Exposure to household air pollution from biomass cookstoves and blood pressure among women in rural Honduras: A cross‐sectional study

Growing evidence links household air pollution exposure from biomass cookstoves with elevated blood pressure. We assessed cross‐sectional associations of 24‐hour mean concentrations of personal and kitchen fine particulate matter (PM_2.5), black carbon (BC), and stove type with blood pressure, adjusting for confounders, among 147 women using traditional or cleaner‐burning Justa stoves in Honduras. We investigated effect modification by age and body mass index. Traditional stove users had mean (standard deviation) personal and kitchen 24‐hour PM_2.5 concentrations of 126 μg/m³ (77) and 360 μg/m³ (374), while Justa stove users’ exposures were 66 μg/m³ (38) and 137 μg/m³ (194), respectively. BC concentrations were similarly lower among Justa stove users. Adjusted mean systolic blood pressure was 2.5 mm Hg higher (95% CI, 0.7‐4.3) per unit increase in natural log‐transformed kitchen PM_2.5 concentration; results were stronger among women of 40 years or older (5.2 mm Hg increase, 95% CI, 2.3‐8.1). Adjusted odds of borderline high and high blood pressure (categorized) were also elevated (odds ratio = 1.5, 95% CI, 1.0‐2.3). Some results included null values and are suggestive. Results suggest that reduced household air pollution, even when concentrations exceed air quality guidelines, may help lower cardiovascular disease risk, particularly among older subgroups.     

Household air pollution and blood markers of inflammation: A cross-sectional analysis

Household air pollution (HAP) from biomass stoves is a leading risk factor for cardiopulmonary outcomes; however, its toxicity pathways and relationship with inflammation markers are poorly understood. Among 180 adult women in rural Peru, we examined the cross-sectional exposure-response relationship between biomass HAP and markers of inflammation in blood using baseline measurements from a randomized trial. We measured markers of inflammation (CRP, IL-6, IL-10, IL-1β, and TNF-α) with dried blood spots, 48-h kitchen area concentrations and personal exposures to fine particulate matter (PM_2.5), black carbon (BC), and carbon monoxide (CO), and 48-h kitchen concentrations of nitrogen dioxide (NO₂) in a subset of 97 participants. We conducted an exposure-response analysis between quintiles of HAP levels and markers of inflammation. Markers of inflammation were more strongly associated with kitchen area concentrations of BC than PM_2.5. As expected, kitchen area BC concentrations were positively associated with TNF-α (pro-inflammatory) concentrations and negatively associated with IL-10, an anti-inflammatory marker, controlling for confounders in single- and multi-pollutant models. However, contrary to expectations, kitchen area BC and NO₂ concentrations were negatively associated with IL-1β, a pro-inflammatory marker. No associations were identified for IL-6 or CRP, or for any marker in relation to personal exposures.     

Reduction in personal exposures to particulate matter and carbon monoxide as a result of the installation of a Patsari improved cook stove in Michoacan Mexico

