Associations between ambient fine particulate air pollution and hypertension: A nationwide cross-sectional study in China

Limited evidence is available regarding the long-term effects of fine particulate (PM_2.5) air pollution on hypertension in developing countries. This study aimed to explore the associations of long-term exposure to PM_2.5 with hypertension prevalence and blood pressure (BP) in China. We conducted a cross-sectional study based on a nationally representative survey (13,975 participants). We estimated the long-term average exposure to PM_2.5 for all subjects during the study period (June 2011 to March 2012) by a satellite-based model with a spatial resolution of 10×10km. We applied multivariable logistic regression models to evaluate the associations between PM_2.5 and hypertension prevalence and linear regression models for the associations between PM_2.5 and systolic BP and diastolic BP. We also explored potential effect modification by stratification analyses. There were 5715 cases of hypertension, accounting for 40.9% of the study population in this analysis. The annual mean exposure to PM_2.5 for all participants was 72.8μg/m³ on average. An interquartile range increase (IQR, 41.7μg/m³) in PM_2.5 was associated with higher prevalence of hypertension with an odds ratio of 1.11 [95% confidence interval (CI): 1.05, 1.17]. Systolic BP increased by 0.60mmHg (95% CI: 0.05, 1.15) per an IQR increase in PM_2.5. The effects of PM_2.5 on hypertension prevalence were stronger among middle-aged, obese and urban participants. This national study indicated that long-term exposure to PM_2.5 was associated with increased prevalence of hypertension and slightly higher systolic BP in China.

Associations between ambient fine particulate air pollution and hypertension: A nationwide cross-sectional study in China

Limited evidence is available regarding the long-term effects of fine particulate (PM_2.5) air pollution on hypertension in developing countries. This study aimed to explore the associations of long-term exposure to PM_2.5 with hypertension prevalence and blood pressure (BP) in China. We conducted a cross-sectional study based on a nationally representative survey (13,975 participants). We estimated the long-term average exposure to PM_2.5 for all subjects during the study period (June 2011 to March 2012) by a satellite-based model with a spatial resolution of 10×10km. We applied multivariable logistic regression models to evaluate the associations between PM_2.5 and hypertension prevalence and linear regression models for the associations between PM_2.5 and systolic BP and diastolic BP. We also explored potential effect modification by stratification analyses. There were 5715 cases of hypertension, accounting for 40.9% of the study population in this analysis. The annual mean exposure to PM_2.5 for all participants was 72.8μg/m³ on average. An interquartile range increase (IQR, 41.7μg/m³) in PM_2.5 was associated with higher prevalence of hypertension with an odds ratio of 1.11 [95% confidence interval (CI): 1.05, 1.17]. Systolic BP increased by 0.60mmHg (95% CI: 0.05, 1.15) per an IQR increase in PM_2.5. The effects of PM_2.5 on hypertension prevalence were stronger among middle-aged, obese and urban participants. This national study indicated that long-term exposure to PM_2.5 was associated with increased prevalence of hypertension and slightly higher systolic BP in China.

Ambient air pollution and primary liver cancer incidence in four European cohorts within the ESCAPE project

BACKGROUND

Tobacco smoke exposure increases the risk of cancer in the liver, but little is known about the possible risk associated with exposure to ambient air pollution.

OBJECTIVES

We evaluated the association between residential exposure to air pollution and primary liver cancer incidence.

METHODS

We obtained data from four cohorts with enrolment during 1985-2005 in Denmark, Austria and Italy. Exposure to nitrogen oxides (NO₂ and NO_X), particulate matter (PM) with diameter of less than 10µm (PM₁₀), less than 2.5µm (PM_2.5), between 2.5 and 10µm (PM_2.5-10) and PM_{2.5 absorbance} (soot) at baseline home addresses were estimated using land-use regression models from the ESCAPE project. We also investigated traffic density on the nearest road. We used Cox proportional-hazards models with adjustment for potential confounders for cohort-specific analyses and random-effects meta-analyses to estimate summary hazard ratios (HRs) and 95% confidence intervals (CIs).

RESULTS

Out of 174,770 included participants, 279 liver cancer cases were diagnosed during a mean follow-up of 17 years. In each cohort, HRs above one were observed for all exposures with exception of PM_{2.5 absorbance} and traffic density. In the meta-analysis, all exposures were associated with elevated HRs, but none of the associations reached statistical significance. The summary HR associated with a 10-μg/m³ increase in NO₂ was 1.10 (95% confidence interval (CI): 0.93, 1.30) and 1.34 (95% CI: 0.76, 2.35) for a 5-μg/m³ increase in PM_2.5.

