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Background and aim: Woodsmoke from household fireplaces contributes significantly to outdoor air pollution in the Netherlands. The current understanding of the respiratory health effects of exposure to smoke from residential wood burning is limited. This study investigated the association between short-term changes in outdoor woodsmoke exposure and lung function, respiratory symptoms, and medication use in adults in the Netherlands. Methods: This study was co-created with citizen scientists and other relevant stakeholders. A panel study was conducted with repeated observations in 46 adults between February and May 2021 in four Dutch towns. Participants recorded their symptoms and medication use in daily diaries, and conducted morning and evening home spirometry measurements. Woodsmoke exposure was characterized by measuring levoglucosan (most specific marker for woodsmoke exposure), black/brown carbon, fine and ultrafine particulate matter at central monitoring sites. Individual woodsmoke perception (smell) was recorded in daily diaries. Linear and logistic regression models were used to investigate the association between respiratory health and woodsmoke exposure. Models were adjusted for time-varying confounders and accounted for repeated observations within participants. Results: Consistent positive associations were found between levoglucosan and shortness of breath (SOB) during rest and extra respiratory medication use. Odds ratios for current day exposure to levoglucosan were 1.12 (95% CI: 0.97, 1.30) for SOB during rest and 1.19 (95% CI: 1.07, 1.33) for extra medication use, expressed per interquartile range of levoglucosan concentrations (69.16 ng/m3). Positive non-significant associations were found between levoglucosan and nasal symptoms, cough and waking up with SOB. No consistent association was found between levoglucosan and lung function. Associations found between woodsmoke markers, SOB during rest and extra medication use remained after the inclusion of PM2.5 and UFP in two-pollutant models. Conclusions: Adults experienced more SOB during rest, nasal symptoms and used more medication to treat respiratory symptoms on days with higher levels of outdoor woodsmoke concentrations. [ABSTRACT FROM AUTHOR]

Objectives Evidence for a relationship between gas cooking and childhood respiratory health is inconsistent and few longitudinal studies have been reported. Our aim was to examine the association between gas cooking and the development of respiratory and allergic outcomes longitudinally in a prospective birth cohort study. Methods The Prevention and Incidence of Asthma and Mite Allergy birth cohort study followed children from birth (1996/1997) until age 8. Annual questionnaires were used to document respiratory and allergic symptoms. Allergic sensitisation and bronchial hyper-responsiveness (BHR) were measured at age 8 in subpopulations. A total of 3590 children were included in the present analysis. We used generalised estimating equations and discrete-time hazard models to study the overall and age-specific associations between exposure to gas cooking and the risk of developing respiratory illnesses. Sensitivity analyses of intermittent, always, current and early exposure to gas cooking were conducted. Results Ever gas cooking exposure was associated with nasal symptoms (sneezing, runny/blocked nose without a cold) during the first 8 years of life (OR=1.32, 95% CI 1.09 to 1.59), but not with lower respiratory tract infections, eczema, allergic sensitisation and BHR. Associations with nasal symptoms were similar among children with intermittent, always, current and early exposure. Among girls only, prevalent asthma was associated with ever gas cooking (OR=1.97, 95% CI 1.05 to 3.72). Conclusions Overall, our findings provide little evidence for an adverse effect of exposure to gas cooking on the development of asthma and allergies. [ABSTRACT FROM AUTHOR]

To cite this article: Abbing-Karahagopian V, van der Gugten AC, van der Ent CK, Uiterwaal C, de Jongh M, Oldenwening M, Brunekreef B, Gehring U. Effect of endotoxin and allergens on neonatal lung function and infancy respiratory symptoms and eczema. Pediatric Allergy Immunology 2012: 23: 448-455. Abstract Background: Exposure to endotoxin and allergens in house dust has been found to be associated with childhood wheeze and asthma. Neonatal lung function is rarely examined in relation to this exposure. Objectives: To assess the association between exposure to endotoxin, house dust mite and cat allergens and neonatal lung function, and respiratory symptoms and eczema in infancy. Methods: In the Wheezing Illnesses Study Leidsche Rijn (WHISTLER) birth cohort study, levels of endotoxin, house dust mite allergens, and cat allergen have been measured in dust samples collected in the child's home. Lung function was measured before age 2 months, and respiratory symptoms and eczema were recorded in a daily diary during the first year of life. Associations of lung function (N = 302), respiratory symptoms (N = 361), and eczema (N = 342) with endotoxin and allergen levels have been studied by means of linear and logistic regression, respectively. Results: Mattress dust endotoxin was associated with a significant increase in neonatal respiratory compliance [adjusted mean difference (95% confidence interval) 2.31 (0.33; 4.29) ml/kPa per interquartile range increase in exposure] and a non-significant decrease in neonatal airway resistance [0.32 (−0.77; 0.14) kPa/l/s]. There were no associations between allergen exposure and neonatal lung function and respiratory symptoms. Conclusions: Environmental exposure to endotoxin may have an important role in the development of lung function. [ABSTRACT FROM AUTHOR]

