There is increasing recognition of the links between air pollution and human health. Epidemiological studies have shown that there are numerous air pollutants that are associated with indoor energy use and with the production processes of industries, and most represent some sort of health implication. However, in-depth and fundamental knowledge of the health impact relationship of most pollutants is limited. This research evaluates the socio-economic and spatial aspects of the health implications of air pollution in Richards Bay (located 200 km north of Durban), KwaZulu-Natal. The research explores community perceptions and complaints relating to human health impacts emanating from air pollution in Richards Bay. The research is informed by a multi-conceptual framework (political economy incorporating political ecology, place perspectives and environmental justice) which influenced the methods chosen in conducting the research. Standard quantitative and qualitative methods were employed in the study to generate data relating to the research objectives. The process of triangulation which is the use of multiple methods that cuts across the qualitativequantitative divide was used. The various sources of information validate and clarify data by deepening and widening an understanding of the main issues under examination. The research was implemented in various communities in Richards Bay that reflect socioeconomic differences, which contributes significantly to ascertain whether health impacts are differentially experienced by different socio-economic groups. Furthermore, the research cross-tabulated experiences, perceptions and coping strategies of different socio-economic groups in the area, especially in relation to upper, middle and lower income clusters. The spatial aspect of the research (mapping of key social and health variables) is a major contribution of this research, which draws from the field of medical geography. Information on the main residential areas was illicitied from documents providing background details on Richards Bay. A purposive sampling approach was adopted to identify the seven communities, namely, Alton, Aquadene/ Brackenham, Arboretum, Meer-en-See, Empangeni Rail, Nseleni and Umhlathuze. Simple random point sampling was used to identify the households within the communities. The number of households in each community was determined using proportionate sampling. Four hundred and seventy nine housholds (479) were interviewed which was deemed to be a statistically relevant sampling size at a 95% confidence level. The study findings indicate that the lower income areas (Nseleni, Empangeni Rail and Umhlathuze) and the middle income areas (Aquadene/ Brackenham and Arboretum) have a more youthful population with a significant number being children, while the upper income areas (Alton and Meer en See) have a more elderly population. A similar trend was also found in relation to household size. There are clearly major variations in household income and employment types in Richards Bay, linked in part to the geographical location of communities based on economic and racial groups. Lower earning respondents were located mostly in the lower status areas which were classified as predominantly African populated areas as per the historical race classification and apartheid segregated areas. More than half of the respondents indicated that industrial smoke was the cause of their present health conditions. Other stated reasons were wide ranging and therefore there was no discernible pattern that emerged in relation to the causes for poor health experienced by the affected household member. However, the data did show that more respondents living in middle/ upper income areas identified causes. Reported health conditions include allergies (30.9%), coughing (29.8%), wheezing (25.5%), chest pains (18.4%) and asthmatic bronchitis/ asthma (17.7%). With regards to health care, the findings from the study show that the economically better off communities (Alton, Aquadene/ Brackenham, Arboretum and Meer en See) used the private, more expensive health care sector while generally households in lower income areas tend to rely on public or traditional health care facilities. An interesting finding was that most respondents rate their general health status as either excellent, good (more respondents from the middle/ upper income areas than the lower income areas) or satisfactory (more respondents from Umhlathuze). A large majority of the respondents reported air pollution as the main problem that is associated with industries in Richards Bay while the health impacts of pollutants from the industries manufacturing processes was the second main cause. The areas deemed to be the most polluted were generally in or in close proximity to the industrial area or the port area. Lower income areas tendered to be most polluted, according to respondents residing in these areas or who lived in similar low income areas. The majority of respondents were found to be living in dwellings/ households made from dwellings constructed with brick and asbestos, brick and zinc, stone and other traditional materials which is indicative of housing in the poorer communities who live in informal dwellings/ households and may be a causal contributing factor of the poor health status of these communities. The participatory mapping exercise conducted during the focus group discussion revealed that participants identified the industrial areas (including the port and surrounds) as the most polluted areas. Areas outside Richards Bay were considered to be the least polluted areas. The research findings indicate that there are a complex mix of socio-economic, environmental and spatial dynamics that influence air pollution and health impacts. Thus, health issues in the context of widespread air pollution concerns are linked to social, political and environmental aspects that require urgent attention. Air pollution and health impacts remain major concerns in many parts of the world, especially in areas of high levels of industrial development such as Richards Bay. The results of this research, therefore supports the findings of other researchers who reveal that communities/ neighborhoods of lower income status are most likely to bear the brunt of negative impacts and that air pollution from indoor uses of energy, behavioral factors such as cigarette smoking and industrial processes contribute to an individual’s/ community’s quality of life. / Thesis (Ph.D.)-University of KwaZulu-Natal, Durban, 2013.

