

We carried out bibliographic searches in PubMed and Embase.com for the period from 1996 to 2008 with the aim of reviewing the scientific literature on the relationship between various sources of indoor air pollution and the respiratory health of children under the age of five. Those studies that included adjusted correlation measurements for the most important confounding variables and which had an adequate population size were considered to be more relevant. The results concerning the relationship between gas energy sources and children's respiratory health were heterogeneous. Indoor air pollution from biomass combustion in the poorest countries was found to be an important risk factor for lower respiratory tract infections. Solvents involved in redecorating, DYI work, painting, and so forth, were found to be related to an increased risk for general respiratory problems. The distribution of papers depending on the pollution source showed a clear relationship with life-style and the level of development.

Activity pattern and personal exposure to nitrogen dioxide in indoor and outdoor microenvironments

People are exposed to air pollution from a range of indoor and outdoor sources. Concentrations of nitrogen dioxide (NO(2)), which is hazardous to health, can be significant in both types of environments. This paper reports on the measurement and analysis of indoor and outdoor NO(2) concentrations and their comparison with measured personal exposure in various microenvironments during winter and summer seasons. Furthermore, the relationship between NO(2) personal exposure in various microenvironments and including activities patterns were also studied. Personal, indoor microenvironments and outdoor measurements of NO(2) levels were conducted using Palmes tubes for 60 subjects. The results showed significant differences in indoor and outdoor NO(2) concentrations in winter but not for summer. In winter, indoor NO(2) concentrations were found to be strongly correlated with personal exposure levels. NO(2) concentration in houses using a gas cooker was higher in all rooms than those with an electric cooker during the winter campaign, whereas there was no significant difference noticed in summer. The average NO(2) levels in kitchens with a gas cooker were twice as high as those with an electric cooker, with no significant difference in the summer period. A time-weighted average personal exposure was calculated and compared with measured personal exposures in various indoor microenvironments (e.g. front doors, bedroom, living room and kitchen); including non-smokers, passive smokers and smoker. The estimated results were closely correlated, but showed some underestimation of the measured personal exposures to NO(2) concentrations. Interestingly, for our particular study higher NO(2) personal exposure levels were found during summer (14.0+/-1.5) than winter (9.5+/-2.4).

Sources of variation for indoor nitrogen dioxide in rural residences of Ethiopia

BACKGROUND

Unprocessed biomass fuel is the primary source of indoor air pollution (IAP) in developing countries. The use of biomass fuel has been linked with acute respiratory infections. This study assesses sources of variations associated with the level of indoor nitrogen dioxide (NO2).

MATERIALS AND METHODS

This study examines household factors affecting the level of indoor pollution by measuring NO2. Repeated measurements of NO2 were made using a passive diffusive sampler. A Saltzman colorimetric method using a spectrometer calibrated at 540 nm was employed to analyze the mass of NO2 on the collection filter that was then subjected to a mass transfer equation to calculate the level of NO2 for the 24 hours of sampling duration. Structured questionnaire was used to collect data on fuel use characteristics. Data entry and cleaning was done in EPI INFO version 6.04, while data was analyzed using SPSS version 15.0. Analysis of variance, multiple linear regression and linear mixed model were used to isolate determining factors contributing to the variation of NO2 concentration.

RESULTS

A total of 17,215 air samples were fully analyzed during the study period. Wood and crop were principal source of household energy. Biomass fuel characteristics were strongly related to indoor NO2 concentration in one-way analysis of variance. There was variation in repeated measurements of indoor NO2 over time. In a linear mixed model regression analysis, highland setting, wet season, cooking, use of fire events at least twice a day, frequency of cooked food items, and interaction between ecology and season were predictors of indoor NO2 concentration. The volume of the housing unit and the presence of kitchen showed little relevance in the level of NO2 concentration.

CONCLUSION

Agro-ecology, season, purpose of fire events, frequency of fire activities, frequency of cooking and physical conditions of housing are predictors of NO2 concentration. Improved kitchen conditions and ventilation are highly recommended.

