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Yadav VK, Malik P, Tirth V, Khan SH, Yadav KK, Islam S, Choudhary N, Inwati GK, Arabi A, Kim DH, Jeon BH. Health and Environmental Risks of Incense Smoke: Mechanistic Insights and Cumulative Evidence. J Inflamm Res 2022; 15:2665-2693. [PMID: 35509323 PMCID: PMC9058426 DOI: 10.2147/jir.s347489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 02/17/2022] [Indexed: 11/23/2022] Open
Abstract
Incense burning is practiced alongside many sacred rituals across different regions of the world. Invariable constituents of incense brands are 21% (by weight) herbal and wood powder, 33% bamboo stick, 35% fragrance material, and 11% adhesive powder. Major incense-combustion outputs include particulate matter (PM), volatile organic content, and polyaromatic hydrocarbons. The relative toxicity of these products is an implicit function of particle size and incomplete combustion, which in turn vary for a specific incense brand. Lately, the attention given to the Air Quality Index by international regulatory bodies has created concern about mounting PM toxicity. The uncharacteristically small physical dimensions of these entities complicates their detection, and with no effect of gravity PM fractions rapidly contribute to oxidative stress, enhancing random biochemical reactions upon being inhaled. Incense burning generates four times the PM extent (45 mg•g−1) of cigarettes (~10 mg•g−1). Several poisonous gases, such as CO, CO2, NO2, and SO2, and the unavoidable challenge of disposing of the burnt incense ash further add to the toxicity. Taken together, these issues demonstrate that incense burning warrants prompt attention. The aim of this article is to highlight the toxicity of incense-combustion materials on the environment and human health. This discussion could be significant in framing future policy regarding ecofriendly incense manufacture and reduced usage.
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Affiliation(s)
- Virendra Kumar Yadav
- Department of Microbiology, School of Sciences, PP Savani University, Surat, Gujarat, 394125, India
| | - Parth Malik
- School of Chemical Sciences, Central University of Gujarat, Gandhinagar, 382030, Gujarat, India
| | - Vineet Tirth
- Mechanical Engineering Department, College of Engineering, King Khalid University, Abha, 61411, Asir, Kingdom of Saudi Arabia
- Research Center for Advanced Materials Science (RCAMS), King Khalid University, Abha, 61413, Asir, Kingdom of Saudi Arabia
| | | | - Krishna Kumar Yadav
- Faculty of Science and Technology, Madhyanchal Professional University, Bhopal, 462044, India
| | - Saiful Islam
- Civil Engineering Department, College of Engineering, King Khalid University, Abha, 61411, Asir, Kingdom of Saudi Arabia
| | - Nisha Choudhary
- Department of Environment Science, School of Sciences, PP Savani University, Kosamba, Surat, Gujarat, 394125, India
| | - Gajendra Kumar Inwati
- Department of Chemistry, DP Chaturvedi College, Rani Durgavati University, Seoni, Madhya Pradesh, 480661, India
| | - Amir Arabi
- Mechanical Engineering Department, College of Engineering, King Khalid University, Abha, 61411, Asir, Kingdom of Saudi Arabia
| | - Do-Hyeon Kim
- Department of Earth Resources and Environmental Engineering, Hanyang University, Seoul, 04763, South Korea
| | - Byong-Hun Jeon
- Department of Earth Resources and Environmental Engineering, Hanyang University, Seoul, 04763, South Korea
- Correspondence: Byong-Hun Jeon, Email
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Lee CW, Vo TTT, Wee Y, Chiang YC, Chi MC, Chen ML, Hsu LF, Fang ML, Lee KH, Guo SE, Cheng HC, Lee IT. The Adverse Impact of Incense Smoke on Human Health: From Mechanisms to Implications. J Inflamm Res 2021; 14:5451-5472. [PMID: 34712057 PMCID: PMC8548258 DOI: 10.2147/jir.s332771] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 10/12/2021] [Indexed: 12/12/2022] Open
Abstract
Incense burning is a very popular activity in daily life among many parts all over the world. A growing body of both epidemiological and experimental evidences has reported the negative effects of incense use on human well-being, posing a potential threat at public significance. This work is a comprehensive review that covers the latest findings regarding the adverse impact of incense smoke on our health, providing a panoramic visualization ranging from mechanisms to implications. The toxicities of incense smoke come directly from its harmful constituents and deposition capacity in the body. Besides, reactive oxygen species-driven oxidative stress and associated inflammation seem to be plausible underlying mechanisms, eliciting various unfavorable responses. Although our current knowledge remains many gaps, this issue still has some important implications.
