Health risk of swimming pool disinfection by-products: a regulatory perspective

While disinfection of swimming pools is indispensable for microbiological safety, it may lead to the formation of disinfection by-products. Most studies agree that inhalation exposure is the predominant pathway of the associated health risks, but assumptions are based on concentrations measured in water and evaporation models. Pool water and air were sampled in 19 swimming pools. Trihalomethanes were detected in all sites; chloroform being the most abundant species. Concentrations ranged between 12.8-71.2 μg/L and 11.1-102.2 μg/m³ in pool water and air, respectively. The individual lifetime carcinogenic risk associated with chloroform in swimming pools exceeded 10^-6 in all age groups for recreational swimmers and 10^-5 for elite swimmers and staff, even if the pool complied with the national standards. Inhalation exposure was estimated and found to be the most relevant, however, different mass transfer models from water measurements significantly under- or overestimated the health burden compared to direct calculation from the concentration in air. The observed health risks call for defining regulatory values and monitoring requirement of indoor air quality in swimming pools.

Carbon trading, co-pollutants, and environmental equity: Evidence from California's cap-and-trade program (2011-2015)

BACKGROUND

Policies to mitigate climate change by reducing greenhouse gas (GHG) emissions can yield public health benefits by also reducing emissions of hazardous co-pollutants, such as air toxics and particulate matter. Socioeconomically disadvantaged communities are typically disproportionately exposed to air pollutants, and therefore climate policy could also potentially reduce these environmental inequities. We sought to explore potential social disparities in GHG and co-pollutant emissions under an existing carbon trading program-the dominant approach to GHG regulation in the US and globally.

METHODS AND FINDINGS

We examined the relationship between multiple measures of neighborhood disadvantage and the location of GHG and co-pollutant emissions from facilities regulated under California's cap-and-trade program-the world's fourth largest operational carbon trading program. We examined temporal patterns in annual average emissions of GHGs, particulate matter (PM2.5), nitrogen oxides, sulfur oxides, volatile organic compounds, and air toxics before (January 1, 2011-December 31, 2012) and after (January 1, 2013-December 31, 2015) the initiation of carbon trading. We found that facilities regulated under California's cap-and-trade program are disproportionately located in economically disadvantaged neighborhoods with higher proportions of residents of color, and that the quantities of co-pollutant emissions from these facilities were correlated with GHG emissions through time. Moreover, the majority (52%) of regulated facilities reported higher annual average local (in-state) GHG emissions since the initiation of trading. Neighborhoods that experienced increases in annual average GHG and co-pollutant emissions from regulated facilities nearby after trading began had higher proportions of people of color and poor, less educated, and linguistically isolated residents, compared to neighborhoods that experienced decreases in GHGs. These study results reflect preliminary emissions and social equity patterns of the first 3 years of California's cap-and-trade program for which data are available. Due to data limitations, this analysis did not assess the emissions and equity implications of GHG reductions from transportation-related emission sources. Future emission patterns may shift, due to changes in industrial production decisions and policy initiatives that further incentivize local GHG and co-pollutant reductions in disadvantaged communities.

CONCLUSIONS

To our knowledge, this is the first study to examine social disparities in GHG and co-pollutant emissions under an existing carbon trading program. Our results indicate that, thus far, California's cap-and-trade program has not yielded improvements in environmental equity with respect to health-damaging co-pollutant emissions. This could change, however, as the cap on GHG emissions is gradually lowered in the future. The incorporation of additional policy and regulatory elements that incentivize more local emission reductions in disadvantaged communities could enhance the local air quality and environmental equity benefits of California's climate change mitigation efforts.

Industrial hygiene, occupational safety and respiratory symptoms in the Pakistani cotton industry

OBJECTIVES

In the cotton industry of Pakistan, 15 million people are employed and exposed to cotton dust, toxic chemicals, noise and physical hazards. The aim of this study was to determine the prevalence of health symptoms, particularly respiratory symptoms, and to measure cotton dust and endotoxin levels in different textile factories of Faisalabad, Pakistan.

METHODS

A cross-sectional investigation was performed in a representative sample of 47 cotton factories in the Faisalabad region in Punjab, Pakistan. Respiratory symptoms of 800 workers were documented by questionnaire. Occupational safety in the factories was assessed by a trained expert following a checklist, and dust and endotoxin levels in different work areas were measured.

