Exposure to secondhand and thirdhand smoke in private vehicles: Measurements in air and dust samples

BACKGROUND

This study aimed to estimate airborne nicotine concentrations and nicotine, cotinine, and tobacco-specific nitrosamines (TSNAs) in settled dust from private cars in Spain and the UK.

METHODS

We measured vapor-phase nicotine concentrations in a convenience sample of 45 private cars from Spain (N = 30) and the UK (N = 15) in 2017-2018. We recruited non-smoking drivers (n = 20), smoking drivers who do not smoke inside the car (n = 15), and smoking drivers who smoke inside (n = 10). Nicotine, cotinine, and three TSNAs (NNK, NNN, NNA) were also measured in settled dust in a random subsample (n = 20). We computed medians and interquartile ranges (IQR) of secondhand smoke (SHS) and thirdhand smoke (THS) compounds according to the drivers' profile.

RESULTS

24-h samples yielded median airborne nicotine concentrations below the limit of quantification (LOQ) (IQR:

CONCLUSIONS

All cars of smokers had measurable SHS and THS pollution, the exposure levels markedly higher in vehicles of drivers where smoking took place. Our results evidence the need for policies to prohibit smoking in vehicles, but also urge for more comprehensive strategies aiming towards the elimination of tobacco consumption.

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Key Words

• Airborne nicotine
• Automobile
• Dust
• Thirdhand smoke
• Tobacco smoke pollution
• Tobacco-specific nitrosamines

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MESH Headings

• Nicotine/analysis
• Cotinine
• Tobacco Smoke Pollution/analysis
• Dust
• Nitrosamines/analysis
• Tobacco

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Affiliation(s)

Xavier Continente Agència de Salut Pública de Barcelona, Pl. Lesseps, 1, 08023, Barcelona, Spain; Centre for Biomedical Research in Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029, Madrid, Spain; Sant Pau Institute of Biomedical Research (IIB Sant Pau), Sant Antoni Maria Claret, 167, 08025, Barcelona, Spain.
Elisabet Henderson Agència de Salut Pública de Barcelona, Pl. Lesseps, 1, 08023, Barcelona, Spain; Sant Pau Institute of Biomedical Research (IIB Sant Pau), Sant Antoni Maria Claret, 167, 08025, Barcelona, Spain.
Laura López-González Agència de Salut Pública de Barcelona, Pl. Lesseps, 1, 08023, Barcelona, Spain.
Esteve Fernández Unitat de Control de Tabac, Institut Català d'Oncologia, Av. Granvia de l'Hospitalet 199-203, 08908, L'Hospitalet de Llobregat, Spain; Institut D'Investigació Biomèdica de Bellvitge, Av. Granvia de l'Hospitalet 199, 08908, L'Hospitalet de Llobregat, Spain; Department of Clinical Sciences, Campus de Bellvitge, School of Medicine and Health Sciences, University of Barcelona, Feixa Llarga, S/n, 08907, L'Hospitalet de Llobregat, Spain; Centre for Biomedical Research in Respiratory Diseases (CIBERES), Av. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029, Madrid, Spain.
Olena Tigova Unitat de Control de Tabac, Institut Català d'Oncologia, Av. Granvia de l'Hospitalet 199-203, 08908, L'Hospitalet de Llobregat, Spain; Institut D'Investigació Biomèdica de Bellvitge, Av. Granvia de l'Hospitalet 199, 08908, L'Hospitalet de Llobregat, Spain; Department of Clinical Sciences, Campus de Bellvitge, School of Medicine and Health Sciences, University of Barcelona, Feixa Llarga, S/n, 08907, L'Hospitalet de Llobregat, Spain; Centre for Biomedical Research in Respiratory Diseases (CIBERES), Av. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029, Madrid, Spain.
Sean Semple Institute for Social Marketing, University of Stirling, Stirling, FK9 4LA, Scotland, UK.
Rachel O'Donnell Institute for Social Marketing, University of Stirling, Stirling, FK9 4LA, Scotland, UK.
Ana Navas-Acién Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, 722 W 168th St, New York, NY, 10032, United States.
Núria Cortés-Francisco Agència de Salut Pública de Barcelona, Pl. Lesseps, 1, 08023, Barcelona, Spain; Centre for Biomedical Research in Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029, Madrid, Spain; Sant Pau Institute of Biomedical Research (IIB Sant Pau), Sant Antoni Maria Claret, 167, 08025, Barcelona, Spain.
Noelia Ramírez Institut d'Investigació Sanitària Pere Virgili, Dr. Mallafré Guasch, 4, 43007, Tarragona, Spain; Universitat Rovira i Virgili, Department of Electronic Engineering, Escorxador, s/n, 43003, Tarragona, Spain; Centre for Biomedical Research in Diabetes and Associated Metabolic Diseases (CIBERDEM), Av. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029, Madrid, Spain.
Ruaraidh Dobson Institute for Social Marketing, University of Stirling, Stirling, FK9 4LA, Scotland, UK.
Maria José López Agència de Salut Pública de Barcelona, Pl. Lesseps, 1, 08023, Barcelona, Spain; Centre for Biomedical Research in Epidemiology and Public Health (CIBERESP), Av. Monforte de Lemos, 3-5, Pabellón 11, Planta 0, 28029, Madrid, Spain; Sant Pau Institute of Biomedical Research (IIB Sant Pau), Sant Antoni Maria Claret, 167, 08025, Barcelona, Spain; Departament de Ciències Experimentals i de la Salut (DCEXS), Universitat Pompeu Fabra, Doctor Aiguader, 88, 08003, Barcelona, Spain.

