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

Comprehensive analysis of classroom microclimate in context to health-related national and international indoor air quality standards

Indoor air quality (IAQ) and indoor air pollution are critical issues impacting urban environments, significantly affecting the quality of life. Nowadays, poor IAQ is linked to respiratory and cardiovascular diseases, allergic reactions, and cognitive impairments, particularly in settings like classrooms. Thus, this study investigates the impact of indoor environmental quality on student health in a university classroom over a year, using various sensors to measure 19 environmental parameters, including temperature, relative humidity, CO2, CO, volatile organic compounds (VOCs), particulate matter (PM), and other pollutants. Thus, the aim of the study is to analyze the implications of the indoor microclimate for the health of individuals working in the classroom, as well as its implications for educational outcomes. The data revealed frequent exceedances of international standards for formaldehyde (HCHO), VOC, PM2.5, NO, and NO2. HCHO and VOCs levels, often originating from building materials and classroom activities, were notably high. PM2.5 levels exceeded both annual and daily standards, while NO and NO2 levels, possibly influenced by inadequate ventilation, also surpassed recommended limits. Even though there were numerous exceedances of current international standards, the indoor microclimate quality index (IMQI) score indicated a generally good indoor environment, remaining mostly between 0 and 50 for this indicator. Additionally, analyses indicate a high probability that some indicators will exceed the current standards, and their values are expected to trend upwards in the future. The study highlighted the need for better ventilation and pollutant control in classrooms to ensure a healthy learning environment. Frequent exceedances of pollutant standards can suggest a significant impact on student health and academic performance. Thus, the present study underscored the importance of continuous monitoring and proactive measures to maintain optimal indoor air quality.

Predicting tropospheric nitrogen dioxide column density in South African municipalities using socio-environmental variables and Multiscale Geographically Weighted Regression

Atmospheric nitrogen dioxide (NO2) pollution is a major health and social challenge in South African induced mainly by fossil fuel combustions for power generation, transportation and domestic biomass burning for indoor activities. The pollution level is moderated by various environmental and social factors, yet previous studies made use of limited factors or focussed on only industrialised regions ignoring the contributions in large parts of the country. There is a need to assess how socio-environmenral factors, which inherently exhibit variations across space, influence the pollution levels in South Africa. This study therefore aimed to predict annual tropospheric NO2 column density using socio-environmental variables that are widely proven in the literature as sources and sinks of pollution. The environmental variables used to predict NO2 included remotely sensed Enhanced Vegetation Index (EVI), Land Surface Temperature and Aerosol Optical Depth (AOD) while the social data, which were obtained from national household surveys, included energy sources data, settlement patterns, gender and age statistics aggregated at municipality scale. The prediction was accomplished by applying the Multiscale Geographically Weighted Regression that fine-tunes the spatial scale of each variable when building geographically localised relationships. The model returned an overall R2 of 0.92, indicating good predicting performance and the significance of the socio-environmental variables in estimating NO2 in South Africa. From the environmental variables, AOD had the most influence in increasing NO2 pollution while vegetation represented by EVI had the opposite effect of reducing the pollution level. Among the social variables, household electricity and wood usage had the most significant contributions to pollution. Communal residential arrangements significantly reduced NO2, while informal settlements showed the opposite effect. The female proportion was the most important demographic variable in reducing NO2. Age groups had mixed effects on NO2 pollution, with the mid-age group (20-29) being the most important contributor to NO2 emission. The findings of the current study provide evidence that NO2 pollution is explained by socio-economic variables that vary widely across space. This can be achieved reliably using the MGWR approach that produces strong models suited to each locality.

Nitrogen dioxide exposure, health outcomes, and associated demographic disparities due to gas and propane combustion by U.S. stoves

Gas and propane stoves emit nitrogen dioxide (NO2) pollution indoors, but the exposures of different U.S. demographic groups are unknown. We estimate NO2 exposure and health consequences using emissions and concentration measurements from >100 homes, a room-specific indoor air quality model, epidemiological risk parameters, and statistical sampling of housing characteristics and occupant behavior. Gas and propane stoves increase long-term NO2 exposure 4.0 parts per billion volume on average across the United States, 75% of the World Health Organization's exposure guideline. This increased exposure likely causes ~50,000 cases of current pediatric asthma from long-term NO2 exposure alone. Short-term NO2 exposure from typical gas stove use frequently exceeds both World Health Organization and U.S. Environmental Protection Agency benchmarks. People living in residences <800 ft2 in size incur four times more long-term NO2 exposure than people in residences >3000 ft2 in size; American Indian/Alaska Native and Black and Hispanic/Latino households incur 60 and 20% more NO2 exposure, respectively, than the national average.

