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Biomedical subjects

Michael Brauer

Publications and source records attributed to Michael Brauer.

27 records · Page 2Linked to original sources
PubMed2003

Air pollution and daily mortality in a city with low levels of pollution.

The concentration-response relationship between daily ambient inhalable particle (particulate matter less than or equal to 10 micro m; PM(10)) concentrations and daily mortality typically shows no evidence of a threshold concentration below which no relationship is observed. However, the power to assess a relationship at very low concentrations of PM(10) has been limited in studies to date. The concentrations of PM(10) and other air pollutants in Vancouver, British Columbia, Canada, from January 1994 through December 1996 were very low: the 50th and 90th percentiles of daily average PM(10) concentrations were 13 and 23 micro g/m(3), respectively, and 27 and 39 ppb, respectively, for 1-hr maximum ozone. Analyses of 3 years of daily pollution (PM(10), ozone, sulfur dioxide, nitrogen dioxide, and carbon monoxide) concentrations and mortality counts showed that the dominant associations were between ozone and total mortality and respiratory and cardiovascular mortality in the summer, and between nitrogen dioxide and total mortality in the winter, although some association with PM(10) may also have been present. We conclude that increases in low concentrations of air pollution are associated with increased daily mortality. These findings may support the notion that no threshold pollutant concentrations are present, but they also raise concern that these effects may not be effects of the measured pollutants themselves, but rather of some other factor(s) present in the air pollution-meteorology mix.

Air Pollutants↗
PubMed2003

Chronic exposure to high levels of particulate air pollution and small airway remodeling.

Recent evidence suggests that chronic exposure to high levels of ambient particulate matter (PM) is associated with decreased pulmonary function and the development of chronic airflow obstruction. To investigate the possible role of PM-induced abnormalities in the small airways in these functional changes, we examined histologic sections from the lungs of 20 women from Mexico City, a high PM locale. All subjects were lifelong residents of Mexico City, were never-smokers, never had occupational dust exposure, and never used biomass fuel for cooking. Twenty never-smoking, non-dust-exposed subjects from Vancouver, British Columbia, Canada, a low PM region, were used as a control. By light microscopy, abnormal small airways with fibrotic walls and excess muscle, many containing visible dust, were present in the Mexico City lungs. Formal grading analysis confirmed the presence of significantly greater amounts of fibrous tissue and muscle in the walls of the airways in the Mexico City compared with the Vancouver lungs. Electron microscopic particle burden measurements on four cases from Mexico City showed that carbonaceous aggregates of ultrafine particles, aggregates likely to be combustion products, were present in the airway mucosa. We conclude that PM penetrates into and is retained in the walls of small airways, and that, even in nonsmokers, long-term exposure to high levels of ambient particulate pollutants is associated with small airway remodeling. This process may produce chronic airflow obstruction.

Aged↗
PubMed2002

Air pollution from traffic and the development of respiratory infections and asthmatic and allergic symptoms in children.

Despite the important contribution of traffic sources to urban air quality, relatively few studies have evaluated the effects of traffic-related air pollution on health, such as its influence on the development of asthma and other childhood respiratory diseases. We examined the relationship between traffic-related air pollution and the development of asthmatic/allergic symptoms and respiratory infections in a birth cohort (n approximately 4,000) study in The Netherlands. A validated model was used to assign outdoor concentrations of traffic-related air pollutants (nitrogen dioxide, particulate matter less than 2.5 micro m in aerodynamic diameter, and "soot") at the home of each subject of the cohort. Questionnaire-derived data on wheezing, dry nighttime cough, ear, nose, and throat infections, skin rash, and physician-diagnosed asthma, bronchitis, influenza, and eczema at 2 years of age were analyzed in relation to air pollutants. Adjusted odds ratios for wheezing, physician-diagnosed asthma, ear/nose/throat infections, and flu/serious colds indicated positive associations with air pollutants, some of which reached borderline statistical significance. No associations were observed for the other health outcomes analyzed. Sensitivity analyses generally supported these results and suggested somewhat stronger associations with traffic, for asthma that was diagnosed before 1 year of age. These findings are subject to confirmation at older ages, when asthma can be more readily diagnosed.

Air Pollutants↗
PubMed2002

Policy uses of particulate exposure estimates.

This paper reviews the uses of particulate exposure estimates for science and policy. We propose a set of normative factors to guide the selection and application of various approaches for exposure assessment. For exposure estimates intended for use in support of the development or air pollution regulations or selection of control strategies, the proposed criteria include--compatibility with policy scope and scale, cost-effectiveness, characterization of uncertainty, political and institutional feasibility, and sensitivity to framing. For exposure assessment in support of epidemiological research, key criteria are-compatability with the specific hypothesis being tested, and compatibility with the temporal and spatial scale of analysis. The various major approaches for estimation of exposure--direct and indirect measurement, empirical and physical modeling--are catalogued and compared with these proposed criteria.

Air Pollutants↗
PubMed2002

Accessible tools for classification of exposure to particles.