The impact of an improved wood burning stove (Patsari) in reducing personal exposures and indoor concentrations of particulate matter (PM(2.5)) and carbon monoxide (CO) was evaluated in 60 homes in a rural community of Michoacan, Mexico. Average PM(2.5) 24-h personal exposure was 0.29 mg/m(3) and mean 48-h kitchen concentration was 1.269 mg/m(3) for participating women using the traditional open fire (fogon). If these concentrations are typical of rural conditions in Mexico, a large fraction of the population is chronically exposed to levels of pollution far higher than ambient concentrations found by the Mexican government to be harmful to human health. Installation of an improved Patsari stove in these homes resulted in 74% reduction in median 48-h PM(2.5) concentrations in kitchens and 35% reduction in median 24-h PM(2.5) personal exposures. Corresponding reductions in CO were 77% and 78% for median 48-h kitchen concentrations and median 24-h personal exposures, respectively. The relationship between reductions in median kitchen concentrations and reductions in median personal exposures not only changed for different pollutants, but also differed between traditional and improved stove type, and by stove adoption category. If these reductions are typical, significant bias in the relationship between reductions in particle concentrations and reductions in health impacts may result, if reductions in kitchen concentrations are used as a proxy for personal exposure reductions when evaluating stove interventions. In addition, personal exposure reductions for CO may not reflect similar reductions for PM(2.5). This implies that PM(2.5) personal exposure measurements should be collected or indoor measurements should be combined with better time-activity estimates, which would more accurately reflect the contributions of indoor concentrations to personal exposures. PRACTICAL IMPLICATIONS: Installation of improved cookstoves may result in significant reductions in indoor concentrations of carbon monoxide and fine particulate matter (PM(2.5)), with concurrent but lower reductions in personal exposures. Significant errors may result if reductions in kitchen concentrations are used as a proxy for personal exposure reductions when evaluating stove interventions in epidemiological investigations. Similarly, time microenvironment activity models in these rural homes do not provide robust estimates of individual exposures due to the large spatial heterogeneity in pollutant concentrations and the lack of resolution of time activity diaries to capture movement through these microenvironments.     

Relationship of personal exposure to volatile organic compounds to home, work and fixed site outdoor concentrations

Personal exposures of 100 adult non-smokers living in the UK, as well as home and workplace microenvironment concentrations of 15 volatile organic compounds were investigated. The strength of the association between personal exposure and indoor home and workplace concentrations as well as with central site ambient air concentrations in medium to low pollution areas was assessed. Home microenvironment concentrations were strongly associated with personal exposures indicating that the home is the driving factor determining personal exposures to VOCs, explaining between 11 and 75% of the total variability. Workplace and central site ambient concentrations were less correlated with the corresponding personal concentrations, explaining up to 11-22% of the variability only at the low exposure end of the concentration range (e.g. benzene concentrations < 2.5 μg m⁻³). One of the reasons for the discrepancies between personal exposures and central site data was that the latter does not account for exposure due to personal activities (e.g. commuting, painting). A moderate effect of season on the strength of the association between personal exposure and ambient concentrations was found. This needs to be taken into account when using fixed site measurements to infer exposures.     

Ultrafine particles and black carbon personal exposures in asthmatic and non‐asthmatic children at school age

Traffic‐related air pollution (TRAP) exposure during childhood is associated with asthma; however, the contribution of the different TRAP pollutants in each microenvironment (home, school, transportation, others) in asthmatic and non‐asthmatic children is unknown. Daily (24‐h) personal black carbon (BC), ultrafine particle (UFP), and alveolar lung‐deposited surface area (LDSA) individual exposure measurements were obtained from 100 children (29 past and 21 current asthmatics, 50 non‐asthmatics) aged 9±0.7 years from the INMA‐Sabadell cohort (Catalonia, Spain). Time spent in each microenvironment was derived by the geolocation provided by the smartphone and a new spatiotemporal map‐matching algorithm. Asthmatics and non‐asthmatics spent the same amount of time at home (60% and 61%, respectively), at school (20% and 23%), on transportation (8% and 7%), and in other microenvironments (7% and 5%). The highest concentrations of all TRAPs were attributed to transportation. No differences in TRAP concentrations were found overall or by type of microenvironment between asthmatics and non‐asthmatics, nor when considering past and current asthmatics, separately. In conclusion, asthmatic and non‐asthmatic children had a similar time‐activity pattern and similar average exposures to BC, UFP, and LDSA concentrations. This suggests that interventions should be tailored to general population, rather than to subgroups defined by disease.     

