Seasonal variation in outdoor,indoor, and personal air pollution exposures of women using wood stoves in the Tibetan Plateau: Baseline assessment for an energy intervention study

Cooking and heating with coal and biomass is the main source of household air pollution in China and a leading contributor to disease burden. As part of a baseline assessment for a household energy intervention program, we enrolled 205 adult women cooking with biomass fuels in Sichuan, China and measured their 48-h personal exposure to fine particulate matter (PM_2.5) and carbon monoxide (CO) in winter and summer. We also measured the indoor 48-h PM_2.5 concentrations in their homes and conducted outdoor PM_2.5 measurements during 101 (74) days in summer (winter). Indoor concentrations of CO and nitrogen oxides (NO, NO₂) were measured over 48-h in a subset of ~ 80 homes. Women's geometric mean 48-h exposure to PM_2.5 was 80 μg/m³ (95% CI: 74, 87) in summer and twice as high in winter (169 μg/m³ (95% CI: 150, 190), with similar seasonal trends for indoor PM_2.5 concentrations (winter: 252 μg/m³; 95% CI: 215, 295; summer: 101 μg/m³; 95% CI: 91, 112). We found a moderately strong relationship between indoor PM_2.5 and CO (r = 0.60, 95% CI: 0.46, 0.72), and a weak correlation between personal PM_2.5 and CO (r = 0.41, 95% CI: − 0.02, 0.71). NO₂/NO ratios were higher in summer (range: 0.01 to 0.68) than in winter (range: 0 to 0.11), suggesting outdoor formation of NO₂ via reaction of NO with ozone is a more important source of NO₂ than biomass combustion indoors. The predictors of women's personal exposure to PM_2.5 differed by season. In winter, our results show that primary heating with a low-polluting fuel (i.e., electric stove or wood-charcoal) and more frequent kitchen ventilation could reduce personal PM_2.5 exposures. In summer, primary use of a gaseous fuel or electricity for cooking and reducing exposure to outdoor PM_2.5 would likely have the greatest impacts on personal PM_2.5 exposure.     

Personal monitoring for nitrogen dioxide exposure: Methodological considerations for a community study

Personal exposure to nitrogen dioxide (NO₂) and time spent in various locations were measured for 66 family members from 19 homes in the Portage, WI area during March 1981. Passive diffusion NO₂ monitors were placed outdoors, in the kitchen, and in one bedroom on each floor of the homes, and were worn by family members. Individuals from gas-cooking homes had significantly higher average NO₂ exposures than those from homes using electricity for cooking (mean difference 19.37 μg/m³). Personal exposures were more closely related to bedroom levels than to kitchen or outdoor concentrations for both cooking fuel groups. Several preliminary models are presented which relate average personal NO₂ exposure to indoor and ambient levels, and also to the proportion of time spent in different locations. These models are capable of explaining nearly 90% of the variation about the mean in personal exposure.     

Personal exposure monitoring to nitrogen dioxide

Measurement of personal exposure to nitrogen dioxide for short and long term was made with a sensitive NO₂ passive sampler by volunteer housewives and office workers in different seasons. These measurements were compared with the simultaneous measurement of outdoor and indoor concentration of the participants. A common result over all the measurements is the potential effect of using an unvented space heater to increase personal exposure. Mean personal exposure and indoor concentration are higher than outdoor levels elevated by the samples exposed to pollutant produced from the heater. Without an NO₂ source indoors, the mean outdoor concentrations are always highest among the data of measurement. A time-weighted indoor/outdoor activity model gives modestly improved estimates of personal exposure over those predicted from measured indoor concentrations alone.     

Estimation of exposure to atmospheric pollutants during pregnancy integrating space–time activity and indoor air levels: Does it make a difference?

