Health risk assessment of indoor air pollution in Finnish ice arenas.

Poor indoor air quality and epidemic carbon monoxide (CO) and nitrogen dioxide (NO(2)) poisonings due to exhaust emissions from ice resurfacers have been continuously reported from enclosed ice arenas for over 30 years. The health risks in users of Finnish ice arenas were analysed in three ways: (1) evaluation of four cases of epidemic CO poisonings, (2) modelling the association between NO(2) exposure and respiratory symptoms among junior ice hockey players, and (3) estimation of the number of arena users at risk of breathing poor quality air due to non-compliance of ice arenas with recommended abatement measures. The common causes for the CO poisonings involving over 300 subjects were large emissions from propane-fuelled ice resurfacer, small arena volume, negligible ventilation, and very recent opening of the arena. Rhinitis (prevalence 18.3%) and cough (13.7%) during or after training or game were significantly associated with the estimated personal NO(2) exposure of young hockey players (n=793) to average concentrations ranging from 21 to 1176 microg/m(3) in their home arena. During a 6-year follow-up of an intensive information campaign the portion of electric resurfacers increased from 9% to 27%, and that of emission control technology on propane-fuelled resurfacers increased from 13% to 84%. The portion of inadequately ventilated arenas decreased from 34% to 25%. However, 48% of the investigated Finnish ice arenas (n=125) did not fully comply with the non-regulatory recommendations. Consequently, 20000 daily users of ice arenas were estimated to remain in 2001 at risk of breathing poor quality air. Modern small and inadequately ventilated ice arenas pose their users (mostly children and young adults) at risk of breathing poor quality air and suffering from acute adverse health effects. Governmental regulations are needed worldwide to ensure safe sports in enclosed ice arenas.

Determinants of personal and indoor PM2.5 and absorbance among elderly subjects with coronary heart disease.

Epidemiological studies have established an association between outdoor levels of fine particles (PM2.5) and cardiovascular health. However, there is little information on the determinants of PM2.5 exposures among persons with cardiovascular disease, a potentially susceptible population group. Daily outdoor, indoor and personal PM2.5 and absorbance (proxy for elemental carbon) concentrations were measured among elderly subjects with cardiovascular disease in Amsterdam, the Netherlands, and Helsinki, Finland, during the winter and spring of 1998-1999 within the framework of the ULTRA study. There were 37 non-smoking subjects in Amsterdam and 47 in Helsinki. In Amsterdam, where there were enough exposure events for analyses, exposure to environmental tobacco smoke (ETS) indoors was a major source of between-subject variation in PM2.5 exposures, and a strong determinant of PM2.5 and absorbance exposures. When the days with ETS were excluded, within-subject variation accounted for 89% of the total variation in personal PM2.5 and 97% in absorbance in Amsterdam. The respective figures were 66% and 61% in Helsinki. In both cities, outdoor levels of PM2.5 and absorbance were major determinants of personal and indoor levels. Traffic was also an important determinant of absorbance: living near a major street increased exposure by 22%, and every hour spent in a motor vehicle by 13% in Amsterdam. The respective increases were 37% and 9% in Helsinki. Cooking was associated with increased levels of both absorbance and PM2.5. Our results demonstrate that by using questionnaires in connection with outdoor measurements, exposure estimation of PM2.5 and its combustion originating fraction can be improved among elderly persons with compromised health.

Personal and microenvironmental concentrations of particles and microbial aerosol in relation to health symptoms among teachers.

A total of 81 randomly selected elementary school teachers participated in two sampling campaigns conducted 2 weeks apart during the winter. A 24-h sample collection was performed using personal and microenvironmental sampling from homes, and an 8-h sample collection was performed from workplaces of the studied subjects. Filters were analyzed for particle mass, absorption coefficient of the filter, and for both total and viable microorganisms. Comprehensive questionnaire responses were collected from the teachers concerning weekly occurred symptoms during the previous 12-month period, and they filled in symptom diaries immediately after each sampling campaign concerning symptoms during the previous 24-h and 7-day periods. The effect of different recall periods on agreement between questionnaire responses was assessed. Factor analysis was used in order to identify factors explaining the pattern of correlations within the personal, home, and work measurements. Moreover, associations between personal, home, and work measurements of pollutants and symptoms were analyzed using general estimation equations. The recall period of 7 days seemed to provide the most reliable data for the health effect assessment. Information from the factor analysis may allow reduction of variables related to the exposure assessment, and better interpretation of results. Both personal exposure and concentrations of pollutants at home were more frequently associated with health symptoms than concentrations at work. In multipollutant analyses, absorbance coefficient was positively associated with eye symptoms, and total bacteria with both cough and blocked nose.