Personal measurement of exposure to black carbon and ultrafine particles in schoolchildren from PARIS cohort (Paris,France)

This study aimed to measure in French children personal exposure concentrations of black carbon (BC) and ultrafine particles (UFP) and to quantify the contribution of different microenvironments (home, school, places of extracurricular activities, transport) to their total exposure. It was conducted on 96 9‐year‐old children from the PARIS birth cohort. BC and UFP were continuously measured by portable devices (microAeth^® AE51 and DiSCmini^®) for a minimum of 24 hours, while participating families simultaneously filled in a space‐time‐activities‐budget questionnaire. BC exposure concentration was higher during trips (principally metro/train and bus), while UFP exposure concentration was higher during indoor activities (mainly eating at restaurants) and in trips. The most important UFP peaks were measured at home, especially during cooking. Home and school together accounted for much of the total exposure, 83.8% for BC and 85.3% for UFP. The contribution of transport to total exposure was 12.4% for BC and 9.7% for UFP, while extracurricular activities were responsible for 3.8% and 5% of the total exposure to BC and UFP, respectively.     

Association of size‐fractionated indoor particulate matter and black carbon with heart rate variability in healthy elderly women in Beijing

Associations between size‐fractionated indoor particulate matter (PM) and black carbon (BC) and heart rate variability (HRV) and heart rate (HR) in elderly women remain unclear. Twenty‐nine healthy elderly women were measured for 24‐hour HRV/HR indices. Real‐time size‐fractionated indoor PM and BC were monitored on the same day and on the preceding day. Mixed‐effects models were applied to investigate the associations between pollutants and HRV/HR indices. Increases in size‐fractionated indoor PM were significantly associated with declines in power in the high‐frequency band (HF), power in the low‐frequency band (LF), and standard deviation of all NN intervals (SDNN). The largest decline in HF was 19% at 5‐minute moving average for an interquartile range (IQR) increase (24 μg/m³) in PM_0.5. The results showed that smaller particles could lead to greater reductions in HRV indices. The reported associations were modified by body mass index (BMI): Declines in HF at 5‐minute average for an IQR increase in PM_0.5 were 34.5% and 1.0% for overweight (BMI ≥25 kg/m²) and normal‐weight (BMI <25 kg/m²) participants, respectively. Moreover, negative associations between BC and HRV indices were found to be significant in overweight participants. Increases in size‐fractionated indoor PM and BC were associated with compromised cardiac autonomic function in healthy elderly women, especially overweight ones.     

Impact of a cleaner‐burning cookstove intervention on blood pressure in Nicaraguan women

Few studies have evaluated the cardiovascular‐related effects of indoor biomass burning or the role of characteristics such as age and obesity status, in this relationship. We examined the impact of a cleaner‐burning cookstove intervention on blood pressure among Nicaraguan women using an open fire at baseline; we also evaluated heterogeneity of the impact by subgroups of the population. We evaluated changes in systolic and diastolic blood pressure from baseline to post‐intervention (range: 273–383 days) among 74 female cooks. We measured indoor fine particulate matter (PM_2.5; N = 25), indoor carbon monoxide (CO; N = 32), and personal CO (N = 30) concentrations. Large mean reductions in pollutant concentrations were observed for all pollutants; for example, indoor PM_2.5 was reduced 77% following the intervention. However, pollution distributions (baseline and post‐intervention) were wide and overlapping. Although substantial reductions in blood pressure were not observed among the entire population, a 5.9 mmHg reduction [95% confidence interval (CI): ?11.3, ?0.4] in systolic blood pressure was observed among women aged 40 or more years and a 4.6 mmHg reduction (95% CI: ?10.0, 0.8) was observed among obese women. Results from this study provide an indication that certain subgroups may be more likely to experience improvements in blood pressure following a cookstove intervention.     

