Long-term, continuous air quality monitoring in a cross-sectional study of three UK non-domestic buildings

Long-term, continuous air quality monitoring has been carried out alongside seasonal passive sampling within a case study a hospital, school and office building, representing a cross-section of the UK non-domestic sector. This approach aimed at adopting state of the art sensor technology to provide a greater understanding of the variations in indoor air quality over time and how these variations relate to both building operation and occupant behavior. The results highlight how the relationship between indoor and outdoor air evolves considerably on both short and long-term basis, with varying behaviors then seen across different sources of pollutants. The mechanically ventilated hospital and school buildings demonstrate the effectiveness of particulate filters, with very low internal concentrations of PM2.5. However, high ventilation rates, combined with the absence of any filtration of NO2, resulted in the hospital having the highest indoor concentrations of NO2 and the highest associated indoor-outdoor ratio. Morning and evening traffic related peaks in NO2 can be observed indoors, with their penetration dependent upon the delivered ventilation rates. This demonstrates the impact of adopting high ventilation rates during peak traffic, and the consequences of CO2 based demand-controlled ventilation systems in polluted urban areas without full filtration. The naturally ventilated office then demonstrates significant seasonal variations, with increased ventilation openings resulting in indoor NO2 concentrations in the summer exceeding those in the winter, despite significant reductions in ambient levels. Conversely, concentrations of indoor pollutants are seen to reduce with increasing ventilation rates, demonstrating the complex balance between the dilution of indoor pollutants and penetration of outdoor sources. Despite significant reductions from the winter to the summer (21.6–11.2 μg/m3), all formaldehyde measurements in the naturally ventilated office exceeded guideline values, indicating improved guidance and product labelling schemes may be required to achieve these guideline concentrations and reduce associated health risks

Personal exposure to air pollution and respiratory health of COPD patients in London

Previous studies have investigated the effects of air pollution on chronic obstructive pulmonary disease (COPD) patients using either fixed site measurements or a limited number of personal measurements, usually for one pollutant and a short time period. These limitations may introduce bias and distort the epidemiological associations as they do not account for all the potential sources or the temporal variability of pollution.We used detailed information on individuals' exposure to various pollutants measured at fine spatio-temporal scale to obtain more reliable effect estimates. A panel of 115 patients was followed up for an average continuous period of 128 days carrying a personal monitor specifically designed for this project that measured temperature, PM10, PM2.5, NO2, NO, CO and O3 at one-minute time resolution. Each patient recorded daily information on respiratory symptoms and measured peak expiratory flow (PEF). A pulmonologist combined related data to define a binary variable denoting an "exacerbation". The exposure-response associations were assessed with mixed-effects models.We found that gaseous pollutants were associated with a deterioration in patients' health. We observed an increase of 16.4% (95% confidence interval: 8.6-24.6%), 9.4% (5.4-13.6%) and 7.6% (3.0-12.4%) in the odds of exacerbation for an interquartile range increase in NO2, NO and CO respectively. Similar results were obtained for cough and sputum. O3 was found to have adverse associations with PEF and breathlessness. No association was observed between particles and any outcome.Our findings suggest that, when considering total personal exposure to air pollutants, mainly the gaseous pollutants affect COPD patients' health

Linking e-health records, patient-reported symptoms and environmental exposure data to characterise and model COPD exacerbations: protocol for the COPE study.

