Respiratory health symptoms among students exposed to different levels of air pollution in a Turkish city

Indoor sulfur dioxide prediction through air quality modeling and assessment of sulfur dioxide and nitrogen dioxide levels in industrial and non-industrial areas

In this study, the levels of sulfur dioxide (SO2) and nitrogen dioxide (NO2) were measured indoors and outdoors using passive samplers in Tymar village (20 homes), an industrial area, and Haji Wsu (15 homes), a non-industrial region, in the summer and the winter seasons. In comparison to Haji Wsu village, the results showed that Tymar village had higher and more significant mean SO2 and NO2 concentrations indoors and outdoors throughout both the summer and winter seasons. The mean outdoor concentration of SO2 was the highest in summer, while the mean indoor NO2 concentration was the highest in winter in both areas. The ratio of NO2 indoors to outdoors was larger than one throughout the winter at both sites. Additionally, the performance of machine learning (ML) approaches: multiple linear regression (MLR), artificial neural network (ANN), and random forest (RF) were compared in predicting indoor SO2 concentrations in both the industrial and non-industrial areas. Factor analysis (FA) was conducted on different indoor and outdoor meteorological and air quality parameters, and the resulting factors were employed as inputs to train the models. Cross-validation was applied to ensure reliable and robust model evaluation. RF showed the best predictive ability in the prediction of indoor SO2 for the training set (RMSE = 2.108, MAE = 1.780, and R2 = 0.956) and for the unseen test set (RMSE = 4.469, MAE = 3.728, and R2 = 0.779) values compared to other studied models. As a result, it was observed that the RF model could successfully approach the nonlinear relationship between indoor SO2 and input parameters and provide valuable insights to reduce exposure to this harmful pollutant.

COVID-19 induced restriction in developing countries and its impacts on pollution load: case study of Lagos mega city

Sudden outbreak of COVID-19 pandemic globally in 2020 warranted urgent course of actions to guide against its escalation. The first and immediate measure adopted by several nations was the imposition of restriction on transport, industrial, commercial and social activities; and this step has thus, provided a platform for the impact assessment of the restrictions on ambient air quality, especially in developing nations such as Nigeria. The levels of four criteria air pollutants (PM_2.5, SO₂, NO₂, and PM₁₀) in ambient air of Lagos city before, during and after the restriction periods were compared to establish the extent of change caused by the restrictions. The results revealed a decline of 74.0, 79.7, 55.0 and 58.5% in the levels of SO₂, NO₂, PM_2.5, and PM₁₀, respectively during the lockdown period. The results also revealed that, despite the huge reduction in the atmospheric emissions witnessed during lockdown period, air quality within the region was still poor, as the levels of most of the pollutants were above the recommended limits. These findings suggested that apart from the restricted activities, there are other air pollution sources within the city which increased the pollution load in the ambient air. Conclusively, while the restriction led to untold economic hardship, it equally enhanced quality of ambient air. Cleaner technology is advocated to ensure reduction in the consumption of fossil fuel instead of the common practice of end-of-pipe technology, for environmental sustainability.

Comparison of metropolitan cities for mortality rates attributed to ambient air pollution using the AirQ model

In the present study, the air pollution dynamics of the metropolitan cities of Balıkesir, Bursa, Istanbul, Kocaeli, Sakarya and Tekirdağ in the Marmara Region, which is the geographical region with the highest urban and industrial activity in Turkey, were examined for the time period between 2016 and 2019. Annual changes in the cities in terms of air pollution, which was examined with a focus on the PM_2.5 parameter as indicated by United Nations (UN) Sustainable Development Goals (SDGs); differences in the cities by years; and the seasonal changes in air pollution in the cities were investigated. Additionally, mortality rates attributed to air pollution were calculated with the AirQ + software based on integrated exposure-response function recommended by the World Health Organization (WHO) and the UN using city-scale statistics of fatal disease cases that can be attributed to air pollution. It was determined that all cities in the Marmara Region study area exceeded the limit PM_2.5 values specified by the European Union (EU) in the years 2016, 2017 and 2018 while only Kocaeli and Tekirdağ were below the limit values in 2019. The limit values specified by the WHO were exceeded in all cities in each year. A total of 46,920 premature deaths attributed to the exceedance of WHO limit values were calculated for the years 2016, 2017, 2018 and 2019 with 11,895, 13,853, 11,748 and 9,429, respectively. Determining national limit values for the PM_2.5 parameter, which is among the most important factors of air pollution, and monitoring it in a sustainable manner using a sufficient number of well-equipped stations is of great importance. This way, national, regional and urban action plans regarding the impact of air pollution on human health, as indicated by UN SDGs, can be prepared.