RESULTS

Prevalence of respiratory disease symptoms (fever, shortness of breath, chest tightness and cough) was generally high and highest in the weaving section of the cotton industry (20-40% depending on symptoms). This section also displayed the poorest occupational safety ratings and the highest levels of inhalable cotton dust (mean±SD 4.6±2.5 vs 0.95±0.65 mg/m(3) in compact units). In contrast, endotoxin levels were highest in the spinning section (median 1521 EU/m(3)), where high humidity is maintained.

CONCLUSIONS

There are still poor working conditions in the cotton industry in Pakistan where workers are exposed to different occupational hazards. More health symptoms were reported from small weaving factories (power looms). There is a dire need for improvements in occupational health and safety in this industrial sector with particular focus on power looms.

Effectiveness of residential wood-burning regulation on decreasing particulate matter levels and hospitalizations in the San Joaquin Valley Air Basin

OBJECTIVES

We examined the impact of Rule 4901, aimed at reducing residential wood burning, on particulate matter levels and hospitalizations in the San Joaquin Valley Air Basin (SJVAB).

METHODS

Using general linear mixed models and generalized estimating equation models, we compared levels of particulate matter and of hospital admissions (age groups = 45-64 and ≥ 65 years) in the SJVAB for cardiovascular disease (CVD), ischemic heart disease (IHD), and chronic obstructive pulmonary disease during the burn seasons before (2000-2003) and after (2003-2006) implementation.

RESULTS

After implementation, we observed reductions of 12%, 11%, and 15% in particulate matter  2.5 micrometers in diameter or smaller (PM2.5), and 8%, 7%, and 11% in coarse particles, in the entire SJVAB and in rural and urban regions of the air basin, respectively. Among those aged 65 years and older, Rule 4901 was estimated to prevent 7%, 8%, and 5% of CVD cases, and 16%, 17%, and 13% of IHD cases, in the entire SJVAB and in rural and urban regions, respectively.

CONCLUSIONS

The study suggests that Rule 4901 is effective at reducing wintertime ambient PM2.5 levels and decreasing hospital admissions for heart disease among people aged 65 years and older.

Trends in children's exposure to second-hand smoke in the INMA-Granada cohort: an evaluation of the Spanish anti-smoking law

The smoke-free legislation implemented in Spain in 2006 imposed a partial ban on smoking in public and work places, but the result did not meet expectations. Therefore, a more restrictive anti-smoking law was passed five years later in 2011 prohibiting smoking in all public places, on public transport, and the workplace. With the objective of assessing the impact of the latter anti-smoking legislation on children's exposure to second-hand smoke (SHS), we assessed parent's smoking habits and children's urine cotinine (UC) concentrations in 118 boys before (2005-2006) and after (2011-2012) the introduction of this law. Repeated cross-sectional follow-ups of the "Environment and Childhood Research Network" (INMA-Granada), a Spanish population-based birth cohort study, at 4-5 years old (2005-2006) and 10-11 years old (2011-2012), were designed. Data were gathered by ad-hoc questionnaire, and median UC levels recorded as an objective indicator of overall SHS exposure. Multivariable logistic regression was used to examine the association between parent's smoking habits at home and SHS exposure, among other potential predictors. An increase was observed in the prevalence of families with at least one smoker (39.0% vs. 50.8%) and in the prevalence of smoking mothers (20.3% vs. 29.7%) and fathers (33.9% vs. 39.0%). Median UC concentration was 8.0ng/mL (interquartile range [IQR]: 2.0-21.8) before legislation onset and 8.7ng/mL (IQR: 2.0-24.3) afterwards. In the multivariable analysis, the smoking status of parents and smoking habits at home were statistically associated with the risk of SHS exposure and with UC concentrations in children. These findings indicate that the recent prohibition of smoking in enclosed public and workplaces in Spain has not been accompanied by a decline in the exposure to SHS among children, who continue to be adversely affected. There is a need to target smoking at home in order to avoid future adverse health effects in a population that has no choice in the acceptance or not of SHS exposure-derived risk.

