Effects of environmental tobacco smoke on respiratory health of boys and girls from kindergarten: results from 15 districts of northern China

The effects of childhood environmental tobacco smoke (ETS) exposure on respiratory symptoms were investigated in 6053 kindergarten-aged children residing in 15 districts of northern China. Responses to a self-administered questionnaire completed by parents of children from 30 kindergartens were used to ascertain children with persistent cough, persistent phlegm, asthma symptom, current asthma, wheeze and wheeze without asthma. In first 2 years ETS exposure and current ETS exposure were associated with increased prevalence of persistent cough, persistent phlegm, wheeze and wheeze without asthma. Among boys, ETS exposure was associated with more respiratory symptoms and diseases than in girls. ETS exposure during pregnancy was associated with asthma symptom [odds ratio (OR), 3.00; 95% confidence interval (CI): 1.28-7.03], current asthma (OR, 3.38; 95% CI: 1.25-9.14), persistent cough (OR, 1.64; 95% CI: 1.13-2.37), persistent phlegm (OR, 1.74; 95% CI: 1.01-3.01), wheeze (OR, 1.75; 95% CI: 1.15-2.68), and wheeze without asthma (OR, 1.46; 95% CI: 1.01-2.37) only among boys. In boys, the adjusted ORs for increased risk of asthma symptom and current asthma for household exposures (> or =10 cigarettes smoked per day vs. none smoked) during workday were 2.04 (95% CI: 1.01-3.89) and 2.76 (95% CI: 1.06-9.58), respectively. We conclude that ETS exposure increases the occurrence of respiratory symptoms and diseases during childhood. Boys may be more susceptible to ETS than girls. PRACTICAL IMPLICATIONS: Environmental tobacco smoke (ETS) is a highly prevalent respiratory irritant. In agreement with previous cross-sectional studies, our study indicates that exposure to ETS may increase the occurrence of respiratory symptoms and diseases in children, and the association of ETS exposure and respiratory health of children increased in strength with number of cigarettes smoked inside the house per day during workday and day-off. Boys may be more susceptible to ETS than girls. These findings support the view that measures should be taken to reduce ETS exposure for children.     

Breastfeeding modifies the effects of environment tobacco smoke exposure on respiratory diseases and symptoms in Chinese children: the Seven Northeast Cities Study

To evaluate the potential effect of interaction between breastfeeding and environmental tobacco smoke (ETS) exposure on respiratory health, we studied 31 049 children (aged 2–14 years) from 25 districts of seven cities in northeast China. Parents of the children completed standardized questionnaires that characterized the children's histories of respiratory symptoms and illness, feeding methods, ETS exposure, and other associated risk factors. Breastfeeding was defined as having been mainly breastfed for 3 months or more. The results showed that the association of ETS exposure with childhood respiratory conditions/diseases was modified by breastfeeding, and the association for nonbreastfed children was stronger than that for breastfed children. In particular, for nonbreastfed children, the odds ratios (ORs) for the effect of current ETS exposure asthma was 1.71 (95% CI: 1.43–2.05); however, the OR for breastfed children was 1.33 (95% CI: 1.20–1.48), indicating that the interactions between breastfeeding and current ETS exposure on asthma were statistically significant (P = 0.019). When stratified by school (kindergarten vs. elementary school), breastfeeding was more protective for asthma‐related symptoms among children from kindergarten. In conclusion, this study shows that breastfeeding is associated with smaller associations between ETS exposure and respiratory conditions in children, suggesting that breastfeeding reduces susceptibility to the respiratory effects of ETS.     

Pre‐ and postnatal exposure to tobacco smoke and respiratory outcomes during the first year

The different role of prenatal and postnatal exposure to tobacco smoke in respiratory outcomes in infants has not yet been clearly established. Our objective is to assess the effects of these exposures on the risk of respiratory outcomes during the first year of life of infants from a Spanish multicenter cohort study. A total of 2506 women were monitored until delivery. About 2039 infants made up the final population. The outcomes were caused by the occurrence of the following: otitis, cough persisting for more than 3 weeks, lower respiratory tract symptoms (wheezing or chestiness), and lower respiratory tract infections (bronchitis, bronchiolitis, or pneumonia). The relationship between prenatal and postnatal exposure and health outcomes was explored using logistic regression analysis. Maternal smoking during pregnancy increased the odds for wheezing (OR: 1.41, 95% CI: 0.99–2.01) and chestiness (OR: 1.46, 95% CI: 1.03–2.01). Postnatal exposure from fathers was associated with otitis (OR: 1.25, 95% CI: 1.01–1.54). Passive exposure at work of non‐smoking mothers during pregnancy was related to cough (OR: 1.62, 95% CI: 1.05–2.51). Exposure to tobacco smoke was related to a higher risk of experiencing respiratory outcomes in young infants. Prenatal exposure was that most clearly associated with the respiratory outcomes analyzed.     

