Distinct Ultrafine Particle Profiles Associated with Aircraft and Roadway Traffic.

The Mobile ObserVations of Ultrafine Particles study was a two-year project to analyze potential air quality impacts of ultrafine particles (UFPs) from aircraft traffic for communities near an international airport. The study assessed UFP concentrations within 10 miles of the airport in the directions of aircraft flight. Over the course of four seasons, this study conducted a mobile sampling scheme to collect time-resolved measures of UFP, CO2, and black carbon (BC) concentrations, as well as UFP size distributions. Primary findings were that UFPs were associated with both roadway traffic and aircraft sources, with the highest UFP counts found on the major roadway (I-5). Total concentrations of UFPs alone (10-1000 nm) did not distinguish roadway and aircraft features. However, key differences existed in the particle size distribution and the black carbon concentration for roadway and aircraft features. These differences can help distinguish between the spatial impact of roadway traffic and aircraft UFP emissions using a combination of mobile monitoring and standard statistical methods.

Development of a computational model to inform environmental surveillance sampling plans for Salmonella enterica serovar Typhi in wastewater.

Typhoid fever-an acute febrile disease caused by infection with the bacterium Salmonella enterica serotype Typhi (S. Typhi)-continues to be a leading cause of global morbidity and mortality, particularly in developing countries with limited access to safe drinking water and adequate sanitation. Environmental surveillance, the process of detecting and enumerating disease-causing agents in wastewater, is a useful tool to monitor the circulation of typhoid fever in endemic regions. The design of environmental surveillance sampling plans and the interpretation of sampling results is complicated by a high degree of uncertainty and variability in factors that affect the final measured pathogens in wastewater samples, such as pathogen travel time through a wastewater network, pathogen dilution, decay and degradation, and laboratory processing methods. Computational models can, to an extent, assist in the design of sampling plans and aid in the evaluation of how different contributing factors affect sampling results. This study presents a computational model combining dynamic and probabilistic modeling techniques to estimate-on a spatial and temporal scale-the approximate probability of detecting S. Typhi within a wastewater system. This model may be utilized to inform environmental surveillance sampling plans and may provide useful insight into selecting appropriate sampling locations and times and interpreting results. A simulated applied modeling scenario is presented to demonstrate the model's functionality for aiding an environmental surveillance study in a typhoid-endemic community.

Development, confirmation, and application of a seeded Escherichia coli process control organism to validate Salmonella enterica serovar Typhi environmental surveillance methods.

Salmonella enterica serovar Typhi (S. Typhi) is the causative agent of Typhoid fever. Blood culture is the gold standard for clinical diagnosis, but this is often difficult to employ in resource limited settings. Environmental surveillance of waste-impacted waters is a promising supplement to clinical surveillance, however validating methods is challenging in regions where S. Typhi concentrations are low. To evaluate existing S. Typhi environmental surveillance methods, a novel process control organism (PCO) was created as a biosafe surrogate. Using a previous described qPCR assay, a modified PCR amplicon for the staG gene was cloned into E. coli. We developed a target region that was recognized by the Typhoid primers in addition to a non-coding internal probe sequence. A multiplex qPCR reaction was developed that differentiates between the typhoid and control targets, with no cross-reactivity or inhibition of the two probes. The PCO was shown to mimic S. Typhi in lab-based experiments with concentration methods using primary wastewater: filter cartridge, recirculating Moore swabs, membrane filtration, and differential centrifugation. Across all methods, the PCO seeded at 10 CFU/mL and 100 CFU/mL was detected in 100% of replicates. The PCO is detected at similar quantification cycle (Cq) values across all methods at 10 CFU/mL (Average = 32.4, STDEV = 1.62). The PCO was also seeded into wastewater at collection sites in Vellore (India) and Blantyre (Malawi) where S. Typhi is endemic. All methods tested in both countries were positive for the seeded PCO. The PCO is an effective way to validate performance of environmental surveillance methods targeting S. Typhi in surface water.

Estimates of the cost to build a stand-alone environmental surveillance system for typhoid in low- and middle-income countries.

