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Mokoena KK, Ethan CJ, Yu Y, Shale K, Fan Y, Liu F, Rong J. The effect of ambient air pollution on circulatory mortality: a short-term exposure assessment in Xi'an, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:22512-22521. [PMID: 31161547 DOI: 10.1007/s11356-019-05463-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 05/14/2019] [Indexed: 05/27/2023]
Abstract
Various studies have illustrated that exposure to ambient air pollution has negative impacts on health. However, little evidence exists on the effects of ambient air pollution on circulatory mortality in Xi'an, China. This study aims to investigate and ascertain the association between short-term exposure to ambient air pollutants and circulatory mortality in Xi'an, China. Daily average concentrations of PM2.5, SO2, and O3, meteorological data (temperature and relative humidity) and daily counts of circulatory mortality were obtained between January 2014 and June 2016. Mortality was stratified by gender and age group (≤ 64 years and ≥ 65 years). A generalized additive model (GAM) with natural splines (NS) was constructed to analyze the relationship between ambient air pollutants and daily circulatory mortality. There were 57,570 cases of circulatory mortality, with cerebrovascular and ischemic heart diseases accounting for 48.5% and 43.5%, respectively. All ambient air pollutants displayed different seasonal patterns. In the single pollutant model, 10 μg/m3 increase in 2-day moving average concentrations of PM2.5, SO2, and O3 was associated with relative risk of 1.288(1.198, 1.388), 1.360(0.877, 2.331), and 1.324(1.059, 1.705) in circulatory mortality, respectively. After adjusting for collinearity in the multi-pollutant model, the effects remained statistically significant. The ≥ 65 years and female sub-groups were associated with a higher risk of circulatory mortality. Short-term exposure to ambient air pollutants plays a pivotal role in the genesis of circulatory mortality in Xi'an. Responses to ambient air pollutants exposure in relation to circulatory mortality are different when analyzed by sub-groups.
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Affiliation(s)
- Kingsley Katleho Mokoena
- School of Public Health, Health Science Center, Xi'an Jiaotong University, 76, Yanta West Road, Xi'an, 710061, Shaanxi, China
- Department of Life Sciences, Central University of Technology, Free State, Bloemfontein, Free State, South Africa
| | - Crystal Jane Ethan
- School of Public Health, Health Science Center, Xi'an Jiaotong University, 76, Yanta West Road, Xi'an, 710061, Shaanxi, China
| | - Yan Yu
- School of Public Health, Health Science Center, Xi'an Jiaotong University, 76, Yanta West Road, Xi'an, 710061, Shaanxi, China.
| | - Karabo Shale
- Department of Environmental and Occupational Studies, Cape Peninsula University of Technology, Cape Town, South Africa
| | - Yameng Fan
- School of Public Health, Health Science Center, Xi'an Jiaotong University, 76, Yanta West Road, Xi'an, 710061, Shaanxi, China
| | - Feng Liu
- Shaanxi Provincial Center for Disease Control and Prevention, Xi'an, Shaanxi, China.
| | - Jie Rong
- School of Public Health, Health Science Center, Xi'an Jiaotong University, 76, Yanta West Road, Xi'an, 710061, Shaanxi, China
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52
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Tibuakuu M, Michos ED, Navas-Acien A, Jones MR. Air Pollution and Cardiovascular Disease: A Focus on Vulnerable Populations Worldwide. CURR EPIDEMIOL REP 2018; 5:370-378. [PMID: 30931239 DOI: 10.1007/s40471-018-0166-8] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Purpose of review Certain subgroups defined by sociodemographics (race/ethnicity, age, sex and socioeconomic status [SES]), geographic location (rural vs. urban), comorbid conditions and country economic conditions (developed vs. developing) may disproportionately suffer the adverse cardiovascular effects of exposure to ambient air pollution. Yet, previous reviews have had a broad focus on the general population without consideration of these potentially vulnerable populations. Recent findings Over the past decade, a wealth of epidemiologic studies have linked air pollutants including particulate matter, oxides of nitrogen, and carbon monoxide to cardiovascular disease (CVD) risk factors, subclinical CVD, clinical cardiovascular outcomes and cardiovascular mortality in certain susceptible populations. Highest risk for poor CVD outcomes from air pollution exist in racial/ethnic minorities, especially in blacks compared to whites in the U.S, those at low SES, elderly populations, women, those with certain comorbid conditions and developing countries compared to developed countries. However, findings are less consistent for urban compared to rural populations. Summary Vulnerable subgroups including racial/ethnic minorities, women, the elderly, smokers, diabetics and those with prior heart disease had higher risk for adverse cardiovascular outcomes from exposure to air pollution. There is limited data from developing countries where concentrations of air pollutants are more extreme and cardiovascular event rates are higher than that of developed countries. Further epidemiologic studies are needed to understand and address the marked disparities in CVD risk conferred by air pollution globally, particularly among these vulnerable subgroups.
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Affiliation(s)
- Martin Tibuakuu
- St. Luke's Hospital, Department of Medicine, Chesterfield, MO, USA.,Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Erin D Michos
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, MD, USA.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Columbia University School of Public Health, New York, NY, USA
| | - Miranda R Jones
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA
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53
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Senthil Kumar S, Muthuselvam P, Pugalenthi V, Subramanian N, Ramkumar KM, Suresh T, Suzuki T, Rajaguru P. Toxicoproteomic analysis of human lung epithelial cells exposed to steel industry ambient particulate matter (PM) reveals possible mechanism of PM related carcinogenesis. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2018; 239:483-492. [PMID: 29684875 DOI: 10.1016/j.envpol.2018.04.049] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 03/25/2018] [Accepted: 04/09/2018] [Indexed: 06/08/2023]
Abstract
Toxicoproteomic analysis of steel industry ambient particulate matter (PM) that contain high concentrations of PAHs and metals was done by treating human lung cancer cell-line, A549 and the cell lysates were analysed using quantitative label-free nano LC-MS/MS. A total of 18,562 peptides representing 1576 proteins were identified and quantified, with 196 proteins had significantly altered expression in the treated cells. Enrichment analyses revealed that proteins associated to redox homeostsis, metabolism, and cellular energy generation were inhibited while, proteins related to DNA damage and repair and other stresses were over expressed. Altered activities of several tumor associated proteins were observed. Protein-protein interaction network and biological pathway analysis of these differentially expressed proteins were carried out to obtain a systems level view of proteome changes. Together it could be inferred that PM exposure induced oxidative stress which could have lead into DNA damage and tumor related changes. However, lowering of cellular metabolism, and energy production could reduce its ability to overcome these stress. This kind of disequilibrium between the DNA damage and ability of the cells to repair the DNA damage may lead into genomic instability that is capable of acting as the driving force during PM induced carcinogenesis.
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Affiliation(s)
- S Senthil Kumar
- Bharathidasan Institute of Technology, Anna University, Tiruchirappalli, 620024, Tamil Nadu, India
| | - P Muthuselvam
- Bharathidasan Institute of Technology, Anna University, Tiruchirappalli, 620024, Tamil Nadu, India
| | - V Pugalenthi
- Bharathidasan Institute of Technology, Anna University, Tiruchirappalli, 620024, Tamil Nadu, India
| | - N Subramanian
- Bharathidasan Institute of Technology, Anna University, Tiruchirappalli, 620024, Tamil Nadu, India
| | - K M Ramkumar
- SRM Research Institute, SRM University, Kattankulathur, 603203, Tamil Nadu, India
| | - T Suresh
- Division of Molecular Target and Gene Therapy Products, National Institute of Health Sciences, Tokyo, 250-9501, Japan
| | - T Suzuki
- Division of Molecular Target and Gene Therapy Products, National Institute of Health Sciences, Tokyo, 250-9501, Japan
| | - P Rajaguru
- Bharathidasan Institute of Technology, Anna University, Tiruchirappalli, 620024, Tamil Nadu, India.
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54
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Li D, Wang JB, Zhang ZY, Shen P, Zheng PW, Jin MJ, Lu HC, Lin HB, Chen K. Association between short-term exposure to ambient air pollution and daily mortality: a time-series study in Eastern China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2018; 25:16135-16143. [PMID: 29594907 DOI: 10.1007/s11356-018-1759-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Accepted: 03/13/2018] [Indexed: 05/10/2023]
Abstract
Few studies were conducted to evaluate health effects of acute exposure to PM2.5 and daily mortality in Asian countries due to lack of large-scale PM2.5 monitoring data. We conducted a time-series study to examine the associations of short-term exposure to four common air pollutants (PM2.5, PM10, NO2, and SO2) and daily mortality in Ningbo, Zhejiang, China. We used generalized addictive model (GAM) to estimate relative risks (RRs) and 95% confidence intervals (CIs) for the association of these four air pollutants with daily mortality. The study included 9365 people in the 2-year study period from 2014 to 2015. SO2 were significantly associated with risk of NAD, RD, and CD mortality with RRs of 1.034 (95% CI 1.004, 1.064), 1.067 (95% CI 1.010, 1.127), and 1.049 (95% CI 1.001, 1.098), respectively.PM2.5 and PM10 were significantly associated with risk of death from NAD mortality in warm season. Similar associations were observed for PM10 (RR = 1.056, 95% CI 1.004, 1.111) and risk of CD mortality. The study provides further evidence that short-term exposure to PM2.5, PM10, NO2, and SO2 are associated with increased risk of daily mortality.
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Affiliation(s)
- Die Li
- Department of Epidemiology and Health Statistics, Zhejiang University School of Public Health, NO. 866 Yuhangtang Road, Xihu District, Hangzhou, 310058, Zhejiang, China
| | - Jian-Bing Wang
- Department of Epidemiology and Health Statistics, Zhejiang University School of Public Health, NO. 866 Yuhangtang Road, Xihu District, Hangzhou, 310058, Zhejiang, China.