Exposure to household air pollution from biomass cookstoves and blood pressure among women in rural Honduras: A cross‐sectional study

Growing evidence links household air pollution exposure from biomass cookstoves with elevated blood pressure. We assessed cross‐sectional associations of 24‐hour mean concentrations of personal and kitchen fine particulate matter (PM_2.5), black carbon (BC), and stove type with blood pressure, adjusting for confounders, among 147 women using traditional or cleaner‐burning Justa stoves in Honduras. We investigated effect modification by age and body mass index. Traditional stove users had mean (standard deviation) personal and kitchen 24‐hour PM_2.5 concentrations of 126 μg/m³ (77) and 360 μg/m³ (374), while Justa stove users’ exposures were 66 μg/m³ (38) and 137 μg/m³ (194), respectively. BC concentrations were similarly lower among Justa stove users. Adjusted mean systolic blood pressure was 2.5 mm Hg higher (95% CI, 0.7‐4.3) per unit increase in natural log‐transformed kitchen PM_2.5 concentration; results were stronger among women of 40 years or older (5.2 mm Hg increase, 95% CI, 2.3‐8.1). Adjusted odds of borderline high and high blood pressure (categorized) were also elevated (odds ratio = 1.5, 95% CI, 1.0‐2.3). Some results included null values and are suggestive. Results suggest that reduced household air pollution, even when concentrations exceed air quality guidelines, may help lower cardiovascular disease risk, particularly among older subgroups.     

Indoor air pollution and self-reported diseases - a case study of NCT of Delhi

People in modern societies often spend 80-90% of their time in indoor environments. It is, therefore, imperative to analyze indoor air quality (IAQ) and its determinants and to consider the contribution of IAQ to possible health outcomes at the household level. Based on empirical data collected from 5949 households from 35 wards of Delhi, it can be summarized that higher proportions of residents live in degraded indoor environmental conditions. The highest risks to health were attached to use of traditional fuels (64%), lack of a kitchen (59%), exposure to environmental tobacco smoke (ETS) (55%), and poor ventilation (55%). Acute respiratory infections (43%) were identified as one of the most prevalent health problems confronted by residents and are strongly associated with use of traditional fuels (adjusted OR 2.7, 95% CI 2.3-3.1). Asthma shows a significant relationship with the use of traditional fuels (adjusted OR 3.8, 95% CI 3.4-4.3), exposure to ETS (adjusted OR 2.5, 95% CI 2.2-2.7), and poor ventilation (adjusted OR 1.26, 95% CI 1.13-1.41). Lung cancer (adjusted OR 1.54, 95% CI 1.38-1.71) and cardiovascular diseases (adjusted OR 2.25, 95% CI 2.01-2.53) also show a strong relationship with ETS exposure. More research is needed. PRACTICAL IMPLICATIONS: The present study can help to create new insights in understanding the gravity of indoor air quality problems in Delhi and can therefore provide interesting material to social scientists, public health officers, planners, and decision makers. The information can be utilized to help formulate comprehensive policies and planning with a humanistic approach for proper urban indoor environments that will be applicable at all administrative levels, viz. local, national, and international, and will also provide an important background for additional research in this area.     

