The increasing popularity of electronic cigarettes (e-cigarettes) and, more recently, the new “heat-not-burn” tobacco products (iQOS) as alternatives to traditional tobacco cigarettes has necessitated further documentation of and research into the composition and potential health risks/benefits of these devices. In a recent study, we compared second-hand exposure to particulate metals and organic compounds from e-cigarettes and traditional cigarettes, by conducting continuous and time-integrated measurements in an indoor environment, followed by computing the emission rates of these species using a single-compartment mass balance model. In this study, we have used a similar approach to further expand our previous analyses by characterizing black carbon, metal particles, organic compounds, and size-segregated particle mass and number concentrations emitted from these devices in addition to the newly marketed iQOS. Analysis of the iQOS side-stream smoke indicated that the particulate emission of organic matter from these devices is significantly different depending on the organic compound. While polycyclic aromatic hydrocarbons (PAHs) were mostly non-detectable in the iQOS smoke, certain n-alkanes, organic acids (such as suberic acid, azelaic acid, and n-alkanoic acids with carbon numbers between 10 and 19) as well as levoglucosan were still emitted in substantial levels from iQOS (up to 2–6 mg/h during a regular smoking regimen). Metal emissions were reduced in iQOS smoke compared to both electronic cigarettes and conventional cigarettes and were mostly similar to the background levels. Another important finding is the presence of carcinogenic aldehyde compounds, including formaldehyde, acetaldehyde, and acrolein, in iQOS smoke, although the levels were substantially lower compared to conventional cigarettes. Copyright © 2017 American Association for Aerosol Research

Atmospheric particulate matter (PM) has multiple adverse effects on human health, high temperatures are also associated with adverse health outcomes, and the frequency of cardiovascular events (CVEs) varies with season. We investigated a hypothesized increase in PM-related accident and emergency (A&E) presentations for CVE with high temperature, warm season, days of high influenza incidence, and in people with a cancer diagnosis, using a time-stratified case-crossover study design. Outcomes were associations of A&E presentation for CVE with atmospheric PM ≤ 10 μm (PM₁₀), season, and air temperature. PM₁₀ levels in the municipality of residence (exposure variable) were estimated by modeling data from local monitoring stations. Conditional logistic regression models estimated odds ratios (OR) with 95% confidence intervals (CI) for presentations in relation to supposed influencers, adjusting for confounders. Study participants were all who presented at the A&E of a large hospital near Milan, Italy, for a CVE (ICD-9: 390–459) from 1st January 2014 to 31st December 2015. There were 1349 A&E presentations for CVE in 2014–2015 and 5390 control days. Risk of A&E presentation was significantly increased on hot days with OR 1.34 (95%CI 1.05–1.71) per 10 μg/m³ PM₁₀ increment (as mean PM₁₀ on day of presentation, and 1 and 2 days before (lags 0–2)), and (for lag 0) in autumn (OR 1.23, 95%CI 1.09–1.37) and winter (OR 1.18, 95%CI 1.01–1.38). Risks were also significantly increased when PM₁₀ was on lag 1, in people with a cancer diagnosis in the spring and summer months (1.88, 95%CI 1.05–3.37), and on days (lags 0–2) of high influenza incidence (OR 2.34, 95%CI 1.01–5.43). PM₁₀ levels exceeded the 50 μg/m³ “safe” threshold recommended by the WHO and Italian legislation for only 3.8% of days during the warm periods of 2014–2015. Greater risk of A&E presentation for CVE in periods of high PM₁₀ and high temperature suggests that “safe” thresholds for PM₁₀ should be temperature-dependent and that the adverse effects of PM₁₀ will increase as temperatures increase due to climate change.

Indoor smoking in public places and workplaces is forbidden in Italy since 2003, but some health concerns are arising from outdoor secondhand smoke (SHS) exposure for non-smokers. One of the biggest Italian Steel Manufacturer, with several factories in Italy and abroad, the Marcegaglia Group, recently introduced the outdoor smoking ban within the perimeter of all their factories. In order to encourage their smoker employees to quit, the Marcegaglia management decided to set up an educational framework by measuring the PM₁, PM_2.5 and PM₁₀ emissions from heavy duty trucks and to compare them with the emissions of cigarettes in an indoor controlled environment under the same conditions. The exhaust pipe of two trucks powered by a diesel engine of about 13.000/14.000 cc³ were connected with a flexible hose to a hole in the window of a container of 36 m³ volume used as field office. The trucks operated idling for 8 min and then, after adequate office ventilation, a smoker smoked a cigarette. Particulate matter emission was thereafter analyzed. Cigarette pollution was much higher than the heavy duty truck one. Mean of the two tests was: PM₁ truck 125.0(47.0), cigarettes 231.7(90.9) p = 0.002; PM_2.5 truck 250.8(98.7), cigarettes 591.8(306.1) p = 0.006; PM₁₀ truck 255.8(52.4), cigarettes 624.0(321.6) p = 0.002. Our findings may be important for policies that aim reducing outdoor SHS exposure. They may also help smokers to quit tobacco dependence by giving them an educational perspective that rebuts the common alibi that traffic pollution is more dangerous than cigarettes pollution.

