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Liu SH, Shaughnessy D, Leslie L, Abbott K, Abraham AG, McCann P, Saldanha IJ, Qureshi R, Li T. Social Determinants of Dry Eye in the United States: A Systematic Review. Am J Ophthalmol 2024; 261:36-53. [PMID: 38242339 PMCID: PMC11031303 DOI: 10.1016/j.ajo.2024.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 01/03/2024] [Accepted: 01/12/2024] [Indexed: 01/21/2024]
Abstract
PURPOSE To conduct a systematic review to summarize current evidence on associations between social determinants of health (SDOH) indicators and dry eye in the United States. DESIGN Systematic review. METHODS We followed a protocol registered on Open Science Framework to include studies that examined associations between SDOH indicators and dry eye. We mapped SDOH indicators to 1 of the 5 domains following the Healthy People 2030 framework and categorized dry eye measures into "dry eye diagnosis and care," "dry eye symptoms," or "ocular surface parameters." We summarized the direction of association between SDOH indicators and dry eye as worsening, beneficial, or null. We used items from the Newcastle Ottawa Scale to assess risk of bias. RESULTS Eighteen studies reporting 51 SDOH indicators, mostly mapped to the neighborhood and built environment domain, were included. Thirteen studies were judged at high risk of bias. Fifteen of 19 (79%) associations revealed an increase in the diagnosis of dry eye or delayed specialty care for it. Thirty-four of 56 (61%) associations unveiled exacerbated dry eye symptoms. Fifteen of 23 (65%) found null associations with corneal fluorescein staining. Ten of 22 (45%) associations revealed an increased tear break up time (45%) whereas another 10 (45%) showed null associations. CONCLUSIONS Most SDOH indicators studied were associated with unfavorable dry eye measures, such as a higher disease burden, worse symptoms, or delayed referral, in the United States. Future investigations between SDOH and dry eye should use standardized instruments and address the domains in which there is an evidence gap.
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Affiliation(s)
- Su-Hsun Liu
- Department of Ophthalmology, School of Medicine (S.H.L., L.L., K.A., P.M., R.Q., T.L.), University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA; Department of Epidemiology (S.H.L., D.S., A.G.A., R.Q., T.L.), Colorado School of Public Health, Aurora, Colorado, USA
| | - Daniel Shaughnessy
- Department of Epidemiology (S.H.L., D.S., A.G.A., R.Q., T.L.), Colorado School of Public Health, Aurora, Colorado, USA
| | - Louis Leslie
- Department of Ophthalmology, School of Medicine (S.H.L., L.L., K.A., P.M., R.Q., T.L.), University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Kaleb Abbott
- Department of Ophthalmology, School of Medicine (S.H.L., L.L., K.A., P.M., R.Q., T.L.), University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Alison G Abraham
- Department of Epidemiology (S.H.L., D.S., A.G.A., R.Q., T.L.), Colorado School of Public Health, Aurora, Colorado, USA
| | - Paul McCann
- Department of Ophthalmology, School of Medicine (S.H.L., L.L., K.A., P.M., R.Q., T.L.), University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Ian J Saldanha
- Department of Epidemiology (I.J.S.), Bloomberg School of Public Health, Baltimore, Maryland, USA; Johns Hopkins Center for Clinical Trials and Evidence Synthesis (I.J.S.), Baltimore, Maryland, USA
| | - Riaz Qureshi
- Department of Ophthalmology, School of Medicine (S.H.L., L.L., K.A., P.M., R.Q., T.L.), University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA; Department of Epidemiology (S.H.L., D.S., A.G.A., R.Q., T.L.), Colorado School of Public Health, Aurora, Colorado, USA
| | - Tianjing Li
- Department of Ophthalmology, School of Medicine (S.H.L., L.L., K.A., P.M., R.Q., T.L.), University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA; Department of Epidemiology (S.H.L., D.S., A.G.A., R.Q., T.L.), Colorado School of Public Health, Aurora, Colorado, USA.
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Totou S, Karmiris E, Kanakis M, Gartaganis P, Petrou P, Kalogeropoulos C, Kozobolis V, Stavrakas P. Impact of flight and equivalent short-term high-altitude exposure on ocular structures and function. MEDICAL HYPOTHESIS, DISCOVERY & INNOVATION OPHTHALMOLOGY JOURNAL 2023; 12:127-141. [PMID: 38476577 PMCID: PMC10926315 DOI: 10.51329/mehdiophthal1478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 12/27/2023] [Indexed: 03/14/2024]
Abstract
Background Exposure to high-altitude conditions during flight or similar activities affects many aspects of visual function, which is critical not only for flight safety but for any altitude-related activity. We aimed to summarize the available literature pertaining to ocular changes during flight or equivalent short-term high-altitude exposure (e.g., hypobaric chamber, effortless ascent lasting ≤ 24 h) and to highlight future research priorities. Methods Using the PubMed/MEDLINE and Web of Science/ISI Web of Knowledge databases with structured search syntax, we conducted a systematic review of the literature spanning a 40-year period (January 1, 1983, to October 10, 2023). Articles pertaining to ocular changes during flight or flight-equivalent exposure to altitude were retrieved. The reference lists of retrieved studies were also searched, and citations of these references were included in the results. Results Of 875 relevant PubMed and ISI publications, 122 qualified for inclusion and 20 more were retrieved from the reference lists of initially selected records, for a total of 142 articles. Reported anterior segment changes included deterioration in tear film stability and increased dry eye incidence, increased corneal thickness, discomfort and bubble formation in contact lens users, refraction changes in individuals with prior refractive surgery, decreased intraocular pressure, and alterations in pupillary reaction, contrast sensitivity, and visual fields. Photoreceptor-visual pathway changes included alterations in both photoreceptors and neuro-transduction, as evidenced in dark adaptation, macular recovery time, reduction in visual field sensitivity, and optic neuritis (likely an element of decompression sickness). Retinochoroidal changes included increases in retinal vessel caliber, retinal blood flow, and choroidal thickness; central serous chorioretinopathy; and retinal vascular events (non-arteritic ischemic optic neuropathy, high-altitude retinopathy, and retinal vein occlusion). Conclusions The effect of short-term high-altitude exposure on the eye is, in itself, a difficult area to study. Although serious impairment of visual acuity appears to be rare, ocular changes, including tear film stability, contact lens wear, central corneal thickness, intraocular pressure, contrast sensitivity, stability of refractive surgeries, retinal vessels, visual fields, and macula recovery time, should be considered in civilian aviators. Our report provides guidance to climbers and lowlanders traveling to altitude if they have pre-existing ocular conditions or if they experience visual symptoms while at altitude. However, key outcomes have been contradictory and comprehensive studies are scarce, especially those pertaining to the choroid and retina. Such studies could not only deepen our understanding of high-altitude ocular pathophysiology, but could also offer valuable information and treatment possibilities for a constellation of other vision-threatening diseases.
