Evaluation of airborne sensory irritants for setting exposure limits or guidelines: A systematic approach

The Underlying Mechanism of Poisoning after the Accidental Inhalation of Aerosolised Waterproofing Spray

Waterproofing sprays can cause acute respiratory symptoms after inhalation, including coughing and dyspnoea shortly after use. Here, we describe two cases where persons used the same brand of waterproofing spray product. In both cases the persons followed the instructions on the product and maximized the ventilation by opening windows and doors; however, they still became affected during the application of the product. Products with the same batch number as that used in one case were tested for their effect on respiration patterns of mice in whole-body plethysmographs and lung surfactant function inhibition in vitro. The product was used in spraying experiments to determine the particle size distribution of the aerosol, both using a can from one case and a can with an identical batch number. In addition, the aerosols in the mouse exposure chamber were measured. Aerosol data from a small-scale exposure chamber and data on the physical and temporal dimensions of the spraying during one case were used to estimate the deposited dose during the spraying events. All collected data point to the spraying of the waterproofing product being the reason that two people became ill, and that the inhibition of lung surfactant function was a key component of this illness.

Exposure limits for indoor volatile substances concerning the general population: The role of population-based differences in sensory irritation of the eyes and airways for assessment factors

Assessment factors (AFs) are essential in the derivation of occupational exposure limits (OELs) and indoor air quality guidelines. The factors shall accommodate differences in sensitivity between subgroups, i.e., workers, healthy and sick people, and occupational exposure versus life-long exposure for the general population. Derivation of AFs itself is based on empirical knowledge from human and animal exposure studies with immanent uncertainty in the empirical evidence due to knowledge gaps and experimental reliability. Sensory irritation in the eyes and airways constitute about 30-40% of OELs and is an abundant symptom in non-industrial buildings characterizing the indoor air quality and general health. Intraspecies differences between subgroups of the general population should be quantified for the proposal of more 'empirical' based AFs. In this review, we focus on sensitivity differences in sensory irritation about gender, age, health status, and vulnerability in people, based solely on human exposure studies. Females are more sensitive to sensory irritation than males for few volatile substances. Older people appear less sensitive than younger ones. However, impaired defense mechanisms may increase vulnerability in the long term. Empirical evidence of sensory irritation in children is rare and limited to children down to the age of six years. Studies of the nervous system in children compared to adults suggest a higher sensitivity in children; however, some defense mechanisms are more efficient in children than in adults. Usually, exposure studies are performed with healthy subjects. Exposure studies with sick people are not representative due to the deselection of subjects with moderate or severe eye or airway diseases, which likely underestimates the sensitivity of the group of people with diseases. Psychological characterization like personality factors shows that concentrations of volatile substances far below their sensory irritation thresholds may influence the sensitivity, in part biased by odor perception. Thus, the protection of people with extreme personality traits is not feasible by an AF and other mitigation strategies are required. The available empirical evidence comprising age, lifestyle, and health supports an AF of not greater than up to 2 for sensory irritation. Further, general AFs are discouraged for derivation, rather substance-specific derivation of AFs is recommended based on the risk assessment of empirical data, deposition in the airways depending on the substance's water solubility and compensating for knowledge and experimental gaps. Modeling of sensory irritation would be a better 'empirical' starting point for derivation of AFs for children, older, and sick people, as human exposure studies are not possible (due to ethical reasons) or not generalizable (due to self-selection). Dedicated AFs may be derived for environments where dry air, high room temperature, and visually demanding tasks aggravate the eyes or airways than for places in which the workload is balanced, while indoor playgrounds might need other AFs due to physical workload and affected groups of the general population.

