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Individuals with COVID-19 who do not require hospitalization are instructed to self-isolate in their residences. Due to high secondary infection rates in household members, there is a need to understand airborne transmission of SARS-CoV-2 within residences. We report the first naturalistic intervention study suggesting a reduction of such transmission risk using portable air cleaners (PACs) with HEPA filters. Seventeen individuals with newly diagnosed COVID-19 infection completed this single-blind, crossover, randomized study. Total and size-fractionated aerosol samples were collected simultaneously in the self-isolation room with the PAC (primary) and another room (secondary) for two consecutive 24-h periods, one period with HEPA filtration and the other with the filter removed (sham). Seven out of sixteen (44%) air samples in primary rooms were positive for SARS-CoV-2 RNA during the sham period. With the PAC operated at its lowest setting (clean air delivery rate [CADR] = 263 cfm) to minimize noise, positive aerosol samples decreased to four out of sixteen residences (25%; p = 0.229). A slight decrease in positive aerosol samples was also observed in the secondary room. As the world confronts both new variants and limited vaccination rates, our study supports this practical intervention to reduce the presence of viral aerosols in a real-world setting.

Background Many respiratory conditions have been attributed to toxic dust and fume exposure in World Trade Center (WTC) rescue and recovery workers, who frequently report symptoms of OSA. We examined the prevalence of new-onset OSA and tested if the prevalence and severity of OSA are related to the presence of chronic rhinosinusitis (CRS). Methods A total of 601 subjects (83% men; age, 33-87 years; BMI, 29.9 ± 5.5 kg/m2) enrolled in the WTC Health Program, excluding those with significant pre-September 11, 2001, snoring or prior CRS, underwent two nights of home sleep testing. OSA was defined as Apnea Hypopnea Index 4% ≥ 5 events/h or respiratory disturbance index of ≥ 15 events/h. CRS was assessed using nasal symptom questionnaires. Results The prevalence of OSA was 75% (25% no OSA, 46% mild OSA, 19% moderate OSA, and 10% severe OSA), and the prevalence of CRS was 43.5%. Compared with no CRS, new and worsening CRS was a significant risk factor for OSA with an OR of 1.80 (95% CI, 1.18-2.73; P = .006) unadjusted and 1.76 (95% CI, 1.08-2.88; P = .02) after adjustment for age, BMI, sex, gastroesophageal reflux disorder, and alcohol use. Conclusions The high prevalence of OSA in WTC responders was not explained fully by obesity and sex. Possible mechanisms for the elevated risk of OSA in subjects with CRS include increased upper airway inflammation and/or elevated nasal/upper airway resistance, but these need confirmation.

Home sleep testing devices are being widely used in diagnosis/screening for obstructive sleep apnea (OSA). We examined differences in OSA metrics obtained from two devices with divergent home monitoring strategies, the Apnea Risk Evaluation System (ARES™, multiple signals plus forehead reflectance oximetry) and the Nonin WristOx2™ (single channel finger transmission pulse oximeter), compared to differences from night-night variability of OSA. One hundred fifty-two male/26 female subjects (BMI = 30.3 ± 5.6 kg/m2, age = 52.5 ± 8.9 years) were recruited without regard to OSA symptoms and simultaneously wore both ARES™ and Nonin WristOx2™ for two nights (n = 351 nights). Automated analysis of the WristOx2 yielded oxygen desaturation index (ODIOx2, ≥4% O2 dips/h), and automated analysis with manual editing of ARES™ yielded AHI4ARES (apneas + hypopneas with ≥4% O2 dips/h) and RDIARES (apneas + hypopneas with ≥4% O2 dips/h or arousal surrogates). Baseline awake oxygen saturation, percent time

