Panel study using novel sensing devices to assess associations of PM2.5 with heart rate variability and exposure sources

Peaks, sources, and immediate health impacts of PM2.5 and PM1 exposure in Indonesia and Taiwan with microsensors

BACKGROUND

Microsensors have been used for the high-resolution particulate matter (PM) monitoring.

OBJECTIVES

This study applies PM and health microsensors with the objective of assessing the peak exposure, sources, and immediate health impacts of PM2.5 and PM1 in two Asian countries.

METHODS

Exposure assessment and health evaluation were carried out for 50 subjects in 2018 and 2019 in Bandung, Indonesia and for 55 subjects in 2019 and 2020 in Kaohsiung, Taiwan. Calibrated AS-LUNG sets and medical-certified RootiRx® sensors were used to assess PM and heart-rate variability (HRV), respectively.

RESULTS

Overall, the 5-min mean exposure of PM2.5 and PM1 was 30.4 ± 20.0 and 27.0 ± 15.7 µg/m3 in Indonesia and 14.9 ± 11.2 and 13.9 ± 9.8 µg/m3 in Taiwan, respectively. The maximum 5-min peak PM2.5 and PM1 exposures were 473.6 and 154.0 µg/m3 in Indonesia and 467.4 and 217.7 µg/m3 in Taiwan, respectively. Community factories and mosquito coil burning are the two most important exposure sources, resulting in, on average, 4.73 and 5.82 µg/m3 higher PM2.5 exposure increments for Indonesian subjects and 10.1 and 9.82 µg/m3 higher PM2.5 exposure for Taiwanese subjects compared to non-exposure periods, respectively. Moreover, agricultural waste burning and incense burning were another two important exposure sources, but only in Taiwan. Furthermore, 5-min PM2.5 and PM1 exposure had statistically significantly immediate impacts on the HRV indices and heart rates of all subjects in Taiwan and the scooter subjects in Indonesia with generalized additive mixed models. The HRV change for a 10 µg/m3 increase in PM2.5 and PM1 ranged from -0.9% to -2.5% except for ratio of low-high frequency, with greater impacts associated with PM1 than PM2.5 in both countries.

IMPACT STATEMENT

This work highlights the ability of microsensors to capture high peaks of PM2.5 and PM1, to identify exposure sources through the integration of activity records, and to assess immediate changes in heart rate variability for a panel of approximately 50 subjects in Indonesia and Taiwan. This study stands out as one of the few to demonstrate the immediate health impacts of peak PM, complementing to the short-term (days or weeks) or long-term effects (months or longer) assessed in most epidemiological studies. The technology/methodology employed offer great potential for researchers in the resource-limited countries with high PM2.5 and PM1 levels.

Detection of impending reflex syncope by means of an integrated multisensor patch-type recorder

We assessed the capability of an integrated multisensory patch-type monitor (RootiRx®) in detecting episodes of reflex (pre)syncope induced by tilt table test (TTT). Firstly, we performed an intrapatient comparison of cuffless systolic blood pressure (SBP), R-R interval (RRI) and variability (power spectrum analysis) obtained by means of the RootiRx® with those obtained with conventional methods (CONV) with validated finger pressure devices at baseline in supine position and repeatedly during TTT in 32 patients affected by likely reflex syncope. Secondly, the LF/HF values obtained with RootiRx® during TTT were analyzed in 50 syncope patients. Compared with baseline supine recordings, during TTT a decrement of median SBP was observed with CONV (-53.5 mmHg) but not with RootiRx® ®(-1 mmHg). Conversely, RRI reduction (CONV: 102 ms; RootiRx®: 127 ms) and RRI Low Frequency/High Frequency powers ratio (LF/HF) increase (CONV: 1.6; RootiRx®: 2.5) were similar. The concordance was good for RRI (0.97 [95% CI 0.96-0.98]) and fair for LF/HF ratio (0.69 [95% CI 0.46-0.83]). During the first 5 min of TTT the LF/HF ratio was higher in patients who later developed syncope than in no-syncope patients. This ratio was significantly different among patients with syncope, presyncope or without symptoms at the time of syncope (p value = 0.02). In conclusion, cuffless RootiRx® was unable to detect rapid drops of SBP occurring during impending reflex syncope and thus cannot be used as a diagnostic tool for hypotensive syncope. On the other hand, RRI mean values and LF/HF power ratios obtained with RootiRx® were consistent with those simultaneously obtained using conventional methods.

