Use of real-time light scattering data to estimate the contribution of infiltrated and indoor-generated particles to indoor air

Quantifying the contribution of ambient and indoor-generated fine particles to indoor air in residential environments

Indoor fine particles (FPs) are a combination of ambient particles that have infiltrated indoors, and particles that have been generated indoors from activities such as cooking. The objective of this paper was to estimate the infiltration factor (Finf ) and the ambient/non-ambient components of indoor FPs. To do this, continuous measurements were collected indoors and outdoors for seven consecutive days in 50 non-smoking homes in Halifax, Nova Scotia in both summer and winter using DustTrak (TSI Inc) photometers. Additionally, indoor and outdoor gravimetric measurements were made for each 24-h period in each home, using Harvard impactors (HI). A computerized algorithm was developed to remove (censor) peaks due to indoor sources. The censored indoor/outdoor ratio was then used to estimate daily Finfs and to determine the ambient and non-ambient components of total indoor concentrations. Finf estimates in Halifax (daily summer median = 0.80; daily winter median = 0.55) were higher than have been reported in other parts of Canada. In both winter and summer, the majority of FP was of ambient origin (daily winter median = 59%; daily summer median = 84%). Predictors of the non-ambient component included various cooking variables, combustion sources, relative humidity, and factors influencing ventilation. This work highlights the fact that regional factors can influence the contribution of ambient particles to indoor residential concentrations.

PRACTICAL IMPLICATIONS

Ambient and non-ambient particles have different risk management approaches, composition, and likely toxicity. Therefore, a better understanding of their contribution to the indoor environment is important to manage the health risks associated with fine particles (FPs) effectively. As well, a better understanding of the factors Finf can help improve exposure assessment and contribute to reduced exposure misclassification in epidemiologic studies.

The effects of PM2.5 and its components from indoor and outdoor sources on cough and wheeze symptoms in asthmatic children

Particulate matter with aerodynamic diameter <2.5 μm (PM2.5) is associated with asthma exacerbation. In the Children's Air Pollution Asthma Study, we investigated the longitudinal association of PM2.5 and its components from indoor and outdoor sources with cough and wheeze symptoms in 36 asthmatic children. The sulfur tracer method was used to estimate infiltration factors. Mixed proportional odds models for an ordinal response were used to relate daily cough and wheeze scores to PM2.5 exposures. The odds ratio associated with being above a given symptom score for a SD increase in PM2.5 from indoor sources (PMIS) was 1.24 (95% confidence interval: 0.92-1.68) for cough and 1.63 (1.11-2.39) for wheeze. Ozone was associated with wheeze (1.82, 1.19-2.80), and cough was associated with indoor PM2.5 components from outdoor sources (denoted with subscript "OS") bromine (BrOS: 1.32, 1.05-1.67), chlorine (ClOS: 1.27, 1.02-1.59) and pyrolyzed organic carbon (OPOS: 1.49, 1.12-1.99). The highest effects were seen in the winter for cough with sulfur (SOS: 2.28, 1.01-5.16) and wheeze with organic carbon fraction 2 (OC2OS: 7.46, 1.19-46.60). Our results indicate that exposure to components originating from outdoor sources of photochemistry, diesel and fuel oil combustion is associated with symptom's exacerbation, especially in the winter. PM2.5 mass of indoor origin was more strongly associated with wheeze than with cough.

Sources of indoor air pollution in New York City residences of asthmatic children

Individuals spend ∼90% of their time indoors in proximity to sources of particulate and gaseous air pollutants. The sulfur tracer method was used to separate indoor concentrations of particulate matter (PM) PM2.5 mass, elements and thermally resolved carbon fractions by origin in New York City residences of asthmatic children. Enrichment factors relative to sulfur concentrations were used to rank species according to the importance of their indoor sources. Mixed effects models were used to identify building characteristics and resident activities that contributed to observed concentrations. Significant indoor sources were detected for OC1, Cl, K and most remaining OC fractions. We attributed 46% of indoor PM2.5 mass to indoor sources related to OC generation indoors. These sources include cooking (NO2, Si, Cl, K, OC4 and OP), cleaning (most OC fractions), candle/incense burning (black carbon, BC) and smoking (K, OC1, OC3 and EC1). Outdoor sources accounted for 28% of indoor PM2.5 mass, mainly photochemical reaction products, metals and combustion products (EC, EC2, Br, Mn, Pb, Ni, Ti, V and S). Other indoor sources accounted for 26% and included re-suspension of crustal elements (Al, Zn, Fe, Si and Ca). Indoor sources accounted for ∼72% of PM2.5 mass and likely contributed to differences in the composition of indoor and outdoor PM2.5 exposures.

Clustering cities with similar fine particulate matter exposure characteristics based on residential infiltration and in-vehicle commuting factors

Epidemiological studies have observed between city heterogeneity in PM2.5-mortality risk estimates. These differences could potentially be due to the use of central-site monitors as a surrogate for exposure which do not account for an individual's activities or ambient pollutant infiltration to the indoor environment. Therefore, relying solely on central-site monitoring data introduces exposure error in the epidemiological analysis. The amount of exposure error produced by using the central-site monitoring data may differ by city. The objective of this analysis was to cluster cities with similar exposure distributions based on residential infiltration and in-vehicle commuting characteristics. Factors related to residential infiltration and commuting were developed from the American Housing Survey (AHS) from 2001 to 2005 for 94 Core-Based Statistical Areas (CBSAs). We conducted two separate cluster analyses using a k-means clustering algorithm to cluster CBSAs based on these factors. The first only included residential infiltration factors (i.e. percent of homes with central air conditioning (AC) mean year home was built, and mean home size) while the second incorporated both infiltration and commuting (i.e. mean in-vehicle commuting time and mean in-vehicle commuting distance) factors. Clustering on residential infiltration factors resulted in 5 clusters, with two having distinct exposure distributions. Cluster 1 consisted of cities with older, smaller homes with less central AC while homes in Cluster 2 cities were newer, larger, and more likely to have central AC. Including commuting factors resulted in 10 clusters. Clusters with shorter in-vehicle commuting times had shorter in-vehicle commuting distances. Cities with newer homes also tended to have longer commuting times and distances. This is the first study to employ cluster analysis to group cities based on exposure factors. Identifying cities with similar exposure distributions may help explain city-to-city heterogeneity in PM2.5 mortality risk estimates.

Fine and ultrafine particle decay rates in multiple homes

Human exposure to particles depends on particle loss mechanisms such as deposition and filtration. Fine and ultrafine particles (FP and UFP) were measured continuously over seven consecutive days during summer and winter inside 74 homes in Edmonton, Canada. Daily average air exchange rates were also measured. FP were also measured outside each home and both FP and UFP were measured at a central monitoring station. A censoring algorithm was developed to identify indoor-generated concentrations, with the remainder representing particles infiltrating from outdoors. The resulting infiltration factors were employed to determine the continuously changing background of outdoor particles infiltrating the homes. Background-corrected indoor concentrations were then used to determine rates of removal of FP and UFP following peaks due to indoor sources. About 300 FP peaks and 400 UFP peaks had high-quality (median R(2) value >98%) exponential decay rates lasting from 30 min to 10 h. Median (interquartile range (IQR)) decay rates for UFP were 1.26 (0.82-1.83) h(-1); for FP 1.08 (0.62-1.75) h(-1). These total decay rates included, on average, about a 25% contribution from air exchange, suggesting that deposition and filtration accounted for the major portion of particle loss mechanisms in these homes. Models presented here identify and quantify effects of several factors on total decay rates, such as window opening behavior, home age, use of central furnace fans and kitchen and bathroom exhaust fans, use of air cleaners, use of air conditioners, and indoor-outdoor temperature differences. These findings will help identify ways to reduce exposure and risk.

Associations of particulate air pollution and daily mortality in 16 Chinese cities: an improved effect estimate after accounting for the indoor exposure to particles of outdoor origin

People typically spend most of their time indoors. We modeled the daily indoor PM10 concentrations of outdoor origin using a set of exposure parameters, including the fraction of residences with air conditionings (AC), the fraction of time that windows are closed when cooling occurs for buildings with AC, the fractions of time that windows are open or closed for buildings with or without AC, the particle penetration factors, air change rates, and surface removal rate constant of PM10. We calculated the time-weighted average of the simulated indoor PM10 concentration of outdoor origin and the original recorded outdoor PM10 concentration. We then evaluated the acute effects of PM10 using traditional and amended exposure metrics in 16 Chinese cities. Compared with the original estimates, the new effect estimates almost doubled, with improved model fit and attenuated between-city heterogeneity. Conclusively, this proposed exposure assessment approach could improve the effect estimates of ambient particles.

