Long-term associations of morbidity with air pollution: A catalog and synthesis

I searched the National Institutes of Health MEDLINE database through January 2017 for long-term studies of morbidity and air pollution and cataloged them with respect to cardiovascular, respiratory, cancer, diabetes, hospitalization, neurological, and pregnancy-birth endpoints. The catalog is presented as an online appendix. Associations with PM_2.5 (particulate matter with an aerodynamic diameter <2.5 μm), PM₁₀ (PM with an aerodynamic diameter <10 μm), and nitrogen dioxide (NO₂) were evaluated most frequently among the 417 ambient air quality studies identified. Associations with total suspended particles (TSP), carbon, ozone, sulfur, vehicular traffic, radon, and indoor air quality were also reported. I evaluated each study in terms of pollutant significance (yes, no), duration of exposure, and publication date. I found statistically significant pollutant relationships (P < 0.05) in 224 studies; 220 studies indicated adverse effects. Among 795 individual pollutant effect estimates, 396 are statistically significant. Pollutant associations with cardiovascular indicators, lung function, respiratory symptoms, and low birth weight are more likely to be significant than with disease incidence, heart attacks, diabetes, or neurological endpoints. Elemental carbon (EC), traffic, and PM_2.5 are most likely to be significant for cardiovascular outcomes; TSP, EC, and ozone (O₃) for respiratory outcomes; NO₂ for neurological outcomes; and PM₁₀ for birth/pregnancy outcomes. Durations of exposure range from 60 days to 35 yr, but I found no consistent relationships with the likelihood of statistical significance. Respiratory studies began ca. 1975; studies of diabetes, cardiovascular, and neurological effects increased after about 2005. I found 72 studies of occupational air pollution exposures; 40 reported statistically significant adverse health effects, especially for respiratory conditions. I conclude that the aggregate of these studies supports the existence of nonlethal physiological effects of various pollutants, more so for non–life-threatening endpoints and for noncriteria pollutants (TSP, EC, PM_2.5 metals). However, most studies were cross-sectional analyses over limited time spans with no consideration of lag or disease latency. Further longitudinal studies are thus needed to investigate the progress of disease incidence in association with air pollution exposure.

Implications: Relationships of air pollution with excess mortality are better known than with long-term antecedent morbidity. I cataloged 489 studies of cardiovascular, respiratory, cancer, and neurological effects, diabetes, and birth outcomes with respect to 12 air pollutants. About half of the studies reported statistically significant relationships, more frequently with noncriteria than with criteria pollutants. Indoor and cumulative exposures, coarse or ultrafine particles, and organic carbon were seldom considered. Significant relationships were more likely with less-severe endpoints such as blood pressure, lung function, or respiratory symptoms than with incidence of cancer, chronic obstructive pulmonary disease (COPD), heart failure, or diabetes. Most long-term studies are based on spatial relationships; longitudinal studies are needed to link the progression of pollution-related morbidity to mortality, especially for the cardiovascular system.     

Particulate matter air pollution and respiratory impact on humans and animals

Air pollution is now fully acknowledged to be a public health problem and a social issue. Particulate matter (PM) concentration has been linked with several clinical manifestations of pulmonary and cardiovascular diseases and is associated with morbidity and mortality induced by respiratory diseases both in human and animals. Current research on airborne particle-induced health effects investigates the critical characteristics of particulate matter that determine their biological effects. Scientific evidence assessed that the size of the airborne particles and their surface area determine the potential to elicit inflammatory injury, oxidative damage, and other biological effects. Thus, the present review paper aims to summarize the current evidences and findings on the effect of air pollution on lung function in both humans and animals.     

