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Li W, Long C, Fan T, Anneser E, Chien J, Goodman JE. Gas cooking and respiratory outcomes in children: A systematic review. GLOBAL EPIDEMIOLOGY 2023; 5:100107. [PMID: 37638371 PMCID: PMC10446006 DOI: 10.1016/j.gloepi.2023.100107] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 04/12/2023] [Accepted: 04/14/2023] [Indexed: 08/29/2023] Open
Abstract
The most recent meta-analysis of gas cooking and respiratory outcomes in children was conducted by Lin et al. [93] in 2013. Since then, a number of epidemiology studies have been published on this topic. We conducted the first systematic review of this epidemiology literature that includes an in-depth evaluation of study heterogeneity and study quality, neither of which was systematically evaluated in earlier reviews. We reviewed a total of 66 relevant studies, including those in the Lin et al. [93] meta-analysis. Most of the studies are cross-sectional by design, precluding causal inference. Only a few are cohort studies that could establish temporality and they have largely reported null results. There is large variability across studies in terms of study region, age of children, gas cooking exposure definition, and asthma or wheeze outcome definition, precluding clear interpretations of meta-analysis estimates such as those reported in Lin et al. [93]. Further, our systematic study quality evaluation reveals that a large proportion of the studies to date are subject to multiple sources of bias and inaccuracy, primarily due to self-reported gas cooking exposure or respiratory outcomes, insufficient adjustment for key confounders (e.g., environmental tobacco smoke, family history of asthma or allergies, socioeconomic status or home environment), and unestablished temporality. We conclude that the epidemiology literature is limited by high heterogeneity and low study quality and, therefore, it does not provide sufficient evidence regarding causal relationships between gas cooking or indoor NO2 and asthma or wheeze. We caution against over-interpreting the quantitative evidence synthesis estimates from meta-analyses of these studies.
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Affiliation(s)
- Wenchao Li
- Gradient, One Beacon St., 17 Floor, Boston, MA 02108, United States of America
| | - Christopher Long
- Gradient, One Beacon St., 17 Floor, Boston, MA 02108, United States of America
| | - Tongyao Fan
- Penn State College of Medicine, Department of Pharmacology, 500 University Drive, Hershey, PA 17033, United States of America
| | - Elyssa Anneser
- Gradient, One Beacon St., 17 Floor, Boston, MA 02108, United States of America
| | - Jiayang Chien
- Gradient, One Beacon St., 17 Floor, Boston, MA 02108, United States of America
| | - Julie E. Goodman
- Gradient, One Beacon St., 17 Floor, Boston, MA 02108, United States of America
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Sauliene I, Valiulis A, Keriene I, Sukiene L, Dovydaityte D, Prokopciuk N, Valskys V, Valskiene R, Damialis A. Airborne pollen and fungi indoors: Evidence from primary schools in Lithuania. Heliyon 2023; 9:e12668. [PMID: 36685406 PMCID: PMC9850001 DOI: 10.1016/j.heliyon.2022.e12668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 10/14/2022] [Accepted: 12/20/2022] [Indexed: 01/05/2023] Open
Abstract
The number of children suffering from respiratory allergies and asthma has been increasing worldwide and, hence, it is crucial to understand the burden of inhalant biological particles present in school facilities, where children spend one third of their life. From the perspective of indoor air quality, while there are numerous studies on outdoor bioaerosol exposure, there are still uncertainties regarding the diversity and deposition of airborne pollen and fungi indoors. When it comes to schools, there is limited research as to the potential bioaerosol exposure. Here we studied the indoor environment of public schools aiming to reveal whether primary schools of different sizes and at localities of different levels of urbanization may exhibit a variability in the biodiversity and abundance of particles of biological origin, which could pose a risk to child health. To achieve this, 11 schools were selected, located in a variety of environments, from downtown, to city centre-periphery, and to the suburbs. Fungal and pollen samples were collected from various surfaces in school classrooms and corridors, using passive air sampling and swab sampling. We demonstrated that fungi and pollen are detected in school premises during and after the vegetation season. The highest diversity of bioaerosols was found on the top of cabinets and windowsills, with Penicillium, Cladosporium and Acremonium being the most abundant indoors. The levels of fungi were higher in schools with more students. The diversity and amount of pollen in the spring were significantly higher than in samples collected in autumn. Our findings complemented existing evidence that bioaerosol measurements in schools (including kindergartens or informal education facilities) are vital. Hence, we here suggest that, in addition to monitoring air quality and bacterial levels indoors, fungi and pollen measurements have to be integrated in the existing regular biomonitoring campaigns so as to prevent exposure, increase awareness and manage efficiently allergic symptomatology.
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Affiliation(s)
- Ingrida Sauliene
- Institute of Regional Development, Siauliai Academy, Vilnius University, Siauliai, Lithuania
| | - Arunas Valiulis
- Clinic of Children's Diseases, Institute of Clinical Medicine, Medical Faculty, Vilnius University, Vilnius, Lithuania,Department of Public Health, Institute of Health Sciences, Medical Faculty, Vilnius University, Vilnius, Lithuania
| | - Ilona Keriene
- Institute of Regional Development, Siauliai Academy, Vilnius University, Siauliai, Lithuania
| | - Laura Sukiene
- Institute of Regional Development, Siauliai Academy, Vilnius University, Siauliai, Lithuania
| | - Dovile Dovydaityte
- Institute of Regional Development, Siauliai Academy, Vilnius University, Siauliai, Lithuania
| | - Nina Prokopciuk
- Clinic of Children's Diseases, Institute of Clinical Medicine, Medical Faculty, Vilnius University, Vilnius, Lithuania
| | - Vaidotas Valskys
- Institute of Biosciences, Life Sciences Center, Vilnius University, Vilnius, Lithuania
| | | | - Athanasios Damialis
- Terrestrial Ecology and Climate Change, Department of Ecology, School of Biology, Faculty of Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece,Corresponding author.
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Putcha N, Woo H, McCormack MC, Fawzy A, Romero K, Davis MF, Wise RA, Diette GB, Koehler K, Matsui EC, Hansel NN. Home Dust Allergen Exposure Is Associated with Outcomes among Sensitized Individuals with Chronic Obstructive Pulmonary Disease. Am J Respir Crit Care Med 2022; 205:412-420. [PMID: 34752729 PMCID: PMC8886951 DOI: 10.1164/rccm.202103-0583oc] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 11/09/2021] [Indexed: 11/16/2022] Open
Abstract
Rationale: Environmental exposures have been associated with adverse outcomes in chronic obstructive pulmonary disease (COPD). Approximately one-third of individuals with COPD have allergic sensitization, but it is unknown whether exposure to allergens in the home is associated with outcomes. Objectives: To determine the prevalence and associations of allergen sensitization with exposure to common indoor allergens with symptoms and exacerbation risk in COPD. Methods: Allergen sensitization to five common indoor allergens was assessed in former smokers with COPD. Home settled dust was assessed for presence of corresponding allergens. Sensitization and exposure status was determined and associations evaluated in adjusted models with longitudinal outcomes including symptoms, lung function, and exacerbations. Interactions were assessed between sensitization/exposure status and lung function. Measurements and Main Results: One hundred eighty-three individuals studied were on average 67.3 years of age (SD, 8.22) with average FEV1 of 53.2% (SD, 17.6%). Seventy-seven percent of participants were exposed to at least one tested allergen, and 17% had sensitization with corresponding allergen exposure. After adjustment, sensitization with exposure was associated with lower lung function (β, -8.29; 95% confidence interval [CI], -14.80 to -1.77), higher St. George's Respiratory Questionnaire Total Score (β, 6.71; 95% CI, 0.17 to 13.25), and higher exacerbation risk (odds ratio, 2.31; 95% CI, 1.11 to 4.79). Associations appeared to be more pronounced among individuals with lower lung function. Conclusions: Allergen exposures are common in COPD and associated with adverse outcomes among those with concomitant allergen sensitization. This study establishes allergens as an important home exposure that potentially could be addressed with comprehensive home environmental modification strategies to improve COPD outcomes.
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Affiliation(s)
- Nirupama Putcha
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Han Woo
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Meredith C. McCormack
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Ashraf Fawzy
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Karina Romero
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Meghan F. Davis
- Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; and
| | - Robert A. Wise
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Gregory B. Diette
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Kirsten Koehler
- Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; and
| | | | - Nadia N. Hansel
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Indoor Air Quality Prior to and Following School Building Renovation in a Mid-Atlantic School District. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182212149. [PMID: 34831903 PMCID: PMC8624555 DOI: 10.3390/ijerph182212149] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 11/12/2021] [Accepted: 11/16/2021] [Indexed: 11/22/2022]
Abstract
Children spend the majority of their time indoors, and a substantial portion of this time in the school environment. Air pollution has been shown to adversely impact lung development and has effects that extend beyond respiratory health. The goal of this study was to evaluate the indoor environment in public schools in the context of an ongoing urban renovation program to investigate the impact of school building renovation and replacement on indoor air quality. Indoor air quality (CO2, PM2.5, CO, and temperature) was assessed for two weeks during fall, winter, and spring seasons in 29 urban public schools between December 2015 and March 2020. Seven schools had pre- and post-renovation data available. Linear mixed models were used to examine changes in air quality outcomes by renovation status in the seven schools with pre- and post-renovation data. Prior to renovation, indoor CO measurements were within World Health Organization (WHO) guidelines, and indoor PM2.5 measurements rarely exceeded them. Within the seven schools with pre- and post-renovation data, over 30% of indoor CO2 measurements and over 50% of indoor temperatures exceeded recommended guidelines from the American Society of Heating, Refrigerating, and Air Conditioning Engineers. Following renovation, 10% of indoor CO2 measurements and 28% of indoor temperatures fell outside of the recommended ranges. Linear mixed models showed significant improvement in CO2, indoor PM2.5, and CO following school renovation. Even among schools that generally met recommendations on key guidelines, school renovation improved the indoor air quality. Our findings suggest that school renovation may benefit communities of children, particularly those in low-income areas with aging school infrastructure, through improvements in the indoor environment.
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Nakhjirgan P, Mahmoodi M, Kashani H, Firooz A, Nabizadeh R, Kermani M, Yunesian M. Air pollution and exacerbation of skin itching and sleep disturbance in Iranian atopic dermatitis patients. JOURNAL OF ENVIRONMENTAL HEALTH SCIENCE & ENGINEERING 2019; 17:811-816. [PMID: 32030154 PMCID: PMC6985420 DOI: 10.1007/s40201-019-00397-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 08/07/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND For about three decades now, the number of people suffering from atopy including atopic dermatitis (AD) has been increasing in developed countries. Genetic background and environmental factors including air pollution play an effective role in its incidence. This study examined the association between air pollutants and exacerbation of AD symptoms including sleep disturbance and itching in AD patients of Tehran. METHODS In this panel study, 31 patients with AD who admitted to Razi Hospital, dermatology hospital in Tehran, entered the research. Daily information including questions on disease symptoms (sleep disturbance, itching) and duration of outdoor stay (in hours) were collected using a questionnaire. The mean 24-h concentrations of PM2.5 and PM10 pollutants were obtained from the Air Quality Control Company. The relationship between the concentrations of the pollutants and exacerbation of the disease symptoms was investigated using the GEE (Generalized Estimating Equations) model. RESULTS There was a significant relationship between the concentrations of air pollutants and exacerbation of sleep disturbance and itching on the same day, before, and after adjusting the effects of the confounding variables, so that the estimated odds ratios (95% confidence interval) between PM10 and PM2.5 and exacerbation of itching were 1.06 (1.02-1.10) and 1.17 (1.07-1.28), respectively. CONCLUSIONS There was a significant statistical relationship between the concentration of particulate matter (PM2.5 and PM10) and exacerbation of sleep disturbance and itching. PM2.5 showed a stronger relationship with the exacerbation of symptoms compared to PM10.
