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Humphrey JL, Kinnee EJ, Robinson LF, Clougherty JE. Disentangling impacts of multiple pollutants on acute cardiovascular events in New York city: A case-crossover analysis. ENVIRONMENTAL RESEARCH 2024; 242:117758. [PMID: 38029813 PMCID: PMC11378578 DOI: 10.1016/j.envres.2023.117758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 10/29/2023] [Accepted: 11/21/2023] [Indexed: 12/01/2023]
Abstract
BACKGROUND Ambient air pollution contributes to an estimated 6.67 million deaths annually, and has been linked to cardiovascular disease (CVD), the leading cause of death. Short-term increases in air pollution have been associated with increased risk of CVD event, though relatively few studies have directly compared effects of multiple pollutants using fine-scale spatio-temporal data, thoroughly adjusting for co-pollutants and temperature, in an exhaustive citywide hospitals dataset, towards identifying key pollution sources within the urban environment to most reduce, and reduce disparities in, the leading cause of death worldwide. OBJECTIVES We aimed to examine multiple pollutants against multiple CVD diagnoses, across lag days, in models adjusted for co-pollutants and meteorology, and inherently adjusted by design for non-time-varying individual and aggregate-level covariates, using fine-scale space-time exposure estimates, in an exhaustive dataset of emergency department visits and hospitalizations across an entire city, thereby capturing the full population-at-risk. METHODS We used conditional logistic regression in a case-crossover design - inherently controlling for all confounders not varying within case month - to examine associations between spatio-temporal nitrogen dioxide (NO2), fine particulate matter (PM2.5), sulfur dioxide (SO2), and ozone (O3) in New York City, 2005-2011, on individual risk of acute CVD event (n = 837,523), by sub-diagnosis [ischemic heart disease (IHD), heart failure (HF), stroke, ischemic stroke, acute myocardial infarction]. RESULTS We found significant same-day associations between NO2 and risk of overall CVD, IHD, and HF - and between PM2.5 and overall CVD or HF event risk - robust to all adjustments and multiple comparisons. Results were comparable by sex and race - though median age at CVD was 10 years younger for Black New Yorkers than White New Yorkers. Associations for NO2 were comparable for adults younger or older than 69 years, though PM2.5 associations were stronger among older adults. DISCUSSION Our results indicate immediate, robust effects of combustion-related pollution on CVD risk, by sub-diagnosis. Though acute impacts differed minimally by age, sex, or race, the much younger age-at-event for Black New Yorkers calls attention to cumulative social susceptibility.
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Affiliation(s)
- Jamie L Humphrey
- Center Public Health Methods; RTI International, Research Triangle Park, NC, 27709, USA
| | - Ellen J Kinnee
- University Center for Social and Urban Research, University of Pittsburgh, Pittsburgh, PA, 15260, USA
| | - Lucy F Robinson
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, 19104, USA
| | - Jane E Clougherty
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, PA, 19104, USA.
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Gao P, Wu Y, He L, Wang L, Fu Y, Chen J, Zhang F, Krafft T, Martens P. Adverse short-term effects of ozone on cardiovascular mortalities modified by season and temperature: a time-series study. Front Public Health 2023; 11:1182337. [PMID: 37361179 PMCID: PMC10288843 DOI: 10.3389/fpubh.2023.1182337] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 05/23/2023] [Indexed: 06/28/2023] Open
Abstract
Introduction Ambient ozone pollution becomes critical in China. Conclusions on the short-term effects of ozone on cardiovascular mortality have been controversial and limited on cause-specific cardiovascular mortalities and their interactions with season and temperature. This research aimed to investigate the short-term effects of ozone and the modifications of season and temperature on cardiovascular mortality. Methods Cardiovascular death records, air pollutants, and meteorological factors in Shenzhen from 2013 to 2019 were analyzed. Daily 1-h maximum of ozone and daily maximum 8-h moving average of ozone were studied. Generalized additive models (GAMs) were applied to evaluate their associations with cardiovascular mortalities in sex and age groups. Effect modifications were assessed by stratifying season and temperature. Results Distributed lag impacts of ozone on total cardiovascular deaths and cumulative effects on mortality due to ischemic heart disease (IHD) were most significant. Population under 65 years old was most susceptible. Majority of significant effects were found in warm season, at high temperature, and at extreme heat. Ozone-associated risks in total deaths caused by hypertensive diseases reduced in warm season, while risks in IHD in males increased at high temperature. Extreme heat enhanced ozone effects on deaths caused by CVDs and IHD in the population under 65 years old. Discussion The revealed cardiovascular impacts of ozone below current national standard of air quality suggested improved standards and interventions in China. Higher temperature, particularly extreme heat, rather than warm season, could significantly enhance the adverse effects of ozone on cardiovascular mortality in population under 65 years old.
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Affiliation(s)
- Panjun Gao
- Department of Health, Ethics and Society, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
| | - Yongsheng Wu
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Lihuan He
- China National Environmental Monitoring Centre, Beijing, China
| | - Li Wang
- Key Laboratory of Land Surface Pattern and Simulation, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China
| | - Yingbin Fu
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Jinrong Chen
- China National Environmental Monitoring Centre, Beijing, China
| | - Fengying Zhang
- China National Environmental Monitoring Centre, Beijing, China
| | - Thomas Krafft
- Department of Health, Ethics and Society, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
| | - Pim Martens
- University College Venlo, Maastricht University, Venlo, Netherlands
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Cao X, You X, Wang D, Qiu W, Guo Y, Zhou M, Chen W, Zhang X. Short-term effects of ambient ozone exposure on daily hospitalizations for circulatory diseases in Ganzhou, China: A time-series study. CHEMOSPHERE 2023; 327:138513. [PMID: 36990357 DOI: 10.1016/j.chemosphere.2023.138513] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 03/01/2023] [Accepted: 03/24/2023] [Indexed: 06/19/2023]
Abstract
Adverse health effects of ambient ozone are getting widespread attention, but the evidence on the relationship between ozone levels and circulatory system diseases are limited and inconsistent. Daily data for ambient ozone levels and hospitalizations for total circulatory diseases and five subtypes in Ganzhou, China from January 1, 2016 to December 31, 2020 were collected. We constructed a generalized additive model with quasi-Poisson regression accounting for lag effects to estimate the associations between ambient ozone levels and the number of hospitalized cases of total circulatory diseases and five subtypes. The differences among gender, age, and season subgroups were furtherly assessed through stratified analysis. A total of 201,799 hospitalized cases of total circulatory diseases were included in the present study, including 94,844 hypertension (HBP), 28,597 coronary heart disease (CHD), 42,120 cerebrovascular disease (CEVD), 21,636 heart failure (HF), and 14,602 arrhythmia. Significantly positive associations were observed between ambient ozone levels and daily hospitalizations for total circulatory diseases and all subtypes except arrhythmia. Each 10 μg/m3 increase in ozone concentration, the risk of hospitalizations for total circulatory diseases, HBP, CHD, CEVD, and HF increased by 0.718% (95% confidence interval, 0.156%-1.284%), 0.956% (0.346%-1.570%), 0.499% (0.057%-0.943%), 0.386% (0.025%-0.748%), and 0.907% (0.118%-1.702%), respectively. The above associations remained significant after adjusting for other air pollutants. The risk of hospitalization for circulatory diseases was higher in warm season (May to October) and varied in gender and age subgroups. This study suggested that short-term exposure to ambient ozone may increase the risk of hospitalizations for circulatory diseases. Our findings reinforce the importance of reducing ambient ozone pollution levels for protecting public health.
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Affiliation(s)
- Xiuyu Cao
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China
| | - Xiaojie You
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China
| | - Dongming Wang
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China
| | - Weihong Qiu
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China; Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - You Guo
- First Affiliated Hospital, Gannan Medical University, Ganzhou, China; Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases, Ministry of Education, Gannan Medical University, Ganzhou, China; School of Public Health and Health Management, Gannan Medical University, Ganzhou, China
| | - Min Zhou
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China
| | - Weihong Chen
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China.
| | - Xiaokang Zhang
- First Affiliated Hospital, Gannan Medical University, Ganzhou, China; Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases, Ministry of Education, Gannan Medical University, Ganzhou, China; School of Public Health and Health Management, Gannan Medical University, Ganzhou, China
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Choi SY, Rha SW, Cha J, Byun JK, Choi BG, Jeong MH. Association of air pollution and 1-year clinical outcomes of patients with acute myocardial infarction. PLoS One 2022; 17:e0272328. [PMID: 35913935 PMCID: PMC9342741 DOI: 10.1371/journal.pone.0272328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 07/18/2022] [Indexed: 11/19/2022] Open
Abstract
Background
Exposure to air pollution (AP) is an important environmental risk factor for increased risk of cardiovascular morbidity and triggering acute myocardial infarction (AMI). However, there are limited data regarding the clinical impact of AP on long-term major clinical outcomes of AMI patients. This study aimed to evaluate the clinical effects of ambient AP concentration on short-term and 1-year clinical outcomes of AMI patients.
Methods
A total of 46,263 eligible patients were enrolled in the Korea Acute Myocardial Infarction (KAMIR) and KAMIR-National Institutes of Health (NIH) registry from January 2006 to December 2015. We performed Cox proportional hazard regression to assess the risk of all-cause death and any-revascularization according to the annual average concentration of AP during one-year follow-up period.
Results
The assessment of the annual average of air pollutants before symptom date and all-cause death up to 30 days showed the hazard ratio (HR) of SO2 per 1 part per billion (ppb) increase was 1.084 (95% confidence interval [CI]: 1.016–1.157), and particulate matter with diameter of 10 microns or less (PM10) per 1 μg/m3 increase was 1.011 (95% CI: 1.002–1.021). The results of the 30-day and one-year all-cause death showed a similar trend. For SO2, the HR per 1 ppb increase was 1.084 (95% CI: 1.003–1.172), and the HR of PM10 was 1.021 (95% CI: 1.009–1.033) per 1 μg/m3 increase. We observed that SO2, CO, and PM10 were associated with an increased risk of incidence for any-revascularization up to one-year.
Conclusion
In some air pollutants, a higher AP concentration was an environmental risk factor for poor prognosis in AMI patients up to 1 year. AMI patients and high-risk individuals need a strategy to reduce or prevent exposure to high AP concentrations.
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Affiliation(s)
- Se Yeon Choi
- Cardiovascular Research Institution, Korea University College of Medicine, Seoul, Korea
| | - Seung-Woon Rha
- Cardiovascular Center, Korea University Guro Hospital, Seoul, Korea
- * E-mail:
| | - Jinah Cha
- Cardiovascular Center, Korea University Guro Hospital, Seoul, Korea
- BK21 Graduate Program, Department of Biomedical Sciences, Korea University College of Medicine, Seoul, Korea
| | - Jae Kyeong Byun
- Cardiovascular Research Institution, Korea University College of Medicine, Seoul, Korea
| | - Byoung Geol Choi
- Cardiovascular Research Institution, Korea University College of Medicine, Seoul, Korea
| | - Myung ho Jeong
- Division of Cardiology, Department of Medicine, Chonnam National University Hospital, Gwangju, Korea
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Posadas-Sánchez R, Vargas-Alarcón G, Cardenas A, Texcalac-Sangrador JL, Osorio-Yáñez C, Sanchez-Guerra M. Long-Term Exposure to Ozone and Fine Particulate Matter and Risk of Premature Coronary Artery Disease: Results from Genetics of Atherosclerotic Disease Mexican Study. BIOLOGY 2022; 11:1122. [PMID: 35892978 PMCID: PMC9332787 DOI: 10.3390/biology11081122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/22/2022] [Accepted: 07/24/2022] [Indexed: 11/26/2022]
Abstract
(1) Background: Epidemiological studies have identified associations between fine particulate matter (PM2.5) and ozone exposure with cardiovascular disease; however, studies linking ambient air pollution and premature coronary artery disease (pCAD) in Latin America are non-existing. (2) Methods: Our study was a case−control analysis nested in the Genetics of Atherosclerotic Disease (GEA) Mexican study. We included 1615 participants (869 controls and 746 patients with pCAD), recruited at the Instituto Nacional de Cardiología Ignacio Chávez from June 2008 to January 2013. We defined pCAD as history of myocardial infarction, angioplasty, revascularization surgery or coronary stenosis > 50% diagnosed before age 55 in men and age 65 in women. Controls were healthy individuals without personal or family history of pCAD and with coronary artery calcification equal to zero. Hourly measurements of ozone and PM2.5 from the Atmospheric Monitoring System in Mexico City (SIMAT in Spanish; Sistema de Monitero Atmosférico de la Ciudad de México) were used to calculate annual exposure to ozone and PM2.5 in the study participants. (3) Results: Each ppb increase in ozone at 1-year, 2-year, 3-year and 5-year averages was significantly associated with increased odds (OR = 1.10; 95% CI: 1.03−1.18; OR = 1.17; 95% CI: 1.05−1.30; OR = 1.18; 95% CI: 1.05−1.33, and OR = 1.13; 95% CI: 1.04−1.23, respectively) of pCAD. We observed higher risk of pCAD for each 5 µg/m3 increase only for the 5-year average of PM2.5 exposure (OR = 2.75; 95% CI: 1.47−5.16), compared to controls. (4) Conclusions: Ozone exposure at different time points and PM2.5 exposure at 5 years were associated with increased odds of pCAD. Our results highlight the importance of reducing long-term exposure to ambient air pollution levels to reduce the burden of cardiovascular disease in Mexico City and other metropolitan areas.
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Affiliation(s)
| | - Gilberto Vargas-Alarcón
- Instituto Nacional de Cardiología Ignacio Chávez, Mexico City 14080, Mexico; (R.P.-S.); (G.V.-A.)
| | - Andres Cardenas
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA 94720, USA;
| | | | - Citlalli Osorio-Yáñez
- Departamento de Medicina Genómica y Toxicología Ambiental, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad Universitaria, Mexico City 04510, Mexico
- Laboratorio de Fisiología Cardiovascular y Trasplante Renal, Unidad de Investigación en Medicina Traslacional, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México and Instituto Nacional de Cardiología Ignacio Chávez, Mexico City 14080, Mexico
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Rahman MM, Begum BA, Hopke PK, Nahar K, Newman J, Thurston GD. Cardiovascular morbidity and mortality associations with biomass- and fossil-fuel-combustion fine-particulate-matter exposures in Dhaka, Bangladesh. Int J Epidemiol 2021; 50:1172-1183. [PMID: 33822936 DOI: 10.1093/ije/dyab037] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Fine-particulate-matter (i.e. with an aerodynamic diameter of ≤2.5 µm, PM2.5) air pollution is commonly treated as if it had 'equivalent toxicity', irrespective of the source and composition. We investigate the respective roles of fossil-fuel- and biomass-combustion particles in the PM2.5 relationship with cardiovascular morbidity and mortality using tracers of sources in Dhaka, Bangladesh. Results provide insight into the often observed levelling of the PM2.5 exposure-response curve at high-pollution levels. METHODS A time-series regression model, adjusted for potentially confounding influences, was applied to 340 758 cardiovascular disease (CVD) emergency-department visits (EDVs) during January 2014 to December 2017, 253 407 hospital admissions during September 2013 to December 2017 and 16 858 CVD deaths during January 2014 to October 2017. RESULTS Significant associations were confirmed between PM2.5-mass exposures and increased risk of cardiovascular EDV [0.27%, (0.07% to 0.47%)] at lag-0, hospitalizations [0.32% (0.08% to 0.55%)] at lag-0 and deaths [0.87%, (0.27% to 1.47%)] at lag-1 per 10-μg/m3 increase in PM2.5. However, the relationship of PM2.5 with morbidity and mortality effect slopes was less steep and non-significant at higher PM2.5 concentrations (during crop-burning-dominated exposures) and varied with PM2.5 source. Fossil-fuel-combustion PM2.5 had roughly a four times greater effect on CVD mortality and double the effect on CVD hospital admissions on a per-µg/m3 basis than did biomass-combustion PM2.5. CONCLUSION Biomass burning was responsible for most PM2.5 air pollution in Dhaka, but fossil-fuel-combustion PM2.5 dominated the CVD adverse health impacts. Such by-source variations in the health impacts of PM2.5 should be considered in conducting ambient particulate-matter risk assessments, as well as in prioritizing air-pollution-mitigation measures and clinical advice.