[Chemical risk in operating rooms and technical progress: the obligations and responsibilities of law]

We are going to consider the specific applications of the new legal system and of the most recent body of laws to those work environments of particular risk, such as healthcare facilities and in particular operating rooms. In such environments, volatile chemicals classified as "dangerous" are used with consequent exposure to "chemical risk", both of those persons professionally involved, depending on the type of activity, and of the patients to whom such activities are addressed in the same environment. Once the chemical risk is framed in the existing regulatory system, it must be specifically evaluated the application of the same principle to the particular chemical risk arising from the use of anesthetic agents in the operating room, for example sevoflurane and desflurane, being careful to test wether and how much this risk can be eliminated or reduced to minimum in relation to the new achievements of the technical progress. So, as soon as the quality of "dangerous chemical agent" of the "volatile chemicals" and of the "volatile liquid anesthetic" (sevoflurane and desflurane) as well--which are characterized by a lower degree of toxicity and for this reason are mostly used in current chemical practice, preferable to some anesthetic gases such as nitrous oxide--is legally verified, it is necessary to relate the scientific and technical data which result from the current "state of art" also to the other binding regulations that are imposed for the "prevention and protection from chemical agents", according to the relative Title IX of the TUSL (Unique text for Safety and Health at Work).

Potential air toxics hot spots in truck terminals and cabs

INTRODUCTION

Hot spots are areas where concentrations of one or more air toxics--organic vapors or particulate matter (PM)--are expected to be elevated. The U.S. Environmental Protection Agency's (EPA*) screening values for air toxics were used in our definition of hot spots. According to the EPA, a screening value "is used to indicate a concentration of a chemical in the air to which a person could be continually exposed for a lifetime ... and which would be unlikely to result in a deleterious effect (either cancer or noncancer health effects)" (U.S. EPA 2006). Our characterization of volatile organic compounds (VOCs; namely 18 hydrocarbons, methyl tert-butyl ether [MTBE], acetone, and aldehydes) was added onto our ongoing National Cancer Institute-funded study of lung cancer and particulate pollutant concentrations (PM with an aerodynamic diameter < or = 2.5 microm [PM2.5], elemental carbon [EC], and organic carbon [OC]) and source apportionment of the U.S. trucking industry. We focused on three possible hot spots within the trucking terminals: upwind background areas affected by nearby industrial parks; downwind areas affected by upwind and terminal sources; and the loading docks and mechanic shops within terminal as well as the interior of cabs of trucks being driven on city, suburban, and rural streets and on highways.

METHODS

In Phase 1 of our study, 15 truck terminals across the United States were each visited for five consecutive days. During these site visits, sorbent tubes were used to collect 12-hour integrated samples of hydrocarbons and aldehydes from upwind and downwind fence-line locations as well as inside truck cabs. Meteorologic data and extensive site information were collected with each sample. In Phase 2, repeat visits to six terminals were conducted to test the stability of concentrations across time and judge the representativeness of our previous measurements. During the repeat site visits, the sampling procedure was expanded to include real-time sampling for total hydrocarbon (HC) and PM2.5 at the terminal upwind and downwind sites and inside the truck cabs, two additional monitors in the yard for four-quadrant sampling to better characterize the influence of wind, and indoor sampling in the loading dock and mechanic shop work areas.

RESULTS

Mean and median concentrations of VOCs across the sampling locations in and around the truck terminals showed significant variability in the upwind concentrations as well as in the intensity of exposures for drivers, loading-dock workers, and mechanics. The area of highest concentrations varied, although the lowest concentrations were always found in the upwind background samples. However, the downwind samples, which included the terminal's contribution, were on average only modestly higher than the upwind samples. In the truck terminal, the mechanic-shop-area concentrations were consistently elevated for many of the VOCs (including the xylenes, alkanes, and acetone) and particulates; the loading-dock concentrations had relatively high concentrations of 1,3-butadiene, formaldehyde, and acetaldehyde; and nonsmoking driver exposures were elevated for benzene, MTBE, styrene, and hexane. Also, the loading dock and yard background concentrations for EC and PM2.5 were highly correlated with many of the VOCs (50% of pairs tested with Spearman r > 0.5 and 75% with r > 0.4); in the mechanic shop VOCs were correlated with EC but not PM2.5 (r = 0.4-0.9 where significant); and for driver exposures VOC correlations with EC and PM2.5 were relatively low, with the exception of a few aromatics, primarily benzene (r = 0.4-0.5). A principal component analysis of background source characteristics across the terminal locations that had repeat site visits identified three different groupings of variables (the "components"). This analysis suggested that a strong primary factor for hydrocarbons (alkanes and aromatics) was the major contributor to VOC variability in the yard upwind measurement. Aldehydes and acetone, which loaded onto the second and third components, were responsible for a smaller contribution to VOC variability. A multi-layer exposure model was constructed using structural equation modeling techniques that significantly predicted the yard upwind concentrations of individual VOCs as a function of wind speed, road proximity, and regional location (R2 = 0.5-0.9). This predicted value for the yard background concentration was then used to calculate concentrations for the loading dock and mechanic shop. Finally, we conducted a detailed descriptive analysis of the real-time data collected in the yard and in truck cabs during the six repeat site visits, which included more than 50 12-hour sessions at each sampling location. The real-time yard monitoring results suggested that under some conditions there was a clear upwind-to-downwind trend indicating a terminal contribution, which was not apparent in the integrated sampling data alone. They also suggested a nonlinear relationship with wind speed: calm conditions (wind speed < 2 mph) were associated with erratic upwind-downwind differences, lower wind speeds (2 to 10 mph) favored transport with little dilution, and higher wind speeds (> 10 mph) favored dilution and dispersal (more so for VOCs than for PM). Finally, an analysis of the real-time data for driver exposures in trucks with a global positioning system (GPS) matched with geographic information system (GIS) data suggested a clear influence of traffic and industrial sources along a given route with peaks in driver exposures. These peaks were largely associated with traffic, major intersections, idling at the terminals, and pickup and delivery (P&D) periods. However, VOCs and PM2.5 had different exposure patterns: VOCs exposures increased when the vehicle was stopped, and PM2.5 exposures increased during travel in traffic.

