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Ren J, Zhang Z, Cui Q, Tian H, Guo Z, Zhang Y, Chen F, Deng Y, Ma Y. The effect of indoor air filtration on biomarkers of inflammation and oxidative stress: a review and meta-analysis of randomized controlled trials. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2024; 31:33212-33222. [PMID: 38687452 DOI: 10.1007/s11356-024-33414-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 04/17/2024] [Indexed: 05/02/2024]
Abstract
Improvement of indoor air quality is beneficial for human health. However, previous studies have not reached consistent conclusions regarding the effects of indoor air filtration on inflammation and oxidative stress. This study aims to determine the relationship between indoor air filtration and inflammation and oxidative stress biomarkers. We conducted an electronic search that evaluated the association of indoor air filtration with biomarkers of inflammation and oxidative stress in five databases (PubMed, Cochrane Library, EMBASE, Web of Science, and Scopus) from the beginning to April 23, 2023. Outcomes included the following markers: interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), malondialdehyde (MDA), 8-hydroxy-2deoxyguanosine (8-OHdG), and 8-iso-prostaglandinF2α (8-isoPGF2α). We extracted data from the included studies according to the system evaluation and the preferred reporting item for meta-analysis (PRISMA) guidelines and used the Cochrane risk of bias tool to assess bias risk. Our meta-analysis included 15 studies with 678 participants to assess the combined effect size. The meta-analysis demonstrated that indoor air filtration could have a marked reduction in IL-6 (SMD: -0.275, 95% CI: -0.545 to -0.005, p = 0.046) but had no significant effect on other markers of inflammation or oxidative stress. Subgroup analysis results demonstrated a significant reduction in 8-OHdG levels in the subgroup with < 1 day of duration (SMD: -0.916, 95% CI: -1.513 to -0.320; p = 0.003) and using filtrete air filter (SMD: -5.530, 95% CI: -5.962 to -5.099; p < 0.001). Our meta-analysis results depicted that indoor air filtration can significantly reduce levels of inflammation and oxidative stress markers. Considering the adverse effects of air pollution on human health, our study provides powerful evidence for applying indoor air filtration to heavy atmospheric pollution.
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Affiliation(s)
- Jingyi Ren
- Department of Nutrition and Food Hygiene, School of Public Health, Hebei Medical University, Hebei Key Laboratory of Environment and Human Health, Shijiazhuang, 050017, China
| | - Zhenao Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Hebei Medical University, Hebei Key Laboratory of Environment and Human Health, Shijiazhuang, 050017, China
| | - Qiqi Cui
- Undergraduate of College of Basic Medicine, Hebei Medical University, Shijiazhuang, 050017, China
| | - Hao Tian
- Department of Nutrition and Food Hygiene, School of Public Health, Hebei Medical University, Hebei Key Laboratory of Environment and Human Health, Shijiazhuang, 050017, China
| | - Zihao Guo
- Undergraduate of College of Public Health, Hebei Medical University, Shijiazhuang, 050017, China
| | - Yadong Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Hebei Medical University, Hebei Key Laboratory of Environment and Human Health, Shijiazhuang, 050017, China
| | - Fengge Chen
- Shijiazhuang Center for Disease Control and Prevention, Shijiazhuang, 050017, China
| | - Yandong Deng
- Department of Ultrasonic, the First Hospital of Hebei Medical University, Shijiazhuang, 050017, China
| | - Yuxia Ma
- Department of Nutrition and Food Hygiene, School of Public Health, Hebei Medical University, Hebei Key Laboratory of Environment and Human Health, Shijiazhuang, 050017, China.
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Abstract
Wildfire smoke (WFS) is a mixture of respirable particulate matter, environmental gases, and other hazardous pollutants that originate from the unplanned burning of arid vegetation during wildfires. The increasing size and frequency of recent wildfires has escalated public and occupational health concerns regarding WFS inhalation, by either individuals living nearby and downstream an active fire or wildland firefighters and other workers that face unavoidable exposure because of their profession. In this review, we first synthesize current evidence from environmental, controlled, and interventional human exposure studies, to highlight positive associations between WFS inhalation and cardiovascular morbidity and mortality. Motivated by these findings, we discuss preventative measures and suggest interventions to mitigate the cardiovascular impact of wildfires. We then review animal and cell exposure studies to call attention on the pathophysiological processes that support the deterioration of cardiovascular tissues and organs in response to WFS inhalation. Acknowledging the challenges of integrating evidence across independent sources, we contextualize laboratory-scale exposure approaches according to the biological processes that they model and offer suggestions for ensuring relevance to the human condition. Noting that wildfires are significant contributors to ambient air pollution, we compare the biological responses triggered by WFS to those of other harmful pollutants. We also review evidence for how WFS inhalation may trigger mechanisms that have been proposed as mediators of adverse cardiovascular effects upon exposure to air pollution. We finally conclude by highlighting research areas that demand further consideration. Overall, we aspire for this work to serve as a catalyst for regulatory initiatives to mitigate the adverse cardiovascular effects of WFS inhalation in the community and alleviate the occupational risk in wildland firefighters.
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Affiliation(s)
- Victoria A Williams
- Department of Bioengineering, Northeastern University, Boston, MA (V.A.W., C.T.Y., N.A.M., J.M.O., C.B.)
| | - Luke R Perreault
- Department of Engineering, Boston College, Chestnut Hill, MA (L.R.P.)
| | - Charbel T Yazbeck
- Department of Bioengineering, Northeastern University, Boston, MA (V.A.W., C.T.Y., N.A.M., J.M.O., C.B.)
| | - Nicholas A Micovic
- Department of Bioengineering, Northeastern University, Boston, MA (V.A.W., C.T.Y., N.A.M., J.M.O., C.B.)
| | - Jessica M Oakes
- Department of Bioengineering, Northeastern University, Boston, MA (V.A.W., C.T.Y., N.A.M., J.M.O., C.B.)
| | - Chiara Bellini
- Department of Bioengineering, Northeastern University, Boston, MA (V.A.W., C.T.Y., N.A.M., J.M.O., C.B.)
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Xia X, Chan KH, Kwok T, Wu S, Man CL, Ho KF. Effects of long-term indoor air purification intervention on cardiovascular health in elderly: a parallel, double-blinded randomized controlled trial in Hong Kong. ENVIRONMENTAL RESEARCH 2024; 247:118284. [PMID: 38253196 DOI: 10.1016/j.envres.2024.118284] [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: 11/26/2023] [Revised: 01/18/2024] [Accepted: 01/19/2024] [Indexed: 01/24/2024]
Abstract
Ambient fine particulate matter (PM2.5) is a leading environmental risk factor globally, and over half of the associated disease burden are caused by cardiovascular disease. Numerous randomized controlled trials (RCT) have investigated the short-term cardiovascular benefits of indoor air purifiers (IAPs), but major knowledge gaps remain on their longer-term benefits. In this 1-year, randomized, double-blinded, parallel controlled trial of 47 elderly (ntrue-purification = 24; nsham-purification = 23) aged ≥70 years, true-purification reduced household PM2.5 levels by 28% and maintained lower exposure throughout the year compared to the sham-purification group. After 12 months of intervention, a significant reduction of diastolic blood pressure was found in the true-purification versus sham-purification group (-4.62 [95% CI: -7.28, -1.96] mmHg) compared to baseline measurement prior to the intervention, whereas systolic blood pressure showed directionally consistent but statistically non-significant effect (-2.49 [95% CI: -9.25, 4.28] mmHg). Qualitatively similar patterns of associations were observed for pulse pressure (-2.30 [95% CI: -6.57, 1.96] mmHg) and carotid intima-media thickness (-10.0% [95% CI: -24.8%, 4.7%]), but these were not statistically significant. Overall, we found suggestive evidence of cardiovascular benefits of long-term IAPs use, particularly on diastolic blood pressure. Evidence on other longer-term cardiovascular traits is less clear. Further trials with larger sample sizes and long-term follow-up are needed across diverse populations to evaluate the cardiovascular benefits of IAPs.
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Affiliation(s)
- Xi Xia
- Department of Occupational and Environmental Health, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China; Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, China; School of Public Health, Shaanxi University of Chinese Medicine, China; The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
| | - Ka Hung Chan
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, UK; Oxford British Heart Foundation Centre of Research Excellence, University of Oxford, UK.
| | - Timothy Kwok
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China; The Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Hong Kong, China
| | - ShaoWei Wu
- Department of Occupational and Environmental Health, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China; Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, China
| | - Chung Ling Man
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
| | - Kin-Fai Ho
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong.
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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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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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Klaver ZM, Crane RC, Ziemba RA, Bard RL, Adar SD, Brook RD, Morishita M. Reduction of Outdoor and Indoor PM 2.5 Source Contributions via Portable Air Filtration Systems in a Senior Residential Facility in Detroit, Michigan. TOXICS 2023; 11:1019. [PMID: 38133420 PMCID: PMC10748160 DOI: 10.3390/toxics11121019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 12/07/2023] [Accepted: 12/12/2023] [Indexed: 12/23/2023]
Abstract
Background: The Reducing Air Pollution in Detroit Intervention Study (RAPIDS) was designed to evaluate cardiovascular health benefits and personal fine particulate matter (particulate matter < 2.5 μm in diameter, PM2.5) exposure reductions via portable air filtration units (PAFs) among older adults in Detroit, Michigan. This double-blind randomized crossover intervention study has shown that, compared to sham, air filtration for 3 days decreased 3-day average brachial systolic blood pressure by 3.2 mmHg. The results also showed that commercially available HEPA-type and true HEPA PAFs mitigated median indoor PM2.5 concentrations by 58% and 65%, respectively. However, to our knowledge, no health intervention study in which a significant positive health effect was observed has also evaluated how outdoor and indoor PM2.5 sources impacted the subjects. With that in mind, detailed characterization of outdoor and indoor PM2.5 samples collected during this study and a source apportionment analysis of those samples using a positive matrix factorization model were completed. The aims of this most recent work were to characterize the indoor and outdoor sources of the PM2.5 this community was exposed to and to assess how effectively commercially available HEPA-type and true HEPA PAFs were able to reduce indoor and outdoor PM2.5 source contributions. Methods: Approximately 24 h daily indoor and outdoor PM2.5 samples were collected on Teflon and Quartz filters from the apartments of 40 study subjects during each 3-day intervention period. These filters were analyzed for mass, carbon, and trace elements. Environmental Protection Agency Positive Matrix Factorization (PMF) 5.0 was utilized to determine major emission sources that contributed to the outdoor and indoor PM2.5 levels during this study. Results: The major sources of outdoor PM2.5 were secondary aerosols (28%), traffic/urban dust (24%), iron/steel industries (15%), sewage/municipal incineration (10%), and oil combustion/refinery (6%). The major sources of indoor PM2.5 were organic compounds (45%), traffic + sewage/municipal incineration (14%), secondary aerosols (13%), smoking (7%), and urban dust (2%). Infiltration of outdoor PM2.5 for sham, HEPA-type, and true HEPA air filtration was 79 ± 24%, 61 ± 32%, and 51 ± 34%, respectively. Conclusions: The results from our study showed that intervention with PAFs was able to significantly decrease indoor PM2.5 derived from outdoor and indoor PM2.5 sources. The PAFs were also able to significantly reduce the infiltration of outdoor PM2.5. The results of this study provide insights into what types of major PM2.5 sources this community is exposed to and what degree of air quality and systolic blood pressure improvements are possible through the use of commercially available PAFs in a real-world setting.
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Affiliation(s)
- Zachary M. Klaver
- Exposure Science Lab, Family Medicine, College of Human Medicine, Michigan State University, East Lansing, MI 48824, USA
| | - Ryan C. Crane
- Exposure Science Lab, Family Medicine, College of Human Medicine, Michigan State University, East Lansing, MI 48824, USA
| | | | - Robert L. Bard
- Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, MI 48109, USA
| | - Sara D. Adar
- School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
| | - Robert D. Brook
- Department of Internal Medicine, Wayne State University, Detroit, MI 48201, USA
| | - Masako Morishita
- Exposure Science Lab, Family Medicine, College of Human Medicine, Michigan State University, East Lansing, MI 48824, USA
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Shah S, Kim E, Kim KN, Ha E. Can individual protective measures safeguard cardiopulmonary health from air pollution? A systematic review and meta-analysis. ENVIRONMENTAL RESEARCH 2023; 229:115708. [PMID: 36940818 DOI: 10.1016/j.envres.2023.115708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 03/15/2023] [Accepted: 03/15/2023] [Indexed: 05/09/2023]
Abstract
Evidence supporting the effect of individual protective measures (IPMs) on air pollution is relatively scarce. In this study, we performed a systematic review and meta-analysis to investigate the effects of air purifiers, air-purifying respirators, and cookstove changes on cardiopulmonary health outcomes. We searched PubMed, Scopus, and Web of Science until December 31, 2022, 90 articles and 39,760 participants were included. Two authors independently searched and selected the studies, extracted information, and assessed each study's quality and risk of bias. We performed meta-analyses when three or more studies were available for each IPMs, with comparable intervention and health outcome. Systematic review showed that IPMs were beneficial in children and elderly with asthma along with healthy individuals. Meta-analysis results showed a reduction in cardiopulmonary inflammation using air purifiers than in control groups (with sham/no filter) with a decrease in interleukin 6 by -0.247 μg/mL (95% confidence intervals [CI] = -0.413, -0.082). A sub-group analysis for air purifier as an IPMs in developing counties reduced fractional exhaled nitric oxide by -0.208 ppb (95% confidence intervals [CI] = -0.394, -0.022). However, evidence describing the effects of air purifying respirator and cook stove changes on cardiopulmonary outcomes remained insufficient. Therefore, air purifiers can serve as efficient IPMs against air pollution. The beneficial effect of air purifiers is likely to have a greater effect in developing countries than in developed countries.
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Affiliation(s)
- Surabhi Shah
- Department of Environmental Medicine, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Eunji Kim
- Department of Environmental Medicine, Ewha Womans University College of Medicine, Seoul, Republic of Korea; Graduate Program in System Health Science and Engineering, College of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Kyoung-Nam Kim
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea.
| | - Eunhee Ha
- Department of Environmental Medicine, Ewha Womans University College of Medicine, Seoul, Republic of Korea; Graduate Program in System Health Science and Engineering, College of Medicine, Ewha Womans University, Seoul, Republic of Korea; Institute of Ewha-SCL for Environmental Health (IESEH), Ewha Womans University College of Medicine, Seoul, Republic of Korea; Department of Medical Science, Ewha Womans University School of Medicine and Ewha Medical Research Institute, Seoul, Republic of Korea.
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8
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Liu Z, Wang Q, Li N, Xu C, Li Y, Zhou J, Liu L, Zhang H, Mo Y, Han F, Xu D. Cardiovascular benefits of air purifier in patients with stable coronary artery disease: A randomized single-blind crossover study. Front Public Health 2023; 10:1082327. [PMID: 36699920 PMCID: PMC9868303 DOI: 10.3389/fpubh.2022.1082327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 12/09/2022] [Indexed: 01/10/2023] Open
Abstract
Background Exposure to PM2.5 will accelerate the progression of cardiovascular diseases. Air purifier can reduce the PM2.5 exposure and theoretically alleviate the influence of PM2.5 on patients with stable coronary artery disease (SCAD). However, few studies of the protective effect showed significant results because the interferent effects of routine medication had not been taken into account. In order to explore the actual effect on patients with SCAD, we conducted a randomized single-blind crossover air purifier intervention trial. Method Levels of PM2.5 exposure during intervention and cardiovascular indicators (inflammation, coagulation, plaque stability, and blood lipids) after intervention were detected, meanwhile the information of drug use was obtained by questionnaire. The kinds of drug used by more than 20% of the subjects were sorted out. And the influence of these drugs on cardiovascular indicators was summarized through literature review. Based on that, the drug use was included as a variable in linear mixed effects models that used to analyze the associations between PM2.5 exposure reduction by air purifier and cardiovascular indicators. Results The result revealed that the interpretation contribution rate of drug use was more than that of PM2.5 exposure. The level of C-reactive protein significantly decreased by 20.93% (95%CI: 6.56%, 33.10%), 23.44% (95%CI: 2.77%, 39.39%) and 24.11% (95%CI: 4.21%, 39.69%) on lag1, lag01 and lag02 respectively, while the level of high-density lipoprotein cholesterol significantly increased by 5.10% (95%CI: 0.69%, 9.05%), 3.71% (95%CI: 0.92%, 6.60%) and 6.48% (95%CI: 2.58%, 10.24%) respectively on lag0, lag1 and lag01 associated with an interquartile range decrease of 22.51 μg/m3 in PM2.5 exposure. Conclusion The study shows positive effects of air purifier on SCAD, and also provides methodological reference for future related research.
