Adverse respiratory and irritant health effects in airport workers in Taiwan

Beyond the Runway: Respiratory health effects of ultrafine particles from aviation in children

Aviation has been shown to cause high particle number concentrations (PNC) in areas surrounding major airports. Particle size distribution and composition differ from motorized traffic. The objective was to study short-term effects of aviation-related UFP on respiratory health in children. In 2017-2018 a study was conducted in a school panel of 7-11 year old children (n = 161) living North and South of Schiphol Airport. Weekly supervised spirometry and exhaled nitric oxide (eNO) measurements were executed. The school panel, and an additional group of asthmatic children (n = 19), performed daily spirometry tests at home and recorded respiratory symptoms. Hourly concentrations of various size fractions of PNC and black carbon (BC) were measured at three school yards. Concentrations of aviation-related particles were estimated at the residential addresses using a dispersion model. Linear and logistic mixed models were used to investigate associations between daily air pollutant concentrations and respiratory health. PNC20, a proxy for aviation-related UFP, was virtually uncorrelated with BC and PNC50-100 (reflecting primarily motorized traffic), supporting the feasibility of separating PNC from aviation and other combustion sources. No consistent associations were found between various pollutants and supervised spirometry and eNO. Major air pollutants were significantly associated with an increase in various respiratory symptoms. Odds Ratios for previous day PNC20 per 3,598pt/cm3 were 1.13 (95%CI 1.02; 1.24) for bronchodilator use and 1.14 (95%CI 1.03; 1.26) for wheeze. Modelled aviation-related UFP at the residential addresses was also positively associated with these symptoms, corroborating the PNC20 findings. PNC20 was not associated with daily lung function, but PNC50-100 and BC were negatively associated with FEV1. PNC of different sizes indicative of aviation and other combustion sources were independently associated with an increase of respiratory symptoms and bronchodilator use in children living near a major airport. No consistent associations between aviation-related UFP with lung function was observed.

A review of health effects associated with exposure to jet engine emissions in and around airports

BACKGROUND

Airport personnel are at risk of occupational exposure to jet engine emissions, which similarly to diesel exhaust emissions include volatile organic compounds and particulate matter consisting of an inorganic carbon core with associated polycyclic aromatic hydrocarbons, and metals. Diesel exhaust is classified as carcinogenic and the particulate fraction has in itself been linked to several adverse health effects including cancer.

METHOD

In this review, we summarize the available scientific literature covering human health effects of exposure to airport emissions, both in occupational settings and for residents living close to airports. We also report the findings from the limited scientific mechanistic studies of jet engine emissions in animal and cell models.

RESULTS

Jet engine emissions contain large amounts of nano-sized particles, which are particularly prone to reach the lower airways upon inhalation. Size of particles and emission levels depend on type of aircraft, engine conditions, and fuel type, as well as on operation modes. Exposure to jet engine emissions is reported to be associated with biomarkers of exposure as well as biomarkers of effect among airport personnel, especially in ground-support functions. Proximity to running jet engines or to the airport as such for residential areas is associated with increased exposure and with increased risk of disease, increased hospital admissions and self-reported lung symptoms.

CONCLUSION

We conclude that though the literature is scarce and with low consistency in methods and measured biomarkers, there is evidence that jet engine emissions have physicochemical properties similar to diesel exhaust particles, and that exposure to jet engine emissions is associated with similar adverse health effects as exposure to diesel exhaust particles and other traffic emissions.

Air pollution and airport apron workers: A neglected occupational setting in epidemiological research

INTRODUCTION

Airport apron workers are occupationally exposed to jet exhaust and major concern is related to the exposure to ultrafine particles (UFP) from aircrafts. To date, little attention has been given to occupational exposures to aircraft-related UFP, although aircraft engines have high emissions of ultrafine particles, which are orders of magnitude higher than residential exposure. UFP could possibly contribute to the development of cancer, heart disease, mental illness, and respiratory symptoms. In addition to particulate matter, apron workers are exposed to other polluting substances associated with vehicles, aircraft exhaust or direct fuel emissions.