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Affiliation(s)
- Styliani Totou
- Department of Ophthalmology, University of Patras, School of Medicine, Patras, Greece
- Hellenic Air Force General Hospital, Athens, Attika, Greece
| | | | - Menelaos Kanakis
- Department of Ophthalmology, University of Patras, School of Medicine, Patras, Greece
| | | | - Petros Petrou
- Department of Ophthalmology, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | | | - Vassilios Kozobolis
- Department of Ophthalmology, University of Patras, School of Medicine, Patras, Greece
| | - Panagiotis Stavrakas
- Department of Ophthalmology, University of Patras, School of Medicine, Patras, Greece
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3
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Lee JJ, Forristal MT, Harney F, Flaherty GT. Eye disease and international travel: a critical literature review and practical recommendations. J Travel Med 2023; 30:taad068. [PMID: 37191043 PMCID: PMC10289526 DOI: 10.1093/jtm/taad068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 05/03/2023] [Accepted: 05/05/2023] [Indexed: 05/17/2023]
Abstract
RATIONALE FOR REVIEW Eye diseases pose a significant public health and economic burden, particularly for travellers exposed to ocular hazards who may lack access to specialist eye care. This article offers an evidence-based review for travel-health practitioners, with a particular emphasis on ocular infections and trauma that are more prevalent among travellers. Providing an overview of these issues will allow travel health practitioners to comprehensively address ophthalmic considerations of travel. METHODS A systematic literature search was conducted on PubMed and Embase electronic databases, using keywords related to travel medicine and ophthalmology. Inclusion was based on the relevant contribution to epidemiology, aetiology, diagnostics, management and long-term consequences of travel-related eye conditions. The data were analysed using narrative synthesis. KEY FINDINGS This literature review highlighted that various travel-related eye conditions may occur. Travellers should be aware of the risk of travel-related ocular complications, which can arise from ocular infections, high-risk activities, high altitude and space travel. The economic and logistical challenges associated with medical tourism for ophthalmic procedures are discussed. For travellers with pre-existing eye conditions or visual impairment, careful planning may be needed to promote eye health and ensure safety of travel. CONCLUSIONS Travel medicine practitioners should have a comprehensive understanding of the major ocular risks associated with overseas travel, including eye infections, eye injuries and solar eye damage. Further research in this area can enhance overall wellness and alleviate the burden of ocular diseases on travellers. Evidence-based guidelines based on research can also improve the quality of care and prevent long-term vision problems.
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Affiliation(s)
- Jay Jun Lee
- Department of Ophthalmology, University Hospital Galway, Galway, Ireland
- Department of Ophthalmology, Temple Street Children’s University Hospital, Dublin, Ireland
| | - Mark T Forristal
- Department of Ophthalmology, University Hospital Galway, Galway, Ireland
| | - Fiona Harney
- Department of Ophthalmology, University Hospital Galway, Galway, Ireland
- School of Medicine, University of Galway, Galway, Ireland
| | - Gerard T Flaherty
- School of Medicine, University of Galway, Galway, Ireland
- School of Medicine, International Medical University, Kuala Lumpur, Malaysia
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Sudden cardiac arrest in commercial airports: Incidence, responses, and implications. Am J Emerg Med 2022; 59:118-120. [PMID: 35834873 DOI: 10.1016/j.ajem.2022.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 06/08/2022] [Accepted: 07/04/2022] [Indexed: 11/21/2022] Open
Abstract
Billions of travelers pass through airports around the world every year. Airports are a relatively common location for sudden cardiac arrest when compared with other public venues. An increased incidence of cardiac arrest in airports may be due to the large volume of movement, the stress of travel, or adverse effects related to the physiological environment of airplanes. Having said that, airports are associated with extremely high rates of witnessed arrests, bystander interventions (eg. CPR and AED use), shockable arrest rhythms, and survival to hospital discharge. Large numbers of people, a high density of public-access AEDs, and on-site emergency medical services (EMS) resources are probably the major reasons why cardiac arrest outcomes are so favorable at airports. The success of the chain of survival found at airports may imply that applying similar practices to other public venues will translate to improvements in cardiac arrest survival. Airports might, therefore, be one model of cardiac arrest preparedness that other public areas should emulate.
