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In 2019, a domestic raw coal ban (RCB) was introduced in Ulaanbaatar, Mongolia. Coal-briquettes have since been promoted in Ger district households, however implications for carbon monoxide (CO) exposure remains uncertain. We obtained 48-hour indoor CO concentrations in 23 Ger district households and compared these to 10 raw-coal households. Information on household characteristics, fuel use behaviour and stove venting practices was collected by survey. Mean 48-hour CO concentrations in coal-briquette households was 6.1 ppm (range 1.5-35.8 ppm) with no signfiicant differences by household, stove or venting factors. Peak time-weighted average CO concentrations exceeded WHO Indoor Air Quality guidelines in 9 (39%) households; with all surpassing the 8-hour guideline (>8.6 ppm); 3(13%) the 24-hour guideline (>6 ppm) and 2(9%) the 1-hour guideline (>30 ppm). Median CO levels were significantly lower in coal-briquette compared to raw coal households (p = 0.049). Indoor CO reduction was associated with RCB implementation although hazardous levels persist in this setting.

This study investigated the correlation between the concentration of air pollutants in two metropolitan cities, Seoul and Incheon, located in South Korea with different urban characteristics and the number of patients with circulatory diseases among residents exposed to air pollution. The residential area was selected as Eunpyeong-gu of Seoul Metropolitan City and the industrial area as Jung-gu of Incheon Metropolitan City. The evaluation period is between 2015 and 2016. The relevant data provide by the Korea governmental agency were analysed to derive the purpose of this study. It was confirmed that PM 10 , PM 2.5 , nitrogen dioxide, carbon monoxide, and sulfur dioxide among air pollutants had an increasing impact on the incidence rate of circulatory diseases. The PM 2.5 was positively correlated with the incidence rate of all circulatory diseases in residential area (p < 0.05). The carbon monoxide showed a positive correlation with circulatory system diseases except for hypertension in residential area. (p < 0.05). The sulfur dioxide was positively correlated with all circulatory diseases in both residential and industrial area (p < 0.05). Based on the results obtained from this study, it was found that there are different types of air pollutants that affect circulatory diseases in residential and industrial areas.

Following the introduction of lead-free frangible ammunition in United States Air Force small arms firing ranges, Combat Arms instructors have routinely reported experiencing adverse health symptoms during live fire training exercises, including sore throat, cough, and headache. Previous studies have found that these symptoms occur despite occupational exposure limits not being exceeded. To better characterize the potential source and mechanisms for health symptoms, a comprehensive characterization of the physicochemical properties of gases and aerosols emitted during the firing of the M9 pistol and M4 rifle using lead-free frangible ammunition was completed. Weapons were fired within a sealed chamber using a remote firing mechanism. A suite of direct-reading instruments and collection-based analytical methods were used to determine the composition of the emissions. Emissions were dominated by carbon monoxide and ultrafine particles. Other prevalent gases included carbon dioxide, ammonia, formaldehyde, hydrogen cyanide, and nitric oxide when measured using Fourier-transform infrared spectroscopy. An electrical, low-pressure impactor showed that, on average, the count median diameter immediately after firing was 36 ± 4 nm (n = 10 rounds) and 32 ± 3 nm (n = 14 rounds) for the M9 pistol and M4 rifle, respectively. Analytical methods were used to determine that emitted particles were primarily composed of soot, copper, and potassium, with trace amounts of calcium, silicon, sodium, sulfur, and zinc. Results from this research confirm prior work and expand upon the characterization of emissions generated from firing lead-free frangible ammunition. By employing multiple methods to measure and analyze data we were able to quantify both total and respirable particle fractions and determine particle morphology and composition. Characterization of the emissions provides insight into potential exposure risks that may lead to the development of adverse health symptoms allowing for the development of strategies for risk mitigation.

Introduction: Carbon monoxide (CO) is a colorless, odorless, and nonirritating gas. The most common exposures are from gas powered appliances such as furnaces, water heaters, stoves, and vehicles. To prevent poisoning, CO detectors with audible alarms were developed. This study aims to evaluate the effectiveness of CO detectors in reducing poisoning in Wisconsin. Methods: Records were queried from National Poison Data System for unintentional CO exposures that occurred in residences in Wisconsin during 2014-2016 ( N  = 703). After applying sample exclusion criteria, notes were abstracted for cases where CO detector use was mentioned ( n  = 408). Logistic regression analyses were used to assess the association between having a CO detector alarm and CO poisoning. Linear regression analyses were used to assess the relationship between having a CO detector alarm and poisoning severity. Results: In logistic models, odds of CO poisoning were 3.2 times higher (95% CI: 1.5, 6.9) among those who had no CO detector compared to those who had a CO detector that alarmed. In linear models, not having a CO detector was associated with a 0.34 point (95% CI: 0.17, 0.54) change in outcome severity score compared to having a CO detector that alarmed. Discussion: Individuals who were exposed to CO in the absence of a CO detector were more likely to be poisoned and to have more severe medical outcomes than those that had a CO detector that alarmed.

Objectives: To develop and test a new system for whole body exposure of small animals to support investigation of the biological effects of aerosol generated by electronic cigarette (e-cig) products under diverse inhalation conditions with improved control and monitoring of the e-cig vape exposure and nicotine delivered to the animal's systemic circulation. Methods: A computer-controlled design, with built-in sensors for real time monitoring of O 2 , CO 2 , relative humidity, and temperature within the exposure chambers and port for measuring total particulate matter (TPM) was developed, constructed and tested. This design accommodates a variety of commercial vaping devices, offers software flexibility to adjust exposure protocols to mimic different users' puffing patterns, enables variable nicotine delivery to the animal's systemic circulation; minimizes travel time and alterations of aerosol quality or quantity by delivering aerosol directly to the exposure chamber, offers local or remote operation of up to six distinct exposure chambers from a single control unit, and can simultaneously test different exposure conditions or products in diverse animal groups, which reduces inter-run variability, saves time, and increases productivity. Results: The time course pattern of TPM concentration during different phases of the exposure cycle was measured. With increased puffing duration or number of exposure cycles, higher TPM exposure and plasma cotinine levels were observed with plasma cotinine levels in the range reported in light or heavy smokers. Conclusion: Overall, this novel, versatile, and durable exposure system facilitates high-throughput evaluation of the relative safety and potential toxicity of a variety of e-cig devices and liquids.

Total hemoglobin mass (Hb mass ) is routinely assessed in studies by the carbon monoxide (CO) rebreathing. Its clinical application is often hindered due to the consequent rise in carboxyhemoglobin (%HbCO) and the concern of CO toxicity. We tested the reproducibility of the CO rebreathing with a CO dose of 0.5 mL/kg body mass (CO 0.5 ) compared to 1.5 mL/kg (CO 1.5 ) and when shortening the CO rebreathing protocol. Therefore, CO rebreathing was performed 1×/day in eight healthy individuals on four consecutive days. On each day, either CO 0.5 (CO 0.5 -1 and CO 0.5 -2) or CO 1.5 (CO 1.5 -1 and CO 1.5 -2) was administered. Venous blood samples to determine %HbCO and quantify Hb mass were obtained prior to, and at 6 (T 6 ), 8 (T 8 ) and 10 min (T 10 ) of CO rebreathing. This protocol was tested at sea level and at 2320 m to investigate the altitude-related measurement error. At sea level, the mean difference (95% limits of agreement) in Hb mass between CO 0.5 -1 and CO 0.5 -2 was 26 g (-26; 79 g) and between CO 1.5 -1 and CO 1.5 -2, it was 17 g (-18; 52 g) . The respective typical error (TE) corresponded to 2.4% (CO 0.5 ) and 1.5% (CO 1.5 ), while it was 6.5% and 3.0% at 2320 m. With CO 0.5 , shortening the CO rebreathing resulted in a TE for Hb mass of 4.4% (T 8 vs. T 10 ) and 14.1% (T 6 vs T 10 ) and with CO 1.5 , TE was 1.6% and 5.8%. In conclusion, the CO dose and rebreathing time for the CO rebreathing procedure can be decreased at the cost of a measurement error ranging from 1.5-14.1%.

