[Show abstract][Hide abstract] ABSTRACT: Background
Exposure to pollution from biomass fuel has been associated with low birthweight in some studies. Few studies have included exposure-response analyses.
We conducted a case-control study of biomass fuel use and reproductive outcome at high altitude in Peru. Cases (n=101) were full term births who were SGA (birth weight <10th percentile for gestational age). Controls (n=101) had a birthweight ≥10th percentile, and were matched to cases on birth week and residence. Biomass fuel use during pregnancy was determined by questionnaire. Carbon monoxide (CO) in the kitchen was measured in a subgroup (n=72). Logistic regression was used to estimate the effects of biofuel and CO on the risk of SGA, controlling for maternal education and parity.
Among cases, 30%, 27% and 44% used gas, gas+biomass, and biomass, respectively, while the figures for controls were 39%, 33%, and 29%. The adjusted odds ratio (OR) for biomass fuel alone compared with gas alone was 4.5 (95% CI: 1.3, 15.5, p=0.02), while the OR for biomass+gas vs. gas alone was 2.1 (0.80–5.5) (p=0.13). Among the subgroup with measured CO, the mean 48-h kitchen CO levels were 4.8, 2.2 and 0.4 ppm for biofuel only, biofuel+gas, and gas respectively. ORs by increasing tertile of CO level were 1.0, 1.16, and 3.53 (test for trend, p=0.02). The exposure-response trend corresponds well with one other study with analogous data.
Despite limited sample size, our data suggest that maternal exposure to biomass smoke and CO, at high altitude, is associated with SGA among term births.
Environmental Research 01/2014; 130:29–33. · 3.24 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: A third of the world's population uses solid fuel derived from plant material (biomass) or coal for cooking, heating, or lighting. These fuels are smoky, often used in an open fire or simple stove with incomplete combustion, and result in a large amount of household air pollution when smoke is poorly vented. Air pollution is the biggest environmental cause of death worldwide, with household air pollution accounting for about 3·5–4 million deaths every year. Women and children living in severe poverty have the greatest exposures to household air pollution. In this Commission, we review evidence for the association between household air pollution and respiratory infections, respiratory tract cancers, and chronic lung diseases. Respiratory infections (comprising both upper and lower respiratory tract infections with viruses, bacteria, and mycobacteria) have all been associated with exposure to household air pollution. Respiratory tract cancers, including both nasopharyngeal cancer and lung cancer, are strongly associated with pollution from coal burning and further data are needed about other solid fuels. Chronic lung diseases, including chronic obstructive pulmonary disease and bronchiectasis in women, are associated with solid fuel use for cooking, and the damaging effects of exposure to household air pollution in early life on lung development are yet to be fully described. We also review appropriate ways to measure exposure to household air pollution, as well as study design issues and potential effective interventions to prevent these disease burdens. Measurement of household air pollution needs individual, rather than fixed in place, monitoring because exposure varies by age, gender, location, and household role. Women and children are particularly susceptible to the toxic effects of pollution and are exposed to the highest concentrations. Interventions should target these high-risk groups and be of sufficient quality to make the air clean. To make clean energy available to all people is the long-term goal, with an intermediate solution being to make available energy that is clean enough to have a health impact.
[Show abstract][Hide abstract] ABSTRACT: ABSTRACT While evidence suggests associations between maternal exposure to air pollution and adverse birth outcomes, pregnant women's exposure to household air pollution in developing countries is understudied. Personal exposures of pregnant women (n = 100) in Trujillo, Peru to air pollutants and their indoor concentrations were measured. The effects of stove-use related characteristics and ambient air pollution on exposure were determined using mixed-effects models. Significant differences in 48-hr kitchen concentrations of particulate matter (PM2.5), carbon monoxide (CO), and nitrogen dioxide (NO2) concentrations were observed across fuel-types (p < 0.05). Geometric mean PM2.5 concentrations were 112 μg/m (3) (CLs: 52, 242 μg/m(3)) and 42 μg/m(3) (21, 82 μg/m(3)) in homes were wood and gas were used respectively. PM2.5 exposure was at levels which recent exposure-response analyses suggest may not result in substantial reduction in health risks even in homes where cleaner burning gas stoves were used.
