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Fine Particles Are More Strongly Associated than Coarse Particles with Acute Respiratory Health Effects in Schoolchildren

Schwartz, Joel1 2; Neas, Lucas M.1 2 3

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From the 1Environmental Epidemiology Program, Department of Environmental Health, Harvard School of Public Health; 2Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School; and 3Department of Epidemiology, Harvard School of Public Health, Boston, MA.

Submitted June 8, 1998; final version accepted May 28, 1999.

Address reprint requests to: Joel Schwartz, Department of Environmental Health, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115.

Lucas M. Neas was supported in part by U.S. Environmental Protection Agency cooperative agreement CR-821762. Joel Schwartz was supported in part by National Institute of Environmental Health Sciences Grants ES 0002 and ES 07410.

Editors’ Note: See related editorial on page 2 of this issue.

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Numerous studies have reported associations between airborne particles and a range of respiratory outcomes from symptoms to mortality. Current attention has been focused on the characteristics of these particles responsible for the adverse health effects. We have reanalyzed three recent longitudinal diary studies to examine the relative contributions of fine and coarse particles on respiratory symptoms and peak expiratory flow in schoolchildren. In the Harvard Six Cities Diary Study, lower respiratory symptoms in a two-pollutant model were associated with an interquartile range increment in fine particles [(for 15 μg/m3 particulate matter (PM) <2.5 μm in aerodynamic diameter (PM2.5), odds ratio = 1.29, 95% confidence limits (CL) = 1.06, 1.57] but not coarse particles (for 8 μg/m3 PM2.5–10, odds ratio = 1.05, 95% CL = 0.90, 1.23). In Uniontown, PA, we found that peak flow was associated with fine particles (for 15 μg/m3 PM2.1, peak flow = −0.91 liters/minute, 95% CL = −0.14, −1.68), especially fine sulfate particles, but not with coarse particles (for 15 μg/m3 PM2.1–10, +1.04 liters/minute, 95% CL = −1.32, +3.40). We found similar results for an equivalent children’s cohort in State College, PA. We conclude that fine particles, especially fine sulfate particles, have much stronger acute respiratory effects than coarse particles.

In recent years, numerous studies have reported associations between airborne particles and a range of respiratory conditions, including respiratory symptoms and pulmonary function deficits, emergency room visits, hospital admissions, and daily deaths. 1 Most of these studies have been done in urban areas, where variation in daily particle concentrations is dominated by variation in the concentration of fine particulate matter (PM), that is, particles less than 2.5 μm in aerodynamic diameter, denoted PM2.5. 2 Only a small number of studies, however, have directly assessed the relative contributions of different particle sizes to health endpoints.

Schwartz et al3 reported that the association between airborne particles and daily deaths in six eastern U.S. cities was with the fine, and not the coarse, particles. Similar results have been reported for the association with hospital admissions in Toronto. 4 Dreher et al5 have shown that the pulmonary toxicity of urban particles varied with size, with the greatest toxicity in those smaller than 1.7 μm. This finding suggests that smaller cutpoints than PM2.5 may be even a better marker of the toxic particle fraction. Other studies have used sulfate aerosols, which are less than 1 micrometer in size, as their exposure, sometimes finding stronger effects than with PM10. 4,6 On the other hand, the Environmental Protection Agency has noted 7 that coarse particles deposit in the upper airways of the lungs and may be more relevant for asthmatic responses and irritation.

To further our understanding of the role of fine vs coarse (between 2.5 and 10 μm in diameter) particles in human health, we have reanalyzed three diary studies of children in which associations have previously been reported between PM10 and respiratory health, using data on fine and coarse mass in each location.

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Subjects and Methods

Harvard Six City Diary Study

The Harvard Six City Study of respirable particles and sulfur oxides was a longitudinal study of the effects of exposure on the respiratory health of children and adults. 8 As part of that study, we selected a sample of 1,844 school children in grades 2 through 5 from six urban areas in the eastern United States (Watertown, MA; Kingston-Harriman, TN; St. Louis, MO; Steubenville, OH; Portage, WI; and Topeka, KS). Parents completed a daily report on the child’s respiratory symptoms, and these reports were collected every 2 weeks. Further details on these cohorts have been published previously. 9 Children kept symptom diaries for a year in each community, but we restricted the analysis to April 1 through August 31 to avoid problems of seasonal variations in ozone and acid aerosols.

A diary day indicating lower respiratory symptoms was defined as any day with a report of at least two of cough, phlegm from chest, pain in chest, or wheezing. A day-at-risk was a diary day following a day with one or no lower respiratory symptom. An incident event was defined as a lower respiratory symptom day that occurred on a day-at-risk. A similar procedure was applied to cough days without any other symptom. By definition, these symptom incidences were independent. The incidence of these symptoms showed no autocorrelation.

We measured air pollution daily during the study period at a single, central-site monitoring station located in a residential area in each community. We collected particulate matter by a dichotomous sampler with an aerodynamic size cut at 10 μm (PM10) and 2.5 μm (PM2.5). This sampler yielded two daily measurements, one of PM2.5 and one of coarse particle mass (CM), which were summed daily to produce a PM10 reading. We also measured sulfate on the fine-particle filter and nephelometry, a light-scattering measure of particles less than 1 micrometer in diameter. The previous study focused on PM10, acid aerosols, and the gaseous pollutants. Associations were reported between PM10 and both coughing and lower respiratory symptoms. Ozone was also associated with coughing.

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Uniontown and State College Diary Studies

As part of the Harvard/Health Canada 24-City Study, cross-sectional studies of respiratory symptoms and pulmonary function in fourth- and fifth-grade children were conducted in the Pennsylvania communities of Uniontown and State College. During the summer of 1990, we enrolled from the cross-sectional cohort a stratified sample of 83 children living in Uniontown to participate in twice-daily measurements of peak expiratory flow rate from June 10 through August 23. 10 This design was repeated among 108 children living in State College from June 29 through August 20, 1991. 11 In both studies, peak expiratory flow rates were measured with a Mini-Wright Peak Flow Meter (Armstrong Medical Industries, Lincolnshire, IL). Each child performed and recorded three unsupervised measurements in the standing position twice daily, once upon arising in the morning and again in the evening before bedtime.

