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1.  Assessing Metal Exposures in a Community near a Cement Plant in the Northeast U.S. 
Cement production is a major source of metals and metalloids in the environment, while exposures to metals and metalloids may impact human health in the surrounding communities. We recruited 185 participants living in the vicinity of a cement plant in the northeast U.S., and measured the levels of aluminum (Al), arsenic (As), cadmium (Cd), lead (Pb), mercury (Hg), and selenium (Se) in blood and Hg in hair samples from them. A questionnaire was used to assess potential sources of Hg exposure. Multivariate regressions and spatial analyses were performed to evaluate the relative importance of different routes of exposures. The metal concentrations in blood or hair samples of our study participants were comparable to the U.S. general or regional population. Smoking contributed significantly to Cd and Pb exposures, and seafood consumption contributed significantly to Hg and As exposures, while variables related to the cement plant were not significantly associated with metal concentrations. Our results suggest that our study population was not at elevated health risk due to metal exposures, and that the contribution of the cement plant to metal exposures in the surrounding community was minimal.
doi:10.3390/ijerph120100952
PMCID: PMC4306904  PMID: 25607604
cement plant; metal pollution; human exposures; blood; hair; mercury; arsenic; lead; cadmium
2.  Linking Student Performance in Massachusetts Elementary Schools with the “Greenness” of School Surroundings Using Remote Sensing 
PLoS ONE  2014;9(10):e108548.
Various studies have reported the physical and mental health benefits from exposure to “green” neighborhoods, such as proximity to neighborhoods with trees and vegetation. However, no studies have explicitly assessed the association between exposure to “green” surroundings and cognitive function in terms of student academic performance. This study investigated the association between the “greenness” of the area surrounding a Massachusetts public elementary school and the academic achievement of the school’s student body based on standardized tests with an ecological setting. Researchers used the composite school-based performance scores generated by the Massachusetts Comprehensive Assessment System (MCAS) to measure the percentage of 3rd-grade students (the first year of standardized testing for 8–9 years-old children in public school), who scored “Above Proficient” (AP) in English and Mathematics tests (Note: Individual student scores are not publically available). The MCAS results are comparable year to year thanks to an equating process. Researchers included test results from 2006 through 2012 in 905 public schools and adjusted for differences between schools in the final analysis according to race, gender, English as a second language (proxy for ethnicity and language facility), parent income, student-teacher ratio, and school attendance. Surrounding greenness of each school was measured using satellite images converted into the Normalized Difference Vegetation Index (NDVI) in March, July and October of each year according to a 250-meter, 500-meter, 1,000-meter, and 2000-meter circular buffer around each school. Spatial Generalized Linear Mixed Models (GLMMs) estimated the impacts of surrounding greenness on school-based performance. Overall the study results supported a relationship between the “greenness” of the school area and the school-wide academic performance. Interestingly, the results showed a consistently positive significant association between the greenness of the school in the Spring (when most Massachusetts students take the MCAS tests) and school-wide performance on both English and Math tests, even after adjustment for socio-economic factors and urban residency.
doi:10.1371/journal.pone.0108548
PMCID: PMC4195655  PMID: 25310542
3.  INTRAUTERINE EXPOSURE TO FINE PARTICULATE MATTER AS A RISK FACTOR FOR INCREASED SUSCEPTIBILITY TO ACUTE BRONCHO-PULMONARY INFECTIONS IN EARLY CHILDHOOD 
Over the last decades many epidemiologic studies considered the morbidity patterns for respiratory diseases and lung function of children in the context of ambient air pollution usually measured in the postnatal period. The main purpose of this study is to assess the impact of prenatal exposure to fine particulate matter (PM2.5) on the recurrent broncho-pulmonary infections in early childhood.
The study included 214 children who had measurements of personal prenatal PM2.5 exposure and regularly collected data on the occurrence of acute bronchitis and pneumonia diagnosed by a physician from birth over the seven-year follow-up. The effect of prenatal exposure to PM2.5 was adjusted in the multivariable logistic models for potential confounders, such as prenatal and postnatal ETS (environmental tobacco smoke), city residence area as a proxy of postnatal urban exposure, children’s sensitization to domestic aeroallergens, and asthma. In the subgroup of children with available PM2.5 indoor levels, the effect of prenatal exposure was additionally adjusted for indoor exposure as well. The adjusted odds ratio (OR) for incidence of recurrent broncho-pulmonary infections (five or more spells of bronchitis and/or pneumonia) recorded in the follow-up significantly correlated in a dose-response manner with the prenatal PM2.5 level (OR = 2.44, 95%CI: 1.12 – 5.36).
In conclusion, the study suggests that prenatal exposure to PM2.5 increases susceptibility to respiratory infections and may program respiratory morbidity in early childhood. The study also provides evidence that the target value of 20 μg/m3 for the 24-hour mean level of PM2.5 protects unborn babies better than earlier established EPA guidelines.
doi:10.1016/j.ijheh.2012.12.014
PMCID: PMC3657308  PMID: 23333083
birth cohort study; fine particulate matter; prenatal and postnatal exposure; bronchitis; pneumonia
4.  Ozone and Ozone By-Products in the Cabins of Commercial Aircraft 
Environmental science & technology  2013;47(9):4711-4717.