Respiratory health of road-side vendors in a large industrialized city

GOAL, SCOPE AND BACKGROUND: The literature reports a high prevalence of respiratory symptoms associated with exposure to motor vehicle exhaust emissions and people exposed to vehicle emissions are at risk of reduced lung function and cardiovascular performance. Although the effect of traffic emissions is a known risk to respiratory health, retailers are often situated along major roads in a busy urban environment to maximise customers. Shop assistants in an air-conditioned environment should be less exposed to traffic fumes and their lung function should be better preserved compared to 'unprotected' vendors exposed directly to vehicle emissions. The lung function of these two groups of workers has not previously been compared. The aims of this study are to determine if there is a difference in the concentration of respirable particles of diameter less than 10 micrometers (PM10) inside and outside air-conditioned shops along a busy major road; and to compare the lung function parameters, blood lead levels and respiratory symptoms between road-side vendors directly 'exposed' to traffic fumes and vendors working in 'protected' air-conditioned shops along the same road. METHODS: Roadside vendors (n=33) and adjacent shop assistants (n=31) were recruited for the study in a district known to have high emissions and pollution measures. All subjects were asked to complete a questionnaire providing the frequency of their respiratory symptoms. Spirometry pulmonary function tests were conducted and exhaled carbon monoxide levels (ECO), oxygen saturation and blood lead levels (BLL) were measured. PM10 level was concurrently measured in the subject's working environment. Pulmonary function data and ECO levels collected from a cohort of university staff aged > or = 30 years (n=92) at a university campus were included for comparison. RESULTS: The concentration of particulate matter (PM10) at the roadside (210 +/- 70 microg/m3) was significantly higher than inside the shops (130 +/- 40 microg/m3). There was no difference in lung function parameters or BLL between the groups, however the forced vital capacity of both groups of vendors was significantly lower than a 'control' cohort of academic institution personnel (n=92). DISCUSSION: This study illustrated that while the level of pollution improved with air conditioning, this may not be sufficient to prevent respiratory consequences. Our data suggests that a reduction in occupational exposure is not enough to protect these workers. CONCLUSIONS: Air-conditioned work environment is insufficient to protect the respiratory system against the adverse effects of exposure to vehicle emissions. RECOMMENDATIONS: The overwhelming effect of exposure during travel to and from work and at home cannot be underestimated. More stringent guidelines to control pollution appear necessary to protect the respiratory health of both shop-keepers and road-side vendors and further studies to explore the effect on respiratory health of the exposure to pollutants associated with commuting to and from work are warranted.     

Air pollutants and health outcomes: Assessment of confounding by influenza

We assessed confounding of associations between short-term effects of air pollution and health outcomes by influenza using Hong Kong mortality and hospitalization data for 1996–2002.Three measures of influenza were defined: (i) intensity: weekly proportion of positive influenza viruses, (ii) epidemic: weekly number of positive influenza viruses ≥4% of the annual number for ≥2 consecutive weeks, and (iii) predominance: an epidemic period with co-circulation of respiratory syncytial virus <2% of the annual positive isolates for ≥2 consecutive weeks. We examined effects of influenza on associations between nitrogen dioxide (NO₂), sulfur dioxide (SO₂), particulate matter with aerodynamic diameter ≤10 μm (PM₁₀) and ozone (O₃) and health outcomes including all natural causes mortality, cardiorespiratory mortality and hospitalization. Generalized additive Poisson regression model with natural cubic splines was fitted to control for time-varying covariates to estimate air pollution health effects. Confounding with influenza was assessed using an absolute difference of >0.1% between unadjusted and adjusted excess risks (ER%).Without adjustment, pollutants were associated with positive ER% for all health outcomes except asthma and stroke hospitalization with SO₂ and stroke hospitalization with O₃. Following adjustment, changes in ER% for all pollutants were <0.1% for all natural causes mortality, but >0.1% for mortality from stroke with NO₂ and SO₂, cardiac or heart disease with NO₂, PM₁₀ and O₃, lower respiratory infections with NO₂ and O₃ and mortality from chronic obstructive pulmonary disease with all pollutants. Changes >0.1% were seen for acute respiratory disease hospitalization with NO₂, SO₂ and O₃ and acute lower respiratory infections hospitalization with PM₁₀. Generally, influenza does not confound the observed associations of air pollutants with all natural causes mortality and cardiovascular hospitalization, but for some pollutants and subgroups of cardiorespiratory mortality and respiratory hospitalization there was evidence to suggest confounding by influenza.     

