Urban and rural exposure to indoor air pollution from domestic biomass and coal burning across China

Although indoor air pollution (IAP) from solid fuel use in the households of the developing countries is estimated to be one of the main health risks worldwide, there is little knowledge of the actual exposure experienced by large populations. We have developed a method to estimate exposure to PM(10) from IAP for large populations, applied to different demographic groups in China. On a national basis we find that 80%-90% of exposure in the rural population results from IAP. For the urban population the contribution is somewhat lower, about 50%-60%. Average exposure is estimated at 340 microg/m(3) (SD 55) in southern cities, and 440 microg/m(3) (SD 40) in northern cities. For the rural population we find average exposure to be 750 microg/m(3) (SD 100) and 680 microg/m(3) (SD 65) in the south and north respectively. Quite surprisingly our results indicate that the heavily polluted northern provinces, largely dependent on coal and believed to have the population with the largest exposure burden, turn out to have medium exposure when IAP is included. We find that the largest exposure burden is in counties relying heavily on biomass, and that there are only small gender differences in exposure.     

Towards an integrative approach of improving indoor air quality

There seems to be a discrepancy between current Indoor Air Quality standards and end-users wishes and demands. Indoor air quality can be approached from three points of view: the human, the indoor air of the space and the sources contributing to indoor air pollution. Standards currently in use mainly address the indoor air of the space. “Other or additional” recommendations and guidelines are required to improve indoor air quality. Even though we do not fully understand the mechanisms behind the physical, chemical, physiological and psychological processes, it is still possible to identify the different ways to be taken regulatory, politically–socially (awareness), technically (process and product) and scientifically. Besides the fact that there is an urgent need to involve medicine and neuro-psychology in research to investigate the mechanisms behind dose-response, health effects and interactions between and with the other factors and parameters of the indoor environment and the human body and mind, a holistic approach is required including the sources, the air and last but not least the human beings (occupants) themselves. This paper mainly focuses on the European situation.     

Indoor air pollution from biomass combustion and respiratory symptoms of women and children in a Zimbabwean village

Rural areas of developing countries are particularly reliant on biomass for cooking and heating. Women and children in these areas are often exposed to high levels of pollutants from biomass combustion that is associated with a range of respiratory symptoms. Domestic exposure to carbon monoxide (CO) and respirable particles (RSPs) in association with respiratory symptoms among women and children in Zimbabwe was investigated in 48 households. Health status and household characteristics were also recorded. In this study, indoor levels of CO and RSPs exceeded World Health Organization (WHO) air quality guidelines in over 95% of kitchens. The level of indoor air pollutants was associated with the area of kitchen windows and the length of cooking time combined with the level of fire combustion. Prevalence of respiratory symptoms was 94% for women and 77% for children. In addition, women reporting respiratory symptoms were exposed to higher levels of RSPs when compared with those reporting no respiratory symptoms. The study results indicated that levels of indoor air pollutants in rural Zimbabwe may contribute to respiratory symptoms in both women and children. PRACTICAL IMPLICATIONS: Levels of respirable particles and carbon monoxide in kitchens in rural Zimbabwe are unacceptably high and measures to reduce levels should be undertaken. Based on the study findings, recommendations for increasing the area of kitchen windows may be considered as a practical method of reducing indoor air pollutants in rural Zimbabwe.     

The effect of ventilation strategies of child care centers on indoor air quality and respiratory health of children in Singapore

This paper reports the effects of ventilation strategies on indoor air quality (IAQ) and respiratory health of children within 104 child care centers (CCCs) in a hot and humid climate. The CCCs were categorized by ventilation strategies: natural (NV), air-conditioned and mechanically ventilated (ACMV), air-conditioned using split units (AC), and hybrid (NV and AC operated intermittently). The concentration levels of IAQ parameters in NV CCCs are characterized by the influence of the outdoors and good dilution of indoor pollutants. The lower ventilation rates in air-conditioned CCCs result in higher concentrations of occupant-related pollutants but lower outdoor pollutant ingress. This study also revealed lower prevalence for most asthma and allergy, and respiratory symptoms in children attending NV CCCs. In multivariate analyses controlled for the effects of confounders, the risk of current rhinitis among children is significantly higher if they attend mechanically ventilated CCCs compared to NV CCCs. Air-conditioned CCCs were also associated with higher adjusted prevalence ratio of severe phlegm and cough symptoms and lower respiratory illness. Finally, children attending CCCs with hybrid ventilation are at high risk for almost all the respiratory symptoms studied. PRACTICAL IMPLICATIONS: This large field study indicates that different ventilation strategies employed by child care centers can cause significant variations in the indoor air quality and prevalence of asthma, allergies and respiratory symptoms of attending children. The higher prevalence rates of allergic and respiratory symptoms among young children, whose immune system is still under-developed, in child care centers, whether fully or partially air-conditioned, suggest that ventilation and plausible growth and propagation mechanisms of allergens and infectious agents be further investigated.     

