Seven-years of alcohol consumption in Australia by wastewater analysis: Exploring patterns by remoteness and socioeconomic factors.

BACKGROUND: Wastewater analysis provides a complementary measure of alcohol use in whole communities. We assessed absolute differences and temporal trends in alcohol consumption by degree of remoteness and socioeconomics indicators in Australia from 2016 to 2023. METHODS: Alcohol consumption estimates from 50 wastewater treatment plants (WWTP) in the Australian National Wastewater Drug Monitoring Program were used. Trends were analysed based on 1) site remoteness: Major Cities, Inner Regional and a combined remoteness category of Outer Regional and Remote, and 2) using two socioeconomic indexes from the Australian Bureau of Statistics (ABS) relating to advantage and disadvantage for Income, education, occupation, and housing. RESULTS: Consumption estimates were similar for Major Cities and Inner Regional areas (14.3 and 14.4L/day/1000 people), but significantly higher in Outer Regional and Remote sites (18.6L/day/1000 people). Consumption was decreasing in Major cities by 4.5% annually, Inner Regional by 2.4%, and 3.5% in the combined Outer Regional and Remote category. Consumption estimates were higher in socioeconomically advantaged quartiles than those of lower advantage (0%-25% mean = 13.0, 75%-100% mean = 17.4). Consumption in all quartiles decreased significantly over the 7 year period with annual rates of decrease of 0.9%, 3.7%, 3.6%, and 3.0% for the lowest to highest quartile, respectively. CONCLUSIONS: Declines in Australian alcohol consumption have been steeper in large urban areas than regional and remote areas. There were smaller annual decreases in the most socioeconomically disadvantaged areas. If continued, these trends may increase Australian health inequalities. Policy and prevention work should be appropriately targeted to produce more equitable long-term outcomes.

Use of artificial sweeteners and caffeine in a population of Hanoi: An assessment by wastewater-based epidemiology.

Monitoring the consumption of artificial sweeteners in the population is essential to help public health authorities understand the level of sugar consumption. There is a gap in knowledge of patterns and levels of artificial sweetener consumption in Vietnam. Using wastewater-based epidemiology (WBE), this study aims to evaluate the use of artificial sweeteners in an urban population in Hanoi, Vietnam. A total of 184 wastewater samples were collected at two sampling sites in an urban canal, receiving sewage from over 400,000 people in three different periods between 2018 and 2020. The population normalized per capita consumption of the five detected artificial sweeteners varied from 0.87 mg d-1 p-1 (sucralose) to 5.2 mg d-1 p-1 (aspartame). The daily consumption of artificial sweeteners was found to be stable throughout the week, however the consumption of artificial sweeteners was influenced by season with higher consumption in summer. Significant correlations (p < 0.01) were found among levels of artificial sweeteners and caffeine in urban canal samples, suggesting these chemicals had common sources. Population-weighted consumption load of artificial sweeteners and caffeine was compared in Vietnam, China and Australia, and the per capita consumption load mainly depended on the habitual of tea/coffee drinking in different countries. This was the first study that provided information on the artificial sweetener consumption by wastewater analysis in Vietnam. However, several sources of uncertainty (sample collection, population estimation, other sources of artificial sweeteners in wastewater, etc.) were acknowledged in this study. Further investigations on the spatial-temporal variation of artificial sweetener consumption with more intensive sampling scheme in Vietnam are recommended.

Young population consume twice as much artificial sweetener than the general population - A wastewater-based assessment in China.

Understanding artificial sweetener consumption patterns and levels in different demographics is important for formulating public health policies on controlling sugar consumption. There is a considerable knowledge gap with respect to the pattern of artificial sweetener consumption in China. To narrow this gap, wastewater analysis was used to assess the temporal patterns of consumption of seven artificial sweeteners in an urban population and a university town in a megacity in South China over a one-year period. Daily influent wastewater samples were collected from an urban catchment and weekly samples collected from a university sub-catchment. Population normalized per capita consumption of the four detected artificial sweeteners (cyclamate, acesulfame, sucralose and saccharin) in the university catchment (1.0-5.9 mg d-1 p-1) was much higher than those in urban catchment (0.5-1.3 mg d-1 p-1), indicating younger population consume more artificial sweeteners than the general population. The daily consumption of artificial sweeteners was found to be stable throughout the week in the urban catchment. Time-series analysis showed that an average increase in temperature of 1 °C was associated with an increase consumption of 33 µg d-1 p-1 for acesulfame, 15 µg d-1 p-1 for sucralose and 14 µg d-1 p-1 for saccharin. This was the first study that objectively quantified the greater consumption of artificial sweeteners (proxy for consumption of artificially sweetened food and beverages) in a younger age group when compared to the general population, which could potentially pose a risk of health related diseases.