Gestational exposure to NO2 aggravates placental senescence

Placental senescence is a normal physiological process of placenta, while premature placental senescence has been confirmed to be associated with some adverse pregnancy complications. Epidemiological studies indicate that NO₂ exposure can aggravate placental senescence which is represented by fibrosis and abnormal telomere homeostasis, etc. In this study, pregnant C57BL/6 mice were exposed to NO₂ (2.5 ppm, 5 h/day) daily in a dynamic exposure chamber throughout the gestation period, and were sacrificed at embryonic day 13.5 (E13.5), E15.5 and E18.5. Placenta were harvested and conducted for histopathological examination and telomere evaluation. Our results showed that gestational NO₂ exposure significantly aggravated placental fibrosis and calcification, and up-regulated the related bio-markers (connective tissue growth factor (Ctgf) and transforming growth factor-β1 (Tgf-β1)) at E18.5. In addition, gestational exposure to NO₂ also activated senescence related pathway (p53/p21) at E18.5. Furthermore, gestational NO₂ exposure significantly shortened telomere length at E18.5, and the expression of telomere homeostasis regulation genes telomeric repeat binding factor 1 (Trf1), protection of telomeres 1a (Pot1a) and Pot1b were significantly increased while telomerase reverse transcriptase (Tert) was suppressed after NO₂ exposure at E13.5 or E18.5, respectively. Importantly, DNA methylation status of the 22^nd at E13.5 and 32^nd at E18.5 site in sub-telomeric region of chromosome 1 was significantly altered. Based on the above results, our present study indicated that gestational NO₂ exposure could lead to premature placental senescence during the late trimester of pregnancy via aggravation of fibrosis and telomere length shortening regulated by telomere regulatory enzyme and DNA methylation.

Lower socioeconomic status strengthens the effect of cooking fuel use on anemia risk and anemia-related parameters: Findings from the Henan Rural Cohort

The established evidence of cooking fuel use and socioeconomic status related to anemia is limited in low- and middle-income countries. The current study aims to examine the independent and combined effects of cooking fuel use and socioeconomic status on anemia risk as well as anemia-related parameters in rural China. A total of 21,050 participants were included from the baseline of the Henan Rural Cohort. Anemia was determined according to the World Health Organization criteria. Data on cooking fuel use (electricity, gas and solid fuel) and socioeconomic status (education and income levels) were collected using a standardized questionnaire by face-to-face interview. Logistic and linear regression models were applied to evaluate the effects of cooking fuel use or socioeconomic indicators on anemia risk, hemoglobin (HGB), red blood count (RBC), and hematocrit (HCT) levels. Using gas or solid fuel for cooking was positively associated with prevalent anemia risk and negatively related to HGB, RBC, and HCT levels compared to using electricity. Significant independent associations were also found between socioeconomic status (education and income levels) and prevalent anemia risk as well as these anemia-related parameters. In general, with decreased socioeconomic status, associations of using gas or solid fuel for cooking with advanced anemia risk as well as lower anemia-related parameters were increased. Furthermore, participants using gas or solid fuel for cooking and with lower education or income level were related to increased high anemia risk as well as low HGB, RBC and HCT levels, compared to those using electricity for cooking and with high education or income level (P <0.05 for all). The finding suggested that lower socioeconomic status strengthens the adverse effect of cooking fuel use on the higher anemia risk and lower HGB, RBC, and HCT levels in rural China.

[Societal inequalities and the urban exposome: Social origins for different exposures]

Today, many epidemiological studies have proved the adverse health consequences of environmental exposure. For instance, air pollution exposure is recognized to be related with respiratory and cardiovascular diseases as well as adverse pregnancy outcomes. Noise nuisances are also known to increase cardiovascular diseases and to disturb the sleeping quality. Inversely, the access and availability of various resources, as parks, green spaces, and playgrounds positively affect health, psychological and physical well-being, and favorable health behaviors. In this present literature review, we will focus on the urban dimension of exposome, defined by Robinson et al. as the accumulation of all urban settings favorable or unfavorable to health, from the time of life in utero [1].