Air pollution exposure prediction approaches used in air pollution epidemiology studies

Epidemiological studies of the health effects of outdoor air pollution have traditionally relied upon surrogates of personal exposures, most commonly ambient concentration measurements from central-site monitors. However, this approach may introduce exposure prediction errors and misclassification of exposures for pollutants that are spatially heterogeneous, such as those associated with traffic emissions (e.g., carbon monoxide, elemental carbon, nitrogen oxides, and particulate matter). We review alternative air quality and human exposure metrics applied in recent air pollution health effect studies discussed during the International Society of Exposure Science 2011 conference in Baltimore, MD. Symposium presenters considered various alternative exposure metrics, including: central site or interpolated monitoring data, regional pollution levels predicted using the national scale Community Multiscale Air Quality model or from measurements combined with local-scale (AERMOD) air quality models, hybrid models that include satellite data, statistically blended modeling and measurement data, concentrations adjusted by home infiltration rates, and population-based human exposure model (Stochastic Human Exposure and Dose Simulation, and Air Pollutants Exposure models) predictions. These alternative exposure metrics were applied in epidemiological applications to health outcomes, including daily mortality and respiratory hospital admissions, daily hospital emergency department visits, daily myocardial infarctions, and daily adverse birth outcomes. This paper summarizes the research projects presented during the symposium, with full details of the work presented in individual papers in this journal issue.

Estimating the concentration of indoor particles of outdoor origin: a review

Recent toxicological results highlight the importance of separating exposure to indoor- and outdoor-generated particles, due to their different physicochemical and toxicological properties. In this framework, a number of studies have attempted to estimate the relative contribution of particles of indoor and outdoor origins to indoor concentrations, using either statistical analysis of indoor and outdoor concentration time-series or mass balance equations. The aim of this work is to review and compare the methodologies developed in order to determine the ambient particle infiltration factor (F(INF)) (i.e., the fraction of ambient particles that enter indoors and remains suspended). The different approaches are grouped into four categories according to their methodological principles: (1) steady-state assumption using the steady-state form of the mass balance equation; (2) dynamic solution of the mass balance equation using complex statistical techniques; (3) experimental studies using conditions that simplify model calculations (e.g., decreasing the number of unknowns); and (4) infiltration surrogates using a particulate matter (PM) constituent with no indoor sources to act as surrogate of indoor PM of outdoor origin. Examination of the various methodologies and results reveals that estimating infiltration parameters is still challenging. The main difficulty lies in the separate calculation of penetration efficiency (P) and deposition rate (k). The values for these two parameters that are reported in the literature vary significantly. Deposition rate presents the widest range of values, both between studies and size fractions. Penetration efficiency seems to be more accurately calculated through the application of dynamic models. Overall, estimates of the infiltration factor generated using dynamic models and infiltration surrogates show good agreement. This is a strong argument in favor of the latter methodology, which is simple and easy to apply when chemical speciation data are available.

Residential indoor PM2.5 in wood stove homes: follow-up of the Libby changeout program

In 2005 through 2008, a small rural mountain valley community engaged in a woodstove changeout program to address concerns of poor ambient air quality. During this program, we assessed changes to indoor air quality before and after the introduction of a new, lower emission woodstove. We previously reported a >70% reduction in indoor PM(2.5) concentrations in homes following the installation of a new Environmental Protection Agency's-certified stove within the home. We report here on follow-up of the experiences in these and other homes over three winters of sample collection. In 21 homes, we compared pre-changeout PM(2.5) concentrations [mean (s.d.) = 45.0 (33.0) μg/m(3)] to multiple post-changeout measures of PM(2.5) concentrations using a DustTrak. The mean reduction (and 95% confidence interval) from pre-changeout to post-changeout was -18.5 μg/m(3) (-31.9, -5.2), adjusting for ambient PM(2.5) , ambient temperature, and other factors. Findings across homes and across years were highly variable, and a subset of homes did not experience a reduction in PM(2.5) following changeout. Reductions were also observed for organic carbon, elemental carbon, and levoglucosan, but increases were observed for dehydroabietic acid and abietic acid. Despite overall improvements in indoor air quality, the varied response across homes may be due to factors other than the introduction of a new woodstove.

PRACTICAL IMPLICATIONS

Biomass combustion is a common source of ambient PM(2.5) in many cold-climate communities. The replacement of older model woodstoves with newer technology woodstoves is a potential intervention strategy to improve air quality in these communities. In addition to ambient air, woodstove changeouts should improve residential indoor air quality. We present results from a multi-winter study to evaluate the efficacy of woodstove changeouts on improving indoor air quality. Reductions in indoor PM(2.5) were evident, but this observation was not consistent across all homes. These findings suggest that other factors beyond the introduction of an improved wood burning device are relevant to improving indoor air quality in wood burning homes.

Prospective study of particulate air pollution exposures, subclinical atherosclerosis, and clinical cardiovascular disease: The Multi-Ethnic Study of Atherosclerosis and Air Pollution (MESA Air)

The Multi-Ethnic Study of Atherosclerosis and Air Pollution (MESA Air) was initiated in 2004 to investigate the relation between individual-level estimates of long-term air pollution exposure and the progression of subclinical atherosclerosis and the incidence of cardiovascular disease (CVD). MESA Air builds on a multicenter, community-based US study of CVD, supplementing that study with additional participants, outcome measurements, and state-of-the-art air pollution exposure assessments of fine particulate matter, oxides of nitrogen, and black carbon. More than 7,000 participants aged 45-84 years are being followed for over 10 years for the identification and characterization of CVD events, including acute myocardial infarction and other coronary artery disease, stroke, peripheral artery disease, and congestive heart failure; cardiac procedures; and mortality. Subcohorts undergo baseline and follow-up measurements of coronary artery calcium using computed tomography and carotid artery intima-medial wall thickness using ultrasonography. This cohort provides vast exposure heterogeneity in ranges currently experienced and permitted in most developed nations, and the air monitoring and modeling methods employed will provide individual estimates of exposure that incorporate residence-specific infiltration characteristics and participant-specific time-activity patterns. The overarching study aim is to understand and reduce uncertainty in health effect estimation regarding long-term exposure to air pollution and CVD.

Asthma randomized trial of indoor wood smoke (ARTIS): rationale and methods

BACKGROUND

Particulate matter (PM) exposures have been linked with poor respiratory health outcomes, especially among susceptible populations such as asthmatic children. Smoke from biomass combustion for residential home heating is an important source of PM in many rural or peri-urban areas in the United States.

AIM

To assess the efficacy of residential interventions that reduce indoor PM exposure from wood stoves and to quantify the corresponding improvements in quality of life and health outcomes for asthmatic children.

DESIGN

The asthma randomized trial of indoor wood smoke (ARTIS) study is an in-home intervention study of susceptible children exposed to biomass combustion smoke. Children, ages 7 to 17, with persistent asthma and living in homes that heat with wood stoves were recruited for this three arm randomized placebo-controlled trial. Two household-level intervention strategies, wood stove replacement and air filters, were compared to a sham air filter placebo. Improvement in quality of life of asthmatic children was the primary outcome. Secondary asthma-related health outcomes included peak expiratory flow (PEF) and forced expiratory volume in first second (FEV(1)), biomarkers in exhaled breath condensate, and frequency of asthma symptoms, medication usage, and healthcare utilization. Exposure outcomes included indoor and outdoor PM(2.5) mass, particle counts of several size fractions, and carbon monoxide.

DISCUSSION

To our knowledge, this was the first randomized trial in the US to utilize interventions targeting residential wood stoves to assess the impact on indoor PM and health outcomes in a susceptible population.

