Contributions of burning incense on indoor air pollution levels and on the health status of patients with chronic obstructive pulmonary disease

Exposure to incense burning, biomarkers, and the physical health of temple workers in Taiwan

Incense burning releases heavy particulate matter (PM) and nitrogen dioxide (NO2), known to have adverse effects on human health. Long-term exposure to PM and NO2 increases inflammatory cytokine levels and can induce respiratory diseases. This study examined the association between incense burning exposure and the health status, especially inflammatory biomarkers, of temple workers and volunteers in Taiwan. The longitudinal observational study compared adult temple workers and volunteers, with long-term incense burning exposure, to residents from outpatient clinics in the Chiayi area. Forced expiratory volume in 1 s (FEV1) and serum and exhaled breath condensate (EBC) cytokines were assessed. Nonparametric Mann-Whitney U tests were used to compare cytokine levels of the exposure and control groups during the cold and hot weather seasons. FEV1 was significantly more diminished in the exposed group than in the control group during the cold season. Exposure status was associated with greater hot-cold seasonal differences in serum interleukins (IL)-1β (regression coefficient (B) = 6.6, 95% confidence interval (CI) = 5.0 to 8.3, p < .001), IL17-A (B = 2.4, 95% CI = 0.3 to 4.5, p = .03), and plasminogen activator inhibitor [PAI]-1 (B = 5.4, 95% CI = 1.5 to 9.3, p = .009). After adjusting for confounders, the groups' serum levels of IL-1β, IL-17A, and PAI-1 significantly differed. EBC cytokines did not show significant differences. Elevated levels of IL-1β, IL17-A, and PAI-1 have been associated with various autoinflammatory syndromes and diseases. Given the cultural significance of incense burning, culturally sensitive interventions, including education, policy development, and program implementation, are crucial to protect individuals' health, especially temple workers, from the adverse effects of exposure, addressing the manufacture, importation, and sale of incense.

A study to characterize the lead isotopic fingerprint in PM2.5 emitted from incense stick and cigarette burning

The incense sticks and cigarettes burning are key sources of particulate matter with a diameter of ≤ 2.5 μm (PM_2.5) in indoor and outdoor air. While lead (Pb) isotope ratios provide valuable insights into the origin of particle pollution, their applicability for investigating these source remains unclear. The Pb isotope ratios in the PM_2.5 emitted from these two sources were analyzed, and effects of brands or nicotine contents on the ratios were assessed. In addition, As, Cr, and Pb were analyzed to investigate whether Pb isotope ratios can serve as an indicator for the source investigation of these metals. We found that average ratios of ²⁰⁶Pb/²⁰⁴Pb, ²⁰⁶Pb/²⁰⁷Pb, and ²⁰⁸Pb/²⁰⁷Pb in cigarettes were heavier than those in incense sticks. Scatter plots of Pb isotope ratios indicated an overlap of values for incense sticks or cigarettes linked to different brands, in that ratios for cigarettes with high nicotine content were heavier than for those with low nicotine content. Scatter plots of As, Cr, or Pb concentration against Pb isotope ratios clearly distinguished the effects of cigarette burning versus incense sticks with respect to PM_2.5 of these metals. Results indicate that brand differences did not affect the determination of PM_2.5 in these two sources. We suggest that Pb isotope ratios can be a useful tool in investigating the influence of incense sticks and of cigarettes (with high or low nicotine content) burning to PM_2.5 and associated metals.

Indoor Exposure and Regional Inhaled Deposited Dose Rate during Smoking and Incense Stick Burning-The Jordanian Case as an Example for Eastern Mediterranean Conditions

Tobacco smoking and incense burning are commonly used in Jordanian microenvironments. While smoking in Jordan is prohibited inside closed spaces, incense burning remains uncontrolled. In this study, particle size distributions (diameter 0.01-25 µm) were measured and inhaled deposited dose rates were calculated during typical smoking and incense stick-burning scenarios inside a closed room, and the exposure was summarized in terms of number and mass concentrations of submicron (PN_Sub) and fine particles (PM_2.5). During cigarette smoking and incense stick-burning scenarios, the particle number concentrations exceeded 3 × 10⁵ cm^-3. They exceeded 5 × 10⁵ cm^-3 during shisha smoking. The emission rates were 1.9 × 10¹⁰, 6.8 × 10¹⁰, and 1.7 × 10¹⁰ particles/s, respectively, for incense, cigarettes, and shisha. That corresponded to about 7, 80, and 120 µg/s, respectively. Males received higher dose rates than females, with about 75% and 55% in the pulmonary/alveolar during walking and standing, respectively. The total dose rates were in the order of 10¹²-10¹³ #/h (10³-10⁴ µg/h), respectively, for PN_Sub and PM_2.5. The above reported concentrations, emissions rates, and dose rates are considered seriously high, recalling the fact that aerosols emitted during such scenarios consist of a vast range of toxicant compounds.

