Pediatric Asthma Attack and Home Paint Exposure

Indoor air pollution and airway health

Because of the disproportionate amount of time that people spend indoors and the complexities of air pollutant exposures found there, indoor air pollution is a growing concern for airway health. Both infiltration of outdoor air pollution into the indoor space and indoor sources (such as smoke from tobacco products, cooking or heating practices and combustion of associated fuels, and household materials) contribute to unique exposure mixtures. Although there is substantial literature on the chemistry of indoor air pollution, research focused on health effects is only beginning to emerge and remains an important area of need to protect public health. We provide a review of emerging literature spanning the past 3 years and relating indoor air exposures to airway health, with a specific focus on the impact of either individual pollutant exposures or common combustion sources on the lower airways. Factors defining susceptibility and/or vulnerability are reviewed with consideration for priority populations and modifiable risk factors that may be targeted to advance health equity.

The relationship between changes in peak expiratory flow and asthma exacerbations in asthmatic children

BACKGROUND

Asthma is one of the most common chronic airway diseases in children. Preventing asthma exacerbation is one of the objectives of all asthma action plans. In patients with poor perception, it is difficult to identify acute asthma exacerbations by clinical asthma score, asthma control test or asthma control questionnaire. The aim of this study is to analyze whether children with asthma have changes in peak expiratory flow(PEF)before an acute asthma exacerbation and to evaluate the relationship between PEF and asthma exacerbation.

METHODS

Basic information (including sex, age, atopy, etc.) and clinical information of asthmatic children who registered in the Electronic China Children's Asthma Action Plan (e-CCAAP) from 1 September 2017 to 31 August 2021 were collected. Subjects with 14 consecutive days of PEF measurements were eligible. Subjects in this study were divided into an exacerbation group and a control group. We analyzed the relationship between changes in PEF% pred and the presence of asthma symptoms.

RESULT

A total of 194 children with asthma who met the inclusion criteria were included, including 144 males (74.2%) and 50 females (25.8%), with a male-to-female ratio of 2.88:1. The mean age of the subjects was 9.51 ± 2.5 years. There were no significant differences in sex, age, allergy history or baseline PEF between the two groups. In children with and without a history of allergy, there was no significant difference between the variation in PEF at 14 days. Patients who only had a reduced in PEF but no symptoms of asthma exacerbation had the greatest reduction in PEF compared to the other groups. The most common cause of acute exacerbations of asthma is upper respiratory tract infection. Among the causes of acute exacerbations of asthma, the variation in PEF caused by air pollution was significantly higher than that of other causes (P < 0.05). In acute exacerbations, the decrease in PEF was significantly greater in the exacerbation group than in the control group. In children with asthma symptoms, there was a decrease in PEF approximately 1.34 days before the onset of symptoms.

CONCLUSION

Children with asthma show a decrease in PEF 1.34 days before the onset of asthma symptoms. We recommend that asthmatic children who show a decrease in PEF should step-up asthma therapy. The most common cause of acute exacerbations of asthma was upper respiratory tract infections, and the variation in PEF caused by air pollution was significantly higher than that caused by other factors.

Near-field exposures and human health impacts for organic chemicals in interior paints: A high-throughput screening

Interior paints contain organic chemicals that might be harmful to painters and building residents. This study aims to develop a high-throughput approach to screen near-field human exposures and health impacts related to organic chemicals in interior paints. We developed mass balance models for both water- and solvent-based paints, predicting emissions during wet and dry phases. We then screened exposures and risks, focusing on Sri Lanka where residential houses are frequently repainted. These models accurately predict paint drying time and indoor air concentrations of organic chemicals. Exposures of both painter and household resident were estimated for 65 organic chemicals in water-based and 26 in solvent-based paints, considering 12 solvents. Chemicals of concerns (CoCs) were identified, and maximum acceptable chemical contents (MACs) were calculated. Water-based paints generally pose lower health risks than solvent-based paints but might contain biocides of high concern. The total human health impact of one painting event on all household adults ranges from 1.5 × 10-3 to 2.1 × 10-2 DALYs for solvent-based paints, and from 4.1 × 10-4 to 9.5 × 10-3 DALYs for water-based paints. The present approach is a promising way to support the formulation of safer paint, and is integrated in the USEtox scientific consensus model for use in life cycle assessment, chemical substitution and risk screening.