The association between ambient NO2 and PM2.5 with the respiratory health of school children residing in informal settlements: A prospective cohort study.

BACKGROUND: No previous epidemiological study has investigated the combined association of long-term ambient nitrogen dioxide (NO2) and particulate matter of diameter size-2.5 (PM2.5) exposure with asthma outcomes among schoolchildren in Africa. OBJECTIVES: This study investigated the independent and co-pollutant association of long-term exposures to ambient air pollutants on asthma-associated outcomes in a cohort of schoolchildren in the Western Cape Province of South Africa. METHODS: A total of 590 grade-4 schoolchildren residing in four informal settlements were studied. Spirometry and fractional exhaled nitric-oxide (FeNO) measurements were conducted, including a standardized questionnaire administered to caregivers at baseline and 12-months follow-up. Annual NO2 and PM2.5 levels were estimated for each child's home using land-use regression modelling. Single- and two-pollutant models were constructed to assess the independent and co-pollutant association of both air pollutants (NO2 and PM2.5) on new cases of asthma-associated outcomes adjusting-for host characteristics, indoor exposures and study area. RESULTS: The annual average concentration of PM2.5 and NO2 were 10.01µg/m3 and 16.62µg/m3 respectively, across the four study areas, and were below the local Standards of 20µg/m3 and 40µg/m3, for both pollutants, respectively. In the two-pollutant-adjusted models, an interquartile range (IQR) increase of 14.2µg/m3 in NO2 was associated with an increased risk of new onset of ocular-nasal symptoms (adjusted odds ratio-aOR: 1.63, 95% CI: 1.01-2.60), wheezing (aOR: 3.57, 95% CI: 1.18-10.92), more than two or more asthma symptom score (aOR: 1.71, 95% CI: 1.02-2.86), and airway inflammation defined as FeNO > 35 ppb (aOR: 3.10, 95% CI: 1.10-8.71), independent of PM2.5 exposures. CONCLUSION: This study provided evidence that ambient NO2 levels below local standards and international guidelines, independent of PM2.5 exposure, increases new cases of asthma-associated outcomes after 12-months.

Asthma-related outcomes associated with indoor air pollutants among schoolchildren from four informal settlements in two municipalities in the Western Cape Province of South Africa.

The health impact of indoor air pollution in informal settlement households has not been extensively studied in South Africa. This cross-sectional study investigated the association between asthma and common indoor exposures among schoolchildren from four informal settlements located in two municipalities in the Western Cape Province. A total of 590 children, aged 9-11 years, were recruited. The International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire was administered to caregivers. Pulmonary function assessment included spirometry and fractional exhaled nitric oxide (FeNO). Phadiatop test for atopy was done. The prevalence of doctor-diagnosed asthma was 3.4% (n = 20) among whom only 50% were on treatment. The prevalence of current wheeze was 12.9%, and 17.6% had airway obstruction (FEV1  < lower limit of normal), while 10.2% had airway inflammation (FeNO > 35 ppb). In adjusted logistic regression models, dampness, visible mold growth, paraffin use for cooking, and passive smoking were associated with a twofold to threefold increased risk in upper and lower airway outcomes. The strongest association was that of visible mold growth with rhinitis (adjusted odds ratio-aOR 3.37, 95% CI: 1.69-6.71). Thus, there is a need for improved diagnosis of childhood asthma and Indoor Air Quality in informal settlement households.

A prospective cohort study on ambient air pollution and respiratory morbidities including childhood asthma in adolescents from the western Cape Province: study protocol.