The Internet of Things (IoT) explores new perspectives and possible improvements in risk assessment practices and shows potential to measure long-term and real-time occupational exposure. This may be of value when monitoring gases with short-term maximum levels and for time-weighted average (TWA) concentrations used in standard measuring practices. A functional embedded system was designed using low-cost carbon monoxide (CO) electrochemical sensors and long-range-wide-area-network radio communication technology (LoRaWAN) was used to enable internet connectivity. This system was utilized to monitor gas levels continuously in the working atmosphere of an incineration plant over a 2-month period. The results show that stable and long-term continuous data transfer was enabled by LoRaWAN, which proved useful for detecting rapid changes in gas levels. However, it was observed that raw data from the low-cost sensors did not meet the NIOSH accuracy criteria of ± 25% of the estimated true concentration based on field data from a co-located gas detector that met the NIOSH accuracy criteria. The new IoT technologies and CO sensor networks shows potential for remote monitoring of exposure in order to: (1) detect rapid changes in CO and other possible hazardous airborne gases; and (2) show the dynamic range of real-time data that may be hazardous for workers in the sampled areas. While the IoT low-cost sensors appear to be useful as a sentinel for monitoring hazardous atmospheres containing CO, the more useful finding may be showing real-time changes and the dynamic range of exposures, thus shedding light on the transient and toxic nature of airborne hazards. More importantly, the low-cost CO sensors are not a clear substitute for the more costly real-time gas detectors that perform within the NIOSH accuracy criteria.

Objective: This prospective study aims to analyze how CO and NO 2 exposure during pregnancy affects birth and placental weight as well as umbilical arterial pH. Study design: The population in study includes 3614 women born in Italy, living in Lombardia Region, consecutively admitted to the Clinica Mangiagalli for an elective cesarean section from January 2004 to December 2006. Outdoor air quality data was provided by the Department of the Regional Environmental Protection Agency and obtained by a network of fixed monitoring stations distributed in eight geographical areas across the region. Results: A positive association was found between birth weight and the concentration of CO to whom women were exposed during the last 10 d of pregnancy (mean change g  + 28, 95% CI +1 to +55, p .04). Conversely, placental weight was not influenced by exposure to CO while a statistically significant weight reduction was related to an increase in NO 2 exposure during the last trimester of pregnancy. Conclusion: Fetal weight was positively associated with an increased exposure to CO during the last 10 d of pregnancy. NO 2 exposure was associated to a placental weight reduction. These findings underline the existence of a complex biological role of such pollutants, especially of CO, in cell oxygenation at a placental level.

Despite the known human health risks associated with excessive heat exposure, particularly in occupational settings, data describing potential heat exposures in school kitchens is scarce, and no published studies to date have performed a quantitative heat exposure assessment for workers employed in this setting. The purpose of this study was to quantify the extent of heat stress in New York City public school kitchens and to assess potential risk of heat-related illness and/or acute injury. Full-shift indoor Wet Bulb Globe Temperature (WBGT) indices, as well as indoor CO 2 and CO concentrations were measured for ten school kitchens. A quantitative exposure assessment for three metabolic work-rate scenarios (light, moderate, heavy) was performed in accordance with the Occupational Safety and Health Administration's (OSHA) Heat Hazard Assessment methodology. The overall mean indoor WBGT index for all ten sites was approximately 25.0 °C (77.0 °F; Standard Deviation [SD] = 2.0 °C). Regarding the estimated Action Limit, 10% of school kitchens sampled exceeded this recommended limit for the light work-rate scenario; 60% of schools exceeded this limit for the moderate work-rate scenario; and 80% of schools exceeded this limit for the heavy work-rate scenario. For the Threshold Limit Value (TLV), none of the kitchens exceeded this limit for the light or moderate work-rate scenarios; 30% of kitchens were in excess of this limit for the heavy work-rate scenario. Mean full-shift CO 2 and CO air concentrations ranged from 435-911 ppm (mean = 648; SD = 158) and 0.0-3.2 ppm (mean = 0.9; SD = 0.9), respectively. The data collected in the current study suggest that kitchen staff employed in New York City public schools may be exposed to excessive indoor heat levels. Adequate work-rest schedules should be implemented for kitchen workers, in addition to other feasible engineering and administrative controls to mitigate potential risk of heat-related illness and/or acute injury.

Objective: To evaluate how asthma-related emergency department visits (AREDV), air pollutant levels, pollen counts, and weather variables changed from 2001 to 2008 in the Bronx, NY. Methods: 42,065 daily AREDV values (1 January 2001 to 31 December 2008) were collected using our institution's Clinical Looking Glass software. Daily values of sulfur dioxide (SO 2 ), carbon monoxide (CO), ozone (O 3 ), nitrogen dioxide (NO 2 ), temperature, and humidity were obtained from the National Climatic Data Center's Bronx station. Daily tree pollen counts were obtained from the Armonk counting station near the Bronx. Median values for each variable were analyzed using the Mann-Whitney test to compare 2001-2004 and 2005-2008 values. Simple linear regression examined associations between AREDV and individual pollutants. Due to seasonal variations of the variables, each season was considered separately. Results: There were significant decreases for AREDV, SO 2 , CO, and humidity for all seasons, and for NO 2 in the spring and winter. Significant increases occurred for O 3 in the spring, fall, and winter; for temperature in the summer and winter; and for tree pollen in the spring. Significant positive associations were found between AREDV and SO 2 , CO, NO 2 , and humidity, respectively, while significant negative associations were found between AREDV and O 3 and temperature, respectively. Conclusions: From 2001 to 2008, significant: a) decreases in AREDV, SO 2 , CO, and humidity for all seasons, and decreases in NO 2 for the spring and winter; and b) increases in O 3 , temperature, and spring tree pollen were observed. By tracking and anticipating environmental and pollutant changes, efforts can be made to minimize AREDV.

Carbon monoxide (CO) exposure levels encountered by wildland firefighters (WLFs) throughout their work shift can change considerably within a few minutes due to the varied tasks that are performed and the changing environmental and fire conditions encountered throughout the day. In a U.S. Forest Service study during the 2009-2012 fire seasons, WLFs from 57 different fires across the U.S. were monitored for CO using CO data-logging detectors while an observer recorded worker tasks, fire characteristics, and environmental conditions at scheduled intervals. Exposures to CO for 735 WLF's work shifts were analyzed to assess the effect of variations among work tasks, fire characteristics, and environmental conditions. Geometric mean full shift time-weighted averages were low at 2.4 parts per million (ppm) and average length of work shift was 11 hr and 15 min. The task with the highest mean CO exposure was sawyer/swamper at 6.8 ppm; workers performing that task had an estimated 9 times higher odds of a having a 1-min CO measurement exceeding 25 ppm than the referent pump task (OR = 8.89, 95% CI = 1.97, 40.24). After adjusting CO exposure limits for shift length, elevation, and work level, 2% and 4% of the WLF's work shifts exceeded the National Institute for Occupational Safety and Health's recommended exposure level and the American Conference of Governmental Industrial Hygienist's threshold limit value, respectively. In regression modeling, variables that were significantly associated with elevated levels of CO exposure included: task, fuel model, wind orientation, crew type, relative humidity, type of attack, and wind speed. In the absence of instruments such as CO detectors that can determine and alert WLFs to elevated CO levels, recognition of the conditions that lead to elevated levels of CO exposure can assist WLFs to effectively use administrative controls, such as work rotations, to minimize exposures.

Carbon monoxide (CO) is an important component of tobacco smoke, but also environmental toxicity. This study analyzed possible correlation between exhaled CO level and oral health indicators in two geographically distributed populations during health-promoting public events organized for local communities in cities with high and low environmental pollution in Poland (907 patients). Self-reported, instructor-led, oral health questionnaire was developed to monitor current and previous mucosal lesion incidence. Exhaled CO correlated with subjects smoking status and environmental CO exposure: highest in smoking inhabitants of Krakow (12 ppm), with lower levels in smokers from Kozienice (6.5 ppm) and non-smokers from Krakow (6 ppm), and lowest for Kozienice non-smokers (2 ppm) (p < 0.001). After propensity score matching and adjustment for smoking status, demography and comorbidities odds ratio for mucosal lesion incidence was 1.46 (1.31-1.63), p < 0.001) per 1 ppm increase of exhaled CO level. This result might implicate a possible role of environmental pollution factors in oral health pathology.

