1
|
Anand A, Castiglia E, Zamora ML. The Association Between Personal Air Pollution Exposures and Fractional Exhaled Nitric Oxide (FeNO): A Systematic Review. Curr Environ Health Rep 2024; 11:210-224. [PMID: 38386269 PMCID: PMC11180488 DOI: 10.1007/s40572-024-00430-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2024] [Indexed: 02/23/2024]
Abstract
PURPOSE OF REVIEW Airway inflammation is a common biological response to many types of environmental exposures and can lead to increased nitric oxide (NO) concentrations in exhaled breath. In recent years, several studies have evaluated airway inflammation using fractional exhaled nitric oxide (FeNO) as a biomarker of exposures to a range of air pollutants. This systematic review aims to summarize the studies that collected personal-level air pollution data to assess the air pollution-induced FeNO responses and to determine if utilizing personal-level data resulted in an improved characterization of the relationship between air pollution exposures and FeNO compared to using only ambient air pollution exposure data. RECENT FINDINGS Thirty-six eligible studies were identified. Overall, the studies included in this review establish that an increase in personal exposure to particulate and gaseous air pollutants can significantly increase FeNO. Nine out of the 12 studies reported statistically significant FeNO increases with increasing personal PM2.5 exposures, and up to 11.5% increase in FeNO per IQR increase in exposure has also been reported between FeNO and exposure to gas-phase pollutants, such as ozone, NO2, and benzene. Furthermore, factors such as chronic respiratory diseases, allergies, and medication use were found to be effect modifiers for air pollution-induced FeNO responses. About half of the studies that compared the effect estimates using both personal and ambient air pollution exposure methods reported that only personal exposure yielded significant associations with FeNO response. The evidence from the reviewed studies confirms that FeNO is a sensitive biomarker for air pollutant-induced airway inflammation. Personal air pollution exposure assessment is recommended to accurately assess the air pollution-induced FeNO responses. Furthermore, comprehensive adjustments for the potential confounding factors including the personal exposures of the co-pollutants, respiratory disease status, allergy status, and usage of medications for asthma and allergies are recommended while assessing the air pollution-induced FeNO responses.
Collapse
Affiliation(s)
- Abhay Anand
- Department of Public Health Sciences, UConn School of Medicine, UConn Health, 263 Farmington Avenue, Farmington, CT, 06030-6325, USA
| | - Elliana Castiglia
- Department of Public Health Sciences, UConn School of Medicine, UConn Health, 263 Farmington Avenue, Farmington, CT, 06030-6325, USA
| | - Misti Levy Zamora
- Department of Public Health Sciences, UConn School of Medicine, UConn Health, 263 Farmington Avenue, Farmington, CT, 06030-6325, USA.
| |
Collapse
|
2
|
Zhang J, Chen Z, Shan D, Wu Y, Zhao Y, Li C, Shu Y, Linghu X, Wang B. Adverse effects of exposure to fine particles and ultrafine particles in the environment on different organs of organisms. J Environ Sci (China) 2024; 135:449-473. [PMID: 37778818 DOI: 10.1016/j.jes.2022.08.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 08/04/2022] [Accepted: 08/08/2022] [Indexed: 10/03/2023]
Abstract
Particulate pollution is a global risk factor that seriously threatens human health. Fine particles (FPs) and ultrafine particles (UFPs) have small particle diameters and large specific surface areas, which can easily adsorb metals, microorganisms and other pollutants. FPs and UFPs can enter the human body in multiple ways and can be easily and quickly absorbed by the cells, tissues and organs. In the body, the particles can induce oxidative stress, inflammatory response and apoptosis, furthermore causing great adverse effects. Epidemiological studies mainly take the population as the research object to study the distribution of diseases and health conditions in a specific population and to focus on the identification of influencing factors. However, the mechanism by which a substance harms the health of organisms is mainly demonstrated through toxicological studies. Combining epidemiological studies with toxicological studies will provide a more systematic and comprehensive understanding of the impact of PM on the health of organisms. In this review, the sources, compositions, and morphologies of FPs and UFPs are briefly introduced in the first part. The effects and action mechanisms of exposure to FPs and UFPs on the heart, lungs, brain, liver, spleen, kidneys, pancreas, gastrointestinal tract, joints and reproductive system are systematically summarized. In addition, challenges are further pointed out at the end of the paper. This work provides useful theoretical guidance and a strong experimental foundation for investigating and preventing the adverse effects of FPs and UFPs on human health.
Collapse
Affiliation(s)
- Jianwei Zhang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Zhao Chen
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Dan Shan
- Department of Medical, Tianjin Stomatological Hospital, School of Medicine, Nankai University, Tianjin 300041, China
| | - Yang Wu
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Yue Zhao
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Chen Li
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin 300070, China; National Demonstration Center for Experimental Preventive Medicine Education (Tianjin Medical University), Tianjin 300070, China
| | - Yue Shu
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Xiaoyu Linghu
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Baiqi Wang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin 300070, China; National Demonstration Center for Experimental Preventive Medicine Education (Tianjin Medical University), Tianjin 300070, China.
| |
Collapse
|
3
|
Zhang X, Zhang H, Wang Y, Bai P, Zhang L, Wei Y, Tang N. Personal PM 2.5-bound PAH exposure and lung function in healthy office workers: A pilot study in Beijing and Baoding, China. J Environ Sci (China) 2023; 133:48-59. [PMID: 37451788 DOI: 10.1016/j.jes.2022.07.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 07/14/2022] [Accepted: 07/14/2022] [Indexed: 07/18/2023]
Abstract
The effect of short-term exposure to polycyclic aromatic hydrocarbons (PAHs) on the respiratory system among healthy residents is unclear. Beijing and Baoding are typical polluted cities in China, and there is little research on PAH exposure and its health effects at the individual level. Fourteen healthy female office workers were recruited in urban Beijing and Baoding, China, in 2019. The personal exposure to fine particulate matter (PM2.5)-bound PAHs and lung function were seasonally monitored. The relationships between PAH exposure and lung function were determined by a generalized mixed linear model. Subjects were exposed to high levels of PAH, in which the benzo[a]pyrene (BaP) level (1.26 ng/m3) was over than Chinese national indoor standard (1 ng/m3). All PAHs concentration was higher in winter than that in summer and autumn. Only benz[a]anthracene (BaA) and chrysene (Chr) exposure showed weak relations with decreased lung function, i.e., a 0.58% and 0.73% decrease in peak expiratory flow at lag 2 day, respectively (p < 0.05). PAHs may not be suitable exposure indicators for short-term change in lung function. Our findings highlight the importance of reducing PAH pollution for public respiratory health protection in heavy-polluted cities of China. This pilot study also provides experience on personal PAH assessment such as estimation of the number of repeated measurements required, which is helpful to determine the relationship between PAH exposure and health effect.
