Assessing the relationship between personal particulate and gaseous exposures of senior citizens living in Baltimore, MD

Associations between ambient, personal, and indoor exposure to fine particulate matter constituents in Dutch and Finnish panels of cardiovascular patients

AIMS

To assess the relation between ambient, indoor, and personal levels of PM2.5 and its elemental composition for elderly subjects with cardiovascular disease.

METHODS

In the framework of a European Union funded study, panel studies were conducted in Amsterdam, the Netherlands and Helsinki, Finland. Outdoor PM2.5 concentrations were measured at a fixed site. Each subject's indoor and personal PM2.5 exposure was measured biweekly for six months, during the 24 hour period preceding intensive health measurements. The absorbance of PM2.5 filters was measured as a marker for diesel exhaust. The elemental content of more than 50% of the personal and indoor samples and all corresponding outdoor samples was measured using energy dispersive x ray fluorescence.

RESULTS

For Amsterdam and Helsinki respectively, a total of 225 and 238 personal, and 220 and 233 indoor measurements, were analysed from 36 and 46 subjects. For most elements, personal and indoor concentrations were lower than and highly correlated with outdoor concentrations. The highest correlations (median r>0.9) were found for sulfur and particle absorbance, which both represent fine mode particles from outdoor origin. Low correlations were observed for elements that represent the coarser part of the PM2.5 particles (Ca, Cu, Si, Cl).

CONCLUSIONS

The findings of this study provide support for using fixed site measurements as a measure of exposure to particulate matter in time series studies linking the day to day variation in particulate matter to the day to day variation in health endpoints, especially for components of particulate matter that are generally associated with fine particles and have few indoor sources. The high correlation for absorbance of PM2.5 documents that this applies to particulate matter from combustion sources, such as diesel vehicles, as well.

Ozone exposure and mortality: an empiric bayes metaregression analysis

BACKGROUND

Results from time-series epidemiologic studies evaluating the relationship between ambient ozone concentrations and premature mortality vary in their conclusions about the magnitude of this relationship, if any, making it difficult to estimate public health benefits of air pollution control measures. We conducted an empiric Bayes metaregression to estimate the ozone effect on mortality, and to assess whether this effect varies as a function of hypothesized confounders or effect modifiers.

METHODS

We gathered 71 time-series studies relating ozone to all-cause mortality, and we selected 48 estimates from 28 studies for the metaregression. Metaregression covariates included the relationship between ozone concentrations and concentrations of other air pollutants, proxies for personal exposure-ambient concentration relationships, and the statistical methods used in the studies. For our metaregression, we applied a hierarchical linear model with known level-1 variances.

RESULTS

We estimated a grand mean of a 0.21% increase (95% confidence interval = 0.16-0.26%) in mortality per 10-microg/m increase of 1-hour maximum ozone (0.41% increase per 10 ppb) without controlling for other air pollutants. In the metaregression, air-conditioning prevalence and lag time were the strongest predictors of between-study variability. Air pollution covariates yielded inconsistent findings in regression models, although correlation analyses indicated a potential influence of summertime PM2.5.

CONCLUSIONS

These findings, coupled with a greater relative risk of ozone in the summer versus the winter, demonstrate that geographic and seasonal heterogeneity in ozone relative risk should be anticipated, but that the observed relationship between ozone and mortality should be considered for future regulatory impact analyses.

Short term effects of particulate matter on cause specific mortality: effects of lags and modification by city characteristics

BACKGROUND

Consistent evidence has shown increased all-cause mortality, and mortality from broad categories of causes associated with airborne particles. Less is known about associations with specific causes of death, and modifiers of those associations.

AIMS

To examine these questions in 20 US cities, between 1989 and 2000.

METHODS

Mortality files were obtained from the National Center for Health Statistics. Air pollution data were obtained from the Environmental Protection Agency website. The associations between daily concentrations of particulate matter of aero-diameter < or =10 microm (PM10) and daily mortality from all-cause and selected causes of death, were examined using a case-crossover design. Temporal effects of PM10 were examined using lag models, in first stage regressions. City specific modifiers of these associations were examined in second stage regressions.

RESULTS

All-cause mortality increased with PM10 exposures occurring both one and two days prior the event. Deaths from heart disease were primarily associated with PM10 on the two days before, while respiratory deaths were associated with PM10 exposure on all three days. Analyses using only one lag underestimated the effects for all-cause, heart, and respiratory deaths. Several city characteristics modified the effects of PM10 on daily mortality. Important findings were seen for population density, percentage of primary PM10 from traffic, variance of summer temperature, and mean of winter temperature.

CONCLUSIONS

There was overall evidence of increased daily mortality from increased concentrations of PM10 that persisted across several days, and matching for temperature did not affect these associations. Heterogeneity in the city specific PM10 effects could be explained by differences in certain city characteristics.

Effect of short-term exposure to low levels of gaseous pollutants on chronic obstructive pulmonary disease hospitalizations

We examined the associations between gaseous pollutants and hospitalization for chronic obstructive pulmonary diseases (COPD) among elderly people living in Vancouver, British Columbia, Canada, a city in which ambient air pollution levels are relatively low. We regressed the logarithm of daily counts of acute COPD hospitalization during the 5-year period from 1994 to 1998 on the daily mean levels of each pollutant, after accounting for seasonal and subseasonal fluctuations, non-Poisson dispersion, and weather variables. Nitrogen dioxide and carbon monoxide were significantly associated with hospitalization for COPD, and the magnitude of effects was increased slightly with increasing days of exposure averaging, with the relative risk for a 7-day average being 1.11 (95%CI: 1.04, 1.20) and 1.08 (1.02, 1.13) for nitrogen dioxide and carbon monoxide, respectively. There was no significant association between either sulfur dioxide or ozone and COPD hospitalization. The combined relative risk for all four gaseous pollutants on COPD hospitalization was 1.21. The effects of gaseous pollutants on COPD hospitalization were not significant after adjustment for PM(10), although its inclusion did not have a marked effect on the point estimates for relative risks. Nitrogen dioxide has a significant impact on COPD hospitalization. Further studies are needed to separate the effects of single pollutants from the combined effects of the complex mixture of air pollutants in urban atmospheres.

