A cross-sectional study of inequalities in digital air pollution information access and exposure reducing behavior uptake in the UK

Air pollution is a pervasive global environmental challenge that presents substantial and differential risk across populations. Individual-level pollution exposure is a function of varying factors, including but not limited to geographic location, proximity to point sources, ventilation, and behavioral patterns. Mounting evidence suggests that informational interventions can play a substantial role in mediating exposures for specific population subgroups and reduce downstream adverse health outcomes. The literature has yet to address whether access to air quality information is sociodemographically stratified, and whether such access correlates with increased uptake of exposure reducing behaviors at the population level. This study represents a first step in answering these questions by analysing responses from the "Clean Air Public Insight Tracker" nationally representative survey (n = 1,993) of the UK population, administered by UK charity Global Action Plan. Results from logistic regression and zero-inflated negative binomial models estimate 28% of the population have accessed air pollution information, while the odds of younger individuals (ages 18-36), men, and non-white individuals of accessing digitally available air quality information are greater that those outside these categories. Additionally, the odds of behavior uptake is greater if an individual accesses digital information sources like the internet, mobile apps or social media, has a higher education qualification or cares for someone with a health condition. These findings contribute to the growing literature surrounding which population groups engage with environmental and health-relevant information channels, and what connects engagement with air quality channels and uptake of exposure reducing behaviors. These results reinforce the need for additional research around air pollution informational alerts and exploring causal links between specific exposure reducing behaviours and improved health outcomes. It can also help inform the flow of resources and targeting of informational campaigns towards sociodemographic groups that are less likely to engage with air quality information.

Interventions for improving indoor and outdoor air quality in and around schools

Students spend nearly one third of their typical day in the school environment, where they may be exposed to harmful air pollutants. A consolidated knowledge base of interventions to reduce this exposure is required for making informed decisions on their implementation and wider uptake. We attempt to fill this knowledge gap by synthesising the existing scientific literature on different school-based air pollution exposure interventions, their efficiency, suitability, and limitations. We assessed technological (air purifiers, HVAC - Heating Ventilation and Air Conditioning etc.), behavioural, physical barriers, structural, school-commute and policy and regulatory interventions. Studies suggest that the removal efficiency of air purifiers for PM_2.5, PM₁₀, PM₁ and BC can be up to 57 %, 34 %, 70 % and 58 %, respectively, depending on the air purification technology compared with control levels in classroom. The HVAC system combined with high efficiency filters has BC, PM₁₀ and PM_2.5 removal efficiency up to 97 %, 34 % and 30 %, respectively. Citizen science campaigns are effective in reducing the indoor air pollutants' exposure up to 94 %. The concentration of PM₁₀, NO₂, O₃, BC and PNC can be reduced by up to 60 %, 59 %, 16 %, 63 % and 77 %, respectively as compared to control conditions, by installing green infrastructure (GI) as a physical barrier. School commute interventions can reduce NO₂ concentration by up to 23 %. The in-cabin concentration reduction of up to 77 % for PM_2.5, 43 % for PNC, 89 % for BC, 74 % for PM₁₀ and 75 % for NO₂, along with 94 % reduction in tailpipe emission of total particles, can be achieved using clean fuels and retrofits. No stand-alone method is found as the absolute solution for controlling pollutants exposure, their combined application can be effective in most of the scenarios. More research is needed on assessing combined interventions, and their operational synchronisation for getting the optimum results.

Perspectives of peripartum people on opportunities for personal and collective action to reduce exposure to everyday chemicals: Focus groups to inform exposure report-back

Participants in biomonitoring studies who receive personal exposure reports seek information to reduce exposures. Many chemical exposures are driven by systems-level policies rather than individual actions; therefore, change requires engagement in collective action. Participants' perceptions of collective action and use of report-back to support engagement remain unclear. We conducted virtual focus groups during summer 2020 in a diverse group of peripartum people from cohorts in the Environmental influences on Child Health Outcomes (ECHO) Program (N = 18). We assessed baseline exposure and collective action experience, and report-back preferences. Participants were motivated to protect the health of their families and communities despite significant time and cognitive burdens. They requested time-conscious tactics and accessible information to enable action to reduce individual and collective exposures. Participant input informed the design of digital report-back in the cohorts. This study highlights opportunities to shift responsibility from individuals to policymakers to reduce chemical exposures at the systems level.