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Affiliation(s)
- Md Mostafijur Rahman
- Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA
| | | | - Philip K Hopke
- Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA.,Center for Atmospheric Science and Engineering, Clarkson University, Potsdam, NY, USA
| | - Kamrun Nahar
- Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA
| | - Jonathan Newman
- Division of Cardiology and Center for the Prevention of Cardiovascular Disease, Department of Medicine, New York University School of Medicine, NY, USA
| | - George D Thurston
- Department of Environmental Medicine, New York University School of Medicine, New York, NY, USA.,Department of Population Health, New York University School of Medicine, New York, NY, USA
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Alexeeff SE, Deosaransingh K, Liao NS, Van Den Eeden SK, Schwartz J, Sidney S. Particulate Matter and Cardiovascular Risk in Adults with Chronic Obstructive Pulmonary Disease. Am J Respir Crit Care Med 2021; 204:159-167. [PMID: 33662228 DOI: 10.1164/rccm.202007-2901oc] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Rationale: People with chronic obstructive pulmonary disease (COPD) have an increased risk of cardiovascular disease and may be more susceptible to air pollution exposure. However, no study has examined the association between long-term fine particulate matter exposure (≤2.5 μm in aerodynamic diameter) and risk of cardiovascular events in this potentially vulnerable population. Objectives: To estimate the association between long-term fine particulate matter and risk of cardiovascular events among adults with COPD. Methods: This retrospective cohort study included 169,714 adults with COPD who were members of the Kaiser Permanente Northern California health plan during 2007-2016. Electronic health record data were linked to 1 km modeled particulate matter ≤2.5 μm in aerodynamic diameter exposure estimates. We fit Cox proportional hazard models, adjusting for age, sex, race/ethnicity, calendar year, smoking, body mass index, comorbidities, medications, and socioeconomic status. In low exposure analyses, we examined effects below the current regulation limit (12 μg/m3). Measurements and Main Results: Among adults with COPD, a 10-μg/m3 increase in 1-year mean fine particulate matter exposure was associated with an elevated risk of cardiovascular mortality (hazard ratio, 1.10; 95% confidence interval [CI], 1.01-1.20). Effects were stronger in low exposure analyses (hazard ratio, 1.88; 95% CI, 1.56-2.27). Fine particulate matter exposure was not associated with acute myocardial infarction or stroke in overall analyses. Conclusions: Long-term fine particulate matter exposure was associated with an increased risk of cardiovascular mortality among adults with COPD. Current regulations may not sufficiently protect those with COPD.
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Affiliation(s)
- Stacey E Alexeeff
- Kaiser Permanente Division of Research, Kaiser Permanente, Oakland, California; and
| | - Kamala Deosaransingh
- Kaiser Permanente Division of Research, Kaiser Permanente, Oakland, California; and
| | - Noelle S Liao
- Kaiser Permanente Division of Research, Kaiser Permanente, Oakland, California; and
| | | | - Joel Schwartz
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Stephen Sidney
- Kaiser Permanente Division of Research, Kaiser Permanente, Oakland, California; and
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Do Ambient Ozone or Other Pollutants Modify Effects of Controlled Ozone Exposure on Pulmonary Function? Ann Am Thorac Soc 2020; 17:563-572. [DOI: 10.1513/annalsats.201908-597oc] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
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Rich DQ, Frampton MW, Balmes JR, Bromberg PA, Arjomandi M, Hazucha MJ, Thurston SW, Alexis NE, Ganz P, Zareba W, Koutrakis P, Thevenet-Morrison K. Multicenter Ozone Study in oldEr Subjects (MOSES): Part 2. Effects of Personal and Ambient Concentrations of Ozone and Other Pollutants on Cardiovascular and Pulmonary Function. Res Rep Health Eff Inst 2020; 2020:1-90. [PMID: 32239870 PMCID: PMC7325421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023] Open
Abstract
INTRODUCTION The Multicenter Ozone Study of oldEr Subjects (MOSES) was a multi-center study evaluating whether short-term controlled exposure of older, healthy individuals to low levels of ozone (O3) induced acute changes in cardiovascular biomarkers. In MOSES Part 1 (MOSES 1), controlled O3 exposure caused concentration-related reductions in lung function with evidence of airway inflammation and injury, but without convincing evidence of effects on cardiovascular function. However, subjects' prior exposures to indoor and outdoor air pollution in the few hours and days before each MOSES controlled O3 exposure may have independently affected the study biomarkers and/or modified biomarker responses to the MOSES controlled O3 exposures. METHODS MOSES 1 was conducted at three clinical centers (University of California San Francisco, University of North Carolina, and University of Rochester Medical Center) and included healthy volunteers 55 to 70 years of age. Consented participants who successfully completed the screening and training sessions were enrolled in the study. All three clinical centers adhered to common standard operating procedures and used common tracking and data forms. Each subject was scheduled to participate in a total of 11 visits: screening visit, training visit, and three sets of exposure visits consisting of the pre-exposure day, the exposure day, and the post-exposure day. After completing the pre-exposure day, subjects spent the night in a nearby hotel. On exposure days, the subjects were exposed for 3 hours in random order to 0 ppb O3 (clean air), 70 ppb O3, and 120 ppm O3. During the exposure period the subjects alternated between 15 minutes of moderate exercise and 15 minutes of rest. A suite of cardiovascular and pulmonary endpoints was measured on the day before, the day of, and up to 22 hours after each exposure. In MOSES Part 2 (MOSES 2), we used a longitudinal panel study design, cardiopulmonary biomarker data from MOSES 1, passive cumulative personal exposure samples (PES) of O3 and nitrogen dioxide (NO2) in the 72 hours before the pre-exposure visit, and hourly ambient air pollution and weather measurements in the 96 hours before the pre-exposure visit. We used mixed-effects linear regression and evaluated whether PES O3 and NO2 and these ambient pollutant concentrations in the 96 hours before the pre-exposure visit confounded the MOSES 1 controlled O3 exposure effects on the pre- to post-exposure biomarker changes (Aim 1), whether they modified these pre- to post-exposure biomarker responses to the controlled O3 exposures (Aim 2), whether they were associated with changes in biomarkers measured at the pre-exposure visit or morning of the exposure session (Aim 3), and whether they were associated with differences in the pre- to post-exposure biomarker changes independently of the controlled O3 exposures (Aim 4). RESULTS Ambient pollutant concentrations at each site were low and were regularly below the National Ambient Air Quality Standard levels. In Aim 1, the controlled O3 exposure effects on the pre- to post-exposure biomarker differences were little changed when PES or ambient pollutant concentrations in the previous 96 hours were included in the model, suggesting these were not confounders of the controlled O3 exposure/biomarker difference associations. In Aim 2, effects of MOSES controlled O3 exposures on forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) were modified by ambient NO2 and carbon monoxide (CO), and PES NO2, with reductions in FEV1 and FVC observed only when these concentrations were "Medium" or "High" in the 72 hours before the pre-exposure visit. There was no such effect modification of the effect of controlled O3 exposure on any other cardiopulmonary biomarker. As hypothesized for Aim 3, increased ambient O3 concentrations were associated with decreased pre-exposure heart rate variability (HRV). For example, high frequency (HF) HRV decreased in association with increased ambient O3 concentrations in the 96 hours before the pre-exposure visit (-0.460 ln[ms2]; 95% CI, -0.743 to -0.177 for each 10.35-ppb increase in O3; P = 0.002). However, in Aim 4 these increases in ambient O3 were also associated with increases in HF and low frequency (LF) HRV from pre- to post-exposure, likely reflecting a "recovery" of HRV during the MOSES O3 exposure sessions. Similar patterns across Aims 3 and 4 were observed for LF (the other primary HRV marker), and standard deviation of normal-to-normal sinus beat intervals (SDNN) and root mean square of successive differences in normal-to-normal sinus beat intervals (RMSSD) (secondary HRV markers). Similar Aim 3 and Aim 4 patterns were observed for FEV1 and FVC in association with increases in ambient PM with an aerodynamic diameter ≤ 2.5 μm (PM2.5), CO, and NO2 in the 96 hours before the pre-exposure visit. For Aim 3, small decreases in pre-exposure FEV1 were significantly associated with interquartile range (IQR) increases in PM2.5 concentrations in the 1 hour before the pre-exposure visit (-0.022 L; 95% CI, -0.037 to -0.006; P = 0.007), CO in the 3 hours before the pre-exposure visit (-0.046 L; 95% CI, -0.076 to -0.016; P = 0.003), and NO2 in the 72 hours before the pre-exposure visit (-0.030 L; 95% CI, -0.052 to -0.008; P = 0.007). However, FEV1 was not associated with ambient O3 or sulfur dioxide (SO2), or PES O3 or NO2 (Aim 3). For Aim 4, increased FEV1 across the exposure session (post-exposure minus pre-exposure) was marginally significantly associated with each 4.1-ppb increase in PES O3 concentration (0.010 L; 95% CI, 0.004 to 0.026; P = 0.010), as well as ambient PM2.5 and CO at all lag times. FVC showed similar associations, with patterns of decreased pre-exposure FVC associated with increased PM2.5, CO, and NO2 at most lag times, and increased FVC across the exposure session also associated with increased concentrations of the same pollutants, reflecting a similar recovery. However, increased pollutant concentrations were not associated with adverse changes in pre-exposure levels or pre- to post-exposure changes in biomarkers of cardiac repolarization, ST segment, vascular function, nitrotyrosine as a measure of oxidative stress, prothrombotic state, systemic inflammation, lung injury, or sputum polymorphonuclear leukocyte (PMN) percentage as a measure of airway inflammation. CONCLUSIONS Our previous MOSES 1 findings of controlled O3 exposure effects on pulmonary function, but not on any cardiovascular biomarker, were not confounded by ambient or personal O3 or other pollutant exposures in the 96 and 72 hours before the pre-exposure visit. Further, these MOSES 1 O3 effects were generally not modified, blunted, or lessened by these same ambient and personal pollutant exposures. However, the reductions in markers of pulmonary function by the MOSES 1 controlled O3 exposure were modified by ambient NO2 and CO, and PES NO2, with reductions observed only when these pollutant concentrations were elevated in the few hours and days before the pre-exposure visit. Increased ambient O3 concentrations were associated with reduced HRV, with "recovery" during exposure visits. Increased ambient PM2.5, NO2, and CO were associated with reduced pulmonary function, independent of the MOSES-controlled O3 exposures. Increased pollutant concentrations were not associated with pre-exposure or pre- to post-exposure changes in other cardiopulmonary biomarkers. Future controlled exposure studies should consider the effect of ambient pollutants on pre-exposure biomarker levels and whether ambient pollutants modify any health response to a controlled pollutant exposure.
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Affiliation(s)
- D Q Rich
- University of Rochester Medical Center, Rochester, New York
| | - M W Frampton
- University of Rochester Medical Center, Rochester, New York
| | - J R Balmes
- University of California at San Francisco
| | | | | | | | - S W Thurston
- University of Rochester Medical Center, Rochester, New York
| | - N E Alexis
- University of North Carolina at Chapel Hill
| | - P Ganz
- University of California at San Francisco
| | - W Zareba
- University of Rochester Medical Center, Rochester, New York
| | - P Koutrakis
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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Air pollutants and outpatient visits for cardiovascular disease in a severe haze-fog city: Shijiazhuang, China. BMC Public Health 2019; 19:1366. [PMID: 31651288 PMCID: PMC6814061 DOI: 10.1186/s12889-019-7690-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 09/25/2019] [Indexed: 12/27/2022] Open
Abstract
Background Many studies have reported the impact of air pollution on cardiovascular disease (CVD), but few of these studies were conducted in severe haze-fog areas. The present study focuses on the impact of different air pollutant concentrations on daily CVD outpatient visits in a severe haze-fog city. Methods Data regarding daily air pollutants and outpatient visits for CVD in 2013 were collected, and the association between six pollutants and CVD outpatient visits was explored using the least squares mean (LSmeans) and logistic regression. Adjustments were made for days of the week, months, air temperature and relative humidity. Results The daily CVD outpatient visits for particulate matter (PM10 and PM2.5), sulphur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and ozone (O3) in the 90th-quantile group were increased by 30.01, 29.42, 17.68, 14.98, 29.34%, and − 19.87%, respectively, compared to those in the <10th-quantile group. Odds ratios (ORs) and 95% confidence intervals (CIs) for the increase in daily CVD outpatient visits in PM10 300- and 500-μg/m3, PM2.5 100- and 300-μg/m3 and CO 3-mg/m3 groups were 2.538 (1.070–6.020), 7.781 (1.681–36.024), 3.298 (1.559–6.976), 8.72 (1.523–49.934), and 5.808 (1.016–33.217), respectively, and their corresponding attributable risk percentages (AR%) were 60.6, 87.15, 69.68, 88.53 and 82.78%, respectively. The strongest associations for PM10, PM2.5 and CO were found only in lag 0 and lag 1. The ORs for the increase in CVD outpatient visits per increase in different units of the six pollutants were also analysed. Conclusions All five air pollutants except O3 were positively associated with the increase in daily CVD outpatient visits in lag 0. The high concentrations of PM10, PM2.5 and CO heightened not only the percentage but also the risk of increased daily CVD outpatient visits. PM10, PM2.5 and CO may be the main factors of CVD outpatient visits.