Air quality is a common concern among indoor ice rink facilities due to the use of gasoline/propane ice resurfacing equipment. Although previous studies have investigated spectator, guest, and skater exposures, a review of the literature revealed little published research regarding ice maintenance employees' exposures. Ice maintenance includes edging and resurfacing. The resurfacer is commonly referred to as a Zamboni®. Edging is almost always followed by resurfacing, but resurfacing frequently happens independently of edging. The purpose of this study was to characterize ice rink maintenance employees' exposures to CO and NO 2 . Employees from four ice rinks in Salt Lake County, Utah were sampled using direct reading instruments during routine ice maintenance activities. Maintenance was divided into four activities: 1) Edging only, 2) Resurfacing after edging (not including edging), 3) Edging and resurfacing (Activities 1 and 2 combined), and 4) Resurfacing only (independent of edging). Activities 1, 2 and 3 were sampled twenty-four (n = 24) times. Activity 4 was sampled eight times. Sampling results were graphed and summarized using descriptive statistics. The highest measured CO concentration was 202 ppm, which occurred during edging. Average CO concentrations for all activities ranged from 0 ppm to 60.4 ppm. Minimal CO exposure was observed when resurfacing occurred without edging, which implies that elevated CO exposure measured while using the resurfacer may be residual CO from prior edging activities. NO 2 concentrations were negligible for all rinks and all activities. Results confirmed that gasoline edgers significantly contribute to indoor CO levels, with peak levels exceeding some recommended exposure levels. Indoor ice rink facilities should monitor employees' CO exposures and implement procedures to limit exposures. This may be achieved by limiting the number of laps taken with the edger or replacing gasoline powered edgers with electric edgers.

Smoke exposure data among U.S. wildland firefighters for carbon monoxide, respirable particulate and respirable crystalline silica are presented from a field surveillance program between 2009 and 2012. Models to predict fireline-average exposure to each inhalation hazard were developed and fit to the available data. The models identify factors to consider when defining similar exposure groups and designing future data collection. Task-based rather than shift-average data collection is important because the work activity representing the majority of fireline time, the position up- or downwind of the fire, and the proportion of time this combination represented were significant factors in the model for carbon monoxide, and all but wind position were significant for respirable particulate matter. The wind position versus the fire was not important for respirable quartz exposure. The crew type was an important factor in each model.

Objective: This study aimed to evaluate the association between asthma prevalence and outdoor air pollution in children in Latin America and the Caribbean., Data Sources: We searched studies in global and regional databases: PubMed, Scopus, LILACS and SciELO., Study Selection: Articles following a cross-sectional design, studying children from 0 to 18 years old, and comparing the prevalence of asthma in two or more areas of LAC countries with different air pollution levels were included. The exclusion criteria comprised air pollution not related to human activities., Results: Database searches retrieved 384 records, while 20 studies were retained for qualitative and 16 for quantitative analysis, representing 48 442 children. We found a positive association, i.e. a higher prevalence of asthma in children living in a polluted environment, with pooled odds ratio (OR) of 1.34 (95% CI: 1.17-1.54). Heterogeneity between studies was moderate (I 2 : 68.39%), while the risk of bias was intermediate or high in 14 studies. In all the subgroup and sensitivity analyses, the pooled ORs were significant and higher than those found in the general analysis Conclusions: Our results showed that living in a polluted environment is significantly associated with children having asthma in LAC. Limitations of this study include the low number of studies performed in LAC countries, differences in methodologies and the risk of bias in individual studies.

The present study reports short-term impact of poor air quality on cardiovascular and respiratory morbidity rate in Delhi. The data on monthly count of patients visiting Out Patient Department (OPD) and hospital admission due to respiratory and cardiovascular illnesses from hospitals along with daily air quality data from air quality monitoring stations of Central Pollution Control Board (CPCB), Government of India, across Delhi were collected for the period 2008 to 2012. A semi-parametric Quasi-Poisson regression model was used to examine the association of high pollution episodes with relative risk of hospital OPD visit and hospital admission due to respiratory and cardiovascular diseases. This study has confirmed the substantial adverse health effects due to air pollution across criterion air pollutants. The study reports the short-term effects of air pollution on morbidity from a time-series study first time in India. The study findings illustrate the evidence of adverse health impact of air pollution from India to the global pool and can influence the policy makers to implement better air quality management system for Indian cities., Abbreviations: OPD: Out Patient Department; IPD: Inpatient Department; RD: Respiratory Disease; CVD: Cardiovascular Disease; COPD: Chronic Obstructive Pulmonary Disease; CPCB: Central Pollution Control Board; NAAQMP: National Ambient Air Quality Monitoring Programme; NAAQS: National Ambient Air Quality Standards; RR; Relative Risk; IMD: Indian Meteorological Department; PM 10 : Particulate Matter less than 10 μm in aerodynamic diameter; SO 2 : Sulphur dioxide; NO 2 : Nitrogen dioxide; CO: Carbon Monoxide; O 3 : Ozone; DCE: Delhi College of Engineering; GTB Hospital: Guru Teg Bahadur Hospital; VPCH: Vallabhbhai Patel Chest Hospital; RMLH: Ram Manohar Lohia Hospital; SJH: Safdarjung Hospital; LNJPH: Lok Narayan Jai Prakash Hospital; GTBH: Guru Teg Bahadur Hospital; AH: Ambedkar Hospital; HRH: Hindu Rao Hospital; ESIH: ESI Hospital; SGRH: Sir Ganga Ram Hospital.

Development of an air quality monitoring network with high spatio-temporal resolution requires installation of a large number of air pollutant monitors. However, state-of-the-art monitors are costly and may not be compatible with wireless data logging systems. In this study, low-cost electro-chemical sensors manufactured by Alphasense Ltd. for detection of CO and oxidative gases (predominantly O 3 and NO 2 ) were evaluated. The voltages from three oxidative gas sensors and three CO sensors were recorded every 2.5 sec when exposed to controlled gas concentrations in a 0.125-m 3 acrylic glass chamber. Electro-chemical sensors for detection of oxidative gases demonstrated sensitivity to both NO 2 and O 3 with similar voltages recorded when exposed to equivalent environmental concentrations of NO 2 or O 3 gases, when evaluated separately. There was a strong linear relationship between the recorded voltages and target concentrations of oxidative gases (R 2 > 0.98) over a wide range of concentrations. Although a strong linear relationship was also observed for CO concentrations below 12 ppm, a saturation effect was observed wherein the voltage only changes minimally for higher CO concentrations (12-50 ppm). The nonlinear behavior of the CO sensors implied their unsuitability for environments where high CO concentrations are expected. Using a manufacturer-supplied shroud, sensors were tested at 2 different flow rates (0.25 and 0.5 Lpm) to mimic field calibration of the sensors with zero air and a span gas concentration (2 ppm NO2 or 15 ppm CO). As with all electrochemical sensors, the tested devices were subject to drift with a bias up to 20% after 9 months of continuous operation. Alphasense CO sensors were found to be a proper choice for occupational and environmental CO monitoring with maximum concentration of 12 ppm, especially due to the field-ready calibration capability. Alphasense oxidative gas sensors are usable only if it is valuable to know the sum of the NO 2 and O 3 concentrations.

Introduction: Installation of ventilated cookstoves has been shown to improve 24-h carbon monoxide (CO) and particulate exposure in the Guatemalan highlands. However, a survey of villagers around San Lucas Tolimán found much higher than expected CO levels. Our purpose is to evaluate the effects of improved cookstoves on CO levels in these villagers., Methods: This is cross sectional observational study in six rural communities. Blood carboxyhemoglobin (SpCO) was measured at three different times during the day. Stove type and location, as well as any respiratory, eye, or general symptoms reported were recorded., Results: 122 patients were included. CO levels were much higher than would be expected in a non-smoking population, with an average level of 4.6 ± 2.3 percent. There was no significant correlation in CO level and stove type or in CO level and time of day. Reported frequency of respiratory and eye symptoms (dyspnea, p = 0.03; cough, p = 0.01; burning eyes, p = 0.001; and excessive tearing, p = 0.001) did vary significantly between improved and unimproved stove groups., Conclusion: This study found high average SpCO levels in all villagers. This suggests that some contributor other than cookstoves may be an additional driver of individual CO exposure in this area.

