Domestic exposure to formaldehyde significantly increases the risk of asthma in young children

Views of general practitioners on indoor environmental health risks in the perinatal period

BACKGROUND

Home is generally perceived as a safety place, whereas the concentration of pollutants, influenced not only by external pollution but also by human activities, the presence of domestic animals, construction and furniture materials, are sometimes greater than outside.

OBJECTIVES

The aim of this study is to determine the general practitioners' (GPs) views on indoor environmental health risks in the perinatal period.

METHODS

Four semi-structured focus group with 31 GPs were conducted in two French departments in November 2009, February, March, and April 2010. The focus group meetings were analyzed using a general thematic analysis.

RESULTS

Perinatal care is a special health issue and a time of privileged sensitization. The attitude of health risks are well known in the case of "traditionally" toxic substances. In the case of "emerging" environmental exposure, these attitudes depend on the knowledge, beliefs, and experience specific to each practitioner. GPs are acquiring a new role in the field of environmental health, while at the same time coming to grips with its own strengths and limitations. The implementation of prevention depends on factors, which are not only specific to the practitioner but also related to the parents and the organization of the medical practice.

CONCLUSION

The sensitization of GPs to environmental medicine, promotion of eco-citizen education, development of research, and the distribution of information are some of the means which need to be implemented to prevent harmful exposure of the infant.

Exposure to indoor pollutants and Wheeze and asthma development during early childhood

Background: This review aimed to summarize existing epidemiological evidence of the association between quantitative estimates of indoor air pollution with early childhood respiratory disease. Methods: We carried out a systematic literature search of peer-reviewed epidemiological studies undertaken in “westernized” countries that have assessed exposure to indoor pollutants and asthma and wheeze from infancy up to the age of 5. Results: The search, between January 2004 and February 2014 yielded 1840 studies for consideration. Following application of eligibility criteria to titles and abstracts 22 independent studies were deemed relevant for further review. Two additional studies were next identified through examination of the references’ lists of these studies. Of these 24 selected studies, 16 adopted a prospective cohort design and 8 were case-control studies. Fourteen studies assessed exposure to bio-aerosols, 8 studies assessed exposure to specific air chemicals and two studies assessed exposure to bio-aerosols and air chemicals. Furthermore, 11 studies examined the association of exposure with asthma and 16 with wheeze. Findings indicate that existing studies have reported contradictory effects of indoor pollutants levels and occurrence of asthma/wheeze. Conclusion: Additional research to establish causality and evaluate interventions to prevent disease onset is needed.

A systematic review of associations between environmental exposures and development of asthma in children aged up to 9 years

OBJECTIVES

Childhood asthma is a complex condition where many environmental factors are implicated in causation. The aim of this study was to complete a systematic review of the literature describing associations between environmental exposures and the development of asthma in young children.

SETTING

A systematic review of the literature up to November 2013 was conducted using key words agreed by the research team. Abstracts were screened and potentially eligible papers reviewed. Papers describing associations between exposures and exacerbation of pre-existing asthma were not included. Papers were placed into the following predefined categories: secondhand smoke (SHS), inhaled chemicals, damp housing/mould, inhaled allergens, air pollution, domestic combustion, dietary exposures, respiratory virus infection and medications.

PARTICIPANTS

Children aged up to 9 years.

PRIMARY OUTCOMES

Diagnosed asthma and wheeze.

RESULTS

14,691 abstracts were identified, 207 papers reviewed and 135 included in the present review of which 15 were systematic reviews, 6 were meta-analyses and 14 were intervention studies. There was consistent evidence linking exposures to SHS, inhaled chemicals, mould, ambient air pollutants, some deficiencies in maternal diet and respiratory viruses to an increased risk for asthma (OR typically increased by 1.5-2.0). There was less consistent evidence linking exposures to pets, breast feeding and infant dietary exposures to asthma risk, and although there were consistent associations between exposures to antibiotics and paracetamol in early life, these associations might reflect reverse causation. There was good evidence that exposures to house dust mites (in isolation) was not associated with asthma risk. Evidence from observational and intervention studies suggest that interactions between exposures were important to asthma causation, where the effect size was typically 1.5-3.0.

CONCLUSIONS

There are many publications reporting associations between environmental exposures and modest changes in risk for asthma in young children, and this review highlights the complex interactions between exposures that further increase risk.

Domestic exposure to volatile organic compounds in relation to asthma and allergy in children and adults

Over the past decades, the prevalence of asthma, allergic disease and atopy has increased significantly and in parallel with the increased use of products and materials emitting volatile organic compounds (VOCs) in the indoor environment. The purpose of this review is to examine the evidence of the relationship between quantitatively measured domestic exposure to VOCs and allergic diseases and allergy in children and adults. Sources, potential immune-inflammatory mechanisms and risks for development and severity of asthma and allergy have been addressed. Available evidence is based on studies that have mainly used observational designs of variable quality. Total, aromatic, aliphatic, microbial VOCs and aldehydes have been the most widely investigated VOC classes, with formaldehyde being the most commonly examined single compound. Overall, the evidence is inadequate to draw any firm conclusions. However, given indicative evidence from a few high-quality studies and significant potential for improvements in asthma outcomes in those with established disease, there is a need to consider undertaking further investigation of the relationship between domestic VOC exposure and asthma/allergy outcomes that should encompass both high-quality, robust observational studies and ultimately clinical trials assessing the impact of interventions that aim to reduce VOC exposure in children and adults with asthma.

