Enhancing Models and Measurements of Traffic-Related Air Pollutants for Health Studies Using Dispersion Modeling and Bayesian Data Fusion

INTRODUCTION

The adverse health effects associated with exposure to traffic-related air pollutants (TRAPs) remain a key public health issue. Often, exposure assessments have not represented the small-scale variation and elevated concentrations found near major roads and in urban settings. This research explores approaches aimed at improving exposure estimates of TRAPs that can reduce exposure measurement error when used in health studies. We consider dispersion models designed specifically for the near-road environment, as well as spatiotemporal and data fusion models. These approaches are implemented and evaluated utilizing data collected in recent modeling, monitoring, and epidemiological studies conducted in Detroit, Michigan.

APPROACH

Dispersion models, which estimate near-road pollutant concentrations and individual exposures based on first principles - and in particular, high fidelity models - can provide great flexibility and theoretical strength. They can represent the spatial variability of TRAP concentrations at locations not measured by conventional and spatially sparse air quality monitoring networks. A number of enhancements to dispersion modeling and mobile on-road emissions inventories were considered, including the representation of link-based road networks and updated estimates of temporal allocation of traffic activity, emission factors, and meteorological inputs. The recently developed Research LINE-source model (RLINE), a Gaussian line-source dispersion model specifically designed for the near-road environment, was used in an operational evaluation that compared predicted concentrations of nitrogen oxides (NOx), carbon monoxide (CO), and PM2.5 (particulate matter ≤ 2.5 µm in aerodynamic diameter) with observed concentrations at air quality monitoring stations located near high-traffic roads. Spatiotemporal and data fusion models provided additional and complementary approaches for estimating TRAP exposures. We formulated both nonstationary universal kriging models that exploit the spatial correlation in the monitoring data, and data fusion models that leverage the information contained in both the monitoring data and the output of numerical models, specifically RLINE. These models were evaluated using observations of nitric oxide (NO), NOx, black carbon (BC), and PM2.5 monitored along transects crossing major roads in Detroit. We also examined model assumptions, including the appropriateness of the covariance functions, errors in RLINE outputs, and the effects of jointly modeling two pollutants and using an updated emission inventory.

RESULTS

For CO and NOx, dispersion model performance was best when monitoring sites were close to major roads, during downwind conditions, during weekdays, and during certain seasons. The ability to discern local and particularly the traffic-related portion of PM2.5 was limited, a result of high background levels, the sparseness of the monitoring network, and large uncertainties for certain sources (e.g., area, fugitive) and some processes (e.g., formation of secondary aerosols). Sensitivity analyses of alternative meteorological inputs and updated emission factors showed some performance gain when using local (on-site) meteorological data and updated inventories. Overall, the operational evaluation suggested RLINE's usefulness for estimating spatially and temporally resolved exposure estimates. The application of the universal kriging models confirmed that wind speed and direction are important drivers of nonstationarity in pollutant concentrations, and that these models can predict exposure estimates that have lower prediction errors than do stationary model counterparts. The application of the Bayesian data fusion models suggested that the RLINE output had a spatially varying additive bias for NOx and PM2.5 and provided little additional information for NOx, besides what is already contained in traffic and geographical information system (GIS) covariates, but had improved estimates of PM2.5 concentrations. Results of the nonstationary Bayesian data fusion model that used RLINE output across a field spanning the measurement sites were similar to a regression-based Bayesian data fusion approach that used only RLINE output at the monitoring locations, with the latter being computationally less burdensome. Using the regression-based Bayesian data fusion model, we found that RLINE with the updated emission inventory provided results that were more useful for estimating NOx concentration at unmonitored sites, but the updated emission inventory did not improve predictions of PM2.5 concentrations. Joint modeling of NOx and PM2.5 was not useful, a result of differences in RLINE's utility in predicting PM2.5 and NOx - useful for the former, but not for the latter - and differences in the spatial dependence structures of the two pollutants. Overall, information provided by RLINE was shown to have the potential to improve spatiotemporal estimates of TRAP concentrations.