Sensory irritation and use of the best available science in setting exposure limits: Issues raised by a scientific panel review of formaldehyde human research studies

As a high production volume chemical with recognized sensory irritation and widespread exposure, the human health risk potential of formaldehyde has been reviewed by many international regulatory agencies and scientific advisory bodies. A scientific panel, the Human Studies Review Board, under the auspices of the EPA's Toxic Substances Control Act (TSCA) program recently reviewed the sensory irritation studies included in the 2022 Draft Integrated Risk Information System (IRIS) Formaldehyde Hazard Assessment in the context of their use in a weight of evidence evaluation of acute inhalation health effects. This panel issued a series of recommendations on the use of these studies for the purposes of calculating exposure limits (e.g., study design preferences; uncertainty adjustment). Considering that these recommendations might reflect topic areas with varying degrees of scientific consensus, this commentary reflects on commonalities and distinctions amongst international formaldehyde exposure limits based on sensory irritation. Notably, each review panel charged with an assessment of the science recommended that no adjustment was needed to account for either exposure duration or human variability. These areas of scientific consensus should be considered as the best available science for the purposes of setting exposure limits in the anticipated TSCA Risk Evaluation on formaldehyde.

Establishing short-term occupational exposure limits (STELs) for sensory irritants using predictive and in silico respiratory rate depression (RD50) models

Sensory irritation is a health endpoint that serves as the critical effect basis for many occupational exposure limits (OELs). Schaper 1993 described a significant relationship with high correlation between the measured exposure concentration producing a 50% respiratory rate decrease (RD50) in a standard rodent assay and the American Conference of Governmental Industrial Hygienists (ACGIH®) Threshold Limit Values (TLVs®) as time-weighted averages (TWAs) for airborne chemical irritants. The results demonstrated the potential use of the RD50 values for deriving full-shift TWA OELs protective of irritant responses. However, there remains a need to develop a similar predictive model for deriving workplace short-term exposure limits (STELs) for sensory irritants. The aim of our study was to establish a model capable of correlating the relationship between RD50 values and published STELs to prospectively derive short-term exposure OELs for sensory irritants. A National Toxicology Program (NTP) database that included chemicals with both an RD50 and established STELs was used to fit several linear regression models. A strong correlation between RD50s and STELs was identified, with a predictive equation of ln (STEL) (ppm) = 0.86 * ln (RD50) (ppm) - 2.42 and an R2 value of 0.75. This model supports the use of RD50s to derive STELs for chemicals without existing exposure recommendations. Further, for data-poor sensory irritants, predicted RD50 values from in silico quantitative structure activity relationship (QSAR) models can be used to derive STELs. Hence, in silico methods and statistical modeling can present a path forward for establishing reliable OELs and improving worker safety and health.

Plethysmograph training: A refinement for collection of respiration data in mice

Inhaled chemicals can harm the airways. Different effects can result in distinct changes in respiratory patterns; the type of change indicates where and how the respiratory system is affected. Furthermore, changes in respiratory patterns may be detected at much lower substance concentrations than those that cause more serious effects, such as histopathological changes. Changes in respiratory patterns can be studied experimentally by monitoring the breathing of mice placed in plethysmographs and exposing head-out to the test substance. The method is well established; however, it is not known if training mice in being restrained in the plethysmograph could increase the quality of data collection. Here we report the results of training mice to be restrained in plethysmographs for 5 consecutive days, with respect to body weight, respiratory parameters, and time spent in the plethysmograph, before they are removed because of unstable breathing patterns. The mice tolerated the procedure better (measured by time in the plethysmograph) on the second day of training than the first day. Training did not change the breathing parameters between days. Breathing parameters stabilized within 5 min after the mice were placed in the plethysmographs on all days. There was an average of 3% weight loss between the first and last days of the training, indicating that the training procedure placed some strain on the animals. Training reduces the number of mice attempting to escape from the plethysmograph.

Update on irritant-induced occupational asthma

PURPOSE OF REVIEW

In this narrative review, we aim to highlight novel research findings on both acute/subacute irritant-induced asthma (IIA) and chronic exposure IIA (also called 'low dose' IIA).

RECENT FINDINGS

Novel case series showed that acute and subacute IIA cases had similar causal agents (e.g., acid or base aerosols/fumes, dusts, mixtures) but had occurred in different circumstances (accidents vs. regular work). Acute and subacute IIA cases had similar clinical characteristics but poorer short-term outcomes than sensitizer-induced occupational asthma patients. Novel large epidemiological studies reported associations between chronic occupational exposure to irritants and current adult-onset asthma and poor asthma control, and with a specific asthma endotype characterized by neutrophilic inflammation and oxidative stress. Recent studies reconfirmed the association of the use of disinfectants and cleaning products (especially sprays) with IIA. A role for genetic susceptibility has been suggested.

