Effects by inhalation of abundant fragrances in indoor air - An overview

Determination of personal exposure to volatile organic compounds and their health risks after the use of mosquito repellents in residential environments using passive sampling

The ubiquitous use of mosquito repellents in homes across Asia, Africa, and South America is related with human exposure to indoor volatile organic compounds (VOCs). There are three primary types of mosquito repellents: those in the form of coils, mats, and liquids. The repellent mechanisms of these products are distinct, resulting in the generation of varying types of VOCs during the repellent process. In this study, the emission characteristics of commercial coil-, mat-, and liquid-type mosquito repellents were observed in a laboratory chamber using real-time measurement. A previously developed personal passive sampler, ePTFE PS, was used to quantify personal exposure to indoor VOCs while 86 volunteers habitually used those three representative types for 3 h in their residence. Notable increase of indoor benzene was observed for coil- and mat-type mosquito repellents, while α-pinene concentration increased significantly following the use of liquid-type mosquito repellent. The average incremental cancer risks for benzene were 10-6 to 10-4 for adults following the use of coil- and mat-type mosquito repellents. The average non-cancer risks for all chemicals were <1 after the use of three types of mosquito repellents. Considering the potential human health risks associated with byproducts (e.g., particulate matter or carbon monoxide from incomplete combustion) emitted after mosquito coil use, further research on this topic is warranted.

Environmental house calls can reduce symptoms of chemical intolerance: a demonstration of personalized exposure medicine

AIM

The goals of this investigation were to 1) identify and measure exposures inside homes of individuals with chemical intolerance (CI), 2) provide guidance for reducing these exposures, and 3) determine whether our environmental house calls (EHCs) intervention could reduce both symptoms and measured levels of indoor air contaminants.

BACKGROUND

CI is an international public health and clinical concern, but few resources are available to address patients' often disabling symptoms. Numerous studies show that levels of indoor air pollutants can be two to five (or more) times higher than outdoor levels. Fragranced consumer products, including cleaning supplies, air fresheners, and personal care products, are symptom triggers commonly reported by susceptible individuals.

METHODS

A team of professionals trained and led by a physician/industrial hygienist and a certified indoor air quality specialist conducted a series of 5 structured EHCs in 37 homes of patients reporting CI.

RESULTS

We report three case studies demonstrating that an appropriately structured home intervention can teach occupants how to reduce indoor air exposures and associated symptoms. Symptom improvement, documented using the Quick Environmental Exposure and Sensitivity Inventory Symptom Star, corresponded with the reduction of indoor air volatile organic compounds, most notably fragrances. These results provide a deeper dive into 3 of the 37 cases described previously in Perales et al. (2022).

DISCUSSION

We address the long-standing dilemma that worldwide reports of fragrance sensitivity have not previously been confirmed by human or animal challenge studies. Our ancient immune systems' 'first responders', mast cells, which evolved 500 million years ago, can be sensitized by synthetic organic chemicals whose production and use have grown exponentially since World War II. We propose that these chemicals, which include now-ubiquitous fragrances, trigger mast cell degranulation and inflammatory mediator release in the olfactory-limbic tract, thus altering cerebral blood flow and impairing mood, memory, and concentration (often referred to as 'brain fog'). The time has come to translate these research findings into clinical and public health practice.

Association of household chemicals use with cognitive function among Chinese older adults

Background

The paucity of empirical evidence supporting a correlation between the utilization of household chemicals and cognitive decline in Chinese older adults.

Methods

The data utilized for this study originated from the Chinese Longitudinal Healthy Longevity Survey (CLHLS 2018). Using regression models to investigate the relationship between exposure to household chemicals and cognitive decline, and evaluate the impact of different fields on cognitive function.

Results

The use of household chemicals was associated with a decline in cognitive function (anti-caries agent, OR = 1.68, P = 0.040; air freshener, OR = 2.48, P = 0.002; disinfectant, OR = 1.40, P = 0.033). The more frequent the use of household chemicals, the worse the cognitive function (Model1: OR = 2.54, P = 0.024; Model2: OR = 3.23, P = 0.006; Model3: OR = 3.59, P = 0.003).

Conclusion

The study has uncovered a correlation between the utilization of household chemicals and cognitive decline in individuals aged 65 years and over in China.

Differences in impact on disease or lung injury depending on the physicochemical characteristics of harmful chemicals in the PAH model

The number of individuals with underlying medical conditions has been increasing steadily. These individuals are relatively vulnerable to harmful external factors. But it has not been proven that the effects of hazardous chemicals may differ depending on their physicochemical properties. This study determines the toxic effects of two chemicals with high indoor exposure risk and different physicochemical properties on an underlying disease model. A pulmonary arterial hypertension (PAH) model was constructed by a single subcutaneous injection of monocrotaline (MCT; 60 mg/kg) into Sprague-Dawley rats. After three weeks, formaldehyde (FA; 2.5 mg/kg) and polyhexamethylene guanidine (PHMG; 0.05 mg/kg) were administered once via intratracheal instillation, and rats were necropsied one week later. Exposure to FA and PHMG affected organ weight and the Fulton and toxicity indices in rats induced with PAH. FA promoted bronchial injury and aggravated PAH, while PHMG only induced alveolar injury. Additionally, the differentially expressed genes were altered following exposure to FA and PHMG, as were the associated diseases (cardiovascular disease and pulmonary fibrosis, respectively). In conclusion, inhaled chemicals with different physicochemical properties can cause damage to organs, such as the lungs and heart, and can aggravate underlying diseases. This study elucidates indoor inhaled exposure-induced toxicities and alerts patients with pre-existing diseases to the harmful chemicals.

Oxidation Mechanism and Toxicity Evolution of Linalool, a Typical Indoor Volatile Chemical Product

Linalool, a high-reactivity volatile chemical product (VCP) commonly found in cleaning products and disinfectants, is increasingly recognized as an emerging contaminant, especially in indoor air. Understanding the gas-phase oxidation mechanism of linalool is crucial for assessing its impact on atmospheric chemistry and human health. Using quantum chemical calculations and computational toxicology simulations, we investigated the atmospheric transformation and toxicity evolution of linalool under low and high NO/HO2· levels, representing indoor and outdoor environments. Our findings reveal that linalool can undergo the novel mechanisms involving concerted peroxy (RO2·) and alkoxy radical (RO·) modulated autoxidation, particularly emphasizing the importance of cyclization reactions indoors. This expands the widely known RO2·-dominated H-shift-driven autoxidation and proposes a generalized autoxidation mechanism that leads to the formation of low-volatility secondary organic aerosol (SOA) precursors. Toxicological analysis shows that over half of transformation products (TPs) exhibited higher carcinogenicity and respiratory toxicity compared to linalool. We also propose time-dependent toxic effects of TPs to assess their long-term toxicity. Our results indicate that the strong indoor emission coupled with slow consumption rates lead to significant health risks under an indoor environment. The results highlight complex indoor air chemistry and health concerns regarding persistent toxic products during indoor cleaning, which involves the use of linalool or other VCPs.

Increase of the indoor concentration of volatile organic compounds after the use of incense and scented candle in studio apartments determined using passive sampling

Burning incenses and scented candles may provide harmful chemicals. Although many studies have evaluated volatile organic chemicals emitted by their use and related health risks, extension of our understanding for guiding appropriate use under various use conditions is necessary. In this study, emission characteristics of commercial incenses and scented candles were evaluated in a laboratory chamber using real-time measurement and the time-weighted average exposure concentrations of monoaromatic compounds and monoterpenes were assessed using passive samplers while volunteers living in a studio apartment use them. After burning incense, the average levels of benzene increased from 1.4 to 100 μg m-3. The presence of a wood core in commercial incense products was the main cause of high benzene emission by burning them although the increase in benzene was also influenced by factors such as the brand of the products, the number of incense sticks burned, the duration of each burning session, and ventilation period. Electrical warming of scented candles increased the levels of monoterpenes by factors of 16-30 on average. Considering the emission characteristics found in this study, exposure to benzene and monoterpenes could be mitigated by cautious use of those products in residential areas.