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Affiliation(s)
- Zhe Liu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Qin Wang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Na Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Chunyu Xu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yunpu Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jun Zhou
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Liu Liu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China,Chaoyang District Center for Disease Control and Prevention, Beijing, China
| | - Haijing Zhang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yang Mo
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Feng Han
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China,National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Dongqun Xu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China,*Correspondence: Dongqun Xu ✉
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Adetona AM, Adetona O, Chartier RT, Paulsen MH, Simpson CD, Rathbun SL, Naeher LP. Differences in Fine Particle Exposure and Estimated Pulmonary Ventilation Rate with Respect to Work Tasks of Wildland Firefighters at Prescribed Burns: A Repeated Measures Study. Ann Work Expo Health 2022; 66:985-997. [PMID: 35652799 PMCID: PMC9551324 DOI: 10.1093/annweh/wxac037] [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: 05/22/2021] [Revised: 04/26/2022] [Accepted: 05/18/2022] [Indexed: 11/13/2022] Open
Abstract
Wildland firefighters (WLFFs) are exposed to a mixture of chemicals found in wildland fire smoke and emissions from nonwildland-fuel smoke sources such as diesel. We investigated compositional differences in exposure to particulate matter and explored differences in ventilation rate and potential inhaled dose relative to the work tasks of WLFFs. Repeated measures on ten professional and two volunteer firefighters were collected on prescribed burn and nonburn days. Personal monitoring consisted of real-time and gravimetric fine particulate matter (PM2.5), carbon monoxide (CO), and accelerometer measurements to estimate ventilation rate and potential dose of PM2.5. The fine particulate matter was analyzed for levoglucosan (LG) and light absorbing carbon as a surrogate for black carbon (BC). Breathing zone personal exposure concentrations of PM2.5, LG, BC, and CO were higher on burn days (P < 0.05). Differences in exposure concentrations were observed between burn day tasks (P < 0.05) with firefighters managing fire boundaries (holders) being exposed to higher CO and LG concentrations and less BC concentrations than those conducting lighting (lighters). While no statistical difference in PM2.5 exposure measures was observed between the two tasks, holders in the study tended to be exposed to higher PM2.5 concentrations (~1.4×), while lighters tended to have more inhaled amounts of PM2.5 (~1.3×). Our findings demonstrate possible diversity in the sources of particulate matter exposure at the fireline and suggest the potential importance of using dose as a metric of inhalation exposure in occupational or other settings.
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Affiliation(s)
- Anna M Adetona
- Department of Environmental Health Science, College of Public Health, University of Georgia, Athens, GA, USA
| | - Olorunfemi Adetona
- Division of Environmental Health Sciences, College of Public Health, The Ohio State University, Columbus, OH, USA
| | | | - Michael H Paulsen
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
| | - Christopher D Simpson
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA
| | - Stephen L Rathbun
- Department of Epidemiology and Biostatistics, College of Public Health, University of Georgia, Athens, GA, USA
| | - Luke P Naeher
- Department of Environmental Health Science, College of Public Health, University of Georgia, Athens, GA, USA
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10
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Marques-da-Silva D, Videira PA, Lagoa R. Registered human trials addressing environmental and occupational toxicant exposures: Scoping review of immunological markers and protective strategies. ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2022; 93:103886. [PMID: 35598754 DOI: 10.1016/j.etap.2022.103886] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 05/11/2022] [Accepted: 05/15/2022] [Indexed: 06/15/2023]
Abstract
Exposure to pollution is a worldwide societal challenge participating in the etiology and progression of different diseases. However, the scarce information hinders our understanding of the actual level of human exposure and its specific effects. Inadequate and excessive immune responses underlie diverse chronic diseases. Yet, it is unclear which and how toxicant exposures affect the immune system functions. There is a multiplicity of immunological outcomes and biomarkers being studied in human trials related to exposure to different toxicants but still without clear evidence of their value as biomarkers of exposure or effect. The main aim of this study was to collect scientific evidence and identify relevant immunological biomarkers used at the clinical level for toxicant exposures. We used the platform clinical trials.gov as a database tool. First, we performed a search combining research items related to toxicants and immunological parameters. The resulting117 clinical trials were examined for immune-related outcomes and specific biomarkers evaluated in subjects exposed to occupational and environmental toxicants. After categorization, relevant immunological outcomes and biomarkers were identified related to systemic and airway inflammation, modulation of immune cells, allergy and autoimmunity. In general, the immune markers related to inflammation are more frequently investigated for exposure to pollutants, namely IL-6, C-reactive protein (CRP) and nitric oxide (NO). Nevertheless, the data also indicated that prospective biomarkers of effect are gaining ground and a guiding representation of the established and novel biomarkers is suggested for upcoming trials. Finally, potential protective strategies to mitigate the adverse effects of specific toxicants are underlined for future studies.
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Affiliation(s)
- Dorinda Marques-da-Silva
- School of Technology and Management, Polytechnic Institute of Leiria, Morro do Lena, Alto do Vieiro, 2411-901 Leiria, Portugal; LSRE-LCM - Laboratory of Separation and Reaction Engineering - Laboratory of Catalysis and Materials, Escola Superior de Tecnologia e Gestão, Instituto Politécnico de Leiria, 2411-901 Leiria, Portugal; ALiCE - Associate Laboratory in Chemical Engineering, Faculty of Engineering, University of Porto, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal.
| | - Paula Alexandra Videira
- UCIBIO - Applied Molecular Biosciences Unit, NOVA School of Science and Technology, NOVA University of Lisbon, 2819-516 Caparica, Portugal; Associate Laboratory i4HB - Institute for Health and Bioeconomy, NOVA School of Science and Technology, NOVA University of Lisbon, 2819-516 Caparica, Portugal
| | - Ricardo Lagoa
- School of Technology and Management, Polytechnic Institute of Leiria, Morro do Lena, Alto do Vieiro, 2411-901 Leiria, Portugal; UCIBIO - Applied Molecular Biosciences Unit, NOVA School of Science and Technology, NOVA University of Lisbon, 2819-516 Caparica, Portugal; Associate Laboratory i4HB - Institute for Health and Bioeconomy, NOVA School of Science and Technology, NOVA University of Lisbon, 2819-516 Caparica, Portugal
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11
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Wittkopp S, Walzer D, Thorpe L, Roberts T, Xia Y, Gordon T, Thurston G, Brook R, Newman JD. Portable air cleaner use and biomarkers of inflammation: A systematic review and meta-analysis. AMERICAN HEART JOURNAL PLUS : CARDIOLOGY RESEARCH AND PRACTICE 2022; 18:100182. [PMID: 38390226 PMCID: PMC10883590 DOI: 10.1016/j.ahjo.2022.100182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
Fine particulate matter air pollution (PM2.5) is a major contributor to cardiovascular morbidity and mortality, potentially via increased inflammation. PM2.5 exposure increases inflammatory biomarkers linked to cardiovascular disease, including CRP, IL-6 and TNFα. Portable air cleaners (PACs) reduce individual PM2.5 exposure but evidence is limited regarding whether PACs also reduce inflammatory biomarkers. We performed a systematic review and meta-analysis of trials evaluating the use of PACs to reduce PM2.5 exposure and inflammatory biomarker concentrations. We identified English-language articles of randomized sham-controlled trials evaluating high efficiency particulate air filters in non-smoking, residential settings measuring serum CRP, IL-6 and TNFα before and after active versus sham filtration, and performed meta-analysis on the extracted modeled percent change in biomarker concentration across studies. Of 487 articles identified, we analyzed 14 studies enrolling 778 participants that met inclusion criteria. These studies showed PACs reduced PM2.5 by 61.5 % on average. Of the 14 included studies, 10 reported CRP concentrations in 570 participants; these showed active PAC use was associated with 7 % lower CRP (95 % CI: -14 % to 0.0 %, p = 0.05). Nine studies of IL-6, with 379 participants, showed active PAC use was associated with 13 % lower IL-6 (95 % CI: [-23 %, -3 %], p = 0.009). Six studies, with 269 participants, reported TNF-α and demonstrated no statistical evidence of difference between active and sham PAC use. Portable air cleaners that reduce PM2.5 exposure can decrease concentrations of inflammatory biomarkers associated with cardiovascular disease. Additional studies are needed to evaluate clinical outcomes and other biomarkers.
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Affiliation(s)
- Sharine Wittkopp
- Leon H. Charney Division of Cardiology, NYU Grossman School of Medicine, United States of America
| | - Dalia Walzer
- Department of Medicine, NYU Grossman School of Medicine, United States of America
| | - Lorna Thorpe
- Department of Population Health, NYU Grossman School of Medicine, United States of America
| | - Timothy Roberts
- Department of Population Health, NYU Grossman School of Medicine, United States of America
| | - Yuhe Xia
- Division of Biostatistics, NYU Grossman School of Medicine, United States of America
| | - Terry Gordon
- Department of Environmental Medicine, NYU Grossman School of Medicine, United States of America
| | - George Thurston
- Department of Environmental Medicine, NYU Grossman School of Medicine, United States of America
| | - Robert Brook
- Division of Cardiovascular Diseases, Wayne State University, United States of America
| | - Jonathan D Newman
- Leon H. Charney Division of Cardiology, NYU Grossman School of Medicine, United States of America
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12
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Exposure to particulate matter: a brief review with a focus on cardiovascular effects, children, and research conducted in Turkey. Arh Hig Rada Toksikol 2021; 72:244-253. [PMID: 34985835 PMCID: PMC8785112 DOI: 10.2478/aiht-2021-72-3563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 11/01/2021] [Indexed: 11/20/2022] Open
Abstract
Exposure to environmental particulate matter (PM), outdoor air pollution in particular, has long been associated with adverse health effects. Today, PM has widely been accepted as a systemic toxicant showing adverse effects beyond the lungs. There are numerous studies, from those in vitro to epidemiological ones, suggesting various direct and indirect PM toxicity mechanisms associated with cardiovascular risks, including inflammatory responses, oxidative stress, changes in blood pressure, autonomic regulation of heart rate, suppression of endothelium-dependent vasodilation, thrombogenesis, myocardial infarction, and fibrinolysis. In addition to these and other health risks, considerations about air quality standards should include individual differences, lifestyle, and vulnerable populations such as children. Urban air pollution has been a major environmental issue for Turkey, and this review will also address current situation, research, and measures taken in our country.
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13
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Abstract
Unhealthy levels of air pollution are breathed by billions of people worldwide, and air pollution is the leading environmental cause of death and disability globally. Efforts to reduce air pollution at its many sources have had limited success, and in many areas of the world, poor air quality continues to worsen. Personal interventions to reduce exposure to air pollution include avoiding sources, staying indoors, filtering indoor air, using face masks, and limiting physical activity when and where air pollution levels are elevated. The effectiveness of these interventions varies widely with circumstances and conditions of use. Compared with upstream reduction or control of emissions, personal interventions place burdens and risk of adverse unintended consequences on individuals. We review evidence regarding the balance of benefits and potential harms of personal interventions for reducing exposure to outdoor air pollution, which merit careful consideration before making public health recommendations with regard to who should use personal interventions and where, when, and how they should be used. Expected final online publication date for the Annual Review of Public Health, Volume 43 is April 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
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Affiliation(s)
- Robert J Laumbach
- Rutgers School of Public Health, and Environmental and Occupational Health Sciences Institute, Piscataway, New Jersey, USA;
| | - Kevin R Cromar
- Marron Institute of Urban Management, New York University, New York, NY, USA.,Departments of Environmental Medicine and Population Health, Grossman School of Medicine, New York University, New York, NY, USA;
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14
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Ren JY, Yin BW, Li X, Zhu SQ, Deng JL, Sun YT, Zhang ZA, Guo ZH, Pei HT, Zhang F, Li RQ, Chen FG, Ma YX. Sesamin attenuates PM 2.5-induced cardiovascular injury by inhibiting ferroptosis in rats. Food Funct 2021; 12:12671-12682. [PMID: 34825691 DOI: 10.1039/d1fo02913d] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Objective: This study aimed to elucidate the pharmacological effects of sesamin (Ses) and its mechanism of action towards PM2.5-induced cardiovascular injuries. Method: Forty Sprague Dawley (SD) rats were randomly divided into five groups: a saline control group; a PM2.5 exposure group; and low-, middle-, and high-dose Ses pretreatment groups. The SD rats were pretreated with different concentrations of Ses for 21 days. Afterward, the rats were exposed to ambient PM2.5 by intratracheal instillation every other day for a total of three times. The levels of inflammatory markers, including tumor necrosis factor-alpha (TNF-α), interleukin-1beta (IL-1β), and interleukin-6 (IL-6), and indicators related to oxidative responses, such as total superoxide dismutase (SOD), reduced glutathione (GSH), glutathione peroxidase (GSH-Px), and malondialdehyde (MDA), were measured in the blood and heart. The expression of ferroptosis-related proteins in heart tissues was determined via western blot and immunohistochemistry. Results: Ses pretreatment substantially ameliorated cardiovascular injuries in rats as evidenced by the decrease in the pathological score and collagen area. The decreased levels of SOD, GSH, and GSH-Px in the heart and serum were inhibited by Ses. In addition, Ses not only notably increased the activity of antioxidant enzymes but also reduced the levels of MDA, CK, LDH, CK-MB, IL-6, TNF-α, IL-1β, and IL-6. Furthermore, Ses pretreatment upregulated the expression levels of GPX4, SLC7A11, TFRC, and FPN1 and inhibited the expression levels of FTH1 and FTL. Conclusion: Ses pretreatment could ameliorate PM2.5-induced cardiovascular injuries perhaps by inhibiting ferroptosis. Therefore, Ses pretreatment may be a novel strategy for the prevention and treatment of PM2.5-induced cardiovascular injury.
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Affiliation(s)
- Jing-Yi Ren
- Department of Nutrition and Food Hygiene, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, Shijiazhuang, 050017, China.
| | - Bo-Wen Yin
- Department of Nutrition and Food Hygiene, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, Shijiazhuang, 050017, China.
| | - Xiang Li
- Undergraduate of College of Public Health, Hebei Medical University, Shijiazhuang, 050017, China
| | - Si-Qi Zhu
- Undergraduate of College of Public Health, Hebei Medical University, Shijiazhuang, 050017, China
| | - Jin-Liang Deng
- Undergraduate of College of Basic Medicine, Hebei Medical University, Shijiazhuang, 050017, China
| | - Yi-Ting Sun
- Undergraduate of College of Basic Medicine, Hebei Medical University, Shijiazhuang, 050017, China
| | - Zhen-Ao Zhang
- Undergraduate of College of Public Health, Hebei Medical University, Shijiazhuang, 050017, China
| | - Zi-Hao Guo
- Undergraduate of College of Public Health, Hebei Medical University, Shijiazhuang, 050017, China
| | - Huan-Ting Pei
- Undergraduate of College of Public Health, Hebei Medical University, Shijiazhuang, 050017, China
| | - Fan Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, Shijiazhuang, 050017, China.
| | - Rui-Qiang Li
- Department of Nutrition and Food Hygiene, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, Shijiazhuang, 050017, China.
| | - Feng-Ge Chen
- Shijiazhuang Center for Disease Control and Prevention, Shijiazhuang, 050017, China
| | - Yu-Xia Ma
- Department of Nutrition and Food Hygiene, School of Public Health, Hebei Medical University, Hebei Province Key Laboratory of Environment and Human Health, Shijiazhuang, 050017, China.
