Characterizing the Indoor-Outdoor Relationship of Fine Particulate Matter in Non-Heating Season for Urban Residences in Beijing

<div><p>Objective</p><p>Ambient fine particulate matter (PM_2.5) pollution is currently a major public health concern in Chinese urban areas. However, PM_2.5 exposure primarily occurs indoors. Given such, we conducted this study to characterize the indoor-outdoor relationship of PM_2.5 mass concentrations for urban residences in Beijing.</p><p>Methods</p><p>In this study, 24-h real-time indoor and ambient PM_2.5 mass concentrations were concurrently collected for 41 urban residences in the non-heating season. The diurnal variation of pollutant concentrations was characterized. Pearson correlation analysis was used to examine the correlation between indoor and ambient PM_2.5 mass concentrations. Regression analysis with ordinary least square was employed to characterize the influences of a variety of factors on PM_2.5 mass concentration.</p><p>Results</p><p>Hourly ambient PM_2.5 mass concentrations were 3–280 μg/m³ with a median of 58 μg/m³, and hourly indoor counterpart were 4–193 μg/m³ with a median of 34 μg/m³. The median indoor/ambient ratio of PM_2.5 mass concentration was 0.62. The diurnal variation of residential indoor and ambient PM_2.5 mass concentrations tracked with each other well. Strong correlation was found between indoor and ambient PM_2.5 mass concentrations on the community basis (coefficients: r≥0.90, p<0.0001), and the ambient data explained ≥84% variance of the indoor data. Regression analysis suggested that the variables, such as traffic conditions, indoor smoking activities, indoor cleaning activities, indoor plants and number of occupants, had significant influences on the indoor PM_2.5 mass concentrations.</p><p>Conclusions</p><p>PM_2.5 of ambient origin made dominant contribution to residential indoor PM_2.5 exposure in the non-heating season under the high ambient fine particle pollution condition. Nonetheless, the large inter-residence variability of infiltration factor of ambient PM_2.5 raised the concern of exposure misclassification when using ambient PM_2.5 mass concentrations as exposure surrogates. PM_2.5 of indoor origin still had minor influence on indoor PM_2.5 mass concentrations, particularly at 11:00–13:00 and 22:00–0:00. The predictive models suggested that particles from traffic emission, secondary aerosols, particles from indoor smoking, resuspended particles due to indoor cleaning and particles related to indoor plants contributed to indoor PM_2.5 mass concentrations in this study. Real-time ventilation measurements and improvement of questionnaire design to involve more variables subject to built environment were recommended to enhance the performance of the predictive models.</p></div

Diurnal variation of pollutant concentrations.

<p>(Note: error bars in the Fig stand for standard deviation of the normalized pollutant concentrations).</p

Descriptive statistics of the concentrations of pollutants.

<p>a. Valid ambient and indoor PM_2.5 mass concentrations were simultaneously available for 33 residences.</p><p>Descriptive statistics of the concentrations of pollutants.</p

The information of variables subject to building characteristics and human behavior.

<p>The information of variables subject to building characteristics and human behavior.</p

Pearson correlation between indoor and ambient PM_2.5 mass concentrations.

<p>Pearson correlation between indoor and ambient PM_2.5 mass concentrations.</p

Predictive model of ambient PM_2.5 mass concentrations.

<p>Predictive model of ambient PM_2.5 mass concentrations.</p

High pneumonia lifetime-ever incidence in Beijing children compared with locations in other countries, and implications for national PCV and Hib vaccination

<div><p>Objectives</p><p>To compare the proportion of Beijing children who have ever had pneumonia (<i>%Pneumonia</i>) to those in other locations, and to estimate by how much national vaccine coverage with Pneumococcal Conjugate Vaccine (PCV) and Haemophilus Influenzae Type b (Hib) could reduce Beijing <i>%Pneumonia</i>.</p><p>Methods</p><p><i>%Pneumonia</i> was obtained for each age group from 1 to 8 years inclusive from 5,876 responses to a cross-sectional questionnaire. Literature searches were conducted for world-wide reports of <i>%Pneumonia</i>. Previous vaccine trials conducted worldwide were used to estimate the pneumococcal (<i>S</i>. <i>pneumoniae</i>) and Hib (<i>H</i>. <i>influenzae)</i> burdens and <i>%Pneumonia</i> as well as the potential for PCV and Hib vaccines to reduce Beijing children’s <i>%Pneumonia</i>.</p><p>Findings</p><p>The majority of pneumonia cases occurred by the age of three. The cumulative <i>%Pneumonia</i> for 3–8 year-old Beijing children, 26.9%, was only slightly higher than the 25.4% for the discrete 3 year-old age group, similar to trends for Tianjin (China) and Texas (USA). Beijing’s <i>%Pneumonia</i> is disproportionally high relative to its Gross National Income (GNI) per capita, and markedly higher than <i>%Pneumonia</i> in the US and other high GNI per capita countries. Chinese diagnostic guidelines recommend chest X-ray confirmation while most other countries discourage it in favor of clinical diagnosis. Literature review shows that chest X-ray confirmation returns far fewer pneumonia diagnoses than clinical diagnosis. Accordingly, Beijing’s <i>%Pneumonia</i> is likely higher than indicated by raw numbers. Vaccine trials suggest that national PCV and Hib vaccination could reduce Beijing’s <i>%Pneumonia</i> from 26.9% to 19.7% and 24.9% respectively.</p><p>Conclusion</p><p>National PCV and Hib vaccination programs would substantially reduce Beijing children’s pneumonia incidence.</p></div

Predictive model of indoor PM_2.5 mass concentrations.

<p>a. the levels of <i>distance to road</i>: 1- ≤ 193 m, 2–194–270 m, 3–271–425 m, 4- >425 m.</p><p>b. the levels of <i>frequency of furniture cleaning</i>: 1- everyday, 2- some times per week, 3- one time for several weeks.</p><p>c. the levels of <i>smoking</i>: 0- no smoking, 1- yes, 1time, 2- yes, multiple times.</p><p>d. the levels of <i>indoor plants</i>: 1- no plants, 2- a few, 3- many.</p><p>e. the levels of <i>frequency of floor cleaning</i>: 1- everyday, 2- some times per week.</p><p>f. the levels of <i>floor cleaning method</i>: 1- only mop, 2- with mop and broom/vacuum.</p><p>g. the levels of <i>traffic route</i>: 1-arterial road (ring roads and express ways), 2-urban highway, 3-quiet street.</p><p>Predictive model of indoor PM_2.5 mass concentrations.</p

Regression analysis of indoor and ambient PM_2.5 mass concentrations.

<p>Regression analysis of indoor and ambient PM_2.5 mass concentrations.</p

Impact of PCV and Hib vaccination on a birth cohort of 122,747, the number of babies born in Beijing in 2012 [1], assuming <i>%Pneumonia</i> to be 26.9% at age 3.

<p>We used the Lucero value for <i>VE</i>_PCV, 27% (15%, 36%) [<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0171438#pone.0171438.ref063" target="_blank">63</a>] and the Theodoratou value for <i>VE</i>_Hib, 18% (-2%, 33%) [<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0171438#pone.0171438.ref013" target="_blank">13</a>]. Potential pneumonia reductions are given for both wholly unvaccinated and vaccinated populations as we have estimated for Beijing.</p