Experimental study for inorganic and organic profiling of toy makeup products: Estimating the potential threat to child health

Inorganic elements are added to toys as impurities to give desired stability, brightness, flexibility, and color; however, these elements may cause numerous health issues after acute or chronic exposure. In this study, the inorganic profile of 14 elements (Al, As, Ba, Cd, Co, Cr, Cu, Hg, Mn, Ni, Se, Sb, Pb, and Zn) in 63 toy makeup products was identified by inductively coupled plasma-mass spectrometry after microwave acid digestion method. Additionally, organic allergen fragrance was investigated by gas chromatography-mass spectrometry. The systemic exposure dosage (SED), margin of safety (MoS), lifetime cancer risk (LCR), hazard quotient (HQ), and hazard indices were used to assess the safety evaluation. Then, 57 out of 63 samples (90.48%) exceeded the limits at least for one toxic element with descending order Ni > Cr > Co > Pb > Sb > Cd > As > Hg. The SED values were compared with tolerable daily intake values and remarkably differences were found for Al and Pb. The MoS values for 57.15% of samples exceeded the limit value for Al, As, Cd, Co, Hg, Mn, Sb, and Zn elements. The LCR values were observed at 100% (n = 63), 79.37% (n = 50), 85.71% (n = 54), 77.78% (n = 49), and 18.87% (n = 10) for Cr, Ni, As, Pb, and Cd, respectively. Also, the skin sensitization risks were obtained for Cr and Ni at 26.980% (n = 17) and 9.52% (n = 6), respectively. The HQ values for 80% of samples were found to be ≥ 1 at least for one parameter. The investigation of fragrance allergens in samples did not show any significant ingredients. As a result, toy makeup products marketed in local stores were found to be predominantly unsafe. Children should be protected from harmful chemicals by regular monitoring and strict measures.

Endothelial-dependent relaxation of α-pinene and two metabolites, myrtenol and verbenol, in isolated murine blood vessels

Epidemiological evidence shows that residential proximity to greenspaces is associated with lower risk of all-cause and cardiovascular mortality; however, the mechanism(s) underlying this link remains unclear. Plants emit biogenic volatile organic compounds such as α-pinene that could elicit beneficial cardiovascular effects. To explore the role of α-pinene more directly, we studied the metabolism and the vascular effects of α-pinene. We found that exposure of mice to α-pinene (1 ppm, 6 h) generated two phase I oxidation metabolites, cis- and trans-verbenol [(1R,2R,5R)-verbenol and (1 R,2S,5R)-verbenol)] and myrtenol [(1S,5R)-(+)-myrtenol] that were identified in urine by GC-MS. Precontracted naïve murine male and female aorta and superior mesenteric artery (SMA) were relaxed robustly (60% tension reduction) by increasing concentrations of α-pinene, myrtenol, and verbenol to 0.3 mM, whereas 1 mM α-pinene was vasotoxic. The SMA was six times more sensitive than the aorta to α-pinene. Both myrtenol and verbenol were equally potent and efficacious as parent α-pinene in male and female SMA. The sensitive portion of the α-pinene-, myrtenol-, and verbenol-induced relaxations in male SMA was mediated by 1) endothelium, 2) eNOS-derived NO, and 3) guanylyl cyclase (GC) activity. Moreover, α-pinene activated the transient receptor potential ankyrin-1 (TRPA1) channel whereas the metabolites did not. Endothelial-derived NO regulates blood flow, blood pressure, and thrombosis, and it is plausible that inhaled (and ingested) α-pinene (or its metabolites) augments NO release to mediate the cardiovascular benefits of exposure to greenness.NEW & NOTEWORTHY A common plant-derived biogenic volatile organic compound, α-pinene, and two of its metabolites, myrtenol and verbenol, stimulate vasorelaxation in murine superior mesenteric artery. Both α-pinene- and its metabolites induce vasorelaxation by activation of the endothelium, nitric oxide, and guanylyl cyclase. α-Pinene also activates the transient receptor potential ankyrin-1. Positive associations between greenness exposure and human cardiovascular health may be a result of the vascular action of α-pinene and its metabolites, a novel consideration.

Determination of terpene levels after the use of essential oil diffusers in vehicles and studio apartments using passive sampling

The exposure levels of selected terpenes (limonene, α- and β-pinenes, and γ-terpinene) emitted by essential oil diffusers in vehicles and studio apartments were assessed using a passive sampling method. A previously developed passive sampler composed of an expanded polytetrafluoroethylene membrane and adsorbent (ePTFE PS) was enlarged and made wearable. Before field deployment, the sampling performance of the modified ePTFE PS for selected terpenes was compared with that of active sampling in a lab-scale 5 m³ test chamber under constant exposure conditions, supporting that passive sampling provides reasonable estimates of the time-weighted exposure concentration. Fifty volunteers were recruited and asked to wear the ePTFE PS while using an essential oil diffuser inside their own vehicle while commuting and in their studio apartment while sleeping. Terpene levels without an essential oil diffuser were very low in vehicles and 47, 3.6, 1.6, and 0.62 μg m^-3 for average concentrations of limonene, α- and β-pinenes, and γ-terpinene in studio apartments, respectively, close to those reported in previous studies. The indoor concentrations of all selected terpenes in vehicles and studio apartments were elevated by the use of essential oil diffusers, especially in vehicles. The average concentration of limonene in vehicles after the use of essential oil diffusers was 11 μg m^-3, which was greater than that before use by a factor of 30. Therefore, cautious usage of essential oil diffusers indoors where the volume is limited, such as a vehicle, is needed to reduce exposure to terpenes.

Chronic exposure to odors at naturally occurring concentrations triggers limited plasticity in early stages of Drosophila olfactory processing

In insects and mammals, olfactory experience in early life alters olfactory behavior and function in later life. In the vinegar fly Drosophila, flies chronically exposed to a high concentration of a monomolecular odor exhibit reduced behavioral aversion to the familiar odor when it is reencountered. This change in olfactory behavior has been attributed to selective decreases in the sensitivity of second-order olfactory projection neurons (PNs) in the antennal lobe that respond to the overrepresented odor. However, since odorant compounds do not occur at similarly high concentrations in natural sources, the role of odor experience-dependent plasticity in natural environments is unclear. Here, we investigated olfactory plasticity in the antennal lobe of flies chronically exposed to odors at concentrations that are typically encountered in natural odor sources. These stimuli were chosen to each strongly and selectively excite a single class of primary olfactory receptor neuron (ORN), thus facilitating a rigorous assessment of the selectivity of olfactory plasticity for PNs directly excited by overrepresented stimuli. Unexpectedly, we found that chronic exposure to three such odors did not result in decreased PN sensitivity but rather mildly increased responses to weak stimuli in most PN types. Odor-evoked PN activity in response to stronger stimuli was mostly unaffected by odor experience. When present, plasticity was observed broadly in multiple PN types and thus was not selective for PNs receiving direct input from the chronically active ORNs. We further investigated the DL5 olfactory coding channel and found that chronic odor-mediated excitation of its input ORNs did not affect PN intrinsic properties, local inhibitory innervation, ORN responses or ORN-PN synaptic strength; however, broad-acting lateral excitation evoked by some odors was increased. These results show that PN odor coding is only mildly affected by strong persistent activation of a single olfactory input, highlighting the stability of early stages of insect olfactory processing to significant perturbations in the sensory environment.

Gas Phase Emissions of Volatile Organic Compounds Arising from the Application of Sunscreens

The speciation of volatile organic compounds (VOCs) emitted from personal care products (PCPs) is complex and contributes to poor air quality and health risks to users via the inhalation exposure pathway. Detailed VOC emission profiles were generated for 26 sunscreen products; consequently, variability was observed between products, even though they were all designed for the same purpose. Some were found to contain fragrance compounds not labelled on their ingredients list. Five contaminant VOCs were identified (benzene, toluene, ethylbenzene, o-xylene, and p-xylene); headspace sampling of an additional 18 randomly selected products indicated that ethanol originating from fossil petroleum was a potential source. The gas phase emission rates of the VOCs were quantified for 15 of the most commonly emitted species using SIFT-MS. A wide range of emission rates were observed between the products. Usage estimates were made based on the recommended dose per body surface area, for which the total mass of VOCs emitted from one full-body application dose was in the range of 1.49 × 103-4.52 × 103 mg and 1.35 × 102-4.11 × 102 mg for facial application (men aged 16+; children aged 2-4). Depending on age and sex, an estimated 9.8-30 mg of ethanol is inhaled from one facial application of sunscreen.

