Association between exhaled breath condensate nitrate + nitrite levels with ambient coarse particle exposure in subjects with airways disease.

OBJECTIVES: Studies of individual inflammatory responses to exposure to air pollution are few but are important in defining the most sensitive markers in better understanding pathophysiological pathways in the lung. The goal of this study was to assess whether exposure to airborne particles is associated with oxidative stress in an epidemiological setting. METHODS: The authors assessed exposure to particulate matter air pollution in four European cities in relation to levels of nitrite plus nitrate (NOx) in exhaled breath condensate (EBC) measurements in 133 subjects with asthma or chronic obstructive pulmonary disease using an EBC capture method developed for field use. In each subject, three measurements were collected. Exposure measurements included particles smaller than 10 µm (PM(10)), smaller than 2.5 µm (PM(2.5)) and particle number counts at a central site, outdoors near the subject's home and indoors. RESULTS: There were positive and significant relationships between EBC NOx and coarse particles at the central sampling sites (increase of 20.4% (95% CI 6.1% to 36.6%) per 10 µg/m(3) increase of coarse particles of the previous day) but not between EBC NOx and other particle measures. Associations tended to be stronger in subjects not taking steroid medication. CONCLUSIONS: An association was found between exposure to ambient coarse particles at central sites and EBC NOx, a marker of oxidative stress. The lack of association between PM measures more indicative of personal exposures (particularly indoor exposure) means interpretation should be cautious. However, EBC NOx may prove to be a marker of PM-induced oxidative stress in epidemiological studies.

Lung function and indicators of exposure to indoor and outdoor particulate matter among asthma and COPD patients.

OBJECTIVES: Misclassification of exposure related to the use of central sites may be larger for ultrafine particles than for particulate matter < or =2.5 microm and < or =10 microm (PM(2.5) and PM(10)) and may result in underestimation of health effects. This paper describes the relative strength of the association between outdoor and indoor exposure to ultrafine particles, PM(2.5) and PM(10) and lung function. METHODS: In four European cities (Helsinki, Athens, Amsterdam and Birmingham), lung function (forced vital capacity (FVC), forced expiratory volume in 1 second (FEV(1)) and peak expiratory flow (PEF)) was measured three times a day for 1 week in 135 patients with asthma or chronic obstructive pulmonary disease (COPD), covering study periods of >1 year. Daily concentrations of particle number, PM(2.5) and PM(10) were measured at a central site in each city and both inside and outside the subjects' homes. RESULTS: Daily average particle number concentrations ranged between 2100 and 66 100 particles/cm(3). We found no association between 24 h average particle number or particle mass concentrations and FVC, FEV(1) and PEF. Substituting home outdoor or home indoor concentrations of particulate air pollution instead of the central site measurements did not change the observed associations. Analyses restricted to asthmatics also showed no associations. CONCLUSIONS: No consistent associations between lung function and 24 h average particle number or particle mass concentrations were found in panels of patients with mild to moderate COPD or asthma. More detailed exposure assessment did not change the observed associations. The lack of association could be due to the high prevalence of medication use, limited ability to assess lagged effects over several days or absence of an effect.

Associations between ambient, personal, and indoor exposure to fine particulate matter constituents in Dutch and Finnish panels of cardiovascular patients.

AIMS: To assess the relation between ambient, indoor, and personal levels of PM2.5 and its elemental composition for elderly subjects with cardiovascular disease. METHODS: In the framework of a European Union funded study, panel studies were conducted in Amsterdam, the Netherlands and Helsinki, Finland. Outdoor PM2.5 concentrations were measured at a fixed site. Each subject's indoor and personal PM2.5 exposure was measured biweekly for six months, during the 24 hour period preceding intensive health measurements. The absorbance of PM2.5 filters was measured as a marker for diesel exhaust. The elemental content of more than 50% of the personal and indoor samples and all corresponding outdoor samples was measured using energy dispersive x ray fluorescence. RESULTS: For Amsterdam and Helsinki respectively, a total of 225 and 238 personal, and 220 and 233 indoor measurements, were analysed from 36 and 46 subjects. For most elements, personal and indoor concentrations were lower than and highly correlated with outdoor concentrations. The highest correlations (median r>0.9) were found for sulfur and particle absorbance, which both represent fine mode particles from outdoor origin. Low correlations were observed for elements that represent the coarser part of the PM2.5 particles (Ca, Cu, Si, Cl). CONCLUSIONS: The findings of this study provide support for using fixed site measurements as a measure of exposure to particulate matter in time series studies linking the day to day variation in particulate matter to the day to day variation in health endpoints, especially for components of particulate matter that are generally associated with fine particles and have few indoor sources. The high correlation for absorbance of PM2.5 documents that this applies to particulate matter from combustion sources, such as diesel vehicles, as well.

Sources and elemental composition of ambient PM(2.5) in three European cities.