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Balmes JR, Arjomandi M, Bromberg PA, Costantini MG, Dagincourt N, Hazucha MJ, Hollenbeck-Pringle D, Rich DQ, Stark P, Frampton MW. Ozone effects on blood biomarkers of systemic inflammation, oxidative stress, endothelial function, and thrombosis: The Multicenter Ozone Study in oldEr Subjects (MOSES). PLoS One 2019; 14:e0222601. [PMID: 31553765 PMCID: PMC6760801 DOI: 10.1371/journal.pone.0222601] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 09/02/2019] [Indexed: 02/01/2023] Open
Abstract
The evidence that exposure to ozone air pollution causes acute cardiovascular effects is mixed. We postulated that exposure to ambient levels of ozone would increase blood markers of systemic inflammation, prothrombotic state, oxidative stress, and vascular dysfunction in healthy older subjects, and that absence of the glutathione S-transferase Mu 1 (GSTM1) gene would confer increased susceptibility. This double-blind, randomized, crossover study of 87 healthy volunteers 55-70 years of age was conducted at three sites using a common protocol. Subjects were exposed for 3 h in random order to 0 parts per billion (ppb) (filtered air), 70 ppb, and 120 ppb ozone, alternating 15 min of moderate exercise and rest. Blood was obtained the day before, approximately 4 h after, and approximately 22 h after each exposure. Linear mixed effect and logistic regression models evaluated the impact of exposure to ozone on pre-specified primary and secondary outcomes. The definition of statistical significance was p<0.01. There were no effects of ozone on the three primary markers of systemic inflammation and a prothrombotic state: C-reactive protein, monocyte-platelet conjugates, and microparticle-associated tissue factor activity. However, among the secondary endpoints, endothelin-1, a potent vasoconstrictor, increased from pre- to post-exposure with ozone concentration (120 vs 0 ppb: 0.07 pg/mL, 95% confidence interval [CI] 0.01, 0.14; 70 vs 0 ppb: -0.03 pg/mL, CI -0.09, 0.04; p = 0.008). Nitrotyrosine, a marker of oxidative and nitrosative stress, decreased with increasing ozone concentrations, with marginal significance (120 vs 0 ppb: -41.5, CI -70.1, -12.8; 70 vs 0 ppb: -14.2, CI -42.7, 14.2; p = 0.017). GSTM1 status did not modify the effect of ozone exposure on any of the outcomes. These findings from healthy older adults fail to identify any mechanistic basis for the epidemiologically described cardiovascular effects of exposure to ozone. The findings, however, may not be applicable to adults with cardiovascular disease.
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Affiliation(s)
- John R. Balmes
- Department of Medicine, University of California at San Francisco, San Francisco, CA, United States of America
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA, United States of America
| | - Mehrdad Arjomandi
- Department of Medicine, University of California at San Francisco, San Francisco, CA, United States of America
- San Francisco Veterans Affairs Medical Center, San Francisco, CA, United States of America
| | - Philip A. Bromberg
- Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, United States of America
- Center for Environmental Medicine, Asthma and Lung Biology, University of North Carolina, Chapel Hill, NC, United States of America
| | | | | | - Milan J. Hazucha
- Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, United States of America
- Center for Environmental Medicine, Asthma and Lung Biology, University of North Carolina, Chapel Hill, NC, United States of America
| | | | - David Q. Rich
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, United States of America
- Department of Medicine, University of Rochester Medical Center, Rochester, NY, United States of America
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, United States of America
| | - Paul Stark
- New England Research Institute, Watertown, MA, United States of America
| | - Mark W. Frampton
- Department of Medicine, University of Rochester Medical Center, Rochester, NY, United States of America
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, United States of America
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12
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Phosri A, Ueda K, Phung VLH, Tawatsupa B, Honda A, Takano H. Effects of ambient air pollution on daily hospital admissions for respiratory and cardiovascular diseases in Bangkok, Thailand. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 651:1144-1153. [PMID: 30360246 DOI: 10.1016/j.scitotenv.2018.09.183] [Citation(s) in RCA: 93] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 09/03/2018] [Accepted: 09/14/2018] [Indexed: 04/13/2023]
Abstract
BACKGROUND Although health effects of air pollutants are well documented in many countries especially in North America and Western Europe, few studies have been conducted in Thailand where pollution mix, weather conditions, and demographic characteristics are different. The present study aimed to investigate the effects of ambient air pollution on hospital admissions for cardiovascular and respiratory diseases in Bangkok, Thailand. METHODS We obtained daily air pollution concentration (O3, NO2, SO2, PM10, and CO) and weather variable monitored in Bangkok from January 2006 to December 2014. Daily hospital admissions for cardiovascular and respiratory diseases were obtained from the National Health Security Office during the study period. A time-series analysis with generalized linear model was used to examine the effects of air pollution on hospital admissions by controlling for long-term trend and other potential confounders. The effect modification by age (0-14 years, 15-64 years, ≥65 years) and gender was also examined. RESULTS An increase of 10 μg/m3 in O3, NO2, SO2, PM10, and 1 mg/m3 in CO at lag 0-1 day was associated with a 0.14% (95% CI: -0.34 to 0.63), 1.28% (0.87 to 1.69), 8.42% (6.16 to 10.74), 1.04% (0.68 to 1.41) and 6.69% (4.33 to 9.11) increase in cardiovascular admission, respectively; and 0.69% (95% CI: 0.18 to 1.21), 1.42% (0.98 to 1.85), 4.49% (2.22 to 6.80), 1.18% (0.79 to 1.57) and 7.69% (5.20 to 10.23) increase in respiratory admission, respectively. The elderly (≥65 years) seemed to be the most susceptible group to the effect of air pollution, whereas the effect estimate for male and female was not significantly different. CONCLUSIONS Results from this study contributed the evidence to support the effects of air pollution (O3, NO2, SO2, PM10, and CO) on hospital admissions for cardiovascular and respiratory diseases, which might be useful for public health intervention in Thailand.
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Affiliation(s)
- Arthit Phosri
- Department of Environmental Engineering, Graduate School of Engineering, Kyoto University, Kyoto, Japan
| | - Kayo Ueda
- Department of Environmental Engineering, Graduate School of Engineering, Kyoto University, Kyoto, Japan.
| | - Vera Ling Hui Phung
- Department of Environmental Engineering, Graduate School of Engineering, Kyoto University, Kyoto, Japan
| | - Benjawan Tawatsupa
- Health Impact Assessment Division, Department of Health, Ministry of Public Health, Nonthaburi, Thailand
| | - Akiko Honda
- Department of Environmental Engineering, Graduate School of Engineering, Kyoto University, Kyoto, Japan
| | - Hirohisa Takano
- Department of Environmental Engineering, Graduate School of Engineering, Kyoto University, Kyoto, Japan
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13
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Rich DQ, Balmes JR, Frampton MW, Zareba W, Stark P, Arjomandi M, Hazucha MJ, Costantini MG, Ganz P, Hollenbeck-Pringle D, Dagincourt N, Bromberg PA. Cardiovascular function and ozone exposure: The Multicenter Ozone Study in oldEr Subjects (MOSES). ENVIRONMENT INTERNATIONAL 2018; 119:193-202. [PMID: 29980042 DOI: 10.1016/j.envint.2018.06.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 05/08/2018] [Accepted: 06/12/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND To date, there have been relatively few studies of acute cardiovascular responses to controlled ozone inhalation, although a number of observational studies have reported significant positive associations between both ambient ozone levels and acute cardiovascular events and long-term ozone exposure and cardiovascular mortality. OBJECTIVES We hypothesized that short-term controlled exposure to low levels of ozone in filtered air would induce autonomic imbalance, repolarization abnormalities, arrhythmia, and vascular dysfunction. METHODS This randomized crossover study of 87 healthy volunteers 55-70 years of age was conducted at three sites using a common protocol, from June 2012 to April 2015. Subjects were exposed for 3 h in random order to 0 ppb (filtered air), 70 ppb ozone, and 120 ppb ozone, alternating 15 min of moderate exercise with 15 min of rest. A suite of cardiovascular endpoints was measured the day before, the day of, and up to 22 h after each exposure. Mixed effect linear and logit models evaluated the impact of exposure to ozone on pre-specified primary and secondary outcomes. Site and time were included in the models. RESULTS We found no significant effects of ozone exposure on any of the primary or secondary measures of autonomic function, repolarization, ST segment change, arrhythmia, or vascular function (systolic blood pressure and flow-mediated dilation). CONCLUSIONS In this multicenter study of older healthy women and men, there was no convincing evidence for acute effects of 3-h, relatively low-level ozone exposures on cardiovascular function. However, we cannot exclude the possibility of effects with higher ozone concentrations, more prolonged exposure, or in subjects with underlying cardiovascular disease. Further, we cannot exclude the possibility that exposure to ambient ozone and other pollutants in the days before the experimental exposures obscured or blunted cardiovascular biomarker response to the controlled ozone exposures.
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Affiliation(s)
- David Q Rich
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, United States of America; Department of Medicine, University of Rochester Medical Center, Rochester, NY, United States of America; Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, United States of America.
| | - John R Balmes
- Department of Medicine, University of California at San Francisco, San Francisco, CA, United States of America; Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA, United States of America
| | - Mark W Frampton
- Department of Medicine, University of Rochester Medical Center, Rochester, NY, United States of America; Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, United States of America
| | - Wojciech Zareba
- Department of Medicine, University of Rochester Medical Center, Rochester, NY, United States of America
| | - Paul Stark
- New England Research Institute, Watertown, MA, United States of America
| | - Mehrdad Arjomandi
- Department of Medicine, University of California at San Francisco, San Francisco, CA, United States of America; San Francisco Veterans Affairs Medical Center, San Francisco, CA, United States of America
| | - Milan J Hazucha
- Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, United States of America; Center for Environmental Medicine, Asthma and Lung Biology, University of North Carolina, Chapel Hill, NC, United States of America
| | | | - Peter Ganz
- Department of Medicine, University of California at San Francisco, San Francisco, CA, United States of America
| | | | | | - Philip A Bromberg
- Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, United States of America; Center for Environmental Medicine, Asthma and Lung Biology, University of North Carolina, Chapel Hill, NC, United States of America
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14
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Linares C, Falcón I, Ortiz C, Díaz J. An approach estimating the short-term effect of NO 2 on daily mortality in Spanish cities. ENVIRONMENT INTERNATIONAL 2018; 116:18-28. [PMID: 29635093 DOI: 10.1016/j.envint.2018.04.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 04/02/2018] [Accepted: 04/02/2018] [Indexed: 05/18/2023]
Abstract
BACKGROUND Road traffic is the most significant source of urban air pollution. PM2.5 is the air pollutant whose health effects have been most closely studied, and is the variable most commonly used as a proxy indicator of exposure to air pollution, whereas evidence on NO2 concentrations per se is still under study. In the case of Spain, there are no specific updated studies which calculate short-term NO2-related mortality. OBJECTIVE To quantify the relative risks (RRs) and attributable risks (ARs) of daily mortality associated with NO2 concentrations recorded in Spain across the study period, 2000-2009; and to calculate the number of NO2-related deaths. MATERIAL AND METHODS We calculated daily mortality due to natural causes (ICD-10: A00 R99), circulatory causes (ICD-10: I00 I99) and respiratory causes (ICD-10: J00 J99) for each province across the period 2000-2009, using data supplied by the National Statistics Institute. Mean daily NO2 concentrations in μg/m3 for each provincial capital were furnished by the Ministry of Agriculture & Environment, along with the equivalent figures for the control pollutants (PM10). To estimate RRs and ARs, we used generalised linear models with a Poisson link, controlling for maximum and minimum daily temperature, trend of the series, seasonalities, and the autoregressive nature of the series. A meta-analysis with random effects was used to estimate RRs and ARs nationwide. RESULTS The overall RRs obtained for Spain, corresponding to increases of 10 μg/m3 in NO2 concentrations were 1.012 (95% CI: 1.010 1.014) for natural-cause mortality, 1.028 (95% CI: 1.019 1.037) for respiratory-cause mortality, and 1.016 (95% CI: 1.012 1.021) for circulatory-cause mortality. This amounted to an annual overall 6085 deaths (95% CI: 3288 9427) due to natural causes, 1031 (95% CI: 466 1585) due to respiratory causes, and 1978 (95% CI: 828 3197) due to circulatory causes. CONCLUSION By virtue of the number of cities involved and the nature of the analysis performed, with quantification of the RRs and ARs of the short-term impact of NO2 on daily mortality in Spain, this study provides an updated estimate of the effect had by this type of pollutant on causes of mortality, and constitutes an important basis for reinforcing public health measures at a national level.
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Affiliation(s)
- Cristina Linares
- Department of Epidemiology and Biostatistics, National School of Public Health, Carlos III Institute of Health, Madrid, Spain.
| | - Isabel Falcón
- Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain
| | - Cristina Ortiz
- Department of Epidemiology and Biostatistics, National School of Public Health, Carlos III Institute of Health, Madrid, Spain
| | - Julio Díaz
- Department of Epidemiology and Biostatistics, National School of Public Health, Carlos III Institute of Health, Madrid, Spain
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15
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Dastoorpoor M, Khanjani N, Bahrampour A, Goudarzi G, Aghababaeian H, Idani E. Short-term effects of air pollution on respiratory mortality in Ahvaz, Iran. Med J Islam Repub Iran 2018; 32:30. [PMID: 30159281 PMCID: PMC6108243 DOI: 10.14196/mjiri.32.30] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Indexed: 11/30/2022] Open
Abstract
Background: Urban air pollutants may affect respiratory mortality. This study was conducted to investigate this effect in Ahvaz, one of the most polluted cities in the world. Methods: The impact of 7 major air pollutants including O3, PM10, NO2, CO, and SO2 were evaluated on respiratory mortality in different gender and age groups using a quasi-Poisson, second degree polynomial constrained, distributed lag model, with single and cumulative lag structures adjusted by trend, seasonality, temperature, relative humidity, weekdays, and holiday. Data were analyzed using the dlnm package in R x64 3.2.5 software. Significance level was set at less than 0.05. Results: In adjusted models, for each IQR increase of O3 in the total population, the risk ratio (RR) for respiratory deaths in 0 to 14- day lags was, respectively, 1.009 (95% CI:1.001-1.016) and 1.009 (95% CI:1.002-1.017), and it was 1.021 (95% CI: 1.002-1.040) in cumulative 0 to 14- day lags. For PM10, in the total population and in adjusted models after 0 to 14- day lags and in cumulative lags of 0 to 14 for an IQR increase in the mean concentration of PM10, the RR for respiratory deaths increased significantly and was, respectively, 1.027 (95% CI:1.002-1.051), 1.029 (95% CI:1.006-1.052), and 1.065 (95% CI:1.005-1.128). NO2 showed a significant association with respiratory deaths only in the 18 to 60 year- old age group and in 9- day lags (RR= 1.318, 95% CI:1.002-1.733). Finally, the results showed that for an IQR increase in the mean concentration of CO and SO2, the adjusted RR for respiratory deaths in 9- day lags in the total population was, respectively, RR= 1.058 (95% CI:1.008-1.111) and 1.126 (95% CI:1.034-1.220). Conclusion: Air pollution in Ahvaz is probably causing increased respiratory mortality.
