Kerosene lighting contributes to household air pollution in rural Uganda.

The literature on the contribution of kerosene lighting to indoor air particulate concentrations is sparse. In rural Uganda, kitchens are almost universally located outside the main home, and kerosene is often used for lighting. In this study, we obtained longitudinal measures of particulate matter 2.5 microns or smaller in size (PM2.5 ) from living rooms and kitchens of 88 households in rural Uganda. Linear mixed-effects models with a random intercept for household were used to test the hypotheses that primary reported lighting source and kitchen location (indoor vs outdoor) are associated with PM2.5 levels. During initial testing, households reported using the following sources of lighting: open-wick kerosene (19.3%), hurricane kerosene (45.5%), battery-powered (33.0%), and solar (1.1%) lamps. During follow-up testing, these proportions changed to 29.5%, 35.2%, 18.2%, and 9.1%, respectively. Average ambient, living room, and kitchen PM2.5 levels were 20.2, 35.2, and 270.0 µg/m3 . Living rooms using open-wick kerosene lamps had the highest PM2.5 levels (55.3 µg/m3 ) compared to those using solar lighting (19.4 µg/m3 ; open wick vs solar, P=.01); 27.6% of homes using open-wick kerosene lamps met World Health Organization indoor air quality standards compared to 75.0% in homes using solar lighting.

Seasonal variability in environmental tobacco smoke exposure in public housing developments.

The risk of tobacco smoking and second-hand smoke (SHS) exposure combined are the leading contributors to disease burden in high-income countries. Recent studies and policies are focusing on reducing exposure to SHS in multiunit housing (MUH), especially public housing. We examined seasonal patterns of SHS levels within indoor common areas located on Boston Housing Authority (BHA) properties. We measured weekly integrated and continuous fine particulate matter (PM2.5) and passive airborne nicotine in six buildings of varying building and occupant characteristics in summer 2012 and winter 2013. The average weekly indoor PM2.5 concentration across all six developments was 9.2 µg/m3, higher during winter monitoring period (10.3 µg/m3) compared with summer (8.0 µg/m3). Airborne nicotine concentrations ranged from no detection to about 5000 ng/m3 (mean 311 ng/m3). Nicotine levels were significantly higher in the winter compared with summer (620 vs. 85 ng/m3; 95% CI: 72-998). Smoking-related exposures within Boston public housing vary by season, building types, and resident smoking policy. Our results represent exposure disparities that may contribute to health disparities in low-income communities and highlight the potential importance of efforts to mitigate SHS exposures during winter when outdoor-indoor exchange rates are low and smokers may tend to stay indoors. Our findings support the use of smoke-free policy as an effective tool to eliminate SHS exposure and protect non-smokers, especially residents of MUH.

Comparison of multiple environmental factors for asthmatic children in public housing.

Nine families of a public housing development in Boston were enrolled in a pilot asthma intervention program designed to gather dense environmental data and generate hypotheses about the relative importance of different contaminants and the viability of interventions. Despite formidable challenges working with this inner-city population, the project team succeeded in gaining active support for the project by forming a partnership with a community-based organization and by building positive relationships between the field team and the residents. Families were provided with physical interventions such as air filters, industrial cleaning and mattress covers to each apartment. Indoor temperature was high and relative humidity low during winter. Insulation of exposed steam pipes did not lower temperature. Cockroach, mouse and pet antigen levels were variable and frequently high in settled dust. Viable fungal spore levels were variable and high in some apartments. Dust-mite allergen levels were below the level of concern. Industrial cleaning led to transient reduction in mouse and cockroach antigen burden. Mattress and pillow covers lowered dust-mite antigen in bedrooms, but not living rooms. Nitrogen dioxide (NO2) levels exceeded ambient concentrations due to use of gas stoves and concentrations of particulate matter with aerodynamic diameter <2.5 microm (PM2.5) were above ambient levels because of smoking. Air filtering systems did not reduce PM levels. Several volatile organic compounds (VOCs) were above adverse risk concentrations. We hypothesize that our findings are consistent with a multifactorial model for exacerbation of asthma in this population and that no single problem dominates.

Identification of selected hormonally active agents and animal mammary carcinogens in commercial and residential air and dust samples.