Air pollution and associated self-reported effects on the exposed students at Malakand division, Pakistan

Air pollution is associated with several severe physical, behavioral, and psychological health risks and glitches. Air pollution has been linked to 11 million premature deaths in Pakistan, out of the total 153 million premature deaths worldwide. Air pollution is continuously growing as a threatening challenge for Pakistan. Keeping this in view, the current study was designed to assess air pollution in terms of air quality index (AQI), particulate matters (PM_2.5 and PM₁₀), SO₂, NO₂, and O₃ over six districts of Malakand division, Northern Pakistan. The second part of the study appraised the associated self-reported effects of air pollution on Pakistani students and the practices, perceptions, and awareness of the students regarding air pollution through a closed-ended questionnaire, administered to 4100 students. The first section of the questionnaire was focused on the physical effects associated with air pollution; the second section was focused on air pollution-linked behavior and psychology; the third portion was focused on perception and awareness of the subjects, whereas the final section was focused on practices and concerns of the subjects regarding air pollution. The students reported that exposure to air pollution significantly affected their physical health, behavior, and psychology. The subjects were aware of the different air pollutants and health complications associated with air pollution, and therefore had adopted preventive measures. It was concluded that air pollution had adverse impacts on the physical and psychological health of the respondents, which consequently altered their behavior. Mass awareness, proper mitigating plan, suitable management, and implementation of strict environmental laws are suggested before the air gets further polluted and becomes life-threatening.

Comparative study on respiratory function among rural women using biomass fuel and non-biomass fuel: evidence of a cross-sectional survey in Bangladesh

Respiratory diseases' mortality and morbidity have been a major public health burden primarily attributed to widespread exposure to indoor and outdoor pollutants in the environment. The study conducted among 510 Bangladeshi women residing in the northeastern zone of the Sylhet division from semi-urban and rural settings to compare the biomass fuel users (N = 255) with the non-biomass users (N = 255). It has been observed that all the symptoms had a higher prevalence among the women who were exposed to biomass fuel compared with those exposed to clean gas fuel. Women exposed to biomass group reported frequent cough and phlegm production episodes during a 3-month timeline before the survey period which was found statistically higher (p < 0.001) compared with that of the clean gas fuel group. Moreover, the use of biomass fuel has been associated with a significant decrease in forced expiratory volume in one second (FEV₁), forced vital capacity (FVC), and peak expiratory flow rate (PEFR). Appropriate strategies from stakeholders and government authorities in disseminating health hazards from biomass fuel along with supporting the community by providing alternative energy sources for cooking can largely impact people's lives.

Urban-level environmental factors related to pediatric asthma

During the 20th century, urbanization has increasing and represented a major demographic and environmental change in developed countries. This ever-changing urban environment has an impact on disease patterns and prevalence, namely on noncommunicable diseases, such as asthma and allergy, and poses many challenges to understand the relationship between the changing urban environment and the children health. The complex interaction between human beings and urbanization is dependent not only on individual determinants such as sex, age, social or economic resources, and lifestyles and behaviors, but also on environment, including air pollution, indoors and outdoors, land use, biodiversity, and handiness of green areas. Therefore, the assessment and identification of the impact of urban environment on children's health have become a priority and many recent studies have been conducted with the goal of better understanding the impacts related to urbanization, characterizing indoor air exposure, identifying types of neighborhoods, or characteristics of neighborhoods that promote health benefits. Thus, this review focuses on the role of urban environmental factors on pediatric asthma.

A meta-analysis of selected near-road air pollutants based on concentration decay rates

Traffic-related air pollution has been associated with various health risks for human populations living near roadways. Understanding the relationship between traffic density and dispersion of vehicle-released air pollutants is important for assessing human exposure to near-road air pollutants. We performed a literature survey targeting publications containing measurement data of traffic-related air pollutants near roads with distance information on their concentration distribution. Concentration decay rates over down-wind distance away from major roads were calculated for black carbon (BC), carbon monoxide (CO) and nitrogen oxides (NO₂ or NO_x) and meta-data analysis on these rates was performed. These analyses showed metadata-based exponential decay rates of 0.0026, 0.0019, 0.0004, and 0.0027 m⁻¹ for BC, CO, NO₂ and NOx, respectively. Using these measurement data-based decay rates, concentrations for BC, CO, NO₂ and NO_x over various near-road distances were predicted. These results are useful for enhancing exposure modeling and thus more reliably assessing the health risk of exposure to near road air pollution.

