The influence of maternal dietary exposure to dioxins and PCBs during pregnancy on ADHD symptoms and cognitive functions in Norwegian preschool children

BackgroundPolychlorinated dibenzo-p-dioxins/dibenzofurans (dioxins) and polychlorinated biphenyls (PCBs) are persistent organic pollutants (POPs) with potentially adverse impact on child neurodevelopment. Whether the potential detrimental effects of dioxins and PCBs on neurodevelopment are of specific or unspecific character is not clear.ObjectivesThe purpose of the current study was to examine the influence of maternal dietary exposure to dioxins and PCBs on ADHD symptoms and cognitive functioning in preschoolers. We aimed to investigate a range of functions, in particular IQ, expressive language, and executive functions.Material and methodsThis study includes n = 1024 children enrolled in a longitudinal prospective study of ADHD (the ADHD Study), with participants recruited from The Norwegian Mother and Child Cohort Study (MoBa). Boys and girls aged 3.5 years participated in extensive clinical assessments using well-validated tools; The Preschool Age Psychiatric Assessment interview (PAPA), Stanford-Binet 5th revision (SB-5), Child Development Inventory (CDI), and Behavior Rating Inventory of Executive Function, Preschool version (BRIEF-P). Maternal dietary exposure to dioxins and PCBs was estimated based on a validated food frequency questionnaire (FFQ) answered mid-pregnancy and a database of dioxin and PCB concentrations in Norwegian foods. Exposure to dioxins and dioxin-like PCBs (dl-compounds) was expressed in total toxic equivalents (TEQ), and PCB-153 was used as marker for non-dioxin-like PCBs (ndl-PCBs). Generalized linear and additive models adjusted for confounders were used to examine exposure-outcome associations.ResultsExposure to PCB-153 or dl-compound was not significantly associated with any of the outcome measures when analyses were performed for boys and girls together. After stratifying by sex, adjusted analyses indicated a small inverse association with language in girls. An increase in the exposure variables of 1 SD was associated with a reduction in language score of − 0.2 [CI − 0.4, − 0.1] for PCB-153 and − 0.2 [CI − 0.5, − 0.1] for dl-compounds in girls. For boys, exposure to PCB-153 or dl-compounds was not associated with language skills. The difference between sex-specific associations was not statistically significant (p-value = 0.13). No sex-specific effects were observed for ADHD-symptoms, IQ scores, or executive functions.ConclusionsWe found no indications that variation in current low-level exposure to PCB-153 or dl-compounds in Norway is associated with variation ADHD-symptoms, verbal/non-verbal IQ, or executive functions including working memory in preschoolers. However, our findings indicated that maternal dietary exposure to PCB-153 or dl-compounds during pregnancy was significantly associated with poorer expressive language skills in preschool girls, although the sex-specific associations were not significantly different.     

Relative effect potency estimates of dioxin-like activity for dioxins,furans, and dioxin-like PCBs in adults based on cytochrome P450 1A1 and 1B1 gene expression in blood

BackgroundIn the risk assessment of PCDDs, PCDFs, and dioxin-like (DL) PCBs, regulatory authorities support the use of the toxic equivalency factor (TEF)-scheme derived from a heterogeneous data set of the relative effect potency (REPs) estimates.ObjectivesWe sought to determine REPs for dioxin-like compounds (DLCs) using expression of cytochrome P450 (CYP) 1A1 and 1B1 mRNA in human peripheral blood mononuclear cells representing two different pathways.MethodsWe used a sex and age adjusted regression-based approach comparing the strength of association between each DLC and the cytochrome P450 (CYP) 1A1 and 1B1 mRNA expression in 320 adults residing in an organochlorine-polluted area of eastern Slovakia.ResultsWe calculated REPs based on CYP1A1 expression for 4 PCDDs, 8 PCDFs, and 1 PCB congener, and based on CYP1B1 expression for 5 PCDFs and 11 PCB congeners. REPs from CYP1A1 correlated with REPs previously derived from thyroid volume (ρ = 0.85; p < 0.001) and serum FT4 (ρ = 0.77; p = 0.009). The 13 log REPs from CYP1A1 correlated with log WHO-TEFs (r = 0.63; p = 0.015) and 11 log PCB REPs with PCB consensus toxicity factors (CTFs) for compounds with WHO-TEFs (r = 0.80; p = 0.003). The complete set of derived 56 log REPs correlated with the log CTFs (r = 0.77; p = 0.001) and log WHO-TEFs (r = 0.81; p < 0.001).ConclusionsREPs calculated from thyroid and cytochrome P450 endpoints realistically reflect human exposure scenarios because they are based on human chronic and low-dose exposures. While the CYP 1A1 seems more suitable for toxicity evaluation of PCDD/Fs, the CYP 1B1 is more apt for PCDFs and PCBs and reflects different pathways.     