Background: Similar to adult smokers, quit attempts among younger smokers almost inevitably result in relapse. Unlike adults, less is known about the process of relapse in this younger age group. A technology-based remote monitoring system may allow for detailed and accurate characterization of smoking and abstinence and would help to improve cessation strategies., Objectives: This study describes a mobile system that captures smoking using breath carbon monoxide (CO) and real-time self-reports of smoking behavior. Compliance, feasibility, acceptability, and accuracy of the system were measured during a quit attempt and subsequent monitoring period., Methods: The mobile application (My Mobile Monitor, M 3 ) combined breath CO with ecological momentary assessment, delivered via smartphone. Participants (N = 16; 75% female) were daily smokers between the ages of 19 and 25, who used the app for 11 days during which they agreed to make a quit attempt. Acceptability, compliance, and abstinence were measured., Results: Participants averaged 22.3 ± 2.0 years old and smoked an average of 13.0 ± 6.1 cigarettes per day. Overall session compliance was 69% and during the quit attempt, 56% of participants abstained from smoking for at least 24 hours. Agreement between self-reported smoking compared to breath CO was generally high, when available for comparison, though underreporting of cigarettes was likely., Conclusion: This study demonstrates feasibility of a remote monitoring app with younger smokers, though improvements to promote compliance are needed. Remote monitoring to detect smoking and abstinence represents a step forward in the improvement of cessation strategies, but user experience and personalization are vital.

Carbon monoxide (CO) increases middle cerebral artery mean flow velocity (MCAV mean ), but the effect of CO on the near-infrared spectroscopy (NIRS) determined cerebral oxygenation (S c O 2 ) is not detailed. In our study, 11 non-smoking subjects breathed 100% O 2 through a closed circuit. A CO 2 scrubber with CO (1.5 mL kg -1 ) was added to the circuit. Two NIRS systems (NIRO-200NX and INVOS-5100) assessed S c O 2 as the ratio of oxygenated to deoxygenated hemoglobin, while venous blood samples were analyzed for carboxyhemoglobin (COHb). After CO/O 2 rebreathing COHb increased to 8.7% (IQR; 7.9-9.4; p = .004) vs. normoxia, but MCAV mean remained stable (55.6 cm s -1 ; 53.1-69.7) compared to inhalation of O 2 (54.6 cm s -1 ; 48.4-62.9; p = .178) and normoxia (54.1 cm s -1 ; 44.5-66.9; p = .055). Also, INVOS-5100 determined S c O 2 increased during CO/O 2 (74.4 ± 7.5%) and O 2 inhalation (73.1 ± 7.2%) compared to normoxia (68.9 ± 6.9%; p < .001). In contrast, NIRO-200NX determined S c O 2 remained unchanged during CO/O 2 and O 2 inhalations but oxygenated and deoxygenated hemoglobin decreased (by 19.7 μM (median; IQR 2.8-34.8; p = .016) and 37.3 μM (30.8-46.6; p = .004), respectively) during inhalation of CO/O 2 compared to inhalation of O 2 . Therefore, NIRO-200NX determined 'total' hemoglobin (sum of O 2 Hb and HHb) decreased (by 62.1 μM; 44.5-78.2; p = .001). In conclusion, exposure to CO did not increase MCAV mean , and neither NIRO-200NX nor INVOS-5100 detected a change in S c O 2 when CO was added to inhalation of oxygen. Unaffected S c O 2 after exposure to CO reflected a similar decrease in oxygenated and deoxygenated hemoglobin suggesting that detection of exposure to CO by NIRS should focus on 'total' hemoglobin rather than on S c O 2 .

This study aimed to compare personal exposures to diesel fuel and a biodiesel blend exhaust in an underground mine. Personal exposure monitoring was performed in a non-operational, hard rock underground mine during use of a load-haul-dump vehicle. Eight-hour time-weighted average (TWA 8 ) exposure concentrations of ultra-low sulfur diesel and 75% biodiesel/25% diesel blend (B75) fuels were compared.  Compared to diesel, use of B75 was associated with relative percent reductions of 22 and 28% in median respirable (r) diesel particulate matter (DPM) and nitrogen dioxide and 25 and 23% increases in median total DPM and nitric oxide TWA 8 exposure concentrations, respectively. Diesel was associated with a slightly greater total geometric mean mass concentration and lower mean surface area concentration.  Although further testing is needed, B75 has the potential to reduce rDPM exposures.

Exposure to carbon monoxide (CO) emitted by chainsaws can negatively impact health in forestry workers. This exploratory study measures CO concentration within the breathing zone of chainsaw operators during motor-manual operations, and discusses the potential influences on CO exposure levels. A CO monitoring instrument was paired with a concurrent video recording of task activities to enable correlation of exact working operations to critical exposure levels. Multiple streams of meteorological data were also collected from sensors worn by the eight professional tree fellers/log makers. Time-weighted averages were applied to investigate levels of CO exposure during a nominal 1-hr monitoring period. The differing task demands and environment were found to influence worker exposure to CO, supporting previous research. Pending further investigation, a number of possible actions are recommended to reduce observed high exposure levels and/or emission concentration.

There is growing use of wood pellet and wood chip boilers in the UK. Elsewhere fatalities have been reported, caused by carbon monoxide poisoning following entry into wood pellet storage areas. The aim of this work was to obtain information on how safely these two fuels are being stored in the UK. Site visits were made to six small-scale boiler systems and one large-scale pellet warehouse, to assess storage practice, risk management systems and controls, user knowledge, and potential for exposure to dangerous atmospheres. Real time measurements were made of gases in the store rooms and during laboratory tests on pellets and chips. Volatile organic compounds (VOCs) emitted and the microbiological content of the fuel was also determined. Knowledge of the hazards associated with these fuels, including confined space entry, was found to be limited at the smaller sites, but greater at the large pellet warehouse. There has been limited risk communication between companies supplying and maintaining boilers, those manufacturing and supplying fuel, and users. Risk is controlled by restricting access to the store rooms with locked entries; some store rooms have warning signs and carbon monoxide alarms. Nevertheless, some store rooms are accessed for inspection and maintenance. Laboratory tests showed that potentially dangerous atmospheres of carbon monoxide and carbon dioxide, with depleted levels of oxygen may be generated by these fuels, but this was not observed at the sites visited. Unplanned ventilation within store rooms was thought to be reducing the build-up of dangerous atmospheres. Microbiological contamination was confined to wood chips.

Exposure to diesel engine exhaust has been linked to increased cancer risk and cardiopulmonary diseases. Diesel exhaust is a complex mixture of chemical substances, including a particulate fraction mainly composed of ultrafine particles, resulting from the incomplete combustion of fuel. Diesel trucks are known to be an important source of diesel-related air pollution, and areas with heavy truck traffic are associated with higher air pollution levels and increased public health problems. Several indicators have been proposed as surrogates for estimating exposures to diesel exhaust but very few studies have focused specifically on monitoring the ultrafine fraction through the measurement of particle number concentrations. The aim of this study is to assess occupational exposures of gate controllers at the port of Montreal, Canada, to diesel engine emissions from container trucks by measuring several surrogates through a multimetric approach which includes the assessment of both mass and number concentrations and the use of direct reading devices. A 10-day measurement campaign was carried out at two terminal checkpoints at the port of Montreal. Respirable elemental and organic carbon, PM1, PM2.5, PMresp (PM4), PM10, PMtot (inhalable fraction), particle number concentrations, particle size distributions, and gas concentrations (NO2, NO, CO) were monitored. Gate controllers were exposed to concentrations of contaminants associated with diesel engine exhaust (elemental carbon GM = 1.6 µg/m(3); GSD = 1.6) well below recommended occupational exposure limits. Average daily particle number concentrations ranged from 16,544-67,314 particles/cm³ (GM = 32,710 particles/cm³; GSD = 1.6). Significant Pearson correlation coefficients were found between daily elemental carbon, PM fractions and particle number concentrations, as well as between total carbon, PM fractions and particle number concentrations. Significant correlation coefficients were found between particle number concentrations and the number of trucks and wind speed (R(2) = 0.432; p < 0.01). The presence of trucks with cooling systems and older trucks with older exhaust systems was associated with peak concentrations on the direct reading instruments. The results highlight the relevance of direct reading instruments in helping to identify sources of exposure and suggest that monitoring particle number concentrations improves understanding of workers' exposures to diesel exhaust. This study, by quantifying workers' exposure levels through a multimetric approach, contributes to the further understanding of occupational exposures to diesel engine exhaust.

