Effects of Exposure to Incense Smoke Associated with Impaired Lung Function and Respiratory Disease: A Systematic Review

The community uses incense (bakhour) through ceremonies, traditional health practices, and aromatherapy. Nevertheless, evidence from experiments and studies of populations suggests that a habit of burning incense makes the lungs work less well. The study investigated the relationship between exposure to incense smoke and impaired lung function and respiratory diseases. Data tracing was carried out systematically following PRISMA guidelines from January to April 2022 and registered in the PROSPERO database. The articles select-ed in this review were cross-sectional, cohort, observational, and experimental studies based on the criteria: (1) animals or humans exposed to incense smoke; (2) exposure to incense smoke which was carried out in-doors or outdoors; (3) the selected articles which were included in the original type of article; (4) the publica-tion year between 2016-2021 and the selected articles entered into reputable journals (Scopus and Web of Science). JBI guidelines and synthesis guidelines without meta-analysis (SWiM) to determine the level of evi-dence and minimize bias and interpretation of results. This study describes respiratory symptoms or diseases, home use of incense, and lung function measurement. Six articles were included; 6 (100%) reported using in-cense indoors, and 5 (83%) reported using incense outside the home. Respiratory symptoms and diseases caused by exposure to incense sticks are 5 (83%) shortness of breath, 6 (100%) wheezing, asthma, and in-flammation of the lungs, 2 (33%) chronic obstructive pulmonary disease, and 4 (67%) allergic rhinitis. In-cense smoke particles decrease lung function based on FVC, FEV, PEFR, and FEF values of 25-75%. The results indicate that smoking incense adversely affects lung function and leads to respiratory diseases. The communi-ty and related parties can minimize and conduct education and prevention related to simultaneous incense exposure in the community to reduce the burden of diseases and disorders due to respiratory incense smoke in areas that use it daily.

Quemadura por inhalación de humo e intoxicación por monóxido de carbono en paciente pediátrico

Introducción: El monóxido de carbono es uno de los mayores contaminantes de la atmósfera terrestre, su toxicidad es bien conocida por el ser humano. Las fuentes productoras responsables de aproximadamente 80 % de las emisiones de monóxido de carbono son los vehículos automotores que utilizan como combustible gasolina o diesel, los procesos industriales que utilizan compuestos del carbono y el fuego dentro de los hogares. Sus efectos tóxicos agudos incluida la muerte se han estudiados ampliamente, no así sus potenciales efectos adversos a largo plazo. Objetivo: Describir el comportamiento de la intoxicación aguda por monóxido de carbono en paciente pediátrico, su diagnóstico y tratamiento. Presentación del caso: paciente de 11 años de edad que sufre intoxicación aguda por monóxido de carbono. Ingresa en el Hospital Universitario procedente del primer nivel de atención médica como urgencia vital. Se estabiliza e identifican las alteraciones multisistémicas producidas por lesiones asociadas con la inhalación de humo y gases tóxicos en espacios cerrados. Se determina su correcto tratamiento. Conclusiones: La forma más pertinente de disminuir la morbilidad y la mortalidad en pacientes como el que se presenta, se basa en dos pilares: la correcta identificación y el acertado manejo para cada intoxicación. La aplicación de estos dos aspectos puede lograr un factor protector. Hay subregistro de la ocurrencia de los casos de intoxicación por monóxido de carbono que no son atendidos en los servicios de salud y de los que producen la muerte inmediata, por lo que es importante su diagnóstico y tratamiento oportuno.

Introduction: Carbon monoxide is one of the largest pollutants in the Earth's atmosphere, its toxicity is well known to humans. The producing sources responsible for approximately 80% of carbon monoxide emissions are motor vehicles that use gasoline or diesel as fuel, industrial processes that use carbon compounds and fire inside homes. Its acute toxic effects including death have been studied extensively, but its potential long-term adverse effects have not been studied. Objective: To describe the behavior of acute carbon monoxide poisoning in pediatric patients, their diagnosis and treatment. Case presentation: 11-year-old patient suffering from acute carbon monoxide poisoning. He is admitted to the University Hospital from the first level of medical care as a vital emergency. Multisystem alterations caused by lesions associated with the inhalation of smoke and toxic gases in enclosed spaces are stabilized and identified. Its correct treatment is determined. Conclusions: The most pertinent way to reduce morbidity and mortality in patients such as the one presented is based on two pillars: correct identification and correct management for each poisoning. The application of these two aspects can achieve a protective factor. There is underreporting of the occurrence of cases of carbon monoxide poisoning that are not treated in health services and those that cause immediate death, so their detection, diagnosis and timely treatment is important.

