1.

REFERENCES

Higgins, E. A., M. T. Lategola, J. M. McKenzie, C. E. Melton,
and J. A, Vaughan: Effects of Ozone on Exercising and Sedentary
Adult Men and Women Representative of the Flight Attendant Popu-
lation, Section III: Effects of Ozone on Hand Steadiness, Heart
Rate, and Short-Term Memory. FAA Office of Aviation Medicine
Report No. FAA~AM-79-20, July 1979.



to ozone. Additional analysis of the interaction reveals that this
increase is accounted for by the nonsmokers (p < .01). There were no
differences in smokers between no-ozone and ozone conditions. During
no-ozone exposure, the nonsmokers had a significantly lower blink rate
and range (p < .01 and p< .05 respectively) than the smokers, so that
a rise in rate was more readily attained by the nonsmokers. Since the
smokers were not permitted to smoke for about 1 aour before exposure, or
during exposure, and differences in blink rate between smokers and non-
smokers were not observed with ozone, no explanation of the mechanism to
this result can be given here. Six smokers and four nonsmokers reported
burning or watering eyes during exposure to ozone. Only one subject

(a smoker) reported burning eyes during the no-ozone exposure. These
subjective symptoms of eye irritation could have influenced, to some
degree, the higher blink rates observed with ozone. Eye irritation
symptoms were not severe and cleared up following exposure. Subjective
symptoms of irritation to the eyes and respiratory tract have been
reported for ozone concentrations in air greater than 1 ppmv, and con-
centrations of 2.0 to 3.7 ppmv have caused irritation to normal human
eyes within 6 min (5). At concentrations that are irritating to human
eyes, ozone was demonstrated not to be injurious to corneas of experi~
mental animals. Exposure of rabbits to 2.0 to 2.8 ppm for 4 hours daily
over a period of 1 to 25 days caused no injury to the corneas, as
detected by clinical examination, by measurement of rate of repair of
artificial epithelial wounds, by histological methods, or by measure-
ment of the activity of several enzymes in the epithelium (5,8,9).

Summary.

Statistical analysis of the results indicated that a 3-h exposure
te 0.30 ppmv of ozone caused only minor effects on the visual parameters
of photopic distant visual acuity, stereoscopic acuity, vertical and ~
lateral phorias, color vision, hand-eye coordination, and peripheral
visual fields. Visual impairment in accummodation was. found with. ozone
when measured by the "out-to-clear" procedure. -Visual:- threshold ‘during ©
dark adaptation was higher with ozone and with the older (50~ to’59-year)
age group who were nonsmokers, but numerical recognition was Higher in
the dark-adapted subjects exposed to ozone only when views: the largest
size numerals. Retinal -bleach recovery times Were also significantly ~~
increased during exposure to ozone. The significantly higher blink rates,
together with subjective reports of tearing and.slight’ to moderate burn-
ing in the eyes of 25 ‘percent of the test subjects, indicated ozone ta’ “
be a temporary irritant which possibly contributed to degradation: of. .
scotopic vision, accommodation, and elevated retinal’ bieach’ Recovery -
times at the ozone concentration examined in this study... ~



Vertical and lateral phorias. The numbers and percentages of
test subjects in the two age groupe which showed effects of ozone on verti-
cal and lateral phorias are presented in Table 9. Changes in vertical
Phorias were small, ranging from 0.00 to 1.00 Prism Diopters (PD), and
a high percentage showed no changes at all. In the total sample, 13
subjects (32.5 percent) had left hyperphoria, and 4 subjects (10 percent)
showed right hyperphoria in one or both exposures. Twenty-three subjects
(57.5 percent) demonstrated vertical orthophoria during both exposures.

The range of values for lateral phorias was 0.00 to 6.00 PD.
Lateral phorias were somewhat improved in some of the smokers and non-
smokers of the 40~ to 49-year age group and in the nonsmokers of the 50-
to 59-year age group; but, as with the vertical phorias, the majority
of the test subjects showed no change from no-ozone to ozone conditions.
In the younger age group, eight subjects (40 percent) had esophoria and
five subjects (25 percent) exophoria « during one or both oth exposures. The
older age group showed 7 subjects (35 percent). with esophoria and 11
subjects (55 percent) with exophoria during one or both exposures.

Accommodation. Mean values of accommodation measured with the
R.A.F. Near Point Rule are shown in Table 10. There was a significant
increase in the number of centimeters necessary to read in the "out-to-
clear" procedure between no-ozone and ozone (p<. .01), but not for the
age groups or between smokers and nonsmokers. No significant differences
were found when the "in-to-blur" procedure was employed.

Farnsworth Panel D-15 color test. Results of this. “test, shown in
Table 11, indicate no effects of exposure to ozone on color discrimination,
and all subjects were error-free in choosing the correct. hues: Individual.
times taken to complete the test ranged from 24 s to 79 s. The 50- to:59-
year age group showed a trend toward longer completion time, witha similar
trend for smokers, but no true cause-and-effect relationships ec
demonstrated statistically.

Hand-eye coordination. The time to complete the hand-eye”
coordination test using the "Etch-a-Sketch" device, together. with. errors.
made, is shown in TableTM 12. Completion times ranged. from. 52 to: 18: -
the 40- to 49-year group, and from 61 to 193 s in the 50- to "$9-year ge:
group. The older grisip ‘iecidedly used more time to complete : the test. _
(p<, -01)., but mean ‘errors exceed those of the 40- to.49-year. age
group. There were no: signit. s<uc “differences found. due.to exposure 2
ozone or to the smokers for either completion time or number. of error
accrued. coe

Blink rate and range. Changes in mean blink rates .and: ranges
are presented in Table 13. The data reveal a highly ‘significant “in
in blink rate from no-ozone to ozone exposures (p<_.01) and:.an inte:
action between the ozone.exposures. and the smoking and nonsmoking: co:
tions (p< .05). Further ‘analysis on interactions between 3g
using the test for simple effects (10) indicated that for nonsmoke

26



(queozz7uszs 3ON) ZT°O = a
(aueoFzFUBTS ION) 40°O = a
(2ueozzFUBTS ION) S9°Z = a
-
“ore | 6'y | 9rze | ze | vs | vroe |] sevz | oy | orce
ee | v9 | gc9z | zee | te | tote || ogre | oro | €r9z | 6% 03 OF |
WTE-OL-NI
JUBDTIFUBTS ION teuOTZIBZ0IUNT |
to’ 34) zs'e = 4 20% pur suozo-oN
(queozzFUBTS ION) SEO = A SISxOUsUON pue siexoug wn
(que oFzTUSTS 3ON) 90°O = A So sdnoig o3y ss072by-4
¢ : i ~ °
6c"e | 69 | WOE | soe | 9 | HEZ |] ve} OB} T6z | zoe | Org" | 6-¥z 65 03 0¢
. \ “
ese | Ts | 64z | zee | 9°9 | Troe || sce} te] zat | ese 1. ses | 6ree|>-- 6% 03 OF
q a
\
aVva'10-O1-1N0
t . Lo .
“Ts  weeH Ss we “Ts ae "Ts Wea ; : ,
: (44) é
(a) (wo) (a) (wo) (a) (us) (a) . (ao) gov
SISyOUSUON GEES Gn ‘SisqouUsuoN CoC
- 4
aNOZO NOZO-ON
UoFIepomMO.5y =“°OT A1GVL



Age-Height-Weight Characteristics
of the Subject Population

TABLE 1.
AGE BRIGHT WEIGHT x
(yr) (cm) (kg)
x 43.0 175.2 76.1 10
NONSMOKERS
SE 0.6 1.5 4.1
|__ 40-49 YEARS _
x 54.5 179.3 84.7 10
NONSMOKERS
SE 0.9 2.9 2.2
50-59 YEARS
z 48.8 177.2 80.4 2a
SE 1.4 1.3 2.5
40-59 YEARS
xX 44.2 176.9 78.7 lo
SMOKERS
SE 1.0 1.8 4.2
40-49 YEARS I
Xx 55.6 176.4 82.0 10
SMOKERS
SE 0.7 2.0 3.6
50-59 YEARS
xX 49.9 176.7 80.3 20
SMOKERS
SE 1.4 1.3 2.7
40-59 YEARS
4 49.4 176.9 80.4 40
ALL SUBJECTS
SE 1.0 0.9 1.8



: TABLE 18. Summary of Ozone Effects

Heart Rate and Short-Term Memory (-)
: Symptoms
t 40-49 S (-)
50-59 S$ +)
40-59 S +)
40-49 NS (+)
50-59 NS (-)
40-59 NS (+)
40-59 S and NS GH)
Spirometry
40-49 NS (+) Fvc
50-59 NS (+) FVC, FEF35_959
40-59 NS (+) Fvc, FEV}
40-49 S : +) FC :
50-59 S (-)
40-59 S (-)
40-59 S and NS (+) PWC, FEV], FEF75~-95%
Vision
Photopic Distant Acuity (-)
Stereoscopic Acuity (-)
Phoria (-)
Accommodation Gt)
Color Vision : (-)
Hand-Eye Coordination (->
Blink Rate
Smokers >)
Nonsuokers (+)

Mesopic Vision

Visual Fields (-)
Retinal Bleach Recovery (+)

Scotopic Vision

Acuity . @
Numerical Recognition (+)

Eye Irritation



REFERENCES

1. Adler, F. H.: Physiology of the Eye, 4th Edition, C. V. Mosby
Co., pp. 706-707, St. Louis, Mo., 1965.

2. Armstrong, H. G.: Principles and Practice of Aviation Medicine,
2nd Edition, Williams and Wilkins Co., pp. 105-106, Baltimore, Md.,
1943.

3. Borish, I. M.: Clinical Refraction, 3d Edition, Volume 2, The
Professional Press, Inc., p. 1026, Chicago, I1l., 1970.

4. Higgins, E. A., M. T. Lategola, J. M. McKenzie, C. E. Melton, and
J. A. Vaughan: Effects of Ozone on Exercising and Sedentary
Adult Men and Women Representative of the Flight Attendant Popu-
lation, Section VI: The Effects of Ozone on Photopic, Mesopic,
and Scotopic Vision. FAA Office of Aviation Medicine Report No.
FAA~AM-79-20, July 1979.

5. Hine, C. H., M. J. Hogan, W. K. McEwen, F. H. Meyers, and
S. R. Mettier: Eye Irritation from Air Pollution, J. AIR POLLUT.
ASSOC., 10:17-20, 1960.

6. Lagerwerff, J. M.: Prolonged Ozone Inhalation and Its Effects on
Visual Parameters, AEROSP. MED., 34:479-486, 1963.

7. McFarland, R. A. and M. B. Fisher: Alterations in Dark Adaptation
as a Functicn of Age, J. GERONTOL., 10:424-428, 1955.

8. Mettier, S. R., Jr., H. K. Boyer, C. H. Hine, and W. K. McEwen:
Study of the Effects of Air Pollutants on the Eye, ARCH. INDUSTR.
HEALTH, 21:1-6, 1960.

9. Mettier, S. R:, Jr., H. K. Boyer, W. K. McEwen, F. Ivanhoe,
F. H. Meyers, and C. KR. Hine: Effects of Air Pollutant Mixtures.
on the Bye, ARCH. ENVIRON. HEALTH, 4:103-107, 1962.

