A new study by researchers at UCLA and Brigham and Women’s Hospital in Boston suggests that improvements in air quality over the past decade have resulted in fewer cases of ear infections in children.

Ear infections are one of the most common illnesses among children, with annual direct and indirect costs of $3 billion to $5 billion in the United States.

“We believe these findings, which demonstrate a direct correlation between air quality and ear infections, have both medical and political significance,” said study co-author Dr. Nina Shapiro, director of pediatric otolaryngology at Mattel Children’s Hospital UCLA and an associate professor of surgery at the David Geffen School of Medicine at UCLA. “The results validate the benefits of the revised Clean Air Act of 1990, which gave the Environmental Protection Agency more authority to implement and enforce regulations reducing air-pollutant emissions. It also shows that the improvements may have direct benefit on health-quality measures.”

The research appears in the February issue of Otolaryngology–Head and Neck Surgery, the official peer-reviewed publication of the American Academy of Otolaryngology–Head and Neck Surgery Foundation.

The researchers reviewed National Health Interview Survey data for 120,060 children between the years of 1997 and 2006 and measured the number of instances of three disease conditions for each year — frequent ear infections (three or more within a year), respiratory allergy and seizure activity, which is not influenced by air quality but was included as a control condition.

These numbers were then cross-referenced with the EPA’s air-quality data on pollutants, including carbon monoxide, nitrous dioxide, sulfur dioxide and particulate matter, for the same time period. The study authors discovered that as air quality steadily improved, the number of cases of frequent ear infections significantly decreased.

The results also showed that there was not an association between improved air quality and improved rates of pediatric respiratory allergy, possibly due to the fact that allergens are not pollutants.

Reference: UCLA, Amy Albin,  Improved air quality linked to fewer pediatric ear infections, January 27, 2010

Schoolchildren, teaching staff and parents are looking forward to the imminent refurbishment which will take place in their schools. Funds from the federal government incentive programme have been earmarked to improve the learning environment, in particular in older school buildings. The federal funds allotted for remediation, modernisation and refurbishment work will not only make schools more beautiful, they will also bring better ambient air. This depends though on the proper choice of building materials by public procurement offices, as unpleasant smells might otherwise be produced by higher emissions of volatile and semi-volatile organic substances. These substances can be the cause of lack of concentration and headaches.

The Federal Environment Agency (UBA) recommends following the advice offered in its Leitfaden für die Innenraumhygiene in Schulgebäuden [Guidebook on indoor air hygiene in school buildings] publication. The Indoor Air Hygiene Commission of the Federal Environment Agency (UBA) has thoroughly revised the publication this year. The guidebook offers advice on how schools can do refurbishment work ecologically and with a view to health, whilst upgrading the buildings, too.  It will make the job of guaranteeing good air quality long-term for those responsible – builders and school administration – a bit easier. It does require the work of professionals, however, also as concerns consideration of potential hazardous materials in existing building structure, as well as use of the appropriate materials and products.

The Blue Angel eco-label is a reliable signpost on building products that are harmless to health. The Blue Angel has been awarded to the following products: parquet, laminate and linoleum floorings, flexible floor covering, sealants for interior use, adhesive for floors, soundproofing and heat insulation materials, composite wood panels, wood chip wall covering, varnishes, and wall paints. Use of these products must be well-balanced, however, so that an adhesive and floor covering used together, for example, do not result in any reactive outgasing.

Using low-emissions products for refurbishment jobs is a key factor for healthy ambient air in classrooms, even though the purchase price of these product groups is initially somewhat more expensive. Downstream clean-up work to correct building defects results in higher costs, as experience at affected schools has shown.

If schoolchildren report headaches, tired eyes and lack of concentration after refurbishment is completed, this hinders successful learning and incurs costs at another point, namely to restore health. Taking environmental criteria into consideration in the public tendering process has become entirely legitimate. Staff at public procurement offices and in municipalities, however, are often still unaware of the changes in the law.

The following UBA publications (in German) are available for free download and provide advice and guidance:

• Leitfaden für die Innenraumhygiene in Schulgebäuden [Guidebook on indoor air hygiene in school buildings]
• The Blue Angel product signpost, Umweltfreundlich bauen, Gesund wohnen [Green building, healthy living]
• The guide Umweltfreundliche Beschaffung – Ökologische & wirtschaftliche Potenziale rechtlich zulässig nutzen [Green procurement - making legal use of ecological & economic potential]
• Schulen, besser Lernen in gesunder Luft [Schools: better learning in healthy air] brochure

Reference: UBA, Incentive programme also benefits schools, Dessau-Roßlau, 9 November 2009

Plumes of harmful air pollutants can be transported across oceans and continents — from Asia to the United States and from the United States to Europe — and have a negative impact on air quality far from their original sources, says a new report by the National Research Council.  Although degraded air quality is nearly always dominated by local emissions, the influence of non-domestic pollution sources may grow as emissions from developing countries increase and become relatively more important as a result of tightening environmental protection standards in industrialized countries.  