Objective: There are few studies on fractional exhaled nitric oxide (FeNO) and respiratory symptoms among adults in tropical areas. The aim was to study associations between FeNO and selected personal factors, respiratory symptoms, allergies, office characteristics and indoor office exposures among office workers (n = 460) from a university in Malaysia., Methods: Information on health was collected by a questionnaire, skin prick test and FeNO measurement. Temperature, relative air humidity, carbon monoxide and carbon dioxide were measured in the offices. Settled dust was vacuumed in the offices and analyzed for endotoxin, (1,3)-β-glucan and house dust mites allergens, namely Dermatophagoides pteronyssinus (Der p 1) and Dermatophagoides farinae (Der f 1). Two-level linear mixed models and multiple logistic regression were used to analyze the associations., Results: One-fourth (25.9%) of the office workers had elevated FeNO level (≥ 25 ppb) and 61.5% had HDM, cat, seafood or pollen allergy. Male gender (p < 0.001), current smoking (p = 0.037), height (p < 0.001) and atopy (p < 0.001) were associated with FeNO. The amount of vacuumed dust was associated with FeNO among atopic subjects (p = 0.009). Asthma and rhinitis symptoms were associated with FeNO (p < 0.05), especially among atopic subjects. In particular, a combination of atopy and elevated FeNO were associated with doctor-diagnosed asthma (p < 0.001), rhinitis (p < 0.001) and airway symptoms last 12 months (p < 0.001)., Conclusion: Gender, smoking, height and atopy are important risk factors for elevated FeNO levels. A combination of allergy testing and FeNO measurement could be useful in respiratory illness epidemiology studies and patient investigations in tropical areas.

This study was conducted to assess the potential of hydrotreated vegetable oil renewable diesel (HVORD) as a control strategy to reduce exposure of workers to diesel aerosols and gases. The effects of HVORD on criteria aerosol and gaseous emissions were compared with those of ultralow sulfur diesel (ULSD). The results of comprehensive testing at four steady-state conditions and one transient cycle were used to characterize the aerosol and gaseous emissions from two older technology engines: (1) a naturally aspirated mechanically controlled and (2) a turbocharged electronically controlled engine. Both engines were equipped with diesel oxidation catalytic converters (DOCs). For all test conditions, both engines emitted measurably lower total mass concentrations of diesel aerosols, total carbon, and elemental carbon when HVORD was used in place of ULSD. For all test conditions, the reductions in total mass concentrations were more substantial for the naturally aspirated than for the turbocharged engine. In the case of the naturally aspirated engine, HVORD also favorably affected total surface area of aerosols deposited in the alveolar region of human lungs (TSAADAR) and the total number concentrations of aerosols. In the case of the turbocharged electronically controlled engine, for some of the test conditions HVORD adversely affected the TSAADAR and total number concentrations of aerosols. In the majority of the test cases involving the naturally aspirated mechanically controlled engine, HVORD favorably affected carbon dioxide (CO2), nitrogen oxides (NOX), and nitric oxide (NO) concentrations, but adversely affected NO2 and total hydrocarbon concentrations, while the effects of the fuels on carbon monoxide (CO) concentrations were masked by the effects of DOC. In the case of the turbocharged electronically controlled engine, the CO2, CO, NOX, NO, and total hydrocarbon concentrations were generally lower when HVORD was used in place of ULSD. The effects of the fuels on NO2 concentrations were masked by the more prominent effects of DOC.

Context: Asian dust events are associated with increased asthma incidence, asthma exacerbation, decreased lung function and increased risk for hospitalization., Objective: The purpose of this study was to evaluate the effect of Asian dust events on asthma exacerbation by socioeconomic status using national health insurance claims data., Materials and Methods: A case-crossover design was used to analyze asthma-related national health insurance claims, air pollutant and climate data from 2007 to 2013 in Seoul and Incheon, Korea. We stratified our analysis by socioeconomic status (health insurance versus medical aid subscribers) and calculated the maximum air pollutant levels and average climate values per day. The number of asthma-related visits to medical institutions per day was compared between "event" and "control" days., Results: Compared with "control days", the average number of asthma-related visits to medical institutions decreased on "event" days and increased 1-5 d thereafter. The number of visits by health insurance subscribers also decreased on "event" days and increased 1-5 d thereafter, while the number of visits by medical aid subscribers did not change on "event" days but increased 1-4 d thereafter., Discussion and Conclusion: Our study confirms that Asian dust events result in an increased number of asthma-related visits to medical institutions. This effect differed by socioeconomic status.

Objective: To examine the seasonality of fetal trisomy 21 and its relationship with ambient air pollutants., Methods: The averaged incidence by month-of-conception of the 113 cases (2002-2009) in our registry was correlated with month of conception and monthly ambient levels of nitrogen oxides (NOx, NO and NO2), sulfur dioxide, carbon monoxide, and ozone as reported by the Hong Kong Environmental Protection Department at the month of, and four-week after, conception., Results: The incidence was highest in February (3.45/1000 births) and lowest in October (1.28/1000 births), and showed a significant difference (p = 0.003) and positive correlation (p = 0.003) from winter to autumn. It was also correlated with NO (p = 0.017) and inversely with ozone (p = 0.014) at conception., Conclusions: Seasonal variation in incidence of fetal trisomy 21 was correlated with ambient levels of nitric oxides and ozone. The role of environmental pollutants on fetal aneuploidy warrants further investigation.

An age-stratified, cross-sectional study was conducted in the US among healthy adult male cigarette smokers, moist snuff consumers, and non-tobacco consumers to evaluate cardiovascular biomarkers of biological effect (BoBE). Physiological assessments included flow-mediated dilation, ankle-brachial index, carotid intima-media thickness and expired carbon monoxide. Approximately one-half of the measured serum BoBE showed statistically significant differences; IL-12(p70), sICAM-1 and IL-8 were the BoBE that best differentiated among the three groups. A significant difference in ABI was observed between the cigarette smokers and non-tobacco consumer groups. Significant group and age effect differences in select biomarkers were identified.

The inhalation toxicity of submarine contaminants is of concern to ensure the health of men and women aboard submarines during operational deployments. Due to a lack of adequate prior studies, potential general, neurobehavioral, reproductive and developmental toxicity was evaluated in male and female rats exposed to mixtures of three critical submarine atmospheric components: carbon monoxide (CO) and carbon dioxide (CO2; levels elevated above ambient), and oxygen (O2; levels decreased below ambient). In a 14-day, 23 h/day, whole-body inhalation study of exposure to clean air (0.4 ppm CO, 0.1% CO2 and 20.6% O2), low-dose, mid-dose and high-dose gas mixtures (high dose of 88.4 ppm CO, 2.5% CO2 and 15.0% O2), no adverse effects on survival, body weight or histopathology were observed. Reproductive, developmental and neurobehavioral performance were evaluated after a 28-day exposure in similar atmospheres. No adverse effects on estrus phase, mating, gestation or parturition were observed. No developmental or functional deficits were observed in either exposed parents or offspring related to motor activity, exploratory behavior or higher-level cognitive functions (learning and memory). Only minimal effects were discovered in parent-offspring emotionality tests. While statistically significant increases in hematological parameters were observed in the offspring of exposed parents compared to controls, these parameters remained within normal clinical ranges for blood cells and components and were not considered adverse. In summary, subacute exposures to elevated concentrations of the submarine atmosphere gases did not affect the ability of rats to reproduce and did not appear to have any significant adverse health effects.