- Research Center for Air Pollution and Health, Zhejiang University, Hangzhou, 310058, Zhejiang, China.
| | - Zhen-Yu Zhang
- John Hopkins School of Public Health, Baltimore, 21218, MD, USA
| | - Peng Shen
- Center for Disease Control and Prevention of Yinzhou District, Ningbo, Zhejiang, 315100, China
| | - Pei-Wen Zheng
- Department of Epidemiology and Health Statistics, Zhejiang University School of Public Health, NO. 866 Yuhangtang Road, Xihu District, Hangzhou, 310058, Zhejiang, China
| | - Ming-Juan Jin
- Department of Epidemiology and Health Statistics, Zhejiang University School of Public Health, NO. 866 Yuhangtang Road, Xihu District, Hangzhou, 310058, Zhejiang, China
| | - Huai-Chu Lu
- Center for Disease Control and Prevention of Yinzhou District, Ningbo, Zhejiang, 315100, China
| | - Hong-Bo Lin
- Center for Disease Control and Prevention of Yinzhou District, Ningbo, Zhejiang, 315100, China.
| | - Kun Chen
- Department of Epidemiology and Health Statistics, Zhejiang University School of Public Health, NO. 866 Yuhangtang Road, Xihu District, Hangzhou, 310058, Zhejiang, China.
- Research Center for Air Pollution and Health, Zhejiang University, Hangzhou, 310058, Zhejiang, China.
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Buteau S, Goldberg MS, Burnett RT, Gasparrini A, Valois MF, Brophy JM, Crouse DL, Hatzopoulou M. Associations between ambient air pollution and daily mortality in a cohort of congestive heart failure: Case-crossover and nested case-control analyses using a distributed lag nonlinear model. ENVIRONMENT INTERNATIONAL 2018; 113:313-324. [PMID: 29361317 DOI: 10.1016/j.envint.2018.01.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 01/09/2018] [Accepted: 01/09/2018] [Indexed: 06/07/2023]
Abstract
BACKGROUND Persons with congestive heart failure may be at higher risk of the acute effects related to daily fluctuations in ambient air pollution. To meet some of the limitations of previous studies using grouped-analysis, we developed a cohort study of persons with congestive heart failure to estimate whether daily non-accidental mortality were associated with spatially-resolved, daily exposures to ambient nitrogen dioxide (NO2) and ozone (O3), and whether these associations were modified according to a series of indicators potentially reflecting complications or worsening of health. METHODS We constructed the cohort from the linkage of administrative health databases. Daily exposure was assigned from different methods we developed previously to predict spatially-resolved, time-dependent concentrations of ambient NO2 (all year) and O3 (warm season) at participants' residences. We performed two distinct types of analyses: a case-crossover that contrasts the same person at different times, and a nested case-control that contrasts different persons at similar times. We modelled the effects of air pollution and weather (case-crossover only) on mortality using distributed lag nonlinear models over lags 0 to 3 days. We developed from administrative health data a series of indicators that may reflect the underlying construct of "declining health", and used interactions between these indicators and the cross-basis function for air pollutant to assess potential effect modification. RESULTS The magnitude of the cumulative as well as the lag-specific estimates of association differed in many instances according to the metric of exposure. Using the back-extrapolation method, which is our preferred exposure model, we found for the case-crossover design a cumulative mean percentage changes (MPC) in daily mortality per interquartile increment in NO2 (8.8 ppb) of 3.0% (95% CI: -0.4, 6.6%) and for O3 (16.5 ppb) 3.5% (95% CI: -4.5, 12.1). For O3 there was strong confounding by weather (unadjusted MPC = 7.1%; 95% CI: 1.7, 12.7%). For the nested case-control approach the cumulative MPC for NO2 in daily mortality was 2.9% (95% CI: -0.9, 6.9%) and for O3 7.3% (95% CI: 3.0, 11.9%). We found evidence of effect modification between daily mortality and cumulative NO2 and O3 according to the prescribed dose of furosemide in the nested case-control analysis, but not in the case-crossover analysis. CONCLUSIONS Mortality in congestive heart failure was associated with exposure to daily ambient NO2 and O3 predicted from a back-extrapolation method using a land use regression model from dense sampling surveys. The methods used to assess exposure can have considerable influence on the estimated acute health effects of the two air pollutants.
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Affiliation(s)
- Stephane Buteau
- Department of Medicine, McGill University, Montreal, Quebec, Canada; Institut national de sante publique du Quebec (INSPQ), Montreal, Quebec, Canada.
| | - Mark S Goldberg
- Department of Medicine, McGill University, Montreal, Quebec, Canada; Division of Clinical Epidemiology, Research Institute of the McGill University Hospital Centre, Montreal, Canada
| | | | - Antonio Gasparrini
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Marie-France Valois
- Department of Medicine, McGill University, Montreal, Quebec, Canada; Division of Clinical Epidemiology, Research Institute of the McGill University Hospital Centre, Montreal, Canada
| | - James M Brophy
- Department of Medicine, McGill University, Montreal, Quebec, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada
| | - Dan L Crouse
- Department of Sociology, University of New Brunswick, Fredericton, New Brunswick, Canada; New Brunswick Institute for Research, Data, and Training, Fredericton, New Brunswick, Canada
| | - Marianne Hatzopoulou
- Department of Civil Engineering, University of Toronto, Toronto, Ontario, Canada
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56
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Short-term Exposure to Ozone and Mortality in Subjects With and Without Previous Cardiovascular Disease. Epidemiology 2018; 27:663-9. [PMID: 27258325 DOI: 10.1097/ede.0000000000000520] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Exposure to ground level ozone (O3) is a public health problem associated with a range of risks across population subgroups. Our aim was to investigate the role of previous cardiovascular diseases (CVDs) in mortality related to short-term O3 exposure. METHODS Deaths between 1990 and 2010 in Stockholm County were matched with previous hospitalizations in Swedish registries. An urban background monitoring station provided hourly values of air quality data, from which we calculated 8-hour running averages and daily 8-hour maximum. We analyzed associations between daily O3 concentrations and mortality among persons with and without previous CVD hospitalization with a generalized additive model adjusted for time trend, influenza, and weather. We also performed two-pollutant models. RESULTS There were 302,283 nontrauma-related deaths, out of which 196,916 had previous CVD hospitalization. The mean concentration of daily maximum 8-hour O3 was 62.9 μg/m. An average 10 μg/m increase in the same and preceding day was associated with an increased mortality of 1.72% (95% confidence interval: 0.44%, 3.02%) in those with prior admission for acute myocardial infarction (AMI), which was more than three times higher than for those with no previous AMI (0.50, 95% confidence interval: 0.10%, 0.89%, P value for interaction 0.098). The association between O3 and mortality remained essentially unchanged in two-pollutant models with NO2, NOx, and PM10. CONCLUSIONS Our study indicates that short-term exposure to O3 is associated with increased mortality in those with a previous hospitalization for AMI.
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57
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The Association between Air Pollution and Outpatient and Inpatient Visits in Shenzhen, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15020178. [PMID: 29360738 PMCID: PMC5858253 DOI: 10.3390/ijerph15020178] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2017] [Revised: 12/18/2017] [Accepted: 01/17/2018] [Indexed: 11/17/2022]
Abstract
Nowadays, air pollution is a severe environmental problem in China. To investigate the effects of ambient air pollution on health, a time series analysis of daily outpatient and inpatient visits in 2015 were conducted in Shenzhen (China). Generalized additive model was employed to analyze associations between six air pollutants (namely SO2, CO, NO2, O3, PM10, and PM2.5) and daily outpatient and inpatient visits after adjusting confounding meteorological factors, time and day of the week effects. Significant associations between air pollutants and two types of hospital visits were observed. The estimated increase in overall outpatient visits associated with each 10 µg/m3 increase in air pollutant concentration ranged from 0.48% (O3 at lag 2) to 11.48% (SO2 with 2-day moving average); for overall inpatient visits ranged from 0.73% (O3 at lag 7) to 17.13% (SO2 with 8-day moving average). Our results also suggested a heterogeneity of the health effects across different outcomes and in different populations. The findings in present study indicate that even in Shenzhen, a less polluted area in China, significant associations exist between air pollution and daily number of overall outpatient and inpatient visits.
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58
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Hassanvand MS, Naddafi K, Malek M, Valojerdi AE, Mirzadeh M, Samavat T, Hezaveh AM, Hodjatzadeh A, Khamseh ME. Effect of long-term exposure to ambient particulate matter on prevalence of type 2 diabetes and hypertension in Iranian adults: an ecologic study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2018; 25:1713-1718. [PMID: 29101696 DOI: 10.1007/s11356-017-0561-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 10/23/2017] [Indexed: 06/07/2023]
Abstract
Air pollution is considered as an environmental risk to health worldwide. Current evidence is mostly from Western populations exposed to lower levels of pollutants. This study was to explore the association of type 2 diabetes (T2D) and hypertension prevalence with exposure to high levels of air pollution in Iranian adults. The air pollution data were obtained from the air quality monitoring stations of five large cities in Iran from 2006 to 2011. The air quality monitoring stations could only detect ambient particulate matter_10 (PM10) during the study period; therefore, the average PM10 concentration was considered for comparison. We grouped the cities as group 1 (Tehran, Shiraz) with PM10 concentration < 100 μg/m3, and group 2 (Kermanshah, Ahwaz, Esfahan) with PM10 concentration > 100 μg/m3. Data from the Surveillance of Risk Factors of Non-Communicable Disease (SuRFNCD) study were used to calculate the prevalence of T2D and hypertension. We assessed the association between air pollution and the prevalence of T2D using logistic regression models. Odds ratios (ORs) with 95% CI for each outcome were calculated after adjusting for age, sex, BMI, physical activity, and other covariates. The 5-year average of PM10 concentration was higher in group 2 (120.15 ± 6.81 μg/m3) compared to group 1 (83.95 ± 7.81 μg/m3). The prevalence of T2D in group 2 was 13.8%, while it was 10.7% in group 1 (p = 0.01), OR = 1.32 (95% CI 1.03-1.69). Similarly, hypertension was more prevalent in group 2 (15.7 vs. 11.9%, p = 0.005, OR = 1.55, 95% CI 1.20-1.99). PM10 is associated with higher prevalence of T2D and hypertension in Iranian adults.
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Affiliation(s)
- Mohammad Sadegh Hassanvand
- Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran
| | - Kazem Naddafi
- Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran
| | - Mojtaba Malek
- Research Center for Prevention of Cardiovascular Disease, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran
| | - Ameneh Ebrahim Valojerdi
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran
| | | | - Tahereh Samavat
- Center for Non-Communicable Diseases Management, Deputy for Health, Ministry of Health and Medical Education, Tehran, Iran
| | - Alireza Mahdavi Hezaveh
- Center for Non-Communicable Diseases Management, Deputy for Health, Ministry of Health and Medical Education, Tehran, Iran
| | - Alieh Hodjatzadeh
- Center for Non-Communicable Diseases Management, Deputy for Health, Ministry of Health and Medical Education, Tehran, Iran
| | - Mohammad Ebrahim Khamseh
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran.