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Affiliation(s)
- Pegah Nakhjirgan
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Poursina Street, Keshavarz Boulevard, Tehran, 1417613151 Iran
| | - Masoumeh Mahmoodi
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Poursina Street, Keshavarz Boulevard, Tehran, 1417613151 Iran
| | - Homa Kashani
- Department of Research Methodology and Data Analysis, Institute for Environmental Research, Tehran University of Medical Sciences, No. 1547, North Kargar Ave., Tehran, 1417993359 Iran
| | - Alireza Firooz
- Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Nabizadeh
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Poursina Street, Keshavarz Boulevard, Tehran, 1417613151 Iran
| | - Majid Kermani
- Department of Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Masud Yunesian
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Poursina Street, Keshavarz Boulevard, Tehran, 1417613151 Iran
- Center for Air Pollution Research, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran
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Zhou S, Young CJ, VandenBoer TC, Kahan TF. Role of location, season, occupant activity, and chemistry in indoor ozone and nitrogen oxide mixing ratios. ENVIRONMENTAL SCIENCE. PROCESSES & IMPACTS 2019; 21:1374-1383. [PMID: 31225544 DOI: 10.1039/c9em00129h] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Understanding the oxidizing environment indoors is important for predicting indoor air quality and its impact on human health. We made continuous time-resolved measurements (30 s) of several oxidants and oxidant precursors (collectively referred to as oxidant*): ozone (O3), nitric oxide (NO), and NO2* - the sum of nitrogen dioxide (NO2) and nitrous acid (HONO). These species were measured in three indoor environments - an occupied residence, a chemistry laboratory, and an academic office - in Syracuse, New York, during two seasons in 2017 and 2018. Oxidant* levels differed greatly between the residence, the lab and the office. Indoor-to-outdoor ratios (I/O) of O3 were 0.03 and 0.67 in the residence and office; I/ONO (I/ONO2*) were 11.70 (1.26) in the residence and 0.13 (1.70) in the office. Little seasonal variability was observed in the lab and office, but O3 and NO2* levels in the residence were greater in spring than in winter, while NO levels were lower. Human activities such as cooking and opening patio doors resulted in large changes in oxidant* mixing ratios in the residence. In situ chamber experiments demonstrated that the increase in O3 and NO2* levels during door-open periods was due to a combination of physical mixing between indoor and outdoor air, gas-phase production of NO2 from O3-NO chemistry, and heterogeneous formation of HONO on indoor surfaces. Our results also highlight the importance of chemistry (with NO, alkenes, and surfaces) in O3 mixing ratios in the residence, especially during door-open periods.
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Affiliation(s)
- Shan Zhou
- Department of Chemistry, Syracuse University, Syracuse, New York 13244, USA
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Young CJ, Zhou S, Siegel JA, Kahan TF. Illuminating the dark side of indoor oxidants. ENVIRONMENTAL SCIENCE. PROCESSES & IMPACTS 2019; 21:1229-1239. [PMID: 31173015 DOI: 10.1039/c9em00111e] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The chemistry of oxidants and their precursors (oxidants*) plays a central role in outdoor environments but its importance in indoor air remains poorly understood. Ozone (O3) chemistry is important in some indoor environments and, until recently, ozone was thought to be the dominant oxidant indoors. There is now evidence that formation of the hydroxyl radical by photolysis of nitrous acid (HONO) and formaldehyde (HCHO) may be important indoors. In the past few years, high time-resolution measurements of oxidants* indoors have become more common and the importance of event-based release of oxidants* during activities such as cleaning has been proposed. Here we review the current understanding of oxidants* indoors, including drivers of the formation and loss of oxidants*, levels of oxidants* in indoor environments, and important directions for future research.
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Affiliation(s)
- Cora J Young
- Department of Chemistry, York University, Canada.
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8
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Cai J, Li B, Yu W, Wang H, Du C, Zhang Y, Huang C, Zhao Z, Deng Q, Yang X, Zhang X, Qian H, Sun Y, Liu W, Wang J, Yang Q, Zeng F, Norbäck D, Sundell J. Household dampness-related exposures in relation to childhood asthma and rhinitis in China: A multicentre observational study. ENVIRONMENT INTERNATIONAL 2019; 126:735-746. [PMID: 30878869 DOI: 10.1016/j.envint.2019.03.013] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 03/05/2019] [Accepted: 03/06/2019] [Indexed: 06/09/2023]
Abstract
During 2010-2012, we conducted an observational study on household environment and health outcomes among 40,010 preschool children from seven cities of China. Here we examined associations of six dampness-related indicators (visible mold spots, visible damp stains, damp clothing and/or bedding, water damage, condensation on windowpane, moldy odor) in the current residence and three dampness-related indicators (visible mold spots, condensation on windowpane, moldy odor) in the early residence with childhood asthma and rhinitis. In the multi-level logistic regression analyses, visible mold spots and visible damp stains in the current residence were significantly associated with the increased odds of doctor-diagnosed asthma and allergic rhinitis during lifetime-ever (adjusted odd ratios (AORs) range: 1.18-1.35). All dampness-related indicators were significantly associated with increased odds of wheeze and rhinitis during lifetime-ever and in the past 12 months (AORs range: 1.16-2.64). The cumulative numbers of damp indicators had positively dose-response relationships with the increased odds of the studied diseases. These associations for wheeze and rhinitis were similar between northern children and southern children. Similar results were found in the sensitive analyses among children without a family history of allergies and among children without asthma and allergic rhinitis. For 3-6 years-old children in mainland of China in 2011, we speculated that about 90,000 (2.02%) children with asthma and about 59,000 (1.09%) children with allergic rhinitis could be attributable to exposing to visible mold spots in the current residence. Our results suggested that early and lifetime exposures to household dampness indicators are risk factors for childhood asthma and rhinitis.
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Affiliation(s)
- Jiao Cai
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing, China; National Centre for International Research of Low-carbon and Green Buildings (Ministry of Science and Technology), Chongqing University, Chongqing, China
| | - Baizhan Li
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing, China; National Centre for International Research of Low-carbon and Green Buildings (Ministry of Science and Technology), Chongqing University, Chongqing, China.
| | - Wei Yu
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing, China; National Centre for International Research of Low-carbon and Green Buildings (Ministry of Science and Technology), Chongqing University, Chongqing, China
| | - Han Wang
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing, China; National Centre for International Research of Low-carbon and Green Buildings (Ministry of Science and Technology), Chongqing University, Chongqing, China
| | - Chenqiu Du
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing, China; National Centre for International Research of Low-carbon and Green Buildings (Ministry of Science and Technology), Chongqing University, Chongqing, China
| | - Yinping Zhang
- School of Architecture, Tsinghua University, Beijing, China
| | - Chen Huang
- School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
| | - Zhuohui Zhao
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Key Lab of Health Technology Assessment, National Health and Family Planning Commission of the People's Republic of China, Fudan University, Shanghai, China
| | - Qihong Deng
- School of Public Health, Central South University, Changsha, Hunan, China
| | - Xu Yang
- College of Life Sciences, Central China Normal University, Wuhan, China
| | - Xin Zhang
- Research Center for Environmental Science and Engineering, Shanxi University, Taiyuan, China
| | - Hua Qian
- School of Energy and Environment, Southeast University, Nanjing, China
| | - Yuexia Sun
- School of Environmental Science and Engineering, Tianjin University, Tianjin, China
| | - Wei Liu
- School of Architecture, Tsinghua University, Beijing, China
| | - Juan Wang
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing, China; Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala SE-751, Sweden
| | - Qin Yang
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing, China; National Centre for International Research of Low-carbon and Green Buildings (Ministry of Science and Technology), Chongqing University, Chongqing, China
| | - Fanbin Zeng
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing, China; National Centre for International Research of Low-carbon and Green Buildings (Ministry of Science and Technology), Chongqing University, Chongqing, China
| | - Dan Norbäck
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala SE-751, Sweden
| | - Jan Sundell
- School of Environmental Science and Engineering, Tianjin University, Tianjin, China
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Zhou S, Young CJ, VandenBoer TC, Kowal SF, Kahan TF. Time-Resolved Measurements of Nitric Oxide, Nitrogen Dioxide, and Nitrous Acid in an Occupied New York Home. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2018; 52:8355-8364. [PMID: 29973042 DOI: 10.1021/acs.est.8b01792] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Indoor oxidizing capacity in occupied residences is poorly understood. We made simultaneous continuous time-resolved measurements of ozone (O3), nitric oxide (NO), nitrogen dioxide (NO2), and nitrous acid (HONO) for two months in an occupied detached home with gas appliances in Syracuse, NY. Indoor NO and HONO mixing ratios were higher than those outdoors, whereas O3 was much lower (sub-ppbv) indoors. Cooking led to peak NO, NO2, and HONO levels 20-100 times greater than background levels; HONO mixing ratios of up to 50 ppbv were measured. Our results suggest that many reported NO2 levels may have a large positive bias due to HONO interference. Nitrous acid, NO2, and NO were removed from indoor air more rapidly than CO2, indicative of reactive removal processes or surface uptake. We measured spectral irradiance from sunlight entering the residence through glass doors; hydroxyl radical (OH) production rates of (0.8-10) × 107 molecules cm-3 s-1 were calculated in sunlit areas due to HONO photolysis, in some cases exceeding rates expected from ozone-alkene reactions. Steady-state nitrate radical (NO3) mixing ratios indoors were predicted to be lower than 1.65 × 104 molecules cm-3. This work will help constrain the temporal nature of oxidant concentrations in occupied residences and will improve indoor chemistry models.