A nationwide wastewater-based assessment of metformin consumption across Australia.

Metformin is the most widely used drug to treat type 2 diabetes. Monitoring spatial patterns of metformin use could provide new insights into treatment of type 2 diabetes and the distribution among populations. This study applied a wastewater-based epidemiological (WBE) approach to estimate metformin use in different populations across Australia and compared these estimates with traditional approaches of surveys and prescription data. Twenty-four-hour influent samples were collected from 75 wastewater treatment plants (WWTPs) across Australia in 2016 and analysed for metformin. Metformin was detected in all samples ranging in concentration from 8.2 to 191 µg/L (median 58 µg/L). Concentrations were converted to population-weighted average consumption at the national level, resulting in an average consumption of 28.6 g/day/1000 people across Australia, which was within 7% of estimates from national prescription statistics. In addition, results for five out of seven states had an estimated prevalence of type 2 diabetes within 20% compared to the traditional epidemiology surveys. Spatial patterns were also observed between urban and rural settings, with higher consumption rates of metformin found in Major Cities (22.5 ± 10.9 g/d/1000 people) and Inner Regional cities (25.4 ± 13.4 g/d/1000 people) than in Outer Regional (17.0 ± 8.1 g/d/1000 people) and Remote areas (15.1 ± 7.4 g/d/1000 people). Consumption estimates were also correlated against socioeconomic factors of the specific catchment areas. Greater metformin use was correlated with populations of lower education and income levels, while positive correlations were found between metformin consumption and consumption of allopurinol, caffeine and venlafaxine. Our study provides more evidence on the distribution of metformin use across Australia, which can be used to develop public health strategies to reduce the overall burden of type 2 diabetes in specific regions.

In-Sewer Stability Assessment of Anabolic Steroids and Selective Androgen Receptor Modulators.

Wastewater-based epidemiology is a potential complementary technique for monitoring the use of performance- and image-enhancing drugs (PIEDs), such as anabolic steroids and selective androgen receptor modulators (SARMs), within the general population. Assessing in-sewer transformation and degradation is critical for understanding uncertainties associated with wastewater analysis. An electrospray ionization liquid chromatography mass spectrometry method for the quantification of 59 anabolic agents in wastewater influent was developed. Limits of detection and limits of quantification ranged from 0.004 to 1.56 µg/L and 0.01 to 4.75 µg/L, respectively. Method performance was acceptable for linearity (R2 > 0.995, few exceptions), accuracy (68-119%), and precision (1-21%RSD), and applicability was successfully demonstrated. To assess the stability of the selected biomarkers in wastewater, we used laboratory-scale sewer reactors to subject the anabolic agents to simulated realistic sewer environments for 12 h. Anabolic agents, including parent compounds and metabolites, were spiked into freshly collected wastewater that was then fed into three sewer reactor types: control sewer (no biofilm), gravity sewer (aerobic conditions), and rising main sewer (anaerobic conditions). Our results revealed that while most glucuronide conjugates were completely transformed following 12 h in the sewer reactors, 50% of the investigated biomarkers had half-lives longer than 4 h (mean residence time) under gravity sewer conditions. Most anabolic agents were likely subject to biofilm sorption and desorption. These novel results lay the groundwork for any future wastewater-based epidemiology research involving anabolic steroids and SARMs.

Assessment of total concentrations of heavy metals in industrial sludges from the North of Vietnam and their potential impact on the ecosystem.

Industrial sludges from wastewater treatment plants of industrial parks and a drinking water treatment plant in northern Vietnam were investigated in this study. The total concentrations of heavy metals (As, Cd, Cu, Cr, Ni, Hg, Pb, Zn) and other elements (Mn, Pd, Sb, V) in the sludges were measured using the ICP-MS method. In addition, the surface characteristics of the samples were analyzed using SEM-EDS and FTIR techniques. According to Vietnam's current waste management regulation, the investigated industrial sludges belonged to the hazardous waste category (with Pb concentration > 300 µg/g). In contrast, the sludge from the drinking water treatment plant had a low content of heavy metals and toxic elements. The sequential extraction method revealed that the heavy metals in the industrial sludges exhibited higher mobilization forms (exchangeable and reduceable fractions) than those in the drinking water sludges. The mobilization ability of heavy metals is probably related to the surface function groups of the sludges, which were dominated by (-COOH) and (-OH) groups. The potential ecological risk assessment calculations indicated that the industrial sludges had high potential risk (with the RI values ranging from 229.7 to 605.4), mainly due to the content of Cd in the sludge samples. Further studies about the fate and transport of Cd and other toxic metals in the sludges are highly recommended to better understand their risk to the surrounding environment, such as groundwater and agricultural soil.

