Traffic-related air pollution: exposure and health effects in Copenhagen street cleaners and cemetery workers

Heat and worker health

Extreme heat negatively impacts cognition, learning, and task performance. With increasing global temperatures, workers may therefore be at increased risk of work-related injuries and illness. This study estimates the effects of temperature on worker health using records spanning 1985-2020 from an Australian mandatory insurance scheme. High temperatures are found to cause significantly more claims, particularly among manual workers in outdoor-based industries. These adverse effects have not diminished across time, with the largest effect observed for the 2015-2020 period, indicating increasing vulnerability to heat. Within occupations, the workers most adversely affected by heat are female, older-aged and higher-earning. Finally, results from firm-level panel analyses show that the percentage increase in claims on hot days is largest at "safer" firms.

Chronic Cough Due to Stable Chronic Bronchitis: CHEST Expert Panel Report

BACKGROUND

Chronic cough due to chronic bronchitis (CB) causes significant impairment in quality of life, and effective treatment strategies are needed. We conducted a systematic review on the management of chronic cough due to CB to update the recommendations and suggestions of the American College of Chest Physicians (CHEST) 2006 guideline on this topic.

METHODS

This systematic review asked three questions: (1) What are the clinical features of the history that suggest a patient's cough-phlegm syndrome is due to CB? (2) Can treatment of stable CB improve or eliminate chronic cough? (3) Can therapy that targets chronic cough due to CB prevent or reduce the occurrence of acute CB exacerbations? Studies of adult patients with CB were included and assessed for relevance and quality. Based on the systematic review, guideline suggestions were developed and voted on by using the CHEST organization methodology.

RESULTS

The search strategy used an assortment of descriptors and assessments to identify studies of chronic cough due to CB.

CONCLUSIONS

The evidence supporting the management of chronic cough due to CB is limited overall and of low quality. This article provides guidance on treatment by presenting suggestions based on the best currently available evidence and identifies gaps in our knowledge and areas for future research.

Assessing the accuracy of commercially available gas sensors for the measurement of ambient ozone and nitrogen dioxide

The objective of the National Institute for Occupational Safety and Health (NIOSH) accuracy criterion is to ensure that measurements from monitoring devices are within ±25% of the true concentration of the analyte with 95% certainty. To determine whether NO2 and O3 sensors meet this criterion, three commercially available units (Cairclip O3/NO2, Aeroqual NO2, and Aeroqual O3 sensors) were co-located three times with validated instruments (NOx chemiluminescence [NO2mon] and photometric O3 analyzers [O3mon]) at an outdoor monitoring station. As cofactors of sensor performance such as temperature (T) and relative humidity (RH) potentially influence the response of NO2 and O3 sensors, corrections for cofactors were made by using T, RH, and the sensor measurements to predict measurements made by NO2mon and O3mon during the first co-location period (training dataset). The developed models were tested in the merged data obtained from the second and third co-location periods (testing dataset). In the training and testing datasets, the mean NO2 as measured by NO2mon was 4.6 ppb (range = 0.4-35 ppb) and 9.4 ppb (range = 1-37 ppb), respectively. The mean O3 in the training and testing datasets as measured by O3mon was 38.8 ppb (range = 1-65 ppb) and 35.7 ppb (range = 1-61 ppb), respectively. None of the sensor measurements in the training dataset were within the NIOSH accuracy criterion (mean error ≥25%). After correcting for cofactors of sensor performance, the accuracy of the Cairclip O3/NO2 and the Aeroqual O3 sensors considerably improved when tested with the testing dataset (mean error = -1% and 14%, respectively). However, the Aeroqual NO2 sensor had an error that was not within ±25%. Raw measurements from the tested sensors may be unsuitable for assessing workers' exposure to NO2 and O3. Corrections for cofactors of Cairclip O3/NO2 and Aeroqual O3 sensor performance are required for more accurate occupational exposure assessment.