INTRODUCTION: Relationships between exacerbations of chronic obstructive pulmonary disease (COPD) and environmental factors such as temperature, humidity and air pollution are not well characterised, due in part to oversimplification in the assignment of exposure estimates to individuals and populations. New developments in miniature environmental sensors mean that patients can now carry a personal air quality monitor for long periods of time as they go about their daily lives. This creates the potential for capturing a direct link between individual activities, environmental exposures and the health of patients with COPD. Direct associations then have the potential to be scaled up to population levels and tested using advanced human exposure models linked to electronic health records. METHODS AND ANALYSIS: This study has 5 stages: (1) development and deployment of personal air monitors; (2) recruitment and monitoring of a cohort of 160 patients with COPD for up to 6 months with recruitment of participants through the Clinical Practice Research Datalink (CPRD); (3) statistical associations between personal exposure with COPD-related health outcomes; (4) validation of a time-activity exposure model and (5) development of a COPD prediction model for London. ETHICS AND DISSEMINATION: The Research Ethics Committee for Camden and Islington has provided ethical approval for the conduct of the study. Approval has also been granted by National Health Service (NHS) Research and Development and the Independent Scientific Advisory Committee. The results of the study will be disseminated through appropriate conference presentations and peer-reviewed journals.This work is funded by the Medical Research Council (MR/L019744/1). MRC-PHE funding has been obtained for a pilot study to collect blood and sputum samples on a subset of 20 participants. Enrolment will take place at The Royal Brompton and Harefield (RBH) and Guy's and St Thomas' (GSTT) NHS Foundation Trusts. Support will be provided by the Respiratory Clinical Research Facility at RBH and the Lane Fox Unit at GSTT. The project is a portfolio adopted by the National Institute for Health Research (NIHR) UK Clinical Research Network (CRN). Additional support was provided by the NIHR Biomedical Research Centre based at GSTT and King's College London.This is the final version of the article. It first appeared from the BMJ Publishing Group via http://dx.doi.org/10.1136/bmjopen-2016-01133

Seasonal variations and the influence of ventilation rates on IAQ: A case study of five low-energy London apartments

The indoor air quality (IAQ) of five low-energy London apartments has been assessed through the measurement of 16 key pollutants, using continuous and diffusive methods across heating and non-heating seasons. This case study approach aimed to assess the presence of pollutants within low-energy apartments and to better understand the role of ventilation and seasonal variations in indoor air quality. The results indicate strong seasonal variations, driven by increased natural ventilation rates over the summer monitoring period. A combined metric for indoor and outdoor pollutants ( Itot) suggests that the IAQ in the winter ( Itot = 17.7) is more than twice as bad as that seen in the summer ( Itot = 8.6). Formaldehyde concentrations were lower in the non-heating season, indicating increased ventilation rates more than offset increased off-gassing, in contrast to findings in other studies. However, increased summertime ventilation rates were observed to increase the proportion of outdoor pollutants entering the internal environment. This resulted in higher indoor concentrations of NO2 in the summer than the winter, despite significant reductions in outdoor concentrations. These results demonstrate the impact of ventilation practices upon IAQ, the influence of occupant actions and the complex relationship ventilation rates play in balancing indoor and outdoor sources of air pollution. </jats:p

Global Associations between Air Pollutants and Chronic Obstructive Pulmonary Disease Hospitalizations: A Systematic Review.

BACKGROUND: Exacerbations are key events in Chronic Obstructive Pulmonary Disease (COPD), affecting lung function decline and quality of life. The effect of exposure to different air pollutants on COPD exacerbations is not clear. OBJECTIVE: To carry out a systematic review examining associations between air pollutants and hospital admissions for COPD exacerbations. DATA SOURCES: MEDLINE, EMBASE, BIOSIS & Science Citation Index, and the Air Pollution Epidemiology Database were searched from 1980 until September 2015. DATA EXTRACTION: Inclusion criteria focused on studies presenting solely a COPD outcome defined by hospital admissions, and a measure of gaseous air pollutants and particle fractions. The association between each pollutant with COPD admissions was investigated in metaanalyses using random-effects models. Analyses were stratified by geographical clusters to investigate the consistency of the evidence worldwide. SYNTHESIS: 46 studies were included and results for all the pollutants under investigation showed marginal positive associations; however the number of included studies was small with high heterogeneity between them and there was evidence of small-study bias. Geographical clustering of the effects of pollution on COPD hospital admissions was evident and reduced heterogeneity significantly. CONCLUSIONS: The most consistent associations was between a 1mg/m3 increase in carbon monoxide levels with COPD related admissions; Odds Ratio: 1.02 (95%CI: 1.01-1.03). The heterogeneity was moderate and there was a consistent positive association in both Europe and North America, although levels were clearly below WHO guideline values. There is mixed evidence on the effects of environmental pollution on COPD exacerbations. Limitations of previous studies included the low spatiotemporal resolution of pollutants, inadequate control for confounding factors, and the use of aggregated health data that ignore personal characteristics. The need for more targeted exposure estimates in a large number of geographical locations is evident.This research was funded by the Medical Research Council (MR/L019744/1 [B.B.]). It was also supported by the Medical Research Council-Public Health England (MRC-PHE) Centre for Environment and Health and the National Ins titute for Health Resear ch (NIHR) Biomedical Research Centre based at Guy’s and St . Thomas’ NHS Foundation Trust and King’s College London

