Method development for thermal desorption-gas chromatography-tandem mass spectrometry (TD-GC-MS/MS) analysis of trace level fluorotelomer alcohols emitted from consumer products.

The scientific foundation for per- and polyfluoroalkyl substances (PFAS) measurements in water, soils, sediments, biosolids, biota, and outdoor air has rapidly expanded; however, there are limited efforts devoted to developing analytical methods to measure vapor-phase PFAS in indoor air. A gas chromatography-tandem mass spectrometry (GC-MS/MS) method coupled with thermal desorption (TD) sorbent tube analysis was developed to quantify trace levels of fluorotelomer alcohols (FTOHs) emitted from consumer products in the indoor environment. Method evaluation included determination of instrument detection limits (IDLs), quality assurance checks of target standards purchased from different vendors, sample loss during storage, and TD sorbent breakthrough with tubes coupled in-series. The IDLs for TD-GC-MS/MS analyses ranged from 0.07 - 0.09 ng/tube. No significant loss of FTOHs was observed during stability tests over 28 days with relative standard deviations (RSDs) of spiked TD tubes ranging from 3.1 - 7.7% and the RSDs of polypropylene copolymer vial storage of standard solutions ranging from 4.3 - 8.4%. TD tube breakthrough was minimal with recovered FTOHs in the second tubes <1% of the spiked concentrations in the first tubes with carrier gas volume up to 20 L. The method has been applied to determine FTOH emissions from three consumer products in micro-scale chambers. A liquid stone cleaner/sealer product contained the highest levels of 6:2, 8:2, and 10:2 FTOHs, while the mattress pad products contained lower levels of 8:2 and 10:2 FTOHs. The emission parameters, including the initial emission factors and first order decay rate constants, were obtained based on the experimental data. The developed methods are sensitive and specific for analysis of all four target FTOHs (4:2, 6:2, 8:2, 10:2 FTOHs) with chamber testing. The methods can be extended to indoor air sampling and could be applicable to ambient air sampling.

Effect of crude oil exploration and exploitation activities on soil, water and air in a Nigerian community.

The continuous degradation of environmental ecosystems (land, water and soil) resulting from crude oil exploration and exploitation activities continues to gain global attention. This study investigates the effects of crude oil exploration and exploitation activities on soil, water and air in the study area. Soil samples were collected in three replicates at depths of 0-15 and 15-30 cm at sampling distances of 20, 100 and 200 m a from core oil exploitation operation area and a control point. Water samples were also taken from within the study area and analyzed using standard procedures. Major pollutants concentrations of particulate matter (PM2.5 and PM10) of the air were also measured using Air Quality Index (AQI). The results reveal that the soil, water and air parameters measured mostly at 20 m from the core oil operation area compromise the allowable standards provided for healthy living. In the same manner, some results at 100 and 200 m were slightly higher than the recommended values in some cases of heavy metals and bacteria activities in the soil. The AQI at 20 m was far above the permissible limit provided by the Environmental Protection Agency while others are gradually drawing towards the limit given for each pollutant. To safeguard the health of the residents of the host community and oil field workers, there is a need for proper and frequent environmental monitoring and assessment by authorized regulatory bodies in Nigeria. This will prevent any future exposure which may endanger the lives of the dwellers.

On-line trace monitoring of volatile halogenated compounds in air by improved thermal desorption-gas chromatography-mass spectrometry.

Volatile halogenated compounds (VHCs) are important industrial chemicals and play a crucial role in potential stratospheric ozone-depletion and global warming. Profiling of VHCs is of great significance but replete with challenges due to the species' richness and diversity. In this study, we developed a novel method employing water removal mode combined with thermal desorption-gas chromatography-mass spectrometry (TD-GC-MS) for on-line measurement of VHCs at the ultratrace level. By removing water with Nafion dryer tandem cold trap device, VHCs could achieve better separation and identification, and detection precision of VHCs lower than 10%. The proposed method exhibited limits of detection for VHCs ranging from 0.1 to 6.2 pptv. Benefiting from the improved trapping efficiency due to water removal, we successfully quantified 34 VHCs at the Shangdianzi background station and achieved a comprehensive assessment of VHCs in ambient air.

The use of exhaled air analysis in discriminating interstitial lung diseases: a pilot study.