Studies of air pollution effects during pregnancy generally only consider exposure in the outdoor air at the home address. We aimed to compare exposure models differing in their ability to account for the spatial resolution of pollutants, space–time activity and indoor air pollution levels. We recruited 40 pregnant women in the Grenoble urban area, France, who carried a Global Positioning System (GPS) during up to 3 weeks; in a subgroup, indoor measurements of fine particles (PM_2.5) were conducted at home (n = 9) and personal exposure to nitrogen dioxide (NO₂) was assessed using passive air samplers (n = 10). Outdoor concentrations of NO₂, and PM_2.5 were estimated from a dispersion model with a fine spatial resolution. Women spent on average 16 h per day at home. Considering only outdoor levels, for estimates at the home address, the correlation between the estimate using the nearest background air monitoring station and the estimate from the dispersion model was high (r = 0.93) for PM_2.5 and moderate (r = 0.67) for NO₂. The model incorporating clean GPS data was less correlated with the estimate relying on raw GPS data (r = 0.77) than the model ignoring space–time activity (r = 0.93). PM_2.5 outdoor levels were not to moderately correlated with estimates from the model incorporating indoor measurements and space–time activity (r = − 0.10 to 0.47), while NO₂ personal levels were not correlated with outdoor levels (r = − 0.42 to 0.03). In this urban area, accounting for space–time activity little influenced exposure estimates; in a subgroup of subjects (n = 9), incorporating indoor pollution levels seemed to strongly modify them.     

Relationships among personal,indoor and outdoor NO2 measurements

Using integrating NO₂ diffusion dosimeters, personal, indoor and outdoor exposures were measured for nine families in Topeka, Kansas. NO₂ exposures in homes that used gas for cooking were clearly different from those in homes that used electricity. The gas-cooking homes had indoor levels three times the outdoor levels. Members of the gas-cooking households had levels twice those of electric-cooking families and twice the outdoor levels. A linear model that includes outdoor concentrations and stove types explains 77% of the variance in observed NO₂ exposure. The differential NO₂ exposures in homes with and without gas stoves should be considered in epidemiologic studies of the health effects of air pollution.     

A badge-type personal sampler for measurement of personal exposure to NO2 and NO in ambient air

A badge-type personal sampler was developed for measuring personal exposure to nitrogen dioxide (NO₂). An absorbent sheet containing triethanolamine (TEA) solution absorbed NO₂ which diffused through five layers of hydrophobic fiber filter. Wind effects on absorption rate were suppressed by these filter layers. NO₂ was measured by the sampler with a sensitivity of 124.8 μg h/m³ (66 ppb h) and an accuracy of within ± 20%. It could be used for measuring personal exposure to NO₂ without interfering with the wearer's daily activities. Nitric oxide (NO) could be measured after a small modification to the sampler provided oxidation ability to the layers of diffusion filter. Three layers of hydrophobic fiber filter were replaced by 12 layers of glass fiber filter containing chromium trioxide solution. NO was oxidized to NO₂ in the oxidation layers and absorbed by the absorbent sheet together with the coexisting NO₂. Sensitivity and accuracy of the sampler for NO were nearly equal to that for NO₂.     

Introduction to and experimental conditions during the first year of the GMR chronic inhalation studies of diesel exhaust

A chronic exposure study was initiated to determine the effects of diesel exhaust on the health of experimental animals. For this purpose, test atmospheres of clean air (control) or freshly diluted diesel exhaust at concentrations of 250, 750, and 1500 μg/m³ were supplied to four 12.6 m³ inhalation chambers which housed rats and guinea pigs. Diesel aerosol size and concentration, as well as chamber temperature and relative humidity, were continually monitored and controlled to maintain the exposure dose levels and an environment of 22±2°C and 50%±20% relative humidity. The concentrations of CO and NO_x were found to be 5.8±1.0 mg/m³ and 7.9±1.0 mg/m³ above ambient in the chamber containing 1500 μg/m³ of particulate. Animals were supplied from the chambers, on a random basis, for both intramural and extramural studies throughout the exposure period. The experiment ran uninterrupted for over twelve months with mean diesel particle mass concentrations within 2% of the target values.     