Using low-cost sensor technologies and advanced computational methods to improve dose estimations in health panel studies: results of the AIRLESS project.

BACKGROUND: Air pollution epidemiology has primarily relied on fixed outdoor air quality monitoring networks and static populations. METHODS: Taking advantage of recent advancements in sensor technologies and computational techniques, this paper presents a novel methodological approach that improves dose estimations of multiple air pollutants in large-scale health studies. We show the results of an intensive field campaign that measured personal exposures to gaseous pollutants and particulate matter of a health panel of 251 participants residing in urban and peri-urban Beijing with 60 personal air quality monitors (PAMs). Outdoor air pollution measurements were collected in monitoring stations close to the participants' residential addresses. Based on parameters collected with the PAMs, we developed an advanced computational model that automatically classified time-activity-location patterns of each individual during daily life at high spatial and temporal resolution. RESULTS: Applying this methodological approach in two established cohorts, we found substantial differences between doses estimated from outdoor and personal air quality measurements. The PAM measurements also significantly reduced the correlation between pollutant species often observed in static outdoor measurements, reducing confounding effects. CONCLUSIONS: Future work will utilise these improved dose estimations to investigate the underlying mechanisms of air pollution on cardio-pulmonary health outcomes using detailed medical biomarkers in a way that has not been possible before.This project is funded under the Newton Fund Programme awarded by Natural Environmental Research Council (NERC Grant NE/N007018/1) with support from Medical Research Council (MRC) and by the National Natural Science Foundation of China (NSFC Grant 81571130100). The NSFC funding is mainly used to support the field work in China, and NERC funding is mainly used for coordination and the further analysis

Difference in ambient-personal exposure to PM2.5 and its inflammatory effect in local residents in urban and peri-urban Beijing, China: results of the AIRLESS project

Measurement of ambient fine particulate matter (PM2.5) is often used as a proxy of personal exposure in epidemiological studies. However, the difference between personal and ambient exposure, and whether it biases the estimates of health effects remain unknown. Based on an epidemiological study (AIRLESS) and simultaneously launched intensive monitoring campaigns (APHH), we quantified and compared the personal and ambient exposure to PM2.5 and the related health impact among residents in Beijing, China. In total, 123 urban and 128 peri-urban non-smoking participants were recruited from two well-established cohorts in Beijing. During winter 2016 and summer 2017, each participant was instructed to carry a validated personal air monitor (PAM) to measure PM2.5 concentration at high spatiotemporal resolution for seven consecutive days in each season. Multiple inflammatory biomarkers were measured, including exhaled NO, blood monocytes counts and C-reactive protein. Linear mixed-effect models were used for the associations between exposure and health outcomes with adjustment for confounders. The average level of daily personal exposure to PM2.5 was consistently lower than using corresponding ambient concentration, and the difference is greater during the winter. The personal to ambient (P/A) ratio of exposure to PM2.5 exhibited an exponentially declining trend, and showed larger variations when ambient PM2.5 levels < 25 μg m−3. Personal exposure to PM2.5 was significantly associated with the increase in respiratory and systemic inflammatory biomarkers; however, the associations were weaker or became insignificant when ambient concentrations were used. Exposure to ambient PM2.5 might not be a good proxy to estimate the health effect of exposure to personal PM2.5

Indoor school environments, physical activity, sitting behaviour and pedagogy: a scoping review

