The VOCs danger: Everyday products such as perfume, skin lotion, hair spray, deodorant, household cleaners are a top source of air pollution

Volatile organic compounds (VOCs) are emitted as gases from certain solids or liquids. VOCs include a variety of chemicals, some of which may have short- and long-term adverse health effects. Concentrations of many VOCs are consistently higher indoors (up to ten times higher) than outdoors. VOCs are emitted by a wide array of products numbering in the thousands.

Everyday products such as perfume, skin lotion, hair spray, deodorant, household cleaners and lawn pesticides are a top source of air pollution, as damaging to air quality as the exhaust from cars and trucks, according to a new report.

Consumer products containing compounds refined from petroleum all release small amounts of smog-producing particles into the air, the researchers explained.

Combined, these products now release as many volatile organic compounds (VOCs) into the atmosphere as vehicle emissions do.

The use of these products emits VOCs in a magnitude that's comparable to what comes out of the tailpipe of your car.

Remember: Consumer products are designed to release VOCs into the air. That's what they do.

Sources of VOCs

Household products, including:

paints, paint strippers and other solvents
wood preservatives
aerosol sprays
cleansers and disinfectants
moth repellents and air fresheners
stored fuels and automotive products
hobby supplies
dry-cleaned clothing

Other products, including:

building materials and furnishings
office equipment such as copiers and printers, correction fluids and carbonless copy paper
graphics and craft materials including glues and adhesives, permanent markers and photographic solutions.

Health Effects from VOCs

Health effects may include:

Eye, nose and throat irritation
Headaches, loss of coordination and nausea
Damage to liver, kidney and central nervous system
Some organics can cause cancer in animals, some are suspected or known to cause cancer in humans.

Key signs or symptoms associated with exposure to VOCs include:

conjunctival irritation
nose and throat discomfort
allergic skin reaction
declines in serum cholinesterase levels

Steps to Reduce Exposure to VOCs

Increase ventilation when using products that emit VOCs.
Meet or exceed any label precautions.
Do not store opened containers of unused paints and similar materials within the school.
Formaldehyde, one of the best known VOCs, is one of the few indoor air pollutants that can be readily measured.
Identify, and if possible, remove the source.
If not possible to remove, reduce exposure by using a sealant on all exposed surfaces of paneling and other furnishings.
Use integrated pest management techniques to reduce the need for pesticides.
Use household products according to manufacturer's directions.
Make sure you provide plenty of fresh air when using these products.
Throw away unused or little-used containers safely; buy in quantities that you will use soon.
Keep out of reach of children and pets.
Never mix household care products unless directed on the label.


Household Products May Pollute the Air as Much as Your Car Does: Study. WebMD,
Volatile Organic Compounds' Impact on Indoor Air Quality | US EPA

Preschool Recurrent Wheezing and Asthma

This is Twitter summary from the 2018 WSAAI meeting. This summary was compiled from the tweets posted by @MatthewBowdish, an allergist/immunologist, who attended the 2018 Western Society of Allergy, Asthma and Immunology (WSAAI) meeting. The tweets were labeled #WSAAI. The text was edited and modified by me.

Leonard Bacharier presented on Management of Preschool Recurrent Wheezing and Asthma.

One of the big challenges for pediatricians has been determining which preschool kids who wheeze go on to develop asthma and who don't.

Estimated prevalence of wheezing identified by latent class analysis:

Modified Asthma Predictive Index (API) (click to enlarge the image).

mAPI: High risk children ages 2-3 include 4 wheezing episodes in the past year PLUS one major criterion (pt w/MD asthma, MD atopic derm, aeroallergen sensitivity) OR two minor criteria (food sens, peripheral eos >4%, non-infectious wheeze).

Stepwise pharmacologic approach for children younger than 5yo with wheezing:

Reviewing results of Individualized therapy for asthma in toddlers (INFANT) study - Fitzpatrick AM et al JACI 2016;138:1608. Differential response between at least two treatments was observed in 75% of children. Take-homes from INFANT: 1) In kids w/aeroallergen sensitivity or eosinophilia, start ICS first. In kids who are not sensitized to aeroallergens or without eosinophilia, you can choose any of the treatments (ICS, prn daily ICS or daily LTRA).

Subgroup analysis of kids w/intermittent asthma or viral-triggered wheezing showed reduced risk of exacerbation w/preemptive high-dose intermittent ICS compared w/placebo (Kaiser SV, Pediatr 2016;137.

Azithro started at the earliest signs of RTIs was effective in reducing the risk of experiencing episodes of severe lower respiratory tract illness. (JAMA 2015;314(19):2034). There was no difference in response by API status, and azithro was well-tolerated with low rates of adverse effects.

Putting these together in an approach that we may be able to use in the clinic:

Research also suggests that if a child does not respond to a given controller, explore other Step 2 therapies before moving on to Step 3 therapies.

Summary slide:

Should nasal allergen challenge become part of standard allergy practice in U.S.?

Allergic rhinitis is a group of symptoms affecting the nose such as runny nose, congestion, sneezing and itchy eyes. These symptoms occur when you breathe in something you are allergic to, such as dust, animal dander, or pollen. Allergic rhinitis affects between 20% and 40% of people.

Nasal allergen challenge (NAC) is a potentially important tool to diagnose allergic rhinitis. It is not frequently used in the U.S.

The EAACI task force recommends a unified protocol for NAC for daily clinical practice. Among the recommendations:

- bilaterally challenge with standardized allergens, with a spray device offering 0.1 ml per nostril.

- systematic catalogue for positivity criteria for established subjective and objective assessment methods as well as a schedule for the challenge procedure

Treatment Options for 
Allergic Rhinitis (AR) (click to enlarge the image).


EAACI Position Paper on the Standardization of Nasal Allergen Challenges

Twitter is great for Allergy/Immunology specialists and patients. What's not to like?

Twitter allows the following important benefits:

- instantaneous access to the latest research publications, developments at national and international meetings
- networking with colleagues
- participation in advocacy
- promoting available clinical trials
- gateway access to resources dedicated to education and support for patients

As a prime example, Matthew Bowdish MD did a tremendous job broadcasting the new developments from the #WSAAI on Twitter, check the hashtag below:

What's not to like?

Professionalism concerns with clinician use of such social media platforms exist but by large benefits outweigh risks. Twitter adoption among the Allergy/Immunology community could be better and should be promoted.


Twitter Use in the Hematopoietic Cell Transplantation Community

Chronic Sinusitis - 2018 WSAAI update

This is a Twitter summary from the 2018 WSAAI meeting. This summary was compiled from the tweets posted by @MatthewBowdish, an allergist/immunologist, who attended the 2018 Western Society of Allergy, Asthma and Immunology (WSAAI) meeting. The tweets were labeled #WSAAI. The text was edited and modified by me.

Rohit Katial on "Chronic Sinusitis: From Nasal Polyps to Biologics.”

There are different phenotypes and endotypes of chronic rhinosinusitis. Chronic rhinosinusitis with and without nasal polyps:

Different types of defense and inflammation in sinus disease:

Whether it's sinus disease, asthma or skin, the main issue is what is happening with inflammation which it occurs on the epithelium, with everything else we're dealing with, IgE, IL5, etc., happening downstream:

Back to the major phenotypes of rhinosinusitis: