Assessment of indoor environment in Paris child day care centers.

BACKGROUND: Children are sensitive to indoor environmental pollution. Up until now there has been a lack of data on air quality in child day care centers. OBJECTIVES: The aim of this study is to document the indoor environment quality of Paris child day care centers by repeated measurements, and to compare pollutant levels in child day care centers with levels in Paris dwellings. METHODS: We selected 28 child day care centers frequented by a random sample of babies who participated in the PARIS birth cohort environmental investigation, and visited the child day care centers for one week twice in one year. Biological contaminants assessed were fungi, endotoxin, dust mite allergens, and chemical pollutants: aldehydes, volatile organic compounds and nitrogen dioxide (NO2). Relative humidity, temperature, and carbon dioxide levels were measured simultaneously. A standardized questionnaire was used to gather information about the buildings and their inhabitants. RESULTS: Airborne endotoxin levels in child day care centers were higher than those found in Paris dwellings. Dust mite allergens in child day care centers were below the threshold level for sensitization in the majority of samples, and in common with dwelling samples. Penicillium and Cladosporium were the most commonly identified genera fungi. The child day care center indoor/outdoor ratio for most chemical pollutants was above unity except for NO2, the levels for NO2 being significantly higher than those measured in homes. CONCLUSION: Chemical and biological contamination in child day care centers appears to be low, apart from endotoxin and NO2. Failure to take child exposure in child day care centers into account could result in an overestimation of children's exposure to other pollutants.

Contribution of ozone to airborne aldehyde formation in Paris homes.

Indoor aldehydes may result from ozone-initiated chemistry, mainly documented by experimental studies. As part of an environmental investigation included in the PARIS birth cohort, the aim of this study was to examine ozone contribution to airborne aldehyde formation in Paris homes. Formaldehyde, acetaldehyde and hexaldehyde levels, as well as styrene, nitrogen dioxide and nicotine concentrations, comfort parameters and carbon dioxide levels, were measured twice during the first year of life of the babies. Ambient ozone concentrations were collected from the closest background station of the regional air monitoring network. Traffic-related nitrogen oxide concentrations in front of the dwellings were estimated by an air pollution dispersion model. Home characteristics and families' way of life were described by questionnaires. Stepwise multiple linear regression models were used to link aldehyde levels with ambient ozone concentrations and a few aldehyde precursors involved in oxidation reactions, adjusting for other indoor aldehyde sources, comfort parameters and traffic-related nitrogen oxides. A 4 and 11% increase in formaldehyde and hexaldehyde levels was pointed out when 8-hour ozone concentrations increased by 20 µg/m(3). The influence of potential precursors such as indoor styrene level and frequent use of air fresheners, containing unsaturated volatile organic compounds as terpenes, was also found. Thus, our results suggest that ambient ozone can significantly impact indoor air quality, especially with regard to formaldehyde and hexaldehyde levels.

Environmental home inspection services in Western Europe.

This review deals with environmental home inspection services in Western Europe provided for patients at the request of attending physicians to improve patient management. Such requests are usually motivated by respiratory or general symptoms which occur or worsen at home. The visit includes a standardised questionnaire as well as environmental sampling such as mite-allergen measurement, mould identification and volatile organic compound (VOC) measurements. Besides, some non-respiratory indoor risks are also taken into account. Following the visit, a report is sent to the family and the attending physician. These services have been developed since the early 1990s, but evaluation of their efficacy is still limited. Some studies have demonstrated a reduction in mite-allergen levels and clinical improvement following the visit and implementation of advice provided to the family. However, more studies are needed to further document efficacy and also perform cost-benefit analysis of these services.

Residential proximity fine particles related to allergic sensitisation and asthma in primary school children.

BACKGROUND: Fine particulate matter has been linked to allergies by experimental and epidemiological data having used aggregated data or concentrations provided by fixed-site monitoring stations, which may have led to misclassification of individual exposure to air pollution. METHODS: A semi-individual design was employed to relate individual data on asthma and allergy of 5338 school children (10.4 +/- 0.7 years) attending 108 randomly chosen schools in 6 French cities to the concentrations of PM2.5 (fine particles with aerodynamic diameter 2.5 microm) assessed in proximity of their homes. Children underwent a medical visit including skin prick test (SPT) to common allergens, exercise-induced bronchial (EIB) reactivity and skin examination for flexural dermatitis. Their parents filled in a standardised health questionnaire. RESULTS: After adjustment for confounders and NO2 as a potential modifier, the odds of suffering from EIB and flexural dermatitis at the period of the survey, past year atopic asthma and SPT positivity to indoor allergens were significantly increased in residential settings with PM2.5 concentrations exceeding 10 microg/m3 (WHO air quality limit values). The relationships were strengthened in long-term residents (current address for at least 8 years). CONCLUSIONS: Findings support the hypothesis that changes in allergy prevalence observed in recent decades might be partly related to interactions between traffic-related air pollution and allergens. Further longitudinal investigations are needed to corroborate such results.