He, Qiqiang. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2009. / Includes bibliographical references (leaves 142-154). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in English and Chinese.

Background: This dissertation comprises research conducted on two distinct projects. Project I focuses on the connection between household air pollution (HAP) from cooking with biomass fuels and blood pressure (BP); this research is situated in the context of a large randomized trial of a cookstove intervention in Ghana, West Africa. The setting of Project II, meanwhile, is the residential environment of New York City, where we explore temperature and humidity conditions in homes and relate these conditions to summertime heat wave risk and to the survival and transmission of respiratory viruses in the winter. Although these projects are quite distinct, each relates to the complex relationship between climate change and health. Reducing HAP to improve health (the focus of Project I) will simultaneously reduce climate change through a reduction in emissions of short-lived climate pollutants into the atmosphere. Meanwhile, furthering our understanding of heat and humidity levels inside urban residences (the focus of Project II) is crucial to our ability to protect health in light of projections for a changing climate. Domestic activities associated with heating, cooling, and cooking are thus very relevant both to human health and to climate change mitigation and adaptation. Objectives and Methods: Our overall objective for Project I was to investigate exposure- response relationships between HAP and BP in a cohort of pregnant women taking part in the Ghana Randomized Air Pollution and Health Study (GRAPHS). We first explored this association in a cross-sectional study (Chapter 1), in which we used 72-hour personal monitoring to ascertain levels of exposure among the GRAPHS women to carbon monoxide (CO), one of the pollutants emitted by traditional wood-fed cooking fires. These exposure data were collected at enrollment into the GRAPHS study, prior to the initiation of cooking with improved cookstoves. We investigated the association between these “baseline” CO exposure levels and the women’s blood pressure at enrollment into GRAPHS. A limitation of this study was that BP was only measured once. We followed this with a second study of 44 women drawn from the same cohort (Chapter 2), for whom we designed BP protocols using 24-hour ambulatory blood pressure monitoring (ABPM), the current gold standard for clinical diagnosis of hypertension. As we were not aware of any prior research in Africa that had employed ABPM, we also designed a parallel BP protocol using home blood pressure monitoring (HBPM) equipment for comparison with ABPM. The use of ABPM with concurrent personal CO monitoring enabled us to investigate hourly associations between CO exposure and changes in BP. We also evaluated BP in these women both before and after the cookstove intervention; this allowed us to investigate whether any changes in BP were associated with switching to an improved cookstove. Our objectives for Project II were to understand the distribution of temperature and humidity conditions in a range of New York City homes during the summer and winter seasons, to evaluate the impact of structural and behavioral factors (e.g. building size, use of air conditioning, and use of humidifiers) on these conditions, and to build models that could help predict indoor conditions from more readily available outdoor measurements. We conducted this research in two ways. We first analyzed a set of indoor temperature and humidity measurements that were collected in 285 New York City apartments during portions of summers 2003-2011 and used these data to simulate indoor conditions during two heat wave scenarios, one of which was more moderate and the other of which was more extreme (Chapter 3). Second, we designed and conducted a new study in which temperature and humidity were monitored in a set of 40 NYC apartments between 2013 and 2015 (Chapters 4-6). This second study enabled us extend our research into the winter season, and also to explore how factors such as air conditioning and humidifier use impacted indoor temperature and humidity. We also investigated relationships between the monitored conditions, self-reported perceptions of the indoor environment, and symptoms that were experienced among household members. Results: In the cross-sectional analysis of CO and BP in the GRAPHS cohort (Chapter 1), we found a significant positive association between CO exposure and diastolic blood pressure (DBP): on average, each 1 ppm increase in exposure to CO was associated with 0.43 mmHg higher DBP [0.01, 0.86]. A non-significant positive trend was also observed for systolic blood pressure (SBP). In our study of the acute relationship between CO exposure and BP (Chapter 2), we determined that peak CO exposure (defined as above the 90th percentile of the exposure distribution, or an average of 4.1ppm) in the two hours prior to BP measurement was