Secondhand smoke in public places in Vietnam: An assessment 5 years after implementation of the tobacco control law.

OBJECTIVES: This study quantified the secondhand smoke (SHS) concentration in a sample of public places in Vietnam to determine changes in SHS levels 5 years after a public smoking ban was implemented. METHODS: Two monitoring campaigns, one in 2013 (before the tobacco control law was implemented) and another in 2018 (5 years after the implementation of the law) were conducted in around 30 restaurants, cafeterias and coffee shops in major cities of Vietnam. Concentrations of PM2.5, as an indicator of SHS, were measured by portable particulate matter monitors (TSI SidePak AM510 and Air Visual Pro). RESULTS: The geometric mean PM2.5 concentration of all monitored venues was 87.7 µg/m3 (83.7-91.9) in the first campaign and 55.2 µg/m3 (53.7-56.7) in the second campaign. Pairwise comparison showed the PM2.5 concentrations in the smoking observed area was triple and double those in the non-smoking area and the outdoor environment. After adjusting for sampling locations and times, the SHS concentration 5 years after the implementation of the tobacco control law reduced roughly 45%. CONCLUSION: The study results indicate an improvement in air quality in public places in Vietnam via both the reduction in PM2.5 levels and the number of people observed smoking. However, greater enforcement of the free-smoke legislation is needed to eliminate SHS in public places in Vietnam.

Low-cost sensors as an alternative for long-term air quality monitoring.

Low-cost air quality sensors are increasingly being used in many applications; however, many of their performance characteristics have not been adequately investigated. This study was conducted over a period of 13 months using low-cost air quality monitors, each comprising two low-cost sensors, which were subjected to a wide range of pollution sources and concentrations, relative humidity and temperature at four locations in Australia and China. The aim of the study was to establish the performance characteristics of the two low-cost sensors (a Plantower PMS1003 for PM2.5 and an Alphasense CO-B4 for carbon monoxide, CO) and the KOALA monitor as a whole under various conditions. Parameters evaluated included the inter-variability between individual monitors, the accuracy of monitors in comparison with the reference instruments, the effect of temperature and RH on the performance of the monitors, the responses of the PM2.5 sensors to different types of aerosols, and the long-term stability of the PM2.5 and CO sensors. The monitors showed high inter-correlations (r > 0.91) for both PM2.5 and CO measurements. The monitor performance varied with location, with moderate to good correlations with reference instruments for PM2.5 (0.44< R2 < 0.91) and CO (0.37< R2 < 0.90). The monitors performed well at relative humidity < 75% and high temperature conditions; however, two monitors in Beijing failed at low temperatures, probably due to electronic board failure. The PM2.5 sensor was less sensitive to marine aerosols and fresh vehicle emissions than to mixed urban background emissions, aged traffic emissions and industrial emissions. The long-term stability of the PM2.5 and CO sensors was good, while CO relative errors were affected by both high and low temperatures. Overall, the KOALA monitors performed well in the environments in which they were operated and provided a valuable contribution to long-term air quality monitoring within the elucidated limitations.

Chlorinated paraffins in indoor dust from Australia: Levels, congener patterns and preliminary assessment of human exposure.

Chlorinated paraffins (CPs) are a group of polychlorinated n-alkanes with high production volumes. Until now, there are only limited data on the levels of CPs in the environment, especially in the indoor environment. In this study, dust samples were collected from 44 indoor environments, including 27 private houses, 10 offices, and 7 vehicles. Short-, medium-, and long-chain CPs were detected in all dust samples. The median concentration of ∑CPs (C10-C21) was 57, 160 and 290 µg/g, in houses, offices, and vehicles, respectively. Medium-chain CPs were the dominant group, on average accounting for 86% of ∑CPs. Cl6 and Cl8 groups had the highest contributions to ∑CPs across all the different microenvironments, while C13 and C14 were the predominant groups of SCCPs and MCCPs. Median exposure to ∑CPs via indoor dust were estimated at 80 ng/kg/day and 620 µg/kg/day for Australian adults and toddlers respectively. The daily intake of CPs via dust, in the worse scenario, was still 2-3 orders of magnitudes lower than the reference doses based on neoplastic effects.