Collapse
Affiliation(s)
- Xuan Zhang
- Graduate School of Medical Sciences, Kanazawa University, Kakuma-machi, Kanazawa 920-1192, Japan
| | - Hao Zhang
- Graduate School of Medical Sciences, Kanazawa University, Kakuma-machi, Kanazawa 920-1192, Japan
| | - Yan Wang
- Graduate School of Medical Sciences, Kanazawa University, Kakuma-machi, Kanazawa 920-1192, Japan
| | - Pengchu Bai
- Graduate School of Medical Sciences, Kanazawa University, Kakuma-machi, Kanazawa 920-1192, Japan
| | - Lulu Zhang
- School of Civil Engineering, Architecture and Environment, Hubei University of Technology, Wuhan 430068, China; Institute of Nature and Environmental Technology, Kanazawa University, Kakuma-machi, Kanazawa 920-1192, Japan
| | - Yongjie Wei
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing 100012, China.
| | - Ning Tang
- Institute of Nature and Environmental Technology, Kanazawa University, Kakuma-machi, Kanazawa 920-1192, Japan; Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kakuma-machi, Kanazawa 920-1192, Japan.
| |
Collapse
|
4
|
Goodarzi B, Azimi Mohammadabadi M, Jafari AJ, Gholami M, Kermani M, Assarehzadegan MA, Shahsavani A. Investigating PM 2.5 toxicity in highly polluted urban and industrial areas in the Middle East: human health risk assessment and spatial distribution. Sci Rep 2023; 13:17858. [PMID: 37857811 PMCID: PMC10587072 DOI: 10.1038/s41598-023-45052-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 10/15/2023] [Indexed: 10/21/2023] Open
Abstract
Exposure to particulate matter (PM) can be considered as a factor affecting human health. The aim of this study was to investigate the concentration of PM2.5 and heavy metals and their influence on survival of A549 human lung cells in exposure to PM2.5 breathing air of Ahvaz city. In order to assess the levels of PM2.5 and heavy metals, air samples were collected from 14 sampling stations positioned across Ahvaz city during both winter and summer seasons. The concentration of heavy metals was determined using ICP OES. Next, the MTT assay [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide] was employed to ascertain the survival rate of A549 cells. The findings from this research demonstrated that average PM2.5 of the study period was (149.5 μg/m3). Also, the average concentration of PM2.5 in the urban area in winter and summer was (153.3- and 106.9 μg/m3) and in the industrial area this parameter was (191.6 and 158.3 μg/m3). The average concentration of metals (ng/m3) of urban areas against industrial, Al (493 vs. 485), Fe (536 vs. 612), Cu (198 vs. 212), Ni (128 vs. 129), Cr (48.5 vs. 54), Cd (118 vs. 124), Mn (120 vs. 119), As (51 vs. 67), Hg (37 vs. 50), Zn (302 vs. 332) and Pb (266 vs. 351) were obtained. The results of the MTT assay showed that the highest percentage of cell survival according to the exposure concentration was 25 > 50 > 100 > 200. Also, the lowest percentage of survival (58.8%) was observed in the winter season and in industrial areas with a concentration of 200 μg/ml. The carcinogenic risk assessment of heavy metals indicated that except for Cr, whose carcinogenicity was 1.32E-03, other metals were in the safe range (10-4-10-6) for human health. The high concentration of PM2.5 and heavy metals can increase respiratory and cardiovascular diseases and reduce the public health level of Ahvaz citizens.
Collapse
Affiliation(s)
- Babak Goodarzi
- Research Center for Environmental Health Technology, Iran University of Medical Sciences, Tehran, Iran
- Department of Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
- Department of Environmental Health Engineering, School of Public Health, Hormozgan University of Medical Sciences, Bandar Abbas, Hormozgan, Iran
| | - Maryam Azimi Mohammadabadi
- Immunology Research Center, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Ahmad Jonidi Jafari
- Research Center for Environmental Health Technology, Iran University of Medical Sciences, Tehran, Iran
- Department of Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
- Air Pollution Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mitra Gholami
- Research Center for Environmental Health Technology, Iran University of Medical Sciences, Tehran, Iran
- Department of Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Majid Kermani
- Research Center for Environmental Health Technology, Iran University of Medical Sciences, Tehran, Iran.
- Department of Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
- Air Pollution Research Center, Iran University of Medical Sciences, Tehran, Iran.
| | - Mohammad-Ali Assarehzadegan
- Immunology Research Center, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences (IUMS), Tehran, Iran.
| | - Abbas Shahsavani
- Environmental and Occupational Hazards Control Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
5
|
Zhang Z, Yuan Q, Wang M, Hu T, Huang Y, Xiu G, Lai S, Gao Y, Lee SC. Exposure and health risk assessment of PM 2.5-bound polycyclic aromatic hydrocarbons during winter at residential homes: A case study in four Chinese cities. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 895:165111. [PMID: 37364838 DOI: 10.1016/j.scitotenv.2023.165111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 06/13/2023] [Accepted: 06/23/2023] [Indexed: 06/28/2023]
Abstract
Residential indoor PM2.5 were concurrently collected in Hong Kong, Guangzhou, Shanghai, and Xi'an during the winter and early spring seasons of 2016-2017, for updating the current knowledge of the spatial variation of indoor air pollution and the potential health risks in China. PM2.5-bound polycyclic aromatic hydrocarbons (PAHs) were characterized, and the associated inhalation cancer risks were assessed by a probabilistic approach. Higher levels of indoor PAHs were identified in Xi'an residences (averaged at 176.27 ng m-3) with those of other cities ranging from 3.07 to 15.85 ng m-3. Traffic-related fuel combustion was identified as a common contributor to indoor PAHs through outdoor infiltration for all investigated cities. Indoor PAHs profiles showed city-specific differences, while distinctions between profiles based on indoor activities or ambient air quality were limited. Similar with the total PAHs concentrations, the estimated toxic equivalencies (TEQ) with reference to benzo[a]pyrene in Xi'an residences (median at 18.05 ng m-3) were above the recommended value of 1 ng m-3 and were magnitudes higher than the other investigated cities with estimated median TEQ ranging from 0.27 to 1.55 ng m-3. Incremental lifetime cancer risk (ILCR) due to PAHs inhalation exposure was identified with a descending order of adult (median at 8.42 × 10-8) > adolescent (2.77 × 10-8) > children (2.20 × 10-8) > senior (1.72 × 10-8) for different age groups. Considering the lifetime exposure-associated cancer risk (LCR), potential risks were identified for residents in Xi'an as an LCR level over 1 × 10-6 was identified for half of the adolescent group (median at 8.96 × 10-7), and exceedances were identified for about 90 % of the groups of adults (10th percentile at 8.29 × 10-7) and seniors (10th percentile at 1.02 × 10-6). The associated LCR estimated for other cities were relatively insignificant.
Collapse
Affiliation(s)
- Zhuozhi Zhang
- Department of Civil and Environmental Engineering, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Qi Yuan
- Department of Civil and Environmental Engineering, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Meng Wang
- Department of Civil and Environmental Engineering, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Tafeng Hu
- State Key Laboratory of Loess and Quaternary Geology (SKLLQG), Key Laboratory of Aerosol Chemistry and Physics, Institute of Earth Environment, Chinese Academy of Sciences (IEECAS), Xi'an 710061, China
| | - Yu Huang
- State Key Laboratory of Loess and Quaternary Geology (SKLLQG), Key Laboratory of Aerosol Chemistry and Physics, Institute of Earth Environment, Chinese Academy of Sciences (IEECAS), Xi'an 710061, China
| | - Guangli Xiu
- School of Resources and Environmental Engineering, East China University of Science and Technology (ECUST), Shanghai 200237, China
| | - Senchao Lai
- The Key Lab of Pollution Control and Ecosystem Restoration in Industry Clusters, Ministry of Education, School of Environment and Energy, South China University of Technology (SCUT), Guangzhou 510006, China
| | - Yuan Gao
- Instrumentation and Service Center for Science and Technology, Beijing Normal University, Zhuhai 519087, China
| | - Shun Cheng Lee
- Department of Civil and Environmental Engineering, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
| |
Collapse
|
6
|
Novak R, Robinson JA, Kanduč T, Sarigiannis D, Kocman D. Simulating the impact of particulate matter exposure on health-related behaviour: A comparative study of stochastic modelling and personal monitoring data. Health Place 2023; 83:103111. [PMID: 37708688 DOI: 10.1016/j.healthplace.2023.103111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 09/03/2023] [Accepted: 09/04/2023] [Indexed: 09/16/2023]
Abstract
Epidemiological and exposure studies concerning particulate matter (PM) often rely on data from sparse governmental stations. While low-cost personal monitors have some drawbacks, recent developments have shown that they can provide fairly accurate and fit-for-purpose data. Comparing a stochastic, i.e., agent-based model (ABM), with environmental, biometric and activity data, collected with personal monitors, could provide insight into how the two approaches assess PM exposure and dose. An ABM was constructed, simulating a PM exposure/dose assessment of 100 agents. Their actions were governed by inherent probabilities of performing an activity, based on population data. Each activity was associated with an intensity level, and a PM pollution level. The ABM results were compared with real-world results. Both approaches had comparable results, showing similar trends and a mean dose. Discrepancies were seen in the activities with the highest mean dose values. A stochastic model, based on population data, does not capture well some specifics of a local population. Combined, personal sensors could provide input for calibration, and an ABM approach can help offset a low number of participants. Implementing a function of agents influencing others transport choice, increased the importance of cycling/walking in the overall dose estimate. Activists, agents with an increased transport influence, did not play an important role at low PM levels. As concentrations rose, higher shares of activists (and their influence) caused the dose to increase. Simulating a person's PM exposure/dose in different scenarios and activities in a virtual environment provides researchers and policymakers with a valuable tool.