The microenvironmental modelling approach to assess children's exposure to air pollution - A review

Exposures to a wide spectrum of air pollutants were associated to several effects on children's health. Exposure assessment can be used to establish where and how air pollutants' exposures occur. However, a realistic estimation of children's exposures to air pollution is usually a great ethics challenge, especially for young children, because they cannot intentionally be exposed to contaminants and according to Helsinki declaration, they are not old enough to make a decision on their participation. Additionally, using adult surrogates introduces bias, since time-space-activity patterns are different from those of children. From all the different available approaches for exposure assessment, the microenvironmental (ME) modelling (indirect approach, where personal exposures are estimated or predicted from microenvironment measurements combined with time-activity data) seemed to be the best to assess children's exposure to air pollution as it takes into account the varying levels of pollution to which an individual is exposed during the course of the day, it is faster and less expensive. Thus, this review aimed to explore the use of the ME modelling approach methodology to assess children's exposure to air pollution. To meet this goal, a total of 152 articles, published since 2002, were identified and titles and abstracts were scanned for relevance. After exclusions, 26 articles were fully reviewed and main characteristics were detailed, namely: (i) study design and outcomes, including location, study population, calendar time, pollutants analysed and purpose; and (ii) data collection, including time-activity patterns (methods of collection, record time and key elements) and pollution measurements (microenvironments, methods of collection and duration and time resolution). The reviewed studies were from different parts of the world, confirming the worldwide application, and mostly cross-sectional. Longitudinal studies were also found enhancing the applicability of this approach. The application of this methodology on children is different from that on adults because of data collection, namely the methods used for collecting time-activity patterns must be different and the time-activity patterns are itself different, which leads to select different microenvironments to the data collection of pollutants' concentrations. The most used methods to gather information on time-activity patterns were questionnaires and diaries, and the main microenvironments considered were home and school (indoors and outdoors). Although the ME modelling approach in studies to assess children's exposure to air pollution is highly encouraged, a validation process is needed, due to the uncertainties associated with the application of this approach.

A model of human nasal epithelial cells adapted for direct and repeated exposure to airborne pollutants

Airway epithelium lining the nasal cavity plays a pivotal role in respiratory tract defense and protection mechanisms. Air pollution induces alterations linked to airway diseases such as asthma. Only very few in vitro studies to date have succeeded in reproducing physiological conditions relevant to cellular type and chronic atmospheric pollution exposure. We therefore, set up an in vitro model of human Airway Epithelial Cells of Nasal origin (hAECN) close to real human cell functionality, specifically adapted to study the biological effects of exposure to indoor gaseous pollution at the environmental level. hAECN were exposed under air-liquid interface, one, two, or three-times at 24 h intervals for 1 h, to air or formaldehyde (200 μg/m(3)), an indoor air gaseous pollutant. All experiments were ended at day 4, when both cellular viability and cytokine production were assessed. Optimal adherence and confluence of cells were obtained 96 h after cell seeding onto collagen IV-precoated insert. Direct and repeated exposure to formaldehyde did not produce any cellular damage or IL-6 production change, although weak lower IL-8 production was observed only after the third exposure. Our model is significantly better than previous ones due to cell type and the repeated exposure protocol.

Modulation of microRNA expression by volatile organic compounds in mouse lung

Volatile organic compounds (VOCs) are one of main pollutants indoors. Exposure to VOCs is associated with cancer, asthma disease, and multiple chemical allergies. Despite the adverse health effects of VOCs, the molecular mechanisms underlying VOCs-induced disease remain largely unknown. MicroRNAs (miRNAs), as key post-transcriptional regulators of gene expression, may influence cellular disease state. To investigate whether lung miRNA expression profiles in mice are modified by VOCs mixture exposure, 44 male Kunming mice were exposed in 4 similar static chambers, 0 (control) and 3 different doses of VOCs mixture (groups 1-3). The concentrations of VOCs mixture were as follows: formaldehyde, benzene, toluene, and xylene 3.0 + 3.3 + 6.0 + 6.0 mg/m(3) , 5.0 + 5.5 + 10.0 + 10.0 mg/m(3) , 10.0 + 11.0 + 20.0 + 20.0 mg/m(3) , respectively, which corresponded to 30, 50, and 100 times of indoor air quality standard in China, after exposure to 2 weeks (2 h/day, 5 days/week). Small RNAs in lung and protein isolated from bronchoalveolar lavage fluid (BALF) were collected and analyzed for miRNA expression using microarray analysis and for interleukin-8 (IL-8) protein levels by enzyme-linked immunosorbent assay, respectively. VOCs exposure altered the miRNA expression profiles in lung in mice. Specifically, 69 miRNAs were significantly differentially expressed in VOCs-exposed samples versus controls. Functional annotation analysis of the predicted miRNA transcript targets revealed that VOCs exposure potentially alters signaling pathways associated with cancer, chemokine signaling, Wnt signaling, neuroactive ligand-receptor interaction, and cell adhesion molecules. IL-8 isolated from BALF and nitric oxide synthase of lung increased significantly, whereas GSH of lung decreased significantly in mice exposed to VOCs. These results indicate that inhalation of VOCs alters miRNA patterns that regulate gene expression, potentially leading to the initiation of cancer and inflammatory diseases.

Environmental burden of disease in Europe: assessing nine risk factors in six countries

BACKGROUND

Environmental health effects vary considerably with regard to their severity, type of disease, and duration. Integrated measures of population health, such as environmental burden of disease (EBD), are useful for setting priorities in environmental health policies and research. This review is a summary of the full Environmental Burden of Disease in European countries (EBoDE) project report.

OBJECTIVES

The EBoDE project was set up to provide assessments for nine environmental risk factors relevant in selected European countries (Belgium, Finland, France, Germany, Italy, and the Netherlands).

METHODS

Disability-adjusted life years (DALYs) were estimated for benzene, dioxins, secondhand smoke, formaldehyde, lead, traffic noise, ozone, particulate matter (PM2.5), and radon, using primarily World Health Organization data on burden of disease, (inter)national exposure data, and epidemiological or toxicological risk estimates. Results are presented here without discounting or age-weighting.

RESULTS

About 3-7% of the annual burden of disease in the participating countries is associated with the included environmental risk factors. Airborne particulate matter (diameter ≤ 2.5 μm; PM2.5) is the leading risk factor associated with 6,000-10,000 DALYs/year and 1 million people. Secondhand smoke, traffic noise (including road, rail, and air traffic noise), and radon had overlapping estimate ranges (600-1,200 DALYs/million people). Some of the EBD estimates, especially for dioxins and formaldehyde, contain substantial uncertainties that could be only partly quantified. However, overall ranking of the estimates seems relatively robust.