10. Winer, B. J.:. Statistical Principles in Experimental Design,
McGraw-Hill Book Co., Inc., pp. 337-344, New York, N. Y., 1962,



-quesq37o8ye 300 suoTIDex030F Sopupeana
(60 $4) LOL a
O34) os eas

(so > 4) Spy ad
(queozsFUsts ION) /O°T = 4

(quesfzTusTsS 30N) O°Z = A

1S*0 6s"0 €s"0 98°0 0-0 19°0
9°0 z¥°0 Teo 65°0 z1°0 9€°0
“as ueaH “a's UROH “a's UuBSH “a's Ueey.
s2AVqMeTOIOTR 8219queTOIDTR :
(ax)
BIS yOusuON Sarsyous SiS {OuSuON S1d4OuS ‘av
aNOZO HNOZO-ON

UOTSTA DFdOIOIG OT AAV



Dime Raeaetigeene tenant per tay re wR RMD

A ata aeNlBOND fhe wrest ee

Spirometry.

The mean values representing displacement of all the spirometry
parameters in ozone and no-ozone experiments are summarized in Table 5.
The corresponding data for the comparison of the smoker and nonsmoker
groups are summarized in Table 6.

As shown in Table 5, the only statistically significant ozone/
no-ozone differenc: in the spirometry data of the smoker groups occurred
in the FVC of the 40- to 49-year age bracket. In the nonsmoker groups
(Table 5), statistically significant displacements occurred in the
ozone/no-ozone differences; (i) in the FVC of the 40- to 49-year age
bracket, (ii) in the FVC and FEF 7s. of the 50- to 59-year age bracket,
and (iii) in the FVC and FEW, of! Ears 2h o- to 59-year age bracket. For
all smokers and nonsmokers combined (Table 5), statistically signif-
icant displacements occurred in the ozone/no-ozone differences of the
FVC, FEV}, and FEF75.957- The relatively few ozone/no-ozone differences
that were statistically significant were somewhat small in magnitude
with a range of 1.3-8.9 percent. Directionally, ozone exposure décreased
the bulk of the spirometric mean values relative to the commensurate. no-
ozone values (Table 5).

As shown in Table 6, none of the ozone/no-ozone spirometric ratio
differences between all the smoker and nonsmoker groups was statistically
significant.

Discussion and Summary.

Symptom Questionnaire.

As shown previously in Table 3, all smokers and nonsmokers combined
manifested small but statistically significant displacements of symptoms: .
associated with ozone exposure. These total-group displacements were. due
mainly to larger symptomatic displacements in the 40- to 49-year-old. non=
smokers both at altitude and postaltitude, and in the 50- to 59-year-old° ~
smokers only at altitude. The largest symptom mean score. of 16.0 in the.

40- to 49-year-old nonsmokers lies between "slight" and “moderate” accord-
ing to the symptom rating scale shown in Figure 3. .

In four ozone studies conducted to date at altitude (si
with treadmill exercise included, and Studies 3 and: 4 under
ditions only) (7), the bulk of the symptom mean scores. o.
at altitude were greater than those occurring. approximatel: 20
cessation of the ozone exposure at the postaltitude time 6:
assessment. This generally corroborates a previous” observa ‘ton
recovery from completely reversible degrees of ozone syaptoms
somewhat rapidly after, cessation of ozone exposure. :

(7), the largest symptom mean score of li. 4 occurred at alt: ;

13



;
is

(aueo;3FUSTS ION) OT"O # 7

(queozsTUsts 30ON) $0°O =

SiayousuoN pue exeyous

(so > 4) 60°9 = a sdnoip ey
2° OT/02 8°L2/02 6°L/0% 0°9%/02 €70T/0z %°L2/0% 0°6/02 0°Sz/0z
0°€/0Z €° 61/02 £°S/0% £°@2/0% 9° L/02 8°6T/02 9°S/0% 92/07,
I
“a's ueey ‘a's uBeR | Jas ueay ‘a's ue
uofF}oVIg UsTTeUS . uoF deag UaTTEUS
S1ayOUSUON s2z2,70Us sisyousu0N srayous

NOZO NOZO-ON

Aapnoy TenszA jueIsta Pdox04E «= */-WIGVL



TABLE OF CONTENTS

SECTION I INTRODUCTION by C. E. Melton
References

SECTION IL GENERAL METHODS by C. E. Melton

SECTION III EFFECTS OF OZONE ON HEART RATE AND SHORT-
TERM MEMORY by E. A. Higgins
Introduction
Results
Heart Rate -
Wechsler Memory Scale
Discussion and Conclusions
References

SECTION IV SPIROMETRY STUDIES AND SYMPTOM
QUESTIONNAIRE by M. T. Lategola
.Methods
Results .
Symptom Questionnaire
Spirometry
Discussion and Summary
Symptom Questionnaire
Spirometry
Summary
References

SECTION V THE @FFECTS OF OZONE ON PHOTOPIC,
MESOPIC, AND SCOTOPIC VISION. by
J. A. Vaughan
Introduction
Methods
Photopic Vision :
Mesopic Vision
Scotopic Vision - Dark ‘Adaptation
Results
Photopic Vision
Visual Acuity :
Stereoscopic Acuity
Vertical and Lateral. Phorias
Accommodation :
Farnsworth Panel D-15 Color ‘Test
Hand-Eye Coordination -.
Blink Rate and Range.
Mesopic ‘Vision
Visual Fields —
Retinal Bleach Recovery Tine

ve

wow

WAUUUN



of blink rate were made by an outside observer looking into the
altitude chamber through a one-way glass temporarily positioned
over the window. One observer counted the eyeblinks with a labora-
tory counter while a second observer timed the procedure for 1 min
with a stopwatch. Four 1-min counts were made by the same observer
on each subject; means and ranges were calculated later.

Mesopic Vision.

The bleach recovery test was conducted using the numbers with
the visual acuity fraction of 20/60 (2.5-mm height) on the slide.
The observer occluded the test numbers and set the test light at 5.5
(on a scale of 7.0) log units, and the test subject again positioned
his head on the chinrest. The bleaching lights (700 £1) were turned
on for 3 min; immediately following the bleach, the observer simul-
taneously removed the occluder and started a stopwatch. Bleach
recovery time was the number of seconds required for the subfect to
read the numbers correctly.

Visual fields were determined under mesopic vision conditions
(chamber lights out but windows uncovered) with the Harrington-Flocks
Multiple Pattern Visual Field Screener (Model B-11). Errors were
recorded for 10 presentations to each eye. 7

Scotopic Vision - Dark Adaptation.

After the subjects were given a final briefing, the overhead
lights were extinguished. Each subject positioned his head onthe
chinrest of the light chamber of the Goldmann-Weekers: Adaptometer
(Haag-Streit) with the test aperture occluded, and two. 60W bleaching
lights reflecting 700 fL were turned on for. a period of 3 min. - ‘Tame~
diately. after the lights. were turned off, the-subject..donned a pair. of:
opaque goggles and wore them for the next 25 min. The subject: then took
off the goggles and repositioned his head on the chinrest. For-:esch: sco--
topic vision test, a black velvet cloth was draped around. the subject's. :
head and shoulders to exclude any ambient light. The ‘subject -was:.
asked to gaze at a dim, red fixation light about 11° above the. test
plate mounted in the aperture.~ The. test plate, 5.5 cm in diameter,
consisted of alternating black and white bars: (100. percent contrast).
The black bars were opaque but the translucent white.bars: traneiitted...
49 percent of the light and were blacklighted by a 9W test. lamp. “The
intensity was controlled by the observer, from 0 to 10. nL-as t-"
brated with the Pritchard Spectra Photometer, Model 1970-1 . The
illumination, intensity. of the test light: was synchronized with.a
mechanically linked. recording arm and stylus.thet traveled verticall
along the ordinate of a chart: attached to a rotating drum.
test light.turned to its. lowest: position: (no light).,° the: ob:
signaled "ready" and-slowly increased the. illumination. wi:
-light. The test: subject. tapsed the instant he could. iden
orientation of the. bara (horizontal, vertical, . OF: oblique)
observer perforated the chart with the stylus’ at that: point.
observer then: changed the orientation of..t! bars and the pi

260

‘Wc emcwtepge pete semnenen rr

1



SECTION IV
SPIROMETRY STUDIES AND SYMPTOM QUESTIONNAIRE
M. T. Lategola
Methods.

In this study (Study 4), experimental orientation of the subjects
consisted of a 45-min exposure to a chamber altitude of 6,000 ft MSL
while breathing only ambient air. During this altitude exposure, each
subject experienced a practice run for each test to be employed during
the actual subsequent experiments. Each subject also underwent spiro-
metric recording of at least three forced vital capacity (FVC) efforts
immediately before and after the altitude orientation session. This
procedure served the dual purpose of practice and additional medical
screening. The sbject was disqualified if postaltitude spirometric
function was abnormally displaced from that of the prealtitude assessment.

After completion of the practice session, each subject who remained
qualified was scheduled to return for two subsequent experiment sessions
which were conducted 1 week apart.

The first procedure of the actual experiment was a symptom
questionnaire. The questionnaire, which is a slight modification of
one used in a previous study (5), is shown in Figure 3. This question-
naire was administered to each subject by the same person throughout
all four of. our ozone studies. The subject was first requested to
perform one maximum-volume inspiration and expiration, and was then
queried concerning the presence and degree of discomfort in each of
five symptom categories as listed in Figure 1. This procedure was
completely repeated by the 10th min after the subject exited the alti-
tude chamber lock as an assessment of immediate residual effects. The
subject was then asked to recall the presetice and degree of discomfort
in each symptom category during the whole altitude period. The numeri-
cal rating for each degree of discomfort is shown in Figure 1.. The.
postaltitude symptomatic response was represented by the summation of
the numerical differences in each symptom category between the prealti-
tude and postaltitude assessments. The symptomatic response for the
whole altitude period was obtained by the same type of mathematical
comparison with the prealtitude assessment. In this manner, each sub-
ject served as his own control in each experiment. Thus characterized,
the symptomatic response of each subject in the no-ozone experiment was
compared to his response in the ozone exposure experiment. — Because
smokers and nonsmokers were used in this study, the effect of ozone'on -
symptoms in these two groups was assessed by comparing the ratio of the
ozone/no-ozone symptomatic response of smokers to the corresponding —
ratio of nonsmokers.



(6,9), ozone concentrations of 0.5 ppmv and 0.75 ppmv clearly and
significantly displaced the spirometric functions of smokers more
than those of nonsmoekers. The statistically significant separation
of smokers’ versus nonsmokers’ spirometric decrements did not occur
until the second hour of ozone exposure. In one cf those studies
(6), the greater decrements in spirometric function which occurred
in the smokers after a 2-h exposure to 0.75 ppmv ozone were paradox-
ically accompanied by symptomatic displacements, which were much
less than the corresponding symptomatic displacements of the non-
smokers. If generally true, this dissociation of symptomatic and
spirometric responses in smokers could make the smokers more vul-
nerable than the nonsmokers to intrapulmonic ozone damage, because
of the diminution or absence of symptomatic warnings during unexpected
ozone exposure.

