A CFD study on the effect of portable air cleaner placement on airborne infection control in a classroom.

The utilization of portable air cleaners (PACs) is a recommended supplemental approach to help remove airborne pathogens and mitigate disease transmission in learning environments. To improve PAC effectiveness, science-based information is needed to optimize their implementation strategies such as the deployment location, height, and number of PACs. In this study, we developed a Computational Fluid Dynamics (CFD) model to assess how PACs perform in occupied classrooms equipped with displacement and mixing ventilation systems. The results show that PACs with a flow rate of 2.6 h-1 reduce the mean aerosol intake of all students by up to 66%. A key benefit of using PACs is to facilitate air mixing and movement in indoor environments with inadequate ventilation, thereby effectively reducing high aerosol concentrations near the infector. Furthermore, our results highlight the impact of PAC location on its performance. PACs achieve the best effectiveness when placed closed to the infector (within a distance <3 m). In the absence of knowing who is infected, deploying a PAC at the center of the room is recommended. Moreover, adjusting PAC flow discharge height to the breathing height of occupants (e.g., 0.9-1.2 m for seated people) can enhance their effectiveness in spaces with poor air mixing.

"If you have light, your heart will be at peace": A qualitative study of household lighting and social integration in southwestern Uganda.

Background: Expanding electrification and access to other clean and affordable energy, such as solar energy, is a critical component of the Sustainable Development Goals, particularly in sub-Saharan Africa where 70% of people are energy insecure. Intervention trials related to access or less polluting household energy alternatives have typically focused on air quality and biological outcomes rather than on how an intervention affects the end user's lived experiences, a key determinant of uptake and adoption outside of a research setting. We explored perceptions of and experiences with a household solar lighting intervention in rural Uganda. Methods: In 2019, we completed a one-year parallel group, randomized wait-list controlled trial of indoor solar lighting systems (ClinicalTrials.gov NCT03351504) in rural Uganda where participants are largely relying on kerosene and other fuel-based lighting received household indoor solar lighting systems. In this qualitative sub-study, we conducted one-on-one, in-depth qualitative interviews with all 80 female participants enrolled in the trial. Interviews explored how solar lighting and illumination impacted participants' lives. We applied a theoretical model linking social integration and health to analyse dynamic interactions across aspects of study participants' lived experiences. Sensors were used to measure daily lighting use before and after receipt of the intervention solar lighting system. Results: Introduction of the solar lighting system increased daily household lighting use by 6.02 (95% confidence intervals (CI) = 4.05-8.00) hours a day. The solar lighting intervention had far-reaching social implications with improved social integration and, consequently, social health. Participants felt that lighting improved their social status, mitigated the stigma of poverty, and increased the duration and frequency of social interactions. Household relationships improved with access to lighting because of reduced conflicts over light rationing. Participants also described a communal benefit of lighting due to improved feelings of safety. At the individual-level, many reported improved self-esteem, sense of well-being, and reduced stress. Conclusion: Improved access to lighting and illumination had far reaching implications for participants, including improved social integration. More empirical research, particularly in the light and household energy field, is needed that emphasizes the impacts of interventions on social health. Registration: ClinicalTrials.gov No. NCT03351504.

Hormone receptor activities of complex mixtures of known and suspect chemicals in personal silicone wristband samplers worn in office buildings.

Humans are exposed to increasingly complex mixtures of hormone-disrupting chemicals from a variety of sources, yet, traditional research methods only evaluate a small number of chemicals at a time. We aimed to advance novel methods to investigate exposures to complex chemical mixtures. Silicone wristbands were worn by 243 office workers in the USA, UK, China, and India during four work shifts. We analyzed extracts of the wristbands for: 1) 99 known (targeted) chemicals; 2) 1000+ unknown chemical features, tentatively identified through suspect screening; and 3) total hormonal activities towards estrogen (ER), androgen (AR), and thyroid hormone (TR) receptors in human cell assays. We evaluated associations of chemicals with hormonal activities using Bayesian kernel machine regression models, separately for targeted versus suspect chemicals (with detection ≥50%). Every wristband exhibited hormonal activity towards at least one receptor: 99% antagonized TR, 96% antagonized AR, and 58% agonized ER. Compared to men, women were exposed to mixtures that were more estrogenic (180% higher, adjusted for country, age, and skin oil abundance in wristband), anti-androgenic (110% higher), and complex (median 836 detected chemical features versus 780). Adjusted models showed strong associations of jointly increasing chemical concentrations with higher hormonal activities. Several targeted and suspect chemicals were important co-drivers of overall mixture effects, including chemicals used as plasticizers, fragrance, sunscreen, pesticides, and from other or unknown sources. This study highlights the role of personal care products and building microenvironments in hormone-disrupting exposures, and the substantial contribution of chemicals not often identifiable or well-understood to those exposures.

