Pollutants from incense smoke cause human lung-cell inflammation

Burning incense, a popular cultural practice in Arabian Gulf countries and elsewhere, generates indoor air pollutants that may cause inflammation in human lung cells, say researchers in the Gillings School of Global Public Health at the University of North Carolina at Chapel Hill.

“Hazard assessment of United Arab Emirates (UAE) incense smoke” appears in the August 2013 issue of Science of the Total Environment. Rebecca Cohen, master’s student in environmental sciences and engineering (ESE); her adviser, Kenneth G. Sexton, now retired ESE research assistant professor; and Karin B. Yeatts, research assistant professor of epidemiology, co-authored the study.

Previous studies, some by Yeatts and other UNC colleagues, have associated incense smoke with a number of health problems, including eye, nose, throat and skin irritation; respiratory symptoms, including asthma; headaches; exacerbation of cardiovascular disease; and changes in lung-cell structure.

Indoor air pollution is an international health concern. The World Health Organization estimates that more than 1 million people a year die from chronic obstructive respiratory disease (COPD), primarily a result of exposure to pollutants from cook stoves and open hearths. Burning incense releases similar pollutants, including carbon monoxide.

In the current study, the authors identified and measured the particles and gases emitted from two kinds of incense typically used in UAE homes. The testing was done over three hours, the typical timeframe during which incense is burned, in a specially designed indoor environmental chamber with a concentration of smoke that might be present in a typical UAE living room.

The researchers analyzed both particulate concentrations and levels of gases such as carbon monoxide, sulfur dioxide, oxides of nitrogen and formaldehyde.

Human lung cells were placed in the chamber to expose them to the smoke, then incubated for 24 hours to allow particulates to settle and the cells to respond. The resulting inflammatory response, a hallmark of asthma and other respiratory problems, was similar to that of lung cells exposed to cigarette smoke.

Incense is burned weekly in about 94 percent of households in the UAE as a cultural practice to perfume clothing and air and to remove cooking odors. Since people there spend more than 90 percent of their time indoors, researchers said, indoor air pollution has become a source of increasing concern.

Adding to the concern is that charcoal briquettes frequently are used to ignite and burn the incense. That adds significantly to potentially harmful levels of carbon monoxide and other pollutants, they noted.

Two types of incense (Oudh and Bahkoor) are most often used. Both are made with agarwood, which is taken from trees that develop an aromatic smell in response to fungal infection. Bahkoor has a number of additives, including sandalwood tree resin, essential oils and other substances.

Researchers found that both types of incense emitted significant amounts of particles, carbon monoxide, formaldehyde, and oxides of nitrogen, resulting in the cellular inflammatory response.

The authors recommended implementing better ventilation in UAE homes when incense is burned, such as opening a door or window to improve air flow. They also suggested using alternatives to charcoal, including electric combustion devices.

Future studies, they proposed, should measure additional compounds caused by incense burning and offer a more in-depth analysis of inflammatory markers.

Gillings School of Global Public Health contact: David Pesci, director of communications, (919) 962-2600, or dpesci@unc.edu.

News Services contact: Kathy Neal, interim health and science editor, (919) 740-5673, or kcneal@unc.edu.

Diet additions may help youth with Type 1 diabetes keep producing own insulin

Adding foods rich in specific amino and fatty acids to the diets of youth with Type 1 diabetes kept them producing some of their own insulin for up to two years after diagnosis, said researchers at the Gillings School of Global Public Health at the University of North Carolina at Chapel Hill.

The youth still required supplemental insulin, but they may have reduced risk of diabetes complications by continuing to produce some of their own insulin, said Elizabeth Mayer-Davis, professor of nutrition at Gillings and medicine at UNC’s School of Medicine, who led the study of more than 1,300 youth. “This also opens the door for a new approach that could really benefit the lives of these children.”

The study, “Nutritional Factors and Preservation of C-Peptide in Youth with Recently Diagnosed Type 1 Diabetes,” was published in the July 2013 issue of the journal Diabetes Care.

The participating youngsters, ranging from toddlers up to age 20, are part of a multi-center “SEARCH for Diabetes in Youth,” the largest U.S. study of childhood diabetes. Mayer-Davis is national co-chair of SEARCH, funded by the national Centers for Disease Control and Prevention and the National Institutes of Health.