Inhalation intake fraction of pollutants from episodic indoor emissions

The intake fraction is the attributable pollutant mass inhaled by an exposed population per unit mass released from a source. In this paper, mathematical models are combined with empirical data to explore how intake fraction varies with governing parameters for episodic indoor pollutant releases, such as those from cleaning, cooking, or smoking. Broadly, the intake fraction depends on building-related factors (e.g., ventilation rate), occupant factors (e.g., occupancy), and pollutant dynamic factors (e.g., sorption). In the simple case of the episodic release of a nonreactive pollutant into a well-mixed indoor space with steady occupancy and constant ventilation and breathing rates, the intake fraction is the ratio of the occupants’ volumetric breathing rate to the building's ventilation flow rate. Factors such as incomplete mixing, time-varying occupancy, and sorptive interactions modify this basic relationship.     

A review: fungal exposure assessment in indoor environments

While the fungal exposure assessment was based on the determination of fungal propagules for a long time, recent progress has led to the development of methodology for other fungal agents, e.g. the fungal cell wall components, metabolites, and allergens, that may be responsible for health effects caused by fungal exposure. This review includes a summary of the sampling techniques and analytical methods that are currently used or are in progress for the fungal exposure assessment. Prospects for the future trends are also discussed. In the future, the development will focus on sampling techniques that allow longer sampling times, a higher sampling efficiency for relevant particle sizes, and better possibilities for a wide range of analyses. In addition, new or modified methodology based on chemical, immunochemical, and molecular biological techniques to measure fungal agents related to health effects will improve the understanding of biological responses caused by fungal exposure.     

Sources, concentrations, and risks of naphthalene in indoor and outdoor air

Naphthalene is a ubiquitous pollutant, and very high concentrations are sometimes encountered indoors when this chemical is used as a pest repellent or deodorant. This study describes the distribution and sources of vapor-phase naphthalene concentrations in four communities in southeast Michigan, USA. Outdoors, naphthalene was measured in the communities and at a near-road site. Indoors, naphthalene levels were characterized in 288 suburban and urban homes. The median outdoor concentration was 0.15 μg/m(3), and a modest contribution from rush-hour traffic was noted. The median indoor long-term concentration was 0.89 μg/m(3), but concentrations were extremely skewed and 14% of homes exceeded 3 μg/m(3), the chronic reference concentration for non-cancer effects, 8% exceeded 10 μg/m(3), and levels reached 200 μg/m(3). The typical excess individual lifetime cancer risk was about 10(-4) and reached 10(-2) in some homes. Important sources include naphthalene's use as a pest repellent and deodorant, migration from attached garages and, to lesser extents, cigarette smoke and vehicle emissions. Excessive use as a repellent caused the highest concentrations. Naphthalene presents high risks in a subset of homes, and policies and actions to reduce exposures, for example, sales bans or restrictions, improved labeling, and consumer education, should be considered. PRACTICAL IMPLICATIONS: Long-term average concentrations of naphthalene in most homes fell into the 0.2-1.7 μg/m(3) range reported as representative in earlier studies. The highly skewed distribution of concentrations results in a subset of homes with elevated concentrations and health risks that greatly exceed US EPA and World Health Organization (WHO) guidelines. The most important indoor source is the use of naphthalene as a pest repellant or deodorant; secondary sources include presence of an attached garage, cigarette smoking, and outdoor sources. House-to-house variation was large, reflecting differences among the residences and naphthalene use practices. Stronger policies and educational efforts are needed to eliminate or modify indoor usage practices of this chemical.     