A spatiotemporal land-use regression model of winter fine particulate levels in residential neighbourhoods

Residential wood burning can be a significant wintertime source of ambient fine particles in urban and suburban areas. We developed a statistical model to predict minute (min) levels of particles with median diameter of <1 μm (PM1) from mobile monitoring on evenings of winter weekends at different residential locations in Quebec, Canada, considering wood burning emissions. The 6 s PM1 levels were concurrently measured on 10 preselected routes travelled 3 to 24 times during the winters of 2008-2009 and 2009-2010 by vehicles equipped with a GRIMM or a dataRAM sampler and a Global Positioning System device. Route-specific and global land-use regression (LUR) models were developed using the following spatial and temporal covariates to predict 1-min-averaged PM1 levels: chimney density from property assessment data at sampling locations, PM2.5 "regional background" levels of particles with median diameter of <2.5 μm (PM2.5) and temperature and wind speed at hour of sampling, elevation at sampling locations and day of the week. In the various routes travelled, between 49% and 94% of the variability in PM1 levels was explained by the selected covariates. The effect of chimney density was not negligible in "cottage areas." The R(2) for the global model including all routes was 0.40. This LUR is the first to predict PM1 levels in both space and time with consideration of the effects of wood burning emissions. We show that the influence of chimney density, a proxy for wood burning emissions, varies by regions and that a global model cannot be used to predict PM in regions that were not measured. Future work should consider using both survey data on wood burning intensity and information from numerical air quality forecast models, in LUR models, to improve the generalisation of the prediction of fine particulate levels.

Particulate matter concentrations in residences: an intervention study evaluating stand-alone filters and air conditioners

This study, a randomized controlled trial, evaluated the effectiveness of free-standing air filters and window air conditioners (ACs) in 126 low-income households of children with asthma. Households were randomized into a control group, a group receiving a free-standing HEPA filter placed in the child's sleeping area, and a group receiving the filter and a window-mounted AC. Indoor air quality (IAQ) was monitored for week-long periods over three to four seasons. High concentrations of particulate matter (PM) and carbon dioxide were frequently seen. When IAQ was monitored, filters reduced PM levels in the child's bedroom by an average of 50%. Filter use varied greatly among households and declined over time, for example, during weeks when pollutants were monitored, filter use was initially high, averaging 84±27%, but dropped to 63±33% in subsequent seasons. In months when households were not visited, use averaged only 34±30%. Filter effectiveness did not vary in homes with central or room ACs. The study shows that measurements over multiple seasons are needed to characterize air quality and filter performance. The effectiveness of interventions using free-standing air filters depends on occupant behavior, and strategies to ensure filter use should be an integral part of interventions.

PRACTICAL IMPLICATIONS

Environmental tobacco smoke (ETS) increased particulate matter (PM) levels by about 14 μg/m3 and was often detected using ETS-specific tracers despite restrictions on smoking in the house as reported on questionnaires administered to caregivers. PM concentrations depended on season, filter usage, relative humidity, air exchange ratios, number of children, outdoor PM levels, sweeping/dusting, and presence of a central air conditioner (AC). Free-standing air filters can be an effective intervention that provides substantial reductions in PM concentrations if the filters are used. However, filter use was variable across the study population and declined over the study duration, and thus strategies are needed to encourage and maintain use of filters. The variability in filter use suggests that exposure misclassification is a potential problem in intervention studies using filters. The installation of a room AC in the bedroom, intended to limit air exchange ratios, along with an air filter, did not lower PM levels more than the filter alone.

Measurement error in environmental epidemiology and the shape of exposure-response curves

Both classical and Berkson exposure measurement errors as encountered in environmental epidemiology data can result in biases in fitted exposure-response relationships that are large enough to affect the interpretation and use of the apparent exposure-response shapes in risk assessment applications. A variety of sources of potential measurement error exist in the process of estimating individual exposures to environmental contaminants, and the authors review the evaluation in the literature of the magnitudes and patterns of exposure measurement errors that prevail in actual practice. It is well known among statisticians that random errors in the values of independent variables (such as exposure in exposure-response curves) may tend to bias regression results. For increasing curves, this effect tends to flatten and apparently linearize what is in truth a steeper and perhaps more curvilinear or even threshold-bearing relationship. The degree of bias is tied to the magnitude of the measurement error in the independent variables. It has been shown that the degree of bias known to apply to actual studies is sufficient to produce a false linear result, and that although nonparametric smoothing and other error-mitigating techniques may assist in identifying a threshold, they do not guarantee detection of a threshold. The consequences of this could be great, as it could lead to a misallocation of resources towards regulations that do not offer any benefit to public health.

Windsor, Ontario Exposure Assessment Study: Design and Methods Validation of Personal, Indoor, and Outdoor Air Pollution Monitoring

The Windsor, Ontario Exposure Assessment Study evaluated the contribution of ambient air pollutants to personal and indoor exposures of adults and asthmatic children living in Windsor, Ontario, Canada. In addition, the role of personal, indoor, and outdoor air pollution exposures upon asthmatic children's respiratory health was assessed. Several active and passive sampling methods were applied, or adapted, for personal, indoor, and outdoor residential monitoring of nitrogen dioxide, volatile organic compounds, particulate matter (PM; PM ≤ 2.5 μm [PM_2.5] and ≤ 10 μm [PM₁₀] in aerodynamic diameter),elemental carbon, ultrafine particles, ozone, air exchange rates, allergens in settled dust, and particulate-associated metals. Participants completed five consecutive days of monitoring during the winter and summer of 2005 and 2006. During 2006, in addition to undertaking the air pollution measurements, asthmatic children completed respiratory health measurements (including peak flow meter tests and exhaled breath condensate) and tracked respiratory symptoms in a diary. Extensive quality assurance and quality control steps were implemented, including the collocation of instruments at the National Air Pollution Surveillance site operated by Environment Canada and at the Michigan Department of Environmental Quality site in Allen Park, Detroit, MI. During field sampling, duplicate and blank samples were also completed and these data are reported. In total, 50 adults and 51 asthmatic children were recruited to participate, resulting in 922 participant days of data. When comparing the methods used in the study with standard reference methods, field blanks were low and bias was acceptable, with most methods being within 20% of reference methods. Duplicates were typically within less than 10% of each other, indicating that study results can be used with confidence. This paper covers study design, recruitment, methodology, time activity diary, surveys, and quality assurance and control results for the different methods used. [Box: see text].

Windsor, Ontario Exposure Assessment Study: Design and Methods Validation of Personal, Indoor, and Outdoor Air Pollution Monitoring

The Windsor, Ontario Exposure Assessment Study evaluated the contribution of ambient air pollutants to personal and indoor exposures of adults and asthmatic children living in Windsor, Ontario, Canada. In addition, the role of personal, indoor, and outdoor air pollution exposures upon asthmatic children's respiratory health was assessed. Several active and passive sampling methods were applied, or adapted, for personal, indoor, and outdoor residential monitoring of nitrogen dioxide, volatile organic compounds, particulate matter (PM; PM ≤2.5 μm [PM_2.5] and ≤ 10 μm [PM₁₀] in aerodynamic diameter), elemental carbon, ultrafine particles, ozone, air exchange rates, allergens in settled dust, and particulate-associated metals. Participants completed five consecutive days of monitoring during the winter and summer of 2005 and 2006. During 2006, in addition to undertaking the air pollution measurements, asthmatic children completed respiratory health measurements (including peak flow meter tests and exhaled breath condensate) and tracked respiratory symptoms in a diary. Extensive quality assurance and quality control steps were implemented, including the collocation of instruments at the National Air Pollution Surveillance site operated by Environment Canada and at the Michigan Department of Environmental Quality site in Allen Park, Detroit, MI. During field sampling, duplicate and blank samples were also completed and these data are reported. In total, 50 adults and 51 asthmatic children were recruited to participate, resulting in 922 participant days of data. When comparing the methods used in the study with standard reference methods, field blanks were low and bias was acceptable, with most methods being within 20% of reference methods. Duplicates were typically within less than 10% of each other, indicating that study results can be used with confidence. This paper covers study design, recruitment, methodology, time activity diary, surveys, and quality assurance and control results for the different methods used. [Box: see text].

An air filter intervention study of endothelial function among healthy adults in a woodsmoke-impacted community

RATIONALE

Particulate air pollution is associated with cardiovascular morbidity. One hypothesized mechanism involves oxidative stress, systemic inflammation, and endothelial dysfunction.

OBJECTIVES

To assess an intervention's impact on particle exposures and endothelial function among healthy adults in a woodsmoke-impacted community. We also investigated the underlying role of oxidative stress and inflammation in relation to exposure reductions.

METHODS

Portable air filters were used in a randomized crossover intervention study of 45 healthy adults exposed to consecutive 7-day periods of filtered and nonfiltered air.

