Joachim D. Pleil

Measurement of volatile organic compounds in exhaled breath as collected in evacuated electropolished canisters

A set of three complementary analytical methods were developed specifically for exhaled breath as collected in evacuated stainless steel canisters using gas chromatographic-mass spectrometric detection. The first is a screening method to quantify the carbon dioxide component (generally at 4-5% concentration), the second method measures the very volatile high-level endogenous compounds [e.g. acetone and isoprene at 500-1000 parts per billion by volume (ppbv), methanol, ethanol, dimethylsulfide at 2-10 ppbv], and the third method is designed to measure trace-level environmental contaminants and other endogenous volatile organic compounds (VOCs) (sub-ppbv) in breath. The canister-based sample format allows all three methods to be applied to each individual sample for complete constituent characterization. Application of these methods is shown to be useful in the following ways: analysis of CO2 levels indicates the approximate quantity of alveolar breath collected (as opposed to whole breath) in a sample; levels of major endogenous compounds are shown to be influenced by physical activities and subsequent recovery periods; and environmental exposures to xenobiotic VOCs can be characterized by assessment of post-exposure breath elimination curves. The instrumentation and methodology are described and example chromatograms and quantitative data plots demonstrating the utility of the methods are presented.

Survey of volatile organic compounds associated with automotive emissions in the urban airshed of São Paulo, Brazil

Abstract The Metropolitan Region of Sao Paulo (MRSP), Brazil, is one of the largest metropolitan areas in the world (population 17 million, approx.) and relies heavily on alcohol-based fuels for automobiles. It is estimated that about 40% of the total volume of fuel is ethanol with some vehicles using pure ethanol and others a gasoline/ethanol blend. As such, Sao Paulo is an excellent example of an oxygenates-dominated airshed of mobile sources and is most likely indicative of the future in heavily populated areas in the US such as Los Angeles where “oxy-fuels” are becoming an important replacement for the conventional pure petroleum-based fuels. In this work, we surveyed the ambient air to identify and quantify the organic compounds associated with the evaporative and exhaust emissions of these fuels and to begin to understand the potential for human exposure. Because this was an initial test without detailed prior knowledge of the airshed of the area, we applied two different air sampling methods for various time periods to assess the ambient concentrations of a variety of polar and nonpolar volatile organic compounds (VOCs). For quality assurance (QA), we collected all the samples in duplicate (whole-air samples in Summa canisters and adsorbent-based samples on Perkin-Elmer Air Toxics tubes) at various flow rates to test performance. All samples were collected over identical time frames, typically for 1-, 2-, and 4-h periods per day at six different locations over a period of 1 week. Overall Sao Paulo results demonstrate that mean concentrations of single-ring aromatics are 2–3 times higher, volatile aldehydes are 5–10 times higher, and simple alcohols 10–100 times higher as compared to results of a recent study performed by EPA in the Los Angeles basin. C 4 –C 11 n -alkanes were only slightly elevated in Sao Paulo.

Clinical breath analysis: discriminating between human endogenous compounds and exogenous (environmental) chemical confounders

Volatile organic compounds (VOCs) in exhaled breath originate from current or previous environmental exposures (exogenous compounds) and internal metabolic (anabolic and catabolic) production (endogenous compounds). The origins of certain VOCs in breath presumed to be endogenous have been proposed to be useful as preclinical biomarkers of various undiagnosed diseases including lung cancer, breast cancer, and cardio-pulmonary disease. The usual approach is to develop difference algorithms comparing VOC profiles from nominally healthy controls to cohorts of patients presenting with a documented disease, and then to apply the resulting rules to breath profiles of subjects with unknown disease status. This approach to diagnosis has a progression of sophistication; at the most rudimentary level, all measurable VOCs are included in the model. The next level corrects exhaled VOC concentrations for current inspired air concentrations. At the highest level, VOCs exhibiting discriminatory value also require a plausible biochemical pathway for their production before inclusion. Although these approaches have all shown some level of success, there is concern that pattern recognition is prone to error from environmental contamination and between-subject variance. In this paper, we explore the underlying assumptions for the interpretation and assignment of endogenous compounds with probative value for assessing changes. Specifically, we investigate the influence of previous exposures, elimination mechanisms and partitioning of exogenous compounds as confounders of true endogenous compounds. We provide specific examples based on a simple classical pharmacokinetic approach to identify potential misinterpretations of breath data and propose some remedies.