SUMMARY

Recent literature provided further understanding of both acute/subacute and chronic exposure IIA, in terms of causes, possible mechanisms, and consequences such as poor asthma control. Research is needed to clarify several aspects of IIA, including its frequency (still likely underestimated), modulating factors, and mechanisms. Research aiming at improving irritant exposure assessment, including intensity/duration, and determining relevant exposure windows would be welcome.

Derivation of thresholds for inhaled chemically reactive irritants: Searching for substance-specific common denominators for read-across prediction

Emergency response planning guideline values are used to protect the public when there has been a short-term chemical release. These values serve the purpose of identifying areas where a hazard exists if the concentration of hazardous chemicals is exceeded for the specified exposure duration. This paper focuses on carbonyl chlorides, a class of highly irritant/corrosive chemical intermediates characterized by the reactive moiety R-COCl. Despite their unifying property of reacting with nucleophilic biopolymers/peptides lining the airways of the respiratory tract, their adverse outcome pathway (AOP), in addition to surface area dose, appears to be dominated by their site(s) of major deposition (liquid) or retention (gas) within the respiratory tract. Thus, the physicochemical properties "phase" and "lipophilicity" become more decisive for the AOP than the chemical structure. This complicates the grouping of portal-of-entry irritant chemicals for the read-across prediction of chemicals, especially those with semivolatile properties. Phosgene (COCl₂) served as a template to predict emergency response planning levels 2 (non-incapacitating, reversible injury) and 3 (nonlethal) for related chemicals such as SOCl₂, formates, and acid chlorides. A rationale and guide to the systematic characterization of uncertainties associated with the lung region, water solubility of the vapor phase, and chemical specificity is given. The approach described in this paper highlights the regional differences and outcomes that are phenotypically described as irritation of the respiratory tract. Especially for such a data-lean group of chemicals, reliable read-across predictions could reduce the uncertainty associated with the derivation of values used for emergency-related risk assessment and management. Likewise, the approach suggested could improve the grouping and categorization of such chemicals, providing a means to reduce animal testing with potentially corrosive chemicals. Overall, the course taken for read-across predictions provided valid estimates as long as emphasis was directed to the physicochemical properties determining the most critical regional injury within the respiratory tract.

Poor Air Quality in Urban Settings: A Comparison of Perceptual Indicators, Causes and Management in Two Cities

Poor air quality (PAQ) is a global concern, especially in urban areas, and is often seen as an important element of social sustainability given its negative impact on health and quality of life. However, little research has been undertaken in cities of the developing world to explore how residents perceive poor air quality, its main causes, what control measures should be used to address PAQ and where the main responsibility rests for implementing control measures. The research described in this paper sought to address these points, using a questionnaire-based survey (n = 262) in Nigeria’s federal capital city of Abuja (n = 137) and the state-capital city of Enugu (n = 125). The survey took place during the COVID-19 pandemic (October 2020 to March 2021), and was stratified to ensure representation across a number of demographic groups such as gender, age, education and income. The results were analysed using the Kruskal–Wallis non-parametric test and Hochberg’s post hoc test available in SPSS version 28. The study found that the ranking of perceptual indicators and the main causes of PAQ had much agreement between respondents from both cities and between demographic groups. Smoke, odour and dust particles were perceived to be the most important indicators of PAQ, while the main sources of PAQ were waste and bush burning, vehicle use and power generators. The two most preferred control measures were proper waste management and the avoidance of bush burning. However, there was a significant difference between the two cities in terms of the main organisations responsible for addressing PAQ, with respondents from Abuja citing the federal government, while those from Enugu cited the state government. Interestingly, younger people in Enugu noted that the government should take more responsibility in controlling PAQ than did the older demographic in that city, but this difference was not seen in Abuja. Overall, this study reveals that residents in these two Nigerian cities clearly recognise their exposure to PAQ and it suggests that these perceptual indicators, and views on sources and interventions should be central to designing policies to control this important issue.

