Secondhand smoke in hospitals of Catalonia (Spain) before and after a comprehensive ban on smoking at the national level

ObjectiveTo assess changes in secondhand smoke exposure by means of airborne nicotine concentrations in public hospitals of Catalonia (Spain) before and after a comprehensive national smoking ban.MethodsWe monitored vapor-phase nicotine concentrations in 44 public hospitals in Catalonia (Spain) before the smoking ban (September–December 2005) and one year after (September–December 2006). We installed 5–7 sampling devices per hospital for 7 days in different places (228 pairs of samples), and 198 pairs of samples were available for the final analysis.ResultsThe median nicotine concentration declined from 0.23 μg/m³ (interquartile range: 0.13–0.63) before the law to 0.10 μg/m³ (interquartile range: 0.02–0.19) after the law (% decline = 56.5, p < 0.01). We observed significant reductions in the median nicotine concentrations in all hospital locations, although secondhand smoke exposure was still present in some places (main hospital entrance, emergency department waiting rooms, fire escapes, and cafeterias).ConclusionsSecondhand smoke in hospitals has decreased after the ban. Assessment of airborne nicotine concentrations appears to be an objective and feasible system to monitor and reinforce the compliance of smoke-free legislations in this setting.     

Long-term air pollution exposure and lung function in 15 year-old adolescents living in an urban and rural area in Germany: The GINIplus and LISAplus cohorts

IntroductionThe impact of outdoor air pollution exposure on long-term lung development and potential periods of increased lung susceptibility remain unknown. This study assessed associations between early-life and current residential exposure to air pollution and lung function at 15-years of age in two German birth cohorts.MethodsFifteen year-old participants living in an urban and rural area in Germany underwent spirometry before and after bronchodilation (N = 2266). Annual average (long-term) exposure to nitrogen dioxide (NO₂), particles with aerodynamic diameters less than 2.5 μg/m³ (PM_2.5) mass and less than 10 μg/m³ (PM₁₀) mass, PM_2.5 absorbance and ozone were estimated to each participant's birth-, 10- and 15-year home address using land-use regression and kriging (ozone only) modelling. Associations between lung function variables and long-term pollutant concentrations were assessed using linear regression models adjusted for host and environmental covariates and recent short-term air pollution exposures.ResultsLong-term air pollution concentrations assessed to the birth-, 10- and 15-year home addresses were not associated with lung function variables, before and after bronchodilation, in the complete or study area specific populations. However, several lung function variables were negatively associated with long-term NO₂ concentrations among asthmatics. For example, NO₂ estimated to the 15-year home address was associated with the ratio of forced expiratory volume in one second to forced vital capacity (FEV₁/FVC) and the mean flow rate between 25% and 75% of FVC (−3.5%, 95% confidence interval [−6.0, −1.0] and −297.4 ml/s [−592.6, −2.1] per 5.9 μg/m³ increase in NO₂, respectively). Nearly all effect estimates for the associations between the short-term PM_2.5 mass, PM₁₀ mass and ozone concentrations and the lung function variables were negative in the complete population.ConclusionsEarly-life and current long-term air pollution exposures and lung function at the age of 15 years were not associated in the complete study population. Asthmatics may represent a vulnerable group.     

Occupational exposure to particulate matter from three agricultural crops in California

Agricultural work is a major contributor to California's and the nation's economy and employs a large number of workers. However, agricultural work can have numerous risks, such as exposure to elevated levels of particulate matter (PM) and other airborne pollutants with potential adverse health effects. To determine the magnitude of occupational exposures, PM levels were assessed for 89 workers from three major crops in California; almonds, melons and tomatoes. Personal samples were collected for PM_2.5 and inhalable PM using personal sampling equipment. Geometric mean concentrations from personal exposure for workers in almonds (inhalable PM = 4368 μg/m³, PM_2.5 = 122 μg/m³, N = 5), tomatoes (inhalable PM = 1410 μg/m³, PM_2.5 = 12 μg/m³, N = 33), and melons (inhalable PM = 1118 μg/m³, PM_2.5 = 19 μg/m³, N = 51) showed high PM exposure when working with these three crops. Large exposure differences by crop were more common than by task (i.e. harvesting, packing and weeding) among the three crops studied. This is the largest study of agricultural workers engaged in hand harvesting, a significant employer of farm labor, and relatively high levels of exposure to PM were measured.     

