Objectives : To investigate the impacts of traffic related air pollution (TRAP) on children’s respiratory health, and to investigate the policies and regulations implemented in other countries and the suggestions from the World Health Organization (WHO) to tackle this problem. Methods and Results: Using relevant keywords, 122 articles were acquired from PubMed and 15 were from MEDLINE via EBSCO host respectively. The articles were published between 1980 to 2013; all of which had examined the impacts of TRAP on children’s respiratory health. After assessing inclusion and exclusion criteria, 9 articles were finally included in this systematic review. Differences in demographic characteristics were studied and compared to determine the association between TRAP exposure and respiratory health impacts on children aged between 1 and 18. Four cross-section surveys and five cohort studies were selected in this review. The association between TRAP exposure and differences in children’s respiratory impacts were demonstrated in all studies. Multiple outcome measures were used to examine changes of children’s respiratory health such as the decline in lung function, incidences of asthma and inflammatory responses. There were 4 out of 9 articles suggesting the decline in lung function was related to TRAP exposure; 5 out of 9 articles showed the relationships between incidences of asthma and inflammatory responses and TRAP exposure and 2 articles mentioned other respiratory symptoms; notably, wheezing and sneezing, runny and stuffed nose. This review finally summarized the results of selected articles stressing that children who lived close to roadway within a 500 meter radius from home, with an early exposure to air pollution in the first year of age and a frequent exposure to heavy road traffic and outdoor air pollutants would experience greater impacts on respiratory health. Conclusion: The positive association between the impacts on children’s respiratory health and TRAP exposure has been determined through this systematic review. Stricter emission control strategies and updated guidelines are required to regulate traffic emission and improve air quality in order to reduce harm and provide a better living environment for our next generations. / published_or_final_version / Public Health / Master / Master of Public Health

abstract / Public Health / Master / Master of Philosophy

Not available / text

Exposure to volatile organic compounds (VOCs) has critical health implications for developing fetuses and subsequently for infants and young children. Research has suggested that this ambient air pollutant can be found indoors in quantities that may be hazardous to human health. In low-income neighborhoods in New York City such as northern Manhattan and the South Bronx, where there are disproportionately high rates of asthma and asthma-related hospitalizations, high rates of indoor exposure to VOCs persist. Simultaneously, as mobile devices expand, applications on mobile devices may be used to educate parents of children who reside in these geographic regions about indoor VOC emission sources and subsequently how to reduce exposure.Therefore, this study sought to assess the role of mobile device applications in reducing household VOCs by assessing the feasibility of existing health applications on both Apple and Android OS mobile devices without the use of a household air monitoring unit. An online survey assessed awareness of VOCs and identified knowledge of both emission sources and reduction methods of household VOCs among a sample of (N = 57) parents/guardians residing in the Northern Manhattan and Southern Bronx regions with children under the age of 5. A series of focus groups were conducted among a subset of participants to assess the adaptability of a mobile application prototype that specifically targets the reduction of VOCs. Lastly, a preliminary mobile device application mockup was created with potential features. The key findings of this study included the following: (a) the author identified no existing mobile device applications that could be utilized as a method for VOC reduction without the use of a physical in-home air monitor; (b) while parents had some baseline awareness of VOCs, there were gaps within their knowledge of VOCs, particularly with emission sources; (c) the feasibility of this proposed application as a potential source of intervention for indoor VOC mitigation was apparent through parent willingness to explore its possible use, while providing ample recommendations for optimal mobile device application design; and (d) the exploratory mockup of the proposed mobile device application was generated with suggested features.