RespiraTox - Development of a QSAR model to predict human respiratory irritants

Respiratory irritation is an important human health endpoint in chemical risk assessment. There are two established modes of action of respiratory irritation, 1) sensory irritation mediated by the interaction with sensory neurons, potentially stimulating trigeminal nerve, and 2) direct tissue irritation. The aim of our research was to, develop a QSAR method to predict human respiratory irritants, and to potentially reduce the reliance on animal testing for the identification of respiratory irritants. Compounds are classified as irritating based on combined evidence from different types of toxicological data, including inhalation studies with acute and repeated exposure. The curated project database comprised 1997 organic substances, 1553 being classified as irritating and 444 as non-irritating. A comparison of machine learning approaches, including Logistic Regression (LR), Random Forests (RFs), and Gradient Boosted Decision Trees (GBTs), showed, the best classification was obtained by GBTs. The LR model resulted in an area under the curve (AUC) of 0.65, while the optimal performance for both RFs and GBTs gives an AUC of 0.71. In addition to the classification and the information on the applicability domain, the web-based tool provides a list of structurally similar analogues together with their experimental data to facilitate expert review for read-across purposes.

In silico approaches in organ toxicity hazard assessment: Current status and future needs for predicting heart, kidney and lung toxicities

The kidneys, heart and lungs are vital organ systems evaluated as part of acute or chronic toxicity assessments. New methodologies are being developed to predict these adverse effects based on in vitro and in silico approaches. This paper reviews the current state of the art in predicting these organ toxicities. It outlines the biological basis, processes and endpoints for kidney toxicity, pulmonary toxicity, respiratory irritation and sensitization as well as functional and structural cardiac toxicities. The review also covers current experimental approaches, including off-target panels from secondary pharmacology batteries. Current in silico approaches for prediction of these effects and mechanisms are described as well as obstacles to the use of in silico methods. Ultimately, a commonly accepted protocol for performing such assessment would be a valuable resource to expand the use of such approaches across different regulatory and industrial applications. However, a number of factors impede their widespread deployment including a lack of a comprehensive mechanistic understanding, limited in vitro testing approaches and limited in vivo databases suitable for modeling, a limited understanding of how to incorporate absorption, distribution, metabolism, and excretion (ADME) considerations into the overall process, a lack of in silico models designed to predict a safe dose and an accepted framework for organizing the key characteristics of these organ toxicants.

Human risk assessment of inhaled irritants: Role of sensory stimulations from spatially separated nociceptors

Contemporary approaches to human health risk assessment for respiratory tract irritants are variable and controversial. This manuscript provides an in-depth analysis and assessment of the applicability of the classical respiratory depression 50 % (RD₅₀) assay with focus on the Log-linear extrapolation of the non-sensory irritant threshold (RD₀ or RD₁₀) relative to the contemporary Point of Departure (POD) U.S.-EPA benchmark approach. Three prototypic volatile chemically reactive irritants are used to exemplify the pros and cons of this alternative approach. These irritants differ in physicochemical properties affecting water-solubility and lipophilicity. Depending on these variables, a vapor may preferentially be retained in the extrathoracic region (ET), the tracheobronchial region (TB), and the pulmonary region (PU); although a smooth transition between these regions occurs at increasingly high concentrations. Each region has its specific nociceptors sensing irritants and regional-specific response to injury. The alternative approach using rats identified the chemical-specific critical region of respiratory tract injury. Statistically derived PODs on ET-TB related sensory irritation provide important information for ET-TB irritants but not for PU irritants. The POD of ET-TB irritants from acute and repeated studies decreased substantially. In summary, statistically derived PODs improve the risk assessment of respiratory tract irritants; however, those from repeated exposures should be given preference to those from acute exposures.