Biomarkers of exposure to passive smoking of school children: frequency and determinants

This study aims to assess the extent of children' exposure to ETS and quantify potential determinants. A total of 2767 children aged 5-14 years participated in an environmental survey in East Germany in 1998-1999 (participation rate 75.9%). A subgroup of 979 children between the ages of 11 and 14 years with complete data on nicotine and cotinine in urine were selected for this analysis. This study population consisted of 73 self-reported smokers (7.5%), 793 non-smokers (81%) and 113 children with missing data on smoking status (11.5%). Nicotine and cotinine concentrations in spontaneous urine sample were determined by high-performance liquid chromatography methods with ultraviolet-detection and corrected for creatinine. Approximately 40% of self-reported non-smokers were exposed to environmental tobacco smoke (ETS) at home. Non-smoking children exposed to parental tobacco smoke at home compared with not exposed showed in average higher nicotine and cotinine concentration (geometric mean 4.7 microg/l vs. 1.4 microg/l and 8.1 microg/l vs. 2.7 microg/l) and the adjusted odds ratio (OR) for detectable biomarkers ranged between 17 and 22. There were increased rates of detectable biomarkers in urine with increasing numbers of smoked cigarettes in the household (adjusted OR increased from 8 to 54). Maternal smoking showed a stronger effect than paternal smoking. Furthermore, low parental education, cold season, height of dwelling (相似文献   

Allergy and respiratory health effects of dampness and dampness‐related agents in schools and homes: a cross‐sectional study in Danish pupils

Little is known about the health effects of school‐related indoor dampness and microbial exposures. In this study, we investigated dampness and dampness‐related agents in both homes and schools and their association with allergy and respiratory health effects in 330 Danish pupils. Classroom dampness was identified based on technical inspection and bedroom dampness on parents' self‐report. Classroom and bedroom dust was analyzed for seven microbial components. Skin prick testing determined atopic sensitization. Lung function was expressed as z‐scores for forced expiratory volume in one‐second (zFEV₁), forced vital capacity (zFVC) and the ratio zFEV₁/zFVC using GLI‐2012 prediction equations. The parents reported children's allergies, airway symptoms, and doctor‐diagnosed asthma. High classroom dampness, but not bedroom dampness, was negatively associated with zFEV₁ (β‐coef. ?0.71; 95% CI ?1.17 to ?0.23) and zFVC (β‐coef. ?0.52; 95% CI ?0.98 to ?0.06) and positively with wheezing (OR 8.09; 95% CI 1.49 to 43.97). No consistent findings were found between any individual microbial components or combination of microbial components and health outcomes. Among other indoor risk factors, environmental tobacco smoke (ETS) decreased zFEV₁ (β‐coef. ?0.22; 95% CI ?0.42 to ?0.02) and zFEV₁/zFVCratio (β‐coef. ?0.26; 95% CI ?0.44 to ?0.07) and increased upper airway symptoms (OR 1.66; 95% CI 1.03–2.66). In conclusion, dampness in classrooms may have adverse respiratory health effects in pupils, but microbial agents responsible for this effect remain unknown.     

Indoor exposure to particulate matter and the incidence of acute lower respiratory infections among children: A birth cohort study in urban Bangladesh

Approximately half of all children under two years of age in Bangladesh suffer from an acute lower respiratory infection (ALRI) each year. Exposure to indoor biomass smoke has been consistently associated with an increased risk of ALRI in young children. Our aim was to estimate the effect of indoor exposure to particulate matter (PM_2.5) on the incidence of ALRI among children in a low‐income, urban community in Bangladesh. We followed 257 children through two years of age to determine their frequency of ALRI and measured the PM_2.5 concentrations in their sleeping space. Poisson regression was used to estimate the association between ALRI and the number of hours per day that PM_2.5 concentrations exceeded 100 μg/m³, adjusting for known confounders. Each hour that PM_2.5 concentrations exceeded 100 μg/m³ was associated with a 7% increase in incidence of ALRI among children aged 0–11 months (adjusted incidence rate ratio (IRR) 1.07, 95% CI 1.01–1.14), but not in children 12–23 months old (adjusted IRR 1.00, 95% CI 0.92–1.09). Results from this study suggest that reducing indoor PM_2.5 exposure could decrease the frequency of ALRI among infants, the children at highest risk of death from these infections.     

How free of tobacco smoke are ‘smoke‐free’ homes?