METHODS

We performed a scoping review on occupational health hazards due to air pollution among apron workers.

RESULTS

Only three epidemiological studies were identified: two cross-sectional studies are of limited relevance due to a small sample size and a lack of quantitative exposure data. One sizeable cohort study performed an individual exposure measurement for UFP and considered relevant confounders. However, current studies are not numerous enough to evaluate an association of occupational air pollution with potential health effects among airport workers.

CONCLUSIONS

The results suggest that current scientific evidence on this topic is sparse. Further observational studies in this occupational work force is highly recommended. For a better understanding of adverse health effects due to air pollution and especially UFP, studies in different countries are essential, since working environments, medical monitoring of workers or safety standards might differ internationally.

Non-volatile particle emissions from aircraft turbine engines at ground-idle induce oxidative stress in bronchial cells

Aircraft emissions contribute to local and global air pollution. Health effects of particulate matter (PM) from aircraft engines are largely unknown, since controlled cell exposures at relevant conditions are challenging. We examined the toxicity of non-volatile PM (nvPM) emissions from a CFM56-7B26 turbofan, the world's most used aircraft turbine using an unprecedented exposure setup. We combined direct turbine-exhaust sampling under realistic engine operating conditions and the Nano-Aerosol Chamber for In vitro Toxicity to deposit particles onto air-liquid-interface cultures of human bronchial epithelial cells (BEAS-2B) at physiological conditions. We evaluated acute cellular responses after 1-h exposures to diluted exhaust from conventional or alternative fuel combustion. We show that single, short-term exposures to nvPM impair bronchial epithelial cells, and PM from conventional fuel at ground-idle conditions is the most hazardous. Electron microscopy of soot reveals varying reactivity matching the observed cellular responses. Stronger responses at lower mass concentrations suggest that additional metrics are necessary to evaluate health risks of this increasingly important emission source.

Copenhagen Airport Cohort: air pollution, manual baggage handling and health

PURPOSE

Copenhagen Airport Cohort 1990-2012 presents a unique data source for studies of health effects of occupational exposure to air pollution (ultrafine particles) and manual baggage handling among airport employees. We describe the extent of information in the cohort and in the follow-up based on data linkage to the comprehensive Danish nationwide health registers. In the cohort, all information is linked to the personal identification number that also is used in Denmark Statistics demographic and socioeconomic databases and in the nationwide health registers.

PARTICIPANTS

The cohort covers 69 175 men in unskilled positions. The exposed cohort includes men in unskilled jobs employed at Copenhagen Airport in the period 1990-2012 either as baggage handlers or in other outdoor work. The reference cohort includes men in unskilled jobs working in the greater Copenhagen area.

FINDINGS TO DATE

The cohort includes environmental Global Positioning System (GPS) measurements in Copenhagen Airport, information on job function/task for each calendar year of employment between 1990 and 2012, exposure to air pollution at residence, average weight of baggage lifted per day and lifestyle. By linkage to registers, we retrieved socioeconomic and demographic data and data on healthcare contacts, drug subscriptions, incident cancer and mortality.

FUTURE PLANS

The size of the cohort and the completeness of the register-based follow-up allow a more accurate assessment of the possible health risks of occupational exposure to ultrafine particles and manual baggage handling at airports than in previous studies. We plan to follow the cohort for the incidence of ischaemic heart diseases, cerebrovascular disease, lung and bladder cancer, asthma and chronic obstructive pulmonary disease, and further for associations between heavy manual baggage handling and musculoskeletal disorders.

TRIAL REGISTRATION

number 2012-41-0199.