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15
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Zhu Y, Song X, Wu R, Fang J, Liu L, Wang T, Liu S, Xu H, Huang W. A review on reducing indoor particulate matter concentrations from personal-level air filtration intervention under real-world exposure situations. INDOOR AIR 2021; 31:1707-1721. [PMID: 34374125 DOI: 10.1111/ina.12922] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 06/28/2021] [Accepted: 07/30/2021] [Indexed: 05/28/2023]
Abstract
Improving air quality in indoor environments where people live is of importance to protect human health. In this systematic review, we assessed the effectiveness of personal-level use of air filtration units in reducing indoor particulate matters (PM) concentrations under real-world situations following systematic review guidelines. A total of 54 articles were included in the review, in which 20 randomized controlled/crossover trials that reported the changes in indoor fine PM (PM2.5 ) concentrations were quantitatively assessed in meta-analysis. Standardized mean differences (SMDs) were calculated for changes in indoor PM concentrations following air filtration interventions. Moderate-to-large reductions of 11%-82% in indoor PM2.5 concentrations were observed with SMD of -1.19 (95% CI: -1.50, -0.88). The reductions in indoor PM concentrations varied by geographical locations, filtration technology employed, indoor environmental characteristics, and air pollution sources. Most studies were graded with low-to-moderate risk of bias; however, the overall certainty of evidence for indoor PM concentration reductions was graded at very low level. Considering the effectiveness of indoor air filtration under practical uses, socio-economic disparities across study populations, and costs of air filter replacement over time, our results highlight the importance of reducing air pollution exposure at the sources.
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Affiliation(s)
- Yutong Zhu
- Department of Occupational and Environmental Health, Peking University School of Public Health, and Peking University Institute of Environmental Medicine, Beijing, China
- Key Laboratory of Molecular Cardiovascular Sciences of Ministry of Education, Health Science Center, Peking University, Beijing, China
| | - Xiaoming Song
- Department of Occupational and Environmental Health, Peking University School of Public Health, and Peking University Institute of Environmental Medicine, Beijing, China
- Key Laboratory of Molecular Cardiovascular Sciences of Ministry of Education, Health Science Center, Peking University, Beijing, China
| | - Rongshan Wu
- Department of Occupational and Environmental Health, Peking University School of Public Health, and Peking University Institute of Environmental Medicine, Beijing, China
- State Key Laboratory of Environmental Criteria and Risk Assessment, State Environmental Protection Key Laboratory of Ecological Effect and Risk Assessment of Chemicals, Chinese Research Academy of Environmental Sciences, Beijing, China
| | - Jiakun Fang
- Department of Occupational and Environmental Health, Peking University School of Public Health, and Peking University Institute of Environmental Medicine, Beijing, China
- Key Laboratory of Molecular Cardiovascular Sciences of Ministry of Education, Health Science Center, Peking University, Beijing, China
| | - Lingyan Liu
- Department of Occupational and Environmental Health, Peking University School of Public Health, and Peking University Institute of Environmental Medicine, Beijing, China
- Key Laboratory of Molecular Cardiovascular Sciences of Ministry of Education, Health Science Center, Peking University, Beijing, China
| | - Tong Wang
- Department of Occupational and Environmental Health, Peking University School of Public Health, and Peking University Institute of Environmental Medicine, Beijing, China
- Key Laboratory of Molecular Cardiovascular Sciences of Ministry of Education, Health Science Center, Peking University, Beijing, China
| | - Shuo Liu
- Department of Occupational and Environmental Health, Peking University School of Public Health, and Peking University Institute of Environmental Medicine, Beijing, China
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Hongbing Xu
- Department of Occupational and Environmental Health, Peking University School of Public Health, and Peking University Institute of Environmental Medicine, Beijing, China
- Key Laboratory of Molecular Cardiovascular Sciences of Ministry of Education, Health Science Center, Peking University, Beijing, China
| | - Wei Huang
- Department of Occupational and Environmental Health, Peking University School of Public Health, and Peking University Institute of Environmental Medicine, Beijing, China
- Key Laboratory of Molecular Cardiovascular Sciences of Ministry of Education, Health Science Center, Peking University, Beijing, China
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16
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Positive Association between Indoor Gaseous Air Pollution and Obesity: An Observational Study in 60 Households. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111447. [PMID: 34769965 PMCID: PMC8582717 DOI: 10.3390/ijerph182111447] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Revised: 10/25/2021] [Accepted: 10/28/2021] [Indexed: 01/02/2023]
Abstract
This study aims to analyze whether exposure to indoor air pollution affects obesity. In our research, we recruited 127 participants, with an average age of 43.30 ± 15.38 years old, residing in 60 households. We monitored indoor air quality for 24 h, and conducted both questionnaire surveys and collected serum samples for analysis, to assess the relationship between indoor air pollutant exposure and obesity. After adjusting for demographic characteristics, the results showed that CO2 exposure is positively associated with being overweight and with a higher risk of being abdominally obese. Exposures to CO and formaldehyde were also positively associated with being overweight. IQR increase in TVOC was positively associated with increases in the risk of a high BMI, being abdominally obese and having a high body fat percentage. Two-pollutant models demonstrate that TVOCs presented the strongest risks associated with overweightness. We concluded that persistent exposure to indoor gaseous pollutants increases the risk of overweightness and obesity, as indicated by the positive association with BMI, abdominal obesity, and percentage body fat. TVOCs display the strongest contribution to obesity.
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17
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Hernandez-Garcia E, Chrysikou E, Kalea AZ. The Interplay between Housing Environmental Attributes and Design Exposures and Psychoneuroimmunology Profile-An Exploratory Review and Analysis Paper in the Cancer Survivors' Mental Health Morbidity Context. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10891. [PMID: 34682637 PMCID: PMC8536084 DOI: 10.3390/ijerph182010891] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 10/08/2021] [Accepted: 10/14/2021] [Indexed: 12/11/2022]
Abstract
Adult cancer survivors have an increased prevalence of mental health comorbidities and other adverse late-effects interdependent with mental illness outcomes compared with the general population. Coronavirus Disease 2019 (COVID-19) heralds an era of renewed call for actions to identify sustainable modalities to facilitate the constructs of cancer survivorship care and health care delivery through physiological supportive domestic spaces. Building on the concept of therapeutic architecture, psychoneuroimmunology (PNI) indicators-with the central role in low-grade systemic inflammation-are associated with major psychiatric disorders and late effects of post-cancer treatment. Immune disturbances might mediate the effects of environmental determinants on behaviour and mental disorders. Whilst attention is paid to the non-objective measurements for examining the home environmental domains and mental health outcomes, little is gathered about the multidimensional effects on physiological responses. This exploratory review presents a first analysis of how addressing the PNI outcomes serves as a catalyst for therapeutic housing research. We argue the crucial component of housing in supporting the sustainable primary care and public health-based cancer survivorship care model, particularly in the psychopathology context. Ultimately, we illustrate a series of interventions aiming at how housing environmental attributes can trigger PNI profile changes and discuss the potential implications in the non-pharmacological treatment of cancer survivors and patients with mental morbidities.
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Affiliation(s)
- Eva Hernandez-Garcia
- The Bartlett Real Estate Institute, The Bartlett School of Sustainable Construction, University College London, London WC1E 6BT, UK;
| | - Evangelia Chrysikou
- The Bartlett Real Estate Institute, The Bartlett School of Sustainable Construction, University College London, London WC1E 6BT, UK;
- Clinic of Social and Family Medicine, Department of Social Medicine, University of Crete, 700 13 Heraklion, Greece
| | - Anastasia Z. Kalea
- Division of Medicine, University College London, London WC1E 6JF, UK;
- Institute of Cardiovascular Science, University College London, London WC1E 6HX, UK
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18
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Xia X, Chan KH, Lam KBH, Qiu H, Li Z, Yim SHL, Ho KF. Effectiveness of indoor air purification intervention in improving cardiovascular health: A systematic review and meta-analysis of randomized controlled trials. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 789:147882. [PMID: 34058577 PMCID: PMC7611692 DOI: 10.1016/j.scitotenv.2021.147882] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 05/07/2021] [Accepted: 05/13/2021] [Indexed: 04/13/2023]
Abstract
Indoor air purifiers are increasingly marketed for their health benefits, but their cardiovascular effects remain unclear. We systematically reviewed and meta-analysed randomized controlled trials (RCTs) on the cardiovascular effects of indoor air purification interventions in humans of all ages. We searched Embase, Medline, PubMed, and Web of Science from inception to 22 August 2020. Fourteen cross-over RCTs (18 publications) were included. Systolic blood pressure (SBP) was significantly reduced after intervention (-2.28 (95% CI: -3.92, -0.64) mmHg). There were tendencies of reductions in diastolic blood pressure (-0.35 [-1.52, 0.83] mmHg), pulse pressure (PP) (-0.86 [-2.07, 0.34] mmHg), C-reactive protein (-0.23 [-0.63, 0.18] mg/L), and improvement in reactive hyperaemia index (RHI) (0.10 [-0.04, 0.24]) after indoor air purification, although the effects were not statistically significant. However, when restricting the analyses to RCTs using physical-type purifiers only, significant improvements in PP (-1.56 [-2.98, -0.15] mmHg) and RHI (0.13 [0.01, 0.25]) were observed. This study found potential evidence on the short-term cardiovascular benefits of using indoor air purifiers, especially for SBP, PP and RHI. However, under the Grading of Recommendations Assessment, Development and Evaluation framework, the overall certainty of evidence was very low, which discourage unsubstantiated claims on the cardiovascular benefits of air purifiers. We have also identified several key methodological limitations, including small sample size, short duration of intervention, and the lack of wash-out period. Further RCTs with larger sample size and longer follow-up duration are needed to clarify the cardiovascular benefits of air purification interventions.
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Affiliation(s)
- Xi Xia
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region.
| | - Ka Hung Chan
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, UK; Oxford British Heart Foundation Centre of Research Excellence, University of Oxford, UK.
| | - Kin Bong Hubert Lam
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, UK.
| | - Hong Qiu
- Institute of Environment, Energy and Sustainability, The Chinese University of Hong Kong, Hong Kong Special Administrative Region.
| | - Zhiyuan Li
- Institute of Environment, Energy and Sustainability, The Chinese University of Hong Kong, Hong Kong Special Administrative Region.
| | - Steve Hung Lam Yim
- Institute of Environment, Energy and Sustainability, The Chinese University of Hong Kong, Hong Kong Special Administrative Region; The Department of Geography and Resource Management, The Chinese University of Hong Kong, Hong Kong Special Administrative Region; Asian School of the Environment, Nanyang Technological University, Singapore.
| | - Kin-Fai Ho
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region.
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19
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Xiang J, Huang CH, Shirai J, Liu Y, Carmona N, Zuidema C, Austin E, Gould T, Larson T, Seto E. Field measurements of PM 2.5 infiltration factor and portable air cleaner effectiveness during wildfire episodes in US residences. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 773:145642. [PMID: 33592483 PMCID: PMC8026580 DOI: 10.1016/j.scitotenv.2021.145642] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 01/13/2021] [Accepted: 01/31/2021] [Indexed: 05/04/2023]
Abstract
Wildfires have frequently occurred in the western United States (US) during the summer and fall seasons in recent years. This study measures the PM2.5 infiltration factor in seven residences recruited from five dense communities in Seattle, Washington, during a 2020 wildfire episode and evaluates the impacts of HEPA-based portable air cleaner (PAC) use on reducing indoor PM2.5 levels. All residences with windows closed went through an 18-to-24-h no filtration session, with five of seven following that period with an 18-to-24-h filtration session. Auto-mode PACs, which automatically adjust the fan speed based on the surrounding PM2.5 levels, were used for the filtration session. 10-s resolved indoor PM2.5 levels were measured in each residence's living room, while hourly outdoor levels were collected from the nearest governmental air quality monitoring station to each residence. Additionally, a time-activity diary in minute resolution was collected from each household. With the impacts of indoor sources excluded, indoor PM2.5 mass balance models were developed to estimate the PM2.5 indoor/outdoor (I/O) ratios, PAC effectiveness, and decay-related parameters. Among the seven residences, the mean infiltration factor ranged from 0.33 (standard deviation [SD]: 0.06) to 0.76 (SD: 0.05). The use of auto-mode PAC led to a 48%-78% decrease of indoor PM2.5 levels after adjusting for outdoor PM2.5 levels and indoor sources. The mean (SD) air exchange rates ranged from 0.30 (0.13) h-1 to 1.41 (3.18) h-1 while the PM2.5 deposition rate ranged from 0.10 (0.54) h-1 to 0.49 (0.47) h-1. These findings suggest that staying indoors, a common protective measure during wildfire episodes, is insufficient to prevent people's excess exposure to wildfire smoke, and provides quantitative evidence to support the utilization of auto-mode PACs during wildfire events in the US.
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Affiliation(s)
- Jianbang Xiang
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA 98195, United States.
| | - Ching-Hsuan Huang
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA 98195, United States
| | - Jeff Shirai
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA 98195, United States
| | - Yisi Liu
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA 98195, United States
| | - Nancy Carmona
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA 98195, United States
| | - Christopher Zuidema
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA 98195, United States
| | - Elena Austin
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA 98195, United States
| | - Timothy Gould
- Department of Civil and Environmental Engineering, University of Washington, Seattle, WA 98195, United States
| | - Timothy Larson
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA 98195, United States; Department of Civil and Environmental Engineering, University of Washington, Seattle, WA 98195, United States
| | - Edmund Seto
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA 98195, United States
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20
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Cheek E, Guercio V, Shrubsole C, Dimitroulopoulou S. Portable air purification: Review of impacts on indoor air quality and health. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 766:142585. [PMID: 33121763 DOI: 10.1016/j.scitotenv.2020.142585] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 09/16/2020] [Accepted: 09/18/2020] [Indexed: 05/22/2023]
Abstract
A systematic literature review was carried out to examine the impact of portable air purifiers (PAPs) on indoor air quality (PM2.5) and health, focussing on adults and children in indoor environments (homes, schools and offices). Analysed studies all showed reductions in PM2.5 of between 22.6 and 92.0% with the use of PAPs when compared to the control. Associations with health impacts found included those on blood pressure, respiratory parameters and pregnancy outcomes. Changes in clinical biochemical markers were also identified. However, evidence for such associations was limited and inconsistent. Health benefits from a reduction in PM2.5 would be expected as the cumulative body of scientific evidence from various cohort studies shows positive impacts of long-term reduction in PM2.5 concentrations. The current evidence demonstrates that using a PAP results in short-term reductions in PM2.5 in the indoor environment, which has the potential to offer health benefits.
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Affiliation(s)
- Emily Cheek
- Air Quality and Public Health Group, Environmental Hazards and Emergencies Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Harwell Campus, Didcot, Oxfordshire, United Kingdom
| | - Valentina Guercio
- Air Quality and Public Health Group, Environmental Hazards and Emergencies Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Harwell Campus, Didcot, Oxfordshire, United Kingdom
| | - Clive Shrubsole
- Air Quality and Public Health Group, Environmental Hazards and Emergencies Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Harwell Campus, Didcot, Oxfordshire, United Kingdom
| | - Sani Dimitroulopoulou
- Air Quality and Public Health Group, Environmental Hazards and Emergencies Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Harwell Campus, Didcot, Oxfordshire, United Kingdom.
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21
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Can Public Spaces Effectively Be Used as Cleaner Indoor Air Shelters during Extreme Smoke Events? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084085. [PMID: 33924413 PMCID: PMC8070163 DOI: 10.3390/ijerph18084085] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 04/09/2021] [Accepted: 04/10/2021] [Indexed: 01/05/2023]
Abstract
During extreme air pollution events, such as bushfires, public health agencies often recommend that vulnerable individuals visit a nearby public building with central air conditioning to reduce their exposure to smoke. However, there is limited evidence that these "cleaner indoor air shelters" reduce exposure or health risks. We quantified the impact of a "cleaner indoor air shelter" in a public library in Port Macquarie, NSW, Australia when concentrations of fine particulate matter (PM2.5) were elevated during a local peat fire and nearby bushfires. Specifically, we evaluated the air quality improvements with central air conditioning only and with the use of portable high efficiency particulate air (HEPA) filter air cleaners. We measured PM2.5 from August 2019 until February 2020 by deploying pairs of low-cost PM2.5 sensors (i) inside the main library, (ii) in a smaller media room inside the library, (iii) outside the library, and (iv) co-located with regulatory monitors located in the town. We operated two HEPA cleaners in the media room from August until October 2019. We quantified the infiltration efficiency of outdoor PM2.5 concentrations, defined as the fraction of the outdoor PM2.5 concentration that penetrates indoors and remains suspended, as well as the additional effect of HEPA cleaners on PM2.5 concentrations. The infiltration efficiency of outdoor PM2.5 into the air-conditioned main library was 30%, meaning that compared to the PM2.5 concentration outdoors, the concentrations of outdoor-generated PM2.5 indoors were reduced by 70%. In the media room, when the HEPA cleaners were operating, PM2.5 concentrations were reduced further with a PM2.5 infiltration efficiency of 17%. A carefully selected air-conditioned public building could be used as a cleaner indoor air shelter during episodes of elevated smoke emissions. Further improvements in indoor air quality within the building can be achieved by operating appropriately sized HEPA cleaners.
