Effects of ozone exposure in Canadians and Southern Californians. Evidence for adaptation?

White Paper: Chemical Sensitivity: History and Phenomenology

Nearly everyone has heard something about chemical sensitivity, either from personal experience with someone who has the condition or from the media. The television series Northern Exposure recently featured a chemically sensitive attorney who lived in a geodesic dome in Alaska, and L.A. Law depicted the struggles of a Persian Gulf veteran with chemical sensitivities who lost his case against the Veterans Administration, but may appeal later in the season. Television news programs and the printed media have showcased patients living spartan existences in remote areas or in aluminum foil-lined rooms. Our views of the illness no doubt are colored by our own personal experiences of it. While some discount or make jokes about chemical sensitivity or these patients, physicians who have seen a number of them are discovering that many appear to be credible individuals with prior good work records who say they became ill following an identifiable exposure to chemicals.

The effects of ozone exposure and associated injury mechanisms on the central nervous system

Ozone (O3) is a component of photochemical smog, which is a major air pollutant and demonstrates properties that are harmful to health because of the toxic properties that are inherent to its powerful oxidizing capabilities. Environmental O3 exposure is associated with many symptoms related to respiratory disorders, which include loss of lung function, exacerbation of asthma, airway damage, and lung inflammation. The effects of O3 are not restricted to the respiratory system or function - adverse effects within the central nervous system (CNS) such as decreased cognitive response, decrease in motor activity, headaches, disturbances in the sleep-wake cycle, neuronal dysfunctions, cell degeneration, and neurochemical alterations have also been described; furthermore, it has also been proposed that O3 could have epigenetic effects. O3 exposure induces the reactive chemical species in the lungs, but the short half-life of these chemical species has led some authors to attribute the injurious mechanisms observed within the lungs to inflammatory processes. However, the damage to the CNS induced by O3 exposure is not well understood. In this review, the basic mechanisms of inflammation and activation of the immune system by O3 exposure are described and the potential mechanisms of damage, which include neuroinflammation and oxidative stress, and the signs and symptoms of disturbances within the CNS caused by environmental O3 exposure are discussed.

Exposure information in environmental health research: current opportunities and future directions for particulate matter, ozone, and toxic air pollutants

Understanding and quantifying outdoor and indoor sources of human exposure are essential but often not adequately addressed in health effect studies for air pollution. Air pollution epidemiology, risk assessment, health tracking, and accountability assessments are examples of health effect studies that require but often lack adequate exposure information. Recent advances in exposure modeling along with better information on time-activity and exposure factor data provide us with unique opportunities to improve the assignment of exposures for both future and ongoing studies linking air pollution to health impacts. In September 2006, scientists from the US Environmental Protection Agency and the Centers for Disease Control and Prevention along with scientists from the academic community and state health departments convened a symposium on air pollution exposure and health to identify, evaluate, and improve current approaches for linking air pollution exposures to disease. This manuscript presents the key issues, challenges, and recommendations identified by the exposure working group, who used case studies of particulate matter, ozone, and toxic air-pollutant exposure to evaluate health effects for air pollution. One of the overarching lessons of this workshop is that obtaining better exposure information for these different health effect studies requires both goal setting for what is needed and mapping out the transition pathway from current capabilities for meeting these goals. Meeting our long-term goals requires definition of incremental steps that provide useful information for the interim and move us toward our long-term goals. Another overarching theme among the three different pollutants and the different health study approaches is the need for integration among alternate exposure-assessment approaches. For example, different groups may advocate exposure indicators, biomonitoring, mapping methods (GIS), modeling, environmental media monitoring, and/or personal exposure modeling. However, emerging research reveals that the greatest progress comes from integration among two or more of these efforts.

Is there an association between lifetime cumulative exposure and acute pulmonary responses to ozone?

OBJECTIVE

To investigate the potential effects of lifetime cumulative ozone (O3) exposure on acute pulmonary responses to O3.