Blood levels of dioxins,furans, dioxin-like PCBs,and TEQs in general populations: A review, 1989–2010

A comprehensive worldwide literature review of blood levels of dioxins and dioxin-like compounds in non-exposed adult general populations was performed. The studies published in 1989–2010 reporting information on polychlorinated dibenzo-para-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs), non-ortho-PCBs (nPCBs), mono-ortho-PCBs (mPCBs) levels and Toxic Equivalencies (TEQs, a summary weighted measure of their combined toxicity) were reviewed. TEQs were calculated using as standard the most recent WHO 2005 reevaluation of Toxic Equivalency Factors (TEFs). Weighted multiple regression analyses adjusted for year, subject's age, type of sample analyzed, method used for values below detection limit, and central tendency measure used were performed for each congener and standardized TEQs (log-transformed). We identified 187 studies regarding 29,687 subjects of 26 countries. Year of blood collection ranged from 1985 to 2008. The studies reporting congener levels 161. In adjusted analyses, European countries showed higher levels of most dioxin-like congeners and TEQs. A strong positive association of subjects' age with most congeners and with TEQ values was found, confirming previous findings. Significant decreases over time (1985–2008) were documented for PCCDs, PCDFs, and TEQs including their contributions. No significant decrease was found for non-ortho-PCBs, notably PCB 126. Only some mono-ortho-PCBs showed clear significant declines. Accordingly, TEQs including only PCB contribution did not decrease over time. In interpreting these findings, it should be considered that for dioxin-like PCBs the analysis period was shorter (17 years), since these compounds were first measured in 1992.     

Market basket study on dietary intake of PCDD/Fs, PCBs, and PBDEs in Finland

We have measured the concentrations of polychlorinated dibenzo-p-dioxins (PCDD/F), polychlorinated biphenyls (PCBs), and polybrominated diphenyl ethers (PBDE) in 10 market baskets consisting of almost 4000 individual food samples representing 228 different food items, and also in the total diet basket. Lower bound concentrations of PCDD/Fs ranged between 0.0057 and 5.6 pg/g fresh weight in the market baskets and the corresponding values for PCBs from 39 to 25,000 pg/g. The fish basket contributed most to the concentrations of dioxins and PCBs, and also to concentrations of PBDEs in which the lower bound range was from 0.82 to 850 pg/g. We also assessed the average daily intakes of these substances by the Finnish adult population. The average daily intake of sum of PCDD/Fs and PCBs as WHO toxic equivalents was assessed to be 115 pg, which was 1.5 pg WHO-TEq/kg body weight using an average mean weight of 76 kg for the general population in Finland. The contribution of fish to the intake of PCDD/Fs was between 94% and 72%, depending on whether lower or upper bound concentrations were used. With respect to PCBs, the contribution of fish was 80%. The calculated intake of PBDEs of 44 ng/day was comparable to intake assessments from other countries. Fish also contributed most to the PBDE intake, but there was some other source of PBDEs that distinguishes the exposure to PBDEs from exposure to PCDD/Fs and PCBs. This additional source seemed to be found in the market basket that included beverages, spices, and sweets.     

Human exposure to PCBs, PBDEs and HBCDs in Ghana: Temporal variation, sources of exposure and estimation of daily intakes by infants

Human exposure to polychlorinated biphenyls (PCBs) and brominated flame retardants (BFRs) such as polybrominated diphenyl ethers (PBDEs) and hexabromocyclododecanes (HBCDs) was evaluated in Ghana using breast milk samples collected in 2004 and 2009. Mean levels and ranges of PBDEs (4.5; 0.86-18 ng/g lw) and PCBs (62; 15-160 ng/g lw) observed in the present study were unexpectedly high, in spite of the fact that Ghana is a non-industrialized country when compared with many of the Asian and European countries. Significant increases were found in the concentrations of PCBs and PBDEs over the years, while no significant increase was observed for HBCDs. Estimated hazard quotient (HQ) showed that all the mothers had HQ values exceeding the threshold of 1 for PCBs, indicating potential health risk for their children. PCBs in dirty oils and obsolete equipment should be of concern as potential sources in Ghana, and e-waste recycling with little or no experience in safe handling could be a threat to this sub-region noted for unregulated disposal of e-waste. The results may point towards an increase in trends in human milk in Ghana, especially in the larger cities but further analysis would be required to confirm this upward trend in levels. This is the first study to report BFRs in human breast milk from Africa, and undoubtedly from Ghana.     