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[Support and guidance in driving for patients with (or suspected of having) Alzheimer's disease or related diseases: position paper]

New ministerial decree restricts driving motorized vehicles for patients with Alzheimer's disease and related disorders. Reisberg stage 3, threshold used to contraindicate driving, appears to correspond to a mild stage of major neurocognitive impairment. A single scale gives an idea of the level of risk but does not provide a holistic assessment. The aim of this consensus is to put forward recommendations from several French learned societies for individualized cognitive assessments to minimize the risks associated with driving and its cessation. Fitness to drive should be raised at the earliest stages of the diagnostic process, and regularly throughout the follow-up. Consult a registered doctor is recommended to all patients wishing to continue driving. All documents must be given to the patient only. An alternative must always be offered to patients who are recommended a modal shift.

Working memory-related alterations in neural oscillations reveal the influence of in-vehicle toluene on cognition at low concentration

Although toluene is a typical in-vehicle pollutant, the impacts of in-vehicle toluene exposure on cognitive functions remain unestablished. Therefore, this study aimed to investigate the effects of short-term toluene exposure in vehicles on working memory based on neural oscillations. In total, 24 healthy adults were recruited. Each subject was exposed to four different concentrations of toluene and divided into 0 ppb, 17.5 ppb, 35 ppb, and 70 ppb groups for self-control studies. After 4 h of exposure to each concentration of toluene, a behavioral test of visual working memory was performed while 19-channel electroencephalogram (EEG) signals were collected. Meanwhile, the power spectral density (PSD) and spatial distribution of working memory encoding, maintenance, and extraction periods were calculated by short-time Fourier transform to clarify the characteristic frequency bands, major brain regions, and characteristic channels of each period. To compare the changes in the characteristic patterns of neural oscillations under the effect of different concentrations of toluene. There was no significant difference in working memory reaction time and correct rate between the groups at different toluene concentrations (p > 0.05). The characteristic frequency band of the working memory neural oscillations in each group was the theta frequency band; the PSD of the theta frequency band was predominantly concentrated in the frontal area, and the characteristic channel was the Fz channel. The whole brain (F = 3.817, p < 0.05; F = 4.758, p < 0.01; F = 3.694, p < 0.05), the frontal area (F = 2.505, p < 0.05; F = 2.839, p < 0.05; F = 6.068, p < 0.05), the Fz channel (F = 3.522, p < 0.05; F = 3.745, p < 0.05; F = 6.526, p < 0.05), and the PSD of working memory in the theta frequency band was significantly increased in the 70 ppb group compared with the other three groups during the coding, maintenance, and retrieval phases of working memory. When the in-vehicle toluene exposure concentration was 70 ppb, the PSD of the characteristic frequency bands of working memory was significantly increased in the whole brain, major brain regions, and characteristic channels.

Preparation and characterization of lignin/nano graphene oxide/styrene butadiene rubber composite for automobile tyre application