METHODS

Fifteen healthy subjects from a larger cohort of young adults were exposed to 200 ppb O3 for 4 hours followed by bronchoscopy and bronchoalveolar lavage 18 hours later. Lung function, symptom questionnaires, and blood samples were obtained before and after each exposure. Subjects' lifetime cumulative O3 exposures were estimated from residential histories and air-quality monitoring data.

RESULTS

Acute exposure to O3 caused decrements in forced expiratory volume in 1 second (FEV1), maximal mid-expiratory flow rate (FEF25-75), and forced expiratory flow rate at 75% of forced vital capacity (FEF75), and an increase in plasma clara cell protein (CC16) level. Changes in CC16 and lower respiratory symptoms, but not in lung function, were positively correlated with lifetime cumulative O3 exposure.

CONCLUSION

Higher lifetime cumulative O3 exposure was associated with airway injury and respiratory symptom responses, but not with airway inflammatory or lung function responses, to acute O3 exposure.

Is there adaptation in the ozone mortality relationship: a multi-city case-crossover analysis

BACKGROUND

Ozone has been associated with daily mortality, mainly in the summer period. Despite the ample literature on adaptation of inflammatory and pulmonary responses to ozone, and the link, in cohort studies, between lung function and mortality risk there has been little done to date to examine the question of adaptation in the acute mortality risk associated with ambient ozone.

METHODS

We applied a case-crossover design in 48 US cities to examine the ozone effect by season, by month and by age groups, particularly focusing on whether there was an adaptation effect.

RESULTS

We found that the same day ozone effect was highest in summer with a 0.5% (95% CI: 0.38, 0.62) increase in total mortality for 10 ppb increase in 8-hr ozone, whilst the effect decrease to null in autumn and winter. We found higher effects in the months May- July with a 0.46% (95% CI: 0.24, 0.68) increase in total mortality for 10 ppb increase in ozone in June, and a 0.65% (95% CI: 0.47, 0.82) increase in mortality during July. The effect decreased in August and became null in September. We found similar effects from the age group 51-60 up to age 80 and a lower effect in 80 years and older.

CONCLUSION

The mortality effects of ozone appear diminished later in the ozone season, reaching the null effect previously reported in winter by September. More work should address this issue and examine the biological mechanism of adaptation.

Prenatal exposure to ozone disrupts cerebellar monoamine contents in newborn rats

Ozone (O3) is widely distributed in environments with high levels of air pollution. Since cerebellar morphologic disruptions have been reported with prenatal O3 exposure, O3 may have an effect on some neurotransmitter systems, such as monoamines. In order to test this hypothesis, we used 60 male rats taken from either, mothers exposed to 1 ppm of O3 during the entire pregnancy, or from mothers breathing filtered and clean air during pregnancy. The cerebellum was extracted at 0, 5, and 10 postnatal days. Tissues were processed in order to analyze by HPLC, dopamine (DA) levels, 3,4 dihydroxyphenilacetic acid (DOPAC) and homovanillic acid (HVA), norepinephrine (NA), serotonin, and 5-hydroxy-indole-acetic acid (5-HIAA) contents. Results showed a decrease of DA, NA, DOPAC and HVA mainly in 0 and 5 postnatal days. There were no changes in 5-HT levels, and 5-HIAA showed an increase after 10 postnatal days. DOPAC + HVA/DA ratio showed changes in 0 and 10 postnatal days, while 5-HIAA/5-HT ratio showed a slight decrease in 0 days. The data suggest that prenatal O3 exposure disrupts the cerebellar catecholamine system rather than the indole-amine system. Disruptions in cerebellar NA could lead to ataxic symptoms and also could limit recovery after cortical brain damage in adults. These finding are important given that recovery mechanisms observed in animals are also observed in humans.