Role of Exhaled Breath Biomarkers in Environmental Health Science

As a discipline of public health, environmental health science is the study of the linkage from environmental pollution sources to eventual adverse health outcome. This progression may be divided into two components, (1) “exposure assessment,” which deals with the source terms, environmental transport, human exposure routes, and internal dose, and (2) “health effects,” which deals with metabolism, cell damage, DNA changes, pathology, and onset of disease. The primary goal of understanding the linkage from source to health outcome is to provide the most effective and efficient environmental intervention methods to reduce health risk to the population. Biomarker measurements address an individual response to a common external environmental stressor. Biomarkers are substances within an individual and are subdivided into chemical markers, exogenous metabolites, endogenous response chemicals, and complex adducts (e.g., proteins, DNA). Standard biomarker measurements are performed in blood, urine, or other biological media such as adipose tissue and lavage fluid. In general, sample collection is invasive, requires medical personnel and a controlled environment, and generates infectious waste. Exploiting exhaled breath as an alternative or supplement to established biomarker measurements is attractive primarily because it allows a simpler collection procedure in the field for numerous individuals. Furthermore, because breath is a gas-phase matrix, volatile biomarkers become more readily accessible to analysis. This article describes successful environmental health applications of exhaled breath and proposes future research directions from the perspective of U.S. Environmental Protection Agency (EPA) human exposure research.

Analysis of Exhaled Breath for Disease Detection

Breath analysis is a young field of research with great clinical potential. As a result of this interest, researchers have developed new analytical techniques that permit real-time analysis of exhaled breath with breath-to-breath resolution in addition to the conventional central laboratory methods using gas chromatography-mass spectrometry. Breath tests are based on endogenously produced volatiles, metabolites of ingested precursors, metabolites produced by bacteria in the gut or the airways, or volatiles appearing after environmental exposure. The composition of exhaled breath may contain valuable information for patients presenting with asthma, renal and liver diseases, lung cancer, chronic obstructive pulmonary disease, inflammatory lung disease, or metabolic disorders. In addition, oxidative stress status may be monitored via volatile products of lipid peroxidation. Measurement of enzyme activity provides phenotypic information important in personalized medicine, whereas breath measurements provide insight into perturbations of the human exposome and can be interpreted as preclinical signals of adverse outcome pathways.

Systemic Exposure to PAHs and Benzene in Firefighters Suppressing Controlled Structure Fires

Turnout gear provides protection against dermal exposure to contaminants during firefighting; however, the level of protection is unknown. We explored the dermal contribution to the systemic dose of polycyclic aromatic hydrocarbons (PAHs) and other aromatic hydrocarbons in firefighters during suppression and overhaul of controlled structure burns. The study was organized into two rounds, three controlled burns per round, and five firefighters per burn. The firefighters wore new or laundered turnout gear tested before each burn to ensure lack of PAH contamination. To ensure that any increase in systemic PAH levels after the burn was the result of dermal rather than inhalation exposure, the firefighters did not remove their self-contained breathing apparatus until overhaul was completed and they were >30 m upwind from the burn structure. Specimens were collected before and at intervals after the burn for biomarker analysis. Urine was analyzed for phenanthrene equivalents using enzyme-linked immunosorbent assay and a benzene metabolite (s-phenylmercapturic acid) using liquid chromatography/tandem mass spectrometry; both were adjusted by creatinine. Exhaled breath collected on thermal desorption tubes was analyzed for PAHs and other aromatic hydrocarbons using gas chromatography/mass spectrometry. We collected personal air samples during the burn and skin wipe samples (corn oil medium) on several body sites before and after the burn. The air and wipe samples were analyzed for PAHs using a liquid chromatography with photodiode array detection. We explored possible changes in external exposures or biomarkers over time and the relationships between these variables using non-parametric sign tests and Spearman tests, respectively. We found significantly elevated (P < 0.05) post-exposure breath concentrations of benzene compared with pre-exposure concentrations for both rounds. We also found significantly elevated post-exposure levels of PAHs on the neck compared with pre-exposure levels for round 1. We found statistically significant positive correlations between external exposures (i.e. personal air concentrations of PAHs) and biomarkers (i.e. change in urinary PAH metabolite levels in round 1 and change in breath concentrations of benzene in round 2). The results suggest that firefighters wearing full protective ensembles absorbed combustion products into their bodies. The PAHs most likely entered firefighters’ bodies through their skin, with the neck being the primary site of exposure and absorption due to the lower level of dermal protection afforded by hoods. Aromatic hydrocarbons could have been absorbed dermally during firefighting or inhaled during the doffing of gear that was off-gassing contaminants.