The aircraft cabin represents a unique indoor environment due to its high surface-to-volume ratio, high occupant density and the potential for high ozone concentrations at cruising altitudes. Ozone was continuously measured and air was sampled on sorbent traps, targeting carbonyl compounds, on 52 transcontinental U.S. or international flights between 2008 and 2010. The sampling was predominantly on planes that did not have ozone scrubbers (catalytic converters). Peak ozone levels on aircraft without catalytic convertors exceeded 100 ppb, with some flights having periods of more than an hour when the ozone levels were > 75ppb. Ozone was greatly reduced on relatively new aircraft with catalytic convertors, but ozone levels on two flights whose aircraft had older convertors were similar to those on planes without catalytic convertors. Hexanal, heptanal, octanal, nonanal, decanal and 6-methyl-5-hepten-2-one (6-MHO) were detected in the aircraft cabin at sub- to low ppb levels. Linear regression models that included the log transformed mean ozone concentration, percent occupancy and plane type were statistically significant and explained between 18 and 25% of the variance in the mixing ratio of these carbonyls. Occupancy was also a significant factor for 6-MHO, but not the linear aldehydes, consistent with 6-MHO’s formation from the reaction between ozone and squalene, which is present in human skin oils.
doi:10.1021/es3046795
PMCID: PMC3683839  PMID: 23517299
5.  HOUSEHOLD PESTICIDE CONTAMINATION FROM INDOOR PEST CONTROL APPLICATIONS IN URBAN LOW-INCOME PUBLIC HOUSING DWELLINGS: A COMMUNITY-BASED PARTICIPATORY RESEARCH 
Environmental science & technology  2013;47(4):2018-2025.
We designed this community-based participatory research (CBPR) project aiming to generate evidence-based research results in order to encourage residents living in urban low-income public housing dwellings engaging in a community-wide integrated pest management (IPM) program with the intention to improve their health and quality of life, as well as household conditions.
We enrolled 20 families and their children in this study in which we utilized environmental exposure assessment (surface wipe and indoor air) tools to quantitatively assessing residential pesticide exposure in young children before the implementation of an IPM program. We analyzed those samples for 19 organophosphate (OP) and pyrethroid pesticides.
The most commonly detected pesticides were pyrethroids, particularly permethrin and cypermethrin with average concentrations of 2.47 and 3.87 µg/m2, respectively. In many dwellings, we detected OPs, which are no longer available on the market, however, their levels are significantly lower than those of pyrethroids. None of the 20 families was free from pesticide contamination in their households, and pesticides were commonly detected in living room and children’s bedroom.
The correlation among household hygienic conditions, the sighting of live pests/pest debris, and the degree of indoor pesticide contamination highlights the failure of conventional chemical-based applications for pest controls. The results from the current study, as well as other recent studies, conducted in low-income public housing, child care centers, and randomly selected homes in the U.S. should accentuate the need for alternative pest management programs that incorporate safer and more sustainable protocols for pest controls.
doi:10.1021/es303912n
PMCID: PMC3578288  PMID: 23363037
Community-based participatory research; CBPR; pesticide exposure; pyrethroids; organophosphate pesticides; public housing; indoor pesticide application
6.  Within- and Between-Child Variation in Repeated Urinary Pesticide Metabolite Measurements over a 1-Year Period 
Environmental Health Perspectives  2013;122(2):201-206.
Background: Children are exposed to pesticides from many sources and routes, including dietary and incidental ingestion, dermal absorption, and inhalation. Linking health outcomes to these exposures using urinary metabolites requires understanding temporal variability within subjects to avoid exposure misclassification.
Objectives: We characterized the within- and between-child variability of urinary organophosphorus and pyrethroid metabolites in 23 participants of the Children’s Pesticide Exposure Study–Washington over 1 year and examined the ability of one to four spot urine samples to categorize mean exposures.
Methods: Each child provided urine samples twice daily over 7- to 16-day sessions in four seasons in 2003 and 2004. Samples were analyzed for five pyrethroid and five organophosphorus (OP) metabolites. After adjusting for specific gravity, we used a customized maximum likelihood estimation linear mixed-effects model that accounted for values below the limit of detection to calculate intraclass correlation coefficients (ICC) and conducted surrogate category analyses.
Results: Within-child variability was 2–11 times greater than between-child variability. When restricted to samples collected during a single season, ICCs were higher in the fall, winter, and spring than in summer for OPs, and higher in summer and winter for pyrethroids, indicating an increase in between-person variability relative to within-person variability during these seasons. Surrogate category analyses demonstrated that a single spot urine sample did not categorize metabolite concentrations well, and that four or more samples would be needed to categorize children into quartiles consistently.
Conclusions: Urinary biomarkers of these short half-life pesticides exhibited substantial within-person variability in children observed over four seasons. Researchers investigating pesticides and health outcomes in children may need repeated biomarker measurements to derive accurate estimates of exposure and relative risks.
Citation: Attfield KR, Hughes MD, Spengler JD, Lu C. 2014. Within- and between-child variation in repeated urinary pesticide metabolite measurements over a 1-year period. Environ Health Perspect 122:201–206; http://dx.doi.org/10.1289/ehp.1306737
doi:10.1289/ehp.1306737
PMCID: PMC3915262  PMID: 24325925
7.  Ambient Site, Home Outdoor and Home Indoor Particulate Concentrations as Proxies of Personal Exposures 
Despite strong longitudinal associations between particle personal exposures and ambient concentrations, previous studies have found considerable inter-personal variability in these associations. Factors contributing to this inter-personal variability are important to identify in order to improve our ability to assess particulate exposures for individuals. This paper examines whether ambient, home outdoor and home indoor particle concentrations can be used as proxies of corresponding personal exposures. We explore the strength of the associations between personal, home indoor, home outdoor and ambient concentrations of sulfate, fine particle mass (PM2.5) and elemental carbon (EC) by season and subject for 25 individuals living in the Boston, MA, USA area. Ambient sulfate concentrations accounted for approximately 70 to 80% of the variability in personal and indoor sulfate levels. Correlations between ambient and personal sulfate, however, varied by subject (0.1 – 1.0), with associations between personal and outdoor sulfate concentrations generally mirroring personal-ambient associations (median subject-specific correlations of 0.8 to 0.9). Ambient sulfate concentrations are good indicators of personal exposures for individuals living in the Boston area, even though their levels may differ from actual personal exposures. The strong associations for sulfate indicate that ambient concentrations and housing characteristics are the driving factors determining personal sulfate exposures. Ambient PM2.5 and EC concentrations were more weakly associated with corresponding personal and indoor levels, as compared to sulfate. For EC and PM2.5, local traffic, indoor sources and/or personal activities can significantly weaken associations with ambient concentrations. Infiltration was shown to impact the ability of ambient concentrations to reflect exposures with higher exposures to particles from ambient sources during summer. In contrast in the winter, lower infiltration can result in a greater contribution of indoor sources to PM2.5 and EC exposures. Placing EC monitors closer to participants’ homes may reduce exposure error in epidemiological studies of traffic-related particles, but this reduction in exposure error may be greater in winter than summer. It should be noted that approximately 20% of the EC data were below the field limit of detection, making it difficult to determine if the weaker associations with the central site for EC were merely a result of methodological limitations.