Associations between short-term exposure to particulate matter and ultrafine particles and myocardial infarction in Augsburg,Germany

BackgroundShort-term exposure to increased particulate matter (PM) concentration has been reported to trigger myocardial infarction (MI). However, the association with ultrafine particles remains unclear.ObjectivesWe aimed to assess the effects of short-term air pollution and especially ultrafine particles on registry-based MI events and coronary deaths in the area of Augsburg, Germany.MethodsBetween 1995 and 2009, the MONICA/KORA myocardial infarction registry recorded 15,417 cases of MI and coronary deaths. Concentrations of PM < 10 μm (PM₁₀), PM < 2.5 μm (PM_2.5), particle number concentration (PNC) as indicator for ultrafine particles, and meteorological parameters were measured in the study region. Quasi-Poisson regression adjusting for time trend, temperature, season, and weekday was used to estimate immediate, delayed and cumulative effects of air pollutants on the occurrence of MI. The daily numbers of total MI, nonfatal and fatal events as well as incident and recurrent events were analysed.ResultsWe observed a 1.3% risk increase (95%-confidence interval: [−0.9%; 3.6%]) for all events and a 4.4% [−0.4%; 9.4%] risk increase for recurrent events per 24.3 μg/m³ increase in same day PM₁₀ concentrations. Nonfatal events indicated a risk increase of 3.1% [−0.1%; 6.5%] with previous day PM₁₀. No association was seen for PM_2.5 which was only available from 1999 on. PNC showed a risk increase of 6.0% [0.6%; 11.7%] for recurrent events per 5529 particles/cm³ increase in 5-day average PNC.ConclusionsOur results suggested an association between short-term PM₁₀ concentration and numbers of MI, especially for nonfatal and recurrent events. For ultrafine particles, risk increases were notably high for recurrent events. Thus, persons who already suffered a MI seemed to be more susceptible to air pollution.     

Association between PM10 concentrations and school absences in proximity of a cement plant in northern Italy

Dusts are one of the main air pollutants emitted during cement manufacturing. A substantial part of these are breathable particles that are less than 10 μm in diameter (PM₁₀), which represent a potential threat for the health of the exposed population. This study aimed at evaluating the short-term effects of PM₁₀ concentrations on the health of children, aged 6–14 years, who attended the schools in Fumane (Italy), in proximity (1.2 km) to a large cement plant. School absenteeism was used as a proxy indicator of child morbidity. Time series of daily school absences and PM₁₀ concentrations were collected for 3 school-years from 2007 to 2010 (541 school-days, 462 children on average). The associations between PM₁₀ concentrations and school absence rates in the same day (lag0) and in the following 4 days (lag1 to lag4) were evaluated using generalised additive models, smoothed for medium/long term trends and adjusted for day of the week, influenza outbreaks, daily temperature and rain precipitations. The average concentration of PM₁₀ in the period was 34 (range: 4–183) μg/m³. An average 10 μg/m³ increase of PM₁₀ concentration in the previous days (lag0–4) was associated with a statistically significant 2.5% (95%CI: 1.1–4.0%) increase in the rate of school absences. The highest increase in the absence rates (2.4%; 95%CI: 1.2–3.5%) was found 2 days after exposure (lag2). These findings provide epidemiological evidence of the acute health effects of PM₁₀ in areas with annual concentrations that are lower than the legal European Union limit of 40 μg/m³, and support the need to establish more restrictive legislative standards.     

Exposure to fine particulate matter during pregnancy and risk of term low birth weight in Jinan,China, 2014–2016

Background

Existing studies exploring the association between low birth weight (LBW) and maternal fine particulate matter (aerodynamic diameter < 2.5 μm, PM_2.5) exposure have presented equivocal results, and one of the possible reasons for this finding might be due to relatively low maternal exposures. In addition, relatively narrow maternal exposure windows to PM_2.5 have not been well established for LBW.