SAMPLE INTEGRITY OF TRACE LEVEL VOLATILE ORGANIC COMPOUNDS IN AMBIENT AIR STORED IN SUMMA@ POLISHED CANISTERS

Abstract Sets of new and used SUMMA® polished stainless steel canisters were tested for storage stability of volatile organic compounds (VOCs). Evacuated canisters were filled at a controlled rate with ambient air containing added concentrations of 15 VOCs (14 chlorinated, one brominated) at

Influence of systems biology response and environmental exposure level on between-subject variability in breath and blood biomarkers

To explain the underlying causes of apparently stochastic disease, current research is focusing on systems biology approaches wherein individual genetic makeup and specific ‘gene–environment’ interactions are considered. This is an extraordinarily complex task because both the environmental exposure profiles and the specific genetic susceptibilities presumably have large variance components. In this article, the focus is on the initial steps along the path to disease outcome namely environmental uptake, biologically available dose, and preclinical effect. The general approach is to articulate a conceptual model and identify biomarker measurements that could populate the model with hard data. Between-subject variance components from different exposure studies are used to estimate the source and magnitude of the variability of biomarker measurements. The intent is to determine the relative effects of different biological media (breath or blood), environmental compounds and their metabolites, different concentration levels, and levels of environmental exposure control. Examples are drawn from three distinct exposure biomarker studies performed by the US Environmental Protection Agency that studied aliphatic and aromatic hydrocarbons, trichloroethylene and methyl tertiary butyl ether. All results are based on empirical biomarker measurements of breath and blood from human subjects; biological specimens were collected under appropriate Institutional Review Board protocols with informed consent of the subjects. The ultimate goal of this work is to develop a framework for eventually assessing the total susceptibility ranges along the toxicological pathway from exposure to effect. The investigation showed that exposures are a greater contributor to biomarker variance than are internal biological parameters.

Adapting concepts from systems biology to develop systems exposure event networks for exposure science research.

Systems exposure science has emerged from the traditional environmental exposure assessment framework and incorporates new concepts that link sources of human exposure to internal dose and metabolic processes. Because many human environmental studies are designed for retrospective exposure evaluations they often do not provide practical toxicological outcome parameters. Our goal was to examine concepts from systems biology research and adapt them to a network approach that maps forward to a perturbation event using two hypothetical examples. The article proposes that environmental exposure studies should not only retrospectively document exposure levels, but also measure biological parameters that can be used to inform relevant systemic changes.

A biomonitoring framework to support exposure and risk assessments.

BACKGROUND Biomonitoring is used in exposure and risk assessments to reduce uncertainties along the source-to-outcome continuum. Specifically, biomarkers can help identify exposure sources, routes, and distributions, and reflect kinetic and dynamic processes following exposure events. A variety of computational models now utilize biomarkers to better understand exposures at the population, individual, and sub-individual (target) levels. However, guidance is needed to clarify biomonitoring use given available measurements and models. OBJECTIVE This article presents a biomonitoring research framework designed to improve biomarker use and interpretation in support of exposure and risk assessments. DISCUSSION The biomonitoring research framework is based on a modified source-to-outcome continuum. Five tiers of biomonitoring analyses are included in the framework, beginning with simple cross-sectional and longitudinal analyses, and ending with complex analyses using various empirical and mechanistic models. Measurements and model requirements of each tier are given, as well as considerations to enhance analyses. Simple theoretical examples are also given to demonstrate applications of the framework for observational exposure studies. CONCLUSION This biomonitoring framework can be used as a guide for interpreting existing biomarker data, designing new studies to answer specific exposure- and risk-based questions, and integrating knowledge across scientific disciplines to better address human health risks.