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22
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Xiang J, Huang CH, Austin E, Shirai J, Liu Y, Seto E. Energy consumption of using HEPA-based portable air cleaner in residences: A monitoring study in Seattle, US. ENERGY AND BUILDINGS 2021; 236:110773. [PMID: 33642668 PMCID: PMC7904108 DOI: 10.1016/j.enbuild.2021.110773] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
Portable air cleaners (PACs), offering both auto and manual (adjustable) operation modes, are commonly used in residences. Compared with adjustable mode, auto mode's advantage of reducing indoor PM2.5 has been previously demonstrated. This study examines the energy consumption of such PACs in six residences recruited in Seattle, United States, and compares the power consumption between auto and adjustable modes. Each residence went through a one-week-long PAC filtration session under auto and adjustable modes, respectively. PAC power consumption, indoor PM2.5, temperature, and relative humidity (RH) were measured at 10-second intervals in each residence. A linear mixed-effects regression (LMER) model was used to compare the PAC power consumption between the two modes after adjusting for indoor PM2.5, temperature, and RH. Results show that the mean (standard deviation) PAC power consumption under adjustable and auto modes were 7.0 (3.5) and 6.8 (2.6) W, respectively. The average monthly energy consumption of continuous PAC operation was estimated to be ~5 kWh for both modes. Based on the LEMR model, PAC power consumption under auto mode was approximately 3% larger than that under adjustable mode, after adjusting for living-room PM2.5, temperature, and RH levels. The implications for PAC operation mode selection in residential environments were discussed.
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Affiliation(s)
- Jianbang Xiang
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA 98195, United States
| | - Ching-Hsuan Huang
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA 98195, United States
| | - Elena Austin
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA 98195, United States
| | - Jeff Shirai
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA 98195, United States
| | - Yisi Liu
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA 98195, United States
| | - Edmund Seto
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA 98195, United States
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23
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O’Dwyer T, Abramson MJ, Straney L, Salimi F, Johnston F, Wheeler AJ, O’Keeffe D, Haikerwal A, Reisen F, Hopper I, Dennekamp M. Sub-Clinical Effects of Outdoor Smoke in Affected Communities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031131. [PMID: 33525316 PMCID: PMC7908479 DOI: 10.3390/ijerph18031131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 01/15/2021] [Accepted: 01/21/2021] [Indexed: 11/21/2022]
Abstract
Many Australians are intermittently exposed to landscape fire smoke from wildfires or planned (prescribed) burns. This study aimed to investigate effects of outdoor smoke from planned burns, wildfires and a coal mine fire by assessing biomarkers of inflammation in an exposed and predominantly older population. Participants were recruited from three communities in south-eastern Australia. Concentrations of fine particulate matter (PM2.5) were continuously measured within these communities, with participants performing a range of health measures during and without a smoke event. Changes in biomarkers were examined in response to PM2.5 concentrations from outdoor smoke. Increased levels of FeNO (fractional exhaled nitric oxide) (β = 0.500 [95%CI 0.192 to 0.808] p < 0.001) at a 4 h lag were associated with a 10 µg/m3 increase in PM2.5 levels from outdoor smoke, with effects also shown for wildfire smoke at 4, 12, 24 and 48-h lag periods and coal mine fire smoke at a 4 h lag. Total white cell (β = −0.088 [−0.171 to −0.006] p = 0.036) and neutrophil counts (β = −0.077 [−0.144 to −0.010] p = 0.024) declined in response to a 10 µg/m3 increase in PM2.5. However, exposure to outdoor smoke resulting from wildfires, planned burns and a coal mine fire was not found to affect other blood biomarkers.
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Affiliation(s)
- Thomas O’Dwyer
- School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia; (T.O.); (L.S.); (F.S.); (D.O.); (A.H.); (I.H.); (M.D.)
| | - Michael J. Abramson
- School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia; (T.O.); (L.S.); (F.S.); (D.O.); (A.H.); (I.H.); (M.D.)
- Correspondence: ; Tel.: +613-9903-0573; Fax: +613-9903-0556
| | - Lahn Straney
- School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia; (T.O.); (L.S.); (F.S.); (D.O.); (A.H.); (I.H.); (M.D.)
| | - Farhad Salimi
- School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia; (T.O.); (L.S.); (F.S.); (D.O.); (A.H.); (I.H.); (M.D.)
| | - Fay Johnston
- Environmental Health, Menzies Institute for Medical Research, University of Tasmania, Hobart 7000, Australia; (F.J.); (A.J.W.)
| | - Amanda J. Wheeler
- Environmental Health, Menzies Institute for Medical Research, University of Tasmania, Hobart 7000, Australia; (F.J.); (A.J.W.)
- Behaviour, Environment and Cognition Program, Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne 3000, Australia
| | - David O’Keeffe
- School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia; (T.O.); (L.S.); (F.S.); (D.O.); (A.H.); (I.H.); (M.D.)
| | - Anjali Haikerwal
- School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia; (T.O.); (L.S.); (F.S.); (D.O.); (A.H.); (I.H.); (M.D.)
| | - Fabienne Reisen
- Climate Science Centre, CSIRO Oceans and Atmosphere, Aspendale 3195, Australia;
| | - Ingrid Hopper
- School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia; (T.O.); (L.S.); (F.S.); (D.O.); (A.H.); (I.H.); (M.D.)
| | - Martine Dennekamp
- School of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia; (T.O.); (L.S.); (F.S.); (D.O.); (A.H.); (I.H.); (M.D.)
- Environmental Public Health Unit, Environment Protection Authority Victoria, Melbourne 3053, Australia
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24
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Chen H, Samet JM, Bromberg PA, Tong H. Cardiovascular health impacts of wildfire smoke exposure. Part Fibre Toxicol 2021; 18:2. [PMID: 33413506 PMCID: PMC7791832 DOI: 10.1186/s12989-020-00394-8] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 12/17/2020] [Indexed: 12/12/2022] Open
Abstract
In recent years, wildland fires have occurred more frequently and with increased intensity in many fire-prone areas. In addition to the direct life and economic losses attributable to wildfires, the emitted smoke is a major contributor to ambient air pollution, leading to significant public health impacts. Wildfire smoke is a complex mixture of particulate matter (PM), gases such as carbon monoxide, nitrogen oxide, and volatile and semi-volatile organic compounds. PM from wildfire smoke has a high content of elemental carbon and organic carbon, with lesser amounts of metal compounds. Epidemiological studies have consistently found an association between exposure to wildfire smoke (typically monitored as the PM concentration) and increased respiratory morbidity and mortality. However, previous reviews of the health effects of wildfire smoke exposure have not established a conclusive link between wildfire smoke exposure and adverse cardiovascular effects. In this review, we systematically evaluate published epidemiological observations, controlled clinical exposure studies, and toxicological studies focusing on evidence of wildfire smoke exposure and cardiovascular effects, and identify knowledge gaps. Improving exposure assessment and identifying sensitive cardiovascular endpoints will serve to better understand the association between exposure to wildfire smoke and cardiovascular effects and the mechanisms involved. Similarly, filling the knowledge gaps identified in this review will better define adverse cardiovascular health effects of exposure to wildfire smoke, thus informing risk assessments and potentially leading to the development of targeted interventional strategies to mitigate the health impacts of wildfire smoke.
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Affiliation(s)
- Hao Chen
- Oak Ridge Institute for Science and Education, Oak Ridge, TN, 37830, USA.
| | - James M Samet
- Public Health and Integrated Toxicology Division, Center for Public Health and Environmental Assessment, U.S. Environmental Protection Agency, Chapel Hill, NC, 27514, USA
| | - Philip A Bromberg
- Center for Environmental Medicine, Asthma and Lung Biology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27514, USA
| | - Haiyan Tong
- Public Health and Integrated Toxicology Division, Center for Public Health and Environmental Assessment, U.S. Environmental Protection Agency, Chapel Hill, NC, 27514, USA.
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25
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Rajagopalan S, Brauer M, Bhatnagar A, Bhatt DL, Brook JR, Huang W, Münzel T, Newby D, Siegel J, Brook RD. Personal-Level Protective Actions Against Particulate Matter Air Pollution Exposure: A Scientific Statement From the American Heart Association. Circulation 2020; 142:e411-e431. [PMID: 33150789 DOI: 10.1161/cir.0000000000000931] [Citation(s) in RCA: 101] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Since the publication of the last American Heart Association scientific statement on air pollution and cardiovascular disease in 2010, unequivocal evidence of the causal role of fine particulate matter air pollution (PM2.5, or particulate matter ≤2.5 μm in diameter) in cardiovascular disease has emerged. There is a compelling case to provide the public with practical personalized approaches to reduce the health effects of PM2.5. Such interventions would be applicable not only to individuals in heavily polluted countries, high-risk or susceptible individuals living in cleaner environments, and microenvironments with higher pollution exposures, but also to those traveling to locations with high levels of PM2.5. The overarching motivation for this document is to summarize the current evidence supporting personal-level strategies to prevent the adverse cardiovascular effects of PM2.5, guide the use of the most proven/viable approaches, obviate the use of ineffective measures, and avoid unwarranted interventions. The significance of this statement relates not only to the global importance of PM2.5, but also to its focus on the most tested interventions and viable approaches directed at particulate matter air pollution. The writing group sought to provide expert consensus opinions on personal-level measures recognizing the current uncertainty and limited evidence base for many interventions. In doing so, the writing group acknowledges that its intent is to assist other agencies charged with protecting public health, without minimizing the personal choice considerations of an individual who may decide to use these interventions in the face of ongoing air pollution exposure.
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26
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Kim S, Lee J, Park S, Rudasingwa G, Lee S, Yu S, Lim DH. Association between Peak Expiratory Flow Rate and Exposure Level to Indoor PM2.5 in Asthmatic Children, Using Data from the Escort Intervention Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207667. [PMID: 33096665 PMCID: PMC7589683 DOI: 10.3390/ijerph17207667] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 10/06/2020] [Accepted: 10/15/2020] [Indexed: 12/23/2022]
Abstract
Various studies have indicated that particulate matter <2.5 μm (PM2.5) could cause adverse health effects on pulmonary functions in susceptible groups, especially asthmatic children. Although the impact of ambient PM2.5 on children’s lower respiratory health has been well-established, information regarding the associations between indoor PM2.5 levels and respiratory symptoms in asthmatic children is relatively limited. This randomized, crossover intervention study was conducted among 26 asthmatic children’s homes located in Incheon metropolitan city, Korea. We aimed to evaluate the effects of indoor PM2.5 on children’s peak expiratory flow rate (PEFR), with a daily intervention of air purifiers with filter on, compared with those groups with filter off. Children aged between 6–12 years diagnosed with asthma were enrolled and randomly allocated into two groups. During a crossover intervention period of seven weeks, we observed that, in the filter-on group, indoor PM2.5 levels significantly decreased by up to 43%. (p < 0.001). We also found that the daily or weekly unit (1 μg/m3) increase in indoor PM2.5 levels could significantly decrease PEFR by 0.2% (95% confidence interval (CI) = 0.1 to 0.5) or PEFR by 1.2% (95% CI = 0.1 to 2.7) in asthmatic children, respectively. The use of in-home air filtration could be considered as an intervention strategy for indoor air quality control in asthmatic children’s homes.
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Affiliation(s)
- Sungroul Kim
- Department of Environmental Sciences, Soonchunhyang University, Asan 31538, Korea; (J.L.); (S.P.); (G.R.); (S.Y.)
- Department of ICT Environmental Health System, Graduate School, Soonchunhyang University, Asan 31538, Korea;
- Correspondence: ; Tel.: +82-41-530-1266
| | - Jungeun Lee
- Department of Environmental Sciences, Soonchunhyang University, Asan 31538, Korea; (J.L.); (S.P.); (G.R.); (S.Y.)
| | - Sujung Park
- Department of Environmental Sciences, Soonchunhyang University, Asan 31538, Korea; (J.L.); (S.P.); (G.R.); (S.Y.)
| | - Guillaume Rudasingwa
- Department of Environmental Sciences, Soonchunhyang University, Asan 31538, Korea; (J.L.); (S.P.); (G.R.); (S.Y.)
| | - Sangwoon Lee
- Department of ICT Environmental Health System, Graduate School, Soonchunhyang University, Asan 31538, Korea;
| | - Sol Yu
- Department of Environmental Sciences, Soonchunhyang University, Asan 31538, Korea; (J.L.); (S.P.); (G.R.); (S.Y.)
| | - Dae Hyun Lim
- Department of Pediatrics, School of Medicine, Inha University, Incheon 22332, Korea;
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27
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Masterson EE, Younglove LB, Perez A, Torres E, Krenz JE, Tchong French MI, Riederer AM, Sampson PD, Metwali N, Min E, Jansen KL, Aisenberg G, Babadi RS, Farquhar SA, Thorne PS, Karr CJ. The home air in agriculture pediatric intervention (HAPI) trial: Rationale and methods. Contemp Clin Trials 2020; 96:106085. [PMID: 32721578 PMCID: PMC7494646 DOI: 10.1016/j.cct.2020.106085] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 07/10/2020] [Accepted: 07/13/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Data addressing air quality effects on children with asthma in rural U.S. communities are rare. Our community engaged research partnership previously demonstrated associations between neighborhood NH3 and ambient PM2.5 and asthma in the agricultural lower Yakima Valley of Washington. As a next step, the partnership desired an intervention approach to address concerns about pediatric asthma in this largely Latino immigrant, farm worker community. OBJECTIVE The Home Air in Agriculture Pediatric Intervention (HAPI) sought to examine the effectiveness of enrichment of an existing asthma education program with portable high-efficiency particulate air (HEPA) cleaners designed to reduce PM2.5 and NH3. We investigated the effect of this enriched approach on these exposures and asthma health measures. DESIGN We randomized children with poorly controlled asthma to a control arm (current asthma education program) or an intervention arm (current asthma education program + placement of two indoor air cleaners in the family's home). Outcomes included (1) 14-day integrated samples of indoor air contaminants (PM2.5 and NH3) at baseline and one-year follow-up and (2) child asthma health metrics at baseline, midpoint (4-6 months) and one-year follow-up. These included the Asthma Control Test, symptoms days, clinical utilization, oral corticosteroid use, pulmonary function, fractional exhaled nitric oxide, and urinary leukotriene E4 concentration. DISCUSSION To our knowledge, this is the first randomized HEPA cleaner intervention designed to assess NH3 as well as PM2.5 and to evaluate health outcomes of children with asthma in an agricultural region.