CONCLUSIONS

All three types of testing sites--upwind and downwind fence-line locations and inside truck cabs while in heavy traffic--met the established definition for a hot spot by having periods with concentrations of pollutants that exceeded the EPA's screening values. Most frequently, the pollutants with concentrations exceeding the screening values were formaldehyde, acetaldehyde, and EC (which serves as a marker for diesel particulate); less frequently they were 1,3-butadiene and benzene. In the case of the downwind location of a single truck terminal without an aggregation of other sources, high concentrations of VOCs and PM were infrequent. Using structural equation modeling, a model was developed that could identify combinations of conditions and factors likely to produce hot spots. Source apportionment analyses showed that EC came predominantly from diesel emissions. As expected from the sites studied, organic vapors associated with vehicle emissions (C6-C8 alkanes and aromatics) were the predominant components of VOCs, followed by formaldehyde and acetaldehyde. For driver exposures, high VOC values were associated with stopped vehicles, and high PM2.5 values were associated with conditions during driving.

Exposure to hazardous volatile pollutants back diffusing from automobile exhaust systems

As back diffusion gases from automobiles are significant sources of in-vehicular pollution, we investigated eight automobiles, five for back diffusion (driving) measurements and three for reference conditions (non-driving). To characterize the back diffusion emission conditions, seven volatile organic compounds (VOC) and four carbonyl compounds (CCs) were measured along with dilution-to-threshold (D/T) ratio. The data obtained from back diffusion measurements were examined after having been divided into three subcategories: (i) driving and non-driving, (ii) with and without automobile upgrading (sealing the inner line), and (iii) differences in CO emission levels. Among the VOCs, the concentrations of toluene (T) was found to be the highest (range: 13.6-155 ppb), while benzene (0.19-1.47 ppb) was hardly distinguishable from its ambient levels. Other VOCs (xylene, trimethylbenzene, and styrene) were generally below <1 ppb. Unlike VOCs, the concentrations (ppb) of CCs were seen at fairly enhanced levels: 30.1-95 (formaldehyde), 34.6-87.2 (acetaldehyde), 4.56-34.7 (propionaldehyde), and 3.45-68.8 (butyraldehyde). The results of our study suggest that the back diffusion phenomenon, if occurring, can deteriorate in-vehicle air, especially with the most imminent health hazards from a compound such as formaldehyde in view of its exceedance pattern over common guidelines.

Applying definitions of "asbestos" to environmental and "low-dose" exposure levels and health effects, particularly malignant mesothelioma

Although asbestos research has been ongoing for decades, this increased knowledge has not led to consensus in many areas of the field. Two such areas of controversy include the specific definitions of asbestos, and limitations in understanding exposure-response relationships for various asbestos types and exposure levels and disease. This document reviews the current regulatory and mineralogical definitions and how variability in these definitions has led to difficulties in the discussion and comparison of both experimental laboratory and human epidemiological studies for asbestos. This review also examines the issues of exposure measurement in both animal and human studies, and discusses the impact of these issues on determination of cause for asbestos-related diseases. Limitations include the lack of detailed characterization and limited quantification of the fibers in most studies. Associated data gaps and research needs are also enumerated in this review.

