Raised exhaled nitric oxide in healthy children is associated with domestic formaldehyde levels

Ganoderma Lucidum from Red Mushroom Attenuates Formaldehyde-Induced Liver Damage in Experimental Male Rat Model

The majority of liver-related illnesses are caused by occupational and domestic exposure to toxic chemicals like formaldehyde (FA), which is widely common in Africa and the world at large. Hence, measures should be taken to protect humans from its hazardous effects. This study, therefore, examines the protective potential of Ganoderma lucidum (100 mg/kg body weight) on formaldehyde-induced (40%) liver oxido-inflammation in male rats. Male Wistar rats, 150-200 g, were allotted into four groups of 10 animals as follows: Group 1 was orally treated with 1 mg/mL distilled water, Group 2 was exposed to a 40% formaldehyde vapor environment for 30 min per day, Group 3 was orally treated with 100 mg/kg ethanol extract of Ganoderma lucidum, and Group 4 was co-administered formaldehyde and 100 mg/kg ethanol extract of Ganoderma lucidum. Rats were then sacrificed 24 h after administering the last dose of treatment, and the livers were excised. Ganoderma lucidum significantly reversed the formaldehyde-mediated reduction in body and organ weight. Ganoderma lucidum administration significantly prevented oxido-inflammation by reducing the levels of hydrogen peroxide and malondialdehyde and increasing the activity of antioxidant enzymes and glutathione contents, as well as the normal level of nitrite and myeloperoxidase production in FA-treated rats. Additionally, Ganoderma lucidum reversed a large decline in proinflammatory markers in formaldehyde. Furthermore, Ganoderma lucidum restores formaldehyde-induced histological alterations in the liver. Collectively, our results provide valuable information on the protective potential of Ganoderma lucidum in protecting formaldehyde-induced liver oxido-inflammation in male rats.

Viruses and non-allergen environmental triggers in asthma

Asthma is a complex inflammatory disease with many triggers. The best understood asthma inflammatory pathways involve signals characterized by peripheral eosinophilia and elevated immunoglobulin E levels (called T2-high or allergic asthma), though other asthma phenotypes exist (eg, T2-low or non-allergic asthma, eosinophilic or neutrophilic-predominant). Common triggers that lead to poor asthma control and exacerbations include respiratory viruses, aeroallergens, house dust, molds, and other organic and inorganic substances. Increasingly recognized non-allergen triggers include tobacco smoke, small particulate matter (eg, PM2.5), and volatile organic compounds. The interaction between respiratory viruses and non-allergen asthma triggers is not well understood, though it is likely a connection exists which may lead to asthma development and/or exacerbations. In this paper we describe common respiratory viruses and non-allergen triggers associated with asthma. In addition, we aim to show the possible interactions, and potential synergy, between viruses and non-allergen triggers. Finally, we introduce a new clinical approach that collects exhaled breath condensates to identify metabolomics associated with viruses and non-allergen triggers that may promote the early management of asthma symptoms.

Damp housing, gas stoves, and the burden of childhood asthma in Australia

OBJECTIVE

To determine the proportion of the national childhood asthma burden associated with exposure to dampness and gas stoves in Australian homes.

DESIGN

Comparative risk assessment modelling study. Setting, participants: Australian children aged 14 years or less, 2011.

MAIN OUTCOME MEASURES

The population attributable fractions (PAFs) and number of disability-adjusted life years (DALYs) for childhood asthma associated with exposure to damp housing and gas stoves.

RESULTS

26.1% of Australian homes have dampness problems and 38.2% have natural gas as the main energy source for cooktop stoves. The PAF for childhood asthma attributable to damp housing was 7.9% (95% CI, 3.2-12.6%), causing 1760 disability-adjusted life years (DALYs; 95% CI, 416-3104 DALYs), or 42 DALYs/100 000 children. The PAF associated with gas stoves was 12.3% (95% CI, 8.9-15.8%), corresponding to 2756 DALYs (95% CI, 1271-4242), or 67 DALYs/100 000 children. If all homes with gas stoves were fitted with high efficiency range hoods to vent gas combustion products outdoors, the PAF and burden estimates were reduced to 3.4% (95% CI, 2.2-4.6%) and 761 DALYs (95% CI, 322-1199).

CONCLUSIONS

Exposure to damp housing and gas stoves is common in Australia, and is associated with a considerable proportion of the childhood asthma burden. Strategies for reducing exposure to indoor dampness and gas combustion products should be communicated to parents of children with or at risk of asthma.

Maternal Exposure to Indoor Air Pollution and Birth Outcomes

There is a growing body of research on the association between ambient air pollution and adverse birth outcomes. However, people in high income countries spend most of their time indoors. Pregnant women spend much of that time at home. The aim of this study was to investigate if indoor air pollutants were associated with poor birth outcomes. Pregnant women were recruited prior to 18 weeks gestation. They completed a housing questionnaire and household chemical use survey. Indoor pollutants, formaldehyde (HCHO), nitrogen dioxide (NO2) and volatile organic compounds (VOCs), were monitored in the women's homes at 34 weeks gestation. Gestational age (GA), birth weight (BW) and length (BL) and head circumference (HC) were collected from birth records. The associations between measured pollutants, and pollution surrogates, were analysed using general linear models, controlling for maternal age, parity, maternal health, and season of birth. Only HCHO was associated with any of the birth outcomes. There was a 0.044 decrease in BW z-score (p = 0.033) and 0.05 decrease in HC z-score (p = 0.06) for each unit increase in HCHO. Although HCHO concentrations were very low, this finding is consistent with other studies of formaldehyde and poor birth outcomes.

Psoriasis and Respiratory Comorbidities: The Added Value of Fraction of Exhaled Nitric Oxide as a New Method to Detect, Evaluate, and Monitor Psoriatic Systemic Involvement and Therapeutic Efficacy

Psoriasis is a chronic inflammatory systemic disease characterized by a wide range of comorbidities. Respiratory comorbidities are currently poorly characterized and with discordant results. The systemic state of inflammation caused by psoriasis acts de novo on respiratory tissues and amplifies preexisting inflammation from asthma or chronic obstructive pulmonary disease. Because the lungs act as a gas exchanger between the internal and external environment, the impact of chronic psoriasis inflammation may be easily assessed through the analysis of exhaled breath. The fraction of exhaled nitric oxide test (FeNO) is a potential noninvasive solution that can provide quantitative and qualitative indices of respiratory airway inflammation. FeNO is routinely used to screen and manage asthmatic patients. Recent pilot studies contain encouraging data that underscore its possible use with systemic inflammatory nonpulmonary diseases, such as psoriasis. FeNO may therefore be a useful tool to evaluate underestimated airway inflammation and at the same time globally evaluate the impact of systemically antipsoriatic therapies.

Fractional Exhaled Nitric Oxide (FeNO) and Spirometry as Indicators of Inhalation Exposure to Chemical Agents in Pathology Workers

OBJECTIVE

The objective of this study was to examine whether fractional exhaled nitric oxide (FeNO) and spirometry can be used as indices to evaluate adverse health effects of low-concentrated chemical inhalation exposure, mainly to formaldehyde.

METHODS

Thirty-three subjects (pathology technicians) and 30 controls (workers without handling any chemicals in the same hospitals) participated in this study. All participants underwent FeNO measurement and spirometry before and after 5 days of work.