Waterpipe cafés are hazardous to your health: Determination of a waterpipe specific calibration factor

Introduction

The use of a waterpipe to smoke tobacco has emerged as a popular trend in the United States. Waterpipe smoking establishments have had an increasing presence in the U.S., despite smoke-free air legislation. Dangers of waterpipe smoking have been documented, but less data has been gathered about the waterpipe café itself. This project sought to determine a waterpipe-specific calibration factor (CF) for measuring waterpipe aerosol, and field-test this CF by conducting surveillance on the existing waterpipe cafés of western and central New York.

Impacto de la nueva legislación sobre tabaquismo (Ley 42/2010) en los niveles de humo ambiental de tabaco en locales de hostelería

Objective

To evaluate pollution by second-hand smoke in a sample of hospitality venues before and after the implementation of smoke-free legislation.

Methods

A cross sectional, before-after study was conducted in 2008 and 2011 after the total ban. A SidePack Aerosol monitor was used both inside and outside the hospitality venues to measure fine breathable particles (PM_2.5). A total of 43 places with pre- and post-legislation measurements were included.

Results

The median indoor pollution in hospitality venues was 204.2 μg/m³ in 2008 and 18.82 μg/m³ in 2011; the average outdoor PM_2.5 concentration was 47.04 μg/m³ in 2008 and 18.82 μg/m³ in 2011. Pollution was higher in bars and cafeterias, followed by pubs and discos. Before the law was implemented, pollution was 4.34 times higher indoors than outdoors; in 2011 the average indoor PM_2.5 concentration decreased by 90.88%.

Conclusions

Only a complete ban is able to protect workers and customers against the health risks of second-hand smoke exposure     

Can air pollution negate the health benefits of cycling and walking?

Active travel (cycling, walking) is beneficial for the health due to increased physical activity (PA). However, active travel may increase the intake of air pollution, leading to negative health consequences. We examined the risk–benefit balance between active travel related PA and exposure to air pollution across a range of air pollution and PA scenarios.The health effects of active travel and air pollution were estimated through changes in all-cause mortality for different levels of active travel and air pollution. Air pollution exposure was estimated through changes in background concentrations of fine particulate matter (PM_2.5), ranging from 5 to 200 μg/m3. For active travel exposure, we estimated cycling and walking from 0 up to 16 h per day, respectively. These refer to long-term average levels of active travel and PM_2.5 exposure.For the global average urban background PM_2.5 concentration (22 μg/m3) benefits of PA by far outweigh risks from air pollution even under the most extreme levels of active travel. In areas with PM_2.5 concentrations of 100 μg/m3, harms would exceed benefits after 1 h 30 min of cycling per day or more than 10 h of walking per day. If the counterfactual was driving, rather than staying at home, the benefits of PA would exceed harms from air pollution up to 3 h 30 min of cycling per day. The results were sensitive to dose–response function (DRF) assumptions for PM_2.5 and PA.PA benefits of active travel outweighed the harm caused by air pollution in all but the most extreme air pollution concentrations.     

Use of electronic cigarettes (e-cigarettes) impairs indoor air quality and increases FeNO levels of e-cigarette consumers

Despite the recent popularity of e-cigarettes, to date only limited data is available on their safety for both users and secondhand smokers. The present study reports a comprehensive inner and outer exposure assessment of e-cigarette emissions in terms of particulate matter (PM), particle number concentrations (PNC), volatile organic compounds (VOC), polycyclic aromatic hydrocarbons (PAH), carbonyls, and metals. In six vaping sessions nine volunteers consumed e-cigarettes with and without nicotine in a thoroughly ventilated room for two hours. We analyzed the levels of e-cigarette pollutants in indoor air and monitored effects on FeNO release and urinary metabolite profile of the subjects. For comparison, the components of the e-cigarette solutions (liquids) were additionally analyzed.During the vaping sessions substantial amounts of 1,2-propanediol, glycerine and nicotine were found in the gas-phase, as well as high concentrations of PM_2.5 (mean 197 μg/m³). The concentration of putative carcinogenic PAH in indoor air increased by 20% to 147 ng/m³, and aluminum showed a 2.4-fold increase. PNC ranged from 48,620 to 88,386 particles/cm³ (median), with peaks at diameters 24–36 nm. FeNO increased in 7 of 9 individuals. The nicotine content of the liquids varied and was 1.2-fold higher than claimed by the manufacturer.Our data confirm that e-cigarettes are not emission-free and their pollutants could be of health concern for users and secondhand smokers. In particular, ultrafine particles formed from supersaturated 1,2-propanediol vapor can be deposited in the lung, and aerosolized nicotine seems capable of increasing the release of the inflammatory signaling molecule NO upon inhalation. In view of consumer safety, e-cigarettes and nicotine liquids should be officially regulated and labeled with appropriate warnings of potential health effects, particularly of toxicity risk in children.     