Indoor air quality in schools of a highly polluted south Mediterranean area

This study aimed at surveying lower secondary schools in southern Italy, in a highly polluted area. A community close to an industrial area and three villages in rural areas was investigated. Indoor temperature, relative humidity (RH), gaseous pollutants (CO₂ and NO₂ ), selected biological pollutants in indoor dust, and the indoor/outdoor mass concentration and elemental composition of PM_2.5 were ascertained. Temperature and RH were within, or close to, the comfort range, while CO₂ frequently exceeded the threshold of 1000 ppm, indicating inadequate air exchange rate. In all the classrooms, median NO₂ levels were above the WHO threshold value. Dermatophagoides p. allergen concentration was below the sensitizing threshold, while high endotoxin levels were detected in the classrooms, suggesting schools may produce significant risks of endotoxin exposure. Concentration and solubility of PM_2.5 elements were used to identify the sources of indoor particles. Indoor concentration of most elements was higher than outdoors. Resuspension was responsible for the indoor increase in soil components. For elements from industrial emission (Cd, Co, Ni, Pb, Sb, Tl, V), the indoor concentration depended on penetration from the outside. For these elements, differences in rural vs industrial concentrations were found, suggesting industrial sources may influence indoor air quality nearby schools.

Human exposure to ozone in school and office indoor environments

BACKGROUND

Although it is recognized that ozone causes acute and chronic health effects and that even trace amounts of ozone are potentially deleterious to human health, information about global and local exposures to ozone in different indoor environments is limited. To synthesize the existing knowledge, this review analyzes the magnitude of and the trends in global and local exposure to ozone in schools and offices and the factors controlling the exposures.

METHODS

In conducting the literature review, Web of Science, SCOPUS, Google Scholar, and PubMed were searched using 38 search terms and their combinations to identify manuscripts, reports, and directives published between 1973 and 2018. The search was then extended to the reference lists of relevant articles.

RESULTS

The calculated median concentration of ozone both in school (8.50 μg/m³) and office (9.04 μg/m³) settings was well below the WHO guideline value of 100 μg/m³ as a maximum 8 h mean concentration. However, a large range of average concentrations of ozone was reported, from 0.8-114 μg/m³ and from 0 to 96.8 μg/m³ for school and office environments, respectively, indicating situations where the WHO values are exceeded. Outdoor ozone penetrating into the indoor environment is the main source of indoor ozone, with median I/O ratios of 0.21 and 0.29 in school and office environments, respectively. The absence of major indoor ozone sources and ozone sinks, including gas-phase reactions and deposition, are the reasons for lower indoor than outdoor ozone concentrations. However, there are indoor sources of ozone that are of significance in certain indoor environments, including printers, photocopiers, and many other devices and appliances designed for indoor use (e.g., air cleaners), that release ozone either intentionally or unintentionally. Due to significantly elevated outdoor ozone concentrations during summer, summer indoor concentrations are typically elevated. In addition, the age of a building and various housing aspects (carpeting, air conditioning, window fans, and window openings) have been significantly associated with indoor ozone levels.

CONCLUSIONS

The existing means for reducing ozone and ozone reaction products in school and office settings are as follows: 1) reduce penetration of outdoor ozone indoors by filtering ozone from the supply air; 2) limit the use of printers, photocopiers, and other devices and appliances that emit ozone indoors; 3) limit gas-phase reactions by limiting the use of materials and products (e.g. cleaning chemicals) the emissions of which react with ozone.

Evaluation of peak expiratory flow in adolescents and its association with inhalable particulate in a Brazilian medium-sized city

ABSTRACT: Introduction: High particulate matter (PM10) concentrations are associated with increased incidence of respiratory symptoms and decreased lung function. This study evaluates the air pollution effects in children’s and adolescents’ lung function using peak expiratory flow (PEF) measurements over a given period, in an area exposed to industrial emissions. Methodology: This was a panel study. The effects of air pollution on respiratory symptoms and PEF were investigated in 117 children and adolescents from three public schools in areas of exposure to air pollution from a mining company in a Brazilian medium-sized city, from 2008 to 2009. The average daily PM10, temperature and humidity were recorded by the monitoring network in the region. Association between daily records of PEF and PM10 was assessed in mixed-effect regression models, controlling for temperature, humidity, and body mass index. Results: About 60,000 PEF measurements were performed. Increases of 14µg/m3 in PM10 were associated with decreased PEF in the morning (-1.04%, 95%CI -1.32; -0.77) and evening (-1.2%, 95%CI -1.49, -0.92). Discussion: We found a significant negative association between particulate matter and peak expiratory flow rate in this population, and these remained significant even after adjusted for temperature, humidity, body mass index, coughing, wheezing and coryza. Conclusion: Adverse effects were found and it suggests an association between increase in PM10 and reduced lung function.