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Affiliation(s)
- Maryam Dastoorpoor
- Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Narges Khanjani
- Environmental Health Engineering Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Abbas Bahrampour
- Physiology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Gholamreza Goudarzi
- Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Environmental Technologies Research Center (ETRC), Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | | | - Esmaeil Idani
- Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Nuvolone D, Petri D, Voller F. The effects of ozone on human health. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2018; 25:8074-8088. [PMID: 28547375 DOI: 10.1007/s11356-017-9239-3] [Citation(s) in RCA: 193] [Impact Index Per Article: 32.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 05/09/2017] [Indexed: 04/16/2023]
Abstract
Ozone is a highly reactive, oxidative gas associated with adverse health outcome, including mortality and morbidity. Data from monitoring sites worldwide show levels of ozone often exceeding EU legislation threshold and the more restrictive WHO guidelines for the protection of human health. Well-established evidence has been produced for short-term effects, especially on respiratory and cardiovascular systems, associated to ozone exposure. Less conclusive is the evidence for long-term effects, reporting suggestive associations with respiratory mortality, new-onset asthma in children and increased respiratory symptom effects in asthmatics. The growing epidemiological evidence and the increasing availability of routinely collected data on air pollutant concentrations and health statistics allow to produce robust estimates in health impact assessment routine. Most recent estimates indicate that in 2013 in EU-28, 16,000 premature deaths, equivalent to 192,000 years of life lost, are attributable to ozone exposure. Italy shows very high health impact estimates among EU countries, reporting 3380 premature deaths and 61 years of life lost (per 100,000 inhabitants) attributable to ozone exposure.
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Affiliation(s)
- Daniela Nuvolone
- Unit of Epidemiology, Regional Health Agency of Tuscany, via Pietro Dazzi 1, Florence, Italy.
| | - Davide Petri
- Unit of Epidemiology, Regional Health Agency of Tuscany, via Pietro Dazzi 1, Florence, Italy
| | - Fabio Voller
- Unit of Epidemiology, Regional Health Agency of Tuscany, via Pietro Dazzi 1, Florence, Italy
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17
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Wu XM, Basu R, Malig B, Broadwin R, Ebisu K, Gold EB, Qi L, Derby C, Green RS. Association between gaseous air pollutants and inflammatory, hemostatic and lipid markers in a cohort of midlife women. ENVIRONMENT INTERNATIONAL 2017; 107:131-139. [PMID: 28732305 PMCID: PMC5584622 DOI: 10.1016/j.envint.2017.07.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 07/10/2017] [Accepted: 07/11/2017] [Indexed: 05/04/2023]
Abstract
BACKGROUND Exposures to ambient gaseous pollutants have been linked to cardiovascular diseases (CVDs), but the biological mechanisms remain uncertain. OBJECTIVES This study examined the changes in CVD marker levels resulting from elevated exposure to ambient gaseous pollutants in midlife women. METHODS Annual repeated measurements of several inflammatory, hemostatic and lipid makers were obtained from 2306 midlife women enrolled in the longitudinal Study of Women's Health Across the Nation (SWAN) between 1999 and 2004. Ambient carbon monoxide (CO), nitrogen dioxide (NO2), and sulfur dioxide (SO2) data were assigned to each woman based on proximity of the monitoring station to her residential address. Short- and long-term exposures were calculated, and their associations with markers were examined using linear mixed-effects regression models, adjusted for demographic, health and other factors. RESULTS Short-term CO exposure was associated with increased fibrinogen, i.e., every interquartile increase of average prior one-week exposure to CO was associated with 1.3% (95% CI: 0.6%, 2.0%) increase in fibrinogen. Long-term exposures to NO2 and SO2 were associated with reduced high-density lipoproteins and apolipoprotein A1, e.g., 4.0% (1.7%, 6.3%) and 4.7% (2.8%, 6.6%) decrease per interquartile increment in prior one-year average NO2 concentration, respectively. Fine particle (PM2.5) exposure confounded associations between CO/NO2 and inflammatory/hemostatic markers, while associations with lipoproteins were generally robust to PM2.5 adjustment. CONCLUSIONS Exposures to these gas pollutants at current ambient levels may increase thrombotic potential and disrupt cholesterol metabolism, contributing to greater risk of CVDs in midlife women. Caution should be exercised in evaluating the confounding by PM2.5 exposure.
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Affiliation(s)
- Xiangmei May Wu
- Air and Climate Epidemiology Section, Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Oakland, CA, USA.
| | - Rupa Basu
- Air and Climate Epidemiology Section, Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Oakland, CA, USA
| | - Brian Malig
- Air and Climate Epidemiology Section, Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Oakland, CA, USA
| | - Rachel Broadwin
- Air and Climate Epidemiology Section, Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Oakland, CA, USA
| | - Keita Ebisu
- Air and Climate Epidemiology Section, Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Oakland, CA, USA
| | - Ellen B Gold
- Department of Public Health Sciences, University of California Davis, School of Medicine, Davis, CA, USA
| | - Lihong Qi
- Department of Public Health Sciences, University of California Davis, School of Medicine, Davis, CA, USA
| | - Carol Derby
- Albert Einstein College of Medicine, Bronx, NY, USA
| | - Rochelle S Green
- Air and Climate Epidemiology Section, Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, Oakland, CA, USA
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Frampton MW, Balmes JR, Bromberg PA, Stark P, Arjomandi M, Hazucha MJ, Rich DQ, Hollenbeck-Pringle D, Dagincourt N, Alexis N, Ganz P, Zareba W, Costantini MG. Multicenter Ozone Study in oldEr Subjects (MOSES): Part 1. Effects of Exposure to Low Concentrations of Ozone on Respiratory and Cardiovascular Outcomes. Res Rep Health Eff Inst 2017; 2017:1-107. [PMID: 31898880 PMCID: PMC7266375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023] Open
Abstract
INTRODUCTION Exposure to air pollution is a well-established risk factor for cardiovascular morbidity and mortality. Most of the evidence supporting an association between air pollution and adverse cardiovascular effects involves exposure to particulate matter (PM). To date, little attention has been paid to acute cardiovascular responses to ozone, in part due to the notion that ozone causes primarily local effects on lung function, which are the basis for the current ozone National Ambient Air Quality Standards (NAAQS). There is evidence from a few epidemiological studies of adverse health effects of chronic exposure to ambient ozone, including increased risk of mortality from cardiovascular disease. However, in contrast to the well-established association between ambient ozone and various nonfatal adverse respiratory effects, the observational evidence for impacts of acute (previous few days) increases in ambient ozone levels on total cardiovascular mortality and morbidity is mixed. Ozone is a prototypic oxidant gas that reacts with constituents of the respiratory tract lining fluid to generate reactive oxygen species (ROS) that can overwhelm antioxidant defenses and cause local oxidative stress. Pathways by which ozone could cause cardiovascular dysfunction include alterations in autonomic balance, systemic inflammation, and oxidative stress. These initial responses could lead ultimately to arrhythmias, endothelial dysfunction, acute arterial vasoconstriction, and procoagulant activity. Individuals with impaired antioxidant defenses, such as those with the null variant of glutathione S-transferase mu 1 (GSTM1), may be at increased risk for acute health effects. The Multicenter Ozone Study in oldEr Subjects (MOSES) was a controlled human exposure study designed to evaluate whether short-term exposure of older, healthy individuals to ambient levels of ozone induces acute cardiovascular responses. The study was designed to test the a priori hypothesis that short-term exposure to ambient levels of ozone would induce acute cardiovascular responses through the following mechanisms: autonomic imbalance, systemic inflammation, and development of a prothrombotic vascular state. We also postulated a priori the confirmatory hypothesis that exposure to ozone would induce airway inflammation, lung injury, and lung function decrements. Finally, we postulated the secondary hypotheses that ozone-induced acute cardiovascular responses would be associated with: (a) increased systemic oxidative stress and lung effects, and (b) the GSTM1-null genotype. METHODS The study was conducted at three clinical centers with a separate Data Coordinating and Analysis Center (DCAC) using a common protocol. All procedures were approved by the institutional review boards (IRBs) of the participating centers. Healthy volunteers 55 to 70 years of age were recruited. Consented participants who successfully completed the screening and training sessions were enrolled in the study. All three clinical centers adhered to common standard operating procedures (SOPs) and used common tracking and data forms. Each subject was scheduled to participate in a total of 11 visits: screening visit, training visit, and three sets of exposure visits, each consisting of the pre-exposure day, the exposure day, and the post-exposure day. The subjects spent the night in a nearby hotel the night of the pre-exposure day. On exposure days, the subjects were exposed for three hours in random order to 0 ppb ozone (clean air), 70 ppb ozone, and 120 ppm ozone, alternating 15 minutes of moderate exercise with 15 minutes of rest. A suite of cardiovascular and pulmonary endpoints was measured on the day before, the day of, and up to 22 hours after, each exposure. The endpoints included: (1) electrocardiographic changes (continuous Holter monitoring: heart rate variability [HRV], repolarization, and arrhythmia); (2) markers of inflammation and oxidative stress (C-reactive protein [CRP], interleukin-6 [IL-6], 8-isoprostane, nitrotyrosine, and P-selectin); (3) vascular function measures (blood pressure [BP], flow-mediated dilatation [FMD] of the brachial artery, and endothelin-1 [ET-1]; (4) venous blood markers of platelet activation, thrombosis, and microparticle-associated tissue factor activity (MP-TFA); (5) pulmonary function (spirometry); (6) markers of airway epithelial cell injury (increases in plasma club cell protein 16 [CC16] and sputum total protein); and (7) markers of lung inflammation in sputum (polymorphonuclear leukocytes [PMN], IL-6, interleukin-8 [IL-8], and tumor necrosis factor-alpha [TNF-α]). Sputum was collected only at 22 hours after exposure. The analyses of the continuous electrocardiographic monitoring, the brachial artery ultrasound (BAU) images, and the blood and sputum samples were carried out by core laboratories. The results of all analyses were submitted directly to the DCAC. The variables analyzed in the statistical models were represented as changes from pre-exposure to post-exposure (post-exposure minus pre-exposure). Mixed-effect linear models were used to evaluate the impact of exposure to ozone on the prespecified primary and secondary continuous outcomes. Site and time (when multiple measurements were taken) were controlled for in the models. Three separate interaction models were constructed for each outcome: ozone concentration by subject sex; ozone concentration by subject age; and ozone concentration by subject GSTM1 status (null or sufficient). Because of the issue of multiple comparisons, the statistical significance threshold was set a priori at P < 0.01. RESULTS Subject recruitment started in June 2012, and the first subject was randomized on July 25, 2012. Subject recruitment ended on December 31, 2014, and testing of all subjects was completed by April 30, 2015. A total of 87 subjects completed all three exposures. The mean age was 59.9 ± 4.5 years, 60% of the subjects were female, 88% were white, and 57% were GSTM1 null. Mean baseline body mass index (BMI), BP, cholesterol (total and low-density lipoprotein), and lung function were all within the normal range. We found no significant effects of ozone exposure on any of the primary or secondary endpoints for autonomic function, repolarization, ST segment change, or arrhythmia. Ozone exposure also did not cause significant changes in the primary endpoints for systemic inflammation (CRP) and vascular function (systolic blood pressure [SBP] and FMD) or secondary endpoints for systemic inflammation and oxidative stress (IL-6, P-selectin, and 8-isoprostane). Ozone did cause changes in two secondary endpoints: a significant increase in plasma ET-1 (P = 0.008) and a marginally significant decrease in nitrotyrosine (P = 0.017). Lastly, ozone exposure did not affect the primary prothrombotic endpoints (MP-TFA and monocyte-platelet conjugate count) or any secondary markers of prothrombotic vascular status (platelet activation, circulating microparticles [MPs], von Willebrand factor [vWF], or fibrinogen.). Although our hypothesis focused on possible acute cardiovascular effects of exposure to low levels of ozone, we recognized that the initial effects of inhaled ozone involve the lower airways. Therefore, we looked for: (a) changes in lung function, which are known to occur during exposure to ozone and are maximal at the end of exposure; and (b) markers of airway injury and inflammation. We found an increase in forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV₁) after exposure to 0 ppb ozone, likely due to the effects of exercise. The FEV₁ increased significantly 15 minutes after 0 ppb exposure (85 mL; 95% confidence interval [CI], 64 to 106; P < 0.001), and remained significantly increased from pre-exposure at 22 hours (45 mL; 95% CI, 26 to 64; P < 0.001). The increase in FVC followed a similar pattern. The increase in FEV₁ and FVC were attenuated in a dose-response manner by exposure to 70 and 120 ppb ozone. We also observed a significant ozone-induced increase in the percentage of sputum PMN 22 hours after exposure at 120 ppb compared to 0 ppb exposure (P = 0.003). Plasma CC16 also increased significantly after exposure to 120 ppb (P < 0.001). Sputum IL-6, IL-8, and TNF-α concentrations were not significantly different after ozone exposure. We found no significant interactions with sex, age, or GSTM1 status regarding the effect of ozone on lung function, percentage of sputum PMN, or plasma CC16. CONCLUSIONS In this multicenter clinical study of older healthy subjects, ozone exposure caused concentration-related reductions in lung function and presented evidence for airway inflammation and injury. However, there was no convincing evidence for effects on cardiovascular function. Blood levels of the potent vasoconstrictor, ET-1, increased with ozone exposure (with marginal statistical significance), but there were no effects on BP, FMD, or other markers of vascular function. Blood levels of nitrotyrosine decreased with ozone exposure, the opposite of our hypothesis. Our study does not support acute cardiovascular effects of low-level ozone exposure in healthy older subjects. Inclusion of only healthy older individuals is a major limitation, which may affect the generalizability of our findings. We cannot exclude the possibility of effects with higher ozone exposure concentrations or more prolonged exposure, or the possibility that subjects with underlying vascular disease, such as hypertension or diabetes, would show effects under these conditions.
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Affiliation(s)
- M W Frampton
- University of Rochester Medical Center, Rochester, New York
| | | | | | - P Stark
- New England Research Institute, Watertown, Massachusetts
| | | | | | - D Q Rich
- University of Rochester Medical Center, Rochester, New York
| | | | - N Dagincourt
- New England Research Institute, Watertown, Massachusetts
| | - N Alexis
- University of North Carolina, Chapel Hill
| | - P Ganz
- University of California, San Francisco
| | - W Zareba
- University of Rochester Medical Center, Rochester, New York
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Ortiz C, Linares C, Carmona R, Díaz J. Evaluation of short-term mortality attributable to particulate matter pollution in Spain. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2017; 224:541-551. [PMID: 28237303 DOI: 10.1016/j.envpol.2017.02.037] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 01/18/2017] [Accepted: 02/16/2017] [Indexed: 05/18/2023]
Abstract
According to the WHO, 3 million deaths are attributable to air pollution due to particulate matter (PM) world-wide. However, there are no specific updated studies which calculate short-term PM-related cause specific mortality in Spain. The objective is to quantify the relative risks (RRs) and attributable risks (ARs) of daily mortality associated with PM10 concentrations, registered in Spanish provinces and to calculate the number of PM-related deaths. We calculated daily mortality due to natural (ICD-10: A00 R99), circulatory (ICD-10: I00 I99) and respiratory causes (ICD-10: J00 J99) for each province across the period 2000-2009. Mean daily concentrations of PM10, NO2 and O3 was used. For the estimate of RRs and ARs, we used generalised linear models with a Poisson link. A meta-analysis was used to estimate RRs and ARs in the provinces with statically significant results. The overall RRs obtained for these provinces, corresponding to increases of 10 μ g/m3 in PM10 concentrations were 1.009 (95% CI: 1.006 1011) for natural, 1.026 (95% CI: 1.019 1033) for respiratory, and 1.009 (95% CI: 1.006 1012) for circulatory-cause mortality. This amounted to an annual overall total of 2683 deaths (95% CI: 852 4354) due to natural, 651 (95% CI: 359 1026) due to respiratory, and 556 (95% CI: 116 1012) due to circulatory causes, with 90% of this mortality lying below the WHO guideline values. This study provides an updated estimate of the effect had by this type of pollutant on causes of mortality, and constitutes an important basis for reinforcing public health measures.
