Levels and health risk assessments of particulate matters (PM2.5 and PM10) in indoor/outdoor air of waterpipe cafés in Tehran, Iran

Climatic conditions and concentrations of BTEX compounds in atmospheric media

Climatic and meteorological conditions are among the factors affecting the ambient concentrations of BTEX compounds. This systematic review and meta-analysis aimed to interrogate the seasonal effect of climatic conditions on the concentrations of BTEX compounds. Three electronic bibliographic databases including Scopus, PubMed, and Web of Science were systematically searched up to November 14, 2023. The search algorithm followed PRISMA guidance and consisted of three groupings of keywords and their possible combinations. For various climatic conditions, the overall mean and 95% confidence interval (CI) of effect size related to BTEX concentrations were calculated using a random-effect model. In total, 104 articles were included for evaluation in this review. BTEX ambient concentration was higher in winter (ranging from 36 out of 79 relevant studies for xylene to 52 out of 97 relevant studies for benzene) followed by summer and autumn. For humidity conditions, the highest exposure values for BTEX were detected for rainy weather (ranging from 3 out of 5 relevant studies for toluene and xylene to 4 out of 5 relevant studies for benzene and ethyl benzene) compared to dry conditions. The pooled concentration (μg/m3) of benzene, toluene, ethyl benzene, and xylene were computed as 2.61, 7.12, 2.21, and 3.61 in spring, 2.13, 7.53, 1.61, and 2.75 in summer, 3.04, 9.59, 3.14, and 5.50 in autumn, and 3.56, 8.71, 2.35, and 3.91 in winter, respectively. Moreover, the pooled concentrations (μg/m3) of BTEX were measured as 2.98, 7.22, 1.90, and 3.03 in dry weather and 3.15, 6.30, 2.14, and 3.86 in rainy or wet weather, respectively. In most seasons, the ambient concentrations of BTEX were higher in countries with low and middle incomes and in Middle Eastern countries and East/Southeast Asia compared to those in other regions (P < 0.001). The increasing concentrations of BTEX in winter and autumn followed by the summer season and during rainy/wet weather appear to be reasonably consistent despite variations in study methods, quality, or geography. Therefore, it is recommended that more serious control measures are considered for decreasing exposure to BTEX in these climatic conditions.

Inhalational exposure to formaldehyde, carcinogenic, and non-carcinogenic risk assessment: A systematic review

Formaldehyde is one of the most widely used substances in a variety of industries, although it was classified as a human carcinogen by the International Agency for Research on Cancer (IARC). The present systematic review was conducted to retrieve studies related to occupational exposure to formaldehyde until November 2, 2022. Aims of the study were to identify workplaces exposed to formaldehyde, to investigate the formaldehyde concentrations in various occupations and to evaluate carcinogenic and non-carcinogenic risks caused by respiratory exposure to this chemical among workers. A systematic search was done in Scopus, PubMed and Web of Science databases to find the studies done in this field. In this review, studies that did not meet the criteria specified by Population, Exposure, Comparator, and Outcomes (PECO) approach were excluded. In addition, the inclusion of studies dealing with the biological monitoring of FA in the body and review studies, conference articles, books, and letters to the editors were avoided. The quality of the selected studies was also evaluated using the Joanna Briggs Institute (JBI) checklist for analytic-cross-sectional studies. Finally, 828 studies were found, and after the investigations, 35 articles were included in this study. The results revealed that the highest formaldehyde concentrations were observed in waterpipe cafes (1,620,000 μg/m³) and anatomy and pathology laboratories (4237.5 μg/m³). Carcinogenic and non-carcinogenic risk indicated the potential health effects for employees due to respiratory exposure as acceptable levels of CR = 1.00 × 10^-4 and HQ = 1, respectively were reported to be exceeded in more than 71% and 28.57% of the investigated studies. Therefore, according to the confirmation of formaldehyde's adverse health effects, it is necessary to adopt targeted strategies to reduce or eliminate exposure to this compound from the occupational usage.

Impact of differential occupational LPG exposure on cardiopulmonary indices, liver function, and oxidative stress in Northwestern city of Nigeria

Exposure to hydrocarbon products has been associated with numerous health risks and toxicities. Outdoor or indoor occupational exposure to highly volatile and lipid-soluble hydrocarbons has been linked to impairment of respiratory, cardiovascular, and liver functions. This study is aimed at determining the potential impact of occupational exposure to liquefied petroleum gas (LPG) in varying work environments. Respiratory symptoms, oxidative stress, cardio-pulmonary, and liver function parameters were assessed among LPG workers in the Kano metropolis, Nigeria. Study subjects were recruited from LPG filling stations and street LPG retail shops. Results of the study showed that the forced vital capacity (FVC) of LPG station workers was significantly lower (2.81 L/min; H = 22.473, p < 0.001) relative to the values recorded among LPG retail shop workers and the controls (3.54 L/min and 4.24 L/min respectively). A similar reduction was seen in the forced expiratory volume in the first second (FEV₁) and the forced expiratory flow in 25-75 % of forced vital capacity (FEF_25-75) obtained from the filling station workers (H = 32.722, p < 0.001 & H = 15.655, p <0.001 respectively). Furthermore, exposure to non-combusted LPG increased systolic blood pressure, mean arterial pressure, and serum liver enzymes. Findings from this study revealed that despite the high amount of coarse particulate matter in LPG retail shops, the filling station workers are more susceptible to the impairment of lung function possibly due to the high quantity of total volatile organic compounds (TVOCs) in the filling station environment.