The concentration of no toxicologic concern (CoNTC) and airborne mycotoxins

The threshold of toxicologic concern (TTC) concept was developed as a method to identify a chemical intake level that is predicted to be without adverse human health effects assuming daily intake over the course of a 70-yr life span. The TTC values are based on known structure-activity relationships and do not require chemical-specific toxicity data. This allows safety assessment (or prioritization for testing) of chemicals with known molecular structure but little or no toxicity data. Recently, the TTC concept was extended to inhaled substances by converting a TTC expressed in micrograms per person per day to an airborne concentration (ng/m(3)), making allowance for intake by routes in addition to inhalation and implicitly assuming 100% bioavailability of inhaled toxicants. The resulting concentration of no toxicologic concern (CoNTC), 30 ng/m(3), represents a generic airborne concentration that is expected to pose no hazard to humans exposed continuously throughout a 70-yr lifetime. Published data on the levels of mycotoxins in agricultural dusts or in fungal spores, along with measured levels of airborne mycotoxins, spores, or dust in various environments, were used to identify conditions under which mycotoxin exposures might reach the CoNTC. Data demonstrate that airborne concentrations of dusts and mold spores sometimes encountered in agricultural environments have the potential to produce mycotoxin concentrations greater than the CoNTC. On the other hand, these data suggest that common exposures to mycotoxins from airborne molds in daily life, including in the built indoor environment, are below the concentration of no toxicologic concern.

Mineral dust exposure in young Indian adults: an effect on lung growth?

BACKGROUND/OBJECTIVE

Long-term occupational exposure to mineral dusts including quartz is known to cause pneumoconiosis but little is known about the effects of such exposure during the period of lung development in childhood. The objective of this study was to investigate the effects on young people of exposure to mineral dusts.

METHODS

We carried out a cross-sectional study of a group of 81 Indian stone crushers (average age 21) and a control group of 72 nearby slum dwellers (average age 21) in order to assess dust exposures, respiratory symptoms and lung function.

RESULTS

Stone crushers' corrected 8-hour time weighted average concentrations of total inhalable dust, respirable dust and respirable crystalline silica were 143 mg/m(3), 39.7 mg/m(3) and 2.29 mg/m(3) respectively, which are 14, 10 and 23 times the UK workplace exposure limits, respectively. Both groups also had high exposures to outdoor and general domestic particulate matter. Compared to controls, stone crushers had significantly more symptoms, lower levels of forced vital capacity (FVC) and forced expiratory time (FET) and higher levels of forced expiratory volume in one second (FEV(1))/FVC ratio and mid-expiratory flow rate (MEF). There were no differences in FEV(1) levels. Symptoms and lung function were not associated with time lived on site or time spent in job. A selection of chest radiographs showed no silicosis by International Labour Office (ILO) criteria.

CONCLUSION

Individuals exposed to mixed mineral dust in childhood and early adult life had excess symptoms and reduced vital capacity without airflow obstruction compared with control subjects. We interpret this as evidence of stunting of lung growth caused by exposure to respirable dust.

Tobacco industry research and efforts to manipulate smoke particle size: implications for product regulation

Over the past half-century of cigarette design, tobacco manufacturers have prioritized efficiency of delivery alongside ease of inhalation and use. As a result, the modern cigarette is uniquely effective at facilitating the absorption of nicotine as well as carcinogens and other toxins. The present study draws on internal tobacco company documents to assess industry consideration of the role of smoke particle size as a potentially controllable influence over inhalation patterns and lung exposure. Tobacco manufacturers evaluated particle size manipulation both as a means of controlling physical and sensory product attributes and as a possible approach to reducing health hazards related to exposure. Industry scientists concluded that the smoke aerosol particle distribution of conventional cigarettes, constructed within common parameters, falls within a narrow and effective inhalation range. However, the internal findings suggest that differences in smoke particle size distribution are possible through less conventional approaches to product design. We propose that particle size be included among the many design features to be considered in emerging tobacco product regulation. However, the present review does not address whether particle size regulation would be a plausible means of substantially reducing addictiveness or harmfulness of cigarettes, and therefore we do not propose it as a high-priority target for regulation.

Health effects following 9/11: implications for occupational health nurses

The attacks on the World Trade Center in 2001 resulted in hazardous environmental exposures of enormous magnitude, bringing about persistent respiratory and psychological problems among survivors. Approximately 40,000 men and women worked at Ground Zero, the former site of the World Trade Center in New York City, and at the Staten Island landfill, the main wreckage depository, in the days, weeks, and months following 9/11. First responders such as firefighters and police, construction workers, and utility and public sector workers were involved. These individuals were at high risk for injury, respiratory complications, and psychological distress from the traumatic event. This article highlights the controversy surrounding 9/11 research and reports, identifies populations at high risk for exposure, and examines the health effects. Occupational health nurses should not only be empowered to provide the best care for workers affiliated with 9/11, but also contribute to research to protect worker health in future disaster responses.