We measured air pollution daily during the study period at a single, central-site monitoring station located in a residential area in each community. We collected particulate matter (in μg/m 3) with two collocated samplers, one with an aerodynamic size cut at 10 μm (PM10) and one with an aerodynamic size cut at 2.1 μm (PM2.1). The difference between these measurements was an estimate of CM. Sulfate particles (in nmol/m 3) were measured by an annular denuder/filter pack over two 12-hour periods, daytime (8:00 am to 8:00 pm) and overnight (8:00 pm to 8:00 am). These previous studies focused on PM2.1, acid aerosols, and the gaseous pollutants. Sulfate particles and particle-strong acidity were associated with cough and with decrements in peak expiratory flow rates. Ozone was also associated with peak flow decrements. In State College, the reanalysis was restricted to the first 4 weeks of the 8-week study period.

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Analytic Strategy

We have chosen to replicate the models used in the previous studies so that any differences in results can be unambiguously attributed to the difference in the pollution variables. Hence, for each study, we first replicated the originally reported results and then repeated the analyses using the different available particle measurements. Because the ability to differentiate between different particle measures depends on the correlation among the measures, we have assessed that correlation in each of the studies. In the Harvard Six City Diary Study, the logistic regression model for the daily symptom incidence rates in each location included dummy variables for city, day of the week, and linear and quadratic temperature terms. In Uniontown and State College, separate linear regression models for the mean deviation in the peak expiratory flow rate in each location adjusted for linear trend, a binary indicator of morning or evening reporting period, the 12-hour average daytime temperature and second-order autocorrelation. Mean deviation was defined as the daily average of the deviation of each subject’s peak flow on that day from the subjects average peak flow. Both morning and evening peak flow measurements were included in the model, but an association with particles was observed only for the evening measurements. The peak flow results for each location were combined using inverse variance weights. In all locations, we have computed effect sizes for an increment in exposure approximately equal to an interquartile range in the pollutant.

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In the Harvard Six City Dairy Study, the correlation among the various fine-particle measures (PM2.5, sulfates, and nephelometry) was high, as expected (Table 1). The correlation between CM and PM2.5 was moderate (0.41) and was lower with the sulfate and nephelometry measures. Because PM2.5 contains some crustal dust, this finding is not unexpected. These low correlations allow an exploration of the independent effects of fine vs coarse mass. Table 2 shows a comparison of the results from the Harvard Six City Diary Study using CM and the fine-particle measures (PM2.5, sulfates, and nephelometry) as exposures. For lower respiratory symptoms, the association was stronger for all of the fine-particle measures than for CM in single-pollutant regressions. A model including both CM and PM2.5 resulted in a substantial reduction in the effect of CM, with little evidence that the remaining effect was different from zero. For cough symptoms, the strongest effect was for nephelometry, closely followed by CM. In two-pollutant models, both nephelometry and CM made independent contributions to explaining cough incidence, with only modest reductions in effect size. In contrast, PM2.5 made little independent contribution to explaining cough symptoms in a two-pollutant model with CM.

Table 1
Table 1
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Table 2
Table 2
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In both Uniontown and State College, fine particles, especially fine sulfate particles, were poorly correlated with CM (Table 1) and were associated with decreased evening peak expiratory flow rates (Table 3). The effect estimates for fine particles were more similar across locations than those for coarse particles and were close to the combined effect estimate. When we scaled each pollutant to its approximate interquartile range, fine-sulfate particle concentrations showed almost twice the decrement in evening peak flow rates as fine-particle mass concentrations. Conversely, coarse particles had little association with evening peak flow in either location, with a combined effect estimate very close to the null value.

Table 3
Table 3
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In both the Harvard Six Cities Diary Study and the Uniontown-State College diaries, fine-particle measures were much more strongly associated with asthma-related responses (increased lower respiratory symptoms and decreased peak flow) than coarse particle mass. Moreover, an interquartile range increment in fine sulfate particles was associated with a larger change in both outcomes than was an interquartile range increment in total PM2.5 mass. This result indicates that the sulfate component of fine particles is a better proxy for the toxic particle constituents than total fine mass. The fine fraction contains constituents other than sulfates, and these may be responsible for the observed health effects of fine particles.

Hence, for acute asthma-related responses as well as daily mortality, fine particles are a stronger predictor of response than are coarse particles. Sulfate particles clearly play an important and perhaps the predominant role in those health associations. Sulfate particles in these study locations are primarily related to the long-range transport of sulfur emissions from coal-burning power plants.

Cough in the absence of any other symptoms was the only response in which coarse particles appeared to contribute to an adverse health effect. For cough-only symptom episodes, both submicron particles (as measured by nephelometry) and coarse particle mass appeared to make independent contributions. This coarse particle effect may be due to particle deposition and irritation in the upper airways.

Airborne particles are a complex mixture of particles differing by size, chemical composition, and structure. Most particles produced in nature are the product of mechanical processes, such as erosion. These are generally referred to as coarse particles and have typical mass median diameters of about 7 μm. The median diameter varies by location; some crustal particles are less than 2.5 μm in aerodynamic diameter. Fine particles are predominantly generated by controlled combustion processes. Substantial human exposure to combustion particles only began with the domestication of fire, and these particles differ in size and depositional pattern from the coarse particles. They typically have mass median diameters of about 0.7 μm and are more likely to deposit in the alveolar region than coarse particles. The U.S. Environmental Protection Agency estimates 8 that the fraction of the total aerosol deposited in the alveolar region of a general population that derives from particles less than 2.5 μm in diameter ranges from 98%, in locations with aerosols similar to Philadelphia, to 80% for aerosols similar to Phoenix.