CONCLUSIONS

The study results should be interpreted and generalized cautiously given the limitations of the data used. Similar analyses in other settings are recommended for confirming and extending our findings. Still, the study highlights considerations that are relevant for exposure estimates used in health studies. The ability of a dispersion model to accurately reproduce and predict a pollutant depends on the pollutant as well as on spatial and temporal factors, such as the distance and direction from the road, time-of-day, and day-of-week. The nature and source of exposure measurement errors should be taken into consideration, particularly in health studies that take advantage of time- activity information that describes where and when individuals are exposed to pollution. Efforts to refine model inputs and improve model performance can be helpful; meteorological inputs may be the most critical. For both dispersion and spatiotemporal statistical models, sufficient and high-quality monitoring data are essential for developing and evaluating these models. Our analyses using Bayesian data fusion models confirm the presence of spatially varying errors in dispersion model outputs and allow quantification of both the magnitude and the spatial nature of these errors. This valuable information can be leveraged in health studies examining air pollution exposure as well as in studies informing regulatory responses.

Ventilation rates in recently constructed U.S. school classrooms

Low ventilation rates (VRs) in schools have been associated with absenteeism, poorer academic performance, and teacher dissatisfaction. We measured VRs in 37 recently constructed or renovated and mechanically ventilated U.S. schools, including LEED and EnergyStar-certified buildings, using CO₂ and the steady-state, build-up, decay, and transient mass balance methods. The transient mass balance method better matched conditions (specifically, changes in occupancy) and minimized biases seen in the other methods. During the school day, air change rates (ACRs) averaged 2.0±1.3 hour^-1 , and only 22% of classrooms met recommended minimum ventilation rates. HVAC systems were shut off at the school day close, and ACRs dropped to 0.21±0.19 hour^-1 . VRs did not differ by building type, although cost-cutting and comfort measures resulted in low VRs and potentially impaired IAQ. VRs were lower in schools that used unit ventilators or radiant heating, in smaller schools and in larger classrooms. The steady-state, build-up, and decay methods had significant limitations and biases, showing the need to confirm that these methods are appropriate. Findings highlight the need to increase VRs and to ensure that energy saving and comfort measures do not compromise ventilation and IAQ.

Interaction between ambient pollutant exposure, CD14 (-159) polymorphism and respiratory outcomes among children in Kwazulu-Natal, Durban

The objective of this study was to determine if the association between exposure to ambient air pollutants such as sulfur dioxide, nitrogen dioxde (NO₂), nitrous oxide (NO), and PM₁₀, and variation in lung function measures was modified by genotype. A validated questionnaire was administered to 71 African children to evaluate prevalence of respiratory symptoms. Atopy was evaluated by skin-prick testing and bihourly measures of lung function (spirometry) were collected. Gaseous air pollutant concentrations were monitored continuously. CD14 polymorphism was genotyped and plasma CD14 levels were measured. There was no statistically significant association between the CD14 (159) CT+TT polymorphism with any asthma-related phenotype. There was a significant association between lung function (forced expiratory volume in 1 second intraday variability) and NO₂ and NO among participants carrying the CD14 CT/TT genotype for lags 1, 2, and the 5-day average. Similarly, statistically significant gene-pollutant interactions ( p < 0.05) were found with NO and CD14 CT/TT at lag 2 and for the 5-day average. While there was no association with any respiratory phenotype (as determined by symptoms), the CD14 CT/TT genotype appeared to be protective to increased exposure to NO₂ and NO.

Sources, concentrations, and risks of naphthalene in indoor and outdoor air

Naphthalene is a ubiquitous pollutant, and very high concentrations are sometimes encountered indoors when this chemical is used as a pest repellent or deodorant. This study describes the distribution and sources of vapor-phase naphthalene concentrations in four communities in southeast Michigan, USA. Outdoors, naphthalene was measured in the communities and at a near-road site. Indoors, naphthalene levels were characterized in 288 suburban and urban homes. The median outdoor concentration was 0.15 μg/m(3), and a modest contribution from rush-hour traffic was noted. The median indoor long-term concentration was 0.89 μg/m(3), but concentrations were extremely skewed and 14% of homes exceeded 3 μg/m(3), the chronic reference concentration for non-cancer effects, 8% exceeded 10 μg/m(3), and levels reached 200 μg/m(3). The typical excess individual lifetime cancer risk was about 10(-4) and reached 10(-2) in some homes. Important sources include naphthalene's use as a pest repellent and deodorant, migration from attached garages and, to lesser extents, cigarette smoke and vehicle emissions. Excessive use as a repellent caused the highest concentrations. Naphthalene presents high risks in a subset of homes, and policies and actions to reduce exposures, for example, sales bans or restrictions, improved labeling, and consumer education, should be considered.

