PM2.5 as a marker of exposure to tobacco smoke and other sources of particulate matter in Cairo, Egypt

Long-term exposure to ambient fine particulate matter and periodontitis: An observational study using nationally representative survey data

AIM

The rising prevalence of periodontitis imposes substantial burdens on individuals and society. Identifying environmental risk factors for periodontitis may contribute to tackling the global public health burden of it. This study aimed to assess the association between long-term exposure to PM2.5 and periodontitis in a nationally representative population from China.

MATERIALS AND METHODS

In this multi-centre cross-sectional study of 372 communities in 31 provinces of Mainland China, we used data from the Fourth National Oral Health Survey of China in 2015-2016, in combination with high-resolution gridded concentrations of fine particulate matter (PM2.5). Logistic regression was applied to assess the relationship between long-term PM2.5 exposure and the risk of periodontitis. In addition, we examined whether the association varied by individual characteristics, and estimated the exposure-response relationship and the risk of damaged tooth in each tooth quadrant.

RESULTS

A total of 8391 participants from 96 cities were diagnosed with periodontitis, accounting for 60.04% (8391/13,459) of the participants. For each 10 μg/m3 increment in 1-, 3- and 5-year average concentrations of PM2.5, the risk of total periodontitis increased by 9.0% (95% confidence interval: 6.0%, 12.0%), 8.0% (6.0, 11·0) and 7.0% (5.0, 10.0), respectively. Mild periodontitis was more strongly associated with PM2.5 exposure than moderate and severe periodontitis. The teeth in the lower anterior, lower posterior or upper anterior are more susceptible to the effect of PM2.5 on the periodontal pocket, calculus and bleeding gums.

CONCLUSIONS

Long-term exposure to PM2.5 is significantly associated with an increased risk of periodontitis in the nationally representative Chinese population. Considering the rising prevalence of periodontitis, considerable costs of treatment, and substantially adverse effects on individuals and society, these findings suggest that stricter air quality regulations may help ease the burden of periodontal disease.

Behavioural Patterns and Growth Performance of Male Wistar Rats Exposed to Cigarette Smoke: Effects of Curcumin and Hesperidin

This study evaluated the behavioural responses of male Wistar rats to normal air or cigarette smoke (CS) and compared the effects of curcumin and hesperidin on growth performance. In experiment 1, male rats were randomised into two groups (n = 10): control and CS-exposed groups. During exposure (four weeks), the dietary and behavioural patterns were monitored. In experiment 2, forty-eight rats were distributed across eight groups (n = 6): normal control, CS control, CS + curcumin (10 mg.kg−1), CS + curcumin (20 mg.kg−1), CS + hesperidin (10 mg.kg−1), CS + hesperidin (20 mg.kg−1), curcumin (20 mg.kg−1), and hesperidin (20 mg.kg−1) for 6 weeks. Growth performance (feed intake, weight gain, and feed conversion ratio FCR) were assessed. In the first experiment, there was no significant difference (P > 0.05) in the body weight of the CS-exposed group compared to the normal control, whereas feed intake was significantly (P > 0.05) lower in the CS-group. The time to access feed and water was higher in the CS-group, while other behavioural responses (locomotion, stand upright, climbing, stand and stare, sniffing, sitting, and digging) were significantly reduced (P < 0.05) compared with normal control, especially after two weeks. In the second experiment, weight gain, feed in-take, and FCR were significantly lower in the CS-exposed group compared to the control group, whereas treatment with curcumin and hesperidin, especially at the higher dose (20 mg.kg−1 b. wt.), significantly improved the growth performance of the CS-exposed groups. This study submits that CS exposure negatively impacts on the growth performance and behavioural patterns and demonstrates the potentials of curcumin and hesperidin in addressing these CS-provoked changes.