Biomonitoring of unmetabolized polycyclic aromatic hydrocarbons (PAHs) in urine of waterpipe/cigarette café workers

Fresh tobacco or the smoke resulting from waterpipe and cigarette contains large amounts of polycyclic aromatic hydrocarbons (PAHs), which consumption can cause releasing of these contaminants into the indoor air of cigarette and waterpipe cafés. This study was conducted to investigate the urinary concentrations of unmetabolized PAH compounds among the employed workers as well as the customers in waterpipe and cigarette cafés along with its association with oxidative stress factors plus kidney injury biomarkers. For this, 35 staffs and 35 customers in these cafés (as an exposed group (EG)), 20 staffs in non-smoking cafés (as 1st control group (CG-1)), and 20 of the public population (as 2nd control group 2 (CG-2)) were chosen and their urine specimens were collected. The results indicated that there is a significant difference between urinary concentration of ƩPAHs in the exposed and control groups (P value < 0.05). Also, "type of tobacco" can be considered as an influential and determining factor for the urinary levels of PAHs among the subjects. Considering the contribution of PAHs to the total toxic equivalents, benzo[a]pyrene (BaP), dibenzo[a,h]anthracene (DahA), and fluoranthene (Flrt) with 32.76%, 27.62%, and 18.65% claimed the largest share in waterpipe/cigarette cafés. The results also indicated a positive and significant relationship between some PAHs and oxidative stress biomarkers as well as uKIM-1 (biomarker for assessing and diagnosing glomerular damage) and TIMP-1 (biomarker of stress in primary steps of injury in tubular cell). Thus, it can be expressed that the workers of these smoking cafés are prone to the detrimental health impacts. Accordingly, proper policies and decisions should be taken to limit the activity of these cafés or proper protective strategies should be adopted to protect the health of exposed individuals.

Urinary profile of PAHs and related compounds in women working in beauty salons

Polycyclic aromatic hydrocarbons (PAHs) are a group of chemical compounds which interest to human biological monitoring researches because of their potential carcinogenic, mutagenic, and teratogenic properties. However, the exposure of female beauticians to these contaminants is not well-reported. For biomonitoring of potential exposure of female cosmeticians to PAHs in beauty salons, urine samples were taken from cosmetologist women (n = 50.00) and housewives (n = 35.00) as the exposure group (EG) and control group (CG), respectively. Next, unmetabolized PAHs levels as well as the concentration of - 1-hydroxypyrene (1-OHP) were analyzed in these specimens. In addition, since benzene has some common source with PAHs, in this study t, t'-Muconic acid (TTMA) level was also determined as the metabolite and indicator of exposure to benzene. The results indicated a high detection frequency of the target compounds (PAHs, 1-OHP and TTMA) in the urine specimens of beauticians. The results also showed that there is a significant difference between the concentration of these pollutants in the urine specimens of the exposure and control groups. The median concentration of ΣPAHs, 1-OHP, and TTMA in the before exposure (BE) specimens collected from the exposure group were 337.42 ng/L, 593.92 ng/L, and 247.90 μg/L, respectively. However, a higher concentration of these contaminants was observed in the after exposure specimens with a median concentration of 423.29 ng/L, 745.03 ng/L, and 310.97 μg/L, respectively. In terms of contribution of PAHs compounds in total toxic equivalents, DahA, BaP, and IndP with 59.03, 28.73, and 2.86 % had the largest share. In this study, it was also observed that some kidney damage biomarkers as well as some oxidative stress injury biomarkers are positively and significantly correlated with the urinary values of ∑PAHs. Thus, it can be concluded that high health risks threaten the female beauticians regarding kidney injury and DNA oxidative stress.

Size distribution, meteorological influence and uncertainty for source-specific risks: PM2.5 and PM10-bound PAHs and heavy metals in a Chinese megacity during 2011-2021

This study aims at exploring size distribution, meteorological influence and uncertainty for source-specific risks of atmospheric particulate matter (PM), which can improve risk-mitigation strategies for health protection. Heavy metals (HMs) and polycyclic aromatic hydrocarbons (PAHs) in PM_2.5 and PM₁₀ were detected in a Chinese megacity during 2011-2021. A new method named as PMFBMR, which combines the Positive Matrix Factorization, Bootstrapping, Mote Carlo and Risk assessment model, was developed to estimate uncertainty of source-specific risks. It was found that PAH risks concentrated in fine PM, while HMs showed high risks in both fine and coarse PMs. For PM_2.5, HQ (non-cancer risk hazard quotient) of gasoline combustion (GC), diesel and heavy oil combustion (DC), coal combustion (CC), industrial source (IS), resuspended dust (RD) and secondary and transport PM (ST) were 0.6, 1.4, 0.9, 1.6, 0.3, and 0.3. ILCR (lifetime cancer risk) of sources were IS (9.2E-05) > DC (2.6E-05) = CC (2.6E-05) > RD (2.2E-05) > GC (1.7E-05) > ST (6.4E-06). PM_2.5 from GC, DC, CC and IS caused higher risks than coarse PM, while coarse PM from RD caused higher risks. Source-specific risks were influenced not only by emissions, but also by meteorological condition and dominant toxic components. Risks of GC and DC were usually high during stable weather. Some high risks of CC, IS and RD occurred at strong WS due to transport or wind-blown resuspension. GC and DC risks (influenced by both PAHs and HMs) showed strong relationship with T, while IS and RD risks (dominated by HMs) showed weak link with meteorological conditions. For uncertainty of source-specific risks, HQ and ILCR were sensitive for different variables, because they were dominated by components with different uncertainties. When using source-specific risks for risk-mitigation strategies, the focused toxic components, used toxic values, PM sizes and uncertainty are necessary to be considered.

