Search

It is estimated that up to half of the world's population burns biomass fuel (wood, crop residues, animal dung and coal) for indoor uses such as cooking, lighting and heating. As a result, a large proportion of women and children are exposed to high levels of household air pollution (HAP). The short and long term effects of these exposures on the respiratory health of this population are not clearly understood. On May 9-11, 2011 NIH held an international workshop on the "Health Burden of Indoor Air Pollution on Women and Children," in Arlington, VA. To gather information on the knowledge base on this topic and identify research gaps, ahead of the meeting we conducted a literature search using PubMed to identify publications that related to HAP, asthma, and chronic obstructive pulmonary disease (COPD). Abstracts were all analyzed and we report on those considered by the respiratory sub study group at the meeting to be most relevant to the field. Many of the studies published are symptom-based studies (as opposed to objective measures of lung function or clinical examination etc.) and measurement of HAP was not done. Many found some association between indoor exposures to biomass smoke as assessed by stove type (e.g., open fire vs. liquid propane gas) and respiratory symptoms such as wheeze and cough. Among the studies that examined objective measures (e.g. spirometry) as a health outcome, the data supporting an association between biomass smoke exposure and COPD in adult women are fairly robust, but the findings for asthma are mixed. If an association was observed between the exposures and lung function, most data seemed to demonstrate mild to moderate reductions in lung function, the pathophysiological mechanisms of which need to be investigated. In the end, the group identified a series of scientific gaps and opportunities for research that need to be addressed to better understand the respiratory effects of exposure to indoor burning of the different forms of biomass fuels.

Introduction Ambient particulate matter (PM) pollution accounted for an estimated 3.1 million deaths and 3% of global disability-adjusted life years in 2010 (Lim et al. 2012). Health studies examining the [...], BACKGROUND: Relationships between air quality and health are well-described, but little information is available about the joint associations between particulate air pollution, ambient temperature, and respiratory morbidity. OBJECTIVES: We evaluated associations between concentrations of particulate matter ≤ 2.5 µm in diameter ([PM.sub.2.5]) and exacerbation of existing asthma and modification of the associations by ambient air temperature. METHODS: Data from 50,356 adult respondents to the Asthma Call-back Survey from 2006-2010 were linked by interview date and county of residence to estimates of daily averages of [PM.sub.2.5] and maximum air temperature. Associations between 14-day average [PM.sub.2.5] and the presence of any asthma symptoms during the 14 days leading up to and including the interview date were evaluated using binomial regression. We explored variation by air temperature using similar models, stratified into quintiles of the 14-day average maximum temperature. RESULTS: Among adults with active asthma, 57.1% reported asthma symptoms within the past 14 days, and 14-day average [PM.sub.2.5] [greater than or equal to] 7.07 µg/[m.sup.3] was associated with an estimated 4-5% higher asthma symptom prevalence. In the range of 4.00-7.06 µg/[m.sup.3] of PM2 5, each 1-µg/[m.sup.3] increase was associated with a 3.4% [95% confidence interval (CI): 1.1, 5.7] increase in symptom prevalence; across categories of temperature from 1.1 to 80.5°F, each 1-µg/[m.sup.3] increase was associated with increased symptom prevalence (1.1-44.4°F: 7.9%; 44.5-58.6°F: 6.9%; 58.7-70.1°F: 2.9%; 70.2-80.5°F: 7.3%). CONCLUSIONS: These results suggest that each unit increase in [PM.sub.2.5] may be associated with an increase in the prevalence of asthma symptoms, even at levels as low as 4.00-7.06 µg/[m.sup.3]. Environ Health Perspect 124:1882-1890; http://dx.doi.org/10.1289/EHP92