Collapse
Affiliation(s)
- Rok Novak
- Department of Environmental Sciences, Jožef Stefan Institute, 1000, Ljubljana, Slovenia; Ecotechnologies Programme, Jožef Stefan International Postgraduate School, 1000, Ljubljana, Slovenia.
| | - Johanna Amalia Robinson
- Department of Environmental Sciences, Jožef Stefan Institute, 1000, Ljubljana, Slovenia; Ecotechnologies Programme, Jožef Stefan International Postgraduate School, 1000, Ljubljana, Slovenia; Center for Research and Development, Slovenian Institute for Adult Education, 1000, Ljubljana, Slovenia.
| | - Tjaša Kanduč
- Department of Environmental Sciences, Jožef Stefan Institute, 1000, Ljubljana, Slovenia.
| | - Dimosthenis Sarigiannis
- Environmental Engineering Laboratory, Department of Chemical Engineering, Aristotle University of Thessaloniki, Thessaloniki, 54124, Greece; HERACLES Research Centre on the Exposome and Health, Center for Interdisciplinary Research and Innovation, Thessaloniki, 57001, Greece; Environmental Health Engineering, Department of Science, Technology and Society, University School of Advanced Study IUSS, Pavia, Italy.
| | - David Kocman
- Department of Environmental Sciences, Jožef Stefan Institute, 1000, Ljubljana, Slovenia.
| |
Collapse
|
7
|
Lei J, Chen R, Liu C, Zhu Y, Xue X, Jiang Y, Shi S, Gao Y, Kan H, Xuan J. Fine and coarse particulate air pollution and hospital admissions for a wide range of respiratory diseases: a nationwide case-crossover study. Int J Epidemiol 2023; 52:715-726. [PMID: 37159523 DOI: 10.1093/ije/dyad056] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 04/20/2023] [Indexed: 05/11/2023] Open
Abstract
BACKGROUND The associations between fine and coarse particulate matter (PM2.5 and PM2.5-10) air pollution and hospital admissions for full-spectrum respiratory diseases were rarely investigated, especially for age-specific associations. We aim to estimate the age-specific associations of short-term exposures to PM2.5 and PM2.5-10 with hospital admissions for full-spectrum respiratory diseases in China. METHODS We conducted an individual-level case-crossover study based on a nationwide hospital-based registry including 153 hospitals across 20 provincial regions in China in 2013-20. We applied conditional logistic regression models and distributed lag models to estimate the exposure- and lag-response associations. RESULTS A total of 1 399 955 hospital admission records for various respiratory diseases were identified. The associations of PM2.5 and PM2.5-10 with total respiratory hospitalizations lasted for 4 days, and an interquartile range increase in PM2.5 (34.5 μg/m3) and PM2.5-10 (26.0 μg/m3) was associated with 1.73% [95% confidence interval (95% CI): 1.34%, 2.12%)] and 1.70% (95% CI: 1.31%, 2.10%) increases, respectively, in total respiratory hospitalizations over lag 0-4 days. Acute respiratory infections (i.e. pneumonia, bronchitis and bronchiolitis) were consistently associated with PM2.5 or PM2.5-10 exposure across different age groups. We found the disease spectrum varied by age, including rarely reported findings (i.e. acute laryngitis and tracheitis, and influenza) among children and well-established associations (i.e. chronic obstructive pulmonary disease, asthma, acute bronchitis and emphysema) among older populations. Besides, the associations were stronger in females, children and older populations. CONCLUSIONS This nationwide case-crossover study provides robust evidence that short-term exposure to both PM2.5 and PM2.5-10 was associated with increased hospital admissions for a wide range of respiratory diseases, and the spectra of respiratory diseases varied by age. Females, children and older populations were more susceptible.
Collapse
Affiliation(s)
- Jian Lei
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Renjie Chen
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Cong Liu
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Yixiang Zhu
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Xiaowei Xue
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Yixuan Jiang
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Su Shi
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Ya Gao
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Haidong Kan
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
- National Center for Children's Health, Children's Hospital of Fudan University, Shanghai, China
| | - Jianwei Xuan
- Health Economic Research Institute, School of Pharmacy, Sun Yat-Shen University, Guangzhou, China
| |
Collapse
|
8
|
Zhang X, Zhang H, Wang Y, Bai P, Zhang L, Wei Y, Tang N. Characteristics and determinants of personal exposure to typical air pollutants: A pilot study in Beijing and Baoding, China. ENVIRONMENTAL RESEARCH 2023; 218:114976. [PMID: 36460073 DOI: 10.1016/j.envres.2022.114976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 11/14/2022] [Accepted: 11/28/2022] [Indexed: 06/17/2023]
Abstract
Personal exposure to fine particulate matter (PM2.5), nitrogen oxides (NOx, NO2 and NO), ozone (O3) and sulfur dioxide (SO2) was repeatedly measured among fourteen office workers in Beijing and Baoding, China in summer, autumn and winter of 2019. Time-activity patterns were simultaneously recorded. Determinants of personal air pollution exposure were investigated for each pollutant via a linear mixed effect model. The personal concentrations of PM2.5, NO2, NO and O3 were higher in autumn and winter than those in summer. A decreasing trend was found in the personal PM2.5 level for a typical indoor population in Beijing, indicating that particulate pollution was effectively controlled in Beijing and its surrounding area. The personal levels of PM2.5, NO2, and O3 were weakly correlated with those monitored at ambient stations and were lower than the respective ambient levels except for PM2.5 in summer and NO2 in winter. This pilot study showed that the indoor air environment, ambient pollution, traffic-related variables and temperature were significant exposure sources for office workers. Our study highlighted the significance of controlling traffic emissions and improving the workplace air quality to protect the health of office workers. More importantly, we demonstrated the feasibility of model development for personal air pollution exposure prediction.
Collapse
Affiliation(s)
- Xuan Zhang
- Graduate School of Medical Sciences, Kanazawa University, Kakuma-machi, Kanazawa, 920-1192, Japan
| | - Hao Zhang
- Graduate School of Medical Sciences, Kanazawa University, Kakuma-machi, Kanazawa, 920-1192, Japan
| | - Yan Wang
- Graduate School of Medical Sciences, Kanazawa University, Kakuma-machi, Kanazawa, 920-1192, Japan
| | - Pengchu Bai
- Graduate School of Medical Sciences, Kanazawa University, Kakuma-machi, Kanazawa, 920-1192, Japan
| | - Lulu Zhang
- School of Civil Engineering, Architecture and Environment, Hubei University of Technology, Wuhan, 430068, China; Institute of Nature and Environmental Technology, Kanazawa University, Kakuma-machi, Kanazawa, 920-1192, Japan
| | - Yongjie Wei
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, 100012, China; Center for Global Health, School of Public Health, Nanjing Medical University, China.
| | - Ning Tang
- Institute of Nature and Environmental Technology, Kanazawa University, Kakuma-machi, Kanazawa, 920-1192, Japan; Institute of Medical, Pharmaceutical and Health Science, Kanazawa University, Kakuma-machi, Kanazawa, 920-1192, Japan.