Comparison of polycyclic aromatic hydrocarbon emissions on gasoline- and diesel-dominated routes

Three diesel-dominated routes (DDRs) and three gasoline-dominated routes (GDRs) were chosen as the study sites. The total number of vehicles on GDRs (47,200) was much higher than that on DDRs (14,500). The concentration of polycyclic aromatic hydrocarbons (PAHs), elemental carbon, organic carbon, and metals from GDR roadsides was higher than that for DDRs. The diagnostic ratios (ANTHR/PHE + ANTHR, FLT/FLT + PYR, BaA/BaA + CHR, and IND/IND + BghiP + ANTHN) all indicated that the major PAH source on DDR and GDR was emissions from vehicle engine combustion. The marked diesel ratios of low molecular weight PAH2.5/T-PAH2.5, methyl-PAH2.5/T-PAH2.5, methyl-PHE/PHE, and Mo/PM2.5 on DDRs were higher than those on GDRs. Significant correlations were found between the number of vehicles and the concentration of T-PAH2.5, Car-PAHs2.5, and BaPeq2.5 on DDRs and GDRs. The increase in the levels of T-PAH2.5, Car-PAHs2.5, and BaPeq2.5 per 100 vehicles on DDRs was about 3.3, 3.5, and 4.2 times higher than that on GDRs, respectively. The higher percentage of high-exhaust volume from the larger amount of diesel vehicles on DDRs than that on GDRs was the main factor leading to these results. The diagnostic ratios BaA2.5/CHR2.5 and (BbF + BkF)2.5/BghiP2.5 showed significant differences between the fine PAH sources emitted on DDRs and GDRs, whereas the diagnostic ratios Me-PAH2.5/T-PAH2.5 and (BbF + BkF)2.5/BghiP2.5 showed good correlations with the percentages of diesel exhaust volume in the total exhaust volume (E(diesel)/E(total)) on DDRs.

A Study of Morbidity Pattern in Street Sweepers: A Cross-sectional Study

BACKGROUND

Street sweepers play an important role in maintaining the health and hygiene within the cities. This job exposes the street sweepers to a variety of risk factors such as dust, toxins and diesel exhaust pollution, which make them vulnerable to develop certain occupational diseases. Therefore, it was thought necessary to study the morbidity profile in this occupational group.

OBJECTIVES

To study the prevalence of morbidities among street sweepers and comparison group.

STUDY DESIGN

A cross-sectional study with a comparison group.

STUDY SETTING

Nagpur Municipal Corporation, Nagpur.

SUBJECTS

THE STUDY INCLUDED TWO GROUPS: (1) A study group comprising 273 street sweepers. (2) A comparison group comprising 142 class IV workers working in the office buildings of Nagpur Municipal Corporation, Nagpur.

MATERIALS AND METHODS

A pretested proforma was used to record the necessary information such as clinical history, sociodemographic factors, findings of clinical examination and investigations performed.

RESULTS AND CONCLUSIONS

THE IMPORTANT MORBIDITIES DETECTED AMONG STREET SWEEPERS WERE THE FOLLOWING: anemia (20.5%), hypertension (9.5%), upper respiratory tract infections (URTI) (7.3%) and chronic bronchitis (5.9%). In the comparison group, important morbidities detected were the following: anemia (20.4%), hypertension (11.3%), hyperacidity (9.9%), URTI (7.0%) and refractive error (7.0%). Chronic bronchitis was detected in two subjects (1.4%) of the comparison group. The prevalence of chronic bronchitis was significantly high among street sweepers than that of subjects of the comparison group. Therefore, it is recommended that further studies with a larger sample size be undertaken to identify the factors responsible for higher prevalence of chronic bronchitis among the street sweepers.

Ambient air pollution and respiratory health effects in mail carriers

Mail carriers represent an occupational group suffering from respiratory symptoms and lung function impairment. Although environmental conditions may play role, information on the effects of air pollution exposure in this population is lacking. The present study was conducted in Athens, Greece, in order to investigate the adverse effects of long-term air pollution exposure on respiratory outcomes in mail carriers. A total of 226 mail carriers and 73 office employees were enrolled. Information on respiratory symptoms, medical, occupational, residential and smoking history was obtained through a questionnaire. Flow-volume curves were performed in the workplace using a portable spirometer. Individualised personal exposure assessment has been applied based on long-term residential and occupational subject history linked with geographical air pollution distribution. Furthermore, personal measurements were obtained for forty-one mail carriers using NO(2) and O(3) passive samplers, assuming that current air pollution exposure is sufficiently representative of long-term, previous exposure to make a plausible link with current health status. The analysis based on exposures estimated on the basis of residential and work addresses showed that the most exposed to PM(10) postal workers have rhinitis at a higher rate (OR=1.67, 95% CI: 1.01-2.75). In mail carriers there is indication that those exposed to higher concentrations of Omicron(3) or PM(10) have a greater possibility to present rhinitis (OR=1.63, 95% CI: 0.93-2.88 and OR=1.70, 95% CI: 0.96-3.03, respectively). The effect of O(3) on rhinitis became even more apparent in the analysis based on exposures assessed by personal measurements (OR=6.74, 95% CI: 1.24-36.55). Exposure to NO(2) was significantly associated with decrements in lung function. For office employees the exposure to air pollutants was not associated to any adverse respiratory outcome. Our findings suggest that air pollution is a contributing factor for the occurrence of rhinitis and lung function impairment in mail carriers.