- , No. 10, Firoozeh St., South Vali-asr Ave., Vali-asr Sq., Tehran, Iran.
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Xia X, Zhang A, Liang S, Qi Q, Jiang L, Ye Y. The Association between Air Pollution and Population Health Risk for Respiratory Infection: A Case Study of Shenzhen, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14090950. [PMID: 28832531 PMCID: PMC5615487 DOI: 10.3390/ijerph14090950] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 08/09/2017] [Accepted: 08/18/2017] [Indexed: 02/08/2023]
Abstract
Nowadays, most of the research on air pollution and its adverse effects on public health in China has focused on megacities and heavily-polluted regions. Fewer studies have focused on cities that are slightly polluted. Shenzhen used to have a favorable air environment, but its air quality has deteriorated gradually as a result of development in recent years. So far, no systematic investigations have been conducted on the adverse effects of air pollution on public health in Shenzhen. This research has applied a time series analysis model to study the possible association between different types of air pollution and respiratory hospital admission in Shenzhen in 2013. Respiratory hospital admission was divided into two categories for comparison analysis among various population groups: acute upper respiratory infection and acute lower respiratory infection. The results showed that short-term exposure to ambient air pollution was significantly associated with acute respiratory infection hospital admission in Shenzhen in 2013. Children under 14 years old were the main susceptible population of acute respiratory infection due to air pollution. PM10, PM2.5 and NO₂ were the primary air pollutants threatening respiratory health in Shenzhen. Though air pollution level is generally relatively low in Shenzhen, it will benefit public health to control the pollution of particulate matter as well as other gaseous pollutants.
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Affiliation(s)
- Xiaolin Xia
- College of Geomatics, Shandong University of Science and Technology, Qingdao 266590, China.
| | - An Zhang
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China.
| | - Shi Liang
- Shenzhen Prevention and Treatment Center for Occupational Disease, Shenzhen 518020, China.
| | - Qingwen Qi
- College of Geomatics, Shandong University of Science and Technology, Qingdao 266590, China.
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China.
| | - Lili Jiang
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China.
| | - Yanjun Ye
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China.
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Allen MJ, Vanos J, Hondula DM, Vecellio DJ, Knight D, Mehdipoor H, Lucas R, Fuhrmann C, Lokys H, Lees A, Nascimento ST, Leung ACW, Perkins DR. Supporting sustainability initiatives through biometeorology education and training. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2017; 61:93-106. [PMID: 28725975 DOI: 10.1007/s00484-017-1408-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Revised: 07/08/2017] [Accepted: 07/09/2017] [Indexed: 06/07/2023]
Abstract
The International Society of Biometeorology (ISB) has covered significant breadth and depth addressing fundamental and applied societal and environmental challenges in the last 60 years. Biometeorology is an interdisciplinary science connecting living organisms to their environment, but there is very little understanding of the existence and placement of this discipline within formal educational systems and institutions. It is thus difficult to project the ability of members of the biometeorological community-especially the biometeorologists of the future-to help solve global challenges. In this paper, we ask: At present, how we are training people to understand and think about biometeorology? We also ask: What are the current tools and opportunities in which biometeorologists might address future challenges? Finally, we connect these two questions by asking: What type of new training and skill development is needed to better educate "biometeorologists of the future" to more effectively address the future challenges? To answer these questions, we provide quantitative and qualitative evidence from an educationally focused workshop attended by new professionals in biometeorology. We identify four common themes (thermal comfort and exposures, agricultural productivity, air quality, and urbanization) that biometeorologists are currently studying and that we expect to be important in the future based on their alignment with the United Nations Sustainable Development Goals. Review of recent literature within each of these thematic areas highlights a wide array of skill sets and perspectives that biometeorologists are already using. Current and new professionals within the ISB have noted highly varying and largely improvised educational pathways into the field. While variability and improvisation may be assets in promoting flexibility, adaptation, and interdisciplinarity, the lack of formal training in biometeorology raises concerns about the extent to which continuing generations of scholars will identify and engage with the community of scholarship that the ISB has developed over its 60-year history.
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Affiliation(s)
- Michael J Allen
- Department of Political Science and Geography, Old Dominion University, 7035 Batten Arts and Letters, Norfolk, VA, USA.
| | - Jennifer Vanos
- Climate, Atmospheric Science, and Physical Oceanography Department Scripps Institution of Oceanography, UC San Diego, San Diego, USA
- Department of Family Medicine and Public Health, School of Medicine, UC San Diego, San Diego, USA
| | - David M Hondula
- School of Geographical Sciences and Urban Planning, Arizona State University, Tempe, AZ, USA
| | - Daniel J Vecellio
- Climate Science Lab, Department of Geography, Texas A&M University, Texas, , College Station, TX, USA
| | - David Knight
- Department of Engineering Education, Virginia Tech, Blacksburg, Virginia, USA
| | - Hamed Mehdipoor
- Department of Geo-Information Processing, Faculty of Geo-Information Science and Earth Observation (ITC), University of Twente, Enschede, The Netherlands
| | - Rebekah Lucas
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Chris Fuhrmann
- Department of Geosciences, Mississippi State University, Mississippi State, MS, USA
| | - Hanna Lokys
- Climatology Group, Institute of Landscape Ecology, University of Münster, Münster, Germany
| | - Angela Lees
- School of Agriculture and Food Sciences, Animal Science Group, The University of Queensland, Gatton, QLD, Australia
| | | | - Andrew C W Leung
- Climate Laboratory, Department of Physical & Environmental Sciences, University of Toronto Scarborough, Toronto, ON, Canada
| | - David R Perkins
- Center for Climate Change Communication, George Mason University, Fairfax, VA, USA
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Association between Air Pollution and Emergency Room Visits for Atrial Fibrillation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017. [PMID: 28632149 PMCID: PMC5486347 DOI: 10.3390/ijerph14060661] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Despite the large prevalence in the population, possible factors responsible for the induction of atrial fibrillation (AF) events in susceptible individuals remain incompletely understood. We investigated the association between air pollution levels and emergency department admissions for AF in Rome. We conducted a 14 years’ time-series study to evaluate the association between the daily levels of air pollution (particulate matter, PM10 and PM2.5, and nitrogen dioxide, NO2) and the daily count of emergency accesses for AF (ICD-9 code: 427.31). We applied an over-dispersed conditional Poisson model to analyze the associations at different lags after controlling for time, influenza epidemics, holiday periods, temperature, and relative humidity. Additionally, we evaluated bi-pollutant models by including the other pollutant and the influence of several effect modifiers such as personal characteristics and pre-existing medical conditions. In the period of study, 79,892 individuals were admitted to the emergency departments of Rome hospitals because of AF (on average, 15.6 patients per day: min = 1, max = 36). Air pollution levels were associated with increased AF emergency visits within 24 h of exposure. Effect estimates ranged between 1.4% (0.7–2.3) for a 10 µg/m3 increase of PM10 to 3% (1.4–4.7) for a 10 µg/m3 increase of PM2.5 at lag 0–1 day. Those effects were higher in patients ≥75 years for all pollutants, male patients for PM10, and female patients for NO2. The presence of previous cardiovascular conditions, but not other effect modifiers, increase the pollution effects by 5–8% depending on the lag. This study found evidence that air pollution is associated with AF emergency visits in the short term.
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Li G, Huang J, Xu G, Pan X, Qian X, Xu J, Zhao Y, Zhang T, Liu Q, Guo X, He T. The short term burden of ambient fine particulate matter on chronic obstructive pulmonary disease in Ningbo, China. Environ Health 2017; 16:54. [PMID: 28587653 PMCID: PMC5461635 DOI: 10.1186/s12940-017-0253-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2016] [Accepted: 05/01/2017] [Indexed: 05/26/2023]
Abstract
BACKGROUND Numerous studies have found associations between ambient fine particulate matter (PM2.5) and increased mortality risk. However, little evidence is available on associations between PM2.5 and years of life lost (YLL). We aimed to estimate the YLL due to chronic obstructive pulmonary disease (COPD) mortality related to ambient PM2.5 exposure. METHODS A time-series study was conducted based on the data on air pollutants, meteorological conditions and 18,472 registered COPD deaths in Ningbo, China, 2011-2015. The effects of PM2.5 on YLL and daily death of COPD were estimated, after controlling long term trend, meteorological index and other confounders. RESULTS The impact of PM2.5 on YLL due to COPD lasted for 5 days (lag 0-4). Per 10 μg/m3 increase in PM2.5 was associated with 0.91 (95%CI: 0.16, 1.66) years increase in YLL. The excess YLL of COPD mortality were 8206 years, and 0.38 day per person in Ningbo from 2011 to 2015. The exposure-response curve of PM2.5 and YLL due to COPD showed a non-linear pattern, with relatively steep at low levels and flattened out at higher exposures.. Furthermore, the effects were significantly higher in the elderly than those in the younger. CONCLUSIONS Our findings explored burden of PM2.5 on YLL due to COPD and highlight the importance and urgency of ambient PM2.5 pollution control and protection of the vulnerable populations.