Heterogeneous chemistry of ozone with floor cleaning agent: Implications of secondary VOCs in the indoor environment

Human daily activities such as cooking, and cleaning can affect the indoor air quality by releasing primary emitted volatile organic compounds (VOCs), as well as by the secondary product compounds formed through reactions with ozone (O₃) and hydroxyl radicals (OH). However, our knowledge about the formation processes of the secondary VOCs is still incomplete. We performed real-time measurements of primary VOCs released by commercial floor-cleaning detergent and the secondary product compounds formed by heterogeneous reaction of O₃ with the constituents of the cleaning agent by use of high-resolution mass spectrometry. We measured the uptake coefficients of O₃ on the cleaning detergent at different relative humidities in dark and under different light intensities (320 nm < λ < 400 nm) relevant for the indoor environment. On the basis of the detected compounds we developed tentative reaction mechanisms describing the formation of the secondary VOCs. Intriguingly, under light irradiation the formation of valeraldehyde was observed based on the photosensitized chemistry of acetophenone which is a constituent of the cleaning agent. Finally, we modeled the observed mixing ratios of three aldehydes, glyoxal, methylglyoxal, and 4-oxopentanal with respect to real-life indoor environment. The results suggest that secondary VOCs initiated by ozone chemistry can additionally impact the indoor air pollution.

The Effect of Human Occupancy on Indoor Air Quality through Real-Time Measurements of Key Pollutants

The primarily emitted compounds by human presence, e.g., skin and volatile organic compounds (VOCs) in breath, can react with typical indoor air oxidants, ozone (O₃), and hydroxyl radicals (OH), leading to secondary organic compounds. Nevertheless, our understanding about the formation processes of the compounds through reactions of indoor air oxidants with primary emitted pollutants is still incomplete. In this study we performed real-time measurements of nitrous acid (HONO), nitrogen oxides (NO_x = NO + NO₂), O₃, and VOCs to investigate the contribution of human presence and human activity, e.g., mopping the floor, to secondary organic compounds. During human occupancy a significant increase was observed of 1-butene, isoprene, and d-limonene exhaled by the four adults in the room and an increase of methyl vinyl ketone/methacrolein, methylglyoxal, and 3-methylfuran, formed as secondary compounds through reactions of OH radicals with isoprene. Intriguingly, the level of some compounds (e.g., m/z 126, 6-methyl-5-hepten-2-one, m/z 152, dihydrocarvone, and m/z 194, geranyl acetone) formed through reactions of O₃ with the primary compounds was higher in the presence of four adults than during the period of mopping the floor with commercial detergent. These results indicate that human presence can additionally degrade the indoor air quality.

Household use of green and homemade cleaning products, wipe application mode, and asthma among French adults from the CONSTANCES cohort

While exposure to irritant and sprayed cleaning products at home is known to have a harmful role in asthma, the potential health effect of other categories or forms has not been investigated. We studied the associations of household use of cleaning products, including green, homemade products, and disinfecting wipes, with asthma based on data from the large French population-based CONSTANCES cohort. Participants completed standardized questionnaires on respiratory health and household use of cleaning products. Cross-sectional associations of cleaning products with current asthma, adjusted for gender, age, smoking status, BMI, and educational level, were evaluated by logistic regressions. Analyses were conducted in 41 570 participants (mean age: 47 years, 56% women, weekly use of the six specific products/forms studied varied from 11% to 37%). Weekly use of irritants (OR = 1.23 [1.13-1.35]), scented (OR = 1.15 [1.06-1.26]), green (OR = 1.09 [1.00-1.20]), and homemade products (OR = 1.19 [1.06-1.34]), as well as sprays (OR = 1.18 [1.08-1.29]), disinfecting wipes (OR = 1.21 [1.09-1.34]) were significantly associated with asthma, with significant trends according to the frequency of use. When they were not co-used with irritants/sprays, associations were reduced and persisted only for disinfecting wipes. Weekly use of disinfecting wipes at home was associated with current asthma, but fewer risks were observed for the use of green and homemade products.

Antibacterial and Oxidative Stress-Protective Effects of Five Monoterpenes from Softwood

Volatile organic compounds (VOC) affect the quality of indoor air. Terpenes and especially monoterpenes are the main molecules emitted from softwood material (coniferous species), which is widely used in construction. The corneal epithelium is one of the first human membranes to encounter VOCs in the air. Moreover, the industrial use of pleasant-scented monoterpenes in cosmetics, food, and detergents exposes people to monoterpenes in their daily lives. In the present study, the health effective properties of five monoterpenes from softwood were tested; cytotoxicity and oxidative stress-protective effects of α- and β-pinenes, R- and S-limonene, and 3-carene were tested in a human corneal epithelial (HCE) cell model system and with two additional in vitro antioxidant tests: oxygen radical absorbance capacity (ORAC) and hydrogen peroxide (H₂O₂) scavenging. Antibacterial efficacies were tested with two bioluminescent bacterial biosensor strains (Escherichia coli K12+pcGLS11 and Staphylococcus aureus RN4220+pAT19) and with minimum inhibitory concentration (MIC) test against Escherichia coli. Only very high concentrations of monoterpenes (0.3–0.5 mg/mL) demonstrated cytotoxicity against HCE cells. Contrary to the original hypothesis, monoterpenes did not exhibit strong antioxidant properties in tested concentrations. However, biosensors and MIC tests indicated clear antibacterial activities for all tested monoterpenes.

Odor perception and symptoms during acrolein exposure in individuals with and without building-related symptoms

Building-related symptoms (BRS) is a significant work-related and public health problem, characterized by non-specific symptoms occurring in a particular building. The cause of BRS is unknown, but certain reactive compounds are suggested risk factors. The aim of this controlled exposure study was to investigate whether BRS cases report more odor annoyance and symptoms and show altered autonomous nervous system (ANS) response during exposure to the reactive aldehyde, acrolein in comparison with referents. Individuals with BRS (n = 18) and referents (n = 14) took part in two exposure sessions (80 min). One session contained heptane alone, and the other heptane and acrolein. Perceived odor annoyance; eye, nose, and throat symptoms; and ANS response were measured continuously. BRS cases did not experience more odor annoyance; eye, nose, and throat symptoms; or altered ANS response in comparison with referents during the exposures. Supplementary analyses revealed that BRS cases that also reported chemical intolerance perceived more symptoms than referents during acrolein exposure. Acrolein exposure at a concentration below previously reported sensory irritation detection thresholds is perceived as more irritating by a subgroup of BRS individuals compared with referents. The results of this study indicate that a subset of individuals with building related symptoms (BRS) has a lowered sensory irritation threshold towards acrolein exposure. Future guidelines on chemical exposures to acrolein should take time and individual sensitivity into account.

How IoT-Driven Citizen Science Coupled with Data Satisficing Can Promote Deep Citizen Science

To study and understand the importance of Internet of Things-driven citizen science (IoT-CS) combined with data satisficing, we set up and undertook a citizen science experiment for air quality (AQ) in four Pakistan cities using twenty-one volunteers. We used quantitative methods to analyse the AQ data. Three research questions (RQ) were posed as follows: Which factors affect CS IoT-CS AQ data quality (RQ1)? How can we make science more inclusive by dealing with the lack of scientists, training and high-quality equipment (RQ2)? Can a lack of calibrated data readings be overcome to yield otherwise useful results for IoT-CS AQ data analysis (RQ3)? To address RQ1, an analysis of related work revealed that multiple causal factors exist. Good practice guidelines were adopted to promote higher data quality in CS studies. Additionally, we also proposed a classification of CS instruments to help better understand the data quality challenges. To answer RQ2, user engagement workshops were undertaken as an effective method to make CS more inclusive and also to train users to operate IoT-CS AQ devices more understandably. To address RQ3, it was proposed that a more feasible objective is that citizens leverage data satisficing such that AQ measurements can detect relevant local variations. Additionally, we proposed several recommendations. Our top recommendations are that: a deep (citizen) science approach should be fostered to support a more inclusive, knowledgeable application of science en masse for the greater good; It may not be useful or feasible to cross-check measurements from cheaper versus more expensive calibrated instrument sensors in situ. Hence, data satisficing may be more feasible; additional cross-checks that go beyond checking if co-located low-cost and calibrated AQ measurements correlate under equivalent conditions should be leveraged.