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

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

Health, work performance, and risk of infection in office-like environments: The role of indoor temperature, air humidity, and ventilation

Epidemiological and experimental studies have revealed the effects of the room temperature, indoor air humidity, and ventilation on human health, work and cognitive performance, and risk of infection. In this overview, we integrate the influence of these important microclimatic parameters and assess their influence in offices based on literature searches. The dose-effect curves of the temperature describe a concave shape. Low temperature increases the risk of cardiovascular and respiratory diseases and elevated temperature increases the risk of acute non-specific symptoms, e.g., dry eyes, and respiratory symptoms. Cognitive and work performance is optimal between 22 °C and 24 °C for regions with temperate or cold climate, but both higher and lower temperatures may deteriorate the performances and learning efficiency. Low temperature may favor virus viability, however, depending on the status of the physiological tissue in the airways. Low indoor air humidity causes vulnerable eyes and airways from desiccation and less efficient mucociliary clearance. This causes elevation of the most common mucous membrane-related symptoms, like dry and tired eyes, which deteriorates the work performance. Epidemiological, experimental, and clinical studies support that intervention of dry indoor air conditions by humidification alleviates symptoms of dry eyes and airways, fatigue symptoms, less complaints about perceived dry air, and less compromised work performance. Intervention of dry air conditions by elevation of the indoor air humidity may be a non-pharmaceutical treatment of the risk of infection by reduced viability and transport of influenza virus. Relative humidity between 40 and 60% appears optimal for health, work performance, and lower risk of infection. Ventilation can reduce both acute and chronic health outcomes and improve work performance, because the exposure is reduced by the dilution of the indoor air pollutants (including pathogens, e.g., as virus droplets), and in addition to general emission source control strategies. Personal control of ventilation appears an important factor that influences the satisfaction of the thermal comfort due to its physical and positive psychological impact. However, natural ventilation or mechanical ventilation can become sources of air pollutants, allergens, and pathogens of outdoor or indoor origin and cause an increase in exposure. The "health-based ventilation rate" in a building should meet WHO's air quality guidelines and dilute human bio-effluent emissions to reach an acceptable perceived indoor air quality. Ventilation is a modifying factor that should be integrated with both the indoor air humidity and the room temperature in a strategic joint control to satisfy the perceived indoor air quality, health, working performance, and minimize the risk of infection.

Respiratory Health Effects of Exposure to Cleaning Products

There is consistent and growing evidence of an epidemic of "asthma-like" symptoms among professional cleaners. Questions include how big is this problem worldwide, which cleaning agents are dangerous, how do they affect the lungs, and is it really asthma? This issue is important to public health because of the increasing number of professional cleaners, many from vulnerable categories. There are implications for anybody exposed to cleaning products during housekeeping, including children. This article uses available evidence to give a broad but concise overview on what we know so far and how we can prevent the cleaning-associated respiratory public health burden.

Risk assessment for irritating chemicals - Derivation of extrapolation factors

Irritation of the eyes and the upper respiratory tract are important endpoints for setting guide values for chemicals. To optimize the use of the often-limited data, we analysed controlled human exposure studies (CHS) with 1-4 h inhalation of the test substance, repeated dose inhalation studies in rodents, and Alarie-Tests and derived extrapolation factors (EF) for exposure duration, inter- and intraspecies differences. For the endpoint irritating effects in the respiratory tract in rodents, geometric mean (GM) values of 1.9 were obtained for the EF for subacute→subchronic (n = 16), 2.1 for subchronic→chronic (n = 40), and 2.9 for subacute→chronic (n = 10) extrapolation. Based on these data we suggest an EF of 2 for subchronic→chronic and of 4 for subacute→chronic extrapolation. In CHS, exposure concentration determines the effects rather than exposure duration. Slight reversible effects during 4 h exposure indicate that an EF of 1 can be considered for assessing chronic exposures. To assess species extrapolation, 10 chemicals were identified with both, reliable rat inhalation studies and CHS. The GM of the ratio between the No Observed Adverse Effect Concentration (NOAEC) in rats and humans was 2.3 and increased to 3.6 when expanding the dataset to all available EF (n = 25). Based on these analyses, an EF of 3 is suggested to extrapolate from a NOAEC in a chronic rat study to a NOAEC in a CHS. The analysis of EFs for the extrapolation from a 50% decrease in respiratory frequency in the Alarie test in mice (RD₅₀) to a NOAEC in a CHS resulted in a GM of 40, for both, the reliable (n = 11) and the overall dataset (n = 19). We propose to use the RD₅₀ from the Alarie test for setting guide values and to use 40 as EF. Efs for intraspecies differences in the human population must account for susceptible persons, most importantly for persons with chemical intolerance (CI), who show subjective signs of irritation at low concentrations. The limited data available do not justify to deviate from an EF of 10 - 20 as currently used in different regulatory settings.