MEASUREMENTS AND MAIN RESULTS

Reactive hyperemia index was measured as an indicator of endothelial function via peripheral artery tonometry, and markers of inflammation (C-reactive protein, interleukin-6, and band cells) and lipid peroxidation (malondialdehyde and 8-iso-prostaglandin F(2α)) were quantified. Air filters reduced indoor fine particle concentrations by 60%. Filtration was associated with a 9.4% (95% confidence interval, 0.9-18%) increase in reactive hyperemia index and a 32.6% (4.4-60.9%) decrease in C-reactive protein. Decreases in particulate matter and the woodsmoke tracer levoglucosan were associated with reduced band cell counts. There was limited evidence of more pronounced effects on endothelial function and level of systemic inflammation among males, overweight participants, younger participants, and residents of wood-burning homes. No associations were noted for oxidative stress markers.

CONCLUSIONS

Air filtration was associated with improved endothelial function and decreased concentrations of inflammatory biomarkers but not markers of oxidative stress. Our results support the hypothesis that systemic inflammation and impaired endothelial function, both predictors of cardiovascular morbidity, can be favorably influenced by reducing indoor particle concentrations.

Validation of continuous particle monitors for personal, indoor, and outdoor exposures

Continuous monitors can be used to supplement traditional filter-based methods of determining personal exposure to air pollutants. They have the advantages of being able to identify nearby sources and detect temporal changes on a time scale of a few minutes. The Windsor Ontario Exposure Assessment Study (WOEAS) adopted an approach of using multiple continuous monitors to measure indoor, outdoor (near-residential) and personal exposures to PM₂.₅, ultrafine particles and black carbon. About 48 adults and households were sampled for five consecutive 24-h periods in summer and winter 2005, and another 48 asthmatic children for five consecutive 24-h periods in summer and winter 2006. This article addresses the laboratory and field validation of these continuous monitors. A companion article (Wheeler et al., 2010) provides similar analyses for the 24-h integrated methods, as well as providing an overview of the objectives and study design. The four continuous monitors were the DustTrak (Model 8520, TSI, St. Paul, MN, USA) and personal DataRAM (pDR) (ThermoScientific, Waltham, MA, USA) for PM₂.₅; the P-Trak (Model 8525, TSI) for ultrafine particles; and the Aethalometer (AE-42, Magee Scientific, Berkeley, CA, USA) for black carbon (BC). All monitors were tested in multiple co-location studies involving as many as 16 monitors of a given type to determine their limits of detection as well as bias and precision. The effect of concentration and electronic drift on bias and precision were determined from both the collocated studies and the full field study. The effect of rapid changes in environmental conditions on switching an instrument from indoor to outdoor sampling was also studied. The use of multiple instruments for outdoor sampling was valuable in identifying occasional poor performance by one instrument and in better determining local contributions to the spatial variation of particulate pollution. Both the DustTrak and pDR were shown to be in reasonable agreement (R² of 90 and 70%, respectively) with the gravimetric PM₂.₅ method. Both instruments had limits of detection of about 5 μg/m³. The DustTrak and pDR had multiplicative biases of about 2.5 and 1.6, respectively, compared with the gravimetric samplers. However, their average bias-corrected precisions were <10%, indicating that a proper correction for bias would bring them into very good agreement with standard methods. Although no standard methods exist to establish the bias of the Aethalometer and P-Trak, the precision was within 20% for the Aethalometer and within 10% for the P-Trak. These findings suggest that all four instruments can supply useful information in environmental studies.

From good intentions to proven interventions: effectiveness of actions to reduce the health impacts of air pollution

BACKGROUND

Associations between air pollution and a multitude of health effects are now well established. Given ubiquitous exposure to some level of air pollution, the attributable health burden can be high, particularly for susceptible populations.

OBJECTIVES

An international multidisciplinary workshop was convened to discuss evidence of the effectiveness of actions to reduce health impacts of air pollution at both the community and individual level. The overall aim was to summarize current knowledge regarding air pollution exposure and health impacts leading to public health recommendations.

DISCUSSION

During the workshop, experts reviewed the biological mechanisms of action of air pollution in the initiation and progression of disease, as well as the state of the science regarding community and individual-level interventions. The workshop highlighted strategies to reduce individual baseline risk of conditions associated with increased susceptibility to the effects of air pollution and the need to better understand the role of exposure duration in disease progression, reversal, and adaptation.

CONCLUSION

We have identified two promising and largely unexplored strategies to address and mitigate air pollution-related health impacts: reducing individual baseline risk of cardiovascular disease and incorporating air pollution-related health impacts into land-use decisions.

Fine particulate matter (PM₂.₅) air pollution and immune status among women in the Seattle area

Changes in immune status have been suggested as a possible biologic mechanism by which particulate matter (PM) air pollution could lead to adverse health effects. The authors studied associations between ambient PM₂.₅ and immune status among 115 postmenopausal, overweight women in the greater Seattle, Washington, area. The authors evaluated 3-day, 30-day, and 60-day average PM₂.₅ values in relation to inflammation markers (C-reactive protein, serum amyloid A, interleukin-6) and functional assays of cellular immunity (natural killer cell cytotoxicity, T-lymphocyte proliferation) at 3 time points for each woman during 1 year. Three-day averaged PM₂.₅ was inversely associated with anti-CD3-stimulated lymphocyte proliferation. There were no notable associations between the inflammation markers and PM₂.₅. If additional studies confirm our findings, then future health effect assessments for PM₂.₅ should consider changes in cellular immunity as an endpoint that may lead to overt clinical disease.

Exploring variation and predictors of residential fine particulate matter infiltration

Although individuals spend the majority of their time indoors, most epidemiological studies estimate personal air pollution exposures based on outdoor levels. This almost certainly results in exposure misclassification as pollutant infiltration varies between homes. However, it is often not possible to collect detailed measures of infiltration for individual homes in large-scale epidemiological studies and thus there is currently a need to develop models that can be used to predict these values. To address this need, we examined infiltration of fine particulate matter (PM(2.5)) and identified determinants of infiltration for 46 residential homes in Toronto, Canada. Infiltration was estimated using the indoor/outdoor sulphur ratio and information on hypothesized predictors of infiltration were collected using questionnaires and publicly available databases. Multiple linear regression was used to develop the models. Mean infiltration was 0.52 ± 0.21 with no significant difference across heating and non-heating seasons. Predictors of infiltration were air exchange, presence of central air conditioning, and forced air heating. These variables accounted for 38% of the variability in infiltration. Without air exchange, the model accounted for 26% of the variability. Effective modelling of infiltration in individual homes remains difficult, although key variables such as use of central air conditioning show potential as an easily attainable indicator of infiltration.

Indoor air pollution and asthma in children

The purpose of this article is to review indoor air pollution factors that can modify asthma severity, particularly in inner-city environments. While there is a large literature linking ambient air pollution and asthma morbidity, less is known about the impact of indoor air pollution on asthma. Concentrating on the indoor environments is particularly important for children, since they can spend as much as 90% of their time indoors. This review focuses on studies conducted by the Johns Hopkins Center for Childhood Asthma in the Urban Environment as well as other relevant epidemiologic studies. Analysis of exposure outcome relationships in the published literature demonstrates the importance of evaluating indoor home environmental air pollution sources as risk factors for asthma morbidity. Important indoor air pollution determinants of asthma morbidity in urban environments include particulate matter (particularly the coarse fraction), nitrogen dioxide, and airborne mouse allergen exposure. Avoidance of harmful environmental exposures is a key component of national and international guideline recommendations for management of asthma. This literature suggests that modifying the indoor environment to reduce particulate matter, NO(2), and mouse allergen may be an important asthma management strategy. More research documenting effectiveness of interventions to reduce those exposures and improve asthma outcomes is needed.

Relationships of outdoor and indoor ultrafine particles at residences downwind of a major international border crossing in Buffalo, NY

During winter 2006, indoor and outdoor ultrafine particle (UFP) size distribution measurements for particles with diameters from 5.6 to 165 nm were taken at five homes in a neighborhood directly adjacent to the Peace Bridge Complex (PBC), a major international border crossing connecting Buffalo, New York to Fort Erie, Ontario. Monitoring with 1-s time resolution was conducted for several hours at each home. Participants were instructed to keep all external windows and doors closed and to refrain from cooking, smoking, or other activity that may result in elevating the indoor UFP number concentration. Although the construction and age for the homes were similar, indoor-to-outdoor comparisons indicate that particle infiltration rates varied substantially. Overall, particle concentrations indoors were lower and less variable than particle concentrations outdoors, with average indoor-outdoor ratios ranging from 0.1 to 0.5 (mean 0.34) for particles between 5.6 and 165 nm in diameter. With no indoor sources, the average indoor-outdoor ratios were lowest (0.2) for 20-nm particles, higher (0.3) for particles <10 nm, and highest (0.5) for particles 70-165 nm.

