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Thorax. Jun 2005; 60(6): 474–479.
PMCID: PMC1747426

Indoor nitrous acid and respiratory symptoms and lung function in adults

Abstract

Background: Nitrogen dioxide (NO2) is an important pollutant of indoor and outdoor air, but epidemiological studies show inconsistent health effects. These inconsistencies may be due to failure to account for the health effects of nitrous acid (HONO) which is generated directly from gas combustion and indirectly from NO2.

Methods: Two hundred and seventy six adults provided information on respiratory symptoms and lung function and had home levels of NO2 and HONO measured as well as outdoor levels of NO2. The association of indoor HONO levels with symptoms and lung function was examined.

Results: The median indoor HONO level was 3.10 ppb (IQR 2.05–5.09), with higher levels in homes with gas hobs, gas ovens, and in those measured during the winter months. Non-significant increases in respiratory symptoms were observed in those living in homes with higher HONO levels. An increase of 1 ppb in indoor HONO was associated with a decrease in forced expiratory volume in 1 second (FEV1) percentage predicted (–0.96%; 95% CI –0.09 to –1.82) and a decrease in percentage FEV1/forced vital capacity (FVC) (–0.45%; 95% CI –0.06 to –0.83) after adjustment for relevant confounders. Measures of indoor NO2 were correlated with HONO (r = 0.77), but no significant association of indoor NO2 with symptoms or lung function was observed. After adjustment for NO2 measures, the association of HONO with low lung function persisted.

Conclusion: Indoor HONO levels are associated with decrements in lung function and possibly with more respiratory symptoms. Inconsistencies between studies examining health effects of NO2 and use of gas appliances may be related to failure to account for this association.

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Selected References

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  • Spicer CW, Kenny DV, Ward GF, Billick IH. Transformations, lifetimes, and sources of NO2, HONO, and HNO3 in indoor environments. Air Waste. 1993 Nov;43(11):1479–1485. [PubMed]
  • Leaderer BP, Naeher L, Jankun T, Balenger K, Holford TR, Toth C, Sullivan J, Wolfson JM, Koutrakis P. Indoor, outdoor, and regional summer and winter concentrations of PM10, PM2.5, SO4(2)-, H+, NH4+, NO3-, NH3, and nitrous acid in homes with and without kerosene space heaters. Environ Health Perspect. 1999 Mar;107(3):223–231. [PMC free article] [PubMed]
  • Lee Kiyoung, Xue Jianping, Geyh Alison S, Ozkaynak Halûk, Leaderer Brian P, Weschler Charles J, Spengler John D. Nitrous acid, nitrogen dioxide, and ozone concentrations in residential environments. Environ Health Perspect. 2002 Feb;110(2):145–150. [PMC free article] [PubMed]
  • Spicer CW, Billick IH, Yanagisawa Y. Nitrous acid interference with passive NO2 measurement methods and the impact on indoor NO2 data. Indoor Air. 2001 Sep;11(3):156–161. [PubMed]
  • Brunekreef B. NO2: the gas that won't go away. Clin Exp Allergy. 2001 Aug;31(8):1170–1172. [PubMed]
  • Rasmussen TR, Brauer M, Kjaergaard S. Effects of nitrous acid exposure on human mucous membranes. Am J Respir Crit Care Med. 1995 May;151(5):1504–1511. [PubMed]
  • Beckett WS, Russi MB, Haber AD, Rivkin RM, Sullivan JR, Tameroglu Z, Mohsenin V, Leaderer BP. Effect of nitrous acid on lung function in asthmatics: a chamber study. Environ Health Perspect. 1995 Apr;103(4):372–375. [PMC free article] [PubMed]
  • Jarvis D, Chinn S, Luczynska C, Burney P. Association of respiratory symptoms and lung function in young adults with use of domestic gas appliances. Lancet. 1996 Feb 17;347(8999):426–431. [PubMed]
  • Burney PG, Luczynska C, Chinn S, Jarvis D. The European Community Respiratory Health Survey. Eur Respir J. 1994 May;7(5):954–960. [PubMed]
  • Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986 Feb 8;1(8476):307–310. [PubMed]
  • Quanjer PH, Tammeling GJ, Cotes JE, Pedersen OF, Peslin R, Yernault JC. Lung volumes and forced ventilatory flows. Report Working Party Standardization of Lung Function Tests, European Community for Steel and Coal. Official Statement of the European Respiratory Society. Eur Respir J Suppl. 1993 Mar;16:5–40. [PubMed]
  • Brauer M, Koutrakis P, Keeler GJ, Spengler JD. Indoor and outdoor concentrations of inorganic acidic aerosols and gases. J Air Waste Manage Assoc. 1991 Feb;41(2):171–181. [PubMed]
  • Khoder MI. Nitrous acid concentrations in homes and offices in residential areas in Greater Cairo. J Environ Monit. 2002 Aug;4(4):573–578. [PubMed]
  • van Strien Robert T, Gent Janneane F, Belanger Kathleen, Triche Elizabeth, Bracken Michael B, Leaderer Brian P. Exposure to NO2 and nitrous acid and respiratory symptoms in the first year of life. Epidemiology. 2004 Jul;15(4):471–478. [PubMed]
  • Künzli N, Ackermann-Liebrich U, Brändli O, Tschopp JM, Schindler C, Leuenberger P. Clinically "small" effects of air pollution on FVC have a large public health impact. Swiss Study on Air Pollution and Lung Disease in Adults (SAPALDIA) - team. Eur Respir J. 2000 Jan;15(1):131–136. [PubMed]
  • Rose G. Sick individuals and sick populations. Int J Epidemiol. 1985 Mar;14(1):32–38. [PubMed]
  • Tunnicliffe WS, Burge PS, Ayres JG. Effect of domestic concentrations of nitrogen dioxide on airway responses to inhaled allergen in asthmatic patients. Lancet. 1994 Dec 24;344(8939-8940):1733–1736. [PubMed]
  • Boezen HM, van der Zee SC, Postma DS, Vonk JM, Gerritsen J, Hoek G, Brunekreef B, Rijcken B, Schouten JP. Effects of ambient air pollution on upper and lower respiratory symptoms and peak expiratory flow in children. Lancet. 1999 Mar 13;353(9156):874–878. [PubMed]

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