BACKGROUND: There is evidence from existing literature that ambient air pollutant exposure in early childhood likely plays an important role in asthma exacerbation and other respiratory symptoms, with greater effect among asthmatic children. However, there is inconclusive evidence on the role of ambient air pollutant exposures in relation to increasing asthma prevalence as well as asthma induction in children. At the population level, little is known about the potential synergistic effects between pollen allergens and air pollutants since this type of association poses challenges in uncontrolled real life settings. In particular, data from sub-Sahara Africa is scarce and virtually absent among populations residing in informal residential settlements. METHODS/DESIGN: A prospective cohort study of 600 school children residing in four informal settlement areas with varying potential ambient air pollutant exposure levels in the Western Cape in South Africa is carried-out. The study has two follow-up periods of at least six-months apart including an embedded panel study in summer and winter. The exposure assessment component models temporal and spatial variability of air quality in the four study areas over the study duration using land-use regression modelling (LUR). Additionally, daily pollen levels (mould spores, tree, grass and weed pollen) in the study areas are recorded. In the panel study asthma symptoms and serial peak flow measurements is recorded three times daily to determine short-term serial airway changes in relation to varying ambient air quality and pollen over 10-days during winter and summer. The health outcome component of the cohort study include; the presence of asthma using a standardised ISAAC questionnaire, spirometry, fractional exhaled nitric-oxide (FeNO) and the presence of atopy (Phadiatop). DISCUSSION: This research applies state of the art exposure assessment approaches to characterize the effects of ambient air pollutants on childhood respiratory health, with a specific focus on asthma and markers of airway inflammation (FeNO) in South African informal settlement areas by considering also pollen counts and meteorological factors. The study will generate crucial data on air pollution and asthma in low income settings in sub-Sahara Africa that is lacking in the international literature.

The Association Between Urinary Concentrations of Organophosphate Metabolites and Asthma-Related Outcomes Among Schoolchildren From Informal Settlements.

Objectives: There is inconsistent evidence on the relationship between pesticide exposure and childhood respiratory outcomes in non-agricultural settings. This study investigated the association between organophosphate (OP) pesticide exposure and asthma-related outcomes in children residing in four informal settlements. Methods: The study was a longitudinal study of 590 schoolchildren, with a 12 months follow-up period. A standardised questionnaire adopted from the International Study of Asthma and Allergies in Childhood was administered to caregivers for child's respiratory symptoms and household characteristics. Spirometry and fractional-exhaled nitric oxide, including a phadiatop test (atopy status) and urinary dialkyl phosphate (DAP) metabolites were measured at baseline and follow-up. DAP metabolites included diethylphosphate (DEP) and dimethyl phosphate (DMP) measured at baseline and follow-up and dimethylthiophosphate (DMTP) measured only at baseline. Results: The mean ages of schoolchildren were 9.9 ± 0.91 years and the overal incidence proportions of new doctor diagnosed asthma was 2.2%. No consistent patterns of increased risk of asthma outcomes with increasing DAP concentrations was found in multivariate analysis. Conclusion: Future studies with longer follow-up periods and repeated OP biomonitoring are recommended.

A synthesis of mercury research in the Southern Hemisphere, part 1: Natural processes.

Recent studies demonstrate a short 3-6-month atmospheric lifetime for mercury (Hg). This implies Hg emissions are predominantly deposited within the same hemisphere in which they are emitted, thus placing increasing importance on considering Hg sources, sinks and impacts from a hemispheric perspective. In the absence of comprehensive Hg data from the Southern Hemisphere (SH), estimates and inventories for the SH have been drawn from data collected in the NH, with the assumption that the NH data are broadly applicable. In this paper, we centre the uniqueness of the SH in the context of natural biogeochemical Hg cycling, with focus on the midlatitudes and tropics. Due to its uniqueness, Antarctica warrants an exclusive review of its contribution to the biogeochemical cycling of Hg and is therefore excluded from this review. We identify and describe five key natural differences between the hemispheres that affect the biogeochemical cycling of Hg: biome heterogeneity, vegetation type, ocean area, methylation hotspot zones and occurence of volcanic activities. We review the current state of knowledge of SH Hg cycling within the context of each difference, as well as the key gaps that impede our understanding of natural Hg cycling in the SH. The differences demonstrate the limitations in using NH data to infer Hg processes and emissions in the SH.

A synthesis of mercury research in the Southern Hemisphere, part 2: Anthropogenic perturbations.

Environmental mercury (Hg) contamination is a global concern requiring action at national scales. Scientific understanding and regulatory policies are underpinned by global extrapolation of Northern Hemisphere Hg data, despite historical, political, and socioeconomic differences between the hemispheres that impact Hg sources and sinks. In this paper, we explore the primary anthropogenic perturbations to Hg emission and mobilization processes that differ between hemispheres and synthesize current understanding of the implications for Hg cycling. In the Southern Hemisphere (SH), lower historical production of Hg and other metals implies lower present-day legacy emissions, but the extent of the difference remains uncertain. More use of fire and higher deforestation rates drive re-mobilization of terrestrial Hg, while also removing vegetation that would otherwise provide a sink for atmospheric Hg. Prevalent Hg use in artisanal and small-scale gold mining is a dominant source of Hg inputs to the environment in tropical regions. Meanwhile, coal-fired power stations continue to be a significant Hg emission source and industrial production of non-ferrous metals is a large and growing contributor. Major uncertainties remain, hindering scientific understanding and effective policy formulation, and we argue for an urgent need to prioritize research activities in under-sampled regions of the SH.

