Luchtvervuiling en gezondheid: de mechanistische inzichten

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1 SYMPOSIUM

2 Luchtvervuiling en gezondheid: de mechanistische inzichten Dr. Ir. Frans de Jongh Longfysioloog Medisch Spectrum Twente, Enschede, the Netherlands Academic Medical Centre, Amsterdam, the Netherlands University of Twente, Enschede, the Netherlands

3 Disclosure belangen spreker (potentiële) belangenverstrengeling GEEN Voor bijeenkomst mogelijk relevante relaties met bedrijven Sponsoring of onderzoeksgeld Honorarium of andere (financiële) vergoeding Aandeelhouder Andere relatie, namelijk

4

5 Definitions lungvolumes TLC IC IRV TV ERV FRC RV Water-spirometer TLC = Total Lung Capacity (6 litre) FRC = Functional Residual Capacity (3 litre) RV = Residual Volume (1.8 litre) TV = Tidal Volume (0.5 litre) IC = Inspiratory Capacity (3 litre) IRV = Inspiratory Residual Volume (2.5 litre) ERV = Expiratory Reserve Volume (1.2 litre)

6 Example of deterministic model n = generation number Conducting zone Respiratory zone Trachea Bronchi Bronchioles Terminal Bronchioles Respiratory Bronchioles Alveolar ducts Alveolar sacs Alveoli n

7 Weibel Lungmodel

8 EM-foto longcappilair 0.5 µm

9 Environmental aerosols Pollution Outdoor (e.g. environment, traffic) Indoor (e.g. house, school, work) Health effects Short term (e.g. hospital admission, mortality) Long term (e.g. decline lung/cardiovascular)

10 Aerosols MMAD = Mass Median Aerodynamic Diameter

11 Aerosols GSD = Geometric Standard Deviation D 84% GSD = = D 50% D 50% D 16% D 50% = median diameter D 84% = that diameter at which 84% of the particles has a smaller diameter

12 MMAD + spread respirable fraction = the particles which enter the target area (e.g. the lungs) Percentage (%) monodispers Difference in spread Too large MMAD Diameter (µm)

13 Comparison of deposition in the same subject Adult Leach CL et al. Presented at the ATS, 2000

14 Impaction Large particles > 5µm Deposit in: - Upper airways - Main bronchi - Spacers L L i i CAU = 1.3 l = 0 ( Stk 0.001) Stk Stk < Stk = ρ d p 2 p U 18µ d ρ p = density of the aerosol particle d p = diameter of the aerosol particle µ = dynamic viscosity of air Taulbee & Yu 1975 J.Appl.Physiol.38 d = characteristic length (airway diameter)

15 Sedimentation Large particles Preferably deposit in peripheral bronchi L s = CAU l (1 e 2n z vs a / π AU ) n z = number of airways in generation number z v s = sedimentation velocity of the aerosol particle = = 2 ρ p d p µ 18 g

16 Diffusion Small particles< 0.1µm Preferably deposit in Peripheral bronchi alveoli L d = CAU l (1 e 36Db l n AU D b = Brownian diffusion coefficient z )

17 - - Other processes Electrostatic forces hydrophobic, hydrofilic - interception (sphere - fibre)

18 Displacement in 1 s (µm) Diameter Sediment Inertial * Diffusion Total , , , , ,8 44 0,5 9,5 0,8 11,9 22 0,2 2,2 0,12 22,3 25 0,1 0,9 0,03 39,2 40 0,05 0,4 0,008 73,0 73 0,02 0,14 0, , ,01 0,07 0, ,0 344 * initial velocity of 1 m/s

19 10 Results d = 5.0 µm TV=500 ml, t i =t e =2s, mouth-breathing, 1 breath total deposition = 81% deposition % Inertia Sedimentation Diffusion Total generation number

20 Results d = 0.01µm TV=500 ml, t i =t e =2s, mouth-breathing, 1 breath total deposition = 83% deposition % generationnumber Inertia Sedimentation Diffusion Total

21 Results d = 0.5µm TV=500 ml, t i =t e =2s, mout-breathing, 1 breath total deposition = 8.3% deposition % generation number Inertia Sedimentation Diffusion Total