Styrene butadiene rubber (SBR), is a synthetic polymer and the most abundantly used in the tire industry, which have good collaborative properties with additives and fillers. In present work, we aim to synthesize SBR composite having the properties of graphene oxide filler and made it to be biodegradable. In composite preparation, we fabricated styrene-butadiene rubber/graphene oxide/lignin composites by adding biodegradable biomolecule of lignin fillers at varying 1-3 wt% quantities amount. Those prepared SBR composites were characterized using advanced analysis techniques, and also their biodegradability was. From microscopy examination results, the morphology of pure SBR composite had been improved after the addition of graphene oxide, while the 1 wt% lignin filled SBR sample revealed well-integrated morphology with crest-and-trough-like feature, showcasing the lignin fibrils could strengthen the molecular interaction between graphene oxide nano sheet and SBR rubber. For 2 wt% lignin filled SBR sample, it exhibited large protuberants due to the aggregation effect of lignin fibrils. However, bulky and bundle structure of protuberant was more significantly formed in 3 wt% lignin filled SBR, as a result of poor interface between lignin and SBR rubber. The porosity had also been improved for 1 wt% lignin filled SBR sample, imparting it with great surface area to act as tire in automobile application. The physico-chemical analysis also detected the trace of graphene oxide and lignin functional groups in the SBR composite. In addition, the thermal analysis revealed those lignin-filled composites had stable heat tolerance behavior, which suitably used in extreme weather condition. Moreover, the 1 wt% lignin filled SBR sample exhibited good characteristics in both mechanical and biodegradable properties. Thus, the composite of 1 wt% lignin filled SBR could be regarded as a promising candidate for green tire application in the future.

Calculating source contributions to urban atmospheric polycyclic aromatic hydrocarbons and nitropolycyclic aromatic hydrocarbons using 1-nitropyrene and pyrene: An application to an Asian dust event

A method to calculate source contributions to atmospheric polycyclic aromatic hydrocarbons (PAHs) and their nitrated congeners (NPAHs) is proposed, using pyrene (Pyr) and 1-nitropyrene (1-NP), as respective representatives of PAHs and NPAHs. This is based on the known increases in NPAH to PAH ratios as combustion temperatures increase. The fractions of 1-NP and Pyr from high temperature combustion sources in total 1-NP and Pyr are respectively calculated as a (0 < a <1) and b (0 < b < 1). By using atmospheric concentrations of Pyr and 1-NP obtained at monitoring sites, contributions of high and low temperature combustion sources were calculated. Using this method, the contributions of automobiles and coal combustion facilities/industries to atmospheric Pyr and 1-NP concentrations were calculated for atmospheric samples collected in Kanazawa, Japan during a seasonal Asian dust event. The results show that Pyr was almost entirely emitted from industries in China and transported long-range to Japan. By contrast, 1-NP was emitted primarily from automobiles in Kanazawa and its surrounding areas, with a small amount of 1-NP possibly transported from China. The proposed method can provide greater clarity on source identification compared to the typically used PAH isomer pairs.

Risk analysis of different transport vehicles in India during COVID-19 pandemic

Due to the airborne nature of viral particles, adequate ventilation has been identified as one suitable mitigation strategy for reducing their transmission. While 'dilution of air by opening the window' has been prescribed by national and international health agencies, unintended detrimental consequences might result in many developing countries with high ambient air pollution. In the present study, PM2.5 exposure concentration and probability of mortality due to PM2.5 in different scenarios were assessed. A COVID airborne infection risk estimator was used to estimate the probability of infection by aerosol transmission in various commuter micro-environments: (a) air conditioned (AC) taxi (b) non-AC taxi (c) bus and (d) autorickshaw. The following were the estimated exposure concentrations in the four types of vehicles during pre-lockdown, during lockdown, and lost-lockdown: AC taxi cars (17.16 μg/m3, 4.52 μg/m3, and 25.09 μg/m3); non-AC taxis: (28.74 μg/m3, 7.56 μg/m3, 42.01 μg/m3); buses (21.79 μg/m3, 5.73 μg/m3, 31.86 μg/m3) autorickshaws (51.30 μg/m3, 3.50 μg/m3, 75 μg/m3). Post-lockdown, the probability of mortality due to PM2.5 was highest for autorickshaws (5.67 × 10-3), followed by non-AC taxis (2.07 × 10-3), buses (1.39 × 10-3), and AC taxis (1.02 × 10-3). This order of risk is inverted for the probability of infection by SARS-COV-2, with the highest for AC taxis (6.10 × 10-2), followed by non-AC taxis (1.71 × 10-2), buses (1.42 × 10-2), and the lowest risk in autorickshaws (1.99 × 10-4). The findings of the present study suggest that vehicles with higher ventilation or air changes per hour (ACH) should be preferred over other modes of transport during COVID-19 pandemic.