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Affiliation(s)
- Shan Zhou
- Department of Chemistry , Syracuse University , Syracuse , New York 13244 , United States
| | - Cora J Young
- Department of Chemistry , York University , Toronto , Ontario M3J 1P3 , Canada
| | - Trevor C VandenBoer
- Department of Chemistry , York University , Toronto , Ontario M3J 1P3 , Canada
| | - Shawn F Kowal
- Department of Chemistry , Syracuse University , Syracuse , New York 13244 , United States
| | - Tara F Kahan
- Department of Chemistry , Syracuse University , Syracuse , New York 13244 , United States
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10
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Berman JD, McCormack MC, Koehler KA, Connolly F, Clemons-Erby D, Davis MF, Gummerson C, Leaf PJ, Jones TD, Curriero FC. School environmental conditions and links to academic performance and absenteeism in urban, mid-Atlantic public schools. Int J Hyg Environ Health 2018; 221:800-808. [PMID: 29784550 DOI: 10.1016/j.ijheh.2018.04.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Revised: 04/26/2018] [Accepted: 04/30/2018] [Indexed: 10/17/2022]
Abstract
School facility conditions, environment, and perceptions of safety and learning have been investigated for their impact on child development. However, it is important to consider how the environment separately influences academic performance and attendance after controlling for school and community factors. Using results from the Maryland School Assessment, we considered outcomes of school-level proficiency in reading and math plus attendance and chronic absences, defined as missing 20 or more days, for grades 3-5 and 6-8 at 158 urban schools. Characteristics of the environment included school facility conditions, density of nearby roads, and an index industrial air pollution. Perceptions of school safety, learning, and institutional environment were acquired from a School Climate Survey. Also considered were neighborhood factors at the community statistical area, including demographics, crime, and poverty based on school location. Poisson regression adjusted for over-dispersion was used to model academic achievement and multiple linear models were used for attendance. Each 10-unit change in facility condition index, denoting worse quality buildings, was associated with a decrease in reading (1.0% (95% CI: 0.1-1.9%) and math scores (0.21% (95% CI: 0.20-0.40), while chronic absences increased by 0.75% (95% CI: 0.30-1.39). Each log increase the EPA's Risk Screening Environmental Indicator (RSEI) value for industrial hazards, resulted in a marginally significant trend of increasing absenteeism (p < 0.06), but no association was observed with academic achievement. All results were robust to school-level measures of racial composition, free and reduced meals eligibility, and community poverty and crime. These findings provide empirical evidence for the importance of the community and school environment, including building conditions and neighborhood toxic substance risk, on academic achievement and attendance.
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Affiliation(s)
- J D Berman
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
| | - M C McCormack
- Johns Hopkins School of Medicine, Baltimore, MD, United States.
| | - K A Koehler
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
| | - F Connolly
- Baltimore Education Research Consortium, Baltimore, MD, United States.
| | - D Clemons-Erby
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
| | - M F Davis
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
| | - C Gummerson
- Johns Hopkins School of Medicine, Baltimore, MD, United States.
| | - P J Leaf
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
| | - T D Jones
- Office of Achievement and Accountability, Baltimore City Public Schools, Baltimore, MD, United States.
| | - F C Curriero
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
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Lappharat S, Taneepanichskul N, Reutrakul S, Chirakalwasan N. Effects of Bedroom Environmental Conditions on the Severity of Obstructive Sleep Apnea. J Clin Sleep Med 2018; 14:565-573. [PMID: 29609708 DOI: 10.5664/jcsm.7046] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 12/27/2017] [Indexed: 12/31/2022]
Abstract
STUDY OBJECTIVES Epidemiological associations have demonstrated the effects of long-term air pollution to obstructive sleep apnea (OSA) through a physiological mechanism linking particulate matter exposure to OSA. This study aimed to determine the relationship between bedroom environmental conditions, OSA severity, and sleep quality. METHODS Sixty-three participants were enrolled for an overnight polysomnography; OSA was diagnosed between May to August 2016. Personal characteristics and sleep quality were obtained by a face-to-face interview. Bedroom environments, including data on particulate matter with an aerodynamic diameter less than 10 μm (PM10), temperature, and relative humidity, were collected by personal air sampling and a HOBO tempt/RH data logger. RESULTS Sixty-eight percent of the participants experienced poor sleep. An elevation in 1-year mean PM10 concentration was significantly associated with an increase in apnea-hypopnea index (beta = 1.04, P = .021) and respiratory disturbance index (beta = 1.07, P = .013). An increase of bedroom temperature during sleep was significantly associated with poorer sleep quality (adjusted odds ratio 1.46, 95% confidence interval 1.01-2.10, P = .044). Associations between PM10 concentration and respiratory disturbance index were observed in the dry season (beta = 0.59, P = .040) but not in the wet season (beta = 0.39, P = .215). PM10 was not associated with subjective sleep quality. CONCLUSIONS Elevation of PM10 concentration is significantly associated with increased OSA severity. Our findings suggest that reduction in exposure to particulate matter and suitable bedroom environments may lessen the severity of OSA and promote good sleep.
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Affiliation(s)
- Sattamat Lappharat
- College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand
| | | | - Sirimon Reutrakul
- Division of Endocrinology and Metabolism, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Ratchathewi, Bangkok, Thailand.,Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Illinois at Chicago, Chicago, Illinois
| | - Naricha Chirakalwasan
- Excellence Center for Sleep Disorders, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.,Division of Pulmonary and Critical Care Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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Respiratory Effects of Indoor Heat and the Interaction with Air Pollution in Chronic Obstructive Pulmonary Disease. Ann Am Thorac Soc 2018; 13:2125-2131. [PMID: 27684429 DOI: 10.1513/annalsats.201605-329oc] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
RATIONALE There is limited evidence of the effect of exposure to heat on chronic obstructive pulmonary disease (COPD) morbidity, and the interactive effect between indoor heat and air pollution has not been established. OBJECTIVES To determine the effect of indoor and outdoor heat exposure on COPD morbidity and to determine whether air pollution concentrations modify the effect of temperature. METHODS Sixty-nine participants with COPD were enrolled in a longitudinal cohort study, and data from the 601 participant days that occurred during the warm weather season were included in the analysis. Participants completed home environmental monitoring with measurement of temperature, relative humidity, and indoor air pollutants and simultaneous daily assessment of respiratory health with questionnaires and portable spirometry. MEASUREMENTS AND MAIN RESULTS Participants had moderate to severe COPD and spent the majority of their time indoors. Increases in maximal indoor temperature were associated with worsening of daily Breathlessness, Cough, and Sputum Scale scores and increases in rescue inhaler use. The effect was detected on the same day and lags of 1 and 2 days. The detrimental effect of temperature on these outcomes increased with higher concentrations of indoor fine particulate matter and nitrogen dioxide (P < 0.05 for interaction terms). On days during which participants went outdoors, increases in maximal daily outdoor temperature were associated with increases in Breathlessness, Cough, and Sputum Scale scores after adjusting for outdoor pollution concentrations. CONCLUSIONS For patients with COPD who spend the majority of their time indoors, indoor heat exposure during the warmer months represents a modifiable environmental exposure that may contribute to respiratory morbidity. In the context of climate change, adaptive strategies that include optimization of indoor environmental conditions are needed to protect this high-risk group from the adverse health effects of heat.
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Paulin LM, Williams D'AL, Peng R, Diette GB, McCormack MC, Breysse P, Hansel NN. 24-h Nitrogen dioxide concentration is associated with cooking behaviors and an increase in rescue medication use in children with asthma. ENVIRONMENTAL RESEARCH 2017; 159:118-123. [PMID: 28797886 PMCID: PMC5623630 DOI: 10.1016/j.envres.2017.07.052] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 07/24/2017] [Accepted: 07/31/2017] [Indexed: 05/06/2023]
Abstract
Exposure to nitrogen dioxide (NO2), a byproduct of combustion, is associated with poor asthma control in children. We sought to determine whether gas-fueled kitchen appliance use is associated with 24-h indoor NO2 concentrations and whether these concentrations are associated with asthma morbidity in children. Children aged 5-12 years old with asthma were eligible. Mean 24-h NO2 concentration was measured in the kitchen over a four-day sampling period and gas stove use was captured in time activity diaries. The relationship between stove and oven use and daily NO2 concentration was analyzed. Longitudinal analysis assessed the effect of daily NO2 exposure on symptoms, inhaler use, and lung function. Multivariate models were adjusted for age, sex, season, and maternal education. Thirty children contributed 126 participant days of sampling. Mean indoor 24-h NO2 concentration was 58(48)ppb with a median (range) of 45(12-276)ppb. All homes had gas stoves and furnaces. Each hour of kitchen appliance use was associated with an 18ppb increase in 24-h NO2 concentration. In longitudinal multivariate analysis, each ten-fold increase in previous-day NO2 was associated with increased nighttime inhaler use (OR = 4.9, p = 0.04). There were no associations between NO2 and lung function or asthma symptoms. Higher previous-day 24-h concentration of NO2 is associated with increased nighttime inhaler use in children with asthma.
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Affiliation(s)
- Laura M Paulin
- Johns Hopkins Pulmonary/Critical Care, Baltimore, MD, United States.
| | - D 'Ann L Williams
- Maryland Department of Health and Mental Hygiene, Baltimore, MD, United States
| | - Roger Peng
- Johns Hopkins Bloomberg School of Public Health, Balitmore, MD, United States
| | - Gregory B Diette
- Johns Hopkins Pulmonary/Critical Care, Baltimore, MD, United States
| | | | - Patrick Breysse
- Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Nadia N Hansel
- Johns Hopkins Pulmonary/Critical Care, Baltimore, MD, United States
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15
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Park DW, Kim SH, Yoon HJ. The impact of indoor air pollution on asthma. ALLERGY ASTHMA & RESPIRATORY DISEASE 2017. [DOI: 10.4168/aard.2017.5.6.312] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Dong Won Park
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Sang-Heon Kim
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Ho Joo Yoon
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
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16
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Madureira J, Paciência I, Cavaleiro-Rufo J, de Oliveira Fernandes E. Indoor pollutant exposure among children with and without asthma in Porto, Portugal, during the cold season. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2016; 23:20539-20552. [PMID: 27464657 DOI: 10.1007/s11356-016-7269-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 07/14/2016] [Indexed: 06/06/2023]
Abstract
Considering the time spent in enclosed spaces, indoor air pollutants are of major interest because of its possible impact on health. However, to date, few studies have analysed the air concentrations of a large set of indoor pollutants of respiratory health relevance in dwellings, particularly in Portugal. This study aimed to measure the concentrations of air pollutants that are present in residential buildings and to investigate whether some clustering pattern of indoor air pollutants exists in the dwellings of children with (case group) and without asthma (control group). Measurements were taken in 30 and 38 dwellings of asthmatic and non-asthmatic schoolchildren, respectively, located in the city of Porto, Portugal, during the cold season (October 2012-April 2013), to assess the concentrations of 12 volatile organic compounds (VOC), aldehydes, PM2.5, PM10, bacteria and fungi. Toluene, d-limonene, formaldehyde, PM2.5, bacteria and fungi are widely present in dwellings, sometimes in relatively high concentrations in reference to WHO guideline values. Moreover, concentrations of CO2 exceeding 1000 ppm were often encountered, indicating that 70 % of all dwellings had poor ventilation (<4 L/s person). While exposures to common dwelling indoor pollutants are similar for schoolchildren with and without asthma, except for d-limonene levels, the identification and control of VOC and PM sources is important and prudent, especially for vulnerable individuals.
