Air pollution by BTEX and the related health risks due to the tobacco smoke, a systematic review

Ali Momen; Arezo Rezaei; Roohollah Rostami

doi:10.18502/japh.v9i3.16682

Ali Momen Department of Occupational Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Arezo Rezaei Environmental Science and Technology Research Center, Department of Environmental Health Engineering, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Roohollah Rostami Department of Environmental Health Engineering, School of Health, Semnan University of Medical Sciences, Semnan, Iran

DOI: https://doi.org/10.18502/japh.v9i3.16682

Keywords: BTEX (Benzene, toluene, ethylbenzene, xylene); Indoor air quality; Smoking; Cigarette; Health risk

Abstract

BTEX is a group of hazardous chemical compounds that include benzene, toluene, ethylbenzene, and xylene. The indoor concentration of BTEX is mostly influenced by tobacco smoking, the region within the house, and seasonal variations. This systematic review analyzed studies on BTEX concentrations in indoor air, using data from Google Scholar, Science Direct, and Springer from 2010 to 2020, and performed statistical analysis with R after thorough data extraction and evaluation. Duplicate studies were removed, and disagreements during the article selection process were resolved by a third reviewer. Out of the 1351 articles obtained from the keyword search, only 13 were eventually selected for this study. The most abundant compound found in houses among BTEX was toluene, with a concentration of 13.80±16.50 µg/m³. The results indicated that the concentration of ƩBTEX in houses where smoking occurred was lower than in houses where no smoking occurred (18.52 vs. 27.66 µg/m³); However, the concentration of benzene in smoking houses was higher than in non-smoking houses (7.17±9.42 vs. 2.65±3.77 µg/m³, unpaired Wilcoxon test: p>0.05). The concentration of BTEX in houses was substantially lower than that in cafes (21.10±31.10 vs. 15,100±9740 µg/m³, unpaired Wilcoxon test: p<0.05). The urban region had the most significant accumulation of all BTEXs, with the industrial and rural sectors following suit. The findings indicated that the average concentration of BTEX in warm months (such as spring and summer) were higher than in cold months (such as fall and winter) within houses (28.50±44.30 vs. 8.60±7.77 µg/m³, unpaired Wilcoxon test: p>0.05). The findings indicated that the Cancer Risk (CR) associated with houses (3.11×10^-6) and cafes (3.54×10^-3) exceeded the permissible threshold. Moreover, the waterpipe cafes that utilized fruit-flavored tobacco had the greatest CR (4.98×10^-3). Furthermore, the presence of smoking, regional factors, and seasonal variations did not result in an increase in the hazard quotient (HQ) in houses beyond the acceptable thresholds. Finally, smoking, seasonal variations, and region had critical impact on indoor BTEX concentrations, and they could increase the risk of carcinogenic potential in the indoor environments.