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Coffaro B, Weisel CP. Reactions and Products of Squalene and Ozone: A Review. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2022; 56:7396-7411. [PMID: 35648815 PMCID: PMC9231367 DOI: 10.1021/acs.est.1c07611] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
This critical review describes the squalene-ozone (SqOz) reaction, or squalene ozonolysis. Ambient ozone penetrates indoors and drives indoor air chemistry. Squalene, a component of human skin oil, contains six carbon-carbon double bonds and is very reactive with ozone. Bioeffluents from people contribute to indoor air chemistry and affect the indoor air quality, resulting in exposures because people spend the majority of their time indoors. The SqOz reaction proceeds through various formation pathways and produces compounds that include aldehydes, ketones, carboxylic acids, and dicarbonyl species, which have a range of volatilities. In this critical review of SqOz chemistry, information on the mechanism of reaction, reaction probability, rate constants, and reaction kinetics are compiled. Characterizations of SqOz reaction products have been done in laboratory experiments and real-world settings. The effect of multiple environmental parameters (ozone concentration, air exchange rate (AER), temperature, and relative humidity (RH)) in indoor settings are summarized. This critical review concludes by identifying the paucity of available exposure, health, and toxicological data for known reaction products. Key knowledge gaps about SqOz reactions leading to indoor exposures and adverse health outcomes are provided as well as an outlook on where the field is headed.
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Affiliation(s)
- Breann Coffaro
- Environmental
and Health Sciences Institute and Graduate Program in Exposure Science, Rutgers, The State University of New Jersey, Piscataway Township, New
Jersey 08854, United
States
| | - Clifford P. Weisel
- Environmental
and Health Sciences Institute and School of Public Health, Rutgers, The State University of New Jersey, Piscataway Township, New
Jersey 08854, United
States
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Wang F, You R, Zhang T, Chen Q. Recent progress on studies of airborne infectious disease transmission, air quality, and thermal comfort in the airliner cabin air environment. INDOOR AIR 2022; 32:e13032. [PMID: 35481932 PMCID: PMC9111434 DOI: 10.1111/ina.13032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 03/03/2022] [Accepted: 03/17/2022] [Indexed: 05/08/2023]
Abstract
Airborne transmission of infectious diseases through air travel has become a major concern, especially during the COVID-19 pandemic. The flying public and crew members have long demanded better air quality and thermal comfort in commercial airliner cabins. This paper reviewed studies related to the airliner cabin air environment that have been published in scientific journals since 2000, to understand the state-of-the-art in cabin air environment design and the efforts made to improve this environment. In this critical review, this paper discusses the challenges and opportunities in studying the cabin air environment. The literature review concluded that current environmental control systems for airliner cabins have done little to stop the airborne transmission of infectious diseases. There were no reports of significant air quality problems in cabins, although passengers and crew members have complained of some health-related issues. The air temperature in cabins needs to be better controlled, and therefore, better thermal comfort models for airliners should be developed. Low humidity is a major complaint from passengers and crew members. Gaspers are used by passengers to adjust thermal comfort, but they do not improve air quality. Various personalized and displacement ventilation systems have been developed to improve air quality and thermal comfort. Air cleaning technologies need to be further developed. Good tools are available for designing a better cabin air environment.
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Affiliation(s)
- Feng Wang
- Tianjin Key Laboratory of Indoor Air Environmental Quality ControlSchool of Environmental Science and EngineeringTianjin UniversityTianjinChina
- Department of Building Environment and Energy EngineeringThe Hong Kong Polytechnic UniversityKowloon, Hong Kong SARChina
| | - Ruoyu You
- Department of Building Environment and Energy EngineeringThe Hong Kong Polytechnic UniversityKowloon, Hong Kong SARChina
| | - Tengfei Zhang
- Tianjin Key Laboratory of Indoor Air Environmental Quality ControlSchool of Environmental Science and EngineeringTianjin UniversityTianjinChina
| | - Qingyan Chen
- Department of Building Environment and Energy EngineeringThe Hong Kong Polytechnic UniversityKowloon, Hong Kong SARChina
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Morrison GC, Eftekhari A, Majluf F, Krechmer JE. Yields and Variability of Ozone Reaction Products from Human Skin. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2021; 55:179-187. [PMID: 33337871 DOI: 10.1021/acs.est.0c05262] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The skin of 20 human participants was exposed to ∼110 ppb O3 and volatile products of the resulting chemistry were quantified in real time. Yields (ppb product emitted/ppb ozone consumed) for 40 products were quantified. Major products of the primary reaction of ozone-squalene included 6-methyl 5-hepten-2-one (6-MHO) and geranyl acetone (GA) with average yields of 0.22 and 0.16, respectively. Other major products included decanal, methacrolein (or methyl vinyl ketone), nonanal, and butanal. Yields varied widely among participants; summed yields ranged from 0.33 to 0.93. The dynamic increase in emission rates during ozone exposure also varied among participants, possibly indicative of differences in the thickness of the skin lipid layer. Factor analysis indicates that much of the variability among participants is due to factors associated with the relative abundance of (1) "fresh" skin lipid constituents (such as squalene and fatty acids), (2) oxidized skin lipids, and (3) exogenous compounds. This last factor appears to be associated with the presence of oleic and linoleic acids and could be accounted for by uptake of cooking oils or personal care products to skin lipids.
