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6 Health Effects from Exposure to Indoor PM
Pages 139-178

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From page 139...
... ; other sources of indoor air pollution have been less studied. The National Academies have conducted two series of workshops on the health risks of indoor exposure to particulate matter.
From page 140...
... Figure 6-1 shows the biological systems that have been associated with health effects associated with exposure to outdoor air pollution. Its content reflects the fact that populations breathing indoor air are exposed to a mixture of outdoor air pollution that has entered the indoor environment and additional PM2.5 exposure generated from sources inside homes and other buildings.
From page 141...
... In general, the literature on pulmonary and cardiovascular effects associated with indoor air pollution is much more established than that of other body systems, such as neurological and reproductive effects. In the review of different body systems, there was an attempt to focus primarily on literature from studies conducted in the United States, if possible.
From page 142...
... Although the report does not include a review of the voluminous literature on smoking, secondhand smoke is addressed in its capacity as a major contributor to indoor PM2.5. The approach taken is to review the major epidemiological literature focused on respiratory effects of indoor fine PM, including those that include biomarkers of effects.
From page 143...
... PM and found that although total PM2.5 exposures were dominated by exposures to non-ambient particles (which were not correlated with ambient fine particle exposures or ambient concentrations) , only exposure to ambient particles were associated with decreased lung function, decreased systolic blood pressure, increased heart rate, and increased supraventricular ectopic heartbeats (Ebelt et al., 2005)
From page 144...
... , and there is a lengthy scientific literature pointing to SHS as a cause of asthma symptoms and exacerbations, and here the exposure metric is often cotinine or nicotine concentrations in a biologic sample. At least two randomized trials of air cleaners in children with asthma exposed to secondhand smoke demonstrated reductions in indoor PM2.5 and biomarkers of SHS exposure and improvements in asthma, including an increase in symptom-free days (Butz et al., 2011)
From page 145...
... Fungal exposure has also been linked to decrements in lung function among COPD patients (Fréalle et al., 2021)
From page 146...
... . Secondhand smoke and indoor air pollution have also been shown to increase the risk of contracting tuberculosis in international studies (Obore et al., 2020)
From page 147...
... Outdoor PM2.5 has been linked to incident asthma and COPD as well as long-term effects on lung function -- either more rapid decline among adults or reduced lung function growth among children. However, secondhand smoke -- a major contributor to indoor PM2.5 -- has repeatedly been associated with reduced lung function growth among healthy children (Okyere et al., 2021)
From page 148...
... Pathways that may explain the cardiovascular health effects of indoor PM include systemic inflammation and oxidative stress responses; activation of the coagulation cascade; alteration of cardiac autonomic response and conduction; and changes in vasomotor tone of the circulatory system. The clinical endpoints include biomarkers of systemic inflammation and oxidative stress, blood pressure, pulse rate, heart rate variability, and electrocardiogram changes.
From page 149...
... of 65 nonsmoking subjects, finding that a 10 μg/m³ increase in total personal-level PM2.5 exposure was associated with systolic blood pressure elevation but that community PM2.5 levels were not associated with cardiovascular outcomes. International studies that focus on biomass fuel use, including those conducted in China, Guatemala, and Peru, provide more consistent evidence of the association between indoor particulate matter and increases in blood pressure.
From page 150...
... However, many of the clinical trials of portable air cleaners have included blood pressure and heart rate and have not found an association between PM reduction and blood pressure improvement. International studies in Guatemala and Bolivia reported a reduction in blood pressure (BP)
From page 151...
... (2008) studied 29 non-smoking elderly individuals investigating the association between both outdoor and indoor air pollution and systemic inflammation.
From page 152...
... air-conditioner filter use reduced VOC as well as PM concentrations in homes in Taiwan and that filtration resulted in a reduction in inflammation and oxidative stress and blood pressure. Susceptibility Factors for Cardiovascular Outcomes Vulnerable populations at increased risk for the cardiovascular health effects associated with exposure to indoor particulate matter include children with asthma, elderly adults, and adults with asthma, chronic obstructive pulmonary disease (COPD)
From page 153...
... . Much of what is known about the association between indoor air pollution and cancer has been generated from studies of biomass burning in low- and middle- income countries and primarily focused on lung cancer (Lee et al., 2020)
From page 154...