Associations between respiratory health and ambient air quality in Canakkale, Turkey: a long-term cohort study

Few epidemiological studies investigating the association between air pollution and health are available in Turkey. The aim of this cohort-type study is to examine the relationships between ambient air quality, respiratory diseases, and decreases in pulmonary function over a year in three different towns in Canakkale: Canakkale Central town (region I), Lapseki town center (region II), and Can town (region III). Region III had four different sub-regions, which were Can town center (region III-A), and the villages located around Can town, namely Durali (region III-B), Kulfal (region III-C), and Yuvalar (region III-D). In the first stage of the study, a detailed questionnaire was completed by the participants (n = 1152) in face-to-face interviews and pulmonary function test (PFT) was performed. In the second stage of the study, PFT measurements were repeated 1 year after the first stage. Particulate matter, SO₂, NO₂, and ozone were gathered from air quality monitoring stations located in the centers of the three regions. The most polluted area was region III, while region I and region II were the least polluted areas. The risk of pulmonary function decline throughout a year was 2.1 times higher in region III, 2.4 times higher both in regions III-B and III-C, and 1.6 times higher for smokers in all regions. In the present study, ambient air quality was worse in region III (industrialized region), which influenced PFT scores and the prognostics for chronic respiratory diseases. The findings of this study should be considered for future investment plans in this region related to human and environmental health needs.

Exposure to air pollution and self-reported effects on Chinese students: A case study of 13 megacities

Air pollution causes severe physical and psychological health complications. Considering China's continuously-deteriorating air quality, this study aimed to assess the self-reported effects of air pollution on the behavior and physical health of the students of 13 densely populated cities, and their awareness, practices, and perception of air pollution and its associated public health risks. A detailed, closed-ended questionnaire was administered to 2100 students from 54 universities and schools across China. The questionnaire, which had 24 questions, was categorized into four sections. The first two sections were focused on air pollution-associated behavior and psychology, and physical effects; while the final two sections focused on the subjects' awareness and perceptions, and practices and concerns about air pollution. The respondents reported that long-term exposure to air pollution had significantly affected their psychology and behavior, as well as their physical health. The respondents were aware of the different adverse impacts of air pollution (respiratory infections, allergies, and cardiovascular problems), and hence had adopted different preventive measures, such as the use of respiratory masks and glasses or goggles, regularly drinking water, and consuming rich foods. It was concluded that air pollution and haze had negative physical and psychological effects on the respondents, which led to severe changes in behavior. Proper management, future planning, and implementing strict environmental laws are suggested before this problem worsens and becomes life-threatening.

Indoor air quality in urban and rural kindergartens: short-term studies in Silesia, Poland

More than 80% of people living in urban areas who monitor air pollution are exposed to air quality levels that exceed limits defined by the World Health Organization (WHO). Although all regions of the world are affected, populations in low-income cities are the most impacted. According to average annual levels of fine particulate matter (PM2.5, ambient particles with aerodynamic diameter of 2.5 μm or less) presented in the urban air quality database issued by WHO in 2016, as many as 33 Polish cities are among the 50 most polluted cities in the European Union (EU), with Silesian cities topping the list. The aim of this study was to characterize the indoor air quality in Silesian kindergartens based on the concentrations of gaseous compounds (SO2, NO2), PM2.5, and the sum of 15 PM2.5-bound polycyclic aromatic hydrocarbons (PAHs), including PM2.5-bound benzo(a)pyrene (BaP), as well as the mutagenic activity of PM2.5 organic extracts in Salmonella assay (strains: TA98, YG1024). The assessment of the indoor air quality was performed taking into consideration the pollution of the atmospheric air (outdoor). I/O ratios (indoor/outdoor concentration) for each investigated parameter were also calculated. Twenty-four-hour samples of PM2.5, SO2, and NO2 were collected during spring in two sites in southern Poland (Silesia), representing urban and rural areas. Indoor samples were taken in naturally ventilated kindergartens. At the same time, in the vicinity of the kindergarten buildings, the collection of outdoor samples of PM2.5, SO2, and NO2 was carried out. The content of BaP and the sum of 15 studied PAHs was determined in each 24-h sample of PM2.5 (indoor and outdoor). In the urban site, statistically lower concentrations of SO2 and NO2 were detected indoors compared to outdoors, whereas in the rural site, such a relationship was observed only for NO2. No statistically significant differences in the concentrations of PM2.5, PM2.5-bound BaP, and Σ15 PAHs in kindergartens (indoor) versus atmospheric (outdoor) air in the two studied areas were identified. Mutagenic effect of indoor PM2.5 samples was twice as low as in outdoor samples. The I/O ratios indicated that all studied air pollutants in the urban kindergarten originated from the ambient air. In the rural site concentrations of SO2, PM2.5 and BaP in the kindergarten were influenced by internal sources (gas and coal stoves).