Effect of airflow pattern and distance on removal of particulate matters and volatile organic compounds from cigarette smoke using Sansevieria trifasciata botanical biofilter

Botanical biofilters can effectively remove indoor air pollution. However, to apply botanical biofilters in situ, the distance of botanical biofilter to the pollutants and airflow pattern can be important factors impacting efficiency. This study examined the removal efficiency of particulate matters (PMs) and volatile organic compounds (VOCs) from cigarette smoke, such as formaldehyde and acetone, at various distances (100 cm, 175 cm, 240 cm, and 315 cm) using a Sansevieria trifasciata botanical biofilter. The botanical biofilter was placed inside a testing room (24 m³) and exposed to cigarette smoke. The pollutants removal efficiency was evaluated for six cycles (24 h/cycle) and one cycle as a recovery period where botanical biofilter was placed under normal conditions for 30 days. Results showed that the botanical biofilter could remove 140-250 μg m^-3, 147-257 μg m^-3, 212-455 μg m^-3 for PM₁, PM_2.5, and PM₁₀, respectively, at 8 h. Total VOCs, formaldehyde, and acetone removal were 40%-65%, 46%-69%, and 31%-61% at 24 h. PMs and VOCs removal efficiency can be affected by both distance and pattern of airflow in the testing room. The highest PM₁ and PM_2.5 elimination appeared at 240 cm and 315 cm, while VOCs removal was high at 100 cm. Botanical biofilter creates airflow vortices around 100 cm, indicating low removal of PMs. This is the first study that demonstrated the effect of airflow patterns on different pollutants removal efficiency.

Secondhand smoke in public places in Vietnam: An assessment 5 years after implementation of the tobacco control law

OBJECTIVES

This study quantified the secondhand smoke (SHS) concentration in a sample of public places in Vietnam to determine changes in SHS levels 5 years after a public smoking ban was implemented.

METHODS

Two monitoring campaigns, one in 2013 (before the tobacco control law was implemented) and another in 2018 (5 years after the implementation of the law) were conducted in around 30 restaurants, cafeterias and coffee shops in major cities of Vietnam. Concentrations of PM2.5, as an indicator of SHS, were measured by portable particulate matter monitors (TSI SidePak AM510 and Air Visual Pro).

RESULTS

The geometric mean PM2.5 concentration of all monitored venues was 87.7 µg/m3 (83.7-91.9) in the first campaign and 55.2 µg/m3 (53.7-56.7) in the second campaign. Pairwise comparison showed the PM2.5 concentrations in the smoking observed area was triple and double those in the non-smoking area and the outdoor environment. After adjusting for sampling locations and times, the SHS concentration 5 years after the implementation of the tobacco control law reduced roughly 45%.

CONCLUSION

The study results indicate an improvement in air quality in public places in Vietnam via both the reduction in PM2.5 levels and the number of people observed smoking. However, greater enforcement of the free-smoke legislation is needed to eliminate SHS in public places in Vietnam.

Indoor air pollutant health prioritization in office buildings

This work presents an original method to identify priority indoor air pollutants in office buildings. It uses both a chronic risk assessment approach by calculating a hazard quotient, and a hazard classification method based on carcinogenic, mutagenic, reprotoxic, and endocrine disruptive effects. A graphical representation of the results provides a comprehensive and concise visualization of all of the information, including the number of buildings where each substance was measured, an indicator of exposure data robustness. Seventy-one out of 342 substances (20%) for which indoor air concentrations have already been measured in office buildings were identified as priority pollutants. The results were compared to previous prioritization studies in various types of indoor environments to assess the reliability of the method and highlight its advantages. Sensitivity analyses were performed to reduce the geographical scope (OECD countries only), time scope (after 2010 only), and measurement duration (working hours only) and showed little influence on the results. Finally, 123 additional substances that could be present in office indoor air but could not be assessed due to the lack of measurement data are proposed for future monitoring surveys to update the prioritization of indoor air pollutants in offices.

Indoor Air Quality Issues for Rocky Mountain West Tribes

Native American populations face considerable health disparities, especially among those who live on reservations, where access to healthcare, education, and safe housing can be limited. Previous research on tribal housing has raised concerns about housing construction, damage, and possible linkage to adverse health effects (e.g., asthma). This community-based participatory research (CBPR) project investigated indoor air quality issues on two Rocky Mountain west reservations. At the onset of the project, the research team formed a partnership with community advisory boards (CABs) consisting of representatives from tribal councils and community members. Research design, implementation, and dissemination all took place in full collaboration with the CABs following approval through official tribal resolutions. Residential homes were monitored for particulate matter with diameter <2.5 microns (PM_2.5) and radon concentrations. Low-cost air quality sensors and activated charcoal radon test kits were placed in tribal households for 6-8 days. A large amount of data were below the sensor limit of quantification (LOQ), but several homes had daily averages that exceeded suggested PM2.5 guidelines, suggestive of the potential for high exposure. Additionally, nearly half of all homes sampled had radon levels above the EPA action level, with mitigation activities initiated for the most concerning homes. Findings from this study indicate the need for future community-wide assessments to determine the magnitude and patterns of indoor air quality issues.