Occupational exposure to ultrafine particles among airport employees--combining personal monitoring and global positioning system

Background

Exposure to ultrafine particles (UFP) has been linked to cardiovascular and lung diseases. Combustion of jet fuel and diesel powered handling equipment emit UFP resulting in potentially high exposure levels among employees working at airports. High levels of UFP have been reported at several airports, especially on the apron, but knowledge on individual exposure profiles among different occupational groups working at an airport is lacking.

Purpose

The aim of this study was to compare personal exposure to UFP among five different occupational groups working at Copenhagen Airport (CPH).

Method

30 employees from five different occupational groups (baggage handlers, catering drivers, cleaning staff and airside and landside security) at CPH were instructed to wear a personal monitor of particle number concentration in real time and a GPS device. The measurements were carried out on 8 days distributed over two weeks in October 2012. The overall differences between the groups were assessed using linear mixed model.

Results

Data showed significant differences in exposure levels among the groups when adjusted for variation within individuals and for effect of time and date (p<0.01). Baggage handlers were exposed to 7 times higher average concentrations (geometric mean, GM: 37×10³ UFP/cm³, 95% CI: 25–55×10³ UFP/cm³) than employees mainly working indoors (GM: 5×10³ UFP/cm³, 95% CI: 2–11×10³ UFP/cm³). Furthermore, catering drivers, cleaning staff and airside security were exposed to intermediate concentrations (GM: 12 to 20×10³ UFP/cm³).

Conclusion

The study demonstrates a strong gradient of exposure to UFP in ambient air across occupational groups of airport employees.

Occupational health and safety assessment of exposure to jet fuel combustion products in air medical transport

INTRODUCTION

Transport medicine personnel are potentially exposed to jet fuel combustion products. Setting-specific data are required to determine whether this poses a risk.

OBJECTIVE

This study assessed exposure to jet fuel combustion products, compared various engine ignition scenarios, and determined methods to minimize exposure.

METHODS

The Beechcraft King Air B200 turboprop aircraft equipped with twin turbine engines, using a kerosene-based jet fuel (Jet A-1), was used to measure products of combustion during boarding, engine startup, and flight in three separate engine start scenarios ("shielded": internal engine start, door closed; "exposed": ground power unit start, door open; and "minimized": ground power unit right engine start, door open). Real-time continuous monitoring equipment was used for oxygen, carbon dioxide, carbon monoxide, nitrogen dioxide, hydrogen sulfide, sulfur dioxide, volatile organic compounds, and particulate matter. Integrated methods were used for aldehydes, polycyclic aromatic hydrocarbons, volatile organic compounds, and aliphatic hydrocarbons. Samples were taken in the paramedic breathing zone for approximately 60 minutes, starting just before the paramedics boarded the aircraft. Data were compared against regulated time-weighted exposure thresholds to determine the presence of potentially harmful products of combustion.

RESULTS

Polycyclic aromatic hydrocarbons, aldehydes, volatile organic compounds, and aliphatic hydrocarbons were found at very low concentrations or beneath the limits of detection. There were significant differences in exposures to particulates, carbon monoxide, and total volatile organic compound between the "exposed" and "minimized" scenarios. Elevated concentrations of carbon monoxide and total volatile organic compounds were present during the ground power unit-assisted dual-engine start. There were no appreciable exposures during the "minimized" or "shielded" scenarios.

CONCLUSION

Air medical personnel exposures to jet fuel combustion products were generally low and did not exceed established U.S. or Canadian health and safety exposure limits. Avoidance of ground power unit-assisted dual-engine starts and closing the hangar door prior to start minimize or eliminate the occupational exposure.

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.

