Total exposure from outdoor and indoor air pollution in the Arctic.

Most of the chemical contaminants and radionuclides that have been identified in the arctic environment are known to have toxic, genotoxic, or carcinogenic endpoints in humans. However, knowledge is lacking on the health effects of exposure to low concentrations of mixtures of the contaminants in various periods of a lifetime, in utero included. Therefore, more detailed study is needed on the implications of present levels of air and food contamination for human health in arctic and subarctic regions, as part of ongoing environmental monitoring programs. Here we outline the prerequisites and precautions for such studies, in particular the rationale for a total human exposure approach. We emphasize using a concept of total exposure and dose analysis (TEDA), covering integration of (1) environmental monitoring, (2) personal monitoring, (3) biological monitoring, (4) analysis of selected biomarkers of individual susceptibility and pre-stages of disease, (5) evaluation of functional changes and adverse health effects reflecting human exposure, and (6) information collected from interviews and questionnaires, taking bias and potential confounders into account.

Nasal reaction to changes in whole body temperature.

The changes in nasal patency following a 1.5 degrees C decrease or increase in whole body temperature were measured in 8 healthy young males, during and after 30 min of immersion in a 15 degrees C cold or a 40 degrees C warm bath, breathing air at the same temperature, in a cross-over experimental design. The nasal reactions were traced by consecutive measurements of changes in nasal cavity volumes by acoustic rhinometry. Swelling of the mucosa during cooling and an almost maximal shrinkage of the mucosa during heating were indicated by respectively a decrease and an increase in nasal cavity volumes. The reactions were determined predominantly by the whole body thermal balance, but were also influenced by the temperature of the inhaled air, either enhanced, reduced or temporarily reversed. The greatest change occurred in the nasal cavity, left or right, which differed most from the final state at the beginning of exposure due to the actual state of nasal cycle.

Inhalation of diethylamine--acute nasal effects and subjective response.

Adult volunteers were exposed to 25 ppm (75 mg/m3) diethylamine in a climate chamber for 15 min in order to study the acute nasal reactions to an exposure equivalent to the present threshold limit value-short-term exposure limit. Changes in nasal volume and nasal resistance were measured by acoustic rhinometry and by rhinomanometry. Acute change in nasal volume, usually seen as acute nasal mucosa response to thermal stimuli, was not observed, nor was an acute change in nasal airway resistance. In a subsequent experiment, the aim was to measure acute sensory effects. Exposure to a concentration increasing from 0 to 12 ppm took place for 60 min, equal to an average concentration of 10 ppm (30 mg/m3). A moderate to strong olfactory response and distinct nasal and eye irritation were observed. In spite of considerable individual variation, the results were in agreement with sensory effect estimates obtained from animal studies.

Moderate cold exposure in the Faroe fishing industry.

Differences in female workers' finger temperatures, manual dexterity, ratings on thermal comfort, and local cooling exposure were studied in three factories in the Faroe Island fishing industry. Environmental temperatures in the factories varied from 5 to 19 degrees C with vertical gradients of 7 degrees C/m, and the mean temperatures of the flushing water varied from 2 to 15 degrees C. Finger temperature varied from 12 to 24 degrees C when measured 2 min after work was stopped, and about one-third of the women experienced thermal discomfort in the fingers during work. The fish temperature increased, on the average, less than 1 degrees C during passage through the production room, notwithstanding the thermal differences among the factories. These findings should be used in attempts to reduce the cold exposure of the workers; but also improved control should be recommended for both environmental and water temperatures in the factories.

Evaluation of the effect of localized skin cooling on nasal airway volume by acoustic rhinometry.

Ten healthy subjects (four men and six women) were subjected to localized skin cooling by submersion for 5 min of both feet and, in another experiment, one hand and forearm into ice-cold water. Repeated measurements of nasal cavity volumes by a new method, acoustic rhinometry, showed characteristic patterns ranging from marked increases in volumes lasting the entire exposure period to transient monophasic or biphasic responses to no change at all. The pattern in individual subjects was reproducible with the two methods of cooling, and it could be characterized by five types when related to baseline measurements during the preexposure period. Because of large minute-to-minute variations, probably determined by local differences and fluctuations in blood flow in tissues through the nose, evaluation of induced changes in the nasal cavity volume cannot be based on single measurements as has frequently been done in the past by using rhinomanometry as the experimental method. The mechanisms behind the characteristic patterns in immediate human nasal response to local skin cooling challenge remains to be explored.

Human response to varying concentrations of toluene.

