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Kleinbeck S, Wolkoff P. 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. Arch Toxicol 2024; 98:617-662. [PMID: 38243103 PMCID: PMC10861400 DOI: 10.1007/s00204-023-03642-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 11/16/2023] [Indexed: 01/21/2024]
Abstract
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.
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Affiliation(s)
- Stefan Kleinbeck
- Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany.
| | - Peder Wolkoff
- National Research Centre for the Working Environment, Copenhagen, Denmark
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Hadrup N, Frederiksen M, Wedebye EB, Nikolov NG, Carøe TK, Sørli JB, Frydendall KB, Liguori B, Sejbaek CS, Wolkoff P, Flachs EM, Schlünssen V, Meyer HW, Clausen PA, Hougaard KS. Asthma-inducing potential of 28 substances in spray cleaning products-Assessed by quantitative structure activity relationship (QSAR) testing and literature review. J Appl Toxicol 2021; 42:130-153. [PMID: 34247391 PMCID: PMC9291953 DOI: 10.1002/jat.4215] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 06/17/2021] [Indexed: 12/27/2022]
Abstract
Exposure to spray cleaning products constitutes a potential risk for asthma induction. We set out to review whether substances in such products are potential inducers of asthma. We identified 101 spray cleaning products for professional use. Twenty‐eight of their chemical substances were selected. We based the selection on (a) positive prediction for respiratory sensitisation in humans based on quantitative structure activity relationship (QSAR) in the Danish (Q)SAR Database, (b) positive QSAR prediction for severe skin irritation in rabbits and (c) knowledge on the substances' physico‐chemical characteristics and toxicity. Combining the findings in the literature and QSAR predictions, we could group substances into four classes: (1) some indication in humans for asthma induction: chloramine, benzalkonium chloride; (2) some indication in animals for asthma induction: ethylenediaminetetraacetic acid (EDTA), citric acid; (3) equivocal data: hypochlorite; (4) few or lacking data: nitriloacetic acid, monoethanolamine, 2‐(2‐aminoethoxy)ethanol, 2‐diethylaminoethanol, alkyldimethylamin oxide, 1‐aminopropan‐2‐ol, methylisothiazolinone, benzisothiazolinone and chlormethylisothiazolinone; three specific sulphonates and sulfamic acid, salicylic acid and its analogue sodium benzoate, propane‐1,2‐diol, glycerol, propylidynetrimethanol, lactic acid, disodium malate, morpholine, bronopol and benzyl alcohol. In conclusion, we identified an asthma induction potential for some of the substances. In addition, we identified major knowledge gaps for most substances. Thus, more data are needed to feed into a strategy of safe‐by‐design, where substances with potential for induction of asthma are avoided in future (spray) cleaning products. Moreover, we suggest that QSAR predictions can serve to prioritise substances that need further testing in various areas of toxicology. We reviewed whether substances in spray cleaning products constitute a potential risk for asthma induction. For this, we identified 101 spray cleaning products for professional use and prioritised their ingredient substances by use of quantitative structure activity relationship (QSAR). We provide a review of 28 selected substances: we give conclusions on their asthma induction potential, as well as a discussion on the use of QSAR for prioritisation of substances, and the major knowledge gaps we encountered.
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Affiliation(s)
- Niels Hadrup
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Marie Frederiksen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Eva B Wedebye
- DTU QSAR Team, Division for Diet, Disease Prevention and Toxicology, Group for Chemical Risk Assessment and GMO, National Food Institute, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Nikolai G Nikolov
- DTU QSAR Team, Division for Diet, Disease Prevention and Toxicology, Group for Chemical Risk Assessment and GMO, National Food Institute, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Tanja K Carøe
- Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Jorid B Sørli
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Karen B Frydendall
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | | | - Camilla S Sejbaek
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Peder Wolkoff
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Esben M Flachs
- Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Vivi Schlünssen
- National Research Centre for the Working Environment, Copenhagen, Denmark.,Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Harald W Meyer
- Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Per A Clausen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Karin S Hougaard
- National Research Centre for the Working Environment, Copenhagen, Denmark.,Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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3
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Johanson G. Are asthmatics more sensitive to irritants? Int J Hyg Environ Health 2020; 226:113488. [PMID: 32088597 DOI: 10.1016/j.ijheh.2020.113488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 01/20/2020] [Accepted: 02/10/2020] [Indexed: 11/16/2022]
Abstract
Asthma is a heterogeneous inflammatory disease characterized by increased airway hyper-responsiveness to external stimuli such as irritants. One may speculate that asthmatics are more sensitive to irritants in the air than healthy subjects, i.e. react at lower concentrations. We reviewed the scientific support for this speculation and investigated to what extent asthma is considered when setting exposure limits and guidance values. We found that the experimental studies comparing healthy and asthmatic subjects are often inconclusive. Still, the available studies are underused, by expert committees and industry alike. Data for a few irritants suggest that asthmatics are up to three-fold more sensitive than the healthy. The most abundant data were found for sulfur dioxide. Here, a benchmark concentration analysis suggests a nine-fold difference in sensitivity. Based on these data a default assessment factor of 10 is suggested when setting exposure limits and guidance values for irritants.