RESULTS

FeNO significantly increased in the subjects with a history of asthma (P < 0.05), whereas forced vital capacity (FVC) and forced expiratory volume in the first second (FEV1) decreased in the subjects (P < 0.05). Furthermore, work duration and pre-work levels of FEV1 in the subjects had a significant association.

CONCLUSION

The results suggest that FeNO, FVC, and FEV1 represent effective health-effect indices of low-concentrated chemical inhalation exposure.

Formaldehyde regulates vascular tensions through nitric oxide-cGMP signaling pathway and ion channels

Formaldehyde (FA) has been linked to the detrimental cardiovascular effects. Here, we explored the effects and mechanisms of FA on rat aortas both in vivo and in vitro. The results presented that FA evidently lowered the blood pressures of rats. The expression levels of BK_Ca subunits α and β1 and iNOS of the aortas were up-regulated by FA in vivo. However, FA markedly reduced the levels of Ca_v1.2 and Ca_v1.3, which are the subunits of L-Ca²⁺ channel. Furthermore, the contents of NO, cGMP and iNOS in the aortas were augmented by FA. To further confirm these findings, the mechanisms accredited to these effects were examined in vitro. The data showed that FA contracted the isolated aortic rings at low concentrations (<300 μM), while it relaxed the rings at high concentrations (>500 μM). The FA-induced vasoconstriction at low concentrations was blocked partly by an inhibitor of ACE. The relaxation caused by FA at high concentrations was attenuated by the inhibitors of NO-cGMP pathway, L-Ca²⁺ channel and BK_Ca channel, respectively. Similarly, the expression of iNOS was strongly enhanced by FA in vitro. The effects of FA on the aortic rings with endothelium were significantly greater than those on the rings without endothelium. Our results indicate that the vasoconstriction of FA at low concentrations might be partially pertinent to endothelin, and the FA-caused vasorelaxation at high concentrations is possibly associated with the NO-cGMP pathway, L-Ca²⁺ channel and BK_Ca channel. This study will improve our understanding of the pathogenic mechanisms for FA-related cardiovascular diseases.

Differential effects of formaldehyde exposure on airway inflammation and bronchial hyperresponsiveness in BALB/c and C57BL/6 mice

Epidemiological evidence suggests that formaldehyde (FA) exposure may influence the prevalence and severity of allergic asthma. However, the role of genetic background in FA-induced asthma-like responses is poorly understood. In the present study, we investigated the nature and severity of asthma-like responses triggered by exposure to different doses of FA together with or without ovalbumin (OVA) in two genetically different mouse strains—BALB/c and C57BL/6. Both mouse strains were divided into two main groups: the non-sensitized group and the OVA-sensitized group. All the groups were exposed to 0, 0.5 or 3.0 mg/m³ FA for 6 h/day over 25 consecutive days. At 24 h after the final FA exposure, the pulmonary parameters were evaluated. We found that FA exposure induced Th2-type allergic responses in non-sensitized BALB/c and C57BL/6 mice. In addition, FA-induced allergic responses were significantly more prominent in BALB/c mice than in C57BL/6 mice. In sensitized BALB/c mice, however, FA exposure suppressed the development of OVA-induced allergic responses. Exposure to 3.0 mg/m³ FA in sensitized C57BL/6 mice also led to suppressed allergic responses, whereas exposure to 0.5 mg/m³ FA resulted in exacerbated allergic responses to OVA. Our findings suggest that FA exposure can induce differential airway inflammation and bronchial hyperresponsiveness in BALB/c and C57BL/6 mice.

Formaldehyde and carbon dioxide air concentrations and their relationship with indoor environmental factors in daycare centers

The aim of this study was to measure the air concentrations of carbon dioxide (CO₂) and formaldehyde (HCHO) in daycare centers to determine relevant influencing factors, including temperature, relative humidity (RH), type of facility, number of children, type of ventilation system, ventilation time, and air cleaning system. The authors measured HCHO, CO₂, temperature, and RH in the center of classrooms in 289 daycare centers. Spearman's correlation and Mann-Whitney analyses were used to examine the relationships and differences in HCHO and CO₂ for varying temperatures, RH values, and categorical indoor environmental factors. There were no significant differences in the HCHO and CO₂ air concentrations with varying numbers of children, ventilation times, or ventilation and air cleaning system types. However, both the HCHO and CO₂ air concentrations were significantly different for varying RH values, which were divided into five categories (p < 0.001). Only the HCHO air concentrations were significantly different for varying temperatures, which were divided into five categories (p < 0.001). Significant correlations were found between HCHO air concentrations and the temperature (r = 0.35, p < 0.0001), RH (r = 0.51, p < 0.0001), and CO₂ (r = 0.36, p < 0.0001). The study results support maintaining an appropriate temperature and RH range for reducing airborne HCHO in daycare centers. Further research is needed to elucidate the precise mechanisms responsible for the relationships observed in this study.

IMPLICATIONS

Data from 289 daycare centers in Seoul, South Korea, indicate that HCHO concentrations show a positive correlation with indoor temperature and relative humidity. This indicates that keeping temperatures low will help keep HCHO concentrations low, by both a direct and an indirect effect, since low temperatures also cause low relative humidity.

Formaldehyde Induces Rho-Associated Kinase Activity to Evoke Airway Hyperresponsiveness

Formaldehyde, a common indoor air pollutant, exacerbates asthma and synergizes with allergen to induce airway hyperresponsiveness (AHR) in animal models. The mechanisms mediating formaldehyde-induced AHR remain poorly understood. We posit that formaldehyde modulates agonist-induced contractile response of human airway smooth muscle (HASM) cells to elicit AHR. HASM cells were exposed to formaldehyde or vehicle and agonist-induced intracellular Ca²⁺ ([Ca²⁺]_i) and myosin light-chain phosphatase (MYPT1) phosphorylation were determined. Air-liquid interface-differentiated human bronchial epithelial (HBE) cells were exposed to formaldehyde or vehicle and cocultured with HASM cells. Agonist-induced [Ca²⁺]_i and MYPT1 phosphorylation were determined in the cocultured HASM cells. Precision-cut human lung slices were exposed to PBS or varying concentrations of formaldehyde, and then carbachol-induced airway narrowing was determined 24 hours after exposure. HASM cells were transfected with nontargeting or nuclear factor erythroid-derived 2, like 2 (Nrf-2)-targeting small interfering RNA and exposed to formaldehyde or vehicle, followed by determination of antioxidant response (quinone oxido-reductase 1 and thioredoxin 1) and basal and agonist-induced MYPT1 phosphorylation. Formaldehyde enhanced the basal Rho-kinase activity and MYPT1 phosphorylation with little effect on agonist-induced [Ca²⁺]_i in HASM cells. Formaldehyde induced Nrf-2-dependent antioxidant response in HASM cells, although the MYPT1 phosphorylation was independent of Nrf-2 induction. Although HBE cells exposed to formaldehyde had little effect on agonist-induced [Ca²⁺]_i or MYPT1 phosphorylation in cocultured HASM cells, formaldehyde enhanced carbachol-induced airway responsiveness in precision-cut human lung slices. In conclusion, formaldehyde induces phosphorylation of the regulatory subunit of MYPT1, independent of formaldehyde-induced Nrf-2 activation in HASM cells. The findings suggest that the Rho kinase-dependent Ca²⁺ sensitization pathway plays a role in formaldehyde-induced AHR.