Detection of fluorotelomer alcohols in indoor environments and their relevance for human exposure

Fluorotelomer alcohols (FTOH) are important precursors of perfluorinated carboxylic acids (PFCA). These neutral and volatile compounds are frequently found in indoor air and may contribute to the overall human exposure to per- and polyfluorinated alkyl substances (PFAS). In this study air samples of ten workplace environments and a car interior were analysed. In addition, extracts and emissions from selected outdoor textiles were analysed in order to establish their potential contribution to the indoor levels of the above-mentioned compounds.Concentrations of FTOHs measured in air ranged from 0.15 to 46.8, 0.25 to 286, and 0.11 to 57.5 ng/m³ for 6:2, 8:2 and 10:2 FTOHs, respectively. The highest concentrations in air were identified in shops selling outdoor clothing, indicating outdoor textiles to be a relevant source of FTOH in indoor workplace environments. Total amounts of FTOH in materials of outdoor textiles accounted for < 0.8–7.6, 12.1–180.9 and 4.65–105.7 μg/dm² for 6:2, 8:2 and 10:2 FTOHs, respectively. Emission from selected textiles revealed emission rates of up to 494 ng/h.The measured data show that a) FTOHs are present in indoor textiles (e.g. carpets), b) they are released at ambient temperatures and c) indoor air of shops selling outdoor textiles contains the highest levels of FTOH. Exposure of humans to perfluorooctanoic acid (PFOA) through absorption of FTOH and subsequent degradation is discussed on the basis of indoor air levels. Calculation of indoor air-related exposure using the median of the measured air levels revealed that exposure is on the same order of magnitude as the recently reported dietary intakes for a background-exposed population. On the basis of the 95th percentile, indoor air exposure to PFOA was estimated to exceed dietary exposure. However, indoor air-related intakes of FTOH are far below the tolerable daily intake (TDI) of PFOA, indicating that there is no risk to health, even when assuming an unrealistic complete degradation of FTOH into PFOA.     

Modeling indoor air pollution of outdoor origin in homes of SAPALDIA subjects in Switzerland

Given the shrinking spatial contrasts in outdoor air pollution in Switzerland and the trends toward tightly insulated buildings, the Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults (SAPALDIA) needs to understand to what extent outdoor air pollution remains a determinant for residential indoor exposure. The objectives of this paper are to identify determining factors for indoor air pollution concentrations of particulate matter (PM), ultrafine particles in the size range from 15 to 300 nm, black smoke measured as light absorbance of PM (PM_absorbance) and nitrogen dioxide (NO₂) and to develop predictive indoor models for SAPALDIA. Multivariable regression models were developed based on indoor and outdoor measurements among homes of selected SAPALDIA participants in three urban (Basel, Geneva, Lugano) and one rural region (Wald ZH) in Switzerland, various home characteristics and reported indoor sources such as cooking. Outdoor levels of air pollutants were important predictors for indoor air pollutants, except for the coarse particle fraction. The fractions of outdoor concentrations infiltrating indoors were between 30% and 66%, the highest one was observed for PM_absorbance. A modifying effect of open windows was found for NO₂ and the ultrafine particle number concentration. Cooking was associated with increased particle and NO₂ levels. This study shows that outdoor air pollution remains an important determinant of residential indoor air pollution in Switzerland.     

