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Background: E-cigarette use has been shown to have short-term acute effects among active users but less is known of the acute passive effects, particularly among individuals with existing respiratory diseases. Objective: To investigate local and systemic effects of short-term passive vape exposure among patients with mild or moderate chronic obstructive pulmonary disease (COPD). Methods: In a double-blinded crossover study 16 non-smoking COPD-patients (mean age 68) were randomly exposed for 4 h to passive vape (median PM 2.5: 18 µg/m 3 (range: 8–333)) and clean air (PM 2.5 3) separated by 14 days. Particles were measured using an ultrafine particle counter (P-TRAK) and a scanning mobility particle sizer (SMPS). Health effects including Surfactant Protein-A (SP-A) and albumin in exhaled air, spirometry, FeNO, and plasma proteins were evaluated before, right after, and 24 hours after exposure. Participants reported symptoms throughout exposure sessions. Data were analyzed using mixed models. Results: SP-A in exhaled air was negatively affected by exposure to vape and several plasma proteins increased significantly. Throat irritation was more pronounced during passive vape exposure, while FVC and FEV 1 decreased, however, not significantly. Conclusions: SP-A in exhaled air and some plasma proteins were affected by passive vape in patients with COPD indicating inflammation, showing that passive vape exposure is potentially harmful.

Specific inhalation challenge (SIC) is the golden standard for identifying specific causes of work-related asthma and rhinoconjunctivitis. Few centres offer SIC as it requires experience, resources and acute treatment facilities. Prior to SIC treatment should be carefully reduced. A control challenge is performed on a separate day. Many new asthma causes have been identified with SIC. SIC provides the basis for optimal treatment and advice.

BACKGROUND: We investigated the effect of chitin on the inflammation and immune modulation of the nasal mucosa. This compound was compared to placebo and as a positive control we used lipopolysaccharide (LPS).METHODS: Fourteen healthy nonsmoking volunteers 22 to 28 years of age were included. All persons underwent exposure to chitin microparticles (CP) and placebo in a randomized double-blinded fashion. In a last session we used LPS from Enterobacter agglomerans in a single-blinded fashion. There were 2 weeks between each session. The outcome measures were Total Nasal Symptom Score (TNSS) and nasal lavage for cytokines and cells at 0, 3, 4, 8 hours.RESULTS: We showed that CP was only weakly inflammatory compared to LPS. In contrast to the LPS response, we did however show an immune-regulatory effect of CP on enhanced interleukin (IL)-4 and IL-6 responses known to downregulate T helper 2 (Th2) responses, indicating a potential beneficial effect of CP for the regulation of the allergic Th2 immune response.CONCLUSION: This study also shows that CP is well tolerated in healthy volunteers, and that does not induce significantly more symptoms compared to placebo. In fact there is a tendency for CP instillation to induce less rhinorrhoea compared to placebo.

Background: In Europe a substantial share of the energy supply is used for domestic heating and cooling. The quality of building insulation thus significantly impacts air pollution.Objectives: To model the effects of an improved building insulation scenario in Europe on air pollution levels and the resulting effects on health and economy.Methods: Projected energy savings between 2005 and 2020 were calculated for an improved building insulation scenario and a business as usual scenario. The resulting changes in emissions (e.g. from power plants) were used in the Comprehensive Air-Quality Model with extensions. Mean annual changes in the main air pollutants were derived for each country. World Health Organization (WHO) and European Union (EU) data on populations and on impacts of pollutants were used to derive health effects and costs. Effects on indoor air quality were not assessed.Results: Projected effects on the mean annual change in PM2.5 varied from −0.008 μg/m3 (Finland) to −0.538 μg/m3 (Belgium). The mean number of life-years (LY) gained annually per 100000 adults was 24.3 LY (range 0.9 to 54.5). The total number of LY gained annually varied from 31 in Finland to 22524 in Germany, totaling 78678 LY in Europe. A total of 7173 cases of persistent chronic bronchitis could be avoided annually. Several other health outcomes improved similarly. The saved societal costs totaled 6.64 billion € annually.Conclusions: In addition to carbon emission reductions, an improved building insulation scenario in Europe would have substantial benefits on health through improvements in air pollution. Health effects and societal cost savings may significantly counterbalance investment costs and should be taken into account when evaluating strategies for mitigation of global warming.

Exposure to particles from combustion of wood is associated with respiratory symptoms, whereas there is limited knowledge about systemic effects. We investigated effects on systemic inflammation, oxidative stress and DNA damage in humans who lived in a reconstructed Viking Age house, with indoor combustion of wood for heating and cooking. The subjects were exposed to high indoor concentrations of PM2.5 (700-3,600 µg/m(3) ), CO (10.7-15.3 ppm) and NO2 (140-154 µg/m(3) ) during a 1-week stay. Nevertheless, there were unaltered levels of genotoxicity, determined as DNA strand breaks and formamidopyrimidine DNA glycosylase and oxoguanine DNA glycosylase 1 sensitive sites in peripheral blood mononuclear cells. There were also unaltered expression levels of OGG1, HMOX1, CCL2, IL8, and TNF levels in leukocytes. In serum, there were unaltered levels of C-reactive protein, IL6, IL8, TNF, lactate dehydrogenase, cholesterol, triglycerides, and high-density lipoproteins. The wood smoke exposure was associated with decreased serum levels of sICAM-1, and a tendency to decreased sVCAM-1 levels. There was a minor increase in the levels of circulating monocytes expressing CD31, whereas there were unaltered expression levels of CD11b, CD49d, and CD62L on monocytes after the stay in the house. In conclusion, even a high inhalation exposure to wood smoke was associated with limited systemic effects on markers of oxidative stress, DNA damage, inflammation, and monocyte activation. Environ. Mol. Mutagen. 2014. © 2014 Wiley Periodicals, Inc.