Organic Fluorine as an Indicator of Per- and Polyfluoroalkyl Substances in Dust from Buildings with Healthier versus Conventional Materials.

Per- and polyfluoroalkyl substances (PFAS) are a class of thousands of persistent, organic fluorinated chemicals added to materials and products mainly to repel stains and water. PFAS have been associated with many adverse human health effects. We aimed to determine whether buildings with "healthier" materials─defined here as reportedly free of all PFAS─exhibit lower PFAS in dust. In addition to analyzing targeted PFAS with available commercial standards, we measured extractable organic fluorine (EOF) as a novel proxy that includes both known and unknown types of PFAS. We measured at least 15 targeted PFAS (n = 24), EOF (n = 24), and total fluorine (TF; n = 14) in dust collected from university common spaces and classrooms, half of which had "healthier" furniture and carpet. We observed lower PFAS contamination in buildings with "healthier" materials: "healthier" rooms had a 66% lower median summed PFAS and a 49% lower Kaplan-Meier estimated mean EOF level in dust in comparison to conventional rooms. The summed targeted PFAS were significantly correlated with EOF but accounted for up to only 9% of EOF, indicating the likely presence of unidentified PFAS. EOF levels explained less than 1% of TF in dust. We emphasize the need to use chemical class-based methods (e.g., EOF) for evaluating class-based solutions and to expand non-PFAS solutions for other building materials.

Inefficient Building Electrification Will Require Massive Buildout of Renewable Energy and Seasonal Energy Storage.

Building electrification is essential to many full-economy decarbonization pathways. However, current decarbonization modeling in the United States (U.S.) does not incorporate seasonal fluctuations in building energy demand, seasonal fluctuations in electricity demand of electrified buildings, or the ramifications of this extra demand for electricity generation. Here, we examine historical energy data in the U.S. to evaluate current seasonal fluctuation in total energy demand and management of seasonal fluctuations. We then model additional electricity demand under different building electrification scenarios and the necessary increases in wind or solar PV to meet this demand. We found that U.S. monthly average total building energy consumption varies by a factor of 1.6×-lowest in May and highest in January. This is largely managed by fossil fuel systems with long-term storage capability. All of our building electrification scenarios resulted in substantial increases in winter electrical demand, enough to switch the grid from summer to winter peaking. Meeting this peak with renewables would require a 28× increase in January wind generation, or a 303× increase in January solar, with excess generation in other months. Highly efficient building electrification can shrink this winter peak-requiring 4.5× more generation from wind and 36× more from solar.

Use, cost-effectiveness, and end user perspectives of a home solar lighting intervention in rural Uganda: a mixed methods, randomized controlled trial.

Energy poverty is prevalent in resource-limited settings, leading households to use inefficient fuels and appliances that contribute to household air pollution. Randomized controlled trials of household energy interventions in low and middle income countries have largely focused on cooking services. Less is known about the adoption and impact of clean lighting interventions. We conducted an explanatory sequential mixed methods study as part of a randomized controlled trial of home solar lighting systems in rural Uganda in order to identify contextual factors determining the use and impact of the solar lighting intervention. We used sensors to track usage, longitudinally assessed household lighting expenditures and health-related quality of life, and performed cost-effectiveness analyses. Qualitative interviews were conducted with all 80 trial participants and coded using reflexive thematic analysis. Uptake of the intervention solar lighting system was high with daily use averaging 8.23 ± 5.30 hours per day. The intervention solar lighting system increased the EQ5D index by 0.025 [95% CI 0.002 - 0.048] and led to an average monthly reduction in household lighting costs by -1.28 [-2.52, -0.85] US dollars, with higher savings in users of fuel-based lighting. The incremental cost-effectiveness ratio for the solar lighting intervention was $2025.72 US dollars per quality adjusted life year (QALY) gained making the intervention cost-effective when benchmarked against the gross domestic product (GDP) per capita in Uganda. Thematic analysis of qualitative data from individual interviews showed that solar lighting was transformative and associated with numerous benefits that fit within a Social Determinants of Health (SDOH) framework. The benefits included improved household finances, improved educational performance of children, increased household safety, improved family and community cohesion, and improved perceived household health. Our findings suggest that household solar lighting interventions may be a cost-effective approach to improve health-related quality of life by addressing SDOH.