Manufacturing and service supply chain resilience to the COVID-19 outbreak: Lessons learned from the automobile and airline industries

There has been an increased interest among scholars to investigate supply chain resilience (SCRes) in manufacturing and service operations during emerging situations. Grounded in the SCRes theory, this study provides insights into the impact of the COVID-19 outbreak on the automobile and airline supply chain. Both the short and long-term response strategies adopted by the two supply chains are assessed, using a combination of qualitative and quantitative techniques in three distinct phases. In phase one, we use a sequential mixed-method for resilience evaluation, integrating Time-to-Recovery (TTR) and Financial Impact (FI) analysis. In phase two, we conduct an empirical survey involving 145 firms to evaluate the short-term SCRes response strategies. In the third phase, we conduct semi-structured interviews with supply chain executives both from the automobile and airline industries to understand the long-term SCRes response strategies. Our findings indicate that: (i) the automobile industry perceived that the best strategies to mitigate risks related to COVID-19, were to develop localized supply sources and use advanced industry 4.0 (I4.0) technologies. (ii) The airline industry on the other hand, perceived that the immediate need was to get ready for business continuity challenges posed by COVID-19, by defining their operations both at the airports and within the flights. (iii) Importantly, both the sectors perceived Big Data Analytics (BDA) to play a significant role by providing real-time information on various supply chain activities to overcome the challenges posed by COVID-19. (iv) Cooperation among supply chain stakeholders is perceived, as needed to overcome the challenges of the pandemic, and to accelerate the use of digital technologies.

Orthodox or traditional medicine? Private or public healthcare? Exploring treatment pathways for occupational health problems among informal automobile artisans

Even though informal workers in developing countries have the most hazardous jobs, there is a sheer neglect for the treatment of their occupational health problems (OHP) in practice and by policies. This qualitative study explored how informal automobile artisans from Nigeria sought care for their OHP. It focused on their choice between orthodox and traditional medicine, between self-care and professional care, and between private and public health-care providers. 43 informal automobile artisans were purposively interviewed. The treatment sought depended on the type, the severity, and the perceived cause of the OHP. The distinction between rational and non-rational explanations of the causes of OHP usually determined the treatment endpoint. The financial means of the artisans and the cost of different treatments were also important factors. The study concluded that in order to develop safer working conditions in the sector, policy makers and artisanal associations should be aware of the considerations that informed the artisans' choices on how to treat OHP .

Calculating sources of combustion-derived particulates using 1-nitropyrene and pyrene as markers

Airborne particulate matter (PM) contains numerous hazardous polycyclic aromatic hydrocarbons (PAHs) as well as their functionalized congeners. However, the lack of useful methods to identify the sources of PM has hindered the development of researches in atmospheric and public health fields. This report proposes a new method for estimating the source contribution of combustion-derived particulate (P_c) by using 1-nitropyrene (1-NP) and pyrene (Pyr) as markers. This is premised on the fact that the formation of nitrogen oxides in the flame gas and the subsequent nitration of PAHs are functions of combustion temperature and therefore the concentration ratios of NPAHs to PAHs are highly temperature dependent. This method divides combustion sources into two groups - high and low temperatures - which here are respectively represented by automobile engine and coal combustion in urban areas. Formulae are derived for combustion-derived particulate (P_c), whose fraction in the total particulate is y (0 < y < 1), and particulates from combustion sources with high temperatures (P_h), whose fraction in P_c is x (0 < x < 1), and low temperatures (P_l), whose fraction is (1 －x). When concentrations of 1-NP and Pyr in P_h and P_l are known, values x and y can be calculated from the formulae by determining atmospheric 1-NP and Pyr concentrations at monitoring sites. Then atmospheric concentrations of P_c, P_h and P_l can be calculated. The proposed method has been applied for total suspended particulate matter (TSP) samples collected in Kanazawa and Kitakyushu (Japan) and Beijing (China) having different types of atmospheric pollution to clarify the change of contributions of automobiles and coal combustion.

Factors that Associate Japanese University Students' Use of Rear Seat Belts on General Roads and Expressways

This study clarifies the prevalence of rear seat belt use among university students and explores the factors that influence seat belt use on general roads and expressways. Questionnaires were distributed to 1,091 students who attended health education lectures: 893 students (81.9%) agreed to participate and met the criteria; among them, 660 (73.9%) provided complete responses. While one-third (33.0%) of rear seat passengers "always" used seat belts on general traffic roads, three-fourths (73.2%) "always" used them on expressways. Multivariate analysis revealed that being male and the perception of obligation and recognition of the benefits of rear seat belt use were associated with use on general roads, whereas the possession of a driver's license and recognition of benefits were associated with use on expressways. Finally, we suggest that educational programs on seat belt use be developed and delivered to general road and expressway users to promote seat belt use.