Volatile and semi-volatile organic compounds of respiratory health relevance in French dwellings

Over the last decades, the prevalence of childhood respiratory conditions has dramatically increased worldwide. Considering the time spent in enclosed spaces, indoor air pollutants are of major interest to explain part of this increase. This study aimed to measure the concentrations of pollutants known or suspected to affect respiratory health that are present in dwellings in order to assess children's exposure. Measurements were taken in 150 homes with at least one child, in Brittany (western France), to assess the concentrations of 18 volatile organic compounds (among which four aldehydes and four trihalomethanes) and nine semi-volatile organic compounds (seven phthalates and two synthetic musks). In addition to descriptive statistics, a principal component analysis (PCA) was used to investigate grouping of contaminants. Formaldehyde was highly present and above 30 μg/m(3) in 40% of the homes. Diethyl phthalate, diisobutyl phthalate, and dimethylphthalate were quantified in all dwellings, as well as Galaxolide and Tonalide. For each chemical family, the groups appearing in the PCA could be interpreted in term of sources. The high prevalence and the levels of these compounds, with known or suspected respiratory toxicity, should question regulatory agencies to trigger prevention and mitigation actions.

Potential hazards of air pollutant emissions from unconventional oil and natural gas operations on the respiratory health of children and infants

Research on air pollutant emissions associated with unconventional oil and gas (UOG) development has grown significantly in recent years. Empirical investigations have focused on the identification and measurement of oil and gas air pollutants [e.g. volatile organic compounds (VOCs), particulate matter (PM), methane] and the influence of UOG on local and regional ambient air quality (e.g. tropospheric ozone). While more studies to better characterize spatial and temporal trends in exposure among children and newborns near UOG sites are needed, existing research suggests that exposure to air pollutants emitted during lifecycle operations can potentially lead to adverse respiratory outcomes in this population. Children are known to be at a greater risk from exposure to air pollutants, which can impair lung function and neurodevelopment, or exacerbate existing conditions, such as asthma, because the respiratory system is particularly vulnerable during development in-utero, the postnatal period, and early childhood. In this article, we review the literature relevant to respiratory risks of UOG on infants and children. Existing epidemiology studies document the impact of air pollutant exposure on children in other contexts and suggest impacts near UOG. Research is sparse on long-term health risks associated with frequent acute exposures - especially in children - hence our interpretation of these findings may be conservative. Many data gaps remain, but existing data support precautionary measures to protect the health of infants and children.

Results of the California Healthy Homes Indoor Air Quality Study of 2011-2013: impact of natural gas appliances on air pollutant concentrations

This study was conducted to assess the current impact of natural gas appliances on air quality in California homes. Data were collected via telephone interviews and measurements inside and outside of 352 homes. Passive samplers measured time-resolved CO and time-integrated NOX , NO2 , formaldehyde, and acetaldehyde over ~6-day periods in November 2011 - April 2012 and October 2012 - March 2013. The fraction of indoor NOX and NO2 attributable to indoor sources was estimated. NOX , NO2 , and highest 1-h CO were higher in homes that cooked with gas and increased with amount of gas cooking. NOX and NO2 were higher in homes with cooktop pilot burners, relative to gas cooking without pilots. Homes with a pilot burner on a floor or wall furnace had higher kitchen and bedroom NOX and NO2 compared to homes without a furnace pilot. When scaled to account for varying home size and mixing volume, indoor-attributed bedroom and kitchen NOX and kitchen NO2 were not higher in homes with wall or floor furnace pilot burners, although bedroom NO2 was higher. In homes that cooked 4 h or more with gas, self-reported use of kitchen exhaust was associated with lower NOX , NO2 , and highest 1-h CO. Gas appliances were not associated with higher concentrations of formaldehyde or acetaldehyde.

Ectoine alleviates behavioural, physiological and biochemical changes in Daphnia magna subjected to formaldehyde

Ectoine (ECT) is produced by halophilic microorganisms in response to various stressful factors. Its protective properties in bacteria and some populations of isolated cells are known; however, no data are available on its protective influence on aquatic invertebrates subjected to a common pollutant, formaldehyde (FA). The purpose of this study was to determine the effects of FA alone (at 20 and 60 mg/L) and in the combination with various concentrations of ECT (5, 10 and 25 mg/L) at various times of exposure on behavioural, physiological and biochemical parameters of Daphnia magna. Specifically, mortality, heart rate, thoracic limb movement, reduced glutathione (GSH)/oxidised glutathione (GSSG) ratio, catalase (CAT) activity and nitric oxide (NOx) levels were determined. The results showed that both concentrations of FA when administered alone induced significant alterations of the determined parameters. On the other hand, animals treated with the combinations of FA + ECT showed decreased mortalities, attenuated inhibition of heart rates and thoracic limb activities, less decreased GSH/GSSG ratios, lower stimulation of CAT activities and NOx levels when compared to the crustaceans subjected to FA alone. The most distinct attenuation of toxic effects was observed in the combinations in which the highest concentrations of ECT were used. The results suggest that oxidative stress induced by FA in daphnids is likely to be alleviated by the antioxidative action of ECT.

Long-Term Formaldehyde Emissions from Medium-Density Fiberboard in a Full-Scale Experimental Room: Emission Characteristics and the Effects of Temperature and Humidity

We studied formaldehyde emissions from the medium-density fiberboard (MDF) in a full-scale experimental room to approximate emissions in actual buildings. Detailed indoor formaldehyde concentrations and temperature and humidity data were obtained for about 29 months. Temperature, relative humidity (RH), and absolute humidity (AH) ranged over -10.9-31.4 °C, 46.5-83.6%, and 1.1-23.1 g/kgair, respectively. Annual cyclical seasonal variations were observed for indoor formaldehyde concentrations and emission rates, exhibiting entirely different characteristics than those in an environmental chamber under constant environmental conditions. The maximum concentration occurred in summer rather than at initial introduction of the material. The concentrations in summer could be a few up to 20 times higher than that in winter, depending on the indoor temperature and humidity conditions. Concentrations decreased by 20-65% in corresponding months of the second year. Indoor formaldehyde concentrations were positively correlated with temperature and AH but were poorly correlated with RH. The combined effects of temperature and AH on formaldehyde emissions from MDF in actual buildings were verified. These detailed long-term experimental results could be used with environmental chamber measurement data to scale up and validate emission models from chambers held at constant conditions to actual buildings.