Smoking increases air pollution levels in city streets: Observational and fine particulate data

IntroductionTo address the paucity of research around smokefree streets, we: (i) refined existing data collection methods; (ii) expanded on the meagre previous research in this area; and (iii) compared results by differing size of urban centre.MethodsWe refined established methods; a solo observer simultaneously observed smoking and measured fine particulate levels (PM_2.5) on a route of shopping streets in central Lower Hutt City, New Zealand.ResultsOver 33.6 h of measurement, mean fine particulate levels were 1.7 times higher when smoking was observed than when it was not (7.9 vs 4.8 μg/m³; p=0.0001).ConclusionsSmoking appeared to be a substantive contributor to fine particulate air pollution in city streets, when compared to levels adjacent to road traffic.     

Night entertainment venues comply poorly with the smoke-free law in Chile

The initial high level of compliance with the Chilean comprehensive national smoke-free law in 2013 is fading, particularly in the hospitality sector. This paper draws attention to how using a simple and low-cost surveillance inquiry may help focus on the use of scarce inspection resources to improve compliance with the law in the hospitality sector. We conducted a cross-sectional assessment of second-hand smoke exposure in night entertainment venues in Santiago, Chile, by measuring particulate matter of less than 2.5 μm (PM_2.5). Smoking where prohibited by law was observed in 36% of the venues visited. Venues where smoking was spotted at the time of the observation had a median PM_2.5 concentration 13 times higher than background concentration on the street. The study shows that a targeted approach for inspection to find pockets of venues with suboptimal compliance is feasible and affordable.     

Associations between particulate matter elements and early-life pneumonia in seven birth cohorts: Results from the ESCAPE and TRANSPHORM projects

Evidence for a role of long-term particulate matter exposure on acute respiratory infections is growing. However, which components of particulate matter may be causative remains largely unknown. We assessed associations between eight particulate matter elements and early-life pneumonia in seven birth cohort studies (N_total = 15,980): BAMSE (Sweden), GASPII (Italy), GINIplus and LISAplus (Germany), INMA (Spain), MAAS (United Kingdom) and PIAMA (The Netherlands). Annual average exposure to copper, iron, potassium, nickel, sulfur, silicon, vanadium and zinc, each respectively derived from particles with aerodynamic diameters ≤ 10 μm (PM₁₀) and 2.5 μm (PM_2.5), were estimated using standardized land use regression models and assigned to birth addresses. Cohort-specific associations between these exposures and parental reports of physician-diagnosed pneumonia between birth and two years were assessed using logistic regression models adjusted for host and environmental covariates and total PM₁₀ or PM_2.5 mass. Combined estimates were calculated using random-effects meta-analysis. There was substantial within and between-cohort variability in element concentrations. In the adjusted meta-analysis, pneumonia was weakly associated with zinc derived from PM₁₀ (OR: 1.47 (95% CI: 0.99, 2.18) per 20 ng/m³ increase). No other associations with the other elements were consistently observed. The independent effect of particulate matter mass remained after adjustment for element concentrations. In conclusion, associations between particulate matter mass exposure and pneumonia were not explained by the elements we investigated. Zinc from PM₁₀ was the only element which appeared independently associated with a higher risk of early-life pneumonia. As zinc is primarily attributable to non-tailpipe traffic emissions, these results may suggest a potential adverse effect of non-tailpipe emissions on health.     