Potential role of ultrafine particles in associations between airborne particle mass and cardiovascular health

Numerous epidemiologic time-series studies have shown generally consistent associations of cardiovascular hospital admissions and mortality with outdoor air pollution, particularly mass concentrations of particulate matter (PM) < or = 2.5 or < or = 10 microm in diameter (PM2.5, PM10). Panel studies with repeated measures have supported the time-series results showing associations between PM and risk of cardiac ischemia and arrhythmias, increased blood pressure, decreased heart rate variability, and increased circulating markers of inflammation and thrombosis. The causal components driving the PM associations remain to be identified. Epidemiologic data using pollutant gases and particle characteristics such as particle number concentration and elemental carbon have provided indirect evidence that products of fossil fuel combustion are important. Ultrafine particles < 0.1 microm (UFPs) dominate particle number concentrations and surface area and are therefore capable of carrying large concentrations of adsorbed or condensed toxic air pollutants. It is likely that redox-active components in UFPs from fossil fuel combustion reach cardiovascular target sites. High UFP exposures may lead to systemic inflammation through oxidative stress responses to reactive oxygen species and thereby promote the progression of atherosclerosis and precipitate acute cardiovascular responses ranging from increased blood pressure to myocardial infarction. The next steps in epidemiologic research are to identify more clearly the putative PM casual components and size fractions linked to their sources. To advance this, we discuss in a companion article (Sioutas C, Delfino RJ, Singh M. 2005. Environ Health Perspect 113:947-955) the need for and methods of UFP exposure assessment.

Traffic related pollution and heart rate variability in a panel of elderly subjects

BACKGROUND

Particulate air pollution has been associated with increased cardiovascular deaths and hospital admissions. To help understand the mechanisms, the types of particles most involved, and the types of persons most susceptible, the association between exposure to summertime air pollution and heart rate variability (HRV) was examined in a panel study of 28 elderly subjects.

METHODS

Subjects were seen once a week for up to 12 weeks and HRV (SDNN, r-MSSD, PNN50, low frequency/high frequency ratio (LFHFR)) was measured for approximately 30 minutes at each session using a defined protocol. Temperature, day of the week, and hour of the day were controlled, and dummy variables for each subject were controlled for subject specific risk factors.

RESULTS

PM2.5 was associated with r-MSSD (-10.1% change for an interquartile range (IQR) increase in exposure (95% CI -2.8 to -16.9)) and PNN50, but stronger associations were seen with black carbon, an indicator of traffic particles, which was also associated with SDNN (-4.6% per IQR (95% CI -2.0 to -7.2)) and LFHFR. Secondary particles were more weakly associated with r-MSSD, as was ozone. No associations were seen with SO2 or NO2. CO had similar patterns of association to black carbon, which disappeared after controlling for black carbon. Black carbon had a substantially higher effect on SDNN in subjects who had had a previous myocardial infarction (-12.7%, 95% CI -5.7 to -19.25).

CONCLUSIONS

Particles, especially from traffic, are associated with disturbances of autonomic control of the heart.

Traffic related air pollution as a determinant of asthma among Taiwanese school children

BACKGROUND

There is evidence that long term exposure to ambient air pollution increases the risk of childhood asthma, but the role of different sources and components needs further elaboration. To assess the effect of air pollutants on the risk of asthma among school children, a nationwide cross sectional study of 32 672 Taiwanese school children was conducted in 2001.

METHODS

Routine air pollution monitoring data for sulphur dioxide (SO2), nitrogen oxides (NOx), ozone (O3), carbon monoxide (CO), and particles with an aerodynamic diameter of 10 microm or less (PM10) were used. Information on individual characteristics and indoor environments was from a parent administered questionnaire (response rate 93%). The exposure parameters were calculated using the mean of the 2000 monthly averages. The effect estimates were presented as odds ratios (ORs) per 10 ppb changes for SO2, NOx, and O3, 100 ppb changes for CO, and 10 microg/m3 changes for PM10.

RESULTS

In a two stage hierarchical model adjusting for confounding, the risk of childhood asthma was positively associated with O3 (adjusted OR 1.138, 95% confidence interval (CI) 1.001 to 1.293), CO (adjusted OR 1.045, 95% CI 1.017 to 1.074), and NOx (adjusted OR 1.005, 95% CI 0.954 to 1.117). Against our prior hypothesis, the risk of childhood asthma was weakly or not related to SO2 (adjusted OR 0.874, 95% CI 0.729 to 1.054) and PM10 (adjusted OR 0.934, 95% CI 0.909 to 0.960).

CONCLUSIONS

The results are consistent with the hypothesis that long term exposure to traffic related outdoor air pollutants such as NOx, CO, and O3 increases the risk of asthma in children.