Automobile injury trends in the contemporary fleet: Belted occupants in frontal collisions

Objective: As vehicle safety technologies and evaluation procedures advance, it is pertinent to periodically evaluate injury trends to identify continuing and emerging priorities for intervention. This study examined detailed injury distributions and injury risk trends in belted occupants in frontal automobile collisions (10 o'clock to 2 o'clock) using NASS-CDS (1998-2015). Methods: Injury distributions were examined by occupant age and vehicle model year (stratified at pre- and post-2009). Logistic regression models were developed to examine the effects of various factors on injury risk (by body region), controlling for delta-V, sex, age, height, body mass index (BMI), vehicle model year (again stratified at 2009). Results: Among other observations, these analyses indicate that newer model year vehicles (model year [MY] 2009 and later) carry less risk of Abbreviated Injury Scale (AIS) 2+ and AIS 3+ injury compared to older model year vehicles, with odds ratios of 0.69 (AIS 2+) and 0.45 (AIS 3+). The largest reductions in risk between newer model year vehicles and older model year vehicles occur in the lower extremities and in the risk of skull fracture. There is no statistically significant change in risk of AIS 3+ rib fracture or sternum injury between model year categories. Females are at greater risk of AIS 2+ and AIS 3+ injury compared to males, with increased risk across most injury types. Conclusions: For belted occupants in frontal collisions, substantial reductions in injury risk have been realized in many body regions in recent years. Risk reduction in the thorax has lagged other body regions, resulting in increasing prevalence among skeletal injuries in newer model year vehicles (especially in the elderly). Injuries also remain common in the arm and hand/wrist for all age ranges studied. These results provide insight into where advances in the field have made gains in occupant protection and what injury types remain to be addressed.

Measuring the impact of driving status: The Centre for Research on Safe Driving-Impact of Driving Status on Quality of Life (CRSD-IDSQoL) tool

BACKGROUND.

Driving an automobile is often considered an activity of daily living and is crucial to quality of life for many individuals. Following driving cessation, quality of life may become compromised.

PURPOSE.

The Centre for Research on Safe Driving-Impact of Driving Status on Quality of Life (CRSD-IDSQoL) was designed to measure various elements of quality of life and how those elements are affected by driving status.

METHOD.

The CRSD-IDSQoL was cross-sectionally administered to a convenience sample of 114 individuals (mean age 65.8 years). Exploratory factor analysis was used to examine the factor structure.

FINDINGS.

The results supported three factors. Following adjustments for conceptual fit, Cronbach's alphas for the Community Mobility, Emotional, and Resources and Safety domains were .82, .84, and .74, respectively. Community Mobility was positively associated with distance driven per week.

IMPLICATIONS.

The CRSD-IDSQoL may be a useful tool to study quality-of-life impacts of driving cessation. Further evaluation of the tool is warranted.

Injury patterns among pedestrians using assistive mobility devices

INTRODUCTION

As the population ages, growing numbers of individuals are turning to assisted mobility devices (AMDs) to maintain independence. These devices often place users in a seated position. Like ambulatory pedestrians, pedestrians seated in an AMD are at risk for involvement in an automobile versus pedestrian crash. The purpose of this study is to compare the injury pattern and comorbidities of standing pedestrians struck by an automobile versus those of seated pedestrians.

METHODS

The Arizona State Trauma Registry was queried for pedestrians struck by an automobile between 2010 and 2015. Using ICD 9 and 10 codes as well as other available documentation, seated pedestrians were identified and matched based on age and gender to standing pedestrians. Presence of co-morbidities, injury pattern, Injury Severity Score (ISS), hospital length of stay (LOS), and mortality were compared between the two groups.

RESULTS

There were 70 seated pedestrians identified, matched to 140 standing pedestrians. Co-morbidities were present in 89% of seated pedestrians vs 66% of standing pedestrians (p = 0.002). Functional dependence was more prevalent in the seated pedestrians (21% vs 1%, p = 0.004). There were not significant differences in the proportion of AIS injuries by body region. However, within the thoracic region, seated pedestrians were more likely to suffer pulmonary contusions: 14% vs 4%, p = 0.05.

CONCLUSIONS

The injury pattern for seated pedestrians differs slightly from that of standing pedestrians struck by an automobile. However, seated pedestrians are more likely to have co-morbid conditions that may complicate care. These findings are important when caring for the injured pedestrian and performing injury prevention outreach.

Role of vehicle inspection policy in climate mitigation: The case of Japan

In 1951, the Japanese government introduced a vehicle safety inspection system and this system has an effect of shortening the 'economic' lifetimes of automobiles and increasing CO₂ emissions associated with vehicle life-cycle. This study develops an integrated assessment framework by combining dynamic discrete choice analysis with life-cycle environmental accounting analysis based on a dynamic stock model. From the empirical results, we found that (1) the economic lifetime of a Prius in the benchmark model is surprisingly short, 5.07 years, due to the strict car inspection system, and this replacement cycle has contributed to increasing CO₂ over time; and (2) abolishing car inspections at the third and fifth years would considerably contribute to reducing life-cycle CO₂ emissions associated with Prius sold during the study period, 1997 to 2016, accounting for approximately one million tons-CO₂ eq. over 20 years. Thus, we conclude that modifying the regulation policy with a focus on the car inspection system to induce car owners to keep their automobiles longer would have environmental benefits.