Elevated perfluorononanoic acid (PFNA) levels, one of many manmade per- and polyfluoroalkyl substances (PFAS), were detected in public water systems/private wells in New Jersey communities. Interventions to end exposure through drinking water were carried out from 2014 to 2016. To evaluate the effectiveness of interventions, a community biomonitoring study was conducted for the communities between 2017 and 2020. A convenience sampling design was used with 120 participants in Year 1 between ages of 20–74 who consumed PFNA-contaminated water. Three blood samples, one year apart, were drawn from each participant and completed for 99 participants. Separated serum samples were measured for 12 PFAS including PFNA. Questionnaires were administered to collect information on demographics and potential sources. Drinking water and house dust collected at the first visit were analyzed for 14 PFAS including PFNA. The PFNA sera levels (Year 1) found 84 out of 120 (70%) participants were higher than the 95th percentile of a nationally representative sample of US adults (NHANES2015-16). Current drinking water and house dust were not significant contributing sources for the study participants. On average, PFNA sera levels were 12 ± 16% (Year 2) and 27 ± 16% (Year 3) lower than the level measured in Year 1 (p 95th percentile of NHANES2015-16) with controlling for physiological covariates. The decline in adult serum PFNA levels seen in the years following a community drinking water intervention suggests the intervention effectively reduced PFNA exposure via drinking water.

Commuting in automobiles can contribute substantially to total traffic-related air pollution (TRAP) exposure, yet measuring commuting exposures for studies of health outcomes remains challenging. To estimate real-world TRAP exposures, we developed and evaluated the robustness of a scripted drive protocol on the NJ Turnpike and local roads between April 2007 and October 2014. Study participants were driven in a car with closed windows and open vents during morning rush hours on 190 days. Real-time measurements of PM2.5, PNC, CO, and BC, and integrated samples of NO2, were made in the car cabin. Exposure measures included in-vehicle concentrations on the NJ Turnpike and local roads and the differences and ratios of these concentrations. Median in-cabin concentrations were 11 μg/m3 PM2.5, 40 000 particles/cm3, 0.3 ppm CO, 4 μg/m3 BC, and 20.6 ppb NO2. In-cabin concentrations on the NJ Turnpike were higher than in-cabin concentrations on local roads by a factor of 1.4 for PM2.5, 3.5 for PNC, 1.0 for CO, and 4 for BC. Median concentrations of NO2 for full rides were 2.4 times higher than ambient concentrations. Results were generally robust relative to season, traffic congestion, ventilation setting, and study year, except for PNC and PM2.5, which had secular and seasonal trends. Ratios of concentrations were more stable than differences or absolute concentrations. Scripted drives can be used for generating reasonably consistent in-cabin increments of exposure to traffic-related air pollution.

Rationale: Obstructive sleep apnea (OSA) is associated with recurrent obstruction, subepithelial edema, and airway inflammation. The resultant inflammation may influence or be influenced by the nasal microbiome. Objectives: To evaluate whether the composition of the nasal microbiota is associated with obstructive sleep apnea and inflammatory biomarkers. Methods: Two large cohorts were used: 1) a discovery cohort of 472 subjects from the WTCSNORE (Seated, Supine and Post-Decongestion Nasal Resistance in World Trade Center Rescue and Recovery Workers) cohort, and 2) a validation cohort of 93 subjects rom the Zaragoza Sleep cohort. Sleep apnea was diagnosed using home sleep tests. Nasal lavages were obtained from cohort subjects to measure: 1) microbiome composition (based on 16S rRNA gene sequencing), and 2) biomarkers for inflammation (inflammatory cells, IL-8, and IL-6). Longitudinal 3-month samples were obtained in the validation cohort, including after continuous positive airway pressure treatment when indicated. Measurements and Main Results: In both cohorts, we identified that: 1) severity of OSA correlated with differences in microbiome diversity and composition; 2) the nasal microbiome of subjects with severe OSA were enriched with Streptococcus, Prevotella, and Veillonella; and 3) the nasal microbiome differences were associated with inflammatory biomarkers. Network analysis identified clusters of cooccurring microbes that defined communities. Several common oral commensals (e.g., Streptococcus, Rothia, Veillonella, and Fusobacterium) correlated with apnea–hypopnea index. Three months of treatment with continuous positive airway pressure did not change the composition of the nasal microbiota. Conclusions: We demonstrate that the presence of an altered microbiome in severe OSA is associated with inflammatory markers. Further experimental approaches to explore causal links are needed.