Effects of ambient air pollutants on asthma medication use and wheezing among fourth-grade school children from 12 Southern California communities enrolled in The Children's Health Study

To investigate the effects of 12 monthly average air pollution levels on monthly prevalence of respiratory morbidity, the authors examined retrospective questionnaire data on 2034 4th-grade children from 12 Southern California communities that were enrolled in The Children's Health Study. Wheezing during the spring and summer months was associated with community levels of airborne particulate matter with a diameter < or = 10 microm (PM10) (odds ratio (OR) = 2.91; 95% confidence interval (CI) = 1.46-5.80), but was not associated with community levels of ozone, nitrogen dioxide, PM2.5 (diameter < or = 2.5), nitric acid, or formic acid. Logistic regression was performed on data stratified into two seasonal groups, spring/summer and fall/winter. Among asthmatics, the monthly prevalence of asthma medication use was associated with monthly levels of ozone, nitric acid, and acetic acid (OR = 1.80 [95%CI = 1.19-2.70]; OR = 1.80 [95%CI = 1.23-2.65]; OR = 1.57 [95% CI = 1.11-2.21]; respectively). Asthma medication use was more prevalent among children who spent more time outdoors--with consequential exposure to ozone--than among children who spent more time indoors (OR = 3.07 [95%CI = 1.61-5.86]; OR = 1.31 [95%CI = 0.47-2.71]; respectively). The authors concluded that monthly variations in some ambient air pollutants were associated with monthly respiratory morbidity among school children.

Ozone exposure alters 5-hydroxy-indole-acetic acid contents in dialysates from dorsal raphe and medial preoptic area in freely moving rats. Relationships with simultaneous sleep disturbances

Ozone (O3) has been reported to affect sleep patterns and also striatal and mesencephalic contents of 5-hydroxy-indole-acetic acid (5-HIAA) in rats. The aim of this work was to elucidate the effects of O3 exposure in rats upon extracellular 5-HIAA levels in the dorsal raphe (DR) and the hypothalamic medial preoptic area (MPO), two structures involved in sleep-wake homeostasis. Exposure to O3 followed a bell-shaped diurnal pattern, similar to that observed in cities with high air pollution levels. The highest O3 concentration employed was 0.5 ppm. Simultaneous polygraphic records were performed to evaluate the concomitant effects of this exposure model on sleep patterns. Results showed that extracellular 5-HIAA levels increased by 28% in the DR (P=0.0213) while paradoxical sleep (PS) decreased by 56% (P=0.0000) during the light O3 exposure phase. A decrease of 32% in 5-HIAA levels in the MPO (P=0.0450), and of 22% in slow wave sleep (SWS) (P=0.0002) and an increase of 21% in wakefulness (P=0.0430) during the dark post-exposure (Dpost) phase were also observed. We propose that the decrease in PS is the behavioral expression of disruptions of serotonergic DR modulation and, that post-exposure effects observed in the MPO can be explained on the basis of the hypothalamic role in the sleep-wake cycle.

Diet restriction modulates lung response and survivability of rats exposed to ozone

Ozone (O(3)) is a powerful oxidant component of photochemical smog polluting the air of urban cities. Exposure to low-level O(3) causes lung injury and increased morbidity of the sensitive segment of population, and exposure to high levels can be lethal to experimental animals. Injury from O(3) exposure is generally associated with free radical formation and oxidative stress. Because diet restriction is proposed to enhance antioxidant status, we examined whether it would influence the response to inhaled O(3). Twenty-four Sprague-Dawley rats, 1 month old, weighing 150 g, were divided into two dietary regimens (12 rats/regimen); one was freely-fed (FF), and the second was diet-restricted (DR) to 20% the average daily intake of the FF. After 60 days of dietary conditioning, the body weight of DR rats was reduced to 50% that of FF rats. Then, in one experiment, two groups (six rats/group), one FF and the other DR, were exposed to 0.8+/-0.1 p.p.m. (1570+/-196 microg/m(3)) O(3), continuously for 3 days. Another two similar groups of rats were exposed to filtered room air and served as matched controls. After exposure, all rats were euthanized and the lungs analyzed for biochemical markers of oxidative stress. In a second experiment, 24 rats were divided into two groups (12 rats/group), one FF and the other DR, then exposed to high-level O(3) for 8 h (4 p.p.m., 7848+/-981 microg/m(3)) and the mortality noted during exposure and for 16 h post-exposure. Following low-level O(3), inhalation, greater alterations were observed in FF rats compared with DR rats. With high-level O(3) exposure, DR rats exhibited a much greater survivability compared with FF rats (90% versus 8%, respectively). These observations suggest that diet restriction leading to significant reduction of body weight is beneficial, and may play a role in the resistance to the adverse effects of O(3).