CONCLUSIONS

With current methods and data, environmental burden of disease estimates support meaningful policy evaluation and resource allocation, including identification of susceptible groups and targets for efficient exposure reduction. International exposure monitoring standards would enhance data quality and improve comparability.

Low-dose formaldehyde delays DNA damage recognition and DNA excision repair in human cells

OBJECTIVE

Formaldehyde is still widely employed as a universal crosslinking agent, preservative and disinfectant, despite its proven carcinogenicity in occupationally exposed workers. Therefore, it is of paramount importance to understand the possible impact of low-dose formaldehyde exposures in the general population. Due to the concomitant occurrence of multiple indoor and outdoor toxicants, we tested how formaldehyde, at micromolar concentrations, interferes with general DNA damage recognition and excision processes that remove some of the most frequently inflicted DNA lesions.

METHODOLOGY/PRINCIPAL FINDINGS

The overall mobility of the DNA damage sensors UV-DDB (ultraviolet-damaged DNA-binding) and XPC (xeroderma pigmentosum group C) was analyzed by assessing real-time protein dynamics in the nucleus of cultured human cells exposed to non-cytotoxic (<100 μM) formaldehyde concentrations. The DNA lesion-specific recruitment of these damage sensors was tested by monitoring their accumulation at local irradiation spots. DNA repair activity was determined in host-cell reactivation assays and, more directly, by measuring the excision of DNA lesions from chromosomes. Taken together, these assays demonstrated that formaldehyde obstructs the rapid nuclear trafficking of DNA damage sensors and, consequently, slows down their relocation to DNA damage sites thus delaying the excision repair of target lesions. A concentration-dependent effect relationship established a threshold concentration of as low as 25 micromolar for the inhibition of DNA excision repair.

CONCLUSIONS/SIGNIFICANCE

A main implication of the retarded repair activity is that low-dose formaldehyde may exert an adjuvant role in carcinogenesis by impeding the excision of multiple mutagenic base lesions. In view of this generally disruptive effect on DNA repair, we propose that formaldehyde exposures in the general population should be further decreased to help reducing cancer risks.

Analysis of microRNA and mRNA expression profiles highlights alterations in modulation of the MAPK pathway under octanal exposure

Previous environmental microRNA (miRNA) studies have investigated a limited number of candidate miRNAs and have not evaluated functional effects on gene expression. In this study, we aimed to identify octanal (OC)-sensitive miRNAs and to characterize the relationships between miRNAs and expression of candidate genes involved in OC-induced toxicity. Microarray analysis identified 15 miRNAs that were differentially expressed in OC-exposed A549 human alveolar cells. Integrated analyses of miRNA and mRNA expression profiles identified significant miRNA-mRNA anti-correlations. GO analysis of 101 putative target genes showed that the biological category 'MAPK signaling pathway' was prominently annotated. Moreover, we detected increased phosphorylation of p38 MAPK in the OC-exposed group. By integrating the transcriptome and microRNAome, we provide evidence that OC can affect MAPK-induced toxicity signaling. Therefore, this study demonstrates the added value of an integrated miRNA-mRNA approach for identifying molecular events induced by environmental pollutants in an in vitro human model.

Amended Safety Assessment of Formaldehyde and Methylene Glycol as Used in Cosmetics

Formaldehyde and methylene glycol may be used safely in cosmetics if established limits are not exceeded and are safe for use in nail hardeners in the present practices of use and concentration, which include instructions to avoid skin contact. In hair-smoothing products, however, in the present practices of use and concentration, formaldehyde and methylene glycol are unsafe. Methylene glycol is continuously converted to formaldehyde, and vice versa, even at equilibrium, which can be easily shifted by heating, drying, and other conditions to increase the amount of formaldehyde. This rapid, reversible formaldehyde/methylene glycol equilibrium is distinguished from the slow, irreversible release of formaldehyde resulting from the so-called formaldehyde releaser preservatives, which are not addressed in this safety assessment (formaldehyde releasers may continue to be safely used in cosmetics at the levels established in their individual Cosmetic Ingredient Review safety assessments).

Respiratory health of 985 children exposed to the World Trade Center disaster: report on world trade center health registry wave 2 follow-up, 2007-2008

BACKGROUND

The World Trade Center (WTC) disaster of September 11, 2001, has been associated with early respiratory problems including asthma in workers, residents, and children. Studies on adults have documented persistence of longer term, 9/11-related respiratory symptoms. There are no comparable reports on children.

METHODS

We surveyed 985 children aged 5-17 years who enrolled in the WTC Health Registry in 2003-04, and who were re-surveyed in 2007-08. Health data were provided by parents in both surveys and focused on respiratory symptoms suggestive of reactive airway impairment (wheezing or the combination of cough and shortness of breath) in the preceding 12 months. At follow-up, adolescents aged 11-17 years completed separate surveys that screened for post-traumatic stress symptoms and behavior problems (Strengths and Difficulties Questionnaire, SDQ). Associations between respiratory symptoms in the prior 12 months with 9/11 exposures and behavioral outcomes were evaluated with univariate and multivariate methods.

RESULTS

Of the 985 children, 142 (14.4%) children reported respiratory symptoms in the prior 12 months; 105 (73.9%) children with respiratory symptoms had previously been diagnosed with asthma. Among children aged 5-10 years, respiratory symptoms were significantly elevated among African-Americans (adjusted odds ratio, (aOR) 3.8; 95% confidence interval (CI) 1.2-11.5) and those with household income below $75,000 (aOR 1.9; CI 1.0-3.7), and was more than twice as great in children with dust cloud exposure (aOR 2.2; CI 1.2-3.9). Among adolescents aged 11-17 years, respiratory symptoms were significantly associated with household income below $75,000 (aOR 2.4; CI 1.2-4.6), and with a borderline or abnormal SDQ score (aOR 2.7, 95% CI 1.4-5.2). Symptoms were reported more than twice as often by adolescents with vs. without dust cloud exposure (24.8% vs. 11.5%) but the adjusted odds ratio was not statistically significant (aOR 1.7; CI 0.9-3.2),

CONCLUSIONS

Most Registry children exposed to the 9/11 disaster in New York City reported few respiratory problems. Respiratory symptoms were associated with 9/11 exposures in younger children and with behavioral difficulties in adolescents. Our findings support the need for continued surveillance of 9/11 affected children as they reach adolescence and young adulthood, and for awareness of both physical and behavioral difficulties by treating clinicians.