BACKGROUND: Fibrotic Interstitial lung diseases (ILD) are a heterogeneous group of chronic lung diseases characterized by diverse degrees of lung inflammation and remodeling. They include idiopathic ILD such as idiopathic pulmonary fibrosis (IPF), and ILD secondary to chronic inflammatory diseases such as connective tissue disease (CTD). Precise differential diagnosis of ILD is critical since anti-inflammatory and immunosuppressive drugs, which are beneficial in inflammatory ILD, are detrimental in IPF. However, differential diagnosis of ILD is still difficult and often requires an invasive lung biopsy. The primary aim of this study is to identify volatile organic compounds (VOCs) patterns in exhaled air to non-invasively discriminate IPF and CTD-ILD. As secondary aim, the association between the IPF and CTD-ILD discriminating VOC patterns and functional impairment is investigated. METHODS: Fifty-three IPF patients, 53 CTD-ILD patients and 51 controls donated exhaled air, which was analyzed for its VOC content using gas chromatograph- time of flight- mass spectrometry. RESULTS: By applying multivariate analysis, a discriminative profile of 34 VOCs was observed to discriminate between IPF patients and healthy controls whereas 11 VOCs were able to distinguish between CTD-ILD patients and healthy controls. The separation between IPF and CTD-ILD could be made using 16 discriminating VOCs, that also displayed a significant correlation with total lung capacity and the 6 min' walk distance. CONCLUSIONS: This study reports for the first time that specific VOC profiles can be found to differentiate IPF and CTD-ILD from both healthy controls and each other. Moreover, an ILD-specific VOC profile was strongly correlated with functional parameters. Future research applying larger cohorts of patients suffering from a larger variety of ILDs should confirm the potential use of breathomics to facilitate fast, non-invasive and proper differential diagnosis of specific ILDs in the future as first step towards personalized medicine for these complex diseases.

Ternary association reactions of H3 O+ , NO+ and O2 +• with N2 , O2 , CO2 and H2 O; implications for selected ion flow tube mass spectrometry analyses of air and breath.

RATIONALE: The reactions of the reagent ions used for trace gas analysis in selected ion flow tube mass spectrometry (SIFT-MS), R+ , viz. H3 O+ , NO+ and O2 + , with the major gases in air and breath samples, M, viz. N2 , O2 , CO2 and H2 O, are investigated. These reactions are seen to form weakly-bound adduct ions, R+ M, by ternary association reactions that must not be mistaken for genuine volatile organic compound (VOC) analyte ions. METHODS: The ternary association rate coefficients mediated by helium (He) carrier gas atoms, k3a , have been determined for all combinations of R+ and M, which form R+ M adduct ions ranging in m/z from 47 (H3 O+ N2 ) to 76 (O2 +• CO2 ). This was achieved by adding variable amounts of M (up to 0.5 mbar pressure) into the He carrier gas (pressure of 1.33 mbar) in a SIFT-MS flow tube at 300 K. Parabolic curvature was observed on some of the semi-logarithmic decay curves that allowed the rate coefficients mediated by M molecules, k3b , to be estimated. RESULTS: Values of k3a were found to range from 1 × 10-31  cm6  s-1 to 5 × 10-29  cm6  s-1 , which form mass spectral R+ M "ghost peaks" of significant strength when analysing VOCs at parts-per-billion concentrations. It was seen that the R+ M adduct ions (except when M is H2 O) react with H2 O molecules by ligand switching forming the readily recognised monohydrates of the initial reagent cations R+ H2 O. Whilst this ligand switching diminishes the R+ M adduct ghost peaks, it does not eliminate them entirely. CONCLUSIONS: The significance of these adduct ions for trace gas analysis by SIFT-MS in the low m/z region is alluded to, and some examples are given of m/z spectral overlaps of the R+ M and R+ H2 O adduct cations with analyte cations of VOCs formed by analysis of complex media like exhaled breath, warning that ghost peaks will be enhanced using nitrogen carrier gas in SIFT-MS.

Gaseous and Particulate Content of Laser Tattoo Removal Plume.