Effect of a solar lighting intervention on fuel-based lighting use and exposure to household air pollution in rural Uganda: A randomized controlled trial.

Solar lighting is an alternative to polluting kerosene and other fuel-based lighting devices relied upon by millions of families in resource-limited settings. Whether solar lighting provides sustained displacement of fuel-based lighting sources and reductions in personal exposure to fine particulate matter (PM2 .5 ) and black carbon (BC) has not been examined in randomized controlled trials. Eighty adult women living in rural Uganda who utilized fuel-based (candles and kerosene lamps) and/or clean (solar, grid, and battery-powered devices) lighting were randomized in a 1:1 ratio to receive a home solar lighting system at no cost to study participants (ClinicalTrials.gov NCT03351504). Among intervention group participants, kerosene lamps were completely displaced in 92% of households using them. The intervention led to an average exposure reduction of 36.1 µg/m3 (95% CI -70.3 to -2.0) in PM2 .5 and 10.8 µg/m3 (95% CI -17.6 to -4.1) in BC, corresponding to a reduction from baseline of 37% and 91%, respectively. Reductions were greatest among participants using kerosene lamps. Displacement of kerosene lamps and personal exposure reductions were sustained over 12 months of follow-up. Solar lighting presents an immediate opportunity for achieving sustained reductions in personal exposure to PM2.5 and BC and should be considered in household air pollution intervention packages.

Indoor humidity levels and associations with reported symptoms in office buildings.

Moderate indoor relative humidity (RH) levels (i.e., 40%-60%) may minimize transmission and viability of some viruses, maximize human immune function, and minimize health risks from mold, yet uncertainties exist about typical RH levels in offices globally and about the potential independent impacts of RH levels on workers' health. To examine this, we leveraged one year of indoor RH measurements (which study participants could view in real time) in 43 office buildings in China, India, Mexico, Thailand, the United Kingdom, and the United States, and corresponding self-report symptom data from 227 office workers in a subset of 32 buildings. In the buildings in this study, 42% of measurements during 9:00 - 17:00 on weekdays were less than 40% RH and 7% exceeded 60% RH. Indoor RH levels tended to be lower in less tropical regions, in winter months, when outdoor RH or temperature was low, and late in the workday. Furthermore, we also found statistically significant evidence that higher indoor RH levels across the range of 14%-70% RH were associated with lower odds of reporting dryness or irritation of the throat and skin among females and unusual fatigue among males in models adjusted for indoor temperature, country, and day of year.

Validation of in vivo toenail measurements of manganese and mercury using a portable X-ray fluorescence device.

BACKGROUND AND OBJECTIVE: Toenail metal concentrations can be used as an effective biomarker for exposure to environmental toxicants. Typically toenail clippings are measured ex vivo using inductively coupled plasma mass spectrometry (ICP-MS). X-ray fluorescence (XRF) toenail metal measurements done on intact toenails in vivo could be used as an alternative to alleviate some of the disadvantages of ICP-MS. In this study, we assessed the ability to use XRF to measure toenail metal concentrations in real-time without having to clip the toenails (i.e., in vivo) in two occupational settings for exposure assessment of manganese and mercury. MATERIALS AND METHODS: The portable XRF method used a 3-min in vivo measurement of toenails prior to clipping and was assessed against ICP-MS measurement of toenail clippings taken immediately after the XRF measurement and work history for a group of welders (n = 16) assessed for manganese exposure and nail salon workers (n = 10) assessed for mercury exposure. RESULTS AND CONCLUSIONS: We identified that in vivo XRF metal measurements were able to discern exposure to manganese in welders and mercury in nail salon workers. We identified significant positive correlations between ICP-MS of clippings and in vivo XRF measures of both toenail manganese (R = 0.59, p = 0.02) and mercury (R = 0.74, p < 0.001), as well as between in vivo XRF toenail manganese and work history among the welders (R = 0.55, p = 0.03). We identified in vivo XRF detection limits to be 0.5 µg/g for mercury and 2.6 µg/g for manganese. Further work should elucidate differences in the timing of exposure using the in vivo XRF method over toenail clippings and modification of measurement time and x-ray setting to further decrease the detection limit. In vivo portable, XRF measurements can be used to effectively measure toenail Mn and Hg in occupational participants in real-time during study visits and at a fraction of the cost.