Archives of Environmental and Occupational Health 11/2013; · 1.19 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Nearly half of the world's population is exposed to household air pollution (HAP) due to long hours spent in close proximity to unvented cooking fires. We aimed to use PM2.5 and CO measurements to characterize exposure to cookstove generated woodsmoke in real time among control (n=10) and intervention (n=9) households in San Marcos, Cajamarca Region, Peru. Real time personal particulate matter with an aerodynamic diameter ≤2.5 µm (PM2.5), and personal and kitchen carbon monoxide (CO) samples were taken. Control households used a number of stoves including open fire and chimney stoves while intervention households used study-promoted chimney stoves. Measurements were categorized into lunch (9am - 1pm) and dinner (3pm - 7pm) periods, where applicable, to adjust for a wide range of sampling periods (2.8- 13.1hrs). During the 4-h time periods, mean personal PM2.5 exposures were correlated with personal CO exposures during lunch (r=0.67 p=0.024 n=11) and dinner (r=0.72 p=0.0011 n=17) in all study households. Personal PM2.5 exposures and kitchen CO concentrations were also correlated during lunch (r=0.76 p=0.018 n=9) and dinner (r=0.60 p=0.018 n=15). CO may be a useful indicator of PM during 4-h time scales measured in real time, particularly during high woodsmoke exposures, particularly during residential biomass cooking.
[Show abstract][Hide abstract] ABSTRACT: Nearly half of the world's population is exposed to household air pollution (HAP) due to long hours spent in close proximity to unvented cooking fires. The effect of woodsmoke exposure on oxidative stress was examined by investigating the association between woodsmoke exposure and biomarkers of DNA oxidation (8-hydroxy-2'-deoxyguanosine [8-OHdG]) and lipid peroxidation (8-isoprostane) among control and intervention stove users. HAP exposure assessment was conducted within the framework of a community-randomized controlled trial of 51 communities in San Marcos Province, Cajamarca Region, Peru. The first morning urine voids after 48h HAP exposure assessment from a subset of 45 control and 39 intervention stove users were analyzed for 8-OHdG and 8-isoprostane. General linear models and correlation analyses were performed. Urinary oxidative stress biomarkers ranged from 11.2 to 2270.0μg/g creatinine (median: 132.6μg/g creatinine) for 8-OHdG and from 0.1 to 4.5μg/g creatinine (median: 0.8μg/g creatinine) for 8-isoprostane among all study subjects (n=84). After controlling for the effects of traffic in the community and eating food exposed to fire among all subjects, cooking time was weakly, but positively associated with urinary 8-OHdG (r=0.29, p=0.01, n=80). Subjects' real-time personal CO exposures were negatively associated with 8-OHdG, particularly the maximum 30-second CO exposure during the sampling period (r=-0.32, p=0.001, n=73). 48h time integrated personal PM2.5 was negatively, but marginally associated with urinary 8-isoprostane (r=-0.21, p=0.09, n=69) after controlling for the effect of distance of homes to the road. Urinary 8-isoprostane levels reported in the available literature are comparable to results found in the current study. However there were relatively high levels of urinary 8-OHdG compared to data in the available literature for 8-OHdG excretion. Results suggest a sustained systemic oxidative stress among these Peruvian women chronically exposed to wood smoke.
Environment international 09/2013; 60C:112-122. · 6.25 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Nearly 3 billion people worldwide rely on solid fuel combustion to meet basic household energy needs. Resulting exposure to air pollution is estimated to cause 4.5% of the global burden of disease. Large variability and a lack of resources for research and development have resulted in highly uncertain exposure estimates. The objective of this paper is to identify research priorities for exposure assessment that will more accurately and precisely define exposure-response relationships of household air pollution necessary to inform future cleaner-burning cookstove dissemination programs.
As part of a May 2011 international workshop, an expert group characterized the state of the science and developed recommendations for exposure assessment of household air pollution.
The following priority research areas were identified to explain variability and reduce uncertainty of household air pollution exposure measurements: improved characterization of spatial and temporal variability for studies examining both short- and long-term health effects; development and validation of measurement technology and approaches to conduct complex exposure assessments in resource-limited settings with a large range of pollutant concentrations; and development and validation of biomarkers for estimating dose. Addressing these priority research areas, which will inherently require an increased allocation of resources for cookstove research, will lead to better characterization of exposure-response relationships.