UNLABELLED: Fourier transform infrared (FTIR) spectra of outdoor, indoor, and personal fine particulate matter (PM(2.5)) samples were collected during the Relationship of Indoor, Outdoor, and Personal Air (RIOPA) study. FTIR spectroscopy provides functional group information about the entire PM(2.5) sample without any chemical preparation. It is particularly important to characterizing the poorly understood organic fraction of PM(2.5). To our knowledge this is the first time that FTIR spectroscopy has been applied to a PM(2.5) exposure study. The results were used to chemically characterize indoor air and personal exposure. Sulfate was strongest in outdoor samples, which is consistent with the generally accepted understanding that sulfate is of outdoor origin. Absorbances attributed to soil dust were also seen in many outdoor and some indoor and personal samples. Inorganic nitrate absorbances were a common feature of many California and some New Jersey samples. Carbonyl absorbances showed substantial variation in strength, number of peaks, and wave number shift between samples, indicating variability in composition and sources. Absorbances attributed to aliphatic hydrocarbon and amide functional groups were enhanced in many personal and indoor samples, which suggested the influence of indoor sources in these homes. We speculate that meat cooking is one possible source of particulate amides. PRACTICAL IMPLICATIONS: To our knowledge this is the first time that FTIR spectroscopy has been used to characterize the composition of indoor and personal PM(2.5). The presence of sulfate, nitrate, ammonium, soil dust and a number of organic functional groups are all detected in one analysis on filter samples without extraction or other sample preparation. Differences between indoor and outdoor spectra are used to identify spectral features due to indoor-generated PM(2.5). Particularly interesting are the much larger aliphatic absorbances, shifts in carbonyl absorbances, and occasional small amide absorbances found in indoor and personal spectra but rarely in outdoor spectra. These observations are important because organics make up a large portion of PM(2.5) mass and their composition and properties are poorly characterized. The properties and behavior of organic compounds in airborne particles are often predicted based on their functional group composition. This analysis begins the development of a better understanding of the functional group composition of indoor and personal PM(2.5) and how it differs from that of outdoor PM(2.5). Eventually this will lead to an improved understanding of the properties, behavior and effects of PM(2.5) of indoor and outdoor origin.

The indoor and outdoor concentrations of 30 polycyclic aromatic hydrocarbons (PAHs) were measured in 55 nonsmoking residences in three urban areas during June 1999-May 2000. The data represent the subset of samples collected within the Relationship of Indoor, Outdoor, and Personal Air study (RIOPA). The study collected samples from homes in Los Angeles, CA, Houston, TX, and Elizabeth, NJ. In the outdoor samples, the total PAH concentrations (sigmaPAH) were 4.2-64 ng m(-3) in Los Angeles, 10-160 ng m(-3) in Houston, and 12-110 ng m(-3) in Elizabeth. In the indoor samples, the concentrations of sigmaPAH were 16-220 ng m(-3) in Los Angeles, 21-310 ng m(-3) in Houston, and 22-350 ng m(-3) in Elizabeth. The PAH profiles of low molecular weight PAHs (3-4 rings) in the outdoor samples from the three cities were not significantly different. In contrast, the profiles of 5-7-ring PAHs in thesethree citieswere significantlydifferent, which suggested different dominant PAH sources. The signatures of 5-7-ring PAHs in the indoor samples in each city were similar to the outdoor profiles, which suggested that indoor concentrations of 5-7-ring PAHs were dominated by outdoor sources. Indoor-to-outdoor ratios of the PAH concentrations showed that indoor sources had a significant effect on indoor concentrations of 3-ring PAHs and a smaller effect on 4-ring PAHs and that outdoor sources dominated the indoor concentrations of 5-7-ring PAHs.