Adverse Birth Outcomes Related to NO2 and PM Exposure: European Systematic Review and Meta-Analysis

There is a growing number of international studies on the association between ambient air pollution and adverse pregnancy outcomes, and this systematic review and meta-analysis has been conducted focusing on European countries, to assess the crucial public health issue of this suspected association on this geographical area. A systematic literature search (based on Preferred Reporting Items for Systematic reviews and Meta-Analyses, PRISMA, guidelines) has been performed on all European epidemiological studies published up until 1 April 2020, on the association between maternal exposure during pregnancy to nitrogen dioxide (NO₂) or particular matter (PM) and the risk of adverse birth outcomes, including: low birth weight (LBW) and preterm birth (PTB). Fourteen articles were included in the systematic review and nine of them were included in the meta-analysis. Our meta-analysis was conducted for 2 combinations of NO₂ exposure related to birth weight and PTB. Our systematic review revealed that risk of LBW increases with the increase of air pollution exposure (including PM₁₀, PM_2.5 and NO₂) during the whole pregnancy. Our meta-analysis found that birth weight decreases with NO₂ increase (pooled beta = −13.63, 95% confidence interval (CI) (−28.03, 0.77)) and the risk of PTB increase for 10 µg/m3 increase in NO₂ (pooled odds ratio (OR) = 1.07, 95% CI (0.90, 1.28)). However, the results were not statistically significant. Our finding support the main international results, suggesting that increased air pollution exposure during pregnancy might contribute to adverse birth outcomes, especially LBW. This body of evidence has limitations that impede the formulation of firm conclusions. Further studies, well-focused on European countries, are called to resolve the limitations which could affect the strength of association such as: the exposure assessment, the critical windows of exposure during pregnancy, and the definition of adverse birth outcomes. This analysis of limitations of the current body of research could be used as a baseline for further studies and may serve as basis for reflection for research agenda improvements.

Exposure to indoor air pollution across socio-economic groups in high-income countries: A scoping review of the literature and a modelling methodology

Disparities in outdoor air pollution exposure between individuals of differing socio-economic status is a growing area of research, widely explored in the environmental health literature. However, in developed countries, around 80% of time is spent indoors, meaning indoor air pollution may be a better proxy for personal exposure. Building characteristics - such as build quality, volume and ventilation - and occupant behaviour, mean indoor air pollution may also vary across socio-economic groups, leading to health inequalities. Much of the existing literature has focused on inequalities in exposure to outdoor air pollution, and there is thus a lack of an evidence base reviewing data for indoor environments. In this study, a scoping review of the literature on indoor air pollution exposures across different socio-economic groups is performed, examining evidence from both monitoring and modelling studies in the developed world. The literature was reviewed, identifying different indoor pollutants, definitions for socio-economic status and pre- and post- housing interventions. Based on the review, the study proposes a modelling methodology for evaluating the effects of environmental policies on different socio-economic populations. Using a sample size calculation, obstacles in obtaining sufficiently large samples of monitored data are demonstrated. A modelling framework for the rapid quantification of daily home exposure is then outlined as a proof of concept. While significant additional research is required to examine inequalities in indoor exposures, modelling approaches may provide opportunities to quantify exposure disparities due to housing and behaviours across populations of different socio-economic status.

Maternal cooking during pregnancy may increase hyperactive behaviors among children aged at around 3 years old

Cooking is one of the main sources of indoor air pollution in China. Given emerging evidence of a link between air pollutants and neurodevelopmental delays, we examined whether maternal experiences with cooking during gestation might increase their child's hyperactivity at 3 years of age. The participants involved 45 518 mothers of children who were newly enrolled at kindergarten in the Longhua District of Shenzhen from 2015 to 2017. The results show that maternal exposure to cooking fumes during pregnancy was related to an increased risk of their offspring having hyperactivity behaviors at the age of 3 years. Compared with pregnant mothers who never cooked, pregnant mothers who cooked sometimes, often, or always had children who showed a significantly higher hyperactivity risk. Households using cooking fuels such as coal, gas during the mothers' pregnancy, exhibited more hyperactivity behaviors in the young child when compared to those using electricity for cooking. In addition, poor ventilation during cooking, while mothers were pregnant, was found to be a significant risk factor for clinical levels of the offspring's hyperactive behaviors. Furthermore, the positive association with maternal cooking during pregnancy and their offsprings' hyperactivity was relatively consistent across strata defined by social class, education, and other covariates.