BACKGROUND: There is increasing awareness of the potential hazards of surgical plumes. The plume associated with laser tattoo removal remains uncharacterized. OBJECTIVE: To determine the gaseous, particulate, and microbiological content of the laser tattoo removal plume. MATERIALS AND METHODS: Air sampling was performed during laser tattoo removal from pig skin and from patients. Measurement of metals, volatile organic compounds (VOCs), carbon monoxide (CO), hydrogen sulfide (HS), and ultrafine particulates (UPs) as well as bacterial 16S ribosomal DNA sequencing were performed. RESULTS: Metals were identified in the plume from both pig and human skin. Volatile organic compounds were found at similar levels within and outside the treatment room. Several bacterial phyla were detected in the treatment room, but not outside. High levels of UPs were measured throughout the treatment room during tattoo removal from pig skin. Ultrafine particulates were detected at low levels in the room periphery during tattoo removal from human skin, but at higher levels in the immediate treatment zone. HS and CO were not detected. CONCLUSION: Metals, VOCs, HS, and CO were found at levels below applicable occupational exposure limits. The presence of bacteria is of uncertain significance, but may be hazardous. High levels of UPs require further investigation.

Is Office Laryngoscopy an Aerosol-Generating Procedure?

OBJECTIVES/HYPOTHESIS: The aims of this work were 1) to investigate whether office laryngoscopy is an aerosol-generating procedure with an optical particle sizer (OPS) during clinical simulation on healthy volunteers, and 2) to critically discuss methods for assessment of aerosolizing potentials in invasive interventions. STUDY DESIGN: Prospective quantification of aerosol and droplet generation during clinical simulation of rigid and flexible laryngoscopy. METHODS: Two healthy volunteers were recruited to undergo both flexible and rigid laryngoscopy. An OPS was used to quantify aerosols and droplets generated for four positive controls relative to ambient particles (speech, breathing, /e/ phonation, and /ae/ phonation) and for five test interventions relative to breathing and phonation (flexible laryngoscopy, flexible laryngoscopy with humming, flexible laryngoscopy with /e/ phonation, rigid laryngoscopy, and rigid laryngoscopy with /ae/ phonation). Particle counts in mean diameter size range from 0.3 to >10 µm were measured with OPS placed at 12 cm from the subject's nose/mouth. RESULTS: None of the laryngoscopy interventions (n = 10 each) generated aerosols above that produced by breathing or phonation. Breathing (n = 40, 1-3 µm, P = .016) and /ae/ phonation (n = 10, 1-3 µm, P = .022; 3-5 µm. P = .083; >5 µm, P = .012) were statistically significant producers of aerosols and droplets. Neither speech nor /e/ phonation (n = 10 each) were associated with statistically significant aerosols and droplet generation. CONCLUSIONS: Using OPS to detect droplets and aerosols, we found that office laryngoscopy is likely not an aerosol-generating procedure. Despite its prior use in otolaryngological literature, an OPS has intrinsic limitations. Our study should be complemented with more sophisticated methods of droplet distribution measurement. LEVEL OF EVIDENCE: 3 Laryngoscope, 130:2637-2642, 2020.

Multi-pathway human exposure risk assessment using Bayesian modeling at the historically largest mercury mining district.

The largest mercury (Hg) mining district in the world is located in Almadén (Spain), with well-known environmental impacts in the surrounding ecosystem. However, the impact of mercury on the health of the inhabitants of this area has not been documented accordingly. This study aims to carry out a probabilistic human health risk assessment using Bayesian modeling to estimate the non-carcinogenic risk related to Hg through multiple exposure pathways. Samples of vegetables, wild mushrooms, fish, soil, water, and air were analyzed, and adult residents were randomly surveyed to adjust the risk models to the specific population data. On the one hand, the results for the non-carcinogenic risk based on Hazard Quotient (HQ) showed unacceptable risk levels through ingestion of Hg-contaminated vegetables and fish, with HQ values 20 and 3 times higher, respectively, than the safe exposure threshold of 1 for the 97.5th percentile. On the other hand, ingestion of mushrooms, dermal contact with soil, ingestion of water, dermal contact with water and inhalation of air, were below the safety limit for the 97.5th percentile, and did not represent a risk to the health of residents. In addition, the probabilistic approach was compared with the conservative deterministic approach, and similar results were obtained. This is the first study conducted in Almadén, which clearly reveals the high levels of human health risk to which the population is exposed due to the legacy of two millennia of Hg mining.

Biomonitoring of the benzene metabolite s-phenylmercapturic acid and the toluene metabolite s-benzylmercapturic acid in urine from firefighters.