A review of mercury pollution in South Africa: current status.

The present paper is a review on the status of mercury (Hg) as a pollutant in South African aquatic ecosystems. Spatial patterns of Hg distribution and bioaccumulation in water resources were investigated by collecting and analyzing multimedia samples for physiochemical and Hg-species determination from 62 sampling sites. The data presented showed a wide range in concentrations, which was expected given the array of environmental parameters, water chemistry and sources of Hg. Generally, higher Hg concentrations were measured in environmental compartments impacted by the major anthropogenic Hg sources which, in South Africa, are largely represented by emissions from coal-fired power stations (i.e. Olifants and Upper Vaal WMAs) and artisanal gold mining (i.e., Inkomati WMA). Ancillary water quality parameters (e.g. pH, temperature, DOC, EC and nutrients) were measured and regressed with the measured Hg concentrations to determine which environmental parameters most influenced regional Hg concentrations. The TotHg (sed) and DOC concentrations were identified as important factors controlling TotHg (aq), while TotHg(sed) were correlated to TotHg (aq). This result is indicative of the combined effects of sediment settling and resuspension in the aquatic environment. In contrast, MeHg (aq) was not correlated to DOC. MeHginvert were correlated to MeHg (sed), while MeHg (fish) were correlated to MeHg (aq) and water quality variables (chlorides--Cl(-) and electrical conductivity--EC). A steady progress has been made in Hg research in South Africa. However, despite the substantial knowledge about Hg toxicity, there are still considerable knowledge gaps on the fate and transport of Hg. Hence, further environmental and human health studies are proposed.

Ambient Air Pollution and Cardiorespiratory Outcomes amongst Adults Residing in Four Informal Settlements in the Western Province of South Africa.

Few studies have investigated the relationship between ambient air pollution and cardiorespiratory outcomes in Africa. A cross-sectional study comprising of 572 adults from four informal settlements in the Western Cape, South Africa was conducted. Participants completed a questionnaire adapted from the European Community Respiratory Health Survey, and the National Health and Nutrition Examination Survey questionnaire. Exposure estimates were previously modelled using Land-Use Regression for Particulate Matter (PM2.5) and Nitrogen Dioxide (NO2) at participants' homes. The median age of the participants was 40.7 years, and 88.5% were female. The median annual NO2 level was 19.7 µg/m3 (interquartile range [IQR: 9.6-23.7]) and the median annual PM2.5 level was 9.7 µg/m3 (IQR: 7.3-12.4). Logistic regression analysis was used to assess associations between outcome variables and air pollutants. An interquartile range increase of 5.12 µg/m3 in PM2.5 was significantly associated with an increased prevalence of self-reported chest-pain, [Odds ratio: 1.38 (95% CI: 1.06-1.80)], adjusting for NO2, and other covariates. The study found preliminary circumstantial evidence of an association between annual ambient PM2.5 exposure and self-reported chest-pain (a crude proxy of angina-related pain), even at levels below the South African National Ambient Air Quality Standards.

Mercury concentrations in water resources potentially impacted by coal-fired power stations and artisanal gold mining in Mpumalanga, South Africa.

Total mercury (TotHg) and methylmercury (MeHg) concentrations were determined in various environmental compartments collected from water resources of three Water Management Areas (WMAs) - viz. Olifants, Upper Vaal and Inkomati WMAs, potentially impacted by major anthropogenic mercury (Hg) sources (i.e coal-fired power stations and artisanal gold mining activities). Aqueous TotHg concentrations were found to be elevated above the global average (5.0 ng/L) in 38% of all aqueous samples, while aqueous MeHg concentrations ranged from below the detection limit (0.02 ng/L) to 2.73 +/- 0.10 ng/L. Total Hg concentrations in surface sediment (0-4 cm) ranged from 0.75 +/- 0.01 to 358.23 +/- 76.83 ng/g wet weight (ww). Methylmercury accounted for, on average, 24% of TotHg concentrations in sediment. Methylmercury concentrations were not correlated with TotHg concentrations or organic content in sediment. The concentration of MeHg in invertebrates and fish were highest in the Inkomati WMA and, furthermore, measured just below the US EPA guideline for MeHg in fish.