Measuring the Building Envelope Penetration Factor for Ambient Nitrogen Oxides

Much of human exposure to nitrogen oxides (NO_x) of ambient origin occurs indoors. Reactions with materials inside building envelopes are expected to influence the amount of ambient NO_x that infiltrates indoors. However, envelope penetration factors for ambient NO_x constituents have never been measured. Here, we develop and apply methods to measure the penetration factor and indoor loss rates for ambient NO_x constituents using time-resolved measurements in an unoccupied apartment unit. Multiple test methods and parameter estimation approaches were tested, including natural and artificial indoor NO_x elevation with and without accounting for indoor oxidation reactions. Twelve of 16 tests yielded successful estimates of penetration factors and indoor loss rates. The penetration factor for NO was confirmed to be ∼1 and the mean (±s.d.) NO₂ penetration factor was 0.72 ± 0.06 with a mean relative uncertainty of ∼15%. The mean (±s.d.) indoor NO₂ loss rate was 0.27 ± 0.12 h^-1, ranging 0.06-0.47 h^-1, with strong correlations with indoor relative and absolute humidity. Indoor NO loss rates were strongly correlated with the estimated ozone concentration in infiltrating air. Results suggest that envelope penetration factors and loss rates for NO_x constituents can be reasonably estimated across a wide range of conditions using these approaches.

Infants' indoor and outdoor residential exposure to benzene and respiratory health in a Spanish cohort

Benzene exposure represents a potential risk for children's health. Apart from being a known carcinogen for humans (group 1 according to IARC), there is scientific evidence suggesting a relationship between benzene exposure and respiratory problems in children. But results are still inconclusive and inconsistent. This study aims to assess the determinants of exposure to indoor and outdoor residential benzene levels and its relationship with respiratory health in infants. Participants were 1-year-old infants (N = 352) from the INMA cohort from Valencia (Spain). Residential benzene exposure levels were measured inside and outside dwellings by means of passive samplers in a 15-day campaign. Persistent cough, low respiratory tract infections and wheezing during the first year of life, and covariates (dwelling traits, lifestyle factors and sociodemographic data) were obtained from parental questionnaires. Multiple Tobit regression and logistic regression models were performed to assess factors associated to residential exposure levels and health associations, respectively. Indoor levels were higher than outdoor ones (1.46 and 0.77 μg/m³, respectively; p < 0.01). A considerable percentage of dwellings, 42% and 21% indoors and outdoors respectively, surpassed the WHO guideline of 1.7 μg/m³ derived from a lifetime risk of leukemia above 1/100 000. Monitoring season, maternal country of birth and parental tobacco consumption were associated with residential benzene exposure (indoor and outdoors). Additionally, indoor levels were associated with mother's age and type of heating, and outdoor levels were linked with zone of residence and distance from industrial areas. After adjustment for confounding factors, no significant associations were found between residential benzene exposure levels and respiratory health in infants. Hence, our study did not support the hypothesis for the benzene exposure effect on respiratory health in children. Even so, it highlights a public health concern related to the personal exposure levels, since a considerable number of children surpassed the abovementioned WHO guideline for benzene exposure.

The use of tree barks and human fingernails for monitoring metal levels in urban areas of different population densities of Porto Alegre, Brazil