BDNF-TrkB pathway mediates neuroprotection of hydrogen sulfide against formaldehyde-induced toxicity to PC12 cells

Formaldehyde (FA) is a common environmental contaminant that has toxic effects on the central nervous system (CNS). Our previous data demonstrated that hydrogen sulfide (H2S), the third endogenous gaseous mediator, has protective effects against FA-induced neurotoxicity. As is known to all, Brain-derived neurotropic factor (BDNF), a member of the neurotrophin gene family, mediates its neuroprotective properties via various intracellular signaling pathways triggered by activating the tyrosine kinase receptor B (TrkB). Intriguingly, our previous data have illustrated the upregulatory role of H2S on BDNF protein expression in the hippocampus of rats. Therefore, in this study, we hypothesized that H2S provides neuroprotection against FA toxicity by regulating BDNF-TrkB pathway. In the present study, we found that NaHS, a donor of H2S, upregulated the level of BDNF protein in PC12 cells, and significantly rescued FA-induced downregulation of BDNF levels. Furthermore, we found that pretreatment of PC12 cells with K252a, an inhibitor of the BDNF receptor TrkB, markedly reversed the inhibition of NaHS on FA-induced cytotoxicity and ablated the protective effects of NaHS on FA-induced oxidative stress, including the accumulation of intracellular reactive oxygen species (ROS), 4-hydroxy-2-trans-nonenal (4-HNE), and malondialdehyde (MDA). We also showed that K252a abolished the inhibition of NaHS on FA-induced apoptosis, as well as the activation of caspase-3 in PC12 cells. In addition, K252a reversed the protection of H2S against FA-induced downregulation of Bcl-2 protein expression and upregulation of Bax protein expression in PC12 cells. These data indicate that the BDNF-TrkB pathway mediates the neuroprotection of H2S against FA-induced cytotoxicity, oxidative stress and apoptosis in PC12 cells. These findings provide a novel mechanism underlying the protection of H2S against FA-induced neurotoxicity.

Hydrogen sulfide inhibits formaldehyde-induced endoplasmic reticulum stress in PC12 cells by upregulation of SIRT-1

Background

Formaldehyde (FA), a well-known environmental pollutant, has been classified as a neurotoxic molecule. Our recent data demonstrate that hydrogen sulfide (H₂S), the third gaseous transmitter, has a protective effect on the neurotoxicity of FA. However, the exact mechanisms underlying this protection remain largely unknown. Endoplasmic reticulum (ER) stress has been implicated in the neurotoxicity of FA. Silent mating type information regulator 2 homolog 1 (SIRT-1), a histone deacetylases, has various biological activities, including the extension of lifespan, the modulation of ER stress, and the neuroprotective action.

Objective

We hypothesize that the protection of H₂S against FA-induced neurotoxicity involves in inhibiting ER stress by upregulation of SIRT-1. The present study attempted to investigate the protective effect of H₂S on FA-induced ER stress in PC12 cells and the contribution of SIRT-1 to the protection of H₂S against FA-induced injuries, including ER stress, cytotoxicity and apoptosis.

Principal Findings

We found that exogenous application of sodium hydrosulfide (NaHS; an H₂S donor) significantly attenuated FA-induced ER stress responses, including the upregulated levels of glucose-regulated protein 78, C/EBP homologous protein, and cleaved caspase-12 expression. We showed that NaHS upregulates the expression of SIRT-1 in PC12 cells. Moreover, the protective effects of H₂S on FA-elicited ER stress, cytotoxicity and apoptosis were reversed by Sirtinol, a specific inhibitor of SIRT-1.

Conclusion/Significance

These data indicate that H₂S exerts its protection against the neurotoxicity of FA through overcoming ER stress via upregulation of SIRT-1. Our findings provide novel insights into the protective mechanisms of H₂S against FA-induced neurotoxicity.

Children's urinary phthalate metabolites and fractional exhaled nitric oxide in an urban cohort

RATIONALE

Phthalates are used widely in consumer products. Exposure to several phthalates has been associated with respiratory symptoms and decreased lung function. Associations between children's phthalate exposures and fractional exhaled nitric oxide (Fe(NO)), a biomarker of airway inflammation, have not been examined.

OBJECTIVES

We hypothesized that urinary concentrations of four phthalate metabolites would be positively associated with Fe(NO) and that these associations would be stronger among children with seroatopy or wheeze.

METHODS

In an urban ongoing birth cohort, 244 children had phthalate metabolites determined in urine collected on the same day as Fe(NO) measurement. Repeated sampling gathered 313 observations between ages 4.9 and 9.1 years. Seroatopy was assessed by specific IgE. Wheeze in the past year was assessed by validated questionnaire. Regression models used generalized estimating equations.

MEASUREMENTS AND MAIN RESULTS

Log-unit increases in urinary concentrations of metabolites of diethyl phthalate (DEP) and butylbenzyl phthalate (BBzP) were associated with a 6.6% (95% confidence interval [CI] 0.5-13.1%) and 8.7% (95% CI, 1.9-16.0%) increase in Fe(NO), respectively, adjusting for other phthalate metabolites and potential covariates/confounders. There was no association between concentrations of metabolites of di(2-ethylhexyl) phthalate or di-n-butyl phthalate and Fe(NO). There was no significant interaction by seroatopy. The BBzP metabolite association was significantly stronger among children who wheeze (P = 0.016).

CONCLUSIONS

Independent associations between exposures to DEP and BBzP and Fe(NO) in a cohort of inner-city children were observed. These results suggest that these two ubiquitous phthalates, previously shown to have substantial contributions from inhalation, are positively associated with airway inflammation in children.

Formaldehyde personal exposure measurements and time weighted exposure estimates in children

Residential concentrations of formaldehyde have been associated with poor respiratory health in children, where formaldehyde has been measured using stationary monitors inside homes. Although children spend most of their time indoors at home, there are few studies of children's personal exposure to formaldehyde. The aim of this study was to investigate the relationship between personal exposure formaldehyde concentrations, microenvironmental concentrations and time weighted exposure estimates in children. Forty-one primary school children (aged between 9 and 12 years) wore a personal passive sampler over two 24h periods in two seasons and completed 24h daily activity diaries and a questionnaire about lifestyle and behaviour. Samplers were co located indoors at home, outdoors at centralised locations and indoors at school for the corresponding period. Personal exposure formaldehyde concentrations in this group of children were generally low with a geometric mean concentration of 9.1 ppb (range <detection limit to 27.3 ppb). There were strong correlations between personal exposure concentrations and both domestic indoor (r(s)=.779, p<0.001) and time weighted estimated (r(s)=.802, p<0.001) concentrations. The time weighted model did not improve the estimate of personal exposure compared with stationary indoor concentrations. Indoor air concentration measured with a single stationary monitor was a suitable surrogate for personal exposure.

Hydrogen sulfide prevents formaldehyde-induced neurotoxicity to PC12 cells by attenuation of mitochondrial dysfunction and pro-apoptotic potential

Hydrogen sulfide (H(2)S) has been shown to act as a neuroprotectant and antioxidant. Numerous studies have demonstrated that exposure to formaldehyde (FA) causes neuronal damage and that oxidative stress is one of the most critical effects of FA exposure. Accumulation of FA is involved in the pathogenesis of Alzheimer's disease (AD). The aim of present study is to explore the inhibitory effects of H(2)S on FA-induced cytotoxicity and apoptosis and the molecular mechanisms underlying in PC12 cells. We show that sodium hydrosulfide (NaHS), a H(2)S donor, protects PC12 cells against FA-mediated cytotoxicity and apoptosis and that NaHS preserves the function of mitochondria by preventing FA-induced loss of mitochondrial membrane potential and release of cytochrome c in PC12 cells. Furthermore, NaHS blocks FA-exerted accumulation of intracellular reactive oxygen species (ROS), down-regulation of Bcl-2 expression, and up-regulation of Bax expression. These results indicate that H(2)S protects neuronal cells against neurotoxicity of FA by preserving mitochondrial function through attenuation of ROS accumulation, up-regulation of Bcl-2 level, and down-regulation of Bax expression. Our study suggests a promising future of H(2)S-based preventions and therapies for neuronal damage after FA exposure.