Prioritizing research for trace pollutants and emerging contaminants in the freshwater environment

Organic chemicals have been detected at trace concentrations in the freshwater environment for decades. Though the term trace pollutant indicates low concentrations normally in the nanogram or microgram per liter range, many of these pollutants can exceed an acceptable daily intake (ADI) for humans. Trace pollutants referred to as emerging contaminants (ECs) have recently been detected in the freshwater environment and may have adverse human health effects. Analytical techniques continue to improve; therefore, the number and frequency of detections of ECs are increasing. It is difficult for regulators to restrict use of pollutants that are a human health hazard; scientists to improve treatment techniques for higher priority pollutants; and the public to modify consumption patterns due to the vast number of ECs and the breadth of literature on the occurrence, use, and toxicity. Hence, this paper examines literature containing occurrence and toxicity data for three broad classes of trace pollutants and ECs (industrials, pesticides, and pharmaceuticals and personal care products (PPCPs)), and assesses the relevance of 71 individual compounds. The evaluation indicates that widely used industrials (BPF) and PPCPs (AHTN, HHCB, ibuprofen, and estriol) occur frequently in samples from the freshwater environment but toxicity data were not available; thus, it is important to establish their ADI. Other widely used industrials (BDE-47, BDE-99) and pesticides (benomyl, carbendazim, aldrin, endrin, ethion, malathion, biphenthrin, and cypermethrin) have established ADI values but occurrence in the freshwater environment was not well documented. The highest priority pollutants for regulation and treatment should include industrials (PFOA, PFOS and DEHP), pesticides (diazinon, methoxychlor, and dieldrin), and PPCPs (EE2, carbamazepine, βE2, DEET, triclosan, acetaminophen, and E1) because they occur frequently in the freshwater environment and pose a human health hazard at environmental concentrations.     

Impact of the composition of combustion generated fine particles on epithelial cell toxicity: influences of metals on metabolism

Inhaled airborne particulate matter (PM) represents a potentially significant health hazard to humans. Exposure to PM strongly correlates with pulmonary inflammation and incidences of severe respiratory distress, including increased hospital admissions for breathing disorders, asthma, emphysema, and chronic bronchitis. PM generated from the combustion of fuel oils and coals contain a number of water-soluble transition metals including Fe, V, and Zn.

We have evaluated the impact of PM types with varying composition collected from the combustion of oils and coals on the health and metabolism of lung cell cultures. Three colorimetric assays (sulforhodamine B (SRB), Janus green, and MTT) have been adapted to quantify the impact of PM on rat lung alveolar type II epithelial cells (RLE-6TN cells). The PM toxicity metrics evaluated were inhibition of cell proliferation (SRB and Janus green) and inhibition of cellular metabolism (MTT). Cell proliferation is inhibited in a consistent dose-dependent manner by PM concentrations from 25 to 250 μg/ml. At a level of 100 μg/ml, oil-derived PM diminishes cell metabolism by as much as 40% relative to controls; the degree of inhibition is strongly dependent on PM particle size and metal content. Conversely, coal-derived PM at the same dosage diminishes cell metabolism by no more than 20% relative to controls. All three assays provide highly repeatable results and consistent toxicity rankings of the PMs evaluated. Overall, metabolic inhibition as measured by the MTT assay was deemed the most appropriate metric for PM toxicity, primarily due to its applicability with in vivo-like confluent cell monolayers.     

Characterization of major chemical components of fine particulate matter in North Carolina

This paper presents measurements of daily sampling of fine particulate matter (PM2.5) and its major chemical components at three urban and one rural locations in North Carolina during 2002. At both urban and rural sites, the major insoluble component of PM2.5 is organic matter, and the major soluble components are sulfate (SO4(2-)), ammonium (NH4(+)), and nitrate (NO3(-)). NH4(+) is neutralized mainly by SO4(2-) rather than by NO3(-), except in winter when SO4(2-) concentration is relatively low, whereas NO3(-) concentration is high. The equivalent ratio of NH4(+) to the sum of SO4(2-) and NO3(-) is < 1, suggesting that SO4(2-) and NO3(-) are not completely neutralized by NH4(+). At both rural and urban sites, SO4(2-) concentration displays a maximum in summer and a minimum in winter, whereas NO3(-) displays an opposite seasonal trend. Mass ratio of NO3(-) to SO4(2-) is consistently < 1 at all sites, suggesting that stationary source emissions may play an important role in PM2.5 formation in those areas. Organic carbon and elemental carbon are well correlated at three urban sites although they are poorly correlated at the agriculture site. Other than the daily samples, hourly samples were measured at one urban site. PM2.5 mass concentrations display a peak in early morning, and a second peak in late afternoon. Back trajectory analysis shows that air masses with lower PM2.5 mass content mainly originate from the marine environment or from a continental environment but with a strong subsidence from the upper troposphere. Air masses with high PM2.5 mass concentrations are largely from continental sources. Our study of fine particulate matter and its chemical composition in North Carolina provides crucial information that may be used to determine the efficacy of the new National Ambient Air Quality Standard (NAAQS) for PM fine. Moreover, the gas-to-particle conversion processes provide improved prediction of long-range transport of pollutants and air quality.     