Summary.

Under essentially sedentary conditions of altitude exposure
(6,000 ft MSL), the threshold for reversible adverse effects of ozone
on subjective symptoms and objective spirometric function in 40- to 59-
year-old men appears to be right at a 3-h exposure to 0.3 ppmv.
Populationwise, this would be relevant to sedentary male passengers
and cockpit aircrew. The general disappearance of ozone symptoms within
4h of cessation of experimental ozone exposure probably implies that
such displacements due to a single exposure of 0.3 ppmv ozone for a 3~h
duration are completely reversible. The symptoms and spirometric func-
tions of the smokers as compared to nonsmokers did not manifest statis-
tically significant differences. The symptom data of this study
strengthened a tentative deduction from Studies. 2 and 3 that, in the
presence of unavoidable exposure tc ozone, some degree of intrapul~
monic protection might be afforded by breathing only through the nose. —



Independently, each subject was given the unrestricted option
of terminating the expsriment at any time of his choosing. Single
indications for immediate termination of the equipment were inap-
propriate dyspnea, audible wheezing, substernal chest pain, ataxic
gait, general pallor, or ECG indications of ischemia and/or arrhythmia.
These cessation criteria are somewhat standard in ozone experiments
of this general type (5). A staff physician and emergency resusci-
tation equipment were immediately available in case of need.

Results.

To compensate for any potential effects due to experimental order,
half the number of males underwent the ozone exposure in the first
experiment, and the remaining half underwent the ozone exposure in
the second experiment. The data were pooled and compared on the basis
of no-ozone versus ozone exposure.

Symptom stionnaire.

Mean scores for subjective symptoms in the no-ozone and ozone
exposure experiments are summarized in Table 3. The symptom mean
scores of smokers and nonsmokers are summarized in Table 4.

As shown in Table 3, the only statistically significant ozone/
no-ozone difference in symptom mean scores of the smoker group occurred
in the 50- to 59-year age bracket at altitude. In the nonsmokers
(Table 3), (i) both the postaltitude and altitude ozone/no-ozone dif-
ferences were statistically significant in the 40- to 49-year age
bracket, and (ii) the altitude ozone/no-ozone difference was statis-
tically significant in the entire 40- to 59-year age bracket. For
all subjects combined (Table 3), the ozone/no-ozone differences both
at altitude and postaltitude were statistically significant. The
largest ozone/no-ozone difference in symptom mean scores of the smoker
groups was 7.0 and occurred at altitude in the 50- to 59-year age
bracket, whereas in the nonsmoker groups the largest difference was
13.0 and occurred at altitude in the 40- to 49-year age bracket..

As shown in Table 4, none of the ozone/no-ozone symptom ratios
between all smoker and nonsmoker age groups was statistically
significant. Also shown in Table 4, the ozone/no-ozone syaptom.
mean ratios of the 40- to 49-year-old nonsmoker group were ‘larger
than corresponding ratios of the 40- to 49-year-old smoker group, 3
whereas the ozone/no-ozone symptom mean ratios of the 50- to 59- :
year-old nonsmoker group were smaller than corresponding. ratios of
the 50- to 59-year-old smoker group.

In the entire study, no experiment had to. be terminated because
of symptomatic stress on the part of any subject.



was repeated twice more within the 2~min period. The subject was then
allowed to remove his head from the apparatus for 6 min, and three more
consecutive measurements were taken in a second 2-min period. This
modified procedure replaced the usual method of measuring dark adapta-
tion (taking a point at 1- or 2-min intervals) because trial runs
demonstrated a large decrease in ozone concentration breathed by the
subject with his head in the adaptometer during the first 30 min,
whereas ozone concentration decrements were small during the two 2-min
test periods.

During the numericai recognition test, the subject maintained
scotopic vision while the observer removed the bar test plate and posi-~
tioned a plastic visual acuity slide on the adaptometer. The slide
contained six groups of numbers in graded sizes, of which only four
groups were used. Each group contained three two-digit numbers. Heights
of the numbers were 1.0 mm, 1.5 mm, 2.5 mm, and 4.5 mm, with visual .
acuity equivalents of 20/25, 20/35, 20/60, and 20/105, respectively,
after correction for viewing distance of 30.cm recommended for the
adaptometer (3). With the occluder in place, the test light at the
lowest position and the subject's head on the chinrest, the observer
removed the occluder and slowly. increased the target illumination until
the subject again signaled "stop," and identified the six numbers. As
before, the subject repeated the procedure until the four groups of
numbers were réad. :

Statistical analysis of the data consisted of an analysis of
variance for a three-factor experiment with repeated measures. Statis~
tically significant interactions were further tested by analysis on ~
interactions between variables using the simple effect method (10).

Results.

Photopic Vision.

Visual acuity. The effects of ozone on distant: visual
in terms of the Snellen fraction, are presented in Table /7..°° Co:
vision was significantly poorer in the older age group,. but: ther:
no differences in visual acuity that could be attributed ‘to. the:
of ozone or to smoking habits. Sixty pércent of the test “subse
the 40- to 49-year age group and 45 percent of the subjects ‘tr.
to 59-year age group tiaintained visual acuities of 20/20 or better. .
(20/13 to 20/20) for a total of 21 subjects, or 52.5 percent in the
complete sample.

Stereoscopic acuity. Results of the analysis: of variance for
stereoscopic acuity showed no significant changes with ‘age
habits, or ozone (Table 8). During preexposure éxaminat: each:
ject wae tested for stéreopsis with a Titus Vision Tester
book teat, both of which presented characters identical with ‘those
the Titmus Vision Tester used during the two actual exposures.~

25


*SieyousuOt pue B1eyOMS Z0J sInsodxe suozO-oU pue aangodxe @uoz0 JO: UOT?
~duny © Se pesserdxe ‘(spTo-1vet-G¢ 03 -05 Pue SEPTO-1Be4-GYy 03, -0y) sdnorB OB:
OA} 10} UOFIFFASpP prepusrs snuyw 10 sN{d ‘ates Aroma JeTSyIS4 Jo ydess ivg

) A J ¢ i ) ¢
© © .°° C)
fo ££ 8 #8
»~ yy a : TM
1a ‘001
" Ole
= - on ia bul
2 = = g
= Fa = 40212
= = 5 ,
i z Ef 2
= = = 0c16
g = = a
: Fy = a
= = = z
3 : z jours
: : osi
SUBAONSNON SY3XOWS SYBXOWSNON SY3xONS
CH Ky os:
“ 010 SUVA 66-05 G10 SUV3A 6b-OF

3WIS AMOWSW Y31SHI3M



‘
|
|
|

eis aes at

SECTIUN III

FIGURE 1.

FIGURE 2.

SECTION IV

FIGURE 3.

LIST OF FIGURES

EFFECTS OF OZONE ON HEART RATE AND SHORT-
TERM MEMORY

Bar graph of mean heart rate, plus or minus
standard deviation, for two age groups (40-
to 49-year-olds and 50- to 59-year-olds),
expressed as a function of ozone exposure
and no-ozone exposure for smokers and
nonsmokers.

Bar graph of Wechsler Memory Scale, plus or
minus standard deviation, for two age
groups (40- to 49-year-olds and 50- to 59-
year-olds), expressed as a function of
ozone exposure and no-ozone exposure for
smokers and nonsmokers.

SPIROMETRY STUDIES AND SYMPTOM QUESTIONNAIRE

Symptom questionnaire.

21



2.

3.

6.

7.

10.

11.

13.

REFERENCES

American College of Chest Physicians, Committee on Pulmonary Disease.
Clinical Spirometry, DIS. CHEST, 43:214-219.

Blackburn, H., H. L. Taylor, H. Okamoto, P. L. Mitchell, P. M. Rautaharju,
and A. C. Kerkhof: Standardization of the Exercise Electrocardiogram: A
Systematic Comparison of Chest Lead Configurations Employed for Monitoring
During Exercise. In Physical Activity and the Heart, M. J. Karvonen and
H. Barry (Eds.), Springfield, Illinois, A. H. Thomas, pp. 101-134, 1966.

Cugell, D. W.: Guide to Modern Lung Function Tests, HOSP. MED., 14:57-68,
1978.

Gelb, A. F., and B. J. MacAnally: Early Detection of Obstructive Lung
Disease by Analysis of Maximal Expiratory Flow-Volume Curves, CHEST,
64:749-753, 1973.

Hackney, J. D., W. S. Linn, R. D. Buckley, E. E. Pedersen, S. K. Karuza,
D. C. Law, and A. Fischer: Experimental Studies on Human Heelth Effects
of Air Pollutants. I. Design Considerations, ARCH. ENVIRON. HEALTH,
30:373-378, 1975.

Hazucha, M., F. Silverman, C. Parent, S. Field, and D. V. Bates: Pulmonary
Function in Man After Short-Term Exposure to Ozone, ARCH. “ENVIRON. HEALTH,
27:183-188, 1973.

Higgins, E. A., M. T. Lategola, J. M. McKenzie, C. E. Melton, and _

J. A. Vaughan: Effects of Ozone on Exercising and Sedentary Adult Men
and Women Representative of the Flight Attendant Population. FAA Office
of Aviation Medicine Report No. FAA~AM-79-20, July 1979.

Horvath, S. M., J. A. Gliner, L. J. Folinebee, and J. FP. Bedi: Physio-
logical Effects of Exposure to Different Concentrations of Ozone. In

Environmental Stress: Individual Human ‘Adaptations, L. J. Folinsbee and
J. A. Wagner (Eds.), Academic Press, pp. 125-148, 1978.

Kerr, H. D., J. T. Kulle, M. L. McIlhaney, and P. Swidersky: Effects st
Ozone on Pulmonary Function in Normal Subjecte, AM. REV. RESPIR. DIS.
111:763-773, 1975.

Kleinfeld, M.: Acute Pulmonary Edema of Chemical Origin, ARCH. ENVIRON. .
HEALTH, 10:942-946, 1965.

Report of the Snowbird Workshop on Standardization. of: spaioiery; y
THOR. SOC. NEWS, 3(3):24-27, 1977.

Stokiager, H. E.1 Ozone Toxicology, ARCH. ENVIRON. HEALTH, 10:7:
1965. eo A ES

Yokoyama, E.: Comparison of the Uptake Rate o£ ‘Insp:
Gases. in the Upper Airway, J. JPN.°SOC. AIR POLLUT.

22.