Intoxicación por monóxido de carbono / Carbon monoxide poisoning

Introducción: A nivel mundial, existe un incremento de las intoxicaciones por monóxido de carbono recibidas en los servicios de urgencia. En Cuba no es frecuente este tipo de intoxicación y existe desconocimiento para su diagnóstico precoz. El monóxido de carbono es un gas inodoro, incoloro, no irritante a las mucosas y altamente tóxico para el hombre. Es un contaminante de la atmósfera terrestre y el agente causal más frecuente de la intoxicación por gases. Objetivo: Describir la intoxicación por monóxido de carbono en un paciente atendido en el Hospital Militar;Dr. Mario Muñoz Monroy de Matanzas, Cuba. Caso clínico: Paciente masculino de 19 años de edad que inhala en un área cerrada, de forma accidental, los gases de la combustión de un vehículo durante 30 minutos. Permaneció en el lugar de la exposición sin medios de protección individual por un período de tres horas y comenzó con síntomas correspondientes a una intoxicación moderada por monóxido de carbono. Ingresó en la sala de cuidados intermedios para tratamiento. Conclusiones: El paciente tuvo una evolución favorable, tratado con oxígeno normobárico e hiperbárico(AU)

Introduction: Worldwide, there is an increase in poisonings by carbon monoxide received in emergency services. In Cuba this type of intoxication is not frequent and there is ignorance for its early diagnosis. Carbon monoxide is an odorless, colorless gas, not irritating to mucous membranes and highly toxic to man. It is a pollutant of the Earth's atmosphere and the most frequent causative agent of gas poisoning. Objective: To describe carbon monoxide poisoning in a patient treated at the Military Hospital Dr. Mario Muñoz Monroy from Matanzas, Cuba. Clinical case: A 19-year-old male patient inhaled in a closed area, accidentally, the combustion gases of a vehicle for 30 minutes. He remained in the place of exposure without means of individual protection for a period of three hours and began with symptoms corresponding to moderate intoxication by carbon monoxide. He was admitted at intermediate care ward for treatment. Conclusions: The patient had a favorable evolution, treated with normobaric and hyperbaric oxygen(AU)

Outbreak investigation of lead neurotoxicity in children from artificial jewelry cottage industry

BACKGROUND@#Although lead neurotoxicity is a known phenomenon, it can often be missed at a primary or secondary care level especially if detailed environmental exposure history is missed.@*METHODS@#This is an outbreak investigation where we observed 15 pediatric cases with neurologic signs and symptoms clustered in a slum area known for an unorganized artificial jewelry industry. Their clinical, biochemical, and epidemiological features were compared with 14 other children from the same region reporting with non-neurological symptoms who were considered as unmatched controls.@*RESULTS@#Cases with neurological manifestations had a higher in-house lead smelting activity [OR 7.2 (95% CI 1.4-38.3)] as compared to controls. Toddlers below 3 years of age were more vulnerable to the effects of lead.@*CONCLUSION@#This study emphasizes that many focal sources of lead poisoning still remain especially in the unorganized sector. In cases presenting with unexplained neurotoxicity, specific occupational and environmental inquiry for chemical poisoning, with special consideration for lead, should be actively pursued.

Inhalation risk assessment of naphthalene emitted from deodorant balls in public toilets

The inhalation of naphthalene used as deodorant balls in public toilets could be an important cancer risk factor. The atmospheric concentration of naphthalene in public toilets (C(in)) was estimated both by a polyurethane foam passive air sampler (PUF-PAS) deployed in nine public toilets in Seoul, Korea and by a steady-state indoor air quality model, including emission estimation using Monte-Carlo simulation. Based on the estimated C(in), cancer risk was also assessed for cleaning workers and the general population. The steady-state C(in) estimated using the estimated emission rate, which assumed that air exchange was the only process by which naphthalene was removed, was much greater than the C(in) value measured using PUF-PAS in nine public toilets, implying the importance of other removal processes, such as sorption to walls and the garments of visitors, as well as decreased emission rate owing to wetting of the naphthalene ball surface. The 95 percentile values of cancer risk for workers based on the estimation by PUF-PAS was 1.6×10⁻⁶, whereas those for the general public were lower than 1×10⁻⁶. The results suggested that naphthalene deodorant balls in public toilets may be an important cancer risk factor especially for the cleaning workers.