The EXPOLIS study: implications for exposure research and environmental policy in Europe.

Exposure analysis is a crucial part of effective management of public health risks caused by pollutants and chemicals in our environment. During the last decades, more data required for exposure analysis has become available, but the need for direct population based measurements of exposures is still clear. The current work (i) describes the European EXPOLIS study, designed to produce this kind of exposure data for major air pollutants in Europe, and the database created to make the collected data available for researchers (ii) reviews the exposure analysis conducted and results published so far using these data and (iii) discusses the implications of the results from the point of view of research and environmental policy in Europe. Fine particle (with 37 elements and black smoke), nitrogen dioxide, volatile organic compounds (30 compounds) and carbon monoxide inhalation exposures and exposure-related questionnaire data were measured in seven European cities during 1996-2000. The EXPOLIS database has been used for exposure analysis of these pollutants for 4 years now and results have been published in approximately 30 peer-reviewed journal papers, demonstrating the versatility, usability and scientific value of such a data set. The multipollutant exposure data from the same subjects in the random population samples allows for analyses of the determinants, microenvironments and sources of exposures to multipollutant mixtures and associations between the different air pollutants. This information is necessary and useful for developing effective policies and control strategies for healthier environment.

Viable fungi and bacteria in personal exposure samples in relation to microenvironments.

Personal exposures to viable fungi and bacteria were compared with the concentrations being assessed by stationary samplers in home and workplace microenvironments. A random sample of 81 elementary school teachers in eastern Finland performed two 24-hour measurement periods in wintertime. Concentrations and prevalences of viable fungi and bacteria on the collection filters were determined by cultivation method. The geometric mean concentration was 3-12 cfu m(-3) for total viable fungi, 0.6-3.7 cfu m(-3) for Penicillium and mainly under 1 cfu m(-3) for other fungi. The samples with higher fungal concentrations also had higher diversity of fungi than samples with lower concentrations. The total number of fungal genera recovered was 39 for personal, 34 for home and 23 for work samples. The variation in concentration of Penicillium explained even 25-95% of the variations of total fungal concentration in personal exposure, home and workplace environments. There was an association between personal exposure and home concentration of viable fungi and between personal exposure and home and work concentrations of viable bacteria. Personal exposure and home concentrations of fungi were higher in rural areas than in urban areas. Our results also indicate that presence of a certain fungus in a microenvironment does not necessarily mean similar findings in personal exposure samples.

Effect of acute carbon monoxide exposure on heart rate variability in patients with coronary artery disease.

Epidemiological studies have shown that air pollution is associated with increased cardiovascular mortality. Although the pathophysiological mechanisms behind this association have remained largely unknown, it has been suggested that changes in cardiac autonomic function may play a role. In this study, we investigated the association between acute carbon monoxide (CO) exposure and cardiac autonomic function as measured by heart rate variability (HRV) in subjects with stable coronary artery disease. Twenty-four hour ambulatory electrocardiographic recording with simultaneous continuous personal CO concentration monitoring was performed in six male patients with angiographically verified coronary artery disease three times with 1-week intervals. Time domain measures of HRV were calculated for 5-min segments before and during the CO exposure periods. For further analysis CO exposures were divided into low (2.7 p.p.m.) CO exposure periods. The mean of maximum CO levels during 61 CO exposure periods was 4.6 p.p.m. (SD 5.0 p.p.m.). High CO exposure was associated with an increase in the square root of the mean of the sum of the squares of differences between adjacent RR intervals (r-MSSD) (P = 0.034). Heart rate remained unchanged during the CO exposure. In conclusion, acute CO exposure which represented most likely exposure derived from traffic seems to modify cardiac autonomic control in patients with stable coronary artery disease.

Inflammatory and cytotoxic potential of the airborne particle material assessed by nasal lavage and cell exposure methods.

