Associations between Incense-Burning Temples and Respiratory Mortality in Hong Kong

Exposure to incense burning, biomarkers, and the physical health of temple workers in Taiwan

Incense burning releases heavy particulate matter (PM) and nitrogen dioxide (NO2), known to have adverse effects on human health. Long-term exposure to PM and NO2 increases inflammatory cytokine levels and can induce respiratory diseases. This study examined the association between incense burning exposure and the health status, especially inflammatory biomarkers, of temple workers and volunteers in Taiwan. The longitudinal observational study compared adult temple workers and volunteers, with long-term incense burning exposure, to residents from outpatient clinics in the Chiayi area. Forced expiratory volume in 1 s (FEV1) and serum and exhaled breath condensate (EBC) cytokines were assessed. Nonparametric Mann-Whitney U tests were used to compare cytokine levels of the exposure and control groups during the cold and hot weather seasons. FEV1 was significantly more diminished in the exposed group than in the control group during the cold season. Exposure status was associated with greater hot-cold seasonal differences in serum interleukins (IL)-1β (regression coefficient (B) = 6.6, 95% confidence interval (CI) = 5.0 to 8.3, p < .001), IL17-A (B = 2.4, 95% CI = 0.3 to 4.5, p = .03), and plasminogen activator inhibitor [PAI]-1 (B = 5.4, 95% CI = 1.5 to 9.3, p = .009). After adjusting for confounders, the groups' serum levels of IL-1β, IL-17A, and PAI-1 significantly differed. EBC cytokines did not show significant differences. Elevated levels of IL-1β, IL17-A, and PAI-1 have been associated with various autoinflammatory syndromes and diseases. Given the cultural significance of incense burning, culturally sensitive interventions, including education, policy development, and program implementation, are crucial to protect individuals' health, especially temple workers, from the adverse effects of exposure, addressing the manufacture, importation, and sale of incense.

A study to characterize the lead isotopic fingerprint in PM2.5 emitted from incense stick and cigarette burning

The incense sticks and cigarettes burning are key sources of particulate matter with a diameter of ≤ 2.5 μm (PM_2.5) in indoor and outdoor air. While lead (Pb) isotope ratios provide valuable insights into the origin of particle pollution, their applicability for investigating these source remains unclear. The Pb isotope ratios in the PM_2.5 emitted from these two sources were analyzed, and effects of brands or nicotine contents on the ratios were assessed. In addition, As, Cr, and Pb were analyzed to investigate whether Pb isotope ratios can serve as an indicator for the source investigation of these metals. We found that average ratios of ²⁰⁶Pb/²⁰⁴Pb, ²⁰⁶Pb/²⁰⁷Pb, and ²⁰⁸Pb/²⁰⁷Pb in cigarettes were heavier than those in incense sticks. Scatter plots of Pb isotope ratios indicated an overlap of values for incense sticks or cigarettes linked to different brands, in that ratios for cigarettes with high nicotine content were heavier than for those with low nicotine content. Scatter plots of As, Cr, or Pb concentration against Pb isotope ratios clearly distinguished the effects of cigarette burning versus incense sticks with respect to PM_2.5 of these metals. Results indicate that brand differences did not affect the determination of PM_2.5 in these two sources. We suggest that Pb isotope ratios can be a useful tool in investigating the influence of incense sticks and of cigarettes (with high or low nicotine content) burning to PM_2.5 and associated metals.

Health and Environmental Risks of Incense Smoke: Mechanistic Insights and Cumulative Evidence

Incense burning is practiced alongside many sacred rituals across different regions of the world. Invariable constituents of incense brands are 21% (by weight) herbal and wood powder, 33% bamboo stick, 35% fragrance material, and 11% adhesive powder. Major incense-combustion outputs include particulate matter (PM), volatile organic content, and polyaromatic hydrocarbons. The relative toxicity of these products is an implicit function of particle size and incomplete combustion, which in turn vary for a specific incense brand. Lately, the attention given to the Air Quality Index by international regulatory bodies has created concern about mounting PM toxicity. The uncharacteristically small physical dimensions of these entities complicates their detection, and with no effect of gravity PM fractions rapidly contribute to oxidative stress, enhancing random biochemical reactions upon being inhaled. Incense burning generates four times the PM extent (45 mg•g⁻¹) of cigarettes (~10 mg•g⁻¹). Several poisonous gases, such as CO, CO₂, NO₂, and SO₂, and the unavoidable challenge of disposing of the burnt incense ash further add to the toxicity. Taken together, these issues demonstrate that incense burning warrants prompt attention. The aim of this article is to highlight the toxicity of incense-combustion materials on the environment and human health. This discussion could be significant in framing future policy regarding ecofriendly incense manufacture and reduced usage.