Concentrations of PCDD/PCDFs and PCBs in retail foods and an assessment of dietary intake for local population of Shenzhen in China

OBJECTIVES: Concentrations of 17 polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) and 18 polychlorinated biphenyls (PCBs) were measured in 11 varieties of food groups collected from retail market of Shenzhen, Guangdong province, China from 2004 to 2006. PCDD/Fs and PCBs dietary intake from varies food for the local population was estimated in the study. METHODS: Concentrations of 17 polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) and 12 dioxin-like polychlorinated biphenyls (PCBs) as well as 6 marker PCBs were measured in 11 varieties of food groups in total 110 food samples by isotope dilution HRGC/HRMS. PCDD/Fs and PCBs dietary intake for local population was estimated using total WHO-TEQ concentration and different food consumption amount of the local population. RESULTS: The median WHO-TEQ concentrations of sum of PCDD/Fs and DL-PCBs varied from 0.0093 pg/g (parts per trillion) in vegetable to 9.89 pg/g in fish. Fish was followed by egg 2.46, chicken 1.73, beef 0.94, mutton 0.82, duck 0.39, pork 0.37, milk powder 0.25, vegetable oil 0.076, cereals 0.022 pg/g and vegetable. The monthly intake of PCDD/Fs and PCBs were 40.9 pg WHO-TEQ/kg b.w. for local population. Sum of fish, livestock, and poultry contributed 77% to the Estimated Monthly Intake (EMI) in local population. CONCLUSION: Estimated dietary intake of PCDD/Fs and DL-PCBs for local population was below the provisional tolerable monthly intake(PTMI) set by Joint FAO/WHO Expert Committee on Food Additives (JECFA).     

Dietary exposure to dioxins and PCBs in a large cohort of pregnant women: Results from the Norwegian Mother and Child Cohort Study (MoBa)

Exposure to dioxins and polychlorinated biphenyls (PCBs) during pregnancy and breastfeeding may result in adverse health effects in children. Prenatal exposure is determined by the concentrations of dioxins and PCBs in maternal blood, which reflect the body burden obtained by long term dietary exposure. The aims of this study were (1) to describe dietary exposure and important dietary sources to dioxins and PCBs in a large group of pregnant women and (2) to identify maternal characteristics associated with high dietary exposure to dioxins and PCBs. Dietary exposure to dioxins (sum of toxic equivalents (TEQs) from dioxin-like (dl) compounds) and PCB-153 in 83,524 pregnant women (gestational weeks 17–22) who participated in the Norwegian Mother and Child Cohort Study (MoBa) during the years 2002–2009 was calculated based on a food frequency questionnaire (FFQ) and a database of dioxin and PCB concentrations in Norwegian food. The median (interquartile range, IQR) intake of PCB-153 (marker of ndl-PCBs) was 0.81 (0.77) ng/kg bw/day. For dioxins and dioxin-like PCBs, the median (IQR) intake was 0.56 (0.37) pg TEQ/kg bw/day. Moreover, 2.3% of the participants had intakes exceeding the tolerable weekly intake (TWI) of 14 pg TEQ/kg bw/week. Multiple regression analysis showed that dietary exposure was positively associated with maternal age, maternal education, weight gain during pregnancy, being a student, and alcohol consumption during pregnancy and negatively associated with pre-pregnancy BMI and smoking. A high dietary exposure to PCB-153 or dl-compounds (TEQ) was mainly explained by the consumption of seagull eggs and/or pate with fish liver and roe. Women who according to Norwegian recommendations avoid these food items generally do not have dietary exposure above the tolerable intake of dioxins and dl-PCBs.     

