Systemic Inflammation Clinical Trial
Official title:
Health Effects Related to Exposure to Particle Pollution From Woodburning
The study intends to focus on health effects and symptoms related to particle exposure from
wood burning stoves
The objective is to determine whether moderate exposure to particles from wood smoke in a
real life situation causes an systemic inflammatory response in peripheral blood or in lower
airways. 24 healthy subjects (normal healthy subjects and mild asthmatics to study the
asthmatic response) is selected for the study. A randomized double blind crossover procedure
will be followed with a PM exposure concentration of 200ug/m3, 400ug/m3 or clean air as the
control exposure. Exposure will take place in a climate chamber using wood burning in an
appropriate wood stove.
Public health is concerned with the physical, mental and environmental health of communities
and populations at risk for disease and injury. Generally, the determination of health
effects associated with indoor and outdoor exposures is difficult since documented
cause-and-effect relationships are rare and the exposure and dosage data is sparse.
Information about actual human exposure to different types of pollution has several
important uses, including informing risk assessments, helping predict the potential
consequences of exposures, and developing exposure criteria for regulations and other public
policy guidance.
Wood-burning stoves have been a popular heating source for decades. Unfortunately,
wood-burning stoves can emit substantial quantities of pollutants to outdoor and indoor air.
Among the pollutants are: chlorinated dioxin, carbon monoxide, methane, volatile organic
compounds (VOC), nitrogen oxides, polycyclic aromatic hydrocarbons (PAH), and fine
particulate matter (PM10, PM2.5, fine and ultra fine particles). Recent studies indicate
that the use of wood-burning stoves for heating of dwellings is one of the important outdoor
particle sources [Glasius et al. 2004] in residential district in Denmark. This has resulted
in an increase in public exposure to indoor and outdoor wood smoke related pollutants, which
has prompted widespread concern about the adverse human health consequences that may be
associated with wood smoke exposure.
Air pollution is a major aggravation of respiratory symptoms and disease. Effects are
decreases in pulmonary function and evidence of inflammation as well as suggestions of
increases in chronic respiratory disease. Orozco-Levi et al. (2006) showed strong
association between wood smoke exposure and obstructive pulmonary disease. Several studies
have shown that especially the small particles, has an effect on airways, and that asthmatic
subjects may be the group at greatest risk from air pollutants. The awareness of the impact
of airborne particles, particularly fine and ultra fine particles, on health is growing. In
recent years, exposure to fine and ultra fine airborne particles has been identified as an
important factor affecting human health [Seaton et al., 1995; Schwartz et al., 1996;
Oberdörster et al., 1994; Alvin et al., 2000]. Several researchers hypothesize that an
increased mortality is associated with the particle levels prevailing in urban air [Jamriska
et al., 1999; Dockery et al., 1993]. Mølhave et al (2000; 2005) have suggested that reactive
short-lived compounds resulting from reactions between ozone and particulate matter cause
indoor air quality complaints and objective health effects such as impaired lung functions.
Particulate air pollution is also known to increase cardiovascular morbidity and mortality.
Still the existing scientific knowledge and foundation for evaluating the underlying
mechanisms and influence of particle exposure on human immune system are limited. Wood smoke
particles, at levels that can be found in smoky indoor environments, seem to affect
inflammation. Barregard et al observed a significant increase in S-Amyloid and Faktor
VIII/vWf after 0, 3 and 20 hours of exposure to wood smoke. After 20 hours also and increase
in Faktor VIII was registred. Surpise-lingly, an IL.-6 decrease was observed after 3 hours.
[Barregard et al, 2006]. The particles may also act by increasing blood coagulation factors
[Seaton et al 1995]. Both effects may be involved in the mechanisms whereby particulate air
pollution affects cardiovascular morbidity and mortality.
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Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Crossover Assignment, Masking: Double Blind (Subject, Investigator)
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