CONCLUSIONS

The results provide suggestive evidence that ambient air pollution may increase the risk of liver cancer. Confidence intervals for associations with NO₂ and NO_X were narrower than for the other exposures.

Association of outdoor air pollution and indoor renovation with early childhood ear infection in China

BACKGROUND

Otitis media (OM) is a common infection in early childhood with repeated attacks that lead to long-term complications and sequelae, but its risk factors still remain unclear.

OBJECTIVE

To examine the risk of childhood OM for different indoor and outdoor air pollutants during different timing windows, with a purpose to identify critical windows of exposure and key components of air pollution in the development of OM.

METHODS

We conducted a retrospective cohort study of 1617 children aged 3-4 years in Changsha, China (2011-2012). Children's life-time prevalence of OM and exposure to indoor air pollution related to home renovation activities were surveyed by a questionnaire administered by the parents. Children's exposure to outdoor air pollution, including nitrogen dioxide (NO₂), sulfur dioxide (SO₂), and particulate matter with an aerodynamic diameter ≤ 10 μm (PM₁₀), was estimated using the measured concentrations at municipal monitoring stations. The odds ratio (OR) and 95% confidence interval (CI) of childhood OM for prenatal and postnatal exposure to indoor and outdoor air pollution were examined by using logistic regression model.

RESULTS

Life-time prevalence of OM in preschool children (7.3%) was associated not only with prenatal exposure to industrial air pollutant with adjusted OR (95% CI) = 1.44 (1.09-1.88) for a 27 μg/m³ increase in SO₂ but also with postnatal exposure to indoor renovations with OR (95% CI) = 1.62 (1.05-2.49) for new furniture and 1.81 (1.12-2.91) for redecoration, particularly in girls. Combined exposure to outdoor SO₂ and indoor renovation significantly increased OM risk. Furthermore, we found that exposure to outdoor SO₂ and indoor renovation were significantly associated with the onset but not repeated attacks of OM.

CONCLUSION

Prenatal exposure to outdoor industrial air pollution and postnatal exposure to indoor renovation are independently associated with early childhood OM in China and may cause the OM onset.

Environmental factors contributed to circannual rhythm of semen quality

We investigated whether human semen parameters present circannual rhythm or not, and whether environmental factors exert on semen quality. This retrospective study used data of patients mainly from Reproductive Medicine Center and Urology and Andrology Clinic of a general hospital in China. Sperm concentration and motility were measured by computer aided sperm analysis (CASA). Sperm morphology was scored based on the strict criteria (WHO, 2010). The Kruskal-Wallis rank test was used to investigate the relationship between semen parameters and season/month. Partial correlation coefficients were used to analyze the relationship between semen parameters and environmental factors. In this study, we found that sperm concentration and total amount per ejaculate were significantly lower in summer and higher in winter. But, sperm progressive motility and motility were significantly higher in spring and summer (from March to June), lower in autumn and winter (September and October). Unexpectedly, normal sperm morphology and mixed agglutination reaction (MAR) positive rate didn't vary along with season or month. Furthermore, temperature was negatively related to sperm concentration and total amount per ejaculate. Precipitation was positively associated with progressive motility and normal sperm morphology, but negatively related to sperm head defect percentage. The length of sunlight was positively related to progressive motility. The Air Quality Index (AQI) was positively associated with semen volume and sperm total amount per ejaculate. These suggest seasonal and monthly variation underlying some semen parameters.

Air Pollution and Children's Health in Chinese

Children can be considered as a high-risk population to environmental stress since some of the organ systems including the immune system and respiratory system are still in development during childhood. During childhood, the impact of environmental pollutants exposure may program child growth and development that have long-term consequences on later health and disease risk. Considering the rapid economic growth in recent decades in China, the impact of ambient air pollution on children health causes concerns. Therefore, we aimed to review the current epidemiological evidence on the effects of air pollution exposure on adverse health outcome, including respiratory diseases, lung function, high blood pressure, cognitive disorder, and obesity in childhood in China. We believe that the findings summarized in our review demonstrate an unequivocal relationship between air pollutants exposure and Chinese children health and these results have large public health influences.

