title: Infants' indoor and outdoor residential exposure to benzene and respiratory health in a Spanish cohort.
abstract: Benzene exposure represents a potential risk for children's health. Apart from being a known carcinogen for humans (group 1 according to IARC), there is scientific evidence suggesting a relationship between benzene exposure and respiratory problems in children. But results are still inconclusive and inconsistent. This study aims to assess the determinants of exposure to indoor and outdoor residential benzene levels and its relationship with respiratory health in infants. Participants were 1-year-old infants (N = 352) from the INMA cohort from Valencia (Spain). Residential benzene exposure levels were measured inside and outside dwellings by means of passive samplers in a 15-day campaign. Persistent cough, low respiratory tract infections and wheezing during the first year of life, and covariates (dwelling traits, lifestyle factors and sociodemographic data) were obtained from parental questionnaires. Multiple Tobit regression and logistic regression models were performed to assess factors associated to residential exposure levels and health associations, respectively. Indoor levels were higher than outdoor ones (1.46 and 0.77 μg/m3, respectively; p < 0.01). A considerable percentage of dwellings, 42% and 21% indoors and outdoors respectively, surpassed the WHO guideline of 1.7 μg/m3derived from a lifetime risk of leukemia above 1/100 000. Monitoring season, maternal country of birth and parental tobacco consumption were associated with residential benzene exposure (indoor and outdoors). Additionally, indoor levels were associated with mother's age and type of heating, and outdoor levels were linked with zone of residence and distance from industrial areas. After adjustment for confounding factors, no significant associations were found between residential benzene exposure levels and respiratory health in infants. Hence, our study did not support the hypothesis for the benzene exposure effect on respiratory health in children. Even so, it highlights a public health concern related to the personal exposure levels, since a considerable number of children surpassed the abovementioned WHO guideline for benzene exposure.
authors.affiliation: Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I, Universitat de València, Avenida de Catalunya 21, 46020, Valencia, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Melchor Fernández Almagro, 3-5, 28029, Madrid, Spain. Electronic address: ferrero_ampsan@gva.es.
authors.forename: Amparo
authors.initials: A
authors.lastname: Ferrero
authors.affiliation: Faculty of Nursing and Chiropody, Universitat de València, Av. Blasco Ibáñez, 13, 46010 Valencia, Spain; Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I, Universitat de València, Avenida de Catalunya 21, 46020, Valencia, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Melchor Fernández Almagro, 3-5, 28029, Madrid, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Esplugues
authors.affiliation: Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Melchor Fernández Almagro, 3-5, 28029, Madrid, Spain; Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I, Universitat de València, Avenida de Catalunya 21, 46020, Valencia, Spain.
authors.forename: Marisa
authors.initials: M
authors.lastname: Estarlich
authors.affiliation: Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I, Universitat de València, Avenida de Catalunya 21, 46020, Valencia, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Melchor Fernández Almagro, 3-5, 28029, Madrid, Spain.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Llop
authors.affiliation: Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I, Universitat de València, Avenida de Catalunya 21, 46020, Valencia, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Melchor Fernández Almagro, 3-5, 28029, Madrid, Spain.
authors.forename: Amparo
authors.initials: A
authors.lastname: Cases
authors.affiliation: Center for Mediterranean Environmental Studies, (CEAM), Parque Tecnológico, Charles R. Darwin, 14, 46980 Paterna, Valencia, Spain.
authors.forename: Enrique
authors.initials: E
authors.lastname: Mantilla
authors.affiliation: Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I, Universitat de València, Avenida de Catalunya 21, 46020, Valencia, Spain; Faculty of Nursing and Chiropody, Universitat de València, Av. Blasco Ibáñez, 13, 46010 Valencia, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Melchor Fernández Almagro, 3-5, 28029, Madrid, Spain.
authors.forename: Ferran
authors.initials: F
authors.lastname: Ballester
authors.affiliation: Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I, Universitat de València, Avenida de Catalunya 21, 46020, Valencia, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Melchor Fernández Almagro, 3-5, 28029, Madrid, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Iñiguez
mesh_terms: D000393:Air Pollutants / Q000032:analysis*; D016902:Air Pollution, Indoor / Q000032:analysis*; D001554:Benzene / Q000032:analysis*; D002648:Child; D004784:Environmental Monitoring; D005260:Female; D006361:Heating; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D012140:Respiratory Tract Diseases / Q000453:epidemiology*; D013030:Spain / Q000453:epidemiology
chemical_list: D000393:Air Pollutants; D001554:Benzene
keywords: Air pollution; Benzene; Infant; Respiratory signs and symptoms; Respiratory tract infections