Although the type and extent of exposure assessment will necessarily depend on the goal and design of the cookstove study, without improved understanding of exposure-response relationships, the level of air pollution reduction necessary to meet the health targets of cookstove interventions will remain uncertain.
Environmental Health Perspectives 07/2013; · 7.26 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Wildland firefighters are occupationally exposed to elevated levels of woodsmoke. Eighteen wildland firefighters were monitored for their personal exposure to particulate matter with median aerodynamic diameter of 2.5 microns (PM2.5), levoglucosan (LG), and carbon monoxide (CO) at 30 prescribed burns at the Savannah River Site, South Carolina. Linear mixed effect models were used to investigate the effect on exposure of various factors and to examine whether the firefighters were able to qualitatively estimate their own exposures. Exposure to PM2.5 and CO was higher when firefighters performed 'holding' tasks compared with 'lighting' duties, whereas exposures to CO and LG were higher when burns were in compartments with predominantly pine vegetation (P < 0.05). Exposures to PM2.5 (64-2068 µg m(-3)) and CO (0.02-8.2 p.p.m.) fell within the ranges observed in previous studies. Some recommended shorter term exposure limits for CO were exceeded in a few instances. The very low LG:PM2.5 ratios in some samples suggest that the exposures of wildland firefighters to pollutants at prescribed burns may be substantially impacted by non-woodsmoke sources. The association of the qualitative exposure estimation of the firefighters with actual PM2.5 and CO measurements (P < 0.01) indicates that qualitative estimation may be used to assess exposure in epidemiology studies.
Annals of Occupational Hygiene 06/2013; · 2.16 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: BACKGROUND: In developing countries, deficiencies in essential micronutrients are common, particularly in pregnant women. Although, biochemical indicators of diet and nutrition are useful to assess nutritional status, few studies have examined such indicators throughout pregnancy in women in developing countries. METHODS: The primary objective of this study was to assess the nutritional status of 78 Peruvian women throughout pregnancy for 16 different nutritional indicators including fat-soluble vitamins and carotenoids, iron-status indicators, and selenium. Venous blood samples from which serum was prepared were collected during trimesters one (n = 78), two (n = 65), three (n = 62), and at term via the umbilical cord (n = 52). Questionnaires were completed to determine the demographic characteristics of subjects. Linear mixed effects models were used to study the associations between each maternal indicator and the demographic characteristics. RESULTS: None of the women were vitamin A and E deficient at any stage of pregnancy and only 1/62 women (1.6%) was selenium deficient during the third trimester. However, 6.4%, 44% and 64% of women had ferritin levels indicative of iron deficiency during the first, second and third trimester, respectively. Statistically significant changes (p <= 0.05) throughout pregnancy were noted for 15/16 nutritional indicators for this Peruvian cohort, with little-to-no association with demographic characteristics. Three carotenoids (beta-carotene, beta-cryptoxanthin and trans-lycopene) were significantly associated with education status, while trans-lycopene was associated with age and beta-cryptoxanthin with SES (p < 0.05). Concentrations of retinol, tocopherol, beta-cryptoxanthin, lutein + zeaxanthin and selenium were lower in cord serum compared with maternal serum (p < 0.05). Conversely, levels of iron status indicators (ferritin, transferrin saturation and iron) were higher in cord serum (p < 0.05). CONCLUSION: The increasing prevalence of iron deficiency throughout pregnancy in these Peruvian women was expected. It was surprising though not to find deficiencies in other nutrients. The results highlight the importance of continual monitoring of women throughout pregnancy for iron deficiency which could be caused by increasing fetal needs and/or inadequate iron intake as pregnancy progresses.
[Show abstract][Hide abstract] ABSTRACT: Wildland firefighters in the United States are occupationally exposed to high levels of woodsmoke. Results from experimental studies show that exposure to woodsmoke induces inflammation. A study was conducted to investigate the effect of occupational woodsmoke exposure on inflammatory biomarkers in firefighters working at prescribed burns. Twelve U.S. Forest Service wildland firefighters at the Savannah River Site, South Carolina, volunteered to give blood samples during four prescribed burns between February and March 2011. Twenty-four paired (pre- and post-work shift) blood samples were collected using dried blood spot method to facilitate repeated sample collection. Inflammatory biomarker concentrations in blood samples were measured using the Meso Scale Discovery multi-spot assay system. Concurrent personal PM(2.5) and CO monitoring of firefighters was conducted. Linear mixed models were used to test whether cross-work shift differences occurred in the following inflammatory biomarkers: IL-1β, IL-8, CRP, SAA, ICAM-1, and VCAM-1. IL-8 showed a significant cross-work shift difference as indicated by a post/pre-work shift ratio of 1.70 (95% CL: 1.35, 2.13; p = 0.0012). Concentrations of IL-8, CRP, and ICAM-1 increased in >50% of samples across work shift. Firefighters who lighted fires as opposed to other work tasks had the largest cross-work shift increase in IL-8. A significant cross-work shift increase in IL-8 in blood samples was observed in healthy wildland firefighters working at prescribed burns. Further research is needed to understand the physiological responses underlying the adverse effects of woodsmoke exposure, and the dose-response relationship between woodsmoke exposure and inflammatory responses.