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Affiliation(s)
- Glenn C Morrison
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, United States
| | - Azin Eftekhari
- Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, United States
| | - Francesca Majluf
- Aerodyne Research Inc., Billerica, Massachusetts 01821, United States
| | - Jordan E Krechmer
- Aerodyne Research Inc., Billerica, Massachusetts 01821, United States
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Impact of Air Pollution and Weather on Dry Eye. J Clin Med 2020; 9:jcm9113740. [PMID: 33233863 PMCID: PMC7699870 DOI: 10.3390/jcm9113740] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 11/16/2020] [Accepted: 11/19/2020] [Indexed: 01/05/2023] Open
Abstract
Air pollution has broad effects on human health involving many organ systems. The ocular surface is an excellent model with which to study the effects of air pollution on human health as it is in constant contact with the environment, and it is directly accessible, facilitating disease monitoring. Effects of air pollutants on the ocular surface typically manifest as dry eye (DE) symptoms and signs. In this review, we break down air pollution into particulate matter (organic and inorganic) and gaseous compounds and summarize the literature regarding effects of various exposures on DE. Additionally, we examine the effects of weather (relative humidity, temperature) on DE symptoms and signs. To do so, we conducted a PubMed search using key terms to summarize the existing literature on the effects of air pollution and weather on DE. While we tried to focus on the effect of specific exposures on specific aspects of DE, environmental conditions are often studied concomitantly, and thus, there are unavoidable interactions between our variables of interest. Overall, we found that air pollution and weather conditions have differential adverse effects on DE symptoms and signs. We discuss these findings and potential mitigation strategies, such as air purifiers, air humidifiers, and plants, that may be instituted as treatments at an individual level to address environmental contributors to DE.
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Breast Cancer Rate and Mortality in Female Flight Attendants: A Systematic Review and Pooled Analysis. Clin Breast Cancer 2020; 20:371-376. [PMID: 32605812 DOI: 10.1016/j.clbc.2020.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 04/15/2020] [Accepted: 05/04/2020] [Indexed: 11/20/2022]
Abstract
Previous reports have suggested that breast cancer is more common among flight attendants than that in the general population. Constant exposure to cosmic radiation and circadian disruption are postulated to be the culprits of the problem. A systematic review was performed by 2 independent reviewers with predefined search strategy, in line with the PRISMA protocol. A total of 43 studies were identified using the preset keywords defined in the study protocol. After excluding irrelevant papers, 12 studies were included for pooled analysis. Ten studies evaluated the breast cancer prevalence in flight attendants, whereas 3 studies evaluated the breast cancer-related deaths. Pooled analysis found that, of the 45,111 flight attendants censored, 1061 (2.35%) had breast cancer. The standardized prevalence ratios were 1.08 (95% confidence interval [CI], 0.37-1.59) and 1.09 (95% Cl, 0.37-1.60), respectively, when compared with the American and European general population. Pooled analysis of the 3 studies on breast cancer mortality found that, of the 44,508 flight attendants censored, 139 (0.32%) had breast cancer-related mortality. Standardized mortality ratios to the American/European general population were 1.8 (95% CI, 0.63-4.25) and 1.3 (95% CI, 0.47-3.15), respectively. A review of the available literature indicates that there is insufficient evidence to suggest an association between cosmic irradiation, circadian disruption, and breast cancer in flight attendants. Breast cancer prevalence and mortality among flight attendants are comparable with that of the general population.
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Veenaas C, Ripszam M, Glas B, Liljelind I, Claeson AS, Haglund P. Differences in chemical composition of indoor air in rooms associated/not associated with building related symptoms. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 720:137444. [PMID: 32325564 DOI: 10.1016/j.scitotenv.2020.137444] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 02/18/2020] [Accepted: 02/18/2020] [Indexed: 06/11/2023]
Abstract
Building related health effects or symptoms (BRS), known also as sick-building syndrome (SBS), are a phenomenon that is not well understood. In this study, air samples from 51 rooms associated with BRS and 34 control rooms were collected on multi-sorbent tubes and analyzed by a non-target approach using comprehensive two-dimensional gas chromatography and high-resolution mass spectrometry techniques. The large amount of data gathered was analyzed using multivariate statistics (principle component analysis (PCA) and partial least squares (PLS)). This new analysis approach revealed that in rooms where people experienced BRS, petrochemicals and chemicals emitted from plastics were abundant, whereas in rooms where people did not experience BRS, flavor and fragrance compounds were abundant. Among the petrochemicals benzene and 2-butoxyethanol were found in higher levels in rooms where people experienced BRS. The levels of limonene were sometimes in the range of reported odor thresholds, and similarly 3-carene and beta-myrcene were found in higher concentrations in indoor air of rooms where people did not experience BRS. It cannot be ruled out that these compounds may have influenced the perceived air quality. However, the overall variability in air concentrations was large and it was not possible to accurately predict if the air in a particular room could cause BRS or not.
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Affiliation(s)
- Cathrin Veenaas
- Department of Chemistry, Umeå University, 90187 Umeå, Sweden.