Combustion particles also differ in physiochemical properties from the coarse particles. They contain higher concentrations of sulfates and nitrates, organic compounds, and more bioavailable transition metals than coarse particles. 5,12,13 These transition metals are factors in the toxicity of the particles. Li et al14 and Gilmour et al15 in 1996 reported that the instillation of 50 to 125 μg of particles removed from PM10 filters in Edinburgh increased the recruitment of neutrophils into the lung and that cultured bronchoalveolar lavage cells produced excess quantities of tumor necrosis factor alpha and major inflammatory protein 2 (MIP2), which are proinflammatory cytokines. Pretreatment with a metal chelating agent reduced the inflammatory response to the urban particles, indicating the role of metals in the inflammatory process.

Costa and Dreher 16 have reported that urban particles produce pulmonary toxicity, with the level of toxicity related to the amount of transition metals that the particles contain. In contrast, Schapira et al17 found that coarse particles from the ash of the Mount St. Helens volcano had less soluble transition metals and showed less toxicity when instilled at the same dose. The toxicity of the combustion particles was substantially reduced when they were washed to remove the soluble metals before instillation in the rat lungs.

Recent studies have directly compared the toxicity of fine particles with that of coarse particles. Dreher et al5 placed fine particles and coarse particles collected from the air in Washington, DC, in the lungs of animals and found substantial toxicity from the fine particles but much less from the coarse particles. Osornio-Vargas et al18 found that particles from a region in Mexico City where combustion particles dominate were much more toxic than the particles from a region where windblown dust is also an important contributor to PM10.

Another recent study used concentrated fine ambient particles 19 drawn from the outside air in Boston, MA. After 3 days of exposure to concentrated ambient particles (6 hours per day at 228–288 μg/m 3), mortality was 37% among rats with induced chronic bronchitis, 19% among rats with monocrotyline-induced inflammation, and none among normal rats. 20 These rats also had elevated levels of tumor necrosis factor alpha and MIP2 in their lungs, and MIP2 in their hearts. Other reports suggest that particles of residual oil fly ash produce pulmonary inflammation in vitro21 and in vivo, 13 that the inflammation was characterized by an alveolar influx of neutrophils that peaked 24 hours after exposure, 22 and that particle toxicity was increased by preexisting inflammation. 23

Human studies generally point in a similar direction. A recent chamber study of exposure to diesel particles at concentrations of 300 μg/m 3 for 1 hour reported increased neutrophils in the lung and in peripheral blood. 24 The great London smog episode of 1952 saw high concentrations of combustion-related fine particles that occurred in stagnant air conditions that would result in low coarse mass levels.

The Mount St. Helens eruption produced high concentrations (10,000 μg/m 3) of dust (coarse particles). Few adverse health effects were seen. A similar result was reported in a study of a dust storm in southeastern Washington State, where particle concentrations exceeded 1,000 μg/m 3. 25 Another study examined 17 dust storm episodes in Spokane, WA, and found no increase in mortality during those episodes. 26 In contrast, an episode in West Germany in 1985 of combustion-derived fine particles at half those concentrations was associated with a substantial increase in daily deaths, hospital admissions, and ambulance calls, 27 as well as increases in plasma viscosity. 28 This finding suggests that the coarse particles are of lesser concern.

In summary, toxicologic and epidemiologic studies indicate that ambient toxic particles are primarily in the fine-particle fraction and that fine sulfate particles from coal combustion are important contributors to these adverse health effects.

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Toxicology and Applied Pharmacology, 171(1): 20-26.
Environmental Health Perspectives
Inhalation of PM2.5 does not modulate host defense or immune parameters in blood or lung of normal human subjects
Harder, SD; Soukup, JM; Ghio, AJ; Devlin, RB; Becker, S
Environmental Health Perspectives, 109(): 599-604.

Environmental Health Perspectives
Airborne particles of the California central valley alter the lungs of healthy adult rats
Smith, KR; Kim, S; Recendez, JJ; Teague, SV; Menache, MG; Grubbs, DE; Sioutas, C; Pinkerton, KE
Environmental Health Perspectives, 111(7): 902-908.
Environmental Health Perspectives
Particle concentrations in inner-city homes of children with asthma: The effect of smoking, cooking, and outdoor pollution
Wallace, LA; Mitchell, H; O'Connor, GT; Neas, L; Lippmann, M; Kattan, M; Koenig, J; Stout, JW; Vaughn, BJ; Wallace, D; Walter, M; Adams, K; Liu, LJS
Environmental Health Perspectives, 111(9): 1265-1272.
Toxicology in Vitro
Biological effects of atmospheric particles on human bronchial epithelial cells. Comparison with diesel exhaust particles
Baulig, A; Sourdeval, M; Meyer, M; Marano, F; Baeza-Squiban, A
Toxicology in Vitro, 17(): 567-573.
Inhalation Toxicology
The effect of coarse ambient particulate matter on first, second, and overall hospital admissions for respiratory disease among the elderly
Chen, Y; Yang, QY; Krewski, D; Burnett, RT; Shi, YL; McGrail, KM
Inhalation Toxicology, 17(): 649-655.
Occupational and Environmental Medicine
Effects on respiratory health of a reduction in air pollution from vehicle exhaust emissions
Burr, ML; Karani, G; Davies, B; Holmes, BA; Williams, KL
Occupational and Environmental Medicine, 61(3): 212-218.
Archives of Environmental Health
Association between particulate air pollution and first hospital admission for childhood respiratory illness in Vancouver, Canada
Yang, QY; Chen, Y; Krewski, D; Shi, YL; Burnett, RT; McGrail, KM
Archives of Environmental Health, 59(1): 14-21.