Health complaints among subjects involved in oil cleanup operations during oil spillage from a Greek tanker "Tasman Spirit"

BACKGROUND

Oil spillage in the sea water is a disaster for marine life and humans in the vicinity. The study aimed at investigating health complaints among subjects involved in oil cleanup operations during a spillage from a Greek oil tanker "Tasman Spirit".

SUBJECTS AND METHODS

The project was conducted under the supervision of the Department of Physiology, College of Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia. The study concerned the respiratory and general health complaints in 50 apparently healthy, non-smoking male workers exposed to crude oil during oil cleanup operations. The exposed group was matched with a similar number of male, non-smoking controls. The health complaints were evaluated based on a comprehensive interview.

RESULTS

The subjects involved in oil cleanup operations had significantly higher rates of health complaints including cough (38%), runny nose (36%), eye irritation/redness (32%), sore throat (28%), headache (28%), nausea (24%) and general illness (18%), compared to their matched controls.

CONCLUSION

Air pollution due to crude oil spillage into sea water may cause respiratory and general health complaints in workers involved in oil cleanup operations.

Annual changes in forced expiratory flows in toll collectors: results from a four years observation

Diesel exhaust (DE) has been accused for various health outcomes including exacerbation of asthma, chronic bronchitis. Exposure to DE has long-term effects on lung development in children and reductions in lung function have been reported. The aim of the study was to evaluate the annual changes in forced expiratory flows among toll collectors in Duzce city from 2002 to 2005. Annual FVC, FEV(1) and MMF changes in smoker and nonsmoker 58 toll collectors and 37 controls selected among men who worked in the same company as officer have been followed up. No significant changes were seen in expiratory flows among smoker-nonsmoker toll collectors and controls (p>0.05). Annual FVC, FEV(1) and MMF changes were not significantly different between smoker and nonsmoker toll collectors. Twelve toll collectors (20.7%) in the study group and 4 (10.8%) controls were found to have FEV(1) and FVC below longitudinal lower limit of normal. The difference between groups did not reach statistically significance (p>0.05). Toll collectors (18/58) and controls (15/37) with spirometric measurements for three times showed no difference according to the rate of annual difference in either FEV(1) (-21.3+/-133.1 ml/yr vs -44.3+/-166.6 (ml/yr) or FVC (13.2+/-202.9 ml/yr vs. -16.1+/-204.2 ml/yr). Further investigations including large groups with long term follow up are needed to observe annual FVC, FEV(1) and MMF changes among toll collectors.

Association between traffic-related black carbon exposure and lung function among urban women

BACKGROUND

Although a number of studies have documented the relationship between lung function and traffic-related pollution among children, few have focused on adult lung function or examined community-based populations.

OBJECTIVE

We examined the relationship between black carbon (BC), a surrogate of traffic-related particles, and lung function among women in the Maternal-Infant Smoking Study of East Boston, an urban cohort in Boston, Massachusetts.

METHODS

We estimated local BC levels using a validated spatiotemporal land-use regression model, derived using ambient and indoor monitor data. We examined associations between percent predicted pulmonary function and predicted BC using linear regression, adjusting for sociodemographics (individual and neighborhood levels), smoking status, occupational exposure, type of cooking fuel, and a diagnosis of asthma or chronic bronchitis.

