Assessing the Impact of Non-Exhaust Emissions on the Asthmatic Airway (IONA) Protocol for a Randomised Three-Exposure Crossover Study

Overview

Journal Int J Environ Res Public Health

Publisher MDPI

Specialties Environmental Health
Public Health

Date 2024 Jul 27

PMID 39063472

Authors

James Scales

Hajar Hajmohammadi

Max Priestman

Luke C McIlvenna

Ingrid E de Boer

Haneen Hassan

Anja H Tremper

Gang Chen

Helen E Wood

David C Green

Klea Katsouyanni

Ian S Mudway

Christopher Griffiths

Affiliations

Soon will be listed here.

Abstract

Background: People living with asthma are disproportionately affected by air pollution, with increased symptoms, medication usage, hospital admissions, and the risk of death. To date, there has been a focus on exhaust emissions, but traffic-related air pollution (TRAP) can also arise from the mechanical abrasion of tyres, brakes, and road surfaces. We therefore created a study with the aim of investigating the acute impacts of non-exhaust emissions (NEEs) on the lung function and airway immune status of asthmatic adults.

Methods: A randomised three-condition crossover panel design will expose adults with asthma using a 2.5 h intermittent cycling protocol in a random order at three locations in London, selected to provide the greatest contrast in the NEE components within TRAP. Lung function will be monitored using oscillometry, fractional exhaled nitric oxide, and spirometry (the primary outcome is the forced expiratory volume in one second). Biomarkers of inflammation and airborne metal exposure will be measured in the upper airway using nasal lavage. Symptom responses will be monitored using questionnaires. Sources of exhaust and non-exhaust concentrations will be established using source apportionment via the positive matrix factorisation of high-time resolution chemical measures conducted at the exposure sites.

Discussion: Collectively, this study will provide us with valuable information on the health effects of NEE components within ambient PM and PM, whilst establishing a biological mechanism to help contextualise current epidemiological observations.

References

King G, Bates J, Berger K, Calverley P, de Melo P, Dellaca R . Technical standards for respiratory oscillometry. Eur Respir J. 2019; 55(2). DOI: 10.1183/13993003.00753-2019. View

. Five insights from the Global Burden of Disease Study 2019. Lancet. 2020; 396(10258):1135-1159. PMC: 7116361. DOI: 10.1016/S0140-6736(20)31404-5. View

McCreanor J, Cullinan P, Nieuwenhuijsen M, Stewart-Evans J, Malliarou E, Jarup L . Respiratory effects of exposure to diesel traffic in persons with asthma. N Engl J Med. 2007; 357(23):2348-58. DOI: 10.1056/NEJMoa071535. View

Delamater P, Finley A, Banerjee S . An analysis of asthma hospitalizations, air pollution, and weather conditions in Los Angeles County, California. Sci Total Environ. 2012; 425:110-8. PMC: 4451222. DOI: 10.1016/j.scitotenv.2012.02.015. View

Steenhof M, Mudway I, Gosens I, Hoek G, Godri K, Kelly F . Acute nasal pro-inflammatory response to air pollution depends on characteristics other than particle mass concentration or oxidative potential: the RAPTES project. Occup Environ Med. 2013; 70(5):341-8. DOI: 10.1136/oemed-2012-100993. View

Chen G, Canonaco F, Tobler A, Aas W, Alastuey A, Allan J . European aerosol phenomenology - 8: Harmonised source apportionment of organic aerosol using 22 Year-long ACSM/AMS datasets. Environ Int. 2022; 166:107325. DOI: 10.1016/j.envint.2022.107325. View

Lippmann M, Chen L, Gordon T, Ito K, Thurston G . National Particle Component Toxicity (NPACT) Initiative: integrated epidemiologic and toxicologic studies of the health effects of particulate matter components. Res Rep Health Eff Inst. 2014; (177):5-13. View

Hopke P, Dai Q, Li L, Feng Y . Global review of recent source apportionments for airborne particulate matter. Sci Total Environ. 2020; 740():140091. PMC: 7456793. DOI: 10.1016/j.scitotenv.2020.140091. View

Sylvester K, Clayton N, Cliff I, Hepple M, Kendrick A, Kirkby J . ARTP statement on pulmonary function testing 2020. BMJ Open Respir Res. 2020; 7(1). PMC: 7337892. DOI: 10.1136/bmjresp-2020-000575. View

10.