Exposure to second-hand tobacco smoke in waterpipe cafés in Barcelona, Spain: An assessment of airborne nicotine and PM2.5

BACKGROUND

Waterpipe tobacco smoking has grown in popularity worldwide, with the prevalence of use increasing in Spain from 6.2% to 10.8% in the last decade, despite the smoking ban enacted in 2010 for all hospitality premises.

OBJECTIVE

To assess exposure to second-hand smoke from waterpipes based on the concentrations of airborne nicotine and particulate matter ≤2.5 μm in diameter (PM_2.5) in a sample of waterpipe cafés in the city of Barcelona (Spain).

METHODS

This cross-sectional study included a sample of 20 waterpipe cafés. Airborne nicotine and PM_2.5 were sampled for 30 min in each venue using a nicotine sampling device connected by a tube to a pump and a TSI SidePak Personal Aerosol Monitor. Five outdoor control locations were also measured. We computed medians, interquartile ranges (IQRs), and maximum values and compared them according to venues' and sampling characteristics using the Kruskall-Wallis and U-Mann Whitney tests. Nicotine and PM_2.5 were correlated by calculating the Spearman-rank correlation coefficient.

RESULTS

The median concentration of nicotine and PM_2.5 were 1.15 and 230.50 μg/m³ in waterpipe cafés and 0.03 and 10.00 μg/m³ in control locations (p<0.05 in both cases). The Spearman correlation coefficient between both markers was 0.61 (95% confidence interval: 0.18-0.84). No differences were found in nicotine or PM_2.5 concentration according to the venues' and sampling characteristics studied, with the exception of area. After stratifying for area, venues >100 m², located in a tourist area, with >15 lit waterpipes, >8 waterpipes/100 m², and a ratio of 2 users per waterpipe or less had significantly higher nicotine concentration.

DISCUSSION

Despite the current smoking ban, which includes hospitality venues, we found nicotine and PM_2.5 levels in Barcelona waterpipe cafés that exceeded the threshold recommended by the World Health Organization. This exposure poses serious risks to the health of both workers and customers and constitutes a non-compliance of the legislation.

Effects of Electronic Cigarettes on Indoor Air Quality and Health

With the rapid increase in electronic cigarette (e-cig) users worldwide, secondhand exposure to e-cig aerosols has become a serious public health concern. We summarize the evidence on the effects of e-cigs on indoor air quality, chemical compositions of mainstream and secondhand e-cig aerosols, and associated respiratory and cardiovascular effects. The use of e-cigs in indoor environments leads to high levels of fine and ultrafine particles similar to tobacco cigarettes (t-cigs). Concentrations of chemical compounds in e-cig aerosols are generally lower than those in t-cig smoke, but a substantial amount of vaporized propylene glycol, vegetable glycerin, nicotine, and toxic substances, such as aldehydes and heavy metals, has been reported. Exposures to mainstream e-cig aerosols have biologic effects but only limited evidence shows adverse respiratory and cardiovascular effects in humans. Long-term studies are needed to better understand the dosimetry and health effects of exposures to secondhand e-cig aerosols.

Effects of Electronic Cigarettes on Indoor Air Quality and Health

With the rapid increase in electronic cigarette (e-cig) users worldwide, secondhand exposure to e-cig aerosols has become a serious public health concern. We summarize the evidence on the effects of e-cigs on indoor air quality, chemical compositions of mainstream and secondhand e-cig aerosols, and associated respiratory and cardiovascular effects. The use of e-cigs in indoor environments leads to high levels of fine and ultrafine particles similar to tobacco cigarettes (t-cigs). Concentrations of chemical compounds in e-cig aerosols are generally lower than those in t-cig smoke, but a substantial amount of vaporized propylene glycol, vegetable glycerin, nicotine, and toxic substances, such as aldehydes and heavy metals, has been reported. Exposures to mainstream e-cig aerosols have biologic effects but only limited evidence shows adverse respiratory and cardiovascular effects in humans. Long-term studies are needed to better understand the dosimetry and health effects of exposures to secondhand e-cig aerosols.

