Exposure assessment approaches to evaluate respiratory health effects of particulate matter and nitrogen dioxide.

Several approaches can be taken to estimate or classify total personal exposures to air pollutants. While personal exposure monitoring (PEM) provides the most direct measurements, it is usually not practical for extended time periods or large populations. This paper describes the use of indirect approaches to estimate total personal exposure for NO2 and particulate matter (PM), summarizes the distributions of these estimates, and compares the effectiveness of these estimates with microenvironmental concentrations for evaluating effects on respiratory function and symptoms. Pollutant concentrations were measured at several indoor and outdoor locations for over 400 households participating in an epidemiological study in Tucson, Arizona. Central site monitoring data were significantly correlated with samples collected directly outside homes, but the former usually had higher pollutant concentrations. Integrated indices of daily total personal exposure were calculated using micro-environmental (ME) measurements or estimates and time-budget diary information. Peak expiratory flow rates (PEFR) were measured for up to four times a day during two-week study periods. In thirty children (ages 6-15 years) with current diagnosed asthma, a significant reduction in PEFR was associated with NO2 levels measured outside of their homes. Additional decrements of morning PEFR were found in those children sleeping in bedrooms with higher measured NO2 levels. Morning and noon PEFR decrements were also linked to higher morning NO2 levels that were measured at central monitoring stations. Effects of PM were also found, but were limited to morning PEFR. No effects were found in non-asthmatic children. The relationship of PEFR to the calculated indices of daily average total exposure were weaker than to the microenvironment concentrations. This suggests that diary and ME monitoring data need to yield better time resolution in order to incorporate short-term average exposures to higher concentrations into the exposure indices and into the analysis of within day health responses.