Bulletin of the American Meteorological Society
Improving national air quality forecasts with satellite aerosol observations
Al-Saadi, J; Szykman, J; Pierce, RB; Kittaka, C; Neil, D; Chu, DA; Remer, L; Gumley, L; Prins, E; Weinstock, L; MacDonald, C; Wayland, R; Dimmick, F; Fishman, J
Bulletin of the American Meteorological Society, 86(9): 1249-+.
Canadian Journal of Soil Science
Transport of trifluralin on wind-eroded sediment
Cessna, AJ; Larney, FJ; Kerr, LA; Bullock, MS
Canadian Journal of Soil Science, 86(3): 545-554.

Journal of the Air & Waste Management Association
Size and composition distributions of particulate matter emissions: Part 1 - Light-duty gasoline vehicles
Robert, MA; VanBergen, S; Kleeman, MJ; Jakober, CA
Journal of the Air & Waste Management Association, 57(): 1414-1428.
Environmental Health Perspectives
The effect of dose and timing of dose on the association between airborne particles and survival
Schwartz, J; Coull, B; Laden, F; Ryan, L
Environmental Health Perspectives, 116(1): 64-69.
Journal of the American Statistical Association
Bayesian analysis and mapping of mortality rates for chronic obstructive pulmonary disease
Nandram, B; Sedransk, J; Pickle, LW
Journal of the American Statistical Association, 95(): 1110-1118.

Environmental Health Perspectives
A combined analysis of the short-term effects of photochemical air pollutants on mortality within the EMECAM project
Saez, M; Ballester, F; Barcelo, MA; Perez-Hoyos, S; Bellido, J; Tenias, JM; Ocana, R; Figueiras, A; Arribas, F; Aragones, N; Tobias, A; Cirera, L; Canada, A
Environmental Health Perspectives, 110(3): 221-228.

Environmental Research
Air pollution and disability days in Toronto: Results from the National Population Health Survey
Stieb, DM; Smith-Doiron, M; Brook, JR; Burnett, RT; Dann, T; Mamedov, A; Chen, Y
Environmental Research, 89(3): 210-219.
Journal of Exposure Analysis and Environmental Epidemiology
Incorporating exposure models in probabilistic assessment of the risks of premature mortality from particulate matter
Yeh, S; Small, MJ
Journal of Exposure Analysis and Environmental Epidemiology, 12(6): 389-403.
Journal of Biosciences
Pulmonary antioxidants exert differential protective effects against urban and industrial particulate matter
Greenwell, LL; Moreno, T; Richards, RJ
Journal of Biosciences, 28(1): 101-107.

Environmental Health Perspectives
Association of expired nitric oxide with occupational particulate exposure
Kim, JY; Wand, MP; Hauser, R; Mukherjee, S; Herrick, RF; Christiani, DC
Environmental Health Perspectives, 111(5): 676-680.
Clinical Reviews in Allergy & Immunology
Airborne environmental injuries and human health
Borchers, AT; Chang, C; Keen, CL; Gershwin, ME
Clinical Reviews in Allergy & Immunology, 31(1): 1-101.

Environmental Toxicology
Indoor and outdoor submicrometer particles: Exposure and epidemiologic relevance ("the 3 indoor Ls")
Franck, U; Tuch, T; Manjarrez, M; Wiedensohler, A; Herbarth, O
Environmental Toxicology, 21(6): 606-613.
X-Ray Spectrometry
EDXRF characterisation of elemental contents in PM2.5 in a medium-sized Swedish city dominated by a modern waste incineration plant
Aboh, IJK; Henriksson, D; Laursen, J; Lundin, M; Pind, N; Lindgren, ES; Wahnstrom, T
X-Ray Spectrometry, 36(2): 104-110.
Environmental Monitoring and Assessment
Multi-objective optimization of air quality monitoring
Sarigiannis, DA; Saisana, M
Environmental Monitoring and Assessment, 136(): 87-99.
Journal of Environmental Science and Health Part A-Toxic/Hazardous Substances & Environmental Engineering
Air pollution simulation and geographical information systems (GIS) applied to Athens International Airport
Theophanides, M; Anastassopoulou, J
Journal of Environmental Science and Health Part A-Toxic/Hazardous Substances & Environmental Engineering, 44(8): 758-766.
Environmental Health Perspectives
Association of fine particulate matter from different sources with daily mortality in six US cities
Laden, F; Neas, LM; Dockery, DW; Schwartz, J
Environmental Health Perspectives, 108(): 941-947.

Journal of Toxicology and Environmental Health-Part A
Flexible modeling of exposure-response relationship between long-term average levels of particulate air pollution and mortality in the American Cancer Society Study
Abrahamowicz, M; Schopflocher, T; Leffondre, K; du Berger, R; Krewski, D
Journal of Toxicology and Environmental Health-Part A, 66(): 1625-1653.
Atmospheric Environment
Performance evaluation of the active-flow personal DataRAM PM2.5 mass monitor (Thermo Anderson pDR-1200) designed for continuous personal exposure measurements
Chakrabarti, B; Fine, PM; Delfino, R; Sioutas, C
Atmospheric Environment, 38(): 3329-3340.
European Journal of Epidemiology
Air pollution and respiratory status in asthmatic children: Hints for a locally based preventive strategy. AIRE study
Ranzi, A; Gambini, M; Spattini, A; Galassi, C; Sesti, D; Bedeschi, M; Messori, A; Baroni, A; Cavagni, G; Lauriola, P
European Journal of Epidemiology, 19(6): 567-576.

X-Ray Spectrometry
Elemental characterization of airborne particles in Khartoum, Sudan
El-Tahir, HM; Lindgren, ES; Habbani, FI
X-Ray Spectrometry, 34(2): 144-152.
Science of the Total Environment
Polycyclic aromatic hydrocarbons associated with particles in ambient air from urban and industrial areas
Rehwagen, M; Muller, A; Massolo, L; Herbarth, O; Ronco, A
Science of the Total Environment, 348(): 199-210.
Science of the Total Environment
Bioreactivity of particulate matter in Beijing air: Results from plasmid DNA assay
Shao, LY; Shi, ZB; Jones, TP; Li, JJ; Whittaker, AG; BeruBe, KA
Science of the Total Environment, 367(1): 261-272.
Atmospheric Chemistry and Physics
Relationships between submicrometer particulate air pollution and air mass history in Beijing, China, 2004-2006
Wehner, B; Birmili, W; Ditas, F; Wu, Z; Hu, M; Liu, X; Mao, J; Sugimoto, N; Wiedensohler, A
Atmospheric Chemistry and Physics, 8(): 6155-6168.