Inhalation risk assessment of naphthalene emitted from deodorant balls in public toilets

The inhalation of naphthalene used as deodorant balls in public toilets could be an important cancer risk factor. The atmospheric concentration of naphthalene in public toilets (C(in)) was estimated both by a polyurethane foam passive air sampler (PUF-PAS) deployed in nine public toilets in Seoul, Korea and by a steady-state indoor air quality model, including emission estimation using Monte-Carlo simulation. Based on the estimated C(in), cancer risk was also assessed for cleaning workers and the general population. The steady-state C(in) estimated using the estimated emission rate, which assumed that air exchange was the only process by which naphthalene was removed, was much greater than the C(in) value measured using PUF-PAS in nine public toilets, implying the importance of other removal processes, such as sorption to walls and the garments of visitors, as well as decreased emission rate owing to wetting of the naphthalene ball surface. The 95 percentile values of cancer risk for workers based on the estimation by PUF-PAS was 1.6×10⁻⁶, whereas those for the general public were lower than 1×10⁻⁶. The results suggested that naphthalene deodorant balls in public toilets may be an important cancer risk factor especially for the cleaning workers.

Health Effects of Radon Exposure

Radon is a naturally occurring radioactive material that is formed as the decay product of uranium and thorium, and is estimated to contribute to approximately half of the average annual natural background radiation. When inhaled, it damages the lungs during radioactive decay and affects the human body. Through many epidemiological studies regarding occupational exposure among miners and residential exposure among the general population, radon has been scientifically proven to cause lung cancer, and radon exposure is the second most common cause of lung cancer after cigarette smoking. However, it is unclear whether radon exposure causes diseases other than lung cancer. Media reports have often dealt with radon exposure in relation to health problems, although public attention has been limited to a one-off period. However, recently in Korea, social interest and concern about radon exposure and its health effects have increased greatly due to mass media reports of high concentrations of radon being released from various close-to-life products, such as mattresses and beauty masks. Accordingly, this review article is intended to provide comprehensive scientific information regarding the health effects of radon exposure.

Evaluación de la exposición de ciclistas a la contaminación del aire: una revisión de la literatura / Evaluation of cyclists exposure to air pollution: a literature review

RESUMEN Objetivos Describir e interpretar las metodologías y resultados de los principales estudios relacionados con el monitoreo de contaminación atmosférica en ciclistas. Métodos Se buscaron y analizaron las investigaciones a nivel nacional e internacional de los últimos diez años en las bases de datos Cochrane, Scopus, Embase, Science Direct y Pubmed. La búsqueda se realizó de Agosto a Septiembre del año 2017 usando los siguientes descriptores de búsqueda para MeSH: air pollution, bicycling, environmental exposure, enviromental health, inhalation exposure, environmental pollutants, transportation, public health y toxicology, y para DeCS: contaminación del aire, ciclismo, exposición a riesgos ambientales, contaminantes ambientales, inhalación, transportes, salud pública y toxicología. Resultados Se identificaron diecinueve artículos publicados elegibles. La mayoría de los estudios se realizaron en Europa y Estados Unidos. En Latinoamérica se han reportado cuatro estudios. Otros estudios buscaban comparar la exposición en distintas rutas en bicicleta, comparar trayectos de una misma ruta, y otros determinar la relación distancia vs exposición. De igual manera, variables como el tráfico vehicular, la distancia a las fuentes de emisión y el tipo de ciclorruta, juegan un papel fundamental en la exposición a contaminantes en ciclistas. Conclusiones Se encontraron diversas variables que influyen de forma directa o indirectamente en la exposición a la contaminación del aire de los usuarios de bicicleta, así como algunos factores que pueden reducir la exposición a estos contaminantes.(AU)