“Air pollution does not recognize national borders; the atmosphere connects distant regions of our planet,” said Charles Kolb, chair of the committee that wrote the report and president and chief executive officer of Aerodyne Research Inc.  “Emissions within any one country can affect human and ecosystem health in countries far downwind.  While it is difficult to quantify these influences, in some cases the impacts are significant from regulatory and public health perspectives.” 

The report examines four types of air pollutants: ozone; particulate matter such as dust, sulfates, or soot; mercury; and persistent organic pollutants such as DDT.  The committee found evidence, including satellite observations, that these four types of pollutants can be transported aloft across the Northern Hemisphere, delivering significant concentrations to downwind continents.  Ultimately, most pollutants’ impacts depend on how they filter down to the surface.  

Current limitations in modeling and observational capabilities make it difficult to determine how global sources of pollution affect air quality and ecosystems in downwind locations and distinguish the domestic and foreign components of observed pollutants.  Yet, some pollutant plumes observed in the U.S. can be attributed unambiguously to sources in Asia based on meteorological and chemical analyses, the committee said.  For example, one study found that a polluted airmass detected at Mt. Bachelor Observatory in central Oregon took approximately eight days to travel from East Asia.  

The health impacts of long-range transport vary by pollutant.  For ozone and particulate matter — which cause respiratory problems and other health effects — the main concern is direct inhalation.  While the amount of ozone and particulate matter transported on international scales is generally quite small compared with domestic sources, neither of these pollutants has a known “threshold,” or concentration below which exposure poses no risk for health impacts.  Therefore, even small incremental increases in atmospheric concentrations can have negative impacts, the committee said.  For instance, modeling studies have estimated that about 500 premature cardiopulmonary deaths could be avoided annually in North America by reducing ozone precursor emissions by 20 percent in the other major industrial regions of the Northern Hemisphere. 

For mercury and persistent organic pollutants, the main health concern is that their transport and deposition leads to gradual accumulation on land and in watersheds, creating an increase in human exposure via the food chain.  For example, people may consume mercury by eating fish.  There is also concern about eventual re-release of “legacy” emissions that have been stored in soils, forests, snowpacks, and other environmental reservoirs. 

In addition, the committee said that projected climate change will lead to a warmer climate and shifts in atmospheric circulation, likely affecting the patterns of emission, transport, transformation, and deposition for all types of pollution.  However, predicting the net impacts of the potential changes is extremely difficult with present knowledge. 

In the coming decades, man-made emissions are expected to rise in East Asia, the report says.  These increases could potentially be mitigated by increasingly stringent pollution control efforts and international cooperation in developing and deploying pollution control technology. 

To enhance understanding of long-range transport of pollution and its impacts, the committee recommended a variety of research initiatives, such as advancing “fingerprinting” techniques to better identify source-specific pollutant characteristics, and examining how emissions from ships and aircraft affect atmospheric composition and complicate the detection of pollution from land-based sources.  The committee emphasized developing an integrated “pollution source-attribution” system that improves capabilities in emissions measurements and estimates; atmospheric chemical and meteorological modeling; long-term, ground-based observations; satellite remote sensing; and process-focused field studies.  

Moreover, the committee stressed that the United States, as both a source and receptor of long-range pollution, has an interest in remaining actively engaged in air pollutants that travel abroad, including support of more extensive international cooperation in research, assessment, and emissions control efforts. 

The report was sponsored by the U.S. Environmental Protection Agency, National Oceanic and Atmospheric Administration, NASA, and National Science Foundation.  The National Academy of Sciences, National Academy of Engineering, Institute of Medicine, and National Research Council make up the National Academies.  They are independent, nonprofit institutions that provide science, technology, and health policy advice under an 1863 congressional charter.  Committee members, who serve pro bono as volunteers, are chosen by the Academies for each study based on their expertise and experience and must satisfy the Academies’ conflict-of-interest standards.  The resulting consensus reports undergo external peer review before completion.  For more information, visit National Academies  A committee roster follows. 

Reference: National Academy of Sciences, Air Pollutants From Abroad a Growing Concern, Says New Report, Washington, September 29. 2009

A toxic cocktail of ultrafine particles is lurking inside road tunnels in concentration levels so high they have the potential to harm drivers and passengers, a new study has found.

The study, which has been published in Atmospheric Environment, measured ultrafine particle concentration levels outside a vehicle travelling through the M5 East tunnel in Sydney. 

Study co-author and director of Queensland University of Technology’s International Laboratory for Air Quality and Health, Professor Lidia Morawska, said road tunnels were locations where maximum exposure to dangerous ultrafine particles in addition to other pollutants occurred. 

“The human health effects of exposure to ultrafine particles produced by fuel combustion are generally regarded as detrimental,” Professor Morawska said. 