Chimney stoves modestly improved Indoor Air Quality measurements compared with traditional open fire stoves: results from a small‐scale intervention study in rural Peru

Nearly half of the world's population depends on biomass fuels to meet domestic energy needs, producing high levels of pollutants responsible for substantial morbidity and mortality. We compare carbon monoxide (CO) and particulate matter (PM_2.5) exposures and kitchen concentrations in households with study‐promoted intervention (OPTIMA‐improved stoves and control stoves) in San Marcos Province, Cajamarca Region, Peru. We determined 48‐h indoor air concentration levels of CO and PM_2.5 in 93 kitchen environments and personal exposure, after OPTIMA‐improved stoves had been installed for an average of 7 months. PM_2.5 and CO measurements did not differ significantly between OPTIMA‐improved stoves and control stoves. Although not statistically significant, a post hoc stratification of OPTIMA‐improved stoves by level of performance revealed mean PM_2.5 and CO levels of fully functional OPTIMA‐improved stoves were 28% lower (n = 20, PM_2.5, 136 μg/m³ 95% CI 54–217) and 45% lower (n = 25, CO, 3.2 ppm, 95% CI 1.5–4.9) in the kitchen environment compared with the control stoves (n = 34, PM_2.5, 189 μg/m³, 95% CI 116–261; n = 44, CO, 5.8 ppm, 95% CI 3.3–8.2). Likewise, although not statistically significant, personal exposures for OPTIMA‐improved stoves were 43% and 17% lower for PM_2.5 (n = 23) and CO (n = 25), respectively. Stove maintenance and functionality level are factors worthy of consideration for future evaluations of stove interventions.     

A comparative study of human exposures to household air pollution from commonly used cookstoves in Sri Lanka

Solid fuel burning cookstoves are a major source of household air pollution (HAP) and a significant environmental health risk in Sri Lanka. We report results of the first field study in Sri Lanka to include direct measurements of both real‐time indoor concentrations and personal exposures of fine particulate matter (PM_2.5) in households using the two most common stove types in Sri Lanka. A purposive sample of 53 households was selected in the rural community of Kopiwatta in central Sri Lanka, roughly balanced for stove type (traditional or improved ‘Anagi’) and ventilation (chimney present or absent). At each household, 48‐h continuous real‐time measurements of indoor kitchen PM_2.5 and personal (primary cook) PM_2.5 concentrations were measured using the RTI MicroPEM^? personal exposure monitor. Questionnaires were used to collect data related to household demographics, characteristics, and self‐reported health symptoms. All primary cooks were female and of an average age of 47 years, with 66% having completed primary education. Median income was slightly over half the national median monthly income. Use of Anagi stoves was positively associated with a higher education level of the primary cook (P = 0.026), although not associated with household income (P = 0.18). The MicroPEM monitors were well‐received by participants, and this study's valid data capture rate exceeded 97%. Participant wearing compliance during waking hours was on average 87.2% on Day 1 and 83.3% on Day 2. Periods of non‐compliance occurred solely during non‐cooking times. The measured median 48‐h average indoor PM_2.5 concentration for households with Anagi stoves was 64 μg/m³ if a chimney was present and 181 μg/m³ if not. For households using traditional stoves, these values were 70 μg/m³ if a chimney was present and 371 μg/m³ if not. Overall, measured indoor PM_2.5 concentrations ranged from a minimum of 33 μg/m³ to a maximum of 940 μg/m³, while personal exposure concentrations ranged from 34 to 522 μg/m³. Linear mixed effects modeling of the dependence of indoor concentrations on stove type and presence or absence of chimney showed a significant chimney effect (65% reduction; P < 0.001) and an almost significant stove effect (24% reduction; P = 0.054). Primary cooks in households without chimneys were exposed to substantially higher levels of HAP than those in households with chimneys, while exposures in households with traditional stoves were moderately higher than those with improved Anagi stoves. As expected, simultaneously measuring both indoor concentrations and personal exposure levels indicate significant exposure misclassification bias will likely result from the use of a stationary monitor as a proxy for personal exposure. While personal exposure monitoring is more complex and expensive than deploying simple stationary devices, the value an active personal PM monitor like the MicroPEM adds to an exposure study should be considered in future study designs.     