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Affiliation(s)
- Guoxing Li
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, 38 Xueyuan Road, Beijing, 100191 China
| | - Jing Huang
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, 38 Xueyuan Road, Beijing, 100191 China
| | - Guozhang Xu
- Ningbo Municipal Center for Disease Control and Prevention, Haishu District, 237 Yongfeng Road, Ningbo, 315010 China
| | - Xiaochuan Pan
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, 38 Xueyuan Road, Beijing, 100191 China
| | - Xujun Qian
- Ningbo First Hospital, 59 Liuting Street, Ningbo, 315010 China
| | - Jiaying Xu
- Tulan University, 6823 St. Charles Avenue, New Orleans, LA 70118 USA
| | - Yan Zhao
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, 38 Xueyuan Road, Beijing, 100191 China
| | - Tao Zhang
- Ningbo Municipal Center for Disease Control and Prevention, Haishu District, 237 Yongfeng Road, Ningbo, 315010 China
| | - Qichen Liu
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, 38 Xueyuan Road, Beijing, 100191 China
| | - Xinbiao Guo
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, 38 Xueyuan Road, Beijing, 100191 China
| | - Tianfeng He
- Ningbo Municipal Center for Disease Control and Prevention, Haishu District, 237 Yongfeng Road, Ningbo, 315010 China
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Zhu J, Zhang X, Zhang X, Dong M, Wu J, Dong Y, Chen R, Ding X, Huang C, Zhang Q, Zhou W. The burden of ambient air pollution on years of life lost in Wuxi, China, 2012-2015: A time-series study using a distributed lag non-linear model. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2017; 224:689-697. [PMID: 28258859 DOI: 10.1016/j.envpol.2017.02.053] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 02/13/2017] [Accepted: 02/22/2017] [Indexed: 05/08/2023]
Abstract
Ambient air pollution ranks high among the risk factors that increase the global burden of disease. Previous studies focused on assessing mortality risk and were sparsely performed in populous developing countries with deteriorating environments. We conducted a time-series study to evaluate the air pollution-associated years of life lost (YLL) and mortality risk and to identify potential modifiers relating to the season and demographic characteristics. Using linear (for YLL) and Poisson (for mortality) regression models and controlling for time-varying factors, we found that an interquartile range (IQR) increase in a three-day average cumulative (lag 0-2 day) concentrations of PM2.5, PM10, NO2 and SO2 corresponded to increases in YLL of 12.09 (95% confidence interval [CI]: 2.98-21.20), 13.69 (95% CI: 3.32-24.07), 26.95 (95% CI: 13.99-39.91) and 24.39 (95% CI: 8.62-40.15) years, respectively, and to percent increases in mortality of 1.34% (95% CI: 0.67-2.01%), 1.56% (95% CI: 0.80-2.33%), 3.36% (95% CI: 2.39-4.33%) and 2.39% (95% CI: 1.24-3.55%), respectively. Among the specific causes of death, cardiovascular and respiratory diseases were positively associated with gaseous pollutants (NO2 and SO2), and diabetes was positively correlated with NO2 (in terms of the mortality risk). The effects of air pollutants were more pronounced in the cool season than in the warm season. The elderly (>65 years) and females were more vulnerable to air pollution. Studying effect estimates and their modifications by using YLL to detect premature death should support implementing health risk assessments, identifying susceptible groups and guiding policy-making and resource allocation according to specific local conditions.
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Affiliation(s)
- Jingying Zhu
- Wuxi Center for Disease Control and Prevention, 499 Jincheng Road, Liangxi District, Wuxi, Jiangsu, 214023, China
| | - Xuhui Zhang
- Wuxi Center for Disease Control and Prevention, 499 Jincheng Road, Liangxi District, Wuxi, Jiangsu, 214023, China
| | - Xi Zhang
- Wuxi Center for Disease Control and Prevention, 499 Jincheng Road, Liangxi District, Wuxi, Jiangsu, 214023, China
| | - Mei Dong
- Wuxi Municipal Environmental Monitoring Center, 58 Caozhangxincun, Liangxi District, Wuxi, Jiangsu, 214025, China
| | - Jiamei Wu
- Wuxi Municipal Meteorological Monitoring Center, 8 Jianheng Road, Xishan District, Wuxi, Jiangsu, 214101, China
| | - Yunqiu Dong
- Wuxi Center for Disease Control and Prevention, 499 Jincheng Road, Liangxi District, Wuxi, Jiangsu, 214023, China
| | - Rong Chen
- Wuxi Center for Disease Control and Prevention, 499 Jincheng Road, Liangxi District, Wuxi, Jiangsu, 214023, China
| | - Xinliang Ding
- Wuxi Center for Disease Control and Prevention, 499 Jincheng Road, Liangxi District, Wuxi, Jiangsu, 214023, China
| | - Chunhua Huang
- Wuxi Center for Disease Control and Prevention, 499 Jincheng Road, Liangxi District, Wuxi, Jiangsu, 214023, China
| | - Qi Zhang
- Wuxi Center for Disease Control and Prevention, 499 Jincheng Road, Liangxi District, Wuxi, Jiangsu, 214023, China
| | - Weijie Zhou
- Wuxi Center for Disease Control and Prevention, 499 Jincheng Road, Liangxi District, Wuxi, Jiangsu, 214023, China.
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Requia WJ, Adams MD, Koutrakis P. Association of PM 2.5 with diabetes, asthma, and high blood pressure incidence in Canada: A spatiotemporal analysis of the impacts of the energy generation and fuel sales. THE SCIENCE OF THE TOTAL ENVIRONMENT 2017; 584-585:1077-1083. [PMID: 28169030 DOI: 10.1016/j.scitotenv.2017.01.166] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 01/23/2017] [Accepted: 01/24/2017] [Indexed: 05/12/2023]
Abstract
Numerous studies have reported an association between fine particulate matter (PM2.5) and human health. Often these relationships are influenced by environmental factor that varies spatially and/or temporally. To our knowledge, there are no studies in Canada that have considered energy generation and fuel sales as PM2.5 effects modifiers. Determining exposure and disease-specific risk factors over space and time is crucial for disease prevention and control. In this study, we evaluated the association of PM2.5 with diabetes, asthma, and High Blood Pressure (HBP) incidence in Canada. Then we explored the impact of the energy generation and fuel sales on association changes. We fit an age-period-cohort as the study design, and we applied an over-dispersed Poisson regression model to estimate the risk. We conducted a sensitivity analysis to explore the impact of variation in clean energy rates and fuel sales on outcomes changes. The study included 117 health regions in Canada between 2007 and 2014. Our findings showed strong association of PM2.5 with diabetes, asthma, and HBP incidence. A two-year increase of 10μg/m3 in PM2.5 was associated with an increased risk of 5.34% (95% CI: 2.28%; 12.53%) in diabetes incidence, 2.24% (95% CI: 0.93%; 5.38%) in asthma incidence, and 8.29% (95% CI: 3.44%; 19.98%) in HBP incidence. Our sensitivity analysis findings suggest higher risks of diabetes, asthma and HBP incidence when there is low clean energy generation. On the other hand, we found lower risk when we considered high rate of clean energy generation. For example, considering only diabetes incidence, we found that the risk in health regions with low rates of clean electricity is approximately 700% higher than the risk in health regions with high rates of clean electricity. Furthermore, our analysis suggested that the risk in regions with low fuel sales is 66% lower than the risk is health regions with low rates of clean electricity. Our study provides support for the creation of effective environmental health public policies that take into account the risk factors present in Canadians health regions.
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Affiliation(s)
- Weeberb J Requia
- School of Geography and Earth Sciences, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada.
| | - Matthew D Adams
- Department of Geography and Environmental Studies, Ryerson University, Canada.
| | - Petros Koutrakis
- Harvard T.H. Chan School of Public Health, Harvard University, United States.
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Costa AF, Hoek G, Brunekreef B, Ponce de Leon AC. Air Pollution and Deaths among Elderly Residents of São Paulo, Brazil: An Analysis of Mortality Displacement. ENVIRONMENTAL HEALTH PERSPECTIVES 2017; 125:349-354. [PMID: 27713111 PMCID: PMC5332200 DOI: 10.1289/ehp98] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 09/12/2016] [Accepted: 09/13/2016] [Indexed: 05/21/2023]
Abstract
BACKGROUND Evaluation of short-term mortality displacement is essential to accurately estimate the impact of short-term air pollution exposure on public health. OBJECTIVES We quantified mortality displacement by estimating single-day lag effects and cumulative effects of air pollutants on mortality using distributed lag models. METHODS We performed a daily time series of nonaccidental and cause-specific mortality among elderly residents of São Paulo, Brazil, between 2000 and 2011. Effects of particulate matter smaller than 10 μm (PM10), nitrogen dioxide (NO2) and carbon monoxide (CO) were estimated in Poisson generalized additive models. Single-day lag effects of air pollutant exposure were estimated for 0-, 1- and 2-day lags. Distributed lag models with lags of 0-10, 0-20 and 0-30 days were used to assess mortality displacement and potential cumulative exposure effects. RESULTS PM10, NO2 and CO were significantly associated with nonaccidental and cause-specific deaths in both single-day lag and cumulative lag models. Cumulative effect estimates for 0-10 days were larger than estimates for single-day lags. Cumulative effect estimates for 0-30 days were essentially zero for nonaccidental and circulatory deaths but remained elevated for respiratory and cancer deaths. CONCLUSIONS We found evidence of mortality displacement within 30 days for nonaccidental and circulatory deaths in elderly residents of São Paulo. We did not find evidence of mortality displacement within 30 days for respiratory or cancer deaths. Citation: Costa AF, Hoek G, Brunekreef B, Ponce de Leon AC. 2017. Air pollution and deaths among elderly residents of São Paulo, Brazil: an analysis of mortality displacement. Environ Health Perspect 125:349-354; http://dx.doi.org/10.1289/EHP98.
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Affiliation(s)
- Amine Farias Costa
- Institute of Social Medicine, Rio de Janeiro State University, Rio de Janeiro, Brazil
- Brazilian National Cancer Institute, Rio de Janeiro, Brazil
- Address correspondence to A.F. Costa, Rua Equador 831, Rio de Janeiro, RJ, Brazil, 20220-410. Telephone: 552132072846. E-mail:
| | - Gerard Hoek
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Bert Brunekreef
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
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Ying Z, Allen K, Zhong J, Chen M, Williams KM, Wagner JG, Lewandowski R, Sun Q, Rajagopalan S, Harkema JR. Subacute inhalation exposure to ozone induces systemic inflammation but not insulin resistance in a diabetic mouse model. Inhal Toxicol 2016; 28:155-63. [PMID: 26986950 DOI: 10.3109/08958378.2016.1146808] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Epidemiological studies suggest that diabetics may be more susceptible to the adverse health effects from exposure to high ambient concentrations of ozone, the primary oxidant gas in photochemical smog. While increased morbidity and mortality from ozone inhalation has been linked to disruption of normal cardiovascular and airway functions, potential effects on glucose and insulin homeostasis are not understood. We tested the hypothesis that ozone exposure would worsen metabolic homeostasis in KKAy mice, a genetic diabetic animal model. Male KKAy mice were exposed to 0.5 ppm ozone for 13 consecutive weekdays, and then assessed for airway, adipose and systemic inflammation, glucose homeostasis, and insulin signaling. Ozone exposure increased plasma TNFα, as well as expression of VCAM-1, iNOS and IL-6 in both pulmonary and adipose tissues. Pro-inflammatory CD11b(+)Gr-1(lo)7/4(hi) macrophages were increased by 200% in adipose tissue, but unchanged in blood. Interestingly, glucose levels were not significantly different in the insulin tolerance test between air- and ozone-exposed mice, whereas fasting insulin levels and HOMA-IR in ozone-exposed animals were significantly reduced. These changes were accompanied by increased insulin signaling in skeletal muscle and liver, but not adipose tissues. Ozone also caused decrease in body weight and plasma leptin. Our results show that in addition to marked local and systemic inflammation, ozone increases insulin sensitivity that may be related to weight loss/leptin sensitization-dependent mechanisms in KKAy mice, warranting further study on the role of hyperglycemia in mediating cardiometabolic effects of ozone inhalation.