Boogaard H, Patton A, Atkinson R, Brook J, Chang H, Crouse D . Long-term exposure to traffic-related air pollution and selected health outcomes: A systematic review and meta-analysis. Environ Int. 2022; 164:107262. DOI: 10.1016/j.envint.2022.107262. View

11.

Fussell J, Franklin M, Green D, Gustafsson M, Harrison R, Hicks W . A Review of Road Traffic-Derived Non-Exhaust Particles: Emissions, Physicochemical Characteristics, Health Risks, and Mitigation Measures. Environ Sci Technol. 2022; 56(11):6813-6835. PMC: 9178796. DOI: 10.1021/acs.est.2c01072. View

12.

Nathan R, Sorkness C, Kosinski M, Schatz M, Li J, Marcus P . Development of the asthma control test: a survey for assessing asthma control. J Allergy Clin Immunol. 2004; 113(1):59-65. DOI: 10.1016/j.jaci.2003.09.008. View

13.

Liu Y, Pan J, Zhang H, Shi C, Li G, Peng Z . Short-Term Exposure to Ambient Air Pollution and Asthma Mortality. Am J Respir Crit Care Med. 2019; 200(1):24-32. DOI: 10.1164/rccm.201810-1823OC. View

14.

Strak M, Hoek G, Steenhof M, Kilinc E, Godri K, Gosens I . Components of ambient air pollution affect thrombin generation in healthy humans: the RAPTES project. Occup Environ Med. 2013; 70(5):332-40. DOI: 10.1136/oemed-2012-100992. View

15.

Ashworth M, Analitis A, Whitney D, Samoli E, Zafeiratou S, Atkinson R . Spatio-temporal associations of air pollutant concentrations, GP respiratory consultations and respiratory inhaler prescriptions: a 5-year study of primary care in the borough of Lambeth, South London. Environ Health. 2021; 20(1):54. PMC: 8105918. DOI: 10.1186/s12940-021-00730-1. View

16.

Steenhof M, Janssen N, Strak M, Hoek G, Gosens I, Mudway I . Air pollution exposure affects circulating white blood cell counts in healthy subjects: the role of particle composition, oxidative potential and gaseous pollutants - the RAPTES project. Inhal Toxicol. 2014; 26(3):141-65. DOI: 10.3109/08958378.2013.861884. View

17.

Rai P, Furger M, El Haddad I, Kumar V, Wang L, Singh A . Real-time measurement and source apportionment of elements in Delhi's atmosphere. Sci Total Environ. 2020; 742:140332. DOI: 10.1016/j.scitotenv.2020.140332. View

18.

Martineau A, Hanifa Y, Witt K, Barnes N, Hooper R, Patel M . Double-blind randomised controlled trial of vitamin D3 supplementation for the prevention of acute respiratory infection in older adults and their carers (ViDiFlu). Thorax. 2015; 70(10):953-60. DOI: 10.1136/thoraxjnl-2015-206996. View

19.

Steenhof M, Gosens I, Strak M, Godri K, Hoek G, Cassee F . In vitro toxicity of particulate matter (PM) collected at different sites in the Netherlands is associated with PM composition, size fraction and oxidative potential--the RAPTES project. Part Fibre Toxicol. 2011; 8:26. PMC: 3180259. DOI: 10.1186/1743-8977-8-26. View

20.

Zheng X, Ding H, Jiang L, Chen S, Zheng J, Qiu M . Association between Air Pollutants and Asthma Emergency Room Visits and Hospital Admissions in Time Series Studies: A Systematic Review and Meta-Analysis. PLoS One. 2015; 10(9):e0138146. PMC: 4575194. DOI: 10.1371/journal.pone.0138146. View