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Affiliation(s)
- Joana Madureira
- Institute of Science and Innovation in Mechanical and Industrial Engineering, Porto, Portugal.
| | - Inês Paciência
- Institute of Science and Innovation in Mechanical and Industrial Engineering, Porto, Portugal
- Faculty of Medicine of University of Porto and Centro Hospitalar São João, Porto, Portugal
| | - João Cavaleiro-Rufo
- Institute of Science and Innovation in Mechanical and Industrial Engineering, Porto, Portugal
- Faculty of Medicine of University of Porto and Centro Hospitalar São João, Porto, Portugal
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Madureira J, Paciência I, Cavaleiro-Rufo J, Fernandes EDO. Indoor air risk factors for schoolchildren's health in Portuguese homes: Results from a case-control survey. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2016; 79:938-953. [PMID: 27644344 DOI: 10.1080/15287394.2016.1210548] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 07/04/2016] [Indexed: 06/06/2023]
Abstract
Allergic diseases have been on the rise in many countries over the past few decades and indoor exposure may be a possible cause. An overall investigation of children's health status and residential indoor air pollutants known or suspected to affect respiratory health was conducted in the homes of primary schoolchildren during winter in Porto, Portugal. In a case-control study (30 case children with asthma and 38 controls) and over a 1-wk monitoring period, air sample collection was conducted in children's bedrooms for the analysis of 12 volatile organic compounds (VOC), aldehydes, particulate matter (PM)2.5, PM10, bacteria, and fungi. Home exposures to indoor pollutants are similar for children with and without asthma, except for d-limonene. For both groups, most VOC were present at low concentrations (median < 5 µg/m(3)) and below the respective World Health Organization (WHO) guidelines. Concentrations of PM2.5, PM10, and bacteria were frequently higher than WHO/reference values (80, 25, and 60% of all studied dwellings, respectively). Concentrations of carbon dioxide (CO2) exceeding 1000 ppm were encountered in 60% of the homes. Although this study does not provide evidence of causative factors for asthmatic status, the postulation that poor indoor air quality in homes heightens the risk of allergic symptoms development among children is conceivable.
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Affiliation(s)
- Joana Madureira
- a Institute of Science and Innovation in Mechanical and Industrial Engineering , Porto , Portugal
| | - Inês Paciência
- a Institute of Science and Innovation in Mechanical and Industrial Engineering , Porto , Portugal
- b Faculty of Medicine , University of Porto, Porto, Portugal & Centro Hospitalar São João , Porto , Portugal
| | - João Cavaleiro-Rufo
- a Institute of Science and Innovation in Mechanical and Industrial Engineering , Porto , Portugal
- b Faculty of Medicine , University of Porto, Porto, Portugal & Centro Hospitalar São João , Porto , Portugal
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18
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Abstract
Air pollution is a leading cause of morbidity and mortality throughout the world, particularly in individuals with existing lung disease. Of the most common air pollutants, particulate matter (PM) is associated with an increased risk of exacerbations and respiratory symptoms in individuals with existing lung disease, and to a lesser extent, in those without known respiratory issues. The majority of published research has focused on the effects of PM exposures on symptoms and health care utilization. Fewer studies focus on the impact of PM on objective measurements of pulmonary function. This review will focus on the effects of PM exposure on objective measurements of lung function in both healthy individuals and those with existing lung disease.
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Affiliation(s)
- Laura Paulin
- Division of Pulmonary and Critical Care, Johns Hopkins School of Medicine, Baltimore, Maryland, 21224-6801, USA
| | - Nadia Hansel
- Division of Pulmonary and Critical Care, Johns Hopkins School of Medicine, Baltimore, Maryland, 21224-6801, USA
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19
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Wang Z, May SM, Charoenlap S, Pyle R, Ott NL, Mohammed K, Joshi AY. Effects of secondhand smoke exposure on asthma morbidity and health care utilization in children: a systematic review and meta-analysis. Ann Allergy Asthma Immunol 2015; 115:396-401.e2. [DOI: 10.1016/j.anai.2015.08.005] [Citation(s) in RCA: 87] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Revised: 07/25/2015] [Accepted: 08/03/2015] [Indexed: 01/29/2023]
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20
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Underhill LJ, Bose S, Williams DL, Romero KM, Malpartida G, Breysse PN, Klasen EM, Combe JM, Checkley W, Hansel NN. Association of Roadway Proximity with Indoor Air Pollution in a Peri-Urban Community in Lima, Peru. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:13466-81. [PMID: 26516875 PMCID: PMC4627043 DOI: 10.3390/ijerph121013466] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Revised: 09/26/2015] [Accepted: 10/09/2015] [Indexed: 12/19/2022]
Abstract
The influence of traffic-related air pollution on indoor residential exposure is not well characterized in homes with high natural ventilation in low-income countries. Additionally, domestic allergen exposure is unknown in such populations. We conducted a pilot study of 25 homes in peri-urban Lima, Peru to estimate the effects of roadway proximity and season on residential concentrations. Indoor and outdoor concentrations of particulate matter (PM2.5), nitrogen dioxide (NO2), and black carbon (BC) were measured during two seasons, and allergens were measured in bedroom dust. Allergen levels were highest for dust mite and mouse allergens, with concentrations above clinically relevant thresholds in over a quarter and half of all homes, respectively. Mean indoor and outdoor pollutant concentrations were similar (PM2.5: 20.0 vs. 16.9 μg/m3, BC: 7.6 vs. 8.1 μg/m3, NO2: 7.3 vs. 7.5 ppb), and tended to be higher in the summer compared to the winter. Road proximity was significantly correlated with overall concentrations of outdoor PM2.5 (rs = −0.42, p = 0.01) and NO2 (rs = −0.36, p = 0.03), and outdoor BC concentrations in the winter (rs = −0.51, p = 0.03). Our results suggest that outdoor-sourced pollutants significantly influence indoor air quality in peri-urban Peruvian communities, and homes closer to roadways are particularly vulnerable.
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Affiliation(s)
- Lindsay J Underhill
- Department of Environmental Health, Boston University School of Public Health, Boston, MA 02118, USA.
| | - Sonali Bose
- Division of Pulmonary and Critical Care, School of Medicine, John Hopkins University, Baltimore, MD 21224, USA.
| | - D'Ann L Williams
- Department of Environmental Health Sciences, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
| | | | - Gary Malpartida
- Laboratorio de Investigacion y Desarrollo, Universidad Peruana Cayetano Heredia, Lima 31, Peru.
| | - Patrick N Breysse
- Department of Environmental Health Sciences, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
| | - Elizabeth M Klasen
- Division of Pulmonary and Critical Care, School of Medicine, John Hopkins University, Baltimore, MD 21224, USA.
| | - Juan M Combe
- Center for Asthma Research, A.B. PRISMA, Lima 32, Peru.
| | - William Checkley
- Division of Pulmonary and Critical Care, School of Medicine, John Hopkins University, Baltimore, MD 21224, USA.
- Program in Global Disease Epidemiology and Control, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
| | - Nadia N Hansel
- Division of Pulmonary and Critical Care, School of Medicine, John Hopkins University, Baltimore, MD 21224, USA.
- Department of Environmental Health Sciences, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
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21
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Semple S, Apsley A, Azmina Ibrahim T, Turner SW, Cherrie JW. Fine particulate matter concentrations in smoking households: just how much secondhand smoke do you breathe in if you live with a smoker who smokes indoors? Tob Control 2015; 24:e205-11. [PMID: 25331379 DOI: 10.1136/tobaccocontrol-2014-051635] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Accepted: 08/28/2014] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Using data on fine particulate matter less than 2.5 μm (PM2.5) concentrations in smoking and non-smoking homes in Scotland to estimate the mass of PM2.5 inhaled by different age groups. METHODS Data from four linked studies, with real-time measurements of PM2.5 in homes, were combined with data on typical breathing rates and time-activity patterns. Monte Carlo modelling was used to estimate daily PM2.5 intake, the percentage of total PM2.5 inhaled within the home environment and the percentage reduction in daily intake that could be achieved by switching to a smoke-free home. RESULTS Median (IQR) PM2.5 concentrations from 93 smoking homes were 31 (10-111) μg/m(3) and 3 (2-6.5) μg/m(3) for the 17 non-smoking homes. Non-smokers living with smokers typically have average PM2.5 exposure levels more than three times higher than the WHO guidance for annual exposure to PM2.5 (10 μg/m(3)). CONCLUSIONS Fine particulate pollution in Scottish homes where smoking is permitted is approximately 10 times higher than in non-smoking homes. Taken over a lifetime many non-smokers living with a smoker inhale a similar mass of PM2.5 as a non-smoker living in a heavily polluted city such as Beijing. Most non-smokers living in smoking households would experience reductions of over 70% in their daily inhaled PM2.5 intake if their home became smoke-free. The reduction is likely to be greatest for the very young and for older members of the population because they typically spend more time at home.
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Affiliation(s)
- Sean Semple
- Respiratory Group, Division of Applied Health Sciences, Scottish Centre for Indoor Air, University of Aberdeen, Aberdeen, UK Centre for Human Exposure Science, Institute of Occupational Medicine, Edinburgh, UK
| | - Andrew Apsley
- Respiratory Group, Division of Applied Health Sciences, Scottish Centre for Indoor Air, University of Aberdeen, Aberdeen, UK Centre for Human Exposure Science, Institute of Occupational Medicine, Edinburgh, UK
| | - Tengku Azmina Ibrahim
- Respiratory Group, Division of Applied Health Sciences, Scottish Centre for Indoor Air, University of Aberdeen, Aberdeen, UK
| | - Stephen W Turner
- Respiratory Group, Division of Applied Health Sciences, Scottish Centre for Indoor Air, University of Aberdeen, Aberdeen, UK
| | - John W Cherrie
- Respiratory Group, Division of Applied Health Sciences, Scottish Centre for Indoor Air, University of Aberdeen, Aberdeen, UK Centre for Human Exposure Science, Institute of Occupational Medicine, Edinburgh, UK
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Bryant-Stephens T, West C, Klein G. Impact of a multi-trigger intervention on seasonal patterns of asthma symptoms in inner city children. J Asthma 2015; 52:565-70. [PMID: 25428770 DOI: 10.3109/02770903.2014.991968] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES Peaks in childhood asthma symptoms and asthma morbidity occur universally in the fall and late winter/early spring. This study examines whether there is a time of the year best suited to implement environmental interventions to attenuate this pattern. METHODS From September 2006 to June 2010, mid-Atlantic inner-city children asthmatics with 1 asthma-related hospitalization (IP) or 2 emergency (ED) visits the year prior to enrollment received 5 in-home self-management education sessions which included multi-trigger avoidance techniques and supplies. Children's daily asthma symptoms were recorded for 12 months by caregivers. RESULTS One-hundred and thirty-six children (48%) completed 12 months of symptoms diaries. Symptom days were reduced by 4.5 days at 12 months follow-up (p < 0.001). Symptom severity improved with a decreased severity score of 29.0 to 7.9 at month 12 (p < 0.001). Sixty-one percent of patients with ≥2 ED visits at baseline dropped to 0-1visits (p < 0.001). Eighty percent of patients with ≥1 IP visits dropped to 0 visits at 12 months (p < 0.001). Patients who received intervention in the summer months had half the average monthly symptoms score (10.8) as those who received intervention in the spring months (20.8). When controlling for environment and morbidity, the summer enrolled group had a significantly lower (p = 0.021) symptom score than those in other seasons. CONCLUSION Home self-management/environmental interventions for this cohort appear to have the greatest effect for those receiving the intervention in the summer and fall. The largest impact occurs in the summer cohort. Further studies with a control group are necessary to confirm these findings.