doi:10.1039/b805991h
PMCID: PMC3779934  PMID: 18728896
8.  EFFECT OF PRENATAL EXPOSURE TO FINE PARTICULATE MATTER ON VENTILATORY LUNG FUNCTION OF PRESCHOOL CHILDREN OF NONSMOKING MOTHERS. KRAKOW INNER CITY BIRTH COHORT PROSPECTIVE STUDY 
SUMMARY
Impaired fetal development is associated with a number of adult chronic diseases and it is believed that these associations arise as a result of the phenomenon of “epigenetic programming”, which involves persisting changes in structure and function of various body organs caused by ambient factors during critical and vulnerable periods of early development. The main goal of the study was to assess the association between lung function in early childhood and prenatal exposure to fine particulate matter (PM2.5 ), which represents a wide range of chemical compounds potentially hazardous for fetal development. Among pregnant women recruited prenatally to the study personal measurements of PM2.5 was performed over 48 hours in the second trimester of pregnancy. After delivery, infants were followed over five years and the interviewers visited participants at their homes to record children’s respiratory symptoms every three months in the child’s first two years of life and every 6 months later. In the fifth year of the follow-up, children were invited for standard lung function testing and quantified by FVC, FEV1 and FEV05 levels. Material consisted of 176 children of nonsmoking mothers, who performed at least two acceptable spirometry measurements. Multivariable linear regression model showed a significant deficit of FVC at the highest quartile of PM2.5 exposure (beta coefficient = − 91.9 , P = 0.008), after adjustment for covariates (age, gender, birth weight, height and wheezing). Also FEV1 level in children was inversely correlated with prenatal exposure to PM2.5, and the average FEV1 deficit amounted to 87.7 ml (P = 0.008) at the higher level of exposure. Although the effect of PM2.5 exposure on FEV05 was proportionally weaker (−72.7, P = 0.026) it was significant as well. The lung function level was inversely and significantly associated with the wheezing recorded over the follow-up. The findings showed that significant lung function deficits in early childhood is associated with prenatal exposure to fine particulate matter, which may affect fetal lung growth.
doi:10.1111/j.1365-3016.2010.01136.x
PMCID: PMC3761386  PMID: 20670230
prenatal exposure; air pollution; birth cohort; lung function; preschool children
9.  Estimation of ultrafine particle concentrations at near-highway residences using data from local and central monitors 
Ultrafine particles (UFP; aerodynamic diameter < 0.1 micrometers) are a ubiquitous exposure in the urban environment and are elevated near highways. Most epidemiological studies of UFP health effects use central site monitoring data, which may misclassify exposure. Our aims were to: (1) examine the relationship between distant and proximate monitoring sites and their ability to predict hourly UFP concentration measured at residences in an urban community with a major interstate highway and; (2) determine if meteorology and proximity to traffic improve explanatory power. Short-term (1 – 3 weeks) residential monitoring of UFP concentration was conducted at 18 homes. Long-term monitoring was conducted at two near-highway monitoring sites and a central site. We created models of outdoor residential UFP concentration based on concentrations at the near-highway site, at the central site, at both sites together and without fixed sites. UFP concentration at residential sites was more highly correlated with those at a near-highway site than a central site. In regression models of each site alone, a 10% increase in UFP concentration at a near-highway site was associated with a 6% (95% CI: 6%, 7%) increase at residences while a 10% increase in UFP concentration at the central site was associated with a 3% (95% CI: 2%, 3%) increase at residences. A model including both sites showed minimal change in the magnitude of the association between the near-highway site and the residences, but the estimated association with UFP concentration at the central site was substantially attenuated. These associations remained after adjustment for other significant predictors of residential UFP concentration, including distance from highway, wind speed, wind direction, highway traffic volume and precipitation. The use of a central site as an estimate of personal exposure for populations near local emissions of traffic-related air pollutants may result in exposure misclassification.
doi:10.1016/j.atmosenv.2012.04.004
PMCID: PMC3640373  PMID: 23645993
Ultrafine particles; highway; community-based participatory research; CBPR; temporal variation; residential exposure
10.  Household concentrations and exposure of children to particulate matter from biomass fuels in The Gambia 
Environmental science & technology  2012;46(6):3519-3527.