Fine particulate matter alters the microecology of the murine respiratory tract

Fine particulate matter is a global challenge to human health. We investigated the effects and potential mechanisms of fine particulate matter on respiratory tract microecology in a lung injury mouse model. BALB/c mice were randomized into exposed and control groups. We found that the levels of soluble tumor necrosis factor receptor I was increased following the PM2.5 exposure. 16S rRNA sequencing of respiratory tract lavage fluid confirmed that the composition of the respiratory tract microecology was altered by the exposure. Lactobacillus was the most abundant of bacterial species present. Collectively, these results establish a link between exposure to fine particulate matter and alterations to the respiratory tract microecology. Elucidation of the underlying mechanisms may lead to treatment strategies in lung injury.

     

Association between air quality and quality of life

Air quality—or its converse, air pollution—is a significant risk factor for human health. Recent studies have reported association between air pollution and human health. There are numerous diseases that may be caused by air pollution such as respiratory infection, lung cancer, cardiovascular disease, chronic obstructive pulmonary disease, and asthma. In this study, the relationship between air quality and quality of life was examined by using canonical correlation analysis. Data of this study was collected from 27 countries. WHO statistics were used as the main source of quality of life data set (Y variables set). European Environment Agency statistics and (for outdoor air-PM10) WHO statistics were used as the main source of air quality data set (X variables set). It is found that there are significant positive correlation between air quality and quality of life.     

The state of ambient air quality in Pakistan—a review

Background and purpose  

Pakistan, during the last decade, has seen an extensive escalation in population growth, urbanization, and industrialization, together with a great increase in motorization and energy use. As a result, a substantial rise has taken place in the types and number of emission sources of various air pollutants. However, due to the lack of air quality management capabilities, the country is suffering from deterioration of air quality. Evidence from various governmental organizations and international bodies has indicated that air pollution is a significant risk to the environment, quality of life, and health of the population. The Government has taken positive steps toward air quality management in the form of the Pakistan Clean Air Program and has recently established a small number of continuous monitoring stations. However, ambient air quality standards have not yet been established. This paper reviews the data being available on the criteria air pollutants: particulate matter (PM), sulfur dioxide, ozone, carbon monoxide, nitrogen dioxide, and lead.     

Monitoring of sources and atmospheric processes controlling air quality in an urban Mediterranean environment

Different monitoring parameters (PM mass concentrations, number–size distribution, black carbon, gaseous pollutants, and chemical composition, among others) are currently used in air quality studies. Urban aerosols are the result of several sources and atmospheric processes, which suggests that a single monitoring technique is insufficient to quantitatively evaluate all of them.This study assesses the suitability of a number of monitoring techniques (PM mass concentrations, number and size distribution of ultra-fine particles, levels of gaseous pollutants, and a complete chemical characterization of PM₁₀ and PM_2.5) by examining the response of those techniques to the different emission sources and/or atmospheric processes affecting an urban Mediterranean area (Barcelona, NE Spain).The results of this work reveal that the PM mass, the number concentration and the chemical composition give different, but complementary, information. Whereas the mineral matter, a key atmospheric aerosol component across the Mediterranean, is not properly quantitatively assessed by measuring sub-micrometric particles, the monitoring of the number concentration is indispensable to interpret the origin of specific aerosol episodes. Furthermore, the chemical composition yields very relevant information to deduce the causes of specific pollution episodes.The number concentration of ultra-fine particles in urban areas is strongly dependent upon vehicle exhaust emissions, which may cause adverse health impacts. Moreover, urban Mediterranean environments are favourable to produce nucleation-mode particles (<20 nm) with photochemical origin. In those cases, these particles are expected to be of high solubility and consequently their toxicity may differ from that of traffic-generated ultra-fine particles. Thus, the use of a single monitoring parameter to evaluate the health effects seems to be not enough.     