Prolonged exposure to low doses of ozone: short- and long-term changes in behavioral performance in mice

Two separate experiments were designed to assess the effects of ozone exposure on outbred CD-1 mice. In the first experiment, adult males were exposed continuously to O3 at 0, 0.3, or 0.6 ppm for 30 days and their behavior was assessed in a 5-min open-field test on exposure days 4 and 19 and on day 3 after the end of the exposure phase. In addition, mice performed a Morris water maze task from exposure day 24 to 28. In the second experiment, adult females were exposed from 30 days prior to the formation of breeding pairs until gestational day 17 to the same doses used in the first experiment. Litters were fostered at birth to untreated dams and neurobehavioral development of the offspring was investigated until adulthood. Specifically, somatic and sensorimotor development [postnatal day (PND) 2-20], homing performance (PND 12), motor activity (PND 21), passive avoidance (PND 22-23), water maze performances (PND 70-74), and response to a nociceptive stimulus (PND 100) were assessed. Results from both experiments confirm that exposure to O3 slightly but selectively affected neurobehavioral performance in rodents. Exposure to O3 did not grossly affect neurobehavioral development, whereas it consistently impaired reversal learning in the Morris water maze test in both prenatally and adult exposed mice. Moreover, longer latency to step-through in the first trial of the passive avoidance test and a decrease in wall rearing in the hot-plate test were recorded in O3 prenatally exposed mice. Except for the first open-field test, altered responses were observed only in animals exposed at the intermediate concentration of the gas. Adaptation and/or onset of compensatory mechanisms might be responsible for the lack of linear dose-response relationships.

Ozone adaptation in mice and its association with ascorbic acid in the lung

We have previously shown that ozone (O(3)) adaptation occurred in rats after daily exposure to an "urban-type" concentration. The adaptation was positively associated with an excess of ascorbic acid (AA) in bronchoalveolar lavage fluid (BALF), suggesting that AA may play a role in the adaptation mechanism. This relationship was not seen at higher and more toxic exposures. The present work exposed mice to low and high levels of O(3) to see if the adaptation-AA relationship is common among rodent species. Male CD-1 mice were studied during repeated 6-h/day exposures to 0.0 or 0.25 ppm O(3) for 10 days and 10 days of recovery in air (experiment 1) and to 0.0, 0.5, or 1.0 ppm O(3) for 5 days (experiment 2). Approximately 20 h after each daily exposure, groups of mice were randomly selected from each concentration type and examined for patterns of response. They were anesthetized (urethane, ip), intubated, and the lungs were lavaged with 37 degrees C saline. BALF was assayed for cells, cell differential, protein, albumin, lactate dehydrogenase, lysozymes, N-acetyl-beta-D-glucosaminidase, gamma-glutamyl transferase, uric acid, glutathione, and AA. Body weight and total lung capacity were also measured. Mice from experiment 1 (10/exposure) were tested for adaptation on day 12 by challenging them with 1.0 ppm O(3) for 6 h and collecting BALF 20 h later. In experiment 2, adaptation was assessed by evaluating the attenuation in response to continued exposure. There was only minimal response to the daily O(3) exposures in experiment 1 except for AA, which was significantly increased in BALF by day 3 and remained elevated well into the recovery period. The O(3)-preexposed mice demonstrated adaptation when compared to their O(3)-naive counterparts. Daily exposure to 1. 0 ppm O(3) in experiment 2 caused weight loss and changes in BALF consistent with toxicity, and neither adaptation nor an excess quantity of AA was seen. The findings in mice were in agreement with those seen in rats and suggest that there may be a common O(3) adaptation mechanism among rodents that involves the regulation of AA in lung lining fluid.