In 1982, seven intravenous drug users injected what they thought was heroin and rapidly developed moderate to severe movement disorders indistinguishable from Parkinson's disease. The disorders proved to be permanent. The street drug they injected was found to contain 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). While some similar sort of chemical insult may play a role in the development of idiopathic Parkinson's disease (PD), a key distinction between PD and the ailment suffered by these addicts is that Parkinson's disease begins mildly and progresses slowly. For this reason, an attempt was made to identify drug abusers who might have come in contact with MPTP but who developed only mild symptoms and who therefore did not come to the attention of the medical community. Ultimately, 22 such cases were found and studied. These patients, all of whom were in the right time and place to have come in contact with the MPTP, and who described acute symptoms consistent with this contact, were found to have symptoms very similar to those of mild Parkinson's disease. The symptoms of rigidity, bradykinesia (or slow movement), and postural instability were indistinguishable from those of Parkinson's disease. Only a milder degree of resting tremor distinguished the addicts from the patients with idiopathic Parkinson's disease. This difference may be accounted for by the fact that the average age of the drug users was much lower than that of the Parkinson's patients. Resting tremor is thought, in cases of PD, to be less severe among the young. It remains to be seen if the drug abusers with mild Parkinson's symptoms progress to more serious symptoms with time. The results of this study indicate that at least one toxic agent is capable of causing a symptoms indistinguishable from those of Parkinson's disease. Further study will determine if, like Parkinson's disease, the neurological damage which results from MPTP toxicity progresses with time. (Consumer Summary produced by Reliance Medical Information, Inc.)

BACKGROUND: Relationships between air quality and health are well-described, but little information is available about the joint associations between particulate air pollution, ambient temperature, and respiratory morbidity. OBJECTIVES: We evaluated associations between concentrations of particulate matter ≤ 2.5 μm in diameter (PM2.5) and exacerbation of existing asthma and modification of the associations by ambient air temperature. METHODS: Data from 50,356 adult respondents to the Asthma Call-back Survey from 2006–2010 were linked by interview date and county of residence to estimates of daily averages of PM2.5 and maximum air temperature. Associations between 14-day average PM2.5 and the presence of any asthma symptoms during the 14 days leading up to and including the interview date were evaluated using binomial regression. We explored variation by air temperature using similar models, stratified into quintiles of the 14-day average maximum temperature. RESULTS: Among adults with active asthma, 57.1% reported asthma symptoms within the past 14 days, and 14-day average PM2.5 ≥ 7.07 μg/m3 was associated with an estimated 4–5% higher asthma symptom prevalence. In the range of 4.00–7.06 μg/m3 of PM2.5, each 1-μg/m3 increase was associated with a 3.4% [95% confidence interval (CI): 1.1, 5.7] increase in symptom prevalence; across categories of temperature from 1.1 to 80.5°F, each 1-μg/m3 increase was associated with increased symptom prevalence (1.1–44.4°F: 7.9%; 44.5–58.6°F: 6.9%; 58.7–70.1°F: 2.9%; 70.2–80.5°F: 7.3%). CONCLUSIONS: These results suggest that each unit increase in PM2.5 may be associated with an increase in the prevalence of asthma symptoms, even at levels as low as 4.00–7.06 μg/m3. [ABSTRACT FROM AUTHOR]

The article focuses on the monitoring of the effect of air pollutants particulate matter (PM) and ozone to health by the U.S. Environmental Protection Agency (EPA). Topics include its association to various health conditions including lung cancer, respiratory and cardiovascular disease, and premature death, the implication of the ozone exposure to health conditions, and the data sources used in the assessment such as population estimate, education and income estimate, and PM and ozone count.

Abstract. Two outbreaks of group A streptococcal abscesses following receipt of diphtheria-tetanus toxoid-pertussis (DTP) vaccine from different manufacturers were reported to the Centers for Disease Control (CDC) in 1982. The clustering of the immunization times of cases, the isolation of the same serotype of Streptococcus from all cases in each outbreak, and the absence of reported abscesses associated with receipt of the same lots of vaccine in other regions of the country, suggest that each outbreak was probably caused by contamination of a single 15-dose vial of vaccine. The preservative thimerosal was present within acceptable limits in unopened vials from the same lot of DTP vaccine in each outbreak. Challenge studies indicate that a strain of Streptococcus from one of the patients can survive up to 15 days in DTP vaccine at 4 Celsius. Contamination of vials during manufacturing would have required survival of streptococci for a minimum of 8 months. Preservatives in multidose vaccine vials do not prevent short-term bacterial contamination. Options to prevent further clusters of streptococcal abscesses are discussed. The only feasible and cost-effective preventive measure now available is careful attention to sterile technique when administering vaccine from multidose vials. [ABSTRACT FROM AUTHOR]

Focuses on the 1990 National Health Interview Survey conducted by the National Center for Health Statistics. Statistical methodology used; Variances in the knowledge of radon according to race, education and income; Environmental health objectives for the Year 2000.