Atmospheric Environment
PM2.5 forecasting in a large city: Comparison of three methods
Perez, P; Salini, G
Atmospheric Environment, 42(): 8219-8224.
International Journal of Environmental Health Research
Respiratory health effects among schoolchildren and their relationship to air pollutants in Korea
Moon, JS; Kim, YS; Kim, JH; Son, BS; Kim, DS; Yang, WH
International Journal of Environmental Health Research, 19(1): 31-48.
Environmental Health Perspectives
Exposure to Concentrated Coarse Air Pollution Particles Causes Mild Cardiopulmonary Effects in Healthy Young Adults
Graff, DW; Cascio, WE; Rappold, A; Zhou, HB; Huang, YCT; Devlin, RB
Environmental Health Perspectives, 117(7): 1089-1094.
Journal of Environmental Science and Health Part A-Toxic/Hazardous Substances & Environmental Engineering
Airborne particulates and polycyclic aromatic hydrocarbons (PAHs) in ambient air in Donghe, Northern China
Wang, W; Tao, S; Wang, WT; Shen, GF; Zhao, JY; Lam, KC
Journal of Environmental Science and Health Part A-Toxic/Hazardous Substances & Environmental Engineering, 44(9): 854-860.
Archives of Environmental Health
Respiratory symptoms and pulmonary function among traffic police in Bangkok, Thailand
Karita, K; Yano, E; Jinsart, W; Boudoung, D; Tamura, K
Archives of Environmental Health, 56(5): 467-470.

Air Pollution X
Measurements of outdoor and indoor submicrometer airborne particulates
Franck, U; Herbarth, O; Manjarrez, M; Schilde, M; Wehner, B; Wiedensohler, A
Air Pollution X, 11(): 435-444.

Journal of Allergy and Clinical Immunology
The role of air pollution in asthma and other pediatric morbidities
Trasande, L; Thurston, GD
Journal of Allergy and Clinical Immunology, 115(4): 689-699.
Atmospheric Environment
Particulate air pollution in six Asian cities: Spatial and temporal distributions, and associated sources
Oanh, NTK; Upadhyaya, N; Zhuang, YH; Hao, ZP; Murthy, DVS; Lestari, P; Villarin, JT; Chengchua, K; Co, HX; Dung, NT; Lindgren, ES
Atmospheric Environment, 40(): 3367-3380.
Environment International
Differentiating the effects of fine and coarse particles on daily mortality in Shanghai, China
Kan, HD; London, SJ; Chen, GH; Zhang, YH; Song, GX; Zhao, NQ; Jiang, LL; Chen, BH
Environment International, 33(3): 376-384.
Fresenius Environmental Bulletin
Vertical profiles of particulate matter over Milan during winter 2005/2006
Ferrero, L; Bolzacchini, E; Petraccone, S; Perrone, MG; Sangiorgi, G; Lo Porto, C; Lazzati, Z; Ferrini, B
Fresenius Environmental Bulletin, 16(6): 697-700.

Atmospheric Environment
A, side-by-side comparison of filter-based PM2.5 measurements at a suburban site: A closure study
Hains, JC; Chen, LWA; Taubman, BF; Doddridge, BG; Dickerson, RR
Atmospheric Environment, 41(): 6167-6184.
Journal of Aerosol Medicine-Deposition Clearance and Effects in the Lung
Modeling age-related particle deposition in humans
Asgharian, B; Menache, MG; Miller, FJ
Journal of Aerosol Medicine-Deposition Clearance and Effects in the Lung, 17(3): 213-224.

Human & Experimental Toxicology
Particulate matter properties and health effects: consistency of epidemiological and toxicological studies
Schwarze, PE; Ovrevik, J; Lag, M; Refsnes, M; Nafstad, P; Hetland, RB; Dybing, E
Human & Experimental Toxicology, 25(): 559-579.
Long-term associations of outdoor air pollution with mortality in Great Britain
Elliott, P; Shaddick, G; Wakefield, JC; de Hoogh, C; Briggs, DJ
Thorax, 62(): 1088-1094.
Indoor Air
Assessment of endotoxin levels in the home and current asthma and wheeze in school-age children
Rennie, DC; Lawson, JA; Kirychuk, SP; Paterson, C; Willson, PJ; Senthilselvan, A; Cockcroft, DW
Indoor Air, 18(6): 447-453.
Toxicological Sciences
The effect of particles on allergic immune responses
Granum, B; Lovik, M
Toxicological Sciences, 65(1): 7-17.

Mutation Research-Genetic Toxicology and Environmental Mutagenesis
Particulate matter, PM 10 & PM 2.5 levels, and airborne mutagenicity in Chiang Mai, Thailand
Vinitketkumnuen, U; Kalayanamitra, K; Chewonarin, T; Kamens, R
Mutation Research-Genetic Toxicology and Environmental Mutagenesis, 519(): 121-131.
PII S1383-5718(02)00130-4
Inhalation Toxicology
The health impact of common inorganic components of fine particulate matter (PM2.5) in ambient air: A critical review
Schlesinger, RB
Inhalation Toxicology, 19(): 811-832.
Atmospheric Environment
Associations between particle physicochemical characteristics and oxidative capacity: An indoor PM10 study in Beijing, China
Shao, LY; Li, JJ; Zhao, HY; Yang, SS; Li, H; Li, WJ; Jones, T; Sexton, K; BeruBe, K
Atmospheric Environment, 41(): 5316-5326.
Inhalation Toxicology
Unsteady-state airflow and particle deposition in a three-generation human lung geometry
Nazridoust, K; Asgharian, B
Inhalation Toxicology, 20(6): 595-610.
Aerosol Science and Technology
Characterizing indoor and outdoor 15 minute average PM2.5 concentrations in urban neighborhoods
Ramachandran, G; Adgate, JL; Pratt, GC; Sexton, K
Aerosol Science and Technology, 37(1): 33-45.
Indoor Air
How do the indoor size distributions of airborne submicron and ultrafine particles in the absence of significant indoor sources depend on outdoor distributions?
Franck, U; Herbarth, O; Wehner, B; Wiedensohler, A; Manjarrez, M
Indoor Air, 13(2): 174-181.