Bone marrow injury induced via oxidative stress in mice by inhalation exposure to formaldehyde

OBJECTIVE

Formaldehyde, a ubiquitous environmental pollutant has been classified as a human leukemogen. However, toxicity of formaldehyde in bone marrow, the target site of leukemia induction, is still poorly understood.

METHODOLOGY/PRINCIPAL FINDINGS

To investigate bone marrow toxicity (bone marrow pathology, hematotoxicity) and underlying mechanisms (oxidative stress, inflammation, apoptosis) in formaldehyde-exposed mice. Male Balb/c mice were exposed to formaldehyde (0, 0.5, and 3.0 mg/m(3)) by nose-only inhalation for 8 hours/day, over a two week period designed to simulate a factory work schedule, with an exposure-free "weekend" on days 6 and 7, and were sacrificed on the morning of day 13. Counts of white blood cells, red blood cells and lymphocytes were significantly (p<0.05) decreased at 0.5 mg/m(3) (43%, 7%, and 39%, respectively) and 3.0 mg/m(3) (52%, 27%, and 43%, respectively) formaldehyde exposure, while platelet counts were significantly increased by 109% (0.5 mg/m(3)) and 67% (3.0 mg/m(3)). Biomarkers of oxidative stress (reactive oxygen species, glutathione depletion, cytochrome P450 1A1 and glutathione s-transferase theta 1 expression), inflammation (nuclear factor kappa-B, tomour necrosis factor alpha, interleukin-1 beta), and apoptosis (activity of cysteine-aspartic acid protease 3) in bone marrow tissues were induced at one or both formaldehyde doses mentioned above.

CONCLUSIONS/SIGNIFICANCE

Exposure of mice to formaldehyde by inhalation induced bone marrow toxicity, and that oxidative stress, inflammation and the consequential apoptosis jointly constitute potential mechanisms of such induced toxicity.

Formaldehyde concentrations in household air of asthma patients determined using colorimetric detector tubes

Formaldehyde is a colorless, pungent gas commonly found in homes and is a respiratory irritant, sensitizer, carcinogen, and asthma trigger. Typical household sources include plywood and particleboard, cleaners, cosmetics, pesticides, and others. Development of a fast and simple measurement technique could facilitate continued research on this important chemical. The goal of this research is to apply an inexpensive short-term measurement method to find correlations between formaldehyde sources and concentration, and formaldehyde concentration and asthma control. Formaldehyde was measured using 30-min grab samples in length-of-stain detector tubes in homes (n = 70) of asthmatics in the Boston, MA area. Clinical status and potential formaldehyde sources were determined. The geometric mean formaldehyde level was 35.1 ppb and ranged from 5 to 132 ppb. Based on one-way ANOVA, t-tests, and linear regression, predictors of log-transformed formaldehyde concentration included absolute humidity, season, and the presence of decorative laminates, fiberglass, or permanent press fabrics (P < 0.05), as well as temperature and household cleaner use (P < 0.10). The geometric mean formaldehyde concentration was 57% higher in homes of children with very poorly controlled asthma compared to homes of other asthmatic children (P = 0.078). This study provides a simple method for measuring household formaldehyde and suggests that exposure is related to poorly controlled asthma.

Role of transient receptor potential ion channels and evoked levels of neuropeptides in a formaldehyde-induced model of asthma in BALB/c mice

OBJECTIVE

Asthma is a complex pulmonary inflammatory disease characterized by the hyper-responsiveness, remodeling and inflammation of airways. Formaldehyde is a common indoor air pollutant that can cause asthma in people experiencing long-term exposure. The irritant effect and adjuvant effect are the two possible pathways of formaldehyde promoted asthma.

METHODOLOGY/PRINCIPAL FINDINGS

To explore the neural mechanisms and adjuvant effect of formaldehyde, 48 Balb/c mice in six experimental groups were exposed to (a) vehicle control; (b) ovalbumin; (c) formaldehyde (3.0 mg/m(3)); (d) ovalbumin+formaldehyde (3.0 mg/m(3)); (e) ovalbumin+formaldehyde (3.0 mg/m(3))+HC-030031 (transient receptor potential ankyrin 1 antagonist); (f) ovalbumin+formaldehyde (3.0 mg/m(3))+ capsazepine (transient receptor potential vanilloid 1 antagonist). Experiments were conducted after 4 weeks of combined exposure and 1-week challenge with aerosolized ovalbumin. Airway hyper-responsiveness, pulmonary tissue damage, eosinophil infiltration, and increased levels of interleukin-4, interleukin-6, interleukin-1β, immunoglobulin E, substance P and calcitonin gene-related peptide in lung tissues were found in the ovalbumin+formaldehyde (3.0 mg/m(3)) group compared with the values seen in ovalbumin -only immunized mice. Except for interleukin-1β levels, other changes in the levels of biomarker could be inhibited by HC-030031 and capsazepine.

CONCLUSIONS/SIGNIFICANCE

Formaldehyde might be a key risk factor for the rise in asthma cases. Transient receptor potential ion channels and neuropeptides have important roles in formaldehyde promoted-asthma.

Formaldehyde concentration and its influencing factors in residential homes after decoration at Hangzhou, China

Air pollution surveys of formaldehyde (HCHO) were conducted in 2324 rooms decorated within one year in 2007-2009 in Hangzhou, China. The mean HCHO concentration (CHCHO) was 0.107 +/- 0.095 mg/m3, and 38.9% of samples exceeded the Chinese National Standard GB 50325-2010. Over the past 3 years, the C(HCHO) decreased with time (p < 0.05). Relationships of potential factors to indoor C(HCHO) were also evaluated. C(HCHO) was related to temperature (T), relative humidity (RH), time duration of the windows and doors being closed before sampling (DC), time duration from the end of decoration to sampling (DR) and source characteristics (d). A model to relate indoor C(HCHO) to these five factors (T, RH, DC, DR, d) was established based on 298 samples (R2 = 0.87). Various factors contributed to C(HCHO) in the following order: T, 43.7%; d, 31.0%; DC, 10.2%; DR, 8.0%; RH, 7.0%; specifically, meteorological conditions (i.e., RH plus T) accounted for 50.7%. The coefficient of T and RH, R(TH), was proposed to describe their combined influence on HCHO emission, which also had a linear relationship (R2 = 0.9387) with HCHO release in a simulation chamber test. In addition, experiments confirm that it is a synergistic action as T and RH accelerate the release of HCHO, and that is a significant factor influencing indoor HCHO pollution. These achievements could lead to reference values of measures for the efficient reduction of indoor HCHO pollution.