Long-Term Exposure to Essential Oils and Cardiopulmonary Health from a Population-Based Study

It is still unknown whether long-term inhalation of indoor air pollutants from ambient essential oil is associated with increased cardiopulmonary events. We recruited 200 healthy homemakers to conduct a prospective observation study in Northern Taiwan. We measured heart rate (HR), systolic blood pressure (SBP), diastolic BP (DBP), peak expiratory flow rate (PEFR), and indoor air pollutants four times per year for each participant between 2008 and 2018. Moreover, a questionnaire related to essential oil usage, home characteristics, and health status was filled out with each participant. The association between essential oil usage and cardiopulmonary health was determined using mixed-effects models. The mixed-effects models showed a significant association between essential oil usage and adverse cardiopulmonary effects including increased HR and BP and decreased % predicted PEFR among participants with heavy use of essential oils. No significant association between essential oils usage and adverse cardiopulmonary effects was observed among participants without essential oils usage or participants with mild use of essential oils (less than one hour per day). We concluded that exposure to indoor air pollution related to essential oils was associated with adverse cardiopulmonary effects among participants with essential oil usage more than one hour per day.

Analytical Determination of Allergenic Fragrances in Indoor Air

Among all the emerging contaminants, fragrances are gaining more relevance for their proven allergenic and, in some cases, endocrine-disrupting properties. To date, little information exists on their concentration in the air. This study aims to fill this gap by developing a method for the determination of semivolatile fragrances in the indoor gaseous phase with sampling protocols usually adopted for the collection of atmospheric particulate matter (sampling time 24 h, flow rate 10 L min−1) and instrumental analysis by gas chromatography coupled with mass spectrometry. The method was developed on 66 analytes and tested at three concentration levels: 20 compounds showed analytical recoveries ≥72% with percentage standard deviations always better than 20%. For most compounds, negligible sampling breakthroughs were observed. The method was then applied to real samples collected in a coffee bar and in a private house. Considering the fragrances for which the method has shown good effectiveness, the highest concentrations were observed for carvone in the coffee bar (349 ng m−3) and camphor in the house (157 ng m−3). As concerns certain or suspected endocrine disruptors, lilyal and galaxolide were detected at both sites, α-isomethylionone was the second most concentrated compound in the house (63.2 ng m−3), musk xylene and musk ketone were present at lower concentration (≈ 1 or 2 ng m−3).

Quantitative Health Risk Assessment of the Chronic Inhalation of Chemical Compounds in Healthcare and Elderly Care Facilities

Previous studies have described the chemical pollution in indoor air of healthcare and care facilities. From these studies, the main objective of this work was to conduct a quantitative health risk assessment of the chronic inhalation of chemical compounds by workers in healthcare and elderly care facilities (hospitals, dental and general practitioner offices, pharmacies and nursing homes). The molecules of interest were 36 volatile and 13 semi-volatile organic compounds. Several professional exposure scenarios were developed in these facilities. The likelihood and severity of side effects that could occur were assessed by calculating the hazard quotient for deterministic effects, and the excess lifetime cancer risk for stochastic effects. No hazard quotient was greater than 1. Three compounds had a hazard quotient above 0.1: 2-ethyl-1-hexanol in dental and general practitioner offices, ethylbenzene and acetone in dental offices. Only formaldehyde presented an excess lifetime cancer risk greater than 1 × 10⁻⁵ in dental and general practitioner offices (maximum value of 3.8 × 10⁻⁵ for general practitioners). The health risk for chronic inhalation of most compounds investigated did not appear to be of concern. Some values tend to approach the acceptability thresholds justifying a reflection on the implementation of corrective actions such as the installation of ventilation systems.

Delayed-Onset Neuropathic Pain after Septoplasty

Postoperative pain following a septoplasty is expected to be mild and limited to a few days after the operation. Chronic pain following the procedure is rare. No cases of delayed-onset neuropathic pain or allodynia have been described in the literature. This paper presents a case of delayed-onset neuropathic pain after septoplasty in a previously pain-free asthmatic patient that was successfully managed by administration of intranasal local anaesthesia. Physical examination and imaging excluded any other cause of neuralgia. A literature review revealed reports of chronic pain in patients following septoplasty if there were nasal contact or compression points or nasal tumours. Separately, acute postseptoplasty allodynia is documented in iatrogenic maxillary nerve damage. However, delayed-onset neuralgic pain, exacerbated by certain environmental triggers, has not been previously described. Facial pain can be debilitating; successfully managing this neuralgic pain with administration of intranasal local anaesthetic had a substantial effect on the patient's quality of life.

Relations of mold, stove, and fragrance products on childhood wheezing and asthma: A prospective cohort study from the Japan Environment and Children's Study

This prospective cohort study aimed to examine the associations between mold growth, type of stoves, and fragrance materials and early childhood wheezing and asthma, using data from the Japan Environment and Children's Study. Mold growth at home, usage of kerosene/gas stove, wood stove/fireplace, and air freshener/deodorizer were surveyed using a questionnaire at 1.5-year-old, and childhood wheezing and doctor-diagnosed asthma during the previous year were obtained using a 3-year-old questionnaire. Multilevel logistic regression analysis was performed to evaluate the association between exposure to childhood wheezing and asthma. A total of 60 529 children were included in the analysis. In multivariate analyses, mold growth and wood stove/fireplace had significantly higher odds ratios (ORs) for wheezing (mold growth: 1.13; 95% CI, 1.06-1.22; wood stove/fireplace: 1.23; 95% CI, 1.03-1.46). All four exposures had no significant ORs for childhood doctor-diagnosed asthma; however, in the supplemental analysis of northern regions, wood stove/fireplace had a significantly higher OR for asthma. Mold growth and wood stove/fireplace had significant associations with childhood wheezing in the northern regions. Mold elimination in the dwellings and use of clean heating (no air pollution emissions) should be taken into consideration to prevent and improve childhood wheezing and asthma.

Odor-active volatile compounds in preterm breastmilk

BACKGROUND

Volatile compounds in breastmilk (BM) likely influence flavor learning and, through the cephalic phase response, metabolism, and digestion. Little is known about the volatile compounds present in preterm BM. We investigated whether maternal or infant characteristics are associated with the profile of volatile compounds in preterm BM.

METHODS

Using solid-phase microextraction coupled with gas chromatography/mass spectrometry, we analyzed volatile compounds in 400 BM samples collected from 170 mothers of preterm infants.

RESULTS

Forty volatile compounds were detected, mostly fatty acids and their esters (FA and FAe), volatile organic compounds (VOCs), aldehydes, terpenoids, alcohols, and ketones. The relative concentration of most FA and FAe increased with advancing lactation and were lower in BM of most socially deprived mothers and those with gestational diabetes (p < 0.05), but medium-chain FAs were higher in colostrum compared to transitional BM (p < 0.001). Infant sex, gestational age, and size at birth were not associated with the profile of volatile compounds in preterm BM.

CONCLUSIONS

Sensory-active volatile FA and FAe are the major contributors to the smell of preterm BM. The associations between lactation stage, maternal characteristics, and volatile compounds, and whether differences in volatile compounds may affect feeding behavior or metabolism, requires further research.

IMPACT

Sensory-active volatile FAs are major contributors to the smell of preterm BM and are influenced by the lactation stage and maternal characteristics. Longitudinal analysis of volatile compounds in preterm BM found that FAs increased with advancing lactation. Colostrum had a higher concentration of medium-chain FAs compared to transitional BM and the concentration of these is associated with socioeconomic status, gestational diabetes, and ethnicity.

The impact of emissions from an essential oil diffuser on cognitive performance

Essential oil products are increasingly used in indoor environments and have been found to negatively contribute to indoor air quality. Moreover, the chemicals and fragrances emitted by those products may affect the central nervous system and cognitive function. This study uses a double-blind between-subject design to investigate the cognitive impact of exposure to the emissions from essential oil used in an ultrasonic diffuser. In a simulated office environment where other environmental parameters were maintained constant, 34 female and 25 male university students were randomly allocated into four essential oil exposure scenarios. The first two scenarios contrast lemon oil to pure deionized water, while the latter two focus on different levels of particulate matter differentiated by HEPA filters with non-scented grapeseed oil as the source. Cognitive function was assessed using a computer-based battery consisting of five objective tests that involve reasoning, response inhabitation, memory, risk-taking, and decision-making. Results show that exposure to essential oil emissions caused shortened reaction time at the cost of significantly worse response inhabitation control and memory sensitivity, indicating potentially more impulsive decision-making. The cognitive responses caused by scented lemon oil and non-scented grapeseed oil were similar, as was the perception of odor pleasantness and intensity.