The typhoid conjugate vaccine is a safe and effective method for preventing Salmonella enterica serovar Typhi (typhoid) and the WHO's guidance supports its use in locations with ongoing transmission. However, many countries lack a robust clinical surveillance system, making it challenging to determine where to use the vaccine. Environmental surveillance is one alternative approach to identify ongoing transmission, but the cost to implement such a strategy is previously unknown. This paper estimated the cost of setting up and operating an environmental surveillance program for thirteen protocols that are in development, including thirteen cost components and twenty-seven pieces of equipment. Unit costs were obtained from research labs involved in protocol development and equipment information was obtained from manufacturers and the expert opinion of individuals in participating labs. We used Monte Carlo simulations to estimate the costs and the input parameters were modeled as distributions to incorporate the uncertainty. Total costs per sample including setup, overhead, and operational costs, range from $357-794 at a scale of 25 sites to $116-532 at 125 sites. Operational costs (ongoing expenditures) range from $218-584 per sample at a scale of 25 sites to $74-421 at 125 sites. Eleven of the thirteen protocols have operational costs below $200, at this higher scale. Protocols with higher up-front equipment costs benefit more from scale efficiencies and sensitivity analyses show that laboratory labor, processes, and consumables are the primary drivers of uncertainty. At scale, environmental surveillance for typhoid may be affordable (depending on the protocol, scale, and geographic context), though cost will need to be considered alongside future evaluations of test sensitivity. Opportunities to leverage existing infrastructure and multi-disease platforms may be necessary to further reduce costs.

Indoor Air Quality Intervention in Schools: Effectiveness of a Portable HEPA Filter Deployment in Five Schools Impacted by Roadway and Aircraft Pollution Sources.

The Healthy Air, Healthy Schools Study was established to better understand the impact of ultrafine particles (UFPs) on indoor air quality in communities surrounding Seattle-Tacoma (Sea-Tac) International Airport. The study team took multipollutant measurements of indoor and outdoor air pollution at five participating school locations to estimate infiltration indoors. The schools participating in this project were located within a 7-mile radius of Sea-Tac International Airport and within 0.5 mile of an active flight path. Based on experimental measures in an unoccupied classroom, infiltration rates of (a) UFPs of aircraft origin, (b) UFPs of traffic origin, and (c) wildfire smoke or other outdoor pollutants were characterized before and after the introduction of a portable high-efficiency particulate air (HEPA) filter intervention. The portable HEPA cleaners were an effective short-term intervention to improve the air quality in classroom environments, reducing the UFP count concentration from one-half to approximately one-tenth of that measured outside. This study is unique in focusing on UFPs in schools and demonstrating that UFPs measured in classroom spaces are primarily of outdoor origin. Although existing research suggests that reducing particulate matter in homes can significantly improve asthma outcomes, further investigation is necessary to establish the benefits to student health and academic performance of reducing UFP exposures in schools.

Persistence of poliovirus types 2 and 3 in waste-impacted water and sediment.

Eradication of poliovirus (PV) is a global public health priority, and as clinical cases decrease, the role of environmental surveillance becomes more important. Persistence of PV and the environmental factors that influence it (such as temperature and sample type) are an important part of understanding and interpreting positive environmental surveillance samples. The objective of this study was to evaluate the persistence of poliovirus type 2 (PV2) and type 3 (PV3) in wastewater and sediment. Microcosms containing either 1) influent wastewater or 2) influent wastewater with a sediment matrix were seeded with either PV2 or PV3, and stored for up to 126 days at three temperatures (4°C, room temperature [RT], and 30°C). Active PV in the liquid of (1), and the sediment and liquid portions of (2) were sampled and quantified at up to 10 time points via plaque assay and RT-qPCR. A suite of 17 models were tested for best fit to characterize decay of PV2 and PV3 over time and determine the time points at which >90% (T90) and >99% (T99) reduction was reached. Linear models assessed the influence of experimental factors (matrix, temperature, virus type and method of detection) on the predicted T90 and T99 values. Results showed that when T90 was the dependent variable, virus type, matrix, and temperature significantly affected decay, and there was a clear interaction between the sediment matrix and temperature. When T99 was the dependent variable, only temperature and matrix type significantly influenced the decay metric. This study characterizes the persistence of both active and molecular PV2 and PV3 in relevant environmental conditions, and demonstrates that temperature and sediment both play important roles in PV viability. As eradication nears and clinical cases decrease, environmental surveillance and knowledge of PV persistence will play a key role in understanding the silent circulation in endemic countries.