ABSTRACT Objectives To describe and interpret the methodologies and results of the main studies related to the monitoring of exposure of cyclists to air pollution. Methods Research and analysis of national and international research of the last ten years in the Cochrane, Scopus, Embase, Science Direct and Pubmed databases. The search was conducted in August and September 2017 using the following search descriptors for MeSH: air pollution, bicycle riding, environmental exposure, environmental health, exposure by inhalation, environmental pollutants, transportation, public health and toxicology. For DeCS: air Pollution, cycling, exposure to environmental risks, environmental pollutants, inhalation, transportation, public health and toxicology. Results Nineteen eligible published articles were identified. Most studies were conducted in Europe and the United States. Four studies have been reported in South America. Other studies seek comparisons on different bicycle routes, compare exposure during variations of the same route, and others determine the distance-exposure relationship. In the same way, variables such as vehicular traffic, distance to the emission sources and the type of bike path, play a fundamental role in the exposure to pollutants in cyclists. Conclusions Several variables were found that influence, directly or indirectly, the cyclists exposure to air pollution, as well as some factors that can reduce this exposure.(AU)

The applications and characters of aerosol exposure device for animal HAO Xin-yan, ZHANG Yuan-hui, GAO Hong / 中国医学装备

Aerosol inhalation exposure device provides important means for the studies of respiratory infectious disease, toxicity identification of chemical substance, vaccine evaluation and drug research, and now it is widely used in many fields included of respiratory diseases research, toxicology, inhalation immunity and safety evaluation. It is essential platform to do aerosol infection experiment of using laboratory animal and toxicology studies about inhalation. With the developments of science and technology and for the demand of reality, the device of aerosol exposure is developing in a more safe, efficient, precise and automatic direction, and it has a wide application prospect. Through reviews the characters and applications of inhalation exposure device, this paper will service as the scientific basis and references for further research and selection on the inhalation exposure device in future.

Effects of passive inhalation of cigarette smoke on structural and functional parameters in the respiratory system of guinea pigs / Efeitos da inalação passiva da fumaça de cigarro em parâmetros estruturais e funcionais no sistema respiratório de cobaias

ABSTRACT Objective: To evaluate the effects of passive inhalation of cigarette smoke on the respiratory system of guinea pigs. Methods: Male guinea pigs were divided into two groups: control and passive smoking, the latter being exposed to the smoke of ten cigarettes for 20 min in the morning, afternoon and evening (30 cigarettes/day) for five days. After that period, inflammatory parameters were studied by quantifying mesenteric mast cell degranulation, as well as oxidative stress, in BAL fluid. In addition, we determined MIP, MEP, and mucociliary transport (in vivo), as well as tracheal contractility response (in vitro). Results: In comparison with the control group, the passive smoking group showed a significant increase in mast cell degranulation (19.75 ± 3.77% vs. 42.53 ± 0.42%; p < 0.001) and in the levels of reduced glutathione (293.9 ± 19.21 vs. 723.7 ± 67.43 nM/g of tissue; p < 0.05); as well as a significant reduction in mucociliary clearance (p < 0.05), which caused significant changes in pulmonary function (in MIP and MEP; p < 0.05 for both) and airway hyperreactivity. Conclusions: Passive inhalation of cigarette smoke caused significant increases in mast cell degranulation and oxidative stress. This inflammatory process seems to influence the decrease in mucociliary transport and to cause changes in pulmonary function, leading to tracheal hyperreactivity.

RESUMO Objetivo: Avaliar os efeitos da inalação passiva da fumaça de cigarro no sistema respiratório de cobaias. Métodos: Foram utilizadas cobaias machos, divididas em dois grupos: controle e tabagismo passivo, esse último exposto à fumaça de dez cigarros por 20 min pela manhã, tarde e noite (30 cigarros/dia) por 5 dias. Após esse período, parâmetros inflamatórios foram estudados através da contagem de degranulação de mastócitos no mesentério e de estresse oxidativo a partir do LBA. Adicionalmente, foram verificadas PImáx, PEmáx, transporte mucociliar (in vivo) e contratilidade traqueal (in vitro). Resultados: Na comparação com o grupo controle, o grupo tabagismo passivo apresentou um aumento significativo na degranulação de mastócitos (19,75 ± 3,77% vs. 42,53 ± 0,42%; p < 0,001), nos níveis de glutationa reduzida (293,9 ± 19,21 vs. 723,7 ± 67,43 nM/g de tecido; p < 0,05) e uma redução significativa no transporte mucociliar (p < 0,05), provocando alterações significativas na função pulmonar, tanto na PImáx como na PEmáx (p < 0,05 para ambas), e hiper-reatividade nas vias aéreas. Conclusões: A inalação passiva da fumaça de cigarro ocasionou aumentos significativos na degranulação de mastócitos e no estresse oxidativo. Esse processo inflamatório parece ter influenciado a diminuição do transporte mucociliar e causado alterações na função pulmonar, proporcionando um quadro de hiper-reatividade traqueal.