Volatile organic compound and particulate matter emissions from an ultrasonic essential oil diffuser

Ultrasonic essential oil diffusers (EODs) are a popular type of indoor scenting source. We performed a chamber study in which we measured the emissions from EODs used with lemon, lavender, eucalyptus, and grapeseed oils. Over the course of 15 min, the most abundant VOCs released from lemon, lavender, eucalyptus, and grapeseed oils were 2.6 ± 0.7 mg of d-limonene, 3.5 ± 0.4 mg of eucalyptol, 1.0 ± 0.1 mg of linalyl acetate, and 0.2 ± 0.02 mg of linalyl acetate, respectively. Each oil had a unique particulate matter (PM) emission profile in terms of size, number density, and rate. The dominant size ranges of the PM were 10-100 nm for lemon oil, 50-100 nm for lavender oil, 10-50 nm for lemon oil, and above 200 nm for grapeseed oil. PM₁ emission rates of approximately 2 mg/h, 0.1 mg/h, and 3 mg/h, were observed for lemon, lavender/eucalyptus, and grapeseed oils, respectively. A fivefold increase in PM₁ emission was measured when the EOD with eucalyptus oil was filled with tap water as opposed to deionized water. Modeling suggests that reasonable use cases of EODs can contribute substantially to primary and secondary PM in indoor environments, but this potential varies depending on the oil and water types used.

Assessment of Personal Relaxation in Indoor-Air Environments: Study in Real Full-Scale Laboratory Houses

The relationship between chemical concentrations in indoor air and the human sense of comfort and relaxation have been reported. We investigated the effect of the sum of volatile organic compounds (ΣVOCs; sum of 79 VOCs) on the level of relaxation in two laboratory houses with almost identical interior and exterior appearances. The electroencephalogram (EEG) was monitored to evaluate the degree of personal relaxation objectively. The experiments were conducted in laboratory houses (LH) A and B with lower and higher levels of ΣVOCs, respectively. A total of 168 healthy volunteers participated, who each performed the task for 20 min, followed by a 10-min break, and EEG was measured during the break. Simultaneously as subjective evaluations, the participants were asked to fill a questionnaire regarding the intensity of odor and preference for the air quality in each LH. The subjective evaluation showed a significant association between ΣVOCs and participants’ relaxation (OR: 2.86, 95%CI: 1.24–6.61), and the objective evaluation indicated that the participants were more relaxed in the LH with lower levels of ΣVOCs than that with higher levels (OR: 3.03, 95%CI: 1.23–7.50). Therefore, the reduction of ΣVOCs and odors in indoor air would have an effect, which is the promotion of relaxation.

Indoor air quality and the associated health risk in primary school buildings in Central Europe - The InAirQ study

The indoor air quality (IAQ) was investigated in sixty-four primary school buildings in five Central European countries (Czech Republic, Hungary, Italy, Poland, and Slovenia). The concentration of volatile organic compounds, aldehydes, PM_2.5 mass, carbon dioxide, radon, as well as physical parameters were investigated during the heating period of 2017/2018. Significant differences were identified for the majority of the investigated IAQ parameters across the countries. The median indoor/outdoor ratios varied considerably. A comprehensive evaluation of IAQ in terms of potential health effects and comfort perception was performed. Hazard quotient values were below the threshold value of 1 with one exception. In contrast, 31% of the school buildings were characterized by hazard index values higher than 1. The maximum cumulative ratio approach highlighted that the concern for non-carcinogenic health effects was either low or the health risk was driven by more substances. The median excess lifetime cancer risk values exceeded the acceptable value of 1 × 10^-6 in the case of radon and formaldehyde. PM_2.5 mass concentration values exceeded the 24 h and annual guideline values set by the World Health Organization in 56 and 85% of the cases, respectively. About 80% of the schools could not manage to comply with the recommended concentration value for carbon dioxide (1000 ppm).

Beyond dermal exposure: The respiratory tract as a target organ in hazard assessments of cosmetic ingredients

Dermal contact is the main route of exposure for most cosmetics; however, inhalation exposure could be significant for some formulations (e.g., aerosols, powders). Current cosmetic regulations do not require specific tests addressing respiratory irritation and sensitisation, and despite the prohibition of animal testing for cosmetics, no alternative methods have been validated to assess these endpoints to date. Inhalation hazard is mainly determined based on existing human and animal evidence, read-across, and extrapolation of data from different target organs or tissues, such as the skin. However, because of mechanistic differences, effects on the skin cannot predict effects on the respiratory tract, which indicates a substantial need for the development of new approach methodologies addressing respiratory endpoints for inhalable chemicals in general. Cosmetics might present a particularly significant need for risk assessments of inhalation exposure to provide a more accurate toxicological evaluation and ensure consumer safety. This review describes the differences in the mechanisms of irritation and sensitisation between the skin and the respiratory tract, the progress that has already been made, and what still needs to be done to fill the gap in the inhalation risk assessment of cosmetic ingredients.

Inhaled exposure to air fresheners aggravated liver injury in a murine model of nonalcoholic fatty acid liver disease

At present, the consumption and use of air fresheners (AFs) is rapidly increasing worldwide for the purposes of odor removal and to create a pleasant odor. Many recent studies have strongly suggested that the potentially hazardous chemicals emitted from AFs may be the primary source of indoor air pollutants and may cause adverse health effects. Despite the presence of hazardous chemicals in AFs, potential adverse health effects and risk assessment of AFs have not yet been established. The incidence of nonalcoholic fatty acid liver disease (NAFLD) around the world is rapidly increasing, as with obesity and diabetes, and is one of the most common causes of liver disease worldwide. Based on the demonstrated evidence that NAFLD could eventually develop into further health complications such as liver failure, cardiovascular disease, liver cirrhosis, or liver cancer, the current study was performed to clarify the relationship between inhaled AF exposure and NAFLD using a high-fructose diet (HFr)-induced murine model. The results from current study clearly demonstrated that AF exposure further exacerbated liver injury in NAFLD-induced mice. Interestingly, the increased expression of fibrosis-related factors and collagen accumulation in the liver of AF-exposed NAFLD-induced mice resulted in nonalcoholic steatohepatitis (NASH)-like phenotype and fibrosis. Taken together, these results strongly suggest that AF exposure may not only induce liver injury but may also exacerbate NAFLD to lead to NASH-like symptoms. Further study is needed to shed light on the detailed mechanisms behind AF-induced liver effects and its potential role in exacerbating NAFLD to more detrimental disease in order to better scientific evidence for risk assessments of indoor AF exposure.

Multiple chemical sensitivity described in the Danish general population: Cohort characteristics and the importance of screening for functional somatic syndrome comorbidity-The DanFunD study

Background

Multiple chemical sensitivity (MCS) is characterized by widespread symptoms attributed to exposure to airborne chemicals. MCS is categorized as a functional somatic syndrome (FSS), and MCS cases often meet the criteria for other types of FSS, e.g. fibromyalgia. The primary aim was to characterize MCS regarding symptom triggers, symptoms, lifestyle and describe demographics, socioeconomics and lifestyle factors associated with MCS. A secondary aim was to examine the implication of FSS comorbidity.

Methods

Data were derived from a random sample of the Danish adult population enrolled in the Danish Study of Functional Disorders (DanFunD; n = 9,656). Questionnaire data comprised information used to delimit MCS and four additional types of FSS, as well as data on demographics, socioeconomics and lifestyle. MCS cases (n = 188) was stratified into subgroups; MCS only (n = 109) and MCS with comorbid FSS (n = 73). Information regarding FSS comorbidities were missing for six MCS cases. MCS subgroups and controls without FSS comorbidities (n = 7,791) were compared by means of logistic regression analyses, adjusted for age and sex.

Results

MCS was associated with female sex, not being in occupation and low social status, but not with age or education. MCS cases reported normal dietary intake and smoking habits and lower alcohol consumption. Additional associations were found between MCS and low rate of cohabitation, sedentarism, daily physically limitations, and poor quality of sleep. However, subgroup analysis revealed that these findings were primarily associated with MCS with comorbid FSS.

Conclusions

MCS was associated with lower socioeconomic status, physically inactivity and poor quality of sleep. Subgroup analysis revealed that several associations was explained by FSS comorbidity, i.e. MCS cases with no comorbid FSS showed normal rate of cohabitation and did not report physical limitations or difficulties sleeping. Overall, our findings emphasise the importance of screening MCS cases for FSS comorbidity both in epidemiological and clinical settings.