The aim of this study was to determine firefighter's exposure to benzene and toluene during a fire drill by monitoring air benzene and toluene, and their corresponding urinary metabolites. A liquid chromatography mass spectrometry (LC-MS) method with a minimal of sample preparation steps was developed for the benzene metabolite s-phenylmercapturic acid (SPMA) and the toluene metabolite s-benzylmercapturic acid (SBMA) in urine. Urine samples and air samples were collected from nine firefighters during and after a fire drill in a non-environmentally refurbished house. Benzene and toluene were detected in the air samples with a median concentration of 15.5 ppm and 3.2 ppm, respectively. The metabolites SPMA and SBMA was also detected in all urine samples donated ≥ three hours after the fire drill with a median concentration of 0.6 µg/g creatinine and 5.9 µg/g creatinine, respectively. By our knowledge, this is the first study detecting SPMA in urine from firefighters.

Analysis of Air Purification Methods in Operating Rooms of Chinese Hospitals.

This research demonstrates the current use of air purification methods in the operating rooms (ORs) in China. 154 hospitals from 6 provinces were included in this survey to reflect the air purification methods of ORs in 2017. Air cleaning technology (ACT) is used in 124 (80.52%) hospitals. We find that the rates of using grade I, III, or IV clean operating room (COR) in tertiary hospitals are all higher than in lower level hospitals; the rate of using ACT in the ORs is higher, too. In addition, general hospitals have higher rate in using ACT in the ORs than specialized hospitals. The highest rate of using ACT in the ORs is in the eastern region of China. The number of hospitals using ACT, ultraviolet light disinfection, and air sterilizers (such as circulating air UV sterilizer) increased yearly. All grades of CORs can be maintained as required by more than 90% hospitals except grade II COR. In this research, we found air purification methods, especially the ACT, are widely used in hospitals' ORs. However, finding the way to select and use different air purification methods correctly is an urgent problem to be solved next.

Intra-individual variation of particles in exhaled air and of the contents of Surfactant protein A and albumin.

INTRODUCTION: Particles in exhaled air (PEx) provide samples of respiratory tract lining fluid from small airways containing, for example, Surfactant protein A (SP-A) and albumin, potential biomarkers of small airway disease. We hypothesized that there are differences between morning, noon, and afternoon measurements and that the variability of repeated measurements is larger between days than within days. METHODS: PEx was obtained in sixteen healthy non-smoking adults on 11 occasions, within one day and between days. SP-A and albumin were quantified by ELISA. The coefficient of repeatability (CR), intraclass correlation coefficient (ICC), and coefficient of variation (CV) were used to assess the variation of repeated measurements. RESULTS: SP-A and albumin increased significantly from morning towards the noon and afternoon by 13% and 25% on average, respectively, whereas PEx number concentration and particle mean mass did not differ significantly between the morning, noon and afternoon. Between-day CRs were not larger than within-day CRs. CONCLUSIONS: Time of the day influences the contents of SP-A and albumin in exhaled particles. The variation of repeated measurements was rather high but was not influenced by the time intervals between measurements.

Evaluating Propofol Concentration in Blood From Exhaled Gas Using a Breathing-Related Partition Coefficient.

BACKGROUND: The anesthetic side effects of propofol still occur in clinical practice because no reliable monitoring techniques are available. In this regard, continuous monitoring of propofol in breath is a promising method, yet it remains infeasible because there is large variation in the blood/exhaled gas partial pressure ratio (RBE) in humans. Further evaluations of the influences of breathing-related factors on RBE would mitigate this variation. METHODS: Correlations were analyzed between breathing-related factors (tidal volume [TV], breath frequency [BF], and minute ventilation [VM]) and RBE in 46 patients. Furthermore, a subset of 10 patients underwent pulmonary function tests (PFTs), and the parameters of the PFTs were then compared with the RBE. We employed a 1-phase exponential decay model to characterize the influence of VM on RBE. We also proposed a modified RBE (RBEM) that was not affected by the different breathing patterns of the patients. The blood concentration of propofol was predicted from breath monitoring using RBEM and RBE. RESULTS: We found a significant negative correlation (R = -0.572; P < .001) between VM and RBE (N = 46). No significant correlation was shown between PFTs and RBE in the subset (N = 10). RBEM demonstrated a standard Gaussian distribution (mean, 1.000; standard deviation [SD], 0.308). Moreover, the predicted propofol concentrations based on breath monitoring matched well with the measured blood concentrations. The 90% prediction band was limited to within ±1 µg·mL. CONCLUSIONS: The prediction of propofol concentration in blood was more accurate using RBEM than when using RBE and could provide reference information for anesthesiologists. Moreover, the present study provided a general approach for assessing the influence of relevant physiological factors and will inform noninvasive and accurate breath assessment of volatile drugs or metabolites in blood.