Wearable Sensor-Based Monitoring of Environmental Exposures and the Associated Health Effects: A Review

Recent advances in sensor technology have facilitated the development and use of personalized sensors in monitoring environmental factors and the associated health effects. No studies have reviewed the research advancement in examining population-based health responses to environmental exposure via portable sensors/instruments. This study aims to review studies that use portable sensors to measure environmental factors and health responses while exploring the environmental effects on health. With a thorough literature review using two major English databases (Web of Science and PubMed), 24 eligible studies were included and analyzed out of 16,751 total records. The 24 studies include 5 on physical factors, 19 on chemical factors, and none on biological factors. The results show that particles were the most considered environmental factor among all of the physical, chemical, and biological factors, followed by total volatile organic compounds and carbon monoxide. Heart rate and heart rate variability were the most considered health indicators among all cardiopulmonary outcomes, followed by respiratory function. The studies mostly had a sample size of fewer than 100 participants and a study period of less than a week due to the challenges in accessing low-cost, small, and light wearable sensors. This review guides future sensor-based environmental health studies on project design and sensor selection.

Effects of COVID-19-Epidemic-Related Changes in Human Behaviors on Air Quality and Human Health in Metropolitan Parks

The outbreak of the new coronavirus pneumonia (Coronavirus disease 2019, COVID-19) created a serious impact on the lives of people around the world. Humans, affected by the COVID-19 virus, must reduce related activities to suppress the spread of this disease. However, the pandemic had a positive impact on the environment due to reduced outdoor activities. The correlation between reduced human outdoor activities and health effects was investigated in this study through two Metropolitan parks in Taichung, Taiwan. The developed low-cost air quality sensors were installed in these two parks to detect the variances in PM2.5 concentrations during the epidemic outbreak. Experimental results indicated that PM2.5 concentrations in these two parks were reduced from about 23.25 and 22.96 μg/m3 to 8.19 and 8.48 μg/m3, respectively, the median absolute deviations (MAD) decreased from 4.21 and 4.57 to 1.71 and 1.35, respectively after the epidemic outbreak, and the calculated standard deviation of all normal-to-normal interval (SDNN) and the ratio of low-frequency power to high-frequency (LF/HF) indicated that the drops of PM2.5 concentrations caused the increased health-related benefits by 73.53% with the variances being low. These results showed that the PM2.5 concentrations displayed high correlations with human activities, which also played important roles in human health effects.

Research Priorities of Applying Low-Cost PM2.5 Sensors in Southeast Asian Countries

The low-cost and easy-to-use nature of rapidly developed PM2.5 sensors provide an opportunity to bring breakthroughs in PM2.5 research to resource-limited countries in Southeast Asia (SEA). This review provides an evaluation of the currently available literature and identifies research priorities in applying low-cost sensors (LCS) in PM2.5 environmental and health research in SEA. The research priority is an outcome of a series of participatory workshops under the umbrella of the International Global Atmospheric Chemistry Project-Monsoon Asia and Oceania Networking Group (IGAC-MANGO). A literature review and research prioritization are conducted with a transdisciplinary perspective of providing useful scientific evidence in assisting authorities in formulating targeted strategies to reduce severe PM2.5 pollution and health risks in this region. The PM2.5 research gaps that could be filled by LCS application are identified in five categories: source evaluation, especially for the distinctive sources in the SEA countries; hot spot investigation; peak exposure assessment; exposure-health evaluation on acute health impacts; and short-term standards. The affordability of LCS, methodology transferability, international collaboration, and stakeholder engagement are keys to success in such transdisciplinary PM2.5 research. Unique contributions to the international science community and challenges with LCS application in PM2.5 research in SEA are also discussed.

Effects of low-frequency noise from wind turbines on heart rate variability in healthy individuals

Wind turbines generate low-frequency noise (LFN, 20-200 Hz), which poses health risks to nearby residents. This study aimed to assess heart rate variability (HRV) responses to LFN exposure and to evaluate the LFN exposure (dB, L_Aeq) inside households located near wind turbines. Thirty subjects living within a 500 m radius of wind turbines were recruited. The field campaigns for LFN (L_Aeq) and HRV monitoring were carried out in July and December 2018. A generalized additive mixed model was employed to evaluate the relationship between HRV changes and LFN. The results suggested that the standard deviations of all the normal to normal R-R intervals were reduced significantly, by 3.39%, with a 95% CI = (0.15%, 6.52%) per 7.86 dB (L_Aeq) of LFN in the exposure range of 38.2-57.1 dB (L_Aeq). The indoor LFN exposure (L_Aeq) ranged between 30.7 and 43.4 dB (L_Aeq) at a distance of 124-330 m from wind turbines. Moreover, households built with concrete and equipped with airtight windows showed the highest LFN difference of 13.7 dB between indoors and outdoors. In view of the adverse health impacts of LFN exposure, there should be regulations on the requisite distances of wind turbines from residential communities for health protection.