This report is based on an independent study carried out by medical professionals of the Fondazione IRCCS Istituto Nazionale dei Tumori (National Cancer Institute) in Milan, Italy, and aimed to assess the incidence of respiratory diseases in a Brazilian community (Piquiá de Baixo, in the city of Açailandia) exposed to extreme air pollution in connection to a local steel manufacturing plant. The study has the objective to contribute to the existing literature on the health risks associated with fine particle pollution (PM2.5) due to steel production with data from Brazil. The study is based on a cross-sectional sample of the resident population of Piquiá de Baixo age 16 or over consisting of 220 people. We collected data about the health conditions of participant subjects in two ways: a) medical history questionnaires and b) clinical assessment of respiratory function through spirometry testing. The results were evaluated based on comparative studies. According to the spirometric tests performed, 28 % of the sample population suffers from respiratory pathologies (for the most part of restrictive rather than obstructive nature). This incidence rate is between six and two times higher than those reported in similar studies carried out in other countries (which range between 4.6 and 14.5 %). In addition, the incidence rate is also significantly high in light of the fact that our sample population did not include the category of subjects most at risk for pulmonary disorders in connection to air pollution caused by the Piquiá steel processing complex: in other words, men and women employed in the steel mills or in connection with their industrial cycle (as many as 434 Piquiá residents age 16 and over were unable to participate to our study due to “work-related reasons”). In light of the above considerations, we believe that our findings contribute to the existing literature on the correlation between pulmonary disease and air pollution in industrialized areas, while warranting further scientific research on the public health consequences of industrial production in Piquiá de Baixo. In turn, on the ethical plane, we believe that research of this nature strengthens the need to advocate for more severe environmental and health policies aimed at limiting the hazards associated with the steel industry in Piquiá and in similar contexts around the world.

Due to the growing popularity of electronic cigarettes (ECs) and heated tobacco products (HTPs) as alternatives to conventional cigarettes (CCs), there is an increasing need to monitor the emissions of these new devices. ECs generate significant concentrations of second-hand aerosol (ECSHA), which is visible in dense clouds and can be smelled. Particulate matter (PM) is an important component of CC, HTP and EC aerosols, and Optical Particle Counters (OPCs) enable its real-time measurement, which is expressed either as the number of particles or as mass. This study specifically addresses the limitations associated with EC mass measurement using OPC technology and identifies the strict necessity of the measurement of a corresponding density (k factor) not only for each specific PM source but also for the desired PM size. Therefore, a standard measurement requires the simultaneous operation of the OPC equipment and a certified reference instrument. Four different OPCs were used. Crucially, this study also proves that this setup may be inapplicable because the extreme volatility of EC-generated aerosols makes it impractical to gauge the correct EC k factor.

Tobacco use and the Western diet are two of the most important and investigated topics in relation to adolescents’ health. In addition, air pollution is a crucial subject for future generations. School is a key social environment that should promote healthy behaviors in children and adolescents. In this field many different programs have been conducted, with mixed results and effectiveness. Research data suggest that comprehensive and multicomponent approaches may have a greater effect on tobacco use and diet, especially when integrated into a community-wide approach. The present work describes a multi-area pilot study called “La Scuola della Salute” (the School of Health) with a focus on the methodological aspects of the intervention. In our study we assessed different web-based and practical experiences related to adolescents’ smoking and dietary behaviors and awareness of smoke-related air pollution. Furthermore, to make adolescents more conscious of smoking and dietary behaviors, we conducted experiential workshops that addressed smoking and environmental pollution, food education, and lifestyle. Teachers and school administrators were involved in the project. At baseline we investigated dietary habits, tobacco use, and individual and social characteristics by means of lifestyle questionnaires. In addition, we collected anthropometric parameters and performance indicators such as exhaled carbon monoxide and urinary fructose to assess smoking and nutrition habits. At the end of the intervention lifestyle questionnaire and biological markers were collected again: knowledge about these topics was significantly improved, and the urinary fructose was able to estimate the levels of obesity in the classes. The integrated approach, combined with the use of biological markers, could be an innovative approach to the promotion of healthy lifestyles among adolescents, but further research is needed.