RESULTS

The sample of 272 women 18-42 years of age included 57% who self-identified as Hispanic versus 43% white, and 18% who were current smokers. Mean +/- SD predicted annual BC exposure level was 0.62 +/- 0.2 microg/m3. In adjusted analysis, BC (per interquartile range increase) was associated with a 1.1% decrease [95% confidence interval (CI), -2.5% to 0.3%] in forced expiratory volume in 1 sec, a 0.6% decrease (95% CI, -1.9% to 0.6%) in forced vital capacity, and a 3.0% decrease (95% CI, -5.8% to -0.2%) in forced mid-expiratory flow rate. We noted differential effects by smoking status in that former smokers were most affected by BC exposure, whereas current smokers were not affected.

CONCLUSION

In this cohort, exposure to traffic-related BC, a component of particulate matter, independently predicted decreased lung function in urban women, when adjusting for tobacco smoke, asthma diagnosis, and socioeconomic status.

A cross-sectional study of respiratory and irritant health symptoms in photocopier workers in Taiwan

Photocopy workers are potentially exposed to high concentrations of a variety of pollutants emitted from photocopiers. The purpose of this study was to assess whether or not there is an excess of adverse health outcomes amongst photocopy employees. A cross-sectional health survey was undertaken to investigate the prevalence of chronic respiratory symptoms and acute irritative symptoms among 74 photocopy workers (exposure group) and 69 employees working in a optical store (control group) near three universities in Kaohsiung, Taiwan. Our study showed that occupational exposure to pollutants emitted from photocopiers was not significantly associated with an excess of chronic respiratory symptoms and acute irritative symptoms in photocopy employees. This study results suggest that the current exposure levels in photocopy centers may be sufficiently safe in well-controlled work environments, especially if the photocopier is handled carefully.

Traffic exposure and lung function in adults: the Atherosclerosis Risk in Communities study

BACKGROUND

Traffic exposure is a major contributor to ambient air pollution for people living close to busy roads. The relationship between traffic exposure and lung function remains inconclusive in adults.

METHODS

A cross-sectional study was conducted to investigate the association between traffic exposure and lung function in the Atherosclerosis Risk in Communities (ARIC) study, a community based cohort of 15 792 middle aged men and women. Traffic density and distance to major roads were used as measures of traffic exposure.

RESULTS

After controlling for potential confounders including demographic factors, personal and neighbourhood level socioeconomic characteristics, cigarette smoking and background air pollution, higher traffic density was significantly associated with lower forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) in women. Relative to the lowest quartile of traffic density, the adjusted differences across increasing quartiles were 5.1, -15.4 and -21.5 ml for FEV1 (p value of linear trend across the quartiles = 0.041) and 1.2, -23.4 and -34.8 ml for FVC (p trend = 0.010). Using distance from major roads as a simpler index of traffic related air pollution exposure, the FEV1 was -15.7 ml (95% CI -34.4 to 2.9) lower and the FVC was -24.2 ml (95% CI -46.2 to -2.3) lower for women living within 150 m compared with subjects living further away. There was no significant effect of traffic density or distance to major roads on lung function in men. The FEV1/FVC ratio was not significantly associated with traffic exposure in either men or women.

CONCLUSIONS

This is the largest published study of traffic exposure and pulmonary function in adults to date. These results add to growing evidence that chronic exposure to traffic related air pollution may adversely affect respiratory health.

Living near main streets and respiratory symptoms in adults: the Swiss Cohort Study on Air Pollution and Lung Diseases in Adults

The Swiss Cohort Study on Air Pollution and Lung Diseases in Adults (SAPALDIA), conducted in 1991 (SAPALDIA 1) in eight areas among 9,651 randomly selected adults aged 18-60 years, reported associations among the prevalence of respiratory symptoms, nitrogen dioxide, and particles with an aerodynamic diameter of less than 10 microg/m3. Later, 8,047 subjects reenrolled in 2002 (SAPALDIA 2). The effects of individually assigned traffic exposures on reported respiratory symptoms were estimated, while controlling for socioeconomic and exposure- and health-related factors. The risk of attacks of breathlessness increased for all subjects by 13% (95% confidence interval: 3, 24) per 500-m increment in the length of main street segments within 200 m of the home and decreased in never smokers by 12% (95% confidence interval: 0, 22) per 100-m increment in distance from home to a main street. Living within 20 m of a main street increased the risks of regular phlegm by 15% (95% confidence interval: 0, 31) and wheezing with breathing problems by 34% (95% confidence interval: 0, 79) in never smokers. In 2002, the effects related to road distance were different from those in 1991, which could be due to changes in the traffic pollution mixture. These findings among a general population provide strong confirmation that living near busy streets leads to adverse respiratory health effects.