Short term seasonal effects of airborne fungal spores on lung function in a panel study of schoolchildren residing in informal settlements of the Western Cape of South Africa.

BACKGROUND: The individual effects of biological constituents of particulate matter (PM) such as fungal spores, on lung function in children are not well known. This study investigated the seasonal short-term effect of daily variation in Alternaria and Cladosporium fungal spores on lung function in schoolchildren. METHODS: This panel study evaluated 313 schoolchildren in informal settlements of the Western Cape of South Africa, exposed to spores of two commonly encountered fungi, Alternaria and Cladosporium species. The children provided forced-expiratory volume in 1-s (FEV1) and peak-expiratory flow (PEF) measurements thrice daily for two consecutive school-weeks in summer and winter. Daily PM10 levels, from a stationary ambient air quality monitor and fungal spore levels using spore traps were measured in each study area throughout the year. The effects of Alternaria and Cladosporium spores, on lung function were analysed for lag periods up to five-days, adjusting-for PM10, other pollen exposures, study area, and other host and meteorological factors. Same-day exposure-response curves were computed for both fungal species. RESULTS: There was more variability in Alternaria spores level with noticeable peaks in summer. There were consistent lag-effects for Alternaria on PEF compared to Cladosporium, with the largest PEF deficit observed in winter (mean deficit: 13.78 L/min, 95%CI: 24.34 to -3.23 L/min) per 10spores/m3 increase in Alternaria spores on lag day-2. Although there were no observable lag-effects for Alternaria and Cladosporium on FEV1, same-day effects of Cladosporium spores on FEV1 was present across both seasons. Threshold effects of Alternaria on both PEF and FEV1 deficits were apparent at levels of 100 spores/m3, but could not be explored for Cladosporium beyond the levels observed during the study. CONCLUSION: The study provides evidence for the independent effects of daily exposure to ambient fungal spores of Alternaria and Cladosporium on lung function deficits, more especially in winter for PEF.

Methylmercury uptake and distribution kinetics in sheepshead minnows, Cyprinodon variegatus, after exposure to Ch3Hg-spiked food.

The distribution kinetics of methylmercury (CH3Hg[II]) was determined in sheepshead minnows (Cyprinodon variegatus) after a single dose of different CH3Hg(II)-spiked food to determine what factors influence the bioavailability, uptake, and redistribution of CH3Hg(II) to various organs of C. variegatus. The kinetics of CH3Hg(II) distribution was measured in the different organs during a period of 0.1 to 35 d after dosage. The CH3Hg(II) distribution kinetics in the different tissues was modeled using a simple multicompartmental pharmacokinetic model, which assumed that blood was the conduit linking the CH3Hg(II) exchange between the different organs. The CH3Hg(II) was taken up into the intestinal tissue within hours after feeding, followed by a slow release to the blood and the other organs of the body. Exchange between the blood and the visceral organs was relatively slow, with maximum CH3Hg(II) uptake in the liver and gill occurring at 1.5 d following dietary exposure. Subsequently, the majority of the CH3Hg(II) was channeled from the viscera to the rest of the body with a substantial lag time after feeding. However, the rate of transfer between tissues in the studies reported here were faster than those measured by others for larger fish.

Mercury concentrations at a historically mercury-contaminated site in KwaZulu-Natal (South Africa).

INTRODUCTION: A mercury (Hg) processing plant previously operating in KwaZulu-Natal Province (South Africa) discharged Hg waste into a nearby river system causing widespread contamination since the 1980s. Although the processing plant ceased operation in the 1990s, Hg contamination (due to residual Hg) remains significant. Previous studies in the area since the plant's closure have found elevated Hg concentrations in fish, and that these concentrations were as a direct consequence of widespread contamination of the Hg processing plant operations conducted between the 1980s and 1990s. OBJECTIVES: This study aimed at investigating the impacts of residual Hg almost 20 years after the plant's closure. METHODS: Water, sediment and biota (invertebrates and fish) were collected in water resources in the vicinity of the processing plant to determine the Hg concentrations in these compartments, as a proxy for assessing the extent to which residual Hg that is reintroduced to the water column becomes bioavailable to biota. For water and sediment samples, higher total mercury (TotHg) and methylmercury (MeHg) concentrations were measured at sampling sites immediately downstream of the Hg processing plant when compared to the upstream sites, while concentrations decreased with distance from the plant. Fish MeHg concentrations measured just below the US EPA guideline for Hg in fish muscle tissue. RESULTS: The results show that the historically Hg-contaminated river system is a potential Hg pollution source due to the residual Hg present in sediment. Any dredging of sediment as a form of remediation in the Mngceweni River is not recommended; however, a Hg monitoring programme is recommended for assessing the bioavailability of resuspended Hg from sediment.

