Short-term effects of the toxic component of traffic-related air pollution (TRAP) on lung function in healthy adults using a powered air purifying respirator (PAPR).

Short-term exposure to traffic-related air pollution (TRAP) are associated with reduced lung function. However, TRAP is a mixture of various gaseous pollutants and particulate matter (PM), and therefore it is unknown that which components of TRAP are responsible for the respiratory toxicity. Using a powered air-purifying respirator (PAPR), we conducted a randomized, double-blind, crossover trial in which 40 adults were exposed to TRAP for 2 h at the sidewalk of a busy road. During the exposure, the participants wore the PAPR fitted with a PM filter, a PM and volatile organic compounds (VOCs) filter, or a sham filter (no filtration, Sham mode). The participants were blinded to the type of filter in their PAPR, and experienced three exposures, once for each intervention mode in random order. We measured two lung function measures (forced expiratory volume in 1 s [FEV1] and forced vital capacity [FVC]) and an airway inflammation marker (fraction of exhaled nitric oxide [FENO]) before and immediately after each exposure, and further measured them at different time periods after exposure. We applied linear mixed effect models to estimate the effects of the interventions on the changes of lung function from baseline values after controlling for other covariates. Compared to baseline, exposing to TRAP decreased FEV1 and FVC, and increased FEV1/FVC and FENO in all three intervention modes. The mixed models showed that with the sham mode as reference, lung function and airway inflammation post exposure were significantly improved by filtering both PM and VOCs, but marginally affected by filtering only PM. In conclusion, the VOCs component of TRAP is responsible for the reduction in lung function caused by short-term exposure to TRAP. However, the result needs to be interpreted cautiously before further verified by laboratory experiment using purely isolated component(s) of TRAP.