Abstract
BackgroundUrban air pollution is an increasing health problem, particularly in Asia, where the combustion of fossil fuels has increased rapidly as a result of industrialization and socio-economic development. The adverse health impacts of urban air pollution are well established, but less is known about effective intervention strategies. In this demonstration study we set out to establish methods to assess whether wearing an R95 activated carbon respirator could reduce intake of polycyclic aromatic hydrocarbons (PAH) in street workers in Hanoi, Vietnam.MethodsIn this demonstration study we performed a cross-over study in which non-smoking participants that worked at least 4 hours per day on the street in Hanoi were randomly allocated to specific respirator wearing sequences for a duration of 2 weeks. Urines were collected after each period, i.e. twice per week, at the end of the working day to measure hydroxy PAHs (OH-PAH) using gas chromatography/high resolution mass spectrometry. The primary endpoint was the urinary concentration of 1-hydroxypyrene (1-OHP).ResultsForty-four participants (54.5% male, median age 40 years) were enrolled with the majority being motorbike taxi drivers (38.6%) or street vendors (34.1%). The baseline creatinine corrected urinary level for 1-OHP was much higher than other international comparisons: 1020 ng/g creatinine (IQR: 604–1551). Wearing a R95 mask had no significant effect on 1-OHP levels: estimated multiplicative effect 1.0 (95% CI: 0.92-1.09) or other OH-PAHs, except 1-hydroxynaphthalene (1-OHN): 0.86 (95% CI: 0.11-0.96).ConclusionsHigh levels of urine OH-PAHs were found in Hanoi street workers. No effect was seen on urine OH-PAH levels by wearing R95 particulate respirators in an area of high urban air pollution, except for 1-OHN. A lack of effect may be de to gaseous phase PAHs that were not filtered efficiently by the respirator. The high levels of urinary OH-PAHs found, urges for effective interventions.Trial registrationISRCTN74390617 (date of assignation: 04/08/2009).
Highlights
Urban air pollution is an increasing health problem, in Asia, where the combustion of fossil fuels has increased rapidly as a result of industrialization and socio-economic development
It is estimated that air pollution in urban areas worldwide causes approximately 3% of adult cardiopulmonary disease deaths approximately 5% of mortality from malignancies of the respiratory tract, and about 1% of mortality from acute respiratory illness (ARI) in children [4]
During the day the participants travelled a median of 6 km per day and spent a median of 10 hours (IQR: 8–12 hours) hours outside on the street
Summary
Urban air pollution is an increasing health problem, in Asia, where the combustion of fossil fuels has increased rapidly as a result of industrialization and socio-economic development. Urban air pollution is an increasing health problem in Asia, where the combustion of fossil fuels has increased rapidly as a result of industrialization and socio-economic development [1,2,3,4,5]. It is estimated that air pollution in urban areas worldwide causes approximately 3% of adult cardiopulmonary disease deaths approximately 5% of mortality from malignancies of the respiratory tract, and about 1% of mortality from acute respiratory illness (ARI) in children [4] This results in 0.80 million premature deaths with 6.4 million years of life lost (YLL) and occurs predominantly in developing countries, with 20%-39% of attributable YLL in the South East Asia Region [4]. It is essential to study the health impacts of air pollution in the large cities of Asia where air pollution levels exceed WHO standards and to develop interventions to reduce the burden of associated morbidity and mortality
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