Photoelectrochemical determination of inorganic mercury in aqueous solutions.

An analytical method using an optical probe in a photoelectrochemical cell for the sensitive and selective determination of aqueous Hg(2+) is presented. A previously synthesized Hg(2+) selective chemosensor, proven to be Hg(2+) sensitive up to 2 microg L(-1), has been immobilized onto indium tin oxide (ITO) electrodes in a composite form with polyaniline. The coated ITO electrode was placed in a photoelectrochemical cell under closed circuit conditions in which the optical recognition of the chemosensor was converted to a measurable signal. A composite of the fluorescent chemosensor, Rhodamine 6G derivative (RS), and polyaniline (PANI) was immobilized on ITO glass plates and subjected to photovoltage measurements in the absence and presence of Hg(2+). The optical responses of the coated electrode were used to determine the sensitivity and selectivity of the immobilized sensor to Hg(2+) in the presence of background ions. The optical response of the PANI-dye coated electrode increased linearly with increasing Hg(2+) concentration in the range 10-150 microg L(-1), with a detection limit of 6 microg L(-1).

Factors controlling the bioavailability of ingested methylmercury to channel catfish and Atlantic sturgeon.

The bioavailability of ingested methylmercury (CH3Hg(III) was investigated in vitro using the gastric and intestinal fluids of channel catfish, Ictalurus punctatus, and Atlantic sturgeon, Acipenser oxyrinchus. Gastric fluid collected from each species was incubated with CH3Hg(II)-spiked sediment or bloodworms, after which the intestinal fluid of each species was added and incubated further. The proportion of CH3Hg(II) solubilized from bloodworms and sediment appeared to be controlled by complexation to amino acids in both the stomach and the intestinal fluids during the digestive process,with the more thorough digestion of bloodworm organic material enhancing CH3Hg(II) solubilization. A greater proportion of CH3Hg(II) was solubilized by the sturgeon fluids compared to the catfish fluids, especially for the sediment incubations. These differences corresponded to the relative amount of amino acids in the fluids of these fish. A comparison of the catfish gastrointestinal solubilization incubations and a CH3-Hg(II) bioaccumulation experiment with bloodworms revealed that the solubilization incubations may be a reasonable surrogate measurement of the bioavailability of CH3Hg(II) to fish. Overall, it appears that digestive processes is the most important controlling factor in the bioavailability of CH3Hg(II) to fish.

Methylmercury accumulation and fluxes across the intestine of channel catfish, Ictalurus punctatus.

The excised intestines of channel catfish, Ictalurus punctatus, were perfused at 20 or 4 degrees C for 1 h 45 min, with methylmercury (CH(3)HgCl) alone, or in the presence of excess L-cysteine (L-Cys), D-cysteine (D-Cys), L-methionine (L-Met); or with ouabain or probenecid to identify the potential CH(3)Hg(II) uptake pathways in fish intestines. A temperature effect was noted, with CH(3)Hg(II) concentrations in tissues perfused at 20 degrees C being higher than at 4 degrees C, substantiating the idea that mechanisms requiring metabolic energy are involved in CH(3)Hg(II) uptake in fish intestines. The results indicate that, when CH(3)Hg(II) is complexed as the CH(3)Hg-L-Cys complex, it is taken up via an L-neutral amino acid carrier and rapidly transported to the serosal side of the intestine. Methylmercury uptake could be inhibited by probenecid and ouabain, although probenecid had less impact on CH(3)Hg(II) uptake than ouabain. Our results for CH(3)Hg(II) uptake in the presence of D-Cys, L-Met in excess of L-Cys, or with a metal mixture further established that CH(3)Hg(II) uptake across fish intestines occurs via a variety of pathways, including an energy-dependent L-neutral amino acid carrier, and that the route and amount of accumulation were a function of CH(3)Hg(II) speciation in the digestive tract of the fish.