Exposing guinea pigs to ozone for 1 wk enhances responsiveness of rapidly adapting receptors

Acute exposure to ozone causes changes in breathing pattern and lung function which may be caused in part by stimulation of rapidly adapting receptors (RARs). The consequences of repeated daily ozone exposure on RAR responsiveness are unknown, although ozone-induced changes in pulmonary function diminish with repeated exposure. Accordingly, we investigated whether repeated daily ozone exposure diminishes the general responsiveness of RARs. Guinea pigs (n = 30) were exposed to 0.5 parts/million ozone or filtered air (8 h/day for 7 days). The animals were then anesthetized, and RAR impulse activity, dynamic compliance (Cdyn), and lung resistance were recorded at baseline and in response to four stimuli: substance P, methacholine, hyperinflation, and removal of positive end-expiratory pressure. Repeated daily ozone exposure exaggerated RAR responses to substance P, methacholine, and hyperinflation without causing physiologically relevant effects on baseline or substance P- and methacholine-induced changes in Cdyn and lung resistance. Because agonist-evoked changes in RAR activity preceded Cdyn changes, the data suggest that repeated daily ozone exposure enhances RAR responsiveness via a mechanism other than changes in Cdyn.

Ozone produces functional deficits in the rat visual pathway

The effects of ozone (O3) have been studied mainly in reference to the respiratory pathways, though some reports have shown that this gas produces noxious effects in brain. The aim of the present work was to study the O3 effects on the central nervous system, focusing on the visual pathway by means of visual evoked potentials technique recording in the visual cortex and the lateral geniculate nucleus of rats exposed to three different concentrations of O3 (0.75, 1.5 and 3.0 ppm). Our results showed that P1, N1 and P2 components were significantly delayed in the visual cortex and lateral geniculate nucleus in those rats exposed to 3.0 ppm of O3. Moreover, the N1 component in the visual cortex was also affected even under exposure to 1.5 ppm of O3. Results suggest that O3 exposure affects the conduction mechanisms and synaptic excitability of the visual pathway. It is known that inhalation of O3 produce a cascade of ozonation products capable of producing lipid peroxidation in the brain. Unevenness of some neurotransmitters has also been referred in animals exposed to this gas. Thus we consider that the delay found in the primary components of the visual evoked potentials could obey to a neurochemical disorder produced by O3 inhalation.

Differential susceptibility to ozone-induced airways hyperreactivity in inbred strains of mice