Public's Health Risk Awareness on Urban Air Pollution in Chinese Megacities: The Cases of Shanghai, Wuhan and Nanchang

This study assessed the public’s health risk awareness of urban air pollution triggered by three megacities in China, and the data are the responses from a sample size of 3868 megacity inhabitants from Shanghai, Nanchang and Wuhan. Descriptive analyses were used to summarize the respondents’ demographics, perceived health risks from air pollution and sources of health-related knowledge on urban air pollution. Chi-square tests were used to examine if participants’ demographics were associated with participant’s general attitudes towards current air quality and the three perceived highest health risks due to urban air pollution. We found low rate of satisfaction of current urban air quality as well as poor knowledge of air pollution related indicator. Participants’ gender, age and travel experience were found to be associated with the satisfaction of current air quality. The knowledge of air pollution related indicator was significantly affected by respondents’ education, monthly income, health status, and sites of study. As many as 46.23% of the participants expressed their feelings of anxiety when exposed to polluted air, especially females, older adults and those with poor health conditions. Most participants believed that coughs/colds, eye problems and skin allergies were the three highest health risks due to urban air pollution based on public education through television/radio, internet and newspaper/magazine. Further public health education is needed to improve public awareness of air pollution and its effects.

Personal exposure of primary school children to BTEX, NO₂ and ozone in Eskişehir, Turkey: relationship with indoor/outdoor concentrations and risk assessment

Personal exposures of 65 primary school children to benzene, toluene, ethyl benzene, xylenes (BTEX), nitrogen dioxide (NO2) and ozone (O3) were measured during 24h by using organic vapor monitors and tailor-made passive samplers. Two schools were selected to represent students living in more polluted (urban) and less polluted (sub-urban) areas in the city of Eskişehir, Turkey. The pollutant concentrations were also measured in indoor and outdoor environments during the personal sampling to investigate the contribution of each micro-environment on measured personal concentrations. Socio-demographic and personal time-activity data were collected by means of questionnaires and half-hour-time resolution activity diaries. Personal exposure concentrations were found to be correlated with indoor home concentrations. Personal, indoor and outdoor concentrations of all studied pollutants except for ozone were found to be higher for the students living at the urban traffic site. Ozone, on the other hand, had higher concentrations at the sub-urban site for all three types of measurements (personal, indoor and outdoor). Analysis of the questionnaire data pointed out to environmental tobacco smoke, use of solvent based products, and petrol station nearby as factors that affect personal exposure concentrations. Cancer and non-cancer risks were estimated using the personal exposure concentrations. The mean cancer risk for the urban school children (1.7×10(-5)) was found to be higher than the sub-urban school children (0.88×10(-5)). Children living with smoking parents had higher risk levels (1.7×10(-5)) than children living with non-smoking parents (1.08×10(-5)). Overall, the risk levels were <1×10(-4). All hazard quotient values for BTEX for the non-cancer health effects were <1 based on the calculations EPA's Risk Assessment Guidance for Superfund (RAGS) part F.

Respiratory and general health complaints in subjects exposed to sandstorm at Riyadh, Saudi Arabia

Objective: Sandstorms are metrological events and frequently occur in many regions throughout the world. Sandstorms are a main source of long-distance transport of dust, air pollution and cause various health problems. This study aimed to investigate the acute respiratory and general health complaints in subjects exposed to sandstorm at Riyadh, Saudi Arabia.

Methodology: The present descriptive study was conducted in the Department of Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia during the period March 2011- June 2012. We selected 517 (308 males, 59.58%) and (209 females, 40.42%), apparently healthy volunteers with mean age 28.6± 3.14 years, who had single outside exposure to sandstorm for the period of 24±2.68 minutes. The acute respiratory and general health complaints were recorded through a comprehensive questionnaire.