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Affiliation(s)
- Chiang-Wen Lee
- Department of Nursing, Division of Basic Medical Sciences, Chronic Diseases and Health Promotion Research Center and Research Center for Chinese Herbal Medicine, Chang Gung University of Science and Technology, Puzi City, Chiayi County, Taiwan
- Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Puzi City, Chiayi County, Taiwan
- Department of Safety Health and Environmental Engineering, Ming Chi University of Technology, New Taipei City, Taiwan
- College of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Thi Thuy Tien Vo
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yinshen Wee
- Department of Pathology, University of Utah, Salt Lake City, UT, USA
| | - Yao-Chang Chiang
- Department of Nursing, Division of Basic Medical Sciences, Chronic Diseases and Health Promotion Research Center and Research Center for Chinese Herbal Medicine, Chang Gung University of Science and Technology, Puzi City, Chiayi County, Taiwan
- Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Puzi City, Chiayi County, Taiwan
| | - Miao-Ching Chi
- Chronic Disease and Health Promotion Research Center, Chang Gung University of Science and Technology, Puzi City, Chiayi County, Taiwan
- Division of Pulmonary and Critical Care Medicine, Chiayi Chang Gung Memorial Hospital, Puzi City, Chiayi County, Taiwan
- Department of Respiratory Care, Chang Gung University of Science and Technology, Puzi City, Chiayi County, Taiwan
| | - Min-Li Chen
- Department of Nursing, Chang Gung Memorial Hospital, Puzi City, Chiayi County, Taiwan
- Graduate Institute of Nursing, Chang Gung University of Science and Technology, Puzi City, Chiayi County, Taiwan
| | - Lee-Fen Hsu
- Department of Respiratory Care, Chang Gung University of Science and Technology, Puzi City, Chiayi County, Taiwan
- Division of Neurosurgery, Department of Surgery, Chang Gung Memorial Hospital, Puzi City, Chiayi County, Taiwan
| | - Mei-Ling Fang
- Center for Environmental Toxin and Emerging-Contaminant Research, Cheng Shiu University, Kaohsiung, Taiwan
- Super Micro Research and Technology Center, Cheng Shiu University, Kaohsiung, Taiwan
| | - Kuan-Han Lee
- Department of Pharmacy, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Su-Er Guo
- Graduate Institute of Nursing, Chang Gung University of Science and Technology, Puzi City, Chiayi County, Taiwan
| | - Hsin-Chung Cheng
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Dentistry, Taipei Medical University Hospital, Taipei, Taiwan
| | - I-Ta Lee
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
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Ravn NH, Halling AS, Berkowitz AG, Rinnov MR, Silverberg JI, Egeberg A, Thyssen JP. How does parental history of atopic disease predict the risk of atopic dermatitis in a child? A systematic review and meta-analysis. J Allergy Clin Immunol 2019; 145:1182-1193. [PMID: 31887393 DOI: 10.1016/j.jaci.2019.12.899] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 11/06/2019] [Accepted: 12/11/2019] [Indexed: 01/09/2023]
Abstract
BACKGROUND Parental history of atopic disease is a well-established risk factor for the development of atopic dermatitis (AD), but several aspects of this association remain unclear. OBJECTIVE We sought to determine the association of parental history of atopic disease with AD in offspring. METHODS We searched PubMed and EMBASE through June 2018 for relevant records and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Pooled odds ratios (ORs) with 95% CI were calculated using random-effects models. RESULTS A total of 163 records covering 149 unique studies were included. Of these, 119 studies were included in the meta-analysis. Individuals with parental history of atopic disease had increased odds of AD (OR, 1.81; 95% CI, 1.65-1.99). Parental asthma (OR, 1.56; 95% CI, 1.18-2.05) and allergic rhinitis (OR, 1.68; 95% CI, 1.34-2.11) had a smaller effect than AD (OR, 3.30; 95% CI, 2.46-4.42). The effect of maternal and paternal history was comparable for all atopic diseases. An increase in odds was observed when comparing the effect of having 1 (OR, 1.30; 95% CI, 1.15-1.47) or 2 atopic parents (OR, 2.08; 95% CI, 1.83-2.36), as well as having a parent with 1 (OR, 1.49; 95% CI, 1.28-1.74) or more atopic diseases (OR, 2.32; 95% CI, 1.92-2.81). CONCLUSIONS This study provides evidence-based risk estimates that may guide physicians who counsel parents with a history of atopic disease about their children's risk of AD. This information is of particular importance for future efforts toward establishing prophylactic interventions for AD on a general population level.
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Affiliation(s)
- Nina H Ravn
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - Anne-Sofie Halling
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | | | - Maria R Rinnov
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - Jonathan I Silverberg
- Departments of Dermatology, Preventive Medicine, and Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Ill
| | - Alexander Egeberg
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - Jacob P Thyssen
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark; National Allergy Research Centre, Herlev and Gentofte Hospital, Hellerup, Denmark.