| |
Collapse
|
9
|
Xie Q, Dai Y, Zhu X, Hui F, Fu X, Zhang Q. High contribution from outdoor air to personal exposure and potential inhaled dose of PM 2.5 for indoor-active university students. ENVIRONMENTAL RESEARCH 2022; 215:114225. [PMID: 36063909 DOI: 10.1016/j.envres.2022.114225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 08/24/2022] [Accepted: 08/25/2022] [Indexed: 06/15/2023]
Abstract
People spend most of their time indoors, isolated from the outdoor environment where serious air pollution usually occurs. To what extent outdoor air pollution contributes to their daily personal exposure and inhaled dose? To fill this knowledge gap, an exposure assessment study was conducted for indoor-active university students during a wintertime period of hazy and non-hazy (clear) days in Beijing. Indoor and outdoor fine particulate matter (PM2.5) samples were collected at six indoor microenvironments, and two outdoor environments representing traffic and ambient exposure in the university, respectively, to estimate the personal exposure of students. The average daily personal exposure and poteantial inhaled dose on hazy days (124.8 ± 72.3 μg m-3 and 2.74 ± 1.53 mg) were much higher than that on clear days (57.5 ± 31.9 μg m-3 and 1.26 ± 0.59 mg), indicating a significant influence from the ambient air quality. The indoor PM2.5 concentrations were significantly and positively correlated with the outdoor ones (r = 0.67-0.96) with an FINF (infiltration factor) range of 0.44-0.81 during sampling periods. The outdoor-origin air contributed 68%-95% to the total indoor PM2.5, the average of which was higher during haze events (87%) than clear periods (73%). Correspondingly, outdoor-origin PM2.5 contributed around 105.4 μg m-3 and 2.41 mg (85% and 89%) to the daily exposure and inhaled dose of college students on hazy days, respectively, compared to just 39.2 μg m-3 and 0.95 mg (68% and 75%) on clear days. Our results highlight the significant contribution of outdoor-origin PM2.5 occurred indoor to both the daily personal exposure and inhaled dose due to air pollution filtration between outdoor and indoor environments. These also suggest a continuous effort not only on ambient air quality improvements, but also on environmental friendly building for public health protection with lower exposure.
Collapse
Affiliation(s)
- Qiaorong Xie
- College of Chemical Engineering and Environment, China University of Petroleum, Beijing, 102249, China; Institute of Surface-Earth System Science, School of Earth System Science, Tianjin University, Tianjin, 300072, China; State Key Laboratory of Atmospheric Boundary Layer Physics and Atmospheric Chemistry, Institute of Atmospheric Physics, Chinese Academy of Sciences, Beijing, 100029, China
| | - Yuqing Dai
- School of Geography, Earth and Environmental Sciences, University of Birmingham, Birmingham, B15 2TT, UK
| | - Xianlei Zhu
- College of Chemical Engineering and Environment, China University of Petroleum, Beijing, 102249, China; Beijing Key Laboratory of Oil and Gas Pollution Control, China University of Petroleum, Beijing, 102249, China.
| | - Fan Hui
- College of Chemical Engineering and Environment, China University of Petroleum, Beijing, 102249, China
| | - Xianqiang Fu
- College of Chemical Engineering and Environment, China University of Petroleum, Beijing, 102249, China
| | - Qiangbin Zhang
- College of Chemical Engineering and Environment, China University of Petroleum, Beijing, 102249, China; Beijing Key Laboratory of Oil and Gas Pollution Control, China University of Petroleum, Beijing, 102249, China.
| |
Collapse
|
10
|
Chen J, Jahn HJ, Sun HZ, Ning Z, Lu W, Ho KF, Ward TJ. Validity of using ambient concentrations as surrogate exposures at the individual level for fine particle and black carbon: A systematic review and meta-analysis. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 312:120030. [PMID: 36037851 DOI: 10.1016/j.envpol.2022.120030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 08/13/2022] [Accepted: 08/20/2022] [Indexed: 06/15/2023]
Abstract
Exposure measurement error is an important source of bias in epidemiological studies. We assessed the validity of employing ambient (outdoor) measurements as proxies of personal exposures at individual levels focusing on fine particles (PM2.5) and black carbon (BC)/elemental carbon (EC) on a global scale. We conducted a systematic review and meta-analysis and searched databases (ISI Web of Science, Scopus, PubMed, Ovid MEDLINE®, Ovid Embase, and Ovid BIOSIS) to retrieve observational studies in English language published from 1 January 2006 until 5 May 2021. Correlation coefficients (r) between paired ambient (outdoor) concentration and personal exposure for PM2.5 or BC/EC were standardized as effect size. We used random-effects meta-analyses to pool the correlation coefficients and investigated the causes of heterogeneity and publication bias. Furthermore, we employed subgroup and meta-regression analyses to evaluate the modification of pooled estimates by potential mediators. This systematic review identified thirty-two observational studies involving 1744 subjects from ten countries, with 28 studies for PM2.5 and 11 studies for BC/EC. Personal PM2.5 exposure is more strongly correlated with ambient (outdoor) concentrations (0.63, 95% confidence interval [CI]: 0.57-0.68) than personal BC/EC exposure (0.49, 95% CI: 0.38-0.59), with significant differences in ṝ (0.14, 95% CI: 0.03-0.25; p < 0.05). The results demonstrated that the health status of participants was a significant modifier of pooled correlations. In addition, the personal to ambient (P/A) ratio for PM2.5 and average ambient BC/EC levels were potential effect moderators of the pooled ṝ. The funnel plots and Egger's regression test indicated inevident publication bias. The pooled estimates were robust through sensitivity analyses. The results support the growing consensus that the validity coefficient of proxy measures should be addressed when interpreting results from epidemiological studies to better understand how strong health outcomes are affected by different levels of PM2.5 and their components.
Collapse
Affiliation(s)
- Jiayao Chen
- Department of Real Estate and Construction, Faculty of Architecture, The University of Hong Kong, Hong Kong, China; Shenzhen Institute of Research and Innovation, The University of Hong Kong, Shenzhen, China.
| | - Heiko J Jahn
- Faculty of Human Sciences, University of Kassel, Kassel, Germany
| | - Haitong Zhe Sun
- Centre for Atmospheric Science, Yusuf Hamied Department of Chemistry, University of Cambridge, Cambridge CB2 1EW, UK; Department of Earth Sciences, University of Cambridge, Cambridge CB2 3EQ, UK
| | - Zhi Ning
- Division of Environment and Sustainability, Hong Kong University of Science and Technology, Hong Kong, China
| | - Weisheng Lu
- Department of Real Estate and Construction, Faculty of Architecture, The University of Hong Kong, Hong Kong, China
| | - Kin Fai Ho
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Tony J Ward
- School of Public and Community Health Sciences, University of Montana, Missoula, MT, USA
| |
Collapse
|
11
|
Chen J, Ward TJ, Ho SSH, Ho KF. Occurrence and Risk Assessment of Personal PM 2.5-Bound Phthalates Exposure for Adults in Hong Kong. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13425. [PMID: 36294006 PMCID: PMC9602720 DOI: 10.3390/ijerph192013425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 10/04/2022] [Accepted: 10/07/2022] [Indexed: 06/16/2023]
Abstract
We performed personal PM2.5 monitoring involving 56 adult residents in Hong Kong. Additionally, paired personal and residential indoor fine particle (PM2.5) samples were collected from 26 homes and from 3 fixed monitoring locations (i.e., outdoor samples). Six PM2.5-bound phthalate esters (PAEs)-including dimethyl phthalate (DMP), diethyl phthalate (DEP), di-n-butyl phthalate (DnBP), butyl benzyl phthalate (BBP), di(2-ethylhexyl) phthalate (DEHP), and di-n-octyl phthalate (DnOP)-were measured using a thermal desorption-gas chromatography/mass spectrometer method. Average ∑6PAEs (i.e., summation of six PAE congeners) concentrations in personal PM2.5 exposure (699.4 ng/m3) were comparable with those in residential indoors (646.9 ng/m3), and both were slightly lower than the outdoor levels. DEHP was the most abundant PAE congener (80.3%-85.0%) and found at the highest levels in different exposure categories, followed by BBP, DnBP, and DnOP. Strong correlations were observed between DEHP with DnBP (rs: 0.81-0.90; p < 0.01), BBP (rs: 0.81-0.90; p < 0.01), and DnOP (rs: 0.87-0.93; p < 0.01) in each exposure category. However, no apparent intercorrelations were shown for PAE congeners. Higher indoor concentrations and a stronger correlation between DMP and DEP were found compared with outdoor concentrations. Principal component analysis affirmed heterogeneous distribution and notable variations in PAE sources across different exposure categories. The average daily intakes of ∑6PAEs and DEHP via inhalation were 0.14-0.17 and 0.12-0.16 μg/kg-day for adults in Hong Kong. A time-weighted model was used to estimate PAE exposures incorporating residential indoor and outdoor exposure and time activities. The inhalation cancer risks attributable to measured and estimated personal exposure to DEHP exceeded the U.S. EPA's benchmark (1 × 10-6). The results provide critical information for mitigation strategies, suggesting that PAEs from both ambient and indoor sources should be considered when exploring the inhalation health risks of PAEs exposure.