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Affiliation(s)
- Cristina Ortiz
- Department of Epidemiology and Biostatistic, National School of Public Health, Carlos III Institute of Health, Madrid, Spain
| | - Cristina Linares
- Department of Epidemiology and Biostatistic, National School of Public Health, Carlos III Institute of Health, Madrid, Spain
| | - Rocio Carmona
- Department of Epidemiology and Biostatistic, National School of Public Health, Carlos III Institute of Health, Madrid, Spain
| | - Julio Díaz
- Department of Epidemiology and Biostatistic, National School of Public Health, Carlos III Institute of Health, Madrid, Spain.
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Krall JR, Hackstadt AJ, Peng RD. A hierarchical modeling approach to estimate regional acute health effects of particulate matter sources. Stat Med 2017; 36:1461-1475. [PMID: 28098412 PMCID: PMC5378603 DOI: 10.1002/sim.7210] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 12/07/2016] [Accepted: 12/07/2016] [Indexed: 11/06/2022]
Abstract
Exposure to particulate matter (PM) air pollution has been associated with a range of adverse health outcomes, including cardiovascular disease hospitalizations and other clinical parameters. Determining which sources of PM, such as traffic or industry, are most associated with adverse health outcomes could help guide future recommendations aimed at reducing harmful pollution exposure for susceptible individuals. Information obtained from multisite studies, which is generally more precise than information from a single location, is critical to understanding how PM impacts health and to informing local strategies for reducing individual-level PM exposure. However, few methods exist to perform multisite studies of PM sources, which are not generally directly observed, and adverse health outcomes. We developed SHared Across a REgion (SHARE), a hierarchical modeling approach that facilitates reproducible, multisite epidemiologic studies of PM sources. SHARE is a two-stage approach that first summarizes information about PM sources across multiple sites. Then, this information is used to determine how community-level (i.e., county-level or city-level) health effects of PM sources should be pooled to estimate regional-level health effects. SHARE is a type of population value decomposition that aims to separate out regional-level features from site-level data. Unlike previous approaches for multisite epidemiologic studies of PM sources, the SHARE approach allows the specific PM sources identified to vary by site. Using data from 2000 to 2010 for 63 northeastern US counties, we estimated regional-level health effects associated with short-term exposure to major types of PM sources. We found that PM from secondary sulfate, traffic, and metals sources was most associated with cardiovascular disease hospitalizations. Copyright © 2017 John Wiley & Sons, Ltd.
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Affiliation(s)
- J. R. Krall
- Department of Biostatistics & Bioinformatics, Emory University, 1518 Clifton Road, Mailstop 1518-002-3AA, Atlanta, GA 30322
| | - A. J. Hackstadt
- Department of Biostatistics, Vanderbilt School of Medicine, 2525 West End Avenue, Suite 11000, Nashville, TN 37203
| | - R. D. Peng
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD 21205
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21
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Freitas SR, Panetta J, Longo KM, Rodrigues LF, Moreira DS, Rosário NE, Silva Dias PL, Silva Dias MAF, Souza EP, Freitas ED, Longo M, Frassoni A, Fazenda AL, Santos E Silva CM, Pavani CAB, Eiras D, França DA, Massaru D, Silva FB, Cavalcante F, Pereira G, Camponogara G, Ferrada GA, Campos Velho HF, Menezes I, Freire JL, Alonso MF, Gácita MS, Zarzur M, Fonseca RM, Lima RS, Siqueira RA, Braz R, Tomita S, Oliveira V, Martins LD. The Brazilian developments on the Regional Atmospheric Modeling System (BRAMS 5.2): an integrated environmental model tuned for tropical areas. GEOSCIENTIFIC MODEL DEVELOPMENT 2017; 10:189-222. [PMID: 32818049 PMCID: PMC7430531 DOI: 10.5194/gmd-10-189-2017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
We present a new version of the Brazilian developments on the Regional Atmospheric Modeling System where different previous versions for weather, chemistry and carbon cycle were unified in a single integrated software system. The new version also has a new set of state-of-the-art physical parameterizations and greater computational parallel and memory usage efficiency. Together with the description of the main features are examples of the quality of the transport scheme for scalars, radiative fluxes on surface and model simulation of rainfall systems over South America in different spatial resolutions using a scale-aware convective parameterization. Besides, the simulation of the diurnal cycle of the convection and carbon dioxide concentration over the Amazon Basin, as well as carbon dioxide fluxes from biogenic processes over a large portion of South America are shown. Atmospheric chemistry examples present model performance in simulating near-surface carbon monoxide and ozone in Amazon Basin and Rio de Janeiro megacity. For tracer transport and dispersion, it is demonstrated the model capabilities to simulate the volcanic ash 3-d redistribution associated with the eruption of a Chilean volcano. Then, the gain of computational efficiency is described with some details. BRAMS has been applied for research and operational forecasting mainly in South America. Model results from the operational weather forecast of BRAMS on 5 km grid spacing in the Center for Weather Forecasting and Climate Studies, INPE/Brazil, since 2013 are used to quantify the model skill of near surface variables and rainfall. The scores show the reliability of BRAMS for the tropical and subtropical areas of South America. Requirements for keeping this modeling system competitive regarding on its functionalities and skills are discussed. At last, we highlight the relevant contribution of this work on the building up of a South American community of model developers.
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Affiliation(s)
- Saulo R Freitas
- Centro de Previsão de Tempo e Estudos Climáticos, Instituto Nacional de Pesquisas Espaciais, Cachoeira Paulista, SP, Brazil
| | - Jairo Panetta
- Divisão de Ciência da Computação, Instituto Tecnológico de Aeronáutica, São Jose dos Campos, SP, Brazil
| | - Karla M Longo
- Centro de Previsão de Tempo e Estudos Climáticos, Instituto Nacional de Pesquisas Espaciais, Cachoeira Paulista, SP, Brazil
| | - Luiz F Rodrigues
- Centro de Previsão de Tempo e Estudos Climáticos, Instituto Nacional de Pesquisas Espaciais, Cachoeira Paulista, SP, Brazil
| | - Demerval S Moreira
- Departamento de Física, Faculdade de Ciências, Universidade Estadual Paulista, Bauru, SP, Brazil
- Centro de Meteorologia de Bauru (IPMet), Bauru, SP, Brazil
| | - Nilton E Rosário
- Universidade Federal de São Paulo, Campus Diadema, Diadema, SP, Brasil
| | - Pedro L Silva Dias
- Instituto de Astronomia, Geofísica e Ciências Atmosféricas, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Maria A F Silva Dias
- Instituto de Astronomia, Geofísica e Ciências Atmosféricas, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Enio P Souza
- Departamento de Ciências Atmosféricas, Universidade Federal de Campina Grande, Campina Grande, PB, Brazil
| | - Edmilson D Freitas
- Instituto de Astronomia, Geofísica e Ciências Atmosféricas, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Marcos Longo
- Embrapa Informática Agropecuária, Campinas, SP, Brazil
| | - Ariane Frassoni
- Centro de Previsão de Tempo e Estudos Climáticos, Instituto Nacional de Pesquisas Espaciais, Cachoeira Paulista, SP, Brazil
| | - Alvaro L Fazenda
- Instituto de Ciências e Tecnologia, Universidade Federal de São Paulo, São Jose dos Campos, SP, Brazil
| | | | - Cláudio A B Pavani
- Centro de Previsão de Tempo e Estudos Climáticos, Instituto Nacional de Pesquisas Espaciais, Cachoeira Paulista, SP, Brazil
| | - Denis Eiras
- Centro de Previsão de Tempo e Estudos Climáticos, Instituto Nacional de Pesquisas Espaciais, Cachoeira Paulista, SP, Brazil
| | - Daniela A França
- Centro de Previsão de Tempo e Estudos Climáticos, Instituto Nacional de Pesquisas Espaciais, Cachoeira Paulista, SP, Brazil
| | - Daniel Massaru
- Centro de Previsão de Tempo e Estudos Climáticos, Instituto Nacional de Pesquisas Espaciais, Cachoeira Paulista, SP, Brazil
| | - Fernanda B Silva
- Centro de Previsão de Tempo e Estudos Climáticos, Instituto Nacional de Pesquisas Espaciais, Cachoeira Paulista, SP, Brazil
| | - Fernando Cavalcante
- Centro de Previsão de Tempo e Estudos Climáticos, Instituto Nacional de Pesquisas Espaciais, Cachoeira Paulista, SP, Brazil
| | - Gabriel Pereira
- Departamento de Geociências, Universidade Federal de São João del-Rei, MG, Brazil
| | | | - Gonzalo A Ferrada
- Centro de Previsão de Tempo e Estudos Climáticos, Instituto Nacional de Pesquisas Espaciais, Cachoeira Paulista, SP, Brazil
| | - Haroldo F Campos Velho
- Laboratório Associado de Computação e Matemática Aplicada, Instituto Nacional de Pesquisas Espaciais, São José dos Campos, SP, Brazil
| | - Isilda Menezes
- Instituto de Ciências Agrárias e Ambientais Mediterrânicas, Universidade de Évora, Évora, Portugal
- Centro Interdisciplinar de Desenvolvimento em Ambiente, Gestão Aplicada e Espaço, Universidade Lusófona de Humanidades e Tecnologia, Campo Grande, Lisboa, Portugal
| | - Julliana L Freire
- Centro de Previsão de Tempo e Estudos Climáticos, Instituto Nacional de Pesquisas Espaciais, Cachoeira Paulista, SP, Brazil
| | - Marcelo F Alonso
- Faculdade de Meteorologia, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - Madeleine S Gácita
- Centro de Previsão de Tempo e Estudos Climáticos, Instituto Nacional de Pesquisas Espaciais, Cachoeira Paulista, SP, Brazil
| | - Maurício Zarzur
- Laboratório Associado de Computação e Matemática Aplicada, Instituto Nacional de Pesquisas Espaciais, São José dos Campos, SP, Brazil
| | - Rafael M Fonseca
- Centro de Previsão de Tempo e Estudos Climáticos, Instituto Nacional de Pesquisas Espaciais, Cachoeira Paulista, SP, Brazil
| | - Rafael S Lima
- Centro de Previsão de Tempo e Estudos Climáticos, Instituto Nacional de Pesquisas Espaciais, Cachoeira Paulista, SP, Brazil
| | - Ricardo A Siqueira
- Centro de Previsão de Tempo e Estudos Climáticos, Instituto Nacional de Pesquisas Espaciais, Cachoeira Paulista, SP, Brazil
| | - Rodrigo Braz
- Centro de Previsão de Tempo e Estudos Climáticos, Instituto Nacional de Pesquisas Espaciais, Cachoeira Paulista, SP, Brazil
| | - Simone Tomita
- Centro de Previsão de Tempo e Estudos Climáticos, Instituto Nacional de Pesquisas Espaciais, Cachoeira Paulista, SP, Brazil
| | - Valter Oliveira
- Centro de Previsão de Tempo e Estudos Climáticos, Instituto Nacional de Pesquisas Espaciais, Cachoeira Paulista, SP, Brazil
| | - Leila D Martins
- Universidade Tecnológica Federal do Paraná, Londrina, PR, Brazil
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Silveira C, Roebeling P, Lopes M, Ferreira J, Costa S, Teixeira JP, Borrego C, Miranda AI. Assessment of health benefits related to air quality improvement strategies in urban areas: An Impact Pathway Approach. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2016; 183:694-702. [PMID: 27641656 DOI: 10.1016/j.jenvman.2016.08.079] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Revised: 05/09/2016] [Accepted: 08/30/2016] [Indexed: 06/06/2023]
Abstract
Air pollution is, increasingly, a concern to our society given the threats to human health and the environment. Concerted actions to improve air quality have been taken at different levels, such as through the development of Air Quality Plans (AQPs). However, air quality impacts associated with the implementation of abatement measures included in AQPs are often neglected. In order to identify the major gaps and strengths in current knowledge, a literature review has been performed on existing methodologies to estimate air pollution-related health impacts and subsequent external costs. Based on this review, the Impact Pathway Approach was adopted and applied within the context of the MAPLIA research project to assess the health impacts and benefits (or avoided external costs) derived from improvements in air quality. Seven emission abatement scenarios, based on individual and combined abatement measures, were tested for the major activity sectors (traffic, residential and industrial combustion and production processes) of a Portuguese urban area (Grande Porto) with severe particular matter (PM10) air pollution problems. Results revealed a strong positive correlation between population density and health benefits obtained from the assessed reduction scenarios. As a consequence, potential health benefits from reduction scenarios are largest in densely populated areas with high anthropic activity and, thus, where air pollution problems are most alarming. Implementation of all measures resulted in a reduction in PM10 emissions by almost 8%, improving air quality by about 1% and contributing to a benefit of 8.8 million €/year for the entire study domain. The introduction of PM10 reduction technologies in industrial units was the most beneficial abatement measure. This study intends to contribute to policy support for decision-making on air quality management.