Background: Exposure to traffic-related air pollution is a risk factor for cardiovascular events, probably involving mechanisms of inflammation and coagulation. Little is known about effects of the short exposures encountered while participating in traffic. Objectives: The objective of the study was to examine effects of exposure of commuters to air pollution on cardiovascular biomarkers. Methods: Thirty-four healthy adult volunteers commuted for 2 hr by bus, car, or bicycle during the morning rush hour. During the commute, exposure to particle number, particulate matter (PM) ≤ 2.5 µm in aerodynamic diameter (PM2.5), PM ≤ 10 µm in diameter (PM10), and soot was measured. We estimated inhaled doses based on heart rate monitoring. Shortly before exposure and 6 hr after exposure, blood samples were taken and analyzed for CC16 (Clara cell protein 16), blood cell count, coagulation markers, and inflammation markers. Between June 2007 and June 2008, 352 pre- and postexposure blood samples were collected on 47 test days. We used mixed models to analyze the associations between exposure and changes in health parameters. Results: We observed no consistent associations between the air pollution exposures and doses and the various biomarkers that we investigated. Conclusions: Air pollution exposure during commuting was not consistently associated with acute changes in inflammation markers, blood cell counts, or blood coagulation markers. [ABSTRACT FROM AUTHOR]

Background: Adult cholesterol concentrations might be influenced by early-life factors, such as breastfeeding and birth weight, referred to as "early programming". How such early factors exert their influence over the life course is still poorly understood. Evidence from studies in children and adolescents is scarce and conflicting. We investigated the influence of 6 different perinatal risk factors on childhood total and HDL cholesterol concentrations and total-to-HDL cholesterol ratio measured at 8 years of age, and additionally we studied the role of the child's current Body Mass Index (BMI). Methods: Anthropometric measures and blood plasma samples were collected during a medical examination in 751 8-yearold children participating in the prospective Prevention and Incidence of Asthma and Mite Allergy (PIAMA) birth cohort study. Linear and logistic regression were performed to estimate associations of total and HDL cholesterol concentrations with breastfeeding, birth weight, infant weight gain, maternal overweight before pregnancy, gestational diabetes and maternal smoking during pregnancy, taking into account the child's current BMI. Results: Linear regressions showed an association between total-to-HDL cholesterol ratio and maternal pre-pregnancy overweight (&bgr; = 0.15, Confidence Interval 95% (CI): 0.02, 0.28), rapid infant weight gain (&bgr; = 0.13, 95%CI: 0.01, 0.26), and maternal smoking during pregnancy (&bgr; = 0.14, 95%CI: 0.00, 0.29). These associations were partly mediated by the child's BMI. Conclusion: Total-to-HDL cholesterol ratio in 8-year-old children was positively associated with maternal pre-pregnancy overweight, maternal smoking during pregnancy and rapid infant weight gain. [ABSTRACT FROM AUTHOR]

Background: Commuters are exposed to high concentrations of air pollutants, but little quantitative information is currently available on differences in exposure between different modes of transport, routes, and fuel types. Objectives: The aim of our study was to assess differences in commuters' exposure to traffic-related air pollution related to transport mode, route, and fuel type. Methods: We measured particle number counts (PNCs) and concentrations of PM2.5 (particulate matter ≤ 2.5 μm in aerodynamic diameter), PM10, and soot between June 2007 and June 2008 on 47 weekdays, from 0800 to 1000 hours, in diesel and electric buses, gasoline- and diesel-fueled cars, and along two bicycle routes with different traffic intensities in Arnhem, the Netherlands. In addition, each-day measurements were taken at an urban background location. Results: We found that median PNC exposures were highest in diesel buses (38,500 particles/cm3) and for cyclists along the high-traffic intensity route (46,600 particles/cm3) and lowest in electric buses (29,200 particles/cm3). Median PM10 exposure was highest from diesel buses (47 μg/m3) and lowest along the high- and low-traffic bicycle routes (39 and 37 μg/m3). The median soot exposure was highest in gasoline-fueled cars (9.0 x 10-5/m), diesel cars (7.9 x 10-5/m), and diesel buses (7.4 x 10-5/m) and lowest along the low-traffic bicycle route (4.9 x 10-5/m). Because the minute ventilation (volume of air per minute) of cyclists, which we estimated from measured heart rates, was twice the minute ventilation of car and bus passengers, we calculated that the inhaled air pollution doses were highest for cyclists. With the exception of PM10, we found that inhaled air pollution doses were lowest for electric bus passengers. Conclusions: Commuters' rush hour exposures were significantly influenced by mode of transport, route, and fuel type. [ABSTRACT FROM AUTHOR]