Windsor, Ontario exposure assessment study: design and methods validation of personal, indoor, and outdoor air pollution monitoring

The Windsor, Ontario Exposure Assessment Study evaluated the contribution of ambient air pollutants to personal and indoor exposures of adults and asthmatic children living in Windsor, Ontario, Canada. In addition, the role of personal, indoor, and outdoor air pollution exposures upon asthmatic children's respiratory health was assessed. Several active and passive sampling methods were applied, or adapted, for personal, indoor, and outdoor residential monitoring of nitrogen dioxide, volatile organic compounds, particulate matter (PM; PM < or = 2.5 microm [PM2.5] and < or = 10 microm [PM10] in aerodynamic diameter), elemental carbon, ultrafine particles, ozone, air exchange rates, allergens in settled dust, and particulate-associated metals. Participants completed five consecutive days of monitoring during the winter and summer of 2005 and 2006. During 2006, in addition to undertaking the air pollution measurements, asthmatic children completed respiratory health measurements (including peak flow meter tests and exhaled breath condensate) and tracked respiratory symptoms in a diary. Extensive quality assurance and quality control steps were implemented, including the collocation of instruments at the National Air Pollution Surveillance site operated by Environment Canada and at the Michigan Department of Environmental Quality site in Allen Park, Detroit, MI. During field sampling, duplicate and blank samples were also completed and these data are reported. In total, 50 adults and 51 asthmatic children were recruited to participate, resulting in 922 participant days of data. When comparing the methods used in the study with standard reference methods, field blanks were low and bias was acceptable, with most methods being within 20% of reference methods. Duplicates were typically within less than 10% of each other, indicating that study results can be used with confidence. This paper covers study design, recruitment, methodology, time activity diary, surveys, and quality assurance and control results for the different methods used.     

Effects of instrument precision and spatial variability on the assessment of the temporal variation of ambient air pollution in Atlanta, Georgia

Data from the U.S. Environmental Protection Agency Air Quality System, the Southeastern Aerosol Research and Characterization database, and the Assessment of Spatial Aerosol Composition in Atlanta database for 1999 through 2002 have been used to characterize error associated with instrument precision and spatial variability on the assessment of the temporal variation of ambient air pollution in Atlanta, GA. These data are being used in time series epidemiologic studies in which associations of acute respiratory and cardiovascular health outcomes and daily ambient air pollutant levels are assessed. Modified semivariograms are used to quantify the effects of instrument precision and spatial variability on the assessment of daily metrics of ambient gaseous pollutants (SO2, CO, NOx, and O3) and fine particulate matter ([PM2.5] PM2.5 mass, sulfate, nitrate, ammonium, elemental carbon [EC], and organic carbon [OC]). Variation because of instrument imprecision represented 7-40% of the temporal variation in the daily pollutant measures and was largest for the PM2.5 EC and OC. Spatial variability was greatest for primary pollutants (SO2, CO, NOx, and EC). Population-weighted variation in daily ambient air pollutant levels because of both instrument imprecision and spatial variability ranged from 20% of the temporal variation for O3 to 70% of the temporal variation for SO2 and EC. Wind     

Comparative health impact assessment of local and regional particulate air pollutants in Scandinavia