PRACTICAL IMPLICATIONS

This study provides insight into the penetration of UFP into homes and the resulting change in particle size distributions as particles move indoors near a major diesel traffic source. Although people spend most of their time in their homes, exposure estimates for epidemiological studies are generally determined using ambient concentrations. The findings of this study will contribute to improved size-resolved UFP exposure estimates for near roadway exposure assessments and epidemiological studies.

Organic compound characterization and source apportionment of indoor and outdoor quasi-ultrafine particulate matter in retirement homes of the Los Angeles Basin

Quasi-ultrafine (quasi-UF) particulate matter (PM(0.25)) and its components were measured in indoor and outdoor environments at four retirement communities in Los Angeles Basin, California, as part of the Cardiovascular Health and Air Pollution Study (CHAPS). The present paper focuses on the characterization of the sources, organic constituents and indoor and outdoor relationships of quasi-UF PM. The average indoor/outdoor ratios of most of the measured polycyclic aromatic hydrocarbons (PAHs), hopanes, and steranes were close to or slightly lower than 1, and the corresponding indoor-outdoor correlation coefficients (R) were always positive and, for the most part, moderately strong (median R was 0.60 for PAHs and 0.74 for hopanes and steranes). This may reflect the possible impact of outdoor sources on indoor PAHs, hopanes, and steranes. Conversely, indoor n-alkanes and n-alkanoic acids were likely to be influenced by indoor sources. A chemical mass balance model was applied to both indoor and outdoor speciated chemical measurements of quasi-UF PM. Among all apportioned sources of both indoor and outdoor particles, vehicular emissions was the one contributing the most to the PM(0.25) mass concentration measured at all sites (24-47% on average).

PRACTICAL IMPLICATIONS

Although people (particularly the elderly retirees of our study) generally spend most of their time indoors, a major portion of the PM(0.25) particles they are exposed to comes from outdoor mobile sources. This is important because, an earlier investigation, also conducted within the Cardiovascular Health and Air Pollution Study (CHAPS), showed that indoor-infiltrated particles from mobile sources are more strongly correlated with adverse health effects observed in the elderly subjects living in the studied retirement communities compared with other particles found indoors (Delfino et al., 2008).

Modeling residential fine particulate matter infiltration for exposure assessment

Individuals spend the majority of their time indoors; therefore, estimating infiltration of outdoor-generated fine particulate matter (PM(2.5)) can help reduce exposure misclassification in epidemiological studies. As indoor measurements in individual homes are not feasible in large epidemiological studies, we evaluated the potential of using readily available data to predict infiltration of ambient PM(2.5) into residences. Indoor and outdoor light scattering measurements were collected for 84 homes in Seattle, Washington, USA, and Victoria, British Columbia, Canada, to estimate residential infiltration efficiencies. Meteorological variables and spatial property assessment data (SPAD), containing detailed housing characteristics for individual residences, were compiled for both study areas using a geographic information system. Multiple linear regression was used to construct models of infiltration based on these data. Heating (October to February) and non-heating (March to September) season accounted for 36% of the yearly variation in detached residential infiltration. Two SPAD housing characteristic variables, low building value, and heating with forced air, predicted 37% of the variation found between detached residential infiltration during the heating season. The final model, incorporating temperature and the two SPAD housing characteristic variables, with a seasonal interaction term, explained 54% of detached residential infiltration. Residences with low building values had higher infiltration efficiencies than other residences, which could lead to greater exposure gradients between low and high socioeconomic status individuals than previously identified using only ambient PM(2.5) concentrations. This modeling approach holds promise for incorporating infiltration efficiencies into large epidemiology studies, thereby reducing exposure misclassification.

Approach to estimating participant pollutant exposures in the Multi-Ethnic Study of Atherosclerosis and Air Pollution (MESA Air)

Most published epidemiology studies of long-term air pollution health effects have relied on central site monitoring to investigate regional-scale differences in exposure. Few cohort studies have had sufficient data to characterize localized variations in pollution, despite the fact that large gradients can exist over small spatial scales. Similarly, previous data have generally been limited to measurements of particle mass or several of the criteria gases. The Multi-Ethnic Study of Atherosclerosis and Air Pollution (MESA Air) is an innovative investigation undertaken to link subclinical and clinical cardiovascular health effects with individual-level estimates of personal exposure to ambient-origin pollution. This project improves on prior work by implementing an extensive exposure assessment program to characterize long-term average concentrations of ambient-generated PM2.5, specific PM2.5 chemical components, and copollutants, with particular emphasis on capturing concentration gradients within cities. This paper describes exposure assessment in MESA Air, including questionnaires, community sampling, home monitoring, and personal sampling. Summary statistics describing the performance of the sampling methods are presented along with descriptive statistics of the air pollution concentrations by city.

In-home particle concentrations and childhood asthma morbidity

BACKGROUND

Although outdoor particulate matter (PM) has been linked to mortality and asthma morbidity, the impact of indoor PM on asthma has not been well established.

OBJECTIVE

This study was designed to investigate the effect of in-home PM on asthma morbidity.

METHODS

For a cohort of 150 asthmatic children (2-6 years of age) from Baltimore, Maryland, a technician deployed environmental monitoring equipment in the children's bedrooms for 3-day intervals at baseline and at 3 and 6 months. Caregivers completed questionnaires and daily diaries during air sampling. Longitudinal data analyses included regression models with generalized estimating equations.

RESULTS

Children were primarily African Americans (91%) from lower socioeconomic backgrounds and spent most of their time in the home. Mean (+/- SD) indoor PM(2.5-10) (PM with aerodynamic diameter 2.5-10 microm) and PM(2.5) (aerodynamic diameter < 2.5 microm) concentrations were 17.4 +/- 21.0 and 40.3 +/- 35.4 microg/m(3). In adjusted models, 10-microg/m(3) increases in indoor PM(2.5-10) and PM(2.5) were associated with increased incidences of asthma symptoms: 6% [95% confidence interval (CI), 1 to 12%] and 3% (95% CI, -1 to 7%), respectively; symptoms causing children to slow down: 8% (95% CI, 2 to 14%) and 4% (95% CI, 0 to 9%), respectively; nocturnal symptoms: 8% (95% CI, 1 to 14%) and 6% (95% CI, 1 to 10%), respectively; wheezing that limited speech: 11% (95% CI, 3 to 19%) and 7% (95% CI, 0 to 14%), respectively; and use of rescue medication: 6% (95% CI, 1 to 10%) and 4% (95% CI, 1 to 8%), respectively. Increases of 10 microg/m(3) in indoor and ambient PM(2.5) were associated with 7% (95% CI, 2 to 11%) and 26% (95% CI, 1 to 52%) increases in exercise-related symptoms, respectively.

CONCLUSIONS

Among preschool asthmatic children in Baltimore, increases in in-home PM(2.5-10) and PM(2.5) were associated with respiratory symptoms and rescue medication use. Increases in in-home and ambient PM(2.5) were associated with exercise-related symptoms. Although reducing PM outdoors may decrease asthma morbidity, reducing PM indoors, especially in homes of inner-city children, may lead to improved asthma health.

Predicting Airborne Particle Levels Aboard Washington State School Buses

School buses contribute substantially to childhood air pollution exposures yet they are rarely quantified in epidemiology studies. This paper characterizes fine particulate matter (PM(2.5)) aboard school buses as part of a larger study examining the respiratory health impacts of emission-reducing retrofits.To assess onboard concentrations, continuous PM(2.5) data were collected during 85 trips aboard 43 school buses during normal driving routines, and aboard hybrid lead vehicles traveling in front of the monitored buses during 46 trips. Ordinary and partial least square regression models for PM(2.5) onboard buses were created with and without control for roadway concentrations, which were also modeled. Predictors examined included ambient PM(2.5) levels, ambient weather, and bus and route characteristics.Concentrations aboard school buses (21 mug/m(3)) were four and two-times higher than ambient and roadway levels, respectively. Differences in PM(2.5) levels between the buses and lead vehicles indicated an average of 7 mug/m(3) originating from the bus's own emission sources. While roadway concentrations were dominated by ambient PM(2.5), bus concentrations were influenced by bus age, diesel oxidative catalysts, and roadway concentrations. Cross validation confirmed the roadway models but the bus models were less robust.These results confirm that children are exposed to air pollution from the bus and other roadway traffic while riding school buses. In-cabin air pollution is higher than roadway concentrations and is likely influenced by bus characteristics.