Spatiotemporally resolved black carbon concentration,schoolchildren's exposure and dose in Barcelona

At city level, personal monitoring is the best way to assess people's exposure. However, it is usually estimated from a few monitoring stations. Our aim was to determine the exposure to black carbon (BC) and BC dose for 45 schoolchildren with portable microaethalometers and to evaluate the relationship between personal monitoring and fixed stations at schools (indoor and outdoor) and in an urban background (UB) site. Personal BC concentra‐tions were 20% higher than in fixed stations at schools. Linear mixed‐effect models showed low R² between personal measurements and fixed stations at schools (R² ≤ 0.28), increasing to R² ≥ 0.70 if considering only periods when children were at schools. For the UB station, the respective R² were 0.18 and 0.45, indicating the importance of the distance to the monitoring station when assessing exposure. During the warm season, the fixed stations agreed better with personal measurements than during the cold one. Children spent 6% of their time on commuting but received 20% of their daily BC dose, due to co‐occurrence with road traffic rush hours and the close proximity to the source. Children received 37% of their daily‐integrated BC dose at school. Indoor environments (classroom and home) were responsible for the 56% BC dose.     

Particulate matter chemical component concentrations and sources in settings of household solid fuel use

Particulate matter (PM) air pollution derives from combustion and non‐combustion sources and consists of various chemical species that may differentially impact human health and climate. Previous reviews of PM chemical component concentrations and sources focus on high‐income urban settings, which likely differ from the low‐ and middle‐income settings where solid fuel (ie, coal, biomass) is commonly burned for cooking and heating. We aimed to summarize the concentrations of PM chemical components and their contributing sources in settings where solid fuel is burned. We searched the literature for studies that reported PM component concentrations from homes, personal exposures, and direct stove emissions under uncontrolled, real‐world conditions. We calculated weighted mean daily concentrations for select PM components and compared sources of PM determined by source apportionment. Our search criteria yielded 48 studies conducted in 12 countries. Weighted mean daily cooking area concentrations of elemental carbon, organic carbon, and benzo(a)pyrene were 18.8 μg m^?3, 74.0 μg m^?3, and 155 ng m^?3, respectively. Solid fuel combustion explained 29%‐48% of principal component/factor analysis variance and 41%‐87% of PM mass determined by positive matrix factorization. Multiple indoor and outdoor sources impacted PM concentrations and composition in these settings, including solid fuel burning, mobile emissions, dust, and solid waste burning.     

Cardiovascular benefits of reducing personal exposure to traffic‐related noise and particulate air pollution: A randomized crossover study in the Beijing subway system

To assess the cardiovascular benefits of protecting against particulate air pollution and noise, we conducted a randomized crossover study with 40 young healthy college students from March to May 2017 in the underground subway, Beijing. Participants each received 4 treatments (no intervention phase [NIP], respirator intervention phase [RIP], headphone intervention phase [HIP], respirator plus headphone intervention phase [RHIP]) in a randomized order during 4 different study periods with 2‐week washout intervals. We measured personal exposure to particulate matter (PM), noise and electrocardiogram (ECG) parameters (heart rate variability (HRV), heart rate (HR) and ST segment changes), ambulatory blood pressure (BP) continuously for 4 hours to investigate the cardiovascular effects. Compared with NIP, most of the HRV parameters increased, especially high frequency (HF) [21.1% (95% CI: 15.7%, 26.9%), 18.2% (95% CI: 12.8%, 23.9%), and 35.5% (95% CI: 29.3%, 42.0%) in RIP, HIP, and RHIP, respectively], whereas ST segment elevation and HR decreased for all 3 modes of interventions. However, no significant differences were observed in BP among the 4 treatments. In summary, short‐term wearing of a respirator and/or headphone may be an effective way to minimize cardiovascular risk induced by air pollution in the subway by improving autonomic nervous function.     