The aim of this study was to evaluate the use of tree barks as a bioindicator of atmospheric pollution in areas of contrasting population densities and to associate the levels of elements found in this bioindicator with those obtained in fingernail samples collected from students living in the same study areas. Tree bark samples were collected from urban areas near highways in regions with high (Area A), intermediate (Area B), and low (Area C) population densities of Porto Alegre, Brazil, and evaluated for chemical elements concentration. Since these areas also differed in traffic density, NO₂ was measured by passive sampling. For a comparative purpose, the elements were also determined in fingernail samples collected from students living in the same areas. Accumulated elements were determined by inductively coupled plasma mass spectrometry (ICP-MS) and principal component analysis (PCA) was used as a tool in exploratory data analysis to identify possible sources. We found that Ba, Cd, Co, Cu, Mg, Mn, Ni, Pb, Sb, Sr, V, and Zn were at higher concentrations in tree barks in Area A, while Cd, Co, Cu, Mg, Mn, Ni, and Sr were at higher levels in students' fingernails of Area A as well. Furthermore, concentrations of elements found in barks were associated with those identified in fingernails collected from students living in the same areas. PCA demonstrated that vehicular traffic explained 66.4 % of the variance in tree bark and 50.8 % of the variance in fingernails. NO₂ levels were significantly different among the areas, what is consistent with their respective vehicular flow and population density. In conclusion, we found conformance of elements levels accumulated in barks and fingernails at three monitoring areas with different profiles. The amount of traffic-related elements accumulated appears to be associated with the degree of urbanization and vehicular flow. Overall, data suggests a relationship between fingernails and tree bark as bioindicators of exposure to metals from air pollution.

A comparison of the human buccal cell assay and the pollen abortion assay in assessing genotoxicity in an urban-rural gradient

Air pollution is exacerbated near heavy traffic roads in cities. Air pollution concentration and composition vary by region and depend on urban-rural gradients. The aim of this study was to evaluate the distribution of air pollution in areas of varying population densities and to compare plant biomonitoring with an established biomarker of human exposure to traffic-related air pollution in children. The areas of study were selected near a major street in 3 different regions. Areas A, B and C represent high, intermediate and low population densities, respectively. Micronucleus assay, an established biomarker of human exposure, was performed in children from these areas. For a plant biomonitoring assay, the pollen abortion assay was performed on Bauhinia variegata in these areas. NO₂ and O₃ concentrations were determined by passive sampling. We report here that the pollen abortion frequency in Bauhinia variegata is correlated with NO₂ concentration (P = 0.004) and is strongly associated with vehicular flow and population density in the studied areas. Micronuclei frequency in buccal cells of children was higher in the regions with more degree of urbanization (P < 0.001) following the same pattern of O₃ concentrations (P = 0.030). In conclusion, our results demonstrate that high concentrations of air pollutants in Porto Alegre are related to both human and plant genotoxicity. Areas with different concentration of pollutants demonstrated to have an urbanization gradient dependent pattern which also reflected on genotoxic damage among these areas.

Determinants of personal exposure to some carcinogenic substances and nitrogen dioxide among the general population in five Swedish cities

Environmental levels of airborne carcinogenic and related substances are comparatively better known than individual exposure and its determinants. We report on a personal monitoring program involving five Swedish urban populations. The aim of the program was to investigate personal exposure to benzene, 1,3-butadiene, formaldehyde, and nitrogen dioxide (NO2). The measurements were performed among 40 inhabitants during seven consecutive days, in one urban area each year, during 2000-2008. The estimated population exposure levels were 1.95 μg/m(3) for benzene, 0.56 μg/m(3) for 1,3-butadiene, 19.4 μg/m(3) for formaldehyde, and 14.1 μg/m(3) for NO2. Statistical analysis using a mixed-effects model revealed that time spent in traffic and time outdoors contributed to benzene and 1,3- butadiene exposure. For benzene, refueling a car was an additional determinant influencing the exposure level. Smoking or environmental tobacco smoke were significant determinants of exposure to NO2, benzene, and 1,3-butadiene. Those with a gas stove had higher NO2 exposure. Living in a single-family house increased the exposure to formaldehyde significantly. In a variance component model, the between-subject variance dominated for 1,3-butadiene and formaldehyde, whereas the between-city variance dominated for NO2. For benzene, the between-subject and between-cities variances were similar.

Prenatal exposure to cooking gas and respiratory health in infants is modified by tobacco smoke exposure and diet in the INMA birth cohort study

BACKGROUND

Studies that have evaluated the association between exposure to gas appliances emissions at home with respiratory health in children obtained heterogeneous and limited results. The aim of this study is to analyze the association between the use of gas cooking at home during pregnancy and respiratory problems in children during their first year of life.

METHODS

In the years 2003 through 2008 pregnant women were enrolled in 4 Spanish areas and visited in different age-points following a common protocol. Outcomes studied (from a questionnaire) were any episode of lower respiratory tract infection (LRTI), wheezing, persistent cough, chestiness and otitis. The association between exposure to gas cooking at home and respiratory outcomes was assessed using logistic regression and adjusting by confounding variables. Some potential effect modifiers (i.e. smoking, fruit and vegetables consumption) were examined.