Ambient Air Pollution and Morbidity in Chinese

The rapid economic growth in China is coupled with a severe ambient air pollution, which poses a huge threat to human health and the sustainable development of social economy. The rapid urbanization and industrialization over the last three decades have placed China as one of countries with the greatest disease burden in world. Notably, the prevalence rate of chronic noncommunicable diseases (CND), including respiratory diseases, CVD, and stroke, in 2010 reaches 16.9%. The continuous growth of the incidence of CND urgent needs for effective regulatory action for health protection. This study aims to evaluate the impact of rapid urbanization on status of ambient air pollution and associated adverse health effects on the incidence and the burden of CND and risk assessment. Our findings would be greatly significant in the prediction of the risk of ambient air pollution on CND and for evidence-based policy making and risk management in China.

Associations of gestational and early life exposures to ambient air pollution with childhood atopic eczema in Shanghai, China

Whether ambient air pollution is associated with childhood atopic eczema is controversial. In this paper, we selected 3358 preschool children who had not altered residences since pregnancy from a cross-sectional study during 2011-2012 in Shanghai, China, and obtained parent-reported data regarding childhood atopic eczema using an improved ISAAC questionnaire. We recorded daily concentrations of SO₂, NO₂, and PM₁₀ throughout the child's lifetime (2006-2012), and calculated period-averaged concentrations for each district where the child lived to represent the child's exposure levels of these pollutants during different periods. In the multiple logistic regression analyses adjusted for potential confounders as well as for the other pollutants in the same periods, childhood atopic eczema was significantly associated with increments of NO₂ in the approximate interquartile range (20μg/m³) during gestational period (adjusted OR, 95% CI for eczema lifetime-ever: 1.80, 1.29-2.49; for eczema in the year prior to the survey: 2.32, 1.57-3.43) and during the first year of life (2.00, 1.40-2.84; 2.16, 1.43-3.28). Exposure to elevated NO₂ in the first two years, three years and total lifetime, as well as exposure to mixtures containing NO₂ in each of these periods, were consistently associated with increased likelihood of childhood eczema. The highest odds ratios were found between exposure to a mixture of SO₂ and NO₂ during total lifetime (increment: 35μg/m³) and childhood eczema (adjusted OR, 95% CI: 2.80, 1.75-4.48; 3.50, 1.98-6.19). No significant associations were found between childhood eczema and ambient SO₂ and PM₁₀ individually or in mixtures. This study indicates that gestational and lifetime exposures to ambient NO₂ are risk factors for atopic eczema in childhood. Exposure to ambient SO₂ and PM₁₀ may enhance the effect of NO₂ exposure on childhood eczema.

Association between ambient air pollution and proliferation of umbilical cord blood cells

It has been established as a common knowledge that ambient air pollution (AAP) has an adverse effect on human health. The pathophysiological mechanism of this impact is likely to be related to the oxidative stress. In the current study we estimate the association between AAP and cell proliferation (CP) of umbilical cord blood cells, representing maternal organism most proximal to the fetal body. Blood samples were tested for proliferation in 292 enrolled Arab-Bedouin women at delivery (July 2012-March 2013). The estimates of AAP were defined by a hybrid satellite based model predicting both PM_2.5 (particles<2.5µm in diameter) and PM₁₀ (particles<10µm in diameter) as well as monitoring stations for gaseous air pollutants. Risk estimates of pollution exposure were adjusted to medical history, household risk factors and meteorological factors on the day of delivery or one week prior. Ambient ozone (O₃) levels on 1, 2, 3and 4 days prior to delivery were associated with lower CP (Prevalence ratio (PR)=0.92, 0.92, 0.93, 0.93, respectively). Increase in inter-quartile range (IOR) of PM_2.5 one day before delivery was associated with 9% increase in CP levels (PR=1.09). The positive direction in association was changed to negative association with CP for PM_2.5 levels measured at more distant time periods (PR=0.90 and 0.93 for lags 5 and 6 days, respectively). Investigation of PM₁₀ levels indicated a similar pattern (PR=1.05 for pollution values recorded one day before delivery and 0.93 and 0.95 for lags of 5 and 6 days, respectively). Carbon monoxide (CO) levels were associated with lower CP on the day of delivery and 1day prior (PR=0.92 and PR=0.94). To conclude, the levels of cell proliferation of umbilical cord blood cells appear to be associated with the AAP. More studies are needed to support our findings.