The risks of exposure to environmental tobacco smoke (ETS) are well established and 'harm reduction' strategies such as smoking outside to protect infants and children from exposure to ETS have been advocated for some time. The aim of this study was to assess the validity of self-reported smoking levels in residential settings. The participants were families (n = 92) randomly selected from lower socioeconomic areas of Perth, Western Australia. Each household was monitored for vapor phase nicotine and particulates with an aerodynamic diameter of < or = 10 microm (PM(10)). Of the 42% (39) households who reported that someone smoked cigarettes at home, only four (4%) said that smoking occurred inside the house. There was a 'moderate' agreement between parental-reported tobacco smoking and levels of nicotine (kappa = 0.55, P < 0.01). There were significant differences in the median levels of air nicotine (P < 0.01) and PM(10) (P < 0.05) between households in which smoking was reported as only occurring outside, and the smoke-free households. PRACTICAL IMPLICATIONS: The study outcome suggests that a strategy based on the separation of children and smoking activity is inadequate to protect the former from ETS at home, and that health professionals should give parents unambiguous advice to give up smoking in order to make their homes a completely smoke-free environment.     

Pre‐natal and post‐natal exposure to pet ownership and lung function in children: The Seven Northeastern Cities Study

To evaluate the association between pre‐natal and post‐natal exposure to pet ownership and lung function in children, a cross‐sectional study named Seven Northeastern Cities (SNEC) study was conducted. In this study, children's lung function including the forced expiratory volume in 1 second (FEV₁), forced vital capacity (FVC), maximal mid‐expiratory flow (MMEF), and peak expiratory flow (PEF) were measured by spirometers, and pet ownership situations were collected by questionnaire. Analyzed by multiple logistic regression and generalized linear modeling, we found that for all subjects, pet exposure in the first 2 years of life was significantly associated with lung function impairment of FVC<85% predicted (adjusted odds ratio [aOR]=1.28; 95% confidence interval [CI]: 1.01, 1.63). For current pet exposure, the increased odds of lung function impairment ranged from 35% (aOR=1.35; 95%CI: 1.12, 1.62) for FVC<85% predicted to 57% (aOR=1.57; 95%CI: 1.29, 1.93) for FEV₁<85% predicted. The in utero exposure was not related to lung function impairment. Compared with other pets, higher odds were observed among children with dogs. When stratified by gender, girls with current pet exposure were more likely to have lung function impairment than boys. It implies self‐reported exposures to pets were negatively associated with lung function among the children under study.     

Variability of total exposure to PM2.5 related to indoor and outdoor pollution sources Krakow study in pregnant women

The study is a part of an ongoing prospective cohort study on the relationship between the exposure to environmental factors during pregnancy and birth outcomes and health of newborns. We have measured personal PM(2.5) level in the group of 407 non-smoking pregnant women during the 2nd trimester of pregnancy. On average, the participants from the city center were exposed to higher exposure than those from the outer city area (GM=42.0 microg/m(3), 95% CI: 36.8-48.0 vs. 35.8 microg/m(3), 95% CI: 33.5-38.2 microg/m(3)). More than 20% of study subjects were affected by high level of PM(2.5) pollution (above 65 microg/m(3)). PM(2.5) concentrations were higher during the heating season (GM=43.4 microg/m(3), 95% CI: 40.1-46.9 microg/m(3)) compared to non-heating season (GM=29.8 microg/m(3), 95% CI: 27.5-32.2 microg/m(3)). Out of all potential outdoor air pollution sources (high traffic density, bus depot, waste incinerator, industry etc.) considered in the bivariate analysis, only the proximity of industrial plant showed significant impact on the personal exposure (GM=54.3 microg/m(3), 95% CI: 39.4-74.8 microg/m(3)) compared with corresponding figure for those who did not declare living near the industrial premises (GM=36.2 microg/m(3), 95% CI: 34.1-38.4 microg/m(3)). The subjects declaring high exposure to ETS (>10 cigarettes daily) have shown very high level of personal exposure (GM=88.8 microg/m(3), 95% CI: 73.9-106.7 microg/m(3)) compared with lower ETS exposure (< or =10 cigarettes) (GM=46.3 microg/m(3), 95% CI: 40.0-53.5 microg/m(3)) and no-ETS exposure group (GM=33.9 microg/m(3), 95% CI: 31.8-36.1 microg/m(3)). The contribution of the background ambient PM(10) level was very strong determinant of the total personal exposure to PM(2.5) and it explained about 31% of variance between the subjects followed by environmental tobacco smoke (10%), home heating by coal/wood stoves (2%), other types of heating (2%) and the industrial plant localization in the proximity of household (1%).     