Occupational exposure in airport personnel: characterization and evaluation of genotoxic and oxidative effects

Airport personnel can be exposed to several polycyclic aromatic hydrocarbons (PAHs) from jet fuel vapours, jet fuel combustion products and diesel exhaust. The aim of this study was to characterize the exposure and to evaluate genotoxic and oxidative effects in airport personnel (n=41) in comparison with a selected control group (n=31). Environmental monitoring of exposure was carried out analysing 23 PAHs on air samples collected from airport apron, airport building and terminal/office area during 5 working days. The urinary 1-hydroxy-pyrene (1-OHP) following 5 working days, was used as biomarker of exposure. Genotoxic effects and early direct-oxidative DNA damage were evaluated by micronucleus (MN) and Fpg-modified comet assay on lymphocytes and exfoliated buccal cells, and by chromosomal aberrations (CA) and sister chromatid exchange (SCE) analyses. For comet assay, tail moment (the product of comet relative tail intensity and length) values from Fpg-enzyme treated cells (TMenz) and from untreated cells (TM) were used as parameters of oxidative and direct DNA damage, respectively. We found 27,703 microg/m(3) total PAHs in airport apron, 17,275 microg/m(3) in airport building and 9,494 microg/m(3) in terminal/office area. Urinary OH-pyrene did not show differences between exposed and controls. The exposed group showed a higher mean value of SCE frequency in respect to controls (4.6 versus 3.8) and an increase (1.3-fold) of total structural CA in particular breaks (up to 2.0-fold) and fragments (0.32% versus 0.00%), whereas there were no differences of MN frequency in both cellular types. Comet assay evidenced in the exposed group a higher value in respect to controls of mean TM and TMenz in both exfoliated buccal cells (TM 118.87 versus 68.20, p=0.001; TMenz 146.11 versus 78.32, p<0.001) and lymphocytes (TM 43.01 versus 36.01, p=0.136; TMenz 55.86 versus 43.98, p=0.003). An oxidative DNA damage was found, for exfoliated buccal cells in the 9.7% and for lymphocytes in the 14.6% of exposed in respect to the absence in controls. Our findings furnish a useful contribution to the characterization of civil airport exposure and suggest the use of comet assay on exfoliated buccal cells to assess the occupational exposure to mixtures of inhalable pollutants at low doses since these cells represent the target tissue for this exposure and are obtained by non-invasive procedure.

Adverse respiratory and irritant health effects in temple workers in Taiwan

Temple workers are potentially exposed to high concentrations of various pollutants emitted from incense burning. The purpose of this study was to assess whether or not there is an excess of adverse health outcomes among temple workers. A cross-sectional health survey was undertaken to investigate the prevalence of chronic respiratory symptoms and acute irritative symptoms among 109 temple workers (exposure group) and 118 church workers (control group) in Kaohsiung, Taiwan. Chronic cough symptoms were significantly more common among the exposed group. Our results also indicate that working in a temple increases the risk for the development of acute irritative symptoms, including nose and throat irritation.

Relationship between ambient air pollution and hospital admissions for cardiovascular diseases in kaohsiung, taiwan

This study was undertaken to determine whether there is an association between air pollutants levels and increased number of hospital admissions for cardiovascular diseases (CVD) in Kaohsiung, Taiwan. Hospital admissions records for CVD and ambient air contaminant data collected from monitoring station in Kaohsiung were obtained for the period 1997-2000. The relative risk of hospital admission for CVD was estimated using a case-crossover approach, controlling for weather variables, day of the week, seasonality, and long-term time trends. In the single-pollutant model, on warm days (> or =25 degrees C) statistically significant positive associations were found between levels of particular matter of < 10 microm aerodynamic diameter (PM10), nitrogen dioxide (NO2), carbon monoxide (CO), and ozone (O3). On cool days (< 25 degrees C), all pollutants except O3 were significantly associated with increased CVD admissions. For the two-pollutant model, CO and O3 were both significant in combination with each of the other four contaminants on warm days. PM10 and NO2 remained significantly associated with elevated CVD admissions on warm days. On cool days, CO and NO2 remained statistically significant in all the two-pollutant models. This study provides evidence that higher levels of ambient contaminants, particularly CO, increase the risk of increased hospital admissions for CVD.