Can we use fixed ambient air monitors to estimate population long-term exposure to air pollutants? The case of spatial variability in the Genotox ER study.

Associations between average total personal exposures to PM2.5, PM10, and NO2 and concomitant outdoor concentrations were assessed within the framework of the Genotox ER study. It was carried out in four French metropolitan areas (Grenoble, Paris, Rouen, and Strasbourg) with the participation, in each site, of 60-90 nonsmoking volunteers composed of two groups of equal size (adults and children) who carried the personal Harvard Chempass multipollutant sampler during 48 h along two different seasons ("hot" and "cold"). In each center, volunteers were selected so as to live (home and work/school) in three different urban sectors contrasted in terms of air pollution (one highly exposed to traffic emissions, one influenced by local industrial sources, and a background urban environment). In parallel to personal exposure measurements, a fixed ambient air monitoring station surveyed the same pollutants in each local sector. A linear regression model was accommodated where the dependent pollutant-specific variable was the difference, for each subject, between the average ambient air concentrations over 48 h and the personal exposure over the same period. The explanatory variables were the metropolitan areas, the three urban sectors, season, and age group. While average exposures to particles were underestimated by outdoor monitors, in almost all cities, seasons, and age groups, differences were lower for NO2 and, in general, in the other direction. Relationships between average total personal exposures and ambient air levels varied across metropolitan areas and local urban sectors. These results suggest that using ambient air concentrations to assess average exposure of populations, in epidemiological studies of long-term effects or in a risk assessment setting, calls for some caution. Comparison of personal exposures to PM or NO2 with ambient air levels is inherently disturbed by indoor sources and activities patterns. Discrepancies between measurement devices and local and regional sources of pollution may also strongly influence how the ambient air concentrations relate to population exposure. Much attention should be given to the selection of the most appropriate monitoring sites according to the study objectives.

Assessment of exposure to traffic pollution using the ExTra index: study of validation.

The ExTra index, produced by the French Scientific Center for Building Physics, evaluates ambient concentrations of transport-related pollutants in front of the work and living places of urban dwellers. This study contributes to the validation of the ExTra index by carrying out measurements in four French cities. It compares nitrogen oxide concentrations (NOx) measured over 6 weeks with passive samplers, and NOx calculated concentrations using the ExTra index. The study takes into account traffic density, topographical parameters (building height, road, and pavement width), weather conditions (wind direction and strength), and background pollution levels. The model was tested at 100 street canyons sites. There were highly significant correlations (0.90 in Grenoble, 0.95 in Nice, 0.89 in Paris, and 0.89 in Toulouse) and good intraclass correlation coefficients (0.75 in Grenoble, 0.91 in Nice, 0.89 in Paris, and 0.86 in Toulouse) between the two series of values. These results suggest that if the ExTra index were to be applied to all the different residences and workplaces of a subject throughout his (her) life, it could be a useful epidemiological tool for studying the long-term health effects of transport-related emissions and for reconstructing individual exposure to such pollution in order to avoid misclassification.

Effects of air pollution on adults with chronic obstructive pulmonary disease.

Few studies have been conducted on the effects of air pollution on patients with chronic obstructive pulmonary disease (COPD). During a 14-mo period, 39 Parisian adults with severe COPD were monitored by their physicians. Daily levels of 4 air pollutants were provided by an urban air-quality network. Exacerbation of COPD was associated only with ozone (O3) (odds ratio [OR] = 1.44 for a 10-microg/m3 increase in O3; 95% confidence interval [CI] = 1.14, 1.82), with a lag of 2-3 days. The effect of O3 was greater in patients whose carbon dioxide pressure (PaCO2) was higher than 43 mm Hg (OR = 1.83; 95% CI = 1.36, 2.47) vs. those with a lower PaCO2 (OR = 1.26; 95% CI = 0.90, 1.77). The effect of O3 was unchanged, regardless of the maintenance medications used. The only air pollutant to which patients with severe COPD were particularly sensitive was O3.