adverse respiratory effects of indoor air pollution€¦ · 3. participants and methods 4...

Joana Madureira, Inês Paciência, Elisabete Ramos, C ristiana Pereira, João P. Teixeira, Gabriela Ventura, Eduardo O. Fernandes, H enrique Barros

Unit of Advanced Studies in Energy in the Built EnvironmentIDMEC-FEUP

Porto, Portugal

Adverse respiratory effects ofindoor air pollution

July 7-12 2014, Hong Kong

Wednesday, July 09, 2014(A6) Health and indoor air epidemiology

Contents

1

1. Objective

2. Participants and Methods

3. Results and Discussion

4. Conclusions

2. Objective

2

To evaluate the association between indoorair exposure and primary school children ´srespiratory symptoms .

3

Cross-Sectional Study

- Building/classroom inspectionchecklist

- Time-activity diary- IAQ measurements

- Health questionnaire- Clinical health examination

Heating Season Nov. 2011-Dec. 2012

• Health assessment (n=1099 participants)


Monday � Friday

• Environmental audit (n=63 classrooms)


4

Parents’ questionnaire

Lung function test

1639 eligible children (8-9 yrs old)(20 schools, 73 classrooms)

n=1099

324 (19.8%)never reply

978 childrenStudy of the associations between IAQ and ISAAC

symptoms (wheeze, nasal allergy, cough and phlegm

episodes).

181 (11.0%)refused

846 childrenStudy of the associations between IAQ and recent symptoms-past 3 months (hand rash or face rash, eczema, eye irritation, runny nose or blocked nose, irritative cough).

1134 (69.2%)participated

n=842

Health Assessment


11

Checklist Time-activity diary

Walkthrough inspection and checklist

Environmental Audit - Survey

4. Collect, evaluate and report results

2. Design study3. Suitable

analysis methods

1. Define monitoring objective *

Conclusions

Recommendations

Statistical evaluation

Quality control of the data

Health complaint

Remediation effectiveness

Guideline compliance

Source attribution

Survey

*Differ in the amountand specificity of therequirements

Results and discussion

Specific objective

Choose sampling strategy and procedure

Identify substances of concern

Identify monitoring sites

Identify data requirements

Visiting inspection

Identify information to record

Define data quality objectives

Choose analytical method

Execute analytical method

Define and apply QA/QC standards

Uncertainty estimation



Volatile organic compounds (1)

Formaldehyde, acetaldehyde (2)

CO (3)

-sampling: stainless-steel tubes containing Tenax®

TA-analyses: GC/MS, ISO 16000-6

-sampling: passive samplers RAD165-analyses: HPLC with UV detector, ISO 16000-4

-electrochemical sensor(equiment with datalogger)

7

IAQ measurementsSampling: - passive: 1 week

- active: 8/24 hours

(1) (2) (3)

Environmental Audit - Survey


8

TSA

MEA

CO2 (1)

Temperature & relative humidity (1)

PM2.5, PM10 (2)

Bacteria & fungi (3)

-infrared non-dispersive sensor-thermistor and thin-film capacitive sensor

-laser photometers based on optical light scattering (equiment with datalogger)

-sampling: single-stage microbiological air impactor + agar plates-analysis: NIOSH 0800, ISO 13098

Sampling active: 8/24 hours

(2) (3)(1)

IAQ measurementsEnvironmental Audit - Survey

n>DL Mean SD Median P25 P75 Min Max

Chemical

Benzene, µg/m3 7 2.16 0.49 2.47 1.58 2.60 1.48 2.67

Toluene, µg/m3 72 15.10 34.50 6.37 4.49 10.40 1.84 202.50

m/p-xylene, µg/m3 71 17.70 59.00 4.97 3.31 6.82 1.21 365.20

o-xylene, µg/m3 68 3.93 6.92 2.30 1.83 3.37 1.09 52.40

d-limonene, µg/m3 71 38.10 44.50 23.10 11.50 48.60 2.77 215.30

α-pinene, µg/m3 63 3.40 5.50 1.75 1.32 2.75 1.01 32.00

T4CE, µg/m3 18 2.90 1.53 2.90 1.77 3.39 1.07 8.25

Naphthalene, µg/m3 6 1.40 0.21 1.33 1.24 1.60 1.15 1.68

Styrene, µg/m3 13 1.41 0.46 1.19 1.17 1.35 1.02 2.66

TVOC, µg/m3 73 172.20 145.20 140.30 85.5 198.40 8.88 820.20

Formaldehyde, µg/m3 73 19.80 10.90 17.50 13.80 23.10 8.24 126.90

Acetaldehyde, µg/m3 73 9.31 7.82 7.65 4.96 10.4 1.92 64.60

CO, mg/m3 -- 0.48 0.44 0.38 0.07 0.68 0.01 1.70

9


DL- detection limit; CO concentrations corresponds to the teaching hours

Chemical parameters bellow existing WHOguidelines and INDEX recommendations values.