Traffic-related air pollution increased the risk of Parkinson's disease in Taiwan: A nationwide study

BACKGROUND

Ambient air pollution has been associated with many health conditions, but little is known about its effects on neurodegenerative diseases, such as Parkinson's disease (PD). In this study, we investigated the influence of ambient air pollution on PD in a nationwide population-based case-control study in Taiwan.

METHODS

We identified 11,117 incident PD patients between 2007 and 2009 from the Taiwanese National Health Insurance Research Database and selected 44,468 age- and gender-matched population controls from the longitudinal health insurance database. The average ambient pollutant exposure concentrations from 1998 through the onset of PD were estimated using quantile-based Bayesian Maximum Entropy models. Basing from logistic regression models, we estimated the odds ratios (ORs) and 95% confidence intervals (CIs) of ambient pollutant exposures and PD risk.

RESULTS

We observed positive associations between NO_x, CO exposures, and PD. In multi-pollutant models, for NO_x and CO above the 75th percentile exposure compared with the lowest percentile, the ORs of PD were 1.37 (95% CI=1.23-1.52) and 1.17 (95% CI=1.07-1.27), respectively.

CONCLUSIONS

This study suggests that ambient air pollution exposure, especially from traffic-related pollutants such as NO_x and CO, increases PD risk in the Taiwanese population.

Associations of gestational and early life exposures to ambient air pollution with childhood respiratory diseases in Shanghai, China: A retrospective cohort study

BACKGROUND

Associations of ambient air pollutants with respiratory health are inconsistent.

OBJECTIVES

We analyzed the associations of gestational and early life exposures to air pollutants with doctor-diagnosed asthma, allergic rhinitis, and pneumonia in children.

METHODS

We selected 3358 preschool children who did not alter residences after birth from a cross-sectional study in 2011-2012 in Shanghai, China. Parents reported children's respiratory health history, home environment, and family lifestyle behaviors. We collected daily concentrations of sulphur dioxide (SO2), nitrogen dioxide (NO2), and particulate matter with an aerodynamic diameter ≤10μm (PM10) during the child's total lifetime (2006-2012) for each district where the children lived. We analyzed the associations using logistic regression models.

RESULTS

After adjusting for covariates and the other studied pollutants, we found that exposure to NO2 (increment of 20μg/m(3)) during the first year of life was significantly associated with asthma [odds ratio (OR)=1.77; 95% confidence interval (CI): 1.29-2.43] and allergic rhinitis (OR=1.67; 95% CI: 1.07-2.61). Exposure to NO2 during gestation, the first two and three years, and over total lifetimewas all consistently associated with increased odds of allergic rhinitis. Quartiles of NO2 concentration during different exposure periods showed a slight dose-response relationship with the studied diseases. These diseases had significant associations with pollutant mixtures that included NO2, but had no significant association with exposures to SO2 and PM10 individually or in mixtures.

CONCLUSIONS

Gestational and early life exposures to ambient NO2 are risk factors for childhood respiratory diseases.

Spatial variations in the associations of term birth weight with ambient air pollution in Georgia, USA

Birth weight is an important indicator of overall infant health and a strong predictor of infant morbidity and mortality, and low birth weight (LBW) is a leading cause of infant mortality in the United States. Numerous studies have examined the associations of birth weight with ambient air pollution, but the results were inconsistent. In this study, a spatial statistical technique, geographically weighted regression (GWR) is applied to explore the spatial variations in the associations of birth weight with concentrations of ozone (O3) and fine particulate matter (PM2.5) in the State of Georgia, USA adjusted for gestational age, parity, and six other socioeconomic, behavioral, and land use factors. The results show considerable spatial variations in the associations of birth weight with both pollutants. Significant positive, non-significant, and significant negative relationships between birth weight and concentrations of each air pollutant are all found in different parts of the study area, and the different types of the relationships are affected by the socioeconomic and urban characteristics of the communities where the births are located. The significant negative relationships between birth weight and O3 indicate that O3 is a significant risk factor of LBW and these associations are primarily located in less-urbanized communities. On the other hand, PM2.5 is a significant risk factor of LBW in the more-urbanized communities with higher family income and education attainment. These findings suggest that environmental and health policies should be adjusted to address the different effects of air pollutants on birth outcomes across different types of communities to more effectively and efficiently improve birth outcomes.

