Health-related quality of life and radioiodine therapy in thyroid cancer patients: a before-and-after study.

OBJECTIVE: Thyroid cancers are on the rise, but the associated vital prognosis and long-term survival rates are very good. Therefore, treated patients' quality of life and psychological well-being are important considerations. The treatment usually involves surgery and radioactive iodine (radioiodine) ablation. This study aims to investigate potential effects of radioiodine ablation therapy on health-related quality of life, anxiety and depression symptoms, and nutritional status at 6 months post-therapy. METHODS: This study included 136 patients diagnosed with thyroid cancer. Absorbed doses to the salivary glands were estimated from dosimeters worn by patients. Patient health-related quality of life, psychological status and nutritional status were assessed before and 6 months after therapy using standardized questionnaires (including SF-36, Hospital Anxiety and Depression (HAD) scale). Statistical analyses included random-effects logistic and linear regressions adjusted for potential confounders. RESULTS: While no significant association was found between radioiodine exposure and anxiety or depression symptoms, or nutritional status, a significant increase in the SF-36 role physical sub- score was observed in relation with the salivary gland dose (ß= 6.54, 95%CI 2.71;10.36 for a 1-Gy increase). CONCLUSIONS: The findings suggest an improved physical health-related quality of life, namely reduced pain and functional impairment, 6 months after radioiodine therapy in thyroid cancer patients. No significant association was found between radioiodine exposure and mental health-related quality of life, anxiety or depression scores nor nutritional status. This study does not provide any evidence that radioiodine therapy has a potentially adverse effect on patient health-related quality of life.

Biocide and other semi-volatile organic compound concentrations in settled indoor dust of CRESPI daycare centers and implication for public health.

This study investigates the presence of biocides and other semi-volatile organic compounds (SVOCs) in cleaning products used in daycare centers and health impact through ingestion of settled dust by young children. In Paris metropolitan area, 106 daycares area were investigated between 2019-2022. Fifteen substances were analyzed in settled indoor dust by gas chromatography-tandem mass spectrometry. Detection rates and concentrations ranged from 5 to 100%, and

The burden of disease attributable to indoor air pollutants in China from 2000 to 2017.

BACKGROUND: High-level exposure to indoor air pollutants (IAPs) and their corresponding adverse health effects have become a public concern in China in the past 10 years. However, neither national nor provincial level burden of disease attributable to multiple IAPs has been reported for China. This is the first study to estimate and rank the annual burden of disease and the financial costs attributable to targeted residential IAPs at the national and provincial level in China from 2000 to 2017. METHODS: We first did a systematic review and meta-analysis of 117 articles from 37 231 articles identified in major databases, and obtained exposure-response relationships for the candidate IAPs. The exposure levels to these IAPs were then collected by another systematic review of 1864 articles selected from 52 351 articles. After the systematic review, ten IAPs with significant and robust exposure-response relationships and sufficient exposure data were finally targeted: PM2·5, nitrogen dioxide, sulphur dioxide, ozone, carbon monoxide, radon, formaldehyde, benzene, toluene, and p-dichlorobenzene. The annual exposure levels in residences were then evaluated in all 31 provinces in mainland China continuously from 2000 to 2017, using the spatiotemporal Gaussian process regression model to analyse indoor originating IAPs, and the infiltration factor method to analyse outdoor originating IAPs. The disability-adjusted life-years (DALYs) attributable to the targeted IAPs were estimated at both national and provincial levels in China, using the population attributable fraction method. Financial costs were estimated by an adapted human capital approach. FINDINGS: From 2000 to 2017, annual DALYs attributable to the ten IAPs in mainland China decreased from 4620 (95% CI 4070-5040) to 3700 (3210-4090) per 100 000. Nevertheless, in 2017, IAPs still ranked third among all risk factors, and their DALYs and financial costs accounted for 14·1% (95% CI 12·3-15·6) of total DALYs and 3·45% (3·01-3·82) of the gross domestic product. Specifically, the rank of ten targeted IAPs in order of their contribution to DALYs in 2017 was PM2·5, carbon monoxide, radon, benzene, nitrogen dioxide, ozone, sulphur dioxide, formaldehyde, toluene, and p-dichlorobenzene. The DALYs attributable to IAPs were 9·50% higher than those attributable to outdoor air pollution in 2017. For the leading IAP, PM2·5, the DALYs attributable to indoor origins are 18·3% higher than those of outdoor origins. INTERPRETATION: DALYs attributed to IAPs in China have decreased by 20·0% over the past two decades. Even so, they are still much higher than those in the USA and European countries. This study can provide a basis for determining which IAPs to target in various indoor air quality standards and for estimating the health and economic benefits of various indoor air quality control approaches, which will help to reduce the adverse health effects of IAPs in China. FUNDING: The National Key Research and Development Program of China and the National Natural Science Foundation of China.