Collapse
Affiliation(s)
- Jiayao Chen
- Department of Real Estate and Construction, The University of Hong Kong, Hong Kong SAR, China
- Shenzhen Institute of Research and Innovation, The University of Hong Kong, Shenzhen 518057, China
| | - Tony J. Ward
- School of Public and Community Health Sciences, University of Montana, Missoula, MT 59801, USA
| | - Steven Sai Hang Ho
- Division of Atmospheric Sciences, Desert Research Institute, Reno, NV 89512, USA
| | - Kin Fai Ho
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| |
Collapse
|
12
|
Li X, Baumgartner J, Barrington-Leigh C, Harper S, Robinson B, Shen G, Sternbach T, Tao S, Zhang X, Zhang Y, Carter E. Socioeconomic and Demographic Associations with Wintertime Air Pollution Exposures at Household, Community, and District Scales in Rural Beijing, China. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2022; 56:8308-8318. [PMID: 35675631 DOI: 10.1021/acs.est.1c07402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The Chinese government implemented a national household energy transition program that replaced residential coal heating stoves with electricity-powered heat pumps for space heating in northern China. As part of a baseline assessment of the program, this study investigated variability in personal air pollution exposures within villages and between villages and evaluated exposure patterns by sociodemographic factors. We randomly recruited 446 participants in 50 villages in four districts in rural Beijing and measured 24 h personal exposures to fine particulate matter (PM2.5) and black carbon (BC). The geometric mean personal exposure to PM2.5 and BC was 72 and 2.5 μg/m3, respectively. The variability in PM2.5 and BC exposures was greater within villages than between villages. Study participants who used traditional stoves as their dominant source of space heating were exposed to the highest levels of PM2.5 and BC. Wealthier households tended to burn more coal for space heating, whereas less wealthy households used more biomass. PM2.5 and BC exposures were almost uniformly distributed by socioeconomic status. Future work that combines these results with PM2.5 chemical composition analysis will shed light on whether air pollution source contributors (e.g., industrial, traffic, and household solid fuel burning) follow similar distributions.
Collapse
Affiliation(s)
- Xiaoying Li
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec H3A 1G1, Canada
- Department of Civil and Environmental Engineering, Colorado State University, Fort Collins, Colorado 80521, United States
| | - Jill Baumgartner
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec H3A 1G1, Canada
- Institute for Health and Social Policy, McGill University, Montreal, Quebec H3A 1G1, Canada
| | - Christopher Barrington-Leigh
- Institute for Health and Social Policy, McGill University, Montreal, Quebec H3A 1G1, Canada
- Bieler School of Environment, McGill University, Montreal, Quebec H3A 2A7, Canada
| | - Sam Harper
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec H3A 1G1, Canada
| | - Brian Robinson
- Department of Geography, McGill University, Montreal, Quebec H3A 0B9, Canada
| | - Guofeng Shen
- Laboratory for Earth Surface Processes, Sino-French Institute for Earth System Science, College of Urban and Environmental Sciences, Peking University, Beijing 100871, China
| | - Talia Sternbach
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec H3A 1G1, Canada
- Institute for Health and Social Policy, McGill University, Montreal, Quebec H3A 1G1, Canada
| | - Shu Tao
- Laboratory for Earth Surface Processes, Sino-French Institute for Earth System Science, College of Urban and Environmental Sciences, Peking University, Beijing 100871, China
| | - Xiang Zhang
- Department of Geography, McGill University, Montreal, Quebec H3A 0B9, Canada
| | - Yuanxun Zhang
- College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China
- CAS Center for Excellence in Regional Atmospheric Environment, Chinese Academy of Sciences, Xiamen 361021, China
| | - Ellison Carter
- Department of Civil and Environmental Engineering, Colorado State University, Fort Collins, Colorado 80521, United States
| |
Collapse
|
13
|
Huo Y, Guo H, Lyu X, Yao D. Emission characteristics, sources, and airborne fate of speciated organics in particulate matters in a Hong Kong residence. INDOOR AIR 2022; 32:e13017. [PMID: 35347786 DOI: 10.1111/ina.13017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 02/04/2022] [Accepted: 03/02/2022] [Indexed: 06/14/2023]
Abstract
A growing number of studies warn of the adverse health effects of indoor particulate matters (PM). However, little is known about the molecular compositions and emission characteristics of PM-bound organics (OM) indoors, a critical group of species with highest concentration and complexity in indoor PM. In a Hong Kong residence where prescribed activities were performed with normal frequency and intensity, we found that the activities significantly elevated not only the total concentration but also the fraction of OM in indoor PM. However, the concentration of the total PM-bound OM outdoors (10.3 ± 0.7 μg/m3 ) surpassed that for the indoor counterpart during the undisturbed period (8.2 ± 0.1 μg/m3 ), that is, period when there was no activity with high emission of PM but the residual effects of previous activities might remain. Emissions of indoor activities involving combustion or high-temperature processes significantly elevated the indoor-to-outdoor (I/O) ratios for a majority of organic species. In addition, gas-to-particle partitioning, secondary formation, carrying-over (residues of pollutants in the air), and re-emission also modulated the I/O ratios of some compounds. Chemically comprehensive emission profiles of speciated organics were obtained for 5 indoor activities in the residence. While the indoor contribution to PM-bound OM was estimated to be not higher than 13.1% during the undisturbed period, carrying-over and/or re-emission seemed to exist for certain compounds emitted from cigarette smoking and incense burning. This study enhances knowledge on emissions and airborne fate of speciated organics in indoor PM.