RESULTS

Among the 2003 children included in the study, a total of 731 (36.6%) had a LRTI episode, 693 (34.6%) experienced wheezing, 302 (15.5%) a persistent cough, 939 (47.4%) chestiness and 620 (31.2%) had an episode of otitis during their first year of life. Gas cookers were present in 45.5% of homes. Exposure to gas cooking in homes was not associated with respiratory outcomes Odds Ratios (OR) were close to 1 and not statistically significant. However, a positive association was found for otitis among infants whose mothers reported low intakes of fruit and vegetables during pregnancy [OR (95% CI) = 1.38 (1.01-1.9)] and also wheezing and chestiness were associated with gas cookers among those children whose mothers smoked during pregnancy.

CONCLUSIONS

In susceptible subjects (those whose mothers smoke and consumed below average fruit and vegetables) we found an association between exposure to gas cooking during pregnancy and risk of wheezing, chestiness and otitis during the first year of life. But more research is needed regarding not only gas cooking and respiratory health but also the possible effect modifier role of diet and tobacco.

In vivo screening to determine neurological hazards of nitrogen dioxide (NO2) using Wistar rats

NO(2) is a well-known indoor and outdoor pollutant that may cause adverse health problems. Recently, accumulating but extremely limited evidences show that NO(2) possibly express neurotoxicity and is responsible for various neurological disorders. In the present study, neurological hazard of NO(2) and possible mechanisms were determined in rat pallium following a repetitive inhalation exposure with various concentrations (5, 10 and 20mg/m(3)). After 7-day exposure (6h/day), observable adverse effects were induced encompassing decreased ratio of brain to body weight, mild brain pathology, increased neuronal apoptosis, altered antioxidants (Cu/Zn-SOD, Mn-SOD, GPx and NO) activity and increasing formation of PCO. NO(2) inhalation also induced augment of oncogenes (c-fos, c-jun) levels, and deregulation of apoptosis-related genes (p53, bax and bcl-2) expression. With all above data, the present report provided essential information for the characterization of the neurotoxic hazard of NO(2) and related mechanisms, which is required in response to the general concern about the vulnerability of the neurological system to it.

Indoor air pollution from gas cooking and infant neurodevelopment

BACKGROUND

Gas cooking is a main source of indoor air pollutants, including nitrogen dioxide and particles. Because concerns are emerging for neurodevelopmental effects of air pollutants, we examined the relationship between indoor gas cooking during pregnancy and infant neurodevelopment.

METHODS

Pregnant mothers were recruited between 2004 and 2008 to a prospective birth cohort study (INfancia y Medio Ambiente) in Spain during the first trimester of pregnancy. Third-trimester questionnaires collected information about the use of gas appliances at home. At age 11 to 22 months, children were assessed for mental development using the Bayley Scales of Infant Development. Linear regression models examined the association of gas cooking and standardized mental development scores (n = 1887 mother-child pairs).

RESULTS

Gas cookers were present in 44% of homes. Gas cooking was related to a small decrease in the mental development score compared with use of other cookers (-2.5 points [95% confidence interval = -4.0 to -0.9]) independent of social class, maternal education, and other measured potential confounders. This decrease was strongest in children tested after the age of 14 months (-3.1 points [-5.1 to -1.1]) and when gas cooking was combined with less frequent use of an extractor fan. The negative association with gas cooking was relatively consistent across strata defined by social class, education, and other covariates.

CONCLUSIONS

This study suggests a small adverse effect of indoor air pollution from gas cookers on the mental development of young children.

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.

Residential exposure to outdoor air pollution during pregnancy and anthropometric measures at birth in a multicenter cohort in Spain

BACKGROUND

A growing body of research suggests that prenatal exposure to air pollution may be harmful to fetal development. We assessed the association between exposure to air pollution during pregnancy and anthropometric measures at birth in four areas within the Spanish Children's Health and Environment (INMA) mother and child cohort study.

