A review of factors surrounding the air pollution exposure to in-pram babies and mitigation strategies

What can be done to protect toddlers from air pollution: Current evidence

PROBLEM

Toddlers are more prone to exposure to widely distributed air pollution and to health damage from it. However, systematic summaries of evidence on protective behaviors against air pollution for toddlers are lacking.

OBJECTIVE

To identify currently available evidence on protective behaviors against air pollution for toddlers.

METHODS

The literature retrieval was performed in selected databases, limited from 2002 to 2022. Studies meeting the following criteria were included and praised: 1) clinical practice guideline, systematic review, expert consensus, recommended practice, randomized control test (RCT) or cohort study published in Chinese or English; 2) studies reporting effects of protective behaviors against air pollution on toddlers' health outcomes or providing recommendation on these behaviors. The evidence in the included studies was extracted, synthesized and graded for evidence summary.

RESULTS

Studies (N = 19) were used for evidence summary development and 35 pieces of best evidence were synthesized, which were divided into three categories, including "avoiding or reducing air pollution generation", "removing existing air pollution", and "avoiding or reducing exposure to existing air pollution".

CONCLUSIONS

More evidence is needed to identify protective measures against outdoor air pollution and tobacco smoke. Research in the future should focus on the safety, effectiveness and feasibility of universal measures implemented in toddlers, and try to develop protective measures specific to toddlers which highlight their special nature.

IMPLICATIONS

The results of this study can help pediatric nurses provide individualized advice and assistance for toddlers and their families, and conduct research on the effectiveness of toddler-targeting protective behaviors more efficiently.

A parent-school initiative to assess and predict air quality around a heavily trafficked school

Many primary schools in the UK are situated in close proximity to heavily-trafficked roads, yet long-term air pollution monitoring around such schools to establish factors affecting the variability of exposure is limited. We co-designed a study to monitor particulate matter in different size fractions (PM₁, PM_2.5, PM₁₀), gaseous pollutants (NO₂, O₃ and CO) and meteorological parameters (ambient temperature, relative humidity) over a period of one year. The period included phases of national COVID-19 lockdown and its subsequent easing and removal. Statistical analysis was used to assess the diurnal patterns, pollution hotspots and underlying factors driving changes. A pollution episode was observed early in January 2021, owing to new year celebration fireworks, when the daily average PM_2.5 was around three-times the World Health Organisation limit. PM_2.5 and NO₂ exceeded the threshold limits on 15 and 10 days, respectively, as the lockdown eased and the school reopened, despite the predominant wind direction often being away from the school towards the roads. The peak concentration levels for all pollutants occurred during morning drop-off hours; however, some weekends showed higher or comparable concentrations to those during weekdays. The strong disproportional Pearson correlation between CO and temperature demonstrated the possible contribution of local sources through biomass burning. The impact of lifting restrictions after removing the weather impact showed that the average pollution levels were low in the beginning and increased by up to 22.7 % and 4.2 % for PM_2.5 and NO₂, respectively, with complete easing of lockdown. The Prophet algorithm was implemented to develop a prediction model using an NO₂ dataset that performed moderately (R², 0.48) for a new monthly dataset. This study was able to build a local air pollution database at a school gate, which enabled an understanding of the air pollution variability across the year and allowed evidence-based mitigation strategies to be devised.

Exposure and dose assessment of school children to air pollutants in a tropical coastal-urban area