~ - SesaNgsermaetr muss:

Spirometry Data, Ozone Versus No-Ozone

Postaltitude Value
Prealtitude Value * 100

FEV, /FVC
FvC xIoo FEF 25-75% FEF 50-75% FEF 75-95%
(1) Ozone X 98.3% 100.4 102.0 102.2 103.3
SE 11 0.4 0.8 1.4 1.2
(1)No-Ozone X] 101.8 99.6 102.6 102.7 104.1
SE 1.0 0.5 1.9 2.2 2.4
(2) Ozone X] 99.8% 99.7 98.0 96.8 93.0%
SE 0.3 0.6 2.4 2.4 2.0
(2)No-Ozone X{ 101.1 100.3 103.1 103.4 101.9
SE 0.4 0.5 2.4 2.2 3.2
(3) Ozone =X! 99.2% 100.2 100.0 99.5 "98.2
SE 0.6 0.3 1.3 1.5 1.6
(3)No-Ozone X] 101.5 200.0 102.9 103.2 103.0 -
C.6 0.4 1.5 1.5 2.0
(4) Ozone X{ 97.9%] 98 100.5 98.9 99.1 93.6
SE 0.6 0 0.5 1.5 1.2 2.6
(4)No-Ozone X} 100.1 | 100. 100.2 101.0 101.9 97.5.
SE 0.6 0. 0.5 1a. 1.0 - 8
(5) Ozone X{ 100.4 | 100. 100.2 101.7 101.7,
SE 11 1 0.8 4.3 6.0,
(5)No-Ozone X| 100.7 | 102 101.6 107.0 108.8
SE 1.3 2 0.8 4.6 5.2
(6) Ozone X] 99.2 99.5 100.4 100.3
SE 0.7 1.0 0.5 2.2
(6)No-Ozone Xj 100.4 | 101.4 100.9 104.0
SE 0.7 12 0.5 2.4
(7) Gzone X| 99-24 99.4% 100.3 "100.2
SE 0.4 0.6 0.3 1.3
(7)No-Ozone X|{ 101.0 {| 101.4 100.5 103.5
SE 0.5 0.6 0.3 1.4

(1) = Nonsmokers, 40-49 years old
(2) = Nonsmokers, 50-59 years old
(3) = Nonsmokers, 40-59 years old
(45) = Smokers, 40-49 years old
G) = Smokers, 50-59 years old
(6) = Smokers, 40-55 years old

(7) = Smokers and Nonsmokers, 40-59; years old =
* = Statistically significant difference (p < 0.05)

ee = Statistically significant difference: (p < 0.01)

a9



SECTION V (Continued)

Scotopic Vision
Scotopic Visual Acuity
Numerical Recognition
Subjective Guesticnnair
Diecussion .
Summary
References

SECTION VI DISCUSSION AND CONCLUSIONS by C. E. Melton
References

27
27
27
28
28

42

43
46



SECTION V (Continued)

Scotopic Vision
Scotopic Visual Acuity
Numerical Recognition
Subjective Questicnnaire
Diecussion :
Summary
References

SECTION VI DISCUSSION AND CONCLUSIONS by C. E. Melton
References

Page

27
27
27
28
28

42

43
46



*“Sioyousuot pur B1eyOMsS Z0J sINsodxe suOzZO-oU pur aansodxa @uoz0, 30 UOT?
~duny © se pesserdxe ‘(spTo-rvet-G¢ 03 -0¢ Pue SEPTO-1BO4-Gy 03, -0y) sdnorB o8y:
0M] AOF UOTISTASP PABpUeIS sHUYH AO SNTd ‘eTeDS Aroma JeT!SyI>H Jo ydei8' reg -Z gyNOTA .

¢ ° ¢
© 2 o
$s. $F
re
Hou g
- i ful
: 2 z
= = oz a
i Z a
: Ef 2
= = 0Li6
= = a
= = am
= = z
= = Onl 4
: : jos
SUBNONSNON SU3NONS SYBXONSNON SY3xONS
SY SS sos:
a 070 SUV3A 64-0 G10 SUV3A 6b-OF

3WIS AYOWSW Y371SHO3M



i jt neat ieee

*

SECTION V

TABLE 11.

TABLE 12.

TABLE 13.

TABLE 14.

TABLE 15.
TABLE 16.
TABLE 17.

SECTION VI

TABLE 18.

(Cont'd)

Time to Complete the Farnsworth Panel D-15
Color Test

Completion Time and Errors of Hand-Eye
Coordination Test

Blink Rate and Range

Number and Percentage of Test Subjects
with Changes in Visual Fields From
No-Ozone to Ozone

Retinal Bleach Recovery Time

Scotopic Vision

The Light Energy Required to Identify
Numerals Under Scotopic Conditions

DISCUSSION AND CONCLUSIONS

Summary of Ozone Effects

35

36

37

38

39
40
41

45



approached statistical significance (p = 0.056) when compared with the
corresponding symptom mean score of the no-ozone exposure.

As reflected in Table 4, no statistically significant differences
occurred in the ozone/no-ozone symptom mean ratios between the smoker
and nonsmoker groups. Although the ozone/no-ozone symptom mean ratios
of all nonsmokers combined were greater than the corresponding values
for all the smokers combined, the direction of these data was the same
in the 40- to 49-year age bracket, but was reversed in the 50- to 59-year
age bracket (Table 4). Two previous studies (6,9) have reported that
symptomatic response to single ozone exposures was greater in nonsmokers
than in smokers. In both these studies (6,9) the subjects were 10 to
20 years younger than in our current study. The ozone concentrations
were greater (0.37-0.75 ppmv), and the duration of the exposure in one
of the two studies (9) was twice as long as in ours.

In our study, the twenty participating smokers had smoked an
average cf 30 to 35 pack years (1 pack year = one pack of cigarettes
per day x 1 year). The nonsmoker group contained 12 subjects who had
never smoked, and 8 who had substantial smoking histories but currently
had not smoked for 0.5 to 20 years. Conjecturally, it is possible that
smoking histories of those in the nonsmoker group may have contributed —
some of the directional variability seen in Table 4.

With only three exceptions, all reported ozone symptoms had disap-
peared within 4.hours after the cessation of ozone exposure. One 40-
year-old smoker reported an irritated throat and cough tasting .8 hours,
and two others (one smoker and one nonsmoker) complained of unusual
fatigue which lasted the remainder of the day. All ozone symptoms gen-
erated in this study appear to have been completely reversible...

Eye discomfort was the most prevalent ozone symptom’ reported in
this study. In descending order, headache, nasal irritation,. and throat
irritation were the next. most prevalent symptoms. This same order. of
symptom. prevalence also occurred in our third identically. conduct
study using younger male subjects (mean age of 25.2 board . The
prevalence of eye discomfort in these two studies. (Studies 3 and &)
in contrast with the more prevalent throat and substernal ‘symptoms ©
occurring in our second ozone study. This. apparent. discrepancy

the experimental protocol... Although the duration of. exposure “to
ppmv ozone at altitude was identical in Studies 2, 3, and 4, the
of three treadmill tests in Study 2 and none. in Studies 3\and 4 ‘aay.
accentuated. throat and substernal. symptoms 1: udy 2 because of

stantial increase in oral ventilation occurr. a
The occurrence of eye testing toward the end of. the.
exposure in Studies 3 and 4, and towards the ee, of. the all
ozone exposure in Study 2, may have accentuated: eye irritation. in
3 and 4 as a function of the greater duration of ozone.
the eye tests. The greater prevalence of. nasal irritat: ¢
and 4 as compared with Study 2 (7) may have resulted from re:

14



i
fF
H
'
i
i
|
j

LEVEL, C2
e
AA 8 9-9 | : ro R

© secs or gg 3h pats vm utzon, Hod GB) on gona
gerne of Ge BASSENGERS AND BERS |

a oh E. A. (Higgins \ “yoo aa

M. T. (Lategola \

Cc. BE. AMelton

| J. A. Naughan

Civil Aeromedical Institute
Federal Aviation Administration
Oklahoma City, Oklahoma

ADA092268

\

8
»,
sO

NN
%
% °

(24 racemes:

Document is availabie to the public through the
National Technical Information Service
Springfield, Virginia 22161.

Prepared. for is
U.S. DEPARTMENT OF TRANSPORTATION 2g
Federal Aviation Administration .
Office of Aviation Medicine a

Washington, D.C. 20591

0PY,

FILE CO

»

oe

0 11 28 N28



* quvoTsFOSTS 30H:
(queatsrusts 30H) 8570 = 4 _200EO Pus ouOZS
(quedzzTuS7s 308) g8°O = A sx@yousUoN pow sxedoms
(aueozz7UBTS 30N) ZS°0 = a sdnoap: o8y
se se 0°z tz off Le "9 tf erty
9% eT Te Ss‘ Te - s*z se Le,
“as WOH “ws DEON fas vFeN TS UH
Con) Cont) yowas (: OR) ; (.0N)
quesTsTUBTS ION :sudTIDeASIUT
(queopzPUBTs 30N) SS°0 = ‘u0zQ pue e10Z0-ON :
(aueotyTUBTS ION) OT"T = A SAeyousUON pus sToxOmS | :
Kto° 34) 26h w a sdnoig e8y re0TIea-d |
ole aac arse €°STt L°8€ 9°TT T've yE2T 6S 03 0S
OST L°6L 9° 9°86 Zot 2°98 8°04 €°70T 69 93 OF
"Ts Ween “Ts ween “ws ween Ts Teen
i OWIL
(s) \ (8) Z (s) (8) (44)
SAS yOUsUON Saayous ‘SAS OUSUON 5 BiVyOus gov
NOZO INOZO-ON
qsej, uoTyeuTpszcog eAq—pueH JO Si011g pue sUTL uoTyeTdwop *7T AIGVL

|



REFERENCES

Higgins, E. A., M. T. Lategola, J. M. McKenzie, C. E. Melton,
and J. A. Vaughan: Effects of Ozone on Exercising and Sedentary
Adult Men and Women Representative of the Flight Attendant Popu-
lation, FAA Office of Aviation Medicine Report No. FAA-AM-79-20,
July 1979.

Lagerwerff, J. M.: Prolonged Ozone Inhalation and Its Effects
on Visual Parameters, AEROSP. MED., 34:479-486, 1963.



oy eo RRA RY

SECTION I
INTRODUCTION
Cc. E. Meiton

Research reported earlier (1) established that 0.30 parts per million
by volume ozone (ppmv, .600ug/m) was the threshold level for mild revers-
ible pulmonary and visual effects on exercising men and women representa-
tive of the flight attendant population. The pulmonary effect consisted
of a restriction of flow and volume of expired air. The effect was inter~
preted ae being due to a constriction, obstruction, or collapse of ter-
minal bronchioles, together with upper respiratory irritation leading to
mild discomfort. The visual effects consisted of conjunctival and corneal
irritation and reduced photopic visual acuity. The latter effect may have
been secondary to eye irritation by causing tearing and/or corneal swelling.
No effects by ozone were found on scotopic vision. This lack of effect
was significant because an earlier report from another laboratory had
reported positive findings in this regard (2).

No effects of ozone were found on blood cells or plasma; negative
results were also found for urinary 17-ketogenic steroids and catecholamines.

Subjective effects of 0.30 ppmv ozone varied from one person to another
and consisted of cough, nose and throat burning, eye irritation, substernal
pain and headache. These symptoms outlasted the period of exposure to ozone
by several hours to several days; all symptoms eventually disappeared,
however. The effects attributed to ozone conformed generally to the symp-
toms reported by flight attendants.

Exercise was clearly an aggravating factor because 0.30 ppmv ozone was
without marked effect on sedentary subjects representative of the flight
attendant population. Exercise exacerbated the effects of ozone by increas—
ing the rate and depth of respiration. Also, exercising subjects breathed
through a mouthpiece, thus circumventing the ozone-scrubbing effect of
nasal breathing. These findings led to the observation that nasal breath-
ing and avoidance of exercise by passengers and crew would minimize effects
of ozone exposure.