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Affiliation(s)
- Zhekang Ying
- a Department of Medicine , Cardiology Division, University of Maryland School of Medicine , Baltimore , MD , USA
| | - Katryn Allen
- b Department of Pathobiology and Diagnostic Investigation , Michigan State University , East Lansing , MH , USA , and
| | - Jixin Zhong
- a Department of Medicine , Cardiology Division, University of Maryland School of Medicine , Baltimore , MD , USA
| | - Minjie Chen
- a Department of Medicine , Cardiology Division, University of Maryland School of Medicine , Baltimore , MD , USA
| | - Keisha M Williams
- b Department of Pathobiology and Diagnostic Investigation , Michigan State University , East Lansing , MH , USA , and
| | - James G Wagner
- b Department of Pathobiology and Diagnostic Investigation , Michigan State University , East Lansing , MH , USA , and
| | - Ryan Lewandowski
- b Department of Pathobiology and Diagnostic Investigation , Michigan State University , East Lansing , MH , USA , and
| | - Qinghua Sun
- c College of Public Health, Ohio State University , Columbus , OH , USA
| | - Sanjay Rajagopalan
- a Department of Medicine , Cardiology Division, University of Maryland School of Medicine , Baltimore , MD , USA
| | - Jack R Harkema
- b Department of Pathobiology and Diagnostic Investigation , Michigan State University , East Lansing , MH , USA , and
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67
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Sun S, Qiu H, Ho KF, Tian L. Chemical components of respirable particulate matter associated with emergency hospital admissions for type 2 diabetes mellitus in Hong Kong. ENVIRONMENT INTERNATIONAL 2016; 97:93-99. [PMID: 27835752 DOI: 10.1016/j.envint.2016.10.022] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Revised: 10/21/2016] [Accepted: 10/21/2016] [Indexed: 05/04/2023]
Abstract
BACKGROUND Epidemiological studies have shown that short-term exposure to particulate matter (PM) mass is associated with diabetes morbidity and mortality, although inconsistencies still exist. Variation of chemical components in PM may have contributed to these inconsistencies. We hypothesize that certain components of respirable particulate matter (PM10), not simply PM10 mass, can exacerbate symptoms or cause acute complications for type 2 diabetes mellitus (T2DM). METHODS We used a Poisson time-series model to examine the association between 17 chemical components of PM10 and daily emergency hospital admissions for T2DM among residents aged 65years or above from January 1998 to December 2007 in Hong Kong. We estimated excess risk (ER%) for T2DM hospitalizations per interquartile range (IQR) increment in chemical component concentrations of days at lag0 through lag3, and the moving average of the same-day and previous-day (lag0-1) in single-pollutant models. To further evaluate the independent effects of chemical components on T2DM, we controlled for PM10 mass, major PM10 chemical components, and gaseous pollutants in two-pollutant models. RESULTS In the single-pollutant models, PM10 components associated with T2DM admissions include: elemental carbon, organic carbon, nitrate, and nickel. The ER% estimates per IQR increment at lag0-1 for these four components were 3.79% (1.63, 5.95), 3.74% (0.83, 6.64), 4.58% (2.17, 6.99), and 1.91% (0.43, 3.38), respectively. Risk estimates for nitrate and elemental carbon were robust to adjustment for co-pollutant concentrations. CONCLUSIONS Short-term exposure to some PM10 chemical components such as nitrate and elemental carbon increases the risk of acute complications or exacerbation of symptoms for the T2DM patients. These findings may have potential biological and policy implications.
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Affiliation(s)
- Shengzhi Sun
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Hong Qiu
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Kin-Fai Ho
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Linwei Tian
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
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Huang CH, Chao DY, Wu CC, Hsu SY, Soon MS, Chang CC, Kor CT, Chang WT, Lian IB. Influenza vaccination and the endurance against air pollution among elderly with acute coronary syndrome. Vaccine 2016; 34:6316-6322. [DOI: 10.1016/j.vaccine.2016.10.054] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 10/07/2016] [Accepted: 10/21/2016] [Indexed: 01/21/2023]
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Zhang Y, Ji X, Ku T, Sang N. Inflammatory response and endothelial dysfunction in the hearts of mice co-exposed to SO 2 , NO 2 , and PM 2.5. ENVIRONMENTAL TOXICOLOGY 2016; 31:1996-2005. [PMID: 26417707 DOI: 10.1002/tox.22200] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2014] [Revised: 09/12/2015] [Accepted: 09/13/2015] [Indexed: 06/05/2023]
Abstract
SO2 , NO2 , and PM2.5 are typical air pollutants produced during the combustion of coal. Increasing evidence indicates that air pollution has contributed to the development and progression of heart-related diseases over the past decades. However, little experimental data and few studies of SO2 , NO2 , and PM2.5 co-exposure in animals exist; therefore, the relevant mechanisms underlying this phenomenon are unclear. An important characteristic of air pollution is that co-exposure persists at a low concentration throughout a lifetime. In the present study, we treated adult mice with SO2 , NO2 , and PM2.5 at various concentrations (0.5 mg/m3 SO2 , 0.2 mg/m3 NO2 6 h/d, with intranasal instillation of 1 mg/kg PM2.5 every other day during these exposures; or 3.5 mg/m3 SO2 , 2 mg/m3 NO2 6 h/d, and 10 mg/kg PM2.5 for 28 d). Blood pressure (BP), heart rate (HR), histopathological damage, and inflammatory and endothelial cytokines in the heart were assessed. The results indicate that co-exposure caused endothelial dysfunction by elevating endothelin-1 (ET-1) expression and repressing the endothelial nitric oxide synthase (eNOS) level as well as stimulating the inflammatory response by increasing the levels of cyclooxygenase-2 (COX-2), inducible nitric oxide synthase (iNOS), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6). Additionally, these alterations were confirmed by histological staining. Furthermore, we observed decreased BP and increased HR after co-exposure. Our results indicate that co-exposure to SO2 , NO2 , and PM2.5 may be a major risk factor for cardiac disease and may induce injury to the hearts of mammals and contribute to heart disease. © 2015 Wiley Periodicals, Inc. Environ Toxicol 31: 1996-2005, 2016.
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Affiliation(s)
- Yingying Zhang
- College of Environment and Resource, Research Center of Environment and Health, Shanxi University, Taiyuan, Shanxi, 030006, People's Republic of China
| | - Xiaotong Ji
- College of Environment and Resource, Research Center of Environment and Health, Shanxi University, Taiyuan, Shanxi, 030006, People's Republic of China
| | - Tingting Ku
- College of Environment and Resource, Research Center of Environment and Health, Shanxi University, Taiyuan, Shanxi, 030006, People's Republic of China
| | - Nan Sang
- College of Environment and Resource, Research Center of Environment and Health, Shanxi University, Taiyuan, Shanxi, 030006, People's Republic of China
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Shao Q, Liu T, Korantzopoulos P, Zhang Z, Zhao J, Li G. Association between air pollution and development of atrial fibrillation: A meta-analysis of observational studies. Heart Lung 2016; 45:557-562. [PMID: 27590407 DOI: 10.1016/j.hrtlng.2016.08.001] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Revised: 07/25/2016] [Accepted: 08/01/2016] [Indexed: 12/21/2022]
Abstract
BACKGROUND Current evidence suggests that gaseous or particulate pollutants may increase the risk of atrial fibrillation (AF), although this association is still uncertain. METHODS We conducted a systematic review of literature using PubMed, Ovid, Embase and Web of Science to identify studies reporting on the association between gaseous (ozone, carbon monoxide, sulfur dioxide, and nitrogen dioxide) or particulate matter 2.5 (PM2.5) and AF risk published until March 2015. The overall effect estimate was presented as the population-attributable risks with 95% CI. We used both fix-effects and random effects models to calculate the overall effect estimate. RESULTS We retrieved 4 studies, involving 461,441 participants. There was a statistically significant association between AF development and all gaseous pollutant as well as PM2.5 [NO: 1.19% (0.70-1.67%), CO: 0.60 (0.20-1.09), SO2: 0.90 (0.60-1.28), O3: 1.09 (0.20-1.86), PM2.5: 0.89 (0.20-1.57)]. CONCLUSIONS Our comprehensive meta-analysis suggests that gaseous or particulate pollutants are associated with the increased risk of AF.
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Affiliation(s)
- Qingmiao Shao
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin 300211, People's Republic of China
| | - Tong Liu
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin 300211, People's Republic of China.
| | | | - Zhiwei Zhang
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin 300211, People's Republic of China
| | - Jianping Zhao
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin 300211, People's Republic of China
| | - Guangping Li
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin 300211, People's Republic of China.
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Goldberg MS, Burnett RT. Re: "a new time-series methodology for estimating relationships between elderly frailty, remaining life expectancy, and ambient air quality". Inhal Toxicol 2016; 28:481-3. [PMID: 27411848 DOI: 10.1080/08958378.2016.1197988] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Mark S Goldberg
- a Department of Medicine , McGill University , Montreal , Quebec , Canada and
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Stanišić Stojić S, Stanišić N, Stojić A. Temperature-related mortality estimates after accounting for the cumulative effects of air pollution in an urban area. Environ Health 2016; 15:73. [PMID: 27401549 PMCID: PMC4940758 DOI: 10.1186/s12940-016-0164-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 06/30/2016] [Indexed: 05/28/2023]
Abstract
BACKGROUND To propose a new method for including the cumulative mid-term effects of air pollution in the traditional Poisson regression model and compare the temperature-related mortality risk estimates, before and after including air pollution data. RESULTS The analysis comprised a total of 56,920 residents aged 65 years or older who died from circulatory and respiratory diseases in Belgrade, Serbia, and daily mean PM10, NO2, SO2 and soot concentrations obtained for the period 2009-2014. After accounting for the cumulative effects of air pollutants, the risk associated with cold temperatures was significantly lower and the overall temperature-attributable risk decreased from 8.80 to 3.00 %. Furthermore, the optimum range of temperature, within which no excess temperature-related mortality is expected to occur, was very broad, between -5 and 21 °C, which differs from the previous findings that most of the attributable deaths were associated with mild temperatures. CONCLUSIONS These results suggest that, in polluted areas of developing countries, most of the mortality risk, previously attributed to cold temperatures, can be explained by the mid-term effects of air pollution. The results also showed that the estimated relative importance of PM10 was the smallest of four examined pollutant species, and thus, including PM10 data only is clearly not the most effective way to control for the effects of air pollution.
