COVID-19 perturbation on US air quality and human health impact assessment

The COVID-19 stay-at-home orders issued in the United States caused significant reductions in traffic and economic activities. To understand the pandemic's perturbations on US emissions and impacts on urban air quality, we developed near-real-time bottom-up emission inventories based on publicly available energy and economic datasets, simulated the emission changes in a chemical transport model, and evaluated air quality impacts against various observations. The COVID-19 pandemic affected US emissions across broad-based energy and economic sectors and the impacts persisted to 2021. Compared with 2019 business-as-usual emission scenario, COVID-19 perturbations resulted in annual decreases of 10-15% in emissions of ozone (O3) and fine particle (PM2.5) gas-phase precursors, which are about two to four times larger than long-term annual trends during 2010-2019. While significant COVID-induced reductions in transportation and industrial activities, particularly in April-June 2020, resulted in overall national decreases in air pollutants, meteorological variability across the nation led to local increases or decreases of air pollutants, and mixed air quality changes across the United States between 2019 and 2020. Over a full year (April 2020 to March 2021), COVID-induced emission reductions led to 3-4% decreases in national population-weighted annual fourth maximum of daily maximum 8-h average O3 and annual PM2.5. Assuming these emission reductions could be maintained in the future, the result would be a 4-5% decrease in premature mortality attributable to ambient air pollution, suggesting that continued efforts to mitigate gaseous pollutants from anthropogenic sources can further protect human health from air pollution in the future.

Influence of Wildfire on Urban Ozone: An Observationally Constrained Box Modeling Study at a Site in the Colorado Front Range

Increasing trends in biomass burning emissions significantly impact air quality in North America. Enhanced mixing ratios of ozone (O3) in urban areas during smoke-impacted periods occur through transport of O3 produced within the smoke or through mixing of pyrogenic volatile organic compounds (PVOCs) with urban nitrogen oxides (NOx = NO + NO2) to enhance local O3 production. Here, we analyze a set of detailed chemical measurements, including carbon monoxide (CO), NOx, and speciated volatile organic compounds (VOCs), to evaluate the effects of smoke transported from relatively local and long-range fires on O3 measured at a site in Boulder, Colorado, during summer 2020. Relative to the smoke-free period, CO, background O3, OH reactivity, and total VOCs increased during both the local and long-range smoke periods, but NOx mixing ratios remained approximately constant. These observations are consistent with transport of PVOCs (comprised primarily of oxygenates) but not NOx with the smoke and with the influence of O3 produced within the smoke upwind of the urban area. Box-model calculations show that local O3 production during all three periods was in the NOx-sensitive regime. Consequently, this locally produced O3 was similar in all three periods and was relatively insensitive to the increase in PVOCs. However, calculated NOx sensitivities show that PVOCs substantially increase O3 production in the transition and NOx-saturated (VOC-sensitive) regimes. These results suggest that (1) O3 produced during smoke transport is the main driver for O3 increases in NOx-sensitive urban areas and (2) smoke may cause an additional increase in local O3 production in NOx-saturated (VOC-sensitive) urban areas. Additional detailed VOC and NOx measurements in smoke impacted urban areas are necessary to broadly quantify the effects of wildfire smoke on urban O3 and develop effective mitigation strategies.

Airborne Emission Rate Measurements Validate Remote Sensing Observations and Emission Inventories of Western U.S. Wildfires

Carbonaceous emissions from wildfires are a dynamic mixture of gases and particles that have important impacts on air quality and climate. Emissions that feed atmospheric models are estimated using burned area and fire radiative power (FRP) methods that rely on satellite products. These approaches show wide variability and have large uncertainties, and their accuracy is challenging to evaluate due to limited aircraft and ground measurements. Here, we present a novel method to estimate fire plume-integrated total carbon and speciated emission rates using a unique combination of lidar remote sensing aerosol extinction profiles and in situ measured carbon constituents. We show strong agreement between these aircraft-derived emission rates of total carbon and a detailed burned area-based inventory that distributes carbon emissions in time using Geostationary Operational Environmental Satellite FRP observations (Fuel2Fire inventory, slope = 1.33 ± 0.04, r² = 0.93, and RMSE = 0.27). Other more commonly used inventories strongly correlate with aircraft-derived emissions but have wide-ranging over- and under-predictions. A strong correlation is found between carbon monoxide emissions estimated in situ with those derived from the TROPOspheric Monitoring Instrument (TROPOMI) for five wildfires with coincident sampling windows (slope = 0.99 ± 0.18; bias = 28.5%). Smoke emission coefficients (g MJ^-1) enable direct estimations of primary gas and aerosol emissions from satellite FRP observations, and we derive these values for many compounds emitted by temperate forest fuels, including several previously unreported species.