Individuals with heightened airways reactivity, such as asthmatics, may be at risk to inflammatory effects of oxidant air pollutants. In the inbred mouse, significant interstrain variation in airways reactivity to acelycholine (ACh) and differential susceptibility to ozone (O3)-induced airways inflammation has been described previously. This study used these murine models to test hypotheses that (1) O3-induced hyperreactivity to ACh is a function of inherent baseline ACh reactivity, and (2) susceptibility to O3-induced inflammation is associated with O3-induced hyperreactivity. Strains (15-25 g, 6-8 weeks) with HYPERREACTIVE (DBA/2J, AKR/J, A/J), HYPOREACTIVE (C3H/HeJ, C57BL/6J, SJL/H), or INTERMEDIATE (129/J) phenotypes for ACh reactivity were exposed for 3 h to 2.0 ppm O3 or air (control). ACh reactivity (25 and 50 micrograms/kg, IV) was assessed 0 and 24 h after exposure. Relative to air controls, mean airways responses to 25 and 50 micrograms/kg ACh 24 h post-O3 increased significantly in the HYPERREACTIVE A/J strain (p < .05). Among HYPOREACTIVE strains, O3 significantly (p < .05) increased the response to 50 micrograms/kg ACh in C57BL/6J and SJL/J strains 24 h postexposure. A/J, C57BL/6J, and SJL/J mice are susceptible to O3-induced lung injury. O3 did not alter ACh reactivity in the other strains. O3 also did not affect airways reactivity to methacholine or carbachol, observations consistent with the hypothesis that O3-induced hyperreactivity to ACh may be due, in part, to O3 effects on cholinesterase function. Treatment of C57BL/6J and A/J mice with an immunosuppressant (cyclophosphamide) or an anti-PMN antibody significantly (p < .05) attenuated circulating and infiltrating polymorphonuclear leukocytes (PMNs), but did not affect O3-induced hyperreactivity. Therefore, O3-induced ACh hyperreactivity was not a function of baseline reactivity, but correlated with susceptibility to acute O3-induced airways injury and inflammation. Pharmacologic studies suggest that although PMNs were associated with O3-induced hyperreactivity, these cells were not the cause of the effect, and that these two events are not codependent.

Sleep-wake disorganization in cats exposed to ozone

The effects of the exposure to ozone in the central nervous system are unknown, as it is doubtful if ozone enters beyond the respiratory tract. However, ozone exposure impairs human performance and induces subjective complaints such as fatigue, lethargy and headache. We studied electrographic aspects of sleep-wake organization in cats, and found that paradoxical sleep was promptly reduced during ozone exposure, followed by a dose-related increase of slow-wave sleep. These findings suggest that high concentrations of ozone or its reaction products induce striking changes in sleep patterns.

Pulmonary function responses of young and older adults to mixtures of O3, NO2 and PAN

The pulmonary function of 32 nonsmokers (eight men and eight women, 18-26 years of age; eight men and eight women, 51-76 years of age) was measured before and after two-hour exposures to (1) filtered air (FA), (2) 0.45 ppm ozone (O3), (3) 0.13 ppm peroxyacetyl nitrate + 0.45 ppm O3 (PAN/O3), (4) 0.60 ppm nitrogen dioxide + 0.45 ppm O3 (NO2/O3), and (5) 0.13 ppm PAN + 0.60 ppm NO2 + 0.45 ppm O3 (PAN/NO2/O3). Subjects alternated 20-minute periods of rest and exercise (ventilation = 25 L/min). Forced vital capacity (FVC) was measured pre-exposure and five-minutes after each exercise period. Forced expiratory volume in one sec (FEV1.0) and forced expiratory flow between 25 and 75 percent of FVC (FEF25-75%) were calculated from the FVC tests. Data were analyzed by 4-factor analysis of variance (sex, age, time period, exposure). The responses of men and women were similar. FA exposure induced no effects. The young subjects' decrements in FVC, FEV1.0 and FEF25-75% became significant (P less than 0.01) after the second exercise period of the O3, NO2/O3 and PAN/NO2/O3 exposures, while the PAN/O3 decrements were significant (P less than 0.01) after the first exercise period. Although PAN/O3 induced significant decrements earlier than the other conditions including O3, the mean pre- to post-exposure decrements for the four conditions including O3 were similar. In contrast, the older subjects had smaller and fewer significant decrements in pulmonary functions. They had significant mean decrements in FVC following the third exercise period of the NO2/O3 and PAN/NO2/O3 exposures, in FEV1.0 after the third exercise period of the PAN/O3 and NO2/O3 exposures, and in FEF 25-75% beginning after the second exercise period of the NO2/O3 exposure. The results suggest that older men and women are less responsive to O3 and mixtures of O3, NO2 and PAN than young men and women, and that O3 is responsible for the decrements observed in pulmonary function.