Indoor Environmental Risk Factors for Respiratory Health in Children

Abstract The indoor environment of 80 houses in the Latrobe Valley, Victoria, Australia was assessed during six visits performed bi-monthly over a period of one year. Children between 7 and 14 years of age residing in the houses were included, resulting in 148 study children, 53 of whom were asthmatic. A respiratory health questionnaire was completed and skin prick tests performed. Significant risk factors for asthma were: exposure to a gas stove (OR=3.15, 95% CI 1.28-7.72), and indoor pets (OR = 2.68, 95% CI 1.07-6.70). Exposure to airborne Aspergillus spores (+10 CFU/m³, OR=1.51, 95% CI 1.05-2.18) was a risk factor for atopy, while exposure to a gas stove (OR=2.32, 95% CI 1.04-5.18) was a risk factor for respiratory symptoms. In conclusion, exposure to gas stoves, fungal spores and pets in the home were identified as statistically significant risk factors for respiratory health in children.     

Environmental exposure to lead in a population of adults living in northern France: lead burden levels and their determinants

As part of the assessment of a site in northern France polluted by metals from two smelters (in particular, lead, cadmium and mercury), a cross-sectional study was carried out which intended to estimate the levels of the lead burden of the adult population living on the site and the factors associated with these levels. The exposed zone included 10 municipalities in the Nord-Pas de Calais region, located in the vicinity of two non-ferrous metal smelters. The soils in these municipalities contained between 100 and 1700 ppm of lead. The non-polluted zone contained 20 municipalities from the same region, drawn randomly from those in the region of comparable size but free from any industrial lead exposure. The adult study population (301 men and 300 women) was stratified according to age, sex, employment status and exposure level. The inclusion criteria required subjects who were aged between 20 and 50 years and had been living in the exposed zone for at least 8 years; the exclusion criteria were pregnancy, cancer, kidney disease and diabetes. No more than 10% of the subjects participating could work at one of the two smelters. Data collection took place at home; visiting nurses interviewed subjects to complete a questionnaire and also took blood samples. The lead assay was performed by atomic absorption spectrometry. The geometric mean of the blood-lead levels was 74 microg/l, 95% CI = 69-80 among men and 49 microg/l, 95% CI = 46-53 among women. Blood-lead levels exceeding 100 microg/l were found among 30% of men and 12% of women. Several factors were associated with variation of the mean blood-lead level: the blood-lead level was significantly higher among the men for subjects living less than 1 km from the smelters (geometric mean x 1.3, 95% CI = 1.1-1.6), for those who drink alcoholic beverages (x 1.1, 95% CI = 1.0-1.2 for consumption of 30 g/day), those who smoke (x 1.2, 95% CI = 1.0-1.3 for 20 cigarettes/day), and for subjects with occupational exposure; among the women, for subjects living less than 1 km from the smelters (geometric mean x 1.5, 95% CI = 1.2-1.7), for those who drink alcohol (x 1.1, 95% CI = 1.1-1.2 for a daily consumption of 10 g), and for women living in a building constructed before 1948 (x 1.2, 95% CI = 1.0-1.4).     

Ambient air pollution and daily mortality in Anshan, China: a time-stratified case-crossover analysis

Few case-crossover studies were conducted in China to investigate the acute health effects of air pollution. We conducted a time-stratified case-crossover analysis to examine the association between air pollution and daily mortality in Anshan, a heavily-polluted industrial city in northeastern China. Daily mortality, air pollution, and weather data in 2004-2006 in Anshan were collected. Time-stratified case-crossover approach was used to estimate the effect of air pollutants (PM₁₀, SO₂, NO₂ and CO) on total and cardiopulmonary mortality. Controls were selected as matched days of the week in the same month. Potential effect modifiers, such as gender and age, were also examined. We found significant associations between air pollution and daily mortality from cardiovascular diseases in Anshan. A 10 μg/m³ elevation of 2-day moving average (lag 01) concentration in PM₁₀, SO₂, NO₂ and CO corresponded to 0.67% (95% CI: 0.29%, 1.04%), 0.38% (95% CI: −0.06%, 0.83%), 2.11% (95% CI: 0.22%, 4.00%) and 0.04% (95% CI: 0.01%, 0.07%) increase of cardiovascular mortality. The associations for total and respiratory mortality were generally positive but statistically insignificant. The air pollution health effects were significantly modified by age, but not by gender. Conclusively, our study showed that short-term exposure to air pollution was associated with increased cardiovascular mortality in Anshan. These findings may have implications for local environmental and social policies.     