Female subjects showed quantitatively the same pulmonary effects shown
by males but at a lower level of exercise, suggesting that fenales are .
more susceptible to ozone than are males. Fewer complaints of "ozone sick-
ness" from flight deck crews than from flight attendants may be related to
the fact that most pilots are males with sedentary duties, whereas most
flight attendants are females and are physically active in flight.

The present study was undertaken tc define the effects of 0.30 ppmv
ozone on flight crew surrogates. The ozone concentration was chosen. because,
as outlined above, 0. 30 ppmv wae found to be the threshold level for’ ‘effects
on flight attendant surrogates.



38U0FIIB19IUT

JUBIFFFUBTS ION
(JUBITZTUBTS ION) BzZ°T = A @U0zZQ pue aU0Z0~ON
(aue2F3TUBTS ION) 7Z0°O = szayomsuON pur sIeyowS
(queoTzTUBTs JON) 0£°O = A sdnoig a8y 1soTawy-4
Tut $'6Z Stet 0°8z elt 0°62 $°6 9°€s. 6S 92 0S
€°Sz ‘0°82 Le 0°9€ z°sz $*8Z L°0% €°te 64 93 OF
‘a's veep ‘a's weay ‘a°s weaR “a's ueeN
(34)
spuodses O12 spuooes 2.
(sp § o4y) (spuooseg ory) 29¥
srey_ousuoy slayoug siey_ousuoN sreyoug
JNOZO 3NOZO-ON

Ayynoy oFdoosos199g “g FIEVL



eafeuuoyysenb wozduss ‘¢ mana

stnguyed ATTveTO. Puv quese7dwogduAs « oxeAeS = of =

buyfouue PUe queserd woxdats = ‘S3RI0POH = oz

' -puypdouwe FOU anq qeserd woxduts =, aeTTS = Ol

*‘gxogmoostp Jo eouesezd: zo eansun = oes =.S *@UOH =O... -

SEMOSWOOSIG OIINWOLAWAS JO amid OI SONTIVE

xeu30: *

—suSepeon
COE)
sHoqyeyexa xepun
——4R0ra

?NI JYOUNOISIG

FANLILTWLSod

SCNLILTy SONLILTWaad WSTTACIHD WOLAWAS

INOZO-ON

INOZO aiwd . STWILINI aw ‘# coarans

al al ol eh wd

“2k?


|
id

(quesp37uszs JON) .Zzo°e = A
(so°. 3-4) ote =a

 queo7yFu87s. 30N. :teueTaoeaeauT

auozo, pur’ atiozo=oN

STSFOUSUON pue sAazONg:-

(queo;zFUsTS ION) O9‘T = J “.; adnoag:28y
ey 19 1 9°6 st 66 te. | gk
€°s £8 €°s €°8 B°€ 00°2 ty 8

HONVa

squeozyyUszs JOU sUOFIOeAaIUF 19Y4IO TTY *(S0° > 4) On" = A ‘OE ueeMzeg :su0F}987930]

(i0' 34) et'st = 4 @U0ZQ pus aU0ZO-ON

(queofzyus8ts JON) ZZ°T =a SAVAOWSUON puke SIBAOUWS
(queofzFUBTS 20N) 98°O = 4 sdnoig ey 280F38Y-J
6h 0°9T 26 T°% 9°s L'6 ork =| Tet] «6S 93 OS
€°6 9°tz $‘OT 8°LT 16 Lot 0°6. est | 6% 03 oF

"as wesH "Ts wea “a's way “Ts Wee
ALVA NITE :

(upa/a) (uyw/a) (urw/a) (vra/a)

sisyouUsuoN sisyous SlayOWSUON sileyousg Gy
INOZO INOZO-ON

aBuey pue a3ey AUTTA “CT ATAVL



TABLE 6.
Smokers Versus Nonsmokers

Ozone: Postaltitude Value
Prealtitude Value

Spirometry Data

S = smoker NS = nonsmoker
(1) = 40-49 years
(2) = 50-59 years
(3) = 40-59 years

20

No-Ozone: Postaltitude Value * 100
Prealtitude Value
FEV, /FVC
FVC FEV, x Too FEF 25-75% FEF 50-75% FEF 75-95%

X}} 97.8| 98.2 100.4 97.9 97.3 95.9
qa) s

SE 0.8] 0.7 0.5 0.7 12 1.3

X|] 97.6] 97.5 100.9 99.7 99.8 99.6
(2) Ns

SE 1.6] 1.5 0.6 2.0 2.3 2.3
8 X}| 99.8] 98.4 98.6 95.3 93.4 91.6

sE{] 0.4] 0.6 0.5 2.2 2.5 — “26 |

X]} 99.0]. 98.2 99.4 95.2 93.7 91.8.
(2)- NS a

SE 0.4] 0.4 0.3 1.7 1.7 2.4,

X}} 98.4] 98.2 . 97.1 96.1 94.8
a) s 99.9

SE 0.5] 0.4 0.3 0.9 11 1.2

X]] 97-91. 97.9 100.2 97.5 96.8 95.7
(3) NS oo ‘ .

SE 0.9} 0.8 0.4 1.4 1.6 ; i ee oe
X= mean. SE = standard errer of the mean.



SS wey owen enna ore

SECTION IL
TABLE 1.

SECTION III

TABLE 2.

SECTION IV

TABLE 3.

TABLE 4.

TABLE 5.
TABLE 6.

SECTION V

TABLE 7.
TABLE 8.
TABLE 9.

Ta'sLE 10.

LIST OF TABLES

GENERAL METHODS

Age-Height-Weight Characteristics of the
Subject Population

EFFECTS OF OZONE ON HEART RATE AND SHORT-
TERM MEMORY

Results of Wechsler Memory Scale (in

Memory Quotient Scores) for Each of the
Groups Studied

SPIROMETRY STUDIES AND SYMPTOM QUESTIONNAIRE

Subjective Syaptom Scores
Ozone Versus No-Ozone

Subjective Symptom Scores
Smokers Versus Nonsmokers

Spirometry Data, Ozone Versus No-Ozone

Spirometry Data
Smokers Versus Nonsnokers

THE EFFECTS OF OZONE ON PHOTOPIC, MESOPIC,
AND SCOTOPIC VISION

Photopic Distant Visual Acuity
Stereoscopic Acuity

Changes in Vertical and ‘Lateral Phorias
From No-Ozone to Ozone Conditions

Accommodation

17

18

19
20

“31



After completing the prealtitude questionnaire, each subject
underwent spirometric assessment of mechanical pulmonary function.
This consisted of recording a minimum of three maximal FVC efforts
using a precalibrated electronic spirometéz*. During each FVC
effort, the subject was seated in an upright position with a rubber
nose clip in place. This FVC maneuver was conducted in accordance
with a standard clinical spirometry procedure (1). The aubject was
allowed to rest for 1 min between maximum FVC efforts. The FVC,

1-s forced expired volume (FEV)), FEV, /FVC x 100 (FEV%), forced
ee orery flow eee 75% ie and forced. endexpiratory flows

and FEF 7 5_. were selected from the data representing
& ne 28605% of three 22088 ‘able FVC efforts. The best effort was
defined as that which yielded the largest sum of FVC + FEV, (11).
All volumes were expressed in liters, corrected to body tedperature
and pressure, saturated (BTPS). The three FEF parameters were
included in this assessment because of their sensitivity in detec-
tion of changes in peripheral airway resistance (3,4). Spirometric
assessment was repeated immediately after the exit of each subject
from the altitude chamber lock. The postaltitude FVC response of
each subject was expressed as. percent of his prealtitude control
value (postaititude value/prealtitude value x 100). The postaititude
responses of the other five spirometry parameters were similarly cal-
culated and expressed. In this manner, each subject served as his
own control in each experiment. Thus characterized, the spirometric
Tesponses of each subject in the no-ozone experiment were compared to
his responses in the ozone exposure experiment. The effect of ozone
on the spirometric responses of the smokers and nonsmokers was
assessed by comparing the ratio of the ozone/no-ozone response of
each spirometry parameter in the smokers to the corresponding ratio
of each spirometry parameter in the nonsmokers.

Prior to ascent to altitude, three adhesive electrodes were |

attached to the chest of each subject for monitoring and recording
(manubrium to V, plus ground) single-lead ECG (2) at altitude.

The three chest electrodes were connected by shielded wires to a
phone jack which was plugged into an Avionics ECG tape recorder
for continuous recording of heart rate as described elsewhere in this
report. A plug-in junction box, accessible within the altitude
chamber, was electrically connected to a standard clinical“ ECG
recorder located on the outside of the chamber,. In the inlikely but
possible event of any subjective cardiac symptoms during altitude
exposure, the phone jack could be unplugged immediately from 't! .
Avionics recorder and. plugged into the: junction box for instantaneous
monitoring and recording of the singlé-lead ECG. "Viewing: t . :
iine recording, an attending staff physician could ‘decide ‘ famedi ely
about termination or continuation of the expérinent, : ‘

*Model M-10, automated spirometer, SRL Medical, Inc., Dayton, Ohio.



different only for the largest numerals (20/105) and show an overall
increase in light energy with ozone (p<_.05). The interaction between
the ozone condition and smoking habics is barely significant at p <_.05
and the analysis by the Simple Effects procedure (10) revealed no sig-
nificant differences among the separate variables of smokers, nonsmokers,
no-ozone, or ozone. The significant result found (for the 20/105 column)
and the interaction were probably caused by distribution of the data,
because the larger numerals are more easily seen and results are more
uniform.

Subjective Questionnaire.

At the postexposure debriefing sessions, 10 test subjects
reported burning and/or watering eyes during exposure to 0.30 ppmv
of ozone. In the 40- to 49-year age group, one smoker and two nonsmokers
complained of slight to moderate burning eyes. No watering eyes were
reported for this age group. In the 50- to 59-year age group, seven
smokers and three nonsmokers reported slight to moderate burning or water-
ing of the eyes during exposure to ozone, but only one subject reported
watering in the no-ozone environment.

Discussion.

_ Analysis of variance revealed some differences in the vision
parameters examined in this experiment attributable to ozone. Lager-
werff (6) also investigated several visual functions in an atmosphere
of ozone. Although methods differed, his results agree. with those of .
this study in that photopic distant visual acuity, stereoscopic acuity,
vertical phoria, and color vision were not significantly influenced by
by a 3-h exposure to 0.30 ppmv of ozone. The data in Table 7 show a
small but significant. increase in the Snellen Fraction between the age
groups; the 50- to 59-year age group had slightly poorer. vision,
which can be attributed to presbyopia. The optical differences are
slight and have-no practical meaning. The hand-eye coordination test
was also not affected during exposute to ozone (Table 12). In each’ con-
dition the older age group took more time to complete the test than
the younger age group, but made about the same number of ‘errors. .