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Affiliation(s)
- Carlos Silveira
- CESAM, Department of Environment and Planning, University of Aveiro, 3810-193 Aveiro, Portugal.
| | - Peter Roebeling
- CESAM, Department of Environment and Planning, University of Aveiro, 3810-193 Aveiro, Portugal
| | - Myriam Lopes
- CESAM, Department of Environment and Planning, University of Aveiro, 3810-193 Aveiro, Portugal
| | - Joana Ferreira
- CESAM, Department of Environment and Planning, University of Aveiro, 3810-193 Aveiro, Portugal
| | - Solange Costa
- EPIUnit, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal; National Institute of Health, Environmental Health Department, 4000-055 Porto, Portugal
| | - João P Teixeira
- EPIUnit, Institute of Public Health, University of Porto, 4050-600 Porto, Portugal; National Institute of Health, Environmental Health Department, 4000-055 Porto, Portugal
| | - Carlos Borrego
- CESAM, Department of Environment and Planning, University of Aveiro, 3810-193 Aveiro, Portugal
| | - Ana I Miranda
- CESAM, Department of Environment and Planning, University of Aveiro, 3810-193 Aveiro, Portugal
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Tomášková H, Tomášek I, Šlachtová H, Polaufová P, Šplíchalová A, Michalík J, Feltl D, Lux J, Marsová M. PM10 Air Pollution and Acute Hospital Admissions for Cardiovascular and Respiratory Causes in Ostrava. Cent Eur J Public Health 2016; 24 Suppl:S33-S39. [DOI: 10.21101/cejph.a4538] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 04/27/2016] [Indexed: 11/15/2022]
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Carugno M, Consonni D, Randi G, Catelan D, Grisotto L, Bertazzi PA, Biggeri A, Baccini M. Air pollution exposure, cause-specific deaths and hospitalizations in a highly polluted Italian region. ENVIRONMENTAL RESEARCH 2016; 147:415-24. [PMID: 26969808 DOI: 10.1016/j.envres.2016.03.003] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 03/01/2016] [Accepted: 03/02/2016] [Indexed: 05/19/2023]
Abstract
BACKGROUND The Lombardy region in northern Italy ranks among the most air polluted areas of Europe. Previous studies showed air pollution short-term effects on all-cause mortality. We examine here the effects of particulate matter with aerodynamic diameter ≤10µm (PM10) and nitrogen dioxide (NO2) exposure on deaths and hospitalizations from specific causes, including cardiac, cerebrovascular and respiratory diseases. METHODS We considered air pollution, mortality and hospitalization data for a non-opportunistic sample of 18 highly polluted and most densely populated areas of the region in the years 2003-2006. We obtained area-specific effect estimates for PM10 and NO2 from a Poisson regression model on the daily number of total deaths or cause-specific hospitalizations and then combined them in a Bayesian random-effects meta-analysis. For cause-specific mortality, we applied a case-crossover analysis. Age- and season-specific analyses were also performed. Effect estimates were expressed as percent variation in mortality or hospitalizations associated with a 10µg/m(3) increase in PM10 or NO2 concentration. RESULTS Natural mortality was positively associated with both pollutants (0.30%, 90% Credibility Interval [CrI]: -0.31; 0.78 for PM10; 0.70%, 90%CrI: 0.10; 1.27 for NO2). Cardiovascular deaths showed a higher percent variation in association with NO2 (1.12%, 90% Confidence Interval [CI]: 0.14; 2.11), while the percent variation for respiratory mortality was highest in association with PM10 (1.64%, 90%CI: 0.35; 2.93). The effect of both pollutants was more evident in the summer season. Air pollution was also associated to hospitalizations, the highest variations being 0.77% (90%CrI: 0.22; 1.43) for PM10 and respiratory diseases, and 1.70% (90%CrI: 0.39; 2.84) for NO2 and cerebrovascular diseases. The effect of PM10 on respiratory hospital admissions appeared to increase with age. For both pollutants, effects on cerebrovascular hospitalizations were more evident in subjects aged less than 75 years. CONCLUSIONS Our study provided a sound characterization of air pollution exposure and its potential effects on human health in the most polluted, and also most populated and productive, Italian region, further documenting the need for effective public health policies.
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Affiliation(s)
- Michele Carugno
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Via San Barnaba, 8, 20122 Milan, Italy.
| | - Dario Consonni
- Epidemiology Unit, Department of Preventive Medicine, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Via San Barnaba, 8, 20122 Milan, Italy
| | - Giorgia Randi
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Via San Barnaba, 8, 20122 Milan, Italy
| | - Dolores Catelan
- Department of Statistics, Informatics and Applications "G. Parenti," University of Florence, Viale Morgagni, 59, 50134 Florence, Italy; Biostatistics Unit, Cancer Prevention and Research Institute (ISPO), Via Cosimo Il Vecchio, 2, 50139 Florence, Italy
| | - Laura Grisotto
- Department of Statistics, Informatics and Applications "G. Parenti," University of Florence, Viale Morgagni, 59, 50134 Florence, Italy
| | - Pier Alberto Bertazzi
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Via San Barnaba, 8, 20122 Milan, Italy; Epidemiology Unit, Department of Preventive Medicine, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Via San Barnaba, 8, 20122 Milan, Italy
| | - Annibale Biggeri
- Department of Statistics, Informatics and Applications "G. Parenti," University of Florence, Viale Morgagni, 59, 50134 Florence, Italy; Biostatistics Unit, Cancer Prevention and Research Institute (ISPO), Via Cosimo Il Vecchio, 2, 50139 Florence, Italy
| | - Michela Baccini
- Department of Statistics, Informatics and Applications "G. Parenti," University of Florence, Viale Morgagni, 59, 50134 Florence, Italy; Biostatistics Unit, Cancer Prevention and Research Institute (ISPO), Via Cosimo Il Vecchio, 2, 50139 Florence, Italy
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Royé D, Taboada JJ, Martí A, Lorenzo MN. Winter circulation weather types and hospital admissions for respiratory diseases in Galicia, Spain. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2016; 60:507-520. [PMID: 26307637 DOI: 10.1007/s00484-015-1047-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Revised: 08/04/2015] [Accepted: 08/04/2015] [Indexed: 06/04/2023]
Abstract
The link between various pathologies and atmospheric conditions has been a constant topic of study over recent decades in many places across the world; knowing more about it enables us to pre-empt the worsening of certain diseases, thereby optimizing medical resources. This study looked specifically at the connections in winter between respiratory diseases and types of atmospheric weather conditions (Circulation Weather Types, CWT) in Galicia, a region in the north-western corner of the Iberian Peninsula. To do this, the study used hospital admission data associated with these pathologies as well as an automatic classification of weather types. The main result obtained was that weather types giving rise to an increase in admissions due to these diseases are those associated with cold, dry weather, such as those in the east and south-east, or anticyclonic types. A second peak was associated with humid, hotter weather, generally linked to south-west weather types. In the future, this result may help to forecast the increase in respiratory pathologies in the region some days in advance.
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Affiliation(s)
- D Royé
- Facultad de Geografía e Historia, Departamento de Geografía, Universidad de Santiago de Compostela, Praza da Universidade 1, 15782, Santiago de Compostela, Spain.
| | - J J Taboada
- Consellera de Medio Ambiente, Territorio e Infraestruturas, Meteogalicia, Rúa Roma 6, 15707, Santiago de Compostela, Spain
| | - A Martí
- Facultad de Geografía e Historia, Departamento de Geografía, Universidad de Santiago de Compostela, Praza da Universidade 1, 15782, Santiago de Compostela, Spain
| | - M N Lorenzo
- Facultad de Ciencias, Departamento de Física Aplicada, Universidad de Vigo, Campus As Lagoas, 32004, Ourense, Spain
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Galán I, Simón L, Flores V, Ortiz C, Fernández-Cuenca R, Linares C, Boldo E, José Medrano M, Pastor-Barriuso R. Assessing the effects of the Spanish partial smoking ban on cardiovascular and respiratory diseases: methodological issues. BMJ Open 2015; 5:e008892. [PMID: 26628524 PMCID: PMC4679921 DOI: 10.1136/bmjopen-2015-008892] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE Recent research has assessed the impact of tobacco laws on cardiovascular and respiratory morbidity. In this study, we also examined whether the association between the implementation of the 2005 Spanish smoking ban and hospital admissions for cardiovascular and respiratory diseases varies according to the adjustment for potential confounders. DESIGN Ecological time series analysis. SETTING Residents of Madrid and Barcelona cities (Spain). OUTCOME Data on daily emergency room admissions for acute myocardial infarction, cerebrovascular disease, chronic obstructive pulmonary disease (COPD), and asthma derived from the 2003-2006 Spanish hospital admissions registry. METHODS Changes in admission rates between 2006 and the 2003-2005 period were estimated using additive Poisson models allowing for overdispersion adjusted for secular trend in admission, seasonality, day of the week, temperature, number of flu and acute respiratory infection cases, pollution levels, tobacco consumption prevalence and, for asthma cases, pollen count. RESULTS In Madrid, fully adjusted models failed to detect significant changes in hospital admission rates for any disease during the study period. In Barcelona, however, hospital admissions decreased by 10.2% (95% CI 3.8% to 16.1%) for cerebrovascular diseases and by 16.0% (95% CI 7.0% to 24.1%) for COPD. Substantial changes in effect estimates were observed on adjustment for linear or quadratic trend. Effect estimates for asthma-related admissions varied substantially when adjusting for pollen count in Madrid, and for seasonality and tobacco consumption in Barcelona. CONCLUSIONS Our results confirm that the potential impact of a smoking ban must be adjusted for the underlying secular trend. In asthma-related admissions, pollen count, seasonality and tobacco consumption must be specified in the model. The substantial variability in effects detected between the two cities of Madrid and Barcelona lends strong support for a nationwide study to assess the overall effect of a smoking ban in Spain and identify the causes of the observed heterogeneity.
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Affiliation(s)
- Iñaki Galán
- National Centre for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ, Madrid, Spain
| | - Lorena Simón
- National Centre for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Víctor Flores
- National Centre for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Cristina Ortiz
- National Centre for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Rafael Fernández-Cuenca
- National Centre for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Cristina Linares
- National School of Public Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Elena Boldo
- National Centre for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Puerta de Hierro Biomedical Research Institute, Madrid, Spain
| | - María José Medrano
- National Centre for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Roberto Pastor-Barriuso
- National Centre for Epidemiology, Instituto de Salud Carlos III, Madrid, Spain
- CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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Kim IS, Jang JY, Kim TH, Park J, Shim J, Kim JB, Byun YS, Sung JH, Yoon YW, Kim JY, Cho YJ, Kim C, Joung B. Guidelines for the prevention and management of cardiovascular disease associated with fine dust/Asian dust exposure. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2015. [DOI: 10.5124/jkma.2015.58.11.1044] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- In-Soo Kim
- Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Ji-Yong Jang
- Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Tae-Hoon Kim
- Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Junbeom Park
- Division of Cardiology, Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Jaemin Shim
- Division of Cardiology, Department of Internal Medicine, Korea University Medical Center, Seoul, Korea
| | - Jin-Bae Kim
- Division of Cardiology, Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea
| | - Young Sup Byun
- Division of Cardiology, Department of Internal Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Jung-Hoon Sung
- Division of Cardiology, Department of Internal Medicine, Bundang CHA Medical Center, CHA University, Seongnam, Korea
| | - Young Won Yoon
- Division of Cardiology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jong-Youn Kim
- Division of Cardiology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Yang-Je Cho
- Department of Neurology and Epilepsy Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Changsoo Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Boyoung Joung
- Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
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Cárdaba Arranz M, Muñoz Moreno MF, Armentia Medina A, Alonso Capitán M, Carreras Vaquer F, Almaraz Gómez A. Health impact assessment of air pollution in Valladolid, Spain. BMJ Open 2014; 4:e005999. [PMID: 25326212 PMCID: PMC4202014 DOI: 10.1136/bmjopen-2014-005999] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To estimate the attributable and targeted avoidable deaths (ADs; TADs) of outdoor air pollution by ambient particulate matter (PM10), PM2.5 and O3 according to specific WHO methodology. DESIGN Health impact assessment. SETTING City of Valladolid, Spain (around 300 000 residents). DATA SOURCES Demographics; mortality; pollutant concentrations collected 1999-2008. MAIN OUTCOME MEASURES Attributable fractions; ADs and TADs per year for 1999-2008. RESULTS Higher TADs estimates (shown here) were obtained when assuming as 'target' concentrations WHO Air Quality Guidelines instead of Directive 2008/50/EC. ADs are considered relative to pollutant background levels. All-cause mortality associated to PM10 (all ages): 52 ADs (95% CI 39 to 64); 31 TADs (95% CI 24 to 39).All-cause mortality associated to PM10 (<5 years): 0 ADs (95% CI 0 to 1); 0 TADs (95% CI 0 to 1). All-cause mortality associated to PM2.5 (>30 years): 326 ADs (95% CI 217 to 422); 231 TADs (95% CI 153 to 301). Cardiopulmonary and lung cancer mortality associated to PM2.5 (>30 years): Cardiopulmonary: 186 ADs (95% CI 74 to 280); 94 TADs (95% CI 36 to 148). Lung cancer : 51 ADs (95% CI 21 to 73); 27 TADs (95% CI 10 to 41).All-cause, respiratory and cardiovascular mortality associated to O3 (all ages): All-cause: 52ADs (95% CI 25 to 77) ; 31 TADs (95% CI 15 to 45). Respiratory: 5ADs (95% CI -2 to 13) ; 3 TADs (95% CI -1 to 8). Cardiovascular: 30 ADs (95% CI 8 to 51) ; 17 TADs (95% CI 5 to 30). Negative estimates which should be read as zero were obtained when pollutant concentrations were below counterfactuals or assumed risk coefficients were below one. CONCLUSIONS Our estimates suggest a not negligible negative impact on mortality of outdoor air pollution. The implementation of WHO methodology provides critical information to distinguish an improvement range in air pollution control.
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Franck U, Leitte AM, Suppan P. Multiple exposures to airborne pollutants and hospital admissions due to diseases of the circulatory system in Santiago de Chile. THE SCIENCE OF THE TOTAL ENVIRONMENT 2014; 468-469:746-56. [PMID: 24064344 DOI: 10.1016/j.scitotenv.2013.08.088] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Revised: 07/23/2013] [Accepted: 08/27/2013] [Indexed: 05/27/2023]
Abstract
BACKGROUND High concentrations of various air pollutants have been associated with hospitalization due to development and exacerbation of cardiovascular diseases. OBJECTIVES We aimed to assess associations between airborne exposures by particulate matter as well as gaseous air pollutants and hospital admissions due to different cardiovascular disease groups in Santiago de Chile. METHODS The study was performed in the metropolitan area of Santiago de Chile during 2004-2007. We applied a time-stratified case-crossover analysis taking temporal variation, meteorological conditions and autocorrelation into account. We computed associations between daily ambient concentrations of carbon monoxide (CO), nitrogen dioxide (NO2), particulate matter (PM10 and PM2.5--particulate matter with aerodynamic diameters less than 10 or 2.5 μm, respectively) or ozone (O3) and hospital admissions for cardiovascular illnesses. RESULTS We found for CO, NO2, PM10 and PM2.5 adverse relationships to cardiovascular admissions while effect strength and lag depended on the pollutant and on the disease group. By trend, in 1-pollutant models most adverse pollutants were NO2 and particulate matter (PM10 and PM2.5) followed by CO, while in 2-pollutant models effects of PM10 persisted in most cases whereas other effects weakened. In addition the strongest effects seemed to be immediate or with a delay of up to 2 days. Adverse effects of ozone could not be detected. CONCLUSIONS Our results provided evidence for adverse health effects of combined exposure to airborne pollutants. Different pollutants accounted for varying adverse effects within different cardiovascular disease groups. Taking case numbers and effect strength of all cardiovascular diseases into account, mitigation measures should address all pollutants but especially NO2, PM10, and CO.
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Affiliation(s)
- Ulrich Franck
- Core Facility Studies, Helmholtz Centre for Environmental Research-UFZ, Leipzig, Germany.