Diesel fuel is commonly used for underground mining equipment, yet diesel engine exhaust is a known human carcinogen. Alternative fuels, including biodiesel, and a natural gas/diesel blend, offer the potential to reduce engine emissions and associated health effects. For this pilot study, exposure monitoring was performed in an underground mine during operation of a load-haul-dump vehicle. Use of low-sulfur diesel, 75% biodiesel/25% diesel blend (B75), and natural gas/diesel blend (GD) fuels were compared. Personal samples were collected for total and respirable diesel particulate matter (tDPM and rDPM, respectively) and total and respirable elemental and organic carbon (tEC, rEC, tOC, rOC, respectively), as well as carbon monoxide (CO), formaldehyde, acetaldehyde, naphthalene, nitric oxide (NO), and nitrogen dioxide (NO2). Compared to diesel, B75 use was associated with a 33% reduction in rDPM, reductions in rEC, tEC, and naphthalene, increased tDPM, tOC, and NO, and no change in rOC, CO, and NO2. Compared to diesel, GD was associated with a 66% reduction in rDPM and a reduction in all other exposures except CO. The alternative fuels tested both resulted in reduced rDPM, which is the basis for the current Mine Safety and Health Administration (MSHA) occupational exposure standard. Although additional study is needed with a wider variety of equipment, use of alternative fuels have the promise of reducing exposures from vehicular exhaust in underground mining settings.

The performance of a recirculating ventilation system with dust filtration was evaluated to determine its effectiveness to improve the air quality in a swine farrowing room of a concentrated animal feeding operation (CAFO). Air was exhausted from the room (0.47 m(3) sec(-1); 1000 cfm), treated with a filtration unit (Shaker-Dust Collector), and returned to the farrowing room to reduce dust concentrations while retaining heat necessary for livestock health. The air quality in the room was assessed over a winter, during which time limited fresh air is traditionally brought into the building. Over the study period, dust concentrations ranged from 0.005-0.31 mg m(-3) (respirable) and 0.17-2.09 mg m(-3) (inhalable). In-room dust concentrations were reduced (41% for respirable and 33% for inhalable) with the system in operation, while gas concentrations (ammonia [NH3], hydrogen sulfide [H2S], carbon monoxide [CO], carbon dioxide [CO2]) were unchanged. The position of the exhaust and return air systems provided reasonably uniform contaminant distributions, although the respirable dust concentrations nearest one of the exhaust ducts was statistically higher than other locations in the room, with differences averaging only 0.05 mg m(-3). Throughout the study, CO2 concentrations consistently exceeded 1540 ppm (industry recommendations) and on eight of the 18 study days it exceeded 2500 ppm (50% of the ACGIH TLV), with significantly higher concentrations near a door to a temperature-controlled hallway that was typically often left open. Alternative heaters are recommended to reduce CO2 concentrations in the room. Contaminant concentrations were modeled using production and environmental factors, with NH3 related to the number of sow in the room and outdoor temperatures and CO2 related to the number of piglets and outdoor temperatures. The recirculating ventilation system provided dust reduction without increasing concentrations of hazardous gases.

Diesel exhaust (DE) contains a variety of toxic air pollutants, including diesel particulate matter (DPM) and gaseous contaminants (e.g., carbon monoxide (CO)). DPM is dominated by fine (PM2.5) and ultrafine particles (UFP), and can be representatively determined by its thermal-optical refractory as elemental carbon (EC) or light-absorbing characteristics as black carbon (BC). The currently accepted reference method for sampling and analysis of occupational exposure to DPM is the National Institute for Occupational Safety and Health (NIOSH) Method 5040. However, this method cannot provide in-situ short-term measurements of DPM. Thus, real-time monitors are gaining attention to better examine DE exposures in occupational settings. However, real-time monitors are subject to changing environmental conditions. Field measurements have reported interferences in optical sensors and subsequent real-time readings, under conditions of high humidity and abrupt temperature changes. To begin dealing with these issues, we completed a controlled study to evaluate five real-time monitors: Airtec real-time DPM/EC Monitor, TSI SidePak Personal Aerosol Monitor AM510 (PM2.5), TSI Condensation Particle Counter 3007, microAeth AE51 BC Aethalometer, and Langan T15n CO Measurer. Tests were conducted under different temperatures (55, 70, and 80°F), relative humidity (10, 40, and 80%), and DPM concentrations (50 and 200 μg/m(3)) in a controlled exposure facility. The 2-hr averaged EC measurements from the Airtec instrument showed relatively good agreement with NIOSH Method 5040 (R(2) = 0.84; slope = 1.17±0.06; N = 27) and reported ∼17% higher EC concentrations than the NIOSH reference method. Temperature, relative humidity, and DPM levels did not significantly affect relative differences in 2-hr averaged EC concentrations obtained by the Airtec instrument vs. the NIOSH method (p < 0.05). Multiple linear regression analyses, based on 1-min averaged data, suggested combined effects of up to 5% from relative humidity and temperature on real-time measurements. The overall deviations of these real-time monitors from the NIOSH method results were ≤20%. However, simultaneous monitoring of temperature and relative humidity is recommended in field investigations to understand and correct for environmental impacts on real-time monitoring data.

Context: Endothelial dysfunction has been suggested as a potential mechanism by which ambient air pollution may cause acute cardiovascular events. Recently, plasma nitrite has been developed as a marker of endothelial dysfunction., Objectives: We examined the changes in plasma nitrite concentration associated with increases in ambient air pollutant concentrations in the previous 7 d., Materials and Methods: We linked up to three measurements of plasma nitrite concentrations obtained from 49 students to 24-h average concentrations of five criteria air pollutants [particle mass < 2.5 µm in aerodynamic diameter (PM(2.5)), carbon monoxide (CO), sulfur dioxide (SO₂), nitrogen dioxide (NO₂), and ozone (O₃)] measured at two monitoring sites closest to Rutgers University campus (6-15 miles) in New Jersey during the years 2006-2009. We examined the change in plasma nitrite associated with each interquartile-range (IQR) increase in pollutant concentration in the previous 24 h and six preceding 24- h periods, using linear mixed models., Results: IQR increases in mean PM(2.5) (7.0 µg/m³) and CO (161.7 parts per billion) concentrations in the first 24 h before the plasma nitrite measurement were associated with increased plasma nitrite concentrations (PM(2.5): 15.5 nanomolar; 95% confidence interval (CI): 2.4, 28.5; CO: 15.6 nanomolar; 95% CI: 2.4, 28.9). Increased plasma nitrite associated with IQR increases in O₃ and SO₂ concentrations over longer lags were observed., Discussion and Conclusion: Rapid increases in plasma nitrite following exposure to ambient air pollutants support the hypothesis that ambient air pollution is associated with inducible nitric oxide synthase-mediated systemic inflammation in humans.

For more than 20 years CSX Transportation (CSXT) has collected exposure measurements from locomotive engineers and conductors who are potentially exposed to diesel emissions. The database included measurements for elemental and total carbon, polycyclic aromatic hydrocarbons, aromatics, aldehydes, carbon monoxide, and nitrogen dioxide. This database was statistically analyzed and summarized, and the resulting statistics and exposure profiles were compared to relevant occupational exposure limits (OELs) using both parametric and non-parametric descriptive and compliance statistics. Exposure ratings, using the American Industrial Health Association (AIHA) exposure categorization scheme, were determined using both the compliance statistics and Bayesian Decision Analysis (BDA). The statistical analysis of the elemental carbon data (a marker for diesel particulate) strongly suggests that the majority of levels in the cabs of the lead locomotives (n = 156) were less than the California guideline of 0.020 mg/m(3). The sample 95th percentile was roughly half the guideline; resulting in an AIHA exposure rating of category 2/3 (determined using BDA). The elemental carbon (EC) levels in the trailing locomotives tended to be greater than those in the lead locomotive; however, locomotive crews rarely ride in the trailing locomotive. Lead locomotive EC levels were similar to those reported by other investigators studying locomotive crew exposures and to levels measured in urban areas. Lastly, both the EC sample mean and 95%UCL were less than the Environmental Protection Agency (EPA) reference concentration of 0.005 mg/m(3). With the exception of nitrogen dioxide, the overwhelming majority of the measurements for total carbon, polycyclic aromatic hydrocarbons, aromatics, aldehydes, and combustion gases in the cabs of CSXT locomotives were either non-detects or considerably less than the working OELs for the years represented in the database. When compared to the previous American Conference of Governmental Industrial Hygienists (ACGIH) threshold limit value (TLV) of 3 ppm the nitrogen dioxide exposure profile merits an exposure rating of AIHA exposure category 1. However, using the newly adopted TLV of 0.2 ppm the exposure profile receives an exposure rating of category 4. Further evaluation is recommended to determine the current status of nitrogen dioxide exposures. [Supplementary materials are available for this article. Go to the publisher's online edition of Journal of Occupational and Environmental Hygiene for the following free supplemental resource: additional text on OELs, methods, results, and additional figures and tables.].