| | - Matyas Ripszam
- Department of Chemistry, Umeå University, 90187 Umeå, Sweden
| | - Bo Glas
- Department of Public Health and Clinical Medicine, Umeå University, 90187 Umeå, Sweden
| | - Ingrid Liljelind
- Department of Public Health and Clinical Medicine, Umeå University, 90187 Umeå, Sweden
| | | | - Peter Haglund
- Department of Chemistry, Umeå University, 90187 Umeå, Sweden
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von Domaros M, Lakey PSJ, Shiraiwa M, Tobias DJ. Multiscale Modeling of Human Skin Oil-Induced Indoor Air Chemistry: Combining Kinetic Models and Molecular Dynamics. J Phys Chem B 2020; 124:3836-3843. [DOI: 10.1021/acs.jpcb.0c02818] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- Michael von Domaros
- Department of Chemistry, University of California, Irvine, California 92697, United States
| | - Pascale S. J. Lakey
- Department of Chemistry, University of California, Irvine, California 92697, United States
| | - Manabu Shiraiwa
- Department of Chemistry, University of California, Irvine, California 92697, United States
| | - Douglas J. Tobias
- Department of Chemistry, University of California, Irvine, California 92697, United States
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12
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Allen JG, MacNaughton P, Cedeno-Laurent JG, Cao X, Flanigan S, Vallarino J, Rueda F, Donnelly-McLay D, Spengler JD. Airplane pilot flight performance on 21 maneuvers in a flight simulator under varying carbon dioxide concentrations. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2019; 29:457-468. [PMID: 30089876 DOI: 10.1038/s41370-018-0055-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 05/14/2018] [Accepted: 06/15/2018] [Indexed: 05/28/2023]
Abstract
BACKGROUND Recent studies suggest that carbon dioxide has an impact on cognitive function performance of office workers at concentrations previously thought to be benign (1000-2500 ppm). The only available data for CO2 on the flight deck indicate that the average CO2 concentrations are typically <1000 ppm, but the 95th percentile concentration can be as high as 1400 ppm, depending on airplane type. METHODS We recruited 30 active commercial airline pilots to fly three 3-h flight segments in an FAA-approved flight simulator with each segment at a different CO2 concentration on the flight deck (700, 1500, 2500 ppm). CO2 concentrations were modified by introducing ultra-pure CO2 into the simulator; ventilation rates remained the same for each segment. The pilots performed a range of predefined maneuvers of varying difficulty without the aid of autopilot, and were assessed by a FAA Designated Pilot Examiner according to FAA Practical Test Standards. Pilots and the Examiner were blinded to test conditions and the order of exposures was randomized. RESULTS Compared to segments at a CO2 concentration of 2500 ppm, the odds of passing a maneuver as rated by the Examiner in the simulator were 1.52 (95% CI: 1.02-2.25) times higher when pilots were exposed to 1500 ppm and 1.69 (95% CI: 1.11-2.55) times higher when exposed to 700 ppm, controlling for maneuver difficulty, Examiner and order of maneuvers. DISCUSSION Examiner rating captured a wider range of performance indicators than output from the flight simulator, which can characterize only a few quantitative aspects of the flight performance. More broadly, these findings suggest that there is a direct effect of carbon dioxide on performance, independent of ventilation, with implications for many other indoor environments that routinely experience CO2 concentrations above 1000 ppm.
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Affiliation(s)
- Joseph G Allen
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Piers MacNaughton
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | | | - Xiaodong Cao
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Skye Flanigan
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jose Vallarino
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | | | - Deborah Donnelly-McLay
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - John D Spengler
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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13
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Cao X, MacNaughton P, Cadet LR, Cedeno-Laurent JG, Flanigan S, Vallarino J, Donnelly-McLay D, Christiani DC, Spengler JD, Allen JG. Heart Rate Variability and Performance of Commercial Airline Pilots during Flight Simulations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16020237. [PMID: 30654438 PMCID: PMC6352143 DOI: 10.3390/ijerph16020237] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 01/08/2019] [Accepted: 01/11/2019] [Indexed: 12/14/2022]
Abstract
Pilots undergo a variety of stressors that may affect their performance during all phases of flight. Heart rate variability (HRV) has been considered as a reliable indicator of the parasympathetic and sympathetic activities of human autonomic nervous system, which can be used to characterize the sympathetic stress response of pilots during flight. In this study, thirty active commercial airline pilots were recruited to fly three flight segments in a Federal Aviation Administration (FAA)-certified A320 flight simulator with each segment at a different carbon dioxide (CO₂) concentration on the flight deck. The pilots performed a series of maneuvers of varying difficulty, and their performance was evaluated by FAA designated pilot examiners. The HRV metrics (SDNN, RMSSD and LF/HF ratio) of each pilot both before and during flight simulations were measured with a Movisens EcgMove3 sensor. The average SDNN, RMSSD and LF/HF ratio of the pilots during flight simulations were 34.1 ± 12.7 ms, 23.8 ± 10.2 ms and 5.7 ± 2.8 respectively. Decreased HRV was associated with aging, obesity and performing difficult maneuvers. Both CO₂ exposure and HRV had an independent effect on the pilot performance, while their interaction was not significant. The generalized additive mixed effect model results showed that a pilot performed better on a maneuver when his stress response was lower, as indicated by higher SDNN and RMSSD and lower LF/HF ratio. An interquartile range (IQR) increase in SDNN (21.97 ms) and RMSSD (16.00 ms) and an IQR decrease in LF/HF ratio (4.69) was associated with an increase in the odds of passing a maneuver by 37%, 22% and 20%, respectively.
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Affiliation(s)
- Xiaodong Cao
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA.
| | - Piers MacNaughton
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA.
| | - Leslie R Cadet
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA.
| | | | - Skye Flanigan
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA.
| | - Jose Vallarino
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA.
| | - Deborah Donnelly-McLay
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA.
| | - David C Christiani
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA.
- Department of Medicine, Massachusetts General Hospital/Harvard Medical School, Boston, MA 02114, USA.
| | - John D Spengler
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA.
| | - Joseph G Allen
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA.
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14
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Slezakova K, Peixoto C, Carmo Pereira MD, Morais S. (Ultra) Fine particle concentrations and exposure in different indoor and outdoor microenvironments during physical exercising. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2019; 82:591-602. [PMID: 31288676 DOI: 10.1080/15287394.2019.1636494] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Although regular exercise improves overall well-being, increased physical activity results in enhanced breathing which consequently leads to elevated exposure to a variety of air pollutants producing adverse effects. It is well-known that one of these ambient air contaminants is ultrafine particles (UFP). Thus, this study aimed to (1) examine exposure to particle number concentrations (PNC) in size ranging from N20-1000 nm in different sport environments and (2) estimate the respective inhalation doses across varying activity scenarios based upon the World Health Organization recommendations for physical activity. PNC were continuously monitored (TSI P-Trak™ condensation particle counter) outdoors (Out1-Out2) and indoors (Ind1-Ind2; fitness clubs) over 4 weeks. Outdoor PNC (total median 12 563 # cm-3; means of 20 367 # cm-3 at Out1 and 7 122 # cm-3 at Out2) were approximately 1.6-fold higher than indoors (total median 7 653 # cm-3; means of 11 861 # cm-3 at Ind1 and 14 200 # cm-3 at Ind2). The lowest doses were inhaled during holistic group classes (7.91 × 107-1.87 × 108 # per kg body weight) whereas exercising with mixed cardio and strength training led to approximately 1.8-fold higher levels. In order to optimize the health benefit of exercises, environmental characteristics of the locations at which physical activities are conducted need to be considered.