Health risk assessment of particulate matter 2.5 in an academic metallurgy workshop

Exposure to indoor PM_2.5 is associated with allergies, eye and skin irritation, lung cancer, and cardiopulmonary diseases. To control indoor PM_2.5 and protect the health of occupants, exposure and health studies are necessary. In this study, exposure to PM_2.5 released in an academic metallurgy workshop was assessed and a health risk assessment was conducted for male and female students and technicians. Polycarbonate membrane filters and an active pump operating at a flow rate of 2.5 L/min were used to collect PM_2.5 from Monday to Friday for 3 months (August-October 2020) from 08:00-16:00. PM_2.5 mass concentrations were obtained gravimetrically, and the Multiple-Path Particle Dosimetry model was used to predict the deposition, retention, and clearance of PM_2.5 in the respiratory tract system. The risk of developing carcinogenic and non-carcinogenic effects among students and technicians was determined. The average PM_2.5 mass concentration for August was 32.6 μg/m³ 32.8 μg/m³ for September, and 32.2 μg/m³ for October. The head region accounted for the highest deposition fraction (49.02%), followed by the pulmonary (35.75%) and tracheobronchial regions (15.26%). Approximately 0.55 mg of PM_2.5 was still retained in the alveolar region 7 days after exposure. The HQ for male and female students was <1 while that of male and female technicians was >1, suggesting that technicians are at risk of developing non-carcinogenic health effects compared with students. The results showed a risk of developing carcinogenic health effects among male and female technicians (>1 × 10^-5 ); however, there was no excess cancer risk for students (<1 × 10^-6 ). This study highlights the importance of exposure and health studies in academic micro-environments such as metallurgy workshops which are often less researched, and exposure is underestimated. The results also indicated the need to implement control measures to protect the health of the occupants and ensure that the workshop rules are adhered to.

Effect of portable air purifier on indoor air quality: reduced exposure to particulate matter and health risk assessment

We sought to investigate the impact of air purifiers in the removal of particular matter (PM)₁₀, PM_2.5, PM_1, and particle number concentration (PNC) in the indoor air of dormitories located at Iran's largest medical university, Tehran University of Medical Sciences. Twelve rooms were selected and randomly assigned to two rooms: sham air purifier system deployed room (SR) and true air purifier system deployed room (TR). All study samples were drawn simultaneously from assigned rooms using portable GRIMM dust monitors for 24 h. The PM monitors of air were positioned in the middle of each room next to the air purifier at the height of the breathing zone (1.5 m in height). The mean PM₁₀, PM_2.5, PM₁, and PNC removal efficiency in rooms with and without a smoker were measured to be 40.7 vs 83.8%, 31.2 vs 78.4%, 29.9 vs 72.3%, and 44.3 vs 75.6%, respectively. The results showed that smoking is an important influencing factor on the indoor air quality; smoking lowered the removal efficiency of PM₁₀, PM_2.5, PM₁, and PNC by 43%, 47%, 43%, and 31%, respectively. An air purifier could decline the PM₁₀ and PM_2.5 even lower than the WHO 24-h guideline level in non-smoker rooms. This study revealed that using household air purifiers in rooms with smokers and non-smokers significantly reduces the non-carcinogenic risks of exposure to PM₁₀ and PM_2.5.

Characteristics and health effects of particulate matter emitted from a waste sorting plant

Solid waste components can be recycled in waste paper and cardboard sorting plants (WPCSP) through a multistep process. This work collected 15 samples every six days from each of the 9 points selected to study the processes taking place in a WPCSP (135 particulate matter samples total). Examining the concentration and size fraction of particulate matter (i.e., PM₁, PM_2.5 and PM₁₀) in WPCSP is an essential issue to notify policy makers about the health impacts on exposed workers. The major activities for increasing of the concentration of PM in various processing units in the WPCSP, especially in hand-picking routes I and II were related to manual dismantling, mechanical grinding, mechanical agitation, and separation and movement of waste. The results of this work showed that a negative correlation between temperature and particulate matter size followed the order PM₁₀ > PM_2.5 > PM₁. Exposure to PM_2.5 and PM₁₀ in the WPCSP lead to possible risk (HI = 5.561 and LTCRs = 3.41 × 10^-6 to 9.43 × 10^-5 for PM_2.5 and HI = 7.454 for PM₁₀). The exposure duration and the previous concentrations had the most effect on the ILCRs and HQs for PM_2.5 and PM₁₀ in all sampling sites. Hence, because WPCSP are infected indoor environments (I/O ratio > 1), the use of control methods such as isolation of units, misting systems, blower systems equipped with bag houses, protective equipment, a mechanical ventilation system, and additional natural ventilation can reduce the amount of suspended PM, enhance worker safety, and increase the recycling rate.