Characterizing peak exposure of secondhand smoke using a real-time PM2.5 monitor

Although short-duration elevated exposures (peak exposures) to pollutants may trigger adverse acute effects, epidemiological studies to understand their influence on different health effects are hampered by lack of methods for objectively identifying peaks. Secondhand smoke from cigarettes (SHS) in the residential environment can lead to peak exposures. The aim of this study was to explore whether peaks in continuous PM2.5 data can indicate SHS exposure. A total of 41 children (21 with and 20 without SHS exposure based on self-report) from 28 families in New York City (NY, USA) were recruited. Both personal and residential continuous PM2.5 monitoring were performed for five consecutive days using MicroPEM sensors (RTI International, USA). A threshold detection method based on cumulative distribution function was developed to identify peaks. When children were home, the mean accumulated peak area (APA) for peak exposures was 297 ± 325 hour*µg/m3 for children from smoking families and six times that of the APA from non-smoking families (~50 ± 54 hour*µg/m3 ). Average PM2.5 mass concentrations for SHS exposed and unexposed children were 24 ± 15 µg/m3 and 15 ± 9 µg/m3 , respectively. The average SHS exposure duration represents ~5% of total exposure time, but ~13% of children's total PM2.5 exposure dose, equivalent to an additional 2.6 µg/m3 per day. This study demonstrated the feasibility of peak analysis for quantifying SHS exposure. The developed method can be adopted more widely to support epidemiology studies on impacts of short-term exposures.

A model for estimating the lifelong exposure to PM2.5 and NO2 and the application to population studies

Numerous epidemiological studies have confirmed the negative influences of air pollutants on human health, where fine particles (PM2.5) and nitrogen dioxide (NO₂) cause the highest health risks. However, the traditional studies have only involved the ambient concentration for a short to medium time period, which ignores the influence of indoor sources, the individual time-activity pattern, and the fact that the health status is impacted by the long-term accumulated exposure. The aim of this paper is to develop a methodology to simulate the lifelong exposure (rather than outdoor concentration) to PM2.5 and NO₂ for individuals in Europe. This method is realized by developing a probabilistic model that integrates an outdoor air quality model, a model estimating indoor air pollution, an exposure model, and a life course trajectory model for predicting retrospectively the employment status. This approach has been applied to samples of two population studies in the frame of the European Commission FP7-ENVIRONMENT research project HEALS (Health and Environment-wide Associations based on Large Population Surveys), where socioeconomic data of the participants have been collected. Results show that the simulated exposures to both pollutants for the samples are influenced by socio-demographic characteristics, including age, gender, residential location, employment status and smoking habits. Both outdoor concentrations and indoor sources play an important role in the total exposure. Moreover, large variances have been observed among countries and cities. The application of this methodology provides valuable insights for the exposure modelling, as well as important input data for exploring the correlation between exposure and health impacts.

Exposure to Secondhand Tobacco Smoke at Airport Terminals

Background

Airports may represent significant sources of secondhand smoke (SHS) exposure for both travelers and employees. While previously common smoking rooms have largely disappeared from US airports, smoking continues to occur outdoors at terminal entrances. SHS may be especially high at arrival areas, since they oftentimes are partially enclosed by overhead departures, creating stagnant microenvironments. This study assessed particulate matter <2.5 microns in diameter (PM2.5), a common surrogate for SHS, at airport terminal locations to evaluate both outdoor exposure risk and possible indoor drift of SHS from outdoor sources.

Methods

A convenience sample of nine airport terminal arrival areas in the US state of Florida was surveyed between February and July 2018. PM2.5 levels were assessed outdoors and indoors at terminal entrances and at control areas far into terminal interiors. We also examined the impact of smoking location on SHS exposure by correlating cigarette and passing vehicle counts with PM2.5 levels at terminals with contrasting proximity of designated smoking locations to terminal entrances.