Chemical contaminant exposures assessed using silicone wristbands among occupants in office buildings in the USA, UK, China, and India.

Little is known about chemical contaminant exposures of office workers in buildings globally. Complex mixtures of harmful chemicals accumulate indoors from building materials, building maintenance, personal products, and outdoor pollution. We evaluated exposures to 99 chemicals in urban office buildings in the USA, UK, China, and India using silicone wristbands worn by 251 participants while they were at work. Here, we report concentrations of polychlorinated biphenyls (PCBs), polybrominated diphenyl ethers (PBDEs) and other brominated flame retardants (BFRs), organophosphate esters (OPEs), phthalates and phthalate alternatives, pesticides, and polycyclic aromatic hydrocarbons (PAHs). First, we found major differences in office worker chemical exposures by country, some of which can be explained by regulations and use patterns. For example, exposures to several pesticides were substantially higher in India where there were fewer restrictions and unique malaria challenges, and exposures to flame retardants tended to be higher in the USA and UK where there were historic, stringent furniture flammability standards. Higher exposures to PAHs in China and India could be due to high levels of outdoor air pollution that penetrates indoors. Second, some office workers were still exposed to legacy PCBs, PBDEs, and pesticides, even decades after bans or phase-outs. Third, we identified exposure to a contemporary PCB that is not covered under legacy PCB bans due to its presence as an unintentional byproduct in materials. Fourth, exposures to novel BFRs, OPEs, and other chemicals commonly used as substitutes to previously phased-out chemicals were ubiquitous. Fifth, some exposures were influenced by individual factors, not just countries and buildings. Phthalate exposures, for example, were related to personal care product use, country restrictions, and building materials. Overall, we found substantial country differences in chemical exposures and continued exposures to legacy phased-out chemicals and their substitutes in buildings. These findings warrant further research on the role of chemicals in office buildings on worker health.

The Effects of Ventilation and Filtration on Indoor PM2.5 in Office Buildings in Four Countries.

Fine particulate matter (PM2.5) is an airborne pollutant associated with negative acute and chronic human health outcomes. Although the majority of PM2.5 research has focused on outdoor exposures, people spend the majority of their time indoors, where PM2.5 of outdoor origin can penetrate. In this work, we measured indoor PM2.5 continuously for one year in 37 urban commercial offices with mechanical or mixed-mode ventilation in China, India, the United Kingdom, and the United States. We found that indoor PM2.5 concentrations were generally higher when and where outdoor PM2.5 was elevated. In India and China, mean workday indoor PM2.5 levels exceeded the World Health Organization's 24-hour exposure guideline of 25 µg/m3 about 17% and 27% of the time, respectively. Our statistical models found evidence that the operation of mechanical ventilation systems could mitigate the intrusion of outdoor PM2.5: during standard work hours, a 10 µg/m3 increase in outdoor PM2.5 was associated with 19.9% increase in the expected concentration of indoor PM2.5 (p<0.0001), compared to a larger 23.4% increase during non-work hours (p<0.0001). Finally, our models found that using filters with ratings of MERV 13-14 or MERV 15+ was associated with a 30.9% (95% CI: -55.0%, +6.2%) or 39.4% (95% CI: -62.0%, -3.4%) reduction of indoor PM2.5, respectively, compared to filters with lower MERV 7-12 ratings. Our results demonstrate the potential efficacy of mechanical ventilation with efficient filtration as a public health strategy to protect workers from PM2.5 exposure, particularly where outdoor levels of PM2.5 are elevated.

Assessing Indoor Dust Interference with Human Nuclear Hormone Receptors in Cell-Based Luciferase Reporter Assays.