Ubiquity, Hazardous Effects, and Risk Assessment of Fragrances in Consumer Products

Purpose of review

The main aims of fragrances are to create pleasing scents or to mask unpleasant odors. We hereby review their main exposure sources, presumed benefits, and unwanted effects, with special attention to allergic contact dermatitis (prevalence, regulatory environment, risk assessment methodology, and preventive measures).

Recent findings

Fragrances elicit positive emotions and presumably have therapeutic benefits related to stress reduction and memory enhancement. However, they also cause detrimental health or environmental effects including contact dermatitis (irritant and/or allergic), non-eczematous contact reactions, photosensitivity, photo-allergy, and immediate contact reactions, which can negatively impact the quality of life. Fragrances are the most frequent chemicals causing contact dermatitis. Their main sources are cosmetics, household products, industrial substances, food flavorings, oral hygiene products, and topical medications. It is difficult for sensitized patients to avoid contact with fragrances, due to their ubiquity and because manufacturers are not willing to volunteer information regarding fragrance ingredients.

Summary

The treatment of contact dermatitis relies on allergens avoidance which does not “cure” the disease (sensitization persists for life) but prevents disabling illness. The patient should understand that avoiding perfume means to avoid all scented goods and not just perfumes.

Labeling fragrances is key in primary prevention (by giving the healthy individual the chance to make an informed choice to avoid risky substances), diagnosis (by helping the practitioner to plan and interpret patch tests), secondary prevention, and prognosis (by allowing the sensitized patient to follow the avoidance instructions). However, only 26 fragrances are mandatory to be declared in cosmetics. The vague labeling of other fragrance ingredients as “perfume” or “fragrance” hampers the diagnostic and preventive approaches. Therefore, in our opinion, declaration should be mandatory for all fragrance ingredients as well as straightforward so most consumers can understand it. Moreover, legislation should be improved to prevent inappropriately high exposures by forbidding stronger allergens, restricting maximum concentrations in the finished product or fields of application, delivering information regarding the risks to the general public, and controlling the compliance of manufacturers with the regulations. Besides, manufacturers should share information regarding the composition in the final products and provide physicians with samples of all fragrance chemicals whenever needed for patch test investigations.

Olfactory Cues in Infant Feeds: Volatile Profiles of Different Milks Fed to Preterm Infants

Background: Smell is determined by odor-active volatile compounds that bind to specific olfactory receptors, allowing us to discriminate different smells. Olfactory stimulation may assist with digestion and metabolism of feeds in the neonate by activation of the cephalic phase response of digestion. Infants' physiological responses to the smell of different milks suggest they can distinguish between breastmilk and infant formula. We aimed to describe the profile of volatile compounds in preterm breastmilk and investigate how this differed from that of other preterm infant feeding options including pasteurized donor breastmilk, breastmilk with bovine milk-based fortifier, human milk-based products and various infant formulas. Methods: Forty-seven milk samples (13 different infant formulas and 34 human milk-based samples) were analyzed. Volatile compounds were extracted using Solid Phase Micro Extraction. Identification and relative quantification were carried out by Gas Chromatography with Mass Spectrometry. Principal Component Analysis (PCA) and one-way Analysis of Variance (ANOVA) with Tukey's HSD (parametric data) or Conover's post-hoc test (non-parametric data) were used as appropriate to explore differences in volatile profiles among milk types. Results: In total, 122 compounds were identified. Breastmilk containing bovine milk-based fortifier presented the highest number of compounds (109) and liquid formula the lowest (70). The profile of volatile compounds varied with 51 compounds significantly different (adjusted p < 0.001) among milk types. PCA explained 47% of variability. Compared to preterm breastmilk, the profile of volatile compounds in breastmilk with added bovine milk-based fortifier was marked by presence of fatty acids and their esters, ketones and aldehydes; infant formulas were characterized by alkyls, aldehydes and furans, and human milk-based products presented high concentrations of aromatic hydrocarbons, terpenoids and specific fatty acids. Conclusions: Sensory-active products of fatty acid oxidation are the major contributors to olfactory cues in infant feeds. Analysis of volatile compounds might be useful for monitoring quality of milk and detection of oxidation products and environmental contaminants. Further research is needed to determine whether these different volatile compounds have biological or physiological effects in nutrition of preterm infants.

Measurements and analysis of non-methane VOC (NMVOC) emissions from major domestic aerosol sprays at "source"

Non-Methane Volatile Organic Compounds (NMVOCs) from domestic aerosol sprays are emerging pollutants and have substantial negative effects on human health and the environment. This study, for the first time, carried out quantification of the NMVOC emissions from off-the-shelf domestic aerosol sprays, at "source" in the UK. These aerosol sprays contain harmful organic compounds as propellants and products. The results showed that the cosmetic category (i.e. body sprays) have higher concentrations of NMVOCs with 93.7 wt% per can compared to households (i.e. air fresheners) with 62 wt%. Also, water-based products showed less NMVOCs in all analyses compared to solvent-based formulations. Direct replacement of Liquefied Petroleum Gas (LPG) propellants from conventional products with 'clean air' (i.e. nitrogen) showed the potential emission reduction of 50%. Hair spray products, however, have the highest ozone forming potential with about 105.1 g of Ozone per litre of the product compared to other domestic aerosol sprays. The level of global warming contribution of the selected aerosol sprays in the UK was measured to be 129.8 ktCO₂e in 2018 and globally, this can be projected to be 3154.6 ktCO₂e in 2020. Furthermore, NMVOC emissions contribution from the domestic aerosol sprays in the UK was measured as 61.2 kt in 2018 based on annual consumption of 520 million cans. Globally this can equate to 1437.6 kt based on the projected usage of 17.5 billion cans. Therefore, it is vital to expedite replacing LPG propellant with nitrogen in a drive for a 'near-zero' emission in aerosol industry. The results presented in this study can also be used to steer policy makers to the potentially brewing danger from an otherwise passive emission source.

Can limonene be a possible candidate for evaluation as an agent or adjuvant against infection, immunity, and inflammation in COVID-19?

Coronavirus disease (COVID-19) caused by novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an ongoing pandemic and presents a public health emergency. It has affected millions of people and continues to affect more, despite the tremendous social preventive measures. The therapeutic strategy relies on suppressing infectivity and inflammation, along with immune modulation. The identification of candidate drugs effective for COVID-19 is crucial, thus many natural products including phytochemicals are also being proposed for repurposing and evaluated for their potential in COVID-19. Among numerous phytochemicals, limonene (LMN), a dietary terpene of natural origin has been recently showed to target viral proteins in the in-silico studies. LMN is one of the main compounds identified in many citrus plants, available and accessible in diets and well-studied for its therapeutic benefits. Due to dietary nature, relative safety and efficacy along with favorable physicochemical properties, LMN has been suggested to be a fascinating candidate for further investigation in COVID-19. LMN showed to modulate numerous signaling pathways and inhibits inflammatory mediators, including cytokines, chemokines, adhesion molecules, prostanoids, and eicosanoids. We hypothesized that given the pathogenesis of COVID-19 involving infection, inflammation, and immunity, LMN may have potential to limit the severity and progression of the disease owing to its immunomodulatory, anti-inflammatory, and antiviral properties. The present article discusses the possibilities of LMN in SARS-CoV-2 infections based on its immunomodulatory, anti-inflammatory, and antiviral properties. Though, the suggestion on the possible use of LMN in COVID-19 remains inconclusive until the in-silico effects confirmed in the experimental studies and further proof of the concept studies. The candidature of LMN in COVID-19 treatment somewhat appear speculative but cannot be overlooked provided favorable physiochemical and druggable properties. The safety and efficacy of LMN are necessary to be established in preclinical and clinical studies before making suggestions for use in humans.