The UCLA population studies of chronic obstructive respiratory disease. 9. Lung function changes associated with chronic exposure to photochemical oxidants; a cohort study among never-smokers

Two cohorts of never-smoking residents of Los Angeles were studied on two occasions five years apart. One cohort (N = 1,099) lived in a community with moderate levels of photochemical pollution and low levels of other pollutants, and the second (N = 1,117) lived in a community with very high levels of photochemical oxidant and relatively high levels of sulfates and particulates. Studies included measurement of forced expiratory volumes and flow rates and single-breath nitrogen washout, as well as use of a standardized questionnaire. The data represent 47 percent of 2,340 and 58 percent of 1,935 residents, respectively, of the original community samples. Mean baseline spirometry and nitrogen washout for those who were and those who were not retested were similar, reflecting the fact that loss to follow-up was primarily due to changes of residence. In the more polluted area there were significantly worse lung function test results for both men and women at baseline and significantly more rapid deterioration at follow-up. Mean changes in nitrogen washout were significantly greater in the more polluted community for both sexes and for all age groups including children. Most of the spirometric test results showed significantly more rapid decline among adults in the more polluted community. These results are consistent with the hypothesis that chronic exposures to a mix of photochemical oxidants, sulfates and particulates are associated with increased loss of lung function, which is especially marked among tests that reflect function of the small airways.

Effects of exposure to 4 ppm nitrogen dioxide in healthy and asthmatic volunteers

Healthy and asthmatic volunteer subjects (N = 25 and N = 23, respectively) were exposed twice each to purified air (control) and to 4 ppm nitrogen dioxide (NO2) in a controlled-environment chamber. Exposures lasted 75 min, and included 15 min each of light exercise (ventilation rate near 25 L/min) and heavy exercise (near 50 L/min). Compared to control, NO2 exposure produced no statistically significant untoward effects on airway resistance, symptoms, heart rate, skin conductance, or self-reported emotional state in normal or asthmatic subjects. Exercise was associated with significantly (P less than .001) increased airway resistance in both subject groups, although the increase in normals was small. In both groups, systolic blood pressure showed small but significant (P less than .01) decreases with NO2 exposure, compared to control. This effect, if real, may relate to formation of a vasodilating nitrite or nitrate from inhaled NO2. The lack of respiratory response contrasts with previous findings elsewhere; at present, this inconsistency is unexplained.

Pulmonary function adaptation to ozone in subjects with chronic bronchitis

Twenty smokers with chronic bronchitis were exposed to 0.41 ppm ozone for 3 hr-day for 5 consecutive days and reexposed 4 days later to determine (1) if they are sensitive to ozone, (2) if they adapt, and (3) if the adaptation lasts longer than 4 days. There were significant decrements in forced vital capacity (FVC) and forced expiratory volume in 3 sec ( FEV3 ) on the first day of the 5-day repeated exposures and also on reexposure 4 days following cessation of the sequential exposures. Symptoms experienced were mild and did not predominate on any exposure days. These results suggest that individuals with chronic bronchitis adapt rapidly to ozone and lose this adaptive phenomenon within 4 days. The small decreases seen in FVC and FEV3 (less than or equal to 3%) appear to impose no more than minimal limitations on their daily activities.

Exposure-effect relationship of selected pulmonary function measurements in subjects exposed to ozone

Healthy adult male volunteer subjects were exposed to 0.15, 0.3, 0.45 and 0.5 ppm ozone (O3) with and without intermittent light exercise. The results suggest that the subject's level of exercise during exposure is considerably related to the magnitude of changes in lung function and the occurrence rate of respiratory symptoms at any given O3 concentration, and that among healthy subjects there is a considerable range of reactivity to O3 exposure. A level of 0.15 ppm O3 with intermittent light exercise produced a significant decrease of specific airway conductance in most subjects and coughing during deep inspiration in five of 15 subjects, while a level of 0.5 ppm O3 produced fewer effects when the subject did not exercise. The nonsmoker is more reactive to O3 than the smoker. The subject's level of exercise during exposure and his smoking habit are two important factors in evaluating the exposure-effect relationship of O3.