Environmental triggers of nocturnal dry cough in infancy: new insights about chronic domestic exposure to formaldehyde in the PARIS birth cohort

Although formaldehyde is a common indoor pollutant, its impact on respiratory symptoms in childhood remains unclear. The aim of this study was to examine the relation between domestic formaldehyde exposure and occurrence of coughing, one of the most prevalent respiratory symptoms during the first year of life of infants from the PARIS birth cohort involving 3840 healthy full-term babies. The presence of respiratory symptoms, including dry cough at night apart from a cold or chest infection in the past 12 months was reported on a standardized health questionnaire. Formaldehyde exposure was estimated for all infants using a predictive model established from data (both repeated measurements and information about determinants of levels) collected in a random sample of infants from the cohort. An unconditional logistic regression was fitted to study the relation between annual domestic formaldehyde exposure and dry cough at night, adjusting for all potential risk factors/confounders. The prevalence of dry cough at night was 14.9%. Parental history of allergy was found to modify the relation between environmental factors and dry cough. Cockroaches, used mattresses, and family stressor events were associated with dry cough in infants with parental allergy history. Conversely, domestic formaldehyde exposure tended to increase occurrence of dry cough at night only among babies without parental history of allergy (adjusted OR per 10 µg/m(3) increase in levels, single imputation approach: 1.45, 95% CI: 1.08-1.96, and Bayesian approach: 1.12, 0.91-1.36). This study suggests that the impact of indoor environmental exposure on dry cough at night in infancy is different depending on the presence or not of parental history of allergy.

Sick building syndrome by indoor air pollution in Dalian, China

This study assessed subjective symptoms related to indoor concentrations of chemicals among residents in a housing estate in Dalian, China, where indoor air pollution by interior decoration materials has recently become a major health problem. Fifty-nine males and 50 females were surveyed for their symptoms related to sick building syndrome. Formaldehyde (HCHO), NO₂, and volatile organic compounds (VOCs) in their dwellings were collected using a diffusion sampler and measured by GC/MS. For residents with one or more symptoms in the past, HCHO, butanol or 1,2-dichloroethane concentrations were significantly greater in their bedrooms or kitchens compared with those of subjects without previous symptoms. For residents with one or more symptoms at the time of the study, 1,1,1-trichloroethane, xylene, butanol, methyl isobutyl ketone, and styrene concentrations in their bedrooms or kitchens were significantly greater compared with those of residents without symptoms. HCHO, NO₂, and VOCs were detected in all rooms, but their levels were lower than the guideline values except for HCHO in two rooms. Chemical substances from interior decoration materials at indoor air levels lower than their guideline values might have affected the health status of residents.

Recent trend in risk assessment of formaldehyde exposures from indoor air

Studies about formaldehyde (FA) published since the guideline of 0.1 mg/m(3) by the World Health Organization (WHO) in 2010 have been evaluated; critical effects were eye and nasal (portal-of-entry) irritation. Also, it was considered to prevent long-term effects, including all types of cancer. The majority of the recent toxicokinetic studies showed no exposure-dependent FA-DNA adducts outside the portal-of-entry area and FA-DNA adducts at distant sites were due to endogenously generated FA. The no-observed-adverse-effect level for sensory irritation was 0.5 ppm and recently reconfirmed in hypo- and hypersensitive individuals. Investigation of the relationship between FA exposure and asthma or other airway effects in children showed no convincing association. In rats, repeated exposures showed no point mutation in the p53 and K-Ras genes at ≤15 ppm neither increased cell proliferation, histopathological changes and changes in gene expression at 0.7 ppm. Repeated controlled exposures (0.5 ppm with peaks at 1 ppm) did not increase micronucleus formation in human buccal cells or nasal tissue (0.7 ppm) or in vivo genotoxicity in peripheral blood lymphocytes (0.7 ppm), but higher occupational exposures were associated with genotoxicity in buccal cells and cultivated peripheral blood lymphocytes. It is still valid that exposures not inducing nasal squamous cell carcinoma in rats will not induce nasopharyngeal cancer or lymphohematopoietic malignancies in humans. Reproductive and developmental toxicity are not considered relevant in the absence of sensory irritation. In conclusion, the WHO guideline has been strengthened.

Indoor air quality in Montréal area day-care centres, Canada

Indoor air quality (IAQ) has been understudied in day-care centres (DCCs), even though it can affect the respiratory health of children. This study was undertaken to assess IAQ in a randomly selected sample of 21 DCCs having space for at least 40 children in Montréal, Canada, and to determine associations between building characteristics and IAQ. Questionnaires on building characteristics and operation of the DCC were administered to managers. Temperature, relative humidity, and concentrations of carbon dioxide (CO(2)), formaldehyde and volatile organic compounds were measured in January and February 2008 in rooms attended by children aged between 18 and 60 months. Most DCCs (81%) had a mechanical ventilation system. Over 85% of the DCCs had a mean CO(2) concentration higher than 1000 ppm, the value generally targeted for comfort in buildings. Mean CO(2) concentrations were significantly lower in DCCs having a floor space meeting the provincial standards. The mean (standard deviation-SD) formaldehyde concentration was 22.9 (8.2) μg/m(3), with all participating DCCs being within Health Canada's Residential IAQ Guideline of 50 μg/m(3). The presence of a mechanical ventilation system and a large surface of play area per child were significantly associated with lower CO(2) levels, explaining 44% of the variance in indoor CO(2) concentrations. The presence of a mechanical ventilation system was also associated with significantly lower formaldehyde and acetaldehyde levels. Moreover, 68% of the variance in indoor acetaldehyde concentrations was explained by CO(2) levels, indicating that CO(2) was a better proxy of ventilation than the presence of a ventilation system, as this latter variable did not imply that the ventilation system was running or functioning adequately. These results demonstrate the need for on-going efforts to ensure sufficient floor space and adequate ventilation in DCCs to maintain good IAQ.