Two Moldy Day-care Centers: a Follow-up Study of Respiratory Symptoms and Infections

Abstract The aim was to study the respiratory symptoms among children exposed to indoor air molds in a day-care environment in Finland. Two day-care centers with a mold problem and two reference day-care centers were included in the study and the health data of the children were collected with a follow-up study of two periods. A total of 229 children 3-7 years old attended the day-care centers. During the first follow-up period, the children in the two day-care centers with mold problems had a significantly increased risk of sore throat, purulent and non-purulent nasal discharge, nasal congestion, hoarseness and common cold. During the second follow-up period, a significantly increased risk of purulent nasal discharge, nasal congestion, hoarseness and cough was observed. Upper respiratory tract symptoms, at least once during the study period, were more prevalent among the children attending mold-problem day-care centers. The mold-exposed children had such symptoms repeatedly or the symptoms were prolonged. In conclusion, in the mold-problem day-care centers, overall morbidity for respiratory symptoms and for common cold increased in comparison with the reference day-care centers.     

Status of the indoor air chemical pollution in Japanese houses based on the nationwide field survey from 2000 to 2005

This paper describes the present state and the changes in indoor air pollution levels by Volatile Organic Compounds (VOCs) in houses in Japan, as revealed through measurements of indoor VOC concentrations and investigations on the actual conditions in the residential environment by means of a questionnaire survey covering a total of more than 10,000 newly built houses over six years (from 2000 to 2005). The VOCs initially measured were formaldehyde, toluene, xylene, and ethylbenzene, followed by the subsequent inclusion of styrene and acetaldehyde.     

Indoor air quality in Michigan schools

Indoor air quality (IAQ) parameters in 64 elementary and middle school classrooms in Michigan were examined for the purposes of assessing ventilation rates, levels of volatile organic compounds (VOCs) and bioaerosols, air quality differences within and between schools, and emission sources. In each classroom, bioaerosols, VOCs, CO(2), relative humidity, and temperature were monitored over one workweek, and a comprehensive walkthough survey was completed. Ventilation rates were derived from CO(2) and occupancy data. Ventilation was poor in many of the tested classrooms, e.g., CO(2) concentrations often exceeded 1000 ppm and sometimes 3000 ppm. Most VOCs had low concentrations (mean of individual species <4.5 microg/m(3)); bioaerosol concentrations were moderate (<6500 count per m(3) indoors, <41,000 count per m(3) outdoors). The variability of CO(2), VOC, and bioaerosol concentrations within schools exceeded the variability between schools. These findings suggest that none of the sampled rooms were contaminated and that no building-wide contamination sources were present. However, localized IAQ problems might remain in spaces where contaminant sources are concentrated and that are poorly ventilated. PRACTICAL IMPLICATIONS: Indoor air quality (IAQ) is a continuing concern for students, parents, teachers, and school staff, leading to many complaints regarding poor IAQ. Investigations of these complaints often include air sampling, which must be carefully conducted if representative data are to be collected. To better understand sampling results, investigators need to account for the variability of contaminants both within and between schools.     

The Danish Twin Apartment Study – Part II: Mathematical modeling of the relative strength of sources of indoor air pollution

Abstract This study deals with the modeling of air pollution in apartments from laboratory measurements of source strengths, using formaldehyde and Total Volatile Organic Compounds (TVOCs) as model pollutants. The sources in two test apartments were grouped into two: building-related sources and occupant-related sources. The measured source strengths and ventilation rates were used for the prediction of concentrations expected in the apartments. These predictions were compared to measurements in the apartment over 12 months. The conclusions were that the model predictions based on emission rates measured in the laboratory can be used to predict the long-term concentration of the two model pollutants in the apartments. Considering the measured differences in ventilation between the apartments, an occupant emission rate of between 0.2 and 0.3 mg/h/kg body weight could be estimated. Based on previous suggested limits of acceptable exposures of humans to VOCs, an acceptable average emission rate of VOCs from building materials in general was estimated to be about 30 (μ/m²/h. The modeling showed that during the first 200 days, building materials dominated the emissions. After this, sources relating to the occupants dominated. On average about half of the VOC pollution originated from the building materials.     

Contribution of incense burning to indoor PM10 and particle-bound polycyclic aromatic hydrocarbons under two ventilation conditions

Burning incense to worship Gods and ancestors is a traditional practice prevalent in Asian societies. This work investigated indoor PM10 concentrations resulting from incense burning in household environments under two conditions: closed and ventilated. The exposure concentrations of particle-bound polycyclic aromatic hydrocarbons (PAHs) were estimated. The factors of potential exposure were also evaluated. Under both conditions, samples were taken at three locations: 0.3, 3.5 and 7 m away from the altar during three periods: incense burning, the first 3 h, and the 4-6 h after cessation of combustion. PAH concentrations of incense smoke were assessed in the laboratory. Personal environment monitors were used as sampling instruments. The results showed a significant contribution of incense burning to indoor PM10 and particulate PAH concentrations. PM10 concentrations near the altar during incense burning were 723 and 178 microg/m3, more than nine and 1.6 times background levels, under closed and ventilated conditions, respectively. Exposure concentrations of particle-bound PAHs were 0.088-0.45 microg/m3 during incense burning. On average, PM10 and associated PAH concentrations were about 371 and 0.23 microg/m3 lower, respectively, in ventilated environments compared with closed conditions. Concentrations were elevated for at least 6 h under closed conditions.     