This study estimates exposure and inhaled dose to air pollutants of children residing in a tropical coastal-urban area in Southeast Brazil. For that, twenty-one children filled their time-activities diaries and wore the passive samplers to monitor NO₂. The personal exposure was also estimated using data provided by the combination of WRF-Urban/GEOS-Chem/CMAQ models, and the nearby monitoring station. Indoor/outdoor ratios were used to consider the amount of time spent indoors by children in homes and schools. The model's performance was assessed by comparing the modelled data with concentrations measured by urban monitoring stations. A sensitivity analyses was also performed to evaluate the impact of the model's height on the air pollutant concentrations. The results showed that the mean children's personal exposure to NO₂ predicted by the model (22.3 μg/m³) was nearly twice to those measured by the passive samplers (12.3 μg/m³). In contrast, the nearest urban monitoring station did not represent the personal exposure to NO₂ (9.3 μg/m³), suggesting a bias in the quantification of previous epidemiological studies. The building effect parameterisation (BEP) together with the lowering of the model height enhanced the air pollutant concentrations and the exposure of children to air pollutants. With the use of the CMAQ model, exposure to O₃, PM₁₀, PM_2.5, and PM₁ was also estimated and revealed that the daily children's personal exposure was 13.4, 38.9, 32.9, and 9.6 μg/m³, respectively. Meanwhile, the potential inhalation daily dose was 570-667 μg for PM_2.5, 684-789 μg for PM₁₀, and 163-194 μg for PM₁, showing to be favourable to cause adverse health effects. The exposure of children to air pollutants estimated by the numerical model in this work was comparable to other studies found in the literature, showing one of the advantages of using the modelling approach since some air pollutants are poorly spatially represented and/or are not routinely monitored by environmental agencies in many regions.

Understanding the effects of roadside hedges on the horizontal and vertical distributions of air pollutants in street canyons

Built-up environments limit air pollution dispersion in street canyons and lead to complex trade-offs between green infrastructure (GI) usage and its potential to reduce near-road exposure. This study evaluated the effects of an evergreen hedge on the distribution of particulate matter (PM₁, PM_2.5, PM₁₀), black carbon (BC) and particle number concentrations (PNCs) in a street canyon in West London. Instrumentation was deployed around the hedge at 13 fixed locations to assess the impact of the hedge on vertical and horizontal concentration distributions. Changes in concentrations behind the hedge were measured with reference to the corresponding sampling point in front of the hedge for all sets of measurements. Results showed a significant reduction in vertical concentrations between 1 and 1.7 m height, with maximum reductions of -16% (PM₁ and PM₁₀) and -17% (PM_2.5) at ∼1 m height. Horizontal concentrations revealed two zones between the building façade and the hedge, with opposite trends: (i) close to hedge (within 0.2 m), where a reduction of PM₁ and PM_2.5 was observed, possibly due to dilution, deposition and the barrier effect; and (ii) 0.2-3 m from the hedge, showing an increase of 13-37% (PM₁) and 7-21% (PM_2.5), possibly due to the blockage effect of the building, restricting dispersion. BC showed a significant reduction at breathing height (1.5 m) of between -7 and -50%, followed by -15% for PNCs in the 0.02-1 µm size range. The ELPI + analyser showed a peak of ∼30 nm. The presence of the hedge led to a ∼39 ± 32% decrease in total PNCs (0.006-10 µm), suggesting a greater removal in different modes, such as a 83 ± 12% reduction in nucleation mode (0.006-0.030 µm), 74 ± 15% in ultrafine (≤0.1 µm), and 34 ± 30% in accumulation mode (0.03-0.3 µm). These findings indicate graded filtering of particles by GI in a near-road street canyon environment. This insight will guide the improved design of GI barriers and the validation of microscale dispersion models.

Assessment and mitigation of toddlers' personal exposure to black carbon before and during the COVID-19 pandemic: A case study in Singapore