Association of early-life exposure to household gas appliances and indoor nitrogen dioxide with cognition and attention behavior in preschoolers

The authors investigated the association of early-life exposure to indoor air pollution with neuropsychological development in preschoolers and assessed whether this association differs by glutathione-S-transferase gene (GSTP1) polymorphisms. A prospective, population-based birth cohort was set up in Menorca, Spain, in 1997-1999 (n = 482). Children were assessed for cognitive functioning (McCarthy Scales of Children's Abilities) and attention-hyperactivity behaviors (Diagnostic and Statistical Manual of Mental Disorders, 4th Edition) at age 4 years. During the first 3 months of life, information about gas appliances at home and indoor nitrogen dioxide concentration was collected at each participant's home (n = 398, 83%). Genotyping was conducted for the GSTP1 coding variant Ile105Val. Use of gas appliances was inversely associated with cognitive outcomes (beta coefficient for general cognition = -5.10, 95% confidence interval (CI): -9.92, -0.28; odds ratio for inattention symptoms = 3.59, 95% CI: 1.14, 11.33), independent of social class and other confounders. Nitrogen dioxide concentrations were associated with cognitive function (a decrease of 0.27 point per 1 ppb, 95% CI: -0.48, -0.07) and inattention symptoms (odds ratio = 1.06, 95% CI: 1.01, 1.12). The deleterious effect of indoor pollution from gas appliances on neuropsychological outcomes was stronger in children with the GSTP1 Val-105 allele. Early-life exposure to air pollution from indoor gas appliances may be negatively associated with neuropsychological development through the first 4 years of life, particularly among genetically susceptible children.

Air pollution and allergic disease

Over the past several decades, there has been increased awareness of the health effects of air pollution and much debate regarding the role of global warming. The prevalence of asthma and allergic disease has risen in industrialized countries, and most epidemiologic studies focus on possible causalities between air pollution and these conditions. This review examines salient articles and summarizes findings important to the interaction between allergies and air pollution, specifically volatile organic compounds, global warming, particulate pollutants, atopic risk, indoor air pollution, and prenatal exposure. Further work is necessary to determine whether patients predisposed to developing allergic disease may be more susceptible to the health effects of air pollutants due to the direct interaction between IgE-mediated disease and air pollutants. Until we have more definitive answers, patient education about the importance of good indoor air quality in the home and workplace is essential. Health care providers and the general community should also support public policy designed to improve outdoor air quality by developing programs that provide incentives for industry to comply with controlling pollution emissions.

Sources of nitrogen dioxide (NO2) in New Zealand homes: findings from a community randomized controlled trial of heater substitutions

Houses in New Zealand have inadequate space heating and a third of households use unflued gas heaters. As part of a large community intervention trial to improve space heating, we replaced ineffective heaters with more effective, non-polluting heaters. This paper assesses the contribution of heating and household factors to indoor NO2 in almost 350 homes and reports on the reduction in NO2 levels due to heater replacement. Homes using unflued gas heaters had more than three times the level of NO2 in living rooms [geometric mean ratio (GMR) = 3.35, 95% CI: 2.83-3.96, P < 0.001] than homes without unflued gas heaters, whereas homes using gas stove-tops had significantly elevated living room NO2 levels (GMR = 1.42, 95% CI: 1.05-1.93, P = 0.02). Homes with heat pumps, flued gas heating, or enclosed wood burners had significantly lower levels of NO2 in living areas and bedrooms. In homes that used unflued gas heaters as their main form of heating at baseline, the intervention was associated with a two-third (67%) reduction in NO2 levels in living rooms, when compared with homes that continued to use unflued gas heaters. Reducing the use of unflued gas heating would substantially lower NO2 exposure in New Zealand homes.

PRACTICAL IMPLICATIONS

Understanding the factors influencing indoor NO2 levels is critical for the assessment and control of indoor air pollution. This study found that homes that used unflued gas combustion appliances for heating and cooking had higher NO2 levels compared with homes where other fuels were used. These findings require institutional incentives to increase the use of more effective, less polluting fuels, particularly in the home environment.