Journal of Occupational and Environmental Hygiene 04/2013; 10(4):173-80. · 1.28 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Household air pollution (HAP) from indoor burning of biomass or coal is a leading global cause of morbidity and mortality, mostly due to its association with acute respiratory infection in children, chronic respiratory and cardiovascular diseases in adults. Interventions that have significantly reduced exposure to HAP improve health outcomes and may reduce mortality. However, we lack robust, specific and field-ready biomarkers to identify populations at greatest risk, and to monitor the effectiveness of interventions. New scientific approaches are urgently needed to develop biomarkers of human exposure that accurately reflect exposure or effect. In this perspective, we describe the global need for such biomarkers, the aims of biomarker development, and the state of development of tests which have the potential for rapid transition from laboratory bench to field use.
[Show abstract][Hide abstract] ABSTRACT: Although the production and use of some persistent organic pollutants (POPs) have been banned or highly restricted, human exposure remains a subject of investigation due to their environmental persistence. Physiological changes during pregnancy may affect the disposition of POPs in the mother's body, and thus fetal exposure. Changes in serum concentrations of organochlorine pesticides (OCPs) and polychlorinated biphenyls (PCBs) across pregnancy trimesters, and trans-placental transfer to the fetus were investigated. Seventy-nine pregnant women in Trujillo, Peru were recruited in the first trimester of pregnancy, and provided blood samples for the analysis of 35 PCB congeners, 9 OCPs, and 11 polybrominated biphenyl diethers (PBDEs). Subsequently, maternal blood samples were collected in the second (n=64) and third trimesters (n=59), and cord blood samples (n=50) were collected at delivery. There were statistically significant changes across trimesters (p<0.05) for both fresh weight (increase) and lipid adjusted concentrations (decrease) of hexachlorobenzene (HCB), 2,2-Bis(4-chlorophenyl)-1,1-dichloroethene (p,p'-DDE), PCB-74, 118, 138-158, 153, 170, 180 and 194. Fresh weight concentrations of these POPs increased from first to third trimester by 10-28%. On the other hand lipid adjusted concentrations decreased from first to third trimester by 16-28%. Serum lipids increased from first to third trimester by 53% indicating the dilution of the POPs in the lipids. Concentrations of 2,2-Bis(4-chlorophenyl)-1,1,1-trichloroethane (p,p'-DDT), its metabolite p,p'-DDE, PCB-118, 138-158, 153, 170 and 180 above their limits of detection were measured in >60% of cord serum samples. Intra-individual correlations in maternal serum concentrations were high for most of the POPs (ρ=0.62-0.99; p<0.05) while correlations between maternal and cord serum concentrations were also high (ρ=0.68-0.99; p<0.05). Results indicate that the disposition in the body and blood concentrations of POPs may change during pregnancy, and show trans-placental transfer of DDT, DDE and PCBs.