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Affiliation(s)
- Svetlana Stanišić Stojić
- />Faculty of Physical Chemistry, University of Belgrade, Studentski Trg 12-16, 11000 Belgrade, Serbia
| | | | - Andreja Stojić
- />Institute of Physics Belgrade, University of Belgrade, Pregrevica 118, 11080 Belgrade, Serbia
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Lavigne E, Yasseen AS, Stieb DM, Hystad P, van Donkelaar A, Martin RV, Brook JR, Crouse DL, Burnett RT, Chen H, Weichenthal S, Johnson M, Villeneuve PJ, Walker M. Ambient air pollution and adverse birth outcomes: Differences by maternal comorbidities. ENVIRONMENTAL RESEARCH 2016; 148:457-466. [PMID: 27136671 DOI: 10.1016/j.envres.2016.04.026] [Citation(s) in RCA: 110] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Revised: 03/24/2016] [Accepted: 04/20/2016] [Indexed: 05/22/2023]
Abstract
BACKGROUND Prenatal exposure to ambient air pollution has been associated with adverse birth outcomes, but the potential modifying effect of maternal comorbidities remains understudied. Our objective was to investigate whether associations between prenatal air pollution exposures and birth outcomes differ by maternal comorbidities. METHODS A total of 818,400 singleton live births were identified in the province of Ontario, Canada from 2005 to 2012. We assigned exposures to fine particulate matter (PM2.5), nitrogen dioxide (NO2) and ozone (O3) to maternal residences during pregnancy. We evaluated potential effect modification by maternal comorbidities (i.e. asthma, hypertension, pre-existing diabetes mellitus, heart disease, gestational diabetes and preeclampsia) on the associations between prenatal air pollution and preterm birth, term low birth weight and small for gestational age. RESULTS Interquartile range (IQR) increases in PM2.5 (2μg/m(3)), NO2 (9ppb) and O3 (5ppb) over the entire pregnancy were associated with a 4% (95% CI: 2.4-5.6%), 8.4% (95% CI: 5.5-10.3%) and 2% (95% CI: 0.5-4.1%) increase in the odds of preterm birth, respectively. Increases of 10.6% (95% CI: 0.2-2.1%) and 23.8% (95% CI: 5.5-44.8%) in the odds of preterm birth were observed among women with pre-existing diabetes while the increases were of 3.8% (95% CI: 2.2-5.4%) and 6.5% (95% CI: 3.7-8.4%) among women without this condition for pregnancy exposure to PM2.5 and NO2, respectively (Pint<0.01). The increase in the odds of preterm birth for exposure to PM2.5 during pregnancy was higher among women with preeclampsia (8.3%, 95% CI: 0.8-16.4%) than among women without (3.6%, 95% CI: 1.8-5.3%) (Pint=0.04). A stronger increase in the odds of preterm birth was found for exposure to O3 during pregnancy among asthmatic women (12.0%, 95% CI: 3.5-21.1%) compared to non-asthmatic women (2.0%, 95% CI: 0.1-3.5%) (Pint<0.01). We did not find statistically significant effect modification for the other outcomes investigated. CONCLUSIONS Findings of this study suggest that associations of ambient air pollution with preterm birth are stronger among women with pre-existing diabetes, asthma, and preeclampsia.
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Affiliation(s)
- Eric Lavigne
- Air Health Science Division, Health Canada, Ottawa, Ontario, Canada; School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada.
| | - Abdool S Yasseen
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Better Outcomes Registry and Network Ontario, Ottawa, Ontario, Canada; Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - David M Stieb
- Population Studies Division, Health Canada, Vancouver, British Columbia, Canada
| | - Perry Hystad
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
| | - Aaron van Donkelaar
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Randall V Martin
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jeffrey R Brook
- Air Quality Research Division, Environment Canada, Downsview, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Daniel L Crouse
- Department of Sociology, University of New Brunswick, Fredericton, New Brunswick, Canada
| | | | - Hong Chen
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Scott Weichenthal
- Air Health Science Division, Health Canada, Ottawa, Ontario, Canada; Institute of Health: Science, Technology and Policy, Carleton University, Ottawa, Ontario, Canada
| | - Markey Johnson
- Air Health Science Division, Health Canada, Ottawa, Ontario, Canada
| | - Paul J Villeneuve
- Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, ON, Canada
| | - Mark Walker
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Better Outcomes Registry and Network Ontario, Ottawa, Ontario, Canada; Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada; Public Health Ontario, Toronto, Ontario, Canada
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Song X, Liu Y, Hu Y, Zhao X, Tian J, Ding G, Wang S. Short-Term Exposure to Air Pollution and Cardiac Arrhythmia: A Meta-Analysis and Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13070642. [PMID: 27367707 PMCID: PMC4962183 DOI: 10.3390/ijerph13070642] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/01/2016] [Revised: 06/18/2016] [Accepted: 06/22/2016] [Indexed: 12/23/2022]
Abstract
The objective was to assess the transient association between air pollution and cardiac arrhythmia. Five databases were searched for studies investigating the association between daily increases in air pollutants (PM2.5, PM10, carbon monoxide, nitrogen dioxide, sulfur dioxide and ozone) and arrhythmia hospitalization or arrhythmia mortality. Two reviewers independently selected studies, extracted data, and assessed risk of bias. Outcomes were analyzed via a random-effects model and reported as relative risk and 95% confidence interval. 25 studies satisfied our inclusion criteria and 23 contributed to the meta-analysis. Arrhythmia hospitalization or mortality were associated with increases in PM2.5 (RR = 1.015 per 10 μg/m³, 95% CI: 1.006-1.024), PM10 (RR = 1.009 per 10 μg/m³, 95% CI: 1.004-1.014), carbon monoxide (RR = 1.041 per 1 ppm, 95% CI: 1.017-1.065), nitrogen dioxide (RR = 1.036 per 10 ppb, 95% CI: 1.020-1.053), and sulfur dioxide (RR = 1.021 per 10 ppb, 95% CI: 1.003-1.039), but not ozone (RR = 1.012 per 10 ppb, 95% CI: 0.997-1.027). Both particulate and gaseous components, with the exception of ozone, have a temporal association with arrhythmia hospitalization or mortality. Compared with Europe and North America, a stronger association was noted in Asia.
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Affiliation(s)
- Xuping Song
- Key Laboratory for Semi-Arid Climate Change of the Ministry of Education, College of Atmospheric Sciences, Lanzhou University, Lanzhou 730000, China.
- Center for Meteorological Environment and Human Health, Lanzhou University, Lanzhou 730000, China.
| | - Yu Liu
- School of Public Health, Lanzhou University, Lanzhou 730000, China.
| | - Yuling Hu
- Key Laboratory for Semi-Arid Climate Change of the Ministry of Education, College of Atmospheric Sciences, Lanzhou University, Lanzhou 730000, China.
- Center for Meteorological Environment and Human Health, Lanzhou University, Lanzhou 730000, China.
| | - Xiaoyan Zhao
- Key Laboratory for Semi-Arid Climate Change of the Ministry of Education, College of Atmospheric Sciences, Lanzhou University, Lanzhou 730000, China.
- Center for Meteorological Environment and Human Health, Lanzhou University, Lanzhou 730000, China.
| | - Jinhui Tian
- Evidence Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China.
| | - Guowu Ding
- School of Public Health, Lanzhou University, Lanzhou 730000, China.
| | - Shigong Wang
- Key Laboratory for Semi-Arid Climate Change of the Ministry of Education, College of Atmospheric Sciences, Lanzhou University, Lanzhou 730000, China.
- Center for Meteorological Environment and Human Health, Lanzhou University, Lanzhou 730000, China.
- College of Atmospheric Sciences, Chengdu University of Information Technology, Chengdu 610225, China.
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Salicio MA, Mana VAM, Fett WCR, Gomes LT, Botelho C. Environmental variables and levels of exhaled carbon monoxide and carboxyhemoglobin in elderly people taking exercise. CIENCIA & SAUDE COLETIVA 2016; 21:1023-32. [PMID: 27076001 DOI: 10.1590/1413-81232015214.14502015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 10/03/2015] [Indexed: 11/21/2022] Open
Abstract
This article aims to analyze levels of exhaled carbon monoxide, carboxyhemoglobinand cardiopulmonary variables in old people practicing exercise in external environments, and correlate them with climate and pollution factors. Temporal ecological study with118 active elderly people in the city of Cuiabá, in the state of Mato Grosso, Brazil. Data were obtained on use of medication, smoking, anthropometric measurements, spirometry, peak flow, oxygen saturation, heart rate, exhaled carbon monoxide, carboxyhemoglobin, climate, number of farm fires and pollution. Correlations were found between on the one hand environmental temperature, relative humidity of the air and number of farmers' fires, and on the other hand levels of carbon monoxide exhaled and carboxyhemoglobin (p < 0.05).There was a correlation between heart rate and changes in environmental temperature, time of exposure to the sun and relative humidity (p < 0.05). In elderly people, environmental factors influence levels of exhaled carbon monoxide, carboxyhemoglobin and heart rate. There is thus a need for these to be monitored during exercise. The use of a carbon monoxide monitor to evaluate exposure to pollutants is suggested.