Exposure to bioaerosols in moisture-damaged indoor environments has been shown to be a potential health risk. The aim of the present study was to evaluate the inflammatory and cytotoxic potential of airborne particle material using both the nasal lavage (NAL) method and a cell exposure study. A 24-h sample collection for airborne particles was performed using personal sampling and microenvironmental measurements in homes and an 8-h sample collection in the working places of the studied subjects. At the end of the sampling period, the production of nitric oxide, tumor necrosis factor alpha, interleukin (IL)-1 beta, IL-4, and IL-6 was analyzed in the NAL samples of the subjects. The same mediators, excluding IL-4, were measured in the cell culture medium of mouse RAW264.7 macrophages, which were exposed to the pooled filter extracts representing personal, home, and workplace exposure of each individual during the 24 h before the NAL. Samplings were repeated after 2 wk. The subjects were divided into groups of "low exposure" and "high exposure" according to the concentrations of viable fungi, viable bacteria, or total microbial amount in the pooled extract. Cytokine levels in the NAL samples of subjects with high microbial exposure were slightly increased compared to the corresponding values of the subjects with low exposure. Filter samples collected from the subjects with high microbial exposure induced a significant increase in the production of cytokines in the RAW264.7 macrophages, as compared to those from the subjects with low exposure. The within-subject variation was low in all of the cytokine measurements, but the correlation between the studied methods was poor. In conclusion, both of the methods discriminate at the group level between subjects with high and low microbial exposure. Sampling of airborne particle material and exposure of the mammalian cells to the obtained samples seems to be highly applicable in the environmental monitoring, whereas examination of the exposed subjects directly, for example by using the NAL method, is essential when association between exposure and health effects is evaluated.

Photometrically measured continuous personal PM(2.5) exposure: levels and correlation to a gravimetric method.

There is evidence that hourly variations in exposure to airborne particulate matter (PM) may be associated with adverse health effects. Still there are only few published data on short-term levels of personal exposure to PM in community settings. The objectives of the study were to assess hourly and shorter-term variations in personal PM(2.5) exposure in Helsinki, Finland, and to compare results from portable photometers to simultaneously measured gravimetric concentrations. The effect of relative humidity on the photometric results was also evaluated. Personal PM(2.5) exposures of elderly persons were assessed for 24 h every second week, resulting in 308 successful measurements from 47 different subjects. Large changes in concentrations in minutes after cooking or changing microenvironment were seen. The median of daily 1-h maxima was over twice the median of 24-h averages. There was a strong significant association between the two means, which was not linear. Median (95th percentile) of the photometric 24-h concentrations was 12.1 (37.7) and of the 24-h gravimetric concentrations 9.2 (21.3) microg/m3. The correlation between the photometric and the gravimetric method was quite good (R2=0.86). Participants spent 94.1% of their time indoors or in a vehicle, where relative humidity is usually low and thus not likely to cause significant effects on photometric results. Even outdoors, the relative humidity had only modest effect on concentrations. Photometers are a promising method to explore the health effects of short-term variation in personal PM(2.5) exposure.

Personal exposures and microenvironmental concentrations of particles and bioaerosols.

The aim of this study was to compare the personal exposure to particles and bioaerosols with that measured by stationary samplers in the main microenvironments, i.e., the home and the workplace. A random sample of 81 elementary school teachers was selected from the 823 teachers working for two councils in eastern Finland for the winter time measurement period. Bioaerosol and other particles were collected on filters by button samplers using personal sampling and microenvironmental measurements in homes and workplaces. The 24-hour sampling period was repeated twice for each teacher. Particle mass, absorption coefficient of the filter and the concentration of viable and total microorganisms were analyzed from each filter. In this paper, the study design, quality assurance principles and results of particle and bioaerosol exposure are described. The results show that particle mass concentrations, absorption coefficient and fungi were higher in personal exposure samples than in home and workplace samples. Furthermore, these concentrations were usually lower in the home than in the workplace. Bacterial concentrations were highest in heavily populated workplaces, while the viable fungi concentrations were lowest in workplaces. The fungi and bacteria results showed high variation, which emphasises the importance of quality assurance (duplicates and field blanks) in the microbial field measurements. Our results indicate that personal exposure measurements of bioaerosols in indoor environments are feasible and supplement the information obtained by stationary samplers.