Indoor air quality survey of nail salons in Boston.

Employees in nail salons, largely Vietnamese immigrant women in Boston, are exposed to a range of volatile organic chemicals from the products used in salons, including solvents, glues and polishes. Some of these chemicals have the potential to cause short and long-term adverse health effects. Only limited research has been performed on assessing occupational exposures. This project aimed to characterize total volatile organic compound (TVOC) and PM2.5 concentrations in nail salons as a function of ventilation, building characteristics, customer and employee occupancy, and type of services being performed. Students conducted sampling in 21 salons in Boston, MA from September to December, 2011. Study visits included: indoor environmental quality measurements (TVOCs, PM2.5 and carbon dioxide), site observations, and an interview. CO2 levels in 15 of 21 salons exceeded 800 ppm, suggesting that these salons may have insufficient ventilation. Higher TVOC and PM2.5 levels were found in salons with less ventilation (as estimated using CO2 concentrations). Contrary to our a priori hypothesis, average levels of TVOCs, CO2 and PM2.5 were consistent throughout salons, indicating that exposures may not be restricted to areas in the salon where work is being performed (e.g., at the manicure table). Higher TVOC concentrations were observed when tasks were being performed, yet were not dependent upon the number of tasks being performed. Improving ventilation conditions in salons to meet minimum outdoor air delivery requirements can reduce exposures to TVOCs.

Assessing risk of health care-acquired Legionnaires' disease from environmental sampling: the limits of using a strict percent positivity approach.

BACKGROUND: Elevated percent positivity (≥30%) of Legionella in hospital domestic water systems has been suggested as a metric for assessing the risk of health care-acquired Legionnaires' disease (LD). METHODS: We examined the validity of this metric by analyzing data from peer-reviewed studies containing reports of Legionella prevalence in hospital water (ie, percent positivity) and temporally matched reports of patients with health care-acquired LD. RESULTS: Our literature review identified 31 peer-reviewed publications reporting matched data. We abstracted a total of 206 data points, representing 119 hospitals, from these articles. We determined that the proposed 30% positivity metric has 59% sensitivity and 74% specificity (ie, a 41% false-negative rate and a 26% false-positive rate). These notable error rates could have significant implications, given that we identified 16 peer-reviewed articles and 6 government guidance documents that referenced the 30% positivity metric as a risk assessment tool. CONCLUSIONS: Environmental sampling of hospital water distribution systems for Legionella can be an important component of risk management for LD. However, the possible consequence of using a percent positivity metric with low sensitivity and specificity is that many hospitals might fail to mitigate when a true risk is present, or might unnecessarily allocate limited resources to deal with a negligible risk.

Elevated corrosion rates and hydrogen sulfide in homes with 'Chinese Drywall'.

In December 2008, the U.S. Consumer Product Safety Commission (CPSC) began receiving reports about odors, corrosion, and health concerns related to drywall originating from China. In response, a detailed environmental health and engineering evaluation was conducted of 41 complaint and 10 non-complaint homes in the Southeast U.S. Each home investigation included characterization of: 1) drywall composition; 2) indoor and outdoor air quality; 3) temperature, moisture, and building ventilation; and 4) copper and silver corrosion rates. Complaint homes had significantly higher hydrogen sulfide concentrations (mean 0.82 vs.

Markers of inflammation in alveolar cells exposed to fine particulate matter from prescribed fires and urban air.

OBJECTIVE: To assess the effect of fine particulate matter (PM(2.5)) from different particle sources on tumor necrosis factor- (TNF-) α, we measured TNF production from rat alveolar macrophages (AM) and human dendritic cells (DC) exposed to PM(2.5) from different sources. METHODS: Fire-related PM(2.5) samples, rural ambient, and urban indoor and outdoor samples were collected in the Southeast United States. Tumor necrosis factor release was measured from rat AM and human DC following incubation with PM(2.5). RESULTS: Tumor necrosis factor release in AMs was greatest for fire-related PM(2.5) compared with other samples (TNF: P value = 0.005; mortality: P value = 0.005). Tumor necrosis factor releases from the DCs and AMs exposed to fire-associated PM(2.5) were strongly correlated (r = 0.87, P value < 0.0001). CONCLUSIONS: Particulate matter exposure produces TNF release consistent with pulmonary inflammation in rat AMs and human DCs, with the response in rat AMs differing by particle source.