Formaldehyde exposure and asthma in children: a systematic review

Despite multiple published studies regarding the association between formaldehyde exposure and childhood asthma, a consistent association has not been identified. Here we report the results of a systematic review of published literature in order to provide a more comprehensive picture of this relationship. After a literature search, we identified seven studies providing quantitative results regarding the association between formaldehyde exposure and asthma in children. Studies were heterogeneous with respect to the definition of asthma. For each study, an odds ratio (OR) and 95% confidence interval (CI) for asthma were abstracted from published results or calculated based on the data provided. We used fixed- and random-effects models to calculate pooled ORs and 95% CIs; measures of heterogeneity were also calculated. A fixed-effects model produced an OR of 1.03 (95% CI, 1.021.04), and random effects model produced an OR of 1.17 (95% CI, 1.011.36), both reflecting an increase of 10 mg/m3 of formaldehyde. Both the Q and I2 statistics indicated a moderate amount of heterogeneity. Results indicate a positive association between formaldehyde exposure and childhood asthma. Given the largely cross-sectional nature of the studies underlying this meta-analysis, further well-designed prospective epidemiologic studies are needed.

Environmental effects on fractional exhaled nitric oxide in allergic children

Fractional exhaled nitric oxide (FeNO) is a non-invasive marker of airway inflammation in asthma and respiratory allergy. Environmental factors, especially indoor and outdoor air quality, may play an important role in triggering acute exacerbations of respiratory symptoms. The authors have reviewed the literature reporting effects of outdoor and indoor pollutants on FeNO in children. Although the findings are not consistent, urban and industrial pollution-mainly particles (PM(2.5) and PM(10)), nitrogen dioxide (NO(2)), and sulfur dioxide (SO(2))-as well as formaldehyde and electric baseboard heating have been shown to increase FeNO, whilst ozone (O(3)) tends to decrease it. Among children exposed to Environmental Tobacco Smoke (ETS) with a genetic polymorphisms in nitric oxide synthase genes (NOS), a higher nicotine exposure was associated with lower FeNO levels. Finally, although more studies are needed in order to better investigate the effect of gene and environment interactions which may affect the interpretation of FeNO values in the management of children with asthma, clinicians are recommended to consider environmental exposures when taking medical histories for asthma and respiratory allergy. Further research is also needed to assess the effects of remedial interventions aimed at reducing/abating environmental exposures in asthmatic/allergic patients.

Formaldehyde exposure and lower respiratory infections in infants: findings from the PARIS cohort study

BACKGROUND

Certain chemical pollutants can exacerbate lower respiratory tract infections (LRIs), a common childhood ailment. Although formaldehyde (FA) is one of the most common air pollutants found in indoor environments, its impact on infant health is uncertain.

OBJECTIVE

Our aim was to determine the impact of FA exposure on the LRI incidence during the first year of life of infants from the Pollution and Asthma Risk: an Infant Study (PARIS) birth cohort.

METHODS

FA was measured in a random sample of 196 infants' dwellings, and exposure to this pollutant was estimated for 2,940 infants using predictive models based on measurements and data about potential determinants of FA levels. Health data were collected from parents by regular self-administered questionnaires. We used multivariate logistic regressions to estimate associations between FA exposure and the occurrence of LRI and wheezy LRI (wLRI), adjusting for potential confounders/risk factors.

RESULTS

During the first year of life, 45.8% of infants had at least one LRI, and LRI occurred simultaneously with wheezing in 48.7% of cases. The FA predictive models correctly classified 70% of dwellings as having high or low exposure, and we estimated that 43.3% of infants were exposed throughout the first year to levels of FA > 19.5 µg/m3. FA exposure was significantly associated with LRI and wLRI before and after adjustment for known LRI risk factors/confounders. For an interquartile increase in FA levels (12.4 μg/m3), we estimated a 32% [95% confidence interval (CI): 11, 55] and 41% (95% CI: 14, 74) increase in the incidence of LRI and wLRI, respectively.

CONCLUSION

The findings of this study suggest that infants exposed to FA at an early age have an increased incidence of LRI.

Adjuvant effects of gaseous formaldehyde on the hyper-responsiveness and inflammation in a mouse asthma model immunized by ovalbumin

Asthma is a complex pulmonary inflammatory disease, which is characterized by airway hyper-responsiveness, airflow obstruction, and airway inflammation. Exposure to a number of chemicals including formaldehyde (FA) can lead to asthma. This study aimed to explore the underlying role of FA exposure in occupational asthma, especially when it is combined with allergen exposure. Balb/c mice were randomly divided into six groups (n = 6/group): (1) saline control; (2) ovalbumin (OVA)-immunized (OVA(imm)) only; (3) 0.5 mg FA/m(3) exposure; (4) OVA(imm) + 0.5 mg FA/m(3); (5) 3.0 mg FA/m(3) FA exposure; and, (6) OVA(imm) + 3.0 mg FA/m(3). These low and high exposure FA levels were adopted from current (0.5 mg/m(3)) and original (3.0 mg/m(3)) Chinese Occupational Threshold Limit Values. Experiments were conducted after 3 week of combined exposure and a 1-week challenge with aerosolized OVA. Airway hyper-responsiveness, pulmonary tissue damage, eosinophil infiltration, and increased interleukin (IL)-4 and IL-6 levels in lung tissues were found in the OVA + 3.0 mg FA/m(3) hosts as compared to values seen in the OVA-immunized only mice. The results here suggest to us that FA exposure can induce and aggravate asthma in Balb/c mice when it is combined with OVA immunization.

Formaldehyde induces neurotoxicity to PC12 cells involving inhibition of paraoxonase-1 expression and activity

1. Formaldehyde (FA) has been found to cause toxicity to neurons. However, its neurotoxic mechanisms have not yet been clarified. Increasing evidence has shown that oxidative damage is one of the most critical effects of formaldehyde exposure. Paraoxonase-1 (PON-1) is a pivotal endogenous anti-oxidant. Thus, we hypothesized that FA-mediated downregulation of PON1 is associated with its neurotoxicity. 2. In the present work, we used PC12 cells to study the neurotoxicity of FA and explore whether PON-1 is implicated in FA-induced neurotoxicity. 3. We found that FA has potent cytotoxic and apoptotic effects on PC12 cells. FA induces an accumulation of intracellular reactive oxygen species along with downregulation of Bcl-2 expression, as well as increased cytochrome c release. FA significantly suppressed the expression and activity of PON-1 in PC12 cells. Furthermore, H(2)S, an endogenous anti-oxidant gas, antagonizes FA-induced cytotoxicity as well as 2-hydroxyquinoline, a specific inhibitor of PON-1, which also induces cytotoxicity to PC12 cells. 4. The results of the present study provide, for the first time, evidence that the inhibitory effect on PON-1 expression and activity is involved in the neurotoxicity of FA, and suggest a promising role of PON-1 as a novel therapeutic strategy for FA-mediated toxicity.

Air pollution: a tale of two countries

The fast growing economies and continued urbanization in Asian countries have increased the demand for mobility and energy in the region, resulting in high levels of air pollution in cities from mobile and stationary sources. In contrast, low level of urbanization in Australia produces low level of urban air pollution. The World Health Organization estimates that about 500,000 premature deaths per year are caused by air pollution, leaving the urban poor particularly vulnerable since they live in air pollution hotspots, have low respiratory resistance due to bad nutrition, and lack access to quality health care. Identifying the differences and similarities of air pollution levels and its impacts, between Indonesia and Australia, will provide best lesson learned to tackle air pollution problems for Pacific Basin Rim countries.