Indoor exposure to ultrafine particles related to domestic activities: A systematic review and meta-analysis.

Ultrafine particles (< 100 nm) are of increasing concern because of their toxicological potential. Emission processes suggest their presence in all environments, including at home, where particularly at-risk populations may be exposed. However, knowledge of their impact on health is still limited, due to difficulties in properly assessing exposure in epidemiological studies. In this context, the objective of this study was to provide a complete summary of indoor exposure to ultrafine particles in highly industrialised countries by examining the domestic activities that influence such exposure. We conducted a systematic review, according to PRISMA guidelines using PubMed, Web of Science and Scopus up to and including 2021. We carried out a qualitative and quantitative analysis of the selected studies with a standardised template. Exposure circumstances, measurement methods, and results were analysed. Finally, a meta-analysis of the measured concentrations was performed to study exposure levels during domestic activities. The review included 69 studies resulting in the analysis of 346 exposure situations. Nine main groups of activities were identified: cooking, which was the most studied, smoking, the use of air-fresheners, cleaning, heating, personal care, printing, do-it-yourself activities, and others. Over 50 different processes were involved in these activities. Based on available particle number concentrations, the highest average of mean concentrations was associated with grilling (14,400 × 103 cm-3), and the lowest with wood stove (18 × 103 cm-3). The highest average of peak concentrations was that for the use of hair dryers (695 × 103 cm-3), and the lowest for the use of air cleaners (11 × 103 cm-3). A hierarchy of domestic activities and related processes leading to ultrafine particle exposure is provided, along with average exposure concentrations at home. However, more extensive measurement campaigns are needed under real-life conditions to improve assessments of indoor exposure to ultrafine particles.

Exposure to Disinfectants and Cleaning Products and Respiratory Health of Workers and Children in Daycares: The CRESPI Cohort Protocol.

Although cleaning tasks are frequently performed in daycare, no study has focused on exposures in daycares in relation to respiratory health. The CRESPI cohort is an epidemiological study among workers (n~320) and children (n~540) attending daycares. The purpose is to examine the impact of daycare exposures to disinfectants and cleaning products (DCP) on the respiratory health of workers and children. A sample of 108 randomly selected daycares in the region of Paris has been visited to collect settled dust to analyze semi-volatile organic compounds and microbiota, as well as sample indoor air to analyze aldehydes and volatile organic compounds. Innovative tools (smartphone applications) are used to scan DCP barcodes in daycare and inform their use; a database then matches the barcodes with the products' compositions. At baseline, workers/parents completed a standardized questionnaire, collecting information on DCP used at home, respiratory health, and potential confounders. Follow-up regarding children's respiratory health (monthly report through a smartphone application and biannual questionnaires) is ongoing until the end of 2023. Associations between DCP exposures and the respiratory health of workers/children will be evaluated. By identifying specific environments or DCP substances associated with the adverse respiratory health of workers and children, this longitudinal study will contribute to the improvement of preventive measures.

Use and storage of pesticides at home in France (the Pesti'home survey 2014).

Some epidemiological studies have raised health concerns following the chronic exposure of pregnant women and children to pesticides in the domestic environment. In France very little is known about potential exposure to pesticides at home. An observational study called Pesti'home was carried out in continental France between July and November 2014. The residential use of pesticides was investigated and an inventory of pesticides and active ingredients used and stored at home was drawn up. Plant protection products, biocides, and human and animal external pest control products were listed during face-to-face interviews. A random sample of households including at least one adult (18-79 years old) was selected following a two-stage stratified random sampling method using the national census database. Within each household, an adult was appointed to answer survey questions. Data related to the interviewee's sociodemographic and housing characteristics, the reported use of pesticides at home, and a visual inventory of all stored pesticides were collected. Overall, 1507 households participated. The participation rate was between 36% and 57% according to the definition chosen. Over the previous 12 months, 75% of households declared that they had used at least one pesticide. Households who used and stored at least one product most frequently used an insecticide (84%). The active ingredients most frequently used by these households as insecticides were pyrethroids, namely tetramethrin and permethrin. The Pesti'home survey collected detailed data on the residential use of pesticides for risk assessment at national and European levels.