Modeling the airborne survival of influenza virus in a residential setting: the impacts of home humidification.

BACKGROUND: Laboratory research studies indicate that aerosolized influenza viruses survive for longer periods at low relative humidity (RH) conditions. Further analysis has shown that absolute humidity (AH) may be an improved predictor of virus survival in the environment. Maintaining airborne moisture levels that reduce survival of the virus in the air and on surfaces could be another tool for managing public health risks of influenza. METHODS: A multi-zone indoor air quality model was used to evaluate the ability of portable humidifiers to control moisture content of the air and the potential related benefit of decreasing survival of influenza viruses in single-family residences. We modeled indoor AH and influenza virus concentrations during winter months (Northeast US) using the CONTAM multi-zone indoor air quality model. A two-story residential template was used under two different ventilation conditions - forced hot air and radiant heating. Humidity was evaluated on a room-specific and whole house basis. Estimates of emission rates for influenza virus were particle-size specific and derived from published studies and included emissions during both tidal breathing and coughing events. The survival of the influenza virus was determined based on the established relationship between AH and virus survival. RESULTS: The presence of a portable humidifier with an output of 0.16 kg water per hour in the bedroom resulted in an increase in median sleeping hours AH/RH levels of 11 to 19% compared to periods without a humidifier present. The associated percent decrease in influenza virus survival was 17.5 - 31.6%. Distribution of water vapor through a residence was estimated to yield 3 to 12% increases in AH/RH and 7.8-13.9% reductions in influenza virus survival. CONCLUSION: This modeling analysis demonstrates the potential benefit of portable residential humidifiers in reducing the survival of aerosolized influenza virus by controlling humidity indoors.

Assessing exposure to granite countertops--Part 1: Radiation.

Humans are continuously exposed to low levels of ionizing radiation. Known sources include radon, soil, cosmic rays, medical treatment, food, and building products such as gypsum board and concrete. Little information exists about radiation emissions and associated doses from natural stone finish materials such as granite countertops in homes. To address this knowledge gap, gross radioactivity, gamma ray activity, and dose rate were determined for slabs of granite marketed for use as countertops. Annual effective radiation doses were estimated from measured dose rates and human activity patterns while accounting for the geometry of granite countertops in a model kitchen. Gross radioactivity, gamma activity, and dose rate varied significantly among and within slabs of granite with ranges for median levels at the slab surface of ND to 3000 cpm, ND to 98,000 cpm, and ND to 1.5E-4 mSv/h, respectively. The maximum activity concentrations of the (40)K, (232)Th, and (226)Ra series were 2715, 231, and 450 Bq/kg, respectively. The estimated annual radiation dose from spending 4 h/day in a hypothetical kitchen ranged from 0.005 to 0.18 mSv/a depending on the type of granite. In summary, our results show that the types of granite characterized in this study contain varying levels of radioactive isotopes and that their observed emissions are consistent with those reported in the scientific literature. We also conclude from our analyses that these emissions are likely to be a minor source of external radiation dose when used as countertop material within the home and present a negligible risk to human health.

Assessing exposure to granite countertops--Part 2: Radon.