Results: A large proportion of the subjects who were exposed to sandstorm had complaints of cough 247 (47.77%), runny nose 264(51.06%), wheeze 173(33.46%), acute asthmatic attack 108 (20.88%), eye irritation / redness 252(48.74%), headache 179 (34.62%), body ache 199 (38.5%), sleep disturbance 157(30.36%) and psychological disturbances 194 (37.52%).

Conclusion: Exposure to sandstorm causes cough, runny nose, wheeze, acute asthmatic attack, eye irritation / redness, headache, body ache, sleep and psychological disturbances. These results indicate that sandstorm is a prolific source of respiratory and general ailments. It is therefore, suggested that an unnecessary exposure to sandstorm must be avoided.

Respiratory involvements among women exposed to the smoke of traditional biomass fuel and gas fuel in a district of Bangladesh

OBJECTIVES

Burning of biomass fuel (cow-dung, crop residue, dried leaves, wood, etc.) in the kitchen releases smoke, which may impair the respiratory functions of women cooking there. This paper aimed to compare the respiratory symptoms between biomass fuel users and gas fuel users in Bangladesh.

METHODS

A cross-sectional survey was conducted through face-to-face interviews and chest examination of 224 adult women using biomass fuel in a rural village and 196 adult women using gas fuel in an urban area.

RESULTS

The prevalence of respiratory involvement (at least one among nine symptoms and two diseases) was significantly higher among biomass users than among gas users (29.9 vs. 11.2 %). After adjustment for potential confounders by a logistic model, the odds ratio (OR) of the biomass users for the respiratory involvement was significantly higher (OR = 3.23, 95 % confidence interval 1.30-8.01). The biomass fuel use elevated symptoms/diseases significantly; the adjusted OR was 3.04 for morning cough, 7.41 for nasal allergy, and 5.94 for chronic bronchitis. The mean peak expiratory flow rate of biomass users (253.83 l/min) was significantly lower than that of gas users (282.37 l/min).

CONCLUSIONS

The study shows significant association between biomass fuel use and respiratory involvement among rural women in Bangladesh, although the potential confounding of urban/rural residency could not be ruled out in the analysis. The use of smoke-free stoves and adequate ventilation along with health education to the rural population to increase awareness about the health effects of indoor biomass fuel use might have roles to prevent these involvements.

Healthy environment--indoor air quality of Brazilian elementary schools nearby petrochemical industry

The mitigation of pollution released to the environment originating from the industrial sector has been the aim of all policy-makers and its importance is evident if the adverse health effects on the world population are considered. Although this concern is controversial, petroleum refinery has been linked to some adverse health effects for people living nearby. Apart from home, school is the most important indoor environment for children and there is increasing concern about the school environment and its impact on health, also in developing countries where the prevalence of pollution is higher. As most of the children spend more than 40% of their time in schools, it is critical to evaluate the pollution level in such environment. In the metropolitan region of Curitiba, South Brazil, five schools nearby industries and highways with high density traffic, were selected to characterize the aerosol and gaseous compounds indoor and outdoor of the classrooms, during 2009-2011. Size segregated aerosol samples were collected for analyses of bulk and single particle elemental profiles. They were analyzed by electron probe X-ray micro-analysis (EPXMA), and by energy-dispersive X-ray fluorescence (EDXRF), to investigate the elemental composition of individual particles and bulk samples. The concentrations of benzene, toluene, ethylbenzene, and xylene (BTEX); NO2; SO2; acetic acid; and formic acid were assessed indoor and outdoor using passive diffusion tubes. BTEX were analyzed by GC-MS and other collected gasses by ion chromatography. Individual exposition of BTEX was assessed by personal passive diffusion tubes. Results are interpreted separately and as a whole with the specific aim of identifying compounds that could affect the health of the scholars. In view of the chemical composition and size distribution of the aerosol particles, local deposition efficiencies in the children's respiratory systems were calculated, revealing the deposition of particles at extrathoracic, tracheobronchial and pulmonary levels.