Exposure to second-hand smoke in primary health care centres in Catalonia, Spain (2006)

The aim of this study was to assess the exposure to second-hand smoke (SHS) in 90 primary health care centres in Catalonia, Spain. We conducted a cross-sectional study between March and October 2006. We measured vapour-phase nicotine as a marker of SHS in main halls, staff rooms, direction areas, and continued care. Sampler devices were exposed for 7 days, and samples were analysed by gas chromatography/mass spectrometry. We compared the median airborne nicotine concentrations with the non-parametric test for medians by sanitary region, sampled location, affiliation to the Smoke-free Primary Health Care Programme, and urban-rural area. From 300 sampler devices installed, 4 were lost, and detectable levels of nicotine were found in 89 samples (30.0%) in 48 different centres (53.3%). The overall median was 0.01 μg/m³, with an interquartile range (IQR) of 0.01-0.07 μg/m³. Median nicotine levels by locations were: reception hall 0.01 μg/m³ (IQR: 0.01-0.06); staff room 0.01 μg/m³ (IQR: 0.01-0.08); direction area 0.01 μg/m³ (IQR: 0.01-0.01); continued care 0.01 μg/m³ (IQR: 0.01-0.07). Results showed that airborne nicotine levels were very low, with 46.7% of primary health centres being free of SHS.     

Long-range fine particulate matter from the 2002 Quebec forest fires and daily mortality in Greater Boston and New York City

During July 2002, forest fires in Quebec, Canada, blanketed the US East Coast with a plume of wood smoke. This “natural experiment” exposed large populations in northeastern US cities to significantly elevated concentrations of fine particulate matter (PM_2.5), providing a unique opportunity to test the association between daily mortality and ambient PM_2.5 levels that are uncorrelated with societal activity rhythms. We obtained PM_2.5 measurement data and mortality data for a 4-week period in July 2002 for the Greater Boston metropolitan area (which has a population of over 1.7 million people) and New York City (which has a population of over 8 million people). Daily average PM_2.5 concentrations were markedly increased for 3 days over this period, reaching as high as 63 μg/m³ for Greater Boston and 86 μg/m³ for New York City from background ambient levels of 4–48 μg/m³ in the non-smoke days. We examined temporal patterns of natural-cause deaths and 24-h ambient PM_2.5 concentrations in July 2002 and did not observe any discernible increase in daily mortality subsequent to the dramatic elevation in ambient PM_2.5 levels. Comparison to mortality rates over the same time periods in 2001 and 2003 showed no evidence of impact. Results from Poisson regression analyses suggest that 24-h ambient PM_2.5 concentrations were not associated with daily mortality. In conclusion, substantial short-term elevation in PM_2.5 concentrations from forest fire smoke were not followed by increased daily mortality in Greater Boston or New York City.     

Air quality at outdoor community events: findings from fine particulate (PM2.5) sampling at festivals in Edmonton,Alberta

Exposure to fine particulate matter (PM_2.5) is associated with a broad range of health risks. This study assessed the impacts of cooking smoke and environmental tobacco smoke on air quality at outdoor community events in Edmonton, Alberta (Canada). Data were collected at three festivals in July–August 2011 using a portable real-time airborne particle monitor. The pooled mean PM_2.5 level was 12.41?μg/m³. Peak readings varied from 52 to 1877?μg/m³. Mean PM_2.5 near food stalls was 35.42?μg/m³, which exceeds the WHO limit for 24?h exposure. Mean PM_2.5 levels with smokers present were 16.39?μg/m³ (all points) and 9.64?μg/m³ (excluding points near food stalls). Although some smokers withdrew from common spaces, on average 20 smokers/hour were observed within 3?m. Extending smoking bans would improve air quality and address related concerns. However, food preparation is a more pressing area for policy action to reduce PM_2.5 exposure at these community events.     

Chronic PM2.5 exposure and risk of infant bronchiolitis and otitis media clinical encounters

Chronic particulate matter less than 2.5 μm in diameter (PM_2.5) exposure can leave infants more susceptible to illness. Our objective is to estimate associations of the chronic PM_2.5 exposure with infant bronchiolitis and otitis media (OM) clinical encounters. We obtained all first time bronchiolitis (n = 18,029) and OM (n = 40,042) clinical encounters among children less than 12 and 36 months of age, respectively, diagnosed from 2001 to 2009 and two controls per case matched on birthdate and gestational age from the Pregnancy to Early Life Longitudinal data linkage system in Massachusetts. We applied conditional logistic regression to estimate odds ratios (OR) and confidence intervals (CI) per 2-μg/m³ increase in lifetime average satellite based PM_2.5 exposure_. Effect modification was assessed by age, gestational age, frequency of clinical encounter, and income. We examined associations between residential distance to roadways, traffic density, and infant bronchiolitis and OM risk. PM_2.5 was not associated with infant bronchiolitis (OR = 1.02, 95% CI = 1.00, 1.04) and inversely associated with OM (OR = 0.97, 95% CI = 0.95, 0.99). There was no evidence of effect modification. Compared to infants living near low traffic density, infants residing in high traffic density had elevated risk of bronchiolitis (OR = 1.23, 95% CI = 1.14, 1.31) but not OM (OR = 0.98, 95% CI = 0.93, 1.02) clinical encounter. We did not find strong evidence to support an association between early-life long-term PM_2.5 exposure and infant bronchiolitis or OM. Bronchiolitis risk was increased among infants living near high traffic density.     