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Affiliation(s)
- Klara Slezakova
- a LEPABE, Faculdade de Engenharia, Universidade do Porto , Porto , Portugal
- b REQUIMTE-LAQV, Instituto Superior de Engenharia do Porto, Instituto Politécnico do Porto , Porto , Portugal
| | - Cátia Peixoto
- b REQUIMTE-LAQV, Instituto Superior de Engenharia do Porto, Instituto Politécnico do Porto , Porto , Portugal
| | | | - Simone Morais
- b REQUIMTE-LAQV, Instituto Superior de Engenharia do Porto, Instituto Politécnico do Porto , Porto , Portugal
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15
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Muttray A, Gosepath J, Schmall F, Brieger J, Mayer-Popken O, Melia M, Letzel S. An acute exposure to ozone impairs human olfactory functioning. ENVIRONMENTAL RESEARCH 2018; 167:42-50. [PMID: 30007872 DOI: 10.1016/j.envres.2018.07.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 06/11/2018] [Accepted: 07/03/2018] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Ozone is a ubiquitous and irritant gas. We questioned whether an acute exposure to 0.2 ppm ozone impaired olfactory functioning. METHODS Healthy, normosmic subjects were exposed according to a parallel group design either to 0.2 ppm ozone (n = 15) or to sham (n = 13) in an exposure chamber for two hours. Possible irritating effects were assessed by questionnaire (range 0-5). The detection threshold of n-butanol was measured with the Sniffin' Sticks test before and after exposure. Olfactory thresholds were logarithmized and a two-way analysis of variance (ANOVA) with repeated measurements was carried out to test the effects of exposure (ozone vs. sham) and time (before vs. after exposure). Additionally, nasal secretions were taken at a preliminary examination and after exposure to determine interleukins 1ß and 8. RESULTS No irritating effects to the upper airways were observed. In the ozone group, the median score for cough increased from 0 to 2 at the end of exposure (sham group 0 and 0, respectively, p < 0.001). The ANOVA showed a main effect for ozone exposure (F (1, 26) = 27.6, p = 0.0002), indicating higher olfactory thresholds in the ozone group. Concentrations of interleukins in nasal secretions did not increase following ozone exposure. CONCLUSIONS This study shows a clear impairment of olfactory functioning following an acute exposure to 0.2 ppm ozone.
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Affiliation(s)
- Axel Muttray
- Institute of Occupational, Social and Environmental Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstraße 1, D-55131 Mainz, Germany.
| | - Jan Gosepath
- Department of Otolaryngology of the University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstraße 1, D-55131 Mainz, Germany
| | - Florian Schmall
- Institute of Occupational, Social and Environmental Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstraße 1, D-55131 Mainz, Germany; Department of Otolaryngology of the University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstraße 1, D-55131 Mainz, Germany
| | - Jürgen Brieger
- Department of Otolaryngology of the University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstraße 1, D-55131 Mainz, Germany
| | - Otfried Mayer-Popken
- Institute of Occupational, Social and Environmental Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstraße 1, D-55131 Mainz, Germany
| | - Michael Melia
- Institute of Occupational, Social and Environmental Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstraße 1, D-55131 Mainz, Germany
| | - Stephan Letzel
- Institute of Occupational, Social and Environmental Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstraße 1, D-55131 Mainz, Germany
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16
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Slezakova K, Peixoto C, Oliveira M, Delerue-Matos C, Pereira MDC, Morais S. Indoor particulate pollution in fitness centres with emphasis on ultrafine particles. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2018; 233:180-193. [PMID: 29073525 DOI: 10.1016/j.envpol.2017.10.050] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 10/10/2017] [Accepted: 10/12/2017] [Indexed: 06/07/2023]
Abstract
Fitness centres (FC) represent a unique indoor microenvironment. Exercising on regular basis provides countless health benefits and improves overall well-being, but if these facilities have poor indoor air quality, the respective exercisers might be subjected to some adverse risks. Considering the limited existent data, this work aimed to evaluate particulate pollution (PM10, PM2.5, and ultrafine particles - UFP) in indoor air of FC and to estimate the respective risks for occupants (both staff and exercising subjects). Sampling was conducted during 40 consecutive days of May-June 2014 in general fitness areas, studios and classrooms (for group activities) of four different fitness centres (FC1-FC4) situated within Oporto metropolitan area, Portugal. The results showed that across the four FC, PM10 ranged between 5 and 1080 μg m-3 with median concentrations (15-43 μg m-3) fulfilling the limit (50 μg m-3) of Portuguese legislation in all FC. PM2.5 (medians 5-37 μg m-3; range 5-777 μg m-3) exceeded thresholds of 25 μg m-3 at some FC, indicating potential risks for the respective occupants; naturally ventilated FC exhibited significantly higher PM ranges (p < 0.05). Similarly, UFPs (range 0.5-88.6 × 103 # cm-3) median concentrations were higher (2-3 times) at FC without controlled ventilation systems. UFP were approximately twice higher (p < 0.05) during the occupied periods (mean of 9.7 × 103vs. 4.8 × 103 # cm-3) with larger temporal variations of UFP levels observed in general fitness areas than in classrooms and studios. Cardio activities (conducted in studios and classrooms) led to approximately twice the UFPs intakes than other types of exercising. These results indicate that even short-term physical activity (or more specifically its intensity) might strongly influence the daily inhalation dose. Finally, women exhibited 1.2 times higher UFPs intake than men thus suggesting the need for future gender-specific studies assessing UFP exposure.