Radon gas ((222)Rn) is a natural constituent of the environment and a risk factor for lung cancer that we are exposed to as a result of radioactive decay of radium ((226)Ra) in stone and soil. Granite countertops, in particular, have received recent media attention regarding their potential to emit radon. Radon flux was measured on 39 full slabs of granite from 27 different varieties to evaluate the potential for exposure and examine determinants of radon flux. Flux was measured at up to six pre-selected locations on each slab and also at areas identified as potentially enriched after a full-slab scan using a Geiger-Muller detector. Predicted indoor radon concentrations were estimated from the measured radon flux using the CONTAM indoor air quality model. Whole-slab average emissions ranged from less than limit of detection to 79.4 Bq/m(2)/h (median 3.9 Bq/m(2)/h), similar to the range reported in the literature for convenience samples of small granite pieces. Modeled indoor radon concentrations were less than the average outdoor radon concentration (14.8 Bq/m(3); 0.4 pCi/l) and average indoor radon concentrations (48 Bq/m(3); 1.3 pCi/l) found in the United States. Significant within-slab variability was observed for stones on the higher end of whole slab radon emissions, underscoring the limitations of drawing conclusions from discrete samples.

The benefits of whole-house in-duct air cleaning in reducing exposures to fine particulate matter of outdoor origin: a modeling analysis.

Health risks of fine particle air pollution (PM(2.5)) are an important public health concern that has the potential to be mitigated in part by interventions such as air cleaning devices that reduce personal exposure to ambient PM(2.5). To characterize exposure to ambient PM(2.5) indoors as a function of residential air cleaners, a multi-zone indoor air quality model was used to integrate spatially resolved data on housing, meteorology, and ambient PM(2.5), with performance testing of residential air cleaners to estimate short-term and annual average PM(2.5) of outdoor origin inside residences of three metropolitan areas. The associated public health impacts of reduced ambient PM(2.5) exposure were estimated using a standard health impact assessment methodology. Estimated indoor levels of ambient PM(2.5) varied substantially among ventilation and air cleaning configurations. The median 24-h average indoor-outdoor ratio of ambient PM(2.5) was 0.57 for homes with natural ventilation, 0.35 for homes with central air conditioning (AC) with conventional filtration, and 0.1 for homes with central AC with high efficiency in-duct air cleaner. Median modeled 24-h average indoor concentrations of PM(2.5) of outdoor origin for those three configurations were 8.4, 5.3, and 1.5 microg/m(3), respectively. The potential public health benefits of reduced exposure to ambient PM(2.5) afforded by air cleaning systems were substantial. If the entire population of single-family homes with central AC in the modeling domain converted from conventional filtration to high-efficiency in-duct air cleaning, the change in ambient PM(2.5) exposure is estimated to result in an annual reduction of 700 premature deaths, 940 hospital and emergency room visits, and 130,000 asthma attacks in these metropolitan areas. In addition to controlling emissions from sources, high-efficiency whole-house air cleaner are expected to reduce exposure to particles of outdoor origin and are projected to be an effective means of managing public health impacts of ambient particle pollution.

Whole house particle removal and clean air delivery rates for in-duct and portable ventilation systems.

A novel method for determining whole house particle removal and clean air delivery rates attributable to central and portable ventilation/air cleaning systems is described. The method is used to characterize total and air-cleaner-specific particle removal rates during operation of four in-duct air cleaners and two portable air-cleaning devices in a fully instrumented test home. Operation of in-duct and portable air cleaners typically increased particle removal rates over the baseline rates determined in the absence of operating a central fan or an indoor air cleaner. Removal rates of 0.3- to 0.5-microm particles ranged from 1.5 hr(-1) during operation of an in-duct, 5-in. pleated media filter to 7.2 hr(-1) for an in-duct electrostatic air cleaner in comparison to a baseline rate of 0 hr(-1) when the air handler was operating without a filter. Removal rates for total particulate matter less than 2.5 microm in aerodynamic diameter (PM2.5) mass concentrations were 0.5 hr(-1) under baseline conditions, 0.5 hr(-1) during operation of three portable ionic air cleaners, 1 hr(-1) for an in-duct 1-in. media filter, 2.4 hr(-1) for a single high-efficiency particle arrestance (HEPA) portable air cleaner, 4.6 hr(-1) for an in-duct 5-in. media filter, 4.7 hr(-1) during operation of five portable HEPA filters, 6.1 hr(-1) for a conventional in-duct electronic air cleaner, and 7.5 hr(-1) for a high efficiency in-duct electrostatic air cleaner. Corresponding whole house clean air delivery rates for PM2.5 attributable to the air cleaner independent of losses within the central ventilation system ranged from 2 m3/min for the conventional media filter to 32 m3/min for the high efficiency in-duct electrostatic device. Except for the portable ionic air cleaner, the devices considered here increased particle removal indoors over baseline deposition rates.