Literature review and summary of perceptions, attitudes, beliefs, and marketing of potentially reduced exposure products: communication implications

Potentially reduced exposure products (PREPs) have continued to enter the market during the 1990s and first part of the 21st century. Attempts by the tobacco industry to develop and market products with implied reductions in adverse health effects (i.e., harm reduction) are not new. Over the last half of the 20th century, the tobacco industry developed and marketed several products that purported to reduce the health risks associated with smoking cigarettes. Among these were filtered cigarettes in the 1950s and light and ultra-light cigarettes in the 1970s and 1980s. This review summarizes published and unpublished research that is directly relevant to the marketing, advertising, and communication about PREPs. The marketing strategies for these new products do not appear to differ from those used by the tobacco industry for light and ultra-light cigarettes. Although smokers report not using the new products in large numbers because of dissatisfaction with taste, they are interested in using products with reduced risk. Despite the absence of explicit health claims by the industry for PREPs, many smokers believe that these products are safer based on the advertising claims of reduced exposure and a belief that claims are approved by the government. No data are available to indicate that PREPs are useful for prevention or cessation of smoking, nor does specific research exist to suggest what health communication messages will provide smokers with accurate information about these products.

Occupational exposure to wood dust in the british woodworking industry in 1999/2000

Exposure to inhalable wood dust and compliance with the British Control of Substances Hazardous to Health (COSHH) Regulations 1999 were assessed at a representative cross-section of the British woodworking industry. Median exposures ranged from 1.5 to 2.8 mg/m(3) across the selected industry groups, the lowest being in sawmilling and planing of wood. Overall, 27% of values exceeded the maximum exposure limit (MEL) at that time of 5 mg/m(3). These results showed that the percentage of exposures above the MEL was less than in a survey carried out 10 years earlier. A wide variation of exposures was identified at different machines and tasks. At least 90% at bandsawing and cross-cut sawing were <5 mg/m(3). In contrast, dust emission at circular sawing, sanding, cleaning and a miscellaneous group of activities was poorly controlled. Between 32 and 50% of results from these categories exceeded 5 mg/m(3). The lower exposures in sawmills were largely attributable to the low usage of sanders and a group of circular saws, to the high use of bandsaws and moulders and to coarser dust from undried timber. Compliance with the COSHH Regulations was inadequate. Companies that claimed to have some form of written COSHH assessment were generally no more effective at controlling exposure to dust than those without an assessment. Similarly the ability of premises that provided information, instruction and training on the risks to health from wood dust and on measures to prevent or control those risks was not generally greater than in those that did not. Maintenance of local exhaust ventilation systems emerged as essential for achieving good control. Companies that followed both the statutory 14-monthly thorough examination and testing schedule and a weekly check system were more successful in this respect than those that did not. In spite of this, local exhaust ventilation alone provided insufficient dust control at several woodworking activities.

Courtesy and the challenges of implementing smoke-free policies in Japan

For decades, the tobacco companies have developed a worldwide campaign to oppose the creation of smoke-free environments. Public health efforts to promote clean indoor air have been uneven throughout the world, and in few places have such efforts faced as many challenges as in Japan. The Japanese market is dominated by Japan Tobacco, which is partly owned by the government, and Philip Morris International is also present in Japan. Japan Tobacco and Philip Morris International have developed campaigns promoting courtesy and tolerance that, until recently, seem to have resonated well with the public. The companies also have supported research promoting ventilation and have funded consultants to act as experts in the area of second-hand smoke exposure. Japan is a critical country to study, partly because of the strength of Japan Tobacco in the country and the growth of Japan Tobacco International in Southeast Asia and the rest of the world, and partly because of Japan's ratification of the World Health Organization Framework Convention on Tobacco Control. This paper uses tobacco industry documents to provide an overview of the tobacco industry's scientific and political efforts to stifle the development of clean indoor measures in Japan. Learning past industry strategies may assist policymakers and advocates in the development of future public health activities.