Spatial variability of fine particle mass, components, and source contributions during the regional air pollution study in St. Louis

Community time-series epidemiology typically uses either 24-hour integrated particulate matter (PM) concentrations averaged across several monitors in a city or data obtained at a central monitoring site to relate PM concentrations to human health effects. If the day-to-day variations in 24-hour integrated concentrations differ substantially across an urban area (i.e., daily measurements at monitors at different locations are not highly correlated), then there is a significant potential for exposure misclassification in community time-series epidemiology. If the annual average concentration differs across an urban area, then there is a potential for exposure misclassification in epidemiologic studies that use annual averages (or multi-year averages) as an index of exposure across different cities. The spatial variability in PM2.5 (particulate matter < or = 2.5 microm in aerodynamic diameter), its elemental components, and the contributions from each source category at 10 monitoring sites in St. Louis, Missouri were characterized using the ambient PM2.5 compositional data set of the Regional Air Pollution Study (RAPS) based on the Regional Air Monitoring System (RAMS) conducted between 1975 and 1977. Positive matrix factorization (PMF) was applied to each ambient PM2.5 compositional data set to estimate the contributions from the source categories. The spatial distributions of components and source contributions to PM2.5 at the 10 sites were characterized using Pearson correlation coefficients and coefficients of divergence. Sulfur and PM2.5 are highly correlated elements between all of the site pairs Although the secondary sulfate is the most highly correlated and shows the smallest spatial variability, there is a factor of 1.7 difference in secondary sulfate contributions between the highest and lowest site on average. Motor vehicles represent the next most highly correlated source component. However, there is a factor of 3.6 difference in motor vehicle contributions between the highest and lowest sites. The contributions from point source categories are much more variable. For example, the contributions from incinerators show a difference of a factor of 12.5 between the sites with the lowest and highest contributions. This study demonstrates that the spatial distributions of elemental components of PM2.5 and contributions from source categories can be highly heterogeneous within a given airshed and thus, there is the potential for exposure misclassification when a limited number of ambient PM monitors are used to represent population-average ambient exposures.

Diabetes enhances vulnerability to particulate air pollution-associated impairment in vascular reactivity and endothelial function

BACKGROUND

Epidemiological studies suggest that people with diabetes are vulnerable to cardiovascular health effects associated with exposure to particle air pollution. Endothelial and vascular function is impaired in diabetes and may be related to increased cardiovascular risk. We examined whether endothelium-dependent and -independent vascular reactivity was associated with particle exposure in individuals with and without diabetes.

METHODS AND RESULTS

Study subjects were 270 greater-Boston residents. We measured 24-hour average ambient levels of air pollution (fine particles [PM2.5], particle number, black carbon, and sulfates [SO4(2-)]) approximately 500 m from the patient examination site. Pollutant concentrations were evaluated for associations with vascular reactivity. Linear regressions were fit to the percent change in brachial artery diameter (flow mediated and nitroglycerin mediated), with the particulate pollutant index, apparent temperature, season, age, race, sex, smoking history, and body mass index as predictors. Models were fit to all subjects and then stratified by diagnosed diabetes versus at risk for diabetes. Six-day moving averages of all 4 particle metrics were associated with decreased vascular reactivity among patients with diabetes but not those at risk. Interquartile range increases in SO4(2-) were associated with decreased flow-mediated (-10.7%; 95% CI, -17.3 to -3.5) and nitroglycerin-mediated (-5.4%; 95% CI, -10.5 to -0.1) vascular reactivity among those with diabetes. Black carbon increases were associated with decreased flow-mediated vascular reactivity (-12.6%; 95% CI, -21.7 to -2.4), and PM2.5 was associated with nitroglycerin-mediated reactivity (-7.6%; 95% CI, -12.8 to -2.1). Effects were stronger in type II than type I diabetes.

CONCLUSIONS

Diabetes confers vulnerability to particles associated with coal-burning power plants and traffic.

Exposure to Ambient and Nonambient Components of Particulate Matter

BACKGROUND

Numerous epidemiologic studies report associations between outdoor concentrations of particles and adverse health effects. Because personal exposure to particles is frequently dominated by exposure to nonambient particles (those originating from indoor sources), we present an approach to evaluate the relative impacts of ambient and nonambient exposures.

METHODS

We developed separate estimates of exposures to ambient and nonambient particles of different size ranges (PM2.5, PM10-2.5 and PM10) based on time-activity data and the use of particle sulfate measurements as a tracer for indoor infiltration of ambient particles. To illustrate the application of these estimates, associations between cardiopulmonary health outcomes and the estimated exposures were compared with associations computed using measurements of personal exposures and outdoor concentrations for a repeated-measures panel study of 16 patients with chronic obstructive pulmonary disease conducted in the summer of 1998 in Vancouver.

RESULTS

Total personal fine particle exposures were dominated by exposures to nonambient particles, which were not correlated with ambient fine particle exposures or ambient concentrations. Although total and nonambient particle exposures were not associated with any of the health outcomes, ambient exposures (and to a lesser extent ambient concentrations) were associated with decreased lung function, decreased systolic blood pressure, increased heart rate, and increased supraventricular ectopic heartbeats. Measures of heart rate variability showed less consistent relationships among the various exposure metrics.

CONCLUSIONS

These results demonstrate the usefulness of separating total personal particle exposures into their ambient and nonambient components. The results support previous epidemiologic findings using ambient concentrations by demonstrating an association between health outcomes and ambient (outdoor origin) particle exposures but not with nonambient (indoor origin) particle exposures.

Ambient Gas Concentrations and Personal Particulate Matter Exposures

BACKGROUND

Data from a previous study conducted in Baltimore, MD, showed that ambient fine particulate matter less than 2.5 mum in diameter (PM2.5) concentrations were strongly correlated with corresponding personal PM2.5 exposures, whereas ambient O3, NO2, and SO2 concentrations were weakly correlated with their personal exposures to these gases. In contrast, many of the ambient gas concentrations were reasonable surrogates of personal PM2.5 exposures.

METHODS

Personal multipollutant exposures and corresponding ambient air pollution concentrations were measured for 43 subjects living in Boston, MA. The cohort consisted of 20 healthy senior citizens and 23 schoolchildren. Simultaneous 24-hour integrated PM2.5, O3, NO2, and SO2 personal exposures and ambient concentrations were measured. All PM2.5 samples were also analyzed for SO4 (sulfate). We analyzed personal exposure and ambient concentration data using correlation and mixed model regression analyses to examine relationships among (1) ambient PM2.5 concentrations and corresponding ambient gas concentrations; (2) ambient PM2.5 and gas concentrations and their respective personal exposures; (3) ambient gas concentrations and corresponding personal PM2.5 exposures; and (4) personal PM2.5 exposures and corresponding personal gas exposures.