A structured review of panel studies used to investigate associations between ambient air pollution and heart rate variability

INTRODUCTION

Dysfunction of the autonomic nervous system is one of the postulated pathways linking short-term exposure to air pollution to adverse cardiovascular outcomes. A hypothesis is that exposure to air pollution decreases heart rate variability, a recognized independent predictor of poorer cardiovascular prognosis.

METHODS

We conducted a structured review of panel studies published between 1946 and July 2015 of the association between ambient air pollution and parameters of heart rate variability reflecting autonomic nervous function. We focused on exposure to mass concentrations of fine particles (PM2.5), nitrogen dioxide (NO2), and ozone (O3), and four commonly used indices of heart rate variability (HRV): standard deviation of all normal-to-normal intervals (SDNN); root mean square of successive differences in adjacent normal-to-normal intervals (RMSSD); high frequency power (HF); and low frequency power (LF). We searched bibliographic databases and references of identified articles and abstracted characteristics of their design and conduct, and synthesized the quantitative findings in graphic form according to health condition of the study population and the functional form of the HRV indices used in the regression analyses.

RESULTS

A total of 33 panel studies were included: 31, 12, and 13 studies were used to investigate ambient exposure to PM2.5, NO2 and O3, respectively. We found substantial variation across studies in terms of design characteristics and statistical methodologies, and we identified some studies that may have had methodological and statistical issues. Because many panel studies were not comparable to each other, meta-analyses were not generally possible, although we were able to pool the results obtained amongst older adults who had cardiovascular disease for the 24-h average concentrations of PM2.5 prior to the heart rate variability measurements. In studies of PM2.5 among older adults with cardiovascular disease, logarithmic transformations of the HRV indices were used in ten studies. Negative associations across all HRV indices were found in 60-86% of these studies for periods of exposures ranging from 5-min to 5-days. The pooled percent changes for an increase of 10μg/m(3) in the 24-h prior to the measurements of HRV were: -2.11% for SDNN (95% confidence interval (95%CI): -4.00, -0.23%), -3.29% for RMSSD (95%CI: -6.32, -0.25%), -4.76% for LF (95%CI: -12.10, 2.58%), and -1.74% for HF (95%CI: -7.79, 4.31%). No transformations were used in seven studies of PM2.5 among older adults with cardiovascular disease, and we found for absolute differences pooled changes in the HRV indices, for an increase of 10μg/m(3), of -0.31ms for SDNN (95%CI: -1.02, 0.41ms) and -1.22ms for RMSSD (95%CI: -2.37; -0.07ms). For gaseous pollutants, negative associations over periods of exposure ranging from 5-min or to 5-days prior to the heart rate variability measurements were reported in 71-83% of studies of NO2 and 57-100% of studies of O3, depending of the indices of heart rate variability. However, many of these studies had statistical or methodological issues, and in the few studies without these issues the confidence intervals were relatively wide and mostly included the null.

CONCLUSIONS AND DISCUSSION

We were not persuaded by the results that there was an association between PM2.5 and any of the four indices of heart rate variability. For NO2 and O3 the number of high-quality studies was insufficient to draw any definite conclusions. Further panel studies with improved design and methodologies are needed to help establish or refute an association between ambient exposure to air pollution and heart rate variability.

Exposure to industrial air pollutant emissions and lung function in children: Canadian Health Measures Survey, 2007 to 2011

BACKGROUND

Long-term exposure to ambient air pollution has been associated with adverse effects on children's lung function. Few studies have examined lung function in relation to industrial emissions of air pollutants.

DATA AND METHODS

This cross-sectional study was based on 2,833 respondents aged 6 to 18 for whom spirometry data were collected by the Canadian Health Measures Survey, 2007 to 2011. The weighted sum of industrial air emissions of nitrogen oxides (NOₓ) and fine particulate matter (PM2.5) within 25 km of the respondent's residence was derived using National Pollutant Release Inventory data. Multivariate linear regression was used to examine the relationship between NOₓ and PM2.5 emissions and forced vital capacity (FVC), the forced expiratory volume in 1 sec (FEV₁), and the ratio of the two (FEV₁/FVC).

RESULTS

Industrial air emissions of NOₓ were not significantly associated with lung function among males or females. Emissions of PM2.5 were negatively associated with FEV₁ and FEV₁/FVC, but not FVC, among males. PM2.5 was not significantly related to lung function among females.