Seasonal variability in environmental tobacco smoke exposure in public housing developments

The risk of tobacco smoking and second‐hand smoke (SHS) exposure combined are the leading contributors to disease burden in high‐income countries. Recent studies and policies are focusing on reducing exposure to SHS in multiunit housing (MUH), especially public housing. We examined seasonal patterns of SHS levels within indoor common areas located on Boston Housing Authority (BHA) properties. We measured weekly integrated and continuous fine particulate matter (PM_2.5) and passive airborne nicotine in six buildings of varying building and occupant characteristics in summer 2012 and winter 2013. The average weekly indoor PM_2.5 concentration across all six developments was 9.2 μg/m³, higher during winter monitoring period (10.3 μg/m³) compared with summer (8.0 μg/m³). Airborne nicotine concentrations ranged from no detection to about 5000 ng/m³ (mean 311 ng/m³). Nicotine levels were significantly higher in the winter compared with summer (620 vs. 85 ng/m³; 95% CI: 72–998). Smoking‐related exposures within Boston public housing vary by season, building types, and resident smoking policy. Our results represent exposure disparities that may contribute to health disparities in low‐income communities and highlight the potential importance of efforts to mitigate SHS exposures during winter when outdoor–indoor exchange rates are low and smokers may tend to stay indoors. Our findings support the use of smoke‐free policy as an effective tool to eliminate SHS exposure and protect non‐smokers, especially residents of MUH.     

Cooking fuel type, household ventilation, and the risk of acute lower respiratory illness in urban Bangladeshi children: a longitudinal study

Acute lower respiratory illnesses (ALRI) are the leading cause of death among children <5 years. Studies have found that biomass cooking fuels are an important risk factor for ALRI. However, few studies have evaluated the influence of natural household ventilation indicators on ALRI. The purpose of this study was to assess the association between cooking fuel, natural household ventilation, and ALRI. During October 17, 2004-September 30, 2005, children <5 years living in a low-income neighborhood of Dhaka, Bangladesh, were assessed weekly for ALRI and surveyed quarterly about biomass fuel use, electric fan ownership, and natural household ventilation (windows, ventilation grates, and presence of a gap between the wall and ceiling). Bivariate and multivariate analyses were performed using generalized estimating equations. Six thousand and seventy-nine children <5 years enrolled during the study period (99% participation) experienced 1291 ALRI. In the multivariate model, ≥2 windows [OR = 0.75, 95% CI = (0.58, 0.96)], ventilation grates [OR = 0.80, 95% CI = (0.65, 0.98)], and not owning an electric fan [OR = 1.50, 95% CI = (1.21, 1.88)] were associated with ALRI; gap presence and using biomass fuels were not associated with ALRI. Structural factors that might improve household air circulation and exchange were associated with decreased ALRI risk. Improved natural ventilation might reduce ALRI among children in low-income families. PRACTICAL IMPLICATIONS: The World Health Organization has stated that controlling pneumonia is a priority for achieving the fourth Millennium Development Goal, which calls for a two-third reduction in mortality of children <5 years old compared to the 1990 baseline. Our study represents an important finding of a modifiable risk factor that might decrease the burden of respiratory illness among children living in Bangladesh and other low-income settings similar to our study site. We found that the existence of at least two windows in the child's sleeping room was associated with a 25% decreased ALRI risk. Increasing available natural ventilation within the household in similar settings has the potential to reduce childhood mortality because of acute lower respiratory illnesses.     