Maternal dietary intake of dioxins and polychlorinated biphenyls and birth size in the Norwegian Mother and Child Cohort Study (MoBa)

Maternal diet not only provides essential nutrients to the developing fetus but is also a source of prenatal exposure to environmental contaminants. We investigated the association between dietary intake of dioxins and PCBs during pregnancy and birth size. The study included 50,651 women from the Norwegian Mother and Child Cohort Study (MoBa). Dietary information was collected by FFQs and intake estimates were calculated by combining food consumption and food concentration of dioxins, dioxin-like PCBs and non-dioxin-like PCBs. We used multivariable regression models to estimate the association between dietary intake of dioxins and PCBs and fetal growth. The contribution of fish and seafood intake during pregnancy was 41% for dietary dioxins and dioxin-like PCBs and 49% for dietary non-dioxin-like PCBs. Further stratified analysis by quartiles of seafood intake during pregnancy was conducted. We found an inverse dose–response association between dietary intake of dioxins and PCBs and fetal growth after adjustment for confounders. Newborns of mothers in the upper quartile of dioxin and dioxin-like PCBs intake had 62 g lower birth weight (95% CI: − 73, − 50), 0.26 cm shorter birth length (95% CI: − 0.31, − 0.20) and 0.10 cm shorter head circumference (95% CI: − 0.14, − 0.06) than newborns of mothers in the lowest quartile of intake. Similar negative associations for intake of dioxins and dioxin-like PCBs were found after excluding women with intakes above the tolerable weekly intake (TWI = 14 pg TEQ/kg bw/week). The negative association of dietary dioxins and PCBs with fetal growth was weaker as seafood intake was increasing. No association was found between dietary dioxin and PCB intake and the risk for small-for-gestational age neonate. In conclusion, dietary intakes of dioxins and PCBs during pregnancy were negatively associated with fetal growth, even at intakes below the TWI.     

Assessing noxious effects of dietary exposure to methylmercury,PCBs and Se coexisting in environmentally contaminated rice in male mice

Polychlorinated biphenyls and methylmercury are two of the most ubiquitous environmental contaminants in Guizhou province. Rice is eaten with almost every meal and provides more calories than any single food in Guizhou province. The estimated tolerable daily intake of total mercury, MeHg, Se and PCBs from Guizhou contaminated rice by Chinese people showed that MeHg and/or PCBs exceeded the corresponding limits. The aim of this study was to characterize the effects of exposure to environmental contaminated rice on neurobehavioral development and neurobiological disruptions in mice. Animals were treated from postnatal day (PND) 22 to 91. At PND 26–91 days of age, mice were tested for neurobehavioural development and neurochemical level changes. We showed that dietary exposure to environmentally contaminated rice gave rise to different changes in antioxidants. Reduced superoxide dismutase (SOD) activity and excess increased nitric oxide (NO) indicated aggravation of oxidative status after long-term dietary intake of Hg and PCBs. Neurobehavioral derangement in the central nervous system and significant delay in the Morris water maze test response on PND 91 are correlated with the increased of c-fos/c-jun expression levels in the cerebral cortex. These results suggest that MeHg neurotoxicity might be a greater hazard than that associated with PCB, but PCB may augment the neurobehavioral deficits caused by increased levels of mercury exposure. The simultaneous intake of selenium might have a protective effect on Hg accumulation in the body, and vitamin C might protect mice against the toxic effects of PCBs. However, the protective role of Se and vitamin C is very limited for multiple-agent pollution. Immediately early genes in the brain response to contaminated rice might be dependent on interaction among NO, NO synthase (NOS), SOD and reduced glutathione (GSH). We should be alert to mental health problems in human beings when any kind of Hg- and PCB-polluted food is consumed.     

A model for the prediction of oil slick movement and spreading using cellular automata

A model for the prediction of oil slick movement and spreading, using Cellular Automata, is presented in this paper. The model is general and can predict the behaviour of oil slicks in regions with complicated boundaries. The effects of winds, surface currents, and oil evaporation have been taken into account. An algorithm for the simulation of oil slick movement and spreading, based on this model, has also been developed and has been used to simulate hypothetical oil slicks in hypothetical geographical regions. The results of the simulation are in qualitative agreement with real oil slick movement and spreading.     