Long term effects of exposure to automobile exhaust on the pulmonary function of female adults in Tokyo, Japan

AIMS

To investigate the chronic effects of air pollution caused mainly by automobiles in healthy adult females.

METHODS

Respiratory symptoms were investigated in 5682 adult females who had lived in the Tokyo metropolitan area for three years or more in 1987; 733 of them were subjected to pulmonary function tests over eight years from 1987 to 1994. The subjects were divided into three groups by the level of air pollution they were exposed to during the study period. The concentrations of nitrogen dioxide and suspended particulate matter were the highest in group 1, and the lowest in group 3.

RESULTS

The prevalence rates of respiratory symptoms in group 1 were higher than those in groups 2 and 3, except for wheezing. Multiple logistic regression analysis showed significant differences in persistent phlegm and breathlessness. The subjects selected for the analysis of pulmonary function were 94, 210, and 102 females in groups 1, 2, and 3, respectively. The annual mean change of FEV(1) in group 1 was the largest (-0.020 l/y), followed by that in group 2 (-0.015 l/y), and that in group 3 (-0.009 l/y). Testing for trends showed a significant larger decrease of FEV(1) with the increase in the level of air pollution.

CONCLUSIONS

The subjects living in areas with high levels of air pollution showed higher prevalence rates of respiratory symptoms and a larger decrease of FEV(1) compared with those living in areas with low levels of air pollution. Since the traffic density is larger in areas with high air pollution, the differences among the groups may reflect the effect of air pollution attributable to particulate matter found in automobile exhaust.

Effects on respiratory health of a reduction in air pollution from vehicle exhaust emissions

AIMS

To determine whether residents of congested streets have a higher prevalence of respiratory symptoms than residents of nearby uncongested streets, and whether their respiratory health improves following a reduction in exposure to traffic related air pollutants.

METHODS

An area was identified where certain streets were subject to air pollution from heavy road traffic, which was likely to improve following the construction of a by-pass. A respiratory survey was conducted among the residents, together with the residents of nearby uncongested streets, at baseline and again a year after the by-pass opened. Measurements were made of air pollutant concentrations in both areas on both occasions.

RESULTS

Initial concentrations of PM10 and PM2.5 were substantially higher in the congested than in the uncongested streets. When the by-pass opened, the volume of heavy goods traffic fell by nearly 50%. PM10 decreased by 23% (8.0 microg/m3) in the congested streets and by 29% (3.4 microg/m3) in the uncongested streets, with similar proportionate falls in PM2.5. There were no clear or consistent differences between the residents of the two areas initially in terms of symptoms or peak flow variability. Repeat questionnaires were obtained from 165 and 283 subjects in the congested and uncongested areas respectively, and showed a tendency for most symptoms to improve in both areas. For chest symptoms, the improvement tended to be greater in the uncongested area, although the difference between the areas was not statistically significant. Rhinitis and rhinoconjunctivitis tended to improve to a greater extent in the congested streets; the difference between the areas was significant for the degree to which rhinitis interfered with daily activities. Peak flow variability tended to improve in the uncongested area.

CONCLUSIONS

The by-pass reduced pollutant levels to a degree that probably alleviates rhinitis and rhinoconjunctivitis but has little effect on lower respiratory symptoms.

Residence near a major road and respiratory symptoms in U.S. Veterans

BACKGROUND

There is evidence that exposure to motor vehicle exhaust is associated with respiratory disease. Studies in children have observed associations with wheeze, hospital admissions for asthma, and decrements in pulmonary function. However, a relationship of adult respiratory disease with exposure to vehicular traffic has not been established.

METHODS

We studied a sample of U.S. male veterans drawn from the general population of southeastern Massachusetts. Information on respiratory symptoms and potential risk factors was collected by questionnaire. We assessed distance from residential addresses to major roadways using geographic information system methodology.