Contribution of solid fuel, gas combustion, or tobacco smoke to indoor air pollutant concentrations in Irish and Scottish homes

There are limited data describing pollutant levels inside homes that burn solid fuel within developed country settings with most studies describing test conditions or the effect of interventions. This study recruited homes in Ireland and Scotland where open combustion processes take place. Open combustion was classified as coal, peat, or wood fuel burning, use of a gas cooker or stove, or where there is at least one resident smoker. Twenty-four-hour data on airborne concentrations of particulate matter<2.5 μm in size (PM2.5), carbon monoxide (CO), endotoxin in inhalable dust and carbon dioxide (CO2), together with 2-3 week averaged concentrations of nitrogen dioxide (NO2) were collected in 100 houses during the winter and spring of 2009-2010. The geometric mean of the 24-h time-weighted-average (TWA) PM2.5 concentration was highest in homes with resident smokers (99 μg/m3--much higher than the WHO 24-h guidance value of 25 μg/m3). Lower geometric mean 24-h TWA levels were found in homes that burned coal (7 μg/m3) or wood (6 μg/m3) and in homes with gas cookers (7 μg/m3). In peat-burning homes, the average 24-h PM2.5 level recorded was 11 μg/m3. Airborne endotoxin, CO, CO2, and NO2 concentrations were generally within indoor air quality guidance levels. PRACTICAL IMPLICATIONS: Little is known about indoor air quality (IAQ) in homes that burn solid or fossil-derived fuels in economically developed countries. Recent legislative changes have moved to improve IAQ at work and in enclosed public places, but there remains a real need to begin the process of quantifying the health burden that arises from indoor air pollution within domestic environments. This study demonstrates that homes in Scotland and Ireland that burn solid fuels or gas for heating and cooking have concentrations of air pollutants generally within guideline levels. Homes where combustion of cigarettes takes place have much poorer air quality.     

Measuring the exposure of infants and children to indoor air pollution from biomass fuels in The Gambia

Indoor air pollution (IAP) from biomass fuels contains high concentrations of health damaging pollutants and is associated with an increased risk of childhood pneumonia. We aimed to design an exposure measurement component for a matched case-control study of IAP as a risk factor for pneumonia and severe pneumonia in infants and children in The Gambia. We conducted co-located simultaneous area measurement of carbon monoxide (CO) and particles with aerodynamic diameter <2.5 microm (PM(2.5)) in 13 households for 48 h each. CO was measured using a passive integrated monitor and PM(2.5) using a continuous monitor. In three of the 13 households, we also measured continuous PM(2.5) concentration for 2 weeks in the cooking, sleeping, and playing areas. We used gravimetric PM(2.5) samples as the reference to correct the continuous PM(2.5) for instrument measurement error. Forty-eight hour CO and PM(2.5) concentrations in the cooking area had a correlation coefficient of 0.80. Average 48-h CO and PM(2.5) concentrations in the cooking area were 3.8 +/- 3.9 ppm and 361 +/- 312 microg/m3, respectively. The average 48-h CO exposure was 1.5 +/- 1.6 ppm for children and 2.4 +/- 1.9 ppm for mothers. PM(2.5) exposure was an estimated 219 microg/m3 for children and 275 microg/m3 for their mothers. The continuous PM(2.5) concentration had peaks in all households representing the morning, midday, and evening cooking periods, with the largest peak corresponding to midday. The results are used to provide specific recommendations for measuring the exposure of infants and children in an epidemiological study. PRACTICAL IMPLICATIONS: Measuring personal particulate matter (PM) exposure of young children in epidemiological studies is hindered by the absence of small personal monitors. Simultaneous measurement of PM and carbon monoxide suggests that a combination of methods may be needed for measuring children's PM exposure in areas where household biomass combustion is the primary source of indoor air pollution. Children's PM exposure in biomass burning homes in The Gambia is substantially higher than concentrations in the world's most polluted cities.     