In order to characterize typical indoor exposures to chemicals of interest for research on breast cancer and other hormonally mediated health outcomes, methods were developed to analyze air and dust for target compounds that have been identified as animal mammary carcinogens or hormonally active agents and that are used in commercial or consumer products or building materials. These methods were applied to a small number of residential and commercial environments to begin to characterize the extent of exposure to these classes of compounds. Phenolic compounds, including nonylphenol, octylphenol, bisphenol A, and the methoxychlor metabolite 2,2-bis(p-hydroxyphenyl)-1,1,1-trichloroethane (HPTE), were extracted, derivatized, and analyzed by gas chromatography/mass spectrometry (GC/MS)-selective ion monitoring (SIM). Selected phthalates, pesticides, polycyclic aromatic hydrocarbons (PAHs), and polychlorinated biphenyls (PCBs) were extracted and analyzed by GC/MS-SIM. Residential and workplace samples showed detectable levels of twelve pesticides in dust and seven in air samples. Phthalates were abundant in dust (0.3-524 micrograms/g) and air (0.005-2.8 micrograms/m3). Nonylphenol and its mono- and di-ethoxylates were prevalent in dust (0.82-14 micrograms/g) along with estrogenic phenols such as bisphenol A and o-phenyl phenol. In this 7-sample pilot study, 33 of 86 target compounds were detected in dust, and 24 of 57 target compounds were detected in air. In a single sample from one home, 27 of the target compounds were detected in dust and 15 in air, providing an indication of chemical mixtures to which humans are typically exposed.

Criteria air pollutants and toxic air pollutants.

This review presents a brief overview of the health effects and exposures of two criteria pollutants--ozone and particulate matter--and two toxic air pollutants--benzene and formaldehyde. These pollutants were selected from the six criteria pollutants and from the 189 toxic air pollutants on the basis of their prevalence in the United States, their physicochemical behavior, and the magnitude of their potential health threat. The health effects data included in this review primarily include results from epidemiologic studies; however, some findings from animal studies are also discussed when no other information is available. Health effects findings for each pollutant are related in this review to corresponding information about outdoor, indoor, and personal exposures and pollutant sources.

Ozone decay rates in residences.

In urban and suburban settings, indoor ozone exposures can represent a significant fraction of an individual's total exposure. The decay rate, one of the factors determining indoor ozone concentrations, is inadequately understood in residences. Decay rates were calculated by introducing outdoor air containing 80-160 parts per billion ozone into 43 residences and monitoring the reduction in indoor concentration as a function of time. The mean decay rate measured in the living rooms of 43 Southern California homes was 2.80 +/- 1.30 hr-1, with an average ozone deposition velocity of 0.049 +/- 0.017 cm/sec. The experimental protocol was evaluated for precision by repeating measurements in one residence on five different days, collecting 44 same-day replicate measurements, and by simultaneous measurements at two locations in six homes. Measured decay rates were significantly correlated with house type and the number of bedrooms. The observed decay rates were higher in multiple-family homes and homes with fewer than three bedrooms. Homes with higher surface-area-to-volume ratios had higher decay rates. The ratio of indoor-to-outdoor ozone concentrations in homes not using air conditioning and open windows was 68 +/- 18%, while the ratio of indoor-to-outdoor ozone was less than 10% for the homes with air conditioning in use.

[Illig-Fanconi disease. First case described in Ecuador]. / Enfermedad de Illig-Fanconi. Primer caso descrito en Ecuador.

We are presenting here one case of Illig-Fanconi disease, in one month old baby otherwise in good health. The clinical evolution was characterized by flares of lesions every fifteen days more or less; these lesions were papules of one to two centimeters of diameter, some of them having a central depression, and leaving a white patches when they cleared up. The disease disappeared completely when the child was six months old, and there were not any recurrence until today. No systemic involvement was detected.

[Recessive dystrophic epidermolysis bullosa (with esophageal involvement)]. / Epidermolisis ampollosa distrófica recesiva (con afectación esofágica).

We are presenting a young man with Epidermolysis Bullosa (Dystrophica recessive type) who had lesions in hands, feet and face; some plaques of alopecia were noted on the scalp. Three years ago the patient showed marked dysphagia due to some esophagus erosions, which have been appearing regularly. One year ago it was necessary to take the patient to the Hospital where a esophagectomy was performed replacing the esophagus by a piece of colon.

[Lymphomatoid papulosis. The first case reported in Ecuador]. / Papulosis linfomatoide. Primer caso descrito en Ecuador.

We present the first case of lymphomatoid papulosis described in Ecuador. The clinicopathologic aspects of the disease are characteristic and make this entity different deserving its individualization . We discuss the different factors that may have some influence in clinical evolution and prognosis . The case presented is interesting because the lesions have only appeared once. Complete healing was observed after twenty days, and no relapse has been noted since then.