Background and Objectives: Particulate Matter (PM), particles of variable but small diameter can penetrate the respiratory system via inhalation, causing respiratory and/or cardiovascular diseases. This study aims to evaluate the association of environmental particulate matter (PM2.5) and black carbon (BC) with respiratory health in users of different transport modes in four roads in Bogotá. Materials and Methods: this was a mixed-method study (including a cross sectional study and a qualitative description of the air quality perception), in 300 healthy participants, based on an exploratory sequential design. The respiratory effect was measured comparing the changes between pre- and post-spirometry. The PM2.5 and black carbon (BC) concentrations were measured using portable devices. Inhaled doses were also calculated for each participant according to the mode and route. Perception was approached through semi-structured interviews. The analysis included multivariate models and concurrent triangulation. Results: The concentration of matter and black carbon were greater in bus users (median 50.67 µg m−3; interquartile range (–IR): 306.7). We found greater inhaled dosages of air pollutants among bike users (16.41 µg m−3). We did not find changes in the spirometry parameter associated with air pollutants or transport modes. The participants reported a major sensory influence at the visual and olfactory level as perception of bad air quality. Conclusions: We observed greater inhaled doses among active transport users. Nevertheless, no pathological changes were identified in the spirometry parameters. People’s perceptions are a preponderant element in the assessment of air quality.

Background Air pollution in most countries exceeds the levels recommended by the World Health Organization, causing up to one-third of deaths due to noncommunicable diseases. Fine particulate matter (PM2.5) and black carbon (BC) from mobile sources are the main contaminants. Objective The aim of this study is to assess the relationship of exposure to air pollutants (PM2.5 and BC) in microenvironments according to respiratory health and physical activity in users traveling by different types of transportation in Bogotá, Colombia. Methods A mixed methods study based on a convergent parallel design will be performed with workers and students. The sample will include 350 healthy transport users traveling by different urban transportation modes in three main routes in Bogotá. The study is broken down into two components: (1) a descriptive qualitative component focused on assessing the individual perception of air pollution using semistructured interviews; and (2) a cross-sectional study measuring the individual exposure to PM2.5 and BC using portable instruments (DustTrak and microAeth, respectively), pulmonary function by spirometry, and physical activity with accelerometry. The analysis will include concurrent triangulation and logistic regression. Results The findings will be useful for the conception, design, and decision-making process in the sectors of health and mobility from public, academy, and private perspectives. This study includes personal measurements of PM2.5 and BC during typical trips in the city to assess the exposure to these contaminants in the major roadways in real time. The study further compares the performance of two different lung tests to identify possible short-term respiratory effects. As a limitation, the protocol will include participants from different institutions in the city, which are not necessarily representative of all healthy populations in Bogotá. In this sense, it is not possible to draw causation conclusions. Moreover, a convergent parallel design could be especially problematic concerning integration because such a design often lacks a clear plan for making a connection between the two sets of results, which may not be well connected. Nevertheless, this study adopts a procedure for how to integrate qualitative and quantitative data in the interpretation of the results and a multilevel regression. The time that participants must live in the city will be considered; this will be controlled in the stratified analysis. Another limitation is the wide age range and working status of the participants. Regional pollution levels and episodes (PM2.5) will be handled as confounding variables. The study is currently in the enrollment phase of the participants. Measurements have been made on 300 participants. Pandemic conditions affected the study schedule; however, the results are likely to be obtained by late 2022. Conclusions This study investigates the exposure to air pollutants in microenvironments in Bogotá, Colombia. To our knowledge, this is the first mixed methods study focusing on PM2.5, BC, and respiratory health effects in a city over 2 meters above sea level. This study will provide an integration of air pollution exposure variables and respiratory health effects in different microenvironments. International Registered Report Identifier (IRRID) PRR1-10.2196/25690

The Particulate Matter (PM), particles of variable but small diameter could penetrate the respiratory system via inhalation, causing respiratory and/or cardiovascular diseases. This study aims to evaluate the association of environmental particulate matter (PM2.5) and black carbon (BC) with respiratory health and physical activity in users traveling by transportation modes over four roads in Bogotá. This was a mixed-method study, in 300 healthy participants, based on a convergent parallel design. Including a descriptive qualitative component focused on asserting the individual perception of air pollution by semi-structured interviews and a cross-sectional study measuring the individual exposure to PM2.5 and BC to evaluate the pulmonary function by spirometry. The analysis included concurrent triangulation and a Poisson regression. This study provides integration of air pollution exposure variables and respiratory health effects in different transport microenvironments. To our knowledge, this is the first mixed-methods study focused on PM2.5, BC, and respiratory health effects in a city above 2.000 meters above sea level.