Surfactant Protein A in particles in exhaled air (PExA), bronchial lavage and bronchial wash - a methodological comparison.

INTRODUCTION: At present, there are few methods available for monitoring respiratory diseases affecting distal airways. Bronchoscopy is the golden standard for sampling the lower airways. The recently developed method for collecting non-volatile material from exhaled air - PExA (Particles in Exhaled air) is a promising new tool, but no direct comparison between the two methods has yet been performed. The aim of the present study was to compare sampling using PExA with bronchial wash (BW) representing the larger more proximal airways and broncho-alveolar lavage (BAL) representing the distal airways. METHODS: 15 healthy non-smoking subjects (7 female/8 male), age 28 ± 4 years, with normal lung function were included in the study. PExA-sampling (2 × 250 ng particles) and bronchoscopy with BW (2 × 20 ml) and BAL (3 × 60 ml sterile saline) was performed. Albumin and Surfactant Protein A (SP-A) were analyzed with ELISA, and analyses of correlation were performed. RESULTS: A significant association was found between BAL-fluid albumin and PExA-albumin (rs:0.65 p = 0.01). There was also an association between SP-A in PExA and BAL, when corrected for albumin concentration (rs:0.61, p = 0.015). When correlating concentrations of albumin and SP-A in bronchial wash and PExA respectively, no associations were found. CONCLUSIONS: This is the first direct comparison between the bronchoscopy-based BW/BAL-fluids and material collected using the PExA methodology. Both albumin and albumin-corrected SP-A concentrations were significantly associated between BAL and PExA, however, no such association was found in either marker between BW and PExA. These results indicate that the PExA method samples the distal airways. PExA is thus considered a new promising non-invasive assessment for monitoring of the distal airways.

Anatomical locations of air for rapid diagnosis of pneumothorax in blunt trauma patients.

Background: Bedside diagnostic ultrasound for traumatic pneumothorax is easy and reliable. However, the thoracic anatomical locations to be examined are debateable. We aimed to study the anatomical locations of blunt traumatic pneumothoraces as defined by chest CT scan to identify the areas that should be scanned while performing bedside diagnostic ultrasound. Methods: This is a retrospective analysis of a data collected for a previous study in blunt trauma patients at our hospital during a 4-year-period with CT confirmed pneumothoraces. The anatomical distribution of the pneumothoraces and their volume were analyzed. Advanced statistical analysis was performed using repeated measures logistic regression models. Results: Seven hundred three patients had a CT scan of the chest. Seventy-four patients (10.5%) were confirmed to have a pneumothorax. Only 64 were included in the study as they did not have a chest tube inserted before the CT scan. Twelve (18.8%) patients had bilateral pneumothorax. Seventy-six pneumothoraces were identified for which 41 patients had a right-sided pneumothorax and 35 patients had a left-sided pneumothorax. 95.1 % of the pneumothoraces detected on the right side were in the whole parasternal area with 75.6% seen in the lower parasternal region only. Similarly, 97.1 % of the pneumothoraces on the left side were seen in the whole parasternal area with 80% seen in the lower parasternal region only. Conclusions: The current study showed that air pockets of blunt traumatic pneumothoraces are mainly located at the parasternal regions especially in pneumothorax with small volume. We recommend a quick ultrasound scanning of the parasternal regions on both sides of the chest from proximal to distal as the appropriate technique for the detection of pneumothoraces in blunt trauma setting.

Year-Long Rhinovirus Infection is Influenced by Atmospheric Conditions, Outdoor Air Virus Presence, and Immune System-Related Genetic Polymorphisms.