Lagerwerff did report a sizable decrease in scotopic vision with
ozone. The values in Table 16 also show that a higher threshold. of:
dark adaptation occurs when the subjects are exposed to ozone. However ,
further analysis of the interactions between variables reveal that this
significant increase is caused by the smokers in the 50- to 59-year-age
group only (p< _.01) but not for the remaining variables. Increase in
visual threshold here. is not caused exclusively by ozone, but is a fac--
tor of age and smoking habits. An earlier study with conditions iden-
tical to this study But with younger test subjects revealed on signifi- .
cant differences in dark adaptation with ozone (4). Fourteen ‘male test
subjects from that study (age 20 to 33 years). were compared with. the :
20 older subjects (50 to 59 yéars) of this study (Table 16). “In the



a A A a A mt
aN

younger age group, the mean visual threshold in terms of light energy
for scotopic vision with no-ozone was 0.46 uL compared with 0.54 uL in
the older age group of Table 16. With ozone, the mean threshold was
0.57 uL for the younger group and 0.72 wL for the older group. Mean
light energy values for the 40~ to 49-year age group were 0.46 wL and
0.50 uL, and were similar to those of the 20- to 33-year group of the
previous study. Adler (1) states that scotopic vision begins at approx-
imately 1.0 uL and is in effect with increasing illumination up to 550
uL. The data of this report are well within that range, and the subjects
may be considered to be dark adapted.

McFarland attributes the limitations in dark adaptation in older
subjects to an interference of normal metabolic processes within indi-
vidual nerve cells of the brain and retina. This interference may operate
through a reduced rate of transfer of essential substances required for
normal metabolic processes (7). The reason why smokers in the older
age group “showed changes with ozone is not clear. Impairment of night
vision by the byproducts of smoking (e.g., carbon monoxide) is gén-
erally ted, and the presence of ozone may be additive and respon- ~
sible for the increase in the final threshold levels ‘for vision in”
older subjects.

Lagerwerff also reported that 76.9 percent of his subjects demon-
strated a net increase in peripheral vision in an ozone concentration of
0.35 ppmv during a 3-h exposure period (6). Values of visual fields of
this study shown in Table 14 do not agree with Lagerwerff's results. The
only categories that showed an increase in visual fields with ozone was -
the left eyes of the smokers in the 50- to 59-year age group and the non-
smokers in the 40- to 49-year age group. Forty to sixty percent of the
subjects showed no change in visual fields with ozone, as measured. with
the Harrington-Fiocks Screener.

The mechanism for the differences in the near point of accommodation
between the "in-to-blur" and the "out-to~clear" procedures is not clear _~
(Table 10). Paired t tests between the two procedures for the subjects in
the ozone condition were not statistically significant in either the 40-
to 49-year age group or the 50- to 59-year age group: Armstrong-(2) ©
describes the "out-to-clear" procedure as part of the examination for pro-~
spective pilots using Prince's rule, but. offers no further information;
data are also lacking in the general literature on the subject. The
causes are not part of the convergence-accommodation controlled at the
higher neurological centers because measurements were monocular, in which
mechanisms involving nuclei of the third cranial nerve do not apply.
Whatever ‘the mechanism, it is probable that the response is not associated
with ozone exposure. :

An increase in the rate of eye blinks is a symptom of eye irritation

from one source or another. Study of the data in Table 13 indicates a
significant increase in blink rate (p<_.01) when subjects are exposed

29



Se ro as

SECTION VI
DISCUSSION AND CONCLUSIONS

Cc. E. Melton

The presence (+) or absence (-) of adverse effects of ozone on
the various measurements made in this study are shown in Table 18. The
reported effects on mentation (3) were not confirmed by the measure-
ment of short-term memory in this study, nor were effects seen on
heart rate. The effects that were seen were related to contact of
ozone with body surfaces such as the respiratory epithelium or the
exposed portion of the eye. In all probability the several effects
on vision were related to tearing and, perhaps, corneal swelling
rather than to blood-borne agents acting on the retina. The visual
effects are inconsistent. They are difficult to explain if it is
assumed that the effects are caused by toxic substances in the blood.
For example, ozone differentiates, with a high level of probability,
between "positi:e" accommodation (in-to-blur) and "negative" accom
modation (out-to-clear). In order to explain this finding, one would
have to postulate different neuromuscular mechanisms for "positive"
and "negative" accommodation, one of which was impaired by ozone and |
one not impaired. Sympathetically mediated active distance accon-. -
modation has been claimed to exist to account for the dioptic change
from the rest point of accommodation to infinity, but not for dioptic -
changes from the near point to che rest point (4). These ocular
effects are more reasonably explained by eye irritation complained
of subjectively by the subjects and shown objectively by the increased
blink rate of some subjects in ozone.

It appears that smoking does mitigate the pulmonary symptoms of
ozone exposure. Adverse spirometric effects of ozone are more numerous
among nonsmokers than among smokers. This mitigating effect of smoking
may be related to ozone scrubbing by residual smoke products’ in the
deep lung, though such an effect could not influence subjective. symp-
toms in the upper portion of the respiratory tract. It is also possible
that smoking desensitizes the respiratory Passages to sensations caused
by acute exposure to ozone.

The data of this study generally confirm those of our earlier a
studies in that 0.30-ppmv ozone is at or near the threshold for adverse
effects of ozone (2). Apparently, there is a good deal of individual.-
variability. Earlier studies showed 0.30 ppmv ozone to be generally .
ineffective on sedentary nonsmoking subjects in their third decade of
life.

The question remains somewhat open regarding the interactifon of, a
ozone level and exercise. Folinsbee has. carried.out some studies -in this
regard and has found that 0.10 ppmv ozone at ground level was innocuous.
with heavy exercise (1). We found. 0.20 ppmv ozone to be innocuous..to
flight attendant surrogates undergoing. intermittent ‘mild exercise at.
altitude. :

43



POOR RENE Nate neni nnn

|

. — orem

Subjective Symptom Scores

Ozone Versus No-Ozone

(Postaltitude)-(Prealtitude)

No-Ozone No-Ozone
4.0 1.0 3.0 - 3.5
2.1 1.0 1.5 1.8
2.5 0.5 9.0 2.0
1.1 0.5 2.8 1.3
3.3 6.8 6.0 2.8
1.2 0.6 1.7 11
10.5 1.0 16.0 3.0
4.0 1.0 4.2-- 1.5
2.0 3.5 7.0 6.0
1.3 2.1 3.7 2.7

G3 NS 6.3 2.3 11.5 4.5
2.3 1.2 2.9 1.5
4.8 1.5 8.8 3.6
1.3 0.7 1.7 0.9

X = mean.’ SE = standard error of the mean.

S = smoker NS = nonemoker

(1) = 40-49 yeara

(2) = 50-59 yeare-

(3) = 40-53. yeers | .

* = Statistically significant difference (p< 0.05)
xk = Statistically significant difference (p <_ 0.01)

(Altitude)~(Prealtitude)





PREFACE

The authors of this report are listed in alphabetical order because the
contributions of each were substantially equal; thus, the order does not imply
seniority.

The report is organized into sections as indicated in the Table of
Contents to facilitate location of data of particular interest. Page numera-
tion runs consecutively throughout the report; references are given at the
end of each section.

The authors would like to acknowledge the contributions of several people
without whom this work could not have been done. They are, in alphabetical
order: Mary Jo Burr, Donna Fitzgerald, Patsy Fowler, Gordon Funkhouser,

Peggy Lyne, Stanley Mullen, Clay Tucker, and Marlene Wicks. Special thanks
are expressed to Drs. Samuel F. Flynn and Clyde Lynn who carried out the
medical examinations on the subjects.

aputien):__=
Gates

was reise S

- wail 90/08



(3ueoFz7Uszs ION) 00°O = 4

(aue2TZTUSTS ION) 06°C = 4

(Aue FzFUBTS ION) 69°Z = A

WWEOT TW TS 30N

su0z0 pus eu0z0-0N

SISAOUSUON Pus sraqows

sdnozp : a8y : SopIWyrd
S‘IT 9°99 €°lt 0°6s 9°21 £64 9°2t 9S "6-07 OS. 3
T'st 9°6€ It 6'8Y €°ST 6°%y Z€T o°0s 6 02 OF.
‘a's uve ‘a's uve ‘as wee ‘as weep
(8) (8) i (8) . (8)
si1ayousuoN sr94ous BIVyOUsSTON saray{oug
aNOZO 1NOZO-ON

38a], IOTOD GT-@ Teue, yIIoMsuAwy BY2 aIeTdWOD OF BTL

‘TT WIavE



oot | OT | COT | OT] OOT | OT | OOT | OT OOT | OT | OOT | OT OOT | OT | OOT | OT BTeIO}, :
os s OL £ 0s 8 09 9 09 9 09 9 08 8, 08 g | e8ueq9 on
oT T 4 z oT T 02 Zz oT T 0 0 0 0 oT T Popesseg
Ov 9 oT T oT T 0z z OE € ov 9 0% z oT T pasoidny
@I1@ (HM (OT @ 1) 1 @ [@ GY [Oy TG) TC) @ T@) 1) T@
BLOYOUS siayous B1ayous si0yous ‘seyous ‘S1OYOUS BlsyOUS B194OUS
-uON -u0N -uoN -uON
[er19IeT TeopaaeA Ter1sseT TeoTsaeA SINOZO
BLIM -
UA 6S OL OS SAONVHD

aK 6 OF OY

sUOTITPUOD oUOZD 03 aBU0ZN-ON Wozs SETACYg TeIEIe] pue TeOTIIeA UF seBueyD “6 FLEVL

33



Sabin paguaadibeeeaicnerkee

SECTION IIr
EFFECTS OF OZONE ON HEART RATE AND SHORT-TERM MEMORY
E. A; Higgins
Introduction.

The rationale for including these measurements in this study is
indicated in the previous report (1). They are also included for
comparing these populations representative of the flight crew with
the previously studied populations.

Results.
Heart Rate.

Data for heart rate are presented in Figure 1. There were no
statistically significant differences between ozone and no-ozone
conditions for either smokers or nonsmokers in either age group.
Also, there were no statistically significant differences when com-
paring smokers with nonsmokers or the 40- to 49-year-old age group
with the 50- to 59-year-old age group.

Wechsler Memory Scale.

Data for the memory quotient derived from the Wechsler Memory
Scale are presented in Figure 2. For this measurement there were
no statistically significant differences between ozone and no-ozone ©
conditions for either smokers or nonsmokers in either age group.
Also, there were no statistically significant differences. when com
paring smokers with nonsmokers or the 40- to 49-year-old age group *
with the 50- to 59-year-old age group. .

Although not pertinent to the effects of ozone, the memory”
quotient scores for the two groups studied ‘this time differed fron.

for this study, there was no statistically | signifi
between scores obtained in the first experiment | .

stient scores for these two groups, both 40- to 49-year- Lae” ‘acd. 50"

to 59~year-olds, were significantly kigher than. for: ‘the groups 7 naa
previously studied. Scores for all groups are ‘shown in Table 2. ©



REFERENCES

Folinsbee, L. J., B. L. Drinkwater, J. F. Bedi, and S. M. Horvath:
The Influence of Exercise on the Pulmonary Function Changes Due
to Exposure to Low Concentrations of Ozone. In Environmental

Stress: Individual Human Adaptations, Lawrence J. Folinsbee,

Jeames A. Wagner, Julian F. Borgia, Barbara L. Drinkwater,
Jeffrey A. Gliner, and John F. Bedi (Eds.), Academic Press,
New York, San Francisco, and landon, 1978.