Urinary concentrations of BTEX in waterpipe smokers and nonsmokers: Investigating the influence of conventional activities and multiple factors

The aim of this study was to compare the concentrations of the benzene, toluene, ethylbenzene, and xylene (BTEX) compounds in the urine of smokers and the control group considering the role of age, weight, job, history of waterpipe and cigarette smoking, and driving time. The chemicals in the urine of 99 smokers and 31 nonsmokers were extracted by liquid-liquid extraction method and their concentrations were measured by liquid injection GC/MS. The mean concentration of benzene, toluene, ethylbenzene, m-xylene, o-xylene, p-xylene, and total BTEX in waterpipe smokers were found to be 471.40, 670.90, 127.91, 167.64, 90.62, 46.04, and 1574.50 ng/g. creatinine, respectively. For the waterpipe&cigarette smokers, the concentration of the compounds were 708.00, 959.00, 146.40, 192.50, 93.30, 53.07, and 2152.00 ng/g.creatinine, respectively. For nonsmokers the concentrations of these compounds were 88.12, 140.40, 36.68, 57.29, 31.53, 26.21, and 380.30 ng/g.creatinine, respectively. Driving time, waterpipe smoking and cigarette smoking were positively associated with BTEX concentration (p < 0.05). Fruity tobacco showed higher concentrations of BTEX compared to the regular tobacco, and athlete persons had les urinary BTEX than the non-athletes. There was not significant correlation between the BTEX and age, height, weight, and BMI. High concentrations of BTEX compounds in the urine of waterpipe and cigarette smokers compared to nonsmokers indicate that waterpipe and cigarette can be an important source of exposure to these compounds and the known adverse effects of these compounds, especially carcinogenicity, threaten the health of smokers.

Urinary level of heavy metals in people working in smoking cafés

Previous researches have reported significant levels of heavy metals in indoor air of smoking cafés. The current research aimed to evaluate the potential exposure of smoking cafés workers to heavy metals through quantifying amounts of these pollutants in urine samples. To this end, 35 waterpipe/cigarette cafés workers were selected as the exposed population, 35 employees from non-smoking cafe' as the control group 1 (CG1) and 25 cases of the normal citizens as the control group 2 (CG2); and their urine samples were taken. Samples were then prepared by acid digestion approach and measured by the ICP in order to determine amount of heavy metals in them. The findings of the current work show the significant difference among urinary levels of metals in the exposed and both CG1 and CG2 (P value < 0.05). Furthermore, urinary metal levels in samples collected from smoking café workers after the exposure were considerably higher than those were collected before the exposure (P-value <0.05). According to the findings, "tobacco type" could be considered as a leading factor for heavy metal exposure in studied smokers. Additionally, a positive and significant association was found between urinary metals and urinary levels of 8-OHdG (a markers of DNA degradation through oxidative stress). Therefore, workers in waterpipe/cigarette café can be classified as high risk people in terms of DNA oxidative damage.

BTEX levels in rural households: Heating system, building characteristic impacts and lifetime excess cancer risk assessment

BTEX (benzene, toluene, ethylbenzene, and xylene) are a group of toxic organic compounds that exposure to them can cause adverse short and long terms health effects. We measured the levels of BTEX in the indoor and outdoor air of rural areas in Ardebil, Iran. We further assessed their health risks and determinants parameters. BTEX were sampled by drawing air through activated charcoal tubes, using low flow SKC pumps. Samples were extracted by adding carbon disulfide and analyzed by subjecting the aromatic fraction to GC-FID. The results indicated that the concentrations of BTEX in the indoor air were significantly higher than those of outdoor (p-value<0.05). The mean indoor concentrations of benzene, toluene, ethylbenzene, and xylene were 41.69 ± 30.70, 96.73 ± 60.75, 38.73 ± 33.59, and 59.42 ± 35.99 μg m^-3, while the mean outdoor concentrations of them were 8.94 ± 7.32, 36.93 ± 21.82, 7.66 ± 5.63, and 18.14 ± 10.25 μg m^-3, respectively. The concentrations of BTEX in indoor and outdoor of the rural areas that used kerosene fuel for heating systems were significantly higher than those used natural gas. The results indicated that the tobacco smoke is a notable temporary source of indoor BTEX. The mean inhalation lifetime cancer risk (LTCR) value of benzene for residents of rural houses with the natural gas and kerosene heating systems were 28.6 × 10^-6 and 97.2 × 10^-6, while for ethylbenzene these figures stood out at 29.1 × 10^-6 and 95.8 × 10^-6, respectively. LTCR value for residents who used kerosene fuel for heating was higher than the World Health Organization (WHO) recommended limit.

The effect of PM2.5-related hazards on biomarkers of bronchial epithelial cells (A549) inflammation in Karaj and Fardis cities

Fine particles (especially PM2.5 particles) in ambient air can cause irreversible effects on human health. In the present study, seasonal variations in toxicity PM2.5 (cell viability and release of pro-inflammatory cytokines) were exposed human lung cells (A549) to concentrations of PM2.5 samples in summer (sPM2.5) and winter (wPM2.5) seasons. Cells were separately exposed to three concentrations of PM2.5 (25, 50, and 100 μg/mL) and three times (12 h, 1 and 2 days). We evaluated cell viability by MTT assay [3- (4, 5-dimethylthiazol-2-yl) -2, 5-diphenyltetrazolium bromide] and liberation of pro-inflammatory cytokines (interleukin-6 and interleukin-8) by the ELISA method. The toxicological results of this study showed that increasing the concentration of PM2.5 particulates and contact time with it reduces cell viability and increases inflammatory responses. Seasonal cytotoxicity of PM2.5 particles in high-traffic areas at summer season compared to winter season was lower. The lowest percent of viability at 2 days of exposure and 100 μg/mL exposure in the winter sample was observed. Also, PM2.5 particles were influential in the amount of interleukins 8 and 6. The average release level of IL-6 and IL-8 in the cold season (winter) and the enormous exposure time and concentrations (2 days-100 μg/mL) was much higher than in the hot season (summer). These values were twice as high for winter PM2.5 samples as for summer samples. The compounds in PM2.5 at different seasons can cause some biological effects. The samples' chemical characteristics in two seasons displayed that the PMs were diverse in chemical properties. In general, heavy metals and polycyclic aromatic hydrocarbons were more in the winter samples. However, the samples of wPM2.5 had a lower mass quota of metals such as aluminum, iron, copper, zinc, and magnesium. Concentrations of chromium, cadmium, arsenic, mercury, nickel, and lead were more significant in the sample of wPM2.5.

Potential cytotoxicity of PM2.5-bound PAHs and toxic metals collected from areas with different traffic densities on human lung epithelial cells (A549)

Laboratory and epidemiological researches have indicated that ambient air particulate matter have a plays critical role in causing diseases. The current research evaluated the chemical attributes of PM2.5 in the ambient air of the cities of Karaj and Fardis and determined its toxicological effects on human lung epithelial cells (A549). In the study city, 16 points were selected from the two high-traffic and low-traffic points for sampling. A sampling of ambient air was carried out in spring, summer, autumn, and winter 2018-19. Air sampling was performed for 24 h according to the EPA-TO/13A guidelines. To analyze of toxic metals and polycyclic aromatic hydrocarbons (PAHs), ICP-OES and GC-MS were used, respectively, and for cell toxicity analysis, an ELISA reader was used. Then from SPSS, Excel and R software were used for statistical analysis. The results of the current study indicated that the concentration of PAHs carcinogenic in the autumn season in high-traffic stations was the highest and equal to 9.3 ng/m3, and in the spring season in the low-traffic stations, it was the lowest and equal to 5.82 ng/m3. In general, during the period of study, Heavy metals including Zn, Fe, Pb, Cu, and Al had the highest concentration compared to other metals. However, Hg, Cr, As, Pb, Cu, Cd, and Zn were higher concentration in the winter and autumn seasons than in the spring and summer seasons. Cell viability measurements by using MTT showed that low-traffic and high-traffic stations had the highest toxicity in autumn season compared to other seasons. (p < 0.05). In general, high-traffic stations had the highest toxicity than low-traffic stations. The general conclusion of the present study was that PM2.5-bound PAHs and toxic metals, due to their high concentration, were toxic pollutants in air for residents of Karaj and Fardis. Also, the high concentration of PM2.5 caused the mitochondrial activity of A549 cells to stop and this stop was more significant in cold seasons and high-traffic areas.

Latent class analysis of initial nicotine dependence among adult waterpipe smokers

Waterpipe (WP) tobacco smoking increases the risk of smoking-related health problems. In this study, we sought to identify the unobserved class memberships of WP-associated initial nicotine dependence (ND) symptoms and assess the predictors of each latent class. This cross-sectional study was conducted among a convenience sample of 900 current (past 30-day) WP smokers who were recruited from 94 WP-serving venues surrounding Tehran and Ardebil metropolitans in Iran. All participants completed a self-administrated questionnaire. We performed latent class analysis using PROC LCA in SAS to identify class memberships of initial ND symptoms using 10-item Hooked on Nicotine Checklist. Five latent classes were identified as non-dependent (25.4 %), low dependent (7.1 %), low-moderate dependent (19.6 %), moderate dependent (15.6 %), and high dependent (32.2 %). Using flavored WP tobacco significantly increased the odds of belonging to low-moderate dependent class [adjusted OR (aOR) = 1.89; 95 % confidence interval (CI): 1.07-3.34] compared to non-dependent class. Also, having academic education decreased the odds of belonging to low-moderate dependent (aOR = 0.43; 95 %CI: 0.26-0.67) and moderate dependent (aOR = 0.39; 95 %CI: 0.23-0.67) class in comparison to non-dependent class. Also, WP smoking initiation at an older age was associated with belonging to high dependent (OR = 2.05; 95 %CI: 1.39-3.03) class compared to non-dependent. This study revealed that nearly half of WP smokers fell under moderate and high-dependent classes. Our findings showed that some items of HONC had more role in the clustering of participants based on ND symptoms. The WP-specific cessation programs and targeted clinical trials should consider the diversity of ND levels among smokers to achieve successful quit rates among these smokers. Additionally, limiting flavors would be a strong strategy to limit the rate of ND, especially among young people who are eager to smoke flavored WP tobacco.