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76
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Zhang F, Liu X, Zhou L, Yu Y, Wang L, Lu J, Wang W, Krafft T. Spatiotemporal patterns of particulate matter (PM) and associations between PM and mortality in Shenzhen, China. BMC Public Health 2016; 16:215. [PMID: 26935584 PMCID: PMC4776388 DOI: 10.1186/s12889-016-2725-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Accepted: 01/12/2016] [Indexed: 12/01/2022] Open
Abstract
Background Most studies on air pollution exposure and its associations with human health in China have focused on the heavily polluted industrial areas and/or mega-cities, and studies on cities with comparatively low air pollutant concentrations are still rare. Only a few studies have attempted to analyse particulate matter (PM) for the vibrant economic centre Shenzhen in the Pearl River Delta. So far no systematic investigation of PM spatiotemporal patterns in Shenzhen has been undertaken and the understanding of pollution exposure in urban agglomerations with comparatively low pollution is still limited. Methods We analyze daily and hourly particulate matter concentrations and all-cause mortality during 2013 in Shenzhen, China. Temporal patterns of PM (PM2.5 and PM10) with aerodynamic diameters of 2.5 (10) μm or less (or less (including particles with a diameter that equals to 2.5 (10) μm) are studied, along with the ratio of PM2.5 to PM10. Spatial distributions of PM10 and PM2.5 are addressed and associations of PM10 or PM2.5 and all-cause mortality are analyzed. Results Annual average PM10 and PM2.5 concentrations were 61.3 and 39.6 μg/m3 in 2013. PM2.5 failed to meet the Class 2 annual limit of the National Ambient Air Quality Standard. PM2.5 was the primary air pollutant, with 8.8 % of days having heavy PM2.5 pollution. The daily PM2.5/PM10 ratios were high. Hourly PM2.5 concentrations in the tourist area were lower than downtown throughout the day. PM10 and PM2.5 concentrations were higher in western parts of Shenzhen than in eastern parts. Excess risks in the number of all-cause mortality with a 10 μg/m3 increase of PM were 0.61 % (95 % confidence interval [CI]: 0.50–0.72) for PM10, and 0.69 % (95 % CI: 0.55–0.83) for PM2.5, respectively. The greatest ERs of PM10 and PM2.5 were in 2-day cumulative measures for the all-cause mortality, 2-day lag for females and the young (0–65 years), and L02 for males and the elder (>65 years). PM2.5 had higher risks on all-cause mortality than PM10. Effects of high PM pollution on mortality were stronger in the elder and male. Conclusions Our findings provide additional relevant information on air quality monitoring and associations of PM and human health, valuable data for further scientific research in Shenzhen and for the on-going discourse on improving environmental policies.
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Affiliation(s)
- Fengying Zhang
- China National Environmental Monitoring Centre, Beijing, 100012, China. .,CAPHRI School of Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands. .,Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, 100101, P. R. China.
| | - Xiaojian Liu
- Shenzhen Center for Disease Control and Prevention, Shenzhen, 518055, China
| | - Lei Zhou
- China National Environmental Monitoring Centre, Beijing, 100012, China
| | - Yong Yu
- China National Environmental Monitoring Centre, Beijing, 100012, China
| | - Li Wang
- CAPHRI School of Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - Jinmei Lu
- Department of Engineering and Safety, University of Tromsø, N-9037, Tromsø, Norway
| | - Wuyi Wang
- Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, 100101, P. R. China.
| | - Thomas Krafft
- CAPHRI School of Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.,Institute of Environment Education and Research, Bharati Vidyapeeth University, Pune, 411043, India
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Diesel Exhaust Worsens Cardiac Conduction Instability in Dobutamine-Challenged Wistar–Kyoto and Spontaneously Hypertensive Rats. Cardiovasc Toxicol 2016; 17:120-129. [DOI: 10.1007/s12012-016-9363-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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78
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Ribeiro AI, Krainski ET, Carvalho MS, Pina MDFD. Where do people live longer and shorter lives? An ecological study of old-age survival across 4404 small areas from 18 European countries. J Epidemiol Community Health 2016; 70:561-8. [DOI: 10.1136/jech-2015-206827] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2015] [Accepted: 12/11/2015] [Indexed: 11/03/2022]
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79
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Lang-Yona N, Shuster-Meiseles T, Mazar Y, Yarden O, Rudich Y. Impact of urban air pollution on the allergenicity of Aspergillus fumigatus conidia: Outdoor exposure study supported by laboratory experiments. THE SCIENCE OF THE TOTAL ENVIRONMENT 2016; 541:365-371. [PMID: 26410711 DOI: 10.1016/j.scitotenv.2015.09.058] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Revised: 09/10/2015] [Accepted: 09/13/2015] [Indexed: 04/15/2023]
Abstract
Understanding the chemical interactions of common allergens in urban environments may help to decipher the general increase in susceptibility to allergies observed in recent decades. In this study, asexual conidia of the allergenic mold Aspergillus fumigatus were exposed to air pollution under natural (ambient) and controlled (laboratory) conditions. The allergenic activity was measured using two immunoassays and supported by a protein mass spectrometry analysis. The allergenicity of the conidia was found to increase by 2-5 fold compared to the control for short exposure times of up to 12h (accumulated exposure of about 50 ppb NO2 and 750 ppb O3), possibly due to nitration. At higher exposure times, the allergenicity increase lessened due to protein deamidation. These results indicate that during the first 12h of exposure, the allergenic potency of the fungal allergen A. fumigatus in polluted urban environments is expected to increase. Additional work is needed in order to determine if this behavior occurs for other allergens.
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Affiliation(s)
- Naama Lang-Yona
- Department of Earth and Planetary Sciences, Weizmann Institute of Science, Rehovot 76100, Israel
| | - Timor Shuster-Meiseles
- Department of Earth and Planetary Sciences, Weizmann Institute of Science, Rehovot 76100, Israel
| | - Yinon Mazar
- Department of Earth and Planetary Sciences, Weizmann Institute of Science, Rehovot 76100, Israel
| | - Oded Yarden
- Department of Plant Pathology and Microbiology, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot 76100, Israel
| | - Yinon Rudich
- Department of Earth and Planetary Sciences, Weizmann Institute of Science, Rehovot 76100, Israel.
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Chen H, Wang J, Li Q, Yagouti A, Lavigne E, Foty R, Burnett RT, Villeneuve PJ, Cakmak S, Copes R. Assessment of the effect of cold and hot temperatures on mortality in Ontario, Canada: a population-based study. CMAJ Open 2016; 4:E48-58. [PMID: 27280114 PMCID: PMC4866918 DOI: 10.9778/cmajo.20150111] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Ambient high temperature is associated with death; however, heat-related risk of death has not been quantified systematically in Ontario, the most populous province in Canada. Less is known about cold-related risk in this population. Our objective was to quantify the health impact from cold and hot temperatures in Ontario. METHODS The study population consisted of all residents of Ontario who died between Jan. 1, 1996, and Dec. 31, 2010, from any nonaccidental cause. A case-crossover analysis was applied to assess the relation between daily temperature fluctuation and deaths from nonaccidental and selected causes in cold (December-February) and warm (June-August) seasons, respectively, adjusting for various potential confounders. Risk estimates were obtained for each census division, then pooled across Ontario. We examined potential effect modification for selected comorbidities and sociodemographic characteristics. RESULTS In warm seasons, each 5°C increase in daily mean temperature was associated with a 2.5% increase in nonaccidental deaths (95% confidence interval [CI] = 1.3% to 3.8%) on the day of exposure (lag 0). In cold seasons, each 5°C decrease in daily temperature was associated with a 3.0% (95% CI 1.8% to 4.2%) increase in nonaccidental deaths, which persisted over 7 days (lag 0-6). The cold-related effects (lag 0-6) were stronger for cardiovascular-related deaths (any cardiovascular death: 4.1%, 95% CI 2.3% to 5.9%; ischemic heart disease: 5.8%, 95% CI 3.6% to 8.1%), especially among people less than 65 years of age (8.0%, 95% CI 3.0% to 13.0%). Conversely, heat most strongly increased respiratory-related deaths during admission to hospital (26.0%, 95% CI 0% to 61.4%). Across Ontario, each 5°C change in daily temperature was estimated to induce 7 excess deaths per day in cold seasons and 4 excess deaths in warm seasons. INTERPRETATION Heat contributed to excess deaths in Ontario, although the effect of cold weather appeared to be greater. Further work is required to better define high-risk subgroups, which might include the homeless and people with inadequately heated housing.