BACKGROUND: Per- and polyfluoroalkyl substances (PFAS), organophosphate esters (OPEs), and polybrominated diphenyl ethers (PBDEs) are hormone-disrupting chemicals that migrate from building materials into air and dust. OBJECTIVES: We aimed to quantify the hormonal activities of 46 dust samples and identify chemicals driving the observed activities. METHODS: We evaluated associations between hormonal activities of extracted dust in five cell-based luciferase reporter assays and dust concentrations of 42 measured PFAS, OPEs, and PBDEs, transformed as either raw or potency-weighted concentrations based on Tox21 high-throughput screening data. RESULTS: All dust samples were hormonally active, showing antagonistic activity toward peroxisome proliferator-activated receptor (PPARγ2) (100%; 46 of 46 samples), thyroid hormone receptor (TRß) (89%; 41 samples), and androgen receptor (AR) (87%; 40 samples); agonist activity on estrogen receptor (ERα) (96%; 44 samples); and binding competition with thyroxine (T4) on serum transporter transthyretin (TTR) (98%; 45 samples). Effects were observed with as little as 4µg of extracted dust. In regression models for each chemical class, interquartile range increases in potency-weighted or unknown-potency chemical concentrations were associated with higher hormonal activities of dust extracts (potency-weighted: ΣPFAS-TRß, ↑28%, p<0.05; ΣOPEs-TRß, ↑27%, p=0.08; ΣPBDEs-TRß, ↑20%, p<0.05; ΣPBDEs-ERα, ↑7.7%, p=0.08; unknown-potency: ΣOPEs-TTR, ↑34%, p<0.05; ΣOPEs-AR, ↑13%, p=0.06), adjusted for chemicals with active, inactive, and unknown Tox21 designations. DISCUSSION: All indoor dust samples exhibited hormonal activities, which were associated with PFAS, PBDE, and OPE levels. Reporter gene cell-based assays are relatively inexpensive, health-relevant evaluations of toxic loads of chemical mixtures that building occupants are exposed to. https://doi.org/10.1289/EHP8054.

Mechanistic transmission modeling of COVID-19 on the Diamond Princess cruise ship demonstrates the importance of aerosol transmission.

Several lines of existing evidence support the possibility of airborne transmission of coronavirus disease 2019 (COVID-19). However, quantitative information on the relative importance of transmission pathways of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains limited. To evaluate the relative importance of multiple transmission routes for SARS-CoV-2, we developed a modeling framework and leveraged detailed information available from the Diamond Princess cruise ship outbreak that occurred in early 2020. We modeled 21,600 scenarios to generate a matrix of solutions across a full range of assumptions for eight unknown or uncertain epidemic and mechanistic transmission factors. A total of 132 model iterations met acceptability criteria (R2 > 0.95 for modeled vs. reported cumulative daily cases and R2 > 0 for daily cases). Analyzing only these successful model iterations quantifies the likely contributions of each defined mode of transmission. Mean estimates of the contributions of short-range, long-range, and fomite transmission modes to infected cases across the entire simulation period were 35%, 35%, and 30%, respectively. Mean estimates of the contributions of larger respiratory droplets and smaller respiratory aerosols were 41% and 59%, respectively. Our results demonstrate that aerosol inhalation was likely the dominant contributor to COVID-19 transmission among the passengers, even considering a conservative assumption of high ventilation rates and no air recirculation conditions for the cruise ship. Moreover, close-range and long-range transmission likely contributed similarly to disease progression aboard the ship, with fomite transmission playing a smaller role. The passenger quarantine also affected the importance of each mode, demonstrating the impacts of the interventions.

Per- and polyfluoroalkyl substances (PFAS) and total fluorine in fire station dust.