Evaluation of ozone emissions and exposures from consumer products and home appliances

Ground‐level ozone can cause serious adverse health effects and environmental impacts. This study measured ozone emissions and impacts on indoor ozone levels and associated exposures from 17 consumer products and home appliances that could emit ozone either intentionally or as a by‐product of their functions. Nine products were found to emit measurable ozone, one up to 6230 ppb at a distance of 5 cm (2 inches). One use of these products increased room ozone concentrations by levels up to 106 ppb (mean, from an ozone laundry system) and personal exposure concentrations of the user by 12–424 ppb (mean). Multiple cycles of use of one fruit and vegetable washer increased personal exposure concentrations by an average of 2550 ppb, over 28 times higher than the level of the 1‐h California Ambient Air Quality Standard for ozone (0.09 ppm). Ozone emission rates ranged from 1.6 mg/h for a refrigerator air purifier to 15.4 mg/h for a fruit and vegetable washer. The use of some products was estimated to contribute up to 87% of total daily exposures to ozone. The results show that the use of some products may result in potential health impacts.     

Exposure to household air pollution from biomass‐burning cookstoves and HbA1c and diabetic status among Honduran women

Household air pollution from biomass cookstoves is estimated to be responsible for more than two and a half million premature deaths annually, primarily in low and middle‐income countries where cardiometabolic disorders, such as Type II Diabetes, are increasing. Growing evidence supports a link between ambient air pollution and diabetes, but evidence for household air pollution is limited. This cross‐sectional study of 142 women (72 with traditional stoves and 70 with cleaner‐burning Justa stoves) in rural Honduras evaluated the association of exposure to household air pollution (stove type, 24‐hour average kitchen and personal fine particulate matter [PM_2.5] mass and black carbon) with glycated hemoglobin (HbA1c) levels and diabetic status based on HbA1c levels. The prevalence ratio (PR) per interquartile range increase in pollution concentration indicated higher prevalence of prediabetes/diabetes (vs normal HbA1c) for all pollutant measures (eg, PR per 84 μg/m³ increase in personal PM_2.5, 1.49; 95% confidence interval [CI], 1.11‐2.01). Results for HbA1c as a continuous variable were generally in the hypothesized direction. These results provide some evidence linking household air pollution with the prevalence of prediabetes/diabetes, and, if confirmed, suggest that the global public health impact of household air pollution may be broader than currently estimated.     

Personal daily exposures to benzo(a)pyrene of taxi drivers in Genoa, Italy

Twenty-four hour personal exposures (both occupational and environmental) to benzo(a)pyrene (BaP) of 15 taxi drivers working in Genoa, Italy, were monitored in May-July 1998 (15 samplings), February 1999 (7 samplings) and June 1999 (7 samplings). The mean BaP exposures measured at these different times were 1.4 ng/m3, 1.23 ng/m3 and 1.22 ng/m3, respectively, values were significantly greater than the levels found in controls (0.16+/-0.2 ng/m3). Mean daily personal BaP exposures of taxi drivers were not statistically different from the mean daily airborne BaP concentrations measured by fixed samplers during the same sampling periods.     

Maternal exposure to carbon monoxide and fine particulate matter during pregnancy in an urban Tanzanian cohort

Low birthweight contributes to as many as 60% of all neonatal deaths; exposure during pregnancy to household air pollution has been implicated as a risk factor. Between 2011 and 2013, we measured personal exposures to carbon monoxide (CO) and fine particulate matter (PM_2.5) in 239 pregnant women in Dar es Salaam, Tanzania. CO and PM_2.5 exposures during pregnancy were moderately high (geometric means 2.0 ppm and 40.5 μg/m³); 87% of PM_2.5 measurements exceeded WHO air quality guidelines. Median and high (75th centile) CO exposures were increased for those cooking with charcoal and kerosene versus kerosene alone in quantile regression. High PM_2.5 exposures were increased with charcoal use. Outdoor cooking reduced median PM_2.5 exposures. For PM_2.5, we observed a 0.15 kg reduction in birthweight per interquartile increase in exposure (23.0 μg/m³) in multivariable linear regression; this finding was of borderline statistical significance (95% confidence interval 0.30, 0.00 kg; P = 0.05). PM_2.5 was not significantly associated with birth length or head circumference nor were CO exposures associated with newborn anthropometrics. Our findings contribute to the evidence that exposure to household air pollution, and specifically fine particulate matter, may adversely affect birthweight.     