Unraveling 50-Year-Old Clues Linking Neurodegeneration and Cancer to Cycad Toxins: Are microRNAs Common Mediators?

Recognition of overlapping molecular signaling activated by a chemical trigger of cancer and neurodegeneration is new, but the path to this discovery has been long and potholed. Six conferences (1962–1972) examined the puzzling neurotoxic and carcinogenic properties of a then-novel toxin [cycasin: methylazoxymethanol (MAM)-β-d-glucoside] in cycad plants used traditionally for food and medicine on Guam where a complex neurodegenerative disease plagued the indigenous population. Affected families showed combinations of amyotrophic lateral sclerosis (ALS), parkinsonism (P), and/or a dementia (D) akin to Alzheimer’s disease (AD). Modernization saw declining disease rates on Guam and remarkable changes in clinical phenotype (ALS was replaced by P-D and then by D) and in two genetically distinct ALS-PDC-affected populations (Kii-Japan, West Papua-Indonesia) that used cycad seed medicinally. MAM forms DNA lesions – repaired by O⁶-methylguanine methyltransferase (MGMT) – that perturb mouse brain development and induce malignant tumors in peripheral organs. The brains of young adult MGMT-deficient mice given a single dose of MAM show DNA lesion-linked changes in cell-signaling pathways associated with miRNA-1, which is implicated in colon, liver, and prostate cancers, and in neurological disease, notably AD. MAM is metabolized to formaldehyde, a human carcinogen. Formaldehyde-responsive miRNAs predicted to modulate MAM-associated genes in the brains of MGMT-deficient mice include miR-17-5p and miR-18d, which regulate genes involved in tumor suppression, DNA repair, amyloid deposition, and neurotransmission. These findings marry cycad-associated ALS-PDC with colon, liver, and prostate cancer; they also add to evidence linking changes in microRNA status both to ALS, AD, and parkinsonism, and to cancer initiation and progression.

Formaldehyde personal exposure measurements and time weighted exposure estimates in children

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

Formaldehyde exposure and asthma in children: a systematic review

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

Irritant-induced airway disorders

Thousands of persons experience accidental high-level irritant exposures each year but most recover and few die. Irritants function differently than allergens because their actions proceed nonspecifically and by nonimmunologic mechanisms. For some individuals, the consequence of a single massive exposure to an irritant, gas, vapor or fume is persistent airway hyperresponsiveness and the clinical picture of asthma, referred to as reactive airways dysfunction syndrome (RADS). Repeated irritant exposures may lead to chronic cough and continual airway hyperresponsiveness. Cases of asthma attributed to repeated irritant-exposures may be the result of genetic and/or host factors.

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

BACKGROUND

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSION

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

Exposure to formaldehyde and its potential human health hazards

A widely used chemical, formaldehyde is normally present in both indoor and outdoor air. The rapid growth of formaldehyde-related industries in the past two decades reflects the result of its increased use in building materials and other commercial sectors. Consequently, formaldehyde is encountered almost every day from large segments of society due to its various sources. Many governments and agencies around the world have thus issued a series of standards to regulate its exposure in homes, office buildings, workshops, public places, and food. In light of the deleterious properties of formaldehyde, this article provides an overview of its market, regulation standards, and human health effects.

Identifying an indoor air exposure limit for formaldehyde considering both irritation and cancer hazards

Formaldehyde is a well-studied chemical and effects from inhalation exposures have been extensively characterized in numerous controlled studies with human volunteers, including asthmatics and other sensitive individuals, which provide a rich database on exposure concentrations that can reliably produce the symptoms of sensory irritation. Although individuals can differ in their sensitivity to odor and eye irritation, the majority of authoritative reviews of the formaldehyde literature have concluded that an air concentration of 0.3 ppm will provide protection from eye irritation for virtually everyone. A weight of evidence-based formaldehyde exposure limit of 0.1 ppm (100 ppb) is recommended as an indoor air level for all individuals for odor detection and sensory irritation. It has recently been suggested by the International Agency for Research on Cancer (IARC), the National Toxicology Program (NTP), and the US Environmental Protection Agency (US EPA) that formaldehyde is causally associated with nasopharyngeal cancer (NPC) and leukemia. This has led US EPA to conclude that irritation is not the most sensitive toxic endpoint and that carcinogenicity should dictate how to establish exposure limits for formaldehyde. In this review, a number of lines of reasoning and substantial scientific evidence are described and discussed, which leads to a conclusion that neither point of contact nor systemic effects of any type, including NPC or leukemia, are causally associated with exposure to formaldehyde. This conclusion supports the view that the equivocal epidemiology studies that suggest otherwise are almost certainly flawed by identified or yet to be unidentified confounding variables. Thus, this assessment concludes that a formaldehyde indoor air limit of 0.1 ppm should protect even particularly susceptible individuals from both irritation effects and any potential cancer hazard.

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

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

Relationships between mite allergen levels, mold concentrations, and sick building syndrome symptoms in newly built dwellings in Japan

This study investigated the possible relationships between exposures to mite allergen and airborne fungi with sick building syndrome (SBS) symptoms for residents living in newly built dwellings. We randomly sampled 5709 newly built dwellings in six prefectures from northern to southern Japan. A total of 1479 residents in 425 households participated in the study by completing questionnaire surveys and agreeing to environmental monitoring for mite allergen (Der 1), airborne fungi, aldehydes, and volatile organic compounds. Stepwise logistic regression analyses adjusted for confounders were used to obtain odds ratios (OR) of mite allergen and fungi for SBS symptoms. Der 1 had a significantly high OR for nose symptoms. Rhodotorula had a significantly high OR for any symptoms, and Aspergillus had significantly high OR for eye symptoms. However, the total colony-forming units had a significantly low OR for throat and respiratory symptoms. Eurotium had a significantly low OR for skin symptoms. In conclusion, dust-mite allergen levels and indoor airborne Rhodotorula and Aspergillus concentrations may result in SBS symptoms in newly built dwellings.