Impact of Climate Change on Indoor Air Quality: A Review.

Climate change can affect the indoor environment due to heat and mass transfers between indoor and outdoor environments. To mitigate climate change impacts and adapt buildings to the changing environment, changes in building characteristics and occupants' behavior may occur. To characterize the effects of climate change on indoor air quality (IAQ), the present review focused on four aspects: (1) experimental and modeling studies that relate IAQ to future environmental conditions, (2) evolution of indoor and outdoor air concentrations in the coming years with regard to temperature rise, (3) climate change mitigation and adaptation actions in the building sector, and (4) evolution of human behavior in the context of climate change. In the indoor environment, experimental and modeling studies on indoor air pollutants highlighted a combined effect of temperature and relative humidity on pollutant emissions from indoor sources. Five IAQ models developed for future climate data were identified in the literature. In the outdoor environment, the increasing ambient temperature may lead directly or indirectly to changes in ozone, particle, nitrogen oxides, and volatile organic compound concentrations in some regions of the world depending on the assumptions made about temperature evolution, anthropogenic emissions, and regional regulation. Infiltration into buildings of outdoor air pollutants is governed by many factors, including temperature difference between indoors and outdoors, and might increase in the years to come during summer and decrease during other seasons. On the other hand, building codes in some countries require a higher airtightness for new and retrofitted buildings. The building adaptation actions include the reinforcement of insulation, implementation of new materials and smart building technologies, and a more systematic and possibly longer use of air conditioning systems in summer compared to nowadays. Moreover, warmer winters, springs, and autumns may induce an increasing duration of open windows in these seasons, while the use of air conditioning in summer may reduce the duration of open windows.

Modeling Primary Emissions of Chemicals from Liquid Products Applied on Indoor Surfaces.

Liquid products applied on material surfaces and human skin, including many household cleaning products and personal care products, can lead to intermittent emissions of chemicals and peak concentrations in indoor air. The existing case-based models do not allow inter-comparison of different use scenarios and emission mechanisms. In this context, the present work developed a mechanistic model based on mass transfer theories, which allowed emissions into the air from the liquid product to be characterized. It also allowed for diffusion into the applied surface during product use and re-emission from the applied surface after the depletion of the liquid product. The model was validated using literature data on chemical emissions following floor cleaning and personal care product use. A sensitivity analysis of the model was then conducted. The percentage of the chemical mass emitted from the liquid to the air varied from 45% (applied on porous material) to 99% (applied on human skin), and the rest was absorbed into the applied material/skin. The peak gas-phase concentration, the time to reach the peak concentration, and the percentage of the liquid-to-air emission depended significantly on the chemical's octanol/gas and material/gas partition coefficients and the diffusion coefficient of the chemical in the applied material/skin.

Semivolatile organic compounds in French schools: Partitioning between the gas phase, airborne particles and settled dust.

The indoor environmental quality in classrooms can largely affect children's daily exposure to indoor chemicals in schools. To date, there has not been a comprehensive study of the concentrations of semivolatile organic compounds (SVOCs) in French schools. Therefore, the French Observatory for Indoor Air Quality (OQAI) performed a field study of SVOCs in 308 nurseries and elementary schools between June 2013 and June 2017. The concentrations of 52 SVOCs, including phthalates, polybrominated diphenyl ethers (PBDEs), polychlorinated biphenyls (PCBs), polycyclic aromatic hydrocarbons (PAHs), synthetic musks, and pesticides, were measured in air and settled dust (40 SVOCs in both air and dust, 12 in either air or dust). The results showed that phthalates had the highest concentrations among the SVOCs in both the air and dust. Other SVOCs, including tributyl phosphate, fluorene, phenanthrene, gamma-hexachlorocyclohexane (gamma-HCH, lindane), galaxolide, and tonalide, also showed high concentrations in both the air and dust. Theoretical equations were developed to estimate the SVOC partitioning between the air and settled dust from either the octanol/air partition coefficient or the boiling point of the SVOCs. The regression constants of the equations were determined using the data set of the present study for phthalates and PAHs.