Chemosensory irritations and pulmonary effects of acute exposure to emissions from oriented strand board

Due to the reduction of air change rates in low-energy houses, the contribution to indoor air quality of volatile organic compounds (VOCs) emitting from oriented strand boards (OSB) has become increasingly important. The aim of this study was to evaluate sensory irritations, pulmonary effects and odor annoyance of emissions from OSB in healthy human volunteers compared to clean air. Twenty-four healthy non-smokers were exposed to clean air and OSB emissions for 2 h under controlled conditions in a 48 m(3) test chamber at three different time points: to fresh OSB panels and to the same panels after open storage for 2 and 8 weeks. Chemosensory irritation, exhaled nitric oxide (NO) concentration, eye blink frequency, lung function and subjective perception of irritation of eyes, nose and throat were examined before, during and after exposure. Additionally, olfactory perception was investigated. Total VOC exposure concentrations reached 8.9 ± 0.8 mg/m(3) for the fresh OSB panels. Emissions consisted predominantly of α-pinene, Δ(3)-carene and hexanal. Two-hour exposure to high VOC concentrations revealed no irritating or pulmonary effects. All the subjective ratings of discomfort were at a low level and the medians did not exceed the expression 'hardly at all.' Only the ratings for smell of emissions increased significantly during exposure in comparison to clean air. In conclusion, exposure of healthy volunteers to OSB emissions did not elicit sensory irritations or pulmonary effects up to a VOC concentration of about 9 mg/m(3). Sensory intensity of OSB emissions in the chamber air was rated as 'neutral to pleasant.'

Non-cancer effects of formaldehyde and relevance for setting an indoor air guideline

There is considerable recent focus and concern about formaldehyde (FA). We have reviewed the literature on FA with focus on chemosensory perception in the airways and lung effects in indoor environments. Concentrations of FA, both personal and stationary, are on average in the order of 0.05 mg/m(3) or less in Europe and North America with the exception of new housing or buildings with extensive wooden surfaces, where the concentration may exceed 0.1 mg/m(3). With the eye the most sensitive organ, subjective irritation is reported at 0.3-0.5 mg/m(3), which is somewhat higher than reported odour thresholds. Objective effects in the eyes and airways occur around 0.6-1 mg/m(3). Dose-response relationships between FA and lung function effects have not been found in controlled human exposure studies below 1 mg/m(3), and epidemiological associations between FA concentrations and exacerbation of asthma in children and adults are encumbered by complex exposures. Neither experimental nor epidemiological studies point to major differences in susceptibility to FA among children, elderly, and asthmatics. People with personal trait of negative affectivity may report more symptoms. An air quality guideline of 0.1 mg/m(3) (0.08 ppm) is considered protective against both acute and chronic sensory irritation in the airways in the general population assuming a log normal distribution of nasal sensory irritation.

Influence of indoor factors in dwellings on the development of childhood asthma

Asthma has become the most common, childhood chronic disease in the industrialized world, and it is also increasing in developing regions. There are huge differences in the prevalence of childhood asthma across countries and continents, and there is no doubt that the prevalence of asthma was strongly increasing during the past decades worldwide. Asthma, as a complex disease, has a broad spectrum of potential determinants ranging from genetics to life style and environmental factors. Environmental factors are likely to be important in explaining the regional differences and the overall increasing trend towards asthma's prevalence. Among the environmental conditions, indoor factors are of particular interest because people spend more than 80% of their time indoors globally. Increasing prices for oil, gas and other sources of primary energy will further lead to better insulation of homes, and ultimately to reduced energy costs. This will decrease air exchange rates and will lower the dilution of indoor air mass with ambient air. Indoor air quality and potential health effects will therefore be an area for future research and for gaining a better understanding of asthma epidemics. This strategic review will summarize the current knowledge of the effects of a broad spectrum of indoor factors on the development of asthma in childhood in Western countries based on epidemiological studies. In conclusion, several epidemiological studies point out, that indoor factors might cause asthma in childhood. Stronger and more consistent findings are seen when exposure to these indoor factors is assessed by surrogates for the source of the actual toxicants. Measurement-based exposure assessments for several indoor factors are less common than using surrogates of the exposure. These studies, however, mainly showed heterogeneous results. The most consistent finding for an induction of asthma in childhood is related to exposure to environmental tobacco smoke, to living in homes close to busy roads, and in damp homes where are visible moulds at home. The causing agents of the increased risk of living in damp homes remained uncertain and needs clarification. Exposure to pet-derived allergens and house dust mites are very commonly investigated and thought to be related to asthma onset. The epidemiological evidence is not sufficient to recommend avoidance measures against pet and dust mites as preventive activities against allergies. More research is also needed to clarify the potential risk for exposure to volatile and semi-volatile organic compounds due to renovation activities, phthalates and chlorine chemicals due to cleaning.

Effects of the indoor environment on the fraction of exhaled nitric oxide in school-aged children

BACKGROUND

The fractional concentration of exhaled nitric oxide (FeNO) appears to be a good marker for airway inflammation in children with asthma.

OBJECTIVE

To evaluate the effect of environmental exposures on exhaled nitric oxide in a community sample of children.

METHODS

The relationship among exhaled nitric oxide, underlying disease and home environmental exposures was examined using questionnaire data and measurement of exhaled nitric oxide in a cross-sectional study of 1135 children that included healthy children, and children with allergies and/or asthma who were attending grades 4 through 6 in Windsor, Ontario.

RESULTS

Among healthy children, there was a positive association between FeNO and occupancy (P<0.02). Compared with forced air and hot water radiant heat, electric baseboard heating was associated with a significant increase of FeNO in healthy children (P=0.007) and children with allergies (P=0.043). FeNO was not associated with environmental tobacco smoke exposure or reported surface mold. The presence of pet dog(s), but not cats, was associated with a significantly lower FeNO in healthy children (P<0.001) and in children with reported allergies (P<0.001).

CONCLUSIONS

The type of heating system, but not previously reported environmental tobacco smoke or mold exposure appears to affect exhaled nitric oxide in children. Exposure to different types of pets may have disparate effects on airway inflammation.

Epidemiology of asthma: risk factors for development

This comprehensive review of the recent literature was undertaken to determine the current state of knowledge of the risk factors involved in the development of asthma in order to focus investigations in a proposed new longitudinal birth cohort study. The origins of asthma appear to lie in the prenatal and early postnatal period, and renewed investigations in this period with long-term close follow-up and objective phenotypic characterization will help to unravel the role of the multiple putative environmental factors in the development of asthma. It is only after understanding these effects that one can hope to design rational prevention studies for asthma.

Formaldehyde exposure and asthma in children: a systematic review

OBJECTIVE

Despite multiple published studies regarding the association between formaldehyde exposure and childhood asthma, a consistent association has not been identified. Here we report the results of a systematic review of published literature in order to provide a more comprehensive picture of this relationship.

DATA SOURCES

After a comprehensive literature search, we identified seven peer-reviewed studies providing quantitative results regarding the association between formaldehyde exposure and asthma in children. Studies were heterogeneous with respect to the definition of asthma (e.g., self-report, physician diagnosis). Most of the studies were cross-sectional.