Domestic exposure to irritant cleaning agents and asthma in women

An adverse role of frequent domestic use of cleaning agents, especially in spray form, on asthma has been reported. However, sparse studies have investigated respiratory health effects of chronic domestic exposure to irritant cleaning agents. This study aims to investigate associations between weekly use of irritant domestic cleaning products and current allergic and non-allergic asthma in a large cohort of elderly women. We used data from the Asthma-E3N nested case-control study on asthma (n = 19,404 women, response rate: 91%, 2011), in which participants completed standardized questionnaires on asthma and on the use of domestic cleaning products including irritants (bleach, ammonia, solvents and acids). Allergic multimorbidity in asthma was assessed from allergic-related medications recorded in drug refunds database. The association between use of irritants and current asthma was estimated by logistic regression (current vs. never asthma) and multinomial logistic regression (never asthma, non-allergic asthma, allergic asthma) adjusted on age, smoking status and body mass index (BMI). In the 12,758 women included in the analysis (mean age: 70 years, current smokers: 4%, BMI ≥ 25 kg/m²: 32%, low education: 11%, current asthma: 23%), 47% reported weekly use of at least one irritant cleaning product at home. Weekly use of irritant products was associated with a higher risk of current asthma (adjusted Odds-Ratio: 1.17, 1.07-1.27). A statistically significant dose-response association was reported (p trend < 0.0001), with both the number of irritant products used weekly (1 irritant: 1.12, 1.02-1.23; 2 irritants: 1.21, 1.05-1.39; 3 irritants or more: 2.08, 1.57-2.75) and the frequency of use (1-3 days/week: 1.12, 1.02-1.23; 4-7 days/week: 1.41,1.22-1.64). A dose-response association was observed with the frequency of products used (p trend < 0.05), for both non-allergic (4-7 days/week: 1.27, 1.02-1.57) and allergic asthma (1.52, 1.27-1.82). In conclusion, weekly use of common cleaning irritants was associated with an increased risk of current asthma, whatever the allergic status.

Indoor air pollution, physical and comfort parameters related to schoolchildren's health: Data from the European SINPHONIE study

Substantial knowledge is available on the association of the indoor school environment and its effect among schoolchildren. In the same context, the SINPHONIE (School indoor pollution and health: Observatory network in Europe) conducted a study to collect data and determine the distribution of several indoor air pollutants (IAPs), physical and thermal parameters and their association with eye, skin, upper-, lower respiratory and systemic disorder symptoms during the previous three months. Finally, data from 115 schools in 54 European cities from 23 countries were collected and included 5175 schoolchildren using a harmonized and standardized protocol. The association between exposures and the health outcomes were examined using logistic regression models on the environmental stressors assessed in classroom while adjusting for several confounding factors; a VOC (volatile organic compound) score defined as the sum of the number of pollutants to which the children were highly exposed (concentration > median of the distribution) in classroom was also introduced to evaluate the multiexposure - outcome association. Schoolchildren while adjusting for several confounding factors. Schoolchildren exposed to above or equal median concentration of PM_2.5, benzene, limonene_, ozone and radon were at significantly higher odds of suffering from upper, lower airways, eye and systemic disorders. Increased odds were also observed for any symptom (sick school syndrome) among schoolchildren exposed to concentrations of limonene and ozone above median values. Furthermore, the risks for upper and lower airways and systemic disorders significantly increased with the VOCs score. Results also showed that increased ventilation rate was significantly associated with decreased odds of suffering from eye and skin disorders whereas similar association was observed between temperature and upper airways symptoms. The present study provides evidence that exposure to IAPs in schools is associated with various health problems in children. Further investigations are needed to confirm our findings.

Chemicals inhaled from spray cleaning and disinfection products and their respiratory effects. A comprehensive review

Spray cleaning and disinfection products have been associated with adverse respiratory effects in professional cleaners and among residents doing domestic cleaning. This review combines information about use of spray products from epidemiological and clinical studies, in vivo and in vitro toxicological studies of cleaning chemicals, as well as human and field exposure studies. The most frequent chemicals in spray cleaning and disinfection products were compiled, based on registrations in the Danish Product Registry. The chemicals were divided into acids, bases, disinfectants, fragrances, organic solvents, propellants, and tensides. In addition, an assessment of selected cleaning and disinfectant chemicals in spray products was carried out. Chemicals of concern regarding respiratory effects (e.g. asthma) are corrosive chemicals such as strong acids and bases (including ammonia and hypochlorite) and quaternary ammonium compounds (QACs). However, the evidence for respiratory effects after inhalation of QACs is ambiguous. Common fragrances are generally not considered to be of concern following inhalation. Solvents including glycols and glycol ethers as well as propellants are generally weak airway irritants and not expected to induce sensitization in the airways. Mixing of certain cleaning products can produce corrosive airborne chemicals. We discuss different hypotheses for the mechanisms behind the development of respiratory effects of inhalation of chemicals in cleaning agents. An integrative assessment is needed to understand how these chemicals can cause the various respiratory effects.

Does the ubiquitous use of essential oil-based products promote indoor air quality? A critical literature review

Essential oils are frequently used as natural fragrances in housecleaning products and air fresheners marketed as green and healthy. However, these substances are volatile and reactive chemical species. This review focuses on the impact of essential oil-based household products on indoor air quality. First, housecleaning products containing essential oils are explored in terms of composition and existing regulations. Specific insight is provided regarding terpenes in fragranced housecleaning products, air fresheners, and pure essential oils. Second, experimental methodologies for terpene monitoring, from sampling to experimental chambers and analytical methods, are addressed, emphasizing the experimental issues in monitoring terpenes in indoor air. Third, the temporal dynamics of terpene emissions reported in the literature are discussed. Despite experimental discrepancies, essential oil-based products are significant sources of terpenes in indoor air, inducing a high exposure of occupants to terpenes. Finally, the fate of terpenes is explored from sorptive and reactive points of view. In addition to terpene deposition on surfaces, indoor oxidants may induce homogeneous and heterogeneous reactions, resulting in secondary pollutants, such as formaldehyde and secondary organic aerosols. Overall, essential oil-based products can negatively impact indoor air quality; therefore, standard protocols and real-scale approaches are needed to explore the indoor physics and chemistry of terpenes, from emissions to reactivity.

The impact of multiple chemical sensitivity on people's social and occupational functioning; a systematic review of qualitative research studies

OBJECTIVE

Social and occupational functioning are important for psychological health. However, quantitative research has suggested that these areas can be adversely affected by multiple chemical sensitivity (MCS). This systematic review therefore sought to explore what qualitative research has suggested about how people with MCS perceive it to affect their social and occupational functioning.

METHOD

Journal articles were included if they were 1) peer reviewed 2) qualitative or mixed methods 3) published in English 4) reported qualitative findings relevant to the review. Studies were excluded if they were 1) descriptive only 2) primarily concerned with environmental intolerances other than chemicals or 3) focussed on specific populations such as veterans. Quality was assessed using the National Institute for Health and Care Excellence (NICE, 2018) qualitative quality criteria. However, quality was not used to determine eligibility for inclusion. Six databases (CINAHL, Medline, PsychArticles, PsychInfo, Scopus and Web of Science) were searched between the 24th of February 2019 and 2nd of March 2019.

RESULTS

Having removed duplicates, database searches identified 388 potential articles. Thirteen of these articles were eligible for inclusion. Following review, no more articles were included from the reference lists of these studies. Meta-aggregation of the findings identified seven categories. These were synthesised into three themes; 'limited access', 'loss & anxiety' and 'seeking engagement'.

CONCLUSIONS

The findings suggested that MCS limits some people's social and occupational functioning. The results warrant further research, and, the development of prevention and intervention strategies. Studies predominantly recruited United States and Canadian females and had several limitations.

Indoor air chemistry: Terpene reaction products and airway effects

Reactive chemistry is ubiquitous indoors with a wealth of complex oxidation reactions; some of these are initiated by both homogeneous and heterogeneous reaction of ozone with unsaturated organic compounds and subsequent the hydroxyl radical, either in the gas-phase or on reactive surfaces. One major focus has been the reaction of common and abundant terpene-based fragrances in indoor air emitted from many wood-based materials, a variety of consumer products, and citrus fruits and flowers. Inhalation of the terpenes themselves are generally not considered a health concern (both acute and long-term) due to their low indoor air concentrations; however, their gas- and surface reactions with ozone and the hydroxyl radical produce a host of products, both gaseous, i. a. formaldehyde, and ultrafine particles formed by condensation/nucleation processes. These reaction products may be of health concern. Human cell bioassays with key reaction products from ozone-initiated terpene reactions have shown some inflammatory reactions, but results are difficult to interpret for human exposure and risk assessment. Acute effects like sensory irritation in eyes and airways are unlikely or present at very low intensity in real life conditions based on rodent and human exposure studies and known thresholds for sensory irritation in eyes and airways and derived human reference values for airflow limitation and pulmonary irritation. Some fragrances and their ozone-initiated reaction products may possess anti-inflammatory properties. However, long-term effects of the reaction products as ultrafine particles are poorly explored. Material and product surfaces with high ozone deposition velocities may significantly impact the perceived air quality by altered emissions from both homogeneous and heterogeneous surface reactions.