Per- and polyfluoroalkyl substances (PFAS) are a class of over 4700 fluorinated compounds used in industry and consumer products. Studies have highlighted the use of aqueous film-forming foams (AFFFs) as an exposure source for firefighters, but little is known about PFAS occurrence inside fire stations, where firefighters spend most of their shifts. In this study, we aimed to characterize PFAS concentrations and sources inside fire stations. We measured 24 PFAS (using LC-MS/MS) and total fluorine (using particle-induced gamma ray emission) in dust from multiple rooms of 15 Massachusetts stations, many of which (60%) no longer use PFAS-containing AFFF at all and the rest of which only use it very rarely. Compared to station living rooms, turnout gear locker rooms had higher dust levels of total fluorine (p < 0.0001) and three PFAS: perfluorohexanoate (PFHxA), perfluoroheptanoate (PFHpA), and perfluorodecanoate (PFDoDA) (p < 0.05). These PFAS were also found on six wipes of station turnout gear. By contrast, the dominant PFAS in living rooms was N-ethyl perfluorooctane sulfonamidoacetic acid (N-MeFOSAA), a precursor to perfluorooctane sulfonate (PFOS) that still persists despite phase-outs almost two decades ago. The Σ24 PFAS accounted for less than 2% of fluorine in dust (n = 39), suggesting the potential presence of unknown PFAS. Turnout gear may be an important PFAS source in stations due to intentional additives and/or contamination from firefighting activities.

Exposures in nail salons to trace elements in nail polish from impurities or pigment ingredients - A pilot study.

Nail polishes have evolved considerably. Toxic elements, such as lead, have been found in nail polish, and it is unclear if new finishes using metallic effect pigments may be contributing to metals exposure in nail technicians. We characterized concentrations of trace elements in 40 nail polishes, 9 technicians' urine, and 20 technicians' toenail clippings from 8 nail salons in the Boston area in 2017. We also collected 24 salon surface wipes from 3 of the salons. Antimony was not disclosed as a nail polish ingredient, yet concentrations (<15 µg/g) were above existing cosmetics guidelines (0.5 µg/g) in five (13%) of the samples. Aluminum (<11,450 µg/g), barium (<11,250 µg/g), iron (<3,270 µg/g), and magnesium (<2375 µg/g) were disclosed as ingredients and were also found on salon surfaces where nail polish was stored or used. Heavy metal impurities in nail polish were not detected for cadmium. Lead and nickel were found at low concentrations (<0.40 µg/g lead, <0.67 µg/g nickel). Tin (p = 0.003) concentrations were higher in nail polish with finishes compared to without. Barium and strontium (both p = 0.0001) concentrations were higher for red nail polishes compared to all other colors. Of those elements in nail polish and salon surfaces, aluminum and iron were detected in toenails, manganese was detected in urine and toenails, and barium was detected in urine at comparable levels to the general population. Besides preventable antimony levels in nail polish, individual metals in nail polish did not appear to be from impurities but mainly from colorants (i.e., pigments) and not major contributors to nail technician exposure. It is unclear if low-level chronic metals mixtures in nail salons are of health concern.

An Unrecognized Hazard in E-Cigarette Vapor: Preliminary Quantification of Methylglyoxal Formation from Propylene Glycol in E-Cigarettes.

Up to 95% of the liquid volume in an e-cigarette consists of propylene glycol. Previous research has shown that propylene glycol can generate diacetyl and formaldehyde when heated. New research shows that propylene glycol can also generate methylglyoxal, an alpha di-carbonyl compound recently shown to cause epithelial necrosis at even lower concentrations than diacetyl, the flavoring chemical associated with bronchiolitis obliterans ("Popcorn Lung"). We analyzed chemical emissions from 13 JUUL pod flavors. Diacetyl and methylglyoxal was detected in 100% of samples with median concentration (range) of 20 µg/m3 (less than limit of quantification: 54 µg/m3) and 4219 µg/m3 (677-15,342 µg/m3), respectively. We also detected acetaldehyde (median concentration: 341 µg/m3) and propionaldehyde (median concentration: 87 µg/m3) in all samples. The recent evidence that methylglyoxal is more cytotoxic to airway epithelial cells than diacetyl makes this an urgent public health concern. Current smokers considering e-cigarettes as a smoking cessation tool, and never users, who may be under the impression that e-cigarettes are harmless, need information on emissions and potential risks to make informed decisions.

Impact of "healthier" materials interventions on dust concentrations of per- and polyfluoroalkyl substances, polybrominated diphenyl ethers, and organophosphate esters.