Background: Asthma is the most common chronic lung disease of childhood, affecting approximately 6 million children in the United States. Although asthma cannot be cured, most of the time, asthma symptoms can be controlled by avoiding or reducing exposure to asthma triggers (allergens and irritants) and by following recommendations for asthma education and appropriate medical care., Methods: CDC analyzed asthma data from the 2001-2016 National Health Interview Survey for children aged 0-17 years to examine trends and demographic differences in health outcomes and health care use., Results: Asthma was more prevalent among boys (9.2%) than among girls (7.4%), children aged ≥5 years (approximately 10%) than children aged <5 years (3.8%), non-Hispanic black (black) children (15.7%) and children of Puerto Rican descent (12.9%) than among non-Hispanic white (white) children (7.1%), and children living in low income families (10.5%) than among those living in families with income ≥250% of the Federal Poverty Level (FPL) (approximately 7%). Asthma prevalence among children increased from 8.7% in 2001 to 9.4% in 2010, and then decreased to 8.3% in 2016. Although not all changes were statistically significant, a similar pattern was observed among subdemographic groups studied, with the exception of Mexican/Mexican-American children, among whom asthma prevalence increased from 5.1% in 2001 to 6.5% in 2016. Among children with asthma, the percentage who had an asthma attack in the past 12 months declined significantly from 2001 to 2016. Whereas asthma prevalence was lower among children aged 0-4 years than among older children, the prevalence of asthma attacks (62.4%), emergency department or urgent care center (ED/UC) visits (31.1%), and hospitalization (10.4%) were higher among children with asthma aged 0-4 years than among those aged 12-17 years (44.8%, 9.6%, and 2.8%, respectively). During 2013, children with asthma aged 5-17 years missed 13.8 million days of school per year (2.6 days per child). Compared with 2003, in 2013, the prevalence of adverse health outcomes and health care use were significantly lower and the prevalence of having an action plan to manage asthma was higher., Conclusions and Implications for Public Health Practice: Asthma remains an important public health and medical problem. The health of children with asthma can be improved by promoting asthma control strategies, including asthma trigger reduction, appropriate guidelines-based medical management, and asthma education for children, parents, and others involved in asthma care., Competing Interests: No conflicts of interest were reported.

Extensive water damage after major hurricanes and floods increases the likelihood of mold contamination in buildings. This report provides information on how to limit exposure to mold and how to identify and prevent mold-related health effects. Where uncertainties in scientific knowledge exist, practical applications designed to be protective of a person's health are presented. Evidence is included about assessing exposure, clean-up and prevention, personal protective equipment, health effects, and public health strategies and recommendations. The recommendations assume that, in the aftermath of major hurricanes or floods, buildings wet for <48 hours will generally support visible and extensive mold growth and should be remediated, and excessive exposure to mold-contaminated materials can cause adverse health effects in susceptible persons regardless of the type of mold or the extent of contamination. For the majority of persons, undisturbed mold is not a substantial health hazard. Mold is a greater hazard for persons with conditions such as impaired host defenses or mold allergies. To prevent exposure that could result in adverse health effects from disturbed mold, persons should 1) avoid areas where mold contamination is obvious; 2) use environmental controls; 3) use personal protective equipment; and 4) keep hands, skin, and clothing clean and free from mold-contaminated dust. Clinical evaluation of suspected mold-related illness should follow conventional clinical guidelines. In addition, in the aftermath of extensive flooding, health-care providers should be watchful for unusual mold-related diseases. The development of a public health surveillance strategy among persons repopulating areas after extensive flooding is recommended to assess potential health effects and the effectiveness of prevention efforts. Such a surveillance program will help CDC and state and local public health officials refine the guidelines for exposure avoidance, personal protection, and clean-up and assist health departments to identify unrecognized hazards.