Evaluating the impact of Mobike on automobile-involved bicycle crashes at the road network level

As a booming system, free-floating bicycle-sharing (denoted as Mobike) attracts a large number of users due to the convenient utilization procedure. However, it brings about a rapid increase of bicycle volume on roadways, resulting in safety problems especially on road segments shared by automobiles and bikes. This study aimed to evaluate impacts of Mobike on automobile-involved bicycle crashes on shared roadways at a macro level, the network level. Relation between traffic volumes and crashes was first established. Then, the travel mode choice before and after supplying Mobike in the market was analyzed, based on which the multi-class multi-modal user equilibrium (MMUE) models were formulated and solved. Two attributes of Mobike, supply quantity and fare, were investigated via various scenarios. Results suggested the Mobike attracted more walkers than auto-users in travel mode choices, which caused the volume increase of bicycles but few volume decline of automobiles and resulted in more crashes. The supply quantity of Mobike had a negative impact on safety, while the fare had a positive effect. The total supply of Mobike in the market should be regulated by governments to avoid over-supply and reduce bicycle crashes. The fares should be also regulated by including taxes and insurances, which can be used to build up more separated bicycle facilities and cover the Mobike accidents, respectively. The findings of this study provide useful information for governments and urban transportation managers to improve bicycle safety and regulate the Mobike market.

Simultaneously reducing CO2 and particulate exposures via fractional recirculation of vehicle cabin air

Prior studies demonstrate that air recirculation can reduce exposure to nanoparticles in vehicle cabins. However when people occupy confined spaces, air recirculation can lead to carbon dioxide (CO2) accumulation which can potentially lead to deleterious effects on cognitive function. This study proposes a fractional air recirculation system for reducing nanoparticle concentration while simultaneously suppressing CO2 levels in the cabin. Several recirculation scenarios were tested using a custom-programmed HVAC (heat, ventilation, air conditioning) unit that varied the recirculation door angle in the test vehicle. Operating the recirculation system with a standard cabin filter reduced particle concentrations to 1000 particles/cm3, although CO2 levels rose to 3000 ppm. When as little as 25% fresh air was introduced (75% recirculation), CO2 levels dropped to 1000 ppm, while particle concentrations remained below 5000 particles/cm3. We found that nanoparticles were removed selectively during recirculation and demonstrated the trade-off between cabin CO2 concentration and cabin particle concentration using fractional air recirculation. Data showed significant increases in CO2 levels during 100% recirculation. For various fan speeds, recirculation fractions of 50-75% maintained lower CO2 levels in the cabin, while still reducing particulate levels. We recommend fractional recirculation as a simple method to reduce occupants' exposures to particulate matter and CO2 in vehicles. A design with several fractional recirculation settings could allow air exchange adequate for reducing both particulate and CO2 exposures. Developing this technology could lead to reductions in airborne nanoparticle exposure, while also mitigating safety risks from CO2 accumulation.

Use, perceptions, and benefits of automotive technologies among aging drivers

Advanced in-vehicle technologies have been proposed as a potential way to keep older adults driving for as long as they can safely do so, by taking into account the common declines in functional abilities experienced by older adults. The purpose of this report was to synthesize the knowledge about older drivers and advanced in-vehicle technologies, focusing on three areas: use (how older drivers use these technologies), perception (what they think about the technologies), and outcomes (the safety and/or comfort benefits of the technologies). Twelve technologies were selected for review and grouped into three categories: crash avoidance systems (lane departure warning, curve speed warning, forward collision warning, blind spot warning, parking assistance); in-vehicle information systems (navigation assistance, intelligent speed adaptation); and other systems (adaptive cruise control, automatic crash notification, night vision enhancement, adaptive headlight, voice activated control). A comprehensive and systematic search was conducted for each technology to collect related publications. 271 articles were included into the final review. Research findings for each of the 12 technologies are synthesized in relation to how older adults use and think about the technologies as well as potential benefits. These results are presented separately for each technology. Can advanced in-vehicle technologies help extend the period over which an older adult can drive safely? This report answers this question with an optimistic “yes.” Some of the technologies reviewed in this report have been shown to help older drivers avoid crashes, improve the ease and comfort of driving, and travel to places and at times that they might normally avoid.