“Effects can range from minor respiratory problems in healthy people, to acute myocardial infarction (heart attack) in people with existing heart complaints. 

Professor Morawska said the study involved more than 300 trips through the four kilometres of the M5 East tunnel, with journeys lasting up to 26 minutes, depending on traffic congestion. 

“What this study aimed to do was identify the concentration levels found in the tunnel. It generated a huge body of data on the concentrations and the results show that, at times, the levels are up to 1000 times higher than in urban ambient conditions,” she said.

She said drivers and occupants of new vehicles which had their windows closed were safer than people travelling in older vehicles. 

“People who are driving older vehicles which are inferior in terms of tightness and also those riding motorcycles or driving convertibles, these people are exposed to incredibly high concentrations,” she said.

“When compared with similar studies reported previously, the measurements here were among the highest recorded concentrations,” she said. 

Professor Morawska said tunnels were becoming an increasingly necessary infrastructure component in many cities across the world. 

“When governments are building tunnels for urban design reasons, they should also consider the impact these tunnels are having on the environment and to people’s health,” she said.

“The study highlights why governments need to consider how they are going to deal with the air pollution levels inside the tunnel and removal of ultrafine particles in the outside environment.” 

The study was conducted jointly by Professor Richard de Dear and his doctoral candidate, Mr Luke Knibbs from Macquarie University, in collaboration with Professor Morawska and Dr Kerrie Mengersen from QUT. 

Reference:   Queensland University of Technology (2009, August 30). Tunnels Concentrate Air Pollution By Up To 1,000 Times. ScienceDaily. Retrieved September 2, 2009

Today, WHO publishes its first guidelines on indoor air quality, addressing dampness and mould. (1) They are the result of a rigorous two-year review of the currently available science by 36 leading experts worldwide, coordinated by the WHO Regional Office for Europe. The authors conclude that occupants of damp or mouldy buildings, both private and public, have up to a 75% greater risk of respiratory symptoms and asthma. The guidelines recommend the prevention or remediation of dampness- and mould-related problems to significantly reduce harm to health. 

“As people spend most of their daily lives in homes, offices, schools, health care facilities or other buildings, the quality of the air they breathe indoors is critical for their health and well-being,” says Dr Srdan Matic, Unit Head, Noncommunicable Diseases and Environment at the WHO Regional Office for Europe. “For the first time, these guidelines offer guidance to public health and other authorities on how to ensure safety and healthy conditions in buildings. We believe that this work will contribute to improving the health of people around the world.”

The book is the first in a series of WHO guidelines on indoor air quality. They are intended for worldwide use, to protect health under various environmental, social and economic conditions. Future publications addressing selected chemicals and combustion products are being prepared. Together, the guidelines will comprise the first-ever comprehensive evidence-based recommendations to tackle indoor air pollution, one of the major causes of death and disease worldwide. 

Globally, about 1.5 million deaths each year, mostly among women and children in developing countries, are associated with the indoor combustion of solid fuels. In the European Union (EU) alone, combustion, chemicals from building materials and dampness cause an annual loss of over 2 million years of healthy life due to premature death or to chronic diseases, such as asthma and cardiovascular diseases. 

In many EU countries, 20–30% of households have problems with dampness. Strong evidence indicates that this is a risk to health. In damp conditions, hundreds of species of bacteria and fungi grow indoors and emit spores, cell fragments and chemicals into the air. Exposure to these contaminants is associated with the incidence or worsening of respiratory symptoms, allergies, asthma and immunological reactions. Children are particularly susceptible. According to recent evidence, 13% of childhood asthma in developed countries in the WHO European Region could be attributable to damp housing. 

Knowledge of indoor air pollutants is the key to enabling action to prevent related health effects and maintain clean air. Many of these actions are beyond the power of individual building users and occupants, and must be taken by public authorities. The guidelines recommend measures to ensure that buildings are well designed, constructed and maintained, and to make adequate housing and occupancy policies. Building owners are responsible for providing healthy workplaces or living environments, free of moisture and mould, by ensuring adequate insulation. Occupants are responsible for managing the use of water, heating and ventilation to avoid excess humidity. 

“In the absence of clear evidence, building standards and regulations have not sufficiently targeted prevention and control of excess moisture. The new guidelines are essential, as they provide reference criteria for what constitutes healthy indoor air,” concludes Dr Michal Krzyzanowski, Regional Adviser, Noncommunicable Diseases and Environment at the WHO Regional Office for Europe, and the leader of the WHO project to draw up the guidelines. “More than 100 studies on the health effects of damp environments were reviewed in the preparation process. This body of evidence forms the basis of the guidelines and provides a solid foundation for action.”

Full Report: Indoor Air Quality Guidelines on Dampness and Mould

The Regional Office web site offers further information on air quality and health.  

Reference: WHO guidelines on indoor air quality: dampness and mould. Copenhagen, WHO Regional Office for Europe, 2009, accessed 16 July 2009.