Lung Transplantation for Chronic Humidifier Disinfectant-Associated Lung Injury / 대한구급학회지

In the spring of 2011, a cluster of lung injuries caused by humidifier disinfectant (HD) usage were reported in Korea. Many patients required mechanical ventilation, extracorporeal membrane oxygenation, and even lung transplantation (LTPL). However, the long-term course of HD-associated lung injury remains unclear because the majority of survivors recovered normal lung function. Here we report a 33-year-old woman who underwent LTPL approximately four years after severe HD-associated lung injury. The patient was initially admitted to the intensive care unit and was supported by a high-flow nasal cannula. Although she had been discharged, she was recurrently admitted to our hospital due to progressive lung fibrosis and a persistent decline in lung function. Finally, sequential double LTPL was successfully performed, and the patient's clinical and radiological findings showed significant improvement. Therefore, we conclude that LTPL can be a therapeutic option for patients with chronic inhalation injury.

Lung Transplantation for Chronic Humidifier Disinfectant-Associated Lung Injury / 대한중환자의학회지

In the spring of 2011, a cluster of lung injuries caused by humidifier disinfectant (HD) usage were reported in Korea. Many patients required mechanical ventilation, extracorporeal membrane oxygenation, and even lung transplantation (LTPL). However, the long-term course of HD-associated lung injury remains unclear because the majority of survivors recovered normal lung function. Here we report a 33-year-old woman who underwent LTPL approximately four years after severe HD-associated lung injury. The patient was initially admitted to the intensive care unit and was supported by a high-flow nasal cannula. Although she had been discharged, she was recurrently admitted to our hospital due to progressive lung fibrosis and a persistent decline in lung function. Finally, sequential double LTPL was successfully performed, and the patient's clinical and radiological findings showed significant improvement. Therefore, we conclude that LTPL can be a therapeutic option for patients with chronic inhalation injury.

The First Successful Heart-Lung Transplant in a Korean Child with Humidifier Disinfectant-Associated Interstitial Lung Disease

From 2006 to 2011, an outbreak of a particular type of childhood interstitial lung disease occurred in Korea. The condition was intractable and progressed to severe respiratory failure, with a high mortality rate. Moreover, in several familial cases, the disease affected young women and children simultaneously. Epidemiologic, animal, and post-interventional studies identified the cause as inhalation of humidifier disinfectants. Here, we report a 4-year-old girl who suffered from severe progressive respiratory failure. She could survive by 100 days of extracorporeal membrane oxygenation support and finally, underwent heart-lung transplantation. This is the first successful pediatric heart-lung transplantation carried out in Korea.

Avaliação da exposição aguda às partículas urbanas concentradas e da exaustão de motores diesel e biodiesel sobre o perfil inflamatório pulmonar e sistêmico de camundongos / Assessment of acute exposure to concentrated urban particles and diesel and biodiesel exhaust about the inflammatory pulmonary profile and systemic of mice

Introdução: Em ambientes urbanos, a exaustão dos carros a diesel é uma importante fonte de partículas e gases que afetam diretamente a saúde das pessoas. Como a adição do biodiesel ao diesel é recente, torna-se necessário avaliar o perfil toxicológico dessas emissões e os possíveis efeitos adversos a saúde. Além do mais, a concentração dos poluentes atmosféricos e sua composição físico-química sofrem influências diretas das condições meteorológicas. Esse estudo tem como foco avaliar o perfil toxicológico dos poluentes primários (emitidos diretamente da fonte) e secundários (gerados a partir das condições atmosféricas) por meio de dois estudos. Objetivos: (Estudo I) Avaliar a exposição aguda da exaustão do diesel e biodiesel no perfil inflamatório pulmonar e sistêmico; (Estudo II) Avaliar se a exposição aguda a baixos níveis de partículas ambientais concentradas (PACs) promovem efeitos cardiopulmonares e sistêmicos; e se a magnitude dessas alterações observadas é influenciada pelos períodos (frio/seco e quente/úmido). Métodos: (Estudo I) Camundongos Balb/C foram expostos ao ar filtrado (AF) e a duas concentrações de MP2,5 (600 e 1200 ?g/m3) tanto da exaustão do combustível diesel (D) quanto do biodiesel (BD). As emissões dos poluentes (MP2,5, NO e NO2), temperatura e umidade foram monitorados em tempo real. Os registros da variabilidade da frequência cardíaca (VFC), frequência cardíaca (FC) e da pressão arterial (PA) foram obtidas 30 minutos após a exposição. Após 24 horas os animais foram eutanasiados e foram coletados o lavado broncoalveolar (LBA), o pulmão, o sangue e a medula óssea para avaliar a inflamação pulmonar e sistêmica. A expressão das citocinas (ET-Ar, ET-Br, INOs, ISO, VCAM, IL-8) foram analisadas nos vasos peribronquiolares e no epitélio brônquico. (Estudo II) Camundongos Balb/C foram expostos ao ar filtrado e as PACs na concentração de 200 ?g/m3 geradas no período frio/seco e quente/úmido. A hiperresponsividade pulmonar, VFC, FC, PA foram...