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Boyle EB, Deziel NC, Specker BL, Collingwood S, Weisel CP, Wright DJ, Dellarco M. Feasibility and informative value of environmental sample collection in the National Children's Vanguard Study. ENVIRONMENTAL RESEARCH 2015; 140:345-353. [PMID: 25913153 DOI: 10.1016/j.envres.2015.04.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Revised: 04/03/2015] [Accepted: 04/04/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND Birth cohort studies provide the opportunity to advance understanding of the impact of environmental factors on childhood health and development through prospective collection of environmental samples. METHODS We evaluated the feasibility and informative value of the environmental sample collection methodology in the initial pilot phase of the National Children's Study, a planned U.S. environmental birth cohort study. Environmental samples were collected from January 2009-September 2010 at up to three home visits: pre-pregnancy (n=306), pregnancy (n=807), and 6-months postnatal (n=117). Collections included air for particulate matter ≤2.5 µm (PM2.5), nitrogen dioxide, ozone, volatile organic compounds (VOCs), and carbonyls; vacuum dust for allergens/endotoxin; water for VOCs, trihalomethanes (THMs), and haloacetic acids (HAAs); and wipe samples for pesticides, semi-volatile organics, and metals. We characterized feasibility using sample collection rates and times and informative value using analyte detection frequencies (DF). RESULTS Among the 1230 home visits, environmental sample collection rates were high across all sample types (mean=89%); all samples except the air PM2.5 samples had collection times <30 min. Informative value was low for water VOCs (median DF=0%) and pesticide floor wipes (median DF=5%). Informative value was moderate for air samples (median DF=35%) and high for water THMs and HAAs (median DF=91% and 75%, respectively). CONCLUSIONS Though collection of environmental samples was feasible, some samples (e.g., wipe pesticides and water VOCs) yielded limited information. These results can be used in conjunction with other study design considerations, such as target population size and hypotheses of interest, to inform the method selection of future environmental health birth cohort studies.
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Affiliation(s)
| | - Nicole C Deziel
- Yale University School of Public Health, Department of Environmental Health Sciences, New Haven, CT, United States
| | - Bonny L Specker
- South Dakota State University, Ethel Austin Martin Program in Human Nutrition, Brookings, SD, United States
| | - Scott Collingwood
- University of Utah, Department of Pediatrics, Salt Lake City, United States
| | - Clifford P Weisel
- Rutgers University, Environmental & Occupational Health Science Institute (EOHSI), Piscataway, NJ, United States
| | - David J Wright
- Westat, 1600 Research Blvd, Rockville, MD, United States
| | - Michael Dellarco
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, United States
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Coker ES, Smit E, Harding AK, Molitor J, Kile ML. A cross sectional analysis of behaviors related to operating gas stoves and pneumonia in U.S. children under the age of 5. BMC Public Health 2015; 15:77. [PMID: 25648867 PMCID: PMC4321321 DOI: 10.1186/s12889-015-1425-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 01/15/2015] [Indexed: 01/31/2023] Open
Abstract
Background Poorly ventilated combustion stoves and pollutants emitted from combustion stoves increase the risk of acute lower respiratory illnesses (ALRI) in children living in developing countries but few studies have examined these issues in developed countries. Our objective is to investigate behaviors related to gas stove use, namely using them for heat and without ventilation, on the odds of pneumonia and cough in U.S. children. Methods The National Health and Nutrition Examination Survey (1988–1994) was used to identify children < 5 years who lived in homes with a gas stove and whose parents provided information on their behaviors when operating their gas stoves and data on pneumonia (N = 3,289) and cough (N = 3,127). Multivariate logistic regression models were used to examine the association between each respiratory outcome and using a gas stove for heat or without ventilation, as well as, the joint effect of both behaviors. Results The adjusted odds of parental-reported pneumonia (adjusted odds ratio [aOR] = 2.08, 95% confidence interval [CI]: 1.08, 4.03) and cough (aOR = 1.66, 95% CI: 1.14, 2.43) were higher among children who lived in homes where gas stoves were used for heat compared to those who lived in homes where gas stoves were only used for cooking. The odds of pneumonia (aOR = 1.76, 95% CI: 1.04, 2.98), but not cough (aOR = 1.23, 95% CI: 0.87, 1.75), was higher among those children whose parents did not report using ventilation when operating gas stoves compared to those who did use ventilation. When considering the joint association of both stove operating conditions, only children whose parents reported using gas stoves for heat without ventilation had significantly higher odds of pneumonia (aOR = 3.06, 95% CI: 1.32, 7.09) and coughing (aOR = 2.07, 95% CI: 1.29, 3.30) after adjusting for other risk factors. Conclusions Using gas stoves for heat without ventilation was associated with higher odds of pneumonia and cough among U.S. children less than five years old who live in homes with a gas stove. More research is needed to determine if emissions from gas stoves ventilation infrastructure, or modifiable behaviors contribute to respiratory infections in children.
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Affiliation(s)
- Eric S Coker
- College of Public Health and Human Sciences, Oregon State University, Milam Hall, Corvallis, OR, 97331, USA.
| | - Ellen Smit
- College of Public Health and Human Sciences, Oregon State University, Milam Hall, Corvallis, OR, 97331, USA.
| | - Anna K Harding
- College of Public Health and Human Sciences, Oregon State University, Milam Hall, Corvallis, OR, 97331, USA.
| | - John Molitor
- College of Public Health and Human Sciences, Oregon State University, Milam Hall, Corvallis, OR, 97331, USA.
| | - Molly L Kile
- College of Public Health and Human Sciences, Oregon State University, Milam Hall, Corvallis, OR, 97331, USA.
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Abstract
The inner city has long been recognized as an area of high asthma morbidity and mortality. A wide range of factors interact to create this environment. These factors include well-recognized asthma risk factors that are not specific to the inner city, the structure and delivery of health care, the location and function of the urban environment, and social inequities. In this article, these facets are reviewed, and successful and unsuccessful interventions are discussed, to understand what is needed to solve this problem.
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Affiliation(s)
- Peter J Gergen
- Allergy, Asthma, Airway Biology Branch (AAABB), MD, USA.
| | - Alkis Togias
- Allergy, Asthma, Airway Biology Branch (AAABB), MD, USA
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Associations between Natural Ventilation for the Child's Bedroom during Night and Childhood Asthma in Shanghai, China. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.proeng.2015.08.1098] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Tripathi P, Hong X, Caruso D, Gao P, Wang X. Genetic determinants in the development of sensitization to environmental allergens in early childhood. IMMUNITY INFLAMMATION AND DISEASE 2014; 2:193-204. [PMID: 25505553 PMCID: PMC4257764 DOI: 10.1002/iid3.38] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Revised: 10/01/2014] [Accepted: 10/03/2014] [Indexed: 11/12/2022]
Abstract
Sensitization to environmental allergens remains one of the strongest risk factors for asthma, and there is likely a genetic basis. We sought to identify genetic determinants for the development of allergic sensitization to environmental allergens, particularly cockroach allergen, in early childhood. A total of 631 children with the information about genotypic data on 895 single nucleotide polymorphisms (SNPs) in 179 candidate genes were selected from an existing dataset (Boston Birth Cohort). Genetic analysis was performed for allergic sensitizations among all subjects and sub-population, Black/African, respectively. Eight SNPs in seven genes showed significant association with allergic sensitization with P < 0.05, including two top SNPs, rs7851969 in JAK2 (P = 0.003) and rs11739089 in CNOT6 (P = 0.008). When analyses were specifically performed for cockroach sensitization, 16 SNPs in 13 genes showed P < 0.05, including five genes with SNPs at P < 0.01 (JAK1, JAK3, IL5RA, FCER1A, and ADAM33). Particularly, haplotype analyses demonstrated that multiple-haplotypes in FCER1A were significantly associated with cockroach sensitization with the strongest association for a 2-marker haplotype (rs6665683T-rs12136904T, P = 0.001). Furthermore, SNP rs6665683 was marginally associated with the levels of cockroach allergen specific IgE. When a similar analysis was performed for house dust mite, four SNPs in three genes (JAK2, MAML1, and NOD1) had P < 0.01. Of these, JAK2 appeared to be an only gene showing association across the sensitizations we analyzed. Some of findings were further validated when analysis was limited to black population. Our study identified several loci that may confer the susceptibility to allergic sensitization, and suggested that sensitization to allergens may depend on their unique loci.
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Affiliation(s)
- Priya Tripathi
- Division of Allergy and Clinical Immunology, Johns Hopkins University School of Medicine Baltimore, Maryland, 21224
| | - Xiumei Hong
- Center on Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health Baltimore, Maryland, 21205
| | - Deanna Caruso
- Center on Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health Baltimore, Maryland, 21205
| | - Peisong Gao
- Division of Allergy and Clinical Immunology, Johns Hopkins University School of Medicine Baltimore, Maryland, 21224
| | - Xiaobin Wang
- Center on Early Life Origins of Disease, Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health Baltimore, Maryland, 21205
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Pacheco CM, Ciaccio CE, Nazir N, Daley CM, DiDonna A, Choi WS, Barnes CS, Rosenwasser LJ. Homes of low-income minority families with asthmatic children have increased condition issues. Allergy Asthma Proc 2014; 35:467-74. [PMID: 25584914 DOI: 10.2500/aap.2014.35.3792] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The home is increasingly associated with asthma. It acts both as a reservoir of asthma triggers and as a refuge from seasonal outdoor allergen exposure. Racial/ethnic minority families with low incomes tend to reside in neighborhoods with low housing quality. These families also have higher rates of asthma. This study explores the hypothesis that black and Latino urban households with asthmatic children experienced more home mechanical, structural condition-related areas of concern than white households with asthmatic children. Participant families (n = 140) took part in the Kansas City Safe and Healthy Homes Program, had at least one asthmatic child, and met income qualifications of no more than 80% of local median income; many were below 50%. Families self-identified their race. Homes were assessed by environmental health professionals using a standard set of criteria and a specific set of on-site and laboratory sampling and analyses. Homes were given a score for areas of concern between 0 (best) and 53 (worst). The study population self-identified as black (46%), non-Latino white (26%), Latino (14.3%), and other (12.9%). Mean number of areas of concern were 18.7 in Latino homes, 17.8 in black homes, 13.3 in other homes, and 13.2 in white homes. Latino and black homes had significantly more areas of concern. White families were also more likely to be in the upper portion of the income. In this set of 140 low-income homes with an asthmatic child, households of minority individuals had more areas of condition concerns and generally lower income than other families.