22 Diffusion Sedimentation Inertial impaction

23 Deposition in upper airways (adults) Insp. collection efficiency nose breathing mouth breathing 1µm 3µm 5µm 10 µm 1.E+00 1.E+01 1.E+02 1.E+03 1.E+04 1.E+05 1.E+06 d 2 Q (um 2 cm 3 s -1 ) Schulz H, Brand P, Heyder J, Chapter5: Particle deposition in the respiratory tract, Lung Biol. In Health and Disease 2000 Vol 143

24 Deposition in upper airways (newborn) Insp. collection efficiency nose breathing child 1month, nose breathing 1µm 3µm 5µm 10 µm 1.E+00 1.E+01 1.E+02 1.E+03 1.E+04 1.E+05 1.E+06 d 2 Q (um 2 cm 3 s -1 ) mouth breathing Phalen RF, Oldham MJ, Mautz WJ: Aerosol deposition in the nose as a function of body size, Health Physics 1989, 57 suppl1,

25 Particulate matter - definitions A complex mixture of airborne solid and liquid particles, including soot, organic material, sulfates, nitrates, other salts, metals, biological materials. PM is measured by its mass (μg/m 3 ) PM inhalable particles PM 10 -PM coarse particles PM fine particles PM ultrafine particles Slides after F. Foristiere Rome Italy, ERS congress 2007

26 Particulate matter - definitions Science 307: , News Focus, March 2005

27 Particles Size? Or Mass? Or Number? Or What? Mass Diameter Number Surface Area (µg/m 3 ) (µ) (per ml) (µ 2 /ml) ,400, Adapted from Donaldson K et al. Occup Environ Med 2001;58:

28 Atmospheric aerosols

29 Atmospheric aerosols mass, dm/dlogdp, µg/m Ultrafines (<0.1 µm) C SO 4 NH 4 NO 3 C PM Local Long-distance combustion Soil transport Al Ca Fe O Si particle aerodynamic diameter, µm

30 Particulate Air Pollution and Mortality Daily average concentration of fine particles (PM 10, PM 2.5 ) have been associated with: - All cause mortality - Respiratory mortality - Cardiovascular mortality

31 Adverse respiratory Adver health effects WHO, Health Guidelines for Vegetation Fire Events, 1999

32 Respiratory effects of Fireworks Lithium and Strontium salts Calcium salts Incandescence of iron (with carbon), charcoal, or lampblack Sodium compounds Barium compounds Copper compounds FIREWORK FUEL Charcoal Sulphur Burning aluminum, titanium, or magnesium powder or flakes Chest research foundation Pune India, ERS 2007

33 Respiratory effects of Fireworks Symptom Pre-existing Prevalence (%) New symptoms Prevalence (%) Total Prevalence (%) Cough Breathlessness Wheeze Percentages of complaining wheeze, breathlessness & cough during Diwali festival n = % 45.50% 40% 31.20% 30% 20% 13.30% 10% 6.10% 0% Wheeze Breathlessness Cough None Chest research foundation Pune India, ERS 2007

34 PM 2.5 and Air Quality (USA) levels of ug/m 3 can be detected as passive smoker (outdoors)

35 Results of stop smoking In 24 pubs in Dublin PM 10 and PM 2.5 was measured before (Oct Mar 2004) and after (Oct Mar 2005) the smoking ban Results (µgm -3 ) Pre ban (sd) Post Ban (sd) %Change p value Ave PM10 79 (48.5) 37.4 (6.6) -53% Ave PM (34.7) 4.97 (1) -87.6% Ave outdoor PM % NS Ave outdoor PM % NS M McCafrey et all. ERS congress 2005

36 PM 2.5 mortality Cause of death RR per 10 µg/m 3 PM2.5 95% c.i. Total Cardiopulmonary Lung cancer All other Pope, JAMA 2002

37 CONCLUSIONS Effects of long term exposure? Effects of (traffic) sources? How to distinguish effects of long term exposure with recent (new) exposures What physical/chemical/biological effects accounts?

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