RESULTS

We found substantial correlations between ambient PM2.5 concentrations and corresponding personal exposures over the course of time. Additionally, our results support the earlier finding that summertime gaseous pollutant concentrations may be better surrogates of personal PM2.5 exposures (especially personal exposures to PM2.5 of ambient origin) than they are surrogates of personal exposures to the gases themselves.

CONCLUSIONS

Particle health effects studies that include both ambient PM2.5 and gaseous concentrations as independent variables must be analyzed carefully and interpreted cautiously, since both parameters may be serving as surrogates for PM2.5 exposures.

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.

Monitor-to-monitor temporal correlation of air pollution in the contiguous US

Numerous studies have reported short-term associations between ambient air pollution concentrations and mortality and morbidity. Particulate matter (PM) was often implicated as the most significant predictor of the health outcomes among the various air pollutants. However, a question remains as to the potential role played by the relative error of exposure estimation associated with each pollutant in defining their relative strengths of association. While most of the recent studies on PM exposure measurements have focused on the temporal correlation between personal exposures and the concentrations observed at ambient air quality monitors (within a few miles from the subjects), there have been few studies that systematically evaluated spatial uniformity of temporal correlation of air pollution within the scale of a city (several tens of miles) for which mortality or morbidity outcomes are aggregated in time-series studies. In this study, spatial uniformity of temporal correlation was examined by computing monitor-to-monitor correlation using available multiple monitors for PM(10) and gaseous criteria pollutants (NO(2), SO(2), CO, and O(3)) in the nationwide data between 1988 and 1997. For each monitor, the median of temporal correlation with other monitors within the Air Quality Control Region (AQCR) was computed. The resulting median monitor-to-monitor correlation was modeled as a function of qualitative site characteristics (i.e., land-use, location-setting, and monitoring-objective) and quantitative information (median separation distance, longitude/latitude or regional indicators) for each pollutant. Generalized additive models (GAM) were used to fit the smooth function of the separation distance and regional variation. The intercepts of the models across pollutants showed the overall rankings in monitor-to-monitor correlation on the average to be: O(3), NO(2), and PM(10), (r approximately 0.6 to 0.8)>CO (r<0.6)>SO(2) (r<0.5). Both the separation distance and regional variation were important predictors of the correlation. For PM(10), for example, the correlation for the monitors along the East Coast was higher by approximately 0.2 than western regions. The qualitative monitor characteristics were often significant predictors of the variation in correlation, but their impacts were not substantial in magnitude for most categories. These results suggest that the apparent regional heterogeneity in PM effect estimates, as well as the differences in the significance of health outcome associations across pollutants, may in part be contributed to by the differences in monitor-to-monitor correlations by region and across pollutants.

Effects of air pollution on heart rate variability: the VA normative aging study

Reduced heart rate variability (HRV), a marker of poor cardiac autonomic function, has been associated with air pollution, especially fine particulate matter [< 2.5 microm in aerodynamic diameter (PM2.5)]. We examined the relationship between HRV [standard deviation of normal-to-normal intervals (SDNN), power in high frequency (HF) and low frequency (LF), and LF:HF ratio] and ambient air pollutants in 497 men from the Normative Aging Study in greater Boston, Massachusetts, seen between November 2000 and October 2003. We examined 4-hr, 24-hr, and 48-hr moving averages of air pollution (PM2.5, particle number concentration, black carbon, ozone, nitrogen dioxide, sulfur dioxide, carbon monoxide). Controlling for potential confounders, HF decreased 20.8% [95% confidence interval (CI), 4.6-34.2%] and LF:HF ratio increased 18.6% (95% CI, 4.1-35.2%) per SD (8 microg/m3) increase in 48-hr PM2.5. LF was reduced by 11.5% (95% CI, 0.4-21.3%) per SD (13 ppb) increment in 4-hr O3. The associations between HRV and PM2.5 and O3 were stronger in people with ischemic heart disease (IHD) and hypertension. The associations observed between SDNN and LF and PM2.5 were stronger in people with diabetes. People using calcium-channel blockers and beta-blockers had lower associations between O3 and PM2.5 with LF. No effect modification by other cardiac medications was found. Exposures to PM2.5 and O3 are associated with decreased HRV, and history of IHD, hypertension, and diabetes may confer susceptibility to autonomic dysfunction by air pollution.

Functional group characterization of indoor, outdoor, and personal PM: results from RIOPA

Fourier transform infrared (FTIR) spectra of outdoor, indoor, and personal fine particulate matter (PM(2.5)) samples were collected during the Relationship of Indoor, Outdoor, and Personal Air (RIOPA) study. FTIR spectroscopy provides functional group information about the entire PM(2.5) sample without any chemical preparation. It is particularly important to characterizing the poorly understood organic fraction of PM(2.5). To our knowledge this is the first time that FTIR spectroscopy has been applied to a PM(2.5) exposure study. The results were used to chemically characterize indoor air and personal exposure. Sulfate was strongest in outdoor samples, which is consistent with the generally accepted understanding that sulfate is of outdoor origin. Absorbances attributed to soil dust were also seen in many outdoor and some indoor and personal samples. Inorganic nitrate absorbances were a common feature of many California and some New Jersey samples. Carbonyl absorbances showed substantial variation in strength, number of peaks, and wave number shift between samples, indicating variability in composition and sources. Absorbances attributed to aliphatic hydrocarbon and amide functional groups were enhanced in many personal and indoor samples, which suggested the influence of indoor sources in these homes. We speculate that meat cooking is one possible source of particulate amides.