The ongoing program Clean Air for Europe (CAFE) is an initiative from the EU Commission to establish a coordinated effort to reach better air quality in the EU. The focus is on particulate matter as it has been shown to have large impact on human health. CAFE requested that WHO make a review of the latest findings on air pollutants and health to facilitate assessments of the different air pollutants and their health effects. The WHO review project on health aspects of air pollution in Europe confirmed that exposure to particulate matter (PM), despite the lower levels we face today, still poses a significant risk to human health. Using the recommended uniform risk coefficients for health impact assessment of PM, regardless of sources, premature mortality related to long-range transported anthropogenic particles has been estimated to be about 3500 deaths per year for the Swedish population, corresponding to a reduction in life expectancy of up to about seven months. The influence of local sources is more difficult to estimate due to large uncertainties when linking available risk coefficients to exposure data, but the estimates indicate about 1800 deaths brought forward each year with a life expectancy reduction of about 2-3 months. However, some sectors of the population are exposed to quite high locally induced concentrations and are likely to suffer excessive reductions in life expectancy. Since the literature increasingly supports assumptions that combustion related particles are associated with higher relative risks, further studies may shift the focus for abatement strategies. CAFE sets out to establish a general cost effective abatement strategy for atmospheric particles. Our results, based on studies of background exposure, show that long-range transported sulfate rich particles dominate the health effects of PM in Sweden. The same results would be found for the whole of Scandinavia and many countries influenced by transboundary air pollution. However, several health studies, including epidemiological studies with a finer spatial resolution, indicate that engine exhaust particles are more damaging to health than other particles. These contradictory findings must be understood and source specific risk estimates have to be established by expert bodies, otherwise it will not be possible to find the most cost effective abatement strategy for Europe. We are not happy with today's situation where every strategy to reduce PM concentrations is estimated to have the same impact per unit change in the mass concentration. Obviously there is a striking need to introduce more specific exposure variables and a higher geographical resolution in epidemiology as well as in health impact assessments.     

An analysis of effects of San Diego wildfire on ambient air quality

The impact of major gaseous and particulate pollutants emitted by the wildfire of October 2003 on ambient air quality and health of San Diego residents before, during, and after the fire are analyzed using data available from the San Diego County Air Pollution Control District and California Air Resources Board. It was found that fine particulate matter (PM) levels exceeded the federal daily 24-hr average standard during the fire. There was a slight increase in some of the gaseous pollutants, such as carbon monoxide, which exceeded federal standards. Ozone (O3) precursors, such as total hydrocarbons and methane gases, experienced elevated concentration during the fire. Fortunately, the absence of sunlight because of the cloud of thick smoke that covered most of the county during the fire appears to have prevented the photochemical conversion of the precursor gases to harmful concentrations of O3. Statistical analysis of the compiled medical surveillance data has been used to establish correlations between pollutant levels in the region and the resultant health problems experienced by the county citizens. The study shows that the increased PM concentration above the federal standard resulted in a significant increase in hospital emergency room visits for asthma, respiratory problems, eye irritation, and smoke inhalation. On the basis of the findings, it is recommended that hospitals and emergency medical facilities engage in pre-event planning that would ensure a rapid response to an impact on the healthcare system as a result of a large wildfire and appropriate agencies engage in the use of all available meteorological forecasting resources, including real-time satellite imaging assets, to accurately forecast air quality and assist firefighting efforts.     

Windsor, Ontario exposure assessment study: design and methods validation of personal, indoor, and outdoor air pollution monitoring

The Windsor, Ontario Exposure Assessment Study evaluated the contribution of ambient air pollutants to personal and indoor exposures of adults and asthmatic children living in Windsor, Ontario, Canada. In addition, the role of personal, indoor, and outdoor air pollution exposures upon asthmatic children's respiratory health was assessed. Several active and passive sampling methods were applied, or adapted, for personal, indoor, and outdoor residential monitoring of nitrogen dioxide, volatile organic compounds, particulate matter (PM; PM-2.5 pm [PM2.5] and < or =10 microm [PM10] in aerodynamic diameter), elemental carbon, ultrafine particles, ozone, air exchange rates, allergens in settled dust, and particulate-associated metals. Participants completed five consecutive days of monitoring during the winter and summer of 2005 and 2006. During 2006, in addition to undertaking the air pollution measurements, asthmatic children completed respiratory health measurements (including peak flow meter tests and exhaled breath condensate) and tracked respiratory symptoms in a diary. Extensive quality assurance and quality control steps were implemented, including the collocation of instruments at the National Air Pollution Surveillance site operated by Environment Canada and at the Michigan Department of Environmental Quality site in Allen Park, Detroit, MI. During field sampling, duplicate and blank samples were also completed and these data are reported. In total, 50 adults and 51 asthmatic children were recruited to participate, resulting in 922 participant days of data. When comparing the methods used in the study with standard reference methods, field blanks were low and bias was acceptable, with most methods being within 20% of reference methods. Duplicates were typically within less than 10% of each other, indicating that study results can be used with confidence. This paper covers study design, recruitment, methodology, time activity diary, surveys, and quality assurance and control results for the different methods used.     