Fatal heat stroke in children found in parked cars: autopsy findings

A common and unfortunate cause for heat stroke-related deaths in children is entrapment in closed vehicles. The aim of this study was to analyze the pathological consequences of such grave events. Autopsy reports of all children that were brought to a national forensic medicine center after being found dead in closed vehicles over a 21-year period (1995-2015) were reviewed. Data extracted were the circumstances of the events, child age, sex, height and weight, time, date and duration of entrapment, and environmental temperatures at the time of entrapment and the autopsy findings. Eight deceased children were brought to the forensic medicine center for autopsy, and seven families consented to the procedure. Autopsy findings included diffuse petechiae and hemorrhages of serosal membranes (n = 7/7) and lung congestion (n = 3/7).

CONCLUSION

Typical autopsy findings following classical heat stroke in children include diffuse petechiae and hemorrhages and lung involvement. These findings are similar to those reported in adults that had died following exertional heat stroke-a very different mechanism of heat accumulation. Prevention of future events can possibly be obtained by public education on the rapid heating of closed vehicles, the vulnerability of children to heat, and the caregiver role in child entrapment.

WHAT IS KNOWN

• A common and unfortunate cause for heat stroke-related deaths in children is entrapment in closed vehicles. The pathological consequences of such grave events have not been previously reported. What is New: • This study is the first to describe autopsy findings from children who were found dead in parked cars. • Autopsy findings included diffuse petechiae hemorrhages of serosal membranes and lung congestion. • These findings are identical to those seen in adults following exertional heat stroke.

Airborne polybrominated diphenyl ethers (PBDEs), polybrominated dibenzo-p-dioxins/furans (PBDD/Fs), and dechlorane plus (DP) in concentrated vehicle parking areas

This study investigated polybrominated diphenyl ethers (PBDEs), polybrominated dibenzo-p-dioxins/furans (PBDD/Fs), and dechlorane plus (DP) in air around three concentrated vehicle parking areas (underground, indoor, and outdoor) in a metropolitan of South China. The parking areas showed higher concentrations of PBDEs, PBDD/Fs, and DP than their adjacent urban area or distinct congener/isomer profiles, which indicate their local emission sources. The highest PBDE and DP concentrations were found in the outdoor parking lot, which might be related to the heating effect of direct sunlight exposure. Multi-linear regression analysis results suggest that deca-BDEs without noticeable transformation contributed most to airborne PBDEs in all studied areas, followed by penta-BDEs. The statistically lower anti-DP fractions in the urban area than that of commercial product signified its degradation/transformation during transportation. Neither PBDEs nor vehicle exhaust contributed much to airborne PBDD/Fs in the parking areas. There were 68.1-100 % of PBDEs, PBDD/Fs, and DP associated with particles. Logarithms of gas-particle distribution coefficients (K ps) of PBDEs were significantly linear-correlated with those of their sub-cooled vapor pressures (p Ls) and octanol-air partition coefficients (K OAs) in all studied areas. The daily inhalation doses of PBDEs, DP, and PBDD/Fs were individually estimated as 89.7-10,741, 2.05-39.4, and 0.12-4.17 pg kg(-1) day(-1) for employees in the parking areas via Monte Carlo simulation.

Adverse associations of car time with markers of cardio-metabolic risk

OBJECTIVE

To examine associations of time spent sitting in cars with markers of cardio-metabolic risk in Australian adults.

METHOD

Data were from 2800 participants (age range: 34-65) in the 2011-12 Australian Diabetes, Obesity and Lifestyle Study. Self-reported time spent in cars was categorized into four groups: ≤15min/day; >15 to ≤30min/day; >30 to ≤60min/day; and >60min/day. Markers of cardio-metabolic risk were body mass index (BMI), waist circumference, systolic and diastolic blood pressure, triglycerides, HDL (high-density lipoprotein)-cholesterol, fasting plasma glucose, 2-h plasma glucose, a clustered cardio-metabolic risk score, and having the metabolic syndrome or not. Multilevel linear and logistic regression analyses examined associations of car time with each cardio-metabolic risk outcome, adjusting for socio-demographic and behavioral variables and medication use for blood pressure and cholesterol/triglycerides.

RESULTS

Compared to spending 15min/day or less in cars, spending more than 1h/day in cars was significantly associated with higher BMI, waist circumference, fasting plasma glucose, and clustered cardio-metabolic risk, after adjusting for socio-demographic attributes and potentially relevant behaviors including leisure-time physical activity and dietary intake. Gender interactions showed car time to be associated with higher BMI in men only.

CONCLUSIONS

Prolonged time spent sitting in cars, in particular over 1h/day, was associated with higher total and central adiposity and a more-adverse cardio-metabolic risk profile. Further studies, ideally using objective measures of sitting time in cars and prospective designs, are needed to confirm the impact of car use on cardio-metabolic disease risk.