Collapse
Affiliation(s)
- Yunxi Huo
- Air Quality Studies, Department of Civil and Environmental Engineering, Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - Hai Guo
- Air Quality Studies, Department of Civil and Environmental Engineering, Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - Xiaopu Lyu
- Air Quality Studies, Department of Civil and Environmental Engineering, Hong Kong Polytechnic University, Hong Kong, Hong Kong
| | - Dawen Yao
- Air Quality Studies, Department of Civil and Environmental Engineering, Hong Kong Polytechnic University, Hong Kong, Hong Kong
| |
Collapse
|
14
|
Chen X, Ward TJ, Ho K, Sarkar C, Webster C. Characteristics and health risks of personal exposure to particle-bound PAHs for Hong Kong adult residents: From ambient pollution to indoor exposure. INDOOR AIR 2022; 32:e12956. [PMID: 34783390 PMCID: PMC9298719 DOI: 10.1111/ina.12956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 10/27/2021] [Accepted: 10/30/2021] [Indexed: 06/13/2023]
Abstract
Research on individual level polycyclic aromatic hydrocarbons (PAHs) exposure is scarce. Moreover, the independent contribution of ambient- and indoor-origin PAHs to personal exposure remains poorly studied. We performed simultaneous ambient, residential indoor, and personal exposure measurements in a panel of healthy adults to investigate particle-bound PAHs, focusing on their carcinogenic congeners (cPAHs). Average PAH concentrations were much higher in ambient and residential indoor than personal exposure, with distinct seasonal variations. We employed chrysene as a tracer to investigate residential indoor and personal PAHs exposure by origin. Personal cPAH exposure was largely attributable to ambient-origin exposures (95.8%), whereas a considerable proportion of residential indoor PAHs was likely attributable to indoor emissions (33.8%). Benzo[a]pyrene equivalent (BaPeq) concentrations of cPAH accounted for 95.2%-95.6% of total carcinogenic potential. Uncertainties in estimated PAHs (and BaPeq) exposure and cancer risks for adults were calculated using the Monte Carlo simulation. Cancer risks attributable to ambient, residential indoor, and personal cPAH inhalation exposures ranged from 4.0 × 10-6 to 1.0 × 10-5 . A time-activity weighted model was employed for personal PAH exposure estimations. Estimated cPAH exposures demonstrate high cancer risks for adults in Hong Kong, suggesting that exposure to indoor-generated PAHs should be of great concern to the general population.
Collapse
Affiliation(s)
- Xiao‐Cui Chen
- Healthy High Density Cities LabHKUrbanLabThe University of Hong KongHong Kong Special Administrative RegionChina
- Shenzhen Institute of Research and InnovationThe University of Hong KongShenzhenChina
| | - Tony J. Ward
- School of Public and Community Health SciencesUniversity of MontanaMissoulaMontanaUSA
| | - Kin‐Fai Ho
- The Jockey Club School of Public Health and Primary CareThe Chinese University of Hong KongHong KongChina
| | - Chinmoy Sarkar
- Healthy High Density Cities LabHKUrbanLabThe University of Hong KongHong Kong Special Administrative RegionChina
| | - Chris Webster
- Healthy High Density Cities LabHKUrbanLabThe University of Hong KongHong Kong Special Administrative RegionChina
| |
Collapse
|
15
|
Lai A, Lee M, Carter E, Chan Q, Elliott P, Ezzati M, Kelly F, Yan L, Wu Y, Yang X, Zhao L, Baumgartner J, Schauer JJ. Chemical Investigation of Household Solid Fuel Use and Outdoor Air Pollution Contributions to Personal PM 2.5 Exposures. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2021; 55:15969-15979. [PMID: 34817986 PMCID: PMC8655976 DOI: 10.1021/acs.est.1c01368] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 11/10/2021] [Accepted: 11/10/2021] [Indexed: 06/13/2023]
Abstract
In communities with household solid fuel use, transitioning to clean stoves/fuels often results in only moderate reductions in fine particulate matter (PM2.5) exposures; the chemical composition of those exposures may help explain why. We collected personal exposure (men and women) and outdoor PM2.5 samples in villages in three Chinese provinces (Shanxi, Beijing, and Guangxi) and measured chemical components, including water-soluble organic carbon (WSOC), ions, elements, and organic tracers. Source contributions from chemical mass balance modeling (biomass burning, coal combustion, vehicles, dust, and secondary inorganic aerosol) were similar between outdoor and personal PM2.5 samples. Principal component analysis of organic and inorganic components identified analogous sources, including a regional ambient source. Chemical components of PM2.5 exposures did not differ significantly by gender. Participants using coal had higher personal/outdoor (P/O) ratios of coal combustion tracers (picene, sulfate, As, and Pb) than those not using coal, but no such trend was observed for biomass burning tracers (levoglucosan, K+, WSOC). Picene and most levoglucosan P/O ratios exceeded 1 even among participants not using coal and biomass, respectively, indicating substantial indirect exposure to solid fuel emissions from other homes. Contributions of community-level emissions to exposures suggest that meaningful exposure reductions will likely require extensive fuel use changes within communities.
Collapse
Affiliation(s)
- Alexandra Lai
- Environmental
Chemistry and Technology Program, University
of Wisconsin-Madison, Madison, Wisconsin 53706, United States
| | - Martha Lee
- Department
of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec H3A 1A3, Canada
| | - Ellison Carter
- Department
of Civil and Environmental Engineering, Colorado State University, Fort
Collins, Colorado 80523, United States
| | - Queenie Chan
- MRC
Centre for Environment and Health, Department of Epidemiology, Biostatics,
and Occupational Health, School of Public Health, Imperial College London, London W2 1PG, U.K.
| | - Paul Elliott
- MRC
Centre for Environment and Health, Department of Epidemiology, Biostatics,
and Occupational Health, School of Public Health, Imperial College London, London W2 1PG, U.K.
| | - Majid Ezzati
- MRC
Centre for Environment and Health, Department of Epidemiology, Biostatics,
and Occupational Health, School of Public Health, Imperial College London, London W2 1PG, U.K.
| | - Frank Kelly
- Department
of Analytical, Environmental, and Forensic Sciences, Kings College London, London SE1 9NH, U.K.
| | - Li Yan
- Department
of Analytical, Environmental, and Forensic Sciences, Kings College London, London SE1 9NH, U.K.
| | - Yangfeng Wu
- Clinical
Research Institute, Peking University, Beijing 100191, China
| | - Xudong Yang
- Department
of Building Science, Tsinghua University, Beijing 100084, China
| | - Liancheng Zhao
- Fuwai
Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical
College, Beijing 100037, China
| | - Jill Baumgartner
- Department
of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec H3A 1A3, Canada
- Institute
for Health and Social Policy, McGill University, Montreal, Quebec H3A 1A3, Canada
| | - James J. Schauer
- Environmental
Chemistry and Technology Program, University
of Wisconsin-Madison, Madison, Wisconsin 53706, United States
- Wisconsin
State Laboratory of Hygiene, University
of Wisconsin-Madison, Madison, Wisconsin 53718, United States
| |
Collapse
|
16
|
Lai A, Baumgartner J, Schauer JJ, Rudich Y, Pardo M. Cytotoxicity and chemical composition of women's personal PM 2.5 exposures from rural China. ENVIRONMENTAL SCIENCE: ATMOSPHERES 2021; 1:359-371. [PMID: 34604754 PMCID: PMC8459644 DOI: 10.1039/d1ea00022e] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 06/27/2021] [Indexed: 12/24/2022]
Abstract
Personal exposure PM samples aid in determining the sources and chemical composition of real-world exposures, particularly in settings with household air pollution. However, their use in toxicological research is limited, despite uncertainty regarding health effects in these settings and evidence of differential toxicity among PM2.5 sources and components. This study used women's PM2.5 exposure samples collected using personal exposure monitoring in rural villages in three Chinese provinces (Beijing, Shanxi, and Sichuan) during summer and winter. Water-soluble organic carbon, ions, elements, and organic tracers (e.g. levoglucosan and polycyclic aromatic hydrocarbons [PAHs]) were quantified in water and organic PM2.5 extracts. Human lung epithelial cells (A549) were exposed to the extracts. Cell death, reactive oxygen species (ROS), and gene expression were measured. Biomass burning contributions were higher in Sichuan samples than in Beijing or Shanxi. Some PM characteristics (total PAHs and coal combustion source contributions) and biological effects of organic extract exposures (cell death, ROS, and cytokine gene expression) shared a common trend of higher levels and effects in winter than in summer for Shanxi and Beijing but no seasonal differences in Sichuan. Modulation of phase I/AhR-related genes (cyp1a1 and cyp1b1) and phase II/oxidative stress-related genes (HO-1, SOD1/2, NQO-1, and catalase) was either low or insignificant, without clear trends between samples. No significant cell death or ROS production was observed for water extract treatments among all sites and seasons, even at possible higher concentrations tested. These results support organic components, particularly PAHs, as essential drivers of biological effects, which is consistent with some other evidence from ambient PM2.5. Direct measurement with personal samplers captures the chemical complexity of PM2.5 exposures better than fixed monitors. To investigate biological effects, lung cells were exposed to extracts of exposure PM2.5 samples.![]()