The explosion and collapse of the World Trade Center (WTC) was a catastrophic event that produced an aerosol plume impacting many workers, residents, and commuters during the first few days after 11 September 2001. Three bulk samples of the total settled dust and smoke were collected at weather-protected locations east of the WTC on 16 and 17 September 2001; these samples are representative of the generated material that settled immediately after the explosion and fire and the concurrent collapse of the two structures. We analyzed each sample, not differentiated by particle size, for inorganic and organic composition. In the inorganic analyses, we identified metals, radionuclides, ionic species, asbestos, and inorganic species. In the organic analyses, we identified polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls, polychlorinated dibenzodioxins, polychlorinated dibenzofurans, pesticides, phthalate esters, brominated diphenyl ethers, and other hydrocarbons. Each sample had a basic pH. Asbestos levels ranged from 0.8% to 3.0% of the mass, the PAHs were > 0.1% of the mass, and lead ranged from 101 to 625 microg/g. The content and distribution of material was indicative of a complex mixture of building debris and combustion products in the resulting plume. These three samples were composed primarily of construction materials, soot, paint (leaded and unleaded), and glass fibers (mineral wool and fiberglass). Levels of hydrocarbons indicated unburned or partially burned jet fuel, plastic, cellulose, and other materials that were ignited by the fire. In morphologic analyses we found that a majority of the mass was fibrous and composed of many types of fibers (e.g., mineral wool, fiberglass, asbestos, wood, paper, and cotton). The particles were separated into size classifications by gravimetric and aerodynamic methods. Material < 2.5 microm in aerodynamic diameter was 0.88-1.98% of the total mass. The largest mass concentrations were > 53 microm in diameter. The results obtained from these samples can be used to understand the contact and types of exposures to this unprecedented complex mixture experienced by the surviving residents, commuters, and rescue workers directly affected by the plume from 11 to 12 September and the evaluations of any acute or long-term health effects from resuspendable dust and smoke to the residents, commuters, and local workers, as well as from the materials released after 11 September until the fires were extinguished. Further, these results support the need to have the interior of residences, buildings, and their respective HVAC systems professionally cleaned to reduce long-term residential risks before rehabitation.

Indoor VOC air concentrations of many compounds are higher than outdoor concentrations due to indoor sources. However, most studies have measured residential indoor air in urban centers so the typical indoor air levels in suburban and rural regions have not been well characterized. Indoor VOC air concentrations were measured in 100 homes in suburban and rural areas in NJ to provide background levels for investigations of the impact from subsurface contamination sources. Of the 57 target compounds, 23 were not detected in any of the homes, and 14 compounds were detected in at least 50% of the homes with detection limits of approximately 1 microg/m3. The common compounds identified included aromatic and aliphatic hydrocarbons from mobile sources, halogenated hydrocarbons commonly used in consumer products or from chlorinated drinking water, acetone and 2-butanone emitted from cosmetic products, and Freons. Typical concentrations were in the low microg/m3 range, though values of tens, hundreds or even thousands of microg/m3 were measured in individual homes in which activities related to specific sources of VOCs were reported. Compounds with known similar sources were highly correlated. The levels observed are consistent with concentrations found in the air of urban homes.

Background Questionnaires are an important component of epidemiologic studies. Maintaining compliance in longitudinal studies is a challenge, particularly from children and adolescents. Objective To implement a Web-based questionnaire for children and adolescents with asthma for daily self-completion, minimizing recall bias and maximizing compliance. Methods We determined symptoms, exposure to asthma triggers, peak expiratory flow rate, and medications taken, including dose and dose time. The Web-based system can be less time-consuming and a source of fewer errors than paper questionnaires and permits review of the data and compliance during the study. The Web programming of the questionnaire included branching, so that questions deemed irrelevant based on a previous response were not presented to participants, minimizing the completion time. Results Sixty-four students with asthma participated nearly daily for between 2 and 4 months. Financial incentives for the participants were calculated in real time based on completion rates. Monitoring of the subject's completion included an extensive administrative hierarchical alert system, enabling the staff to target individuals who fell behind in entries and needed the most encouragement. Conclusions Similar compliance and completion rates were obtained using the Web-based questionnaire as reported for smaller paper questionnaires by parents of children. The Web-based system provides a mechanism to obtain daily responses directly from an age group not often accessible by traditional questionnaire approaches.