A comparison of SARS-CoV-2 wastewater concentration methods for environmental surveillance.

Wastewater1 surveillance of SARS-CoV-2 may be a useful supplement to clinical surveillance as it is shed in feces, there are many asymptomatic cases, and diagnostic testing can have capacity limitations and extended time to results. Although numerous studies have utilized wastewater surveillance for SARS-CoV-2, the methods used were developed and/or standardized for other pathogens. This study evaluates multiple methods for concentration and recovery of SARS-CoV-2 and seeded human coronavirus OC43 from municipal primary wastewater and/or sludge from the Greater Seattle Area (March-July 2020). Methods evaluated include the bag-mediated filtration system (BMFS), with and without Vertrel™ extraction, skimmed milk flocculation, with and without Vertrel™ extraction, polyethylene glycol (PEG) precipitation, ultrafiltration, and sludge extraction. Total RNA was extracted from wastewater concentrates and analyzed for SARS-CoV-2 and OC43 with RT-qPCR. Skimmed milk flocculation without Vertrel™ extraction performed consistently over time and between treatment plants in Seattle-area wastewater with the lowest average OC43 Cq value and smallest variability (24.3; 95% CI: 23.8-24.9), most frequent SARS-CoV-2 detection (48.8% of sampling events), and highest average OC43 percent recovery (9.1%; 95% CI: 6.2-11.9%). Skimmed milk flocculation is also beneficial because it is feasible in low-resource settings. While the BMFS had the highest average volume assayed of 11.9 mL (95% CI: 10.7-13.1 mL), the average OC43 percent recovery was low (0.7%; 95% CI: 0.4-1.0%). Ultrafiltration and PEG precipitation had low average OC43 percent recoveries of 1.0% (95% CI: 0.5-1.6%) and 3.2% (95% CI: 1.3-5.1%), respectively. The slopes and efficiency for the SARS-CoV-2 standard curves were not consistent over time, confirming the need to include a standard curve each run rather than using a single curve for multiple plates. Results suggest that the concentration and detection methods used must be validated for the specific water matrix using a recovery control to assess performance over time.

Feasibility of the Bag-Mediated Filtration System for Environmental Surveillance of Poliovirus in Kenya.

The bag-mediated filtration system (BMFS) was developed to facilitate poliovirus (PV) environmental surveillance, a supplement to acute flaccid paralysis surveillance in PV eradication efforts. From April to September 2015, environmental samples were collected from four sites in Nairobi, Kenya, and processed using two collection/concentration methodologies: BMFS (> 3 L filtered) and grab sample (1 L collected; 0.5 L concentrated) with two-phase separation. BMFS and two-phase samples were analyzed for PV by the standard World Health Organization poliovirus isolation algorithm followed by intratypic differentiation. BMFS samples were also analyzed by a cell culture independent real-time reverse transcription polymerase chain reaction (rRT-PCR) and an alternative cell culture method (integrated cell culture-rRT-PCR with PLC/PRF/5, L20B, and BGM cell lines). Sabin polioviruses were detected in a majority of samples using BMFS (37/42) and two-phase separation (32/42). There was statistically more frequent detection of Sabin-like PV type 3 in samples concentrated with BMFS (22/42) than by two-phase separation (14/42, p = 0.035), possibly due to greater effective volume assayed (870 mL vs. 150 mL). Despite this effective volume assayed, there was no statistical difference in Sabin-like PV type 1 and Sabin-like PV type 2 detection between these methods (9/42 vs. 8/42, p = 0.80 and 27/42 vs. 32/42, p = 0.18, respectively). This study demonstrated that BMFS can be used for PV environmental surveillance and established a feasible study design for future research.

Detection of potentially pathogenic enteric viruses in environmental samples from Kenya using the bag-mediated filtration system.