PRACTICAL IMPLICATIONS

Long-term average concentrations of naphthalene in most homes fell into the 0.2-1.7 μg/m(3) range reported as representative in earlier studies. The highly skewed distribution of concentrations results in a subset of homes with elevated concentrations and health risks that greatly exceed US EPA and World Health Organization (WHO) guidelines. The most important indoor source is the use of naphthalene as a pest repellant or deodorant; secondary sources include presence of an attached garage, cigarette smoking, and outdoor sources. House-to-house variation was large, reflecting differences among the residences and naphthalene use practices. Stronger policies and educational efforts are needed to eliminate or modify indoor usage practices of this chemical.

Particulate matter concentrations in residences: an intervention study evaluating stand-alone filters and air conditioners

This study, a randomized controlled trial, evaluated the effectiveness of free-standing air filters and window air conditioners (ACs) in 126 low-income households of children with asthma. Households were randomized into a control group, a group receiving a free-standing HEPA filter placed in the child's sleeping area, and a group receiving the filter and a window-mounted AC. Indoor air quality (IAQ) was monitored for week-long periods over three to four seasons. High concentrations of particulate matter (PM) and carbon dioxide were frequently seen. When IAQ was monitored, filters reduced PM levels in the child's bedroom by an average of 50%. Filter use varied greatly among households and declined over time, for example, during weeks when pollutants were monitored, filter use was initially high, averaging 84±27%, but dropped to 63±33% in subsequent seasons. In months when households were not visited, use averaged only 34±30%. Filter effectiveness did not vary in homes with central or room ACs. The study shows that measurements over multiple seasons are needed to characterize air quality and filter performance. The effectiveness of interventions using free-standing air filters depends on occupant behavior, and strategies to ensure filter use should be an integral part of interventions.

PRACTICAL IMPLICATIONS

Environmental tobacco smoke (ETS) increased particulate matter (PM) levels by about 14 μg/m3 and was often detected using ETS-specific tracers despite restrictions on smoking in the house as reported on questionnaires administered to caregivers. PM concentrations depended on season, filter usage, relative humidity, air exchange ratios, number of children, outdoor PM levels, sweeping/dusting, and presence of a central air conditioner (AC). Free-standing air filters can be an effective intervention that provides substantial reductions in PM concentrations if the filters are used. However, filter use was variable across the study population and declined over the study duration, and thus strategies are needed to encourage and maintain use of filters. The variability in filter use suggests that exposure misclassification is a potential problem in intervention studies using filters. The installation of a room AC in the bedroom, intended to limit air exchange ratios, along with an air filter, did not lower PM levels more than the filter alone.

Sources and migration of volatile organic compounds in mixed-use buildings

We examined concentrations and migration of volatile organic compounds (VOCs) in ten mixed-use buildings in southeast Michigan, USA. In an office and work zone in each building, air exchange rates (AERs) were measured using perfluorocarbon tracers, and over 96 VOC species were measured by GC/MS over a 7-day period. VOCs were then apportioned to sources in offices, work zones, and outdoors using a two-zone mass balance model. AERs averaged 3.9 h (0.2-14.2 h) in offices and 1.9 h (0.4-3.5 h) in work zones. The dominant VOCs included aromatics, terpenes and alkanes. VOC concentrations were uniform in the smaller spaces, and more variable in some of the very large spaces. Apportionments depended on the VOC and building, but emissions in industrial zones of buildings often migrated to office areas where they frequently accounted for the bulk of VOC concentrations. Outdoor sources accounted for most benzene and carbon tetrachloride, and a small fraction of aromatic and aliphatic compounds. This study shows that pollutant migration can be a significant and not uncommon problem in mixed-use buildings, and it demonstrates the need for better control of emissions and pollutant migration.