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Affiliation(s)
- Erin E Masterson
- Department of Environmental & Occupational Health Sciences, University of Washington, Seattle, WA, United States of America.
| | - Lisa B Younglove
- Department of Environmental & Occupational Health Sciences, University of Washington, Seattle, WA, United States of America
| | - Adriana Perez
- Yakima Valley Farm Worker's Clinic, Toppenish, WA, United States of America
| | - Elizabeth Torres
- Northwest Communities Education Center, Radio KDNA, Granger, WA, United States of America
| | - Jennifer E Krenz
- Department of Environmental & Occupational Health Sciences, University of Washington, Seattle, WA, United States of America
| | - Maria I Tchong French
- Department of Environmental & Occupational Health Sciences, University of Washington, Seattle, WA, United States of America
| | - Anne M Riederer
- Department of Environmental & Occupational Health Sciences, University of Washington, Seattle, WA, United States of America
| | - Paul D Sampson
- Department of Statistics, University of Washington, Seattle, WA, United States of America
| | - Nervana Metwali
- Department of Occupational and Environmental Health, University of Iowa, Iowa City, IA, United States of America
| | - Esther Min
- Department of Environmental & Occupational Health Sciences, University of Washington, Seattle, WA, United States of America
| | - Karen L Jansen
- Department of Environmental & Occupational Health Sciences, University of Washington, Seattle, WA, United States of America
| | - Gino Aisenberg
- School of Social Work, University of Washington, Seattle, WA, United States of America
| | - Ryan S Babadi
- Department of Environmental & Occupational Health Sciences, University of Washington, Seattle, WA, United States of America
| | - Stephanie A Farquhar
- Department of Environmental & Occupational Health Sciences, University of Washington, Seattle, WA, United States of America; Department of Health Services, University of Washington, Seattle, WA, United States of America
| | - Peter S Thorne
- Department of Occupational and Environmental Health, University of Iowa, Iowa City, IA, United States of America
| | - Catherine J Karr
- Department of Environmental & Occupational Health Sciences, University of Washington, Seattle, WA, United States of America; Department of Pediatrics, University of Washington, Seattle, WA, United States of America
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28
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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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29
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Liu S, Huang Q, Wu Y, Song Y, Dong W, Chu M, Yang D, Zhang X, Zhang J, Chen C, Zhao B, Shen H, Guo X, Deng F. Metabolic linkages between indoor negative air ions, particulate matter and cardiorespiratory function: A randomized, double-blind crossover study among children. ENVIRONMENT INTERNATIONAL 2020; 138:105663. [PMID: 32203810 DOI: 10.1016/j.envint.2020.105663] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Revised: 03/07/2020] [Accepted: 03/12/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND Ionization air purifiers, which purify particulate matter (PM) by producing vast number of negative air ions (NAI), are widely used. Recent study implied that ionization air purification could bring respiratory benefits but deterioration of heart rate variability (HRV). However, its underlying molecular mechanisms remain unclear. OBJECTIVES To explore the molecular linkages between indoor NAI, decreased PM and the cardiorespiratory effect after purification. METHODS Urine samples were collected from 44 healthy children three times of each study period (real and sham purification) in an existing randomized, double-blind crossover study. Ultra-high performance liquid chromatography/mass spectrometry was conducted in metabolomics analysis, the associations between indoor NAI, decreased PM and the cardiorespiratory function were investigated via the meet-in-metabolite approach (MIMA) based on statistical and metabolic pathway analysis. Mixed-effect models were used to establish associations between exposure, health parameters and metabolites. RESULTS Twenty-eight and fourteen metabolites were identified with significant correlations to NAI and PM, respectively. Besides, eight and eighteen metabolites were separately associated with respiratory function and HRV. The increased NAI and decreased PM improved respiratory function mainly with eight pathways, promoting energy production, anti-inflammation and anti-oxidation capacity. Decreased PM ameliorated HRV with six main pathways, increasing energy production and anti-inflammation capacity while increased NAI deteriorated HRV with five main pathways, lowering energy generation and anti-oxidation capacity. CONCLUSIONS Increased NAI and decreased PM ameliorated respiratory function by increasing energy production, improving anti-inflammation and anti-oxidation capacity. Decreased PM improved cardiac autonomic function by increasing energy production and anti-inflammation capacity, while these benefits were overcast by massive NAI via lowering energy generation and anti-oxidation capacity with different metabolic pathways.
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Affiliation(s)
- Shan Liu
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Qingyu Huang
- Key Laboratory of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen 361021, China
| | - Yan Wu
- Key Laboratory of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen 361021, China
| | - Yi Song
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China
| | - Wei Dong
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Mengtian Chu
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Di Yang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Xi Zhang
- Key Laboratory of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen 361021, China
| | - Jie Zhang
- Key Laboratory of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen 361021, China; State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen 361102, China
| | - Chen Chen
- Department of Building Science, School of Architecture, Tsinghua University, Beijing 100084, China
| | - Bin Zhao
- Department of Building Science, School of Architecture, Tsinghua University, Beijing 100084, China
| | - Heqing Shen
- Key Laboratory of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen 361021, China; State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen 361102, China
| | - Xinbiao Guo
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Furong Deng
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
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30
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Stauffer DA, Autenrieth DA, Hart JF, Capoccia S. Control of wildfire-sourced PM2.5 in an office setting using a commercially available portable air cleaner. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2020; 17:109-120. [PMID: 32160140 DOI: 10.1080/15459624.2020.1722314] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
A steady increase in wildfire event severity and season length has led to greater potential for exposure to fine particulate matter associated with wildfire smoke. Research has found fine particulate matter to be correlated with a myriad of health ailments and thus effective strategies for controlling exposures are needed. In this study, a correction factor associated with wildfire-sourced fine particulate matter was established for a TSI SidePak AM520 by conducting sampling with a co-located MetOne BAM 1020. Portable air cleaner efficacy was assessed by simultaneously measuring PM2.5 mass concentrations in two identical offices with the inclusion of a portable air cleaner in one. The relationship between indoor and outdoor PM2.5 mass concentrations was assessed by comparing concentrations recorded in an office to those recorded at the nearest National Ambient Air Quality Standards monitoring station. Results revealed that a portable air cleaner reduced indoor fine particulate matter within an office by 73% and 92% during working and non-working hours, respectively, and that a strong significant correlation (ρ = .91, p = 0.00) existed between indoor and outdoor fine particulate matter mass concentration measurements. A direct relationship between indoor and outdoor PM2.5 mass concentrations was observed during this study, suggesting that elevated fine particulate matter concentrations due to wildfire smoke could be a concern in the indoor work environment; however the current study determined that the use of a portable air cleaner can substantially decrease fine particulate matter concentrations even in an active office setting.
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Affiliation(s)
- Dylan A Stauffer
- School of Mines and Engineering, Safety, Health and Industrial Hygiene Department, Montana Technological University, Butte, Montana
| | - Daniel A Autenrieth
- School of Mines and Engineering, Safety, Health and Industrial Hygiene Department, Montana Technological University, Butte, Montana
| | - Julie F Hart
- School of Mines and Engineering, Safety, Health and Industrial Hygiene Department, Montana Technological University, Butte, Montana
| | - Stella Capoccia
- College of Letters, Sciences, and Professional Studies, Department of Biological Sciences, Montana Technological University, Butte, Montana
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31
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Azimi P, Stephens B. A framework for estimating the US mortality burden of fine particulate matter exposure attributable to indoor and outdoor microenvironments. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2020; 30:271-284. [PMID: 30518794 PMCID: PMC7039807 DOI: 10.1038/s41370-018-0103-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 09/25/2018] [Accepted: 11/12/2018] [Indexed: 05/21/2023]
Abstract
Exposure to fine particulate matter (PM2.5) is associated with increased mortality. Although epidemiology studies typically use outdoor PM2.5 concentrations as surrogates for exposure, the majority of PM2.5 exposure in the US occurs in microenvironments other than outdoors. We develop a framework for estimating the total US mortality burden attributable to exposure to PM2.5 of both indoor and outdoor origin in the primary non-smoking microenvironments in which people spend most of their time. The framework utilizes an exposure-response function combined with adjusted mortality effect estimates that account for underlying exposures to PM2.5 of outdoor origin that likely occurred in the original epidemiology populations from which effect estimates are derived. We demonstrate the framework using several different scenarios to estimate the potential magnitude and bounds of the US mortality burden attributable to total PM2.5 exposure across all non-smoking environments under a variety of assumptions. Our best estimates of the US mortality burden associated with total PM2.5 exposure in the year 2012 range from ~230,000 to ~300,000 deaths. Indoor exposure to PM2.5 of outdoor origin is typically the largest total exposure, accounting for ~40-60% of total mortality, followed by residential exposure to indoor PM2.5 sources, which also drives the majority of variability in each scenario.
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Affiliation(s)
- Parham Azimi
- Department of Civil, Architectural, and Environmental Engineering, Illinois Institute of Technology, Chicago, IL, USA
| | - Brent Stephens
- Department of Civil, Architectural, and Environmental Engineering, Illinois Institute of Technology, Chicago, IL, USA.
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32
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James C, Bernstein DI, Cox J, Ryan P, Wolfe C, Jandarov R, Newman N, Indugula R, Reponen T. HEPA filtration improves asthma control in children exposed to traffic-related airborne particles. INDOOR AIR 2020; 30:235-243. [PMID: 31743467 PMCID: PMC7895332 DOI: 10.1111/ina.12625] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 10/18/2019] [Accepted: 11/14/2019] [Indexed: 05/20/2023]
Abstract
Traffic-related airborne particles are associated with asthma morbidity. The aim of this study was to assess the impact of a high-efficiency particulate air (HEPA) filtration on the concentrations of traffic particles and the resultant effect on children with asthma. Forty-three children with asthma were enrolled in this double-blind, placebo-controlled crossover design. A HEPA air cleaner or a placebo "dummy" was placed in participants' homes for four weeks, interrupted by a one-month washout period, before crossing over to the other treatment arm for four weeks. Air sampling and health outcomes, including asthma control (ACQ) and quality of life (AQLQ) measures, were completed prior to and at the end of each treatment arm. Indoor concentrations of traffic particles were significantly reduced with the HEPA treatment but not with the "dummy" treatment. In participants with poorly controlled asthma and lower quality of life at baseline, ACQ and AQLQ scores were significantly improved (1.3 to 0.9, P = .003 and 4.9 to 5.5, P = .02, respectively) following the HEPA treatment. In this study, HEPA filtration is associated with improved clinical outcomes and quality of life measures in children with uncontrolled asthma.
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Affiliation(s)
- Christine James
- Division of Immunology, Rheumatology, and Allergy, Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - David I Bernstein
- Division of Immunology, Rheumatology, and Allergy, Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Jennie Cox
- Department of Environmental Health, University of Cincinnati, Cincinnati, OH, USA
| | - Patrick Ryan
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | | | - Roman Jandarov
- Department of Environmental Health, University of Cincinnati, Cincinnati, OH, USA
| | - Nicholas Newman
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Reshmi Indugula
- Department of Environmental Health, University of Cincinnati, Cincinnati, OH, USA
| | - Tiina Reponen
- Department of Environmental Health, University of Cincinnati, Cincinnati, OH, USA
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Bard RL, Ijaz MK, Zhang JJ, Li Y, Bai C, Yang Y, Garcia WD, Creek J, Brook RD. Interventions to Reduce Personal Exposures to Air Pollution: A Primer for Health Care Providers. Glob Heart 2020; 14:47-60. [PMID: 31036302 DOI: 10.1016/j.gheart.2019.02.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 02/26/2019] [Indexed: 12/19/2022] Open
Affiliation(s)
- Robert L Bard
- Department of Internal Medicine, Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, MI, USA
| | - M Khalid Ijaz
- Research and Development, RB, Montvale, NJ, USA; Department of Biology, Medgar Evers College of the City University of New York, Brooklyn, NY, USA.
| | - Junfeng Jim Zhang
- Nicholas School of the Environment and Duke Global Health Institute, Duke University, Durham, NC, USA; Duke Kunshan University, Kunshan, China
| | - Yuguo Li
- Department of Mechanical Engineering, The University of Hong Kong, Pokfulam Road, Hong Kong, China
| | - Chunxue Bai
- Department of Pulmonary Medicine, Shanghai Respiratory Research Institute Zhongshan Hospital, Fudan University, Shanghai, China
| | | | | | - John Creek
- Research and Development, RB, Montvale, NJ, USA
| | - Robert D Brook
- Department of Internal Medicine, Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, MI, USA
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Dong W, Liu S, Chu M, Zhao B, Yang D, Chen C, Miller MR, Loh M, Xu J, Chi R, Yang X, Guo X, Deng F. Different cardiorespiratory effects of indoor air pollution intervention with ionization air purifier: Findings from a randomized, double-blind crossover study among school children in Beijing. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2019; 254:113054. [PMID: 31473392 DOI: 10.1016/j.envpol.2019.113054] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 08/10/2019] [Accepted: 08/12/2019] [Indexed: 05/27/2023]
Abstract
Indoor air pollution is associated with numerous adverse health outcomes. Air purifiers are widely used to reduce indoor air pollutants. Ionization air purifiers are becoming increasingly popular for their low power consumption and noise, yet its health effects remain unclear. This randomized, double-blind crossover study is conducted to explore the cardiorespiratory effects of ionization air purification among 44 children in Beijing. Real or sham purification was performed in classrooms for 5 weekdays. Size-fractionated particulate matter (PM), black carbon (BC), ozone (O3), and negative air ions (NAI) were monitored, and cardiorespiratory functions were measured. Mixed-effect models were used to establish associations between exposures and health parameters. Real purification significantly decreased PM and BC, e.g. PM0.5, PM2.5, PM10 and BC were decreased by 48%, 44%, 34% and 50%, respectively. O3 levels were unchanged, while NAI was increased from 12 cm-3 to 12,997 cm-3. Real purification was associated with a 4.4% increase in forced exhaled volume in 1 s (FEV1) and a 14.7% decrease in fractional exhaled nitrogen oxide (FeNO). However, heart rate variability (HRV) was altered negatively. Interaction effects of NAI and PM were observed only on HRV, and alterations in HRV were greater with high NAI. Ionization air purifier could bring substantial respiratory benefits, however, the potential negative effects on HRV need further investigation.
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Affiliation(s)
- Wei Dong
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Shan Liu
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Mengtian Chu
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Bin Zhao
- Department of Building Science, School of Architecture, Tsinghua University, Beijing 100084, China
| | - Di Yang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Chen Chen
- Department of Building Science, School of Architecture, Tsinghua University, Beijing 100084, China
| | - Mark R Miller
- University/BHF Centre for Cardiovascular Science, Queens Medical Research Institute, The University of Edinburgh, 47 Little France Crescent Edinburgh, EH16 4TJ, UK
| | - Miranda Loh
- Institute of Occupational Medicine, Research Avenue North Riccarton, Edinburgh, EH14 4AP, UK
| | - Junhui Xu
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Rui Chi
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Xuan Yang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Xinbiao Guo
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Furong Deng
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China.
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35
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Maestas MM, Brook RD, Ziemba RA, Li F, Crane RC, Klaver ZM, Bard RL, Spino CA, Adar SD, Morishita M. Reduction of personal PM 2.5 exposure via indoor air filtration systems in Detroit: an intervention study. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2019; 29:484-490. [PMID: 30420725 PMCID: PMC7021209 DOI: 10.1038/s41370-018-0085-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 04/26/2018] [Accepted: 05/15/2018] [Indexed: 05/19/2023]
Abstract
The adverse health effects of fine particulate matter (PM < 2.5 μm in diameter [PM2.5]) air pollution are well-documented. There is a growing body of evidence that high-efficiency particulate arrestance (HEPA) filtration can reduce indoor PM2.5 concentrations and deliver some health benefits via the reduction of exposure to PM. However, few studies have tested the ability of portable air filtration systems to lower overall personal-level PM2.5 exposures. The Reducing Air Pollution in Detroit Intervention Study (RAPIDS) was designed to evaluate cardiovascular health benefits and personal PM2.5 exposure reductions via indoor portable air filtration systems among senior citizens in Detroit, Michigan. We evaluated the utility of two commercially available high-efficiency (HE: true-HEPA) and low-efficiency (LE: HEPA-type) indoor air filtration to reduce indoor PM2.5 concentrations and personal PM2.5 exposures for 40 participants in a double-blinded randomized crossover intervention. Each participant was subjected to three intervention scenarios: HE, LE, or no filter (control) of three consecutive days each, during which personal, indoor, and outdoor PM2.5 concentrations were measured daily. For mean indoor PM2.5 concentrations, we observed 60 and 52% reductions using HE and LE filters, respectively, relative to no filtration. Personal PM2.5 exposures were reduced by 53 and 31% using HE and LE filters, respectively, when compared with the control scenario. To our knowledge, this is the first indoor air filtration intervention study to examine the effectiveness of both HE and LE filters in reducing personal PM2.5 exposures.
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Affiliation(s)
- Melissa M Maestas
- Exposure Science Lab, Family Medicine, College of Human Medicine, Michigan State University, East Lansing, MI, USA
| | - Robert D Brook
- Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, MI, USA
| | | | - Fengyao Li
- Exposure Science Lab, Family Medicine, College of Human Medicine, Michigan State University, East Lansing, MI, USA
| | - Ryan C Crane
- Exposure Science Lab, Family Medicine, College of Human Medicine, Michigan State University, East Lansing, MI, USA
| | - Zachary M Klaver
- Exposure Science Lab, Family Medicine, College of Human Medicine, Michigan State University, East Lansing, MI, USA
| | - Robert L Bard
- Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, MI, USA
| | | | - Sara D Adar
- School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Masako Morishita
- Exposure Science Lab, Family Medicine, College of Human Medicine, Michigan State University, East Lansing, MI, USA.