Effects of air pollution on lung function and symptoms of asthma, rhinitis and eczema in primary school children

Health effects of ambient air pollution were studied in three groups of schoolchildren living in areas (suburban, urban and urban-traffic) with different air pollution levels in Eskişehir, Turkey. This study involved 1,880 students aged between 9 and 13 years from 16 public primary schools. This two-season study was conducted from January 2008 through March 2009. Symptoms of asthma, rhinitis and eczema were determined by the International Study of Asthma and Allergies in Childhood questionnaire in 2008. Two lung function tests were performed by each child for summer and winter seasons with simultaneous ambient air measurements of ozone (O3), nitrogen dioxide (NO2) and sulfur dioxide (SO2) by passive sampling. Effects of air pollution on impaired lung function and symptoms in schoolchildren were estimated by multivariate logistic regression analyses. Girls with impaired lung function (only for the summer season evaluation) were more observed in suburban and urban areas when compared to urban-traffic area ([odds ratio (OR) = 1.49; 95 % confidence interval (CI) 1.04-2.14] and [OR = 1.69 (95 % CI 1.06-2.71)] for suburban vs. urban-traffic and urban vs. urban-traffic, respectively). Significant association between ambient ozone concentrations and impaired lung function (for an increase of 10 μg m(-3)) was found only for girls for the summer season evaluation [OR = 1.11 (95 % CI 1.03-1.19)]. No association was found for boys and for the winter season evaluation. No association was found between any of the measured air pollutants and symptoms of current wheeze, current rhinoconjunctivitis and current itchy rash. The results of this study showed that increasing ozone concentrations may cause a sub-acute impairment in lung function of school aged children.

Urbanisation, urbanicity, and health: a systematic review of the reliability and validity of urbanicity scales

Background

Despite a plethora of studies examining the effect of increased urbanisation on health, no single study has systematically examined the measurement properties of scales used to measure urbanicity. It is critical to distinguish findings from studies that use surrogate measures of urbanicity (e.g. population density) from those that use measures rigorously tested for reliability and validity. The purpose of this study was to assess the measurement reliability and validity of the available urbanicity scales and identify areas where more research is needed to facilitate the development of a standardised measure of urbanicity.

Methods

Databases searched were MEDLINE with Full Text, CINAHL with Full Text, and PsycINFO (EBSCOhost) as well as Embase (Ovid) covering the period from January 1970 to April 2012. Studies included in this systematic review were those that focused on the development of an urbanicity scale with clearly defined items or the adoption of an existing scale, included at least one outcome measure related to health, published in peer-reviewed journals, the full text was available in English and tested for validity and reliability.

Results

Eleven studies met our inclusion criteria which were conducted in Sri Lanka, Austria, China, Nigeria, India and Philippines. They ranged in size from 3327 to 33,404 participants. The number of scale items ranged from 7 to 12 items in 5 studies. One study measured urban area socioeconomic disadvantage instead of urbanicity. The emerging evidence is that increased urbanisation is associated with deleterious health outcomes. It is possible that increased urbanisation is also associated with access and utilisation of health services. However, urbanicity measures differed across studies, and the reliability and validity properties of the used scales were not well established.

Conclusion

There is an urgent need for studies to standardise measures of urbanicity. Longitudinal cohort studies to confirm the relationship between increased urbanisation and health outcomes are urgently needed.

Effects of Lung Support Formula on respiratory symptoms among older adults: results of a three-month follow-up study in Shanghai, China

Background

With the acceleration of industrialization in low or middle-income nations, the prevalence of respiratory symptoms among older adults is even more significant now in China. Contemporary treatments using Western medicine, such as anti-inflammatory regimens, may be effective in relieving the symptoms, but may have unexpected side effects. Some natural products may be effective in improving respiratory functions, yet their efficacies remain to be examined in randomized, placebo-controlled studies. To evaluate the effects of Lung Support Formula, a nutritional supplement which contains naturally derived Chinese herbal medicines, we conducted a clinical study among older adults in Shanghai, China.

Methods

A total of 100 patients over 50 years old were recruited and blindly randomized into the treatment or control group. The subjects took either 1 Lung Support Formula capsule or a placebo capsule twice a day for 12 weeks. All subjects were followed-up every 4 weeks to perform investigative and clinical examinations. Repeated measure of analysis of variance was employed to compare the trend of respiratory symptoms scores between the 2 groups during 12 weeks of follow-up.

Results

Fifty patients from the treatment group and 49 patients in the control group completed the 3-month follow-up. No adverse events were reported in the treatment duration. The percentage of patients reported to have chronic cough, chronic expectoration and chronic bronchitis were significantly decreased in the treatment group when compared with baseline after a 3-month intervention (P < 0.05). The respiratory symptoms scores declined gradually with the lapse of time (P < 0.05) in the treatment group and there were no significant changes in the control group by repeated measure of analysis of variance (P > 0.05).

