Respiratory Health Effects of Exposure to Low-NOx Unflued Gas Heaters in the Classroom: A Double-Blind, Cluster-Randomized, Crossover Study

There are long-standing concerns about adverse effects of gas appliances on respiratory health. However, the potential adverse effect of low-NOx (nitrogen oxide) unflued gas heaters on children’s health has not been assessed. Our goal was to compare the respiratory health effects and air quality consequences of exposure to low-NOx unflued gas heaters with exposure to non–indoor-air-emitting flued gas heaters in school classrooms. We conducted a double-blind, cluster-randomized, crossover study in 400 primary school students attending 22 schools in New South Wales, Australia. Children measured their lung function and recorded symptoms and medication use twice daily. Nitrogen dioxide (NO₂) and formaldehyde concentrations were measured in classrooms using passive diffusion badges.NO₂ concentrations were, on average, 1.8 times higher [95% confidence interval (CI), 1.6–2.1] and formaldehyde concentrations were, on average, 9.4 ppb higher (95% CI, 5.7–13.1) during exposure to unflued gas versus flued gas heaters. Exposure to the unflued gas heaters was associated with increased cough reported in the evening [odds ratio (OR) = 1.16; 95% CI, 1.01–1.34] and wheeze reported in the morning (OR = 1.38; 95% CI, 1.04–1.83). The association with wheeze was greater in atopic subjects. There was no evidence of an adverse effect on lung function. We conclude that classroom exposure to low-NOx unflued gas heaters causes increased respiratory symptoms, particularly in atopic children, but is not associated with significant decrements in lung function. It is important to seek alternative sources of heating that do not have adverse effects on health

Ultrafine Particles from Traffic Emissions and Children's Health (UPTECH) in Brisbane, Queensland (Australia): Study design and implementation

Ultrafine particles are particles that are less than 0.1 micrometres (µm) in diameter. Due to their very small size they can penetrate deep into the lungs, and potentially cause more damage than larger particles. The Ultrafine Particles from Traffic Emissions and Children’s Health (UPTECH) study is the first Australian epidemiological study to assess the health effects of ultrafine particles on children’s health in general and peripheral airways in particular. The study is being conducted in Brisbane, Australia. Continuous indoor and outdoor air pollution monitoring was conducted within each of the twenty five participating school campuses to measure particulate matter, including in the ultrafine size range, and gases. Respiratory health effects were evaluated by conducting the following tests on participating children at each school: spirometry, forced oscillation technique (FOT) and multiple breath nitrogen washout test (MBNW) (to assess airway function), fraction of exhaled nitric oxide (FeNO, to assess airway inflammation), blood cotinine levels (to assess exposure to second-hand tobacco smoke), and serum C-reactive protein (CRP) levels (to measure systemic inflammation). A pilot study was conducted prior to commencing the main study to assess the feasibility and reliably of measurement of some of the clinical tests that have been proposed for the main study. Air pollutant exposure measurements were not included in the pilot study

Protective effects of ursodeoxycholic acid on ceftriaxone-induced hepatic injury in rats

Ceftriaxone is a broad-spectrum semisynthetic cephalosporin antibiotic that causes partial damage in the liver manifested by transient elevation in some biochemical parameters. In this study, our aim was to investigate the use of ursodeoxycholic acid (UDCA) in prevention of the hepatotoxic effect and biochemical changes induced by ceftriaxone in rats. Rats were divided into six groups (control, UDCA 20 mg/kg, ceftriaxone 180 mg/kg, UDCA + ceftriaxone 180 mg/kg, ceftriaxone 360 mg/kg, and UDCA + ceftriaxone 360 mg/kg). Ceftriaxone was injected intraperitoneally, and UDCA was given orally daily for four consecutive weeks. Then liver functions (serums AST, ALT, ALP, direct bilirubin, and total protein) were assessed. Histopathological examination was performed. Treatment of animals with ceftriaxone caused elevated activities of serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) as well as total bilirubin level. These elevations in liver enzymes were decreased by combination ceftriaxone with UDCA. In addition, ceftriaxone caused a significant increase in malondialdehyde (MDA) and nitric oxide (NO) content but significant decrease in glutathione (GSH) content. Combination of UDCA and ceftriaxone resulted in a significant decrease in MDA, NO content and significantly elevated GSH content. It could be concluded that UDCA acts as an effective hepatoprotective agent against liver dysfunction caused by ceftriaxone, and this effect might be related to its antioxidant properties. Hepatic functions should be monitored, and the dose should be adjusted during ceftriaxone therapy

Pattern of chronic urticaria and value of autologous serum skin test in Sohag Province, Upper Egypt