Ozone chemistry in western U.S. wildfire plumes

Wildfires are a substantial but poorly quantified source of tropospheric ozone (O₃). Here, to investigate the highly variable O₃ chemistry in wildfire plumes, we exploit the in situ chemical characterization of western wildfires during the FIREX-AQ flight campaign and show that O₃ production can be predicted as a function of experimentally constrained OH exposure, volatile organic compound (VOC) reactivity, and the fate of peroxy radicals. The O₃ chemistry exhibits rapid transition in chemical regimes. Within a few daylight hours, the O₃ formation substantially slows and is largely limited by the abundance of nitrogen oxides (NO_x). This finding supports previous observations that O₃ formation is enhanced when VOC-rich wildfire smoke mixes into NO_x-rich urban plumes, thereby deteriorating urban air quality. Last, we relate O₃ chemistry to the underlying fire characteristics, enabling a more accurate representation of wildfire chemistry in atmospheric models that are used to study air quality and predict climate.

Variability and Time of Day Dependence of Ozone Photochemistry in Western Wildfire Plumes

Understanding the efficiency and variability of photochemical ozone (O₃) production from western wildfire plumes is important to accurately estimate their influence on North American air quality. A set of photochemical measurements were made from the NOAA Twin Otter research aircraft as a part of the Fire Influence on Regional to Global Environments and Air Quality (FIREX-AQ) experiment. We use a zero-dimensional (0-D) box model to investigate the chemistry driving O₃ production in modeled plumes. Modeled afternoon plumes reached a maximum O₃ mixing ratio of 140 ± 50 ppbv (average ± standard deviation) within 20 ± 10 min of emission compared to 76 ± 12 ppbv in 60 ± 30 min in evening plumes. Afternoon and evening maximum O₃ isopleths indicate that plumes were near their peak in NO_x efficiency. A radical budget describes the NO_x volatile - organic compound (VOC) sensitivities of these plumes. Afternoon plumes displayed a rapid transition from VOC-sensitive to NO_x-sensitive chemistry, driven by HO_x (=OH + HO₂) production from photolysis of nitrous acid (HONO) (48 ± 20% of primary HO_x) and formaldehyde (HCHO) (26 ± 9%) emitted directly from the fire. Evening plumes exhibit a slower transition from peak NO_x efficiency to VOC-sensitive O₃ production caused by a reduction in photolysis rates and fire emissions. HO_x production in evening plumes is controlled by HONO photolysis (53 ± 7%), HCHO photolysis (18 ± 9%), and alkene ozonolysis (17 ± 9%).

A multicentre prospective double blinded randomised controlled trial of intravenous iron (ferric Derisomaltose (FDI)) in Iron deficient but not anaemic patients with chronic kidney disease on functional status

BACKGROUND

Iron deficiency (ID) is common in patients with chronic kidney disease (CKD). Intravenous (IV) iron in heart failure leads to improvement in exercise capacity and improvement in quality-of-life measurements; however, data in patients with CKD are lacking.

METHODS

The Iron and the Heart Study was a prospective double blinded randomised study in non-anaemic CKD stages 3b-5 patients with ID which investigated whether 1000 mg of IV iron (ferric derisomaltose (FDI)) could improve exercise capacity in comparison to placebo measured at 1 and 3 months post infusion. Secondary objectives included effects on haematinic profiles and haemoglobin, safety analysis and quality of life questionnaires (QoL).

RESULTS

We randomly assigned 54 patients mean (SD) age for FDI (n = 26) 61.6 (10.1) years vs placebo (n = 28; 57.8 (12.9) years) and mean eGFR (33.2 (9.3) vs. 29.1 (9.6) ml/min/1.73m2) at baseline, respectively. Adjusting for baseline measurements, six-minute walk test (6MWT) showed no statistically significant difference between arms at 1 month (p = 0.736), or 3 months (p = 0.741). There were non-significant increases in 6MWT from baseline to 1 and 3 months in the FDI arm. Haemoglobin (Hb) at 1 and 3 months remained stable. There were statistically significant increases in ferritin (SF) and transferrin saturation (TSAT) at 1 and 3 months (p < 0.001). There was a modest numerical improvement in QoL parameters. There were no adverse events attributable to IV iron.