Enteric virus environmental surveillance via a highly sensitive method is critical, as many enteric viruses have low infectious doses and can persist in the environment for extended periods. This study determined the potential of the novel bag-mediated filtration system (BMFS) to recover human enteric viruses and pepper mild mottle virus (PMMoV) from wastewater and wastewater-impacted surface waters, examined PMMoV use as a fecal contamination indicator in Kenya, and identified potential BMFS process controls. From April 2015 to April 2016, BMFS samples were collected from seven sites in Kenya (n = 59). Enteroviruses and PMMoV were detected in 100% of samples, and human adenovirus, human astrovirus, hepatitis A virus, norovirus GI, norovirus GII, sapovirus, and human rotavirus were detected in the majority of samples. The consistent detection of enteroviruses and PMMoV suggests that these viruses could be used as indicators in similarly fecally contaminated sites and BMFS process controls. As contamination of surface water sources remains a global issue, enteric virus environmental surveillance is necessary. This study demonstrates an effective way to sample large volumes of wastewater and wastewater-impacted surface waters for the detection of multiple enteric viruses simultaneously.

Para niños saludables: a community intervention trial to reduce organophosphate pesticide exposure in children of farmworkers.

BACKGROUND: Exposure to organophosphate (OP) pesticides is an occupational hazard for farmworkers and affects their children through the take-home pathway. OBJECTIVES: We examined the effectiveness of a randomized community intervention to reduce pesticide exposure among farmworkers and their children. METHODS: We conducted a baseline survey of a cross-sectional sample of farmworkers (year 1) in 24 participating communities. Communities were randomized to intervention or control. After 2 years of intervention, a new cross-sectional survey of farmworkers was conducted (year 4). Farmworkers with a child 2-6 years of age were asked to participate in a substudy in which urine was collected from the farmworker and child, and dust was collected from the home and the vehicle driven to work. RESULTS: The median concentration of urinary metabolites was higher in year 4 than in year 1 for dimethylthiophosphate (DMTP) and dimethyldithiophosphate in adults and for DMTP for children. There were significant increases within both the intervention and control communities between year 1 and year 4 (p < 0.005); however, the differences were not significant between study communities after adjusting for year (p = 0.21). The dust residue data showed azinphos-methyl having the highest percentage of detects in vehicles (86% and 84% in years 1 and 4, respectively) and in house dust (85% and 83% in years 1 and 4, respectively). There were no significant differences between intervention and control communities after adjusting for year (p = 0.49). CONCLUSIONS: We found no significant decreases in urinary pesticide metabolite concentrations or in pesticide residue concentrations in house and vehicle dust from intervention community households compared with control community households after adjusting for baseline. These negative findings may have implications for future community-wide interventions.

Usability of a Personal Air Pollution Monitor: Design-Feedback Iterative Cycle Study.

BACKGROUND: There is considerable evidence that exposure to fine particulate matter (PM2.5) air pollution is associated with a variety of adverse health outcomes. However, true exposure-outcome associations are hampered by measurement issues, including compliance and exposure misclassification. OBJECTIVE: This paper describes the use of the design-feedback iterative cycle to improve the design and usability of a new portable PM2.5 monitor for use in an epidemiologic study of personal air pollution measures. METHODS: In total, 10 adults carried on their person a prefabricated PM2.5 monitor for 1 week over 3 waves of the iterative cycle. At the end of each wave, they participated in a 30-minute moderated focus group and completed 2 validated questionnaires on usability and views on research. The topics addressed included positives and negatives of the monitor, charging and battery life, desired features, and changes to the monitor from each previous wave. They also completed a log to record device wear time each day. The log also provided space to record any issues that may have arisen with the device or for general comments during the week of collection. RESULTS: The major focus group topics included device size, noise, battery and charge time, and method for carrying the device. These topics formed the basis of iterative design changes; by the final cycle, the device was reasonably smaller, quieter, held a longer charge, and was more convenient to carry. System usability scores improved systematically across each wave (median scores of 50-66 on a 100-point scale), as did median daily wear time (approximately 749-789 minutes). CONCLUSIONS: Both qualitative and quantitative measures showed an improvement in device usability over the 3 waves. This study demonstrates how the design-feedback iterative cycle can be used to improve the usability of devices manufactured for use in large epidemiologic studies on personal air pollution exposures.

Improvement of the Bag-Mediated Filtration System for Sampling Wastewater and Wastewater-Impacted Waters.

