Association between indoor nitrous acid, outdoor nitrogen dioxide, and asthma attacks: results of a pilot study

The association between nitrogen dioxide (NO₂) and asthma has been investigated. However, conventional NO₂ assays measure nitrous acid (HONO) as NO₂. In this pilot epidemiological observational study, we assessed exposure to indoor HONO and some air pollutants in pediatric asthma patients and examined possible association between exposure and asthma symptoms. Indoor HONO and nitric oxide (NO), which are primarily generated by the combustion of certain substances, were significantly associated with asthma attacks in 2010. In 2010, indoor HONO was closely correlated with indoor NO than with outdoor NO₂. Conversely, in 2012, indoor HONO was closely correlated with outdoor NO₂ and NO than with indoor NO₂ and NO. Outdoor NO₂ was significantly associated with asthma attacks in 2012. Our results highlight the need for further epidemiological studies of the association between indoor HONO and asthma symptoms using multivariate analyses to examine the role of NO₂ in asthma symptoms. Abbreviations: CXCL1: the chemokine (C-X-C motif) ligand 1; EP: the entire study period; FP: the first half of study period; HONO: nitrous acid; NO: nitric oxide; NO₂: nitrogen dioxide; OH radical: hydroxyl radical; SP: the second half of study period; TNF-α: tumor necrosis factor-α; US EPA: United States Environmental Protection Agency; WHO: World Health Organization.

Air pollution and asthma control in the Epidemiological study on the Genetics and Environment of Asthma

BACKGROUND

The associations between exposure to air pollution and asthma control are not well known. The objective of this study was to assess the association between long-term exposure to NO(2), O(3) and PM(10) and asthma control in the follow-up of the Epidemiological study on the Genetics and Environment of Asthma (EGEA2) (2003-2007).

METHODS

Modelled outdoor NO(2), O(3) and PM(10) estimates were linked to each residential address using the 4 km grid air pollutant surface developed by the French Institute of Environment in 2004. Asthma control was assessed in 481 subjects with current asthma using a multidimensional approach following the 2006-2009 Global Initiative for Asthma guidelines. Multinomial and ordinal logistic regressions were conducted adjusted for sex, age, body mass index, education, smoking and use of inhaled corticosteroids. The association between air pollution and the three domains of asthma control (symptoms, exacerbations and lung function) was assessed. ORs are reported per IQR.

RESULTS

Median concentrations (in micrograms per cubic metre) were 32 (IQR 25-38) for NO(2) (n=465), 46 (41-52) for O(3) and 21 (18-21) for PM(10) (n=481). In total, 44%, 29% and 27% had controlled, partly controlled and uncontrolled asthma, respectively. The ordinal ORs for O(3) and PM(10) with asthma control were 1.69 (95% CI 1.22 to 2.34) and 1.35 (95% CI 1.13 to 1.64), respectively. When including both pollutants in the same model, both associations persisted. Associations were not modified by sex, smoking status, use of inhaled corticosteroids, atopy, season of examination or body mass index. Both pollutants were associated with each of the three main domains of control.

CONCLUSIONS

The results suggest that long-term exposure to PM(10) and O(3) is associated with uncontrolled asthma in adults, defined by symptoms, exacerbations and lung function.

Corrosive effects from the deposition of gaseous pollutants on surfaces of cultural and artistic value inside museums

The objectives of the project were to assess the critical relationships between environmental factors and damage of the artifacts and other cultural property exposed inside museums, by studying: (a) the outdoor/indoor pollutant concentration and their transfer inside the museum; (b) the distribution and circulation of pollutants inside the museum influenced by various factors; (c) chemical interactions between pollutants in the gas phase leading to removal and/or formation of secondary pollutants; (d) the final deposition of the indoor pollutants on surfaces of artistic interest and the damage on them, governed by strictly defined physicochemical parameters. All the above information, together with the main factors influencing each stage, were obtained by applying the methodology developed and described in detail here. Measurements of rate constants of reactions in the gas phase, of physicochemical deposition parameters on artefacts, and the synergistic effects of pollutants on the deposition parameters, were conducted. Seven PC programmes for analysing the experimental data were written and used. The pollutants, the solid materials and the museums chosen in this programme are only examples needed to develop the necessary methodology. The numerical results obtained serve the purpose of exemplifying the procedures and not enriching the world's bibliography with useless empirical information. Two commercially available protectives for marble were investigated from the point of view of their reactivity towards SO2 by using a diffusional technique. From measurements of SO2 concentration carried out on three types of marble, the deposition velocities have been calculated. Indoor monitoring of the church of San Luigi dei Francesi and of the Museo della Civiltá Romana in Rome has shown that indoor production of nitrous acid most likely results from heterogeneous reactions indoors, on the walls and the exposed surfaces.