Thirty two males and 39 females aged 31-50 were exposed for 7 h to one of the three following conditions: (1) Clean air, (2) constant exposure to 100 ppm toluene, or (3) a varying exposure with the same time-weighted average, but with peaks of 300 ppm every 30 min. During exposure the subjects exercised in three 15-min periods with a load of 50 to 100 W. Exposure to toluene caused significant (P less than 0.05) complaints about poor air quality, altered temperature and noise perception, increased irritation in the nose and the lower airways, feeling of intoxication, and there were tendencies (P less than 0.1) towards irritation in the throat, headache and dizziness. In the four performance tests there was a tendency towards a lower score in a vigilance test while no effect of toluene exposure was seen in a peg board test, a five choice serial reaction test, or a colour test, indicating only minimal if any effect on the psychomotor or visual performance. There was no difference in the acute effects caused by the exposure containing peak concentrations and by the constant exposure.

Toluene metabolism during exposure to varying concentrations combined with exercise.

The urinary excretion of hippuric acid (HA) and ortho-cresol (O-cr) in man was measured in two studies of 7-h exposure to toluene in a climate chamber, either constant concentration of 100 ppm or varying concentrations containing peaks of 300 ppm but with a time-weighted average of 100 ppm. In Study A, four males were exposed to clean air and to constant and varying concentrations of toluene in combination with rest and with 100 W exercise in 140 min. Exercise increased end exposure excretion rate of HA and O-cr by 47 and 114%, respectively. After exposure, all excess HA was excreted within 4 h, while O-cr was eliminated with a half life of about 3 h. Alveolar air concentration of toluene varied between 21 and 31 ppm during constant exposure and between 13 and 57 ppm during varying exposure, but no difference in mean alveolar toluene concentration or in metabolite excretion was seen between the exposure schedules. In Study B, 32 males and 39 females aged between 31 and 50 years were exposed once to either clean air, constant or varying concentrations of toluene. Background excretion rate of HA was 0.97 +/- 0.75 mg/min (1.25 +/- 1.05 g/g creatinine) and rose to 3.74 +/- 1.40 mg/min (3.90 +/- 1.85 g/g cr) during the last 3 h of exposure to 100 ppm toluene. The corresponding figures for O-cr were 0.05 +/- 0.05 micrograms/min (0.08 +/- 0.14 mg/g cr), and 2.04 +/- 0.84 micrograms/min (2.05 +/- 1.18 mg/g cr). The individual creatinine excretion rate was considerably influenced by sex, body weight and smoking habits, thus influencing the metabolite concentration standardised in relation to creatinine. It is concluded that both metabolites are estimates of toluene exposure. O-cr is more specific than HA, but the individual variation in excretion of both metabolites is large, and when implementing either of them as biological exposure indices, the influence of sex, body size, age as well as consumption of tobacco and alcohol has to be considered.

Response of solvent-exposed printers and unexposed controls to six-hour toluene exposure.

The acute effects of toluene were studied in 43 male printers and 43 control subjects matched according to sex, age, educational level, and smoking habits. The mean age of the subjects was 36 (range 29-50) years. The printers had been exposed to solvents for 9 to 25 years during employment at flexo and rotogravure printing plants, while the controls had no history of solvent exposure. Each subject was exposed once in a climate chamber to either 100 ppm of toluene or clean air for 6.5 h preceded by a 1-h acclimatization period. The effects of toluene were measured from subjective votes with linear analogue rating scales on 16 items, and on the performance of 10 different tests measuring psychomotor skills, perceptual skills, and vigilance. Exposure to 100 ppm of toluene compared with exposure to clean air caused discomfort with complaints of low air quality, strong odor, fatigue, sleepiness, a feeling of intoxication, and irritation of the eyes, nose and throat. Furthermore, the subjects exposed to toluene showed decreased manual dexterity, decreased color discrimination, and decreased accuracy in visual perception. There was no significant difference in the effects of toluene on printers compared to those of toluene on controls, but tendencies toward a greater sensitivity were seen for the printers in two tests.

Middle ear effusion in children and the indoor environment: an epidemiological study.

A prospective study of 337 children was carried out during a 3-month period. The purpose of the study was to evaluate the importance of indoor environmental factors in homes and day-care institutions for the incidence of middle ear effusion (MEE). The indoor environmental factors measured in institutions were carbon dioxide, temperature, and relative humidity. Conditions in the homes were assessed by a questionnaire. Middle ear effusion was measured by tympanometry. No relationship was found between indoor environmental factors and MEE, with the exception of parental smoking at home, which increased the frequency of MEE in children.

Effect of ethanol, cimetidine and propranolol on toluene metabolism in man.