Physical activity levels in children are low and sitting time high, despite the health benefits of regular physical activity and limited sitting. Children spend a large proportion of their time at school, hence school-based interventions targeting physical activity and sitting behaviour may be important. Whilst some aspects of school buildings, their layout and furniture may influence children's physical activity and sitting, these effects could be intertwined with pedagogical approaches. This scoping review aims to identify gaps in the research literature regarding the influence of the indoor school environment on pedagogical approaches and on physical activity and sitting. In primary schools, it was found that physical activity can be integrated into lessons with some benefits on academic behaviour and possibly academic performance. Overall, however, the role of the indoor built environment is poorly investigated, although a handful of studies suggest that a radical change in primary school classrooms may increase physical activity and that stand-biased desks may be promising. This study provides a contribution to the emerging research fields of ‘active design’ from the perspective of indoor school design, highlighting a dearth of research, especially on sitting and for secondary education, and a lack of relevant conceptual frameworks

Understanding the patterns and health impact of indoor air pollutant exposures in Bradford, UK: a study protocol

Introduction Relative to outdoor air pollution, there is little evidence examining the composition and concentrations of indoor air pollution and its associated health impacts. The INGENIOUS project aims to provide the comprehensive understanding of indoor air pollution in UK homes. Methods and analysis ‘Real Home Assessment’ is a cross-sectional, multimethod study within INGENIOUS. This study monitors indoor air pollutants over 2 weeks using low-cost sensors placed in three rooms in 300 Born in Bradford (BiB) households. Building audits are completed by researchers, and participants are asked to complete a home survey and a health and behaviour questionnaire, in addition to recording household activities and health symptoms on at least 1 weekday and 1 weekend day. A subsample of 150 households will receive more intensive measurements of volatile organic compound and particulate matter for 3 days. Qualitative interviews conducted with 30 participants will identify key barriers and enablers of effective ventilation practices. Outdoor air pollution is measured in 14 locations across Bradford to explore relationships between indoor and outdoor air quality. Data will be analysed to explore total concentrations of indoor air pollutants, how these vary with building characteristics, and whether they are related to health symptoms. Interviews will be analysed through content and thematic analysis. Ethics and dissemination Ethical approval has been obtained from the NHS Health Research Authority Yorkshire and the Humber (Bradford Leeds) Research Ethics Committee (22/YH/0288). We will disseminate findings using our websites, social media, publications and conferences. Data will be open access through the BiB, the Open Science Framework and the UK Data Service

Introduction to the special issue "in-depth study of air pollution sources and processes within Beijing and its surrounding region (APHH-Beijing)"

© 2019 Author(s). The Atmospheric Pollution and Human Health in a Chinese Megacity (APHH-Beijing) programme is an international collaborative project focusing on understanding the sources, processes and health effects of air pollution in the Beijing megacity. APHH-Beijing brings together leading China and UK research groups, state-of-the-art infrastructure and air quality models to work on four research themes: (1) sources and emissions of air pollutants; (2) atmospheric processes affecting urban air pollution; (3) air pollution exposure and health impacts; and (4) interventions and solutions. Themes 1 and 2 are closely integrated and support Theme 3, while Themes 1-3 provide scientific data for Theme 4 to develop cost-effective air pollution mitigation solutions. This paper provides an introduction to (i) the rationale of the APHH-Beijing programme and (ii) the measurement and modelling activities performed as part of it. In addition, this paper introduces the meteorology and air quality conditions during two joint intensive field campaigns-a core integration activity in APHH-Beijing. The coordinated campaigns provided observations of the atmospheric chemistry and physics at two sites: (i) the Institute of Atmospheric Physics in central Beijing and (ii) Pinggu in rural Beijing during 10 November-10 December 2016 (winter) and 21 May-22 June 2017 (summer). The campaigns were complemented by numerical modelling and automatic air quality and low-cost sensor observations in the Beijing megacity. In summary, the paper provides background information on the APHH-Beijing programme and sets the scene for more focused papers addressing specific aspects, processes and effects of air pollution in Beijing