Infiltration of forest fire and residential wood smoke: an evaluation of air cleaner effectiveness

Communities impacted by fine-particle air pollution (particles with an aerodynamic diameter less than 2.5 microm; PM(2.5)) from forest fires and residential wood burning require effective, evidence-based exposure-reduction strategies. Public health recommendations during smoke episodes typically include advising community members to remain indoors and the use of air cleaners, yet little information is available on the effectiveness of these measures. Our study attempted to address the following objectives: to measure indoor infiltration factor (F(inf)) of PM(2.5) from forest fires/wood smoke, to determine the effectiveness of high-efficiency particulate air (HEPA) filter air cleaners in reducing indoor PM(2.5), and to analyze the home determinants of F(inf) and air cleaner effectiveness (ACE). We collected indoor/outdoor 1-min PM(2.5) averages and 48-h outdoor PM(2.5) filter samples for 21 winter and 17 summer homes impacted by wood burning and forest fire smoke, respectively, during 2004-2005. A portable HEPA filter air cleaner was operated indoors with the filter removed for one of two sampling days. Particle F(inf) and ACE were calculated for each home using a recursive model. We found mean F(inf)+/-SD was 0.27+/-0.18 and 0.61+/-0.27 in winter (n=19) and summer (n=13), respectively, for days when HEPA filters were not used. Lower F(inf)+/-SD values of 0.10+/-0.08 and 0.19+/-0.20 were found on corresponding days when HEPA filters were in place. Mean+/-SD ACE ([F(inf) without filter-F(inf) with filter]/F(inf) without filter) in winter and summer were 55+/-38% and 65+/-35%, respectively. Number of windows and season predicted F(inf) (P<0.001). No significant predictors of ACE were identified. Our findings show that remaining indoors combined with use of air cleaner can effectively reduce PM(2.5) exposure during forest fires and residential wood burning.

Changes in lung function and airway inflammation among asthmatic children residing in a woodsmoke-impacted urban area

Fine particulate matter (PM(2.5)) is associated with respiratory effects, and asthmatic children are especially sensitive. Preliminary evidence suggests that combustion-derived particles play an important role. Our objective was to evaluate effect estimates from different PM(2.5) exposure metrics in relation to airway inflammation and lung function among children residing in woodsmoke-impacted areas of Seattle. Nineteen children (ages 6-13 yr) with asthma were monitored during the heating season. We measured 24-h outdoor and personal concentrations of PM(2.5) and light-absorbing carbon (LAC). Levoglucosan (LG), a marker of woodsmoke, was also measured outdoors. We partitioned PM(2.5) exposure into its ambient-generated (E(ag)) and nonambient (E(na)) components. These exposure metrics were evaluated in relation to daily changes in exhaled nitric oxide (FE(NO)), a marker of airway inflammation, and four lung function measures: midexpiratory flow (MEF), peak expiratory flow (PEF), forced expiratory volume in the first second (FEV(1)), and forced vital capacity (FVC). E(ag), but not E(na), was correlated with combustion markers. Significant associations with respiratory health were seen only among participants not using inhaled corticosteroids. Increases in FE(NO) were associated with personal PM(2.5), personal LAC, and E(ag) but not with ambient PM(2.5) or its combustion markers. In contrast, MEF and PEF decrements were associated with ambient PM(2.5), its combustion markers, and E(ag), but not with personal PM(2.5) or personal LAC. FEV(1) was associated only with ambient LG. Our results suggest that lung function may be especially sensitive to the combustion-generated component of ambient PM(2.5), whereas airway inflammation may be more closely related to some other constituent of the ambient PM(2.5) mixture.

Characterization of fine particulate matter in Ohio: indoor, outdoor, and personal exposures

Ambient, indoor, and personal PM2.5 concentrations were assessed based on an exhaustive study of PM2.5 performed in Ohio from 1999 to 2000. Locations in Columbus, one in an urban corridor and the other in a suburban area were involved. A third rural location in Athens, Ohio, was also established. At all three locations, elementary schools were utilized to determine outdoor, indoor, and personal PM2.5 concentrations for fourth and fifth grade students using filter-based measurements. Three groups of 30 students each were used for personal sampling at each school. Continuous ambient PM2.5 mass concentrations were also measured with tapered element oscillating microbalances (TEOMs). At all three sites, personal and indoor PM2.5 concentrations exceeded outdoor levels. This trend is consistent on all week days and most evident in the spring as compared to fall and winter. The ambient PM2.5 concentrations were similar among the three sites, suggesting the existence of a common regional source influence. At all the three sites, larger variations were found in personal and indoor PM2.5 than ambient levels. The strongest correlations were found between indoor and personal concentrations, indicating that personal PM2.5 exposures were significantly affected by indoor PM2.5 than by ambient PM2.5. This was further confirmed by the indoor to outdoor (I/O) ratios of PM2.5 concentrations, which were greater when school was in session than non-school days when the students were absent.

Evaluation of the recursive model approach for estimating particulate matter infiltration efficiencies using continuous light scattering data

Quantifying particulate matter (PM) infiltration efficiencies (F(inf)) in individual homes is an important part of PM exposure assessment because individuals spend the majority of time indoors. While F(inf) of fine PM has most commonly been estimated using tracer species such as sulfur, here we evaluate an alternative that does not require particle collection, weighing and compositional analysis, and can be applied in situations with indoor sources of sulfur, such as environmental tobacco smoke, gas pilot lights, and humidifier use. This alternative method involves applying a recursive mass balance model (recursive model, RM) to continuous indoor and outdoor concentration measurements (e.g., light scattering data from nephelometers). We show that the RM can reliably estimate F(inf), a crucial parameter for determining exposure to particles of outdoor origin. The RM F(inf) estimates showed good agreement with the conventional filter-based sulfur tracer approach. Our simulation results suggest that the RM F(inf) estimates are minimally impacted by measurement error. In addition, the average light scattering response per unit mass concentration was greater indoors than outdoors; after correcting for differences in light scattering response the median deviation from sulfur F(inf) was reduced from 15 to 11%. Thus, we have verified the RM applied to light scattering data. We show that the RM method is unable to provide satisfactory estimates of the individual components of F(inf) (penetration efficiency, air exchange rate, and deposition rate). However, this approach may allow F(inf) to be estimated in more residences, including those with indoor sources of sulfur. We show that individual homes vary in their infiltration efficiencies, thereby contributing to exposure misclassification in epidemiological studies that assign exposures using ambient monitoring data. This variation across homes indicates the need for home-specific estimation methods, such as the RM or sulfur tracer, instead of techniques that give average estimates of infiltration across homes.

Kinetic analysis of competition between aerosol particle removal and generation by ionization air purifiers

Ionization air purifiers are increasingly used to remove aerosol particles from indoor air. However, certain ionization air purifiers also emit ozone. Reactions between the emitted ozone and unsaturated volatile organic compounds (VOC) commonly found in indoor air produce additional respirable aerosol particles in the ultrafine (<0.1 microm) and fine (<2.5 microm) size domains. A simple kinetic model is used to analyze the competition between the removal and generation of particulate matter by ionization air purifiers under conditions of a typical residential building. This model predicts that certain widely used ionization air purifiers may actually increase the mass concentration of fine and ultrafine particulates in the presence of common unsaturated VOC, such as limonene contained in many household cleaning products. This prediction is supported by an explicit observation of ultrafine particle nucleation events caused by the addition of D-limonene to a ventilated office room equipped with a common ionization air purifier.