Background: Chronic urticaria (CU) is a debilitating disorder with variable clinical course. It is characterized by hives occurring for at least 6 weeks, and is classified as spontaneous or inducible. Objective: The aim of this study was to detect the pattern of CU, to study association between results of autologous serum skin test (ASST) and urticaria severity score (USS), and to detect serum levels of anti IgE receptors antibodies. Methods: This study included all patients attending the Dermatology Outpatient Clinic, Sohag University Hospital, who were diagnosed as CU from April 2015 to March 2016. ASST and serum level of anti IgE receptor antibodies was assessed using ELISA. Data were analyzed by SPSS version 16, using descriptive statistics, Kruskal-Wallis and Mann-Whitney U test. Results: A total of 108 patients with CU were included in the study. Females with mean age 33±12.4 years were more affected. A total of 58.3% complained of CSU, 6.5% physical urticaria and 35.2% mixed type of CU. According to USS, mild score represented 20.4%, moderate 46.3% and severe in 33.3%. ASST showed positive in 38% of patients. There was a statistically significant relation between ASST and USS and duration of CU. This indicates that more severe symptoms and prolonged duration of CU are observed in positive ASST (autoreactive type). In all, 91% of the anti IgE receptor antibodies positive patients had positive ASST. Conclusion: In conclusion, chronic urticaria is not an uncommon disease in our locality which represented 1.13% of our patients. Urticaria severity score and duration of urticaria was higher in positive ASST patients and hence the autoreactive type

The relationship between ultrafine particles from traffic emissions and children’s health (UPTECH) - Preliminary exposure data

Currently there is a limited body of epidemiological data on the effects of ultrafine (UF) particles (<0.1 µm) on human health, particularly children. Therefore this large project seeks to determine the effect of the exposure to airborne UF particles emitted from motor vehicles on the health of children in schools. To achieve this air quality data as well as respiratory data will be collected at 25 primary schools in Brisbane Metropolitan Area (BMA) over the next two years. This paper presents the preliminary data collected at 3 schools out of 25 planned, which will be used to estimate the exposure profile at the schools

The effects of Ultrafine Particles from Traffic Emissions on Children’s Health (UPTECH): Study design

The motivation of this study was the limited body of epidemiological data on the effects of ultrafine (UF) particles (<0.1 µm) on human health, particularly children. Therefore this project seeks to determine the effect of the exposure to airborne UF particles emitted from motor vehicles on the health of children in schools. To achieve this, firstly a comprehensive study design had to be developed, and some of its aspects validated, to encompass the immense complexity of this project. This paper presents the results of this work

Respiratory Health before and after the Opening of a Road Traffic Tunnel: A Planned Evaluation

<div><h3>Objective</h3><p>The construction of a new road tunnel in Sydney, Australia, and concomitant reduction in traffic on a major road presented the opportunity to study the effects of this traffic intervention on respiratory health.</p> <h3>Methods</h3><p>We made measurements in a cohort of residents in the year before the tunnel opened (2006) and in each of two years afterwards (2007–2008). Cohort members resided in one of four exposure zones, including a control zone. Each year, a respiratory questionnaire was administered (n = 2,978) and a panel sub-cohort (n = 380) performed spirometry once and recorded peak expiratory flow and symptoms twice daily for nine weeks.</p> <h3>Results</h3><p>There was no consistent evidence of improvement in respiratory health in residents living along the bypassed main road, despite a reduction in traffic from 90,000 to 45,000 vpd. Residents living near tunnel feeder roads reported more upper respiratory symptoms in the survey but not in the panel sub-cohort. Residents living around the tunnel ventilation stack reported more upper and lower respiratory symptoms and had lower spirometric volumes after the tunnel opened. Air pollutant levels measured near the stack did not increase over the study period.</p> <h3>Conclusion</h3><p>The finding of adverse health effects among residents living around the stack is unexpected and difficult to explain, but might be due to unmeasured pollutants or risk factors or an unrecognized pollutant source nearby. The lack of improvement in respiratory health among people living along the bypassed main road probably reflects a minimal change in exposure due to distance of residence from the road.</p> </div

Odds ratios for symptoms reported in the diary panel sub-cohort in 2007 and in 2008 relative to 2006, adjusted for change in the control zone, (n = 380).

a<p>OR-odds of higher values on the ordinal scale (symptoms experienced: 0 days; 1–10% of days;10–20% of days; and 21–100% of days) compared with lower values, assuming proportional odds.</p>b<p>Adjusted for: age; gender; diagnosis of asthma at baseline; smoker; ETS; gas stove or oven; unflued gas heating; education and employment status.</p