PRACTICAL IMPLICATIONS

Pollutant exposures in industrial, commercial, and institutional buildings arise from indoor and outdoor sources that can be identified, apportioned, and controlled with knowledge of emission sources and building airflows. We show that multi-tracer techniques are an effective and practical means of determining airflows and exchange rates in large buildings. In examining a set of mixed-use buildings, a substantial fraction of VOC exposures in otherwise relatively 'clean' offices is due to pollutant migration from 'dirty' zones of the building. This indicates the need for corrective actions to minimize exposures of office workers that are unwanted and probably unknown to building managers. These actions should include better control of emissions, isolation or control of air and pollutant flows between building zones, and documentation of the effectiveness of such measures when strong emission sources are present.

PCBs in air, soil and milk in industrialized and urban areas of KwaZulu-Natal, South Africa

Information regarding polychlorinated biphenyls (PCBs) in environmental media in Africa is limited. This paper presents results of a monitoring program conducted in KwaZulu-Natal Province, South Africa designed to characterize levels, trends and sources of airborne PCBs. Particulate and vapor samples were sampled over the 2004-2005 period at three sites. The total PCB concentration averaged 128+/-47 pgm(-3), and levels were highest in winter. Tri- through hexa-congeners predominated, and the vapor fraction was predominant. Several tetra- through hexa-chlorinated congeners had levels comparable to those at urban sites in the northern hemisphere, but hepta- through deca-congeners resembled levels at background sites. PCB source areas, deduced using spatial and temporal patterns, compositional information and trajectory analyses, likely included local, regional and global sources. Soils at three rural sites showed high PCB concentrations, and milk from a local dairy showed PCB concentrations comparable to USA levels in year 2000.

Indoor air quality in Michigan schools

Indoor air quality (IAQ) parameters in 64 elementary and middle school classrooms in Michigan were examined for the purposes of assessing ventilation rates, levels of volatile organic compounds (VOCs) and bioaerosols, air quality differences within and between schools, and emission sources. In each classroom, bioaerosols, VOCs, CO(2), relative humidity, and temperature were monitored over one workweek, and a comprehensive walkthough survey was completed. Ventilation rates were derived from CO(2) and occupancy data. Ventilation was poor in many of the tested classrooms, e.g., CO(2) concentrations often exceeded 1000 ppm and sometimes 3000 ppm. Most VOCs had low concentrations (mean of individual species <4.5 microg/m(3)); bioaerosol concentrations were moderate (<6500 count per m(3) indoors, <41,000 count per m(3) outdoors). The variability of CO(2), VOC, and bioaerosol concentrations within schools exceeded the variability between schools. These findings suggest that none of the sampled rooms were contaminated and that no building-wide contamination sources were present. However, localized IAQ problems might remain in spaces where contaminant sources are concentrated and that are poorly ventilated.

PRACTICAL IMPLICATIONS

Indoor air quality (IAQ) is a continuing concern for students, parents, teachers, and school staff, leading to many complaints regarding poor IAQ. Investigations of these complaints often include air sampling, which must be carefully conducted if representative data are to be collected. To better understand sampling results, investigators need to account for the variability of contaminants both within and between schools.

A probabilistic model for silver bioaccumulation in aquatic systems and assessment of human health risks

Silver (Ag) is discharged in wastewater effluents and is also a component in a proposed secondary water disinfectant. A steady-state model was developed to simulate bioaccumulation in aquatic biota and assess ecological and human health risks. Trophic levels included phytoplankton, invertebrates, brown trout, and common carp. Uptake routes included water, food, or sediment. Based on an extensive review of the literature, distributions were derived for most inputs for use in Monte Carlo simulations. Three scenarios represented ranges of dilution and turbidity. Compared with the limited field data available, median estimates of Ag in carp (0.07-2.1 micrograms/g dry weight) were 0.5 to 9 times measured values, and all measurements were within the predicted interquartile range. Median Ag concentrations in biota were ranked invertebrates > phytoplankton > trout > carp. Biotic concentrations were highest for conditions of low dilution and low turbidity. Critical variables included Ag assimilation efficiency, specific feeding rate, and the phytoplankton bioconcentration factor. Bioaccumulation of Ag seems unlikely to result in toxicity to aquatic biota and humans consuming fish. Although the highest predicted Ag concentrations in water (> 200 ng/L) may pose chronic risks to early survival and development of salmonids and risks of argyria to subsistence fishers, these results occur under highly conservative conditions.