Rhinovirus is a common picornavirus with over 150 serotypes and three species, which is responsible for half of the human common cold cases. In people with chronic respiratory conditions and elders, it may also cause life-threatening diseases. Transmission routes are not definitively established but may involve direct human-to-human and indirect transmission (surfaces and aerosols based). In the present study, year-long presence of virus was tested by qPCR in the nostrils of young healthy volunteers and indoor and outdoor air samples. Results were correlated to atmospheric conditions (meteorological and air quality parameters) and voluntaries immune system-related genetic polymorphisms (TOLLIP rs5743899, IL6 rs1800795, IL1B rs16944, TNFA rs1800629) typed by PCR-RFLP. Nasal samples showed increased frequency and viral titers of Rhinovirus in spring and autumn. No indoor air samples tested positive for Rhinovirus, whereas outdoor air samples tested positive in late autumn. Sun radiation, atmospheric SO2, and benzene levels correlated with nostrils Rhinovirus detection. Both IL6 and TOLLIP polymorphisms but not TNFA or IL1B influenced Rhinovirus detection in the nostrils of voluntaries. Taken together, the results indicate that Rhinovirus circulation is determined by environmental conditions (weather, air-borne virus, and air pollution) and genetically encoded individual variation in immunity.

Diode laser photoacoustic spectroscopy of CO2, H2S and O2 in a differential Helmholtz resonator for trace gas analysis in the biosciences and petrochemistry.

Photoacoustic spectroscopy in a differential Helmholtz resonator has been employed with near-IR and red diode lasers for the detection of CO2, H2S and O2 in 1 bar of air/N2 and natural gas, in static and flow cell measurements. With the red distributed feedback (DFB) diode laser, O2 can be detected at 764.3 nm with a noise equivalent detection limit of 0.60 mbar (600 ppmv) in 1 bar of air (35-mW laser, 1-s integration), corresponding to a normalised absorption coefficient α = 2.2 × 10-8 cm-1 W s1/2. Within the tuning range of the near-IR DFB diode laser (6357-6378 cm-1), CO2 and H2S absorption features can be accessed, with a noise equivalent detection limit of 0.160 mbar (160 ppmv) CO2 in 1 bar N2 (30-mW laser, 1-s integration), corresponding to a normalised absorption coefficient α = 8.3 × 10-9 cm-1 W s1/2. Due to stronger absorptions, the noise equivalent detection limit of H2S in 1 bar N2 is 0.022 mbar (22 ppmv) at 1-s integration time. Similar detection limits apply to trace impurities in 1 bar natural gas. Detection limits scale linearly with laser power and with the square root of integration time. At 16-s total measurement time to obtain a spectrum, a noise equivalent detection limit of 40 ppmv CO2 is obtained after a spectral line fitting procedure, for example. Possible interferences due to weak water and methane absorptions have been discussed and shown to be either negligible or easy to correct. The setup has been used for simultaneous in situ monitoring of O2, CO2 and H2S in the cysteine metabolism of microbes (E. coli), and for the analysis of CO2 and H2S impurities in natural gas. Due to the inherent signal amplification and noise cancellation, photoacoustic spectroscopy in a differential Helmholtz resonator has a great potential for trace gas analysis, with possible applications including safety monitoring of toxic gases and applications in the biosciences and for natural gas analysis in petrochemistry. Graphical abstract.

Influence of the Arrangement of Surgical Light Axes on the Air Environment in Operating Rooms.

Purpose: Surgical lights in the operating rooms are typically installed in a single axis in the center of the room or in two axes on both sides of the operating table. In the single-axis installation, the air-conditioning outlet cannot be placed in the center of the ceiling, which may affect the air current. Therefore, we measured the air current and cleanliness in two equivalent operating rooms using a vertical laminar airflow system equipped with either single-axis or double-axis surgical lights. Methods: Air current was measured using a three-dimensional ultrasonic anemometer. Cleanliness was evaluated by measuring the amount of dust before and after air-conditioner activation. To visualize the air current, smoke was illuminated on a sheet of laser light while the air-conditioning was stopped, and changes after air-conditioning activation were observed. Results: In the single-axis room, an oblique fast air current flowing from the surrounding air outlet toward the center was observed, and the flow velocity fluctuated greatly. In the double-axis room, uniform downward laminar airflow was observed. The amount of dust at the center decreased significantly faster in the double-axis room; thus, the cleanliness at the center was higher in the double-axis room. Persistent stagnation of smoke was observed below the single-axis lighting, whereas smoke below the double-axis lighting was immediately dispersed and the air cleared even when surgical lights were in the position for surgery. Conclusion: Uniform vertical laminar airflow was formed and high cleanliness was achieved in the center of the room when the surgical lights were arranged in two axes.

cfDNA in exhaled breath condensate (EBC) and contamination by ambient air: toward volatile biopsies.