Particulate matter (PM) is an important metric for studying the health effects of household air pollution. There are limited data on PM exposure for children in homes that use biomass fuels, and no previous study has used direct measurement of personal exposure in children younger than 5 years of age. We estimated PM2.5 exposure for 1,266 children in The Gambia by applying the cookhouse PM2.5-CO relationship to the child’s CO exposure. Using this indirect method, mean PM2.5 exposure for all subjects was 135 ± 38 μg/m3; 25% of children had exposures of 151 μg/m3 or higher. Indirectly-estimated exposure was highest among children who lived in homes that used firewood (collected or purchased) as their main fuel (144 μg/m3) compared to those who used charcoal (85 μg/m3). To validate the indirect method, we also directly measured PM2.5 exposure on 31 children. Mean exposure for this validation dataset was 65 ± 41 μg/m3 using actual measurement and 125 ± 54 μg/m3 using the indirect method based on CO exposure. The correlation coefficient between direct measurements and indirect estimates was 0.01. Children in The Gambia have relatively high PM2.5 exposure. There is a need for simple methods that can directly measure PM2.5 exposure in field studies.
doi:10.1021/es203047e
PMCID: PMC3309066  PMID: 22304223
Indoor air pollution; biomass fuels; child survival; global health; Africa; particulate matter; exposure assessment; statistical model
11.  Exposure to flame retardant chemicals on commercial airplanes 
Environmental Health  2013;12:17.
Background
Flame retardant chemicals are used in materials on airplanes to slow the propagation of fire. These chemicals migrate from their source products and can be found in the dust of airplanes, creating the potential for exposure.
Methods
To characterize exposure to flame retardant chemicals in airplane dust, we collected dust samples from locations inside 19 commercial airplanes parked overnight at airport gates. In addition, hand-wipe samples were also collected from 9 flight attendants and 1 passenger who had just taken a cross-country (USA) flight. The samples were analyzed for a suite of flame retardant chemicals. To identify the possible sources for the brominated flame retardants, we used a portable XRF analyzer to quantify bromine concentrations in materials inside the airplanes.
Results
A wide range of flame retardant compounds were detected in 100% of the dust samples collected from airplanes, including BDEs 47, 99, 153, 183 and 209, tris(1,3-dichloro-isopropyl)phosphate (TDCPP), hexabromocyclododecane (HBCD) and bis-(2-ethylhexyl)-tetrabromo-phthalate (TBPH). Airplane dust contained elevated concentrations of BDE 209 (GM: 500 ug/g; range: 2,600 ug/g) relative to other indoor environments, such as residential and commercial buildings, and the hands of participants after a cross-country flight contained elevated BDE 209 concentrations relative to the general population. TDCPP, a known carcinogen that was removed from use in children’s pajamas in the 1970’s although still used today in other consumer products, was detected on 100% of airplanes in concentrations similar to those found in residential and commercial locations.
Conclusion
This study adds to the limited body of knowledge regarding exposure to flame retardants on commercial aircraft, an environment long hypothesized to be at risk for maximum exposures due to strict flame retardant standards for aircraft materials. Our findings indicate that flame retardants are widely used in many airplane components and all airplane types, as expected. Most flame retardants, including TDCPP, were detected in 100% of dust samples collected from the airplanes. The concentrations of BDE 209 were elevated by orders of magnitude relative to residential and office environments.
doi:10.1186/1476-069X-12-17
PMCID: PMC3599095  PMID: 23413926
Flame retardants; Airplanes; Dust exposure; Hand-wipe samples
12.  JOINT EFFECT OF PRENATAL EXPOSURE TO FINE PARTICULATE MATTER AND INTAKE OF PARACETAMOL (ACETAMINOPHEN) IN PREGNANCY ON ONSET OF ECZEMA IN EARLY CHILDHOOD. PROSPECTIVE BIRTH COHORT STUDY 
The Science of the total environment  2011;409(24):5205-5209.
Prenatal Paracetamol (Acetaminophen) has been associated with increased risk of allergic disease in early childhood, an association that could be due to increased altered susceptibility induced by air pollutants. The main goal of the study was to test the hypothesis that prenatal Paracetamol exposure increases the risk of developing eczema in early childhood and that this association is stronger for children who are exposed prenatally to higher concentrations of fine particulate matter (PM2.5). The study sample consisted of 322 women recruited from January 2001 to February 2004 in the Krakow inner city area who gave birth to term babies and completed 5-year follow-up. Paracetamol use in pregnancy was collected by interviews and prenatal personal exposure to over 48 hours was measured in all recruited women in the second trimester of PM2.5 pregnancy. After delivery, every three months in the first 24 months of the newborn’s life and every 6 months later, a detailed standardized face-to-face interview on the infant’s health was administered to each mother by a trained interviewer. During the interviews at each of the study periods after birth, a history of eczema was recorded.
By Cox proportional hazard regression, prenatal exposure to Paracetamol increased the risk of eczema by 20% and PM2.5 by 6%, albeit non significantly. However, the the joint exposure to Paracetamol and higher prenatal PM2.5 was significant and doubled the risk of eczema symptoms (HR = 2.07, 95%CI: 1.01 – 4.34). The findings suggest that even very small doses of Paracetamol in pregnancy may affect the occurrence of allergy outcomes such as eczema in early childhood but only at the co-exposure to higher fine particulate matter.
doi:10.1016/j.scitotenv.2011.08.068
PMCID: PMC3428593  PMID: 21962593
birth cohort study; eczema; children; acetaminophen; pregnancy; prenatal fine particulate matter
13.  Metal sources and exposures in the homes of young children living near a mining-impacted Superfund site 
Children living near hazardous waste sites may be exposed to environmental contaminants, yet few studies have conducted multi-media exposure assessments, including residential environments where children spend most of their time. We sampled yard soil, house dust, and particulate matter with aerodynamic diameter <2.5 in 59 homes of young children near an abandoned mining area and analyzed samples for lead (Pb), zinc (Zn), cadmium (Cd), arsenic (As), and manganese (Mn). In over half of the homes, dust concentrations of Pb, Zn, Cd, and As were higher than those in soil. Proximity to mine waste (chat) piles and the presence of chat in the driveway significantly predicted dust metals levels. Homes with both chat sources had Pb, Zn, Cd, and As dust levels two to three times higher than homes with no known chat sources after controlling for other sources. In contrast, Mn concentrations in dust were consistently lower than in soil and were not associated with chat sources. Mn dust concentrations were predicted by soil concentrations and occupant density. These findings suggest that nearby outdoor sources of metal contaminants from mine waste may migrate indoors. Populations farther away from the mining site may also be exposed if secondary uses of chat are in close proximity to the home.