Control of asthma triggers in indoor air with air cleaners: a modeling analysis.

BACKGROUND: Reducing exposure to environmental agents indoors shown to increase asthma symptoms or lead to asthma exacerbations is an important component of a strategy to manage asthma for individuals. Numerous investigations have demonstrated that portable air cleaning devices can reduce concentrations of asthma triggers in indoor air; however, their benefits for breathing problems have not always been reproducible. The potential exposure benefits of whole house high efficiency in-duct air cleaners for sensitive subpopulations have yet to be evaluated. METHODS: We used an indoor air quality modeling system (CONTAM) developed by NIST to examine peak and time-integrated concentrations of common asthma triggers present in indoor air over a year as a function of natural ventilation, portable air cleaners, and forced air ventilation equipped with conventional and high efficiency filtration systems. Emission rates for asthma triggers were based on experimental studies published in the scientific literature. RESULTS: Forced air systems with high efficiency filtration were found to provide the best control of asthma triggers: 30-55% lower cat allergen levels, 90-99% lower risk of respiratory infection through the inhalation route of exposure, 90-98% lower environmental tobacco smoke (ETS) levels, and 50-75% lower fungal spore levels than the other ventilation/filtration systems considered. These results indicate that the use of high efficiency in-duct air cleaners provide an effective means of controlling allergen levels not only in a single room, like a portable air cleaner, but the whole house. CONCLUSION: These findings are useful for evaluating potential benefits of high efficiency in-duct filtration systems for controlling exposure to asthma triggers indoors and for the design of trials of environmental interventions intended to evaluate their utility in practice.

Airborne fungal spores in a cross-sectional study of office buildings.

Airborne fungal spores were measured in 44 office buildings in the summer and winter throughout the continental United States, as part of the Building Assessment, Survey and Evaluation (BASE) program. Six indoor air and two outdoor air samples were collected on a single day from each building. The cross-sectional and repeated measure design afforded evaluation of between-building and within-building variability of fungal spore levels in buildings. Total fungal spore concentrations in indoor air ranged from < 24 to 1000 spores/m3, except for one building with natural ventilation where indoor levels were approximately 9000 spores/m3. Indoor air concentrations of total spores did not vary significantly between winter and summer or morning and afternoon monitoring periods or among climate zones or locations within a test area. Indoor-outdoor ratios of total spore concentrations typically ranged between 0.01 and 0.1 and were approximately seven times greater in winter than summer because of relatively low outdoor levels in the winter. The indoor-outdoor ratio of total spore concentrations for a building was consistent (reliability coefficient = 0.91) among repeated measures. Distributions of rank correlation coefficients for spore types in pairs of individual indoor-outdoor and indoor-indoor samples were weakly correlated (Spearman correlation = 0.2 on average). When spore type data were aggregated among samples from the same building, the central tendency of the rank correlation coefficients increased to 0.45. Rank correlation coefficients were also proportional to the number of spore types present in the samples that were compared. The BASE study provides normative data on concentrations of fungal spores that can aid in identification of problematic levels of mold in buildings.

Detection of airborne rhinovirus and its relation to outdoor air supply in office environments.