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36
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Tunno B, Longley I, Somervell E, Edwards S, Olivares G, Gray S, Cambal L, Chubb L, Roper C, Coulson G, Clougherty JE. Separating spatial patterns in pollution attributable to woodsmoke and other sources, during daytime and nighttime hours, in Christchurch, New Zealand. ENVIRONMENTAL RESEARCH 2019; 171:228-238. [PMID: 30685575 DOI: 10.1016/j.envres.2019.01.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 01/03/2019] [Accepted: 01/14/2019] [Indexed: 06/09/2023]
Abstract
During winter nights, woodsmoke may be a predominant source of air pollution, even in cities with many sources. Since two major earthquakes resulted in major structural damage in 2010 and 2011, reliance on woodburning for home heating has increased substantially in Christchurch, New Zealand (NZ), along with intensive construction/demolition activities. Further, because NZ is a relatively isolated western country, it offers the unique opportunity to disentangle multiple source impacts in the absence of long-range transport pollution. Finally, although many spatial saturation studies have been published, and levoglucosan is an established tracer for woodburning emissions, few studies have monitored multiple sites simultaneously for this or other organic constituents, with the ability to distinguish spatial patterns for daytime vs. nighttime hours, in complex urban settings. We captured seven-day integrated samples of PM2.5, and elemental and organic tracers of woodsmoke and diesel emissions, during "daytime" (7 a.m. - 5:30 p.m.) and "nighttime" (7 p.m. - 5:30 a.m.) hours, at nine sites across commercial and residential areas, over three weeks in early winter (May 2014). At a subset of six sites, we also sampled during hypothesized "peak" woodburning hours (7 p.m. - 12 a.m.), to differentiate emissions during "active" residential woodburning, vs. overnight smouldering. Concentrations of PM2.5 were, on average, were twice as high during nighttime than daytime [µ = 18.4 (SD = 6.13) vs. 9.21 (SD = 6.13) µg/m3], with much greater differences in woodsmoke tracers (i.e., levoglucosan [µ = 1.83 (SD = 0.82) vs. 0.34 (SD = 0.17) µg/m3], potassium) and indicators of treated- or painted-wood burning (e.g., arsenic, lead). Only nitrogen dioxide, calcium, iron, and manganese (tracers of vehicular emissions) were higher during daytime. Levoglucosan and most PAHs were higher during "active" woodburning, vs. overnight smouldering. Our time-stratified spatial saturation detected strong spatial variability throughout the study area, which distinctly differed during daytime vs. night time hours, and quantified the substantial contribution of woodsmoke to overnight spatial variation in PM2.5 across Christchurch. Daytime vs. nighttime differences were greater than those observed across sites. Traffic, especially diesel, contributed substantially to daytime NO2 and spatial gradients in non-woodsmoke constituents.
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Affiliation(s)
- Brett Tunno
- University of Pittsburgh Graduate School of Public Health, Department of Environmental and Occupational Health, Pittsburgh, PA, United States
| | - Ian Longley
- National Institute of Water and Atmospheric Research (NIWA), Auckland, New Zealand
| | - Elizabeth Somervell
- National Institute of Water and Atmospheric Research (NIWA), Auckland, New Zealand
| | - Sam Edwards
- National Institute of Water and Atmospheric Research (NIWA), Auckland, New Zealand
| | - Gustavo Olivares
- National Institute of Water and Atmospheric Research (NIWA), Auckland, New Zealand
| | - Sally Gray
- National Institute of Water and Atmospheric Research (NIWA), Auckland, New Zealand
| | - Leah Cambal
- University of Pittsburgh Graduate School of Public Health, Department of Environmental and Occupational Health, Pittsburgh, PA, United States
| | - Lauren Chubb
- University of Pittsburgh Graduate School of Public Health, Department of Environmental and Occupational Health, Pittsburgh, PA, United States
| | - Courtney Roper
- University of Pittsburgh Graduate School of Public Health, Department of Environmental and Occupational Health, Pittsburgh, PA, United States
| | - Guy Coulson
- National Institute of Water and Atmospheric Research (NIWA), Auckland, New Zealand
| | - Jane E Clougherty
- University of Pittsburgh Graduate School of Public Health, Department of Environmental and Occupational Health, Pittsburgh, PA, United States; Drexel University Dornsife School of Public Health, Department of Environmental and Occupational Health, Philadelphia, PA, United States.
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Shukla A, Bunkar N, Kumar R, Bhargava A, Tiwari R, Chaudhury K, Goryacheva IY, Mishra PK. Air pollution associated epigenetic modifications: Transgenerational inheritance and underlying molecular mechanisms. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 656:760-777. [PMID: 30530146 DOI: 10.1016/j.scitotenv.2018.11.381] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 10/23/2018] [Accepted: 11/25/2018] [Indexed: 05/28/2023]
Abstract
Air pollution is one of the leading causes of deaths in Southeast Asian countries including India. Exposure to air pollutants affects vital cellular mechanisms and is intimately linked with the etiology of a number of chronic diseases. Earlier work from our laboratory has shown that airborne particulate matter disturbs the mitochondrial machinery and causes significant damage to the epigenome. Mitochondrial reactive oxygen species possess the ability to trigger redox-sensitive signaling mechanisms and induce irreversible epigenomic changes. The electrophilic nature of reactive metabolites can directly result in deprotonation of cytosine at C-5 position or interfere with the DNA methyltransferases activity to cause alterations in DNA methylation. In addition, it also perturbs level of cellular metabolites critically involved in different epigenetic processes like acetylation and methylation of histone code and DNA hypo or hypermethylation. Interestingly, these modifications may persist through downstream generations and result in the transgenerational epigenomic inheritance. This phenomenon of subsequent transfer of epigenetic modifications is mainly associated with the germ cells and relies on the germline stability of the epigenetic states. Overall, the recent literature supports, and arguably strengthens, the contention that air pollution might contribute to transmission of epimutations from gametes to zygotes by involving mitochondrial DNA, parental allele imprinting, histone withholding and non-coding RNAs. However, larger prospective studies using innovative, integrated epigenome-wide metabolomic strategy are highly warranted to assess the air pollution induced transgenerational epigenetic inheritance and associated human health effects.
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Affiliation(s)
- Anushi Shukla
- Department of Molecular Biology, ICMR-National Institute for Research in Environmental Health, Bhopal, India
| | - Neha Bunkar
- Department of Molecular Biology, ICMR-National Institute for Research in Environmental Health, Bhopal, India
| | - Rajat Kumar
- Department of Molecular Biology, ICMR-National Institute for Research in Environmental Health, Bhopal, India
| | - Arpit Bhargava
- Department of Molecular Biology, ICMR-National Institute for Research in Environmental Health, Bhopal, India
| | - Rajnarayan Tiwari
- Department of Molecular Biology, ICMR-National Institute for Research in Environmental Health, Bhopal, India
| | - Koel Chaudhury
- School of Medical Science & Technology, Indian Institute of Technology, Kharagpur, India
| | - Irina Y Goryacheva
- Department of General and Inorganic Chemistry, Saratov State University, Saratov, Russia
| | - Pradyumna K Mishra
- Department of Molecular Biology, ICMR-National Institute for Research in Environmental Health, Bhopal, India.
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38
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Barn P, Gombojav E, Ochir C, Boldbaatar B, Beejin B, Naidan G, Galsuren J, Legtseg B, Byambaa T, Hutcheon JA, Janes C, Janssen PA, Lanphear BP, McCandless LC, Takaro TK, Venners SA, Webster GM, Allen RW. The effect of portable HEPA filter air cleaner use during pregnancy on fetal growth: The UGAAR randomized controlled trial. ENVIRONMENT INTERNATIONAL 2018; 121:981-989. [PMID: 30213473 DOI: 10.1016/j.envint.2018.08.036] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 07/19/2018] [Accepted: 08/15/2018] [Indexed: 05/22/2023]
Abstract
BACKGROUND Fine particulate matter (PM2.5) exposure may impair fetal growth. AIMS/OBJECTIVES Our aim was to assess the effect of portable high efficiency particulate air (HEPA) filter air cleaner use during pregnancy on fetal growth. METHODS The Ulaanbaatar Gestation and Air Pollution Research (UGAAR) study is a single-blind randomized controlled trial conducted in Ulaanbaatar, Mongolia. Non-smoking pregnant women recruited at ≤18 weeks gestation were randomized to an intervention (1-2 air cleaners in homes from early pregnancy until childbirth) or control (no air cleaners) group. Participants were not blinded to their intervention status. Demographic, health, and birth outcome data were obtained via questionnaires and clinic records. We used unadjusted linear and logistic regression and time-to-event analysis to evaluate the intervention. Our primary outcome was birth weight. Secondary outcomes were gestational age-adjusted birth weight, birth length, head circumference, gestational age at birth, and small for gestational age. The study is registered at ClinicalTrials.gov (NCT01741051). RESULTS We recruited 540 participants (272 control and 268 intervention) from January 9, 2014 to May 1, 2015. There were 465 live births and 28 losses to follow up. We previously reported a 29% (95% CI: 21, 37%) reduction in indoor PM2.5 concentrations with portable HEPA filter air cleaner use. The median (25th, 75th percentile) birth weights for control and intervention participants were 3450 g (3150, 3800 g) and 3550 g (3200, 3800 g), respectively (p = 0.34). The intervention was not associated with birth weight (18 g; 95% CI: -84, 120 g), but in a pre-specified subgroup analysis of 429 term births the intervention was associated with an 85 g (95% CI: 3, 167 g) increase in mean birth weight. CONCLUSIONS HEPA filter air cleaner use in a high pollution setting was associated with greater birth weight only among babies born at term.
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Affiliation(s)
- Prabjit Barn
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby V5A 1S6, Canada.
| | - Enkhjargal Gombojav
- School of Public Health, Mongolian National University of Medical Sciences, Zorig Street, Ulaanbaatar 14210, Mongolia
| | - Chimedsuren Ochir
- School of Public Health, Mongolian National University of Medical Sciences, Zorig Street, Ulaanbaatar 14210, Mongolia
| | - Buyantushig Boldbaatar
- School of Public Health, Mongolian National University of Medical Sciences, Zorig Street, Ulaanbaatar 14210, Mongolia
| | - Bolor Beejin
- Ministry of Health of Mongolia, Olympic Street-2, Government building VIII, Sukhbaatar District, Ulaanbaatar, Mongolia
| | - Gerel Naidan
- School of Public Health, Mongolian National University of Medical Sciences, Zorig Street, Ulaanbaatar 14210, Mongolia
| | - Jargalsaikhan Galsuren
- School of Public Health, Mongolian National University of Medical Sciences, Zorig Street, Ulaanbaatar 14210, Mongolia
| | - Bayarkhuu Legtseg
- Sukhbaatar District Health Center, 11 Horoo, Tsagdaagiin Gudamj, Sukhbaatar District, Ulaanbaatar, Mongolia
| | - Tsogtbaatar Byambaa
- Ministry of Health of Mongolia, Olympic Street-2, Government building VIII, Sukhbaatar District, Ulaanbaatar, Mongolia
| | - Jennifer A Hutcheon
- Faculty of Medicine, Department of Obstetrics & Gynaecology, University of British Columbia, 4500 Oak Street, Vancouver V6H 2N1, Canada
| | - Craig Janes
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West,Waterloo N2L 3G1, Canada
| | - Patricia A Janssen
- School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver V6T 1Z3, Canada
| | - Bruce P Lanphear
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby V5A 1S6, Canada
| | - Lawrence C McCandless
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby V5A 1S6, Canada
| | - Tim K Takaro
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby V5A 1S6, Canada
| | - Scott A Venners
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby V5A 1S6, Canada
| | - Glenys M Webster
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby V5A 1S6, Canada
| | - Ryan W Allen
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby V5A 1S6, Canada
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Cole CA, Carlsten C, Koehle M, Brauer M. Particulate matter exposure and health impacts of urban cyclists: a randomized crossover study. Environ Health 2018; 17:78. [PMID: 30428890 PMCID: PMC6237024 DOI: 10.1186/s12940-018-0424-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 10/30/2018] [Indexed: 05/25/2023]
Abstract
BACKGROUND Cycling and other forms of active transportation provide health benefits via increased physical activity. However, direct evidence of the extent to which these benefits may be offset by exposure and intake of traffic-related air pollution is limited. The purpose of this study is to measure changes in endothelial function, measures of oxidative stress and inflammation, and lung function in healthy participants before and after cycling along a high- and low- traffic route. METHODS Participants (n = 38) bicycled for 1 h along a Downtown and a Residential designated bicycle route in a randomized crossover trial. Heart rate, power output, particulate matter air pollution (PM10, PM2.5, and PM1) and particle number concentration (PNC) were measured. Lung function, endothelial function (reactive hyperemia index, RHI), C-reactive protein, interleukin-6, and 8-hydroxy-2'-deoxyguanosine were assessed within one hour pre- and post-trial. RESULTS Geometric mean PNC exposures and intakes were higher along the Downtown (exposure = 16,226 particles/cm3; intake = 4.54 × 1010 particles) compared to the Residential route (exposure = 9367 particles/cm3; intake = 3.13 × 1010 particles). RHI decreased following cycling along the Downtown route and increased on the Residential route; in mixed linear regression models, the (post-pre) change in RHI was 21% lower following cycling on the Downtown versus the Residential route (-0.43, 95% CI: -0.79, -0.079) but RHI decreases were not associated with measured exposure or intake of air pollutants. The differences in RHI by route were larger amongst females and older participants. No consistent associations were observed for any of the other outcome measures. CONCLUSIONS Although PNC exposures and intakes were higher along the Downtown route, the lack of association between air pollutant exposure or intake with RHI and other measures suggests other exposures related to cycling on the Downtown route may have been influential in the observed differences between routes in RHI. TRIAL REGISTRATION ClinicalTrials.gov, NCT01708356 . Registered 16 October 2012.
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Affiliation(s)
- Christie A. Cole
- School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC V6T 1Z3 Canada
| | - Christopher Carlsten
- Air Pollution Exposure Lab, Department of Medicine, University of British Columbia, 2775 Laurel Street 7th Floor, Vancouver, BC V5Z 1M9 Canada
| | - Michael Koehle
- School of Kinesiology and Division of Sport & Exercise Medicine, University of British Columbia, 2176 Health Sciences Mall, Vancouver, BC V6T 1Z3 Canada
| | - Michael Brauer
- School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC V6T 1Z3 Canada
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Cox J, Isiugo K, Ryan P, Grinshpun SA, Yermakov M, Desmond C, Jandarov R, Vesper S, Ross J, Chillrud S, Dannemiller K, Reponen T. Effectiveness of a portable air cleaner in removing aerosol particles in homes close to highways. INDOOR AIR 2018; 28:818-827. [PMID: 30133950 PMCID: PMC6188808 DOI: 10.1111/ina.12502] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 08/19/2018] [Indexed: 05/18/2023]
Abstract
Outdoor traffic-related airborne particles can infiltrate a building and adversely affect the indoor air quality. Limited information is available on the effectiveness of high efficiency particulate air (HEPA) filtration of traffic-related particles. Here, we investigated the effectiveness of portable HEPA air cleaners in reducing indoor concentrations of traffic-related and other aerosols, including black carbon (BC), PM2.5 , ultraviolet absorbing particulate matter (UVPM) (a marker of tobacco smoke), and fungal spores. This intervention study consisted of a placebo-controlled cross-over design, in which a HEPA cleaner and a placebo "dummy" were placed in homes for 4-weeks each, with 48-hour air sampling conducted prior to and during the end of each treatment period. The concentrations measured for BC, PM2.5 , UVPM, and fungal spores were significantly reduced following HEPA filtration, but not following the dummy period. The indoor fraction of BC/PM2.5 was significantly reduced due to the HEPA cleaner, indicating that black carbon was particularly impacted by HEPA filtration. This study demonstrates that HEPA air purification can result in a significant reduction of traffic-related and other aerosols in diverse residential settings.