Method design and validation for the determination of uranium levels in human urine using high-resolution alpha spectrometry

Quantification of uranium in human urine is a valuable technique for assessing occupational and public exposure to uranium. A reliable method has been developed and validated in the ARPANSA Radiochemistry Laboratory by means of standard radiochemical separation and purification techniques and measurement using high-resolution alpha spectrometry. This method can be used to evaluate the levels of naturally occurring 234U, 235U and 238U in urine. Method design and validation is the process of defining an analytical requirement, and then confirming that the method under consideration has performance capabilities consistent with what the application requires. The method was designed to measure levels down to 2 mBq/day of total uranium, corresponding to approximately 1/100th of the annual committed effective dose of 20 mSv. Validation tests were developed to assess selectivity, accuracy, recovery and quantification of uncertainty. The radiochemical recovery of this method was measured using (232)U tracer. The typical minimum detectable concentration for total uranium for 24-h urine samples is approximately 0.6 mBq/day or 0.019 microg/day.     

Development and validation of a dynamical atmosphere-vegetation-soil HTO transport and OBT formation model

A numerical model simulating transport of tritiated water (HTO) in atmosphere-soil-vegetation system, and, accumulation of organically bound tritium (OBT) in vegetative leaves was developed. Characteristic of the model is, for calculating tritium transport, it incorporates a dynamical atmosphere-soil-vegetation model (SOLVEG-II) that calculates transport of heat and water, and, exchange of CO₂. The processes included for calculating tissue free water tritium (TFWT) in leaves are HTO exchange between canopy air and leaf cellular water, root uptake of aqueous HTO in soil, photosynthetic assimilation of TFWT into OBT, and, TFWT formation from OBT through respiration. Tritium fluxes at the last two processes are input to a carbohydrate compartment model in leaves that calculates OBT translocation from leaves and allocation in them, by using photosynthesis and respiration rate in leaves. The developed model was then validated through a simulation of an existing experiment of acute exposure of grape plants to atmospheric HTO. Calculated TFWT concentration in leaves increased soon after the start of HTO exposure, reaching to equilibrium with the atmospheric HTO within a few hours, and then rapidly decreased after the end of the exposure. Calculated non-exchangeable OBT amount in leaves linearly increased during the exposure, and after the exposure, rapidly decreased in daytime, and, moderately nighttime. These variations in the calculated TFWT concentrations and OBT amounts, each mainly controlled by HTO exchange between canopy air and leaf cellular water and by carbohydrates translocation from leaves, fairly agreed with the observations within average errors of a factor of two.     

Prediction of SVOC vegetation and atmospheric concentrations using calculated deposition velocities

A simple modeling concept was previously applied to study air-foliage exchange of both polybrominated diphenyl ethers (PBDEs) and polycyclic aromatic hydrocarbons (PAHs) using field measurements. In this paper, the predictive capabilities of this framework were tested using an independent set of data collected at the same sampling location for a different time period. Firstly, atmospheric (particle-bound and gaseous phase) PBDE and PAH concentrations were used to predict their accumulation in spruce needles. Conversely, we used PBDE and PAH concentrations in vegetation to predict their atmospheric concentrations. In both cases, calculated and measured values showed good agreement, providing evidence that the developed framework and our derived deposition velocities can be used as a predictive tool for these two different classes of semi-volatile organic compounds.     

Development and validation of an enzyme-linked immunosorbent assay for vitellogenin in Chinese loach (Misgurnus angaillicaudatus)

A competitive enzyme-linked immunosorbent assay (ELISA) was developed for the quantification of vitellogenin (Vtg) in the plasma of Chinese loach (Misgurnus angaillicaudatus). Vtg was isolated by anion exchange membrane chromatography from the plasma of 17beta-estradiol (E(2))-treated loach. Polyclonal antibody against Vtg was raised in rabbits, and the specificity of the antibody was assessed by Western blotting analysis. No cross-reactivity was observed with plasma from male loach. Plasma samples from vitellogenic females and E(2)-treated males were diluted parallel with the purified Vtg standard curve in the ELISA. The detection limit of the assay was 5.7 ng ml(-) (1) and a working range of the standard curve was between 15.6 and 1000 ng ml(-) (1). The intra- and inter-assay coefficients of variations were 6.9% and 10.4%, respectively. The recovery was 104.4%. The assay was applied for measuring vitellogenin concentration in the plasma from 24 wild Chinese loach from Lianyungang, Jiangsu Province, in October 2003. It was found that, in addition to females (plasma Vtg concentration ranging from 518.4 microg ml(-) (1) to 1922.3 microg ml(-) (1)), male loach showed low plasma Vtg--from undetectable (two fish) to 2.9+/-0.7 microg ml(-) (1) (mean+/-S.D.). The results indicate that this method provides a valuable tool for the study of estrogenic effect in Chinese loach.     