Results

Although outdoor PM2.5 levels (mean 17.9, SD 6.1 µg/m³) were significantly higher than indoors (p < 0.001), there was no difference between indoor areas directly inside terminal entrances and areas much further interior (mean 8.8, SD 2.6 vs mean 8.5, SD 3.0 µg/m³, p=0.49). However, when smoking areas were in close proximity to terminal entrances, the number of lit cigarettes and vehicular traffic per minute predicted 70% of the variance of PM2.5 levels (p < 0.001), which was attributable mostly to the cigarette number (β = 0.83; 95% CI (0.55 to 1.11); p < 0.001). This effect was not observed at smoking areas further away.

Conclusion

PM2.5 data did not suggest indoor drift from outside smoking. Nevertheless, absolute exposure outdoors was high and correlated with the location of designated smoking areas. Further studies are needed to examine the effect of microclimate formation on exposure risk.

Cigarette Smoke Particles-Induced Airway Hyperreactivity in Vivo and in Vitro

Cigarette smoke is a well-known strong risk factor for inducing airway hyperreactivity (AHR), but the underlying molecular mechanisms are not fully understood. In the present study, mouse in-vivo and in-vitro models were used to study effects of dimethyl sulfoxide (DMSO)-extracted cigarette smoke particles (DSP) on the airway, and to explore the underlying molecular mechanisms that are involved in DSP-induced AHR. In mouse in-vivo model, DSP (0.75, 1.5 or 3 µL/mL) was administered intranasally daily for 7 d. At the end of this period, lung functions were measured with flexiVent™. The results showed that the mice exhibited AHR in a dose-dependent manner following methacholine inhalation in vivo. In mouse in-vitro organ culture model, exposure of mouse tracheal segments to DSP (0.1 µL/mL) with or without the following pharmacological inhibitors: specific c-Jun-N-terminal kinase (JNK) inhibitor SP600125 (10 µM) or the anti-inflammatory drug dexamethasone (1 µM). DSP-induced bradykinin receptor-mediated airway contraction with increased mRNA and protein expressions for bradykinin B1 and B2 receptors could be significantly reduced by SP600125 or dexamethasone. In conclusion, the present study demonstrates that DSP could induce AHR in vivo and in vitro. In addition to this, the upregulation of bradykinin receptors in airway is most likely one of the underlying molecular mechanisms involved.

Evidence of Biomass Smoke Exposure as a Causative Factor for the Development of COPD

Chronic obstructive pulmonary disease (COPD) is a progressive disease of the lungs characterised by chronic inflammation, obstruction of airways, and destruction of the parenchyma (emphysema). These changes gradually impair lung function and prevent normal breathing. In 2002, COPD was the fifth leading cause of death, and is estimated by the World Health Organisation (WHO) to become the third by 2020. Cigarette smokers are thought to be the most at risk of developing COPD. However, recent studies have shown that people with life-long exposure to biomass smoke are also at high risk of developing COPD. Most common in developing countries, biomass fuels such as wood and coal are used for cooking and heating indoors on a daily basis. Women and children have the highest amounts of exposures and are therefore more likely to develop the disease. Despite epidemiological studies providing evidence of the causative relationship between biomass smoke and COPD, there are still limited mechanistic studies on how biomass smoke causes, and contributes to the progression of COPD. This review will focus upon why biomass fuels are used, and their relationship to COPD. It will also suggest methodological approaches to model biomass exposure in vitro and in vivo.

Sources, health effects and control strategies of indoor fine particulate matter (PM2.5): A review

Indoor air quality is directly influenced by indoor PM_2.5. Short-term and long-term exposure of PM_2.5 in the micro environment would severely detriment the health of both humans and animals. The researches both at home and abroad dating from 2000 were analyzed and summarized mainly in the following 3 sections: source apportionment, health effects and control methods. Health effects were illustrated in both epidemiology and toxicology. The epidemiology was explicated in morbidity and mortality, the toxicology was illuminated in inflammatory reaction, oxidative stress, genotoxicity, mutagenicity and carcinogenicity. Control methods were showed in two aspects (sources and means of transmission), of which each was resolved by corresponding control strategy. Abundant investigations indicated that comprehensive control strategies were needed for sources decrement and health burden mitigation of indoor PM_2.5. Based on the increasingly wide research of indoor PM_2.5, the concept of indoors was essentially expanded, and on the basis of the summary of all the aspects mentioned above, both the scope and depth of indoor PM_2.5 research were found insufficiently. Meantime, the potential direction of development in indoor PM_2.5 research were projected, in hope of contributing to further relevant study of engineers in ambient environment and building environment.