Rhinoviruses are major causes of morbidity in patients with respiratory diseases; however, their modes of transmission are controversial. We investigated detection of airborne rhinovirus in office environments by polymerase chain reaction technology and related detection to outdoor air supply rates. We sampled air from 9 A.M. to 5 P.M. each workday, with each sample run for 1 work week. We directly extracted RNA from the filters for nested reverse transcriptase-polymerase chain reaction analysis of rhinovirus. Nasal lavage samples from building occupants with upper respiratory infections were also collected. Indoor carbon dioxide (CO2 concentrations were recorded every 10 minutes as a surrogate for outdoor air supply. To increase the range of CO2 concentrations, we adjusted the outdoor air supply rates every 3 months. Generalized additive models demonstrated an association between the probability of detecting airborne rhinovirus and a weekly average CO2 concentration greater than approximately 100 ppm, after controlling for covariates. In addition, one rhinovirus from a nasal lavage contained an identical nucleic acid sequence similar to that in the building air collected during the same week. These results suggest that occupants in buildings with low outdoor air supply may have an increased risk of exposure to infectious droplet nuclei emanating from a fellow building occupant.

Airborne rhinovirus detection and effect of ultraviolet irradiation on detection by a semi-nested RT-PCR assay.

BACKGROUND: Rhinovirus, the most common cause of upper respiratory tract infections, has been implicated in asthma exacerbations and possibly asthma deaths. Although the method of transmission of rhinoviruses is disputed, several studies have demonstrated that aerosol transmission is a likely method of transmission among adults. As a first step in studies of possible airborne rhinovirus transmission, we developed methods to detect aerosolized rhinovirus by extending existing technology for detecting infectious agents in nasal specimens. METHODS: We aerosolized rhinovirus in a small aerosol chamber. Experiments were conducted with decreasing concentrations of rhinovirus. To determine the effect of UV irradiation on detection of rhinoviral aerosols, we also conducted experiments in which we exposed aerosols to a UV dose of 684 mJ/m2. Aerosols were collected on Teflon filters and rhinovirus recovered in Qiagen AVL buffer using the Qiagen QIAamp Viral RNA Kit (Qiagen Corp., Valencia, California) followed by semi-nested RT-PCR and detection by gel electrophoresis. RESULTS: We obtained positive results from filter samples that had collected at least 1.3 TCID50 of aerosolized rhinovirus. Ultraviolet irradiation of airborne virus at doses much greater than those used in upper-room UV germicidal irradiation applications did not inhibit subsequent detection with the RT-PCR assay. CONCLUSION: The air sampling and extraction methodology developed in this study should be applicable to the detection of rhinovirus and other airborne viruses in the indoor air of offices and schools. This method, however, cannot distinguish UV inactivated virus from infectious viral particles.

A study of indoor carbon dioxide levels and sick leave among office workers.

BACKGROUND: A previous observational study detected a strong positive relationship between sick leave absences and carbon dioxide (CO2) concentrations in office buildings in the Boston area. The authors speculated that the observed association was due to a causal effect associated with low dilution ventilation, perhaps increased airborne transmission of respiratory infections. This study was undertaken to explore this association. METHODS: We conducted an intervention study of indoor CO2 levels and sick leave among hourly office workers employed by a large corporation. Outdoor air supply rates were adjusted periodically to increase the range of CO2 concentrations. We recorded indoor CO2 concentrations every 10 minutes and calculated a CO2 concentration differential as a measure of outdoor air supply per person by subtracting the 1-3 a.m. average CO2 concentration from the same-day 9 a.m. - 5 a.m. average concentration. The metric of CO2 differential was used as a surrogate for the concentration of exhaled breath and for potential exposure to human source airborne respiratory pathogens. RESULTS: The weekly mean, workday, CO2 concentration differential ranged from 37 to 250 ppm with a peak CO2 concentration above background of 312 ppm as compared with the American Society of Heating, Refrigeration and Air-conditioning Engineers (ASHRAE) recommended maximum differential of 700 ppm. We determined the frequency of sick leave among 294 hourly workers scheduled to work approximately 49,804.2 days in the study areas using company records. We found no association between sick leave and CO2 differential CONCLUSIONS: The CO2 differential was in the range of very low values, as compared with the ASHRAE recommended maximum differential of 700 ppm. Although no effect was found, this study was unable to test whether higher CO2 differentials may be associated with increased sick leave.