In this manuscript we describe various alternative tools to estimate exposure to particles. We stress methods that are cost effective and widely available to those throughout the world. The use of surrogate measures arises from the need to estimate exposures of large populations where individual measurements are not feasible, for predictive modeling or to assess exposures rapidly before personal monitoring campaigns can be implemented. In addition, an understanding of the relationship between exposures and surrogate variables can be useful in helping to identify mitigation strategies to reduce exposures. We have separated the various alternative exposure measures by the scales of impact, describing approaches to assess regional, urban and household indoor air quality. In particular, we emphasize scenarios that are relevant to particle exposures that may be experienced in developing countries as a result of domestic energy use for cooking and heating. In all cases the approaches we describe are applicable to large populations as the data collection techniques are relatively inexpensive and specifically applicable on a population basis for risk assessment, epidemiology or to evaluate determinants of exposure and health outcomes. The ultimate use of the assessed exposures will determine the relevance of potential surrogate measures.

Air Pollutants↗
PubMedDate not supplied

Exposures and their determinants in radiographic film processing.

Radiographers process X-ray films using developer and fixer solutions that contain chemicals known to cause or exacerbate asthma. In a study in British Columbia, Canada, radiographers' personal exposures to glutaraldehyde (a constituent of the developer chemistry), acetic acid (a constituent of the fixer chemistry), and sulfur dioxide (a byproduct of sulfites, present in both developer and fixer solutions) were measured. Average full-shift exposures to glutaraldehyde, acetic acid, and sulfur dioxide were 0.0009 mg/m3, 0.09 mg/m3, and 0.08 mg/m3, respectively, all more than one order of magnitude lower than current occupational exposure limits. Local exhaust ventilation of the processing machines and use of silver recovery units lowered exposures, whereas the number of films processed per machine and the time spent near the machines increased exposures. Personnel in clinic facilities had higher exposures than those in hospitals. Private clinics were less likely to have local exhaust ventilation and silver recovery units. Their radiographers spent more time in the processor areas and processed more films per machine. Although exposures were low compared with exposure standards, there are good reasons to continue practices to minimize or eliminate exposures: glutaraldehyde and hydroquinone (present in the developer) are sensitizers; the levels at which health effects occur are not yet clearly established, but appear to be lower than current standards; and health effects resulting from the mixture of chemicals are not understood. Developments in digital imaging technology are making available options that do not involve wet-processing of photographic film and therefore could eliminate the use of developer and fixer chemicals altogether.

Acetic Acid↗
PubMedDate not supplied

Assessing population exposures to motor vehicle exhaust.

The need is growing for a better assessment of population exposures to motor vehicle exhaust in proximity to major roads and highways. This need is driven in part by emerging scientific evidence of adverse health effects from such exposures and policy requirements for a more targeted assessment of localized public health impacts related to road expansions and increasing commercial transportation. The momentum for improved methods in measuring local exposures is also growing in the scientific community, as well as for discerning which constituents of the vehicle exhaust mixture may exert greater public health risks for those who are exposed to a disproportionate share of roadway pollution. To help elucidate the current state-of-the-science in exposure assessments along major roadways and to help inform decision makers of research needs and trends, we provide an overview of the emerging policy requirements, along with a conceptual framework for assessing exposure to motor-vehicle exhaust that can help inform policy decisions. The framework includes the pathway from the emission of a single vehicle, traffic emissions from multiple vehicles, atmospheric transformation of emissions and interaction with topographic and meteorologic features, and contact with humans resulting in exposure that can result in adverse health impacts. We describe the individual elements within the conceptual framework for exposure assessment and discuss the strengths and weaknesses of various approaches that have been used to assess public exposures to motor vehicle exhaust.

Environment↗
PubMedDate not supplied

Population health effects of air quality changes due to forest fires in British Columbia in 2003: estimates from physician-visit billing data.

BACKGROUND: Major forest fires near populated areas during 2003 exacted a huge economic toll on communities in British Columbia. We designed a study to examine associations between PM2.5 and PM10 levels and physician visits in two affected communities. METHODS: Measurements of 24-hour averages of particulate matter (PM10 and PM2.5) obtained from the monitoring network of the BC Ministry of Water, Land and Air Protection were used to define weeks where forest fires resulted in increases in ambient PM. Weekly rates of physician visits for respiratory (ICD-9 codes 460-519), cardiovascular (390-459) and mental illnesses (290-319) obtained through the Medical Services Plan of BC, were compared for 2003 and aggregates of the 10 previous years. RESULTS: Both the Kelowna and Kamloops regions experienced five weeks of elevated 24-hour average PM levels, although maximum levels in Kelowna were greater. In the Kelowna region, increases in physician visits for respiratory diseases of between 46 and 78% above 10-year mean rates were observed for three weeks during the forest fire period. Similar effects were not observed in Kamloops. Effects on visits for cardiovascular diseases or mental disorders were not seen in either community. INTERPRETATION: Forest fire smoke was associated with an excess of respiratory complaints in Kelowna area residents. The lack of a similar effect in Kamloops is likely due to the population being exposed to lower levels of PM. The absence of apparent cardiovascular health effects may be due to selective effects of forest fire smoke on respiratory tract disease.

Air Pollution↗