Respiratory problems are common among wildland firefighters. However, there are few studies directly linking occupational exposures to respiratory effects in this population. Our objective was to characterize wildland fire fighting occupational exposures and assess their associations with cross-shift changes in lung function. We studied 17 members of the Alpine Interagency Hotshot Crew with environmental sampling and pulmonary function testing during a large wildfire. We characterized particles by examining size distribution and mass concentration, and conducting elemental and morphological analyses. We examined associations between cross-shift lung function change and various analytes, including levoglucosan, an indicator of wood smoke from burning biomass. The levoglucosan component of the wildfire aerosol showed a predominantly bimodal size distribution: a coarse particle mode with a mass median aerodynamic diameter about 12 μm and a fine particle mode with a mass median aerodynamic diameter < 0.5 μm. Levoglucosan was found mainly in the respirable fraction and its concentration was higher for fire line construction operations than for mop-up operations. Larger cross-shift declines in forced expiratory volume in one second were associated with exposure to higher concentrations of respirable levoglucosan (p < 0.05). Paired analyses of real-time personal air sampling measurements indicated that higher carbon monoxide (CO) concentrations were correlated with higher particulate concentrations when examined by mean values, but not by individual data points. However, low CO concentrations did not provide reliable assurance of concomitantly low particulate concentrations. We conclude that inhalation of fine smoke particles is associated with acute lung function decline in some wildland firefighters. Based on short-term findings, it appears important to address possible long-term respiratory health issues for wildland firefighters. [Supplementary materials are available for this article. Go to the publisher's online edition of Journal of Occupational and Environmental Hygiene for the following free supplemental resources: a file containing additional information on historical studies of wildland fire exposures, a file containing the daily-exposure-severity questionnaire completed by wildland firefighter participants at the end of each day, and a file containing additional details of the investigation of correlations between carbon monoxide concentrations and other measured exposure factors in the current study.].

Lead-free ammunition is becoming increasingly popular because of the environmental and human health issues associated with the use of leaded ammunition. However, there is a lack of data on the emissions produced by firing such ammunition. We report emission factors for toxic gases and particle-bound compounds produced by firing lead-free ammunition in a test chamber. Carbon monoxide, ammonia, and hydrogen cyanide levels within the chamber were analysed by Fourier transform infrared spectroscopy, while total suspended particles and respirable particles were determined gravimetrically. The metal content of the particulate emissions was determined and the associated organic compounds were characterized in detail using a method based on thermal desorption coupled to gas chromatography and mass spectrometry. The particulate matter (∼30 mg/round) consisted primarily of metals such as Cu, Zn, and Fe along with soot arising from incomplete combustion. Nitrogen-containing heterocyclic aromatic compounds such as carbazole, quinolone, and phenazine were responsible for some of the 25 most significant chromatographic peaks, together with PAHs, diphenylamine, and phthalates. Emission factors were determined for PAHs and oxygenated PAHs; the latter were less abundant in the gun smoke particles than in domestic dust and diesel combustion smoke. This may be due to the oxygen-deficient conditions that occur when the gun is fired. By using an electrical low pressure impactor, it was demonstrated that more than 90% of the particles produced immediately after firing the weapon had diameters of less than 30 nm, and so most of the gun smoke particles belonged to the nanoparticle regime.

Investigations of carbon monoxide (CO-related poisonings and deaths on houseboats were conducted by the Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health. These investigations measured hazardous CO concentrations on and around houseboats that utilize gasoline-powered generators. Engineering control devices were developed and tested to mitigate this deadly hazard. CO emissions were measured using various sampling techniques which included exhaust emission analyzers, detector tubes, evacuated containers (grab air samples analyzed by a gas chromatograph), and direct-reading CO monitors. CO results on houseboats equipped with gasoline-powered generators without emission controls indicated hazardous CO concentrations exceeding immediately dangerous to life and health (IDLH) levels in potentially occupied areas of the houseboat. Air sample results on houseboats that were equipped with engineering controls to remove the hazard were highly effective and reduced CO levels by over 98% in potentially occupied areas. The engineering control devices used to reduce the hazardous CO emissions from gasoline-powered generators on houseboats were extremely effective at reducing CO concentrations to safe levels in potentially occupied areas on the houseboats and are now beginning to be widely used.

This study was undertaken to determine whether there was an association between fine particles (PM₂.₅) levels and hospital admissions for congestive heart failure (CHF) in Taipei, Taiwan. Hospital admissions for CHF and ambient air pollution data for Taipei were obtained for the period 2006-2010. The relative risk of hospital admissions was estimated using a case-crossover approach, controlling for weather variables, day of the week, seasonality and long-term time trends. For the single pollutant model (without adjustment for other pollutants), increased CHF admissions were significantly associated with PM₂.₅ both on warm days (>23 °C) and cool days (<23 °C), with an interquartile range increase associated with a 13% (95% CI = 9-17%) and 3% (95% CI = 0-7%) increase in CHF admissions, respectively. In the two-pollutant models, PM₂.₅ remained significant after the inclusion of SO₂ or O₃ both on warm and cool days. This study provides evidence that higher levels of PM₂.₅ increase the risk of hospital admissions for CHF.

Susceptible sub-populations with existing disease have exhibited stronger relationships between air quality and mortality in time-series studies, but their associated life expectancies have largely been overlooked. Murray and Nelson developed a new time-series model that estimated a small unobserved (frail) sub-population and their resulting life expectancies in Philadelphia, including environment relationships. As a further example in a different geographic area, we used this model with 1987-2000 daily mortality data in Chicago and found a stable frail population at risk of ∼900 persons with a mean life expectancy of ∼11 days; fewer than two daily deaths were associated with air pollution. We considered daily concentrations of CO, NO₂, O₃, PM₁₀ and SO₂, and found PM₁₀ and O₃ to have stronger associations with frail mortality. Our estimates of life expectancy and air pollution and temperature relationships are similar to those found in other studies that used different methods. Temperature was more important than air pollution during the 1995 heat wave, when mortality risks increased dramatically after 2 d exposure and life expectancies decreased to 3-5 d. Modeling this event separately had substantial effects on lagged mortality--air pollution relationships and the population at risk. The premises of the Murray-Nelson model were supported by simultaneously considering an additional subgroup of non-frail individuals; they contributed only ∼1% of total elderly deaths. We conclude that frail life expectancies estimated by the Murray-Nelson model are robust, and that under these conditions non-frail persons have little risk of acute mortality, with or without contributions from air pollution.

Introduction: Air pollution increases the risk of cardiovascular diseases. A proposed mechanism is that local airway inflammation leads to systemic inflammation, affecting coagulation and the long-term risk of atherosclerosis. One major source of air pollution is wood burning. Here we investigate whether exposure to two kinds of wood smoke, previously shown to cause airway effects, affects biomarkers of systemic inflammation, coagulation and lipid peroxidation., Methods: Thirteen healthy adults were exposed to filtered air followed by two sessions of wood smoke for three hours, one week apart. One session used smoke from the start-up phase of the wood-burning cycle, and the other smoke from the burn-out phase. Mean particle mass concentrations were 295 µg/m³ and 146 µg/m³, and number concentrations were 140,000/cm³ and 100,000/cm³, respectively. Biomarkers were analyzed in samples of blood and urine taken before and several times after exposure. Results after wood smoke exposure were adjusted for exposure to filtered air., Results: Markers of systemic inflammation and soluble adhesion molecules did not increase after wood smoke exposure. Effects on markers of coagulation were ambiguous, with minor decreases in fibrinogen and platelet counts and mixed results concerning the coagulation factors VII and VIII. Urinary F₂-isoprostane, a consistent marker of in vivo lipid peroxidation, unexpectedly decreased after wood smoke exposure., Conclusions: The effects on biomarkers of inflammation, coagulation and lipid peroxidation do not indicate an increased risk of cardiovascular diseases in healthy adults by short-term exposure to wood smoke at these moderate doses, previously shown to cause airway effects.