Impact of personally measured pollutants on cardiac function

Epidemiological studies have shown associations between ambient air pollution and changes in heart rate variability (HRV). However, studies using personal air pollution measurements, especially with exposure averages <24 h, are still rare.Between February and March 2008 HRV data as well as personal exposure to particulate matter <2.5 μm (PM_2.5), and particle number concentrations (PNC) were collected in five volunteers for up to 8.3 h on a 5 min resolution. Information about the participant's whereabouts was also collected. Mixed models were used to analyze concurrent and up to 30 min delayed effects of air pollutants as well as being in traffic on 5 min-averages of heart rate (HR), high and low frequency power (HF and LF), standard deviation of all normal-to-normal intervals (SDNN), and the root mean square of successive interval differences (RMSSD). Results are presented as %-change from the mean per increase in interquartile range of air pollutant.In total, 474 5-min segments were available for analysis. We observed concurrent and delayed reductions in SDNN of about 0.8–1.0% in association with a 5.4 μg/m³ increase in PM_2.5. However, being in traffic by car led to an increase of about 20% 10–14 min and 15–19 min later. An increase in PM_2.5 or PNC was associated with lagged decreases for RMSSD and HF. We detected concurrent reductions in RMSSD (−17.6% [95%-confidence interval: 29.1; −4.3]) when being in traffic by bike/foot. Being in traffic by car was associated with an immediate reduction in LF while more delayed increases in LF were observed when being in traffic by bike/foot. Air pollution and traffic effects on HR were less consistent.These rapid changes in HRV within 30 min might be mediated by the autonomic nervous system in response to direct reflexes from receptors in the lungs.     

Effect of long-term exposure to air pollution on anxiety and depression in adults: A cross-sectional study

Background

The association between exposure to air pollutants and mental disorders among adults has been suggested, although results are not consistent.

Associations between ambient air pollution and bone turnover markers in 10-year old children: Results from the GINIplus and LISAplus studies

Negative associations between bone turnover markers and bone mineral density have been reported. In order to study the association between ambient air pollution and bone turnover markers, as indicators of bone loss, we investigated associations between land-use regression modeled air pollution (NO₂, PM_2.5 mass, PM_{2.5 – 10} [coarse particles], PM₁₀ mass and PM_2.5 absorbance) and bone turnover markers in 2264 children aged 10 years. Serum osteocalcin and C-terminal telopeptide of type I collagen (CTx), measured by Modular-System (Roche), were the two bone turnover markers considered in this analysis. In total population, NO₂, PM_{2.5 – 10} and PM₁₀ mass exposure were positively and significantly associated with both osteocalcin and CTx. A 2.5 (95% CI: 0.6, 4.4) ng/ml increase in osteocalcin and a 24.0 (95% CI: 6.7, 41.3) ng/L increase in CTx were observed per IQR (6.7 μg/m³) increase in NO₂, independent of socioeconomic status, sex, age, pubertal status, fasting status and total physical activity. The estimated coefficients were 3.0 (95% CI: 0.1, 5.8) for osteocalcin and 32.3 (95% CI: 6.1, 58.5) for CTx with PM_{2.5 – 10}; 3.2 (95% CI: 0.0, 6.4) for osteocalcin and 30.7 (95% CI: 1.7, 59.7) for CTx with PM₁₀. Children living close to a major road (≤ 350 m) had higher levels of both osteocalcin (1.4 [−1.2, 4.0] ng/ml) and CTx (16.2 [−7.4, 39.8] ng/L). The adverse impact of ambient air pollution on bone turnover rates observed in one of the study areas showed stimulation of more such studies.