Assessing Human Exposure to SVOCs in Materials, Products, and Articles: A Modular Mechanistic Framework.

A critical review of the current state of knowledge of chemical emissions from indoor sources, partitioning among indoor compartments, and the ensuing indoor exposure leads to a proposal for a modular mechanistic framework for predicting human exposure to semivolatile organic compounds (SVOCs). Mechanistically consistent source emission categories include solid, soft, frequent contact, applied, sprayed, and high temperature sources. Environmental compartments are the gas phase, airborne particles, settled dust, indoor surfaces, and clothing. Identified research needs are the development of dynamic emission models for several of the source emission categories and of estimation strategies for critical model parameters. The modular structure of the framework facilitates subsequent inclusion of new knowledge, other chemical classes of indoor pollutants, and additional mechanistic processes relevant to human exposure indoors. The framework may serve as the foundation for developing an open-source community model to better support collaborative research and improve access for application by stakeholders. Combining exposure estimates derived using this framework with toxicity data for different end points and toxicokinetic mechanisms will accelerate chemical risk prioritization, advance effective chemical management decisions, and protect public health.

Indoor air pollutant health prioritization in office buildings.

This work presents an original method to identify priority indoor air pollutants in office buildings. It uses both a chronic risk assessment approach by calculating a hazard quotient, and a hazard classification method based on carcinogenic, mutagenic, reprotoxic, and endocrine disruptive effects. A graphical representation of the results provides a comprehensive and concise visualization of all of the information, including the number of buildings where each substance was measured, an indicator of exposure data robustness. Seventy-one out of 342 substances (20%) for which indoor air concentrations have already been measured in office buildings were identified as priority pollutants. The results were compared to previous prioritization studies in various types of indoor environments to assess the reliability of the method and highlight its advantages. Sensitivity analyses were performed to reduce the geographical scope (OECD countries only), time scope (after 2010 only), and measurement duration (working hours only) and showed little influence on the results. Finally, 123 additional substances that could be present in office indoor air but could not be assessed due to the lack of measurement data are proposed for future monitoring surveys to update the prioritization of indoor air pollutants in offices.

Indoor air quality in shopping and storage areas.

In retail stores, workers are constantly exposed to new manufactured goods. The issue of the exposure of retail workers to volatile organic compounds (VOCs) should clearly be considered. Therefore, this study provides data regarding VOC concentrations in ten French retail stores. The stores were chosen to represent various products: sports goods, shoes and leather, furniture, car equipment, bazaars, online-sales storage, clothes, books, DIY (do-it-yourself), and household appliances. VOCs and aldehydes were actively sampled on the same day in five to seven locations per building and outdoors. Toluene and formaldehyde were omnipresent with indoor concentrations reaching 252 and 53 µg/m3 , respectively. The car equipment store, followed by clothing, shoes, and leather, and DIY stores showed the worst indoor air quality. High concentrations were measured, for example, the maximum α-pinene concentration in the furniture and DIY stores was 364 and 141 µg/m3 , respectively, and the heptane concentration in the car equipment store reached 1,316 µg/m3 . Two VOCs classified as toxic to reproduction were measured: hexane in the car equipment store and the bazaar, and dimethylformamide in the sports goods store. This study shows some disparities in the indoor concentrations among different locations in the same store, particularly between sales and storage areas.

Toward setting public health guidelines for chemicals in indoor settled dust?

Indoor settled dust may result in substantial human exposure to chemicals, especially by ingestion following hand-to-mouth or hand-to-object-to-mouth contact. As with other environmental media related to exposure, dust may thus be subject to regulation. An international scientific workshop was convened in Paris in September 2019 firstly to assess the relevance for public health of setting guidelines for indoor settled dust, and secondly to discuss scientific and technical challenges related to such guidelines. The main discussions and conclusions, with consensus achieved, are reported herein. Discussions concerned general considerations, objectives and definitions, relevance for a health-based guideline, units of measure, and finally derivation of the guideline. These points should be addressed when considering an indoor settled dust guideline as part of a policy to reduce exposure indoors to a given chemical or group of chemicals.