Residential indoor and outdoor fine particle (PM(2.5)) organic (OC) and elemental carbon (EC) concentrations (48 h) were measured at 173 homes in Houston, TX, Los Angeles County, CA, and Elizabeth, NJ as part of the Relationship of Indoor, Outdoor and Personal Air (RIOPA) study. The adsorption of organic vapors on the quartz fiber sampling filter (a positive artifact) was substantial indoors and out, accounting for 36% and 37% of measured OC at the median indoor (8.2 microg C/m(3)) and outdoor (5.0 microg C/m(3)) OC concentrations, respectively. Uncorrected, adsorption artifacts would lead to substantial overestimation of particulate OC both indoors and outdoors. After artifact correction, the mean particulate organic matter (OM=1.4 OC) concentration indoors (9.8 microg/m(3)) was twice the mean outdoor concentration (4.9 microg/m(3)). The mean EC concentration was 1.1 microg/m(3) both indoors and outdoors. OM accounted for 29%, 30% and 29% of PM(2.5) mass outdoors and 48%, 55% and 61% of indoor PM(2.5) mass in Los Angeles Co., Elizabeth and Houston study homes, respectively. Indirect evidence provided by species mass balance results suggests that PM(2.5) nitrate (not measured) was largely lost during outdoor-to-indoor transport, as reported by Lunden et al. This results in dramatic changes with outdoor-to-indoor transport in the mass and composition of ambient-generated PM(2.5) at California homes. On average, 71% to 76% of indoor OM was emitted or formed indoors, calculated by (1) Random Component Superposition (RCS) model and (2) non-linear fit of OC and air exchange rate data to the mass balance model. Assuming that all particles penetrate indoors (P=1) and there is no particle loss indoors (k=0), a lower bound estimate of 41% of indoor OM was indoor-generated (mean). OM appears to be the predominant species in indoor-generated PM(2.5), based on species mass balance results. Particulate OM emitted or formed indoors is substantial enough to alter the concentration, composition and behavior of indoor PM(2.5). One interesting effect of increased indoor OM concentrations is a shift in the gas-particle partitioning of polycyclic aromatic hydrocarbons (PAHs) from the gas to the particle phase with outdoor-to-indoor transport.

The Relationship of Indoor, Outdoor and Personal Air (RIOPA) Study was undertaken to evaluate the contribution of outdoor sources of air toxics, as defined in the 1990 Clean Air Act Amendments, to indoor concentrations and personal exposures. The concentrations of 18 volatile organic compounds (VOCs), 17 carbonyl compounds, and fine particulate matter mass (PM(2.5)) were measured using 48-h outdoor, indoor and personal air samples collected simultaneously. PM2.5 mass, as well as several component species (elemental carbon, organic carbon, polyaromatic hydrocarbons and elemental analysis) were also measured; only PM(2.5) mass is reported here. Questionnaires were administered to characterize homes, neighborhoods and personal activities that might affect exposures. The air exchange rate was also measured in each home. Homes in close proximity (