[Show abstract][Hide abstract] ABSTRACT: Experimental studies indicate that exposure to woodsmoke could induce oxidative stress. However studies have not been conducted among the general population and specialized occupational groups despite the existence of elevated woodsmoke exposure situations. Therefore, we investigated whether there were across workshift changes in oxidative stress biomarkers among wildland firefighters who are occupationally exposed to elevated levels of woodsmoke. We collected pre- and post-workshift urine samples from 19 wildland firefighters before and after prescribed burns. We measured malondialdehyde (MDA) and 8-oxo-7,8-dihydro-2'-deoxyguanosine (8-oxo-dG) in the samples, and analyzed whether there were cross-shift changes in their levels, and the relationships between the changes and the length of firefighting career, age of firefighter, and quantified workshift exposure to particulate matter. Overall no significant cross-shift change was observed for 8-oxodG or MDA in the urine samples of the firefighters. Changes in both biomarkers were also not associated with PM(2.5), which was used as a marker of exposure. However, overall unadjusted geometric mean 8-oxo-dG levels in the samples (31μg/g creatinine) was relatively higher compared to those measured in healthy individuals in many occupational or general population studies. Additionally, cross-shift changes in 8-oxo-dG excretion were dependent on the length of firefighting career (p=0.01) or age of the subject (p=0.01). Significant increases in 8-oxo-dG level from pre-shift to post-shift were observed for those who had been firefighters for 2years or less. The results indicate that oxidative stress response measured as cross-shift changes in 8-oxo-dG may depend on age or the length of a firefighter's career. These results suggest the need to investigate the longer term health effects of cumulative exposure of woodsmoke exposure among wildland firefighters, because increased body burden of oxidative stress is a risk factor for many diseases and is theorized to be involved in aging.
Science of The Total Environment 02/2013; 449C:269-275. · 3.26 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Women and children in developing countries are often exposed to high levels of air pollution including polycyclic aromatic hydrocarbons (PAHs), which may negatively impact their health, due to household combustion of biomass fuel for cooking and heating. We compared creatinine adjusted hydroxy-PAH (OH-PAH) concentrations in pregnant women in Trujillo, Peru who cook with wood to levels measured in those who cook with kerosene, liquefied petroleum gas or a combination of fuels. Seventy-nine women were recruited for the study between May and July 2004 in the first trimester of their pregnancy. Urine samples were collected from the subjects in the first, second and third trimesters for OH-PAH analyses. The concentrations of the OH-PAHs were compared across the type of fuel used for cooking and pregnancy trimesters. The relationships between OH-PAHs levels in the first trimester and concurrently measured personal exposures to PM(2.5), carbon monoxide and nitrogen dioxide together with their indoor and outdoor air concentrations were also investigated. Women cooking with wood or kerosene had the highest creatinine adjusted OH-PAH concentrations compared with those using gas, coal briquette or a combination of fuels. Concentrations of creatinine adjusted 2-hydroxy-fluorene, 3-hydroxy-fluorene, 1-hydroxy-fluorene, 2-hydroxy-phenanthrene and 4-hydroxy-phenanthrene were significantly higher (p<0.05) in women who used wood or kerosene alone compared with women who used liquefied petroleum gas (LPG), coal briquette or a combination of fuels. An increase in the concentrations of creatinine adjusted 9-hydroxy-fluorene, 1-hydroxy-phenanthrene, 2-hydroxy-phenanthrene, 4-hydroxy-phenanthrene and 1-hydroxy-pyrene in the third trimesters was also observed. Weak positive correlation (Spearman correlation coefficient, ρ<0.4; p<0.05) was observed between all first trimester creatinine adjusted OH-PAHs and indoor (kitchen and living room), and personal 48-h TWA PM(2.5). Women who cooked exclusively with wood or kerosene had higher creatinine adjusted OH-PAH levels in their urine samples compared to women who cooked with LPG or coal briquette.
Environment international 01/2013; 53C:1-8. · 6.25 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: ABSTRACT Exposure to combustion products from wildland fires causes respiratory irritation and decreased lung function among firefighters. The authors evaluated carbon monoxide (CO) exposures of a group of wildland firefighters who conducted prescribed burns in the southeastern United States of America. A total of 149 person-days of samples were collected using data logging CO monitors. A questionnaire was administered to collect data on job tasks and self-reported smoke exposure. Overall, the highest exposures were seen amongst firefighters assigned to holding and mop-up tasks (geometric mean [GM]: 2.6 ppm), whereas the lowest were associated with lighting and jobs such as burn boss (GM: 1.6 and 0.3 ppm, respectively). The self-reported smoke exposure showed a significant linear trend with increasing CO exposure. The numbers of acres burned or burn duration, however, were not good predictors of exposure.