INTERPRETATION

The associations that emerged between lung function and industrial emissions of PM2.5 among males were consistent with airway obstruction. Further research is warranted to investigate the gender differences observed in this study.

Life cycle impact assessment modeling for particulate matter: A new approach based on physico-chemical particle properties

Particulate matter (PM) causes severe damage to human health globally. Airborne PM is a mixture of solid and liquid droplets suspended in air. It consists of organic and inorganic components, and the particles of concern range in size from a few nanometers to approximately 10μm. The complexity of PM is considered to be the reason for the poor understanding of PM and may also be the reason why PM in environmental impact assessment is poorly defined. Currently, life cycle impact assessment is unable to differentiate highly toxic soot particles from relatively harmless sea salt. The aim of this article is to present a new impact assessment for PM where the impact of PM is modeled based on particle physico-chemical properties. With the new method, 2781 characterization factors that account for particle mass, particle number concentration, particle size, chemical composition and solubility were calculated. Because particle sizes vary over four orders of magnitudes, a sound assessment of PM requires that the exposure model includes deposition of particles in the lungs and that the fate model includes coagulation as a removal mechanism for ultrafine particles. The effects model combines effects from particle size, solubility and chemical composition. The first results from case studies suggest that PM that stems from emissions generally assumed to be highly toxic (e.g. biomass combustion and fossil fuel combustion) might lead to results that are similar compared with an assessment of PM using established methods. However, if harmless PM emissions are emitted, established methods enormously overestimate the damage. The new impact assessment allows a high resolution of the damage allocatable to different size fractions or chemical components. This feature supports a more efficient optimization of processes and products when combating air pollution.

Methodological issues related to pooling results from panel studies of heart rate variability and its association with ambient air pollution

Reviews of observational studies and subsequent meta-analyses are challenging to interpret because of potential methodological issues and biases inherent in studies. In reviewing panel studies of the association between heart rate variability and ambient air pollution we identified a number of methodological issues that make difficult interpreting and pooling findings from longitudinal studies, notably issues related to associations arising from different type of designs, differences in design characteristics, including study populations, measurements of heart rate variability (e.g., duration and condition of the electrocardiogram recordings), exposure assessment (e.g., types of monitoring), metrics of exposure used, and parameters estimated from regression models. We conclude that many panel studies of the association between heart rate variability and ambient air pollution may not be comparable to each other, and thus caution must be exercised to avoid misleading conclusions.

Association between Ambient Air Pollution and Hospital Emergency Admissions for Respiratory and Cardiovascular Diseases in Beijing: a Time Series Study

OBJECTIVE

To investigate the association between ambient air pollution and hospital emergency admissions in Beijing.

METHODS

In this study, a semi-parametric generalized additive model (GAM) was used to evaluate the specific influences of air pollutants (PM10, SO2, and NO2) on hospital emergency admissions with different lag structures from 2009 to 2011, the sex and age specific influences of air pollution and the modifying effect of seasons on air pollution to analyze the possible interaction.

RESULTS

It was found that a 10 μg/m3 increase in concentration of PM10 at lag 03 day, SO2 and NO2 at lag 0 day were associated with an increase of 0.88%, 0.76%, and 1.82% respectively in overall emergency admissions. A 10 μg/m3 increase in concentration of PM10, SO2 and NO2 at lag 5 day were associated with an increase of 1.39%, 1.56%, and 1.18% respectively in cardiovascular disease emergency admissions. For lag 02, a 10 μg/m3 increase in concentration of PM10, SO2 and NO2 were associated with 1.72%, 1.34%, and 2.57% increases respectively in respiratory disease emergency admissions.

CONCLUSION

This study further confirmed that short-term exposure to ambient air pollution was associated with increased risk of hospital emergency admissions in Beijing.

A GIS-based spatial correlation analysis for ambient air pollution and AECOPD hospitalizations in Jinan, China

BACKGROUND

Acute exacerbations of COPD (AECOPD) are important events during disease procedure. AECOPD have negative effect on patients' quality of life, symptoms and lung function, and result in high socioeconomic costs. Though previous studies have demonstrated the significant association between outdoor air pollution and AECOPD hospitalizations, little is known about the spatial relationship utilized a spatial analyzing technique- Geographical Information System (GIS).

OBJECTIVE

Using GIS to investigate the spatial association between ambient air pollution and AECOPD hospitalizations in Jinan City, 2009.