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Washington DM, Curtis LM, Waite K, Wolf MS, Paasche-Orlow MK. Sociodemographic Factors Mediate Race and Ethnicity-associated Childhood Asthma Health Disparities: a Longitudinal Analysis. J Racial Ethn Health Disparities 2017; 5:928-938. [PMID: 29188553 DOI: 10.1007/s40615-017-0441-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 10/05/2017] [Accepted: 10/09/2017] [Indexed: 11/24/2022]
Abstract
BACKGROUND Race and ethnicity-based disparities in childhood asthma are well established. We characterized the longitudinal effects associated with being African-American/Black or Hispanic/Latino on a range of asthma outcomes, and the extent to which sociodemographic factors, caregiver health literacy, education level, and asthma knowledge mediate these associations. METHODS Children ages 8-15 and their caregivers (n = 544) in the Chicago Initiative to Raise Asthma Health Equity (CHIRAH) cohort completed interviews every 3 months for 1.5 years. Health literacy was measured with the Rapid Estimate of Adult Literacy in Medicine (REALM). Other covariates include sex, age, education level, income, smoke exposure, asthma duration, employment status, and insurance status. We conducted a series of models to evaluate these factors as mediators of the relationship between race/ethnicity and (1) asthma knowledge, (2) asthma-related quality of life, (3) asthma severity, and (4) asthma control based on NAEPP/EPR-3 2007 guidelines. RESULTS African-American race and Hispanic/Latino ethnicity were significantly associated with all outcomes when compared to Whites. Adjusting for sociodemographic factors resulted in the most significant mediation of racial/ethnic disparities in all outcomes. Health literacy was a partial mediator of race/ethnic disparities in asthma knowledge and asthma-related quality of life. Asthma knowledge remained significantly associated with race and ethnicity, and race remained associated with asthma-related quality of life. CONCLUSIONS African-American race and Hispanic/Latino ethnicity are significantly associated with worse asthma compared to Whites in longitudinal analyses. Sociodemographic factors are potent mediators of these disparities, and should be considered when designing interventions to reduce asthma disparities. Health literacy and education level are partial mediators.
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Affiliation(s)
- David M Washington
- Boston Medical Center, Boston, MA, USA. .,Internal Medicine and Pediatrics, Texas Gulf Coast Medical Systems, 250 Blossom Street, Suite 400, Webster, TX, 77598, USA.
| | - Laura M Curtis
- Northwestern University: Feinberg School of Medicine, Chicago, IL, USA
| | | | - Michael S Wolf
- Northwestern University: Feinberg School of Medicine, Chicago, IL, USA
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Chen YC, Ho WC, Yu YH. Adolescent lung function associated with incense burning and other environmental exposures at home. INDOOR AIR 2017; 27:746-752. [PMID: 27859699 PMCID: PMC5484285 DOI: 10.1111/ina.12355] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 11/12/2016] [Indexed: 06/06/2023]
Abstract
Incense burning is a popular cultural and religious practice, but whether exposure to incense smoke has effects on lung function is unclear. We investigated association between lung function and incense burning exposure and other household exposures in adolescents who participated in a mass asthma-screening program. Information on asthmatic status and associated factors was obtained from parent-completed questionnaires and student-completed video questionnaires. Approximately 10% of students received lung function examinations. Valid lung function data of 5010 students aged 14-16 years in northern Taiwan were analyzed. Forced vital capacity (FVC) and forced expiratory flow in 1 second (FEV1 ) were compared by incense burning status and other types of exposures for adolescents. Overall, 70.6% of students were exposed to incense smoke at home. The mean FVC and FEV1 measures were lower among adolescents with daily exposure to incense burning than those without such exposure (P<.05). Sharing bedroom was also associated with decreased FVC and FEV1 . After controlling for confounding factors, multivariable linear regression analysis with generalized estimation equation showed that FVC was negatively associated with daily exposure to incense burning, sharing a bedroom, and living in a house adjacent to a traffic road. Such associations were also observed in FEV1 . Daily exposure to incense burning is associated with impaired adolescent lung function.