published_or_final_version / Urban Planning and Environmental Management / Master / Master of Science in Urban Planning

published_or_final_version / Community Medicine / Master / Master of Philosophy

Dissertation submitted in compliance with the requirements for the Masters Degree in Technology: Environmental Health, Durban Institute of Technology, 2005. / South Durban is in the province of Kwazulu-Natal in South Africa and is home to two international petro-chemical refineries, a paper mill, sewage works, an international airport, a chemical tank farm with approximately 970 tanks, a number of landfill sites, an airport, various processing and manufacturing industries which are all in close proximity to residential and recreational areas. This area is known as the South Durban Industrial Basin (SDIB). Serious concerns have arisen about the potential health impacts that could arise from ambient air pollution from these industries. Learners and staff at the Settlers Primary School situated in Merebank, a suburb in the SDIB, perceived themselves to be at risk for air pollutant related health effects owing to the schools’ geographic location. The aims of this study was a) to determine the prevalence of asthma among learners from Grades 3 and 6 and staff at Settlers Primary School and b) To investigate whether outdoor air pollutant concentrations of sulphur dioxide (SO2), oxides of nitrogen (NOx), ozone (O3), total reduced sulphur (TRS), carbon monoxide (CO) and respirable particulate matter less than 10 microns (PM10) were associated with increased signs and symptoms of asthma in the study population. / M

Age-related cognitive decline is a growing public health issue as increases in life expectancy are expected to substantially raise the prevalence of cognitive impairment and dementia. An estimated 46.8 million individuals are currently living with dementia, with the global prevalence expected to double every 20 years. Emerging evidence suggests that ambient air pollution from traffic and other sources may be an important risk factor for cognitive decline in addition to its association with other cardiovascular and neurological outcomes. The aim of this dissertation was to first investigate the association between long-term exposure to ambient air pollution and cognitive decline among older adults in an urban population within Northern Manhattan. I then set out to assess specific mechanisms involved in the association between long-term exposure to ambient air pollution and cognitive decline, specifically investigating the ApoE4 allele, age, and current smoking behavior as effect modifiers of the association between long-term exposure to ambient air pollution and cognitive decline. I found evidence of an adverse effect of ambient air pollution on the cognitive functioning of older adults. Overall, exposure to higher levels of ambient air pollution was highly predictive of lower cognitive scores, but at baseline only. Contrary to the current hypothesis, limited evidence was found for an association between estimates of air pollution and trajectories of cognitive decline. The patterns of effect were similar across pollutant types and cognitive domains in this aging, urban population. I found strong evidence of effect modification by smoking status, where contrary to the hypothesis; the overall effects of ambient air pollution on cognition and cognitive decline were stronger among individuals who never smoked. The impact of effect modification by age category was most prominent in the memory and language cognitive domains. Among individuals less than 75 years old at baseline, there was a stronger association between a one IQR increase in air pollutants and cognitive domain scores at baseline as compared to individuals 75 years and older. I did not observe conclusive evidence of an association between air pollution and cognition in models stratified by APOE-4 status. To my knowledge, this is the largest study to analyze the association of ambient air pollution on cognition and cognitive decline over time in a racially and ethnically diverse sample. These results further support the current evidence on the role of air pollution on accelerated cognitive aging and brain health.