A National Wastewater Monitoring Program for a better understanding of public health: A case study using the Australian Census.

Wastewater contains a large range of biological and chemical markers of human activity and exposures. Through systematic collection and analysis of these markers within wastewater samples it is possible to measure the public health of whole populations. The analysis of effluent and biosolids can also be used to understand the release of chemicals from wastewater treatment plants into the environment. Wastewater analysis and comparison with catchment specific data (e.g. demographics) however remains largely unexplored. This manuscript describes a national wastewater monitoring study that combines influent, effluent and biosolids sampling with the Australian Census. An archiving program allows estimation of per capita exposure to and consumption of chemicals, public health information, as well as per capita release of chemicals into the environment. The paper discusses the study concept, critical steps in setting up a coordinated national approach and key logistical and other considerations with a focus on lessons learnt and future applications. The unique combination of archived samples, analytical data and associated census-derived population data will provide a baseline dataset that has wide and potentially increasing applications across many disciplines that include public health, epidemiology, criminology, toxicology and sociology.

Exploratory assessment of outdoor and indoor airborne black carbon in different locations of Hanoi, Vietnam.

Black carbon (BC) is a significant component of atmospheric particulate matter, especially in areas affected by combustion emissions. Despite the fact that air pollution is a great concern in Vietnam, there are no studies on the level of BC in the outdoor and indoor environment. In this exploratory study, an assessment of urban BC concentrations was conducted through monitoring of both outdoor and indoor BC concentrations in three households and one working office at different locations across Hanoi. PM2.5 and meteorology data were also obtained for this monitoring period to evaluate the association between them and the outdoor BC concentration. Overall, the mean indoor and mean outdoor BC concentrations by 30 second-logs for the monitoring period were 4.42 µg/m3 and 4.89 µg/m3, respectively. Time-series analysis of paired indoor and outdoor BC concentrations suggested that indoor BC level was usually influenced by outdoor BC level (r = 0.78, p < 0.001). In this study, we observed a significant positive association between outdoor BC and PM2.5 (r = 0.39, p < 0.001) while outdoor BC negatively correlated with wind speed (r = -0.34, p < 0.001). The level of outdoor BC in Hanoi measured in this study is relatively high and should be confirmed by further studies.

Applications of low-cost sensing technologies for air quality monitoring and exposure assessment: How far have they gone?

Over the past decade, a range of sensor technologies became available on the market, enabling a revolutionary shift in air pollution monitoring and assessment. With their cost of up to three orders of magnitude lower than standard/reference instruments, many avenues for applications have opened up. In particular, broader participation in air quality discussion and utilisation of information on air pollution by communities has become possible. However, many questions have been also asked about the actual benefits of these technologies. To address this issue, we conducted a comprehensive literature search including both the scientific and grey literature. We focused upon two questions: (1) Are these technologies fit for the various purposes envisaged? and (2) How far have these technologies and their applications progressed to provide answers and solutions? Regarding the former, we concluded that there is no clear answer to the question, due to a lack of: sensor/monitor manufacturers' quantitative specifications of performance, consensus regarding recommended end-use and associated minimal performance targets of these technologies, and the ability of the prospective users to formulate the requirements for their applications, or conditions of the intended use. Numerous studies have assessed and reported sensor/monitor performance under a range of specific conditions, and in many cases the performance was concluded to be satisfactory. The specific use cases for sensors/monitors included outdoor in a stationary mode, outdoor in a mobile mode, indoor environments and personal monitoring. Under certain conditions of application, project goals, and monitoring environments, some sensors/monitors were fit for a specific purpose. Based on analysis of 17 large projects, which reached applied outcome stage, and typically conducted by consortia of organizations, we observed that a sizable fraction of them (~ 30%) were commercial and/or crowd-funded. This fact by itself signals a paradigm change in air quality monitoring, which previously had been primarily implemented by government organizations. An additional paradigm-shift indicator is the growing use of machine learning or other advanced data processing approaches to improve sensor/monitor agreement with reference monitors. There is still some way to go in enhancing application of the technologies for source apportionment, which is of particular necessity and urgency in developing countries. Also, there has been somewhat less progress in wide-scale monitoring of personal exposures. However, it can be argued that with a significant future expansion of monitoring networks, including indoor environments, there may be less need for wearable or portable sensors/monitors to assess personal exposure. Traditional personal monitoring would still be valuable where spatial variability of pollutants of interest is at a finer resolution than the monitoring network can resolve.