Environmental surveillance of poliovirus (PV) plays an important role in the global program for eradication of wild PV. The bag-mediated filtration system (BMFS) was first developed in 2014 and enhances PV surveillance when compared to the two-phase grab method currently recommended by the World Health Organization (WHO). In this study, the BMFS design was improved and tested for its usability in wastewater and wastewater-impacted surface waters in Nairobi, Kenya. Modifications made to the BMFS included the size, color, and shape of the collection bags, the filter housing used, and the device used to elute the samples from the filters. The modified BMFS concentrated 3-10 L down to 10 mL, which resulted in an effective volume assayed (900-3000 mL) that was 6-20 times greater than the effective volume assayed for samples processed by the WHO algorithm (150 mL). The system developed allows for sampling and in-field virus concentration, followed by transportation of the filter for further analysis with simpler logistics than the current methods. This may ultimately reduce the likelihood of false-negative samples by increasing the effective volume assayed compared to samples processed by the WHO algorithm, making the BMFS a valuable sampling system for wastewater and wastewater-impacted surface waters.

Dermal absorption of benzo[a]pyrene into human skin from soil: Effect of artificial weathering, concentration, and exposure duration.

In vitro assessments of 14C-benzo[a]pyrene (BaP) absorption through human epidermis were conducted with the sub-63-µm fraction of four test soils containing different amounts of organic and black carbon. Soils were artificially weathered for eight weeks and applied to epidermis at nominal BaP concentrations of 3 and 10 mg/kg for 8 or 24 h. Experiments were also conducted at 24 h with unweathered soils and with BaP deposited onto skin from acetone at a comparable chemical load. For the weathered soils, absorption was independent of the amount of organic or black carbon, the mass in the receptor fluid was proportional to exposure duration but independent of concentration, and the mass recovered in the skin after washing was proportional to concentration and independent of exposure time. Results from the weathered and unweathered soils were similar except for the mass recovered in the washed skin, which was lower for the weathered soil only at the higher concentration. We hypothesize that chemical concentrations exceeded the BaP sorption capacity accessible within the artificial weathering timeframe for all soils tested, and that BaP mass in the washed skin was dominated by particles that were not removed by washing. Fluxes into and through skin from soils were lower by an order of magnitude than from acetone-deposited BaP.

Biologic monitoring to characterize organophosphorus pesticide exposure among children and workers: an analysis of recent studies in Washington State.

We examined findings from five organophosphorus pesticide biomonitoring studies conducted in Washington State between 1994 and 1999. We compared urinary dimethylthiophosphate (DMTP) concentrations for all study groups and composite dimethyl alkylphosphate (DMAP) concentrations for selected groups. Children of pesticide applicators had substantially higher metabolite levels than did Seattle children and farmworker children (median DMTP, 25 microg/L; p < 0.0001). Metabolite levels of children living in agricultural communities were elevated during periods of crop spraying. Median DMTP concentrations for Seattle children and farmworker children did not differ significantly (6.1 and 5.8 microg/L DMTP, respectively; p = 0.73); however, the DMAP concentrations were higher for Seattle children than for farmworker children (117 and 87 nmol/L DMAP, respectively; p = 0.007). DMTP concentrations of U.S. children 6-11 years of age (1999-2000 National Health and Nutrition Examination Survey population) were higher than those of Seattle children and farmworker children at the 75th, 90th, and 95th percentiles. DMTP concentrations for workers actively engaged in apple thinning were 50 times higher than DMTP concentrations for farmworkers sampled outside of peak exposure periods. We conclude that workers who have direct contact with pesticides should continue to be the focus of public health interventions and that elevated child exposures in agricultural communities may occur during active crop-spraying periods and from living with a pesticide applicator. Timing of sample collection is critical for the proper interpretation of pesticide biomarkers excreted relatively soon after exposure. We surmise that differences in dietary exposure can explain the similar exposures observed among farmworker children, children living in the Seattle metropolitan area, and children sampled nationally.

Child dermal sediment loads following play in a tide flat.