Automobile windshield washer fluid: A potential source of transmission for Legionella

Epidemiological evidence suggesting driving cars to be a risk factor for legionellosis has prompted public health studies to investigate vehicle windshield washer fluid as a novel transmission source of this disease. The goal of the current study was to investigate whether or not windshield washer fluid could serve as a potential source of transmission for Legionella. A wide variation in the survival of L. pneumophila was observed when incubated in different washer fluids at 25 and 37 °C, however, one brand tested supported Legionella survival similar to or greater than sterilized deionized water. In addition, 1 L of tap water contained in a washer fluid reservoir was able to support population growth and survival of Legionella for several months. In a field study examining the windshield washer fluid of 12 elementary school buses, Legionella were detected from 84% of samples at a high concentration of 8.1×10(4) CFU/mL. Culturable cells were also detected in aerosolized washer fluid during washer fluid spray. By demonstrating survival in certain windshield washer fluids, growth within washer fluid reservoirs, and the presence of viable cells in bus washer fluid spray, we have provided evidence suggesting the potential for a novel route of Legionella exposure.

Scenes of fathering: The automobile as a place of occupation

OBJECTIVE

While occupations are increasingly analyzed within contexts, other than the home, the ordinary places that facilitate occupations have been overlooked. The aim of this article is to explore the automobile as a place of occupation using data from an ethnographic study of fathers of children with disabilities.

METHODS

Qualitative data obtained through observations and interviews with the fathers and their families were analyzed using a narrative approach. Properties that influence interactions include opportunities to communicate, the vehicle itself, and electronics.

RESULTS

Driving children in the automobile fulfills fathering responsibilities and is a time for connecting. For the fathers in this study, the automobile represents a place for negotiating complex demands of fathering.

CONCLUSIONS

This study demonstrates not only the importance of the automobile, but also the influence of the immediate space on the construction of occupations.

Profiling pediatric patients involved in automobile crashes in Japan

Introduction:

There is little data concerning the injuries induced by being run over in children.

Problem:

Characteristics of injuries suffered in children by being run over were investigated.

Materials and Methods:

Between January 1998 and December 2007, the medical charts were retrospectively reviewed to investigate characteristics of the injuries in pediatric patients run over by a car. Patients meeting the following criteria were included: (1) age ≤ 12 years old; (2) the patient was struck by an automobile. The subjects were divided into three groups by the mechanisms of injury: (1) run over; (2) carried away; (3) contact.

Results:

Twelve patients had been run over, 44 patients were carried away and 44 patients had been hit by a car (contact). The average age in the run over group was the lowest, followed by that in the carried away group and that in the contact group was the highest. The children's coma score and injury severity score were not significantly different among the three groups; however, the average chest abbreviated injury score was the highest in the run over group, followed by that in the carried away group and that in the contact group was the lowest. The average duration of admission and survival rate among three groups, were not significantly different.

Conclusion:

The patients who were injured due to being run over by a car, tended to be younger and to have severe chest injury.

Daytime running lights in the USA: what is the impact on vehicle crashes in Minnesota?

Background

Daytime running lights (DRLs) are a safety feature intended to reduce crashes by increasing the contrast between vehicles and the background.

Aims

The purpose of this study was to determine whether there is an association between vehicles in the USA being equipped with DRLs and crash rates.

Methods

This was a retrospective study using the Minnesota Department of Transportation (MNDOT) Crash Database from 1995 to 2002. Crash reports included in the analyses were limited to accidents involving vehicles 1995 or newer (DRLs not available on prior models) and limited to ideal conditions: (1) daylight, (2) optimal visibility, and (3) dry road surface. The vehicle identification number (VIN) was used to determine the make, model, and year. This information was cross-referenced with a National Highway Traffic Safety Administration table of manufacturer listed DRL conditions to determine vehicle DRL status. Crude crash rates for vehicles were calculated relative to the number of all registered vehicles in Minnesota in 2004, for models 1995–2002. Ninety-five percent confidence intervals (CI) for the rates were constructed assuming a Poisson error distribution.

Results

During 1995–2002, there were 184,637 vehicles (1995 or newer) with identifiable VINs involved in accidents which occurred under the specified test conditions. Of these vehicles, 37,909 were determined to have standard DRLs and 146,728 were determined to be models without DRLs (including those listed as DRL optional). The crash rate among vehicles without standard DRLs was 1.73 (95% CI: 1.71–1.75) times higher than the rate for vehicles with standard DRLs. The rate ratio was also significant for fatal vehicle crash rates 1.48 (95% CI: 1.23–1.76).

Conclusion

Minnesota vehicles equipped with DRLs were associated with a statistically significant lower crash rate compared to vehicles without DRLs from 1995 to 2002.