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Affiliation(s)
- Jennie Cox
- Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio
| | - Kelechi Isiugo
- Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio
| | - Patrick Ryan
- Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Sergey A Grinshpun
- Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio
| | - Michael Yermakov
- Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio
| | - Colleen Desmond
- Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio
| | - Roman Jandarov
- Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio
| | - Stephen Vesper
- United States Environmental Protection Agency, Cincinnati, Ohio
| | - James Ross
- Lamont-Doherty Earth Observatory of Columbia University, Palisades, New York
| | - Steven Chillrud
- Lamont-Doherty Earth Observatory of Columbia University, Palisades, New York
| | - Karen Dannemiller
- Civil, Environmental & Geodetic Engineering, College of Engineering, The Ohio State University, Columbus, Ohio
- Environmental Health Sciences, College of Public Health, The Ohio State University, Columbus, Ohio
| | - Tiina Reponen
- Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio
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Morishita M, Adar SD, D'Souza J, Ziemba RA, Bard RL, Spino C, Brook RD. Effect of Portable Air Filtration Systems on Personal Exposure to Fine Particulate Matter and Blood Pressure Among Residents in a Low-Income Senior Facility: A Randomized Clinical Trial. JAMA Intern Med 2018; 178:1350-1357. [PMID: 30208394 PMCID: PMC6233749 DOI: 10.1001/jamainternmed.2018.3308] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
IMPORTANCE Fine particulate matter (smaller than 2.5 μm) (PM2.5) air pollution is a major global risk factor for cardiovascular (CV) morbidity and mortality. Few studies have tested the benefits of portable air filtration systems in urban settings in the United States. OBJECTIVE To investigate the effectiveness of air filtration at reducing personal exposures to PM2.5 and mitigating related CV health effects among older adults in a typical US urban location. DESIGN, SETTING, AND PARTICIPANTS This randomized, double-blind crossover intervention study was conducted from October 21, 2014, through November 4, 2016, in a low-income senior residential building in Detroit, Michigan. Forty nonsmoking older adults were enrolled, with daily CV health outcome and PM2.5 exposure measurements. INTERVENTIONS Participants were exposed to the following three 3-day scenarios separated by 1-week washout periods: unfiltered air (sham filtration), low-efficiency (LE) high-efficiency particulate arrestance (HEPA)-type filtered air, and high-efficiency (HE) true-HEPA filtered air using filtration systems in their bedroom and living room. MAIN OUTCOMES AND MEASURES The primary outcome was brachial blood pressure (BP). Secondary outcomes included aortic hemodynamics, pulse-wave velocity, and heart rate variability. Exposures to PM2.5 were measured in the participants' residences and by personal monitoring. RESULTS The 40 participants had a mean (SD) age of 67 (8) years (62% men). Personal PM2.5 exposures were significantly reduced by air filtration from a mean (SD) of 15.5 (10.9) μg/m3 with sham filtration to 10.9 (7.4) μg/m3 with LE fitration and 7.4 (3.3) μg/m3 with HE filtration. Compared with sham filtration, any filtration for 3 days decreased brachial systolic and diastolic BP by 3.2 mm Hg (95% CI, -6.1 to -0.2 mm Hg) and 1.5 mm Hg (95% CI, -3.3 to 0.2 mm Hg), respectively. A continuous decrease occurred in systolic and diastolic BP during the 3-day period of LE filtration, with a mean of 3.4 mm Hg (95% CI, -6.8 to -0.1 mm Hg) and 2.2 mm Hg (95% CI, -4.2 to -0.3 mm Hg), respectively. For HE filtration, systolic and diastolic BP decreased by 2.9 mm Hg (95% CI, -6.2 to 0.5 mm Hg) and 0.8 mm Hg (95% CI, -2.8 to 1.2 mm Hg), respectively. Most secondary outcomes were not significantly improved. CONCLUSIONS AND RELEVANCE Results of this study showed that short-term use of portable air filtration systems reduced personal PM2.5 exposures and systolic BP among older adults living in a typical US urban location. The use of these relatively inexpensive systems is potentially cardioprotective against PM2.5 exposures and warrants further research. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT03334565.
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Affiliation(s)
- Masako Morishita
- Department of Family Medicine, College of Human Medicine, Michigan State University, East Lansing
| | - Sara D Adar
- School of Public Health, University of Michigan, Ann Arbor
| | | | | | - Robert L Bard
- Division of Cardiovascular Medicine, University of Michigan, Ann Arbor
| | | | - Robert D Brook
- Division of Cardiovascular Medicine, University of Michigan, Ann Arbor
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Martenies SE, Batterman SA. Effectiveness of Using Enhanced Filters in Schools and Homes to Reduce Indoor Exposures to PM 2.5 from Outdoor Sources and Subsequent Health Benefits for Children with Asthma. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2018; 52:10767-10776. [PMID: 30141330 DOI: 10.1021/acs.est.8b02053] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Filters can reduce indoor concentrations of particulate matter (PM2.5), but their benefits have not been well-characterized. This study investigates exposure, health, and cost impacts of high efficiency filters in homes and schools, focusing on the asthma-related outcomes. Reductions in indoor exposures to PM2.5 from outdoor sources with enhanced filters (e.g., MERV 12) are estimated using probabilistic indoor air quality models, and avoided health impacts are quantified using health impact assessment. These methods are applied using data from Detroit, Michigan, an urban region with elevated asthma rates. Replacing inefficient filters with enhanced filters in schools would reduce the PM2.5-attributable asthma burden by 13% annually, with higher benefits for more efficient filters. Marginal costs average $63 per classroom or $32 per child with asthma per year. In homes, using efficient furnace filters or air cleaners yields 11 to 16% reductions in the asthma burden with an annualized marginal costs of $151-494 per household. Additional benefits include reductions in health risk for adults and lower exposures to other contaminants such as PM from indoor sources. On the basis of the included health outcomes, efficient filters in schools in particular is a potentially cost-efficient way to reduce the asthma-related health burden for children.
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Affiliation(s)
- Sheena E Martenies
- Environmental and Radiological Sciences , Colorado State University , 1681 Campus Delivery , Fort Collins , Colorado 80523 , United States
| | - Stuart A Batterman
- Environmental Health Sciences , University of Michigan School of Public Health , 1415 Washington Heights , Ann Arbor , Michigan 48109 , United States
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Reis H, Reis C, Sharip A, Reis W, Zhao Y, Sinclair R, Beeson L. Diesel exhaust exposure, its multi-system effects, and the effect of new technology diesel exhaust. ENVIRONMENT INTERNATIONAL 2018; 114:252-265. [PMID: 29524921 DOI: 10.1016/j.envint.2018.02.042] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 02/24/2018] [Accepted: 02/24/2018] [Indexed: 11/07/2023]
Abstract
Exposure to diesel exhaust (DE) from vehicles and industry is hazardous and affects proper function of organ systems. DE can interfere with normal physiology after acute and chronic exposure to particulate matter (PM). Exposure leads to potential systemic disease processes in the central nervous, visual, hematopoietic, respiratory, cardiovascular, and renal systems. In this review, we give an overview of the epidemiological evidence supporting the harmful effects of diesel exhaust, and the numerous animal studies conducted to investigate the specific pathophysiological mechanisms behind DE exposure. Additionally, this review includes a summary of studies that used biomarkers as an indication of biological plausibility, and also studies evaluating new technology diesel exhaust (NTDE) and its systemic effects. Lastly, this review includes new approaches to improving DE emissions, and emphasizes the importance of ongoing study in this field of environmental health.
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Affiliation(s)
- Haley Reis
- Loma Linda University School of Medicine, 11175 Campus Street, Loma Linda, CA 92350, USA
| | - Cesar Reis
- Department of Preventive Medicine, Loma Linda University Medical Center, 24785 Stewart Street, Suite 204, Loma Linda, CA 92354, USA; Loma Linda University School of Medicine, 11175 Campus Street, Loma Linda, CA 92350, USA.
| | - Akbar Sharip
- Department of Occupational Medicine, Loma Linda University Medical Center, 328 East Commercial Road, Suite 101, San Bernardino, CA 92408, USA
| | - Wenes Reis
- Department of Preventive Medicine, Loma Linda University Medical Center, 24785 Stewart Street, Suite 204, Loma Linda, CA 92354, USA
| | - Yong Zhao
- School of Public Health and Management, Chongqing Medical University, Chongqing, China; Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China; The Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, China
| | - Ryan Sinclair
- Center for Community Resilience, School of Public Health, Loma Linda University, Loma Linda, CA 92350, USA
| | - Lawrence Beeson
- Center for Nutrition, Healthy Lifestyle, and Disease Prevention, School of Public Health, Loma Linda University, Loma Linda, CA 92350, USA.
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Day DB, Xiang J, Mo J, Clyde MA, Weschler CJ, Li F, Gong J, Chung M, Zhang Y, Zhang J(J. Combined use of an electrostatic precipitator and a high-efficiency particulate air filter in building ventilation systems: Effects on cardiorespiratory health indicators in healthy adults. INDOOR AIR 2018; 28:360-372. [PMID: 29288500 PMCID: PMC5903943 DOI: 10.1111/ina.12447] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Accepted: 12/19/2017] [Indexed: 05/08/2023]
Abstract
High-efficiency particulate air (HEPA) filtration in combination with an electrostatic precipitator (ESP) can be a cost-effective approach to reducing indoor particulate exposure, but ESPs produce ozone. The health effect of combined ESP-HEPA filtration has not been examined. We conducted an intervention study in 89 volunteers. At baseline, the air-handling units of offices and residences for all subjects were comprised of coarse, ESP, and HEPA filtration. During the 5-week long intervention, the subjects were split into 2 groups, 1 with just the ESP removed and the other with both the ESP and HEPA removed. Each subject was measured for cardiopulmonary risk indicators once at baseline, twice during the intervention, and once 2 weeks after baseline conditions were restored. Measured indoor and outdoor PM2.5 and ozone concentrations, coupled with time-activity data, were used to calculate exposures. Removal of HEPA filters increased 24-hour mean PM2.5 exposure by 38 (95% CI: 31, 45) μg/m3 . Removal of ESPs decreased 24-hour mean ozone exposure by 2.2 (2.0, 2.5) ppb. No biomarkers were significantly associated with HEPA filter removal. In contrast, ESP removal was associated with a -16.1% (-21.5%, -10.4%) change in plasma-soluble P-selectin and a -3.0% (-5.1%, -0.8%) change in systolic blood pressure, suggesting reduced cardiovascular risks.
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Affiliation(s)
- Drew B Day
- Global Health Institute and Nicholas School of the Environment, Duke University, Box 90328, Durham, NC 27708, USA
| | - Jianbang Xiang
- Department of Building Science, Tsinghua University, Beijing 100084, China
- Beijing Key Laboratory of Indoor Air Quality Evaluation and Control, Beijing 100084, China
| | - Jinhan Mo
- Department of Building Science, Tsinghua University, Beijing 100084, China
- Beijing Key Laboratory of Indoor Air Quality Evaluation and Control, Beijing 100084, China
| | - Merlise A Clyde
- Department of Statistical Science, Duke University, 214A Old Chemistry Building, Box 90251, Durham, NC 27708, USA
| | - Charles J Weschler
- Department of Building Science, Tsinghua University, Beijing 100084, China
- Beijing Key Laboratory of Indoor Air Quality Evaluation and Control, Beijing 100084, China
- Environmental and Occupational Health Sciences Institute, Rutgers University, Robert Wood Johnson Medical School, Room N100, 675 Hoes Lane West, Piscataway, NJ 08854, USA
| | - Feng Li
- Department of Respiratory Medicine, Shanghai General Hospital, Shanghai Jiao Tong University, 100 Haining Road, Shanghai, China 200080
| | - Jicheng Gong
- Department of Environmental Science, Peking University, 116 Old Geosciences Building, Beijing, China 100871
| | - Mingkei Chung
- Department of Biomedical Informatics, Harvard Medical School, Harvard University, 10 Shattuck Street, Boston, MA 02115, USA
| | - Yinping Zhang
- Department of Building Science, Tsinghua University, Beijing 100084, China
- Beijing Key Laboratory of Indoor Air Quality Evaluation and Control, Beijing 100084, China
| | - Junfeng (Jim) Zhang
- Global Health Institute and Nicholas School of the Environment, Duke University, Box 90328, Durham, NC 27708, USA
- Department of Environmental Science, Peking University, 116 Old Geosciences Building, Beijing, China 100871
- Duke Kunshan University, No. 8 Duke Avenue, Kunshan, Jiangsu Province, China 215316
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Wang Y, Duan H, Meng T, Shen M, Ji Q, Xing J, Wang Q, Wang T, Niu Y, Yu T, Liu Z, Jia H, Zhan Y, Chen W, Zhang Z, Su W, Dai Y, Zhang X, Zheng Y. Reduced serum club cell protein as a pulmonary damage marker for chronic fine particulate matter exposure in Chinese population. ENVIRONMENT INTERNATIONAL 2018; 112:207-217. [PMID: 29277064 DOI: 10.1016/j.envint.2017.12.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 12/15/2017] [Accepted: 12/15/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Exposure to fine particulate matter (PM2.5) pollution is associated with increased morbidity and mortality from respiratory diseases. However, few population-based studies have been conducted to assess the alterations in circulating pulmonary proteins due to long-term PM2.5 exposure. METHODS We designed a two-stage study. In the first stage (training set), we assessed the associations between PM2.5 exposure and levels of pulmonary damage markers (CC16, SP-A and SP-D) and lung function in a coke oven emission (COE) cohort with 558 coke plant workers and 210 controls. In the second stage (validation set), significant initial findings were validated by an independent diesel engine exhaust (DEE) cohort with 50 DEE exposed workers and 50 controls. RESULTS Serum CC16 levels decreased in a dose response manner in association with both external and internal PM2.5 exposures in the two cohorts. In the training set, serum CC16 levels decreased with increasing duration of occupational PM2.5 exposure history. An interquartile range (IQR) (122.0μg/m3) increase in PM2.5 was associated with a 5.76% decrease in serum CC16 levels, whereas an IQR (1.06μmol/mol creatinine) increase in urinary 1-hydroxypyrene (1-OHP) concentration was associated with a 5.36% decrease in serum CC16 levels in the COE cohort. In the validation set, the concentration of serum CC16 in the PM2.5 exposed group was 22.42% lower than that of the controls and an IQR (1.24μmol/mol creatinine) increase in urinary 1-OHP concentration was associated with a 12.24% decrease in serum CC16 levels in the DEE cohort. CONCLUSIONS Serum CC16 levels may be a sensitive marker for pulmonary damage in populations with high PM2.5 exposure.
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Affiliation(s)
- Yanhua Wang
- Key Laboratory of Chemical Safety and Health, National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Huawei Duan
- Key Laboratory of Chemical Safety and Health, National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Tao Meng
- Key Laboratory of Chemical Safety and Health, National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Meili Shen
- Key Laboratory of Chemical Safety and Health, National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Qianpeng Ji
- Key Laboratory of Chemical Safety and Health, National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China; Faculty of Public Health, Weifang Medical University, Weifang, China
| | - Jie Xing
- Faculty of Public Health, Weifang Medical University, Weifang, China
| | - Qingrong Wang
- Key Laboratory of Chemical Safety and Health, National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China; Faculty of Public Health, Weifang Medical University, Weifang, China
| | - Ting Wang
- Key Laboratory of Chemical Safety and Health, National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yong Niu
- Key Laboratory of Chemical Safety and Health, National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Tao Yu
- Key Laboratory of Chemical Safety and Health, National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhong Liu
- Jinan Municipal Center for Disease Control and Prevention, Jinan, China
| | | | | | - Wen Chen
- Faculty of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Zhihu Zhang
- Shandong Academy of Occupational Health and Occupational Medicine, Jinan, China
| | - Wenge Su
- Laigang Hospital attached to Taishan Medical University, Laiwu, China
| | - Yufei Dai
- Key Laboratory of Chemical Safety and Health, National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xuchun Zhang
- Laigang Hospital attached to Taishan Medical University, Laiwu, China
| | - Yuxin Zheng
- School of Public Health, Qingdao University, Qingdao, China.