RESULTS

Adjusting for cigarette smoking, age, and occupational exposure to dust, men living within 50 m of a major roadway were more likely to report persistent wheeze (odds ratio [OR] = 1.3; 95% confidence interval [CI] = 1.0-1.7) compared with those living more than 400 m away. The risk was observed only for those living within 50 m of heavily trafficked roads (>/=10,000 vehicles/24 h): OR = 1.7; CI = 1.2-2.4). The risk of patients experiencing chronic phlegm while living on heavily trafficked roads also increased (OR = 1.4; CI = 1.0-2.0), although there was little evidence for an association with chronic cough. This association was not dependent on preexisting doctor-diagnosed chronic respiratory or heart disease.

CONCLUSIONS

Exposure to vehicular emissions by living near busy roadways might contribute to symptoms of chronic respiratory disease in adults.

Evidence for Increased Risks of Preterm Delivery in a Population Residing near a Freeway in Taiwan

Traffic emissions are a major source of air pollution in urban areas. The results of recent studies have suggested that air pollution may be related to adverse pregnancy outcomes such as low birth weight and preterm delivery. The authors investigated the association between traffic-related air pollution and preterm deliveries. The study group included all first-parity singleton live births that occurred during 1992-1997 to women who lived in a zone along the Zhong-Shan Freeway in Taiwan (N = 6,251). The zone was defined as areas 1,500-m wide on either side of the freeway; it was located in the San-Ming, Nan-Tzu, Chienchen, and Linya wards-all of which are residential areas in East Kaohsiung. The prevalence of deliveries of preterm birth infants was significantly higher among mothers who lived within 500 m of the freeway than among mothers who resided 500-1,500 m from the freeway. In their analysis, the authors controlled for several confounders (e.g., maternal age, season, marital status, maternal education, infant gender). The adjusted odds ratio was 1.30 (95% confidence interval = 1.03, 1.65) for delivery of preterm infants born to mothers who lived within 500 m of the freeway. Such data provide additional support for the hypothesis that air pollution can affect the outcome of pregnancy.

Assessment of exposure to traffic pollution using the ExTra index: study of validation

The ExTra index, produced by the French Scientific Center for Building Physics, evaluates ambient concentrations of transport-related pollutants in front of the work and living places of urban dwellers. This study contributes to the validation of the ExTra index by carrying out measurements in four French cities. It compares nitrogen oxide concentrations (NOx) measured over 6 weeks with passive samplers, and NOx calculated concentrations using the ExTra index. The study takes into account traffic density, topographical parameters (building height, road, and pavement width), weather conditions (wind direction and strength), and background pollution levels. The model was tested at 100 street canyons sites. There were highly significant correlations (0.90 in Grenoble, 0.95 in Nice, 0.89 in Paris, and 0.89 in Toulouse) and good intraclass correlation coefficients (0.75 in Grenoble, 0.91 in Nice, 0.89 in Paris, and 0.86 in Toulouse) between the two series of values. These results suggest that if the ExTra index were to be applied to all the different residences and workplaces of a subject throughout his (her) life, it could be a useful epidemiological tool for studying the long-term health effects of transport-related emissions and for reconstructing individual exposure to such pollution in order to avoid misclassification.

Adverse respiratory and irritant health effects in airport workers in Taiwan

Airport workers are potentially exposed to aviation fuel or jet stream exhaust. The purpose of this study was to assess if there was an excess of adverse health outcomes among airport workers. Self-reported adverse chronic respiratory symptoms and acute irritative symptoms were assessed in a cross-sectional study among 106 airport workers (exposure group) and 305 terminal or office workers (control group) at the Kaohsiung International Airport (KIA), Taiwan. The prevalence rates for acute irritative symptoms were not significantly different between groups. A possible explanation may be that the concentration of volatile organic compounds (VOCs) that airport workers are exposed to is not sufficient to induce acute irritative symptoms, although this is not known for certain since data on the concentration of VOCs are lacking in this study. Chronic respiratory symptoms (cough and dyspnea), however, were significantly more common among the exposed group.

Exposure to cold and draught, alcohol consumption, and the NS-phenotype are associated with chronic bronchitis: an epidemiological investigation of 3387 men aged 53-75 years: the Copenhagen Male Study

OBJECTIVES

This study was performed to estimate the strength of association between chronic bronchitis and lifetime exposure to occupational factors, current lifestyle, and the NS-phenotype in the MNS blood group among middle aged and elderly men.