doi:10.1038/jes.2011.21
PMCID: PMC3161168  PMID: 21587306
house dust; indoor air pollution; metals; mine waste; residential exposures; Tar Creek Superfund Site
14.  Report of Workshop on Traffic, Health, and Infrastructure Planning 
Recent air pollutant measurement data document unique aspects of the air pollution mixture near roadways, and an expanding body of epidemiological data suggests increased risks for exacerbation of asthma and other respiratory diseases, premature mortality, and certain cancers and birth outcomes from air pollution exposures in populations residing in relatively close proximity to roadways. The Workshop on Traffic, Health, and Infrastructure Planning, held in February 2004, was convened to provide a forum for interdisciplinary discussion of motor vehicle emissions, exposures and potential health effects related to proximity to motor vehicle traffic. This report summarizes the workshop discussions and findings regarding the current science on this issue, identifies planning and policy issues related to localized motor vehicle emissions and health concerns, and provides recommendations for future research and policy directions.
PMCID: PMC2714822  PMID: 16983859
air pollution; exposure assessment; health effects; motor vehicle emissions; traffic proximity
15.  Effects of Prenatal and Perinatal Exposure to Fine Air Pollutants and Maternal Fish Consumption on the Occurrence of Infantile Eczema 
Background
As there is a scarcity of evidence on potential hazards and preventive factors for infantile eczema operating in the prenatal period, the main goal of this study was to assess the role of prenatal exposure to fine particulate matter and environmental tobacco smoke (ETS) in the occurrence of infant eczema jointly with the possible modulating effect of maternal fish consumption.
Methods
The study sample consisted of 469 women enrolled during pregnancy, who gave birth to term babies (>36 weeks of gestation). Among all pregnant women recruited, personal measurements of fine particulate matter (PM2.5) were performed over 48 h in the second trimester of pregnancy. After delivery, every 3 months in the first year of the newborn's life, a detailed, standardized, face-to-face interview was administered to each mother, in the process of which a trained interviewer recorded any history of infantile eczema and data on potential environmental hazards. The estimated risk of eczema related to higher prenatal exposure to fine particulate matter (PM2.5 >53.0 μg/m3) and postnatal ETS as well as the protective effect of maternal fish intake were adjusted for potential confounders in a multivariable logistic regression model.
Results
While the separate effects of higher prenatal PM2.5 and postnatal ETS exposure were not statistically significant, their joint effect appeared to have a significant influence on the occurrence of infantile eczema [odds ratio 2.39, 95% confidence interval (CI) 1.10–5.18]. With maternal fish intake of more than 205 g/week, the risk of eczema decreased by 43% (odds ratio 0.57, 95% CI 0.35–0.93). The incidence rate ratio (IRR) for eczema symptoms, estimated from the Poisson regression model, was increased with both higher exposure to prenatal PM2.5 and postnatal ETS (IRR 1.55, 95% CI 0.99–2.44) and in children of atopic mothers (IRR 1.35, 95% CI 1.04–1.75) but was lower in girls (IRR 0.78, 95% CI 0.61–1.00). The observed preventive effect of fish consumption on the frequency of eczema symptoms was consistent with the results of the logistic analysis (IRR 0.72, 95% CI 0.52–0.99).
Conclusions
The findings indicate that higher prenatal exposure to fine particulate matter combined with postnatal exposure to ETS may increase the risk of infant eczema, while maternal fish intake during pregnancy may reduce the risk of infantile eczema.
doi:10.1159/000320376
PMCID: PMC3047761  PMID: 21293147
Fish consumption; Prenatal exposure to fine particles; Cow's milk allergy; Passive tobacco smoke; Cohort study
16.  Fetal Window of Vulnerability to Airborne Polycyclic Aromatic Hydrocarbons on Proportional Intrauterine Growth Restriction 
PLoS ONE  2012;7(4):e35464.
Background
Although the entire duration of fetal development is generally considered a highly susceptible period, it is of public health interest to determine a narrower window of heightened vulnerability to polycyclic aromatic hydrocarbons (PAHs) in humans. We posited that exposure to PAHs during the first trimester impairs fetal growth more severely than a similar level of exposure during the subsequent trimesters.
Methods
In a group of healthy, non-smoking pregnant women with no known risks of adverse birth outcomes, personal exposure to eight airborne PAHs was monitored once during the second trimester for the entire cohort (n = 344), and once each trimester within a subset (n = 77). Both air monitoring and self-reported PAH exposure data were used in order to statistically estimate PAH exposure during the entire gestational period for each individual newborn.
Results
One natural-log unit increase in prenatal exposure to the eight summed PAHs during the first trimester was associated with the largest decrement in the Fetal Growth Ratio (FGR) (−3%, 95% Confidence Interval (CI), −5 to −0%), birthweight (−105 g, 95% CI, −188 to −22 g), and birth length (−0.78 cm, 95% CI, −1.30 to −0.26 cm), compared to the unit effects of PAHs during the subsequent trimesters, after accounting for confounders. Furthermore, a unit exposure during the first trimester was associated with the largest elevation in Cephalization Index (head to weight ratio) (3 μm/g, 95% CI, 1 to 5 μm/g). PAH exposure was not associated with evidence of asymmetric growth restriction in this cohort.