A review of the impact of fireworks on particulate matter in ambient air

To determine the impact of fireworks (FW) and firecrackers (FC) on particulate matter (PM) in ambient air, we reviewed evidence related to ambient PM during FW/FC periods; specifically, PM concentration, size, morphology, chemical components, including water-soluble ions and trace metals, and associated human health risks caused by exposure to FW/FC PM were reviewed. A large body of research suggests that outdoor ambient PM levels increase significantly during FW/FC displays. Furthermore, FW/FC PM remains suspended in the air, contributing to high PM concentrations for a long period. Increased PM from burning FW and FC mainly comprises fine and ultrafine spherical particles. Elevated levels of various trace metals, ions, elemental carbon (EC), organic carbon (OC), and organics in PM are present during FW/FC periods.Implications: Unique physical and chemical properties of ambient PM during short-term FW/FC burning can lead to a substantial increase in adverse health effects compared with during non-FW/FC periods. Further epidemiological and toxicological research into the potential health effects resulting from exposure to various pollutants from FW/FC is vital. Geographical distributions of PM concentrations during FW displays highlight the importance of implementing PM controls at the regional level and formulating stricter protective environmental legislation, particularly in Asian (e.g., India, China, or Taiwan) where festivals are not the only periods celebrated with FW/FC.     

Lung bioaccessibility of contaminants in particulate matter of geological origin

Human exposure to particulate matter (PM) has been associated with adverse health effects. While inhalation exposure to airborne PM is a prominent research subject, exposure to PM of geological origin (i.e., generated from soil/soil-like material) has received less attention. This review discusses the contaminants in PM of geological origin and their relevance for human exposure and then evaluates lung bioaccessibility assessment methods and their use. PM of geological origin can contain toxic elements as well as organic contaminants. Observed/predicted PM lung clearance times are long, which may lead to prolonged contact with lung environment. Thus, certain exposure scenarios warrant the use of in vitro bioaccessibility testing to predict lung bioavailability. Limited research is available on lung bioaccessibility test development and test application to PM of geological origin. For in vitro tests, test parameter variation between different studies and concerns about physiological relevance indicate a crucial need for test method standardization and comparison with relevant animal data. Research is recommended on (1) developing robust in vitro lung bioaccessibility methods, (2) assessing bioaccessibility of various contaminants (especially polycyclic aromatic hydrocarbons (PAHs)) in PM of diverse origin (surface soils, mine tailings, etc.), and (3) risk characterization to determine relative importance of exposure to PM of geological origin.     

Air Quality Criteria—Toxicological Appraisal for Oxidants,Nitrogen Oxides,and Hydrocarbons

The ultimate aim of toxicological studies is to determine the effects of pollutants on the health and welfare of human beings. To get this it is essential to conduct animal studies to evaluate the potential toxicity of different pollutants. Toxicological appraisal of the photochemical oxidant type of air pollution shows: (1) The effects are primarily on the lungs and the senses. (2) There is impairment of pulmonary function in humans at concentrations found in polluted air. (3) Both ozone and nitrogen dioxide tend to oxidize in animals the lung tissue for a time. This process creates agents which have the potential for cross-linking structural proteins, and this process initiates inflammation which accelerates cell turnover rates. Both crosslinking and cell turnover rates are factors in aging, which may thus be accelerated by years of repeated exposure to oxidants. (4) Long-term exposure to low levels of nitrogen dioxide can produce pre-emphasematous lesions in the lungs of rats and mice. Studies with other species are needed. (5) Ozone, nitrogen dioxide, and dilute irradiated car exhausts increase susceptibility to respiratory infection.

The constant search for more sophisticated and sensitive techniques to detect subtle changes indicative of pre-disease conditions should not be relaxed. Such techniques will provide chronic disease predictors of great relevance as air quality criteria.