Respiratory medication sales and urban air pollution in Brussels (2005 to 2011)

BackgroundWe investigated the associations between daily sales of respiratory medication and air pollutants in the Brussels-Capital Region between 2005 and 2011.MethodsWe used over-dispersed Poisson Generalized Linear Models to regress daily individual reimbursement data of prescribed asthma and COPD medication from the social security database against each subject's residential exposure to outdoor particulate matter (PM₁₀) or NO₂ estimated, by interpolation from monitoring stations. We calculated cumulative risk ratios (RR) and their 95% confidence intervals (CI) for interquartile ranges (IQR) of exposure for different windows of past exposure for the entire population and for seven age groups.ResultsMedian daily concentrations of PM₁₀ and NO₂ were 25 μg/m³ (IQR = 17.1) and 38 μg/m³ (IQR = 20.5), respectively. PM₁₀ was associated with daily medication sales among individuals aged 13 to 64 y. For NO₂, significant associations were observed among all age groups except > 84 y. The highest RR were observed for NO₂, among adolescents, including three weeks lags (RR = 1.187 95%CI: 1.097–1.285).ConclusionThe associations found between temporal changes in exposure to air pollutants and daily sales of respiratory medication in Brussels indicate that urban air pollution contributes to asthma and COPD morbidity in the general population.     

Association between long-term exposure to air pollution and mortality in France: A 25-year follow-up study

IntroductionLong-term exposure to air pollution (AP) has been shown to have an impact on mortality in numerous countries, but since 2005 no data exists for France.ObjectivesWe analyzed the association between long-term exposure to air pollution and mortality at the individual level in a large French cohort followed from 1989 to 2013.MethodsThe study sample consisted of 20,327 adults working at the French national electricity and gas company EDF-GDF. Annual exposure to PM₁₀, PM_10–2.5, PM_2.5, NO₂, O₃, SO₂, and benzene was assessed for the place of residence of participants using a chemistry-transport model and taking residential history into account. Hazard ratios were estimated using a Cox proportional-hazards regression model, adjusted for selected individual and contextual risk factors. Hazard ratios were computed for an interquartile range (IQR) increase in air pollutant concentrations.ResultsThe cohort recorded 1967 non-accidental deaths. Long-term exposures to baseline PM_2.5, PM_10-25, NO₂ and benzene were associated with an increase in non-accidental mortality (Hazard Ratio, HR = 1.09; 95% CI: 0.99, 1.20 per 5.9 μg/m³, PM_10-25; HR = 1.09;95% CI: 1.04, 1.15 per 2.2 μg/m³, NO₂: HR = 1.14; 95% CI: 0.99, 1.31 per 19.3 μg/m³ and benzene: HR = 1.10; 95% CI: 1.00, 1.22 per 1.7 μg/m³).The strongest association was found for PM₁₀: HR = 1.14; 95% CI: 1.05, 1.25 per 7.8 μg/m³. PM₁₀, PM_10-25 and SO₂ were associated with non-accidental mortality when using time varying exposure. No significant associations were observed between air pollution and cardiovascular and respiratory mortality.ConclusionLong-term exposure to fine particles, nitrogen dioxide, sulfur dioxide and benzene is associated with an increased risk of non-accidental mortality in France. Our results strengthen existing evidence that outdoor air pollution is a significant environmental risk factor for mortality. Due to the limited sample size and the nature of our study (occupational), further investigations are needed in France with a larger representative population sample.     

Effect of cigarette smoking on residential NO2 levels

Two studies evaluating the levels and sources of nitrogen dioxide in approximately 90 employee homes in the Richmond area with continuous sampling during the weeks of August 5, 1980, and February 9, 1981, were performed using samplers in the living room, bedroom, kitchen, and outdoors. Additional data were collected concerning appliance usage, heating/cooling plant, ventilation and cigarette smoking. Results were analyzed using BMDP routines. The largest contributor to NO₂ concentration was found to be gas-fired kitchen appliances. The mean kitchen level for homes with gas appliances during the winter study was 188 μg/m³. Excluding participants with gas kitchens, incremental influence due to cigarette smoking was detected. The 7-day, 3-room average level of NO₂ in the homes of nonsmokers and smokers without gas-fired appliances was 12 and 15 μg/m³, respectively, in the summer. The corresponding winter values were 19 and 22 μg/m³. Furthermore, the individual levels of NO₂ in the homes of smokers were generally below both the adjacent outdoor level and the National Ambient Air Quality Standard limit for annual exposure.     