Conclusion
PAH exposure appears to exert the greatest adverse effect on fetal growth during the first trimester. The present data support the need for the protection of pregnant women and the embryo/fetus, particularly during the earliest stage of pregnancy.
doi:10.1371/journal.pone.0035464
PMCID: PMC3335852  PMID: 22545107
17.  Steel Dust in the New York City Subway System as a Source of Manganese, Chromium, and Iron Exposures for Transit Workers 
The United States Clean Air Act Amendments of 1990 reflected increasing concern about potential effects of low-level airborne metal exposure on a wide array of illnesses. Here we summarize results demonstrating that the New York City (NYC) subway system provides an important microenvironment for metal exposures for NYC commuters and subway workers and also describe an ongoing pilot study of NYC transit workers' exposure to steel dust. Results from the TEACH (Toxic Exposure Assessment, a Columbia and Harvard) study in 1999 of 41 high-school students strongly suggest that elevated levels of iron, manganese, and chromium in personal air samples were due to exposure to steel dust in the NYC subway. Airborne concentrations of these three metals associated with fine particulate matter were observed to be more than 100 times greater in the subway environment than in home indoor or outdoor settings in NYC. While there are currently no known health effects at the airborne levels observed in the subway system, the primary aim of the ongoing pilot study is to ascertain whether the levels of these metals in the subway air affect concentrations of these metals or related metabolites in the blood or urine of exposed transit workers, who due to their job activities could plausibly have appreciably higher exposures than typical commuters. The study design involves recruitment of 40 transit workers representing a large range in expected exposures to steel dust, the collection of personal air samples of fine particulate matter, and the collection of blood and urine samples from each monitored transit worker.
doi:10.1093/jurban/jti006
PMCID: PMC3142770  PMID: 15738337
Bioavailability; Chromium; Dose-response; Hazardous air pollutants; Iron; Manganese; Metro; Steel dust; Subway; transit workers; Underground railway
18.  Elevated Airborne Exposures of Teenagers to Manganese, Chromium, and Iron from Steel Dust and New York City’s Subway System 
There is increasing interest in potential health effects of airborne exposures to hazardous air pollutants at relatively low levels. This study focuses on sources, levels, and exposure pathways of manganese, chromium, and iron among inner-city high school students in New York City (NYC) and the contribution of subways. Samples of fine particulate matter (PM2.5) were collected during winter and summer over 48 h periods in a variety of settings including inside homes, outdoors, and personal samples (i.e., sampling packs carried by subjects). PM2.5 samples were also collected in the NYC subway system. For NYC, personal samples had significantly higher concentrations of iron, manganese, and chromium than did home indoor and ambient samples. The ratios and strong correlations between pairs of elements suggested steel dust as the source of these metals for a large subset of the personal samples. Time–activity data suggested NYC subways as a likely source of these elevated personal metals. In duplicate PM2.5 samples that integrated 8 h of underground subway exposure, iron, manganese, and chromium levels (>2 orders of magnitude above ambient levels) and their ratios were consistent with the elevated personal exposures. Steel dust in the NYC subway system was the dominant source of airborne exposures to iron, manganese, and chromium for many young people enrolled in this study, with the same results expected for other NYC subway riders who do not have occupational exposures to these metals. However, there are currently no known health effects at the exposure levels observed in this study.
PMCID: PMC3142791  PMID: 14968857
19.  Modeling Spatial Patterns of Traffic-Related Air Pollutants in Complex Urban Terrain 
Environmental Health Perspectives  2011;119(6):852-859.
Background
The relationship between traffic emissions and mobile-source air pollutant concentrations is highly variable over space and time and therefore difficult to model accurately, especially in urban settings with complex terrain. Regression-based approaches using continuous real-time mobile measurements may be able to characterize spatiotemporal variability in traffic-related pollutant concentrations but require methods to incorporate temporally varying meteorology and source strength in a physically interpretable fashion.
Objective
We developed a statistical model to assess the joint impact of both meteorology and traffic on measured concentrations of mobile-source air pollutants over space and time.
Methods
In this study, traffic-related air pollutants were continuously measured in the Williamsburg neighborhood of Brooklyn, New York (USA), which is affected by traffic on a large bridge and major highway. One-minute average concentrations of ultrafine particulate matter (UFP), fine particulate matter [≤ 2.5 μm in aerodynamic diameter (PM2.5)], and particle-bound polycyclic aromatic hydrocarbons were measured using a mobile-monitoring protocol. Regression modeling approaches to quantify the influence of meteorology, traffic volume, and proximity to major roadways on pollutant concentrations were used. These models incorporated techniques to capture spatial variability, long- and short-term temporal trends, and multiple sources.
Results
We observed spatial heterogeneity of both UFP and PM2.5 concentrations. A variety of statistical methods consistently found a 15–20% decrease in UFP concentrations within the first 100 m from each of the two major roadways. For PM2.5, temporal variability dominated spatial variability, but we observed a consistent linear decrease in concentrations from the roadways.
Conclusions
The combination of mobile monitoring and regression analysis was able to quantify local source contributions relative to background while accounting for physically interpretable parameters. Our results provide insight into urban exposure gradients.
doi:10.1289/ehp.1002519
PMCID: PMC3114822  PMID: 21262596
mobile measurements; mobile sources; regression; spatial variation; ultrafine particles; urban air quality
20.  Higher Fish Consumption in Pregnancy May Confer Protection against the Harmful Effect of Prenatal Exposure to Fine Particulate Matter 
Annals of Nutrition & Metabolism  2010;56(2):119-126.
Background/Aim
The objective of this study was to assess a hypothesized beneficial effect of fish consumption during the last trimester of pregnancy on adverse birth outcomes resulting from prenatal exposure to fine air particulate matter.