PRACTICAL IMPLICATIONS

Various factors can cause sick building syndrome symptoms. This study focused on biologic factors such as dust-mite allergen and airborne fungi in newly built dwellings in Japan. Dust-mite allergen levels were significantly associated with higher rates of nose symptoms, airborne Rhodotorula concentrations were significantly associated with higher rates of any symptoms, and Aspergillus concentrations were significantly associated with higher rates of eye symptoms. Measures should be taken to reduce mite allergen levels and fungal concentrations in these dwellings.

[Indoor air quality in schools]

Indoor air quality in schools has received particular attention over the past several years. Children are considered as one of the most sensitive groups to atmospheric pollution because their bodies are actively growing and they breathe higher volumes of air relative to their body weights than adults do. They also spend more time in school or group structures (preschools, day nurseries) than in any indoor environments other than the home. The analysis of children's exposure to air pollution at school requires the identification of the main pollutant sources present in these educational institutions. Both a strong contribution of outdoor pollution and a very specific pollution bound to school activities such as the use of paints, markers, glues, and manufactured ink eraser pens, exist. The ventilation in school buildings also plays an important role in air quality. A higher air exchange may improve thermal comfort and air quality. The cause of indoor air pollution is a combinatory effect of physical, chemical, and biological factors, and the adequacy of ventilation in the environment. Several pollutants have been reported to exist in classrooms such as bacteria, molds, volatile organic compounds, persistent organic pollutants and microparticles. There is a correlation between the concentrations of the pollutants and onset of health problems in schoolchildren. We observe predominantly respiratory symptoms as well as a prevalence of respiratory diseases such as asthma and allergies. This study shows that poor indoor air quality affects children's health.

Epigenetic changes induced by air toxics: formaldehyde exposure alters miRNA expression profiles in human lung cells

BACKGROUND

Exposure to formaldehyde, a known air toxic, is associated with cancer and lung disease. Despite the adverse health effects of formaldehyde, the mechanisms underlying formaldehyde-induced disease remain largely unknown. Research has uncovered microRNAs (miRNAs) as key posttranscriptional regulators of gene expression that may influence cellular disease state. Although studies have compared different miRNA expression patterns between diseased and healthy tissue, this is the first study to examine perturbations in global miRNA levels resulting from formaldehyde exposure.

OBJECTIVES

We investigated whether cellular miRNA expression profiles are modified by formaldehyde exposure to test the hypothesis that formaldehyde exposure disrupts miRNA expression levels within lung cells, representing a novel epigenetic mechanism through which formaldehyde may induce disease.

METHODS

Human lung epithelial cells were grown at air-liquid interface and exposed to gaseous formaldehyde at 1 ppm for 4 hr. Small RNAs and protein were collected and analyzed for miRNA expression using microarray analysis and for interleukin (IL-8) protein levels by enzyme-linked immunosorbent assay (ELISA).

RESULTS

Gaseous formaldehyde exposure altered the miRNA expression profiles in human lung cells. Specifically, 89 miRNAs were significantly down-regulated in formaldehyde-exposed samples versus controls. Functional and molecular network analysis of the predicted miRNA transcript targets revealed that formaldehyde exposure potentially alters signaling pathways associated with cancer, inflammatory response, and endocrine system regulation. IL-8 release increased in cells exposed to formaldehyde, and results were confirmed by real-time polymerase chain reaction.

CONCLUSIONS

Formaldehyde alters miRNA patterns that regulate gene expression, potentially leading to the initiation of a variety of diseases.

Quantitative assessments of indoor air pollution and respiratory health in a population-based sample of French dwellings

BACKGROUND

Various volatile organic compounds (VOCs) have been related to respiratory health effects, but have generally been assessed individually without taking into account the fact that such pollutants are highly correlated to one other.

AIMS

We investigated the effects of exposure to various VOC, and considered their combined effect on adult asthma and rhinitis.

METHOD

A national cross-sectional representative survey conducted by the Indoor Air Quality Observatory objectively assessed 20 VOCs in 490 main dwellings in France. A standardized questionnaire determined the prevalence of asthma and rhinitis among 1012 inhabitants of the dwellings (≥ 15 years). Marginal models for binary outcome were used to relate VOCs exposure to asthma and rhinitis, controlling for potential confounders. A global score representing the number of VOCs in each dwelling with an elevated concentration (using the 3(rd) quartile value of the distribution as a threshold value) was then derived as a measure of the combined effect of VOCs. Specific scores were built using a similar approach, grouping VOCs by family.

RESULTS

Asthma (8.6%) was significantly associated with N-undecane and 1,2,4-trimethylbenzene and rhinitis (38.3%) with ethylbenzene, trichloroethylene, m/p- and o-xylene. The global VOC score was associated with a significant risk of asthma and rhinitis (odds ratio (OR) of 1.40 and 1.22, respectively, for 5 additional VOCs with high exposure level). Both specific scores for aromatic hydrocarbons and aliphatic hydrocarbons were associated with a significantly risk of asthma (OR=1.12; 95% confidence interval (CI): 1.01-1.24 and OR=1.41; 95% CI=1.03-1.93, respectively). The specific VOC score for halogenated hydrocarbons was associated with a significant risk of rhinitis (OR=1.28; 95% CI: 1.07-1.54).

CONCLUSION

We have shown that high concentrations of VOCs in homes were associated with an increasing prevalence of asthma and rhinitis in adults.