Bacteria bioaerosol in the indoor air of educational microenvironments: Measuring exposures and assessing health effects

Exposure to bioaerosols has been identified to be linked the incidence of various health effects, i.e., infectious diseases, acute toxic effects, allergies, and cancer. The aim of this study was to determine the bacterial bioaerosols in the indoor air of the educational environments of Ardabil universities and to evaluate the exposure and to determine its health risk. In this cross-sectional study, different sections of the educational environments of Ardabil universities were studied. For differential diagnosis of bacteria, methods such as gram staining and biochemical detection methods including DNAse, catalase, oxidase, coagulase, bile esculin hydrolysis test, urease, citrate test, antibiotic resistance to novobiocin and Bacitracin, optochin, glucose uptake, and other differential tests were used. For sampling, a single-stage Anderson sampler was used at a flow rate of 28.3 l at a duration of 10 min per minute. The results showed that, in medical school of Ardabil University of Medical Sciences, the average concentration of bacteria in the outdoor air of school, halls, classes and rooms of professors and staff were 18, 88.4, 76.6, and 77.4 CFU/m³, respectively, and, in Ardabil Islamic Azad University, the average bacterial concentration was 103, 97, 124, and 132 CFU/m³ in the outdoor air of the schools, halls, classrooms, and rooms of professors and staff, respectively. The predominant bacterial species in indoor air are S. aureus, S. epidermidis, Actinomycetes, and Bacillus, respectively. As results indicated, the concentration of bacterial bioaerosols in indoor air is within the standard levels, but due to frequency of bacterial species, occurrence of different in lung and intestinal diseases can be expected among faculty, staff and students in the long-term.

Characteristics of flavored and non-flavored waterpipe tobacco users: a real-world setting study

We aimed to compare sociodemographic characteristics, smoking patterns, beliefs and perceptions, nicotine dependence, and psychological indicators between flavored waterpipe (WP) tobacco (FWT) and non-flavored WP tobacco (non-FWT) smokers in Iran. A cross-sectional study was conducted in 94 WP-serving venues surrounding Tehran and Ardabil metropolitans in Iran. Convenience sampling was applied to select 900 current WP smokers [508 (56%) FWT-only and 392 (44%) non-FWT-only smokers] aged 18 years and older. Multivariable logistic regression was used to examine the independent characteristics of FWT and non-FWT smokers. Compared to non-FWT smokers, FWT smokers were younger (adjusted odds ratio [AOR]=0.88, 95% confidence interval [CI]: 0.87-0.90) and more likely to have ≥ 1 sibling who smoked WP (AOR=1.54, 95% CI: 1.06-2.24), share WP with others (AOR=2.52, 95% CI: 1.68-3.77), report current cigarette smoking (AOR=2.05, 95% CI: 1.23-3.42), and report confidence in quitting at any time (AOR=3.64, 95% CI: 2.45-5.39). FWT smokers were less likely to have seen (AOR=0.40, 95% CI: 0.27-0.60) or read (AOR=0.44, 95% CI: 0.24-0.80) warning messages on WP tobacco packages relative to non-FTW smokers. The most common self-reported reason for smoking WP was entertainment for both groups, followed by stress relief for non-FWT smokers and the escape from loneliness for FWT smokers. FWT-only smokers differ from non-FWT-only smokers in several aspects including being younger, having more positive beliefs and perceptions regarding WP use, and having higher cigarette smoking prevalence. These findings will help in developing more effective and targeted policies and cessation interventions for WP smokers according to flavor type they use, especially in the Middle East.

Exposure to BTEX concentration and the related health risk assessment in printing and copying centers

This study was derived to investigation of BTEX (benzene, toluene, ethylbenzene, xylenes) concentrations in printing and copying centers (PCCs) in Ardabil city of Iran. Fifty-three PCCs were randomly selected from all the 136 number of PCCs and BTEX was sampled form their indoor air. The results showed that the concentration of BTEX in the indoor air PCCs is lower than the OELs (occupational exposure limit) in all cases. The obtained mean concentrations of benzene, toluene, ethylbenzene, and xylene were 93.6±63.2, 150.6±99.2, 34.3±16.8, and 29.5±15.2 μg/m³ respectively. Type of printer, number of printing and copying device, and type of ventilation system had significant influence on the BTEX concentration. The mean inhalation lifetime cancer risk (LTCR) value for benzene and ethylbenzene in the indoor air of the PCCs with LaserJet and inkjet printers was 44.4 × 10^-6 and 153.3 × 10^-6, and 23.4×10^-6 and 54.2× 10^-6, respectively, which were higher than EPA (Environmental Protection Agency) and World Health Organization (WHO) recommended limits. The hazard quotient (HQ) of benzene in the indoor air of the PCCs with inkjet printers was >1, which indicates that the non-carcinogenic risks associated with exposure to these compounds are considerable.

Airborne particulate matter in Tehran's ambient air

In recent decades, particulate matter (PM) concentrations in Tehran have exceeded the World Health Organization's (WHO) guideline on most days. In this study, a search protocol was defined by identifying the keywords, to carry out a systematic review of the concentrations and composition of PM in Tehran's ambient air. For this purpose, searches were done in Scopus, PubMed, and Web of Science in 2019. Among the founded articles (197 in Scopus, 61 in PubMed, and 153 in Web of Science). The results show that in Tehran, the annual average PM₁₀ exceeded the WHO guidelines and for more than 50.0% of the days, the PM_2.5 concentration was more than WHO 24-h guidance value. The PM concentration in Tehran has two seasonal peaks due to poorer dispersion and suspension from dry land, respectively. Tehran has two daily PM peaks due to traffic and changes in boundary-layer heights; one just after midnight and the other during morning rush hour. Indoor concentrations of PM10 and PM2.5 in Tehran were 10.6 and 21.8 times higher than the corresponding values in ambient air. Tehran represents a unique case of problems of controlling PM because of its geographical setting, emission sources, and land use. This review provided a comprehensive assessment for decision makers to assist them in making appropriate policy decisions to improve the air quality. Considering factors such as diversity of resources, temporal and spatial variations, and urban location is essential in developing control plans. Also future studies should focus more on PM reduction plans.