Photogrammetric Engineering and Remote Sensing
Information fusion for computational assessment of air quality and health effects
Sarigiannis, DA; Soulakellis, NA; Sifakis, NI
Photogrammetric Engineering and Remote Sensing, 70(2): 235-245.

Gaceta Sanitaria
Impact of particulate matter with diameter of less than 2.5 microns [PM2.5] on daily hospital admissions in 0-10-year-olds in Madrid. Spain [2003-2005]
Linares, C; Diaz, J
Gaceta Sanitaria, 23(3): 192-197.
Journal of the Air & Waste Management Association
Effect of the fine fraction of particulate matter versus the coarse mass and other pollutants on daily mortality in Santiago, Chile
Cifuentes, LA; Vega, J; Kopfer, K; Lava, LB
Journal of the Air & Waste Management Association, 50(8): 1287-1298.

Environmental Research
Determining the threshold effect of ozone on daily mortality: an analysis of ozone and mortality in Seoul, Korea, 1995-1999
Kim, SY; Lee, JT; Hong, YC; Ahn, KJ; Kim, H
Environmental Research, 94(2): 113-119.
Journal of Aerosol Science
Chemical and morphological analysis of airborne particles at a tunnel construction site
Kaegi, R
Journal of Aerosol Science, 35(5): 621-632.
X-Ray Spectrometry
On the elemental composition of PM2.5 in central Cairo, Egypt
Boman, J; Shaltout, AA; Abozied, AM; Hassan, SK
X-Ray Spectrometry, 42(4): 276-283.
Environmental Health Perspectives
Estimating the exposure-response relationships between particulate matter and mortality within the APHEA multicity project
Samoli, E; Analitis, A; Touloumi, G; Schwartz, J; Anderson, HR; Sunyer, J; Bisanti, L; Zmirou, D; Vonk, JM; Pekkanen, J; Goodman, P; Paldy, A; Schindler, C; Katsouyanni, K
Environmental Health Perspectives, 113(1): 88-95.

Environmental Science & Technology
Source identification of fine particles in Washington, DC, by expanded factor analysis modeling
Begum, BA; Hopke, PK; Zhao, WX
Environmental Science & Technology, 39(4): 1129-1137.
Journal of Epidemiology
Traffic-related air pollution and respiratory symptoms in children living along trunk roads in Chiba Prefecture, Japan
Shima, M; Nitta, Y; Adachi, M
Journal of Epidemiology, 13(2): 108-119.

Journal of Exposure Analysis and Environmental Epidemiology
Comparing exposure metrics in the relationship between PM2.5 and birth weight in California
Basu, R; Woodruff, TJ; Parker, JD; Saulnier, L; Schoendorf, KC
Journal of Exposure Analysis and Environmental Epidemiology, 14(5): 391-396.
Atmospheric Environment
Exotic dust incursions into central Spain: Implications for legislative controls on atmospheric particulates
Moreno, T; Querol, X; Alastueya, A; Viana, M; Gibbons, W
Atmospheric Environment, 39(): 6109-6120.
Atmospheric Environment
Variations in atmospheric PM trace metal content in Spanish towns: Illustrating the chemical complexity of the inorganic urban aerosol cocktail
Moreno, T; Querol, X; Alastuey, A; Viana, M; Salvador, P; de la Campa, AS; Artinano, B; de la Rosa, J; Gibbons, W
Atmospheric Environment, 40(): 6791-6803.
Journal of Hazardous Materials
Seasonal and spatial trends of suspended-particle associated polycyclic aromatic hydrocarbons in urban Shizuoka, Japan
Kume, K; Ohura, T; Noda, T; Amagai, T; Fusaya, M
Journal of Hazardous Materials, 144(): 513-521.
Polish Journal of Environmental Studies
Influence of vehicular traffic on concentration and particle surface composition of PM10 and PM2.5 in Zabrze, Poland
Rogula-Kozlowska, W; Pastuszka, JS; Talik, E
Polish Journal of Environmental Studies, 17(4): 539-548.

Building and Environment
Reducing particle exposures in a tropical office building using electrostatic precipitators
Zuraimi, MS; Tham, KW
Building and Environment, 44(): 2475-2485.
Inhaled Particles X
High Temporal Resolution Measurements of Roadside Particle Size Distributions and Their Implications for Exposure
Tomlin, AS; Young, DT; Lingard, JJN; Agius, EL
Inhaled Particles X, 151(): -.
ARTN 012025
Philosophical Transactions of the Royal Society of London Series A-Mathematical Physical and Engineering Sciences
Differential epidemiology of ambient aerosols
Anderson, HR
Philosophical Transactions of the Royal Society of London Series A-Mathematical Physical and Engineering Sciences, 358(): 2771-2785.

New England Journal of Medicine
Fine particulate air pollution and mortality in 20 US cities
Sarnat, JA; Schwartz, J; Suh, HH
New England Journal of Medicine, 344(): 1253-1254.

Archives of Environmental Health
Effects of air pollution on the prevalence and incidence of asthma in children
Shima, M; Nitta, Y; Ando, M; Adachi, M
Archives of Environmental Health, 57(6): 529-535.