Black carbon (BC), an important indicator of traffic-related air pollution (TRAP) in urban environments, is receiving increased attention because of its adverse health effects. Personal exposure (PE) of adults to BC has been widely studied, but little is known about the exposure of young children (toddlers) to BC in cities. We carried out a pilot study to investigate the integrated daily PE of toddlers to BC in a city-state with a high population density (Singapore). We studied the impact of urban traffic on the PE of toddlers to BC by comparing and contrasting on-road traffic flow (i.e., volume and composition) in Singapore in 2019 (before the COVID-19 pandemic) and in 2020 (during the COVID-19 pandemic). Our observations indicate that the daily BC exposure levels and inhaled doses increased by about 25% in 2020 (2.9 ± 0.3 μg m-3 and 35.5 μg day-1) compared to that in 2019 (2.3 ± 0.4 μg m-3 and 28.5 μg day-1 for exposure concentration and inhaled dose, respectively). The increased BC levels were associated with the increased traffic volume on both weekdays and weekends in 2020 compared to the same time period in 2019. Specifically, we observed an increase in the number of trucks as well as cars/taxis and motorcycles (private transport) and a decline in the number of buses (public transport) in 2020. The implementation of lockdown measures in 2020 resulted in significant changes in the time, place and duration of PE of toddlers to BC. The recorded daily time-activity patterns indicated that toddlers spent almost all the time in indoor environments during the measurement period in 2020. When we compared different ventilation options (natural ventilation (NV), air conditioning (AC), and portable air cleaner (PAC)) for mitigation of PE to BC in the home environment, we found a significant decrease (>30%) in daily BC exposure levels while using the PAC compared to the NV scenario. Our case study shows that the PE of toddlers to BC is of health concern in indoor environments in 2020 because of the migration of the increased TRAP into naturally ventilated residential homes and more time spent indoors than outdoors. Since toddlers' immune system is weak, technological intervention is necessary to protect their health against inhalation exposure to air pollutants.

Indoor-outdoor relationships of airborne nanoparticles, BC and VOCs at rural and urban preschools

Health risks caused by exposure to black carbon (BC) and nanoparticles (NP) are well studied, although no standard currently exists for them worldwide. Exposure to children may lead to serious health effects due to their increased vulnerability and longer time spend inside the classrooms, making it important to assess the factors that affect air quality in preschools. Thus, this work aims to evaluate indoor-outdoor (I/O) relationships of NPs in the 10-420 nm range, BC and volatile organic compounds (VOCs) at rural and urban preschools (aged 3-5 years) between May 2016 and July 2017. Factorial analysis was applied to identify the possible emission sources. Prior communalities were estimated by the squared multiple correlations with all other variables. We used the varimax rotation method and the criterion for factor selection was the number of eigenvalues greater than one. Results indicate that BC and NP were 4- and 3.2-times higher in urban outdoor caused by traffic emissions, respectively. Highest concentrations occurred during rush hours and during the pickup time of children. In urban school, BC was directly related to accumulation mode (N_49-205), while in the rural area, BC was related to local traffic and particles from pulp industries in the regional background. Nucleation mode (N_11-36) was related to traffic emissions in urban school, while in the rural school was related with secondary formation of particles. Mean I/O ratios of BC and NP in the urban (0.54; 0.51) and rural (0.71; 0.91) schools, respectively, suggested that their higher concentrations occurred in outdoors. VOCs were higher indoor in urban (I/O = 1.97) and rural (I/O = 2.22) sites, indicating these pollutants are generated inside, regardless of urban or rural sites. These findings suggest the necessity of improving ventilation and commuting styles to lower the exposure of children to air pollutants in and around school environments.

A primary school driven initiative to influence commuting style for dropping-off and picking-up of pupils

The use of cars for drop-off and pick-up of pupils from schools is a potential cause of pollution hotspots at school premises. Employing a joint execution of smart sensing technology and citizen science approach, a primary school took an initiative to co-design a study with local community and researchers to generate data and provide information to understand the impact on pollution levels and identify possible mitigation measures. This study was aimed to assess the hotspots of vehicle-generated particulate matter ≤2.5 μm (PM_2.5) and ≤10 μm (PM₁₀) at defined drop-off/pick-up points and its ingress into a nearby naturally ventilated primary school classroom. Five different locations were selected inside school premises for measurements during two peak hours: morning (MP; 0730-0930 h; local time), evening (EP; 1400-1600 h), and off-peak (OP; 1100-1300 h) hours for comparison. These represent PM measurements at the main road, pick-up point at the adjoining road, drop-off point, a classroom, and the school playground. Additional measurements of carbon dioxide (CO₂) were taken simultaneously inside and outside (drop-off point) the classroom to understand its build-up and ingress of outdoor PM. The results demonstrated nearly a three-fold increase in the concentrations of fine particles (PM_2.5) during drop-off hours compared to off-peak hours indicated the dominant contribution of car queuing in the school premises. Coarse particles (PM_2.5-10) were prevalent in the school playground, while the contribution of fine particles as a result of traffic congestion became more pronounced during drop-off hours. In the naturally ventilated classroom, the changes in indoor PM_2.5 concentrations during both peak hours (0.58 < R² < 0.67) were followed by the outdoor concentration at the drop-off point. This initiative resulted in valuable information that might be used to influence school commuting style and raise other important issues such as the generally fairly high PM_2.5 concentrations in the playground and future classroom ventilation plans.