Association of subjective health symptoms with indoor air quality in European office buildings: The OFFICAIR project.

The aim of this study was to explore the association between the building-related occupants' reported health symptoms and the indoor pollutant concentrations in a sample of 148 office rooms, within the framework of the European OFFICAIR research project. A large field campaign was performed in 37 office buildings among eight countries, which included (a) 5-day air sampling of volatile organic compounds (VOCs), aldehydes, ozone, and NO2 (b) collection of information from 1299 participants regarding their personal characteristics and health perception at workplace using online questionnaires. Stepwise and multilevel logistic regressions were applied to investigate associations between health symptoms and pollutant concentrations considering personal characteristics as confounders. Occupants of offices with higher pollutant concentrations were more likely to report health symptoms. Among the studied VOCs, xylenes were associated with general (such as headache and tiredness) and skin symptoms, ethylbenzene with eye irritation and respiratory symptoms, a-pinene with respiratory and heart symptoms, d-limonene with general symptoms, and styrene with skin symptoms. Among aldehydes, formaldehyde was associated with respiratory and general symptoms, acrolein with respiratory symptoms, propionaldehyde with respiratory, general, and heart symptoms, and hexanal with general SBS. Ozone was associated with almost all symptom groups.

Predicting the rate constants of semivolatile organic compounds with hydroxyl radicals and ozone in indoor air.

Semivolatile organic compounds (SVOCs) in air can react with hydroxyl radicals (OH), nitrate radicals (NO3) and ozone (O3). Two questions regarding SVOC reactivity with OH, NO3 and O3 in the gas and particle phases remain to be addressed: according to the existing measurements in the literature, which are the most reactive SVOCs in air, and how can the SVOC reactivity in the gas and particle phases be predicted? In the present study, a literature review of the second-order rate constant (k) was carried out to determine the SVOC reactivity with OH, NO3 and O3 in the gas and particle phases in ambient and indoor air at room temperature. Measured k values were available in the literature for 90 polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls (PCBs), organophosphates, dioxins, di(2-ethylhexyl)phthalate (DEHP) and pesticides including pyrifenox, carbamates and terbuthylazine. PAHs and organophosphates were found to be more reactive than dioxins and PCBs. Based on the obtained data, quantitative structure-activity relationship (QSAR) models were developed to predict the k value using quantum chemical, molecular, physical property and environmental descriptors. Eight linear and nonlinear statistical models were employed, including regression models, bagging, random forest and gradient boosting. QSAR models were developed for SVOC/OH reactions in the gas and particle phases and SVOC/O3 reactions in the particle phase. Models for SVOC/NO3 and SVOC/O3 reactions in the gas phase could not be developed due to the lack of measured k values for model training. The least absolute shrinkage and selection operator (LASSO) regression and random forest models were identified as the most effective models for SVOC reactivity prediction according to a comparison of model performance metrics.

Aggregate and cumulative chronic risk assessment for pyrethroids in the French adult population.

Pyrethroids are commonly used as insecticides in households, in agriculture or in veterinary and medicinal products. This study aimed to assess cumulative aggregate exposure to cyfluthrin, cypermethrin, deltamethrin and permethrin in adults in France and the associated health risk, and to identify major contributions of exposure sources and routes. External chronic exposures were estimated from dietary and several environmental sources for the oral, inhalation and dermal routes. Internal concentrations of five associated metabolites were simulated with a physiologically-based pharmacokinetic model. The predicted urinary concentrations were in same order of magnitude as those of the French ENNS biomonitoring survey. Dietary exposure, especially from cereals and animal products, was the major source of exposure. For the 1% of adults most highly exposed, dermal exposure to permethrin through medicinal and veterinary products was an important source of exposure. Considering alterations of motor, sensory and autonomic division, all individual margins of exposure were higher than 100, suggesting that no neurotoxic risk associated with the cumulative aggregate exposure to these four pyrethroids is expected for the French adult population.

Modeling the bioaccessibility of inhaled semivolatile organic compounds in the human respiratory tract.