Aluminum, iron, and lead content of respirable particulate samples from a personal monitoring study

Samples of respirable particulate matter collected during a personal monitoring study in Topeka, KS, were analyzed for iron, aluminum, and lead content. The sampling protocol and instrumentation are described in detail. Lead indoor concentrations (median = 79 ng/m³) were found to be less than both personal (median = 112 ng/m³) and outdoor lead concentrations (median = 106 ng/m³). The indoor, outdoor, and personal levels of iron and aluminum were not significantly different. In addition, it was determined that outdoor respirable particulate mass does not correlate well with the personal or indoor metal concentrations, and that the amount of time spent in motor vehicles is a relatively good indicator of lead exposures. The relationships between indoor, outdoor, and personal lead are discussed in greater detail, with references to supporting evidence from other studies.     

Measurement and health risk assessment of PM2.5, flame retardants,carbonyls and black carbon in indoor and outdoor air in kindergartens in Hong Kong

Indoor air pollution is closely related to children's health. Polybrominated diphenyl ethers (PBDEs) and dechlorane plus (DP) transmitted through indoor PM_2.5 and dust, along with carbonyl compounds and black carbon (BC) aerosol were analysed in five Hong Kong kindergartens. The results showed that 60% of the median PM_2.5 levels (1.3 × 10¹ to 2.9 × 10¹ μg/m³ for indoor; 9.5 to 8.8 × 10¹ μg/m³ for outdoor) in the five kindergartens were higher than the guidelines set by the World Health Organization (2.5 × 10¹ μg/m³). Indoor PM_2.5 mass concentrations were correlated with outdoor PM_2.5 in four of the kindergartens. The PBDEs (0.10–0.64 ng/m³ in PM_2.5; 0.30–2.0 × 10² ng/g in dust) and DP (0.05–0.10 ng/m³ in PM_2.5; 1.3–8.7 ng/g in dust) were detected in 100% of the PM_2.5 and dust samples. Fire retardant levels in the air were not correlated with the levels of dust in this study. The median BC concentrations varied by > 7-fold from 8.8 × 10² ng/m^− 3 to 6.7 × 10³ ng/m^− 3 and cooking events might have caused BC concentrations to rise both indoors and outdoors. The total concentrations of 16 carbonyls ranged from 4.7 × 10¹ μg/m³ to 9.3 × 10¹ μg/m³ indoors and from 1.9 × 10¹ μg/m³ to 4.3 × 10¹ μg/m³ outdoors, whilst formaldehyde was the most abundant air carbonyl. Indoor carbonyl concentrations were correlated with outdoor carbonyls in three kindergartens. The health risk assessment showed that hazard indexes (HIs) HIs of non-cancer risks from PBDEs and DPs were all lower than 0.08, whilst non-cancer HIs of carbonyl compounds ranged from 0.77 to 1.85 indoors and from 0.50 to 0.97 outdoors. The human intake of PBDEs and DP through inhalation of PM_2.5 accounted for 78% to 92% of the total intake. The cancer hazard quotients (HQs) of formaldehyde ranged from 4.5E − 05 to 2.1E − 04 indoors and from 1.9E − 05 to 6.2E − 05 outdoors. In general, the indoor air pollution in the five Hong Kong kindergartens might present adverse effects to children, although different schools showed distinct pollution levels, so indoor air quality might be improved through artificial measures. The data will be useful to developing a feasible management protocol for indoor environments.     

Investigation of volatile organic compounds and phthalates present in the cabin air of used private cars

The presence of selected volatile organic compounds (VOCs) including aromatic, aliphatic compounds and low molecular weight carbonyls, and a target set of phthalates were investigated in the interior of 23 used private cars during the summer and winter. VOC concentrations often exceeded levels typically found in residential indoor air, e.g. benzene concentrations reached values of up to 149.1 µg m^− 3. Overall concentrations were 40% higher in summer, with temperatures inside the cars reaching up to 70 °C. The most frequently detected phthalates were di-n-butyl-phthalate and bis-(2-ethylhexyl) phthalate in concentrations ranging from 196 to 3656 ng m^− 3.     