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Affiliation(s)
- Y. C. Chen
- Department of Health ManagementCollege of MedicineI‐Shou UniversityYanchao DistrictKaohsiungTaiwan
- Bachelor's Degree Program for Indigenous Peoples in Long‐term CareI‐Shou UniversityYanchao DistrictKaohsiungTaiwan
| | - W. C. Ho
- Department of Public HealthChina Medical UniversityTaichungTaiwan
| | - Y. H. Yu
- Department of Internal MedicineDivisions of Pulmonary and Critical Care MedicineChina Medical University HospitalTaichungTaiwan
- School of MedicineChina Medical UniversityTaichungTaiwan
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O'Connor TM, Cusack R, Landers S, Bredin CP. Holy Saturday asthma. BMJ Case Rep 2014; 2014:bcr-2014-203861. [PMID: 24626388 DOI: 10.1136/bcr-2014-203861] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 61-year-old man complained of cough and dyspnoea after exposure to colophony-containing solder fumes at work. A histamine challenge test confirmed airway hyper-responsiveness, and colophony-challenge demonstrated a 16.7% drop in peak expiratory flow rate (PEFR), supporting a diagnosis of colophony-induced occupational asthma. At review, the patient presented with cough, dyspnoea and wheeze that occurred acutely when exposed to the fumes from burning incense during Easter Saturday services, necessitating his departure from the church. Inhalation challenge tests using two blends of incense used at his church (Greek and Vatican) led to identical symptoms and a significant reduction in forced expiratory volume in 1 s 15 min after exposure and PEFRs up to 48 h after exposure, indicating an early and late phase asthmatic reaction. This is the first report of coexistent colophony and incense-induced asthma. The similarities in chemical structures between abietic acid in colophony and boswellic acid in incense suggest a common mechanism.
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Affiliation(s)
- Terence M O'Connor
- Department of Respiratory Medicine, Mercy University Hospital, Cork, Ireland
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Induction of CYP1A1, CYP1A2, CYP1B1, increased oxidative stress and inflammation in the lung and liver tissues of rats exposed to incense smoke. Mol Cell Biochem 2014; 391:127-36. [DOI: 10.1007/s11010-014-1995-5] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Accepted: 01/29/2014] [Indexed: 10/25/2022]
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Solis-Soto MT, Patiño A, Nowak D, Radon K. Association between environmental factors and current asthma, rhinoconjunctivitis and eczema symptoms in school-aged children from Oropeza Province--Bolivia: a cross-sectional study. Environ Health 2013; 12:95. [PMID: 24192069 PMCID: PMC4228317 DOI: 10.1186/1476-069x-12-95] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2013] [Accepted: 10/30/2013] [Indexed: 05/09/2023]
Abstract
BACKGROUND In recent years, the prevalence of asthma, rhinoconjunctivitis and eczema symptoms in childhood has considerably increased in developing countries including Bolivia, possibly due to changes in lifestyle, environmental and domestic factors. This study aimed to assess the association between environmental factors and asthma, rhinoconjuctivitis and eczema symptoms in school-aged children from Oropeza Province in Chuquisaca, Bolivia. METHODS A cross-sectional study was performed in 2340 children attending the fifth grade in 36 randomly selected elementary schools in Oropeza province. The prevalence of symptoms was determined using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. Environmental factors were assessed by the ISAAC environmental questionnaire including questions related to exposure to pets, farm animals, indoor and outdoor pollution, presence of disease vectors at home and precarious household conditions. Generalized linear mixed-effects models were adjusted for age, sex and place of living. RESULTS Thirty seven percent of children reported that at least one of their parents smoked at home. Wood or coal was used as cooking fuel in 19% of the homes and 29% reported intense truck traffic on the street where they lived. With respect to hygiene conditions, 86% reported exposure to dogs, 59% exposure to cats and 36% regular contact to farm animals. More than one precarious household condition was reported by 8% of children. In the adjusted model exposure to dog (adjusted OR 1.4; CI 95% 1.0-1.9), cat (1.2; 1.0-1.5), farm animals (1.5; 1.2-1.8); intense truck traffic (1.3; 1.0-1.6), parents smoking at home (1.2; 1.0-1.5), presence of disease vectors at home (fourth quartile vs. first quartile: 1.6; 1.2-2.3) and two or more precarious household conditions (1.5; 1.0-2.2) were significantly associated with rhinoconjunctivitis symptoms. The associations were similar for asthma and eczema symptoms; however it did not reach the level of statistical significance for all items. CONCLUSION Our results support previous findings reported for poor communities especially in Latin America, showing that lower hygiene conditions did not have protective effect against asthma and rhinoconjunctivitis and eczema symptoms.
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Affiliation(s)
| | - Armando Patiño
- Departmental Service of Health (SEDES) - Chuquisaca, Bolivia, South America
| | - Dennis Nowak
- Institute for Occupational, Social and Environmental Medicine, Occupational and Environmental Epidemiology & Net Teaching Unit, University Hospital Munich (LMU), Munich, Germany
| | - Katja Radon
- Institute for Occupational, Social and Environmental Medicine, Occupational and Environmental Epidemiology & Net Teaching Unit, University Hospital Munich (LMU), Munich, Germany
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