Type 1 diabetes is almost always diagnosed between infancy and young adulthood, according to the American Diabetes Association. The body’s pancreas is unable to produce adequate amounts of the hormone insulin, required to metabolize food properly and create energy for the body’s cells.

Leucine, one of the branched-chain amino acids researchers looked at, is known to stimulate secretion. It is found in dairy products, meats, soy products, eggs, nuts and products made with whole wheat. Long-chain omega-3 fatty acids are found in fatty fish such as salmon.

The researchers analyzed how much (if any) insulin the subjects were producing up to two years after their diagnosis and compared this with nutritional intake.

Mayer-Davis noted the study reflects subjects eating actual foods rich in these nutrients, not taking supplements.

Link to the study: http://care.diabetesjournals.org/content/36/7/1842.full.pdf+html

School of Public Health contact: David Pesci, dpesci@unc.edu, (919) 962-2600.

News Services contact: Kathy Neal, kcneal@unc.edu, (919) 740-5673.

Study: Young children with autism benefit regardless of high-quality treatment model

Researchers at the University of North Carolina at Chapel Hill have found that preschoolers with Autism Spectrum Disorder (ASD) who receive high-quality early intervention benefit developmentally regardless of the treatment model used—a surprising result that may have important implications for special-education programs and school classrooms across the country.

“This is the first study designed to compare long-standing comprehensive treatment models for young children with ASD,” said Brian Boyd, a fellow at UNC’s Frank Porter Graham Child Development Institute (FPG) and one of the study’s co-principal investigators. Boyd also is an assistant professor in occupational science and occupational therapy in UNC’s School of Medicine.

“We know that more children are being diagnosed with ASD each year, and that it can cost an estimated $3.2 million to treat each child over a lifetime. Understanding that a child can benefit from a high-quality program, rather than a specialized program, may help reduce those costs by decreasing the need for teachers and other school practitioners to be trained to deliver multiple specialized services,” Boyd said. He stressed it remains important to ensure educators are trained to provide high-quality programs that meet the special behavioral, communication and other needs of children with ASD.

Previous research has shown that when children with ASD have access to early intervention via treatment programs, they improve developmentally. Until now, however, debate has persisted over which approach to use, said Boyd. The study appeared in the June issue of Journal of Autism and Developmental Disorders.

Two frequently used comprehensive treatment models have a long history: LEAP (Learning Experiences and Alternative Program for Preschoolers and their Parents) and TEACCH (now known only by its acronym).

FPG’s study examined the relative effects of the LEAP and TEACCH school-based comprehensive treatment models when compared to each other and to special-education programs that do not use a specific model. The multisite study took place only in high-quality classrooms and enrolled 74 teachers and 198 3- to 5-year-olds in public school districts.

The study found that children made gains over the school year regardless of the classroom’s use of LEAP, TEACCH or no specific comprehensive treatment model. “Each group of children showed significant positive change in autism severity, communication and fine- motor skills,” said Kara Hume, FPG scientist and co-author. “No statistically significant differences were found among models, which challenged our initial expectations—and likely the field’s.”

“This study may shift the field’s thinking about comprehensive treatment models designed for young children with ASD,” said co-author Samuel L. Odom, FPG’s director and the study’s principal investigator. “Perhaps it’s not the unique features of the models that most contribute to child gains but the common features of the models that most influence child growth.”

Researchers from East Tennessee State University, the University of Miami, Florida International University, University of Minnesota and Griffith University also participated in the study.

Original article: “Comparative Efficacy of LEAP, TEACCH and Non-Model-Specific Special Education Programs for Preschoolers with Autism Spectrum Disorders,” Journal of Autism and Developmental Disorders, published online June 2013.

http://link.springer.com/article/10.1007/s10803-013-1877-9

Note: Brian Boyd may be reached at brian_boyd@med.unc.edu or (919) 843-4465.

Frank Porter Graham Child Development Institute contact: Dave Shaw, communications director, dave@unc.edu or (919) 966-0867.

News Services contact: Kathy Neal, interim health and science editor, kcneal@unc.edu or (919) 740-5673 (cell).