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Affiliation(s)
- Klara Slezakova
- REQUIMTE-LAQV, Instituto Superior de Engenharia do Porto, Instituto Politécnico do Porto, R. Dr. António Bernardino de Almeida 431, 4200-072 Porto, Portugal; LEPABE, Departamento de Engenharia Química, Faculdade de Engenharia, Universidade do Porto, R. Dr. Roberto Frias, 4200-465 Porto, Portugal
| | - Cátia Peixoto
- REQUIMTE-LAQV, Instituto Superior de Engenharia do Porto, Instituto Politécnico do Porto, R. Dr. António Bernardino de Almeida 431, 4200-072 Porto, Portugal
| | - Marta Oliveira
- REQUIMTE-LAQV, Instituto Superior de Engenharia do Porto, Instituto Politécnico do Porto, R. Dr. António Bernardino de Almeida 431, 4200-072 Porto, Portugal
| | - Cristina Delerue-Matos
- REQUIMTE-LAQV, Instituto Superior de Engenharia do Porto, Instituto Politécnico do Porto, R. Dr. António Bernardino de Almeida 431, 4200-072 Porto, Portugal
| | - Maria do Carmo Pereira
- LEPABE, Departamento de Engenharia Química, Faculdade de Engenharia, Universidade do Porto, R. Dr. Roberto Frias, 4200-465 Porto, Portugal.
| | - Simone Morais
- REQUIMTE-LAQV, Instituto Superior de Engenharia do Porto, Instituto Politécnico do Porto, R. Dr. António Bernardino de Almeida 431, 4200-072 Porto, Portugal.
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17
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Calonge M, Labetoulle M, Messmer EM, Shah S, Akova YA, Boboridis KG, Merayo-Lloves J, Aragona P, Benítez-Del-Castillo J, Geerling G, Rolando M, Baudouin C. Controlled Adverse Environment Chambers in Dry Eye Research. Curr Eye Res 2018; 43:445-450. [PMID: 29336696 DOI: 10.1080/02713683.2017.1420197] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Dry eye disease (DED) is a common condition with signs and symptoms that vary depending on a wide range of environmental factors to which people are exposed in their daily lives. Factors such as variable temperature, airflow velocity, relative humidity, seasonality, and pollutants can alter the rate of tear film evaporation, improving or exacerbating symptoms of DED. Results from currently available clinical tests do not always correlate well with patient-reported symptoms, and the continually changing environment and variability in DED symptoms present challenges for the design and conduct of clinical trials. Controlled adverse environment chambers allow standardization of temperature, humidity, and airflow and may minimize potential confounding factors in clinical investigations. Their use can promote accurate study of the pathophysiology of DED, discovery of disease biomarkers, and assessment of the effect of various therapeutic approaches on patients' symptoms. Controlled adverse environment chambers have been used to simulate indoor surroundings such as airplane cabins and to test their effects on contact lens wearers. This review summarizes how these chambers may be useful for the development, approval, and differentiation of potential new treatments for DED.
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Affiliation(s)
- Margarita Calonge
- a Instituto Oftalmobiologia Aplicada (IOBA), University of Valladolid , Valladolid , Spain.,b CIBER-BBN , Valladolid , Spain
| | - Marc Labetoulle
- c Department of Ophthalmology , Bicêtre University Hospital , Le Kremlin-Bicêtre , France
| | - Elisabeth M Messmer
- d Department of Ophthalmology , Ludwig Maximilian University , Munich , Germany
| | - Sunil Shah
- e Birmingham and Midland Eye Centre , Birmingham City Hospital , Birmingham , UK
| | - Yonca A Akova
- f Department of Ophthalmology , Bayindir Hospital , Ankara , Turkey
| | - Kostas G Boboridis
- g Oculoplastic and Ocular Surface Disease , Aristotle University of Thessaloniki , Thessaloniki , Greece
| | - Jesús Merayo-Lloves
- h Instituto Universitario Fernández-Vega, University of Oviedo , Oviedo , Spain
| | - Pasquale Aragona
- i Department of Biomedical Sciences, University of Messina , Messina , Italy
| | | | - Gerd Geerling
- k Department of Ophthalmology , University Hospital , Düsseldorf , Germany
| | - Maurizio Rolando
- l Department of Neuroscience, Ophthalmology and Genetics , University of Genoa , Genoa , Italy
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18
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Weisel CP, Fiedler N, Weschler CJ, Ohman-Strickland P, Mohan KR, McNeil K, Space D. Human symptom responses to bioeffluents, short-chain carbonyls/acids, and long-chain carbonyls in a simulated aircraft cabin environment. INDOOR AIR 2017; 27:1154-1167. [PMID: 28440000 PMCID: PMC5638674 DOI: 10.1111/ina.12392] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 04/14/2017] [Indexed: 05/04/2023]
Abstract
Occupants of aircraft have reported an array of symptoms related to general discomfort and irritation. Volatile organic compounds (VOCs) have been suggested to contribute to the reported symptoms. VOCs are from products used, bioeffluents from people and oxidation reaction products. Thirty-six healthy, young female subjects rated symptoms and environmental quality during an eight-hour exposure to groups of compounds often present in aircraft: (i) long-chain carbonyls, (ii) simulated bioeffluents, and (iii) short-chain carbonyls/organic acids. Statistically more symptoms were identified for the simulated bioeffluents and, to a lesser extent, short-chain carbonyls/organic acids compared to a control condition, although they remained in the acceptable range. There were three temporal patterns in the environmental quality and symptom reports: (i) an adaptive response (immediate increases followed by a decline); (ii) an apparent physiological effect (increases one to three hours into the exposure that remained elevated); and (iii) no statistical differences in reported environmental quality or symptom severity compared to the control air conditions. Typical concentrations found in aircraft can cause transitory symptoms in healthy individuals questioning the adequacy of current standards. Understanding the effects on individuals sensitive to air pollutants and methods to remove the compounds causing the greatest symptom responses are needed.