associated with elevations in hourly systolic BP (4.3 mmHg [95% CI: 1.1, 7.4]) and diastolic BP (4.5 mmHg [95% CI: 1.9, 7.2]), as compared to BP following lower CO exposures. We also observed a non-significant trend toward lower BP following initiation of cooking with an improved cookstove. Lastly, we demonstrated that ABPM was a feasible and well-tolerated tool for BP assessment in a rural West African setting. For Project II in New York City, we first determined that there was a great deal of variability in indoor summer heat index (HI) between homes in association with similar outdoor conditions, and that this variability increased with increasing outdoor heat (Chapter 3). Our simulation of a moderate heat wave led us to conclude that the hottest 5% of the homes would reach peak indoor heat index (HI) values of 39°C. In a more extreme heat wave simulation, HI in the hottest 5% of homes reached a peak of 41oC and did not drop below 34oC for the entire nine- day simulated heat wave period. Our second indoor monitoring study yielded the following findings: in the summer season (Chapter 4), we found significant differences in indoor temperature and heat index according to the type of air conditioning (AC) in the home. Homes with central AC were the coolest, followed by homes with ductless AC, window AC, and no AC. Apartments on the top floor of a building were significantly hotter than other apartments regardless of the presence of AC. During the winter season (Chapter 5), median vapor pressure in our sample of apartments was 6.5mb. Comparing humidity levels in the apartments to a threshold of 10mb vapor pressure that has been proposed as protective against influenza virus transmission, levels of absolute humidity in the homes remained below this threshold for 86% of the winter: a total of over three months. Residential use of humidifiers was not associated with higher indoor humidity levels. Larger building size (above 100 units) was significantly associated with lower humidity, while the presence of a radiator heating system was non-significantly associated with higher humidity. Lastly, perceptions of indoor temperature and measured temperature were significantly associated in both the summer and the winter (Chapter 6), while sleep quality was inversely related to measured indoor temperature in the summer season only. Reports of heat- stress symptoms were associated with perceived, but not measured, temperature in the summer season. Conclusions: The work presented in this dissertation adds to a growing body of evidence on the importance of exposures in the domestic environment to health and well-being. The research reported here on household air pollution in Ghana documents an exposure-response relationship between air pollution from cookstoves and elevations in blood pressure, on both a chronic and an acute basis. As elevated BP is a known risk factor for cardiovascular disease (CVD), our research provides support for a plausible factor linking HAP exposure to CVD. Meanwhile, our research on temperature and humidity in New York City residences provides concrete data to supplement the very slim literature to date documenting these conditions in the home environment, where Americans spend over half their time. We conclude, first, that AC may not be fully protective against summertime heat risk, and second, that the levels of humidity we observed in residential environments are consistent with levels that have been shown to promote enhanced survival and transmission of respiratory viruses in experimental settings. We suggest that interventions that can reduce exposure to household air pollution and excess indoor heat can also mitigate climate change, and that with thoughtful planning we can improve health at the same time as we foster resiliency in the face of a changing climate.

In conclusion, the current air pollution levels in Hong Kong had a risk for school children's respiratory and cardiovascular health. In comparison between the highly- and least-polluted districts, a rise of 8 mug/m 3 annual mean for PM10 concentration was significantly associated with increased risks for some respiratory symptoms such as wheezing, cough, and phlegm, with decreased lung function in FEF25-75% and FEF75%, and with decreased cardiopulmonary fitness in predicted VO2max, after adjustment for confounding factors. An increase of 13 mug/m3 annual mean for NO2 in the moderately-polluted district did not individually cause adverse effects on children's respiratory and cardiopulmonary health. Physical activity appears to have no positive health effects on the children's VO2max in moderately- and highly-polluted districts. / In the past year preceding the study (May 2003 to April 2004), the annual means for PM10, NO2, SO2 and O3 were respectively 55.1 mug/m3, 51.4 mug/m3, 15.4 mug/m3, and 42.5 mug/m3 in the least-polluted district (LPD); 56.3 mug/m3, 64.7 mug/m3, 15.2 mug/m3, and 35.2 mug/m3 in the moderately-polluted district (MPD); and 63.8 mug/m3, 64.1 mug/m3, 22.2 mug/m3, and 31.7 mug/m3 in the highly-polluted district (HPD). The 99th percentiles were 178 mug/m3, 158 mug/m 3, 104 mug/m3, and 140 mug/m3 in the LPD; 169 mug/m3, 181 mug/m3, 106 mug/m 3, and 113 mug/m3 in the MPD; and 226 mug/m 3, 177 mug/m3, 140 mug/m3, and 137 mug/m 3 in the HPD. The average daily 1-h maximum O3 (peak O 3) was 83.7 mug/m3 in the LPD, 73.6 mug/m 3 in the MPD, and 64.8 mug/m3 in the HPD. / Lung function indices included FVC, FEV1, FEV 1/FVC, FEF25-75%, FEF25%, and FEF75%. Children in the HPD had lower FEV 1/FVC, FEF25-75%, and FEF25% than those in both the LPD and MPD, after controlling for their corresponding confounders. In comparison between the LPD and HPD, the adjusted mean differences for FEV1/FVC, FEF25-75%, and FEF25% were respectively 1.39%, 85 ml, and 113 ml in boys, and 1.60%, 86 ml, and 225 ml in girls. In addition, the decreased FEF75% of HPD was found in boys (62 ml) but not in girls. When comparing the MPD with LPD, the increased FEF25% was observed in girls in the LPD (158 ml), whereas boys in the LPD had lower FEF75% than those in the MPD (81 ml). There were no significant differences in children's FVC and FEV1 between districts. / The multistage fitness test (MFT) with the Matsuzaka's function was employed to predict cardiopulmonary fitness (VO2max) of children. After adjustment for the factors, girls in the LPD had significantly higher VO 2max than those in the MPD and HPD by 0.19 and 0.75 ml·kg -1 ·min-1 respectively. The VO 2max among boys in the LPD was 0.48 ml·kg-1 ·min -1 higher than those in the HPD. When we compared the VO 2max between students in MPD and HPD, higher VO2max in both boys and girls in the MPD were observed---by 0.49 and 0.56 ml·kg -1 ·min-1 respectively. In LPD, significantly higher VO2max values were observed in both boys and girls who were physically active (children who took part in sports and/or vigorous free play at least three times a week for at least 30 minutes each time) compared with those who were not (0.71 and 0.65 ml·kg-1 ·min -1 respectively), but those differences in VO2max among students in MPD and HPD were small and insignificant. / There were totally 2,641 (82.9%) children who participated in the study, and 2,203 participants were involved in analyses. After adjustment for confounding factors, girls living in the HPD had significantly increased odds ratios (ORs) for wheezing without cold (4.75), cough at night (1.71), phlegm without cold (3.61), compared with those in the LPD. Boys in the HPD had increased OR only for phlegm without cold (1.88). When comparing the MPD with LPD, the adjusted OR for cough at night achieved significance in girls (1.74) and marginal significance in boys (1.40). Sneeze with itchy-watery eyes and current/ever allergic rhinitis had negative associations with district. In comparison with LPD, the decreased OR for sneeze with itchy-watery eye in girls in HPD (0.65) reached statistical significance. Both boys and girls in MPD had significantly decreased ORs for current allergic rhinitis (0.72 and 0.50 respectively) and for ever allergic rhinitis (0.74 and 0.55 respectively). There were no significant differences in the prevalence rates of asthma and bronchitis between districts. / To explore associations between air pollution and respiratory and cardiovascular health of school children, a cross-sectional study was conducted among 3,186 primary school children in P3 and P4 from three districts with different air pollution levels in Hong Kong during March to June in 2004. / Gao Yang. / "August 2005." / Source: Dissertation Abstracts International, Volume: 67-11, Section: B, page: 6339. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2005. / Includes bibliographical references (p. 137-154). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in English and Chinese. / School code: 1307.

This thesis investigates how air pollution, both natural and anthropogenic, affects changes in the proximal small intestine and ileum microbiota profile, as well as intestinal barrier integrity, histological changes, and inflammation. APO-E KO mice on a high fat diet were randomly selected to be exposed by whole body inhalation to either wood smoke (WS) or mixed vehicular exhaust (MVE), with filtered air (FA) acting as the control. Intestinal integrity and histology were assessed by observing expression of well- known structural components tight junction proteins (TJPs), matrix metallopeptidase-9 (MMP-9), and gel-forming mucin (MUC2), as well known inflammatory related factors: TNF-α, IL-1β, and toll-like receptor (TLR)-4. Bacterial profiling was done using DNA analysis of microbiota within the ileum, utilizing 16S metagenomics sequencing (Illumina miSeq) technique. Overall results of this experiment suggest that air pollution, both anthropogenic and natural, cause a breach in the intestinal barrier with an increase in inflammatory factors and a decrease in beneficial bacteria. This evidence suggests the possibility of air pollution being a potential causative agent of intestinal disease as well as a possible contributing mechanism for induction of systemic inflammation.