... As described in previous chapters, outdoor air pollution is a major component of the indoor air environment in addition to PM being generated by indoor sources. Studies focused on exposures that occur indoors and potential neurobehavioral and cognitive effects such as in offices and schools are increasingly being pursued.
From page 155...
... . Outdoor Air Pollution and Prenatal and Childhood Neurological Effects There have been multiple reports of relationships between prenatal and early childhood exposures to ambient air pollution, including PM2.5, and neurological outcomes, primarily behavioral effects and school performance.
From page 156...
... Indoor Exposure to PM2.5 and Neurological Effects There is a scarcity of population-based studies of indoor air pollution and neurological health effects in adults. A study of 628 households in the United Arab Emirates examined a number of indoor air pollutants, including particulate matter, collecting health information from household members using in-person interviews (Yeatts et al., 2012)
From page 157...
... These associations remained when controlled for type of school, educational quality, commuting, and smoking at home. An association between indoor air pollution exposure during pregnancy and autistic-like behavior in offspring has also been reported.
From page 158...
... (2017) published a systematic review and meta-analysis of the association between ambient fine particulate matter and preterm birth or term low birth weight.
From page 159...
... A small number of studies focused on gestational diabetes and gestational blood pressure, differences in sex ratio, birth defects, and mental health morbidity (Evans et al., 2022)
From page 160...
... To date the studies have focused on outdoor air pollution, and reviews point to compelling evidence of a link between metabolic syndrome and exposure to air pollution. In a systematic review and meta-analysis of the association between long-term ambient PM exposure and metabolic syndrome risk, Ning et al.
From page 161...
... They are directed both to indoor air and particulate matter researchers and to EPA and other funders of such research. The indoor environment research community should use emerging consumer-grade sensors and statistical modeling to estimate indoor and personal PM exposure at a larger scale to facilitate the conduct of large-scale population-based epidemiologic studies.
From page 162...
... It will not be possible to identify and to formulate practical mitigation strategies for disproportionately affected populations until there is a clear understanding of who is affected by them and how their circumstances shape the determination of effective interventions. The indoor air research community should support the conduct of studies that evaluate the full impact of policies on PM2.5 exposure and health, including cost–benefit analyses that incorporate an estimate of the economic and public health costs of not implementing interventions.
From page 163...
... 2022. Maternal and childhood ambient air pollution exposure and mental health symptoms and psychomotor development in children: An Australian population-based longitudinal study.
From page 164...
... 2013. Wheeze in infancy: Protection associated with yeasts in house dust contrasts with increased risk associated with yeasts in indoor air and other fungal taxa.
From page 165...
... 2011. A randomized trial of air cleaners and a health coach to improve indoor air quality for inner-city children with asthma and secondhand smoke exposure.
From page 166...
... 2017. Long-term indoor air conditioner filtration and cardiovascular health: A randomized crossover intervention study.
From page 167...
... 2018. Indoor black carbon of outdoor origin and oxidative stress biomarkers in patients with chronic obstructive pulmonary disease.
From page 168...
... American Journal of Respiratory and Critical Care Medicine, 187(10)
From page 169...
... 2013. An indoor air filtration study in homes of elderly: Cardiovascular and respiratory effects of exposure to particulate matter.
From page 170...
... 2017. Association between ambient fine particulate matter and preterm birth or term low birth weight: An updated systematic review and meta-analysis.
From page 171...
... 2022. Factors influencing classroom exposures to fine particles, black carbon, and nitrogen dioxide in inner-city schools and their implications for indoor air quality.
From page 172...
... 2018. Effect of portable air filtration systems on personal exposure to fine particulate matter and blood pressure among residents in a low-income senior facility: A randomized clinical trial.
From page 173...
... and Wang, L., 2020. Association between indoor air pollution, tobacco smoke and tuberculosis: an updated systematic review and meta-analysis.
From page 174...
... 2023. Indoor air pollution and impaired cardiac autonomic function in chronic obstructive pulmonary disease.
From page 175...
... Indoor Air, 32(1)
From page 176...
... 2005. Acute blood pressure responses in healthy adults during controlled air pollution exposures.
From page 177...
... 2022. Efficacy of air filtration and education interventions on indoor fine particulate matter and child lower respiratory tract infections among rural U.S.
From page 178...
... 2018. Global association between ambient air pollution and blood pressure: A systematic review and meta-analysis.


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