PRACTICAL IMPLICATIONS

To our knowledge this is the first time that FTIR spectroscopy has been used to characterize the composition of indoor and personal PM(2.5). The presence of sulfate, nitrate, ammonium, soil dust and a number of organic functional groups are all detected in one analysis on filter samples without extraction or other sample preparation. Differences between indoor and outdoor spectra are used to identify spectral features due to indoor-generated PM(2.5). Particularly interesting are the much larger aliphatic absorbances, shifts in carbonyl absorbances, and occasional small amide absorbances found in indoor and personal spectra but rarely in outdoor spectra. These observations are important because organics make up a large portion of PM(2.5) mass and their composition and properties are poorly characterized. The properties and behavior of organic compounds in airborne particles are often predicted based on their functional group composition. This analysis begins the development of a better understanding of the functional group composition of indoor and personal PM(2.5) and how it differs from that of outdoor PM(2.5). Eventually this will lead to an improved understanding of the properties, behavior and effects of PM(2.5) of indoor and outdoor origin.

Ambient air pollution and atherosclerosis in Los Angeles

Associations have been found between long-term exposure to ambient air pollution and cardiovascular morbidity and mortality. The contribution of air pollution to atherosclerosis that underlies many cardiovascular diseases has not been investigated. Animal data suggest that ambient particulate matter (PM) may contribute to atherogenesis. We used data on 798 participants from two clinical trials to investigate the association between atherosclerosis and long-term exposure to ambient PM up to 2.5 microm in aerodynamic diameter (PM2.5). Baseline data included assessment of the carotid intima-media thickness (CIMT), a measure of subclinical atherosclerosis. We geocoded subjects' residential areas to assign annual mean concentrations of ambient PM2.5. Exposure values were assigned from a PM2.5 surface derived from a geostatistical model. Individually assigned annual mean PM2.5 concentrations ranged from 5.2 to 26.9 microg/m3 (mean, 20.3). For a cross-sectional exposure contrast of 10 microg/m3 PM2.5, CIMT increased by 5.9% (95% confidence interval, 1-11%). Adjustment for age reduced the coefficients, but further adjustment for covariates indicated robust estimates in the range of 3.9-4.3% (p-values, 0.05-0.1). Among older subjects (greater than or equal to 60 years of age), women, never smokers, and those reporting lipid-lowering treatment at baseline, the associations of PM2.5 and CIMT were larger with the strongest associations in women 60 years of age (15.7%, 5.7-26.6%). These results represent the first epidemiologic evidence of an association between atherosclerosis and ambient air pollution. Given the leading role of cardiovascular disease as a cause of death and the large populations exposed to ambient PM2.5, these findings may be important and need further confirmation.

Source apportionment of fine particles in Washington, DC, utilizing temperature-resolved carbon fractions

Integrated ambient particulate matter < or =2.5 microm in aerodynamic diameter (PM2.5) samples were collected at a centrally located urban monitoring site in Washington, DC, on Wednesdays and Saturdays using Interagency Monitoring of Protected Visual Environments samplers. Particulate carbon was analyzed using the thermal optical reflectance method that divides carbon into four organic carbon fractions, pyrolyzed organic carbon, and three elemental carbon fractions. A total of 35 variables measured in 718 samples collected between August 1988 and December 1997 were analyzed. The data were analyzed using Positive Matrix Factorization and 10 sources were identified: sulfate (SO4(2-))-rich secondary aerosol I (43%), gasoline vehicle (21%), SO4(2-)-rich secondary aerosol II (11%), nitrate-rich secondary aerosol (9%), SO4(2-)-rich secondary aerosol III (6%), incinerator (4%), aged sea salt (2%), airborne soil (2%), diesel emissions (2%), and oil combustion (2%). In contrast to a previous study that included only total organic carbon and elemental carbon fractions, motor vehicles were separated into fractions identified as gasoline vehicle and diesel emissions containing carbon fractions whose abundances were different between the two sources. This study indicates that the temperature-resolved carbon fraction data can be utilized to enhance source apportionment, especially with respect to the separation of diesel emissions from gasoline vehicle sources. Conditional probability functions using surface wind data and deduced source contributions aid in the identifications of local sources.

Assessing the importance of different exposure metrics and time-activity data to predict 24-H personal PM2.5 exposures

Personal PM(2.5) data from two recent exposure studies, the Scripted Activity Study and the Older Adults Study, were used to develop models predicting 24-h personal PM(2.5) exposures. Both studies were conducted concurrently in the summer of 1998 and the winter of 1999 in Baltimore, MD. In the Scripted Activity Study, 1-h personal PM(2.5) exposures were measured. Data were used to identify significant factors affecting personal exposures and to develop 1-h personal exposure models for five different micro-environments. By incorporating the time-activity diary data, these models were then combined to develop a time-weighted microenvironmental personal model (model M1AD) to predict the 24-h PM(2.5) exposures measured for individuals in the Older Adults Study. Twenty-four-hour time-weighted models were also developed using 1-h ambient PM(2.5) levels and time-activity data (model A1AD) or using 24-h ambient PM(2.5) levels and time-activity data (model A24AD). The performance of these three models was compared to that using 24-h ambient concentrations alone (model A24). Results showed that factors affecting 1-h personal PM(2.5) exposures included air conditioning status and the presence of environmental tobacco smoke (ETS) for indoor micro-environments, consistent with previous studies. ETS was identified as a significant contributor to measured 24-h personal PM(2.5) exposures. Staying in an ETS-exposed microenvironment for 1 h elevated 24-h personal PM(2.5) exposures by approximately 4 microg/m 3 on average. Cooking and washing activities were identified in the winter as significant contributors to 24-h personal exposures as well, increasing 24-h personal PM(2.5) exposures by about 4 and 5 microg/m 3 per hour of activity, respectively. The ability of 3 microenvironmental personal exposure models to estimate 24-h personal PM(2.5) exposures was generally comparable to and consistently greater than that of model A24. Results indicated that using time-activity data with 1-h exposure information, either as micro-environment-specific exposures (model M1AD) or as ambient concentrations (model A1AD), improves our ability to estimate 24-h personal PM(2.5) exposure over the model using 24-h averaged ambient levels alone (model A24). Model performance was higher in the summer than in the winter season. In addition, higher crude R(2) values were reported for subjects participating in both seasons, where the R(2) values equaled.53,.55,.46, and.38 for models M1AD, A1AD, A24AD, and A24, respectively. The low predictive ability of the microenvironmental exposure models in the winter might, in part, be attributed to the narrow dynamic range of personal PM(2.5) exposures.