Dermal contact with sediment is sometimes identified as a pathway of concern in risk assessments. Dermal exposure to sediment is poorly characterized and exposure assessors may rely on default soil adherence values. The purpose of this study was to obtain sediment adherence data for a genuine exposure scenario, child play in a tide flat. This study reports direct measurements of sediment loadings on five body parts (face, forearms, hands, lower legs and feet) after play in a tide flat. Each of nine subjects participated in two timed sessions and pre- and post-activity sediment loading data were collected. Geometric mean (geometric standard deviation) dermal loadings (mg/cm(2)) on the face, forearm, hands, lower legs and feet for the combined sessions were 0.04 (2.9), 0.17 (3.1), 0.49 (8.2), 0.70 (3.6) and 21 (1.9), respectively. Participants' parents completed questionnaires regarding their child's typical activity patterns during tide flat play, exposure frequency and duration, clothing choices, bathing practices and clothes laundering. Data presented in this paper supplement very limited prior adherence data for sediment contact scenarios. Results will be useful to risk assessors considering exposure scenarios involving child activities at a coastal shoreline or tide flat.

Evaluation of take-home organophosphorus pesticide exposure among agricultural workers and their children.

We analyzed organophosphorus pesticide exposure in 218 farm worker households in agricultural communities in Washington State to investigate the take-home pathway of pesticide exposure and to establish baseline exposure levels for a community intervention project. House dust samples (n = 156) were collected from within the homes, and vehicle dust samples (n = 190) were collected from the vehicles used by the farm workers to commute to and from work. Urine samples were obtained from a farm worker (n = 213) and a young child (n = 211) in each household. Dust samples were analyzed for six pesticides, and urine samples were analyzed for five dialkylphosphate (DAP) metabolites. Azinphosmethyl was detected in higher concentrations (p < 0.0001) than the other pesticides: geometric mean concentrations of azinphosmethyl were 0.53 micro g/g in house dust and 0.75 micro g/g in vehicle dust. Dimethyl DAP metabolite concentrations were higher than diethyl DAP metabolite concentrations in both child and adult urine (p < 0.0001). Geometric mean dimethyl DAP concentrations were 0.13 micro mol/L in adult urine and 0.09 micro mol/L in child urine. Creatinine-adjusted geometric mean dimethyl DAP concentrations were 0.09 micro mol/g in adult urine and 0.14 micro mol/g in child urine. Azinphosmethyl concentrations in house dust and vehicle dust from the same household were significantly associated (r2 = 0.41, p < 0.0001). Dimethyl DAP levels in child and adult urine from the same household were also significantly associated (r2 = 0.18, p < 0.0001), and this association remained when the values were creatinine adjusted. The results of this work support the hypothesis that the take-home exposure pathway contributes to residential pesticide contamination in agricultural homes where young children are present.

Pesticide take-home pathway among children of agricultural workers: study design, methods, and baseline findings.

Farmworkers are exposed to pesticides and may take home pesticide residues to their families. In this paper, self-reported pesticide exposure and home practices to reduce the amount of pesticide residues taken home were examined among 571 farmworkers. Urine samples from a subsample of farmworkers and children and dust samples from households and vehicles also assessed pesticide exposure. Overall, 96% of respondents reported exposure to pesticides at work. Many employers did not provide resources for hand washing. Farmworkers' protective practices to keep pesticide residues out of the home were at a low level. In a subset of respondents, pesticide levels above the limit of quantitation were seen in the urine of children and adults and in house and vehicle dust. The results support the take-home pathway of pesticide exposure. Ways must be found to reduce this pesticide exposure among children of farmworkers.

Dermal absorption of environmental contaminants from soil and sediment: a critical review.

Risk assessment of hazardous wastes sites may require characterization of the dermal availability of chemical contaminants in soil and/or sediment. Current U.S. Environmental Protection Agency guidance for assessment of dermal exposures to contaminants in water and soil was finalized in 2004 as a supplement (Part E) to the Risk Assessment Guidance for Superfund (RAGS). The soil protocol presented in RAGS Part E is less sophisticated than the water protocol and is supported by less empirical data. Investigations of dermal absorption of soil and sediment-borne contaminants that have been conducted to date include in vitro and in vivo experiments using both human and surrogate skin. A review of that literature was conducted with attention to relevant criteria including consideration of layering effects, degree of chemical saturation of soil, appropriateness of particle size distribution employed, soil-chemical contact time, and continuity of soil-skin contact (in in vivo studies). Most studies published to date are deficient by virtue of execution or reporting on one or more of the selected criteria. In addition the lack of methodological standardization evident in the literature hinders systematic evaluation of results. Since additional experimental work is needed, general agreement on acceptable approaches would be useful. Recommendations for good practice are presented.