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Barn P, Gombojav E, Ochir C, Laagan B, Beejin B, Naidan G, Boldbaatar B, Galsuren J, Byambaa T, Janes C, Janssen PA, Lanphear BP, Takaro TK, Venners SA, Webster GM, Yuchi W, Palmer CD, Parsons PJ, Roh YM, Allen RW. The effect of portable HEPA filter air cleaners on indoor PM 2.5 concentrations and second hand tobacco smoke exposure among pregnant women in Ulaanbaatar, Mongolia: The UGAAR randomized controlled trial. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 615:1379-1389. [PMID: 29751442 DOI: 10.1016/j.scitotenv.2017.09.291] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Revised: 09/20/2017] [Accepted: 09/27/2017] [Indexed: 05/22/2023]
Abstract
BACKGROUND Portable HEPA filter air cleaners can reduce indoor fine particulate matter (PM2.5), but their use has not been adequately evaluated in high pollution settings. We assessed air cleaner effectiveness in reducing indoor residential PM2.5 and second hand smoke (SHS) exposures among non-smoking pregnant women in Ulaanbaatar, Mongolia. METHODS We randomized 540 participants to an intervention group receiving 1 or 2 HEPA filter air cleaners or a control group receiving no air cleaners. We followed 259 intervention and 253 control participants to the end of pregnancy. We measured one-week indoor residential PM2.5 concentrations in early (~11weeks gestation) and late (~31weeks gestation) pregnancy and collected outdoor PM2.5 data from centrally-located government monitors. We assessed blood cadmium in late pregnancy. Hair nicotine was quantified in a subset (n=125) to evaluate blood cadmium as a biomarker of SHS exposure. We evaluated air cleaner effectiveness using mixed effects and multiple linear regression models and used stratified models and interaction terms to evaluate potential modifiers of effectiveness. RESULTS The overall geometric mean (GM) one-week outdoor PM2.5 concentration was 47.9μg/m3 (95% CI: 44.6, 51.6μg/m3), with highest concentrations in winter (118.0μg/m3; 110.4, 126.2μg/m3). One-week indoor and outdoor PM2.5 concentrations were correlated (r=0.69). Indoor PM2.5 concentrations were 29% (21, 37%) lower in intervention versus control apartments, with GMs of 17.3μg/m3 (15.8, 18.8μg/m3) and 24.5μg/m3 (22.2, 27.0μg/m3), respectively. Air cleaner effectiveness was greater when air cleaners were first deployed (40%; 31, 48%) than after approximately five months of use (15%; 0, 27%). Blood cadmium concentrations were 14% (4, 23%) lower among intervention participants, likely due to reduced SHS exposure. CONCLUSIONS Portable HEPA filter air cleaners can lower indoor PM2.5 concentrations and SHS exposures in highly polluted settings.
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Affiliation(s)
- Prabjit Barn
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby V5A 1S6, Canada.
| | - Enkhjargal Gombojav
- School of Public Health, Mongolian National University of Medical Sciences, Zorig Street, Ulaanbaatar 14210, Mongolia.
| | - Chimedsuren Ochir
- School of Public Health, Mongolian National University of Medical Sciences, Zorig Street, Ulaanbaatar 14210, Mongolia.
| | - Bayarkhuu Laagan
- Sukhbaatar District Health Center, 11 Horoo, Tsagdaagiin Gudamj, Sukhbaatar District, Ulaanbaatar, Mongolia
| | - Bolor Beejin
- Mongolian National Center for Public Health, Olympic Street 2, Ulaanbaatar, Mongolia.
| | - Gerel Naidan
- School of Public Health, Mongolian National University of Medical Sciences, Zorig Street, Ulaanbaatar 14210, Mongolia
| | - Buyantushig Boldbaatar
- School of Public Health, Mongolian National University of Medical Sciences, Zorig Street, Ulaanbaatar 14210, Mongolia
| | - Jargalsaikhan Galsuren
- School of Public Health, Mongolian National University of Medical Sciences, Zorig Street, Ulaanbaatar 14210, Mongolia
| | - Tsogtbaatar Byambaa
- Mongolian National Center for Public Health, Olympic Street 2, Ulaanbaatar, Mongolia.
| | - Craig Janes
- School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo N2L 3G1, Canada.
| | - Patricia A Janssen
- School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver V6T 1Z3, Canada.
| | - Bruce P Lanphear
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby V5A 1S6, Canada.
| | - Tim K Takaro
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby V5A 1S6, Canada.
| | - Scott A Venners
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby V5A 1S6, Canada.
| | - Glenys M Webster
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby V5A 1S6, Canada.
| | - Weiran Yuchi
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby V5A 1S6, Canada.
| | - Christopher D Palmer
- New York State Department of Health, Wadsworth Center, Albany, NY, PO Box 509, 12201, USA; School of Public Health, University at Albany, State University of New York, One University Place, Rensselaer, NY 12144, USA.
| | - Patrick J Parsons
- New York State Department of Health, Wadsworth Center, Albany, NY, PO Box 509, 12201, USA; School of Public Health, University at Albany, State University of New York, One University Place, Rensselaer, NY 12144, USA.
| | - Young Man Roh
- College of Health Sciences, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul 02841, Republic of Korea
| | - Ryan W Allen
- Faculty of Health Sciences, Simon Fraser University, 8888 University Drive, Burnaby V5A 1S6, Canada.
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Brugge D, Simon MC, Hudda N, Zellmer M, Corlin L, Cleland S, Lu EY, Rivera S, Byrne M, Chung M, Durant JL. Lessons from in-home air filtration intervention trials to reduce urban ultrafine particle number concentrations. BUILDING AND ENVIRONMENT 2017; 126:266-275. [PMID: 29398771 DOI: 10.1016/j.buildenv.2017.10007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
BACKGROUND Exposure to airborne ultrafine particle (UFP; <100 nm in aerodynamic diameter) is an emerging public health problem. Nevertheless, the benefit of using high efficiency particulate arrestance (HEPA) filtration to reduce UFP concentrations in homes is not yet clear. METHODS We conducted a randomized crossover study of HEPA filtration without a washout period in 23 homes of low-income Puerto Ricans in Boston and Chelsea, MA (USA). Most participants were female, older adults who were overweight or obese. Particle number concentrations (PNC, a proxy for UFP) were measured indoors and outdoors at each home continuously for six weeks. Homes received both HEPA filtration and sham filtration for three weeks each in random order. RESULTS Median PNC under HEPA filtration was 50-85% lower compared to sham filtration in most homes, but we found no benefit in terms of reduced inflammation; associations between hsCRP, IL-6, or TNFRII in blood samples and indoor PNC were inverse and not statistically significant. CONCLUSIONS Limitations to our study design likely contributed to our findings. Limitations included carry-over effects, a population that may have been relatively unresponsive to UFP, reduction in PNC even during sham filtration that limited differences between HEPA and sham filtration, window opening by participants, and lack of fine-grained (room-specific) participant time-activity information. Our approach was similar to other recent HEPA intervention studies of particulate matter exposure and cardiovascular risk, suggesting that there is a need for better study designs.
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Affiliation(s)
- Doug Brugge
- Department of Public Health and Community Medicine, Tufts University School of Medicine, 136 Harrison Ave., Boston, MA 02111
- Jonathan M. Tisch College of Civic Life, Lincoln Filene Hall, Tufts University, Medford, MA 02155
- Department of Civil and Environmental Engineering, Tufts University School of Engineering, Tufts University, Medford, MA 02155
| | - Matthew C Simon
- Department of Civil and Environmental Engineering, Tufts University School of Engineering, Tufts University, Medford, MA 02155
| | - Neelakshi Hudda
- Department of Civil and Environmental Engineering, Tufts University School of Engineering, Tufts University, Medford, MA 02155
| | - Marisa Zellmer
- Department of Civil and Environmental Engineering, Tufts University School of Engineering, Tufts University, Medford, MA 02155
| | - Laura Corlin
- Department of Civil and Environmental Engineering, Tufts University School of Engineering, Tufts University, Medford, MA 02155
| | | | - Eda Yiqi Lu
- University of Massachusetts Amherst, 360 Campus Center Way, Amherst, MA 01003
| | - Sonja Rivera
- Department of Public Health and Community Medicine, Tufts University School of Medicine, 136 Harrison Ave., Boston, MA 02111
| | - Megan Byrne
- Department of Community Health, Tufts University, Medford, MA 02155
| | - Mei Chung
- Department of Public Health and Community Medicine, Tufts University School of Medicine, 136 Harrison Ave., Boston, MA 02111
| | - John L Durant
- Department of Civil and Environmental Engineering, Tufts University School of Engineering, Tufts University, Medford, MA 02155
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Brugge D, Simon MC, Hudda N, Zellmer M, Corlin L, Cleland S, Lu EY, Rivera S, Byrne M, Chung M, Durant JL. Lessons from in-home air filtration intervention trials to reduce urban ultrafine particle number concentrations. BUILDING AND ENVIRONMENT 2017; 126:266-275. [PMID: 29398771 PMCID: PMC5791918 DOI: 10.1016/j.buildenv.2017.10.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
BACKGROUND Exposure to airborne ultrafine particle (UFP; <100 nm in aerodynamic diameter) is an emerging public health problem. Nevertheless, the benefit of using high efficiency particulate arrestance (HEPA) filtration to reduce UFP concentrations in homes is not yet clear. METHODS We conducted a randomized crossover study of HEPA filtration without a washout period in 23 homes of low-income Puerto Ricans in Boston and Chelsea, MA (USA). Most participants were female, older adults who were overweight or obese. Particle number concentrations (PNC, a proxy for UFP) were measured indoors and outdoors at each home continuously for six weeks. Homes received both HEPA filtration and sham filtration for three weeks each in random order. RESULTS Median PNC under HEPA filtration was 50-85% lower compared to sham filtration in most homes, but we found no benefit in terms of reduced inflammation; associations between hsCRP, IL-6, or TNFRII in blood samples and indoor PNC were inverse and not statistically significant. CONCLUSIONS Limitations to our study design likely contributed to our findings. Limitations included carry-over effects, a population that may have been relatively unresponsive to UFP, reduction in PNC even during sham filtration that limited differences between HEPA and sham filtration, window opening by participants, and lack of fine-grained (room-specific) participant time-activity information. Our approach was similar to other recent HEPA intervention studies of particulate matter exposure and cardiovascular risk, suggesting that there is a need for better study designs.
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Affiliation(s)
- Doug Brugge
- Department of Public Health and Community Medicine, Tufts University School of Medicine, 136 Harrison Ave., Boston, MA 02111
- Jonathan M. Tisch College of Civic Life, Lincoln Filene Hall, Tufts University, Medford, MA 02155
- Department of Civil and Environmental Engineering, Tufts University School of Engineering, Tufts University, Medford, MA 02155
| | - Matthew C Simon
- Department of Civil and Environmental Engineering, Tufts University School of Engineering, Tufts University, Medford, MA 02155
| | - Neelakshi Hudda
- Department of Civil and Environmental Engineering, Tufts University School of Engineering, Tufts University, Medford, MA 02155
| | - Marisa Zellmer
- Department of Civil and Environmental Engineering, Tufts University School of Engineering, Tufts University, Medford, MA 02155
| | - Laura Corlin
- Department of Civil and Environmental Engineering, Tufts University School of Engineering, Tufts University, Medford, MA 02155
| | | | - Eda Yiqi Lu
- University of Massachusetts Amherst, 360 Campus Center Way, Amherst, MA 01003
| | - Sonja Rivera
- Department of Public Health and Community Medicine, Tufts University School of Medicine, 136 Harrison Ave., Boston, MA 02111
| | - Megan Byrne
- Department of Community Health, Tufts University, Medford, MA 02155
| | - Mei Chung
- Department of Public Health and Community Medicine, Tufts University School of Medicine, 136 Harrison Ave., Boston, MA 02111
| | - John L Durant
- Department of Civil and Environmental Engineering, Tufts University School of Engineering, Tufts University, Medford, MA 02155
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Rokoff LB, Koutrakis P, Garshick E, Karagas MR, Oken E, Gold DR, Fleisch AF. Wood Stove Pollution in the Developed World: A Case to Raise Awareness Among Pediatricians. Curr Probl Pediatr Adolesc Health Care 2017; 47:123-141. [PMID: 28583817 PMCID: PMC5556683 DOI: 10.1016/j.cppeds.2017.04.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Use of wood for residential heating is regaining popularity in developed countries. Currently, over 11 million US homes are heated with a wood stove. Although wood stoves reduce heating costs, wood smoke may adversely impact child health through the emission of gaseous and particulate air pollutants. Our purpose is to raise awareness of this environmental health issue among pediatricians. To summarize the state of the science, we performed a narrative review of articles published in PubMed and Web of Science. We identified 36 studies in developed countries that reported associations of household wood stove use and/or community wood smoke exposure with pediatric health outcomes. Studies primarily investigated respiratory outcomes, with no evaluation of cardiometabolic or neurocognitive health. Studies found community wood smoke exposure to be consistently associated with adverse pediatric respiratory health. Household wood stove use was less consistently associated with respiratory outcomes. However, studies of household wood stoves always relied on participant self-report of wood stove use, while studies of community wood smoke generally assessed air pollution exposure directly and more precisely in larger study populations. In most studies, important potential confounders, such as markers of socioeconomic status, were unaccounted for and may have biased results. We conclude that studies with improved exposure assessment, that measure and account for confounding, and that consider non-respiratory outcomes are needed. While awaiting additional data, pediatricians can refer patients to precautionary measures recommended by the US Environmental Protection Agency (EPA) to mitigate exposure. These include replacing old appliances with EPA-certified stoves, properly maintaining the stove, and using only dry, well-seasoned wood. In addition, several studies have shown mechanical air filters to effectively reduce wood stove pollution exposure in affected homes and communities.
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Affiliation(s)
- Lisa B Rokoff
- Division of Endocrinology, Boston Children's Hospital, Boston, MA
| | - Petros Koutrakis
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Eric Garshick
- Pulmonary, Allergy, Sleep, and Critical Care Medicine Section, VA Boston Healthcare System, Boston, MA; Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Margaret R Karagas
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Diane R Gold
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA; Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Abby F Fleisch
- Division of Endocrinology, Boston Children's Hospital, Boston, MA
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Kasurinen S, Jalava PI, Happo MS, Sippula O, Uski O, Koponen H, Orasche J, Zimmermann R, Jokiniemi J, Hirvonen MR. Particulate emissions from the combustion of birch, beech, and spruce logs cause different cytotoxic responses in A549 cells. ENVIRONMENTAL TOXICOLOGY 2017; 32:1487-1499. [PMID: 27678477 DOI: 10.1002/tox.22369] [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: 06/17/2016] [Revised: 09/05/2016] [Accepted: 09/10/2016] [Indexed: 05/10/2023]
Abstract
According to the World Health Organization particulate emissions from the combustion of solid fuels caused more than 110,000 premature deaths worldwide in 2010. Log wood combustion is the most prevalent form of residential biomass heating in developed countries, but it is unknown how the type of wood logs used in furnaces influences the chemical composition of the particulate emissions and their toxicological potential. We burned logs of birch, beech and spruce, which are used commonly as firewood in Central and Northern Europe in a modern masonry heater, and compared them to the particulate emissions from an automated pellet boiler fired with softwood pellets. We determined the chemical composition (elements, ions, and carbonaceous compounds) of the particulate emissions with a diameter of less than 1 µm and tested their cytotoxicity, genotoxicity, inflammatory potential, and ability to induce oxidative stress in a human lung epithelial cell line. The chemical composition of the samples differed significantly, especially with regard to the carbonaceous and metal contents. Also the toxic effects in our tested endpoints varied considerably between each of the three log wood combustion samples, as well as between the log wood combustion samples and the pellet combustion sample. The difference in the toxicological potential of the samples in the various endpoints indicates the involvement of different pathways of toxicity depending on the chemical composition. All three emission samples from the log wood combustions were considerably more toxic in all endpoints than the emissions from the pellet combustion. © 2016 Wiley Periodicals, Inc. Environ Toxicol 32: 1487-1499, 2017.
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Affiliation(s)
- Stefanie Kasurinen
- Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland
| | - Pasi I Jalava
- Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland
| | - Mikko S Happo
- Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland
| | - Olli Sippula
- Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland
- HICE-Helmholtz Virtual Institute of Complex Molecular Systems in Environmental Health-Aerosols and Health, German Research Center for Environmental Health, Helmholtz Association, München, Germany
| | - Oskari Uski
- Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland
| | - Hanna Koponen
- Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland
| | - Jürgen Orasche
- HICE-Helmholtz Virtual Institute of Complex Molecular Systems in Environmental Health-Aerosols and Health, German Research Center for Environmental Health, Helmholtz Association, München, Germany
- Joint Mass Spectrometry Center, Cooperation Group Comprehensive Molecular Analytics, German Research Center for Environmental Health, Helmholtz Zentrum München, Germany
| | - Ralf Zimmermann
- HICE-Helmholtz Virtual Institute of Complex Molecular Systems in Environmental Health-Aerosols and Health, German Research Center for Environmental Health, Helmholtz Association, München, Germany
- Joint Mass Spectrometry Center, Cooperation Group Comprehensive Molecular Analytics, German Research Center for Environmental Health, Helmholtz Zentrum München, Germany
- Department of Analytical and Technical Chemistry, Institute of Chemistry, University of Rostock, Rostock, Germany
| | - Jorma Jokiniemi
- Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland
| | - Maija-Riitta Hirvonen
- Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland
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