In a climatic exposure chamber four healthy volunteers were exposed to 100ppm toluene, 100ppm toluene + ethanol, 100ppm toluene + cimetidine, and 100ppm toluene + propranolol for 7h each at random over four consecutive days. A control experiment and 3.5h of exposure to 200ppm toluene were also performed. Ethanol inhibited toluene metabolism by 0.5 as expressed by the urinary excretion of two of the metabolites of toluene, namely o-cresol and hippuric acid. In agreement with this, the mean alveolar concentration of toluene was greater by 1.7 during ethanol exposure; 45 min after discontinuation of exposure the increase was by 3.3. Neither cimetidine nor propranolol changed toluene metabolism significantly. The results indicate that ethanol may prolong the time interval in which toluene is retained in the human body in persons simultaneously exposed to ethanol and toluene. When using o-cresol or hippuric acid in biological monitoring of persons occupationally exposed to toluene, the consumption of ethanol should be considered.

A prospective epidemiological investigation of secretory otitis media and tubal dysfunction in children attending day-care centers. Serial tympanometry with an interval of two weeks.

The present investigation included 373 children aged 9 months to 7 years, cared for in nine kindergartens and one nursery home. Serial tympanometries were carried out at 2-week intervals. A Madsen Electronics ZS 330 tympanoscope was used for the measurements. To identify A, C1, C2 and B tympanograms, middle ear pressure, compliance and stapedial reflex were measured. After correction for age and other factors which could influence the prevalence of B and C2 tympanograms (number of siblings and parental smoking, which was included in an investigation of the indoor environment of the same children), no significant difference was found in the prevalence of these types of tympanograms, even though the number of children attending the different day-care centers ranged from 19 to 72. No significant difference was found in the prevalence of the A, C1, C2 and B tympanograms between right and left ears, but there was a significant difference in the prevalence of the A tympanograms in boys and girls, but not in C1, C2 and B tympanograms. The maximum prevalence of B tympanograms was found in 1-year-old children, decreasing to the age of 7 years.

Antipyrine clearance during experimental and occupational exposure to toluene.

Exposure to toluene vapour enhances hepatic microsomal enzyme function in animals as assessed by the metabolism of the test drug antipyrine. Thirty six printing trade workers with long term occupational exposure to a mixture of organic solvents and 39 matched controls were randomly allocated into four groups. Eighteen printers and 21 controls were exposed to 100 ppm of toluene during 6.5 hours in an exposure chamber. The remaining 18 printers and 18 controls were exposed to 0 ppm of toluene under similar conditions. The salivary clearance of antipyrine was measured immediately after the stay in the exposure chamber to investigate a possible acute change in liver function and was repeated two weeks later, shortly before the summer vacation. Antipyrine clearance was measured again at the end of the summer vacation-four weeks after exposure. To study a possible effect of chronic exposure on antipyrine clearance 12 printing trade workers with 17 years (median) of occupational exposure to toluene vapour at concentrations of about 100 ppm were investigated before and four weeks after cessation of exposure. No difference in antipyrine clearance was found either within the groups or between the groups at any of the measurements.

Urinary hippuric acid and orthocresol excretion in man during experimental exposure to toluene.

It is not known whether urinary excretion of hippuric acid (HA) or orthocresol (O-Cr) is to be preferred for the biological monitoring of workers with occupational exposure to toluene. To study this, 42 printing trade workers with more than 10 years' exposure to a mixture of organic solvents including toluene (0-20 ppm) and 43 control subjects matched by age, smoking habits, and living accommodation were investigated. Each matched pair was randomised to an experimental exposure of either 100 ppm or 0 ppm toluene for 6.5 hours under controlled conditions in an exposure chamber. Urinary excretion of HA and O-Cr was determined by high pressure liquid chromatography from samples obtained before exposure, during the first three hours, and during the last 3.5 hours of exposure. No difference in HA and O-Cr excretion was found between printing trade workers and controls. The median O-Cr excretion increased 29 times during exposure, whereas the HA excretion increased only five times. Thus only 3% of the O-Cr excretion originated from other sources than toluene whereas the corresponding value for HA was 19%. Standardisation of the concentrations of HA and O-Cr in relation to urinary creatinine reduced the relative variation by 29% and 56% respectively. This was not reduced further by expressing the excretions as average excretion rates based on total volume of urine collected. Background urinary O-Cr excretion was three to four times higher among smokers than non-smokers, probably due to the content of O-Cr in cigarettes. The O-Cr excretion in unexposed smokers was, however, 10 times lower that that of the non-smokers during the end of the experimental exposure to 100 ppm toluene.