METHODS

The study was carried out within the frameworks of the Copenhagen Male Study. Of 3387 men 3331 men with a mean age of 63 (range 53-75) years could be classified by prevalence of chronic bronchitis. As well as the completion of a large questionnaire on health, lifestyle, and working conditions, all participants had a thorough examination, including measurements of height and weight and blood pressure and a venous blood sample was taken for the measurement of serum cotinine and MNS typing; 16.5% of the men had the NS-phenotype. Chronic bronchitis was defined as cough and phlegm lasting 3 months or more for at least 2 years; 14.6% had chronic bronchitis.

RESULTS

Smoking and smoke inhalation were the factors most strongly associated with prevalence of chronic bronchitis. There were three major new findings: (a) long term (>5 years) occupational exposure to cold and draught was associated with a significantly increased prevalence of chronic bronchitis; compared with others, and adjusted for confounders, the odds ratio (OR) with 95% confidence interval (95% CI) was 1.4 (1.1 to 1.7), p=0.004; (b) a significant J shaped association existed between alcohol use and bronchitis, p<0.001, with the lowest prevalence found among moderate users; (c) a significant gene by environment association existed between smoking and the NS-phenotype in the MNS blood group; only among smokers was the NS-phenotype associated with a significantly decreased risk of chronic bronchitis, OR 0.67 (0.47-0.97), p=0.02. Other well known associations between dust, fumes, and even exposure to solvents and bronchitis were confirmed.

CONCLUSION

The results emphasise the multifactorial nature of chronic bronchitis, and show some hitherto unrecognised associations between cold and draught exposure, alcohol consumption, and the NS-phenotype and chronic bronchitis.

Adverse health effects among household waste collectors in Taiwan

Household waste collectors (HWCs) are potentially exposed to a variety of bioaerosols and toxic materials. Collection of household waste is also a job which requires repeated heavy physical activity such as lifting, carrying, pulling, and pushing. The object of this study was to assess whether there is an excess of adverse health outcomes among HWCs. The subjects were all current employees of the Household Waste Collection Department in the County of Kaohsiung, Taiwan. The survey questionnaire was completed by 533 HWCs and 320 office workers. Our data indicate that household waste collection presents a risk for the development of chronic respiratory symptoms (cough, phlegm, wheezing, and chronic bronchitis), musculoskeletal symptoms (low back pain and elbow/wrist pain), and injuries caused by sharp objects.

Urban CO exposure and its health effects on traffic policemen in Ankara

Carbon monoxide (CO) is an important component of air pollution caused by traffic exhaust fumes. CO can cause chronic poisoning which shows its first symptoms as headaches, blurry vision, difficulty in concentration, and confusion. With the increasing number of vehicles in metropolitan areas of Turkey, the CO level has also increased in the city air as is the case in the capital city of Ankara, especially at certain locations. As far as the effects of CO on humans are concerned, traffic policemen are the population group under risk due to their inhalation of CO-rich air while on duty at the crowded cross-sections of the city. The traffic policemen on duty at these cross-sections are exposed to these high levels of CO for at least 6 h. This study was performed to investigate the traffic policemen (traffic organizers) who are exposed to high concentrations of CO at crowded cross-sections of Ankara City and to find out if chronic CO intoxication exits among this risk group. The CO levels in the ambient air at these cross-sections have also been compared to, and correlated with measurements of CO in the expired air of the target population. Additional factors like smoking, general health status, type of heating systems used at home, etc., have been taken into consideration by evaluating special questionnaires filled out by the policemen. A control group of clerk policemen, who were not engaged in street traffic activities was formed for comparative purposes.

Mechanisms of cell death induced by nitric oxide and peroxynitrite in Calu-1 cells

S-nitrosoglutathione (GSNO) is an important physiological redox form of nitric oxide (NO) and serves as an NO-releasing compound. 3-Morpholinosydnonimine hydrochloride (SIN-1) produces NO and superoxide anion (O(2)(·-)) which results in the formation of peroxynitrite (ONOO(-)). We investigate the cytotoxicity, cell death mechanisms and gene expression of NO and ONOO(-) in human lung epithelial cells show NO induced apoptosis and DNA genomic fragmentation. Whereas, ONOO(-) induced cell death more characteristic of necrosis than apoptosis. The concentrations of GSNO and SIN-1 required to cause death in 50% of cells were greater than 1 mM. Several gene products are important in controling the apoptotic and necrotic processes. Of these, bcl-2, bax and hsp 70 were studied. The level of expression of bcl-2 was dramatically decreased in cells treated with SIN-1 or GSNO, while the expression level of bax, the heterodimer of bcl-2, did not significant change. In addition, a roughly two-fold increase of hsp 70 was found in cells treated with SIN-1. There were no significant changes in hsp 70 levels in cells treated with GSNO.