Quantification of air pollution exposure to in-pram babies and mitigation strategies

Young children are particularly vulnerable to air pollution exposure during their early childhood development, yet research on exposure to in-pram babies in different types of single/double prams is limited. This work aims to mimick their exposure to multiple air pollutants - particulate matter ≤10 µm in aerodynamic diameter (PM₁₀), ≤2.5 µm (PM_2.5; fine particles), ≤1 µm (PM₁), ≤0.10 µm (measured as particle number concentration, PNC) - in three different types of prams (single pram facing the road; single pram facing parents; double pram facing the road). We also assessed the differences in exposure concentrations between typical adult and in-pram baby breathing height via simultaneous measurements besides assessing their physico-chemical properties (morphology and elemental composition). In addition, we analysed the impact of pram covers in mitigating in-pram exposure concentrations of selected pollutants. We carried out a total of 89 single runs, repeating on a 2.1 km long pre-defined route between an origin-destination pair (the University of Surrey to a local school) during the morning (08:00-10:00 h; local time) and afternoon (15:00-17:00 h) hours. These run simulated morning drop-off and afternoon pick-off times of school children. Overall, the experimental runs took about 66 h and covered the total length of 145 km. Substantial variability is observed in measured concentrations of different pollutants within each run (e.g., up to 290-times for PNC) and between different runs performed during different times of the day (e.g., ~62% variability in average PNC; ~7% for PM₁ and 8% for PM_2.5 during morning versus afternoon). The average in-pram concentration of fine particles was always higher by up to 44% compared with adult breathing height during both morning and afternoon runs. The comparison of exposure concentrations at two different sitting heights of double pram showed that PNC concentrations were higher by about 72% at the bottom seat compared to the top seat. Scanning electron microscope (SEM) analysis of PM_2.5-10 revealed traces of brake wear, tyre wear and re-suspended dust minerals with the predominance of brake and tyre wear emissions at baby height compared with a relatively larger share of earth crust elements at adult height. For mitigation measures, pram covers reduced concentrations of small-sized particles by as much as 39% (fine particles) and 43% (coarse particles). Our results reinforce the need for mitigating exposures to in-pram babies, especially at urban pollution hotspots such as busy congested roads, bus stops, and traffic intersections.

Understanding Spatial Variability of Air Quality in Sydney: Part 2—A Roadside Case Study

Motivated by public interest, the Clean Air and Urban Landscapes (CAUL) hub deployed instrumentation to measure air quality at a roadside location in Sydney. The main aim was to compare concentrations of fine particulate matter (PM2.5) measured along a busy road section with ambient regional urban background levels, as measured at nearby regulatory air quality stations. The study also explored spatial and temporal variations in the observed PM2.5 concentrations. The chosen area was Randwick in Sydney, because it was also the subject area for an agent-based traffic model. Over a four-day campaign in February 2017, continuous measurements of PM2.5 were made along and around the main road. In addition, a traffic counting application was used to gather data for evaluation of the agent-based traffic model. The average hourly PM2.5 concentration was 13 µg/m3, which is approximately twice the concentrations at the nearby regulatory air quality network sites measured over the same period. Roadside concentrations of PM2.5 were about 50% higher in the morning rush-hour than the afternoon rush hour, and slightly lower (reductions of <30%) 50 m away from the main road, on cross-roads. The traffic model under-estimated vehicle numbers by about 4 fold, and failed to replicate the temporal variations in traffic flow, which we assume was due to an influx of traffic from outside the study region dominating traffic patterns. Our findings suggest that those working for long hours outdoors at busy roadside locations are at greater risk of suffering detrimental health effects associated with higher levels of exposure to PM2.5. Furthermore, the worse air quality in the morning rush hour means that, where possible, joggers and cyclists should avoid busy roads around these times.