DATA EXTRACTION

For each study, an odds ratio (OR) and 95% confidence interval (CI) for asthma were either abstracted from published results or calculated based on the data provided. Characteristics regarding the study design and population were also abstracted.

DATA SYNTHESIS

We used fixed- and random-effects models to calculate pooled ORs and 95% CIs; measures of heterogeneity were also calculated. A fixed-effects model produced an OR of 1.03 (95% CI, 1.021.04), and random effects model produced an OR of 1.17 (95% CI, 1.011.36), both reflecting an increase of 10 microg/m3 of formaldehyde. Both the Q and I2 statistics indicated a moderate amount of heterogeneity.

CONCLUSIONS

Results indicate a significant positive association between formaldehyde exposure and childhood asthma. Given the largely cross-sectional nature of the studies underlying this meta-analysis, further well-designed prospective epidemiologic studies are needed.

Irritant and adjuvant effects of gaseous formaldehyde on the ovalbumin-induced hyperresponsiveness and inflammation in a rat model

BACKGROUND

Formaldehyde (FA) is a common indoor air pollutant that can cause asthma in people experiencing long-term exposure. While FA and other man-made chemicals contribute to the stimulation of asthma in the general population, the underlying molecular pathogenesis of this relationship is not yet well understood.

OBJECTIVE

To explore FA as an irritant for the onset of asthma and as an adjuvant for the induction of allergy.

METHODS

In the present study, 40 Wistar rats in five experimental groups were exposed to: (i) saline; (ii) ovalbumin (OVA); (iii) OVA + FA at 417 ppb; (iv) OVA + FA at 2500 ppb; and (v) FA at 2500 ppb. Current and prior occupational exposure limits in China were established at 417 ppb and 2500 ppb, respectively. Gaseous FA was administrated to the animals for 6 h/day before and during OVA immunization or saline treatment. Measured outcomes included in situ lung function analysis, cytokine measurement, and histological changes in the rat lungs.

RESULTS

The airway reactivity, lung histological changes, pulmonary interleukin-4 secretion, and eosinophil infiltration in the OVA and FA exposed rats were significantly higher after gaseous FA exposures of 417 and 2500 ppb. While FA exposure alone did not induce significant structural changes to the airway, and the rate of inflammatory cell infiltration was the same as for the control group, pulmonary levels of interferon-gamma were significantly elevated in the exposed rats.

CONCLUSIONS

FA may be an irritant as well as serve as an adjuvant for the onset of asthma or asthma-like symptoms.

The toxic effects of formaldehyde on the nervous system

Formaldehyde (FA) is found in the polluted atmosphere of cities, domestic air (e.g., paint, insulating materials, chipboard and plywood, fabrics, furniture, paper), and cigarette smoke, etc.; therefore, everyone and particularly susceptible children may be exposed to FA. FA is also widely used in industrial and medical settings and as a sterilizing agent, disinfectant, and preservative. Therefore, employees may be highly exposed to it in there settings. Of particular concern to the authors are anatomists and medical students, who can be highly exposed to formaldehyde vapor during dissection sessions. Formaldehyde is toxic over a range of doses; chances of exposure and subsequent harmful effects are increased as (room) temperature increases, because of FA's volatility. Many studies have been conducted to evaluate the effects of FA during systemic and respiratory exposures in rats. This review compiles that literature and emphasizes the neurotoxic effects of FA on neuronal morphology, behavior, and biochemical parameters. The review includes the results of some of the authors' work related to FA neurotoxicity, and such neurotoxic effects from FA exposure were experimentally demonstrated. Moreover, the effectiveness of some antioxidants such as melatonin, fish omega-3, and CAPE was observed in the treatment of the harmful effects of FA. Despite the harmful effects from FA exposure, it is commonly used in Turkey and elsewhere in dissection laboratories. Consequently, all anatomists must know and understand the effects of this toxic agent on organisms and the environment, and take precautions to avoid unnecessary exposure. The reviewed studies have indicated that FA has neurotoxic characteristics and systemic toxic effects. It is hypothesized that inhalation of FA, during the early postnatal period, is linked to some neurological diseases that occur in adults. Although complete prevention is impossible for laboratory workers and members of industries utilizing FA, certain precautions can be taken to decrease and/or prevent the toxic effects of FA.

Air pollution and increased levels of fractional exhaled nitric oxide in children with no history of airway damage

Air pollution is associated with a wide range of adverse respiratory events. In order to study the mechanism associated with these effects, the relationships between fractional exhaled nitric oxide (FeNO), a potential marker of airway inflammation, and exposure to air pollution were examined in schoolchildren. FeNO was measured in 104 children (34 asthmatics and 70 non-asthmatics) drawn from the general population simultaneously with air pollution assessments (fine particles with an aerodiameter under 2.5 microm, nitrogen dioxide, acetaldehyde, and formaldehyde, with pumps and passive samplers) in schoolyards and classrooms. Asthmatics exhaled more FeNO than non-asthmatics. FeNO levels were significantly elevated in both asthmatic and non-asthmatic children exposed to high concentrations of formaldehyde, acetaldehyde, and PM(2.5). Differences between high versus low exposure in non-asthmatics resulted in an FeNO increase ranging from 45% for indoor acetaldehyde to 62% for indoor PM(2.5). Stronger associations were found in non-asthmatic children who were atopic, suggesting that atopic children may be more sensitive to air pollution than non-atopic children. Exposure to air pollution may lead to airway inflammation, as measured by FeNO, in schoolchildren. These associations occur even in children with no history of airway damage and seem to be enhanced in atopic subjects.

Assessment and predictor determination of indoor aldehyde levels in Paris newborn babies' homes

Exposure to indoor chemical air pollutants expected to be potentially involved in allergic respiratory diseases in infants is poorly documented. A specific environmental investigation included in a birth cohort study was carried out to first assess indoor airborne aldehyde levels, using passive devices and their variability within 1 year (1, 6, 9 and 12 months) in the bedroom of 196 Paris infants, and second, to identify predictors for aldehyde concentrations using interviewer administered questionnaires about housing factors. Comfort parameters and carbon dioxide levels were measured simultaneously. Aldehydes were detected in almost all dwellings and geometric mean levels (geometric standard deviation) at the first visit were respectively for formaldehyde, acetaldehyde, hexanal, and pentanal 19.4 (1.7) microg/m(3), 8.9 (1.8) microg/m(3), 25.3 (3.1) microg/m(3), 3.7 (2.3) microg/m(3), consistent with earlier published results. Generalized Estimating Equation multivariate analyses showed that, apart from comfort parameters, aeration and season, the main indoor aldehyde sources were either continuous (building materials and coverings especially when they were new) or discontinuous (smoking, use of air fresheners and cleaning products, DIY etc...). Finally, the data collected by questionnaires should be sufficient to enable us to classify each infant in our cohort study according to his/her degree of exposure to the main aldehydes.

PRACTICAL IMPLICATIONS

This analysis contributed to document indoor aldehyde levels in Parisian homes and to identify factors determining these levels. In the major part of newborn babies' homes, indoor formaldehyde levels were above the guideline value of 10 microg/m(3) proposed by the French Agency for Environmental and Occupational Health Safety for long-term exposure. Given this result, it is essential to study the health impact of exposure to aldehydes especially formaldehyde on the incidence of respiratory and allergic symptoms, particularly during the first months of life.