Objectives Monitoring studies have shown that commuters are exposed to high air pollution concentrations, but there is limited evidence of associated health effects. We carried out a study to investigate the acute respiratory health effects of air pollution related to commuting by bicycle. Methods Twelve healthy adults cycled a low- and a high-traffic intensity route during morning rush hour in Utrecht, The Netherlands. Exposure to traffic-related air pollution was characterised by measurements of PM10, soot and particle number. Before, directly after and 6 h after cycling we measured lung function (FEV1, FVC, PEF), exhaled NO (FENO) and respiratory symptoms. The association between post- minus pre-exposure difference in health effects and exposure during cycling was evaluated with linear regression models. Results The average particle number concentration was 59% higher, while the average soot concentration was 39% higher on the high-traffic route than on the low-traffic route. There was no difference for PM10. Contrary to our hypothesis, associations between air pollution during cycling and lung function changes immediately after cycling were mostly positive. Six hours after cycling, associations between air pollution exposure and health were mostly negative for lung function changes and positive for changes in exhaled NO, although non-significant. Conclusions We found substantial differences in ultrafine particle number and soot exposure between two urban cycling routes. Exposure to ultrafine particles and soot during cycling was weakly associated with increased exhaled NO, indicative of airway inflammation, and decrements in lung function 6 h after exposure. A limitation of the study was the relatively small sample size. [ABSTRACT FROM AUTHOR]

The guidelines of the American Thoracic Society (ATS) and the European Respiratory Society (ERS) for standardized measurements of exhaled nitric oxide (NO) state that for online measurements the inhaled air should be free of NO. As it is not always possible to create an NO-free environment, inhalation through an NO-scrubber is used. To describe the relationship between ambient NO and measurements of fractional exhaled NO (FENO) and nasal NO (nNO) investigated according to the ATS–ERS guidelines in a large population of children. The present work makes use of data collected during the 8-yr follow-up of the Dutch PIAMA birth cohort study. FENO and nNO were measured in three hospitals in a total of 1005 children with a NIOX chemiluminescence analyser. In two hospitals, almost half of the measured ambient NO levels exceeded 5 p.p.b. Maximum levels were >100 p.p.b. in all hospitals. Despite its large variation, ambient NO did not have an effect on FENO, but it did have a significant impact on nNO in two of the three centres. The currently recommended technique including inhalation through an NO scrubber effectively deals with variable levels of ambient NO on FENO. In contrast, ambient NO has an effect on measurements of nNO. [ABSTRACT FROM AUTHOR]

Few epidemiological studies report on reliability of exposure measurements even though this significantly influences the results of correlation and regression analysis often used in these studies. Poor reliability of exposure measurement reduces the ability to detect a true association between a certain component and health outcome variables. The aim of this study was to determine the ratio of the within-home and between-home components of variance of a number of biocontaminants measured in house dust in the framework of an international study conducted in the Netherlands, Germany and Sweden (the AIRALLERG study). To this end, duplicate dust samples were collected from children's beds and from living room floors in over 100 homes. Samples were taken at the same point in time. Variables considered were the dust mass collected in mg/m2 and the concentrations of the house dust mite allergens Der p 1 and Der f 1, cat allergen Fel d 1, endotoxin, (1 → 3)-β-D-glucan and extracellular polysaccharides, all per gram of dust and per square meter of sampling surface. An analysis of variance showed that the within-home variance was small compared to the between-home variance for most variables (mostly less than half) with the exception of glucan on mattresses, when expressed in μg/g. Investigation of variation over time is needed for a more complete assessment of the use of these variables in epidemiological analyses of exposure–response relationships.Journal of Exposure Science and Environmental Epidemiology (2007) 17, 134–140. doi:10.1038/sj.jes.7500482; published online 5 April 2006 [ABSTRACT FROM AUTHOR]

Background: Spirometric lung function measurements have been proven to be excellent objective markers of respiratory morbidity. The use of different types of spirometers in epidemiological and clinical studies may present systematically different results affecting interpretation and implication of results. We aimed to explore considerations in the use of different spirometers in epidemiological studies by comparing forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) measurements between the Masterscreen pneumotachograph and EasyOne spirometers. We also provide a correction equation for correcting systematic differences using regression calibration.Methods: Forty-nine volunteers had lung function measured on two different spirometers in random order with at least three attempts on each spirometer. Data were analysed using correlation plots, Bland and Altman plots and formal paired t-tests. We used regression calibration to provide a correction equation.Results: The mean (SD) FEV1 and FVC was 3.78 (0.63) L and 4.78 (0.63) L for the Masterscreen pneumotachograph and 3.54 (0.60) L and 4.41 (0.83) L for the EasyOne spirometer. The mean FEV1 difference of 0.24 L and mean FVC difference of 0.37 L between the spirometers (corresponding to 6.3 and 8.4% difference, respectively) were statistically significant and consistent between younger (< 30 years) and older volunteers (> 30 years) and between males and females. Regression calibration indicated that an increase of 1 L in the EasyOne measurements corresponded to an average increase of 1.032 L in FEV1 and 1.005 L in FVC in the Masterscreen measurements.Conclusion: Use of different types of spirometers may result in significant systematic differences in lung function values. Epidemiological researchers need to be aware of these potential systematic differences and correct for them in analyses using methods such as regression calibration. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "Exposure to traffic exhaust and night cough during early childhood: the CCAAPS birth cohort," by H. Sucharew and colleagues.