Potential health benefit of reducing household solid fuel use in Shanxi province, China

Indoor air pollution from solid fuel use has severe health effects. 60% of the Chinese population lives in rural areas, where most people rely on solid fuels for cooking and heating. We estimate exposure by combining information on the amount of time spent in different microenvironments and estimates of the particle concentrations (PM(10)) in these environments. According to our estimates, 70% of the exposure experienced by the rural population is due to indoor air pollution (IAP). The urban coal using population experience a 17% increase in exposure from IAP. We apply Monte Carlo simulations to quantify variability and uncertainty in the exposure, morbidity and mortality estimates. We find that applying Monte Carlo simulations reduces the estimated uncertainty compared to analytical methods based on approximate distributions and the central limit theorem. We find that annually about 4% (geometric S.D. sigma(g), 3.2) and 35% (sigma(g), 2.6) of the deaths in the urban and rural populations, respectively, could be avoided by switching to clean fuels. Upgrading the stoves in rural areas to the standard found in urban areas is estimated to reduce mortality by 23% (sigma(g), 3.1). Moreover, we estimate that chronic respiratory illness (CRI) in children can be reduced by, respectively, about 9% (sigma(g), 2.5) and 80% (sigma(g) 1.9) by switching to clean fuels in the urban and rural areas. Upgrading the stoves in rural areas is estimated to reduce CRI in children with about 58% (sigma(g) 2.3). For adults the reduction in CRI was estimated to be 6% (sigma(g) 2.4) and 45% (sigma(g) 1.8) for the urban and rural population following a fuel switch, and 31% (sigma(g) 2.4) for the rural population from stove improvements. Contrary to our expectations we find small gender differences in exposure. We ascribe that to comparable kitchen and living area concentrations and similar indoor occupation times for the genders. Young children and the elderly spend the most time indoors, and have the highest daily exposure in the coal using population. The rural population experience higher exposure than the urban population, even though the outdoor air is significantly cleaner in rural areas.     

Respiratory inflammatory responses among occupants of a water-damaged office building

The National Institute for Occupational Safety and Health (NIOSH) received a request for evaluation of a water-damaged office building which housed approximately 1300 employees. Workers reported respiratory conditions that they perceived to be building related. We hypothesized that these symptoms were associated with airways inflammation. To test this hypothesis, we assessed airways inflammation in employees using exhaled breath condensate (EBC) and the fraction of exhaled nitric oxide (FENO). In September 2001, a health questionnaire was offered to all employees. Based on this questionnaire, NIOSH invited 356 symptomatic and asymptomatic employees to participate in a medical survey. In June 2002, these employees were offered questionnaire, spirometry, methacholine challenge test, allergen skin prick testing, EBC and FENO. FENO or EBC were completed by 239 participants. As smoking is highly related to the measurements that we used in this study, we included only the 207 current non-smokers in the analyses. EBC interleukin-8 (IL-8) levels, but not nitrite, were significantly higher among workers with respiratory symptoms and in the physician-diagnosed asthmatic group. Of the analyses assessed, EBC IL-8 showed the most significant relationship with a number of symptoms and physician-diagnosed asthma. PRACTICAL IMPLICATIONS: Implementation of exhaled breath condensate and exhaled nitric oxide in indoor air quality problems.     

The link between symptoms of office building occupants and in-office air pollution: the Indoor Air Pollution Index

The lack of an effective indoor air quality (IAQ) metric causes communication concerns among building tenants (the public), building managers (decision-makers), and IAQ investigators (engineers). The Indoor Air Pollution Index (IAPI) is developed for office buildings to bridge this communication discord. The index, simple and easily understood, employs the range of pollutant concentrations and concentrations in the subject building to estimate a unitless single number, the IAPI, between 0 (lowest pollution level and best IAQ) and ten (highest pollution level and worst IAQ). The index provides a relative measure of indoor air pollution for office buildings and ranks office indoor air pollution relative to the index distribution of the US office building population. Furthermore, the index associates well with occupant symptoms, percentage of occupants with persistent symptoms. A tree-structured method is utilized in conjunction with the arithmetic mean as the aggregation function. The hierarchical structure of the method renders not only one index value, but also several sub-index values that are critical in the study of an office air environment. The use of the IAPI for IAQ management is illustrated with an example. The decomposition of the index leads to the ranking of sampled pollutants by their relative contribution to the index and the identification of dominant pollutant(s). This information can be applied to design an effective strategy for reducing in-office air pollution.