Performance evaluation of a sorbent tube sampling method using short path thermal desorption for volatile organic compounds

Air sampling, using sorbents, thermal desorption and gas chromatography, is a versatile method for identifying and quantifying trace levels of volatile organic compounds (VOCs). Thermal desorption can provide high sensitivity, appropropriate choices of sorbents and method parameters can accommodate a wide range of compounds and high humidity, and automated short-path systems can minimize artifacts, losses and carry-over effects. This study evaluates the performance of a short-path thermal desorption method for 77 VOCs using laboratory and field tests and a dual sorbent system (Tenax GR, Carbosieve SIII). Laboratory tests showed that the method requirements for ambient air sampling were easily achieved for most compounds, e.g., using the average and standard deviation across target compounds, blank emissions were < or = 0.3 ng per sorbent tube for all target compounds except benzene, toluene and phenol; the method detection limit was 0.05 +/- 0.08 ppb, reproducibility was 12 +/- 6%, linearity, as the relative standard deviation of relative response factors, was 16 +/- 9%, desorption efficiency was 99 +/- 28%, samples stored for 1-6 weeks had recoveries of 87 +/- 9%, and high humidity samples had recoveries of 102 +/- 12%. Due to sorbent, column and detector characteristics, performance was somewhat poorer for phenol groups, ketones, and nitrogen containing compounds. The laboratory results were confirmed in an analysis of replicate samples collected in two field studies that sampled ambient air along roadways and indoor air in a large office building. Replicates collected under field conditions demonstrated good agreement except for very low concentrations or large (> 41 volume) samples of high humidity air. Overall, the method provides excellent performance and satisfactory throughput for many applications.

Selection and evaluation of air pollution exposure indicators based on geographic areas

Geographic exposure indicators (GEIs) use point estimates of ambient air pollutant concentrations to characterize the exposure of populations residing within a specified area. Both zone- and proximity-type GEIs have been widely employed in epidemiological studies and other applications to identify regions or populations at high risk. Their use requires a number of assumptions, for example, pollutant concentrations should be homogeneous within the area, and concentrations should differ between areas in a predictable manner. These assumptions have not been rigorously examined. This paper evaluates the most common types of GEIs as surrogate measures of ambient air pollutant exposures. Statistical measures proposed to evaluate GEIs include accuracy, homogeneity, misclassification and statistical power. GEIs and statistical measures are evaluated in two case studies that use different air pollution sources and an air quality dispersion model. The case studies show that pollutant levels may vary substantially within a small area, and significant errors and exposure misclassification may result if the GEI represents a large geographic area. GEIs based on residential proximity to a pollution source should not be used for elevated emission sources, and the use of proximity measures is discouraged for ground level sources. A systematic evaluation is suggested to evaluate and improve the accuracy of the GEIs used in epidemiological and other applications.

Residence location as a measure of environmental exposure: a review of air pollution epidemiology studies

Residence location has long been used to indicate environmental exposure in many epidemiological studies. This indicator is easy to establish, requires little exposure or monitoring data, and is potentially applicable to many types of investigations. The validity, accuracy and utility of residence location as an exposure indicator, however, is challenged by current concerns regarding multiple exposure pathways, persistent and toxic contaminants, and cumulative exposures from non-point, mobile and point sources. This paper reviews 45 epidemiological studies that use residence location to identify study populations and estimate air pollution exposures. Thirteen (29%) of the studies determined environmental exposures based on "proximity" measures, usually the distance from a subject's residence to a pollutant source. Other studies used "zones" presumed to have equal pollutant levels. Several studies combined zone and proximity approaches. Exposures were quantified using monitoring data in 27 (60%) studies and dispersion modeling in two (4%) studies. Sixteen (36%) studies did not use any environmental data to quantify exposure. A total of 31 (69%) of the studies reported significant associations between health endpoints and the pollutant exposures represented by residence location. In general, comprehensive and systematic approaches to identify and estimate population exposures were not used, and the exposure estimates were therefore deemed likely to have great uncertainty. Unless exposure levels among groups are verified, it cannot be determined whether nonsignificant associations between exposures and health endpoints indicate a lack of measurable health effects, or are merely a result of exposure misclassification. Site-specific and quantitative exposure assessments are needed to better quantify and confirm exposures within such studies, as well as to permit interpretations and comparisons across studies.

