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Causes for Concern: Air Quality and Health Effects

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Air quality affects the health of all people but some individuals ... Human odor threshold = 200 ppb. Limonene and Ozone. Mouse bioassay of airway irritation ... – PowerPoint PPT presentation

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Title: Causes for Concern: Air Quality and Health Effects


1
Causes for Concern Air Quality and Health Effects
  • Dennis Ownby, M.D.

2
You are what you BREATHE!
3
Major Issues
  • Air quality affects the health of all people but
    some individuals may be more susceptible to
    adverse effects
  • very young
  • lung diseases
  • heart disease
  • elderly
  • Are current air quality standards adequate to
    insure good health
  • Are there important interactions between air
    pollutants and other airborne materials

4
Environmental Tobacco Smoke
5
ETS Exposure and SIDS
  • Black infants
  • OR 2.9 with combined exposure OR 2.4 with
    passive exposure
  • White infants
  • OR 4.1 or combined exposure
  • OR 2.2 for passive exposure

Schoendorf KC, Kiely JL. Pediatr 199290905-908
6
Cigarette Smoke Exposure and Lower Respiratory
Tract Illness (LRTI)
  • Meta-analysis of 21 publications
  • 1966 - 1995
  • Hospitalization for LRTI if a parent smokes
  • OR 1.93 infants and children
  • OR 1.71 lt 2 years
  • OR 1.25 from 3 to 6 years

Li JS, et al. Pediatr Pulmonology 1999275-13
7
Environmental Tobacco Smoke
  • 43 percent of American children ages 211 are
    exposed to secondhand smoke at home
  • Secondhand smoke is responsible for an estimated
    3,000 lung cancer deaths among U.S. nonsmokers
    each year

8
Smoking by Children
  • 17.3 of 6th graders smoked every day!
  • 36.1 of 12th graders smoked every day!
  • Native Americans 43.7, white 37.8, and public
    school 28.5, had highest rates of smoking

Westphal J, et al. South Med J 200093579-84
9
Outdoor Pollution
10
Contribution of Air Pollution to Hospitalizations
  • National database, 1999-2002
  • hospital admission rates
  • Cardiovascular, respiratory outcomes
  • PM 2.5 levels
  • 204 US urban counties, gt200,000
  • 11.5 million Medicare enrollees, gt 65 years of age

Dominici F, et al. JAMA 20062951127-34
11
Contribution of Air Pollution to Hospitalizations
  • Short term exposure to PM 2.5 increased risk for
    hospitalization for all cardiovascular and
    respiratory diagnoses
  • Greatest increase with heart failure
  • 1.28 increase per 10 µg/m3

Dominici F, et al. JAMA 20062951127-34
12
Ozone and Mortality
  • Current and previous day ozone concentrations
    were significantly associated with acute
    myocardial infarctions in France
  • Especially in men 55-64 years old without prior
    ischemic heart disease

Ruidavits J-B, et al. Circulation 2005111563-69
13
Effects of Ozone on the Nose
  • 49 healthy, nonsmoking, men
  • Average age 23.54.2 years
  • Residents of Veracruz, Mexico
  • 35 men taken to Mexico City for 15 days, then
    returned to Veracruz
  • None had histories of nasal disease or nasal
    symptoms prior to the study
  • Complete physical and otorhinolaryngologic exams

Calderon-Garciduenas L, et al Environ Health
Perspect 19941021074-80
14
Effects of Ozone on the Nose
Percent of Subjects
Hours of Exposure in Mexico City
adapted from
Calderon-Garciduenas L, et al Environ Health
Perspect 19941021074-80
15
Asthma in Atlanta, 1996 Olympics
  • During the 1996 Olympic Games, acute asthma
    events in 1-16 year old children decreased
  • 41.6 in Medicaid data
  • 44.1 in HMO data
  • 11.1 in two pediatric EDs
  • 19.1 in hospital discharge data
  • Peak daily ozone decreased 27.9

Friedman MS, et al. JAMA 2001285897-905
16
Low-level Ozone and Fine Particles Associated
with Asthma Symptoms in Children
  • 271 children
  • Younger than 12 years
  • Physician diagnosed asthma
  • Living in southern New England
  • April 1 through September 30, 2001
  • 50-ppb increase in ozone
  • 35 increase in wheeze
  • 47 increase in chest tightness