Pain Perception, Brain Connectivity, and Neurochemistry in Healthy, Capsaicin-Sensitive Subjects

Most of the occupational exposure limits (OELs) are based on local irritants. However, exposure to much lower concentrations of irritant substances can also lead to health complaints from workers. Exposure to irritants is often accompanied by strong unpleasant odors, and strong odors might have distracting effects and hence pose a safety risk. The findings obtained in human exposure studies with chemically sensitive, stressed, or anxious persons suggest that their ability to direct attention away from the odorous exposure and to focus on a cognitive task is reduced. In addition, after repeated odor exposure, these persons show signs of sensitization, i.e., difficulties in ignoring or getting used to the exposure. The question arises as to whether certain health conditions are accompanied by a change in sensitivity to odors and irritants, so that these persons are potentially more distracted by odors and irritants and therefore more challenged in working memory tasks than nonsusceptible persons. In our study, susceptible persons with sensory airway hyperreactivity ("capsaicin-sensitive") respond more strongly to mechanical skin stimuli than controls and show altered network connectivity. Capsaicin-sensitive subjects have a lower pain threshold and thus are more sensitive to mechanical skin stimuli. The intrinsic functional connectivity of their saliency network is higher, and the lower the GABAergic tone of the thalamus, the higher their pain sensitivity to mechanical stimuli. It seems that the increased communication between resting-state networks promotes a stronger perception of the sensory input signal. The results can be used to inform about actual risks (i.e., attention diversion and increased risk of accidents) and "pseudo" risks such as odor perception without a negative impact on one's well-being. This way, uncertainties that still prevail in the health assessment of odorous and sensory irritating chemicals could be reduced.

Effect of dibenz(b,f)-1,4-oxazepine aerosol on the breathing pattern and respiratory variables by continuous recording and analysis in unanaesthetised mice

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Dibenz (b,f)-1,4-oxazepine (CR) is a riot control agent.

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Respiratory variables and breathing pattern were recorded continuously in mice.

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CR produced concentration dependent sensory irritation without pulmonary irritation.

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Concentrations below 158.2 mg/m³ showed recovery to normal breathing.

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Study shows CR causes sensory irritation only and may not cause lung injury.

A riot control agent has to be a sensory irritant of a reversible type without pulmonary irritation as the later can cause lung injury. The aim of the present study is to continuously record and analyse breathing pattern and respiratory variables of dibenz (b,f)-1,4-oxazepine (CR) in unanaesthetised mice during and after exposure. The lowest concentration of 0.65 mg/m³ did not produce any effect on the breathing pattern. As high as 500 fold increase (315.9 mg/m³) in the concentration was used and no mortality was observed. CR produced a concentration dependent sensory irritation, without pulmonary irritation or airflow obstruction, showing that it may not cause any lung injury. The sensory irritation was initiated within 5 min of exposure due to the activation of TRPA1 receptors of the upper respiratory tract. Immediate recovery of normal breath without sensory irritation was observed in all the concentrations except the highest concentration of 315.9 mg/m³. Corresponding to the sensory irritation there was concentration dependent respiratory depression. The 50 percent respiratory depression (RD₅₀) in this experiment was 152 mg/m³ and the estimated threshold limit value for occupational exposure was 4.56 mg/m³. The present study shows that CR causes sensory irritation only which is completely recoverable.

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

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

A short-term inhalation study to assess the reversibility of sensory irritation in human volunteers