Nonlinear associations between blood lead in children, age of child, and quantity of soil lead in metropolitan New Orleans

Previous studies identified a curvilinear association between aggregated blood lead (BL) and soil lead (SL) data in New Orleans census tracts. In this study we investigate the relationships between SL (mg/kg), age of child, and BL (μg/dL) of 55,551 children in 280 census tracts in metropolitan New Orleans, 2000 to 2005. Analyses include random effects regression models predicting BL levels of children (μg/dL) and random effects logistic regression models predicting the odds of BL in children exceeding 15, 10, 7, 5, and 3 μg/dL as a function of age and SL exposure. Economic benefits of SL reduction scenarios are estimated. A unit raise in median SL^0.5 significantly increases the BL level in children (b = 0.214 p = < 0.01), and a unit change in Age^0.5 significantly increases child BL (b = 0.401, p = < 0.01). A unit change in Age^0.5 increases the odds of a child BL exceeding 10 μg/dL by a multiplicative factor of 1.23 (95% CI 1.21 to 1.25), and a unit (mg/kg) addition of SL increases the odds of child BL > 10 μg/dL by a factor of 1.13 (95% CI 1.12 to 1.14). Extrapolating from regression results, we find that a shift in SL regulatory standard from 400 to 100 mg/kg provides each child with an economic benefit ranging from $4710 to $12,624 ($US 2000). Children's BL is a curvilinear function of both age and level of exposure to neighborhood SL. Therefore, a change in SL regulatory standard from 400 to 100 mg/kg provides children with substantial economic benefit.     

Burden of disease attributable to air pollutants from municipal solid waste incinerators in Seoul, Korea: a source-specific approach for environmental burden of disease

Few studies have attempted to quantify the integrated health burden, incorporating both mortality and morbidity as these factors pertain to air pollutants, on the population in the vicinity of the incinerators. The aims of this study are to estimate the attributable burden of disease caused by incinerators in Seoul, Korea and to present an approach based on source-specific exposure for the estimation of the environmental burden of disease (EBD). With particular attention on the development of a measurement means of the source-specific, exposure-based population attributable fraction (PAF), we integrated air dispersion modeling, Geographic Information Systems (GIS), the population distribution of exposure, and the exposure-response relationship. We then estimated the PAFs caused by additional concentrations of four air pollutants (PM₁₀, NO_2, SO₂, and CO) emitted from four municipal solid waste incinerators (MSWIs) in Seoul in 2007. We, finally, estimated the attributable burden of disease, using the estimated PAF and the disability-adjusted life years (DALY) method developed by the Global Burden of Disease Group of the World Health Organization (WHO).The PAF for NO₂ to all-cause mortality was assessed at approximately 0.02% (95% CI: 0.003-0.036%), which was the highest among all air pollutants. The PAFs for respiratory and cardiovascular disease were 0.12% (95% CI: 0.01-0.16%) and 0.10% (95% CI: 0.04-0.16%), respectively. The sum of the attributable burden of disease for four pollutants was about 297 person-years (PYs) (95% CI: 121-472 PYs) when the incinerators observed to the emission standards. The attributable burdens of respiratory disease and cardiovascular disease were about 0.2% and 0.1%, respectively, of the total burden of respiratory disease and cardiovascular disease of Seoul citizens for the year 2007. Although the air emissions from one risk factor, an incinerator, are small, the burden of disease can be significant to the public health when population exposure is considered.     

Urinary 1-hydroxypyrene in children living in city and rural residences in Denmark

AIMS: The present study aims to assess the biological uptake in children of polycyclic aromatic hydrocarbons measured as 1-hydroxypyrene in urine from children living in city and rural residences. METHODS: 103 children living in Copenhagen and 101 children living in rural residences of Denmark collected urine samples Monday to Friday morning. Each day, the family filled in a printed diary that included questions about the time and activity patterns of the child. Multiple regression analyses were used to identify predictors of the excreted 1-hydroxypyrene level. RESULTS: During the week, the children excreted on average 0.07 [95% CI: 0.01-0.41] micromol urinary 1-hydroxypyrene per mol creatinine. Children living in urban residences excreted 0.02 [95% CI: 0.01-0.05] micromol more 1-hydroxypyrene than children living in rural residences. This was confirmed in the multiple regression analysis showing a 29% (95% CI: 2-64%) higher excretion among urban children than rural children. Moreover, the regression analysis showed that for each hour per day spent outside the children excreted 58% (1.58 [1.22-2.03]) more 1-hydroxypyrene in urine. CONCLUSION: The present study indicates that children living in urban residences are more exposed to PAH than children living in rural residences. Time spent outdoors increased the excretion of 1-hydroxypyrene, which was most evident among urban children. Higher concentrations of ambient air pollution in urban areas may explain this finding. No influence of environmental tobacco smoke, cooking habits, and heating facilities was detected.