"I am an air quality scientist"- Using citizen science to characterise school children's exposure to air pollution

Children are particularly vulnerable to the harmful effects of air pollution. To tackle this issue and implement effective strategies to reduce child exposure, it is important to understand how children are exposed to this risk. This study followed a citizen science approach to air pollution monitoring, aiming to characterise school children's exposure to air pollution and to analyse how a citizen science approach to data collection could contribute to and enhance the research process. 258 children across five London primary schools attended air pollution education sessions and measured air pollution for a week using backpacks with built-in air quality sensors. Children received a summary of the results, advice and information on how to reduce exposure to air pollution. Data on the impact of the approach on the school community were collected using surveys and focus groups with children and their parents and interviews with the teachers involved. The unique data set obtained permitted us to map different routes and modes of transport used by the children and quantify different exposure levels. We identified that, on average, children were exposed to higher levels of air pollution when travelling to and from school, particularly during the morning journey where air pollution levels were on average 52% higher than exposures at school. Children who walked to and from school through busy main roads were exposed to 33% higher levels of air pollution than those who travelled through back streets. The findings from this study showed that using a citizen science approach to data collection, where children are actively involved in the research process, not only facilitated the gathering of a large data set by encouraging participation and stimulating adherence with the study protocol, but also increased children's awareness of air pollution, encouraging them to adopt positive behaviour changes to reduce their exposure.

Perceptions and knowledge of air pollution and its health effects among caregivers of childhood cancer survivors: a qualitative study

BACKGROUND

Emerging research suggests that survivors of childhood and adolescent cancers are at risk for morbidity and mortality associated with air pollutants. However, caregiver perceptions of the effects of air pollution are unknown. Thus, to address this gap we described caregivers' perceptions of air pollution's impact on general population health and specifically on childhood cancer survivors, and caregivers' air pollution information-seeking and exposure reduction behaviors.

METHODS

Participants were Utah residents, ≥18 years, and caregiver of a childhood cancer survivor who had completed treatment. Semi-structured interviews were conducted with caregivers to describe their perspectives on air quality, how air pollution impacts health (general population and survivor health), and their information seeking and exposure reduction behaviors. Interviews were recorded, transcribed, and analyzed through two rounds of structured coding.

RESULTS

Caregivers (N = 13) were non-Hispanic white and primarily females (92.3%) between 30 and 49 years old (46.2%). Most families lived within the Wasatch Front (69.2%), the main metropolitan of Utah. Two categories emerged pertaining to caregiver's perceptions of air pollution: 1) Limited awareness about the health effects of air pollution, and 2) Unsuccessful information seeking and minimal exposure reduction behaviors. All caregivers held negative perceptions of air pollution in Utah, but most were unaware of how pollution affects health. While some families limited air pollution exposure by avoiding outdoor activity or physically leaving the region, few practiced survivor-specific exposure reduction. Nearly half of caregivers worried about potential effects of air pollution on survivor health and wanted more information.

CONCLUSIONS

Despite negative perceptions of air pollution, caregivers were divided on whether air pollution could impact survivor health. Few caregivers engaged in exposure reduction for their cancer survivor. As air pollution levels increase in the U.S., continued research on this topic is essential to managing cancer survivor respiratory and cardiovascular health.

Do flame retardant concentrations change in dust after older upholstered furniture is replaced?

Upholstered furniture has been a major source of chemical flame retardant (FR) exposures in US homes since the 1970s. FRs are a large group of chemicals, many of which are associated with adverse health effects, including cancer, reproductive toxicity, and neurotoxicity. California homes have some of the highest dust concentrations of FRs, due to Technical Bulletin 117 (TB117), California's outdated flammability standard for furniture foam that was generally followed across the US and Canada. In 2014, this standard was updated to a smolder standard for furniture fabric called TB117-2013, and it is no longer reliant on FRs. This update provided an opportunity to measure differences in FR dust levels in California homes before and after residents replaced older upholstered furniture, or its foam, with products that met the new standard and were expected to be FR-free. We collected dust from homes of participants who had plans to replace older upholstered furniture, or furniture foam, with FR-free options. We returned for follow-up dust collection six, 12, and 18 months following replacement. Concentrations of three polybrominated diphenyl ethers (PBDEs) (BDE-47, BDE-99, BDE-100), three chlorinated organophosphate ester FRs (tris(2-chloroethyl) phosphate (TCEP), tris(2-chloroisopropyl) phosphate (TCIPP), and tris(1,3-dichloroisopropyl) phosphate (TDCIPP)), and one aryl organophosphate ester FR triphenyl phosphate (TPHP), were widely detected in participant homes. All measured FRs decreased in nearly all homes after the older upholstered furniture was replaced. The decreases in FRs were significant in both homes that replaced entire pieces of furniture and those that replaced only the furniture foam. This study demonstrates that replacing older upholstered furniture or foam significantly reduces concentrations of a range of FRs in the home. Foam replacement offers a potentially more economic alternative that produces a lower volume of waste.