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Affiliation(s)
- Christina M. Pacheco
- Center for American Indian Community Health, University of Kansas Medical Center, Kansas City, Kansas, USA
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Hu Y, Liu W, Huang C, Zou ZJ, Zhao ZH, Shen L, Sundell J. Home dampness, childhood asthma, hay fever, and airway symptoms in Shanghai, China: associations, dose-response relationships, and lifestyle's influences. INDOOR AIR 2014; 24:450-463. [PMID: 24571077 DOI: 10.1111/ina.12104] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Accepted: 02/20/2013] [Indexed: 06/03/2023]
Abstract
Numerous studies of associations between dampness and respiratory diseases have been conducted, but their implications remain inconclusive. In this study of 13,335 parent-reported questionnaires (response rate: 85.3%), we analyzed associations between home dampness and asthma and related symptoms in 4- to 6-year-old children in a cross-sectional study of Shanghai. Indicators of home dampness were strongly and significantly associated with dry cough, wheeze, and rhinitis symptoms. In the current residence, children with visible mold spots (VMS) exposure had 32% higher risk of asthma (adjusted OR, 95% CI: 1.32, 1.07-1.64); damp clothing and/or bedding (frequently) was strongly associated with dry cough (1.78, 1.37-2.30); condensation on windows was strongly associated with hay fever (1.60, 1.27-2.01). In the early-life residence, VMS or damp stains (frequently) were strongly associated with dry cough (2.20, 1.55-3.11) and rhinitis ever (1.57, 1.11-2.21). Associations between dampness and diseases among children with or without family history of atopy were similar. The total number of dampness indicators had strong dose-response relationships with investigated health outcomes. Actions, including opening windows of the child's room at night and cleaning the child's room frequently, could potentially mitigate 25% of home VMS, thereby preventing more than 1.5% of attributable risk of the studied symptoms.
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Affiliation(s)
- Y Hu
- Department of Building Environment and Equipment Engineering, School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
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30
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Social disadvantage and asthma control in children. Paediatr Respir Rev 2014; 15:256-62; quiz 262-3. [PMID: 24928775 PMCID: PMC4146695 DOI: 10.1016/j.prrv.2014.04.017] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 04/29/2014] [Indexed: 12/22/2022]
Abstract
This review discusses various aspects of social disadvantage and their association with poor asthma control, including socioeconomic status, exposure to psychosocial stress and violence, minority affiliation, environmental concerns such as allergens and pollution, and poverty in rural settings. Each of these elements has been linked with worsened asthma outcomes in children. Known and hypothesized mechanisms behind these associations are described in an effort to further understand the complex entity of poorly controlled asthma among socially deprived children. Intervention studies to improve asthma outcomes in these vulnerable populations are also described.
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Camacho-Rivera M, Kawachi I, Bennett GG, Subramanian SV. Associations of neighborhood concentrated poverty, neighborhood racial/ethnic composition, and indoor allergen exposures: a cross-sectional analysis of los angeles households, 2006-2008. J Urban Health 2014; 91:661-76. [PMID: 24771244 PMCID: PMC4134442 DOI: 10.1007/s11524-014-9872-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Although racial/ethnic, socioeconomic, and neighborhood factors have been linked to asthma, and the association between indoor allergens and asthma is well documented, few studies have examined the relationship between these factors and indoor allergens. We examined the frequency of reported indoor allergens and differences by racial/ethnic, socioeconomic, and neighborhood characteristics among a diverse sample of Los Angeles households. Multilevel logistic regression models were used to analyze the data from 723 households from wave 2 of the Los Angeles Family and Neighborhood Survey. The reported presence of rats, mice, cockroaches, mold, pets, and tobacco smoke were the primary outcomes of interest. Hispanic and Asian households had a nearly threefold increase in the odds of reporting cockroaches compared to non-Hispanic Whites (OR, 2.85; 95 % CI 1.38-5.88 and OR, 2.62; 95 % CI 1.02-6.73, respectively) even after adjusting for socioeconomic factors. Primary caregivers who had obtained a high school degree were significantly less likely to report the presence of mice and cockroaches compared to primary caregivers with less than a high school degree (OR, 0.19; 95 % CI 0.08-0.46 and OR, 0.39; 95 % CI 0.23-0.68, respectively). Primary caregivers with more than a high school degree were also less likely to report the presence of rats, mice, and cockroaches within their households, compared to those with less than a high school degree. Compared to renters, home owners were less likely to report the presence of mice, cockroaches, and mold within their households. At the neighborhood level, households located within neighborhoods of high concentrated poverty (where the average poverty rate is at least 50 %) were more likely to report the presence of mice and cockroaches compared to households in low concentrated poverty neighborhoods (average poverty rate is 10 % or less), after adjusting for individual race/ethnicity and socioeconomic characteristics. Our study found evidence in support of neighborhood-level racial/ethnic and socioeconomic influences on indoor allergen exposure, above and beyond individual factors. Future studies should continue to explore individual and neighborhood-level racial/ethnic and socioeconomic differences in household allergen exposures across diverse contexts.
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Affiliation(s)
- Marlene Camacho-Rivera
- Department of Population Health, North Shore-Long Island Jewish Health System, Great Neck, NY, USA
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Kanchongkittiphon W, Gaffin JM, Phipatanakul W. The indoor environment and inner-city childhood asthma. Asian Pac J Allergy Immunol 2014; 32:103-10. [PMID: 25003723 PMCID: PMC4110514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Accepted: 03/21/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVE Exposure to indoor pollutants and allergens has been speculated to cause asthma symptoms and exacerbations and influence the risk of developing asthma. The aim of this article is to review the medical literature regarding the role of the indoor environment on inner-city childhood asthma. DATA SOURCES A literature search was performed in PubMed. Studies focusing on inner-city indoor allergen, childhood asthma, and environmental controls were included. RESULTS The prevalence of asthma in children is increasing especially in inner-city area. Exposure to high levels of indoor allergens and pollutants has been related to asthma development. Studies have shown that mouse, cockroach, pets, dust mite, mold, tobacco smoke, endotoxin and nitrogen dioxide are the important exposures. Recent studies have shown that indoor environmental control is beneficial in reducing asthma morbidity and development. CONCLUSIONS Inner-city children are exposed to various indoor allergens and pollutants that may lead to asthma development and exacerbation of existing asthma. Multifaceted environmental controls are beneficial in improving asthma symptom and maybe a viable prevention strategy. Further prospective studies of environmental intervention are needed to further identify effective strategies to improve and prevent asthma symptoms in inner-city children.
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Affiliation(s)
- Watcharoot Kanchongkittiphon
- Division of Allergy and Immunology, Boston Children’s Hospital, Boston, MA, U.S
- Harvard Medical School, Boston, MA, U.S
- Department of Pediatrics, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Jonathan M. Gaffin
- Harvard Medical School, Boston, MA, U.S
- Division of Respiratory Diseases, Boston Children’s Hospital, Boston, MA, U.S
| | - Wanda Phipatanakul
- Division of Allergy and Immunology, Boston Children’s Hospital, Boston, MA, U.S
- Harvard Medical School, Boston, MA, U.S
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Wright LS, Phipatanakul W. Environmental remediation in the treatment of allergy and asthma: latest updates. Curr Allergy Asthma Rep 2014; 14:419. [PMID: 24488258 DOI: 10.1007/s11882-014-0419-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
In the modern era, the prevalence of asthma and allergies are increasing. It has been speculated that environmental exposures are contributing to this rise. Several studies demonstrate that common indoor allergen exposures exacerbate asthma. Minimizing exposure to allergens and remediating the environment play a critical role in the treatment of asthma and allergies. The most effective environmental control measures are tailored multifaceted interventions which include education, thorough cleaning, using high-efficiency particulate air (HEPA) filters, integrated pest management, and maintenance of these practices.
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Affiliation(s)
- Lakiea S Wright
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA,
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Coleman AT, Rettiganti M, Bai S, Brown RH, Perry TT. Mouse and cockroach exposure in rural Arkansas Delta region homes. Ann Allergy Asthma Immunol 2014; 112:256-60. [PMID: 24491312 DOI: 10.1016/j.anai.2014.01.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Revised: 01/03/2014] [Accepted: 01/04/2014] [Indexed: 11/24/2022]
Abstract
BACKGROUND Home characteristics and aeroallergen exposure in rural US children with asthma are poorly described. OBJECTIVE To examine the relationship between cockroach and mouse allergen concentrations and home characteristics of children with asthma in the rural Arkansas Delta. METHODS The home environments of rural children with asthma were examined using home environment questionnaire and home inspection. Bedroom and kitchen dust was analyzed for cockroach and mouse allergen concentrations. RESULTS The median age of participants was 9 years, and 84% were African American. Most participants (78%) resided in single-family homes. Evidence of cockroaches was detected in 13% of homes and evidence of rodents was detected in 23% of homes. Detectable Bla g 1 was found in 58% of kitchens and 43% of bedrooms, Bla g 2 was detected in 37% of kitchens and 28% of bedrooms, and Mus m 1 was found in 81% of kitchens and 97% of bedrooms. Evidence of cockroaches in any room was associated with Bla g 1 concentrations of ≥2 U/g (odds ratio 21.71, 95% confidence interval 4.26-118.39) and Bla g 2 concentrations of ≥2 U/g (odds ratio 21.90 95% confidence interval 4.30-138.91). Multifamily vs single-family dwellings were more likely to have Bla g 2 concentrations of ≥2 U/g (odds ratio 3.52, 95% confidence interval 1.0-11.82). Home characteristics were not associated with Mus m 1. CONCLUSION Mouse and cockroach allergens were detected in most rural homes; however, concentrations were relatively low compared with those previously reported in inner-city homes. Few home characteristics predicted allergen concentrations. Further studies are needed to establish clinically relevant associations that might place rural children with asthma at risk for poor clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT00590304.
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Affiliation(s)
- Amaziah T Coleman
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Mallikarjuna Rettiganti
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas; Arkansas Children's Hospital Research Institute, Little Rock, Arkansas
| | - Shasha Bai
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, Ohio
| | - Rita H Brown
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Tamara T Perry
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas; Arkansas Children's Hospital Research Institute, Little Rock, Arkansas.
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Stoner AM, Anderson SE, Buckley TJ. Ambient air toxics and asthma prevalence among a representative sample of US kindergarten-age children. PLoS One 2013; 8:e75176. [PMID: 24058662 PMCID: PMC3776728 DOI: 10.1371/journal.pone.0075176] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Accepted: 08/12/2013] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Criteria pollutants have been associated with exacerbation of children's asthma, but the role of air toxics in relation to asthma is less clear. Our objective was to evaluate whether exposure to outdoor air toxics in early childhood increased asthma risk or severity. METHODS Air toxics exposure was estimated using the 2002 National Air toxics Assessment (NATA) and linked to longitudinal data (n=6950) from a representative sample of US children born in 2001 and followed through kindergarten-age in the Early Child Longitudinal Study-Birth Cohort (ECLS-B). RESULTS Overall, 17.7% of 5.5 year-olds had ever been told by a healthcare professional they had asthma, and 6.8% had been hospitalized or visited an emergency room for an asthma attack. Higher rates of asthma were observed among boys (20.1%), low-income (24.8%), and non-Hispanic black children (30.0%) (p≤0.05). Air toxics exposure was greater for minority race/ethnicity (p<0.0001), low income (p<0.0001), non-rural area (p<0.001). Across all analyses, greater air toxics exposure, as represented by total NATA respiratory hazard index, or when limited to respiratory hazard index from onroad mobile sources or diesel PM, was not associated with a greater prevalence of asthma or hospitalizations (p trend >0.05). In adjusted logistic regression models, children exposed to the highest respiratory hazard index were not more likely to have asthma compared to those exposed to the lowest respiratory hazard index of total, onroad sources, or diesel PM. CONCLUSIONS Early childhood exposure to outdoor air toxics in a national sample has not previously been studied relative to children's asthma. Within the constraints of the study, we found no evidence that early childhood exposure to outdoor air toxics increased risk for asthma. As has been previously reported, it is evident that there are environmental justice and disparity concerns for exposure to air toxics and asthma prevalence in US children.