Archives of Environmental and Occupational Health 01/2013; 68(1):55-9. · 1.19 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: BACKGROUND/OBJECTIVE: A study was undertaken at the United States Department of Energy's Savannah River Site (SRS), Aiken, South Carolina to investigate radionuclide activity concentrations in litter and duff from select areas at SRS. Litter (i.e. vegetative debris) and duff (i.e. highly decomposed vegetative debris) can often be the major fuels consumed during prescribed burns and have potential to release radiological contaminants into the environment. METHODS: Repeated samples from 97 locations were collected systematically across SRS and analyzed for radionuclide activity. Radionuclide activity concentrations found in litter and duff were compared. As spatial trends were of interest, spatial distributions of radionuclide activity concentrations found in litter and duff and spatial dependency amongst the data were explored. RESULTS: (7)Be, (40)K, and (137)Cs showed statistically significant proportional differences between litter and duff samples. Duff sample concentrations for (137)Cs (p < 0.0001) and (40)K (p = 0.0015) were statistically higher compared to litter samples. (7)Be activity concentrations were statistically higher in litter as compared to duff (p < 0.0001). For (40)K litter and duff samples, spatial correlation tests were not significant at p = 0.05 and the maps did not indicate any apparent high concentrations centered near possible radionuclide sources (i.e. SRS facilities). For (7)Be litter samples, significant spatial correlation was calculated (p = 0.0085). No spatial correlation was evident in the (7)Be duff samples (p = 1.0000) probably due to small sample size (n = 7). (137)Cs litter and duff samples showed significant spatial correlations (p < 0.0001 and p < 0.0001, respectively). CONCLUSIONS: To date, few studies characterize radionuclide activity concentrations in litter and duff, and to our knowledge none present spatial analysis. Key findings show that across SRS, (137)Cs is the primary radionuclide of concern, with the highest number of samples reported above MDC in litter (51.4%) and duff samples (83.2%). However, (137)Cs litter and duff spatial trends in the maps generated from the kriging parameters do not appear to directly link the areas with higher activity concentrations with SRS facilities. The results found herein provide valuable baseline monitoring data for future studies of forest surface fuels and can be used to evaluate changes in radioactivity in surface fuels in the southeast region of the U.S.
Journal of Environmental Management 12/2012; 115C:217-226. · 3.06 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Multiple air monitoring campaigns were conducted from 2003 to 2007 during the months of December through April in which time-integrated monitoring of PM2.5 was performed during 55 prescribed burn (PB) events administered under select meteorological conditions. The data were analyzed using a generalized additive mixed-model (GAMM) where the logarithm of PM2.5 concentrations were modeled as the sum of linear and non-linear functions of our covariates of interest after accounting for the confounding associated with the grouping structure of our data and spatial dependency. Our model explained 61% of the variance of log transformed PM2.5. The GAM component of the model (i.e. our covariates of interest) explained 40% of that variance and the mixed-model component (i.e. random-effects and spatial correlation) explained 21%. Within burn events, concentrations across our air monitoring grid were significantly influenced by the distance from burn perimeter to air monitor and the proportion of time the air monitor was in line with the wind field over the burn. Among burns, variation was significantly influenced by burn duration, burn size, mode of ignition, and regional background PM2.5; indicating the importance of these for fire management. Measures of burn intensity and meteorology were found to be insignificant in our model; however, it is possible that some of these effects were absorbed by the random-effects of our model. These findings demonstrate that downwind exposure is largely a function of wind direction combined with distance from the burn and that emissions from one burn to the next are dependent on burn size, duration, and mode of ignition.
[Show abstract][Hide abstract] ABSTRACT: The objective of this study was to assess the utility of urinary Clara cell protein (CC16) as a biomarker of increased lung epithelial permeability in non-smokers exposed to outdoor secondhand smoke. Twenty-eight healthy non-smoking adults visited outdoor patios of a restaurant and a bar where non-participants smoked and an open-air control with no smokers on three weekend days in a crossover study; subjects visited each site once for 3 h. Urine samples were collected at baseline, immediately post exposure and next morning, and analyzed for CC16. Changes in CC16 across location types or with cigarette count were analyzed using mixed-effect models, which included all subjects and stratified by gender. Urinary CC16 was higher in males (n=9) compared with females (n=18) at all measurement occasions (P<0.002), possibly reflecting prostatic contamination. Urinary CC16 from pre-exposure to post-exposure was higher following visits to restaurant and bar sites compared with the control among females but this increase did not reach statistical significance. Post-exposure to pre-exposure urinary CC16 ratios among females increased with cigarette count (P=0.048). Exposure-related increases in urinary CC16 were not seen among males. In conclusion, urinary CC16 may be a useful biomarker of increased lung epithelial permeability among female non-smokers; further work will be required to evaluate its applicability to males.Journal of Exposure Science and Environmental Epidemiology advance online publication, 18 July 2012; doi:10.1038/jes.2012.68.