This article focuses on air pollution in specific urban microenvironments and conditions characterized by high relative concentration levels and by possible risk to human health. For this reason, monitoring of particle number concentration (PNC) with a wide, size-resolved particle-size range, and CO (an indicator of combustion sources, e.g., traffic), was performed in a variety of microenvironments. Concentrations of ultrafine particles (UFPs), size-fractionated particulate matter (PM), and carbon monoxide (CO) were measured in the central area of Milan over three-week-long periods, one each during summer, autumn, and winter, with three monitoring sessions per day. Experimental data were collected continuously during each monitoring period along an established urban pathway. To assess the relevance of time and spatial factors affecting atmospheric concentrations of UFPs, PM, and CO data were collected while walking or moving by different private and public means of transport. Measurements were divided on the basis of different microenvironments (MEs), seasons, days of the week, and periods of the day. Data analysis shows statistically significant differences across MEs and monitoring periods. The highest measured median concentrations and data variability were observed for busy streets, walking or moving by motorized vehicle (CO, UFP) and in metro trains (PM); the lowest concentrations were observed in park areas and in indoor environments. The highest concentrations were measured during working day morning monitoring sessions. Regarding seasonal variation, UFP, PM, and CO showed different patterns: the highest median concentrations were observed in summer for CO, and in autumn and winter for the UFP and PM. Appreciable differences among all MEs and monitoring periods were observed: concentration patterns and variations appear related to typical sources of urban pollutants (traffic), proximity to sources, and time of day. [Supplementary materials are available for this article. Go to the publisher's online edition of Journal of Occupational and Environmental Hygiene for the following free supplemental resource: a file containing Table VI: Tau b (Kendall) index for non-parametric correlation tau test.].

NIOSH/NCI (National Institute of Occupational Safety and Health and National Cancer Institute) developed exposure estimates for respirable elemental carbon (REC) as a surrogate for exposure to diesel exhaust (DE) for different jobs in eight underground mines by year beginning in the 1940s-1960s when diesel equipment was first introduced into these mines. These estimates played a key role in subsequent epidemiological analyses of the potential relationship between exposure to DE and lung cancer conducted in these mines. We report here on a reanalysis of some of the data from this exposure assessment. Because samples of REC were limited primarily to 1998-2001, NIOSH/NCI used carbon monoxide (CO) as a surrogate for REC. In addition, because CO samples were limited, particularly in the earlier years, they used the ratio of diesel horsepower (HP) to the mine air exhaust rate as a surrogate for CO. There are considerable uncertainties connected with each of these surrogate-based steps. The estimates of HP appear to involve considerable uncertainty, although we had no data upon which to evaluate the magnitude of this uncertainty. A sizable percentage (45%) of the CO samples used in the HP to CO model was below the detection limit which required NIOSH/NCI to assign CO values to these samples. In their preferred REC estimates, NIOSH/NCI assumed a linear relation between C0 and REC, although they provided no credible support for that assumption. Their assumption of a stable relationship between HP and CO also is questionable, and our reanalysis found a statistically significant relationship in only one-half of the mines. We re-estimated yearly REC exposures mainly using NIOSH/NCI methods but with some important differences: (i) rather than simply assuming a linear relationship, we used data from the mines to estimate the CO-REC relationship; (ii) we used a different method for assigning values to nondetect CO measurements; and (iii) we took account of statistical uncertainty to estimate bounds for REC exposures. This exercise yielded significantly different exposure estimates than estimated by NIOSH/NCI. However, this analysis did not incorporate the full range of uncertainty in REC exposures because of additional uncertainties in the assumptions underlying the modeling and in the underlying data (e.g. HP and mine exhaust rates). Estimating historical exposures in a cohort is generally a very difficult undertaking. However, this should not prevent one from recognizing the uncertainty in the resulting estimates in any use made of them.

Context: The use of carbon monoxide detectors may prevent deaths due to unintentional carbon monoxide poisoning. Currently, there is limited data regarding the characteristics of residential carbon monoxide detector use., Objective: To determine the characteristics of residential carbon monoxide detector use., Methods: A survey was administered to a convenience, cross-sectional sample of Emergency Department patients between June and August 2011. Inclusion criteria included patients who were older than 18 years, able to understand written or spoken English or Spanish, and lived in independent residential settings. Survey questions assessed the presence or absence of carbon monoxide and smoke detectors within the participant's home, the frequency of regular battery changes for both devices, location of carbon monoxide detectors within the home, and reasons for not installing carbon monoxide detectors (if applicable). Correlations between racial background, geographical area of residence (urban versus suburban), and income were also assessed., Results: A total of 1030 patients were surveyed. While 97.8% of respondents reported smoke detector use, only 44.4% had home carbon monoxide detectors installed. Only 17.2% had carbon monoxide detectors installed in or near their sleeping area, the correct location for detector placement. Carbon monoxide detector usage was found to be lowest among households earning less than $25,999 per year (27.3% reported having detectors), non-Caucasians (only 42.0% of African-Americans and 24.7% of Hispanics surveyed reported using detectors compared with 57.8% of Caucasians), renters, and urban residents. Reasons given for not having a carbon monoxide detector varied; many answers were consistent with a lack of awareness of the importance of using carbon monoxide detectors., Discussion and Conclusions: Residential carbon monoxide detectors were underutilized compared to smoke detectors. Increased public education, especially for minorities and lower income populations, is necessary regarding the use of carbon monoxide detectors for poisoning prevention.

Combustion emissions cause pro-atherosclerotic responses in apolipoprotein E-deficient (ApoE/⁻) mice, but the causal components of these complex mixtures are unresolved. In studies previously reported, ApoE⁻/⁻ mice were exposed by inhalation 6 h/day for 50 consecutive days to multiple dilutions of diesel or gasoline exhaust, wood smoke, or simulated "downwind" coal emissions. In this study, the analysis of the combined four-study database using the Multiple Additive Regression Trees (MART) data mining approach to determine putative causal exposure components regardless of combustion source is reported. Over 700 physical-chemical components were grouped into 45 predictor variables. Response variables measured in aorta included endothelin-1, vascular endothelin growth factor, three matrix metalloproteinases (3, 7, 9), metalloproteinase inhibitor 2, heme-oxygenase-1, and thiobarbituric acid reactive substances. Two or three predictors typically explained most of the variation in response among the experimental groups. Overall, sulfur dioxide, ammonia, nitrogen oxides, and carbon monoxide were most highly predictive of responses, although their rankings differed among the responses. Consistent with the earlier finding that filtration of particles had little effect on responses, particulate components ranked third to seventh in predictive importance for the eight response variables. MART proved useful for identifying putative causal components, although the small number of pollution mixtures (4) can provide only suggestive evidence of causality. The potential independent causal contributions of these gases to the vascular responses, as well as possible interactions among them and other components of complex pollutant mixtures, warrant further evaluation.

Artificial Neural Network (ANN) models were developed and applied in order to predict the total weekly number of Childhood Asthma Admission (CAA) at the greater Athens area (GAA) in Greece. Hourly meteorological data from the National Observatory of Athens and ambient air pollution data from seven different areas within the GAA for the period 2001-2004 were used. Asthma admissions for the same period were obtained from hospital registries of the three main Children's Hospitals of Athens. Three different ANN models were developed and trained in order to forecast the CAA for the subgroups of 0-4, 5-14-year olds, and for the whole study population. The results of this work have shown that ANNs could give an adequate forecast of the total weekly number of CAA in relation to the bioclimatic and air pollution conditions. The forecasted numbers are in very good agreement with the observed real total weekly numbers of CAA.

This study aims to describe the epidemiology of unintentional non-fire related CO fatalities in the UK and to relate this information to sources of CO. Data from the CO-Gas Safety Society (COGSS) database was analysed and compared with data from the English House Condition Survey (EHCS). There were 462 deaths from the COGSS database, from 1 January 1996 to 31 December 2007 inclusive. The relative risk for death due to non-gas vs gas fuels was 10.52 (95% CI 7.71-14.34). The main weakness of the study is the likely underascertainment of CO deaths in the database. However, this study has identified specific risk factors for CO-related deaths in the UK; the use of non-gas fuels has not previously been highlighted as a significant cause of CO poisoning, and the relative risk (although not the absolute risk) of CO-related fatalities from these fuels is substantial.