The ontogeny, distribution, and regulation of alcohol dehydrogenase 3: implications for pulmonary physiology

Class III alcohol dehydrogenase (ADH3), also termed formaldehyde dehydrogenase or S-nitrosoglutathione reductase, plays a critical role in the enzymatic oxidation of formaldehyde and reduction of nitrosothiols that regulate bronchial tone. Considering reported associations between formaldehyde vapor exposure and childhood asthma risk, and thus potential involvement of ADH3, we reviewed the ontogeny, distribution, and regulation of mammalian ADH3. Recent studies indicate that multiple biological and chemical stimuli influence expression and activity of ADH3, including the feedback regulation of nitrosothiol metabolism. The levels of ADH3 correlate with, and potentially influence, bronchial tone; however, data gaps remain with respect to the expression of ADH3 during postnatal and early childhood development. Consideration of ADH3 function relative to the respiratory effects of formaldehyde, as well as to other chemical and biological exposures that might act in an additive or synergistic manner with formaldehyde, might be critical to gain better insight into the association between formaldehyde exposure and childhood asthma.

Nitric oxide in exhaled and aspirated nasal air as an objective measure of human response to indoor air pollution

The concentration of nitric oxide (NO) in exhaled and aspirated nasal air was used to objectively assess human response to indoor air pollutants in a climate chamber exposure experiment. The concentration of NO was measured before exposure, after 2, and 4.5 h of exposure, using a chemiluminescence NO analyzer. Sixteen healthy female subjects were exposed to two indoor air pollutants and to a clean reference condition for 4.5 h. Subjective assessments of the environment were obtained by questionnaires. After exposure (4.5 h) to the two polluted conditions a small increase in NO concentration in exhaled air was observed. After exposure to the reference condition the mean NO concentration was significantly reduced compared to pre-exposure. Together these changes resulted in significant differences in exhaled NO between exposure to reference and polluted conditions. NO in nasal air was not affected by the exposures. The results may indicate an association between polluted indoor air and subclinical inflammation.

PRACTICAL IMPLICATIONS

Measurement of nitric oxide in exhaled air is a possible objective marker of subclinical inflammation in healthy adults.

Protective effects of melatonin against formaldehyde-induced oxidative damage and apoptosis in rat testes: an immunohistochemical and biochemical study

This study investigated the protective effects of melatonin against formaldehyde-induced oxidative damage and apoptosis in rat testes. A total of 21 male Wistar rats were divided into three groups. Group I was used as a control, Group II was injected every other day with formaldehyde for 1 month, whereas Group III was injected every other day with formaldehyde and melatonin for 1 month. At the end of the experimental period animals were sacrificed and the testes removed and dissected from the surrounding tissues for immunohistochemical evaluation. In addition, the levels of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), and malondialdehyde (MDA) were determined. The levels of SOD and GSH-Px decreased significantly, whereas the level of MDA significantly increased in animals treated with formaldehyde compared with the controls. Apoptosis of spermatogenetic and Leydig cells of testicular tissues was observed. In contrast, rats with melatonin SOD and GSH-Px enzyme activity increased whereas MDA levels decreased with formaldehyde exposure along with apoptosis. In view of the present findings, it is suggested that melatonin treatment may prevent formaldehyde-induced oxidative damage and apoptosis in rat testes.

Protective effect of melatonin against formaldehyde-induced kidney damage in rats

This study was undertaken to investigate the protective effects of melatonin against formaldehyde-induced renal damage in rats. For this purpose, 21 male Wistar rats were divided into three groups. The animals in Group I were used as a control, whereas the rats in group II were injected every other day with formaldehyde. The rats in group III received melatonin daily while exposed to formaldehyde. At the end of the 14-day experimental period, all rats were killed by decapitation, and the kidneys were removed. Some of the renal tissue specimens were used for determination of superoxide dismutase, glutatione peroxidase enzyme activities, and malondialdehyde levels. The remaining kidney tissue specimens were used for light microscopic evaluation. The renal tissue activities of superoxide dismutase and glutatione peroxidase were significantly decreased, and malondialdehyde levels were significantly increased in rats treated with formaldehyde compared with those of the control animals. In the light microscopic evaluation of this group, degenerative glomerules, vacuolization and dilatation of distal tubules, and vascular congestion were detected. However, an increase was observed in activities of superoxide dismutase and glutatione peroxidase enzymes, and a decrease of malondialdehyde levels in animals treated with formaldehyde plus melatonin was observed. Furthermore, the histopathological changes caused by formaldehyde were disappeared except for minimal tubular dilatation in this group. In conclusion, the biochemical and histological findings of our study suggest that melatonin administration prevents formaldehyde-induced oxidative renal damage in rats.

Laryngeal edema and metabolic acidosis after Omnicide ingestion

INTRODUCTION

Glutaraldehyde and quaternary ammonium compounds are widely used as disinfectants and sterilizing agents. Glutaraldehyde is irritating to the eyes and upper respiratory tract, and has been associated with occupational asthma. Acute oral ingestion of a concentrated solution has not been previously reported in humans.

CASE REPORT

A 19-year-old woman presented after deliberate ingestion of a biocide containing glutaraldehyde and a quaternary ammonium compound. She developed respiratory distress and severe metabolic acidosis 10 hours after admission. Marked laryngeal edema was noted when she was being intubated. She eventually improved following supportive care and was discharged alive after 9 hospital days.

DISCUSSION

There are no reports of acute ingestions of both glutaraldehyde and quaternary ammonium compounds. As both these substances are known to cause metabolic acidosis, localized edema, erosion and sensitization of both the respiratory and alimentary tract. The clinical effect may be additive or synergistic.

CONCLUSIONS

Omnicide ingestion should be closely monitored for metabolic acidosis and laryngeal edema which may progress to upper airway obstruction requiring urgent airway stabilization.

Mechanistic and dose considerations for supporting adverse pulmonary physiology in response to formaldehyde

Induction of airway hyperresponsiveness and asthma from formaldehyde inhalation exposure remains a debated and controversial issue. Yet, recent evidences on pulmonary biology and the pharmacokinetics and toxicity of formaldehyde lend support for such adverse effects. Specifically, altered thiol biology from accelerated enzymatic reduction of the endogenous bronchodilator S-nitrosoglutathione and pulmonary inflammation from involvement of Th2-mediated immune responses might serve as key events and cooperate in airway pathophysiology. Understanding what role these mechanisms play in various species and lifestages (e.g., child vs. adult) could be crucial for making more meaningful inter- and intra-species dosimetric extrapolations in human health risk assessment.

Indoor air quality and respiratory health of children

Indoor air pollution (IAP) is an important environmental health issue in developing countries and is a major contributor to mortality and morbidity from acute lower respiratory illness in children. In developed countries, IAP in homes is not nearly as severe as it can be in developing countries; however, evidence suggests that it does contribute significantly to the risk of adverse respiratory health in children. Children spend the majority of their time indoors, mostly at home. Homes are built so that air exchange between the indoor and outdoor environments is minimised and there is a large range of pollution emission sources inside. For many pollutants, indoor concentrations regularly exceed those outdoors. Although there has been considerable interest in the health effects of IAP, questions still remain regarding the role of IAP in the exacerbation and/or development of respiratory disease. Prospective, longitudinal studies are required to better clarify the contribution of IAP to the respiratory health of children.