Source apportionment of urban fine particle mass (PM(2.5)) was performed from data collected during 1998-1999 in Amsterdam (The Netherlands), Erfurt (Germany) and Helsinki (Finland), using principal component analysis (PCA) and multiple linear regression. Six source categories of PM(2.5) were identified in Amsterdam. They were traffic-related particles (30% of the average PM(2.5)), secondary particles (34%), crustal material (7%), oil combustion (11%), industrial and incineration processes (9%), and sea salt (2%). The unidentified PM(2.5) fraction was 7% on the average. In Erfurt, four source categories were extracted with some difficulties in interpretation of source profiles. They were combustion emissions related to traffic (32%), secondary PM (32%), crustal material (21%) and industrial processes (8%). In Erfurt, 3% of PM(2.5) remained unidentified. Air pollution data and source apportionment results from the two Central European cities were compared to previously published results from Helsinki, where about 80% of average PM(2.5) was attributed to transboundary air pollution and particles from traffic and other regional combustion sources. Our results indicate that secondary particles and local combustion processes (mainly traffic) were the most important source categories in all cities; their impact on the average PM(2.5) was almost equal in Amsterdam and Erfurt whereas, in Helsinki, secondary particles made up for as much as half of the total average PM(2.5).

Personal exposure to fine particulate matter in elderly subjects: relation between personal, indoor, and outdoor concentrations.

The time-series correlation between ambient levels, indoor levels, and personal exposure to PM2.5 was assessed in panels of elderly subjects with cardiovascular disease in Amsterdam, the Netherlands, and Helsinki, Finland. Subjects were followed for 6 months with biweekly clinical visits. Each subject's indoor and personal exposure to PM2.5 was measured biweekly, during the 24-hr period preceding the clinical visits. Outdoor PM2.5 concentrations were measured at fixed sites. The absorption coefficients of all PM2.5 filters were measured as a marker for elemental carbon (EC). Regression analyses were conducted for each subject separately, and the distribution of the individual regression and correlation coefficients was investigated. Personal, indoor, and ambient concentrations were highly correlated within subjects over time. Median Pearson's R between personal and outdoor PM2.5 was 0.79 in Amsterdam and 0.76 in Helsinki. For absorption, these values were 0.93 and 0.81 for Amsterdam and Helsinki, respectively. The findings of this study provide further support for using fixed-site measurements as a measure of exposure to PM2.5 in epidemiological time-series studies.

[Relationship between air pollution due to traffic, decreased lung function and airway symptoms in children]. / Samenhang tussen luchtverontreiniging door verkeer, vermindering van longfunctie en luchtwegsymptomen bij kinderen.

OBJECTIVE: To assess whether air pollution by traffic was related to lung function and chronic respiratory symptoms in children living. DESIGN: Descriptive. SETTING: The province of South Holland, the Netherlands. METHODS: In the period May through July of 1995 pulmonary function tests and questionnaires were obtained from 1,092 and 1,068 children respectively in six city districts near busy motorways in the province of South Holland. In the same period, indoor measurements were performed at 12 schools of NO2, black smoke and PM10 dust density. Lung function data were analysed by multiple linear regression and respiratory symptoms were analysed by multiple logistic regression. As independent variables, distance between motorway and home, passenger car traffic density and lorry traffic density on the motorway, and black smoke and NO2 concentrations in schools were taken. RESULTS: Significant differences in lung function and respiratory symptoms were found between children living in different city districts. Lung function as well as symptoms were associated with lorry traffic density on the motorway. The validity of these findings was supported by associations between black smoke concentrations (representative for diesel soot) and lung function as well as respiratory symptoms. In contrast, there was no association between passenger car traffic counts or NO2 and lung function or respiratory symptoms. CONCLUSION: The results suggest that air pollution by lorry traffic can lead to reduced lung function and to an increased prevalence of chronic respiratory symptoms in children living near major motorways.

Effects of fine and ultrafine particles on cardiorespiratory symptoms in elderly subjects with coronary heart disease: the ULTRA study.

The ULTRA Study, a study investigating the association between fine and ultrafine particulate air pollution and cardiorespiratory health, was conducted during the winter of 1998-1999 in Amsterdam, the Netherlands; Erfurt, Germany; and Helsinki, Finland. At each study center, a panel of elderly subjects with coronary heart disease recorded cardiac and respiratory symptoms in a diary. Exposure to ambient air pollution was characterized by measuring daily mass concentrations of particles smaller than 10 micro m (PM(10)) and 2.5 micro m (PM(2.5)), number concentrations of ultrafine particles (NC(0.01-0.1)), and gases. Odds ratios for the relation of symptoms to air pollution, adjusted for time trend, respiratory infections, and meteorologic variables, were mostly homogeneous across the centers. No association was found between air pollution and chest pain. A 10- micro g/m(3) increase in PM(2.5) was positively associated with the incidence of shortness of breath (odds ratio (OR) = 1.12, 95% confidence interval (CI): 1.02, 1.24) and with avoidance of activities (OR = 1.09, 95% CI: 0.97, 1.22). NC(0.01-0.1) was only associated with the prevalence of avoidance of activities (OR = 1.10, 95% CI: 1.01, 1.19). In conclusion, PM(2.5) was associated with some cardiac symptoms in three panels of elderly subjects. PM(2.5 )was more strongly related to cardiorespiratory symptoms than ultrafine particles were.