Annali Di Chimica
A boxmodel develpoment to study the relationships between the photo-oxidants and the particles formation in the troposphere
Pozzoli, L; Bolzacchini, E; Van Dingenen, R; Hjiorth, J; Dentener, F; Perrone, G; Rindone, B; Librando, V
Annali Di Chimica, 93(4): 447-456.

Atmospheric Environment
Combining data from multiple monitors in air pollution mortality time series studies
Roberts, S
Atmospheric Environment, 37(): 3317-3322.
Toxicology and Applied Pharmacology
Vanilloid receptor activation by 2- and 10-mu m particles induces responses leading to apoptosis in human airway epithelial cells
Agopyan, N; Bhatti, T; Yu, S; Simon, SA
Toxicology and Applied Pharmacology, 192(1): 21-35.
European Journal of Epidemiology
Airborne particulate matter and premature deaths in urban Europe: the new WHO guidelines and the challenge ahead as illustrated by Spain - Commentary
Moreno, T; Querol, X; Alastuey, A; Ballester, F; Gibbons, W
European Journal of Epidemiology, 22(1): 1-5.
Tobacco Control
Residual tobacco smoke: measurement of its washout time in the lung and of its contribution to environmental tobacco smoke
Invernizzi, G; Ruprecht, A; De Marco, C; Paredi, P; Boffi, R
Tobacco Control, 16(1): 29-33.
Journal of Allergy and Clinical Immunology
Acute respiratory health effects of air pollution on children with asthma in US inner cities
O'Connor, GT; Neas, L; Vaughn, B; Kattan, M; Mitchell, H; Crain, EF; Evans, R; Gruchalla, R; Morgan, W; Stout, J; Adams, GK; Lippmann, M
Journal of Allergy and Clinical Immunology, 121(5): 1133-1139.
Circulation Journal
Effects of Fine Particulate Matter on Daily Mortality for Specific Heart Diseases in Japan
Ueda, K; Nitta, H; Ono, M
Circulation Journal, 73(7): 1248-1254.

American Journal of Respiratory and Critical Care Medicine
Concentrated Ambient Ultrafine Particle Exposure Induces Cardiac Changes in Young Healthy Volunteers
Samet, JM; Rappold, A; Graff, D; Cascio, WE; Berntsen, JH; Huang, YCT; Herbst, M; Bassett, M; Montilla, T; Hazucha, MJ; Bromberg, PA; Devlin, RB
American Journal of Respiratory and Critical Care Medicine, 179(): 1034-1042.
Environmental Science & Technology
Potential Impact of Climate Change on Air Pollution-Related Human Health Effects
Tagaris, E; Liao, KJ; Delucia, AJ; Deck, L; Amar, P; Russell, AG
Environmental Science & Technology, 43(): 4979-4988.
Journal of Investigational Allergology and Clinical Immunology
Urban Air Pollution and Climate Change as Environmental Risk Factors of Respiratory Allergy: An Update
D'Amato, G; Cecchi, L; D'Amato, M; Liccardi, G
Journal of Investigational Allergology and Clinical Immunology, 20(2): 95-102.

Environmental Science & Technology
Comparison of light scattering devices and impactors for particulate measurements in indoor, outdoor, and personal environments
Liu, LJS; Slaughter, JC; Larson, TV
Environmental Science & Technology, 36(): 2977-2986.
Air pollution and health
Brunekreef, B; Holgate, ST
Lancet, 360(): 1233-1242.

Toxicology and Applied Pharmacology
Negatively charged 2- and 10-mu m particles activate vanilloid receptors, increase cAMP, and induce cytokine release
Agopyan, N; Li, L; Yu, S; Simon, SA
Toxicology and Applied Pharmacology, 186(2): 63-76.
X-Ray Spectrometry
Concentrations and sources of trace elements in particulate air pollution, Dar es Salaam, Tanzania, studied by EDXRF
Bennet, C; Jonsson, P; Lindgren, ES
X-Ray Spectrometry, 34(1): 1-6.
Toxicology Letters
Effects of PM2.5 components in the release of amphiregulin by human airway epithelial cells
Rumelhard, M; Ramgolam, K; Auger, F; Dazy, AC; Blanchet, S; Marano, F; Baeza-Squiban, A
Toxicology Letters, 168(2): 155-164.
Atmospheric Environment
Coarse particulate matter concentrations from residential outdoor sites associated with the North Carolina Asthma and Children's Environment Studies (NC-ACES)
Chen, FL; Williams, R; Svendsen, E; Yeatts, K; Creason, J; Scott, J; Terrell, D; Case, M
Atmospheric Environment, 41(6): 1200-1208.
Atmospheric Environment
Association between ionic composition of fine and coarse aerosol soluble fraction and peak expiratory flow of asthmatic patients in Sao Paulo city (Brazil)
Bourotte, C; Curl-Amarante, AP; Forti, MC; Pereira, LAA; Braga, AL; Lotufo, PA
Atmospheric Environment, 41(): 2036-2048.
Air Pollution XV
Human exposure against particles: the indoor-outdoor problem
Franck, U; Tuch, T; Manjarrez, M; Wiedensohler, A; Herbarth, O
Air Pollution XV, 101(): 477-485.
Jama-Journal of the American Medical Association
Coarse particulate matter air pollution and hospital admissions for cardiovascular and respiratory diseases among medicare patients
Peng, RD; Chang, HH; Bell, ML; McDermott, A; Zeger, SL; Samet, JM; Dominici, F
Jama-Journal of the American Medical Association, 299(): 2172-2179.

Energy & Fuels
C-13 NMR analysis of soot produced from model compounds and a coal
Solum, MS; Sarofim, AF; Pugmire, RJ; Fletcher, TH; Zhang, HF
Energy & Fuels, 15(4): 961-971.
Environmental Health Perspectives
Air conditioning and source-specific particles as modifiers of the effect of PM10 on hospital admissions for heart and lung disease
Janssen, NAH; Schwartz, J; Zanobetti, A; Suh, HH
Environmental Health Perspectives, 110(1): 43-49.