Air pollution: a tale of two countries

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

Indoor air pollution and childhood asthma: variations between urban and rural areas

Health effects of indoor pollution have been investigated overall in urban areas. To compare the potential effect of home air pollutants on asthma in urban and rural houses, two case-control populations, composed of children living in the city (32 asthmatics and 31 controls) and in the countryside (24 asthmatics and 27 controls) were included. During 1 week, nitrogen dioxide, fine particles, and volatile organic compounds (formaldehyde, acetaldehyde, benzene, toluene, ethylbenzene, and xylenes) were assessed at home. Urban dwellings were found to be more polluted than rural ones, with concentrations up to two times higher. In the whole population, exposure to acetaldehyde and toluene was significantly associated with a higher risk of asthma. In the urban population, the association with toluene was significant in children studied during winter, and with toluene, xylenes, and ethylbenzene when cases were restricted to current asthmatics. In rural settings, a relationship between asthma and formaldehyde exposure was observed (OR = 10.7; 95% CI 1.69-67.61). Our findings suggest that daily continuous exposures to pollutants may be implicated in asthma, even in the case of low exposure, as those found in rural areas. Our results could also indicate a specific effect of indoor pollution in the rural environment.

PRACTICAL IMPLICATIONS

Everyday exposure to indoor pollution was associated with a higher risk of childhood asthma. These findings suggest that even at low concentrations, pollutants could be implicated in asthma and reinforce the importance of establishing guideline values to improve indoor air quality by limiting sources or by optimizing ventilation. Specific effects could occur in rural environments where pollution differs from urban area.

Formaldehyde interferes with airway epithelium integrity and functions in a dose- and time-dependent manner

Formaldehyde (HCHO) is a common indoor air pollutant. To assess its potential role and mechanism of action in asthma, we exposed the bronchial epithelial cell lines Calu-3 and 16HBE to HCHO (70-7000 μM) according to two exposure schedules (30 min and 24 h), before measuring cell viability, necrosis and apoptosis, reactive oxygen species production, cytokine release, as well as trans-epithelial electrical resistance (TEER) of cell monolayers. Whereas exposure to HCHO for 30 min had a limited effect on cell viability, exposure for 24h to 1400-7000 μM HCHO induced a pronounced dose-dependent cell death. The important decrease in cell viability observed after 24h exposure to the highest concentrations of HCHO (1400-7000 μM) was accompanied by important LDH release and ROS production, whereas a 4h exposure to lower HCHO concentrations (350 μM) induced cell apoptosis. Also, exposure to HCHO for 30 min dose-dependently inhibited basal and lipopolysaccharide-induced interleukin-6 (IL-6) and IL-8 production by bronchial epithelial cells. As well, HCHO triggered a dose- and time-dependent decrease in TEER of Calu-3 cell monolayers. The present work demonstrates that HCHO interferes with airway epithelium integrity and functions, and may thus modulate the onset and the severity of asthma. However, importantly, conditions of exposure to HCHO, e.g. level and duration, are determinant in the nature of the effects triggered by the pollutant.

Porous silica spheres as indoor air pollutant scavengers

Porous silica spheres were investigated for their effectiveness in removing typical indoor air pollutants, such as aromatic and carbonyl-containing volatile organic compounds (VOCs), and compared to the commercially available polymer styrene-divinylbenzene (XAD-4). The silica spheres and the XAD-4 resin were coated on denuder sampling devices and their adsorption efficiencies for VOCs evaluated using an indoor air simulation chamber. Real indoor sampling was also undertaken to evaluate the affinity of the silica adsorbents for a variety of indoor VOCs. The silica sphere adsorbents were found to have a high affinity for polar carbonyls and found to be more efficient than the XAD-4 resin at adsorbing carbonyls in an indoor environment.

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

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

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

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

Formaldehyde exposure and asthma in children: a systematic review

OBJECTIVE

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

DATA SOURCES

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

DATA EXTRACTION

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

DATA SYNTHESIS

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

CONCLUSIONS

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

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

BACKGROUND

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Proximity to chipboard industries increases the risk of respiratory and irritation symptoms in children: the Viadana study

Emissions related to wood production processes are a recognized health hazard for professionally exposed subjects. The health effects of living close to wood industries are not known, particularly in the pediatric population. We aimed at investigating if living close to chipboard industries is a health hazard for the children in the Viadana district (Northern Italy). In December 2006, all the children (3-14 years) living in the Viadana district, where two big chipboard industries are located, were surveyed through a parental questionnaire (n=3854). The children were geocoded, and the distance of their houses/schools from the closest wood plant was computed. Independently of sex, age, nationality, residential area, traffic, parents' education, passive/parental smoking, questionnaire compiler and his/her environmental concern, the children living at <2 km from chipboard industries had a greater prevalence of respiratory (OR=1.33, 95%CI: 1.11, 1.60), cough/phlegm (OR=1.43, 95%CI: 1.08, 1.88), nose/throat/mouth (OR=1.47, 95%CI: 1.23, 1.75), eye (OR=1.24, 95%CI: 1.04, 1.48) symptoms, school-days lost (OR=1.24, 95%CI: 1.04, 1.48), and emergency (OR=2.14, 95%CI: 1.47, 3.11) and hospital (OR=2.21, 95%CI: 1.17, 4.18) admissions. There was an inverse dose-response relationship between the adverse health outcomes considered and the distance from the plants. The attributable fractions for the children living close to the chipboard industries were substantial, ranging from 13% (eye symptoms) to 27% (cough/phlegm). The present findings suggest that emissions from chipboard industries might have a serious impact on children's health status and should therefore be reduced and closely monitored.

Formaldehyde dehydrogenase: beyond phase I metabolism

Formaldehyde dehydrogenase, formally Class III alcohol dehydrogenase (ADH3), has recently been discovered to partially regulate nitrosothiol homeostasis by catalyzing the reduction of the endogenous nitrosylating agent S-nitrosoglutathione (GSNO). Several studies have implicated this enzyme, and in particular GSNO reduction, as playing an important role in conditions such as asthma, cardiovascular disease, and immune function. While ADH3 has received considerable attention in the biomedical literature where it is often referred to as GSNO reductase (GSNOR), ADH3-mediated GSNO reduction has received comparatively less attention in the environmental toxicology community. Herein, evidences for a role of ADH3 in cell signaling through thiol homeostasis is highlighted, underscoring that the enzyme functions more broadly than to metabolize formaldehyde.

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

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

PRACTICAL IMPLICATIONS

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