Methods
The cohort consisted of 481 nonsmoking women with singleton pregnancies, of 18–35 years of age, who gave birth at term. All recruited women were asked about their usual diet over the period of pregnancy. Measurements of particulate matter less than 2.5 μm in size (PM2.5) were carried out by personal air monitoring over 48 h during the second trimester of pregnancy. The effect of PM2.5 and fish intake during gestation on the birth weight of the babies was estimated from multivariable linear regression models, which beside the main independent variables considered a set of potential confounding factors such as the size of the mother (height, prepregnancy weight), maternal education, parity, the gender of the child, gestational age and the season of birth.
Results
The study showed that the adjusted birth weight was significantly lower in newborns whose mothers were exposed to particulate matter greater than 46.3 μg/m3 (β coefficient = −97.02, p = 0.032). Regression analysis stratified by the level of maternal fish consumption (in tertiles) showed that the deficit in birth weight amounted to 133.26 g (p = 0.052) in newborns whose mothers reported low fish intake (<91 g/week). The birth weight deficit in newborns whose mothers reported medium (91–205 g/week) or higher fish intake (>205 g/week) was insignificant. The interaction term between PM2.5 and fish intake levels was also insignificant (β = −107,35, p = 0.215). Neither gestational age nor birth weight correlated with maternal fish consumption.
Conclusions
The results suggest that a higher consumption of fish by women during pregnancy may reduce the risk of adverse effects of prenatal exposure to toxicants and highlight the fact that a full assessment of adverse birth outcomes resulting from prenatal exposure to ambient hazards should consider maternal nutrition during pregnancy.
doi:10.1159/000275918
PMCID: PMC2842166  PMID: 20134157
Air pollutants; Prenatal exposure; Fish consumption; Birth size; Cohort study
21.  Nitrogen dioxide concentrations in neighborhoods adjacent to a commercial airport: a land use regression modeling study 
Environmental Health  2010;9:73.
Background
There is growing concern in communities surrounding airports regarding the contribution of various emission sources (such as aircraft and ground support equipment) to nearby ambient concentrations. We used extensive monitoring of nitrogen dioxide (NO2) in neighborhoods surrounding T.F. Green Airport in Warwick, RI, and land-use regression (LUR) modeling techniques to determine the impact of proximity to the airport and local traffic on these concentrations.
Methods
Palmes diffusion tube samplers were deployed along the airport's fence line and within surrounding neighborhoods for one to two weeks. In total, 644 measurements were collected over three sampling campaigns (October 2007, March 2008 and June 2008) and each sampling location was geocoded. GIS-based variables were created as proxies for local traffic and airport activity. A forward stepwise regression methodology was employed to create general linear models (GLMs) of NO2 variability near the airport. The effect of local meteorology on associations with GIS-based variables was also explored.
Results
Higher concentrations of NO2 were seen near the airport terminal, entrance roads to the terminal, and near major roads, with qualitatively consistent spatial patterns between seasons. In our final multivariate model (R2 = 0.32), the local influences of highways and arterial/collector roads were statistically significant, as were local traffic density and distance to the airport terminal (all p < 0.001). Local meteorology did not significantly affect associations with principal GIS variables, and the regression model structure was robust to various model-building approaches.
Conclusion
Our study has shown that there are clear local variations in NO2 in the neighborhoods that surround an urban airport, which are spatially consistent across seasons. LUR modeling demonstrated a strong influence of local traffic, except the smallest roads that predominate in residential areas, as well as proximity to the airport terminal.
doi:10.1186/1476-069X-9-73
PMCID: PMC2996366  PMID: 21083910
22.  EARLY WHEEZING PHENOTYPES AND SEVERITY OF RESPIRATORY ILLNESS IN VERY EARLY CHILDHOOD. STUDY ON INTRAUTERINE EXPOSURE TO FINE PARTICLE MATTER 
Environment international  2009;35(6):877-884.
The main goal of the paper was to assess the pattern of risk factors having an impact on the onset of early wheezing phenotypes in the birth cohort of 468 two-year olds and to investigate the severity of respiratory illness in the two-year olds in relation to both wheezing phenotypes, environmental tobacco smoke (ETS) and personal PM2.5 exposure over pregnancy period (fine particulate matter). The secondary goal of the paper was to assess possible association of early persistent wheezing with the length of the baby at birth. Pregnant women were recruited from ambulatory prenatal clinics in the first and second trimester of pregnancy. Only women 18–35 years of age, who claimed to be non-smokers, with singleton pregnancies, without illicit drug use and HIV infection, free from chronic diseases were eligible for the study. In the statistical analysis of respiratory health of children multinomial logistic regression and zero-inflated Poisson regression models were used. Approximately one third of the children in the study sample experienced wheezing in the first two years of life and in about two third of cases (67%) the symptom developed already in the first year of life. The early wheezing was easily reversible and in about 70% of infants with wheezing the symptom receded in the second year of life. The adjusted relative risk ratio (RRR) of persistent wheezing increased with maternal atopy (RRR = 3.05; 95%CI: 1.30 – 7.15), older siblings (RRR = 3.05; 95%CI: 1.67 – 5.58) and prenatal ETS exposure (RRR= 1.13; 95%CI: 1.04 – 1.23), but was inversely associated with the length of baby at birth (RRR = 0.88; 95%CI: 0.76 – 1.01). The adjusted incidence risk ratios (IRR) of coughing, difficult breathing, runny/stuffy nose and pharyngitis/tonsillitis in wheezers were much higher than that observed among non-wheezers and significantly depended on prenatal PM2.5 exposure, older siblings and maternal atopy. The study shows a clear inverse association between maternal age or maternal education and respiratory illnesses and calls for more research efforts aiming at explanation of factors hidden behind proxy measures of quality of maternal care of babies. The data support the hypothesis that burden of respiratory symptoms in early childhood and possibly in later life may be programmed already in prenatal period when the respiratory system is completing its growth and maturation.
doi:10.1016/j.envint.2009.03.004
PMCID: PMC2709737  PMID: 19394697
wheezing phenotypes; respiratory symptoms; prenatal and postnatal environmental air quality; birth cohort study
23.  Within-Neighborhood Patterns and Sources of Particle Pollution: Mobile Monitoring and Geographic Information System Analysis in Four Communities in Accra, Ghana 
Environmental Health Perspectives  2010;118(5):607-613.