Correlation between the amounts of polycyclic aromatic hydrocarbons and mutagenicity of airborne particulate samples from Taichung City, Taiwan

Taichung is the largest city in the central part of Taiwan, and its air pollution problems are similar to those in other large cities around the world. To evaluate the potential of the air pollution and identify major pollutant sources in this city, 181 airborne particulate samples were collected biweekly from seven locations around Taichung over an entire year. The mutagenicity of acetone extracts of the air samples was evaluated using the Salmonella/microsomal test with Salmonella typhimurium TA98 in the presence and absence of S9 mixtures. The air samples from September 1994 showed the highest direct and indirect mutagenicity among the 12 months, whereas those from October and June had the lowest direct and indirect mutagenicity, respectively. To elucidate the correlation between mutagenicity and polycyclic aromatic hydrocarbons (PAHs), high-performance liquid chromatography was used to determine the amount of each of 10 PAHs in the air samples. Among the 10 PAHs, the monthly average amount of B[g,h,i]P in the samples was the highest, followed by B[a]FA, B[a]P, and B[k]FA. Linear regression analysis showed a positive correlation between monthly average total amounts of PAHs and indirect mutagenicity. The monthly average amount of B[g,h,i]P was correlated more with indirect mutagenicity than with other PAHs. B[g,h,i]P is an indicator PAH emitted from both diesel and gasoline engine exhaust. Thus, we suggest that mobile air pollutant sources in Taichung City may be more significant than stationary ones. Moreover, B[g,h,i]P seems to act as a mutagenicity indicator compound in air samples from Taichung City.

Increased risk of lung cancer among different types of professional drivers in Denmark

OBJECTIVES

To study risk of lung cancer among groups of professional drivers probably exposed to different levels of traffic exhaust fumes.

METHODS

A nationwide case-control study (1970-89) based on employees comprising 28,744 men with primary lung cancer and incidence density sampled matched controls (1:1). Employment histories were reconstructed back to 1964 for each study subject from the records of a nationwide pension scheme with compulsory membership. Socioeconomic status was derived from the individual job title taken from the national population registry. Information on tobacco smoking habits was available from historical surveys. Relative risks were estimated by odds ratios (ORs) based on conditional logistic regression analyses.

RESULTS

In total 2251 of the male lung cancer cases had been employed as bus, lorry, taxi, or unspecified drivers. No significant difference in tobacco smoking habits was found among professional male Danish drivers and the total employed population. The OR for lung cancer adjusted for socioeconomic status was 1.6 (95% confidence interval (95% CI) 1.2 to 2.2) among taxi drivers, who were considered to be exposed to the highest concentrations of vehicle exhaust fumes, and 1.3 (1.2 to 1.5) for bus and lorry drivers. The OR was 1.4 (1.3 to 1.5) for unspecified drivers. The adjusted risk of lung cancer increased significantly with increasing duration of employment as a driver, and the risk was highest for long term taxi drivers with 10 years of lag time (OR 3.0; 1.2 to 6.8).

CONCLUSION

Occupational factors, probably exposure to vehicle exhaust, seems to play an important part in the development of lung cancer among drivers.

Serum immunoglobulin E and hyaluronate levels in children living along major roads

To assess the effects of automobile exhaust on human health, we determined serum concentrations of total immunoglobulin E and hyaluronate in 185 schoolchildren who lived in a district that contained major roads. Serum immunoglobulin E levels were elevated in children who had asthma or wheezing, but levels did not differ with respect to distance of their homes from the major roads. Serum hyaluronate levels were higher in children who lived less than 50 m from the roadside, compared with children who resided a greater distance from roads. The difference, however, was significant only in a subgroup of children in whom immunoglobulin E levels exceeded 250 IU/ml. Our results suggest that serum hyaluronate levels in children reflect the effects of traffic-related air pollution. Children with high immunoglobulin E levels appeared to be particularly susceptible to the effects of automobile exhaust.