Sensory irritation is an acute adverse effect caused by chemicals that stimulate chemoreceptors of the upper respiratory tract or the mucous membranes of the outer eye. The avoidance of this end point is of uttermost importance in regulatory toxicology. In this study, repeated exposures to ethyl acrylate were analyzed to investigate possible carryover effects from day to day for different markers of sensory irritation. Thirty healthy subjects were exposed for 4 h on five subsequent days to ethyl acrylate at concentrations permitted by the German occupational exposure limit at the time of study. Ratings of eye irritation as well as eye blinking frequencies indicate the elicitation of sensory irritation. These markers of sensory irritation showed a distinct time course on every single day. However, cumulative carryover effects could not be identified across the week for any marker. The rhinological and biochemical markers could not reveal hints for more pronounced sensory irritation. Neither increased markers of neurogenic inflammation nor markers of immune response could be identified. Furthermore, the performance on neurobehavioral tests was not affected by ethyl acrylate and despite the strong odor of ethyl acrylate the participants improved their performances from day to day. While the affected physiological marker, the increased eye blinking frequency stays roughly on the same level across the week, subjective markers like perception of eye irritation decrease slightly from day to day though the temporal pattern of, i.e., eye irritation perception stays the same on each day. A hypothetical model of eye irritation time course derived from PK/PD modeling of the rabbit eye could explain the within-day time course of eye irritation ratings repeatedly found in this study more precisely.

Passive exposure of non-smokers to E-Cigarette aerosols: Sensory irritation, timing and association with volatile organic compounds

AIM

The current study examined symptoms of irritation reported by non-smokers passively exposed to e-cigarette aerosols and their timing and association with the concentrations of volatile organic compounds (VOCs) produced.

METHODS

40 healthy non-smoking adults were exposed to e-cigarette aerosols for 30 min in a 35 m³ room. Second-hand e-cigarette aerosol (SHA) was produced by an experienced e-cigarette user using a standardized topography and two resistance settings (exposure 0.5 Ohm and 1.5 Ohm), in addition to a control session (no emissions). PM_2.5 and PM_1.0 were continuously measured over the duration of exposure, while Volatile Organic Compounds (VOCs) were recorded at 0, 15 and 30 min (t₀, t₁₅ and t₃₀) of exposure. Each participant completed an irritation questionnaire at t₀, t_15, t₃₀ of exposure and t₆₀ (30 min post-exposure) on ocular, nasal, throat-respiratory symptoms of irritation and general complaints. Kruskal-Wallis H test for PM comparisons, repeated measures ANOVA for VOCs and Generalized Estimating Equations for symptoms of irritation and association with VOCs were used for statistical analysis.

RESULTS

20 males and 20 females, with a mean age of 24.6 years (SD = 4.3) and exhaled CO < 7 ppm participated. PM concentrations in both experimental sessions were higher than the Control (p < 0.001). The most commonly reported symptoms were burning, dryness, sore throat, cough, breathlessness and headache. During both experimental sessions, ocular, nasal, throat-respiratory symptoms and general complaints increased significantly (p < 0.05). Ocular and nasal symptoms returned to baseline by t₆₀ (p > 0.05) while throat-respiratory symptoms were still significantly higher at t₆₀ (p = 0.044). VOCs were significantly associated with reported nasal and throat-respiratory symptoms in both experimental sessions (p < 0.05).

CONCLUSION

A 30-min exposure to SHA provoked symptoms of sensory irritation and general complaints that lasted up to 30 min after the exposure and were positively associated with the concentrations of the VOC mixture emitted.

Activation of TRPA1 by volatile organic chemicals leading to sensory irritation

Many volatile organic chemicals (VOCs) have not been tested for sensory pulmonary irritation. Development of in vitro non-animal sensory irritation assay suitable for a large number of chemicals is needed to replace the mouse assay. An adverse outcome pathway (AOP) is designed to provide a clear description of the biochemical and cellular processes leading to toxicological effects or an adverse outcome. The AOP for chemical sensory pulmonary irritation was developed according to the Organization for Economic Co-operation and Development guidance including the Bradford Hill criteria for a weight of evidence to determine the confidence of the AOP. The proposed AOP is based on an in-depth review of the relevant scientific literature to identify the initial molecular event for respiratory irritation. The activation of TRPA1 receptor (transient receptor potential cation channel, subfamily A, member 1) is the molecular initial event (MIE) leading to sensory irritation. A direct measure of TRPA1 activation in vitro should identify chemical sensory irritants and provide an estimate of potency. Fibroblasts expressing TRPA1 are used to determine TRPA1 activation and irritant potency. We report a linear relationship between the in vivo RD₅₀ and the in vitro pEC₅₀ values (R=0.81) to support this hypothesis. We propose that this in vitro assay after additional analysis and validation could serve as a suitable candidate to replace the mouse sensory irritation assay.

