Domestic biomass fuel combustion and chronic bronchitis in two rural Bolivian villages.

BACKGROUND: Chronic bronchitis is an important public health problem worldwide. A study was undertaken to examine the association between exposure to air pollution from domestic biomass fuel combustion and chronic bronchitis in two rural Bolivian highland villages: a village in which cooking is done exclusively indoors and a village in which cooking is done primarily outdoors. Apart from this difference, the villages were virtually identical in terms of socioeconomic status, climate, altitude, access to health care, and other potential confounders. METHODS: Pollution exposure was assessed by combining information on concentrations of particulate matter of <10 microm diameter (PM(10)) in 12 randomly selected households in each village in all potential microenvironments of exposure with time allocation information. The prevalence of chronic bronchitis was assessed using the British Medical Research Council's questionnaire on individuals >20 years of age in both villages (n = 241). RESULTS: Daily pollution exposure was significantly higher in the indoor cooking village (range for adults: 9840-15 120 microg-h/m(3)) than in the outdoor cooking village (range for adults: 5520-6240 microg-h/m(3)) for both seasons and for men and women. The overall prevalence of chronic bronchitis was 22% and 13% for the indoor and outdoor cooking villages, respectively. Logistic regression analysis, which excluded the few smokers present in the population, showed a 60% reduced risk of chronic bronchitis in the outdoor cooking village compared with the indoor cooking village (OR 0.4; 95% CI 0.2 to 0.8; p = 0.0102) after adjusting for age and sex. Individuals aged >40 years were 4.3 times more likely to have chronic bronchitis than the younger age group (OR = 4.3; 95% CI 2.0 to 9.3; p = 0.0002). There was no significant difference in the prevalence of chronic bronchitis in men and women. CONCLUSIONS: The results of this study suggest an association between chronic bronchitis and exposure to domestic biomass fuel combustion, but further large scale studies from other areas of the developing world are needed to confirm the association. Results from this and other studies will assist the development of culturally acceptable and feasible alternatives to the high exposure cooking stoves currently being used by most people worldwide.

Childhood asthma.

Asthma prevalence in children has increased 58% since 1980. Mortality has increased by 78%. The burden of the disease is most acute in urban areas and racial/ethnic minority populations. Hospitalization and morbidity rates for nonwhites are more than twice those for whites. Asthma is characterized by recurrent wheezing, breathlessness, chest tightness, and coughing. Research in the past decade has revealed the importance of inflammation of the airways in asthma and clinical treatment to reduce chronic inflammation. Asthma is associated with production of IgE to common environmental allergens including house dust mite, animal dander, cockroach, fungal spores, and pollens. Some interventions to reduce symptoms through control of dust mite and animal dander have had positive results. Control of symptoms through interventions to reduce exposures to cockroach antigen has not been reported. Studies illustrating causal effects between outdoor air pollution and asthma prevalence are scant. Increases in asthma prevalence have occurred at the same time as general improvements in air quality. However, air quality appears to exacerbate symptoms in the child who already has the disease. Decreased pulmonary function has been associated with exposure to particulates and bronchial hyperresponsiveness to smoke, SO(2) and NO(2). Symptoms have been correlated with increased levels of respirable particulates, ozone, and SO(2). Interventions that reduce the negative outcomes in asthma associated with outdoor environmental factors have not been reported. Control of asthma in children will entail the collaborative efforts of patients, family, clinical professionals, and school personnel, as well as community-wide environmental control measures and conducive national and local policies based on sound research.

Application of recent advances in aerosol sampling science towards the development of improved sampling devices: the way ahead.

This paper reviews the framework that underpins the development of a new generation of personal samplers capable of operating at much lower flowrates that those of the current generation and so capable of being used for exposure assessment not only for 'traditional' occupational populations (i.e., industrial workers) but also for people exposed to aerosols in the ambient atmosphere (including children). The opportunity for this new generation of samplers stems from the availability of very light and compact low-flowrate pumps. The development and deployment of such instruments presents: (a) physical challenges in terms of how to collect particle size fractions in a manner which is consistent with the new particle size-selective sampling criteria, and (b) analytical challenges in terms of how to quantitate the much smaller amounts of collected material that need to be analysed. The paper lays out the physical and analytical scenarios, and points the way forward to how such challenges can be overcome. Work is already in progress in several countries to develop prototype instruments for applications like those described.

Detection of oxidative mutagens in an urban air-particulate extract: a preliminary study.

The Ames assays strains TA98 and TA100 have been useful in characterizing complex mixtures from organic solvent extracts of particles from diesel-powered vehicles, ambient air, and other sources. In this paper we report preliminary experiments using TA102, a bacterial strain that detects compounds that can oxidize DNA, to characterize the mutagenicity of an ambient air sample collected in Ann Arbor, MI. Four sets of ambient air filters were collected in duplicate over a period of several days. The mutagenicities of methylene chloride extracts of these filters were compared using strains TA98, TA100 and TA102. The concentration-mutagenicity data for TA98 and TA100 were linear over the concentration range 0-200 micrograms extract/plate. The mutagenicity of the extracts using TA102 was much lower than the other two strains and was non-linear over the concentration range tested. These results suggest that it would be difficult to use TA102 to identify the oxidative mutagens present in an ambient air particulate extract.

Indoor and outdoor concentrations of inorganic acidic aerosols and gases.

Annular denuder-filter pack sampling systems were used to make indoor and outdoor measurements of aerosol strong H+, SO4(2-), NH4+, NO3- and NO2-, and the gaseous pollutants SO2, HNO3, HONO and NH3 during summer and winter periods in Boston, Massachusetts. Outdoor levels of SO2, HNO3, H+ and SO4(2-) exceeded their indoor concentrations during both seasons. Winter indoor/outdoor ratios were lower than during the summer, probably due to lower air exchange rates during the winter period. During both monitoring periods, indoor/outdoor ratios of aerosol strong H+ were 40-50 percent of the indoor/outdoor SO4(2-) ratio. Since aerosol strong acidity is typically associated with SO4(2-), this finding is indicative of neutralization of the acidic aerosol by the higher indoor NH3 levels. Geometric mean indoor/outdoor NH3 ratios of 3.5 and 23 respectively were measured for the summer and winter sampling periods. For HONO, NH3, NH4+ and NO2-, indoor concentrations were significantly higher than ambient levels. Indoor levels of NO3- were slightly less than outdoor concentrations.

Exposures to acidic aerosols.

Ambient monitoring of acid aerosols in four U.S. cities and in a rural region of southern Ontario clearly show distinct periods of strong acidity. Measurements made in Kingston, TN, and Steubenville, OH, resulted in 24-hr H+ ion concentrations exceeding 100 nmole/m3 more than 10 times during summer months. Periods of elevated acidic aerosols occur less frequently in winter months. The H+ determined during episodic conditions in southern Ontario indicates that respiratory tract deposition can exceed the effects level reported in clinical studies. Observed 12-hr H+ concentrations exceeded 550 nmole/m3 (approximately 27 micrograms/m3 H2SO4). The maximum estimated 1-hr concentration exceeded 1500 nmole/m3 for H+ ions. At these concentrations, an active child might receive more than 2000 nmole of H+ ion in 12 hr and in excess of 900 nmole during the hour when H2SO4 exceeded 50 micrograms/m3.