Woodsmoke health effects: a review

The sentiment that woodsmoke, being a natural substance, must be benign to humans is still sometimes heard. It is now well established, however, that wood-burning stoves and fireplaces as well as wildland and agricultural fires emit significant quantities of known health-damaging pollutants, including several carcinogenic compounds. Two of the principal gaseous pollutants in woodsmoke, CO and NOx, add to the atmospheric levels of these regulated gases emitted by other combustion sources. Health impacts of exposures to these gases and some of the other woodsmoke constituents (e.g., benzene) are well characterized in thousands of publications. As these gases are indistinguishable no matter where they come from, there is no urgent need to examine their particular health implications in woodsmoke. With this as the backdrop, this review approaches the issue of why woodsmoke may be a special case requiring separate health evaluation through two questions. The first question we address is whether woodsmoke should be regulated and/or managed separately, even though some of its separate constituents are already regulated in many jurisdictions. The second question we address is whether woodsmoke particles pose different levels of risk than other ambient particles of similar size. To address these two key questions, we examine several topics: the chemical and physical nature of woodsmoke; the exposures and epidemiology of smoke from wildland fires and agricultural burning, and related controlled human laboratory exposures to biomass smoke; the epidemiology of outdoor and indoor woodsmoke exposures from residential woodburning in developed countries; and the toxicology of woodsmoke, based on animal exposures and laboratory tests. In addition, a short summary of the exposures and health effects of biomass smoke in developing countries is provided as an additional line of evidence. In the concluding section, we return to the two key issues above to summarize (1) what is currently known about the health effects of inhaled woodsmoke at exposure levels experienced in developed countries, and (2) whether there exists sufficient reason to believe that woodsmoke particles are sufficiently different to warrant separate treatment from other regulated particles. In addition, we provide recommendations for additional woodsmoke research.

Effect of particulate air pollution on lung function in adult and pediatric subjects in a Seattle panel study

STUDY OBJECTIVE

To determine whether increased exposure to particulate matter air pollution (PM), measured with personal, residential, or central site monitoring, was associated with pulmonary function decrements in either adults with COPD or children with asthma.

PARTICIPANTS

We studied 57 adults with or without COPD and 17 children aged 6 to 13 years with physician-diagnosed asthma in Seattle during a 3-year panel study.

STUDY DESIGN AND MEASUREMENTS

Indoor and outdoor PM measurements were made at subjects' homes. The subjects wore personal exposure monitors for 10 consecutive 24-h periods, and PM was also measured at a central outdoor location. We assessed the within-subject effect of particulate exposure on FEV(1) and peak expiratory flow (PEF) in adults, and maximal midexpiratory flow (MMEF), PEF, FEV(1), and symptoms in children.

RESULTS

FEV(1) decrements were associated with 1-day lagged central site PM </= 2.5 microm in diameter (PM(2.5)) in adult subjects with COPD. In children not receiving antiinflammatory medication, same day indoor, outdoor, and central site exposures to PM(2.5) were associated with decrements in MMEF, PEF, and FEV(1). Associations with PM(2.5) and lung function decrements were also observed for 1-day lagged indoor (MMEF, PEF, FEV(1)) and personal (PEF only) exposures. Antiinflammatory medication use in children significantly attenuated the PM effect on airflow rates and volumes.

CONCLUSIONS

This study found consistent decrements in MMEF in children with asthma who were not receiving medications. It is notable that effects were observed even though PM exposures were low for an urban area. These findings suggest the need for future larger studies of PM effects in this susceptible population that repeatedly measure spirometry to include MMEF and potentially more sensitive markers of airway inflammation such as exhaled breath condensate and exhaled nitric oxide.

Exposure time and place: do COPD patients differ from the general population?

Time-activity patterns in a panel of 70 patients with COPD (35 males) are compared to an age-matched subgroup from the randomly sampled Canadian Human Activity Pattern Survey. Total time indoors and outdoors were similar in both groups but significantly more indoor time in COPD subjects was spent at home than the indoor time of controls, who were more often indoors elsewhere. As part of improving their indoor air at home, COPD subjects were significantly more likely to have air conditioning at home. These results suggest that while outdoor air exposure strategies need not differ in COPD subjects from normals, indoor mitigation strategies should emphasize source pollutant control in the patient's home.

Distributions of PM2.5 source strengths for cooking from the Research Triangle Park particulate matter panel study

Emission rates, decay rates, and cooking durations are reported from continuous PM2.5 (particulate matter less than 2.5 microm) concentrations measured using personal DataRam nephelometers (1-min time resolution) from the Research Triangle Park (RTP) PM panel study. The study (n = 37 participants) included monitoring for 7 consecutive days in each of four consecutive seasons (summer 2000 through spring 2001). Cooking episodes (n = 411) were selected using time-activity diaries and criteria for cooking event duration, peak concentration level, and decay curve quality. Averaged across all cooking events, mean source strengths were 36 mg/min (median = 12 mg/min), mean decay rates were 0.27 h(-1) (0.17 h(-1)), and mean cooking durations were 11 min (7 min). Cooking events were further separated into one of seven categories representing cooking method: burned food (oven cooking, toaster, or stovetop cooking), grilling, microwave, toaster oven, frying, oven cooking, and stovetop cooking. The highest mean source strengths were identified from burned food (mean = 470 mg/min), grilling (173 mg/min), and frying (60 mg/ min); differences between both burned food and grilling compared with all remaining cooking methods were statistically significant. Source strengths, decay rates, and cooking durations were also compared by season and typical meal times (8:00 a.m., 12:00 p.m., and 6:00 p.m.); differences were generally not statistically significant for these cases. Mean source strengths using electric appliances were typically a factor of 2 greater than those using gas appliances for identical cooking methods (frying, oven cooking, or stovetop cooking), although in all cases the difference was not statistically significant. Distributions of source strengths and decay rates for cooking events were also compared among study subjects to assess both within- and between-subject variability. Each subject's distribution of source strengths during the study tended to be either lower than the overall study average (and with lower variability) or higher than the overall study average (and with higher variability). No relationships could be found between source strength and either subject characteristics (age, gender, employment status) or home characteristic (daily air exchange rate). The large number of cooking events and the broad range of cooking activities included in this analysis makes the reported distributions of PM2.5 source strengths useful for probabilistic exposure modeling even though the study population was limited.

Fine particulate air pollution and cardiorespiratory effects in the elderly

BACKGROUND

Past studies of air pollution effects among sensitive subgroups have produced inconsistent results. Our objective was to determine relationships between various measures of air pollution and cardiorespiratory effects in older subjects.

METHODS

We conducted a study that included repeated measurements of pulmonary function (arterial oxygen saturation) and cardiac function (heart rate and blood pressure) in a panel of 88 subjects (>57 years of age) in Seattle during the years 1999 to 2001. Subjects were healthy or had lung or heart disease. Each subject participated in sessions of 10 consecutive days of exposure monitoring and collection of health outcomes for up to 2 sessions. Associations between health outcomes and indoor, outdoor, and personal measures of particulate matter </=2.5 micrometers (PM2.5) or particulate matter </=10 micrometers (PM10) were evaluated using generalized estimating equations with an exchangeable working correlation matrix and robust standard errors. The model included terms for the within-subject, within-session effect; the within- subject, between-session effect; and an interaction term for medication usage. The model controlled for temperature, relative humidity, body mass index, and age.

RESULTS

Associations between air pollution and health measurements were found primarily in healthy subjects. Healthy subjects taking no medications had decreases in heart rate associated with indoor and outdoor PM2.5 and PM10. Healthy subjects on medication had small increases in systolic blood pressure associated with indoor PM2.5 and outdoor PM10. Heterogeneity analysis found differences among the health groups for associations with particulate air pollution in heart rate but not in blood pressure.

CONCLUSION

Modest concentrations of air pollutants were associated with small changes in cardiac function.

Exposure and measurement contributions to estimates of acute air pollution effects

Air pollution health effect studies are intended to estimate the effect of a pollutant on a health outcome. The definition of this effect depends upon the study design, disease model parameterization, and the type of analysis. Further limitations are imposed by the nature of exposure and our ability to measure it. We define a plausible exposure model for air pollutants that are relatively nonreactive and discuss how exposure varies. We discuss plausible disease models and show how their parameterizations are affected by different exposure partitions and by different study designs. We then discuss a measurement model conditional on ambient concentrations and incorporate this into the disease model. We use simulation studies to show the impact of a range of exposure model assumptions on estimation of the health effect in the ecologic time series design. This design only uses information from the time-varying ambient source exposure. When ambient and nonambient sources are independent, exposure variation due to nonambient source exposures behaves like Berkson measurement error and does not bias the effect estimates. Variation in the population attenuation of ambient concentrations over time does bias the estimates with the bias being either positive or negative depending upon the association of this parameter with ambient pollution. It is not realistic to substitute measured average personal exposures into time series studies because so much of the variation in personal exposures comes from nonambient sources that do not contribute information in the time series design. We conclude that general statements about the implications of measurement error need to be conditioned on the health effect study design and the health effect parameter to be estimated.

