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. 2018 Jan 8;13:2.
doi: 10.1186/s12995-017-0182-5. eCollection 2018.

Acute Diesel Exhaust Exposure and Postural Stability: A Controlled Crossover Experiment

Free PMC article

Acute Diesel Exhaust Exposure and Postural Stability: A Controlled Crossover Experiment

Jason Curran et al. J Occup Med Toxicol. .
Free PMC article


Recent epidemiological evidence connects ambient air pollutants to adverse neurobehavioural effects in adults. In animal models, subchronic controlled exposures to diesel exhaust (DE) have also showed evidence of neuroinflammation. Evidence suggests that DE not only affects outcomes commonly associated with cognitive dysfunction, but also balance impairment. We conducted a controlled human exposure experiment with 28 healthy subjects (average age = 28 years (SD = 7.1; range = 21-49); and 40% female) who were exposed to two conditions, filtered air (FA) and DE (300 μg PM2.5/m3) for 120 min, in a double-blinded crossover study with randomized exposures separated by four weeks. Postural stability was assessed by the Balance Error Scoring System (BESS), a brief, easily-administered test of static balance. The BESS consists of a sequence of three stances performed on two surfaces. With hands on hips and eyes closed, each stance is held for 20 s. "Error" points are awarded for deviations from those stances. Pre- and immediately post-exposure BESS "error" point totals were calculated and the difference between the two timepoints were compared for each of the two exposure conditions. A mixed effect model assessed the significance of the association. While our data demonstrates a trend of reduced postural stability in response to exposure to DE, exposure was not significantly associated with BESS value. This is the first study to investigate changes in postural stability as a result of exposure to DE in human subjects.

Keywords: Air pollution; Balance; Bess; Crossover design; Diesel exhaust; Exposure; Postural stability; Traffic.

Conflict of interest statement

Consent forms were approved by the University of British Columbia Clinical Research Ethics Board (# H12–03025), Vancouver Coastal Health Ethics Board (# V12–03025), and Health Canada’s Research Ethics Board (# 2012–0040). All subjects participating in the study provided informed, written consent.Not applicable.The authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.


Fig. 1
Fig. 1
Outline of the EAPOC study design. Each crossover condition (FA/DE) was separated by a four-week washout period
Fig. 2
Fig. 2
Stances used in Balance Error Scoring System (BESS): (i) double-leg stance; (ii) single-leg stance (standing on the non-dominant limb); (iii) tandem stance; (iv) double-leg stance with foam; (v), single leg on foam; and, (vi) tandem stance on foam
Fig. 3
Fig. 3
A sum of all Balance Error Scoring System (BESS) stance scores at baseline and post-exposure timepoints for sham condition (filtered air) and diesel exhaust condition

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