Collapse
Affiliation(s)
- Alexandra Lai
- Department of Earth and Planetary Sciences, Weizmann Institute of Science Rehovot Israel
| | - Jill Baumgartner
- Institute for Health and Social Policy, Department of Epidemiology, Biostatistics, and Occupational Health, McGill University Montreal Quebec Canada
| | - James J Schauer
- Environmental Chemistry & Technology Program, University of Wisconsin-Madison Madison WI USA
| | - Yinon Rudich
- Department of Earth and Planetary Sciences, Weizmann Institute of Science Rehovot Israel
| | - Michal Pardo
- Department of Earth and Planetary Sciences, Weizmann Institute of Science Rehovot Israel
| |
Collapse
|
17
|
Niu X, Jones T, BéruBé K, Chuang HC, Sun J, Ho KF. The oxidative capacity of indoor source combustion derived particulate matter and resulting respiratory toxicity. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 767:144391. [PMID: 33429274 DOI: 10.1016/j.scitotenv.2020.144391] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 11/27/2020] [Accepted: 12/01/2020] [Indexed: 06/12/2023]
Abstract
Indoor air pollution sources with emissions of fine particles (PM2.5), including environmental tobacco smoke (ETS) and incense smoke (IS) deteriorate indoor air quality and may cause respiratory diseases in humans. This study characterized the emission factors (EFs) of five types of tobacco and incense in Hong Kong using an environmental chamber. Human alveolar epithelial cells (A549) were exposed to PM2.5 collected from different indoor sources to determine their cytotoxicity. The PM2.5 EF of ETS (109.7±36.5 mg/g) was higher than IS (97.1±87.3 mg/g). The EFs of total polycyclic aromatic hydrocarbons (PAHs) and carbonyls for IS were higher than ETS, and these two combustion sources showed similar distributions of individual PAHs and carbonyls. Oxidative damage and inflammatory responses (i.e. DNA damage, 8-hydroxy-desoxyguanosine (8-OHdG), tumor necrosis factor-α (TNF-α) and interlukin-6 (IL-6)) of A549 cells was triggered by exposure to PM2.5 generated from ETS and IS. Different indoor sources showed different responses to oxidative stress and inflammations due to the accumulation effects of mixed organic compounds. High molecular weight PAHs from incense combustion showed higher correlations with DNA damage markers, and most of the PAHs from indoor sources demonstrated significant correlations with inflammation. Exposure to anthropogenic produced combustion emissions such as ETS and IS results in significant risks (e.g. lung cancer) to the alveolar epithelium within the distal human respiratory tract, of which incense emissions posed a higher cytotoxicity.
Collapse
Affiliation(s)
- Xinyi Niu
- School of Human Settlements and Civil Engineering, Xi'an Jiaotong University, Xi'an 710049, China
| | - Tim Jones
- School of Earth and Ocean Sciences, Cardiff University, Museum Avenue, Cardiff CF10 3YE, UK
| | - Kelly BéruBé
- School of Biosciences, Cardiff University, Museum Avenue, Cardiff CF10 3US, UK
| | - Hsiao-Chi Chuang
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Jian Sun
- Department of Environmental Science and Engineering, Xi'an Jiaotong University, Xi'an, 710049, China
| | - Kin Fai Ho
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.
| |
Collapse
|
18
|
Chen XC, Chuang HC, Ward TJ, Sarkar C, Webster C, Cao J, Hsiao TC, Ho KF. Toxicological effects of personal exposure to fine particles in adult residents of Hong Kong. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2021; 275:116633. [PMID: 33561752 DOI: 10.1016/j.envpol.2021.116633] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 01/26/2021] [Accepted: 01/29/2021] [Indexed: 06/12/2023]
Abstract
Toxicological studies have demonstrated the associations between fine particle (PM2.5) components and various cytotoxic endpoints. However, few studies have investigated the toxicological effects of source-specific PM2.5 at the individual level. To investigate the potential impact of source-specific PM2.5 on cytotoxic effects, we performed repeated personal PM2.5 monitoring of 48 adult participants in Hong Kong during the winter and summer of 2014-2015. Quartz filters were analyzed for carbonaceous aerosols and water-soluble ions in PM2.5. Teflon filters were collected to determine personal PM2.5 mass and metal concentrations. The toxicological effects of personal PM2.5 exposure-including cytotoxicity, inflammatory response, and reactive oxygen species (ROS) production-were measured using A549 cells in vitro. Personal PM2.5 samples collected in winter were more effective than those collected in summer at inducing cytotoxicity and the expression of proinflammation cytokine IL-6. By contrast, summer personal PM2.5 samples induced high ROS production. We performed a series of statistical analyses, Spearman correlation and a source apportionment approach with a multiple linear regression (MLR) model, to explore the sources contributing most significantly to personal PM2.5 bioreactivity. Secondary inorganic species and transition metals were discovered to be weak-to-moderately associated with cytotoxicity (rs: 0.26-0.55; p < 0.01) and inflammatory response (rs: 0.26-0.44; p < 0.05), respectively. Carbonaceous aerosols (i.e., organic and elemental carbon; rs: 0.23-0.27; p < 0.05) and crustal material (Mg and Ca) was positively associated with ROS generation. The PMF-MLR models revealed that tailpipe exhaust and secondary sulfate contributed to ROS generation, whereas secondary nitrate was the major contributor to PM2.5 cytotoxicity and inflammation. These results improve and variate the arguments for practical policies designed to mitigate the risks posed by air pollution sources and to protect public health.
Collapse
Affiliation(s)
- Xiao-Cui Chen
- Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Hong Kong Special Administrative Region, China; Shenzhen Institute of Research and Innovation, The University of Hong Kong, Shenzhen, China
| | - Hsiao-Chi Chuang
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Tony J Ward
- School of Public and Community Health Sciences, University of Montana, Missoula, MT, USA
| | - Chinmoy Sarkar
- Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Chris Webster
- Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Junji Cao
- Key Laboratory of Aerosol, SKLLQG, Institute of Earth Environment, Chinese Academy of Sciences, Xi'an, China
| | - Ta-Chih Hsiao
- Graduate Institute of Environmental Engineering, National Taiwan University, Taipei, Taiwan
| | - Kin-Fai Ho
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.
| |
Collapse
|
19
|
Assessing Approaches of Human Inhalation Exposure to Polycyclic Aromatic Hydrocarbons: A Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18063124. [PMID: 33803562 PMCID: PMC8003068 DOI: 10.3390/ijerph18063124] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 03/16/2021] [Indexed: 01/12/2023]
Abstract
Polycyclic aromatic hydrocarbons (PAHs) are a class of important organic pollutants widely emitted from anthropogenic activities, with a general distribution in the gas and particulate phases. Some PAHs are carcinogenic, teratogenic, and mutagenic. Inhalation exposure to PAHs is correlated with adverse health outcomes in the respiratory and cardiovascular systems. Thus, it is significant to determine the exposure level of the general population. This study summarizes the evaluation methods for PAH exposure, focusing on different exposure parameters. External exposure can be determined via the collection of the environmental pollution concentration through active samplers or passive samplers during environmental monitoring or personal sampling. Time-activity patterns give critical exposure information that captures the exposure period, origin, and behaviors. Modeling is a labor-less approach for human exposure estimation, and microenvironmental exposure requires specific research. It is important to select appropriate methods to quantify the exposure level to provide accurate data to establish the exposure–risk relationship and make scientific suggestions for the protection of public health.