The Potential Benefits of Therapeutic Treatment Using Gaseous Terpenes at Ambient Low Levels

Biological volatile organic compounds (BVOCs) are emitted abundantly from the flora. Among BVOCs, monoterpenes (MTs) have been used for aromatherapy (e.g., forest bathing) to treat human physiological and psychological conditions. However, relatively little is known about the therapeutic effects of MTs at low part per billion by volume (ppbv) levels. The effects of artificial MTs on human subjects were assessed by both olfactory and therapeutic parameters (brain alpha waves and stress index). Gaseous standards of three monoterpenes (i.e., α-pinene, β-pinene, and d-limonene) prepared at low ppbv levels were used individually and as mixtures. Fifty-nine healthy and non-asthmatics volunteer university students were selected for the test. All human subjects inhaled low ppbv levels of monoterpene in the testing room. Brain alpha waves and stress index were investigated during the inhalation time. Questionnaires were also used after testing. It was found that the detection threshold of MTs was close to 5 ppbv. When the MT levels increased from 0 to 20 ppbv, the mean values of brain alpha waves derived from all participants increased from 9.8 to 15.1. In contrast, the stress index values declined from 46.2 to 34.7. The overall results suggest that MTs have great potential to positively affect the relaxation state of subjects in a manner similar to forest bathing in terms of short-term effect. They can thus be applied as potential therapeutic media for mental health care.

Exploring the science, safety, and benefits of air care products: perspectives from the inaugural air care summit

Seventy-one percent of US households purchase air care products. Air care products span a diverse range of forms, including scented aerosol sprays, pump sprays, diffusers, gels, candles, and plug-ins. These products are used to eliminate indoor malodors and to provide pleasant scent experiences. The use of air care products can lead to significant benefits as studies have shown that indoor malodor can cause adverse effects, negatively impacting quality of life, hygiene, and the monetary value of homes and cars, while disproportionately affecting lower income populations. Additionally, studies have also shown that scent can have positive benefits related to mood, stress reduction, and memory enhancement among others. Despite the positive benefits associated with air care products, negative consumer perceptions regarding the safety of air care products can be a barrier to their use. During the inaugural Air Care Summit, held on 18 May 2018 in the Washington, DC, metropolitan area, multidisciplinary experts including industry stakeholders, academics, and scientific and medical experts were invited to share and assess the existing data related to air care products, focusing on ingredient and product safety and the benefits of malodor removal and scent. At the Summit's completion, a panel of independent experts representing the fields of pulmonary medicine, medical and clinical toxicology, pediatric toxicology, basic science toxicology, occupational dermatology and experimental psychology convened to review the data presented, identify potential knowledge gaps, and suggest future research directions to further assess the safety and benefits of air care products.

Fragrance inhalation and adverse health effects: The question of causation

The toxicology of fragrance materials is largely well understood. Although most are benign, a minority have the potential to cause adverse health effects, notably allergic contact dermatitis resulting from skin sensitization. As a consequence, industry guidelines have banned certain materials and strictly limited the use of others. Recently, data have been published that have been interpreted to suggest that inhalation of fragrances is associated with the occurrence of a variety of health effects, ranging from headaches to asthma attacks. In this review, the evidence basis for these assertions is examined critically and the biological basis and mechanistic plausibility for causation by fragranced products of these health effects is explored. This review concludes that respiratory effects, including irritation and allergy appear highly unlikely to occur by this route. While some sensory/psychosomatic effects are possible, this does not explain the very high rates of adverse effects reported in the recently published questionnaire studies, which this review concludes are more likely to be attributed to methodological weaknesses. Ultimately, it is concluded that adverse health effects arising from fragrance inhalation are uncommon and remain to be identified and confirmed by methodologically rigorous epidemiological investigations supported by a convincing biological and mechanistic basis.

Combined Assessment of Preschool Childrens' Exposure to Substances in Household Products

Understanding how indoor-air contaminants affect human health is of critical importance in our developed society. We assessed the combined exposure by inhalation of preschool children and children to household products. A total of 1175 families with 72 infants, 158 toddlers, 230 children, and 239 youths were surveyed to determine the combined respiratory exposure concentrations and amounts associated with 21 substances in eight household product groups. We determined the mean concentrations of these substances in each product, and derived reference toxicity values based on the information gathered in order to identify respiratory health risks. On average, cleaners were used at a rate of 1.0 × 10³ g/month, while coating agents and other substances were used at 43 g/month. The combined inhalation exposure concentrations of methanol to infants and toddlers were 5.1 and 4.2 mg/m³ per month, respectively, with values of 2.1 and 1.7 mg/m³ for isopropanol, respectively. Risks to preschool children and children should be assessed on the basis of the toxicity values of combined exposed hazardous substances, as well as their combined concentrations and amounts. This exposure assessment approach can be used to establish improved guidelines for products that may pose inhalation hazards to preschool children and children.

The influence of air-dispersed essential oils from lemon (Citrus limon) and silver fir (Abies alba) on airborne bacteria and fungi in hospital rooms

Airborne bacteria and fungi are an ongoing problem in hospitals. Because of the antimicrobial activities of essential oils (EOs) dispersion of EOs into the air may help to reduce this contamination. The aim of this study was to evaluate the efficacy of the dispersion of selected EOs in reducing the microbial contamination in two hospital wards. The study was carried out at two wards of a 1,227-bed acute-care hospital in Austria. The concentration of airborne bacteria and fungi was measured in patient rooms before and after dispersion of a mixture of Citrus limon EO and Abies alba EO. Before dispersion of the EOs in both wards the mean concentration of bacteria was in a typical range (123 colony forming units (CFU) m^-3 and 104 CFU m^-3) while the mean concentration of fungi differed substantially (155 CFU m^-3 and 28 CFU m^-3). After dispersion of the EOs, a reduction in both bacterial and fungal contamination was observed. In the first two hours the mean concentration of airborne bacteria and fungi was reduced by approximately 40% and 30%-60% respectively. The selected EO mixture is effective in reducing the microbial contamination of the indoor air.

Inhalation exposure factors from the use of household products in South Korea

Exposure assessment, a fundamental element of the risk assessment process, is the estimation of what consumers may be exposed to by using household products. Reliable exposure factors were investigated to understand the pattern of household products usage. Six household product categories were selected and divided by application types. Two surveys were carried out and 6397 participants completed the web-based questionnaires, and laboratory evaluations were also conducted to measure the actual level of exposure (g/use). We focused more on inhalation exposure from products (and/or their application types) that affect indoor air such as diffusible types. To estimate actual exposure amounts, the time spent to apply the products was investigated from the beginning to end of the product use. For spraying type products, the consumer could be exposed to the maximum amount of used product while using the triggering action and pressing the button on the aerosol spray product, and during cleaning, adhesion, and coating target, consumer could be exposed continuously. For diffuser type products, exposure duration was the time for which consumers were exposed to the diffused product. The exposure amount for trigger and aerosol spray type products were measured using the time taken to trigger or spray the product and the mass generated from the same. This study provides valuable information on the individual exposure factors that may be useful to conduct accurate exposure assessments and to manage household products.

Inhalation of Japanese cedar (Cryptomeria japonica) wood odor causes psychological relaxation after monotonous work among female participants

Essential oils have potential to mitigate stress symptoms and treat symptoms related to mental health. Few studies have investigated the effects of wood-derived aromatics on endocrinological and psychological responses in an actual space. In this study, we evaluated the effects of essential oil derived from Japanese cedar (Cryptomeria japonica) wood on the recovery state of female participants after they performed monotonous work. We determined the levels of salivary stress markers to describe the endocrinological responses. And we also used questionnaires to assess the perception of the odor of experimental rooms and psychological states. We found that olfactory stimulation with the volatile compounds of essential oil derived from Japanese cedar wood modulates mood states, and may transiently decrease sympathetic nervous activity. We suggest that olfactory stimulation with the volatile compounds of essential oil derived from Japanese cedar wood could be useful for maintaining mental health among women.