Artemisinin, Related Sesquiterpenes, and Essential Oil in Artemisia annua During a Vegetation Period in Vietnam

The active principle of ARTEMISIA ANNUA L., artemisinin, is currently being developed to a registered antimalarial drug. For production purposes, plants with a high artemisinin content are required. We followed the development of the artemisinin content and of the biosynthetically related sesquiterpenes artemisinic acid, arteannuin B, and artemisitene in A. ANNUA plants, during a vegetation period in Vietnam, where this species is indigenous. In addition, the essential oil content and composition were studied. Samples of leaves, buds, flowers, or post-bloom flowers and fruits were taken at different stages: vegetative (5, 6, and 8 months old), at mass formation of buds (9 months), at full bloom (10 months), and post-bloom (10S months). The highest artemisinin content (0.86% dry wt) was present in the leaves of 5 months-old plants. At this stage also the highest leaf yield was found. Subsequently, the artemisinin content gradually dropped. At the age of 5 months the highest artemisinic acid and arteannuin B contents, 0.16 and 0.08% dry wt, respectively, were found as well. Artemisitene was present at all stages of development, ranging from 0.002 to 0.09% dry wt. With 1.9% v/w, the essential oil content was maximal just before flowering and was composed of 55% monoterpenes and 45% sesquiterpenes. At all other stages (0.4 - 1.0% v/w oil) this ratio was ca. 30%/70%. The main components of the oil were camphor and germacrene-D.

Mucuna pruriens: improvement of the biotechnological production of the anti-Parkinson drug L-dopa by plant cell selection

Routinely grown cell suspension cultures of Mucuna pruriens L. (Fabaceae) were able to endogenously accumulate the anti-Parkinson drug L-dihydroxyphenylalanine (L-dopa) in the range between 0.2 and 2% on a dry weight (DW) basis. The green colour that developed in light-exposed cultures, appeared to be a suitable marker to select cells with an increased L-dopa biosynthesis and/or phenoloxidase activity. For this purpose, saccharose concentrations from 0 to 4% (w/v), and light intensities of 1,000 and 2,000 lux, were involved in the selection procedure. After 6 months, photomixotrophic callus cultures with a rapid growth and a high L-dopa content of 0.9% (DW) were obtained on 2% saccharose and under 1,000 lux. The cell suspensions, derived from these calli, accumulated up to 6% (DW) L-dopa, which was the highest stable content ever measured in cultures of M. pruriens. An L-dopa yield of approximately 1.2 g/l was calculated after 6 days of growth. In contrast, compared wtih the standard-grown parent cell line, the phenoloxidase activity, and consequently the bioconversion capacity as measured after entrapment in calcium alginate, of these high-producing cultures was approximately threefold lower.

The accumulation and isolation of coniferin from a high-producing cell suspension of Linum flavum L

Cell suspensions of Linum flavum L. contained large amounts (2 g·l(-1)) of the glucoside coniferin which was accumulated endogenously up to 12.4% on a dryweight basis. Callus material contained 5.6%, while in leaves of in-vitro-grown plantlets, the origin of the callus and suspension cultures, no coniferin could be detected. Leaf, callus and suspension material were compared for metabolite accumulation and associated enzyme activities. High coniferin contents corresponded with low 5-methoxypodophyllotoxin levels. A reciprocal relationship between β-glucosidase (E.C. 3.2.1.21) activity and coniferin accumulation was found. No relationship between peroxidase (E.C. 1.11.1.7) activity and coniferin accumulation or 5-methoxypodophyllotoxin could be demonstrated. Finally, a rapid and effective isolation procedure for coniferin was developed.