Respiratory symptoms of flight attendants during high-altitude flight: possible relation to cabin ozone exposure

The smaller size and lighter weight of the Boeing 747SP aircraft, introduced into passenger service in 1976, permitted higher-altitude flight than older commercial aircraft and thus potentially greater ozone exposure for those of board. Concerned flight attendants distributed questionnaires relating to symptoms experienced on the Boeing 747SP and/or conventional 747 aircraft to Los Angeles- and New York-based flight attendants. Respondents reported symptoms by frequency and severity and by in-flight and after-flight occurrence. Based on the assessment of three health scientists as to ozone-relatedness, the frequency of "definite" and "probable" ozone-related symptoms of any severity reported by both groups of attendants was significantly associated with 747SP flights (chi-squares: P less than 0.05). After-flight symptoms significantly associated with 747SP experience, although fewer in number than in-flight symptoms, were all in the scientists' "definite" category. In 21 flight attendants who complained of moderate to severe symptoms during 747SP flights, a battery of pulmonary function tests performed approximately two weeks after their last 747SP flight failed to reveal abnormalities. The symptom questionnaire results are consistent with possible exposure of cabin attendants to toxic levels of ozone during the higher-altitude flights of the Boeing 747SP compared to conventional 747 aircraft.

Ozone inhibition of tissue cholinesterase in guinea pigs

This study sought to determine if ozone at levels known to induce bronchial hyperreactivity in guinea pigs would inhibit tissue cholinesterase activity. Male, Hartley guinea pigs were exposed to filtered air, 0.1 ppm ozone, or 0.8 ppm ozone for 1 hr. Two hours after exposure, brain, lung, and diaphragm tissue samples were frozen for assay of cholinesterase activity. Brain cholinesterase activity was only minimally inhibited in either ozone exposure group. Both levels of ozone significantly inhibited lung cholinesterase activity compared to control animals' activity: a 17% decrease in activity in the 0.1 ppm ozone group (P less than .05) and a 16% decrease in the 0.8 ppm ozone group (P less than .05). Ozone at 0.8 ppm also inhibited activity in the diaphragm by 14% (P less than .02). To determine the degree of involvement of cholinesterase inhibition in bronchial hyperreactivity, parathion pretreated animals were challenged with histamine and the pulmonary function changes monitored. Parathion-treated animals had a peak resistance increase of 330 +/- 104% (mean +/- SE), while the control vehicle animals' increase was 165 +/- 48%. The differences were not statistically significant, but show that cholinesterase inhibition may contribute to ozone-induced bronchial hyperreactivity.

The pulmonary and extrapulmonary effects of ozone

The toxicity of ozone is solely due to its action as an oxidant. It is an extremely reactive gas which rapidly forms intermediate oxidizing derivatives after inhalation. High concentrations cause death from pulmonary oedema. Both pulmonary and extrapulmonary toxicity have been observed at lower concentrations of ozone, including those currently present in urban air. Pulmonary cellular and subcellular membranes appear to be particularly susceptible. A primary mechanism of this effect is the oxidative decomposition of polyunsaturated fatty acids, which has been demonstrated in rodent lungs after inhalation of ozone. Supporting evidence includes the potentiation of ozone toxicity by vitamin E deficiency and an increased use of this antioxidant vitamin during repetitive exposure to ozone. Other membrane effects include oxidation of thiol groups and, perhaps, of tryptophan. Microsomal alterations include a loss of lung cytochrome P450 which may also be related to lipid peroxidation. Extrapulmonary toxicity is not directly due to ozone but may represent in effect due to lipid peroxide decomposition products, particularly malonaldehyde. This three-carbon dialdehyde has been shown to alter cell membrane fluidity and to have mutagenic properties; the latter perhaps due to cross-linkage of DNA to histone.