Use of toenail-bounded heavy metals to characterize occupational exposure and oxidative stress in workers of waterpipe/cigarette cafés

Tobacco smoke is known for releasing metals in indoor air of waterpipe/cigarette cafés. However, the worker exposure to metals, and its association with oxidative stress in these cafés are still unclear. To this end, 54 workers and 38 customers from waterpipe/cigarette cafés (the exposed group), 30 workers from non-smoking cafés (the control group 1 (CG_1)) and 32 individuals from the general population (the control group 2 (CG_2)) were selected and toenails samples were then taken from them. Our findings revealed a significant difference in terms of toenail-bounded metal levels between the exposure and control groups (CG_1 and CG_2) (Mann-Whitney U test, Pvalue < 0.05). This study has also indicated that "type of tobacco" could be considered as a predictor for toenail-bounded heavy metals. Furthermore, our research's results suggest that toenail-bounded heavy metals are positively and significantly correlated with urinary levels of 8- hydroxy-2'-deoxyguanosine (8-OHdG, as a biomarker for the degradation of deoxyribonucleic acid (DNA) oxidative stress). Therefore, it can be concluded that workers of waterpipe/cigarette cafés are at high risks of adverse health of DNA oxidative degradation.

The acute effects of short term exposure to particulate matter from natural and anthropogenic sources on inflammation and coagulation markers in healthy young adults

Airborne particulate matter is associated with increasing the risk of cardiovascular diseases. The purpose of this study was to investigate the association between air pollution conditions and MDA, vWF, and fibrinogen markers in the blood of two panels of healthy young individuals in an urban area in Tehran city with a high air pollution background and another group was living in a rural area (Ahmad Abad Mostofi), with a low air pollution background. In each group, 4 blood samples were taken as follows: one in inversion days, the second in winter, but during the existence of normal condition in terms of air pollution, the third sample in the spring during the normal condition in terms of air pollution and the fourth sample during the dust storm conditions. In the urban and rural groups, there was a significant difference between the concentration of MDA, vWF, fibrinogen between inversion and cold season control conditions, and between dust storm conditions and warm season control conditions (p < 0.05). The results showed that the association of dust storm condition on the measured biomarkers was stronger than the inversion condition, which health consideration in the dust conditions be taken into account similar to the inversion conditions.

The effects of ventilation and building characteristics on indoor air quality in waterpipe cafés

To determine the concentration of carbon monoxide (CO) and particulate matter (PMs), indoor air samples were collected from 60 waterpipe cafés in Ardabil city of Iran. Moreover, the influence of several structural, operational, and ventilation system were evaluated on the concentration of the selected pollutants. The results showed that the mean concentration of CO (12.0 ± 7.2 mg/m³) and PMs (PM₁ = 171.5 ± 119.6 μg/m³, PM_2.5 = 303.3 ± 201.9 μg/m³, PM₁₀ = 440.3 ± 272.2 μg/m³) were notably higher than the guideline levels. According to the results, open face/café area was influenced by the natural ventilation rate and the mean air exchange rate was 3.1 ± 1.1 min^-1. The natural ventilation has a functional role on air quality of the cafes, and fan-type mechanical ventilation was influencing factor on CO concentration when the natural ventilation was restricted. "Type of used charcoal" had the highest influence on the releasing of pollutants inside the cafés as the pollutant concentrations were lower for simple (raw) charcoal compared with the favored (aromatic) one. The results indicated that the building characteristics and natural ventilation considerably affect air quality of the cafes.

Association between exposure to ambient fine particulate matter and prevalence of type 2 diabetes in Iran: an ecological study

Epidemiological evidence for the link between long-term exposure to air particulate matter (PM_2.5) and occurrence of type 2 diabetes (T2D) is limited such that little is known about the effect of PM_2.5 exposure and adult T2D prevalence. Thus, the aim of this ecological study is to evaluate the contribution of ambient PM_2.5 exposure to the adult T2D prevalence in the large population of Iran. The study was conducted based on Iran's large-scale cross-sectional surveilling non-communicable diseases (NCDs) risk factors (Timpka et al. 2015b). A total of 31,050 participants were enrolled in three sequential processes of study using cluster random sampling. PM_2.5 data in the urban area of 31 provinces of Iran were acquired from Tehran Air Quality Control Company (AQCC) and the Department of Environment (DoE) of Iran during 2012-2016. Moreover, major and minor diabetes risk factors were considered; the Pearson correlation and a stepwise regression model were performed to estimate associations between risk factors and diabetes and prediabetes prevalence. The results showed T2D prevalence was more frequent among women (10.61%) than men (9.35%). A weak positive correlation was observed between PM_2.5 level and diabetes prevalence with a correlation coefficient of 0.275, although there was no significant association between PM_2.5 value and prediabetes prevalence. Moreover, none of the variables included in the regression model could predict the prevalence of diabetes and prediabetes. According to our study results, it can be suggested that investigating the association between PM_2.5 exposure and T2D prevalence at individual level may provide a better understanding of PM_2.5 exposure and the risk of T2D prevalence.