Comparison of indoor and outdoor air quality at two staff quarters in Hong Kong

The indoor and outdoor air quality of two staff quarters of Hong Kong Polytechnic University at Tsim Sha Tsui East (TSTE) and Shatin (ST) were investigated. The air sampling was carried out in winter for about two months starting from January to February of 1996. Fifteen flats from each staff quarter were randomly selected for indoor/outdoor air pollutant measurements. The pollutants measured were NO_x, NO, NO₂, SO₂, CO, and O₃. The variations of pollutant concentrations between indoor and outdoor air were investigated on weekday mornings, weekday evenings, weekend mornings, and weekend evenings. All indoor/outdoor pollutant concentrations measured did not exceed the ASHRAE/NAAQS standard. The carbon monoxide concentrations indoors were systemically higher than those outdoors at the TSTE and the ST quarters, both on weekdays and Sunday, which indicates there are CO sources indoors. Except for CO, the indoor levels of other pollutants (NO_x, NO, NO₂, SO₂, and O₃) are lower than those outdoors. There was a significant correlation (P < 0.05) between indoor and outdoor concentrations for SO₂ and O₃ at both the TSTE and the ST quarters. Except for O₃, the mean concentrations of all the pollutants in the TSTE quarters, both indoor and outdoor, were higher than that of the ST quarters in all sampling periods. All indoor and outdoor O₃ levels were lower at the TSTE quarters than those at the ST quarters. The O₃ ratios of TSTE/ST were 0.72 outdoor and 0.79 indoor. This can be explained by the NO titration reaction through NO conversion to NO₂.     

Inflammatory markers in relation to long-term air pollution

Long-term exposure to ambient air pollution can lead to chronic health effects such as cancer, cardiovascular and respiratory disease. Systemic inflammation has been hypothesized as a putative biological mechanism contributing to these adverse health effects. We evaluated the effect of long-term exposure to air pollution on blood markers of systemic inflammation.We measured a panel of 28 inflammatory markers in peripheral blood samples from 587 individuals that were biobanked as part of a prospective study. Participants were from Varese and Turin (Italy) and Umea (Sweden). Long-term air pollution estimates of nitrogen oxides (NO_x) were available from the European Study of Cohorts for Air Pollution Effects (ESCAPE). Linear mixed models adjusted for potential confounders were applied to assess the association between NO_x and the markers of inflammation.Long-term exposure to NO_x was associated with decreased levels of interleukin (IL)-2, IL-8, IL-10 and tumor necrosis factor-α in Italy, but not in Sweden. NO_x exposure levels were considerably lower in Sweden than in Italy (Sweden: median (5th, 95th percentiles) 6.65 μg/m³ (4.8, 19.7); Italy: median (5th, 95th percentiles) 94.2 μg/m³ (7.8, 124.5)). Combining data from Italy and Sweden we only observed a significant association between long-term exposure to NO_x and decreased levels of circulating IL-8.We observed some indication for perturbations in the inflammatory markers due to long-term exposure to NO_x. Effects were stronger in Italy than in Sweden, potentially reflecting the difference in air pollution levels between the two cohorts.     

Associations between short-term exposure to nitrogen dioxide and mortality in 17 Chinese cities: The China Air Pollution and Health Effects Study (CAPES)