Gent JF, et al. JAMA 20032901859-67
17
How to Potentiate Ozone Effects at Home
18
(No Transcript)
19
What is orange oil?
20
d-Limonene
  • Major component of the oil of citrus rinds
  • Most common terpene in the world
  • Made by gt300 plants
  • 6 oz of orange juice 5.49 mg
  • Black pepper, nutmeg, mango
  • Human odor threshold 200 ppb

21
Limonene and Ozone
  • Mouse bioassay of airway irritation
  • O3 at 4 ppm limonene at 48 ppm
  • Result 33 reduction in mean respiratory rate
    after 30 minutes of exposure of mice
  • Products formaldehyde, formic acid, acetone,
    acrolein, and acetic acid

Clausen PA, et al. Environment International
200126511-22
22
Association of VOC Exposure and Asthma
Rumchev K, et al. Thorax 200459746
23
Indoor Air and Adult Asthma
  • 330, 18-70 year old Denver residents invited to
    participate (mean age 46 years)
  • Asthma on medication
  • No other chronic medical conditions limiting
    activity
  • 164 nonsmokers submitted valid information
  • predominately white, female, well-educated,
    employed
  • 3 month history of daily symptoms, medication
    use, physician and ER visits, indoor exposures

Ostro BD, et al. Am J Resp Crit Care Med
19941491400-1406
24
Indoor Air and Adult Asthma
  • Nocturnal Asthma Restricted Activity
  • Source OR 95 p OR 95
    p
  • Gas stove 1.30 1.07-1.58 0.009 2.86
    2.27-3.59 0.0001
  • ETS 1.24 1.00-1.53 0.04 2.08
    1.63-2.64 0.0001
  • Work 1.19 1.00-1.42 0.05 1.08
    0.84-1.40 0.52
  • Fireplace 1.59 1.28-1.97 0.001 1.30
    0.97-1.76 0.08

Ostro BD, et al. Am J Resp Crit Care Med
19941491400-1406
25
What about air pollutants and allergies?
26
Why is It?
  • People in rural areas have higher exposure to
    allergens like grass and ragweed than city
    dwellers
  • City dwellers are more likely than those in rural
    areas to be allergic to grass and ragweed
  • Is there something in the city that increases
    allergies?

27
Diesel Exhaust and Allergens
  • Diesel exhaust particles are small enough to be
    inhaled in many cases
  • In laboratory experiments diesel exhaust
    particles are potent inducers of allergic
    responses to allergens
  • Is this important in our daily environment?

28
Road Traffic, Respiratory Symptoms, and Allergic
Sensitization in Children
  • 7-12 year old children from 24 Dutch schools near
    roadways
  • Monitored traffic as cars and trucks and air
    pollution at each school for 1 year
  • Lung function tests, BHR, allergen skin tests
  • ISAAC questionnaires of child respiratory symptoms

Janssen NAH, et al. Environ Health Perspect
20031111512-18
29
Road Traffic, Respiratory Symptoms, and Allergic
Sensitization in Children
  • Adjusted ORs for truck traffic and -
  • Respiratory symptoms
  • current wheeze 1.96 (0.88 - 4.38)
  • current conjunctivitis 2.57 (1.00 - 6.58)
  • hay fever ever 2.40 (0.77 - 7.49)
  • Skin prick tests
  • any allergen 1.38 (0.67 - 2.85)
  • outdoor allergen 2.83 (1.18 - 6.82)

Janssen NAH, et al. Environ Health Perspect
20031111512-18
30
Air Cleaners and Humidifiers or How We Improve
Indoor Air
31
Humidifiers
  • 3535 children Southern California
  • 1993 they were 4th, 7th, or 10th graders
  • Followed 5 years or to graduation
  • 256 new cases of asthma
  • Humidifier RR 1.7 (1.2-2.4)
  • Any pet RR 1.6 (1.0-2.5)
  • Dog RR 1.4 (1.0-2.0)

McConnell R. et al. Epidemiology 200213288-295
32
You are what you BREATHE!
33
In conclusion, On Earth Day, 1970, a famous
Georgia resident said
34
(No Transcript)
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