Higgins, E. A., M. T. Lategola, J. M. McKenzie, C. E. Melton,
and J. A. Vaughan: Effects of Ozone on Exercising and Sedentary
Adult Mer: and Women Representative of the Flight Attendant Popu-
lation. FAA Office of Aviation Medicine Report No. FAA-AM-79-20,
July 1979.

Lagerwerff, J. M.: Prolonged Ozone Inhalation and Its Effects
on Visual Parameters, AEROSP. MED., 34:479-486, 1963.

Siebeck, R.: . Die antagonistische Innervation der Akkommodation
und die Akkommodationsruhelage, VON GRAEFES ARCH. OPHTH.,
153:425-437, 1953.

*U.S GOVERMENT PRINTING OFFICE : 1980 0-522-440/6307



+ g2eyomsuou pus siexous 103 einsodxe euoz0-ou puB eAnsodxe U0ZO JO UOT.
-ouny 8 se pesserdxe ‘(spTo-18ak-65 03 -0G pur spTO-1Bek-Gy 03 -04) ednoi8 :
a8e ong 103 ‘uoTZeTAep PrepuBIS shuTM Jo sNTd ‘e284, 22eey UPN Jo YdeIs seq *T TANTS

a0 SUV3A 6S-0¢ Q10 SUV3A 6b -Ob
3LVY¥ LYVSH NVAW

| §
y 7s
af >
. 4
4os °
v
- m
= 4o. z
= 2
= S
= 4 os m
: SYBXOWSNON SY3NOWS SUBMOWSNON SU3NOWS
: uu. cnabennaet) sos
i
{



Technical Report Documentation Page

V. Report No. 2. Government Accession No. ‘3. Recipient's Catalog No.
FAA-AM-80- AD— pog226¥
© Title end Subtitle 3. Report Date

EFFECTS OF OZONE (0.30 PARTS PER MILLION, 600 ug/m?) March 1980
ON SEDENTARY MEN REPRESENTATIVE OF AIRLINE PASSENGERS | § Performing Organization Code
AND COCKPIT CREWMEMBERS

8. Performing Organization Report No.

7. Author's)

E. A. H: ns, M. T. Lategola, C. E. Melton, and

3A: Vaighan” aa ,

9. Perforning Organization Neme end Address 10. Tork Unit No. (TRAIS)
FAA Civil Aeromedical Institute

P.0. Box 25082 TI. Contract or Grant No.

Oklahoma City, Oklahoma 73125

13. Type of Report end Period Covered

12. Sponsoriag Agency Nome ond Address
Office of Aviaticn Medicine

Federal Aviation Administration
800 Independence Avenue, S.W. 14. Sponsering Agency Code
Washington, D.C. 20591

15. Supplementary Notes

Work was done under approved Tasks AM-E~79-PHY-119 and AM-E-80-PHY-124.

16. Abstroct
This study was undertaken to determine the effects of 0.30 ppmv ozone on 40 men
representative of airline pilots. All were medically fit; 20 were smokers and

20 were nonsmokers. Subjects were divided into two age groups, 40-49 years and
50-59 years. The experiments consisted of exposure to 0.30 ppmv ozone and, on

another occasion, to air only for 3 h at a simulated altitude of 6,000 ft mean sea
level. Subjects were sedentary throughout the experiment. Ozone had no effect on
heart rate and short-term memory. The group showed a statistically significant
incidence of symptoms related to ozone exposure; most. were shown by the 40- to 49-—
year-old nonsmoking group while at altitude and postaltitude, and in smokers in the.
50- to 59-year age group only at altitude. Eye irritation was the commonest. symptor,
followed by headache, nasal irritation, and throat irritation. Data showed sig-
nificant effects of. ozone on forced expiratory volume, i-second forced expiratory
volume, and forced end-expiratory flow. :. The pulsoosty’ ‘effect of ozone appears to.

be principally on the small airways. fe _

Impairment of visual accommodation was associated with ozone. Dark adaptation
threshold was elevated in ozone in‘the 50- to, 9-year” nonsmoking age group. Retinal
bleach recovery time was retarded ina blink rate was “‘Bigher during ozone exposure.

It is concluded that 0.30 ppav oxdne : is hear--threshold for ‘adverse effects of: ozone.
The data are also applicable to Passenger whectit data sane category asthese

sedentary subjects. L. *

17. Key Words *

Air pollution, Ozone, Respiration, Visi ible to the public! thre
Heart rate, Short-term memory, d_—s| the National “Yedhnical Information Service
steadiness, Airline operations, Airline | Springfield Vifginia 22161. .
pilots, Airline passengers a : i ee

19. Security Classif. (of this report) 20. Security Clessif. ry

Unclassified Unclassified.

Form DOT F 1700.7 (8-72) _ Reproduction of completed siege evtherized

Qe 32.0



was a significant increase in blink rate (p<_.01) from no-ozone to ozone,
but not for smokers, and a significant decrease from smokers to nonsmokers
(p < .01) in the no-ozone condition but not with ozone. There were no
significant differences for smokers between no-ozone and ozone. Analysis
of the ranges of the four blink rates measured at each exposure showed
significant decreases between smokers and nonsmokers (p < .05) but with

no significant interactions or differences caused by smokers or the ozone
concentration. Mean blink rates ranged from 4.0 B/min to 42.8 B/min (the
latter in subject No. 05, who wore contact lenses, demonstrating the largest
range of 18 B/min). The smallest range in blink rates was 1 (4 to 5 B/min)
by subject No. 32. .

Mesopic Vi-ion.

Visual fields. Values measured with the Harrington-Flocks
Screener are summarized in Table 14 in terms of numbers of subjects and
Percentage change from no-ozone. Analysis of variance revealed no sig-
nificant differences between no-ozone and ozone, or between smokers and
nonsmokers. There was a significant increase in number of errors made
by the 50- to 59-year age group over the 40- to 49-year age group (F =
4.90, p<_.05). The increase in mean errors indicates a loss in visual.
fields that is attributed to the presbyopic eye, but not to ozone.
Forty to sixty percent of the test subjects showed no changes in visual
field from the conditions of no-ozone to ozone. *

Retinal bleach recovery time. The time required for the subject
to correctly identify two-digit numbers at 20/60 visual acuity under dim
illumination following a 3-min bleach is price Ge fa Table 15. There “was

to 300 8. The levels of ozone concentration of this study.
the neurochemical recovery of the bleached retina to. a. ‘cons:

Scotopic Vision.

Scotopic visual acuity. The values of Table 16 ; indicate
mean responses to light energy after about one-half hour in total
and quantify the levels of dark adaptation under these. conditt
overall light energy was significantly higher (p <.05) for
exposed to ozone than with no-ozone. Further ‘analysis (10:
simple effects test indicated an interaction: between no-ozone and
for smokers (p < .01) but not for nonsmokers. There was. also. an.
of an increase in light energy with ozone’ for ‘smokers of th
year age group (p< .01). There is evidence. from the data,
ozone dces inhibit the process of dark adaptation.

Numerical recognition. The means and “standard. a
the light ‘energy required for dark~adapted subjects to read

of two-digit numbers.are shown in-Table 17. . Values are significant Ly

27

j


soe ee hate

nasal breathing in Studies 3 and 4. Under the essentially sedentary
conditions of Studies 3 and 4, nasal breathing would have a greater
probability of occurring than either oronasal or oral breathing. If
nasal breathing did predominate in Studies 3 and 4, it could explain
some of the diminution of thoracic symptoms and spirometric displace-
ments of Studies 3 and 4 as compared to Study 2. The presence of
nasal scrubbing of ozone (12,13) may have actually reduced the intrapul-
monic exposure to ozone in Studies 3 and 4, whereas the nonoptional
switch from nasal to increased oral breathing during the treadmill
tests of Study 2 may have relatively accentuated the intrapulmonic
exposure to ozone. If generally true, this deduction suggests that,,
in the presence of an unavoidable exposure to ozone, some degree of
intrapulmonic protection might be afforded by breathing only :through
the nose. This temporary expedience may have increased significance
for individuals who may have increased intrapulmonic sensitivity to
ozone due to such conditions as asthmatic allergies.

The fact that qualitative differences between the ozone.and no-
ozone symptom mean scores did occur in this study, and that some of
those differences reached statistical significance, most probably means
that a 3-h exposure of older males (40 to 59 years) to 0.3 ppmv ozone
at altitude under essentialiy sedentary conditions is right at the
threshold of symptomatic effects of ozone.

Spirometry.

As shown in Table 5, all smokers and nonsmkers combined
manifested smail but statistically significant ozone/no-ozone. dif-
ferences in FVC, FEV,, and FEF7«_. With only one exception within
the smoker groups, the statisticali¢ significant spirometric dif-
ferences of all subjects combined were due to those occurring within
the nonsmoker groups (Table 5). In the nonsmoking younger males
(mean age of 25.2 yeors) of Study 3 (7), only one spirometric param-
eter (FEFsq_75%) manifested a statistically significant ozone/no-ozone
difference.

The fact that some small but statistically significant ozone/
no-ozone spirometric differences did occur in Study 4 probably means
that a 3-h exposure to: 0.3 ppmv ozone at altitude under somewhat
sedentary conditions is right at the threshold (10) for spirometric
effects of ozone.

As shown in Table 6, none of the smoker/nonsmoker diffe

in the ozone/no-ozone spirometric ratios were statistically: ignificant. ”

A qualitative trend of greater ozone/no-ozone. decreases in the smokers, ”
as compared to nonsmokers, was not apparent in the mean values of. -.
Table 6. ‘This probably means that the experimental conditions of:

ozone exposure used in Study 4 were insufficient to reach the’ thresh—
old of separation for smokers versus nonsmokers. That such. a thresh-
old exists is evidenced in two other studies (6,9) which compared
smokers’ and nonsmokers’ responses to greater ozone concentrations,

longer durations, and intermittent exercise. In ‘those studies

15



NOTICE

This document is disseminated under the sponsorship of the
Department of Transportation in the interect of information

exchange. The United States Government assumes no liability
for its content or use thereof.



OOT | OT |; OOT] OT }/OOT} OT | COT] OT CCT; OT | OOT | OT OOT | OT |: GOT} OT “ STer0 |

os | s | oy | v |loy | -% | ov | & ov | ¢ | 09 | 9 J] ov | %.] ov | » | auuy on | 8
oy | > | ov | » Ifor | t jos | gs oz | z [oz | z oy | v-] o¢ | € pepeateg
ot | t | oz | z |los | s | ot | t ov} ¢ | oz | z oz | z | of | € | peacaduy

(%) TC) TG) TO) TG) TC) Te) TO) GTC) |G) TO) TT Ge) 10) TT)

i a1 EC a1 wa EG EY] a Ex]
| sSarayousuoy siayoug sle,ousuON si1ayoug aN0ZO
- HLIA..|2 0.
Uk 6S OL OS UA 67 OL OF SHONVED

sUu0ZO 03 |U0ZO-ON BOI, Spreza TensTA Uz
se8uey) 43TM s30efqng 38a] yo e8equec10q pue z9quNN *yT ATUVL

|



SECTION V

THE EFFECTS OF OZONE ON PHOTOPIC,
MESOPIC, AND SCOTOPIC VISION

J. A. Vaughan
Introduction.

The assessment of the possibility of impaired vision ‘caused by
the exposure of human test subjects to ozone was determined by a bat-
tery of 12 vision tests conducted when the subjects were light adapted
(photopic vision), twilight or semidark adapted (mesopic vision), or
dark adapted (scotopic vision). The following tests were given for
each of the above illumination categories: Photopic vision included
tests for distant visual acuity, stereoscopic acuity, vertical and
lateral phorias, accommodation, hand-eye coordination, color vision,
and blink rate; mesopic vision tests consisted of determinations of
visual fields and retinal bleach recovery; and scotopic vision was
assessed by dark adaptation and numerical recognition.