METHODS

414 AECOPD hospitalization cases in Jinan, 2009 were enrolled in our analysis. Monthly concentrations of five monitored air pollutants (NO2, SO2, PM10, O3, CO) during January 2009-December 2009 were provided by Environmental Protection Agency of Shandong Province. Each individual was geocoded in ArcGIS10.0 software. The spatial distribution of five pollutants and the temporal-spatial specific air pollutants exposure level for each individual was estimated by ordinary Kriging model. Spatial autocorrelation (Global Moran's I) was employed to explore the spatial association between ambient air pollutants and AECOPD hospitalizations. A generalized linear model (GLM) using a Poisson distribution with log-link function was used to construct a core model.

RESULTS

At residence, concentrations of SO2, PM10, NO2, CO, O3 and AECOPD hospitalization cases showed statistical significant spatially clustered. The Z-score of SO2, PM10, CO, O3, NO2 at residence is 15.88, 13.93, 12.60, 4.02, 2.44 respectively, while at workplace, concentrations of PM10, SO2, O3, CO and AECOPD hospitalization cases showed statistical significant spatially clustered. The Z-score of PM10, SO2, O3, CO at workplace is 11.39, 8.07, 6.10, and 5.08 respectively. After adjusting for potential confounders in the model, only the PM10 concentrations at workplace showed statistical significance, with a 10 μg/m(3) increase of PM10 at workplace associated with a 7% (95%CI: [3.3%, 10%]) increase of hospitalizations due to AECOPD.

CONCLUSIONS

Ambient air pollution is correlated with AECOPD hospitalizations spatially. A 10 μg/m(3) increase of PM10 at workplace was associated with a 7% (95%CI: [3.3%, 10%]) increase of hospitalizations due to AECOPD in Jinan, 2009. As a spatial data processing tool, GIS has novel and great potential on air pollutants exposure assessment and spatial analysis in AECOPD research.

Associations between ambient air pollution and bone turnover markers in 10-year old children: results from the GINIplus and LISAplus studies

Negative associations between bone turnover markers and bone mineral density have been reported. In order to study the association between ambient air pollution and bone turnover markers, as indicators of bone loss, we investigated associations between land-use regression modeled air pollution (NO2, PM2.5 mass, PM2.5 - 10 [coarse particles], PM10 mass and PM2.5 absorbance) and bone turnover markers in 2264 children aged 10 years. Serum osteocalcin and C-terminal telopeptide of type I collagen (CTx), measured by Modular-System (Roche), were the two bone turnover markers considered in this analysis. In total population, NO2, PM2.5 - 10 and PM10 mass exposure were positively and significantly associated with both osteocalcin and CTx. A 2.5 (95% CI: 0.6, 4.4) ng/ml increase in osteocalcin and a 24.0 (95% CI: 6.7, 41.3) ng/L increase in CTx were observed per IQR (6.7μg/m(3)) increase in NO2, independent of socioeconomic status, sex, age, pubertal status, fasting status and total physical activity. The estimated coefficients were 3.0 (95% CI: 0.1, 5.8) for osteocalcin and 32.3 (95% CI: 6.1, 58.5) for CTx with PM2.5 - 10; 3.2 (95% CI: 0.0, 6.4) for osteocalcin and 30.7 (95% CI: 1.7, 59.7) for CTx with PM10. Children living close to a major road (≤ 350m) had higher levels of both osteocalcin (1.4 [-1.2, 4.0] ng/ml) and CTx (16.2 [-7.4, 39.8] ng/L). The adverse impact of ambient air pollution on bone turnover rates observed in one of the study areas showed stimulation of more such studies.

Prenatal air pollution exposure and ultrasound measures of fetal growth in Los Angeles, California

BACKGROUND

Few previous studies examined the impact of prenatal air pollution exposures on fetal development based on ultrasound measures during pregnancy.

METHODS

In a prospective birth cohort of more than 500 women followed during 1993-1996 in Los Angeles, California, we examined how air pollution impacts fetal growth during pregnancy. Exposure to traffic related air pollution was estimated using CALINE4 air dispersion modeling for nitrogen oxides (NOx) and a land use regression (LUR) model for nitrogen monoxide (NO), nitrogen dioxide (NO2) and NOx. Exposures to carbon monoxide (CO), NO2, ozone (O3) and particles <10μm in aerodynamic diameter (PM10) were estimated using government monitoring data. We employed a linear mixed effects model to estimate changes in fetal size at approximately 19, 29 and 37 weeks gestation based on ultrasound.