Chemical parameters in classrooms ( n=73)

10


Mean SD Median P25 P75 Min Max

Physical and comfort

PM2.5, µg/m3 94 40 82 67 106 39 244

PM10, µg/m3 139 49 127 109 167 56 320

CO2, ppm 1669 601 1469 1195 2104 829 3111

Ventilation, l/s per person 0.87 1.38 0.33 0.21 0.78 0.11 7.21

Temperature, ºC 20.5 2.06 20.8 19.2 21.7 14.3 24.6

Relative humidity, % 55 10 54 50 65 34 74

Microbiological

Bacteria, CFU/m3 3626 2269 3224 1784 5430 168 8372

Fungi, CFU/m3 323 235 240 169 400 61 1322

WHO AQ guidelines (24 hr)PM2.5 = 25 µg/m3

PM10 = 50 µg/m3

ASHRAE

CO2 =1000 ppmPortuguese legislation

Bacteria = 500 CFU/m3PM, CO2 and bacteria exceededthe existing guidelines values.

Note: data corresponds to the teaching hours, except the ventilation rate estimation

Physical, comfort parameters and biological agents in classrooms ( n=73)

No significant association found between chemical,physical and microbiological agents and eczema, eyeirritation and nose symptoms (present past 3 months).


Associations between indoor exposure variables and children’s health outcomes

11

Toluenem/p-xylene; o-

xylened-limoneneα-pinene

TVOCFormaldehydeAcetaldehyde

CO

PM2.5,PM10CO2

TemperatureRel. humidity

BacteriaFungi

•Wheeze (<12 months), Wheeze (<30 days)•Ever nasal allergy•Cough episodesǂ

•Phlegm episodesǂ

•Skin symptoms•Eczema•Eye irritation•Nose symptoms•Irritating cough

No significant association found between otherchemical parameters and wheeze, nasal allergy, coughand phlegm episodes.

ISAAC question*

Recent symptoms**

*Ever, past year and past monthǂ apart common colds

** past 3 months

Indoor air exposure vs. health outcomes


Association between indoor TVOC levels and wheeze (n=978)

Children exposed to TVOC at levels approximately ≥100 µg/m3

had a twofold increased risk of having asthma-related symptoms.

Wheeze (<12 months) Wheeze (<30 days)

TVOC, µg/m3 OR (95% CI) aOR (95% CI) OR (95% CI) aOR (95% CI)

<101.87 1 1 1 1

101.87-189.93 1.58 (0.96-2.61) 1.67 (0.93-3.00) 1.95 (0.89-4.26) 2.56 (1.05-6.25)

≥189.94 1.42 (0.86-2.32) 1.64 (0.94-2.85) 2.22 (1.05-4.67) 2.67 (1.15-6.18)

adjusted OR for age, sex, mother’s education, body mass index, relative humidity and temperature.

12


Wheeze (<12 months) Wheeze (<30 days)

OR (95% CI) aOR (95% CI) OR (95% CI) aOR (95% CI)PM2.5, µg/m3

<72.53 1 1 1 172.53-97.92 1.35 (0.81-2.26) 1.72 (0.96-3.08) 1.44 (0.64-3.22) 1.44 (0.62-3.39)

≥97.93 1.48 (0.88-2.48) 1.90 (1.04-3.45) 2.20 (1.02-4.74) 2.28 (1.00-5.18)

PM10, µg/m3

<116.77 1 1 1 1116.77-137.88 1.07 (0.64-1.80) 1.23 (0.66-2.27) 1.85 (0.78-4.39) 1.58 (0.61-4.09)

≥137.89 1.48 (0.90-2.45) 1.93 (1.07-3.49) 2.96 (1.30-6.73) 3.00 (1.23-7.33)

13


Associations between indoor PM2.5 and PM10 levels and wheeze (n=978)


Higher PM2.5 and PM10 levels increase the odds of asthma-likesymptoms; the association was stronger for PM10.


Increasing odds of irritating cough with increasing levels of PM2.5and PM10 were found.

Nose symptoms Irritating cough

OR (95% CI) aOR (95% CI) OR (95% CI) aOR (95% CI)

PM2.5, µg/m3

<72.53 1 1 1 172.53-97.92 1.14 (0.63-2.03) 1.05 (0.55-2.00) 1.50 (1.04-2.14) 1.54 (1.04-2.28)

≥97.93 1.78 (1.03-3.10) 1.52 (0.82-2.82) 1.49 (1.03-2.16) 1.54 (1.03-2.31)

PM10, µg/m3

<116.77 1 1 1 1116.77-137.88 1.56 (0.85-2.83) 1.01 (0.51-2.01) 1.44 (1.00-2.08) 1.52 (1.01-2.30)

≥137.89 2.15 (1.20-3.84) 1.66 (0.88-3.15) 1.52 (1.05-2.19) 1.64 (1.08-2.47)

14


Associations between indoor PM2.5 and PM10 levels and irritating cough (n=846)



• All chemical´s concentrations in the classrooms were ingeneral below the existing WHO guideline values.

• PM2.5 and PM10, levels generally exceeded the establishedguidelines values.

• CO2 values exceed recommended limits.

• Children exposed to TVOC at levels over 100 µg/m3 had atwofold increased risk of having asthma-related symptoms.

• The present study supports the pro-inflammatory role of PM2.5and PM10, especially among the most susceptible children.

5. Conclusions

15

Obrigada!Thank you!

July 7-12 2014, Hong Kong

Wednesday, July 09, 2014(A6) Health and Indoor air epidemiology

Joana [email protected]

This study is supported by the Portuguese Foundation for Science and Technology(FCT) through the ARIA project (PTDC/DTP-SAP/1522/2012).

adverse respiratory effects of indoor air pollution€¦ · 3. participants and methods 4...

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