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

The contribution of outdoor particulate matter (PM) to residential indoor concentrations is currently not well understood. Most importantly, separating indoor PM into indoor- and outdoor-generated components will greatly enhance our knowledge of the outdoor contribution to total indoor and personal PM exposures. This paper examines continuous light scattering data at 44 residences in Seattle, WA. A newly adapted recursive model was used to model outdoor-originated PM entering indoor environments. After censoring the indoor time-series to remove the influence of indoor sources, nonlinear regression was used to estimate particle penetration (P, 0.94 +/- 0.10), air exchange rate (a, 0.54 +/- 0.60 h(-1)), particle decay rate (k, 0.20 +/- 0.16 h(-1)), and particle infiltration (F(inf), 0.65 +/- 0.21) for each of the 44 residences. All of these parameters showed seasonal differences. The F(inf) estimates agree well with those estimated from the sulfur-tracer method (R2 = 0.78). The F(inf) estimates also showed robust and expected behavior when compared against known influencing factors. Among our study residences, outdoor-generated particles accounted for an average of 79 +/- 17% of the indoor PM concentration, with a range of 40-100% at individual residences. Although estimates of P, a, and k were dependent on the modeling technique and constraints, we showed that a recursive mass balance model combined with our censoring algorithms can be used to attribute indoor PM into its outdoor and indoor components and to estimate an average P, a, k, and F(inf), for each residence.

Using sulfur as a tracer of outdoor fine particulate matter

Six homes in the metropolitan Boston area were sampled between 6 and 12 consecutive days for indoor and outdoor particle volume and mass concentrations, particle elemental concentrations, and air exchange rates (AERs). Indoor/outdoor (I/O) ratios of nighttime (i.e., particle nonindoor source periods) sulfur, PM2.5 and the specific particle size intervals were used to provide estimates of the effective penetration efficiency. Mixed models and graphical displays were used to assess the ability of the I/O ratios for sulfur to estimate corresponding I/O ratios for PM2.5 and the various particle sizes. Results from this analysis showed that particulate sulfur compounds were primarily of outdoor origin and behaved in a manner that was representative of total PM2.5 in Boston, MA. These findings support the conclusion that sulfur can be used as a suitable tracer of outdoor PM2.5 for the homes sampled in this study. Sulfur was more representative of particles of similar size (0.06-0.5 microm), providing evidence that the size composition of total PM2.5 is an important characteristic affecting the robustness of sulfur-based estimation methods.

Accessible tools for classification of exposure to particles

In this manuscript we describe various alternative tools to estimate exposure to particles. We stress methods that are cost effective and widely available to those throughout the world. The use of surrogate measures arises from the need to estimate exposures of large populations where individual measurements are not feasible, for predictive modeling or to assess exposures rapidly before personal monitoring campaigns can be implemented. In addition, an understanding of the relationship between exposures and surrogate variables can be useful in helping to identify mitigation strategies to reduce exposures. We have separated the various alternative exposure measures by the scales of impact, describing approaches to assess regional, urban and household indoor air quality. In particular, we emphasize scenarios that are relevant to particle exposures that may be experienced in developing countries as a result of domestic energy use for cooking and heating. In all cases the approaches we describe are applicable to large populations as the data collection techniques are relatively inexpensive and specifically applicable on a population basis for risk assessment, epidemiology or to evaluate determinants of exposure and health outcomes. The ultimate use of the assessed exposures will determine the relevance of potential surrogate measures.

Exposure misclassification and threshold concentrations in time series analyses of air pollution health effects

Linear, no-threshold relationships are typically reported for time series studies of air pollution and mortality. Since regulatory standards and economic valuations typically assume some threshold level, we evaluated the fundamental question of the impact of exposure misclassification on the persistence of underlying personal-level thresholds when personal data are aggregated to the population level in the assessment of exposure-response relationships. As an example, we measured personal exposures to two particle metrics, PM2.5 and sulfate (SO4(2-)), for a sample of lung disease patients and compared these with exposures estimated from ambient measurements Previous work has shown that ambient:personal correlations for PM2.5 are much lower than for SO4(2-), suggesting that ambient PM2.5 measurements misclassify exposures to PM2.5. We then developed a method by which the measured:estimated exposure relationships for these patients were used to simulate personal exposures for a larger population and then to estimate individual-level mortality risks under different threshold assumptions. These individual risks were combined to obtain the population risk of death, thereby exhibiting the prominence (and the value) of the threshold in the relationship between risk and estimated exposure. Our results indicated that for poorly classified exposures (PM2.5 in this example) population-level thresholds were apparent at lower ambient concentrations than specified common personal thresholds, while for well-classified exposures (e.g., SO4(2-)), the apparent thresholds were similar to these underlying personal thresholds. These results demonstrate that surrogate metrics that are not highly correlated with personal exposures obscure the presence of thresholds in epidemiological studies of larger populations, while exposure indicators that are highly correlated with personal exposures can accurately reflect underlying personal thresholds.