Environmental Science & Technology
Livestock ammonia management and particulate-related health benefits
McCubbin, DR; Apelberg, BJ; Roe, S; Divita, F
Environmental Science & Technology, 36(6): 1141-1146.
Environmental Health Perspectives
The influence of ambient coarse particulate matter on asthma hospitalization in children: Case-crossover and time-series analyses
Lin, M; Chen, Y; Burnett, RT; Villeneuve, PJ; Krewski, D
Environmental Health Perspectives, 110(6): 575-581.

Experimental Lung Research
Response of human alveolar macrophages to ultrafine, fine, and coarse urban air pollution particles
Becker, S; Soukup, JM; Sioutas, C; Cassee, FR
Experimental Lung Research, 29(1): 29-44.
Journal of Geophysical Research-Atmospheres
Aerosol time-of-flight mass spectrometry during the Atlanta Supersite Experiment: 1. Measurements
Liu, DY; Wenzel, RJ; Prather, KA
Journal of Geophysical Research-Atmospheres, 108(): -.
ARTN 8426
Ambient air particles from four European cities increase the primary cellular response to allergen in the draining lymph node
Nygaard, UC; Alberg, T; Bleumink, R; Aase, A; Dybing, E; Pieters, R; Lovik, M
Toxicology, 207(2): 241-254.
Public Health
An enquiry into the respiratory health effects on a rural community of a soil mound erected close to residential property
Olowokure, B; Wardle, SA; Beaumont, M; Duggal, HV; Colling, G
Public Health, 119(3): 217-222.
Environmental Health Perspectives
Fine particulate matter (PM2.5) air pollution and selected causes of postneonatal infant mortality in California
Woodruff, TJ; Parker, JD; Schoendorf, KC
Environmental Health Perspectives, 114(5): 786-790.
Journal of Allergy and Clinical Immunology
Nasal inflammation and personal exposure to fine particles PM2.5 in asthmatic children
Nikasinovic, L; Just, J; Sahraoui, F; Seta, N; Grimfeld, A; Momas, I
Journal of Allergy and Clinical Immunology, 117(6): 1382-1388.
Frontiers in Bioscience
Fine urban atmospheric particulate matter modulates inflammatory gene and protein expression in human bronchial epithelial cells
Baulig, A; Blanchet, S; Rumelhard, M; Lacroix, G; Marano, F; Baeza-Squiban, A
Frontiers in Bioscience, 12(): 771-782.

Atmospheric Environment
Recreational atmospheric pollution episodes: Inhalable metalliferous particles from firework displays
Moreno, T; Querol, X; Alastuey, A; Minguillon, MC; Pey, J; Rodriguez, S; Miro, JV; Felis, C; Gibbons, W
Atmospheric Environment, 41(5): 913-922.
Environmental Health Perspectives
Exposure assessment of particulate matter for susceptible populations in Seattle
Liu, LJS; Box, M; Kalman, D; Kaufman, J; Koenig, J; Larson, T; Lumley, T; Sheppard, L; Wallace, L
Environmental Health Perspectives, 111(7): 909-918.

Journal of Toxicology and Environmental Health-Part A
Assessing the importance of different exposure metrics and time-activity data to predict 24-h personal PM2.5 exposures
Chang, LT; Koutrakis, P; Catalano, PJ; Suh, HH
Journal of Toxicology and Environmental Health-Part A, 66(): 1825-1846.
Inhalation Toxicology
Optimization of route of administration for coexposure to ovalbumin and particle matter to induce adjuvant activity in respiratory allergy in the mouse
Steerenberg, PA; van Dalen, WJ; Withagen, CET; Dormans, JAMA; van Loveren, H
Inhalation Toxicology, 15(): 1309-1325.
Inhalation Toxicology
Influence of relatively low level of particulate air pollution on hospitalization for COPD in elderly people
Chen, Y; Yang, QY; Krewski, D; Shi, Y; Burnett, RT; McGrail, K
Inhalation Toxicology, 16(1): 21-25.
Remote Sensing of Clouds and the Atmosphere Viii
Satellite-derived determination of PM10 concentration and of the associated risk on public health
Sarigiannis, D; Sifakis, NI; Soulakellis, N; Tombrou, M; Schafer, K
Remote Sensing of Clouds and the Atmosphere Viii, 5235(): 408-416.
X-Ray Spectrometry
EDXRF and TXRF analysis of elemental size distributions and environmental mobility of airborne particles in the city of Riga, Latvia
Viksna, A; Lindgren, ES; Standzenieks, P; Jacobsson, J
X-Ray Spectrometry, 33(6): 414-420.
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Atmospheric Environment
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Inhalation Toxicology
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Toxicological Sciences
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Gaceta Sanitaria
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Occupational and Environmental Medicine
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Journal of Toxicology and Environmental Health-Part A-Current Issues
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Toxicology in Vitro
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An analysis of the association between respiratory symptoms in subjects with asthma and daily air pollution in Spokane, Washington
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Atmospheric Chemistry and Physics
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Atmospheric Environment
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Proceedings of the 4th International Academic Conference on Environmental and Occupational Medicine
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Journal of Environmental Management
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Atmospheric Environment
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Control of early diagenesis processes on trace metal (Cu, Zn, Cd, Pb and U) and metalloid (As, Sb) behaviors in mining- and smelting-impacted lacustrine environments of the Bolivian Altiplano
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Journal of Occupational and Environmental Medicine
Association Between Fine Particulate Matter and Oxidative DNA Damage May Be Modified in Individuals With Hypertension
Kim, JY; Prouty, LA; Fang, SC; Rodrigues, EG; Magari, SR; Modest, GA; Christiani, DC
Journal of Occupational and Environmental Medicine, 51(10): 1158-1166.
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pollution; particulate matter; respiratory disorders; children; cohort studies

© 2000 Lippincott Williams & Wilkins, Inc.

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