Background: In urban environments, the exhaust of diesel cars is an important source of particles and gases that directly affect people's health. As the addition of biodiesel to diesel is recent, it is necessary to evaluate the toxicological profile of these emissions and the possible adverse health effects. Moreover, the concentration of air pollutants and their physico-chemical composition suffer direct influences of weather conditions. This study aims to evaluate the toxicological profile of primary pollutants (emitted directly from the source) and secondary (generated from the weather conditions) through two studies. Objectives: (Study I) Evaluate the acute exposure of diesel and biodiesel exhaust in pulmonary and systemic inflammatory profile. (Study II) Evaluated whether acute exposure to low levels of concentrated ambient particles (CAPs) promotes cardiopulmonary and systemic effects; and whether the magnitude of these observed changes is influenced by periods (cold/dry and warm/humid). Methods: (Study I) Balb/C mice were exposed for two hours to filtered air (FA) and two doses (600 and 1200 ?g/m3) of both diesel (D) and biodiesel (BD) fuels. The PM2.5, NO, and NO2 concentrations, air temperature and humidity were monitored in real time. HRV (time and frequency domain), HR and BP parameters were collected after 30 minutes of exposure. After 24 hours were available the bronchoalveolar lavage (BALf), lung histology, blood and bone marrow for pulmonar and systemic inflammation analysis. The cytokines expression (ET-Ar, ET-Br, INOs, ISO, VCAM, IL-8) were available on peribronchiolar vessels and bronchial epithelium. (Study II) Balb/C mice were exposed to 200 ?g/m3 to concentrated ambient particles (CAPs) and filtered air (FA) in cold/dry and warm/humid periods. Lung hyper-responsiveness, heart rate, heart rate variability and blood pressure were evaluated 30 minutes after the exposures. After 24 hours, blood and tissue sampling were...

Establishment and evaluation of a whole-body dynamic inhalation exposure system / 军事医学

Objective To establish a whole-body dynamic inhalation exposure system for toxicological studies on highly toxic chemicals, and to evaluate the safety and applicability of the system.Methods The safety and standardization of the laboratory were ensured after positive and negative pressure protection and airtight protection were finished.By modifying and optimizing the key technological units of the exposure chamber, the relationships between aerosol concentrations in the chamber and the push rate, exposure time and different monitoring points were investigated.Results and Conclusion Multi-protection was achieved, including the independent exposure chamber, negative pressure experiment and positive pressure protection under working conditions.The laboratory meets the demands of safety and specifications.The exposure aerosol concentrations in the chamber are uniform, stable and controllable while the air is dynamically flowing.The whole-body dynamic inhalation exposure system can meet the need for toxicological studies on highly toxic chemicals.

Health risk represented by inhaling polycyclic aromatic hydrocarbons (PAH) during daily commuting involving using a high traffic flow route in Bogotá / Exposición a hidrocarburos aromáticos policíclicos durante desplazamientos diarios en una vía de alto flujo vehicular en Bogotá

Objective Assessing the risk to health by inhaling particles and particle-bound PAH during daily commuting along a high traffic flow route/corridor in Bogotá. Methods A van was equipped with a PAS2000 photo-electric sensor for real-time measurement of particle-bound PAH and a Dust Trakfor monitoring PM10 concentration; it drove along typical commuting routes in the city. Exposure to particles and particle-bound PAH was assessed by using an inhalation intake model. Results A similar trend was observed for both PM10 and PAH concentration, indicating that traffic was the same source for both contaminants. Extreme PM10 and PAH inhalation concentrations were recorded every time direct bus and microbus emissions were measured by the van. Inhalation model results indicated that exposure was significantly greater when using a venues having mixed traffic use (i.e. buses, microbuses, passenger vehicles, motorcycles) compared to using roads where the TransMilenio system (articulated buses) had been implemented. Conclusions The results may support evaluating bus drivers, commuters and bike users' exposure to toxic compounds in the city.(AU)