CONCLUSION

This study demonstrated a short-term beneficial effect of FDI on exercise capacity, but it was not significant despite improvements in parameters of iron status, maintenance of Hb concentration, and numerical increases in functional capacity and quality of life scores. A larger study will be required to confirm if intravenous iron is beneficial in iron deficient non-anaemic non-dialysis CKD patients without heart failure to improve the 6MWT.

TRIAL REGISTRATION

European Clinical Trials Database (EudraCT) No: 2014-004133-16 REC no: 14/YH/1209 Date First Registered: 2015-02-17 and date of end of trail 2015-05-23 Sponsor ref R1766 and Protocol No: IHI 141.

Occupational exposure to volatile organic compounds and health risks in Colorado nail salons

Nail salon technicians face chronic exposure to volatile organic compounds (VOCs), which can lead to adverse health outcomes including cancer. In this study, indoor levels of formaldehyde, as well as benzene, toluene, ethylbenzene and xylene, were measured in 6 Colorado nail salons. Personal exposure VOC measurements and health questionnaires (n = 20) were also performed; questionnaires included employee demographics, health symptoms experienced, and protective equipment used. Cancer slope factors from the United States Environmental Protection Agency (US EPA) and anthropometric data from the Centers for Disease Control and Prevention were then used to estimate cancer risk for workers, assuming 20-yr exposures to concentrations of benzene and formaldehyde reported here. Results show that 70% of surveyed workers experienced at least one health issue related to their employment, with many reporting multiple related symptoms. Indoor concentrations of formaldehyde ranged from 5.32 to 20.6 μg m^-3, across all 6 salons. Indoor concentrations of toluene ranged from 26.7 to 816 μg m^-3, followed by benzene (3.13-51.8 μg m^-3), xylenes (5.16-34.6 μg m^-3), and ethylbenzene (1.65-9.52 μg m^-3). Formaldehyde levels measured in one salon exceeded the Recommended Exposure Limit from the National Institute for Occupational Safety and Health. Cancer risk estimates from formaldehyde exposure exceeded the US EPA de minimis risk level (1 × 10^-6) for squamous cell carcinoma, nasopharyngeal cancer, Hodgkin's lymphoma, and leukemia; leukemia risk exceeded 1 × 10^-4 in one salon. The average leukemia risk from benzene exposure also exceeded the US EPA de minimis risk level for all demographic categories modeled. In general, concentrations of aromatic compounds measured here were comparable to those measured in studies of oil refinery and auto garage workers. Cancer risk models determined that 20-yr exposure to formaldehyde and benzene concentrations measured in this study will significantly increase worker's risk of developing cancer in their lifetime.

Efficacy and tolerability of accelerated-dose low-molecular-weight iron dextran (Cosmofer) in patients with chronic kidney disease

INTRODUCTION

The Renal NSF advocates correction of anaemia in chronic kidney disease patients. Oral iron is often insufficient, while intravenous supplementation replenishes and maintains iron stores. There is a need to administer high doses of iron in a single rapid infusion to enable efficient costs, effective utilisation of time for patients and staff and optimal use of resources.

METHODS

We performed a prospective study of consecutive patients referred for iron dextran (Cosmofer) therapy. This was administered over 2 h 40 min compared with the normal regime of 4-6 h. Blood pressure was recorded throughout administration. Adverse drug reactions were recorded over 2 weeks. Serum ferritin, haemoglobin and estimated glomerular filtration rate were measured at baseline and 3 months.

RESULTS

One hundred patients (59 male, mean age 69 years), received a median dose of 1,000 mg Cosmofer in a median time of 2 h 40 min. Mean serum ferritin rose from 178 at baseline to 413 μg/l (p < 0.001). Mean haemoglobin rose by 1.5 g/dl (p < 0.001). There was no decline in estimated glomerular filtration rate after 3 months. No adverse reactions were noted.

CONCLUSION

We demonstrated that accelerated administration of iron dextran is safe and effective with no short-term effects on renal function. This resulted in a time saving of approximately 67 hours.