Journal of Exposure Science and Environmental Epidemiology 07/2012; · 3.19 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: With an increase in indoor smoking bans, many smokers smoke outside establishments and near their entrances, which has become a public health concern.
We characterized the exposure of nonsmokers to secondhand smoke (SHS) outside a restaurant and bar in Athens, Georgia, where indoor smoking is banned, using salivary cotinine and urinary 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL).
In a crossover study, we assigned 28 participants to outdoor patios of a restaurant and a bar and an open-air site with no smokers on three weekend days; participants visited each site once and stayed for 3 hr. We collected saliva and urine samples immediately before and after the visits (postexposure) and on the following morning and analyzed samples for cotinine and total NNAL, respectively. Regression models were fitted and changes in biomarkers were contrasted between locations.
Postexposure and preexposure geometric mean salivary cotinine concentrations differed by 0.115 ng/mL [95% confidence interval (CI): 0.105, 0.126)] and by 0.030 ng/mL (95% CI: 0.028, 0.031) for bar and restaurant visits, respectively. There were no significant post- and preexposure differences in cotinine levels after control site visits, and changes after bar and restaurant site visits were significantly different from changes after control site visits (p < 0.001). Results comparing next-day and preexposure salivary cotinine levels were similar. Next-day creatinine-corrected urinary NNAL concentrations also were higher than preexposure levels following bar and restaurant visits [1.858 pg/mg creatinine higher (95% CI: 0.897, 3.758) and 0.615 pg/mg creatinine higher (95% CI: 0.210, 1.761), respectively], and were significantly different from changes after the control visits (p = 0.005).
Salivary cotinine and urinary NNAL increased significantly in nonsmokers after outdoor SHS exposure. Our findings indicate that such exposures may increase risks of health effects associated with tobacco carcinogens.
Environmental Health Perspectives 04/2012; 120(7):1010-6. · 7.26 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Public transport vehicle drivers, especially in highly polluted or trafficked areas, are exposed to high levels of air pollutants. In this study, we assessed the influence of traffic on levels of hydroxy polycyclic aromatic hydrocarbons (OH-PAHs) in commercial bus drivers in Trujillo, Peru, by measuring the within-shift changes in the urinary whole weight and creatinine-corrected concentrations of the PAH metabolites. We measured personal PM(2.5) as a proxy of exposure to traffic emission. Urine samples were collected daily from two bus drivers and three minivan drivers in Trujillo, pre-, mid-, post-work shift and on days when the drivers were off work (total n = 144). Ten OH-PAH metabolites were measured in the urine samples. Drivers were also monitored for exposure to PM(2.5) (n = 41). Daily work shift (mean = 13.1 ± 1.3 hr) integrated PM(2.5) was measured in the breathing zones of the drivers for an average of 10.5 days per driver. The differences across shift in OH-PAH concentrations were not statistically significant except for urinary 2-hydroxyfluorene (2-FLU) (p = 0.04) and 4-hydroxyphenanthrene (4-PHE) (p = 0.01) and creatinine-corrected 4-hydroxyphenanthrene (p = 0.01). Correlation between pairs of hydroxy-PAHs (ρ = 0.50 to 0.93) were highest for mid-shift samples. Concentrations of PM(2.5) (geometric mean = 64 μg/m(3); 95% confidence limits = 52 μg/m(3), 78 μg/m(3)) is similar to those measured in many other studies of traffic exposure. There was significant change across work shift for concentrations of only two of the OH-PAHs (2-FLU and 4-PHE). Results indicate that the drivers may have had limited time for clearance of PAH exposure from the body between work shifts. Comparisons of the concentrations of creatinine-corrected hydroxy-PAH to those reported in other studies indicate that exposure of public transport drivers to PAH could be similar. By following the subjects over multiple days, this study gives an indication of appropriate exposure situations for the use of hydroxy-PAHs and will be beneficial in designing future occupational studies of PAH exposure.
Journal of Occupational and Environmental Hygiene 04/2012; 9(4):217-29. · 1.28 Impact Factor