Objetivo El presente estudio buscó estimar la exposición a material particulado e Hidrocarburos Aromáticos Poli cíclicos (HAP) asociados a partículas durante el desplazamiento diario de la población en una vía de alto flujo vehicular en Bogotá. Método Se instaló un equipo "dust-track" para la medición de partículas y un equipo fotoeléctrico "PAS2000" para la medición de los HAP, ambos en un vehículo tipo van que replicó el desplazamiento diario de personas de la casa al trabajo y viceversa. Con el fin de valorar la exposición personal a estos contaminantes según el tipo de vía se usó un modelo de inhalación. Resultados Se observó una tendencia similar entre la concentración del material particulado menor a 10 micrómetros (PM10) y los HAP, indicando que ambos provienen del tráfico principalmente. El modelo de inhalación mostró que las concentraciones a las que está expuesta una persona son mayores en vías con diferentes tipologías de vehículos (carros, buses y busetas, camiones, motocicletas) que en vías de uso exclusivo público para el sistema TransMilenio. Conclusiones Los resultados de este estudio son útiles en la evaluación de la población a contaminantes tóxicos del aire y pueden ser utilizados para apoyar políticas públicas destinadas al mejoramiento de la calidad del aire.(AU)

Effect of Agglomeration on the Toxicity of Nano-sized Carbon Black in Sprague-Dawley Rats

OBJECTIVES: Recent studies have shown that nano-sized carbon black is more toxic than large respirable carbon black because of its higher surface area. However, it is not clear if carbon black made larger by agglomeration demonstrates decreased toxicity. The purpose of this study was to verify if agglomeration affects the toxicity of carbon black using three differently prepared nano-sized carbon black aerosols in nose-only inhalation chambers for 13 weeks. METHODS: Printex 90 was selected as a representative nano-sized carbon black. To generate aerosols of three different types of agglomerates, Printex 90 was dispersed in distilled water by three different methods: vortex, vortex+sonication, and vortex+sonication with dispersion in a stabilizer. Then, the three differently prepared solutions were aerosolized through venturi nozzles. Male Sprague-Dawley rats were exposed to Printex 90 aerosols in a nose-only exposure chamber for 6 h/d, 5 d/wk for 13 weeks at a concentration of approximately 9 mg/m3. RESULTS: Numbers of total cells in the bronchoalveolar lavage (BAL) fluid, macrophages, and polymorphonuclear leukocytes were increased and carbon black masses were clearly seen in BAL cells and lung tissues of rats exposed to Printex 90. However, few differences were found between the three differently agglomerated aerosols. In addition, there were no significant differences in other parameters, such as body weight, lung function or cytokine levels in BAL fluid following carbon black exposure. CONCLUSIONS: Only mild to moderate respiratory effects were found in rats exposed to nano-sized carbon black at 9 mg/m3 for 13 weeks. Agglomeration did not affect the toxicity of nano-sized carbon particles.

A Case of Acute Respiratory Failure After Trichloroethylene Inhalation

Trichloroethylene (TCE, C2HCl3), which was introduced as a gas for general anesthesia and analgesia in early 1900's has been widely used in industry as an organic solvent. Occupational exposure to TCE is an important medical problem. Manifestations of acute exposure to TCE include mucocutaneous irritation, hepatotoxicity, cognitive impairment, sleep, headache, respiratory insufficiency and death. We report a 38-year-old man who was admitted to a department of emergency medicine after occupational inhalation exposure to TCE. He rapidly developed semicoma and respiratory depression. After mechanical ventilation, hypercapnea and hypoxemia disappeared and his mental state again became alert. Careful evaluation and proper respiratory support are important for respiratory failure after occupational TCE inhalation.