Fine PM measurements: personal and indoor air monitoring

This review compiles personal and indoor microenvironment particulate matter (PM) monitoring needs from recently set research objectives, most importantly the NRC published "Research Priorities for Airborne Particulate Matter (1998)". Techniques and equipment used to monitor PM personal exposures and microenvironment concentrations and the constituents of the sampled PM during the last 20 years are then reviewed. Development objectives are set and discussed for personal and microenvironment PM samplers and monitors, for filter materials, and analytical laboratory techniques for equipment calibration, filter weighing and laboratory climate control. The progress is leading towards smaller sample flows, lighter, silent, independent (battery powered) monitors with data logging capacity to store microenvironment or activity relevant sensor data, advanced flow controls and continuous recording of the concentration. The best filters are non-hygroscopic, chemically pure and inert, and physically robust against mechanical wear. Semiautomatic and primary standard equivalent positive displacement flow meters are replacing the less accurate methods in flow calibration, and also personal sampling flow rates should become mass flow controlled (with or without volumetric compensation for pressure and temperature changes). In the weighing laboratory the alternatives are climatic control (set temperature and relative humidity), and mechanically simpler thermostatic heating, air conditioning and dehumidification systems combined with numerical control of temperature, humidity and pressure effects on flow calibration and filter weighing.

Development and laboratory performance evaluation of a personal cascade impactor

This paper presents the design and laboratory evaluation of a personal cascade impactor. The system is compact, lightweight, and uses a single battery-operated sampling pump. It operates at a flow rate of 5 L/min and consists of four impaction stages, each equipped with slit-shaped acceleration nozzles, and a backup filter. The impactor was calibrated using polydisperse particles. The 50% cut points of the four stages were 9.6, 2.6, 1.0, and 0.5 microm, respectively. The backup filter is placed downstream of the fourth stage and is used to collect the particles with an aerodynamic diameter smaller than 0.5 microm (dp < 0.5 microm). The major feature of this novel sampler is its ability not only to fractionate the particles with an aerodynamic diameter smaller than 10 microm to the various size fractions, but also to collect them onto relatively small polyurethane foam substrates without using adhesives. Although the impaction substrates are not coated with adhesives such as grease or mineral oil, particle bounce and re-entrainment losses were found to be insignificant. Interstage losses of particles smaller than 0.5 microm were less than 10%; for fine particles, less than 5%; and for coarse particles, less than 12%. The pressure drop across the four stages and the backup filter were 0.015 kPa (0.153 cm H2O),0.025 kPa (0.255 cm H2O), 0.274 kPa (2.794 cm H2O), 0.323 kPa (3.294 cm H2O), and 0.370 kPa (3.773 cm H2O), respectively. Particles can be easily recovered from the foam substrates using aqueous extraction.

Personal exposure of Paris office workers to nitrogen dioxide and fine particles

AIMS

(1) To obtain an overall estimate of variability of personal exposure of Paris office workers to fine particles (PM(2.5)) and nitrogen dioxide (NO(2)), and to quantify their microenvironmental determinants. (2) To examine the role of potential determinants of indoor concentrations.

METHODS

Sixty two office workers in a Paris municipal administration (all non-smokers) were equipped with personal samplers: passive samplers for 48 hours for NO(2) (n = 62), and active pumps for 24 hours for PM(2.5) (n = 55). Simultaneous measurements were performed in homes and offices; the local air monitoring network provided ambient concentrations. A time activity diary was used to weight measured concentrations by time spent in each microenvironment in order to estimate exposure concentrations.

RESULTS

On average, PM(2.5) personal exposure (30.4 microg/m(3)) was higher than corresponding in-home (24.7 microg/m(3)) and ambient concentrations (16.7 microg/m(3)). Personal exposure to NO(2) (43.6 microg/m(3)) was significantly higher than in-home concentrations (35.1 microg/m(3)) but lower than the background outdoor level (60.1 microg/m(3)). Personal exposures to PM(2.5) and NO(2) were not significantly different from in-office concentrations. PM(2.5) and NO(2) personal exposures were not significantly correlated. In-home, in-office, in-transit, outdoor time weighted concentrations, and time spent in other indoor microenvironments explain respectively 86% and 78% of personal variations in PM(2.5) and NO(2). In-home PM(2.5) concentration was primarily influenced by exposure to environmental tobacco smoke, and secondly by the ambient level (R(2) = 0.20). NO(2) in-home concentration was affected mostly by the ambient level and gas cooking time (R(2) = 0.14).

CONCLUSION

While results show the major contribution of in-home and in-office concentrations to both NO(2) and PM(2.5) personal exposures, the identification of indoor level determinants was not very conclusive.

Comparison of light scattering devices and impactors for particulate measurements in indoor, outdoor, and personal environments

Short-term monitoring of individual particulate matter (PM) exposures on subjects and inside residences in health effect studies have been sparse due to the lack of adequate monitoring devices. The recent development of small and portable light scattering devices, including the Radiance nephelometer (neph) and the personal DataRAM (pDR) has made this monitoring possible. This paper evaluates the performance of both the passive pDR and neph (without any size fractionation inlet) against measurements from both Harvard impactors (HI2.5) and Harvard personal environmental monitors (HPEM2.5) for PM2.5 in indoor, outdoor, and personal settings. These measurements were taken at the residences and on the person of nonsmoking elderly subjects across the metropolitan Seattle area and represent a wide range of light scattering measurements directly related to exposures and health effects. At low PM levels, nephs provided finer resolution and more precise measurements (precision = 3-8% and uncertainty = 2.8 x 10(-7) m(-1) or <1 microg/m3) than the pDRs. The unbiased precision of pDRs above 10 microg/m3 is around 5% (with an unbiased uncertainty of 4.4 microg/m3). The 24-h average responses of the pDR and neph, as compared to 24-h integrated gravimetric measurements, are not affected by indoor sources of PM. When regressed against 24-h gravimetric measurements, nephs showed higher coefficients of determination (R2 = 0.81-0.93) than pDRs (R2 = 0.77-0.84). The default mass calibration on the pDRs generally overestimated indoor HI2.5 measurements by 56%. When carried by subjects, the pDR overestimated the HPEM2.5 measurements by approximately 27%. Collocated real-time indoor nephs and pDRs at diverse residential sites had varied coefficients of determination across homes (R2 = 0.75-0.96), and the difference between pDR and neph responses increased during cooking hours. This difference was larger during baking or frying episodes than during other cooking or cleaning activities. Relative humidity, ranging between 25% and 64% indoors in our study, was not a significant factor affecting the differences in neph or pDR response. In summary, for nonsmoking residences, the mass scattering efficiency (m2/g) of a stationary indoor neph on a 24-h basis does not vary by residence, including residences with and without cooking activities. This is also true forthe pDR. These same stationary indoor pDRs and nephs correlate well with each other, even on a 10-min basis, in the absence of indoor source activities. The fact that these activities comprised a relatively small percentage (cooking + cleaning = 2.3%) of the overall sampling time meant that the overall correlation between these two instruments for all time periods was good. However, when examining the cooking and cleaning periods separately, the correlation was not very good. Thus, during these short-term PM episodes, the 24-h average calibrations versus gravimetric mass should be used with caution. Both devices should be potentially useful in future exposure assessment and health effects studies.