Background
Sources of air pollution in developing country cities include transportation and industrial pollution, biomass and coal fuel use, and resuspended dust from unpaved roads.
Objectives
Our goal was to understand within-neighborhood spatial variability of particulate matter (PM) in communities of varying socioeconomic status (SES) in Accra, Ghana, and to quantify the effects of nearby sources on local PM concentration.
Methods
We conducted 1 week of morning and afternoon mobile and stationary air pollution measurements in four study neighborhoods. PM with aerodynamic diameters ≤ 2.5 μm (PM2.5) and ≤ 10 μm (PM10) was measured continuously, with matched global positioning system coordinates; detailed data on local sources were collected at periodic stops. The effects of nearby sources on local PM were estimated using linear mixed-effects models.
Results
In our measurement campaign, the geometric means of PM2.5 and PM10 along the mobile monitoring path were 21 and 49 μg/m3, respectively, in the neighborhood with highest SES and 39 and 96 μg/m3, respectively, in the neighborhood with lowest SES and highest population density. PM2.5 and PM10 were as high as 200 and 400 μg/m3, respectively, in some segments of the path. After adjusting for other factors, the factors that had the largest effects on local PM pollution were nearby wood and charcoal stoves, congested and heavy traffic, loose dirt road surface, and trash burning.
Conclusions
Biomass fuels, transportation, and unpaved roads may be important determinants of local PM variation in Accra neighborhoods. If confirmed by additional or supporting data, the results demonstrate the need for effective and equitable interventions and policies that reduce the impacts of traffic and biomass pollution.
doi:10.1289/ehp.0901365
PMCID: PMC2866674  PMID: 20056591
Africa; biomass; geographic information system; particulate matter; poverty; spatial; urbanization
24.  Ancillary Benefits for Caregivers of Children with Asthma Participating in an Environmental Intervention Study to Alleviate Asthma Symptoms 
Providing care for children with asthma can be demanding and time-intensive with far-reaching effects on caregivers’ lives. Studies have documented childhood asthma symptom reductions and improved asthma-related quality of life (AQOL) with indoor allergen-reducing environmental interventions. Few such studies, however, have considered ancillary benefits to caregivers or other family members. Ancillary benefits could be derived from child health improvements and reduced caregiving burden or from factors such as improved living environments or social support that often accompanies intensive residential intervention efforts. As part of the Boston Healthy Public Housing Initiative (HPHI), a longitudinal single-cohort intervention study of asthmatic children, we examined trends in caregivers’ quality of life related to their child’s asthma (caregiver AQOL) using monthly Juniper Caregiver Asthma Quality of Life Questionnaires (AQLQ) for 32 primary caregivers to 42 asthmatic children aged 4 to 17 years. Longitudinal analyses were used to examine caregiver AQOL trends and their relationship to the child’s AQOL, then to consider additional predictors of caregiver AQOL. Caregiver AQLQ improved significantly over the course of the study with overall improvements significantly correlated with child AQOL (p = 0.005). However, caregiver AQOL improved most in the months before environmental interventions, while children’s AQOL improved most in the months following. Time trends in caregiver AQOL, controlling for child AQOL, were not explained by available social support or caregiver stress measures. Our findings suggest potential participation effects not adequately captured by standard measures. Future environmental intervention studies should more formally consider social support and participation effects for both children and caregivers
doi:10.1007/s11524-008-9341-4
PMCID: PMC2648883  PMID: 19184446
Urban childhood asthma; Quality of life; Environmental interventions; Psychological factors
25.  Determinants of Allergen Concentrations in Apartments of Asthmatic Children Living in Public Housing 
Journal of Urban Health   2007;84(2):185-197.
There is growing evidence linking poor housing conditions and respiratory diseases, including asthma. The association between housing conditions and asthma in the inner city has been attributed in part to cockroach and mouse infestation and the resulting allergen exposures. Multiple social and behavioral factors can influence environmental exposures and health conditions, necessitating a thorough examination of such factors. As part of the Healthy Public Housing Initiative, we evaluated the association between physical and household characteristics and pest-related allergen levels in three public housing developments in Boston, MA. We detected cockroach allergens (Bla g 1 and Bla g 2) in bedroom air, bed, and especially high concentrations in kitchen samples. In multivariate Tobit regressions controlling for development and season, clutter and lack of cleanliness in the apartment were associated with a tenfold increase in Bla g 1 concentration in the air, a sevenfold increase in Bla g 1 and an eightfold increase in Bla g 2 concentrations in the bed, and an 11-fold increase in Bla g 2 in the kitchen (p<0.05 for all). Holes in the wall/ceiling were associated with a six- to 11-fold increase in kitchen cockroach allergen concentrations (p<0.05). Occupancy in an apartment unit of 2 years or more was also associated with increased cockroach allergen concentrations. In contrast, there were low concentrations of mouse urinary protein in this population. In conclusion, these results suggest that interventions in these homes should focus on reducing cockroach allergen concentrations and that building-wide interventions should be supplemented with targeted efforts focused on high-risk units.
doi:10.1007/s11524-006-9146-2
PMCID: PMC2231632  PMID: 17216349
Asthma; Allergen; Cockroach; Mouse; Home characteristics; Low-income; Community-based participatory research

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