Assessment of drugs and personal care products biomarkers in the influent and effluent of two wastewater treatment plants in Ho Chi Minh City, Vietnam.

Wastewater samples were collected at the influent and effluent of two wastewater treatment plants (WWTPs) in Ho Chi Minh City, Vietnam and then pooled to daily samples over multiple days using 6 hourly grab samples. The aim was to provide a first assessment of the occurrence, consumption, removal and release of a range of organic chemicals including pharmaceuticals and personal care products (PPCPs), illicit drugs, an artificial sweetener, tobacco and its metabolites and alcohol biomarkers (referred to here as DPCPBs). Nineteen DPCPBs were detected via direct measurement of filtered wastewater on LC-MS/MS with a concentration range of 0.05-38µg/L. Caffeine and paracetamol were the most prominent compounds detected in the influent, while acesulfame was found at the highest concentration in the effluent of both WWTPs. Mean concentrations of metabolites of tobacco (nicotine: 7.6µg/L, cotinine: 1.4µg/L and hydroxycotinine: 1.7µg/L) and alcohol (ethyl sulphate: 3.3µg/L) were lower than those of European countries. Consumption rates based on daily mass loads and catchment population data obtained from the WWTPs were <10g/d/1000 pp for the majority of selected PPCPs, except for caffeine (300g/d/1000 pp) and paracetamol (320g/d/1000 pp). Consumption rates for codeine and methamphetamine were 0.05g/d/1000 pp and 0.17g/d/1000 pp, respectively. Consistently across the two WWTPs most of the chemicals (10) showed >80% apparent removal rate from the wastewater, three chemicals showed apparent removal efficiency of approximately 50%; and the removal efficiency could not be assessed for 5 compounds due to their low concentrations in the influent. Based on the fraction of treated and untreated wastewater (10:90) that is released into the receiving environment we estimated a total discharge of approximately 170kg per day of DPCPBs in Ho Chi Minh City.

Emission and health risk assessment of volatile organic compounds in various processes of a petroleum refinery in the Pearl River Delta, China.

The process-specific emission of volatile organic compounds (VOCs) from a petroleum refinery in the Pearl River Delta, China was monitored to assess the health risk from VOCs to workers of this refinery. Over 60 VOCs were detected in the air samples collected from various sites in the refining, basic chemical, and wastewater treatment areas of the refinery using gas chromatography-mass spectrometry/flame ionization detection. The health risks of VOCs to the refinery workers were assessed using US Environmental Protection Agency (US EPA) and American Conference of Governmental Industrial Hygienists (ACGIH) methods. Monte Carlo simulation and sensitivity analysis were implemented to assess the uncertainty of the health risk estimation. The emission results showed that C5-C6 alkanes, including 2-methylpentane (17.6%), 2,3-dimethylbutane (15.4%) and 3-methylpentane (7.7%), were the major VOCs in the refining area. p-Diethylbenzene (9.3%), 2-methylpentane (8.1%) and m-diethylbenzene (6.8%) were dominant in the basic chemical area, and 2-methylpentane (20.9%), 2,3-dimethylbutane (11.4%) and 3-methylpentane (6.5%) were the most abundant in the wastewater treatment area. For the non-cancer risk estimated using the US EPA method, the total hazard ratio in the basic chemical area was the highest (3.1 × 103), owing to the highest level of total concentration of VOCs. For the cancer risk, the total cancer risks were very high, ranging from 2.93 × 10-3 (in the wastewater treatment area) to 1.1 × 10-2 (in the basic chemical area), suggesting a definite risk. Using the ACGIH method, the total occupational exposure cancer risks of VOCs in the basic chemical area were the highest, being much higher than those of refining and wastewater treatment areas. Among the areas, the total occupational exposure risks in the basic chemical and refining areas were >1, which suggested a cancer threat to workers in these areas. Sensitivity analysis suggested that improving the accuracy of VOC concentrations themselves in future research would advance the health risk assessment.

Organophosphate and brominated flame retardants in Australian indoor environments: Levels, sources, and preliminary assessment of human exposure.