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Affiliation(s)
- Alexis M. Stoner
- Division of Environmental Health Sciences, the Ohio State University College of Public Health, Columbus, Ohio, United States of America
| | - Sarah E. Anderson
- Division of Epidemiology, the Ohio State University College of Public Health, Columbus, Ohio, United States of America
| | - Timothy J. Buckley
- Division of Environmental Health Sciences, the Ohio State University College of Public Health, Columbus, Ohio, United States of America
- * E-mail:
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Lin W, Brunekreef B, Gehring U. Meta-analysis of the effects of indoor nitrogen dioxide and gas cooking on asthma and wheeze in children. Int J Epidemiol 2013; 42:1724-37. [PMID: 23962958 DOI: 10.1093/ije/dyt150] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Since the meta-analysis on the association between indoor nitrogen dioxide (NO2) and childhood respiratory illness in 1992, many new studies have been published. The quantitative effects of indoor NO2 on respiratory illness have not been estimated in a formal meta-analysis since then. We aimed to quantify the association of indoor NO2 and its main source (gas cooking) with childhood asthma and wheeze. METHODS We extracted the association between indoor NO2 (and gas cooking) and childhood asthma and wheeze from population studies published up to 31 March 2013. Data were analysed by inverse-variance-weighted, random-effects meta-analysis. Sensitivity analyses were conducted for different strata. Publication bias and heterogeneity between studies were investigated. RESULTS A total of 41 studies met the inclusion criteria. The summary odds ratio from random effects meta-analysis for asthma and gas cooking exposure was 1.32 [95% confidential interval (CI) 1.18-1.48], and for a 15-ppb increase in NO2 it was 1.09 (95% CI 0.91-1.31). Indoor NO2 was associated with current wheeze (random effects OR 1.15; 95% CI 1.06-1.25). The estimates did not vary much with age or between regions. There was no evidence of publication bias. CONCLUSIONS This meta-analysis provides quantitative evidence that, in children, gas cooking increases the risk of asthma and indoor NO2 increases the risk of current wheeze.
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Affiliation(s)
- Weiwei Lin
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands and Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
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Johnson M, Macneill M, Grgicak-Mannion A, Nethery E, Xu X, Dales R, Rasmussen P, Wheeler A. Development of temporally refined land-use regression models predicting daily household-level air pollution in a panel study of lung function among asthmatic children. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2013; 23:259-67. [PMID: 23532094 DOI: 10.1038/jes.2013.1] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2012] [Accepted: 10/17/2012] [Indexed: 05/20/2023]
Abstract
Regulatory monitoring data and land-use regression (LUR) models have been widely used for estimating individual exposure to ambient air pollution in epidemiologic studies. However, LUR models lack fine-scale temporal resolution for predicting acute exposure and regulatory monitoring provides daily concentrations, but fails to capture spatial variability within urban areas. This study coupled LUR models with continuous regulatory monitoring to predict daily ambient nitrogen dioxide (NO(2)) and particulate matter (PM(2.5)) at 50 homes in Windsor, Ontario. We compared predicted versus measured daily outdoor concentrations for 5 days in winter and 5 days in summer at each home. We also examined the implications of using modeled versus measured daily pollutant concentrations to predict daily lung function among asthmatic children living in those homes. Mixed effect analysis suggested that temporally refined LUR models explained a greater proportion of the spatial and temporal variance in daily household-level outdoor NO(2) measurements compared with daily concentrations based on regulatory monitoring. Temporally refined LUR models captured 40% (summer) and 10% (winter) more of the spatial variance compared with regulatory monitoring data. Ambient PM(2.5) showed little spatial variation; therefore, daily PM(2.5) models were similar to regulatory monitoring data in the proportion of variance explained. Furthermore, effect estimates for forced expiratory volume in 1 s (FEV(1)) and peak expiratory flow (PEF) based on modeled pollutant concentrations were consistent with effects based on household-level measurements for NO(2) and PM(2.5). These results suggest that LUR modeling can be combined with continuous regulatory monitoring data to predict daily household-level exposure to ambient air pollution. Temporally refined LUR models provided a modest improvement in estimating daily household-level NO(2) compared with regulatory monitoring data alone, suggesting that this approach could potentially improve exposure estimation for spatially heterogeneous pollutants. These findings have important implications for epidemiologic studies - in particular, for research focused on short-term exposure and health effects.
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Affiliation(s)
- Markey Johnson
- Air Health Science Division, Water Air and Climate Change Bureau, Health Canada, 269 Laurier Avenue West, Ottawa, Ontario, Canada K1A 0K9.
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Abstract
Asthma is a complex condition that requires individualized interventions. The purpose of this article is to describe the relationship between the physical and social environments with asthma symptoms, present evidence that supports environmental interventions in asthma control and the implications for asthma management. There is evidence that indoor and outdoor allergens relate to asthma morbidity. Knowledge about which environmental exposures present risk is essential because many of these exposures can be modified, reduced, or eliminated. The community health nurse should provide care relative to the client's indoor and outdoor environment and existing allergens.
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Affiliation(s)
- Yvonne M Sterling
- LSU Health New Orleans School of Nursing, New Orleans, Louisiana 70112, USA.
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Paulin LM, Williams D, Oberweiser C, Diette GB, Breysse PN, McCormack MM, Matsui EC, Peng R, Metts TA, Hansel NN. Indoor Air Quality in Central Appalachia Homes Impacted by Wood and Coal Use. ACTA ACUST UNITED AC 2013; 4:67-71. [PMID: 27738549 DOI: 10.4236/jep.2013.41007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Though the high prevalence of biomass fuel use in the developing world is widely known, the use of burning biomass for cooking and heating in the developed world is under-recognized. Combustion materials including coal and wood are also used for heating in some areas of the United States. We conducted a pilot study to assess the feasibility of conducting indoor environmental monitoring in rural Appalachia. We sought to explore the type of biomass being used for home heating and its impact upon indoor air quality in non-heating and heating seasons. Residential indoor air monitoring for particulate matter (PM) and nitrogen dioxide (NO2) was conducted in Lee County, Virginia. Homes had evidence of poor indoor air quality with high concentrations of indoor PM and a large burden of cigarette smoking. Further characterization of indoor combustion material use in this region to determine the health impacts associated with such exposures is warranted.
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Affiliation(s)
- Laura M Paulin
- Division of Pulmonary and Critical Care, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, USA
| | - D'Ann Williams
- Division of Environmental Health Engineering, Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | | | - Gregory B Diette
- Division of Pulmonary and Critical Care, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, USA
| | - Patrick N Breysse
- Division of Environmental Health Engineering, Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Meredith M McCormack
- Division of Pulmonary and Critical Care, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, USA
| | - Elizabeth C Matsui
- Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, USA
| | - Roger Peng
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Tricia A Metts
- Department of Environmental Health, East Tennessee State University College of Public Health, Johnson City, USA
| | - Nadia N Hansel
- Division of Pulmonary and Critical Care, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, USA
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Kueny A, Berg J, Chowdhury Y, Anderson N. Poquito a poquito: how Latino families with children who have asthma make changes in their home. J Pediatr Health Care 2013; 27:e1-11. [PMID: 23237616 DOI: 10.1016/j.pedhc.2011.02.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2010] [Revised: 01/28/2011] [Accepted: 02/13/2011] [Indexed: 12/29/2022]
Abstract
INTRODUCTION The purpose of this study was to assess the cultural and environmental barriers to making asthma-focused changes in the homes of Latino families with children who have asthma. METHODS A descriptive qualitative design guided data collection and analysis in this study. Participating families described their experiences in caring for their children with asthma and the barriers they encountered when trying to modify their home environments and manage their children's asthma symptoms. RESULTS Families discussed a spectrum of methods to manage their children's asthma symptoms, including barriers they experienced and successful changes they made in their homes. "Little by little" parents made minor adjustments, as they were able, to alleviate their children's asthma symptoms. DISCUSSION Nurses working with Latino families who experience similar barriers can use these findings to guide inquiries about families' successful changes in their home environment and use them as a starting place to work collaboratively with families to reduce their children's asthma exacerbations. This process will allow nurses to use culturally and family tailored interventions to fit their needs and goals.
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Tang N, Yoda Y, Otani N, Kameda T, Toriba A, Hayakawa K, Shima M. Personal and atmospheric concentrations of ozone in southeastern Hyogo prefecture, Japan. Chem Pharm Bull (Tokyo) 2012; 60:962-6. [PMID: 22863698 DOI: 10.1248/cpb.c12-00105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Twenty-one data sets composed of readings collected by atmospheric ozone monitors worn by individuals on their clothing and installed outside their home or office were collected using Ogawa passive ozone samplers in southeastern Hyogo prefecture, Japan from September 12 to 13, 2011. The concentrations of personal and outdoor ozone ranged from not detectable to 23.2 ppb and from 4.7 to 38.3 ppb, respectively. The mean concentration of personal exposure to ozone was 3.7 ppb and was significantly lower than that of outdoor ozone (18.5 ppb). This suggests that the concentrations of outdoor ozone affect personal ozone exposure. However, in this study, we found no correlation between the concentrations of personal ozone and the total time spent outdoors or the time of day the individual was outside. In contrast, the mean concentrations of outdoor ozone were similar to those of ozone measured at the 12 nearest Ambient Monitoring Stations (AMSs). However, when the AMS was situated near a main road, the regional ozone levels were underestimated.
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Affiliation(s)
- Ning Tang
- Department of Public Health, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya 663-8501, Japan.
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Apelberg BJ, Hepp LM, Avila-Tang E, Gundel L, Hammond SK, Hovell MF, Hyland A, Klepeis NE, Madsen CC, Navas-Acien A, Repace J, Samet JM, Breysse PN. Environmental monitoring of secondhand smoke exposure. Tob Control 2012; 22:147-55. [PMID: 22949497 PMCID: PMC3639351 DOI: 10.1136/tobaccocontrol-2011-050301] [Citation(s) in RCA: 98] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The complex composition of secondhand smoke (SHS) provides a range of constituents that can be measured in environmental samples (air, dust and on surfaces) and therefore used to assess non-smokers' exposure to tobacco smoke. Monitoring SHS exposure (SHSe) in indoor environments provides useful information on the extent and consequences of SHSe, implementing and evaluating tobacco control programmes and behavioural interventions, and estimating overall burden of disease caused by SHSe. The most widely used markers have been vapour-phase nicotine and respirable particulate matter (PM). Numerous other environmental analytes of SHS have been measured in the air including carbon monoxide, 3-ethenylpyridine, polycyclic aromatic hydrocarbons, tobacco-specific nitrosamines, nitrogen oxides, aldehydes and volatile organic compounds, as well as nicotine in dust and on surfaces. The measurement of nicotine in the air has the advantage of reflecting the presence of tobacco smoke. While PM measurements are not as specific, they can be taken continuously, allowing for assessment of exposure and its variation over time. In general, when nicotine and PM are measured in the same setting using a common sampling period, an increase in nicotine concentration of 1 μg/m3 corresponds to an average increase of 10 μg/m3 of PM. This topic assessment presents a comprehensive summary of SHSe monitoring approaches using environmental markers and discusses the strengths and weaknesses of these methods and approaches.