Per- and polyfluoroalkyl substances (PFAS), polybrominated diphenyl ethers (PBDEs), and organophosphate esters (OPEs) are found in building materials and associated with thyroid disease, infertility, and impaired development. This study's objectives were to (1) compare levels of PFAS, PBDEs, and OPEs in dust from spaces with conventional versus "healthier" furniture and carpet, and (2) identify other product sources of flame retardants in situ. We measured 15 PFAS, 8 PBDEs, and 19 OPEs in dust from offices, common areas, and classrooms having undergone either no intervention (conventional rooms in older buildings meeting strict fire codes; n = 12), full "healthier" materials interventions (rooms with "healthier" materials in buildings constructed more recently or gut-renovated; n = 7), or partial interventions (other rooms with at least "healthier" foam furniture but more potential building contamination; n = 28). We also scanned all materials for bromine and phosphorus as surrogates of PBDEs and OPEs respectively, using x-ray fluorescence. In multilevel regression models, rooms with full "healthier" materials interventions had 78% lower dust levels of PFAS than rooms with no intervention (p < 0.01). Rooms with full "healthier" interventions also had 65% lower OPE levels in dust than rooms with no intervention (p < 0.01) and 45% lower PBDEs than rooms with only partial interventions (p < 0.10), adjusted for covariates related to insulation, electronics, and furniture. Bromine loadings from electronics in rooms were associated with PBDE concentrations in dust (p < 0.05), and the presence of exposed insulation was associated with OPE dust concentrations (p < 0.001). Full "healthier" materials renovations successfully reduced chemical classes in dust. Future interventions should address electronics, insulation, and building cross-contamination.

Associations between Acute Exposures to PM2.5 and Carbon Dioxide Indoors and Cognitive Function in Office Workers: A Multicountry Longitudinal Prospective Observational Study.

Despite evidence of the air pollution effects on cognitive function, little is known about the acute impact of indoor air pollution on cognitive function among the working-age population. We aimed to understand whether cognitive function was associated with real-time indoor concentrations of particulate matter (PM2.5) and carbon dioxide (CO2). We conducted a prospective observational longitudinal study among 302 office workers in urban commercial buildings located in six countries (China, India, Mexico, Thailand, the United States of America, and the United Kingdom). For 12 months, assessed cognitive function using the Stroop color-word test and Addition-Subtraction test (ADD) via a mobile research app. We found that higher PM2.5 and lower ventilation rates, as assessed by CO2 concentration, were associated with slower response times and reduced accuracy (fewer correct responses per minute) on the Stroop and ADD for 8 out 10 test metrics. Each interquartile (IQR) increase in PM2.5 (IQR=8.8 µg/m3) was associated with a 0.82% (95%CI: 0.42, 1.21) increase in Stroop response time, a 6.18% (95% CI: 2.08, 10.3) increase in Stroop interference time, a 0.7% (95% CI: -1.38, -0.01) decrease in Stroop throughput, and a 1.51% (95% CI: -2.65, -0.37) decrease in ADD throughput. For CO2, an IQR increase (IQR=315ppm) was associated with a 0.85% (95% CI: 0.32, 1.39) increase in Stroop response time, a 7.88% (95% CI: 2.08, 13.86) increase in Stroop interference time, a 1.32% (95% CI: -2.3, -0.38) decrease in Stroop throughput, and a 1.13% (95% CI: 0.18, 2.11) increase in ADD response time. A sensitivity analysis showed significant association between PM2.5 in four out of five cognitive test performance metrics only at levels above 12 µg/m3. Enhanced filtration and higher ventilation rates that exceed current minimum targets are essential public health strategies that may improve employee productivity.

Health Equity, Schooling Hesitancy, and the Social Determinants of Learning.

At least 62 million K-12 students in North America-disproportionately low-income children of color- have been physically out of school for over a year due to the COVID-19 pandemic. These children are at risk of significant academic, social, mental, and physical harm now and in the long-term. We review the literature about school safety and the conditions that shape families' and teachers' choices to return to in-person schooling. We identify four causes of schooling hesitancy in the U.S. even where schools can be safely reopened: high community transmission rates; the politicization of school re-openings; long-term racialized disinvestment in urban districts; and parents' rational calculations about their family's vulnerability due to the social determinants of health. Given the deep interconnections between the social determinants of health and of learning, and between schooling hesitancy and community vulnerability, stark inequities in in-person schooling access and take-up are likely to persist. We recommend that school districts invest in scientifically-based facilities upgrades, increased nursing and counseling staffing, and preparation for schools to serve as pediatric vaccination sites. School districts should also apply lessons from public health about addressing vaccine hesitancy to the challenge of schooling hesitancy by investing time in humble listening to parents and teachers about their concerns.