RESULTS

Exposure to traffic-derived air pollution during 29 to 37 weeks was negatively associated with biparietal diameter at 37 weeks gestation. For each interquartile range (IQR) increase in LUR-based estimates of NO, NO2 and NOx, or freeway CALINE4 NOx we estimated a reduction in biparietal diameter of 0.2-0.3mm. For women residing within 5km of a monitoring station, we estimated biparietal diameter reductions of 0.9-1.0mm per IQR increase in CO and NO2. Effect estimates were robust to adjustment for a number of potential confounders. We did not observe consistent patterns for other growth endpoints we examined.

CONCLUSIONS

Prenatal exposure to traffic-derived pollution was negatively associated with fetal head size measured as biparietal diameter in late pregnancy.

Associations between ambient air pollution and daily mortality among elderly persons in Montreal, Quebec

BACKGROUND

Persons with underlying health conditions may be at higher risk for the short-term effects of air pollution. We have extended our original mortality time series study in Montreal, Quebec, among persons 65 years of age and older, for an additional 10 years (1990-2003) to assess whether these associations persisted and to investigate new health conditions.

METHODS AND RESULTS

We created subgroups of subjects diagnosed with major health conditions one year before death using billing and prescription data from the Quebec Health Insurance Plan. We used parametric log-linear Poisson models within the distributed lag non-linear models framework, that were adjusted for long-term temporal trends and daily maximum temperature, for which we assessed associations with NO2, O3, CO, SO2, and particles with aerodynamic diameters 2.5 μm in diameter or less (PM2.5). We found positive associations between daily non-accidental mortality and all air pollutants but O3 (e.g., for a cumulative effect over a 3-day lag, with a mean percent change (MPC) in daily mortality of 1.90% [95% confidence interval: 0.73, 3.08%] for an increase of the interquartile range (17.56 μg m(-3)) of NO2). Positive associations were found amongst persons having cardiovascular disease (cumulative MPC for an increase equal to the interquartile range of NO2=2.67%), congestive heart failure (MPC=3.46%), atrial fibrillation (MPC=4.21%), diabetes (MPC=3.45%), and diabetes and cardiovascular disease (MPC=3.50%). Associations in the warm season were also found for acute and chronic coronary artery disease, hypertension, and cancer. There was no persuasive evidence to conclude that there were seasonal associations for cerebrovascular disease, acute lower respiratory disease (defined within 2 months of death), airways disease, and diabetes and airways disease.

CONCLUSIONS

These data indicate that individuals with certain health conditions, especially those with diabetes and cardiovascular disease, hypertension, atrial fibrillation, and cancer, may be susceptible to the short-term effects of air pollution.

The response of the foliar antioxidant system and stable isotopes (δ(13)C and δ(15)N) of white willow to low-level air pollution

In this study we aimed to determine and elucidate the effect of ambient air pollution on the foliar antioxidant system and stable carbon and nitrogen isotopes of white willow (Salix alba L.). We grew white willow in uniform potting soil in the near vicinity of sixteen air quality monitoring stations in Belgium where nitrogen dioxide (NO2), ozone, sulfur dioxide and particulate matter concentrations were continuously measured. The trees were exposed to ambient air during six months (April-September 2011), and, thereafter, the degree of lipid peroxidation and foliar content of antioxidant molecules (ascorbate, glutathione, polyphenols, flavonoids), antioxidant enzymes (superoxide dismutase, ascorbate peroxidase, peroxidase) and foliar stable carbon (δ(13)C) and nitrogen (δ(15)N) isotopes were measured. We found that lipid peroxidation was caused by air pollution stress, arising from high ambient NO2 concentrations, as shown by an increased amount of malondialdehyde. The antioxidant system was activated by increasing the amount of polyphenols at monitoring stations with a high atmospheric NO2 and low O3 concentration, while no increase of key enzymes (e.g., ascorbate, glutathione) was observed. The δ(13)C also decreased with increasing NO2 concentrations and decreasing O3 concentrations, probably reflecting a decreased net photosynthesis and/or a concomitant decrease of (13)CO2 in the atmosphere. Shade also influenced foliar δ(13)C and the content of leaf ascorbate and glutathione.