Determination of pulmonary irritant threshold concentrations of hexamethylene-1,6-diisocyanate (HDI) prepolymers by bronchoalveolar lavage in acute rat inhalation studies according to TRGS 430

Pulmonary irritant threshold concentrations of two hexamethylene-1,6-diisocyanate (HDI)-based prepolymers (I: polymeric emulsfier modified and II: oligomeric allophanate modified) were determined in acute inhalation studies according to TRGS 430 (Dangerous Substances Technical Rule, isocyanates, Germany), based on benchmark extrapolation of bronchoalveolar lavage fluid (BALF) total protein. It was also investigated if the method is robust enough to be transferred to an independent laboratory. Five male Wistar rats per group were exposed nose-only to the test substances as liquid aerosols to concentrations of 0, 0.5, 3, 15 mg/m(3) for both test substances with an additional test group at 50 mg/m(3) for test substance I. The duration of the exposure was 6h, followed by serial sacrifices 1 day, 3 days and 7 days post exposure. BALF was analyzed for biochemical and cytological markers indicative for injury of the bronchoalveolar region. The exposure of rats to test substance I and II caused dose depended lung irritation with BALF total protein concentration being the most sensitive indicator of pulmonary effects. The extrapolated no observed adverse effect level of test substance I was 1.1 mg/m(3) and that of test substance II 2.3 mg/m(3). The acute pulmonary irritant threshold concentrations were found to be similar to those reported by [Pauluhn, J., 2004. Pulmonary irritant potency of polyisocyanate aerosols in rats: comparative assessment of irritant threshold concentrations by bronchoalveolar lavage. J. Appl. Toxicol. 24, 231-247] for HDI-homopolymers and other HDI-based polyisocyanates, and were at least 30 times higher than the MAK (occupational exposure limit) value for the HDI monomer (0.035 mg/m(3)). Thus the EBW (exposure assessment value) for these two HDI-based prepolymers can be established at 10x MAK, i.e. at 0.35 mg/m(3).

Secondhand tobacco smoke exposure in New Zealand bars: results prior to implementation of the bar smoking ban

AIMS

To measure secondhand smoke (SHS) levels in New Zealand bars prior to smokefree legislation enacted on 10 December 2004.

METHODS

Thirty bars were randomly selected from urban, surburban, and surrounding rural areas of Auckland, Wellington, and Invercargill. Bars were visited (on a Friday or Saturday night for a 3-hour stay between 1800 and 2400 hours) in July/August/September 2004 (winter) and again in October/November 2004 (spring). Each bar was visited by a group of 4 or 5 non-smokers participating in the study. All groups of participants spent a 3-hour block of continuous time in the bar. Saliva samples (approximately 0.5-2 mL) were provided immediately prior to entering the bar as well as 5-15 minutes after leaving the bar. Each group recorded the initial impression of air quality and ventilation, the number of observed lit cigarettes over three 10-minute intervals throughout the evening, and the number of patrons at each interval. In addition, any general comments about the venue (relevant to bar attendance or air quality on the evening) was recorded. Cotinine, the main metabolite of nicotine, was measured in saliva samples using Liquid Chromatography with tandem Mass Spectrometry (LC-MS-MS).

RESULTS

In all bars, and in all volunteers, exposure to SHS was evident. Saliva cotinine increased after 3 hours in the bar (mean increase=0.66 ng/mL, SE=0.03 ng/mL, p value of <0.0001). The 30 bars randomly selected provided a good spectrum of SHS exposures, with mean cotinine increasing by approximately 8-fold. Smaller population centres showed greater exposures to SHS. A north-south gradient of exposure was also seen (highest exposures were in Southland). Higher exposures were seen in the winter than in the spring. The objective measures of SHS exposure correlated strongly with the volunteers' subjective observation of ventilation, air quality, and counts of lit cigarettes. One exception was where objective salivary markers indicated that even "seemingly smokefree" venues with "good ventilation" produced discernable levels of SHS exposure.

CONCLUSIONS

We have utilised an objective, non-invasive scientific approach to assess SHS smoke exposure in patrons of New Zealand bars. Our results clearly indicate exposure to SHS, with regional and seasonal variation, prior to the introduction of smokefree legislation.

Development of acute inhalation reference exposure levels(RELs) to protect the public from predictable excursions of airborne toxicants

Uniform guidelines have been developed for the derivation of 1-h acute inhalation reference exposure levels (RELs) applicable to the general public exposed routinely to hazardous substances released into the environment. Existing acute exposure guidance values developed by other organizations have been examined, and strengths and weaknesses in these existing guidelines have been identified. The results of that examination have led to the development of a reproducible and resource-intensive methodology to calculate acute inhalation RELs for 41 prioritized chemicals. Approaches to estimating levels protective against mild and severe acute effects are discussed in this report. The default methodology is the no-observed-adverse-effect level (NOAEL)/uncertainty factor (UF) approach using mainly reports in the peer-reviewed toxicological and medical literature. For two well-studied chemicals, ammonia and formaldehyde, the data allowed a benchmark dose (or concentration) methodology, as a departure from the default options, to be used. However, better human dose-response data from, for example, improved workplace monitoring correlated with symptoms, and more extensive epidemiological studies are needed before the departure from default approaches can be expanded to more substances.