Collapse
|
20
|
Exposure to Atmospheric Particulate Matter-Bound Polycyclic Aromatic Hydrocarbons and Their Health Effects: A Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18042177. [PMID: 33672189 PMCID: PMC7926315 DOI: 10.3390/ijerph18042177] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 02/17/2021] [Accepted: 02/18/2021] [Indexed: 12/16/2022]
Abstract
Particulate matter (PM) is a major factor contributing to air quality deterioration that enters the atmosphere as a consequence of various natural and anthropogenic activities. In PM, polycyclic aromatic hydrocarbons (PAHs) represent a class of organic chemicals with at least two aromatic rings that are mainly directly emitted via the incomplete combustion of various organic materials. Numerous toxicological and epidemiological studies have proven adverse links between exposure to particulate matter-bound (PM-bound) PAHs and human health due to their carcinogenicity and mutagenicity. Among human exposure routes, inhalation is the main pathway regarding PM-bound PAHs in the atmosphere. Moreover, the concentrations of PM-bound PAHs differ among people, microenvironments and areas. Hence, understanding the behaviour of PM-bound PAHs in the atmosphere is crucial. However, because current techniques hardly monitor PAHs in real-time, timely feedback on PAHs including the characteristics of their concentration and composition, is not obtained via real-time analysis methods. Therefore, in this review, we summarize personal exposure, and indoor and outdoor PM-bound PAH concentrations for different participants, spaces, and cities worldwide in recent years. The main aims are to clarify the characteristics of PM-bound PAHs under different exposure conditions, in addition to the health effects and assessment methods of PAHs.
Collapse
|
21
|
Jain RB. Contributions of dietary, demographic, disease, lifestyle and other factors in explaining variabilities in concentrations of selected monohydroxylated polycyclic aromatic hydrocarbons in urine: Data for US children, adolescents, and adults. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2020; 266:115178. [PMID: 32688109 DOI: 10.1016/j.envpol.2020.115178] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 06/23/2020] [Accepted: 07/03/2020] [Indexed: 06/11/2023]
Abstract
Data from National Health and Nutrition Examination Survey for 2003-2014 for US children aged 6-11 years (N = 2097), adolescents aged 12-19 ears (N = 2642), and adults aged ≥ 20 years (N = 9170) were analyzed to investigate the effects of dietary, demographic, disease, lifestyle, and other factors on concentrations of nine metabolites of polycyclic aromatic hydrocarbons (PAH) in urine. PAHs analyzed were: 1-hydroxynaphthalene, 2-hydroxynaphthalene, 2-hydroxyfluorene, 3-hydroxyfluorene, 9-hydroxyfluorene, 1-hydroxyphenanthrene, 2-hydroxyphenanthrene, 3-hydroxyphenanthrene, and 1-hydroxypyrene. Adults with diabetes were found to have higher adjusted levels of 1-hydroxynaphthalene (4139 vs. 3622 ng/L, p < 0.01) than nondiabetics. Adults with albuminuria had higher adjusted levels of 1-hydroxynaphthalene (4140 vs.3621 ng/L, p < 0.01) and 2-hydroxynaphthalene (6039 vs. 5468 ng/L, p < 0.01) than those without albuminuria. Children with albuminuria had lower adjusted levels of 9-hydroxyfluorene (162 vs. 187 ng/L, p = 0.04), 1-hydroxyphenanthrene (92 vs. 108 ng/L, p < 0.01), and 1-hydroxypyrene (118 vs. 138 ng/L, p < 0.01) than those without albuminuria. The ratios of smoker to nonsmoker adjusted levels for adults varied from a low of 1.4 for 2-hydroxyphenanthrene to a high of 5.6 for 3-hydroxyfluorene. Exposure to environmental tobacco smoke at home was associated with higher levels of most OH-PAHs among children, adolescents, and adults. Consumption of red meat not processed at high temperatures was associated with increased levels of 1-hydroxypyrene (β = 0.00040, p = 0.01), 1-, 2-, and 3-hydroxyphenanthrene, 3-, and 9-hydroxyfluorene. Consumption of red meat processed at high temperatures was associated with increased levels of 2-hydroxynaphthalene (β = 0.00046, p = 0.02) among adults. Consumption of fish processed at high temperatures was associated with decreased levels of 1-hydroxynaphtahlene (β = - 0.00088, p < 0.01), 2-, 3-, and 9-hydroxyfluorene, 1-, 2-, and 3-hydroxyphenanthrene. Among adults, alcohol consumption and caffeine may be associated with increased levels of certain OH-PAHs. Oxidative stress and inflammation associated with exposure to PAHs are associated with albuminuria and have the potential to lead to the development of diabetes.
Collapse
Affiliation(s)
- Ram B Jain
- 2959 Estate View Ct, Dacula, Ga, 30019, USA.
| |
Collapse
|
22
|
Shezi B, Mathee A, Cele N, Ndabandaba S, Street RA. Occupational Exposure to Fine Particulate Matter (PM 4 and PM 2.5) during Hand-Made Cookware Operation: Personal, Indoor and Outdoor Levels. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7522. [PMID: 33081113 PMCID: PMC7602743 DOI: 10.3390/ijerph17207522] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 10/02/2020] [Accepted: 10/05/2020] [Indexed: 01/04/2023]
Abstract
(1) Exposure of informal artisanal cookware makers to fine particles has not yet been characterized. The aim of this study was to characterize occupational exposure to fine particulate matter (PM4 and PM2.5) levels and fine particulate matter (PM2.5) elemental components; (2) Artisanal cookware makers were recruited from five cookware making sites. Exposure to fine particulate matter was measured for 17 male participants. SidePak personal aerosol monitors (AM520) were used to measure personal exposure to PM4, while a DustTrak monitor and an E-sampler were used to assess indoor and outdoor PM2.5 levels, respectively. A questionnaire was administered to capture information on demographic characteristics. The chemical characterization of indoor and outdoor PM2.5 filter mass was conducted using Wavelength Dispersive X-ray Fluorescence. Time series record of 15-min averages for indoor and outdoor PM2.5 levels were assessed; (3) The median (range) was 124 µg/m3 (23-100,000), 64 µg/m3 (1-6097) and 12 µg/m3 (4-1178), respectively, for personal PM4, indoor and outdoor PM2.5. The highest levels for many of the elemental components of PM2.5 were found in the outdoor PM2.5 filter mass and (4). The information generated during this study may assist in extending occupational health and safety strategies to artisanal cookware makers and developing targeted prevention initiatives.
Collapse
Affiliation(s)
- Busisiwe Shezi
- Environment and Health Research Unit, South African Medical Research Council, Johannesburg 2094, South Africa;
- Department of Environmental Health, Faculty of Health Sciences, University of Johannesburg, Johannesburg 2094, South Africa
| | - Angela Mathee
- Environment and Health Research Unit, South African Medical Research Council, Johannesburg 2094, South Africa;
- Department of Environmental Health, Faculty of Health Sciences, University of Johannesburg, Johannesburg 2094, South Africa
- Department of Environmental Health, Nelson Mandela University, Port Elizabeth 6019, South Africa
| | - Nokulunga Cele
- Environment and Health Research Unit, South African Medical Research Council, Durban 4001, South Africa; (N.C.); (S.N.); (R.A.S.)
| | - Sipho Ndabandaba
- Environment and Health Research Unit, South African Medical Research Council, Durban 4001, South Africa; (N.C.); (S.N.); (R.A.S.)
| | - Renee A. Street
- Environment and Health Research Unit, South African Medical Research Council, Durban 4001, South Africa; (N.C.); (S.N.); (R.A.S.)
- University of KwaZulu-Natal, Discipline of Occupational and Environmental Health, School of Nursing and Public Health, Durban 4001, South Africa
| |
Collapse
|