The purpose of this experiment was to compare the effects on vision — :
of male test subjects in room air (no-ozone) to those experienced atan
ozone concentration of 0.30 ppmv, both at a simulated altitude of 6,000 ft.

Methods.

The 40 male test subjects were separated equally into two age |
groups of 40 to 49 years and 50 to 59 years. Each age group of. 20:
subjects was further separated into 10 smokers and. 10 ‘nonsmokere.. Atl
of the test subjects were examined for normal distant visual: ac ,
near visual ‘acuity, and stereoscopic: acuity before being selec:
the experiment, and wore’ corrective lenses when required: for’-good:
vision during the two exposure periods. . In the 40- to. 49-year: agé

roup, six subjects (30. percent) needed no ‘prescription lenses, six:

30 percent) wore spherical corrective: lenses, seven (35 percent:
bifocals, and one subject (5 percent). wore contact lense: Tai ‘the: 50~
to 59-year age group, all the subjects: wore corrective lenses; of:
which four (20 percent) were spherical, 14 (70 Percent): were: e bifocals,
and two (10 percent) were trifocal lenses. :

EY»
“for. :

Photopic Vision.

phoria (slide LPF-1). Accommodation was'}
Force Near. Point Rule, using techniques. of
blur." Color vision was determined with the Fa
Color Test. The hand-eye coordination. task“:const:
Sketch" with a design. consisting: of::two: parallel:

Plastic overlay: The: subject: was required. to: “dra
limiting lines on the overlay..-The procedure was. timed
watch and errors were ‘recorded ona Polaroid: ‘photog

23



: '
qusorsTuB ts’ 30N “SeuoFIoeseINT
(aueoyzgTuszs ION) OT'O = 4 ‘: ‘ auozo pur. auozo-0N ” . . es
(aueofsTuB]s 30N) G0°O = a. — SxeyOMBION puE erBqORIS ”
(so" > 4) 60°9 = a sdnoap oy
Z°OT/02 8°L2/0 6°L/02% 0°92/02 €°OT/0Z 2°L7/02 0°6/07 0°S2/0Z 6S 93 0S.
0°€/07 €° 61/02 €°S/G2 L£°%2/07 9° L/07 8°6T/0% 9°S/02 9°%/02 67 3 ov .
6
; “a's ueay “a's uBey | “as ure ‘a's i a
j wuoFzoeATMZ UsTTeus ; uoF oeAg UseTTeus . (a4)
| 1 S124OUSUON s12y4oug s1syousUON BIaAOUS _ wy
j NOZO aNOZO-ON /

A3pNoy TenszA yueystq Wdoqoud = */ AIGVL



TABLE 4. Subjective Symptom Scores

Smokers Versus Nonsmokers

Ozone: (Postaltitude)- Ozone: (Altitude)-
(Prealtitude) x 100 (Prealtitude) xX 100
Ne-Ozone: (Postaltitude)- No-Ozone: (Altitude)-
(Prealtitude) (Prealtitude)
x 451 262
qa) s
SE 197.7 123.6
x 955 1090
ql) NS
SE 400.6 450.5
x 270 841
(2) §
SE 96.7 278.2
¥ 254 292
(2) NS
SE 125.1 191.5
x 360 551
(3) s
SE 109.1 162.4
x 604 691
(3) Ns . .
SE 219.5 255.20. <=
X= mean. SE = standard error of the mean.
S = smoker NS = nonsmoker
(1) = 40-49 years
(2) = 50-59 years
(3) = 40-59 years



De ee neem een ans

SECTION II
GENERAL METHODS
Cc. E. Melton

Age, height, and weight characteristics of the subjec= population
are shown in Table 1. All subjects were given a medical examination
prior to their acceptance as subjects. Those who were found medically
fit were fully briefed on the purposes, procedures, and hazards of the
project. Each subject then signed an informed consent document and
was given training at altitude on each experimental test.

The actual experimental sessions consisted of exposure on one
occasion to 0.30 ppmv ozone and, on another occasion, to air oniy for
3 h in a hypobaric chamber at a simulated altitude of 6,000 ft above mean
sea level (MSL). The order of presentation of experimental conditions
was balanced; i.e., half the subjects were exposed to ozone first and
half to air only first. Exposures were separated by 1 week. Fech sub-
Ject thus served as is own control.

When subjects reported to the laboratory at 0800 for experimental
sessions, they changed into a surgical scrub suit. and were given ini-
tial tests as detailed in later sections of this report. Each subject
was then given a standard breakfast consisting of two siices of bacon,
two scrambled eggs, two pieces of buttered toast with jelly, and 8 oz
of whole milk. No other food or drink was given during the experimental
periods.

In earlier experiments with 0.20 ppmv ozone, blood was drawn after
exposure, and preexposure and postexposure urine collections were made
from subjects in order to test for extrapulmonary effects of ozone. No
extrapulmonary effects were found that could be attributed to orone, but
effects were found related to the order of experiments. Subjects showed
stress responses related to their first exposure regardless of whether
it was to ozone or to air only. In order to equalize this stress effect
in later experiments, including the one reported here, blood anc urine
collections were made according to the same procedures as previously used.

The hypobaric chamber was kept at 72° F with a relative humidity of
10-12 percent. Ozone was generated by the action of ultraviolet light
on ambient air; six ozone generators were required to attain the required
concentration of ozone. .

Ozone levels were monitcred with an AID Model 560 ozone meter.
This chemiluminescent instrument and its Model 565 calibrator were
checked against a NASA Dasibi (UV absorption) instrument that was cal-
ibrated against a primary standard at the Jet Propulsion Laboratory.
The AID instruments were found to agree closely with the NASA instrument.
Calibration of the AID instrument was checked daily at altitude prior
to experimental sessions. The output of the instrument was recorded.
continuously throughout experimental sessions oa a strip chart tecorde:;
variations in chamber ozone level were compensated by varying the. ozone
amount generated.



ae

quNoTsTUBTS Jom PBUOT32NIsI01

(so° 3 4) yey ea. @u0z0 pue au0z0-oN

; (QUBOFITUBTS JON) CLO = a SIDAOWSUCN PUB 61340"S
(QuvoTzFUsTS ION) €O°O = A ‘ sdnory o8y _ 0 88073 CH-I
2°99 9°€6 76% soe 7°09" 0°16 6°99 L°9L 6S 02 0S a
i 9°96 9°€OT $*68 £°90T "9°09 2°08 s°Ts t°99 . 6% 03 OF
i .
i ‘a's ube “a's , UBW “a's we “a's ue,
(8) aAIL (8) aL (4x)
. av
| Si1SyOUSUON Bisjous j BISAOMSUON ‘BaAsqouS
; NOZO NOZO-ON

sUTL Araaodsy yoReTH TeUFIey “ST ATAVL



(sor > 4)
82°S

QueotzTUBTs ION)
z9°0

(aueDF37U8TS ION)

(auedpzTUBTS 30M)
(aupotzTUszs 30N)

(38d; ZFUBTS ION)

82°0

080

(ue. 73 FURTS ION)
st‘0

(queotzFUszS ION)

|“ (aueoTzFUBTS JON) (3Ue>TFTUBTS 30N)
TT'O

(ued; Z7UBTS ON)

(aueozzFUBTS ION)

o0°0 = a

22°0 = 4 ‘szeqomsuo poe sz040ms

auozg "pus. ari0z0=0N .

r TRUUOFFFUSTS JOU SIEM GUOTIVIDIUT SuUTUPeUSY “(s0° sa 0z°Y Ta OF Lrrariyd ave. TeUOyITEIOIUL |.

T7'Z 00°0 €€°0 0070 =4 oT |
s0t/6z 09/07 ‘st /0z ‘Sz70e _ i
sero | zé-z| e8°z | ze | asco | serz| vere | ese] | oreo | zee | ce°z J €z-z | 0270 | O8-T ‘2e€ wel cas
soo | occz| ce7v | et°9 | cro | goez| zevy | 2279] | vero | Ete | C8: | ZE°9 | Gz°O | GH'T | 9Z"% veg | weEH
6s 03-06 :
veo | eyet| tz-e | ote | 080 | o€'T| Gyre | c6°z} | Oz-O | GL°T | BS"e | THE ceo | sort |as-z [os-z | “ars
vs'0 | c6°t| ot-y | o9rs | seco | ev-z|eces | zee} | Ty°0 | 62°z | €z°9 | Lt-9 | Gy°O | TO°Z |TZ"y |OE°9 | wee
6% 02 OF
S3a0qUeTFIUA Sazoque TTT s320qeeT TILT S330qNCTTTLTN
Cot/oz 09/0z St/oz Sz/oz |sot/oz 09/0z St/oz Sz/0z | HOT/Oz 0970z St/Oz Sz/oz |soT/Oz 09/02 St/oz sz/oz
Sreyomsuon SrS90NS Sis qousUON “srsyous eT
(ax)
aNOZO @N0ZO-ON aov

SUOTIFPUOD oFdoOJoVs Aepun sTe1swny AzTIVEPT 03 perznbey AJzeum 34871 SUL °LT FIGVL



TABLE 2. Results of Wecisler Memory Scale (in Memory
Quotient Scores) for Each of the Groups Stud‘ed

Ozone Age of Mean Memory

Study Subjects Quotient Standard

Number Sex (in years) Score Deviation N
1 M 21-35 118.0 + 91 15
1 Fr 21-35 117.0 + 13.0 12
2 M 21-35 115.0 + 13.5 14
2 21-35 116.0 + 10.4 14
3 M 21-35 122.0 + 11.6 14
3 F 21-35 120.0 413.4 14
ae M 40-49 130.7 #161 20
ae M 50-59 127.4 + 19.0 20
* This Study

Discussion an¢ Conclusions.

For the two measurements reported in this section, heart rate and
short-term memory, ozone had no effect when presented for 3 h at 0.30
ppmv to subjects representative of the flight crew population. Also,
there were no statistically significant differences between the two age
groupe, 40-49 years old and 50-59 years old. Neither were there any~
statistically significant differences between ‘suckers and nonsaokers.

The reason for a lack of order effect_ for the ‘Wechsler Memory Scale
in these older males, which was present in the younger groups: studied
previously, is not readily apparent. It is possible that: these cider men
have had greater experience at the type of thinking and ‘te: ting -presented
by the Wechsler Memory Scale. than did the younger subject: 7
for the older men were significantly higher. Further.
the younger groups were paid non-FAA subjects. Thirty-six OF the forty
participants in these older age groups were nonpaid voiunteers ‘from
the FAA's Mike Monroney Aeronautical Center sand ‘hola Prtnartty: managerial .
and téchnical Positions.