Issues that must be addressed for risk assessment of mixed exposures: the U.S. EPA experience with air quality

Humans are routinely exposed to a complex mixture of air pollutants in both their outdoor and indoor environments. The wide diversity of these exposure scenarios and potential for regional transport present the health scientist with a challenge of how to appropriately address complex air pollution mixtures. Similarly, regulators are faced with mixture issues ranging from exposures, to health outcomes, and to associated uncertainties that are in need of more definitive and strategic information to support informed decisions. This article provides a perspective of an empiricist on the background related to the issue of air pollution mixtures. Historic and current regulatory platforms for dealing with mixtures are described. Using the topic of particulate air pollution, general guidance through the nuances of potential interactions among PM constituents is provided, along with alterative approaches and examples, and how these support scientific and regulatory agendas. The impact of new cell and molecular technologies is inevitable, and we must be prepared to take advantage of these and other cross-cutting methods as they become available. Such innovative approaches hold the secret to high-throughput biologic dissection of component interactions and mixture profiles, which will aid in the assessment of risk.

Environmental tobacco smoke in the nonsmoking section of a restaurant: a case study

This study tested the concentrations of environmental tobacco smoke (ETS) components in a small restaurant/pub with smoking and nonsmoking areas-a facility outfitted with a heat-recovery ventilation system and directional airflow. The ETS levels in the nonsmoking area were compared with those in other similar restaurants/pubs where indoor smoking is altogether prohibited. The results indicate that ETS component concentrations in the nonsmoking section of the facility in question were not statistically different (P < 0.05) from those measured in similar facilities where smoking is prohibited. The regulatory implications of these findings are that ventilation techniques for restaurants/pubs with separate smoking and nonsmoking areas are capable of achieving nonsmoking area ETS concentrations that are comparable to those of similar facilities that prohibit smoking outright.

Litigation on behalf of victims of exposure to environmental tobacco smoke. The experience from the USA

BACKGROUND

For a quarter of a century, lawsuits have been filed on behalf of individuals who have been harmed by exposure to environmental tobacco smoke (ETS).

METHODS

A review of hundreds of legal cases where exposure to ETS was the basis for the lawsuit was undertaken. The history of ETS-based lawsuits was categorised and analysed.

RESULTS

While ETS-based lawsuits have arisen in a variety of divergent settings, there have been an increasing number of instances in which individuals have achieved relief from exposure to ETS and/or monetary compensation for having been so exposed. Such successful outcomes make it easier for others to achieve similar results through litigation.

CONCLUSION

Lawsuits will probably continue to be a viable remedy in assisting those being harmed by exposure to ETS, both-inside and outside the USA.

Strategies for setting occupational exposure limits for particles

To set occupational exposure limits (OELs) for aerosol particles, dusts, or chemicals, one has to evaluate whether mechanistic considerations permit identification of a no observed effect level (NOEL). In the case of carcinogenic effects, this can be assumed if no genotoxicity is involved, and exposure is considered safe if it does not exceed the NOEL. If tumor induction is associated with genotoxicity, any exposure is considered to be of risk, although a NOEL may be identified in the animal or human exposure studies. This must also be assumed when no information on the carcinogenic mechanism, including genotoxicity, is available. Aerosol particles, especially fibrous dusts, which include man-made mineral fiber(s) (MMMF), present a challenge for toxicological evaluation. Many MMMF that have been investigated have induced tumors in animals and genotoxicity in vitro. Since these effects have been associated with long-thin fiber geometry and high durability in vivo, all fibers meeting such criteria are considered carcinogenic unless the opposite has been demonstrated. This approach is practicable. Investigations on fiber tumorigenicity/genotoxicity should include information on dose response, pathobiochemistry, particle clearance, and persistence of the material in the target organ. Such information will introduce quantitative aspects into the qualitative approach that has so far been used to classify fibrous dusts as carcinogens. The rationales for classifying the potential carcinogenicity of MMMF and for setting OELs used by the different European committees and regulatory agencies are described.