Concentrations of nine organophosphate flame retardants (OPFRs) and eight polybrominated diphenyl ethers (PBDEs) were measured in samples of indoor dust (n = 85) and air (n = 45) from Australian houses, offices, hotels, and transportation (buses, trains, and aircraft). All target compounds were detected in indoor dust and air samples. Median ∑9OPFRs concentrations were 40 µg/g in dust and 44 ng/m3 in indoor air, while median ∑8PBDEs concentrations were 2.1 µg/g and 0.049 ng/m3. Concentrations of FRs were higher in rooms that contained carpet, air conditioners, and various electronic items. Estimated daily intakes in adults are 14000 pg/kg body weight/day and 330 pg/kg body weight/day for ∑9OPFRs and ∑8PBDEs, respectively. Our results suggest that for the volatile FRs such as tris(2-chloroethyl) phosphate (TCEP) and TCIPP, inhalation is expected to be the more important intake pathway compared to dust ingestion and dermal contact.

Measuring spatial and temporal trends of nicotine and alcohol consumption in Australia using wastewater-based epidemiology.

BACKGROUND AND AIMS: Tobacco and alcohol consumption remain priority public health issues world-wide. As participation in population-based surveys has fallen, it is increasingly challenging to estimate accurately the prevalence of alcohol and tobacco use. Wastewater-based epidemiology (WBE) is an alternative approach for estimating substance use at the population level that does not rely upon survey participation. This study examined spatio-temporal patterns in nicotine (a proxy for tobacco) and alcohol consumption in the Australian population via WBE. METHODS: Daily wastewater samples (n = 164) were collected at 18 selected wastewater treatment plants across Australia, covering approximately 45% of the total population. Nicotine and alcohol metabolites in the samples were measured using liquid chromatography-tandem mass spectrometry. Daily consumption of nicotine and alcohol and its associated uncertainty were computed using Monte Carlo simulations. Nation-wide daily average and weekly consumption of these two substances were extrapolated using ordinary least squares and mixed-effect models. FINDINGS: Nicotine and alcohol consumption was observed in all communities. Consumption of these substances in rural towns was three to four times higher than in urban communities. The spatial consumption pattern of these substances was consistent across the monitoring periods in 2014-15. Nicotine metabolites significantly reduced by 14-25% (P = 0.001-0.008) (2014-15) in some catchments. Alcohol consumption remained constant over the studied periods. Strong weekly consumption patterns were observed for alcohol but not nicotine. Nation-wide, the daily average consumption per person (aged 15-79 years) was estimated at approximately 2.5 cigarettes and 1.3-2.0 standard drinks (weekday-weekend) of alcohol. These estimates were close to the sale figure and apparent consumption, respectively. CONCLUSIONS: Wastewater-based epidemiology is a feasible method for objectively evaluating the geographic, temporal and weekly profiles of nicotine and alcohol consumption in different communities nationally.

Exploratory assessment of indoor and outdoor particle number concentrations in Hanoi households.

No studies have been conducted in Vietnam to understand the levels of atmospheric ultrafine particles, despite having adverse health effects. Information about indoor air quality in Vietnam is also limited. Hence we aimed to conduct the first assessment of ultrafine particle concentrations in terms of particle number (PN) in Hanoi, by simultaneously measuring indoor and outdoor PN concentrations from six households at different locations across the city in January 2016. We also acquired PM2.5 data for this monitoring period from an air quality monitoring station located at the US Embassy in Hanoi, to compare the general trends between PN and PM2.5 concentrations. The mean daily indoor and outdoor PN concentrations for the monitoring period were 1.9×104p/cm3 and 3.3×104p/cm3, respectively, with an increase during rush hour traffic. It was concluded that traffic was the main contributor to outdoor PN concentrations, with agricultural burning having a small influence at one study location. The mean ratio of indoor to outdoor PN concentrations for all six sites was 0.66±0.26, which points to outdoor air as the main driver of indoor PN concentrations, rather than indoor sources. These PN concentrations and I/O ratios are similar to those reported for a number of cities in developed countries. However, in contrast to PN, ambient mean PM2.5 concentrations in Hanoi (60-70µg/m3) were significantly higher than those typically recorded in developed countries. These findings demonstrate that urban particle mass (PM2.5) concentrations are not indicative of the PN concentrations, which can be explained by different sources contributing to PN and PM, and that direct measurements of PN are necessary to provide information about population exposure to ultrafine particles and for management of air quality.