Pediatric emergency room visits for asthma were studied in relation to air quality indices in a spatio-temporal investigation of approximately 130,000 visits (approximately 6,000 for asthma) to the major emergency care centers in Atlanta, Georgia, during the summers of 1993-1995. Generalized estimating equations, logistic regression, and Bayesian models were fitted to the data. In logistic regression models comparing estimated exposures of asthma cases with those of the nonasthma patients, controlling for temporal and demographic covariates and using residential zip code to link patients to spatially resolved ozone levels, the estimated relative risk per 20 parts per billion (ppb) increase in the maximum 8-hour ozone level was 1.04 (p < 0.05). The estimated relative risk for particulate matter less than or equal to 10 microm in aerodynamic diameter (PM10) was 1.04 per 15 microg/m3 (p < 0.05). Exposure-response trends (p < 0.01) were observed for ozone (>100 ppb vs. <50 ppb: odds ratio = 1.23, p = 0.003) and PM10 (>60 microg/m3 vs. <20 microg/m3: odds ratio = 1.26, p = 0.004). In models with ozone and PM10, both terms became nonsignificant because of collinearity of the variables (r= 0.75). The other analytical approaches yielded consistent findings. This study supports accumulating evidence regarding the relation of air pollution to childhood asthma exacerbation.

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Average daily dietary exposures to 11 contaminants were estimated for approximately 120,000 U.S. adults by combining data on annual diet, as measured by a food frequency questionnaire, with contaminant residue data for table-ready foods that were collected as part of the annual U.S. Food and Drug Administration Total Diet Study. The contaminants included in the analysis were four heavy metals (arsenic, cadmium, lead, mercury), three organophosphate pesticides (chlorpyrifos, diazinon, malathion), and four organochlorine pesticides (dieldrin, p,p'-DDE, lindane, heptachlor epoxide). Dietary exposures to these contaminants were highly variable among individuals, spanning two to three orders of magnitude. Intraindividual exposures to the metals, organophosphates, and organochlorines were estimated to be strongly correlated; Pearson's correlation coefficients ranged from 0.28 for lindane:dieldrin to 0.84 for lead:mercury. For some of the compounds (e.g., arsenic and dieldrin), a substantial fraction of the population was estimated to have dietary intakes in excess of health-based standards established by the EPA. Before use for risk assessment or epidemiologic purposes, however, the validity of the exposure estimates must be evaluated by comparison with biological indicators of chronic exposure. Because of their low detection rate in table-ready foods, the estimated distributions of exposures for dieldrin, p,p'-DDE, heptachlor epoxide, lindane, diazinon, and chlorpyrifos were found to be sensitive to assumed values for nondetect samples. Reliable estimates of the population distribution of dietary exposures to most other contaminants cannot be made currently, due to their low rate of detection in table-ready foods. Monitoring programs that use more sensitive study designs and population-based assessments for other subpopulations should be a priority for future research.ImagesFigure 1.Figure 2.Figure 3.Figure 4.

As part of the National Human Exposure Assessment Survey (NHEXAS) in Maryland, we collected indoor air, carpet dust, exterior soil, and duplicate diet samples from a stratified random sample of 80 individuals to evaluate aggregate daily exposure, contributions of specific pathways of exposure, and temporal variation in exposure to chlorpyrifos. We collected samples from each participant in up to six equally spaced sampling cycles over a year and analyzed them for chlorpyrifos. We used chlorpyrifos concentrations in each medium and self-reported rates of time spent inside at home, time and frequency of contact with carpet, frequency of contact with soil, and weights of the duplicate diet samples to derive exposure to chlorpyrifos from each medium as well as average daily aggregate exposure (nanograms per day). The mean aggregate daily exposure to chlorpyrifos of 36 measurements obtained from 31 people was 1,390 ng/day (SD, 2,770 ng/day). Exposure from inhalation of indoor air accounted for 84.7% of aggregate daily exposure to chlorpyrifos on average. Chlorpyrifos concentrations in indoor air and carpet dust and the corresponding exposure rates were significantly correlated. Repeated short-term measurements of chlorpyrifos in carpet dust from individual residences were strongly correlated over time (reliability coefficient, R = 0.90), whereas the short-term measurements of chlorpyrifos in indoor air (R = 0.55) and solid food (R = 0.03) had moderate to weak reliability. Exposure to chlorpyrifos through those media and in aggregate based on direct measurements reported in this study can be used to understand better the accuracy of pesticide safety assessments.