The Relationship of Indoor, Outdoor and Personal Air (RIOPA) study was designed to investigate residential indoor, outdoor and personal exposures to several classes of air pollutants, including volatile organic compounds, carbonyls and fine particles (PM2.5). Samples were collected from summer, 1999 to spring, 2001 in Houston (TX), Los Angeles (CA) and Elizabeth (NJ). Indoor, outdoor and personal PM2.5 samples were collected at 212 nonsmoking residences, 162 of which were sampled twice. Some homes were chosen due to close proximity to ambient sources of one or more target analytes, while others were farther from sources. Median indoor, outdoor and personal PM2.5 mass concentrations for these three sites were 14.4, 15.5 and 31.4 microg/m3, respectively. The contributions of ambient (outdoor) and nonambient sources to indoor and personal concentrations were quantified using a single compartment box model with measured air exchange rate and a random component superposition (RCS) statistical model. The median contribution of ambient sources to indoor PM2.5 concentrations using the mass balance approach was estimated to be 56% for all study homes (63%, 52% and 33% for California, New Jersey and Texas study homes, respectively). Reasonable variations in model assumptions alter median ambient contributions by less than 20%. The mean of the distribution of ambient contributions across study homes agreed well for the mass balance and RCS models, but the distribution was somewhat broader when calculated using the mass balance model with measured air exchange rates.

Methyl tertiary-butyl ether (MTBE) is the most commonly used oxygenated compound added to gasoline to reduce ambient carbon monoxide levels. Complaints about perceived MTBE exposures and adverse health symptoms have been registered in several states, including New Jersey (NJ). Fueling automobiles is the activity thought to cause the highest environmental MTBE exposures. The current study was conducted to determine the MTBE concentrations inside automobile cabins during fueling, which represents the peak exposure that can occur at full service gasoline service stations, such as those that exist in NJ. Air samples were collected at service stations located on the NJ and PA turnpikes from March 1996 to July 1997 during which the MTBE content in gasoline varied. A bimodal distribution of MTBE concentrations was found in the cabin of the cars while fueling. The median MTBE, benzene and toluene in cabin concentrations were 100, 5.5 and 18 ppb, respectively, with the upper concentrations of the distribution exceeding 1 ppm for MTBE and 0.1 ppm for benzene and toluene. The highest in cabin concentrations occurred in a car that had a malfunctioning vapor recovery system and in a series of cars sampled on an unusually warm, calm winter day when the fuel volatility was high, the evaporation maximal and the dispersion by wind minimal. The in-cabin concentrations were typically higher when the car window was opened during the entire fueling process. Thus, exposure to MTBE during fueling can be reduced by properly maintaining the integrity of the fuel system and keeping the windows closed during fueling.

Concentrations of polycyclic aromatic hydrocarbons (PAHs), PM2.5, and organic and elemental carbon (OC and EC) were measured in 48 h integrated samples collected in the indoor and outdoor air in Los Angeles, CA, Houston, TX, and Elizabeth, NJ from July 1999 to June 2000. The objective of the study was to evaluate the hypothesis that outdoor air pollution contributed strongly to indoor air pollution. The measured partition coefficients of PAHs, Kp,meas, in the individual samples were well correlated with the compounds’ sub-cooled liquid vapor pressure, pLo. Values of Kp,meas varied by about two orders of magnitude for any given value of vapor pressure. These variations in gas/particle partitioning of PAHs were higher than the estimated systematic and random error of Kp,meas and are related to the aerosol characteristics and sampling conditions. Stepwise multiple linear regression analysis (MLR) of the pooled data, which included pLo at 25°C, temperature, fOC and fEC as independent variables, explains 84.5% of the variability of the partition coefficients. This is higher than the explained variance when pLo is used as a single parameter (77.5%). The relative importance of each variable for prediction of PAH partition coefficient is determined by partial coefficients of determination. Vapor pressure at 25°C (RpoL2=0.84) and temperature (RT2=0.21) are the two most important predictors followed by fEC (RfEC2=0.12) and fOC (RfOC2=0.038). Both EC and OC carbon are important predictors of gas/particle partitioning of PAHs, with EC being a better predictor. Because EC is highly correlated with (and is a good tracer of) primary combustion-generated OC, this result suggests that PAHs more readily sorb on combustion-generated aerosol containing EC. Enrichment of the indoor aerosol in non-combustion OC suggests that sorption of PAHs is more important in the indoor air compared to the outdoor air. The MLR developed in this work will improve prediction of gas/particle partitioning of PAHs in indoor and outdoor air.