Acute Health Effects Due to Ultrafine Particles From Candles and Cooking

Study Overview
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Brief Summary
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People spend up to 90% of their life indoor, and the way we live and behave in our homes has substantial effects on our health and well-being. Particle contamination is suggested to have substantial negative effects on health, with candles and cooking emitting the largest amount of particles, thus being the largest contributors to indoor air pollution. The overall aim of the present project is to contribute to increased understanding of the association between indoor particulate air pollution and health and well-being.

Detailed Description
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Introduction: People spend up to 90% of their life indoor, and the way we live and behave in our homes has substantial effects on our health and well-being. Particle contamination is suggested to have substantial negative effects on health, with candles and cooking emitting the largest amount of particles, thus being the largest contributors to indoor air pollution. Little is known about the potential adverse health effects of candles and cooking, and people with asthma may be more susceptible. Aim: To investigate local and systemic effects of short-term exposure to lit candles and cooking among young asthmatics. Design: In a randomised double-blinded cross-over study non-smoking asthmatics (18-25 years) were exposed for five hours at three different exposure conditions separated by 14 days; A) clean filtered air, B) lit candles and C) cooking emissions under controlled environmental conditions. Measurements: TSI P-TRAK Ultrafine Particle Counter was used for particle counts. Health effects, including lung function (FEV1/FVC) and fraction of exhaled nitric oxide (FeNO) were evaluated in relation to local and systemic effects prior to, right after and 24 h. after exposure. Analysis: Mixed methods approach taking both time and exposure into account.

Official Title
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THE ULTRAFINE PROJECT - A Study of Acute Health Effects of Exposure to Particles Generated by Candles and Cooking

Conditions
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Candle Burning, Cooking, Lung Function Decreased, DNA Damage, Subjective Health, Asthma

Intervention / Treatment
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* Other: Particles from candles
* Other: Particles from cooking
* Other: Clean Air


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Aged 15-25 Medically treated / physician diagnosed mild seasonal asthma Never smoker or ex-smoker ≥ 6 months Allergy > 1 common allergy Exclusion Criteria: Any other disease that could influence the study parameters Conditions that prevent safe access to the climate chambers (such as claustrophobia) Perennial asthma Need for continuous medical treatment for asthma Pregnancy

Ages Eligible for Study
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Minimum Age: 15 Years
Maximum Age: 25 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Crossover Assignment
Interventional Model Description: A randomised double-blinded crossover study
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Sham Comparator: Clean Air<br>Just clean air - no exposure | Other: Clean Air<br>* Nothing but clean air<br>|
| Experimental: Cooking<br>Four ovens were frying pork - one at a time. When the first oven finished, the next oven started and so forth for approx. 7 hours. | Other: Particles from cooking<br>* Generating fine and ultrafine particles from frying pork in an oven<br>|
| Experimental: Candles<br>10 lit candles were placed at a table. Burning for approx. 7 hours with light ventilation. | Other: Particles from candles<br>* Generating fine and ultrafine particles from lit candles<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Particles in Exhaled Air (Surfactant Protein A & Albumin) | PExA: Subjects performed repeated breath maneuvers allowing for airway closure and re-opening, and exhaled particles were optically counted and collected on a membrane using the (novel) PExA® instrument set-up. | Time Frame: At baseline (0 hour), after exposure (5 hours), and the day after exposure (24 hours) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Lung Function (FEV1 & FVC) | Spirometry | At baseline (0 hour), after exposure (5 hours), and the day after exposure (24 hours) | 
| Change in Fractional exhaled nitric oxide (FENO) | NIOX VERO system; Aerocrine AB, Sweden | At baseline (0 hour), after exposure (5 hours), and the day after exposure (24 hours) | 
| Change in Blood samples | Cytokines (IL-8), DNA-damages | At baseline (0 hour), after exposure (5 hours), and the day after exposure (24 hours) | 
| Change in nasal volume (using Acoustic rhinometry) | Is used to assess the nasal cross sectional area and volume. The left and right nasal cavity were studied alternatively until three reproducible measurements were obtained. The minimum cross sectional cavity area was calculated from the means of the measurements. By integration of the area-distance curve, the sum of the volume 2 to 4 (vol2-4) from the nostril was determined on both sides. | At baseline (0 hour), after exposure (5 hours), and the day after exposure (24 hours) | 
| Change in biomarkers in Saliva Sample | An oral svap from Salivette was placed in the mouth of the participant to collect saliva by gently chewing the swab for one minute. Afterwards the saturated swab was removed to the suspended insert and closed firmly with a lid. Then the sample was transferred to a freezer and stored for -80 C until further analysis. The sample will be analyzed for biomarkers (amylase, cortisol, substance P, lysozyme and secretory IgA.) | At baseline (0 hour), after exposure (5 hours), and the day after exposure (24 hours) | 
| Change in Subjective Symptoms | In the exposure chamber participants were asked to fill out a symptom questionnaire every 30 minute regarding their well-being and experienced symptoms in eyes, nose and throat. The participants were asked to score their evaluation (rate the strength) of symptoms by placing a cross on a 130 mm open Visual Analogue Scale (VAS). The intensity of any discomfort was registered as the length in mm from the left of the scale to the marker. The scores were rated from 0 to 100% with highest number corresponding to highest discomfort. Health effects were evaluated in relation to rated changes in symptoms. | Every 30 minute during 5 hours of exposure | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Particle contamination, Indoor air, Acute health effects, RCT, Asthma