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Affiliation(s)
- Benjamin J Apelberg
- Department of Epidemiology, Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health, 615N. Wolfe St, Baltimore, Maryland 21205, USA.
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43
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Schreier HMC, Chen E. Socioeconomic status and the health of youth: a multilevel, multidomain approach to conceptualizing pathways. Psychol Bull 2012; 139:606-54. [PMID: 22845752 DOI: 10.1037/a0029416] [Citation(s) in RCA: 124] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Previous research has clearly established associations between low socioeconomic status (SES) and poor youth physical health outcomes. This article provides an overview of the main pathways through which low SES environments come to influence youth health. We focus on 2 prevalent chronic health problems in youth today, asthma and obesity. We review and propose a model that encompasses (a) multiple levels of influence, including the neighborhood, family and person level; (b) both social and physical domains in the environment; and finally (c) dynamic relationships between these factors. A synthesis of existing research and our proposed model draw attention to the notion of adverse physical and social exposures in youth's neighborhood environments altering family characteristics and youth psychosocial and behavioral profiles, thereby increasing youth's risk for health problems. We also note the importance of acknowledging reciprocal influences across levels and domains (e.g., between family and child) that create self-perpetuating patterns of influence that further accentuate the impact of these factors on youth health. Finally, we document that factors across levels can interact (e.g., environmental pollution levels with child stress) to create unique, synergistic effects on youth health. Our model stresses the importance of evaluating influences on youth's physical health not in isolation but in the context of the broader social and physical environments in which youth live. Understanding the complex relationships between the factors that link low SES to youth's long-term health trajectories is necessary for the creation and implementation of successful interventions and policies to ultimately reduce health disparities.
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Affiliation(s)
- Hannah M C Schreier
- Department of Psychology, University of British Columbia, Vancouver, British Columbia V6T 1Z4, Canada.
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Portnoy J, Kennedy K, Sublett J, Phipatanakul W, Matsui E, Barnes C, Grimes C, Miller JD, Seltzer JM, Williams PB, Bernstein JA, Bernstein DI, Blessing-Moore J, Cox L, Khan DA, Lang DM, Nicklas RA, Oppenheimer J. Environmental assessment and exposure control: a practice parameter--furry animals. Ann Allergy Asthma Immunol 2012; 108:223.e1-15. [PMID: 22469456 DOI: 10.1016/j.anai.2012.02.015] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2012] [Accepted: 02/21/2012] [Indexed: 12/20/2022]
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Portnoy J, Kennedy K, Sublett J, Phipatanakul W, Matsui E, Barnes C, Grimes C, Miller JD, Seltzer JM, Williams PB, Bernstein JA, Bernstein DI, Blessing-Moore J, Cox L, Khan DA, Lang DM, Nicklas RA, Oppenheimer J. Environmental assessment and exposure control: a practice parameter--furry animals. Ann Allergy Asthma Immunol 2012. [PMID: 22469456 DOI: 10.1016/j.anai.2012.02.015.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/01/2022]
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Sun Y, Sundell J. Life style and home environment are associated with racial disparities of asthma and allergy in Northeast Texas children. THE SCIENCE OF THE TOTAL ENVIRONMENT 2011; 409:4229-4234. [PMID: 21802705 DOI: 10.1016/j.scitotenv.2011.07.011] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2011] [Revised: 06/28/2011] [Accepted: 07/05/2011] [Indexed: 05/31/2023]
Abstract
A high prevalence and racial disparities in asthma and allergy have been observed in American children. This study aimed to identify risk factors for asthma and allergy among children, and their contribution to racial disparities in allergy prevalence. A population-based cross-sectional study was carried out among children aged 1-8 years in Northeast Texas 2008-2009. The health conditions, life style and home environment of 3766 children were surveyed by parental questionnaires through e.g. daycares, elementary school, and medical clinics. Among participants who indicated their ethnicity, 255 were Mexican-Americans, 178 Afro-Americans and 969 Caucasians. Afro-American children had a significantly higher prevalence of asthma and eczema. Caucasian had the highest prevalence of rhinitis. Compared to Mexican-American children, Afro-American and Caucasian children were breast fed shorter time, more often went to day care center, had pets and environmental tobacco smoke exposure at home more often. For all children, being at a day care center, being exposed to dampness and environmental tobacco smoke at home were strong risk factors for asthma and allergy. Central air conditioning system was associated with an increased prevalence of wheeze among Mexican-American children, while pets were associated with an increased risk of rhinitis among Afro-American and Caucasian children. Caucasian children were generally not healthier than relatively poor Mexican-American children. Differences in the prevalence of asthma and allergy between races cannot be explained by socioeconomic status only. Life style and home environmental exposures are important risk factors for asthma and allergy in Northeast Texas children.
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Affiliation(s)
- Yuexia Sun
- Texas Institute of Allergy, Indoor Environment and Energy (TxAIRE), University of Texas at Tyler, 3900 University Blvd, Tyler, Tx 75799, USA.
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Indoor environment and children's health: recent developments in chemical, biological, physical and social aspects. Int J Hyg Environ Health 2011; 215:1-18. [PMID: 21889403 DOI: 10.1016/j.ijheh.2011.07.008] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2011] [Revised: 07/22/2011] [Accepted: 07/25/2011] [Indexed: 12/11/2022]
Abstract
Much research is being carried out into indoor exposure to harmful agents. This review focused on the impact on children's health, taking a broad approach to the indoor environment and including chemical, microbial, physical and social aspects. Papers published from 2006 onwards were reviewed, with regards to scientific context. Most of publications dealt with chemical exposure. Apart from the ongoing issue of combustion by-products, most of these papers concerned semi volatile organic compounds (such as phthalates). These may be associated with neurotoxic, reprotoxic or respiratory effects and may, therefore, be of particular interest so far as children are concerned. In a lesser extent, volatile organic compounds (such as aldehydes) that have mainly respiratory effects are still studied. Assessing exposure to metals is still of concern, with increasing interest in bioaccessibility. Most of the papers on microbial exposure focused on respiratory tract infections, especially asthma linked to allergens and bio-aerosols. Physical exposure includes noise and electromagnetic fields, and articles dealt with the auditory and non auditory effects of noise. Articles on radiofrequency electromagnetic fields mainly concerned questions about non-thermal effects and papers on extremely low-frequency magnetic fields focused on the characterization of exposure. The impact of the indoor environment on children's health cannot be assessed merely by considering the effect of these different types of exposure: this review highlights new findings and also discusses the interactions between agents in indoor environments and also with social aspects.
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Toledo M, Rozov T, Leone C. Prevalence of asthma and allergies in 13- to 14-year-old adolescents and the frequency of risk factors in carriers of current asthma in Taubaté, São Paulo, Brazil. Allergol Immunopathol (Madr) 2011; 39:284-90. [PMID: 21237553 DOI: 10.1016/j.aller.2010.09.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2010] [Revised: 09/18/2010] [Accepted: 09/23/2010] [Indexed: 11/24/2022]
Abstract
BACKGROUND The objectives of this study were to determine the prevalence of asthma and allergies in 13- to 14-year-old adolescents in the city of Taubaté, São Paulo, Brazil using the INTERNATIONAL STUDY OF ASTHMA AND ALLERGIES IN CHILDHOOD (ISAAC) questionnaire and to describe the presence of risk factors in current asthma carriers. METHODS We used a cross-sectional study involving 920 adolescents who completed the ISAAC questionnaire and answered additional questions regarding smoking and the presence of pets and/or insects at home. RESULTS The mean prevalence rate of "current asthma" was 15.3% and "asthma ever" was 6.8%. The mean prevalence rate of "current rhinitis" was 36.6% and "rhinitis ever" 37.6%. The prevalence of "eczema ever" was 16.2%. The frequency of active smoking was low (0.7%), and the presence of indoor animals (34%) and of insects (55.1%) was high. CONCLUSIONS The prevalence of "current asthma" was twice as high as that of "asthma ever". There was no association between risk factors studied and current asthma.
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Abstract
Cockroach allergy is a health problem in many parts of the world. In urban environments, indoor exposure to cockroach allergens involves a risk of asthma. The aim of this study was to measure the mass fraction of Bla g 1, a major allergen of the German cockroach (Blatella germanica) in 30 house samples, collected at random from Zagreb area households, Croatia. Dust samples were collected on cellulose filters by vacuuming living rooms floors. After extraction, Bla g 1 was detected using the commercial enzyme-linked immunosorbent assay (ELISA). Only four of the thirty households had detectable Bla g 1 levels, and only in one was its concentration higher than 2.0 U g(-1), the threshold associated with sensitisation. The Bla g 1 ELISA proved highly sensitive, with the detection limit of 0.12 U g(-1). The within- and between-assay imprecision was 8.9 % and 14.4 %, respectively, and accuracy 85 % to 120 %. Low Bla g 1 levels in the household dust support previously reported low prevalence of skin sensitisation to B. germanica among Zagreb residents. Further monitoring should reveal if there are differences in cockroach allergen exposure and sensitisation between households from other geographic areas in Croatia.
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Hansel NN, Matsui EC, Rusher R, McCormack MC, Curtin-Brosnan J, Peng RD, Mazique D, Breysse PN, Diette GB. Predicting future asthma morbidity in preschool inner-city children. J Asthma 2011; 48:797-803. [PMID: 21861602 DOI: 10.3109/02770903.2011.604887] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND AND AIMS Children living in the inner city are particularly vulnerable to asthma. While we know much about factors that affect near-term outcomes in inner-city children, there is little evidence to guide clinicians on what to expect in the coming years, especially in preschool children. The purpose of our study was to determine which clinical and environmental factors are predictive of poor long-term asthma control in preschool inner-city children. MATERIALS AND METHODS Baseline characteristics determined to be potential predictors of asthma severity were examined: demographics, asthma symptoms, medication use, healthcare utilization, early life medical history, family history, allergen exposure and allergic disease, and pollutant exposure. Bivariate and multivariate analyses were performed using logistic regression to examine the association of predictors of asthma severity with healthcare utilization at 2 years. RESULTS Of the 150 children at baseline, the follow-up rate was 83% at 2 years; therefore, 124 children were included in final analyses. At baseline, the mean age was 4.4 years and participants were predominantly African-American (90%). Most of the children were atopic and 32.5% reported using inhaled corticosteroids. Nighttime awakening from asthma and a history of pneumonia were predictive of future poor control. CONCLUSION Preschool children with nighttime awakening from asthma and a history of pneumonia may deserve closer monitoring to prevent future asthma morbidity.
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Affiliation(s)
- Nadia N Hansel
- Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
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