The bioaccessibility of semivolatile organic compounds (SVOCs) via inhalation has rarely been studied, as indicated by the literature. There is no model to calculate the SVOC bioaccessibility following inhalation, and measurement data have focused on only a few polycyclic aromatic hydrocarbons (PAHs) in the particle phase. The present work developed a mechanistic model to address the mass transfer of inhaled SVOCs among the gas, particle and mucus phases in the human respiratory tract. The model considers (1) the SVOC partitioning between the gas and particle phases as well as between the gas and mucus phases and (2) the deposition of gas- and particle-phase SVOCs in the mucus of the respiratory tract. Based on the model, the inhalation bioaccessibility for 72 SVOCs was calculated. The SVOCs were measured in French dwellings at the nationwide scale, and their median concentrations in both the gas and particle phases were used for the bioaccessibility calculations. The results show that the inhalation bioaccessibility varies considerably from one compound to another, e.g., between 0.62 and 1.00 for phthalates, between 0.71 and 0.79 for polybrominated diphenyl ethers (PBDEs), between 0.48 and 0.56 for polychlorinated biphenyls (PCBs), between 0.48 and 1.00 for different chemical families of pesticides and between 0.48 and 0.90 for PAHs.

On-line coupling of thermal extraction with gas chromatography / tandem mass spectrometry for the analysis of semivolatile organic compounds in a few milligrams of indoor dust.

An original multiresidue method based on thermal extraction (TE) and gas chromatography/tandem mass spectrometry (GC/MS/MS) was developed to simultaneously quantify, from a very small amount of sample (a few milligrams), a wide range of concerning SVOCs, including polycyclic musks, organochlorines (OCs), organophosphates (OPs), oxadiazolones, polycyclic aromatic hydrocarbons (PAHs), polybromodiphenylethers (PBDEs), polychlorobiphenyls (PCBs), phthalates and pyrethroids, in indoor settled dust. Method limits of quantification (LOQs) ranged from 5 ng g-1 for PCBs, oxadiazon, 4,4'-DDE and 4,4'-DDT to 2000 ng g-1 for DEHP for a 2 mg sample of sieved dust. The proposed method was successfully validated in terms of accuracy and precision via replicate analysis of four different standard reference materials (SRMs 1649b (Urban Dust), 2585 (Organic Contaminants in House Dust), 2786 and 2787 (Fine Atmospheric Particulate Matter)) supplied by the National Institute of Standards and Technology (NIST) and was applied to five real indoor settled dust samples collected in French schools. In addition, its performance was compared to that of a previously published method based on pressurized liquid extraction (PLE) and GC/MS/MS. The different results obtained demonstrate the advantages of the proposed method over conventional methods and illustrate its two main features: i) its ease of use and very rapid implementation in only three steps (sieving, weighing and analysis), which make it particularly appropriate for environmental monitoring programs and large-scale studies, and ii) its ability to precisely and accurately quantify a wide range of SVOCs from trace (a few ng g-1) to highly concentrated (several mg g-1) compounds from only 2 mg of sieved dust.

Daylight and School Performance in European Schoolchildren.

: Aims and objectives: Lighting constitutes a critical issue in school design because of its importance as a strong enabler of performance, which is crucial for child development. However, data on light impacts on school performance are scarce. The main objective of this study was to assess the relationship between daylighting conditions in classrooms and mathematical and logical test scores. METHODS: The population-based SINPHONIE (Schools Indoor Pollution and Heath: Observatory Network in Europe) study provides information on relationships between lighting conditions and school performance for 2670 elementary schoolchildren, aged 8-13 years from 155 classrooms in 53 schools across 12 European countries. These data were acquired through direct physical assessments and questionnaires completed by teachers, schoolchildren, and their parents, allowing for estimations of multiple objective daylight indicators, as well as subjective parameters such as the perception of lighting. Schoolchildren performed an attention/concentration exam that included simple mathematical exercises in addition to a logical ciphering test. The corresponding performance scores were compared against multiple daylighting parameters. RESULTS: A positive relationship was found between performance scores and type of window shading, latitude, percentage of window facing south, and window glazing, with the highest impact due to the window-to-floor area ratio. CONCLUSION: Data collected in the SINPHONIE study across 12 European countries indicate that daylighting parameters are relevant to schoolchildren's performance. As SINPHONIE was not designed specifically with lighting in mind, dedicated studies covering a wide range of classroom configurations would be enlightening.