Indoor/outdoor relationships for PM2.5 and associated carbonaceous pollutants at residential homes in Hong Kong - case study

Six residences were selected (two roadside, two urban, and two rural) to evaluate the indoor-outdoor characteristics of PM(2.5) (aerodynamic diameter <2.5 microm) carbonaceous species in Hong Kong during March and April 2004. Twenty-minute-averaged indoor and outdoor PM(2.5) concentrations were recorded by DustTrak samplers simultaneously at each site for 3 days to examine diurnal variability of PM(2.5) mass concentrations and their indoor-to-outdoor (I/O) ratios. Daily (24-h average) indoor/outdoor PM(2.5) samples were collected on pre-fired quartz-fiber filters with battery-powered portable mini-volume samplers and analyzed for organic and elemental carbon (OC, EC) by thermal/optical reflectance (TOR) following the Interagency Monitoring of Protected Visual Environments (IMPROVE) protocol. The average indoor and outdoor concentrations of 24 h PM(2.5) were 56.7 and 43.8 microg/m(3), respectively. The short-term PM(2.5) profiles indicated that the penetration of outdoor particles was an important contributor to indoor PM(2.5), and a household survey indicated that daily activities were also sources of episodic peaks in indoor PM(2.5). The average indoor OC and EC concentrations of 17.1 and 2.8 microg/m(3), respectively, accounted for an average of 29.5 and 5.2%, respectively, of indoor PM(2.5) mass. The average indoor OC/EC ratios were 5.8, 9.1, and 5.0 in roadside, urban, and rural areas, respectively; while average outdoor OC/EC ratios were 4.0, 4.3, and 4.0, respectively. The average I/O ratios of 24 h PM(2.5), OC, and EC were 1.4, 1.8, and 1.2, respectively. High indoor-outdoor correlations (r(2)) were found for PM(2.5) EC (0.96) and mass (0.81), and low correlations were found for OC (0.55), indicative of different organic carbon sources indoors. A simple model implied that about two-thirds of carbonaceous particles in indoor air are originated from outdoor sources.

PRACTICAL IMPLICATIONS

Indoor particulate pollution has received more attentions in Asia. This study presents a case study regarding the fine particulate matter and its carbonaceous compositions at six residential homes in Hong Kong. The characteristics and relationship of atmospheric organic and elemental carbon were discussed indoors and outdoors. The distribution of eight carbon fractions was first reported in indoor samples to interpret potential sources of indoor carbonaceous particles. The data set can provide significant scientific basis for indoor air quality and epidemiology study in Hong Kong and China.

Pulmonary effects of indoor- and outdoor-generated particles in children with asthma

Most particulate matter (PM) health effects studies use outdoor (ambient) PM as a surrogate for personal exposure. However, people spend most of their time indoors exposed to a combination of indoor-generated particles and ambient particles that have infiltrated. Thus, it is important to investigate the differential health effects of indoor- and ambient-generated particles. We combined our recently adapted recursive model and a predictive model for estimating infiltration efficiency to separate personal exposure (E) to PM2.5 (PM with aerodynamic diameter < or = 2.5 microm) into its indoor-generated (Eig) and ambient-generated (Eag) components for 19 children with asthma. We then compared Eig and Eag to changes in exhaled nitric oxide (eNO), a marker of airway inflammation. Based on the recursive model with a sample size of eight children, Eag was marginally associated with increases in eNO [5.6 ppb per 10-microg/m3 increase in PM2.5; 95% confidence interval (CI), -0.6 to 11.9; p = 0.08]. Eig was not associated with eNO (-0.19 ppb change per 10 microg/m3). Our predictive model allowed us to estimate Eag and Eig for all 19 children. For those combined estimates, only Eag was significantly associated with an increase in eNO (Eag: 5.0 ppb per 10-microg/m3 increase in PM2.5; 95% CI, 0.3 to 9.7; p = 0.04; Eig: 3.3 ppb per 10-microg/m3 increase in PM2.5; 95% CI, -1.1 to 7.7; p = 0.15). Effects were seen only in children who were not using corticosteroid therapy. We conclude that the ambient-generated component of PM2.5 exposure is consistently associated with increases in eNO and the indoor-generated component is less strongly associated with eNO.

Use of personal-indoor-outdoor sulfur concentrations to estimate the infiltration factor and outdoor exposure factor for individual homes and persons

A study of personal, indoor, and outdoor exposure to PM2.5 and associated elements has been carried out for 37 residents of the Research Triangle Park area in North Carolina. Participants were selected from persons expected to be at elevated risk from exposure to particles, and included 29 persons with hypertension and 8 cardiac patients with implanted defibrillators. Participants were monitored for 7 consecutive days in each of four seasons. One goal of the study was to estimate the contribution of outdoor PM2.5 to indoor concentrations. This depends on the infiltration factor Finf, the fraction of outdoor PM2.5 remaining airborne after penetrating indoors. After confirming with our measurements the findings of previous studies that sulfur has few indoor sources, we estimated an average Finf for each house based on indoor/outdoor sulfur ratios. These estimates ranged from 0.26 to 0.87, with a median value of 0.55. Since these estimates apply only to particles of size similar to that of sulfur particles (0.06-0.5 microm diameter), and since larger particles (0.5-2.5 microm) have lower penetration rates and higher deposition rates, these estimates are likely to be higher than the true infiltration factors for PM2.5 as a whole. In summer when air conditioners were in use, the sulfur-based infiltration factor was at its lowest (averaging 0.50) for most homes, whereas the average Finf for the other three seasons was 0.62-0.63. Using the daily estimated infiltration factor for each house, we calculated the contribution of outdoor PM2.5 to indoor air concentrations. The indoor-generated contributions to indoor PM2.5 had a wider range (0-33 microg/m3) than the outdoor contributions (5-22 microg/m3). However, outdoor contributions exceeded the indoor-generated contributions in 27 of 36 homes. A second goal of the study was to determine the contribution of outdoor particles to personal exposure. This is determined by the "outdoor exposure factor" Fpex, the fraction of outdoor PM2.5 contributing to personal exposure. As with Finf, we estimated Fpex by the personal/outdoor sulfur ratios. The estimates ranged from 0.33 to 0.77 with a median value of 0.53. Outdoor air particles were less important for personal exposures than for indoor concentrations, with the median outdoor contribution to personal exposure just 49%. We regressed the outdoor contributions to personal exposures on measured outdoor PM2.5 at the central site. The regressions had R2 values ranging from 0.19 to 0.88 (median = 0.73). These values provide an indication of the extent of misclassification error in epidemiological estimates of the effect of outdoor particles on health.

Indoor and outdoor polycyclic aromatic hydrocarbons in residences surrounding a Söderberg aluminum smelter in Canada

Ambient air in 18 residences surrounding an aluminum smelter were sampled to study the relationship between indoor and outdoor polycyclic aromatic hydrocarbons (PAHs). Objectives of the study were to quantify the indoor distribution of PAHs, indoor/outdoor (I/O) concentration ratios, and the relationship among PAH compounds. Correlation coefficients inside residences suggested an indoor source of 2-3 ring PAHs and an external source of 4-6 ring PAHs. The I/O ratios of 4-6 ring PAHs for homes without any substantial indoor sources were below unity, indicating that the presence of these PAHs was attributable to the aluminum smelter. Least squares linear regression of the coupled measurements without indoor sources of 5-6 ring PAHs resulted in average infiltration efficiencies (P(PAH)) of 0.49, 0.20, and 0.47 for benzo[a]pyrene, benzo[k]fluoranthene, and benzo[g,h,i]perylene, respectively. These P(PAH) values suggest that simultaneous measurements of indoor and outdoor concentrations of PAHs > 4 rings predominantly associated with the fine fraction of particulate matter could provide useful estimates of particle infiltration efficiency. Overall, study results indicate that when an industrial facility is the main source of outdoor 4-6 ring PAHs, the contribution of facility emissions may greatly exceed indoor sources in nonsmoking residences.