Demonstrating the Applicability of Smartwatches in PM2.5 Health Impact Assessment

Smartwatches are being increasingly used in research to monitor heart rate (HR). However, it is debatable whether the data from smartwatches are of high enough quality to be applied in assessing the health impacts of air pollutants. The objective of this study was to assess whether smartwatches are useful complements to certified medical devices for assessing PM_2.5 health impacts. Smartwatches and medical devices were used to measure HR for 7 and 2 days consecutively, respectively, for 49 subjects in 2020 in Taiwan. Their associations with PM_2.5 from low-cost sensing devices were assessed. Good correlations in HR were found between smartwatches and certified medical devices (r_s > 0.6, except for exercise, commuting, and worshipping). The health damage coefficients obtained from smartwatches (0.282% increase per 10 μg/m³ increase in PM_2.5) showed the same direction, with a difference of only 8.74% in magnitude compared to those obtained from certified medical devices. Additionally, with large sample sizes, the health impacts during high-intensity activities were assessed. Our work demonstrates that smartwatches are useful complements to certified medical devices in PM_2.5 health assessment, which can be replicated in developing countries.

A community-based study on associations between PM2.5 and PM1 exposure and heart rate variability using wearable low-cost sensing devices

Few studies have investigated the effect of personal PM_2.5 and PM₁ exposures on heart rate variability (HRV) for a community-based population, especially in Asia. This study evaluates the effects of personal PM_2.5 and PM₁ exposure on HRV during two seasons for 35 healthy adults living in an urban community in Taiwan. The low-cost sensing (LCS) devices were used to monitor the PM levels and HRV, respectively, for two consecutive days. The mean PM_2.5 and PM₁ concentrations were 13.7 ± 11.4 and 12.7 ± 10.5 μg/m³ (mean ± standard deviation), respectively. Incense burning was the source that contributed most to the PM_2.5 and PM₁ concentrations, around 9.2 μg/m³, while environmental tobacco smoke exposure had the greatest impacts on HRV indices, being associated with the highest decrease of 20.2% for high-frequency power (HF). The results indicate that an increase in PM_2.5 concentrations of one interquartile range (8.7 μg/m³) was associated with a change of -1.92% in HF and 1.60% in ratio of LF to HF power (LF/HF). Impacts on HRV for PM₁ were similar to those for PM_2.5. An increase in PM₁ concentrations of one interquartile range (8.7 μg/m³) was associated with a change of -0.645% in SDNN, -1.82% in HF and 1.54% in LF/HF. Stronger immediate and lag effects of PM_2.5 exposure on HRV were observed in overweight/obese subjects (body mass index (BMI) ≥24 kg/m²) compared to the normal-weight group (BMI <24 kg/m²). These results indicate that even low-level PM concentrations can still cause changes in HRV, especially for the overweight/obese population.

Concurrent assessment of personal, indoor, and outdoor PM2.5 and PM1 levels and source contributions using novel low-cost sensing devices

The intensity, frequency, duration, and contribution of distinct PM2.5 sources in Asian households have seldom been assessed; these are evaluated in this work with concurrent personal, indoor, and outdoor PM2.5 and PM1 monitoring using novel low-cost sensing (LCS) devices, AS-LUNG. GRIMM-comparable observations were acquired by the corrected AS-LUNG readings, with R2 up to 0.998. Twenty-six non-smoking healthy adults were recruited in Taiwan in 2018 for 7-day personal, home indoor, and home outdoor PM monitoring. The results showed 5-min PM2.5 and PM1 exposures of 11.2 ± 10.9 and 10.5 ± 9.8 µg/m3 , respectively. Cooking occurred most frequently; cooking with and without solid fuel contributed to high PM2.5 increments of 76.5 and 183.8 µg/m3 (1 min), respectively. Incense burning had the highest mean PM2.5 indoor/outdoor (1.44 ± 1.44) ratios at home and on average the highest 5-min PM2.5 increments (15.0 µg/m3 ) to indoor levels, among all single sources. Certain events accounted for 14.0%-39.6% of subjects' daily exposures. With the high resolution of AS-LUNG data and detailed time-activity diaries, the impacts of sources and ventilations were assessed in detail.