Exhaled breath is a source of volatile and nonvolatile biomarkers in the body that can be accessed non-invasively and used for monitoring. The collection of lung secretions by conventional methods such as bronchoalveolar lavage, induced sputum collection, and core biopsies is limited by the invasive nature of these methods. Non-invasive collection of exhaled breath condensate (EBC) provides fluid samples that are representative of airway lining fluids. Various volatile and nonvolatile biomarkers can be detected in volatile condensates, such as H2O2, nitric oxide, lipid mediators, cytokines, chemokines, DNA, and microRNAs. Studies have examined cell-free DNA (cfDNA) in plasma samples from non-small-cell lung cancer patients, offering to new insights and fostering development of the liquid biopsy. However, few studies have examined cfDNA in EBC samples. This study examined whether EBC is an appropriate source of cfDNA using housekeeping-gene-specific primer probes and quantitative real-time polymerase chain reaction in healthy subjects. Ambient (room) air is contaminated with DNA, so caution is needed. Preliminary studies indicated that volatile biopsies are becoming an important diagnostic tool in lung cancer.

Comparison of air-filled and water-filled catheters for use in cystometric assessment.

INTRODUCTION AND HYPOTHESIS: To determine whether pressure readings measured with air-filled catheter (AFC) and water-filled catheter (WFC) systems are equivalent during cystometric assessment, especially in case of pressure measurements at Valsalva manoeuvres and coughs. METHODS: Twenty-five subjects were recruited. The commercially available 7-Fr TDOC AFC, which simultaneously reads water and air pressures in the bladder and rectum, was used to compare filling and voiding data recordings. Data were compared using paired t-tests, Bland-Altman plots and linear correlation methods, respectively. RESULTS: Pressure readings measured by the two systems showed a good correlation at Valsalva manoeuvres [R2 = 0.988, 0.968 for vesical pressure (Pves) and abdominal pressure (Pabd), respectively] and at coughs (R2 = 0.972, 0.943 for Pves and Pabd, respectively). There was a statistically significant difference between the two different measurement modalities at coughs (p < 0.01), initial resting pressure (p < 0.01) and the maximum pressure at detrusor overactivity (p < 0.01). This indicated that the difference between the two measurement modalities during Valsalva manoeuvres could reach up to 5.2 cmH2O and 8.1 cmH2O in Pves and Pabd measurements, respectively. During coughs, the difference could reach up to 20 cmH2O and 19.5 cmH2O in Pves and Pabd measurements, respectively. CONCLUSIONS: Pressure recordings from AFC and WFC systems appear to be interchangeable for some urodynamics parameters such as Pves at Valsalva manoeuvres if the baseline pressure is compensated, but not for fast-changing pressure signals such as coughs. This has to be considered when pressures are being taken with the AFC.

Air pollutants associated with smoking in indoor/outdoor of waterpipe cafés in Tehran, Iran: Concentrations, affecting factors and health risk assessment.

Despite increasingly growth in waterpipe smoking in Tehran, so far no study has been conducted on the air quality of the waterpipe and cigarette cafés. Thirty-six cafés were selected and the concentration of three pollutants including formaldehyde, carbon monoxide and nicotine were measured in both indoor and outdoor air of cafés two times (week-day and weekend's session). Air sampling was performed for 180 min for each pollutant. It was observed that the concentration of pollutants inside the cafés was higher during weekend session (with a higher number of "active waterpipe heads") compared with findings during the week-day sessions. Furthermore, the concentration of pollutants in the indoor air of the cafés was significantly higher than that of the outdoors (p < 0.05). According to path analysis, the number of "active waterpipe heads" had the maximum impact on generation of pollutants inside the cafés, followed by the type of tobacco as the second influential factor. The average of lifetime cancer risk (LTCR) resulted by formaldehyde exposure through inhalation in waterpipe (WS), cigarette (CS), waterpipe and cigarette (WCS) and none-smoking (NS) cafés in week-day and weekend sessions were estimated to be 111 × 10-5 and 61.2 × 10-5, 33.7 × 10-5 and 39.4 × 10-5, 271 × 10-5 and 322 × 10-5, and 4.80 × 10-5 and 5.90 × 10-5, respectively, which exceed the limit value by the U.S.EPA and WHO. The concentration of pollutants in the indoor air of smoking cafés in Tehran is significantly high, such that it can pose serious risks for the health of both personnel and customers. Therefore, decision makers are expected to enact applicable and strict policies so as to abate this public health risk.