Characterising professional drivers' exposure to traffic-related air pollution: Evidence for reduction strategies from in-vehicle personal exposure monitoring

Professional drivers working in congested urban areas are required to work near harmful traffic related pollutants for extended periods, representing a significant, but understudied occupational risk. This study collected personal black carbon (BC) exposures for 141 drivers across seven sectors in London. The aim of the study was to assess the magnitude and the primary determinants of their exposure, leading to the formulation of targeted exposure reduction strategies for the occupation. Each participant's personal BC exposures were continuously measured using real-time monitors for 96 h, incorporating four shifts per participant. 'At work' BC exposures (3.1 ± 3.5 µg/m³) were 2.6 times higher compared to when 'not at work' (1.2 ± 0.7 µg/m³). Workers spent 19% of their time 'at work driving', however this activity contributed 36% of total BC exposure, highlighting the disproportionate effect driving had on their daily exposure. Taxi drivers experienced the highest BC exposures due to the time they spent working in congested central London, while emergency services had the lowest. Spikes in exposure were observed while driving and were at times greater than 100 µg/m³. The most significant determinants of drivers' exposures were driving in tunnels, congestion, location, day of week and time of shift. Driving with closed windows significantly reduced exposures and is a simple behaviour change drivers could implement. Our results highlight strategies by which employers and local policy makers can reduce professional drivers' exposure to traffic-related air pollution.

Cumulative exposure characteristics of vegetable farmers exposed to Chlorpyrifos in Central Java - Indonesia; a cross-sectional study

Background

Agriculture is a major economic sector in Indonesia. Chemical pesticides are widely being used in agriculture for controlling pest. There is a growing concern that pesticide exposure, particularly chlorpyrifos (CPF) exposure, combined with other occupational characteristics that determine the level of exposure, can lead to further health impacts for farmers. Our objective was to evaluate the cumulative exposure characteristics among farmers exposed to CPF by using a validated algorithm.

Methods

We conducted a cross-sectional study of 152 vegetable farmers aged 18–65 who actively used CPF for at least 1 year in Central Java, Indonesia. Subject characteristics were obtained using a structured interviewer-administered questionnaire, addressed for sociodemographic and work-related characteristics. The cumulative exposure level (CEL) was estimated as a function of the intensity level of pesticide exposure (IL), lifetime years of pesticide use and the number of days spraying per year. CEL was subsequently classified into two groups, high and low exposure groups. The difference in characteristics of the study population was measured using Chi-square, independent-t or Mann-Whitney test. Association between CEL and its characteristics variables were performed by multiple linear regression.

Results

Seventy-one subjects (46.7%) were classified as the high exposure group. The use of multiple pesticide mixtures was common among our study population, with 94% of them using 2 or more pesticides. 73% reported direct contact with concentrated pesticides product, and over 80% reported being splashed or spilt during preparation or spraying activity. However, we found that the proportion of proper personal protective equipment (PPE) use in our subjects was low. Higher volume of mixture applied (p <  0.001) and broader acres of land (p = 0.001) were associated with higher cumulative exposure level, while using long-sleeved clothes and long pants (p <  0.05) during pesticide spraying were associated with lower cumulative exposure after adjusted for age and gender.

Conclusions

These findings indicate an inadequate knowledge of using pesticides properly. Thus, we recommend comprehensive training on pesticide usage and encourage proper PPE to reduce the exposure level.