As part of a longitudinal investigation of environmental exposures to selected chemical contaminants, concentrations of the pesticide metabolites 1-naphthol (1NAP), 3,5,6-trichloro-2-pyridinol (TCPY), malathion dicarboxylic acid (MDA), and atrazine mercapturate (AM) were measured in repeated samples obtained from 80 individuals in Maryland during 1995±1996. Up to six urine samples were collected from each individual at intervals of approximately 8 weeks over a 1-year period (i.e., one sample per participant in each of six cycles). 1NAP (median=4.2 g/l and 3.3 g/g creatinine) and TCPY (median=5.3 g/l and 4.6. g/g creatinine) were present in over 80% of the samples, while MDA and AM were detected infrequently (6.6% and <1% of samples, respectively). Geometric mean (GM) concentrations of 1NAP in urine did not vary significantly among sampling cycles. In contrast, GM concentrations of TCPY were significantly greater in samples collected during the spring and summer of 1996 than in the preceding fall and winter. Repeated measurements of 1NAP and TCPY from the same individual over time were highly variable. The average range of 1NAP and TCPY concentrations from the same individual were approximately 200% and 50% greater than the respective population mean levels. Geometric mean (GM) TCPY concentrations differed significantly between Caucasian (n=42, GM=5.7 g/g creatinine) and African-American (n=11, GM=4.0 g/g) participants and among education levels, but were not significantly different among groups classified by gender, age, or household income. In future research, environmental measurements of the parent compounds and questionnaire data collected concurrently with the biomarker data will be used to characterize the determinants of variability in the urinary pesticide metabolite levels.

A novel method for determining whole house particle removal and clean air delivery rates attributable to central and portable ventilation/air cleaning systems is described. The method is used to characterize total and air-cleaner-specific particle removal rates during operation of four in-duct air cleaners and two portable air-cleaning devices in a fully instrumented test home. Operation of in-duct and portable air cleaners typically increased particle removal rates over the baseline rates determined in the absence of operating a central fan or an indoor air cleaner. Removal rates of 0.3- to 0.5-microm particles ranged from 1.5 hr(-1) during operation of an in-duct, 5-in. pleated media filter to 7.2 hr(-1) for an in-duct electrostatic air cleaner in comparison to a baseline rate of 0 hr(-1) when the air handler was operating without a filter. Removal rates for total particulate matter less than 2.5 microm in aerodynamic diameter (PM2.5) mass concentrations were 0.5 hr(-1) under baseline conditions, 0.5 hr(-1) during operation of three portable ionic air cleaners, 1 hr(-1) for an in-duct 1-in. media filter, 2.4 hr(-1) for a single high-efficiency particle arrestance (HEPA) portable air cleaner, 4.6 hr(-1) for an in-duct 5-in. media filter, 4.7 hr(-1) during operation of five portable HEPA filters, 6.1 hr(-1) for a conventional in-duct electronic air cleaner, and 7.5 hr(-1) for a high efficiency in-duct electrostatic air cleaner. Corresponding whole house clean air delivery rates for PM2.5 attributable to the air cleaner independent of losses within the central ventilation system ranged from 2 m3/min for the conventional media filter to 32 m3/min for the high efficiency in-duct electrostatic device. Except for the portable ionic air cleaner, the devices considered here increased particle removal indoors over baseline deposition rates.

To obtain information on recycling behavior for selected populations, demographic data and measurements of materials in trash containers and recycling bins were collected from a random sample of 87 residences in Athens-Clarke County, Georgia. The recycling efficiency (RE) for each household had a mean of 45% and exhibited a bimodal distribution characterized by 1 group of households with near-zero RE and a second group with RE from 75% to 100%. Annual household income, home-ownership status, and level of education attained by the lead recycler were significantly associated with RE. The results of this study indicate that greater participation in recycling programs among low socioeconomic status households in this population may yield greater increases in waste reduction than enhanced RE of current participants. Additional research is required to evaluate the degree to which these findings can be generalized to other communities.

Arsenic, cadmium, and lead have been associated with various forms of cancer, nephrotoxicity, central nervous system effects, and cardiovascular disease in humans. Drinking water is a well-recognized pathway of exposure to these metals. To improve understanding of the temporal dimension of exposure to As, Cd, and Pb in drinking water, we obtained 381 samples of tap and/or tap/filtered water and self-reported rates of drinking water consumption from 73 members of a stratified random sample in Maryland. Data were collected at approximately 2-month intervals from September 1995 through September 1996. Concentrations of As (range < 0.2-13.8 microg/L) and Pb (< 0.1-13.4 microg/L) were within the ranges reported for the United States, as were the rates of drinking water consumption (median < 0.1-4.1 L/day). Cd was present at a detectable level in only 8.1% of the water samples. Mean log-transformed concentrations and exposures for As and Pb varied significantly among sampling cycles and among respondents, as did rates of drinking water consumption, according to a generalized linear model that accounted for potential correlation among repeated measures from the same respondent. We used the intraclass correlation coefficient of reliability to attribute the total variance observed for each exposure metric to between-person and within-person variability. Between-person variability was estimated to account for 67, 81, and 55% of the total variance in drinking water consumption, As exposure (micrograms per day), and Pb exposure (micrograms per day), respectively. We discuss these results with respect to their implications for future exposure assessment research, quantitative risk assessment, and environmental epidemiology.