Resumen: Introducción: las guías de práctica clínica (GPC) optimizan la atención médica basada en la mejor evidencia disponible. En Colombia, existen más de 60 GPC basadas en la evidencia desde 2013. Dichas herramientas han sido promovidas por entes nacionales e internacionales. Sin embargo, la información publicada a partir de una muestra de múltiples prestadores de servicios de salud (PSS) sobre el uso en la práctica de estas herramientas es limitada. Objetivo: identificar factores que los PSS asocian al conocimiento, barreras y uso de las GPC elaboradas por el Gobierno de Colombia a partir del 2013. Métodos: estudio transversal con muestreo aleatorio simple con reemplazo por departamentos colombianos que envió encuestas a los PSS por correo electrónico durante 2019. Se utilizaron modelos multivariado para identificar factores asociados al conocimiento, barreras y uso de las GPC. Resultados: El 91% de las respuestas provenientes de los PSS refirió conocer las GPC y el 85% las ha usado alguna vez. Además, el 89% percibió barreras al momento de usar las GPC. Si identificó que los PSS privados, personal joven y quienes realizan tareas administrativas tienen más probabilidad a acceder a las GPC. Así mismo, los PSS de baja complejidad, personal joven y administrativo son quienes reportaron mayor uso de las GPC. Por último, el personal clínico fue quien reportó mayores desafíos para usar las guías. Conclusiones: El conocimiento y uso de GPC es alto entre los PSS; no obstante, la presencia de barreras al momento de usarlas constituye una oportunidad de mejora en la implementación y adherencia a las GPC en los PSS. Objetivo: identificar factores que los PSS asocian al conocimiento, barreras y uso de las GPC elaboradas por el Gobierno de Colombia a partir del 2013. Métodos: estudio transversal con muestreo aleatorio simple con reemplazo por departamentos colombianos que envió encuestas a PSS por correo electrónico entre noviembre y diciembre de 2019. Se utilizaron modelos multivariado para identificar los factores asociados al conocimiento, barreras y uso de las GPC. Resultados: El 91% de las respuestas provenientes de PSS refirió conocer las GPC y el 85% las ha usado alguna vez. Sin embargo, el 89% percibió barreras al momento de usar las GPC. Las respuestas de PSS privados tenían menor probabilidad de usar las GPC. Conclusiones: El conocimiento y uso de GPC es alto entre los PSS, no obstante, la presencia de barreras al momento de usarlas constituye una oportunidad de mejora en la implementación y adherencia a las GPC en los PSS.

BACKGROUND Air pollution in most countries exceeds the levels recommended by the World Health Organization, causing up to one-third of deaths due to non-communicable diseases. Particulate matter (PM) and black carbon (BC) from mobile sources are the main contaminants. OBJECTIVE This research will aim to assess the relationship of exposure to air pollutants in microenvironments (PM2.5 and BC), with respiratory health and physical activity in users traveling by different types of transportation in Bogotá METHODS A mixed-methods study based on a convergent parallel design will be carried out with workers and students, the sample will include 350 healthy transport users traveling by different urban transportation modes in three main routes in Bogotá. The study will be performed into two components. First, a descriptive qualitative component focused on asserting the individual perception of air pollution by semi-structured interviews. Second, a cross-sectional study towards a) measuring the individual exposure to PM2.5 and BC using portable instruments (DustTrak and microAeth, respectively) b) measuring the pulmonary function by spirometry; c) assessing physical activity with Accelerometry. The analysis will include a concurrent triangulation and logistic regression. This protocol was approved by the technical and ethical committee of Instituto Nacional de Salud, protocol number 7, issued on April 4, 2019. Informed consent will be obtained from all participants before conducting the study. RESULTS The findings, from a public/academy/private perspective, will be useful for the conception, design, and decision-making process in both sectors: health and mobility. This study includes personal measurements of PM2.5 and BC during typical trips in the city, allowing to know in real-time the exposure to these contaminants in the major roadways. Also, the study compares two different lung tests to identify possible short-term respiratory effects. As a limitation, the protocol will include participants from different institutions in the city which are not necessarily representative of all healthy populations in Bogota. In this sense, it is not possible to draw causation conclusions. In spite, convergent parallel designs could be especially problematic concerning integration because they often lack a clear plan for making a connection between the two sets of results. In this case, this kind of design is left with two separate sets of results that may not be well connected. Nevertheless, the study counts with a procedure for how to integrate qualitative and quantitative data in the interpretation of the results and also a logistic regression. The time that participants have to live in the city will be taken into account; this will be controlled in the stratified analysis. Another limitation is the wide age range and working status of the participants. Regional pollution levels and episodes (PM2.5) will be handled as confounding variables. Since the use of masks is part of the strategy for prevention and control that can limit the spread of COVID-19, as a biosecurity protocol all participants will use surgical face masks during field measurements. CONCLUSIONS In this study, it is hypothesized the exposure to air pollutants in microenvironments in Bogotá, Colombia. To our knowledge, this is the first mixed-methods study focused on PM2.5, BC, and respiratory health effects in a city above 2.000 meters above sea level. This study will provide an integration of air pollution exposure variables and respiratory health effects in different microenvironments.