The mystery of dry indoor air - An overview

"Dry air" is a major and abundant indoor air quality complaint in office-like environments. The causality of perceived "dry air" and associated respiratory effects continues to be debated, despite no clear definition of the complaint, yet, has been provided. The perception of "dry air" is semantically confusing without an associated receptor but mimics a proto-state of sensory irritation like a cooling sensation. "Dry air" may also be confused with another common indoor air quality complaint "stuffy air", which mimics the sense of no fresh air and of nasal congestion. Low indoor air humidity (IAH) was dismissed more than four decades ago as cause of "dry air" complaints, rather indoor pollutants was proposed as possible exacerbating causative agents during the cold season. Many studies, however, have shown adverse effects of low IAH and beneficial effects of elevated IAH. In this literature overview, we try to answer, "What is perceived "dry air" in indoor environments and its associated causalities. Many studies have shown that the perception is caused not only by extended exposure to low IAH, but also simultaneously with and possibly exacerbated by indoor air pollutants that aggravate the protective mucous layer in the airways and the eye tear film. Immanent diseases in the nose and airways in the general population may also contribute to the overall complaint rate and including other risk factors like age of the population, use of medication, and external factors like the local ambient humidity. Low IAH may be the single cause of perceived "dry air" in the elderly population, while certain indoor air pollutants may come into play among susceptible people, in addition to baseline contribution of nasal diseases. Thus, perceived "dry air" intercorrelates with dry eyes and throat, certain indoor air pollutants, ambient humidity, low IAH, and nasal diseases.

Ventilatory disorders associated with occupational inhalation exposure to nitrogen trihydride (ammonia)

Respiratory effects of long term exposure to low levels of ammonia have not been thoroughly investigated. In this cross sectional study, 124 male subjects (67 high exposed and 57 low exposed), occupationally exposed to low levels of ammonia and 120 male referent individuals were investigated. Airborne concentrations of ammonia were measured and subjects underwent spirometry tests prior to and at end of their daily work shift. Average concentrations of ammonia in the breathing zones of the high and low exposed employees were found to be 1.35 ± 4.59 and 0.29 ± 0.31 ppm, respectively. Additionally, mean baseline values of some parameters of pulmonary function such as Vital Capacity (VC) and Forced Expiratory Volume in the first second (FEV1) in the high exposed group were significantly lower than those of referent individuals. Similarly, significant reversible cross shift decrements were noted in FEV1, VC and Forced Vital Capacity (FVC) of exposed employees. These findings indicate that exposure to low levels of ammonia is associated with significant chronic irreversible and acute reversible decrements in the lungs' functional capacity.

Asthma trigger perceptions are associated with work disability

OBJECTIVE

To study the association between perceptions of various triggers of asthma and employment status.

METHODS

A questionnaire was administered to all those adults living in the city of Tampere, Finland, who were entitled to special reimbursement for asthma medication by the Social Insurance Institution (n = 2613). The response rate was 79%. The study population (n = 1657) consisted of individuals who worked full-time (n = 967), were unemployed (n = 197), had all-cause work disability (n = 334), or were retired due to old age (n = 159). Given a list of potential asthma triggers, the respondents were asked how often (never/sometimes/often) the trigger caused or worsened their asthma symptoms during leisure time.

RESULTS

After adjusting for background variables (age, sex, smoking, and professional status), frequency of asthma symptoms, and the use of asthma medication during the last year, any individual trigger identified as asthma-relevant was associated with having work disability (vs. working full-time). The highest odds ratio (OR) was found for vehicle exhaust (OR 5.0, CI 2.2-11.4). We found similar but less consistent associations between asthma trigger perceptions and unemployment. No elevated ORs were found regarding asthma trigger perceptions for old-age retirement.

CONCLUSIONS

Perceptions of asthma triggers are associated with all-cause work disability. Our findings suggest that asthmatics have excess trigger perceptions that are not explained by asthma alone. Asthmatics need to be informed that inaccurate trigger perceptions may develop, and how they are induced, because unnecessary trigger avoidance may interfere with work life.