Daily air pollution effects on children's respiratory symptoms and peak expiratory flow

To identify acute respiratory health effects associated with air pollution due to coal combustion, a subgroup of elementary school-aged children was selected from a large cross-sectional study and followed daily for eight months. Children were selected to obtain three equal-sized groups: one without respiratory symptoms, one with symptoms of persistent wheeze, and one with cough or phlegm production but without persistent wheeze. Parents completed a daily diary of symptoms from which illness constellations of upper respiratory illness (URI) and lower respiratory illness (LRI) and the symptom of wheeze were derived. Peak expiratory flow rate (PEFR) was measured daily for nine consecutive weeks during the eight-month study period. Maximum hourly concentrations of sulfur dioxide, nitrogen dioxide, ozone, and coefficient of haze for each 24-hour period, as well as minimum hourly temperature, were correlated with daily URI, LRI, wheeze, and PEFR using multiple regression models adjusting for illness occurrence or level of PEFR on the immediately preceding day. Respiratory illness on the preceding day was the most important predictor of current illness. A drop in temperature was associated with increased URI and LRI but not with increased wheeze or with a decrease in level of PEFR. No air pollutant was strongly associated with respiratory illness or with level of PEFR, either in the group of children as a whole, or in either of the symptomatic subgroups; the pollutant concentrations observed, however, were uniformly lower than current ambient air quality standards. Moreover, since exposure estimation based on monitoring of ambient air likely results in misclassification of the true exposure, the negative findings of this study must be interpreted cautiously.

Health effects of air pollution due to coal combustion in the Chestnut Ridge region of Pennsylvania: cross-section survey of children

A cross-sectional study of 4,071 children aged 6-11 yr of age from a rural region of Western Pennsylvania was conducted in spring of 1979. Standardized children's questionnaires were distributed to the parents and returned by the children to school, where spirometry was performed. The region was divided into low-, moderate-, and high-pollution areas on the basis of the 1974-1978, 3-hr, 24-hr, and annual averages for sulfur dioxide (SO2). Seventeen monitoring stations in the region and a triangulation procedure were used to estimate centroid levels in each geographic residence area. After adjusting the respiratory symptom response outcomes and the pulmonary function levels for known predictors, no significant association was noted for level of SO2. However, the highest exposure categories were only slightly above the present annual and 24-hr National Air Quality Standards for SO2. We conclude that at levels of exposure to which these children were exposed, only by study of potentially sensitive subsets or measures of acute response would it be possible to detect respiratory outcomes associated with ambient air pollution.

Health effects of air pollution due to coal combustion in the Chestnut Ridge Region of Pennsylvania: results of cross-sectional analysis in adults

Respiratory questionnaires (ATS-DLD-78) were administered to 5557 adult women in a rural area of Western Pennsylvania to evaluate the health effects of air pollution resulting from coal combustion. Air pollution data were derived from 17 air quality monitor sites and stratified to define low, medium, and high pollution areas. The means of 4 yr (1975-1978) annual averages for sulfur dioxide in each strata were 62, 66, and 99 micrograms/m3, respectively. Total suspended particulates were not tested as a risk factor because they reflected air pollution from sources other than coal combustion (e.g., agricultural, road dusts). Risks of respiratory symptoms were evaluated in a multiple logistic model that adjusted for several potential confounding factors. The risk of "wheeze most days or nights" in nonsmokers residing in the high and medium pollution areas was 1.58 and 1.26 (P = .02), respectively, relative to residents in the low pollution area. In the subset of residents who had lived in the same location for at least 5 yr, relative risks increased to 1.95 and 1.40 (P less than .01), respectively. An increased risk of grade 3 dyspnea in nonsmokers was associated with sulfur dioxide but did not achieve statistical significance (P = .11), and there was no association of cough or phlegm and air pollution in nonsmokers. Cigarette smoking characteristics were the major determinant of respiratory symptoms in smokers, and no independent association of air pollution was found. This study suggests that wheezing may be associated with ambient exposure to sulfur dioxide in nonsmokers, but no effect of sulfur dioxide on cigarette smokers was observed.(ABSTRACT TRUNCATED AT 250 WORDS)