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Costa S, Ferreira J, Silveira C, Costa C, Lopes D, Relvas H, Borrego C, Roebeling P, Miranda AI, Teixeira JP. Integrating health on air quality assessment--review report on health risks of two major European outdoor air pollutants: PM and NO₂. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART B, CRITICAL REVIEWS 2014; 17:307-40. [PMID: 25333993 DOI: 10.1080/10937404.2014.946164] [Citation(s) in RCA: 85] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Quantifying the impact of air pollution on the public's health has become an increasingly critical component in policy discussion. Recent data indicate that more than 70% of the world population lives in cities. Several studies reported that current levels of air pollutants in urban areas are associated with adverse health risks, namely, cardiovascular diseases and lung cancer. IARC recently classified outdoor air pollution and related particulate matter (PM) as carcinogenic to humans. Despite the air quality improvements observed over the last few years, there is still continued widespread exceedance within Europe, particularly regarding PM and nitrogen oxides (NOx). The European Air Quality Directive 2008/50/EC requires Member States to design appropriate air quality plans for zones where air quality does not comply with established limit values. However, in most cases, air quality is only quantified using a combination of monitored and modeled data and no health impact assessment is carried out. An integrated approach combining the effects of several emission abatement measures on air quality, impacts on human health, and associated implementation costs enables an effective cost-benefit analysis and an added value to the decision-making process. Hence, this review describes the basic steps and tools for integrating health into air quality assessment (health indicators, exposure-response functions). In addition, consideration is given to two major outdoor pollutants: PM and NO2. A summary of the health metrics used to assess the health impact of PM and NO2 and recent epidemiologic data are also described.
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Affiliation(s)
- Solange Costa
- a National Institute of Public Health , Environmental Health Department , Porto , Portugal
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Suissa L, Fortier M, Lachaud S, Staccini P, Mahagne MH. Ozone air pollution and ischaemic stroke occurrence: a case-crossover study in Nice, France. BMJ Open 2013; 3:e004060. [PMID: 24319276 PMCID: PMC3855570 DOI: 10.1136/bmjopen-2013-004060] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES Relationship between low-level air pollution and stroke is conflicting. This study was conducted to document the relationship between outdoor air pollution and ischaemic stroke occurrence. DESIGN Time-stratified case-crossover analysis. SETTING University Hospital of Nice, France. PARTICIPANTS All consecutive patients with ischaemic stroke living in Nice admitted in the University Hospital of Nice (France) between January 2007 and December 2011. MAIN OUTCOME MEASURE Association (adjusted OR) between daily levels of outdoor pollutants (ozone (O3), nitrogen dioxide (NO2), particulate matter (PM10) and sulfur dioxide (SO2)) and ischaemic stroke occurrence. RESULTS 1729 patients with ischaemic stroke (mean age: 76.1±14.0 years; men: 46.7%) were enrolled. No significant association was found between stroke occurrence and short-term effects of all pollutants tested. In stratified analysis, we observed significant associations only between recurrent (n=280) and large artery ischaemic stroke (n=578) onset and short-term effect of O3 exposure. For an increase of 10 µg/m(3) of O3 level, recurrent stroke risk (mean D-1, D-2 and D-3 lag) was increased by 12.1% (95% CI 1.5% to 23.9%) and large artery stroke risk (mean D-3 and D-4 lag) was increased by 8% (95% CI 2.0% to 16.6%). Linear dose-response relationship for both subgroups was found. CONCLUSIONS Our results confirm the relationship between low-level O3 exposure and ischaemic stroke in high vascular risk subgroup with linear exposure-response relation, independently of other pollutants and meteorological parameters. The physiopathological processes underlying this association between ischaemic stroke and O3 exposure remain to be investigated.
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Affiliation(s)
- Laurent Suissa
- Stroke Center, University Hospital of Nice, Nice, France
| | - Mikael Fortier
- Department of Emergency Medicine, University Hospital of Nice, Nice, France
| | | | - Pascal Staccini
- Department of Medical Information, University Hospital of Nice, Nice, France
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Steinvil A, Shmueli H, Ben-Assa E, Leshem-Rubinow E, Shapira I, Berliner S, Kordova-Biezuner L, Rogowski O. Environmental exposure to combustion-derived air pollution is associated with reduced functional capacity in apparently healthy individuals. Clin Res Cardiol 2013; 102:583-91. [PMID: 23619759 DOI: 10.1007/s00392-013-0569-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Accepted: 04/17/2013] [Indexed: 01/01/2023]
Abstract
Prior toxicological exposure reports demonstrated the decremental effect of several air pollutants on the metabolic equivalents achieved during exercise testing (METs). There are no prior large scale epidemiological reports about the effect of environmental air pollution exposure on those parameters. We analyzed a cohort of apparently healthy individuals attending a screening survey program held between 2003 and 2009. Participants were included if residing within an 11 km radius from the nearest air pollution monitoring station. Linear regression models were fitted for the metabolic equivalents and adjusted to short- and long-term air pollutant exposure (particulate matter under 10 micron, sulfur dioxide, nitrogen dioxide, carbon monoxide and ozone). The models were adjusted for possible confounders that affect air pollution and stress testing measurements. The study population comprised 6,612 individuals (4,201 males and 2,411 females). We found a statistically significant short- and long-term negative correlation between air pollutants, mainly CO and NO2 and between the metabolic equivalents achieved. A similar short-term effect was found for SO2. We conclude that exposure to combustion-derived air pollutants has a short- and long-term decremental effect on cardiorespiratory fitness as measured by exercise stress testing. Our epidemiological data support previous toxicological reports.
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Affiliation(s)
- Arie Steinvil
- Department of Cardiology, Tel Aviv Sourasky Medical Center, 6 Weizman st., 64239, Tel Aviv, Israel.
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Pascal M, Corso M, Chanel O, Declercq C, Badaloni C, Cesaroni G, Henschel S, Meister K, Haluza D, Martin-Olmedo P, Medina S. Assessing the public health impacts of urban air pollution in 25 European cities: results of the Aphekom project. THE SCIENCE OF THE TOTAL ENVIRONMENT 2013; 449:390-400. [PMID: 23454700 DOI: 10.1016/j.scitotenv.2013.01.077] [Citation(s) in RCA: 163] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2012] [Revised: 11/11/2012] [Accepted: 01/16/2013] [Indexed: 04/15/2023]
Abstract
INTRODUCTION The Aphekom project aimed to provide new, clear, and meaningful information on the health effects of air pollution in Europe. Among others, it assessed the health and monetary benefits of reducing short and long-term exposure to particulate matter (PM) and ozone in 25 European cities. METHOD Health impact assessments were performed using routine health and air quality data, and a common methodology. Two scenarios were considered: a decrease of the air pollutant levels by a fixed amount and a decrease to the World Health Organization (WHO) air quality guidelines. Results were economically valued by using a willingness to pay approach for mortality and a cost of illness approach for morbidity. RESULTS In the 25 cities, the largest health burden was attributable to the impacts of chronic exposure to PM2.5. Complying with the WHO guideline of 10 μg/m(3) in annual mean would add up to 22 months of life expectancy at age 30, depending on the city, corresponding to a total of 19,000 deaths delayed. The associated monetary gain would total some €31 billion annually, including savings on health expenditures, absenteeism and intangible costs such as well-being, life expectancy and quality of life. CONCLUSION European citizens are still exposed to concentrations exceeding the WHO recommendations. Aphekom provided robust estimates confirming that reducing urban air pollution would result in significant health and monetary gains in Europe. This work is particularly relevant now when the current EU legislation is being revised for an update in 2013.
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Affiliation(s)
- M Pascal
- Institut de Veille Sanitaire, Saint Maurice, France.
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Zheng S, Wang M, Wang S, Tao Y, Shang K. Short-term effects of gaseous pollutants and particulate matter on daily hospital admissions for cardio-cerebrovascular disease in Lanzhou: evidence from a heavily polluted city in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2013; 10:462-77. [PMID: 23358231 PMCID: PMC3635155 DOI: 10.3390/ijerph10020462] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2012] [Revised: 01/04/2013] [Accepted: 01/16/2013] [Indexed: 11/18/2022]
Abstract
Panel studies show a consistent association between increase in the cardiovascular hospitalizations with air pollutants in economically developed regions, but little evidence in less developed inland areas. In this study, a time-series analysis was used to examine the specific effects of major air pollutants [particulate matter less than 10 microns in diameter (PM10), sulfur dioxide (SO2), and nitrogen dioxides (NO2)] on daily hospital admissions for cardio-cerebrovascular diseases in Lanzhou, a heavily polluted city in China. We examined the effects of air pollutants for stratified groups by age and gender, and conducted the modifying effect of seasons on air pollutants to test the possible interaction. The significant associations were found between PM10, SO2 and NO2 and cardiac disease admissions, SO2 and NO2 were found to be associated with the cerebrovascular disease admissions. The elderly was associated more strongly with gaseous pollutants than younger. The modifying effect of seasons on air pollutants also existed. The significant effect of gaseous pollutants (SO2 and NO2) was found on daily hospital admissions even after adjustment for other pollutants except for SO2 on cardiac diseases. In a word, this study provides the evidence for the detrimental short-term health effects of urban gaseous pollutants on cardio-cerebrovascular diseases in Lanzhou.
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Affiliation(s)
- Shan Zheng
- College of Atmospheric Science, Center for Meteorological Environment and Human Health, Lanzhou University, the Gansu key Laboratory of Arid Climate Change and Reducing Disaster, Lanzhou 730000, China; E-Mails: (S.Z.); (M.W.); (K.S.)
| | - Minzhen Wang
- College of Atmospheric Science, Center for Meteorological Environment and Human Health, Lanzhou University, the Gansu key Laboratory of Arid Climate Change and Reducing Disaster, Lanzhou 730000, China; E-Mails: (S.Z.); (M.W.); (K.S.)
| | - Shigong Wang
- College of Atmospheric Science, Center for Meteorological Environment and Human Health, Lanzhou University, the Gansu key Laboratory of Arid Climate Change and Reducing Disaster, Lanzhou 730000, China; E-Mails: (S.Z.); (M.W.); (K.S.)
- Author to whom correspondence should be addressed; E-Mail: ; Tel./Fax: +86-0931-8915-728
| | - Yan Tao
- College of Earth and Environmental Sciences, Lanzhou University, Lanzhou 730000, China; E-Mail:
| | - Kezheng Shang
- College of Atmospheric Science, Center for Meteorological Environment and Human Health, Lanzhou University, the Gansu key Laboratory of Arid Climate Change and Reducing Disaster, Lanzhou 730000, China; E-Mails: (S.Z.); (M.W.); (K.S.)
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Farhat N, Ramsay T, Jerrett M, Krewski D. Short-Term Effects of Ozone and PM<sub>2.5</sub> on Mortality in 12 Canadian Cities. ACTA ACUST UNITED AC 2013. [DOI: 10.4236/jep.2013.412a1003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Franchini M, Guida A, Tufano A, Coppola A. Air pollution, vascular disease and thrombosis: linking clinical data and pathogenic mechanisms. J Thromb Haemost 2012; 10:2438-51. [PMID: 23006215 DOI: 10.1111/jth.12006] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
The public health burden of air pollution has been increasingly recognized over the last decades. Following the first assessed adverse effects on respiratory diseases and lung cancer, a large body of epidemiologic and clinical studies definitely documented an even stronger association of air pollution exposure with cardiovascular mortality and morbidity, particularly related to atherothrombotic (coronary and cerebrovascular) disease. Particulate matter (PM), mainly that with lower aerodynamic diameter (fine and ultrafine PM), is responsible for the most severe effects, due to its capacity to transport toxic substances deep into the lower airways. These effects have been shown to occur not only after short-term exposure to elevated concentrations of pollutants, but even after long-term relatively low levels of exposure. Vulnerable subjects (elderly persons and those with preexisting cardiopulmonary diseases) show the highest impact. Fewer and conflicting data also suggest an association with venous thromboembolism. Although not completely elucidated, a series of mechanisms have been hypothesized and tested in experimental settings. These phenomena, including vasomotor and cardiac autonomic dysfunction, hemostatic unbalance, oxidative stress and inflammatory response, have been shown to change over time and differently contribute to the short-term and long-term adverse effects of pollution exposure. Beyond environmental health policies, crucial for improving air quality and reducing the impact of such an elusive threat to public health, the recognition and assessment of the individual risk, together with specific advice, should be routinely implemented in the strategies of primary and secondary cardiovascular prevention.
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Affiliation(s)
- M Franchini
- Department of Transfusion Medicine and Hematology, Carlo Poma Hospital, Mantova, Italy
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Migliaretti G, Berchialla P. Observational approaches in the study of the effects of Total Suspended Particulates (TSP) exposure. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2012; 23:392-399. [PMID: 23173997 DOI: 10.1080/09603123.2012.743113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Literature contains mainly reports of observations based on time-series, or those of a case-crossover analysis design or, although less frequently, case control studies. However, data obtained by different approaches are difficult to compare based on different and non-homogenous population. The principal aim of this research was to compare the estimated risks obtained by differing approaches based on the same population study in the period 2006-2009. The data were based on a total of 44,200 residents in the city of Turin, hospitalised for respiratory diseases (ICD 460-519) in the period 2006-2009. Total suspended particulates (TSP), measured in µg/m(3), are the most commonly used predictors of urban pollution. The association between hospital admission for respiratory diseases and TSP exposure was investigated using at the same time the time-series, case-crossover and case-control approaches. The analyses show a general comparability of the case-crossover design stratified for time and the time-series approach, and the case control approach provided a more unstable estimation of risks. In conclusion, our results seem to indicate that the different approaches studied seem to offer comparable results.
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Affiliation(s)
- Giuseppe Migliaretti
- a Department of Public Health and Microbiology , University of Turin , Turin , Italy
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The effects of particulate matter air pollution on respiratory health and on the cardiovascular system. Zdr Varst 2012. [DOI: 10.2478/v10152-012-0022-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The effects of particulate matter air pollution on respiratory health and on the cardiovascular system
Particulate matter (PM) is a major component of urban air pollution and has a significant effect on human health. Natural PM sources are volcanic eruptions, dust storms, forest and grassland fires, living vegetation and sea spray. Traffic, domestic heating, power plants and various industrial processes generate significant amounts of anthropogenic PM. PM consists of a complex mixture of solid and liquid particles of organic and inorganic substances suspended in the air. The chemical composition of particles is very complex and depends on emission sources, meteorological conditions and their aerodynamic diameter. Several epidemiological studies have demonstrated that exposure to PM of varying size fractions is associated with an increased risk of respiratory and cardiovascular diseases. Adverse health effects have been documented from studies of both acute and chronic exposure. The most severe effects in terms of overall health burden include a significant reduction in life expectancy by a several months for the average population, which is linked to long-term exposure to moderate concentrations of PM. Nevertheless, numerous deaths and serious cardiovascular and respiratory problems have also been attributed to short-term exposure to peak levels of PM. Although many studies attribute greater toxicity to smaller size fractions, which are able to penetrate deeper into the lung, the molecular mechanisms and the size fractions of the PM that are responsible for the observed diseases are not completely understood.