Few multi-city studies in Asian developing countries have examined the acute health effects of ambient nitrogen dioxide (NO₂). In the China Air Pollution and Health Effects Study (CAPES), we investigated the short-term association between NO₂ and mortality in 17 Chinese cities. We applied two-stage Bayesian hierarchical models to obtain city-specific and national average estimates for NO₂. In each city, we used Poisson regression models incorporating natural spline smoothing functions to adjust for long-term and seasonal trend of mortality, as well as other time-varying covariates. We examined the associations by age, gender and education status. We combined the individual-city estimates of the concentration–response curves to get an overall NO₂–mortality association in China. The averaged daily concentrations of NO₂ in the 17 Chinese cities ranged from 26 μg/m³ to 67 μg/m³. In the combined analysis, a 10-μg/m³ increase in two-day moving averaged NO₂ was associated with a 1.63% [95% posterior interval (PI), 1.09 to 2.17], 1.80% (95% PI, 1.00 to 2.59) and 2.52% (95% PI, 1.44 to 3.59) increase of total, cardiovascular, and respiratory mortality, respectively. These associations remained significant after adjustment for ambient particles or sulfur dioxide (SO₂). Older people appeared to be more vulnerable to NO₂ exposure. The combined concentration–response curves indicated a linear association. Conclusively, this largest epidemiologic study of NO₂ in Asian developing countries to date suggests that short-term exposure to NO₂ is associated with increased mortality risk.     

Prenatal exposure to organochlorine compounds and neuropsychological development up to two years of life

Polychlorinated biphenyls (PCB), hexachlorobenzene (HCB), and dichlorodiphenyl dichloroethylene (pp′DDE) are persistent, bioaccumulative, and toxic environmental pollutants with potential neurotoxic effects. Despite a growing body of studies investigating the health effects associated with these compounds, their specific effects on early neuropsychological development remain unclear. We investigated such neuropsychological effects in a population-based birth cohort based in three regions in Spain (Sabadell, Gipuzkoa, and Valencia) derived from the INMA [Environment and Childhood] Project. The main analyses in this report were based on 1391 mother–child pairs with complete information on maternal levels of organochlorine compounds and child neuropsychological assessment (Bayley Scales of Infant Development) at age 14 months. We found that prenatal PCB exposure, particularly to congeners 138 and 153, resulted in impairment of psychomotor development (coefficient = − 1.24, 95% confidence interval = − 2.41, − 0.07), but found no evidence for effects on cognitive development. Prenatal exposure to pp′DDE or HCB was not associated with early neuropsychological development. The negative effects of exposure to PCBs on early psychomotor development suggest that the potential neurotoxic effects of these compounds may be evident even at low doses.     

Exposure to inhaled THM: Comparison of continuous and event-specific exposure assessment for epidemiologic purposes

Trihalomethanes (THMs) (chloroform, bromoform, dibromochloromethane, and bromodichloromethane) are the most abundant by-products of chlorination. People are exposed to THMs through ingestion, dermal contact and inhalation. The objective of this study was to compare two methods for assessing THM inhalation: a direct method with personal monitors assessing continuous exposure and an indirect one with microenvironmental sampling and collection of time–activity data during the main event exposures: bathing, showering and swimming. This comparison was conducted to help plan a future epidemiologic study of the effects of THMs on the upper airways of children. 30 children aged from 4 to 10 years were included. They wore a 3M^™ 3520 organic vapor monitor for 7 days. We sampled air in their bathrooms (during baths or showers) and in the indoor swimming pools they visited and recorded their time–activity patterns. We used stainless steel tubes full of Tenax^® to collect air samples. All analyses were performed with Gas Chromatography and Mass Spectrometry (GC-MS). Chloroform was the THM with the highest concentrations in the air of both bathrooms and indoor swimming pools. Its continuous and event exposure measurements were significantly correlated (r_s = 0.69 p < 0.001). Continuous exposures were higher than event exposures, suggesting that the event exposure method does not take into account some influential microenvironments. In an epidemiologic study, this might lead to random exposure misclassification, thus underestimation of the risk, and reduced statistical power. The continuous exposure method was difficult to implement because of its poor acceptability and the fragility of the personal monitors. These two points may also reduce the statistical power of an epidemiologic study. It would be useful to test the advantages and disadvantages of a second sample in the home or of modeling the baseline concentration of THM in the home to improve the event exposure method.