COVID-19, staying at home, and domestic violence

We analyze how staying at home during the COVID-19 pandemic affects the rates of domestic violence in the U.S. Using police dispatch and crime data from 36 police and sheriff's departments and mobile device tracking data, we find that reported incidents of domestic violence increase as more people stay at home. Specifically, we estimate that staying at home due to COVID-19 increased domestic violence by over 5% on average from March 13 to May 24, 2020. This is consistent with a theory of exposure reduction, where victims and abusers stuck at home are more likely to fight.

Individual and population level protection from particulate matter exposure by wearing facemasks

Because of the severe air pollution in northern China, facemasks have gained popularity in this area in recent years. Although the results of previous studies have shown the effectiveness of wearing facemasks for intercepting particles, the individual differences and the overall health benefits of wearing facemasks have not been comprehensively documented. In this study, using both model and personal tests under various conditions, we test eight major brands of facemasks for their removal efficiencies (REs) of particulate matter (PM) in six size ranges (from 0.3 μm to >10 μm). The results are used to assess the overall exposure reduction at the individual and population levels in Beijing. We find significant differences in REs among PM sizes, facemask brands, pollution levels, and genders. Combining the information on the usage of various brands, facemask wearing rates, and PM_2.5 concentrations in the ambient and indoor air in this area, we evaluate the overall effect of facemask wearing on PM_2.5 exposure reduction. It is quantitatively demonstrated that because people spend most time indoors, facemask protection is limited. For facemask wearers, the overall exposure can be reduced by less than 20%, whereas the reduction rate is as low as 2.4 ± 1.6% for the entire adult populations even in the year with the highest level of pollution with an annual mean PM_2.5 concentration of 102 ± 98 μg∙m^-3. As a strategy of self-protection from long-term exposure to particulate matter, wearing facemasks outdoors is inferior to the installation of indoor air purifiers.

Improving the work environment in the fluorescent lamp recycling sector by optimizing mercury elimination

One of the main issues in the fluorescent lamp recycling sector is the mercury contamination of output fractions and occupational exposure associated with recycling operations. The aim of this study is to carry out effective mercury mass balance determinations and improve mercury recovery by finding the optimal levels for the recycling process parameters. These optimizations will allow upstream mercury emissions to be reduced, which will help to avoid mercury exposure among WEEE recycling workers. Firstly, the distribution of mercury was assessed in new and spent lamps. For new fluorescent tubes, the mean percentage of mercury in the solid phase is lower in new fluorescent tubes (19.5% with 5.5% in glass, 9.7% in end caps and 4.3% in luminescent powder) than in spent tubes (33.3% with 8.3% in glass, 12.9% in end caps and 12.1% in luminescent powder). The parametric study also shows that the finer the grains of glass, the higher the concentration of mercury (1.2 µg Hg/g for glass size particle >1000 µm and 152.0 µg Hg/g for glass size particle <100 µm); the crushing time required for the optimal removal of mercury from spent tubes is 24 h; on average 71% of the mercury is desorbed at a temperature of 400 °C. The effects of air flow rate, rotation speed and number of balls could not be determined due to wide variations in the results. It is recommended that recycling companies employ processes combining as heating and mixing techniques for the recovery of mercury from lamps in order to both (i) remove as much of the mercury as possible in vapor form and (ii) avoid adsorption of the mercury at new sites created during the crushing process.

Where to locate transit stops: Cross-intersection profiles of ultrafine particles and implications for pedestrian exposure

Epidemiological studies have shown that exposure to traffic-related pollutants increases incidence of adverse health outcomes. Transit users in cities across the globe commonly spend 15-45 min or more waiting at transit stops each day, often at locations with high levels of pollution from traffic. Here, we investigate the characteristics of concentration profiles of ultrafine particles (UFP) with 5 m spatial resolution across intersections, to determine the best place to site transit stops to minimize exposures. Cross-intersection UFP profiles were derived from 1744 profiles covering 90 m before and after each intersection center with a mobile monitoring platform. Measurements were made at 10 signalized intersections located at six urban sites, each with a distinct built environment, during both mornings and afternoons. Measurements were made within 1.5 m of the sidewalk and approximately at breathing height (1.5 m above ground level) to approximate sidewalk exposures. UFP profiles were strongly influenced by high emissions from vehicle stops and accelerations, and peaked within 30 m of intersection centers; from there concentrations decreased sharply with distance. Peak concentrations averaged about 90% higher than the minima along the block. They were accompanied by more frequent and larger transient concentration spikes, increasing the chance of people near the intersection being exposed to both short-term extremely high concentration spikes and higher average concentrations. The decays are somewhat larger before the intersection than after the intersection, however as siting transit stops after intersections is preferred for smooth traffic flow, we focus on after the intersection. Simple time-duration exposure calculations combined with breathing rates suggest moving a bus stop from 20 to 40-50 m after the intersection can reduce transit-users' exposure levels to total UFP substantially, in proportion to the reciprocal of the magnitude of elevation at the intersection.