Passive dosimeters for nitrogen dioxide in personal/indoor air sampling: a review

Accurate measurement of nitrogen dioxide concentrations in both outdoor and indoor environments, including personal exposures, is a fundamental step for linking atmospheric nitrogen dioxide levels to potential health and ecological effects. The measurement has been conducted generally in two ways: active (pumped) sampling and passive (diffusive) sampling. Diffusion samplers, initially developed and used for workplace air monitoring, have been found to be useful and cost-effective alternatives to conventional pumped samplers for monitoring ambient, indoor and personal exposures at the lower concentrations found in environmental settings. Since the 1970s, passive samplers have been deployed for ambient air monitoring in urban and rural sites, and to determine personal and indoor exposure to NO2. This article reviews the development of NO2 passive samplers, the sampling characteristics of passive samplers currently available, and their application in ambient and indoor air monitoring and personal exposure studies. The limitations and advantages of the various passive sampler geometries (i.e., tube, badge, and radial type) are also discussed. This review provides researchers and risk assessors with practical information about NO2 passive samplers, especially useful when designing field sampling strategies for exposure and indoor/outdoor air sampling.

Predictors of concentrations of nitrogen dioxide, fine particulate matter, and particle constituents inside of lower socioeconomic status urban homes

Air pollution exposure patterns may contribute to known spatial patterning of asthma morbidity within urban areas. While studies have evaluated the relationship between traffic and outdoor concentrations, few have considered indoor exposure patterns within low socioeconomic status (SES) urban communities. In this study, part of a prospective birth cohort study assessing asthma etiology in urban Boston, we collected indoor and outdoor 3-4 day samples of nitrogen dioxide (NO2) and fine particulate matter (PM2.5) in 43 residences across multiple seasons from 2003 to 2005. Homes were chosen to represent low SES households, including both cohort and non-cohort residences in similar neighborhoods, and consisted almost entirely of multiunit residences. Reflectance analysis and X-ray fluorescence spectroscopy were performed on the particle filters to determine elemental carbon (EC) and trace element concentrations, respectively. Additionally, information on home characteristics (e.g. type, age, stove fuel) and occupant behaviors (e.g. smoking, cooking, cleaning) were collected via a standardized questionnaire. The contributions of outdoor and indoor sources to indoor concentrations were quantified with regression analyses using mass balance principles. For NO2 and most particle constituents (except outdoor-dominated constituents like sulfur and vanadium), the addition of selected indoor source terms improved the model's predictive power. Cooking time, gas stove usage, occupant density, and humidifiers were identified as important contributors to indoor levels of various pollutants. A comparison between cohort and non-cohort participants provided another means to determine the influence of occupant activity patterns on indoor-outdoor ratios. Although the groups had similar housing characteristics and were located in similar neighborhoods, cohort members had significantly higher indoor concentrations of PM2.5 and NO2, associated with indoor activities. We conclude that the effect of indoor sources may be more pronounced in high-density multiunit dwellings, and that future epidemiological studies in these populations should explicitly consider these sources in assigning exposures.

Housing characteristics and indoor concentrations of nitrogen dioxide and formaldehyde in Quebec City, Canada

Concentrations of nitrogen dioxide and formaldehyde were determined in a study of 96 homes in Quebec City, Canada, between January and April 2005. In addition, relative humidity, temperature, and air change rates were measured in homes, and housing characteristics were documented through a questionnaire to occupants. Half of the homes had ventilation rates below 7.5 L/s person. Nitrogen dioxide (NO2) and formaldehyde concentrations ranged from 3.3 to 29.1 microg/m3 (geometric mean 8.3 microg/m3) and from 9.6 to 90.0 microg/m3 (geometric mean of 29.5 microg/m3), respectively. The housing characteristics documented in the study explained approximately half of the variance of NO2 and formaldehyde. NO2 concentrations in homes were positively correlated with air change rates (indicating a significant contribution of outdoor sources to indoor levels) and were significantly elevated in homes equipped with gas stoves and, to a lesser extent, in homes with gas heating systems. Formaldehyde concentrations were negatively correlated with air change rates and were significantly elevated in homes heated by electrical systems, in those with new wooden or melamine furniture purchased in the previous 12 months, and in those where painting or varnishing had been done in the sampled room in the previous 12 months. Results did not indicate any significant contribution of indoor combustion sources, including wood-burning appliances, to indoor levels of formaldehyde. These results suggest that formaldehyde concentrations in Quebec City homes are caused primarily by off-gassing, and that increasing air change rates in homes could reduce exposure to this compound. More generally, our findings confirm the influence of housing characteristics on indoor concentrations of NO2 and formaldehyde.