Identification of Modifiable Risk Factors of Exacerbations Chronic Respiratory Diseases with Airways Obstruction, in Vietnam

OBJECTIVES

to determine modifiable risk factors of exacerbations in chronic respiratory diseases with airways obstruction (i.e., asthma and COPD) in southern Vietnam.

METHODS

an environmental and health-related behavioural questionnaire was submitted to patients with both chronic respiratory symptoms and airways obstruction. An exacerbation was defined as any acute worsening in clinical symptoms requiring a change in treatment, in a patient receiving prophylactic therapy.

RESULTS

235 patients were evaluated, including 131 (56%) chronic obstructive pulmonary disease (COPD) and 104 (44%) asthmatics. There were 75% males and 69% smokers. Occupational exposure accounted for 66%, mainly among construction and industry workers. Smoking was associated with more severe airways obstruction. Respiratory exacerbations were reported in 56/235 patients (24%). The risk of exacerbation was increased in patients with a lower education level, exposure to occupational pollutants, cumulative smoking ≥ 20 pack year, housing space < 10 m², and poorly ventilated housing. Based on multivariate analysis, the risk of exacerbation remained significantly higher among patients with occupational exposure and low housing space per person.

CONCLUSIONS

besides smoking cessation, more supportive policies, including improvement of occupational environment and housing design for better ventilation, are needed to prevent the severity of chronic respiratory diseases in Vietnam.

Stable C and N isotopes of PM2.5 and size-segregated particles emitted from incense stick and cigarette burning

This work measured the δ¹³C and δ¹⁵N signatures in PM_2.5 and size-segregated particles emitted from incense stick and cigarette burning in different brands or nicotine contents for pollution source identification indoors. Three popular brands of incense stick and cigarette were selected for experiments. A personal environmental monitoring sampler and a Sioutas cascade impactor were used to collect PM_2.5 and size-segregated particles, respectively, for isotopic signatures analyses. Our data showed that both δ¹³C and δ¹⁵N values were heavier from incense stick burning (δ¹³C: 27.3 ± 0.5; δ¹⁵N: 8.63 ± 1.35) than cigarette (δ¹³C: 28.5 ± 0.2; δ¹⁵N: 4.15 ± 0.69). The scatter plots of δ¹³C and TC/PM_2.5 and of δ¹⁵N and TN/PM_2.5 can be applied to distinguish particle pollution sources and assess the influence of cigarette burning to PM_2.5 according to different nicotine contents. The δ¹³C values in size-segregated particles were similar to incense stick or cigarette burning; the δ¹³C values in PM_2.5 were significantly higher than those in size-segregated particles. However, the nitrogen amount was too low in most of the size-segregated particles to analyze δ¹⁵N from incense stick and cigarette burning. These results suggest that the δ¹³C signatures on PM_2.5 cannot represent the isotopic characteristics of size-segregated particles and δ¹⁵N has limitation for pollution source identification of different particle sizes.

Health and Environmental Risks of Incense Smoke: Mechanistic Insights and Cumulative Evidence

Incense burning is practiced alongside many sacred rituals across different regions of the world. Invariable constituents of incense brands are 21% (by weight) herbal and wood powder, 33% bamboo stick, 35% fragrance material, and 11% adhesive powder. Major incense-combustion outputs include particulate matter (PM), volatile organic content, and polyaromatic hydrocarbons. The relative toxicity of these products is an implicit function of particle size and incomplete combustion, which in turn vary for a specific incense brand. Lately, the attention given to the Air Quality Index by international regulatory bodies has created concern about mounting PM toxicity. The uncharacteristically small physical dimensions of these entities complicates their detection, and with no effect of gravity PM fractions rapidly contribute to oxidative stress, enhancing random biochemical reactions upon being inhaled. Incense burning generates four times the PM extent (45 mg•g⁻¹) of cigarettes (~10 mg•g⁻¹). Several poisonous gases, such as CO, CO₂, NO₂, and SO₂, and the unavoidable challenge of disposing of the burnt incense ash further add to the toxicity. Taken together, these issues demonstrate that incense burning warrants prompt attention. The aim of this article is to highlight the toxicity of incense-combustion materials on the environment and human health. This discussion could be significant in framing future policy regarding ecofriendly incense manufacture and reduced usage.

The Adverse Impact of Incense Smoke on Human Health: From Mechanisms to Implications

Incense burning is a very popular activity in daily life among many parts all over the world. A growing body of both epidemiological and experimental evidences has reported the negative effects of incense use on human well-being, posing a potential threat at public significance. This work is a comprehensive review that covers the latest findings regarding the adverse impact of incense smoke on our health, providing a panoramic visualization ranging from mechanisms to implications. The toxicities of incense smoke come directly from its harmful constituents and deposition capacity in the body. Besides, reactive oxygen species-driven oxidative stress and associated inflammation seem to be plausible underlying mechanisms, eliciting various unfavorable responses. Although our current knowledge remains many gaps, this issue still has some important implications.