Exposure to second-hand tobacco smoke in waterpipe cafés in Barcelona, Spain: An assessment of airborne nicotine and PM2.5

BACKGROUND

Waterpipe tobacco smoking has grown in popularity worldwide, with the prevalence of use increasing in Spain from 6.2% to 10.8% in the last decade, despite the smoking ban enacted in 2010 for all hospitality premises.

OBJECTIVE

To assess exposure to second-hand smoke from waterpipes based on the concentrations of airborne nicotine and particulate matter ≤2.5 μm in diameter (PM_2.5) in a sample of waterpipe cafés in the city of Barcelona (Spain).

METHODS

This cross-sectional study included a sample of 20 waterpipe cafés. Airborne nicotine and PM_2.5 were sampled for 30 min in each venue using a nicotine sampling device connected by a tube to a pump and a TSI SidePak Personal Aerosol Monitor. Five outdoor control locations were also measured. We computed medians, interquartile ranges (IQRs), and maximum values and compared them according to venues' and sampling characteristics using the Kruskall-Wallis and U-Mann Whitney tests. Nicotine and PM_2.5 were correlated by calculating the Spearman-rank correlation coefficient.

RESULTS

The median concentration of nicotine and PM_2.5 were 1.15 and 230.50 μg/m³ in waterpipe cafés and 0.03 and 10.00 μg/m³ in control locations (p<0.05 in both cases). The Spearman correlation coefficient between both markers was 0.61 (95% confidence interval: 0.18-0.84). No differences were found in nicotine or PM_2.5 concentration according to the venues' and sampling characteristics studied, with the exception of area. After stratifying for area, venues >100 m², located in a tourist area, with >15 lit waterpipes, >8 waterpipes/100 m², and a ratio of 2 users per waterpipe or less had significantly higher nicotine concentration.

DISCUSSION

Despite the current smoking ban, which includes hospitality venues, we found nicotine and PM_2.5 levels in Barcelona waterpipe cafés that exceeded the threshold recommended by the World Health Organization. This exposure poses serious risks to the health of both workers and customers and constitutes a non-compliance of the legislation.

Indoor air quality in waterpipe cafés: exposure level to particulate matter

Waterpipe is increasingly being used worldwide. Despite waterpipe cafés gaining popularity among Iranian population, there is a paucity of research measuring exposures and assessing the health effects of waterpipe smoke in these places. The objective of the current study was to investigate the exposure to PM10, PM2.5, and PM1 concentrations and risk assessment of PM2.5 exposures in different age groups in the indoor air of waterpipe cafés. The study samples were taken from indoor air of 50 waterpipe cafés in Ardabil, Iran. The PM10, PM2.5, and PM1 concentrations were assessed using a portable GRIMM dust monitors. The mean (±SD) concentrations of indoor air PM10, PM2.5, and PM1 were 765 ± 352, 624 ± 327, and 500 ± 305 μg/m3, respectively. The mean of HQ (hazard quotient) for PM2.5 in all age groups of 16 and older was > 1, which corresponds to an unacceptably high risk for human health. Also, the mean of ELCRs (excess lifetime cancer risk) for PM2.5 in different age groups exceeded the limit value by the USEPA. The results indicated that the PM concentration is significantly influenced by the number of waterpipe smokers, type of ventilation system, and kind of tobacco. Therefore, waterpipe cafés are a potential source for exposure to PM10, PM2.5, and PM1 and increase the risk of respiratory diseases and cardiovascular problems among waterpipe smokers.

Bioaerosols in the waterpipe cafés: genera, levels, and factors influencing their concentrations

This study was conducted in order to assess the exposure to bacterial and fungal bioaerosols in the air of waterpipe cafés (AWPCs), in the hose of waterpipe (HWP), and in the water bowl of the waterpipe (WBWP) and to investigate the factors influence increasing the contamination levels in waterpipe cafés in Ardabil. From all the 50 cafés studied, the samples were taken from air and from water contained in water bowl and hose for bacterial and fungal analyses. The results demonstrated that the mean numbers of bacteria and fungi in the indoor air of café, hose, and water bowl were 33.90 ± 14.86 and 25.24 ± 1.99 CFU/m³, 72.16 ± 29.55 and 72.78 ± 42.45 CFU/plate, 53.7 ± 25.46 and 25.26 ± 13.94 CFU/ml, respectively. The predominant bacterial genera in waterpipe cafés were Pseudomonas and Bacillus in air, Staphylococcus and Pseudomonas in the hose, and Staphylococcus and Pseudomonas in the water bowl, respectively. The predominant fungal species in waterpipe cafés were Penicillium and Cladosporium in air, yeast and Fusarium in the hose, and Paecilomyces and yeast in the water bowl, respectively. The results of statistical analysis showed that there was a significant relationship between the mean concentrations of bacterial aerosol and qualitative variables such as type of heating system, materials of wall and ceiling, traditional restaurants, interior supermarkets, moisturized walls, the number of people, area of cafés, and temperature. But there was no significant relationship between these variables and the mean concentration of fungal aerosols. The results also showed that the levels of bioaerosols were high in the air, hose, and water bowl of the waterpipe. Therefore, cafés can be a potential source for the transmission of pathogenic agents and increase the risk of respiratory diseases among waterpipe smoking individuals.