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Nuvolone D, Balzi D, Chini M, Scala D, Giovannini F, Barchielli A. Short-term association between ambient air pollution and risk of hospitalization for acute myocardial infarction: results of the cardiovascular risk and air pollution in Tuscany (RISCAT) study. Am J Epidemiol 2011; 174:63-71. [PMID: 21597098 DOI: 10.1093/aje/kwr046] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Air pollutant levels have been widely associated with increased hospitalizations and mortality from cardiovascular disease. In this study, the authors focused on pollutant levels and triggering of acute myocardial infarction (AMI). Data on AMI hospitalizations, air quality, and meteorologic conditions were collected in 6 urban areas of Tuscany (central Italy) during 2002-2005. Levels of particulate matter with an aerodynamic diameter ≤10 μm (PM(10)) (range of 4-year mean values, 28.15-40.68 μg/m(3)), nitrogen dioxide (range, 28.52-39.72 μg/m(3)), and carbon monoxide (range, 0.86-1.28 mg/m(3)) were considered, and increases of 10 μg/m(3) (0.1 mg/m(3) for carbon monoxide) were analyzed. A time-stratified case-crossover approach was applied. Area-specific conditional regression models were fitted, adjusting for time-dependent variables. Stratified analyses and analyses in bipollutant models were performed. Pooled estimates were derived from random-effects meta-analyses. Among 11,450 AMI hospitalizations, the meta-analytical odds ratio at lag(2) (2-day lag) was 1.013 (95% confidence interval (CI): 1.000, 1.026) for PM(10), 1.022 (95% CI: 1.004, 1.041) for nitrogen dioxide, and 1.007 (95% CI: 1.002, 1.013) for carbon monoxide. More susceptible subgroups were elderly persons (age ≥75 years), females, and older patients with hypertension and chronic obstructive pulmonary disease. This study adds to evidence for a short-term association between air pollutants and AMI onset, also evident at low pollutant levels, suggesting a need to focus on more vulnerable subjects.
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Affiliation(s)
- Daniela Nuvolone
- Epidemiology Unit, Regional Agency for Public Health of Tuscany, Florence, Italy
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Vencloviene J, Grazuleviciene R, Babarskiene R, Dedele A, Grazulevicius T. Short-term nitrogen dioxide exposure and geomagnetic activity interaction: contribution to emergency hospitalization for acute coronary syndrome. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2011; 21:149-160. [PMID: 21506035 DOI: 10.1080/09603123.2010.515671] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
We investigated whether extremely geomagnetic activity may modify the association between short-term nitrogen dioxide (NO₂) exposure and emergency hospitalization for acute coronary syndrome (ACS). A case-crossover study design was used to analyze ACS in 6,594 hospitalized patients at the Clinic of Kaunas, Lithuania. We evaluated the associations between NO₂, geomagnetic activity and the rate of emergency admissions for ACS by logistic regression controlling for seasonal variation, weekdays and meteorological factors. Ambient NO₂ pollution interquartile range increase (IQR) on the day of admission and previous day (lag 0-1) in patients below 65 years of age increase the risk of ACS equal to 24% (95% CI 0.96-1.60). Evidence of effect modification by combined NO₂ and geomagnetic activity was observed in relation to ACS, adjusted OR was 1.61; 95% CI 1.03-2.53. In conclusion, these findings suggest that geomagnetic activity variations may increase the traffic-related air pollution effect on ACS, and highlight environmental factors associated with ischemic heart disease course.
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Choi M, Curriero FC, Johantgen M, Mills MEC, Sattler B, Lipscomb J. Association between ozone and emergency department visits: an ecological study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2011; 21:201-221. [PMID: 21547815 DOI: 10.1080/09603123.2010.533366] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The objective of this study was to examine the association between the levels of ozone concentration and emergency department (ED) visits for respiratory and cardiovascular conditions in Maryland in the United States by considering temporal and spatial characteristics, including socioeconomic status (SES), as a covariate. This study used multiple large datasets derived from government agencies for data of ozone, weather, census, and ED visits to represent Maryland in the summer of 2002. Block kriging was used to estimate the daily ozone and weather factors by ZIP code-day level. Results from a negative binomial regression showed that a 10-ppb increment of the 8-hr ozone level as a three-day average was associated with increased respiratory ED visits by 2.4%, after adjusting for weather factors, SES, and day of the week. For cardiovascular ED visits, an increment of 10 ppb of the 8-hr ozone level as a five-day average increased by 3.5%.
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Affiliation(s)
- Mona Choi
- College of Nursing, Yonsei University, Seodaemoon-Gu, Seoul, Republic of Korea.
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Liping Jiang, Hong Dai, Qinghua Sun, Chengyan Geng, Yue Yang, Tao Wu, Xiaoou Zhang, Laifu Zhong. Ambient particulate matter on DNA damage in HepG2 cells. Toxicol Ind Health 2010; 27:87-95. [PMID: 20947658 DOI: 10.1177/0748233710387001] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Ambient particulate matter (PM) has been reported to be associated with increased respiratory, cardiovascular, and malignant lung diseases. The aim of the present study was to investigate the variability of the DNA-damage induced by thoracic particles (PM( 10)) sampled in different locations and seasons (2006) in Dalian, China, in human hepatoma G2 (HepG2) cells. Significant differences in percentage of tail DNA induced by the extractable organic matter of PM(10) were revealed between summer and winter seasons and among monitoring sites in single cell gel electrophoresis (SCGE) assay. The percentage of tail DNA in HepG2 cells significantly increased in a dose-dependent manner after exposure to 7.5 and 30 μg/mL extractable organic matter of PM(10) for 1 hour. In order to clarify the underlying mechanisms, we evaluated the level of reactive oxygen species (ROS) production with the 2, 7-dichloro-fluorescein diacetate (DCFH-DA) assay. Significantly increased level of ROS was observed in HepG2 cells at higher concentrations (15 and 30 μg/mL). Significantly increased levels of 8-hydroxydeoxyguanosine (8-OHdG) were also shown in HepG2 cells. In this study, the accumulation of nuclear factor kappa B (NF-κB) p65 protein induced by the extractable organic matter of PM(10) was detected by western blotting in HepG2 cells, and the protein expression of NF-κB p65 significantly increased after the treatment with 30 μg/mL extractable organic matter of PM(10) for 24 hours. These results indicate that the extractable organic matter of PM(10) causes DNA strand breaks in HepG2 cells, and significant differences in percentage of tail DNA in dependence on locality and season are revealed. The extractable organic matter of PM(10) exerts DNA damage effects in HepG2 cells, probably through oxidative DNA damage induced by intracellular ROS, increase of 8-OHdG formation, and protein expression of NF-κB p65.
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Affiliation(s)
- Liping Jiang
- China-Japanese Joint Institute for Medical and Pharmaceutical Science, Dalian Medical University, West Segment of South Lvshun Road, Dalian, Liaoning, China
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Stafoggia M, Forastiere F, Faustini A, Biggeri A, Bisanti L, Cadum E, Cernigliaro A, Mallone S, Pandolfi P, Serinelli M, Tessari R, Vigotti MA, Perucci CA. Susceptibility Factors to Ozone-related Mortality. Am J Respir Crit Care Med 2010; 182:376-84. [DOI: 10.1164/rccm.200908-1269oc] [Citation(s) in RCA: 93] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Brook RD, Rajagopalan S, Pope CA, Brook JR, Bhatnagar A, Diez-Roux AV, Holguin F, Hong Y, Luepker RV, Mittleman MA, Peters A, Siscovick D, Smith SC, Whitsel L, Kaufman JD. Particulate matter air pollution and cardiovascular disease: An update to the scientific statement from the American Heart Association. Circulation 2010; 121:2331-78. [PMID: 20458016 DOI: 10.1161/cir.0b013e3181dbece1] [Citation(s) in RCA: 3826] [Impact Index Per Article: 273.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
In 2004, the first American Heart Association scientific statement on "Air Pollution and Cardiovascular Disease" concluded that exposure to particulate matter (PM) air pollution contributes to cardiovascular morbidity and mortality. In the interim, numerous studies have expanded our understanding of this association and further elucidated the physiological and molecular mechanisms involved. The main objective of this updated American Heart Association scientific statement is to provide a comprehensive review of the new evidence linking PM exposure with cardiovascular disease, with a specific focus on highlighting the clinical implications for researchers and healthcare providers. The writing group also sought to provide expert consensus opinions on many aspects of the current state of science and updated suggestions for areas of future research. On the basis of the findings of this review, several new conclusions were reached, including the following: Exposure to PM <2.5 microm in diameter (PM(2.5)) over a few hours to weeks can trigger cardiovascular disease-related mortality and nonfatal events; longer-term exposure (eg, a few years) increases the risk for cardiovascular mortality to an even greater extent than exposures over a few days and reduces life expectancy within more highly exposed segments of the population by several months to a few years; reductions in PM levels are associated with decreases in cardiovascular mortality within a time frame as short as a few years; and many credible pathological mechanisms have been elucidated that lend biological plausibility to these findings. It is the opinion of the writing group that the overall evidence is consistent with a causal relationship between PM(2.5) exposure and cardiovascular morbidity and mortality. This body of evidence has grown and been strengthened substantially since the first American Heart Association scientific statement was published. Finally, PM(2.5) exposure is deemed a modifiable factor that contributes to cardiovascular morbidity and mortality.
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Sarnat SE, Klein M, Sarnat JA, Flanders WD, Waller LA, Mulholland JA, Russell AG, Tolbert PE. An examination of exposure measurement error from air pollutant spatial variability in time-series studies. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2010; 20:135-46. [PMID: 19277071 PMCID: PMC3780363 DOI: 10.1038/jes.2009.10] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2008] [Accepted: 12/05/2008] [Indexed: 05/20/2023]
Abstract
Relatively few studies have evaluated the effects of heterogeneous spatiotemporal pollutant distributions on health risk estimates in time-series analyses that use data from a central monitor to assign exposures. We present a method for examining the effects of exposure measurement error relating to spatiotemporal variability in ambient air pollutant concentrations on air pollution health risk estimates in a daily time-series analysis of emergency department visits in Atlanta, Georgia. We used Poisson generalized linear models to estimate associations between current-day pollutant concentrations and circulatory emergency department visits for the 1998-2004 time period. Data from monitoring sites located in different geographical regions of the study area and at different distances from several urban geographical subpopulations served as alternative measures of exposure. We observed associations for spatially heterogeneous pollutants (CO and NO(2)) using data from several different urban monitoring sites. These associations were not observed when using data from the most rural site, located 38 miles from the city center. In contrast, associations for spatially homogeneous pollutants (O(3) and PM(2.5)) were similar, regardless of the monitoring site location. We found that monitoring site location and the distance of a monitoring site to a population of interest did not meaningfully affect estimated associations for any pollutant when using data from urban sites located within 20 miles from the population center under study. However, for CO and NO(2), these factors were important when using data from rural sites located > or = 30 miles from the population center, most likely owing to exposure measurement error. Overall, our findings lend support to the use of pollutant data from urban central sites to assess population exposures within geographically dispersed study populations in Atlanta and similar cities.
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Neslihan D, Nurten S. Effects of work place carbon monoxide exposure on blood viscosity. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2010; 65:49-53. [PMID: 20147004 DOI: 10.1080/19338240903392640] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Both blood viscosity and carbon monoxide (CO) has been associated with cardiovascular diseases (CVDs). In order to investigate the effects of chronic low-level CO exposure on the determinants of blood viscosity (hematocrit, plasma viscosity, erythrocyte deformability, and erythrocyte aggregation), 10 men exposed to CO at work for at least 6 months and 10 healthy controls were included in the study. Plasma viscosity was determined by a cone-plate viscometer, erythrocyte deformability and erythrocyte aggregation by laser-assisted optical rotational cell analyzer. Mean plasma viscosity of the group exposed to CO (1.4 +/- 0.1 mPa.sn) was significantly higher than that of the controls (1.2 +/- 0.06 mPa.sn) (p < .05). Plasma fibrinogen level of the CO group (275 +/- 11 mg/dL) was slightly higher than that of the controls (263 +/- 14 mg/dL). The rise in plasma viscosity by chronic low-level CO exposure may be the mechanism of CO-induced increase in the risk for CVDs.
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Affiliation(s)
- Dikmenoğlu Neslihan
- Department of Physiology, Hacettepe University Faculty of Medicine, Ankara, Turkey.
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Polichetti G, Cocco S, Spinali A, Trimarco V, Nunziata A. Effects of particulate matter (PM(10), PM(2.5) and PM(1)) on the cardiovascular system. Toxicology 2009; 261:1-8. [PMID: 19379789 DOI: 10.1016/j.tox.2009.04.035] [Citation(s) in RCA: 143] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2009] [Revised: 04/08/2009] [Accepted: 04/13/2009] [Indexed: 02/08/2023]
Abstract
Several studies have demonstrated that exposure to particulate matter (PM) of different size fractions is associated with an increased risk of cardiovascular disease (CVD). In this review, we have taken into consideration the possible correlation between the "short term" and "long term" effects of PM exposure and the onset of CVDs as well as the possible molecular mechanisms by which PM elicits the development of these events. Particularly, it is here underlined that these adverse health effects depend not only on the level of PM concentration in the air but also on its particular internal composition. Furthermore, we have also synthesized the findings gleaned from those few studies indicating that PM produced by tobacco smoke can give rise to cardiovascular injury.
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Affiliation(s)
- Giuliano Polichetti
- Department of Neuroscience, School of Medicine, Federico II University of Naples, Via S. Pansini 5, 80131 Naples, Italy.
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Buadong D, Jinsart W, Funatagawa I, Karita K, Yano E. Association between PM10 and O3 levels and hospital visits for cardiovascular diseases in Bangkok, Thailand. J Epidemiol 2009; 19:182-8. [PMID: 19525614 PMCID: PMC3924107 DOI: 10.2188/jea.je20080047] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background The association between air pollution and cardiovascular diseases is well known, but previous studies only assessed mortality and hospital admissions in North America, Europe, and Northeast Asia. Few studies have been conducted in less-developed countries in regions with a tropical climate. This study evaluated whether short-term exposures to fine particulate matter (PM10) and ozone (O3) were associated with hospital visits for cardiovascular diseases (CVD; ICD-10th, I00–I99) in central Bangkok, Thailand. Methods Data from hospital records were obtained from 3 major government hospitals. All hospital visits were stratified by age group and category of CVD. Daily PM10 and O3 levels reported by the Pollution Control Department from April 2002 to December 2006 (1736 days) were used in a time-series analysis with a generalized additive model procedure. Results Exposure on the previous day to PM10 and O3 had a positive association with hospital visits for CVD among elderly (≥65 years) individuals. The increase in CVD hospital visits in this age group was 0.10% (95% CI, 0.03–0.19) with a 10 µg/m3 increase in PM10, and 0.50% (95% CI, 0.19–0.81) with an increase in O3. Conclusions In central Bangkok, a short-term association was observed between increases in daily levels of PM10 and O3 and the number of daily emergency hospital visits for CVD, particularly among individuals aged ≥65 years.
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Affiliation(s)
- Dongruethai Buadong
- Interdepartment Graduate Program in Environmental Science, Graduate School, Chulalongkorn University, Bangkok, Thailand
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Pollution atmosphérique et maladies cardiovasculaires : éléments apportés par le programme de surveillance air et santé. ARCH MAL PROF ENVIRO 2009. [DOI: 10.1016/j.admp.2009.03.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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50
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Oxidative stress and anti-oxidative defense in schoolchildren residing in a petrochemical industry environment. Indian Pediatr 2009; 47:233-9. [DOI: 10.1007/s13312-010-0045-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2008] [Accepted: 02/27/2009] [Indexed: 02/02/2023]
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