Predicting personal exposure of pregnant women to traffic-related air pollutants

As epidemiological studies report associations between ambient air pollution and adverse birth outcomes, it is important to understand determinants of exposures among pregnant women. We measured (48-h, personal exposure) and modeled (using outdoor ambient monitors and a traffic-based land-use regression model) NO, NO(2), fine particle mass and absorbance in 62 non-smoking pregnant women in Vancouver, Canada on 1-3 occasions during pregnancy (total N=127). We developed predictive models for personal measurements using modeled ambient concentrations and individual determinants of exposure. Geometric mean exposures of personal samples were relatively low (GM (GSD) NO=37 ppb (2.0); NO(2)=17 ppb (1.6); 'soot', as filter absorbance=0.8 10(-5) m(-1) (1.5); PM(2.2)=10 microg m(-3) (1.6)). Having a gas stove (vs. electric stove) in the home was associated with exposure increases of 89% (NO), 44% (NO(2)), 20% (absorbance) and 35% (fine PM). Interpolated concentrations from outdoor fixed-site monitors were associated with all personal exposures except NO(2). Land-use regression model estimates of outdoor air pollution were associated with personal NO and NO(2) only. The effects of outdoor air pollution on personal samples were consistent, with and without adjustment for other individual determinants (e.g. gas stove). These findings improve our understanding of sources of exposure to air pollutants among pregnant women and support the use of outdoor concentration estimates as proxies for exposure in epidemiologic studies.     

VOC exposures in California early childhood education environments

Little information exists about exposures to volatile organic compounds (VOCs) in early childhood education (ECE) environments. We measured 38 VOCs in single‐day air samples collected in 2010‐2011 from 34 ECE facilities serving California children and evaluated potential health risks. We also examined unknown peaks in the GC/MS chromatographs for indoor samples and identified 119 of these compounds using mass spectral libraries. VOCs found in cleaning and personal care products had the highest indoor concentrations (d‐limonene and decamethylcyclopentasiloxane [D5] medians: 33.1 and 51.4 μg/m³, respectively). If reflective of long‐term averages, child exposures to benzene, chloroform, ethylbenzene, and naphthalene exceeded age‐adjusted “safe harbor levels” based on California's Proposition 65 guidelines (10^?5 lifetime cancer risk) in 71%, 38%, 56%, and 97% of facilities, respectively. For VOCs without health benchmarks, we used information from toxicological databases and quantitative structure–activity relationship models to assess potential health concerns and identified 12 VOCs that warrant additional evaluation, including a number of terpenes and fragrance compounds. While VOC levels in ECE facilities resemble those in school and home environments, mitigation strategies are warranted to reduce exposures. More research is needed to identify sources and health risks of many VOCs and to support outreach to improve air quality in ECE facilities.     

Exposure to ultrafine particles in children until 18 years of age: A systematic review

Airborne ultrafine particles (UFP) have been related to adverse health effects, but exposure in vulnerable population groups such as children is still not well understood. We aim to review the scientific literature regarding personal exposure to UFP in different microenvironments in populations until 18 years of age. The bibliographical search was carried out in July 2019 using the online database PubMed and was completed with references in articles found in the search. We selected the studies that used continuous counters and measured UFP levels in both specific microenvironment (houses, schools, transport, etc) and personal exposure. Finally, 32 studies fulfilled the criteria: of these, 10 analyzed personal exposure and 22 examined UFP levels in the microenvironment (especially in schools or nurseries (18/22)) and five in various microenvironments (including dwellings and means of transport, where exposure levels were higher). The characteristics of the microenvironments with the greatest levels of UFP were being close to heavy traffic or near cooking and cleaning activities. This review revealed the wide differences in exposure assessment methodologies that could lead to a lack of uniform and comparable information about the real UFP exposure in children.