The association between personal measurements of environmental exposure to particulates and heart rate variability

BACKGROUND

Epidemiologic evidence indicates that airborne particulates are associated with mortality risk, predominately from heart disease. This may occur through changes in the cardiac autonomic nervous system, witnessed by changes in heart rate variability.

METHODS

This short-term longitudinal study used continuous personal particulate matter measurements to examine the effects of exposure to particulate matter less than 2.5 microm in diameter (PM2.5) on heart rate and rate variability in 20 relatively young, healthy male workers. Continuous exposure and cardiac monitoring were performed on each subject on a nonwork day. The 5-minute standard deviation of the normal-to-normal interval was used as the main measure of heart rate variability.

RESULTS

Mixed-effects regression models estimate an average 1.4% (95% confidence limits = -2.1, -0.6) decrease in the 5-minute standard deviation of the normal-to-normal interval for each 100 microg/m3 increase in the 3-hour PM2.5 moving average, and small increases in heart rate, after adjustment for potential confounding factors. Predicted effects of exposure were greatest using the 3-hour averaging interval for PM2.5 and decreased in magnitude using shorter and longer intervals.

CONCLUSIONS

These results reveal an association between cardiac autonomic function and environmental PM2.5 exposure. These observed associations may result from decreased vagal or increased sympathetic tone.

Measurements of children's exposures to particles and nitrogen dioxide in Santiago, Chile

An exposure study of children (aged 10-12 years) living in Santiago, Chile, was conducted. Personal, indoor and outdoor fine and inhalable particulate matter (< 2.5 .m in diameter, PM2.5 and < 10 microm in diameter, PM10, respectively), and nitrogen dioxide (NO2) were measured during pilot (N = 8) and main (N = 20) studies, which were conducted during the winters of 1998 and 1999, respectively. For the main study, personal, indoor and outdoor 24-h samples were collected for five consecutive days. Similar mean personal, indoor and outdoor PM2.5 concentrations (69.5, 68.5 and 68.1 microg/m3, respectively) were found. However, for coarse particles (calculated as the difference between measured PM10 and PM2.5, PM2.5-10), indoor and outdoor levels (35.4 and 47.4 microg/m3) were lower than their corresponding personal exposures (76.3 microg/m3). Indoor and outdoor NO2 concentrations were comparable (35.8 and 36.9 ppb) and higher than personal exposures (25.9 ppb). Very low ambient indoor and personal O3 levels were found, which were mostly below the method's limit of detection (LOD). Outdoor particles contributed significantly to indoor concentrations, with effective penetration efficiencies of 0.61 and 0.30 for PM2.5 and PM2.5-10, respectively. Personal exposures were strongly associated with indoor and outdoor concentrations for PM2.5, but weakly associated for PM2.5-10. For NO2, weak associations were obtained for indoor-outdoor and personal-outdoor relationships. This is probably a result of the presence of gas cooking stoves in all the homes. Median I/O, P/I and P/O ratios for PM2.5 were close to unity, and for NO2 they ranged between 0.64 and 0.95. These ratios were probably due to high ambient PM2.5 and NO2 levels in Santiago, which diminished the relative contribution of indoor sources and subjects' activities to indoor and personal PM2.5 and NO2 levels.

Association of heart rate variability with occupational and environmental exposure to particulate air pollution

BACKGROUND

Airborne particulate matter has been linked to excess morbidity and mortality. Recent attention has focused on the effects of particulate exposure on cardiac autonomic control. Inhaled particulates may affect the autonomic nervous system either directly, by eliciting a sympathetic stress response, or indirectly, through inflammatory cytokines produced in the lungs and released into the circulation.

METHODS AND RESULTS

This longitudinal study examined the association of particulates </=2.5 microm in diameter (PM(2.5)) with heart rate variability (HRV) in an occupational cohort (N=40). Continuous monitoring of exposure and HR was performed during and away from work. PM(2.5) levels were higher than ambient levels typically reported in Boston, 0.167+/-3.205 mg/m(3) (geometric mean+/-geometric SD). We found a 2.66% decrease (95% CI, -3.75% to -1.58%) in the 5-minute SD of normal RR intervals (SDNN) for every 1 mg/m(3) increase in the 4-hour moving PM(2.5) average and a 1.02% increase (95% CI, 0.59% to 1.46%) in HR after adjusting for potential confounding factors. The decrease in SDNN became larger as the averaging interval increased.

CONCLUSIONS

Workers experienced altered cardiac autonomic control after exposure to occupational and environmental PM(2.5). There appears to be either a long-acting (several hours) and a short-acting (several minutes) component to the mechanism of action that may be related to the production of cytokines and the sympathetic stress response, respectively, or a cumulative effect that begins shortly after exposure begins. The clinical significance of these effects in a healthy working population is unclear.