Effects of nitrous acid exposure on human mucous membranes

Nitrous acid (HONO) is formed both indirectly from the reaction of nitrogen dioxide (NO2) with water on indoor surfaces, and directly during combustion. This gaseous pollutant may be a previously unrecognized causal factor in assessments of nitrogen oxide exposure effects. The present study is the first attempt to evaluate exposure effects of HONO on the human airways and the mucous membranes of the eyes and nose. Fifteen healthy adult nonsmokers were exposed for 3.5 h in a double-blind, balanced protocol to clean air, 77, and 395 ppb HONO. Each exposure was preceded by a 1-h baseline measurement period, and exposures were separated by 1 wk. There was a 10-min exercise period during exposure. Effects measurements included assessment of bronchial reactivity, measurement of specific airway conductance, spirometry, acoustic rhinometry, nasal lavage, tear-fluid cytology, a CO2 eye-provocation test, evaluation of eye redness, and subjective sensations. Effects of HONO exposure on the eyes were found as exposure-related changes in tear-fluid cytology. In particular, the number of squamous cells increased by 20, 67, and 80% following exposure to clean air, 77, and 395 ppb HONO, respectively (p = 0.004). Possible indications of exposure effects on sensitivity to CO2 eye provocation and on specific airway conductance were also measured. For specific airway conductance there was an approximate 10% decrease in conductance following exercise in association with HONO exposure, compared with a 2% decrease with clean air (p = 0.038).

Effect of nitrous acid on lung function in asthmatics: a chamber study

Nitrous acid, a component of photochemical smog and a common indoor air pollutant, may reach levels of 100 ppb where gas stoves and unvented portable kerosene heaters are used. Nitrous acid is a primary product of combustion and may also be a secondary product by reaction of nitrogen dioxide with water. Because the usual assays for nitrogen dioxide measure several oxides of nitrogen (including nitrous acid) together, previous studies of indoor nitrogen dioxide may have included exposure to and health effects of nitrous acid. To assess the respiratory effects of nitrous acid exposure alone, we carried out a double-blinded crossover chamber exposure study with 11 mildly asthmatic adult subjects. Each underwent 3-hr exposures to 650 ppb nitrous acid and to filtered room air with three 20-min periods of moderate cycle exercise. Symptoms, respiratory parameters during exercise, and spirometry after exercise were measured. A statistically significant decrease in forced vital capacity was seen on days when subjects were exposed to nitrous acid. This effect was most marked at 25 min and 85 min after exposure began. Aggregate respiratory and mucous membrane symptoms were also significantly higher with nitrous acid. We conclude that this concentration and duration of exposure to nitrous acid alters lung mechanics slightly, does not induce significant airflow obstruction, and produces mild irritant symptoms in asthmatics.

Effects of low-level winter air pollution concentrations on respiratory health of Dutch children

During three consecutive winters acute effects of air pollution on respiratory health of more than 1000 children living in four nonindustrial communities in the Netherlands have been investigated. Each child performed between 6 and 10 pulmonary function tests on predetermined days. The occurrence of acute respiratory symptoms in the children was registered in a daily diary filled out by the parents of the children for periods of 3 months. Exposure to air pollution was characterized by the ambient concentration of sulfur dioxide, nitrogen dioxide, PM10, fine particle sulfate, fine particle nitrate, and nitrous acid. No major winter air pollution episode occurred during these winters. Concentrations of acid aerosol were low. A weak negative association between the concentrations of nitrogen dioxide, PM10, aerosol sulfate, aerosol nitrate, nitrous acid, and pulmonary function was found. Sulfur dioxide concentration was not associated with pulmonary function. No association of the concentration of the measured pollutants with daily incidence and prevalence of acute respiratory symptoms was found.