METHODS

Exposure to ambient nitrogen dioxide (NO2) and benzene was estimated for the residence of each woman (n = 2,337) for each trimester and for the entire pregnancy. Outcomes included birth weight, length, and head circumference. The association between residential outdoor air pollution exposure and birth outcomes was assessed with linear regression models controlled for potential confounders. We also performed sensitivity analyses for the subset of women who spent more time at home during pregnancy. Finally, we performed a combined analysis with meta-analysis techniques.

RESULTS

In the combined analysis, an increase of 10 µg/m3 in NO2 exposure during pregnancy was associated with a decrease in birth length of -0.9 mm [95% confidence interval (CI), -1.8 to -0.1 mm]. For the subset of women who spent ≥ 15 hr/day at home, the association was stronger (-0.16 mm; 95% CI, -0.27 to -0.04). For this same subset of women, a reduction of 22 g in birth weight was associated with each 10-µg/m3 increase in NO2 exposure in the second trimester (95% CI, -45.3 to 1.9). We observed no significant relationship between benzene levels and birth outcomes.

CONCLUSIONS

NO2 exposure was associated with reductions in both length and weight at birth. This association was clearer for the subset of women who spent more time at home.

Social factors associated with nitrogen dioxide (NO2) exposure during pregnancy: the INMA-Valencia project in Spain

Numerous studies have focused on the effects of exposure to air pollution on health; however, certain subsets of the population tend to be more exposed to such pollutants depending on their social or demographic characteristics. In addition, exposure to toxicants during pregnancy may play a deleterious role in fetal development as fetuses are especially vulnerable to external insults. The present study was carried out within the framework of the INMA (Infancia y Medio Ambiente or Childhood and the Environment) multicenter cohort study with the objective of identifying the social, demographic, and life-style factors associated with nitrogen dioxide (NO(2)) exposure in the subjects in the cohort. The study comprised 785 pregnant women who formed part of the INMA cohort in Valencia, Spain. Outdoor levels of NO(2) were measured at 93 sampling sites spread over the study area during four different sampling periods lasting 7 days each. Multiple regression models were used for mapping outdoor NO(2) throughout the area. Individual exposure was assigned as: 1) the estimated outdoor NO(2) levels at home, and 2) the average of estimated outdoor NO(2) levels at home and work, weighted according to the time spent in each environment. The subjects' socio-demographic and life-style information was obtained through a questionnaire. In the multiple linear analyses, the outdoor NO(2) levels assigned to each home were taken to be the dependent variable. Other variables included in the model were: age, country of origin, smoking during pregnancy, parity, season of the year, and social class. These same variables remained in the model when the dependent variable was changed to the NO(2) levels adjusted for the subjects' time-activity patterns. We found that younger women, those coming from Latin American countries, and those belonging to the lower social strata were exposed to higher NO(2) levels, both as measured outside their homes as well as when time-activity patterns were taken into account. These subgroups also have a higher probability of being exposed to NO(2) levels over 40 μg/m(3), which is the annual limit for maximum safe exposure, as established by European Directive 2008/50/EC.

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 air concentrations of BTEX and determinants in a cohort of one-year old children in Valencia, Spain

BTEX is the commonly used term for a group of toxic compounds (benzene, toluene, ethyl benzene, ortho-xylene and meta- and para-xylene), some of which, most notably benzene, are known carcinogens. The aim of this study is to measure the BTEX levels both inside and outside the homes of 352 one-year old children from the Valencia cohort of the INMA study (Spain) and to analyze the determinants of these levels. Passive samplers were used to measure BTEX levels during a 15day period and a questionnaire was administered to gather information on potentially associated factors (sociodemographics, residential conditions, and lifestyle). The average concentrations of benzene, toluene, ethyl benzene, ortho-xylene, and meta- and para-xylene were 0.9, 3.6, 0.6, 0.6, and 1.0μg/m(3), respectively. On average, the indoor levels of all the compounds were approximately 2.5 times higher than those observed outdoors. Factors associated with higher BTEX concentrations inside the home were being the child of a mother of non-Spanish origin, living in a house that had been painted within the last year, living in an apartment, and not having air conditioning. Higher outdoor concentrations of BTEX depend on the residence being situated in a more urban zone, being located within the city limits, having living in a building with more than one story, residing in an area with a greater frequency of traffic, and the season of the year in which the sample was taken. The data thus obtained provide helpful information not only for implementing measures to reduce exposure to these pollutants, but also for evaluating the relation between such exposure and possible health risks for the children in the cohort.