Conclusions

The clinical research shows that use of Lung Support Formula shows significant improvements of respiratory symptoms and is well-tolerated in short-term use among older adults. An additional study involving more subjects and longer-term follow-up would be needed to provide convincing evidence of the improvement of respiratory symptoms in the treatment group.

Respiratory health status of children from two different air pollution exposure settings of Sri Lanka: a cross-sectional study

BACKGROUND

Health effects due to air pollution is becoming a major public health problem with growing traffic congestion and establishment of small- to medium-scale industries with poor emission controls in urban cities of Sri Lanka.

METHODS

Respiratory health status of 7- to 10-year-old children in two settings (urban and semi-urban) was assessed using standard questionnaires. Information on socio-demographic characteristics and potential determinants of both outdoor and indoor air pollutants exposure levels were also obtained. The respiratory health status of children in the two settings was compared.

RESULTS

We found that children from the urban setting had a significantly higher prevalence of wheezing within the last 12 months as compared to children from the semi-urban setting (adjusted OR = 2.02; 95% CI = 1.13-3.59). Indoor cooking with unclean fuels was a risk factor for wheezing independent of the area of residence (adjusted OR = 1.57; 95% CI = 1.01-2.46).

CONCLUSIONS

Poor indoor air quality was a major determinant of wheezing for the overall study group. Children from urban areas of Sri Lanka have poorer respiratory health status as compared to children from semi-urban areas. Besides poor outdoor air quality, this difference may also be due to other unexplored factors which may differ between urban and semi-urban areas in Sri Lanka.

Evaluation of air quality by passive and active sampling in an urban city in Turkey: current status and spatial analysis of air pollution exposure

Concentrations of air pollutants, nitrogen dioxide (NO(2)), sulfur dioxide (SO(2)), ozone (O(3)), particulate matter (PM(2.5) and PM(10)), trace metals, and polycyclic aromatic hydrocarbons (PAHs) were measured in 2008 and 2009 in the city of Eskişehir, central Turkey. Spatial distributions of NO(2), SO(2), and ozone were determined by passive sampling campaigns carried out during two different seasons with fairly large spatial coverage. A basic population exposure assessment was carried out employing Geographical Information System techniques by combining population density maps with pollutant distribution maps of NO(2) and SO(2). It was found that 95 % of the population is exposed to NO(2) levels close to the World Health Organization guideline value. Regarding SO(2), a large proportion of the population (83 %) is exposed to levels above the WHO second interim target value. Concentrations of all the pollutants showed a seasonal pattern increasing in winter period, except for ozone having higher concentrations in summer season. Daily PM(10) and PM(2.5) concentrations exceeded European Union limit values almost every sampling day. Toxic fractions of the measured PAHs were calculated and approximately fourfold increase was observed in winter period. Copper, Pb, Sn, As, Cd, Zn, Sb, and Se were found to be moderately to highly enriched in PM(10) fraction, indicating anthropogenic input to those elements measured. Exposure assessment results indicate the need for action to reduce pollutant emissions especially in the city center. Passive sampling turns out to be a practical and economical tool for air quality assessment with large spatial coverage.

Performance evaluation of a tailor-made passive sampler for monitoring of tropospheric ozone

INTRODUCTION

This study presents the performance evaluation of a tailor-made passive sampler developed for the monitoring of tropospheric ozone.

METHODS

The performance of the passive sampler was tested in the field conditions in terms of accuracy, precision, blank values, detection limit, effects of some parameters such as sampling site characteristics and sampling period on the field blanks, self-consistency, experimental and theoretical uptake rates, shelf life and comparison with commercial passive samplers.

RESULTS

There was an agreement (R (2) = 0.84) between the responses of passive sampler and the continuous automatic analyser. The accuracy of the sampler, expressed as percent relative error, was obtained lower than 15%. Method precision in terms of coefficient of variance for three simultaneously applied passive samplers was 12%. Sampler detection limit was 2.42 μg m(-3) for an exposure period of 1 week, and the sampler can be stored safely for a period of up to 8 weeks before exposure. Satisfactory self-consistency results showed that extended periods gave the same integrated response as a series of short-term samplers run side by side. The uptake rate of ozone was found to be 10.21 mL min(-1) in a very good agreement with the theoretical uptake rate (10.32 mL min(-1)). The results of the comparison study conducted against a commercially available diffusion tube (Gradko diffusion tube) showed a good linear relationship (R (2) = 0.93) between two passive samplers.

CONCLUSIONS

The sampler seems suitable to be used in large-scale measurements of ozone where no data are available or the number of existing automated monitors is not sufficient.