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Affiliation(s)
- Gunnar Johanson
- Integrative Toxicology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
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Shim J, Lee H, Park D, Won Lee J, Bae B, Chang Y, Kim J, Kim HY, Kang H. Aggravation of asthmatic inflammation by chlorine exposure via innate lymphoid cells and CD11c intermediate macrophages. Allergy 2020; 75:381-391. [PMID: 31402462 DOI: 10.1111/all.14017] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 06/11/2019] [Accepted: 07/01/2019] [Indexed: 02/03/2023]
Abstract
BACKGROUND Chlorine is widely used in daily life as disinfectant. However, chronic exposure to chlorine products aggravates allergic TH 2 inflammation and airway hyperresponsiveness (AHR). Innate lymphoid cells (ILCs) in airways contribute to the inception of asthma in association with virus infection, pollution, and excess of nutrient, but it is not known whether chronic chlorine exposure can activate innate immune cells. The aim of this study was to evaluate the impact of chlorine inhalation on the innate immunity such as ILCs and macrophages in relation with the development of asthma by using murine ovalbumin (OVA) sensitization/challenge model. METHODS Six-week-old female BALB/c mice were sensitized and challenged with OVA in the presence and absence of chronic low-dose chlorine exposure by inhalation of naturally vaporized gas of 5% sodium hypochlorite solution. AHR, airway inflammatory cells, from BALF and the population of ILCs and macrophages in the lung were evaluated. RESULTS The mice exposed to chlorine with OVA (Cl + OVA group) showed enhanced AHR and eosinophilic inflammation compared to OVA-treated mice (OVA group). The population of TH 2 cells, ILC2s, and ILC3s increased in Cl + OVA group compared with OVA group. CD11cint macrophages also remarkably increased in Cl + OVA group compared with OVA group. The deletion of macrophages by clodronate resulted in reduction of ILC2s and ILC3s population which was restored by adoptive transfer of CD11cint macrophages. CONCLUSIONS Chronic chlorine inhalation contributes to the exacerbation of airway inflammation in asthmatic airway by mobilizing pro-inflammatory macrophage into the lung as well as stimulating group 2 and 3 ILCs.
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Affiliation(s)
- Ji‐Su Shim
- Division of Allergy and Clinical Immunology, Department of Internal Medicine Seoul National University College of Medicine Seoul Korea
- Department of Internal Medicine Ewha Womans University College of Medicine Seoul Korea
| | - Hyun‐Seung Lee
- Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center Seoul National University College of Medicine Seoul Korea
| | - Da‐Eun Park
- Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center Seoul National University College of Medicine Seoul Korea
| | - Ji Won Lee
- Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center Seoul National University College of Medicine Seoul Korea
| | - Boram Bae
- Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center Seoul National University College of Medicine Seoul Korea
| | - Yuna Chang
- Laboratory of Mucosal Immunology in Department of Biomedical Sciences Seoul National University College of Medicine Seoul Korea
| | - Jihyun Kim
- Laboratory of Mucosal Immunology in Department of Biomedical Sciences Seoul National University College of Medicine Seoul Korea
| | - Hye Young Kim
- Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center Seoul National University College of Medicine Seoul Korea
- Laboratory of Mucosal Immunology in Department of Biomedical Sciences Seoul National University College of Medicine Seoul Korea
| | - Hye‐Ryun Kang
- Division of Allergy and Clinical Immunology, Department of Internal Medicine Seoul National University College of Medicine Seoul Korea
- Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center Seoul National University College of Medicine Seoul Korea
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Achanta S, Jordt SE. Toxic effects of chlorine gas and potential treatments: a literature review. Toxicol Mech Methods 2019; 31:244-256. [PMID: 31532270 DOI: 10.1080/15376516.2019.1669244] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Chlorine gas is one of the highly produced chemicals in the USA and around the world. Chlorine gas has several uses in water purification, sanitation, and industrial applications; however, it is a toxic inhalation hazard agent. Inhalation of chlorine gas, based on the concentration and duration of the exposure, causes a spectrum of symptoms, including but not limited to lacrimation, rhinorrhea, bronchospasm, cough, dyspnea, acute lung injury, death, and survivors develop signs of pulmonary fibrosis and reactive airway disease. Despite the use of chlorine gas as a chemical warfare agent since World War I and its known potential as an industrial hazard, there is no specific antidote. The resurgence of the use of chlorine gas as a chemical warfare agent in recent years has brought speculation of its use as weapons of mass destruction. Therefore, developing antidotes for chlorine gas-induced lung injuries remains the need of the hour. While some of the pre-clinical studies have made substantial progress in the understanding of chlorine gas-induced pulmonary pathophysiology and identifying potential medical countermeasure(s), yet none of the drug candidates are approved by the U.S. Food and Drug Administration (FDA). In this review, we summarized pathophysiology of chlorine gas-induced pulmonary injuries, pre-clinical animal models, development of a pipeline of potential medical countermeasures under FDA animal rule, and future directions for the development of antidotes for chlorine gas-induced lung injuries.
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Affiliation(s)
| | - Sven-Eric Jordt
- Department of Anesthesiology, Duke University School of Medicine, Durham, NC, USA.,Department of Pharmacology and Cancer Biology, Duke University School of Medicine, Durham, NC, USA
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Wolkoff P. The mystery of dry indoor air - An overview. ENVIRONMENT INTERNATIONAL 2018; 121:1058-1065. [PMID: 30389384 DOI: 10.1016/j.envint.2018.10.053] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 10/23/2018] [Accepted: 10/26/2018] [Indexed: 06/08/2023]
Abstract
"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.
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Affiliation(s)
- Peder Wolkoff
- National Research Centre for the Working Environment, Lersø Parkallé 105, DK-2100 Copenhagen, Denmark.
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