Gwo-Hwa Wan

The relationship between exposure to air pollutants and fetal growth outcomes has shown inconsistency, and only a limited number of studies have explored the impact of air pollution on gestational hypertension and birth outcomes. This study aimed to evaluate how maternal exposure to air pollutants and blood pressure could influence fetal birth outcomes. A total of 55 women with gestational hypertension and 131 healthy pregnant women were enrolled in this study. Data pertaining to personal characteristics, prenatal examinations, outdoor air pollutant exposure, and fetal birth outcomes were collected. The study revealed that fetal birth weight and abdominal circumference exhibited a significant reduction among women with gestational hypertension compared to healthy pregnant women, even after adjustments for body mass index, gestational age, and exposure to air pollutants had been made. Moreover, maternal exposure to outdoor air pollutants displayed a notable correlation with decreased birth length of fetuses. Consequently, the study concluded that maternal blood pressure and exposure to outdoor air pollutants during pregnancy potentially stand as pivotal factors influencing fetal birth outcomes. Graphical abstract

Aerosolized drug therapy is a common approach in treating respiratory diseases in clinical practice. This study aimed to assess air quality in the pediatric intensive care unit (PICU) of the medical center and investigate variations in drug concentration relative to the patient’s position during aerosolized drug treatment. To monitor air quality and aerosolized drug concentrations in the PICU, we conducted bi-weekly 24-hour samplings over a month. Monitored air quality parameters included temperature, relative humidity (RH), carbon dioxide (CO2), particulate matter (PM), total volatile organic compounds (TVOCs), and aerosolized drug levels in the air. The study also used a small volume nebulizer (SVN) to analyze the relationship between aerosolized drug concentration and distance from a simulated patient. This study revealed that the average concentrations of CO2, PM10 (an aerodynamic diameter equal to or less than 10 μm), and PM2.5 (an aerodynamic diameter less than 2.5 μm) in the PICU met Taiwan’s Ministry of Environment (MOENV) indoor air quality standards. However, the hourly average concentration of TVOCs in the PICU was almost twice the MOENV standard. The concentration of acetylcysteine in the air showed a positive association with both RH and CO2 concentration. Additionally, drug concentrations measured at 1 m, 1.6 m, and 3 m from the SVN were significantly lower than those measured at 0.1 m from the SVN. Continuous monitoring of TVOCs and CO2 in the PICU is necessary. During aerosol therapy, it is crucial for medical staff and family members to maintain a safe distance or integrate a HEPA (high-efficiency particulate air) filter into the ventilator circuit system. This precautionary step aims to minimize unwarranted exposure and maintain hospital air quality.

No consistent results from past studies have been found on the relationship between the effects of air pollutant exposure, preterm birth (PTB) and low birth weight (LBW) in fetuses. This study aimed to analyze the impact of high concentrations of air pollutants on the health outcomes of fetuses, especially regarding PTB and LBW. This study used keywords related to air pollutants, pregnancy, and birth outcomes, to search the literature within the databases of the Cochrane Library, PubMed, and Embase, which were published as of July 26, 2022. A total of 24 studies were included in this meta-analysis. This meta-analysis revealed that nitrogen dioxide (NO₂) exposure throughout pregnancy was associated with an increased risk of PTB. Maternal exposure to PM_2.5 (particulate matter sized less than 2.5 μm) during gestation was associated with the risk of LBW. The findings of this meta-analysis provide an important foundation for evaluating the relationship between exposure of air pollutants and fetal birth outcomes in countries with severe air pollution in the future.

Objective: Air pollution is associated with the prevalence of respiratory diseases. This study aimed to evaluate the impacts of outdoor air pollutants and indoor Dermatophagoides pteronyssinus 1 (Der p 1) exposure on levels of fractional exhaled nitric oxide (FeNO), exhaled breath condensate (EBC) pH, and pulmonary function in atopic children. Methods: This study recruited 59 atopic mild-to-moderate asthmatic children and 23 atopic non-asthmatic children. Data on personal characteristics, FeNO, EBC pH, and pulmonary function were collected. Group 1 allergens of Der p 1 were measured on the tops of mattresses and on bedroom floors in the children’s homes, and outdoor air pollutant concentrations were estimated from air quality monitoring stations, using the ordinary kriging method. Results: Exposure levels of outdoor air pollutants, except for particulate matter (PM)_2.5, for the recruited children met outdoor air quality standards set by the Taiwan Environmental Protection Agency. The lag effect of outdoor PM₁₀ exposure was negatively associated with the forced expiratory volume in one second (FEV₁) [(Lag 1: β=–0.771, p = 0.028), and O₃ (Lag 1–7: β=–2.02, p = 0.04, Lag 1–28: β=–3.213, p = 0.029)]. Median pulmonary function parameters differed significantly in forced vital capacity (FVC) (p = 0.004) and FEV₁ (p = 0.024) values between atopic asthmatic and non-asthmatic children. No association was found between the FeNO/EBC pH level and exposure to Der p 1 allergen and air pollutants in the recruited children. Conclusions: Outdoor PM₁₀ and O₃ exposure was associated with reduction in FEV₁ in atopic asthmatic and non-asthmatic children.