Bioanalytical screening methods for dioxins and dioxin-like compounds a review of bioassay/biomarker technology.

Determination of environmental pollutants utilizing biodetectors such as bioassays, biomarkers, enzyme immunoassays (EIAs), or other bioanalytical tools is a continuously growing area. The present literature review describes the principles and advantages/limitations of several bioanalytical detection methods (BDMs) for the screening and diagnosis of dioxin and dioxin-like compounds. This study characterizes briefly the family of dioxin and dioxin-like compounds, discusses potential Ah receptor (AhR) ligands and cytochrome P-450 (CYP) 1A1-enzyme-inducing compounds. 'Milestones' in the development of BDMs are summarized and explained in detail for a number of bioanalytical tools that can be used to detect these classes of dioxin-like persistent bioaccumulative toxicants (PBTs). The design of a screening profile with a battery of bioassays/biomarkers coupled with the chemical analysis is evaluated. The relative potencies (REPs) to 2,3,7,8-TCDD for dioxin-like compounds are reviewed for various BDMs and the differences are noted.     

Assessment, validation and intercomparison of operational models for predicting tritium migration from routine discharges of nuclear power plants: the case of Loire River

During last decades, a number of projects have been launched to validate models for predicting the behaviour of radioactive substances in the environment. The project of the "Aquatic" working group of the project EMRAS (Environmental Modelling for Radiation Safety) organised by the International Atomic Energy Agency (IAEA) was based on the validation and assessment of models for predicting the behaviour of radionuclides in the aquatic ecosystems. The present paper describes a blind test of models aimed at assessing the dispersion of tritium releases in the Loire River (France), on a large domain ( approximately 350km) and on a period of six months, by comparing the results obtained by operational-to-experimental values of tritium concentration at Angers, a city along the Loire River. The common conclusion is that the models used by the different participants namely 1D models and models based on a schematic hydraulic (box models) are reliable tools for tritium transport modelling. Nevertheless, the importance of proper and detailed hydrological data for the appropriate prediction of pollutant migration in water is demonstrated by the example provided during this study.     

Performance assessment studies of models for water flow and radionuclide transport in vegetated soils using lysimeter data

Increasingly the burial of nuclear waste in deep underground repositories is being regarded as a safe long-term solution for disposal. However, to support this safety assessment models of the associated risks are required. An important component of these models is the upward migration of radionuclides from a contaminated water table into arable and pasture crops. A five-year experiment to investigate the processes which control these transfers has been undertaken at Imperial College. Selected data from this experiment were made available to participants of the BIOMOVS II programme in order to allow them to perform blind hydrological and radionuclide transport simulations. The results show the importance of correctly characterising the soil hydrology and indicate that model conceptualisations derived from surface contamination studies may not adequately capture the various processes which influence the upward movement of radionuclides in the vadose zone. These include not only the water movement, but also chemical and biological processes. Finally, the difficulty and importance of a priori parameter selection is highlighted.     

Measurement of carbon monoxide concentrations in indoor and outdoor locations using personal exposure monitors

On 15 dates, 5000 measurements of carbon monoxide (CO) were made in downtown commercial settings in four California towns and cities (San Francisco, Palo Alto, Mountain View, and Los Angeles), using personal exposure monitoring (PEM) instruments. Altogether, 588 different commercial settings were visited, and indoor and outdoor locations were sampled at each setting. On 11 surveys, two CO PEM's were carried about 0.15–6 m apart, giving 1706 pairs of observations that showed good agreement: the correlation coefficient was r = 0.97 or greater, and the average difference was less than 1 ppm (μL/L) by volume. Of 210 indoor settings (excluding parking garages), 204 (97.1%) had average CO concentrations less than 9 ppm (μL/L); of 368 outdoor settings, 356 (96.7%) had average CO concentrations less than 9 ppm (μL/L). For a given date and commercial setting, CO concentrations were found to be relatively stable over time, permitting levels to be characterized by making only brief visits to each setting. The data indicate that most commercial settings experience CO concentrations above zero indoors, because CO tends to seep into buildings from vehicular emissions outside. Levels in these locations usually are not above 5 ppm (μL/L) and seldom are higher than the U.S. health-related ambient air quality standards for CO. However, indoor garages and buildings with attached indoor parking areas are exceptions and can experience relatively high CO concentrations.