Severe Acute Fibrinous and Organizing Pneumonia with Acute Respiratory Distress Syndrome / 결핵및호흡기질환

Acute fibrinous and organizing pneumonia is a newly recognized pattern of acute lung injury. A 49-year-old female presented with a cough and worsening dyspnea on exertion. She had no history of smoking and no specific past medical history except exposure of home humidifier containing sterilizer. A chest computed tomography scan showed patchy consolidation with fibrosis in the right lower lobe and ill-defined centrilobular ground glass opacity in both lungs. The pathological findings were patchy areas of lung parenchyma with fibrin deposits in the alveolar ducts and alveoli, and fibrin balls with hemosiderin deposition in the alveolar spaces. The histological pattern of our case is differentiated from diffuse alveolar damage by the absence of hyaline membranes, and from eosinophilic pneumonia by the lack of eosinophils. In our case, the patient was treated with corticosteroid pulse therapy. However, the clinical course became aggravated and she died within two weeks.

Efeitos da poluição do ar na função respiratória de escolares, Rio de Janeiro, RJ / Efectos de la polución del aire en la función respiratoria de escolares, Rio de Janeiro, Sureste de Brasil / Effect of air pollution on lung function in schoolchildren in Rio de Janeiro, Brazil

OBJETIVO: Analisar a associação entre exposição diária à poluição do ar e função respiratória de escolares. MÉTODOS: Estudo de painel com uma amostra aleatória de 118 escolares (seis a 15 anos de idade) da rede pública do Rio de Janeiro (RJ), residentes até 2 km do local do estudo. Dados sobre características das crianças foram obtidos por questionário, incluindo o International Study of Asthma and Allergies in Childhood. Exames diários de pico de fluxo foram realizados para medir a função respiratória. Dados diários dos níveis de PM10, SO2, O3, NO2 e CO, temperatura e umidade foram fornecidos por um monitor móvel. As medidas repetidas de função respiratória foram associadas aos níveis dos poluentes por meio de modelo multinível ajustado por tendência temporal, temperatura, umidade do ar, exposição domiciliar ao fumo, ser asmático, altura, sexo, peso e idade das crianças. RESULTADOS: O pico de fluxo expiratório médio foi 243,5 l/m (dp=58,9). A menor média do pico de fluxo expiratório foi 124 l/m e a maior 450 l/m. Para o aumento de 10 µg/m³ de PM10 houve uma diminuição de 0,34 l/min na média do pico de fluxo no terceiro dia...

OBJECTIVE: To assess the association between daily exposure to air pollution and lung function in school children. METHODS: Panel study with a random sample of 118 students (between 6 and 15 years of age), enrolled in a public school of the city of Rio de Janeiro, state of Rio de Janeiro, and living within 2 km of the study site. Data on students' characteristics were obtained with a questionnaire, including the International Study of Asthma and Allergies in Childhood - ISAAC. Daily peak expiratory flow measurements were taken to measure lung function. Daily data on PM10, SO2, O3, NO2 and CO levels, temperature and humidity were provided by a portable monitor. Repeated measurements of lung function were associated with pollutant levels with a multilevel model adjusted for time trend, temperature, air humidity, exposure to smoking at home, presence of asthma, height, sex, weight and age of children. RESULTS: Mean peak expiratory flow was 243.5 l/m (sd=58.9). The lowest mean peak expiratory flow was 124 l/m, and the highest, 450 l/m. For the 10 µg/m³ increase in PM10, there was a 0.34 l/min decrease in mean peak flow on the third day...

OBJETIVO: Analizar la asociación entre exposición diaria a la polución del aire y función respiratoria de escolares. MÉTODOS: Estudio de painel con una muestra aleatoria de 118 escolares (seis a 15 años de edad) de la red pública de Río de Janeiro (Sureste de Brasil), residentes hasta 2 km de la localidad de estudio. Datos sobre características de los niños fueron obtenidos por cuestionario, incluyendo el International Study of Asthma and Allergies in Childhood. Exámenes diarios de pico de flujo fueron realizados para medir la función respiratoria. Datos diarios de los niveles de PM10, SO2, O3, NO2 y CO, temperatura y humedad fueron providenciados por un monitor móvil. Las medidas repetidas de función respiratoria fueron asociadas a los niveles de los contaminantes por medio de modelo multinivel ajustado por tendencia temporal, temperatura, humedad del aire, exposición domiciliar al humo de cigarro, ser asmático, altura, sexo, peso y edad de los niños. RESULTADOS: El pico de flujo de expiración promedio fue de 243,5 l/m (dp=58,9). El menor pico promedio del flujo de expiración fue 124 l/m y el mayor 450 l/m. Para el aumento de 10 ?g/m³ de PM10 hubo una disminución de 0,34 l/min en el promedio de pico de flujo en el tercer día...