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Affiliation(s)
- Clifford P. Weisel
- Environmental and Occupational Health Sciences Institute, School of Public Health, Rutgers University, Piscataway, NJ 08854
- Corresponding Author:
| | - Nancy Fiedler
- Environmental and Occupational Health Sciences Institute, School of Public Health, Rutgers University, Piscataway, NJ 08854
| | - Charles J. Weschler
- Environmental and Occupational Health Sciences Institute, Robert Wood Johnson Medical School, Rutgers University, Piscataway, NJ 08854
| | - Pamela Ohman-Strickland
- Environmental and Occupational Health Sciences Institute, School of Public Health, Rutgers University, Piscataway, NJ 08854
| | - Krishnan R. Mohan
- Environmental and Occupational Health Sciences Institute, Robert Wood Johnson Medical School, Rutgers University, Piscataway, NJ 08854
| | - Kathy McNeil
- Environmental and Occupational Health Sciences Institute, Robert Wood Johnson Medical School, Rutgers University, Piscataway, NJ 08854
| | - David Space
- Environmental Control Systems, Boeing Commercial Aircraft Group, Seattle, WA 98203
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Han HK, Luk SM, Kinsella MT. A case report of ocular chemical injury secondary to ozone gas. Acta Ophthalmol 2017; 95:e348-e349. [PMID: 27473677 DOI: 10.1111/aos.13171] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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20
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Elderberry Supplementation Reduces Cold Duration and Symptoms in Air-Travellers: A Randomized, Double-Blind Placebo-Controlled Clinical Trial. Nutrients 2016; 8:182. [PMID: 27023596 PMCID: PMC4848651 DOI: 10.3390/nu8040182] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 03/14/2016] [Accepted: 03/18/2016] [Indexed: 01/28/2023] Open
Abstract
Intercontinental air travel can be stressful, especially for respiratory health. Elderberries have been used traditionally, and in some observational and clinical studies, as supportive agents against the common cold and influenza. This randomized, double-blind placebo-controlled clinical trial of 312 economy class passengers travelling from Australia to an overseas destination aimed to investigate if a standardised membrane filtered elderberry (Sambucus nigra L.) extract has beneficial effects on physical, especially respiratory, and mental health. Cold episodes, cold duration and symptoms were noted in a daily diary and assessed using the Jackson score. Participants also completed three surveys containing questions regarding upper respiratory symptoms (WURSS-21) and quality of life (SF-12) at baseline, just before travel and at 4-days after travel. Most cold episodes occurred in the placebo group (17 vs. 12), however the difference was not significant (p = 0.4). Placebo group participants had a significantly longer duration of cold episode days (117 vs. 57, p = 0.02) and the average symptom score over these days was also significantly higher (583 vs. 247, p = 0.05). These data suggest a significant reduction of cold duration and severity in air travelers. More research is warranted to confirm this effect and to evaluate elderberry's physical and mental health benefits.
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21
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Wolkoff P, Crump DR, Harrison PTC. Pollutant exposures and health symptoms in aircrew and office workers: Is there a link? ENVIRONMENT INTERNATIONAL 2016; 87:74-84. [PMID: 26641522 DOI: 10.1016/j.envint.2015.11.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 11/04/2015] [Accepted: 11/09/2015] [Indexed: 06/05/2023]
Abstract
Sensory effects in eyes and airways are common symptoms reported by aircraft crew and office workers. Neurological symptoms, such as headache, have also been reported. To assess the commonality and differences in exposures and health symptoms, a literature search of aircraft cabin and office air concentrations of non-reactive volatile organic compounds (VOCs) and ozone-initiated terpene reaction products were compiled and assessed. Data for tricresyl phosphates, in particular tri-ortho-cresyl phosphate (ToCP), were also compiled, as well as information on other risk factors such as low relative humidity. A conservative health risk assessment for eye, airway and neurological effects was undertaken based on a "worst-case scenario" which assumed a simultaneous constant exposure for 8h to identified maximum concentrations in aircraft and offices. This used guidelines and reference values for sensory irritation for eyes and upper airways and airflow limitation; a tolerable daily intake value was used for ToCP. The assessment involved the use of hazard quotients or indexes, defined as the summed ratio(s) (%) of compound concentration(s) divided by their guideline value(s). The concentration data suggest that, under the assumption of a conservative "worst-case scenario", aircraft air and office concentrations of the compounds in question are not likely to be associated with sensory symptoms in eyes and airways. This is supported by the fact that maximum concentrations are, in general, associated with infrequent incidents and brief exposures. Sensory symptoms, in particular in eyes, appear to be exacerbated by environmental and occupational conditions that differ in aircraft and offices, e.g., ozone incidents, low relative humidity, low cabin pressure, and visual display unit work. The data do not support airflow limitation effects. For ToCP, in view of the conservative approach adopted here and the rareness of reported incidents, the health risk of exposure to this compound in aircraft is considered negligible.
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Affiliation(s)
- Peder Wolkoff
- National Research Centre for the Working Environment, Denmark.
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