Researcher and institutional review board perspectives on the benefits and challenges of reporting back biomonitoring and environmental exposure results

As the number of personal exposure studies expands and trends favor greater openness and transparency in the health sciences, ethical issues arise around reporting back individual results for contaminants without clear health guidelines. Past research demonstrates that research participants want their results even when the health implications are not known. The experiences of researchers and institutional review boards (IRBs) in studies that have reported personal chemical exposures can provide insights about ethical and practical approaches while also revealing areas of continued uncertainty. We conducted semi-structured interviews with 17 researchers and nine IRB members from seven personal exposure studies across the United States to investigate their experiences and attitudes about the report-back process. Researchers reported multiple benefits of report-back, including increasing retention and recruitment, advancing environmental health literacy, empowering study participants to take actions to reduce exposures, encouraging shifts in government and industry practices, and helping researchers discover sources of exposure through participant consultation. Researchers also reported challenges, including maintaining ongoing contact with participants, adopting protocols for notification of high exposures to chemicals without health guidelines, developing meaningful report-back materials, and resource limitations. IRB members reported concern for potential harm to participants, such as anxiety about personal results and counterproductive behavior changes. In contrast, researchers who have conducted personal report-back in their studies said that participants did not appear overly alarmed and noted that worry can be a positive outcome to motivate action to reduce harmful exposures. While key concerns raised during the early days of report-back have been substantially resolved for scientists with report-back experience, areas of uncertainty remain. These include ethical tensions surrounding the responsibility of researchers to leverage study results and resources to assist participants in policy or community-level actions to reduce chemical exposures, and how to navigate report-back to vulnerable populations.

Does drywall installers' innovative idea reduce the ergonomic exposures of ceiling installation: A field case study

OBJECTIVE

The study was conducted to assess an intervention suggested by the workers to reduce the physical or ergonomic exposures of the drywall installation task.

METHODS

The drywall installers were asked to brainstorm on innovative ideas that could reduce their ergonomic exposures during the drywall installation work. The workers proposed the idea of using a 'deadman' (narrow panel piece) to hold the panels to the ceiling while installing them. The researcher collected quantitative exposure data (PATH, 3DSSPP) at the baseline and intervention phases and compared the phases to find out any change in the exposure while using the 'deadman'.

RESULTS

Results showed that ergonomic exposures (such as overhead arm and awkward trunk postures and heavy load handling) were reduced at the intervention phase while using the 'deadman' with an electrically operated lift.

CONCLUSION

The concept of the 'deadman', which was shown to help reduce musculoskeletal exposures during ceiling installation, can be used to fabricate a permanent ergonomic tool to support the ceiling drywall panel.

At the crossroads: Hazard assessment and reduction of health risks from arsenic in private well waters of the northeastern United States and Atlantic Canada

This special issue contains 12 papers that report on new understanding of arsenic (As) hydrogeochemistry, performance of household well water treatment systems, and testing and treatment behaviors of well users in several states of the northeastern region of the United States and Nova Scotia, Canada. The responsibility to ensure water safety of private wells falls on well owners. In the U.S., 43 million Americans, mostly from rural areas, use private wells. In order to reduce As exposure in rural populations that rely on private wells for drinking water, risk assessment, which includes estimation of population at risk of exposure to As above the EPA Maximum Contaminant Level, is helpful but insufficient because it does not identify individual households at risk. Persistent optimistic bias among well owners against testing and barriers such as cost of treatment mean that a large percentage of the population will not act to reduce their exposure to harmful substances such as As. If households are in areas with known As occurrence, a potentially large percentage of well owners will remain unaware of their exposure. To ensure that everyone, including vulnerable populations such as low income families with children and pregnant women, is not exposed to arsenic in their drinking water, alternative action will be required and warrants further research.