Background: Three billion individuals worldwide rely on biomass fuel (crops, dung, wood) for cooking and heating, mostly in the developing world. Incomplete combustion of these biomass fuels in inefficient cookstoves leads to high levels of household air pollution (HAP). Health conditions resulting from HAP are responsible for approximately 1.6 million premature deaths each year. Of the diseases associated with HAP exposure, lower respiratory infections (LRIs) are the leading cause of death for children under five worldwide. There is a great need to understand the etiology of HAP-associated LRIs to inform health interventions and to improve treatments. Ultimately, however, the only way to prevent the disease burden from HAP is to stop exposure. Policies and programs to promote the use of clean fuels for cooking are a pivotal prevention strategy. Methods: All three studies draw from an established cohort in Ghana. The Ghana Randomized Air Pollution and Health Study (GRAPHS), was a cookstove intervention trial in Kintampo, Ghana. Participants were randomized to a more efficient biomass cookstove arm, a liquefied petroleum gas (LPG) stove arm, or the traditional cookstove arm (baseline). The principal outcome of GRAPHS was childhood pneumonia. The first chapter utilizes banked nasal swabs from GRAPHS to assess the relationship between HAP exposures and a panel of known respiratory pathogens. In the second chapter we leverage data on stove use during GRAPHS, and then follow a sub cohort 6 months prior to and 6 months after the GRAPHS termination date. We employ a novel construct, suspended use, to understand the factors associated with people stopping LPG use. The third chapter tests a new randomized intervention on a subset of the GRAPHS participants. We provide free cookstoves, and allocate participants to one of four arms: a behavior change intervention, an intervention where LPG fuel is directly delivered to their home, a dual intervention of behavior change and fuel delivery, or a control arm. We track their stove use to identify the most effective intervention on sustained use. Results: In Chapter 1, we find that the traditional cookstove users had a higher mean number of microbial species than the LPG (LPG: 2.71, 3-stone: 3.34, p<0.0001, n = 260). This difference was driven by increased bacterial (p<0.0001) rather than viral species presence (non-significant). Adjusted exposure-response analyses, however, produced null results. Chapter 2 identifies several factors associated with reduced or suspended LPG use of intervention cookstoves, including: experience of burns, types of food made, and access to biomass fuels. Finally, in Chapter 3 results show increased use for all three intervention arms, the largest for the direct delivery arm with an increased weekly use of 4.7 minutes per week (p<0.001). Conclusions: Transition away from traditional biomass stoves is projected to curb the health effects of HAP by mitigating exposure, but the full benefits of newer clean cookstove technologies can only be realized if use of these new stoves is absolute and sustained. This work enhances our understanding of the etiology of HAP-associated pneumonia, the drivers of clean cookstove suspension, and informs policies designed to promote clean cookstove sustained use, thus reducing the burden of disease associated with exposure. We recommend future use of the suspended use paradigm in research to inform future household energy interventions. Additionally, we encourage policymakers to incorporate health behavior change theory and approaches in cookstove intervention and promotion efforts.

In 1990, the Clean Air Act (CAA) Amendments authorized the regulation of 188 hazardous air pollutants (HAP). Exposure to HAPs at sufficient concentrations and durations can increase both cancer and serious adverse non-carcinogenic effects. The purpose of this study was to conduct a human health risk assessment using data of 43 HAPs from five monitor sites in Portland, Oregon during July 1999-August 2000. HAP concentrations were compared to carcinogenic and non-carcinogenic (health) benchmark concentrations; and emission sources were determined for HAPs that exceeded health benchmark concentrations. Additionally, cancer risks were determined for subpopulations and compared to cancer risks generated for the general population. Results of this study indicate that 20 HAPs exceeded carcinogenic benchmark concentrations (corresponding to a risk level of 1 x 10������) in at least one location. Chromium compounds posed the highest cancer risk (3.5 x 10������). Seventeen HAPs exceeded carcinogenic benchmark concentrations at all five sites. Seventy-five percent (%) of the total cumulative cancer risk was contributed by chromium compounds, 1,3-butadiene, formaldehyde and 1,1,2,2-tetrachloroethane. Three HAPs, chromium compounds, acrolein, and formaldehyde, exceeded non-carcinogenic hazard ratios of 1.0. Releases from area sources accounted for the largest percentage of HAPs that exceeded health benchmark concentrations. With respect to subpopulations, asthmatics teenagers (age 11-16) and asthmatic adults (age 18-50), had slightly elevated cancer risks of 1.4 x 10������ and 1.2 x 10������. respectively, compared to the general population risk level of 1 x 10������. Results of this study indicate that several HAPs pose a potential human health concern in Portland and that efforts should be made to reduce their emissions. Additional studies are warranted to further assess potential human health risks and the extent of HAPs in Portland, Oregon. / Graduation date: 2003