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Affiliation(s)
- Hong Chen
- Public Health Ontario (Chen, Wang, Li, Copes); Dalla Lana School of Public Health (Chen, Foty, Villeneuve, Copes), University of Toronto, Toronto, Ont.; Institute for Clinical Evaluative Sciences (Chen), Toronto, Ont.; Climate Change and Health Office (Yagouti), Health Canada; Air Health Science Division (Lavigne), Health Canada; Department of Epidemiology and Community Medicine (Lavigne), University of Ottawa, Ottawa, Ont.; Sick Kids Hospital (Foty), Toronto, Ont.; Population Studies Division (Burnett, Cakmak), Health Canada; Department of Health Sciences (Villeneuve), Carleton University, Ottawa, Ont
| | - Jun Wang
- Public Health Ontario (Chen, Wang, Li, Copes); Dalla Lana School of Public Health (Chen, Foty, Villeneuve, Copes), University of Toronto, Toronto, Ont.; Institute for Clinical Evaluative Sciences (Chen), Toronto, Ont.; Climate Change and Health Office (Yagouti), Health Canada; Air Health Science Division (Lavigne), Health Canada; Department of Epidemiology and Community Medicine (Lavigne), University of Ottawa, Ottawa, Ont.; Sick Kids Hospital (Foty), Toronto, Ont.; Population Studies Division (Burnett, Cakmak), Health Canada; Department of Health Sciences (Villeneuve), Carleton University, Ottawa, Ont
| | - Qiongsi Li
- Public Health Ontario (Chen, Wang, Li, Copes); Dalla Lana School of Public Health (Chen, Foty, Villeneuve, Copes), University of Toronto, Toronto, Ont.; Institute for Clinical Evaluative Sciences (Chen), Toronto, Ont.; Climate Change and Health Office (Yagouti), Health Canada; Air Health Science Division (Lavigne), Health Canada; Department of Epidemiology and Community Medicine (Lavigne), University of Ottawa, Ottawa, Ont.; Sick Kids Hospital (Foty), Toronto, Ont.; Population Studies Division (Burnett, Cakmak), Health Canada; Department of Health Sciences (Villeneuve), Carleton University, Ottawa, Ont
| | - Abderrahmane Yagouti
- Public Health Ontario (Chen, Wang, Li, Copes); Dalla Lana School of Public Health (Chen, Foty, Villeneuve, Copes), University of Toronto, Toronto, Ont.; Institute for Clinical Evaluative Sciences (Chen), Toronto, Ont.; Climate Change and Health Office (Yagouti), Health Canada; Air Health Science Division (Lavigne), Health Canada; Department of Epidemiology and Community Medicine (Lavigne), University of Ottawa, Ottawa, Ont.; Sick Kids Hospital (Foty), Toronto, Ont.; Population Studies Division (Burnett, Cakmak), Health Canada; Department of Health Sciences (Villeneuve), Carleton University, Ottawa, Ont
| | - Eric Lavigne
- Public Health Ontario (Chen, Wang, Li, Copes); Dalla Lana School of Public Health (Chen, Foty, Villeneuve, Copes), University of Toronto, Toronto, Ont.; Institute for Clinical Evaluative Sciences (Chen), Toronto, Ont.; Climate Change and Health Office (Yagouti), Health Canada; Air Health Science Division (Lavigne), Health Canada; Department of Epidemiology and Community Medicine (Lavigne), University of Ottawa, Ottawa, Ont.; Sick Kids Hospital (Foty), Toronto, Ont.; Population Studies Division (Burnett, Cakmak), Health Canada; Department of Health Sciences (Villeneuve), Carleton University, Ottawa, Ont
| | - Richard Foty
- Public Health Ontario (Chen, Wang, Li, Copes); Dalla Lana School of Public Health (Chen, Foty, Villeneuve, Copes), University of Toronto, Toronto, Ont.; Institute for Clinical Evaluative Sciences (Chen), Toronto, Ont.; Climate Change and Health Office (Yagouti), Health Canada; Air Health Science Division (Lavigne), Health Canada; Department of Epidemiology and Community Medicine (Lavigne), University of Ottawa, Ottawa, Ont.; Sick Kids Hospital (Foty), Toronto, Ont.; Population Studies Division (Burnett, Cakmak), Health Canada; Department of Health Sciences (Villeneuve), Carleton University, Ottawa, Ont
| | - Richard T Burnett
- Public Health Ontario (Chen, Wang, Li, Copes); Dalla Lana School of Public Health (Chen, Foty, Villeneuve, Copes), University of Toronto, Toronto, Ont.; Institute for Clinical Evaluative Sciences (Chen), Toronto, Ont.; Climate Change and Health Office (Yagouti), Health Canada; Air Health Science Division (Lavigne), Health Canada; Department of Epidemiology and Community Medicine (Lavigne), University of Ottawa, Ottawa, Ont.; Sick Kids Hospital (Foty), Toronto, Ont.; Population Studies Division (Burnett, Cakmak), Health Canada; Department of Health Sciences (Villeneuve), Carleton University, Ottawa, Ont
| | - Paul J Villeneuve
- Public Health Ontario (Chen, Wang, Li, Copes); Dalla Lana School of Public Health (Chen, Foty, Villeneuve, Copes), University of Toronto, Toronto, Ont.; Institute for Clinical Evaluative Sciences (Chen), Toronto, Ont.; Climate Change and Health Office (Yagouti), Health Canada; Air Health Science Division (Lavigne), Health Canada; Department of Epidemiology and Community Medicine (Lavigne), University of Ottawa, Ottawa, Ont.; Sick Kids Hospital (Foty), Toronto, Ont.; Population Studies Division (Burnett, Cakmak), Health Canada; Department of Health Sciences (Villeneuve), Carleton University, Ottawa, Ont
| | - Sabit Cakmak
- Public Health Ontario (Chen, Wang, Li, Copes); Dalla Lana School of Public Health (Chen, Foty, Villeneuve, Copes), University of Toronto, Toronto, Ont.; Institute for Clinical Evaluative Sciences (Chen), Toronto, Ont.; Climate Change and Health Office (Yagouti), Health Canada; Air Health Science Division (Lavigne), Health Canada; Department of Epidemiology and Community Medicine (Lavigne), University of Ottawa, Ottawa, Ont.; Sick Kids Hospital (Foty), Toronto, Ont.; Population Studies Division (Burnett, Cakmak), Health Canada; Department of Health Sciences (Villeneuve), Carleton University, Ottawa, Ont
| | - Ray Copes
- Public Health Ontario (Chen, Wang, Li, Copes); Dalla Lana School of Public Health (Chen, Foty, Villeneuve, Copes), University of Toronto, Toronto, Ont.; Institute for Clinical Evaluative Sciences (Chen), Toronto, Ont.; Climate Change and Health Office (Yagouti), Health Canada; Air Health Science Division (Lavigne), Health Canada; Department of Epidemiology and Community Medicine (Lavigne), University of Ottawa, Ottawa, Ont.; Sick Kids Hospital (Foty), Toronto, Ont.; Population Studies Division (Burnett, Cakmak), Health Canada; Department of Health Sciences (Villeneuve), Carleton University, Ottawa, Ont
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Chan MPL, Weinhold RS, Thomas R, Gohlke JM, Portier CJ. Environmental Predictors of US County Mortality Patterns on a National Basis. PLoS One 2015; 10:e0137832. [PMID: 26629706 PMCID: PMC4668104 DOI: 10.1371/journal.pone.0137832] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Accepted: 08/22/2015] [Indexed: 11/23/2022] Open
Abstract
A growing body of evidence has found that mortality rates are positively correlated with social inequalities, air pollution, elevated ambient temperature, availability of medical care and other factors. This study develops a model to predict the mortality rates for different diseases by county across the US. The model is applied to predict changes in mortality caused by changing environmental factors. A total of 3,110 counties in the US, excluding Alaska and Hawaii, were studied. A subset of 519 counties from the 3,110 counties was chosen by using systematic random sampling and these samples were used to validate the model. Step-wise and linear regression analyses were used to estimate the ability of environmental pollutants, socio-economic factors and other factors to explain variations in county-specific mortality rates for cardiovascular diseases, cancers, chronic obstructive pulmonary disease (COPD), all causes combined and lifespan across five population density groups. The estimated models fit adequately for all mortality outcomes for all population density groups and, adequately predicted risks for the 519 validation counties. This study suggests that, at local county levels, average ozone (0.07 ppm) is the most important environmental predictor of mortality. The analysis also illustrates the complex inter-relationships of multiple factors that influence mortality and lifespan, and suggests the need for a better understanding of the pathways through which these factors, mortality, and lifespan are related at the community level.
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Affiliation(s)
- Melissa P. L. Chan
- Environmental Sciences Program, Southern Illinois University Edwardsville, Edwardsville, IL, 62026, United States of America
- * E-mail:
| | - Robert S. Weinhold
- Independent Researcher and Journalist, Colorado City, CO, 81019, United States of America
| | - Reuben Thomas
- School of Public Health, University of California, Berkeley, CA, 85736, United States of America
| | - Julia M. Gohlke
- School of Public Health, University of Alabama, Birmingham, AL, 35294, United States of America
| | - Christopher J. Portier
- National Center for Environmental Health and Agency for Toxic Substances and Disease Registry, U.S. Centers for Disease and Prevention, Atlanta, GA 30341, United States of America
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César ACG, Carvalho JA, Nascimento LFC. Association between NOx exposure and deaths caused by respiratory diseases in a medium-sized Brazilian city. ACTA ACUST UNITED AC 2015; 48:1130-5. [PMID: 26421866 PMCID: PMC4661030 DOI: 10.1590/1414-431x20154396] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Accepted: 05/21/2015] [Indexed: 12/04/2022]
Abstract
Exposure to nitrogen oxides (NOx) emitted by burning fossil fuels has been associated
with respiratory diseases. We aimed to estimate the effects of NOx exposure on
mortality owing to respiratory diseases in residents of Taubaté, São Paulo, Brazil,
of all ages and both sexes. This time-series ecological study from August 1, 2011 to
July 31, 2012 used information on deaths caused by respiratory diseases obtained from
the Health Department of Taubaté. Estimated daily levels of pollutants (NOx,
particulate matter, ozone, carbon monoxide) were obtained from the Centro de Previsão
de Tempo e Estudos Climáticos Coupled Aerosol and Tracer Transport model to the
Brazilian developments on the Regional Atmospheric Modeling System. These
environmental variables were used to adjust the multipollutant model for apparent
temperature. To estimate association between hospitalizations owing to asthma and air
pollutants, generalized additive Poisson regression models were developed, with lags
as much as 5 days. There were 385 deaths with a daily mean (±SD) of 1.05±1.03 (range:
0-5). Exposure to NOx was significantly associated with mortality owing to
respiratory diseases: relative risk (RR)=1.035 (95% confidence interval [CI]:
1.008-1.063) for lag 2, RR=1.064 (95%CI: 1.017-1.112) lag 3, RR=1.055 (95%CI:
1.025-1.085) lag 4, and RR=1.042 (95%CI: 1.010-1.076) lag 5. A 3 µg/m3
reduction in NOx concentration resulted in a decrease of 10-18 percentage points in
risk of death caused by respiratory diseases. Even at NOx concentrations below the
acceptable standard, there is association with deaths caused by respiratory
diseases.
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Affiliation(s)
- A C G César
- Instituto Federal de Educação, Ciência e Tecnologia de São Paulo, Bragança Paulista, SP, Brasil
| | - J A Carvalho
- Faculdade de Engenharia de Guaratinguetá, Universidade Estadual Paulista, Guaratinguetá, SP, Brasil
| | - L F C Nascimento
- Faculdade de Engenharia de Guaratinguetá, Universidade Estadual Paulista, Guaratinguetá, SP, Brasil
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Männistö T, Mendola P, Grantz KL, Leishear K, Sundaram R, Sherman S, Ying Q, Liu D. Acute and recent air pollution exposure and cardiovascular events at labour and delivery. Heart 2015; 101:1491-8. [PMID: 26105036 PMCID: PMC5575746 DOI: 10.1136/heartjnl-2014-307366] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 05/26/2015] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE To study the relationship between acute air pollution exposure and cardiovascular events during labour/delivery. METHODS The Consortium on Safe Labor (2002-2008), an observational US cohort with 223,502 singleton deliveries provided electronic medical records. Air pollution exposure was estimated by modified Community Multiscale Air Quality models. Cardiovascular events (cardiac failure/arrest, stroke, myocardial infarcts and other events) were recorded in the hospital discharge records for 687 pregnancies (0.3%). Logistic regression with generalised estimating equations estimated the relationship between cardiovascular events and daily air pollutant levels for delivery day and the 7 days preceding delivery. RESULTS Increased odds of cardiovascular events were observed for each IQR increase in exposure to nitric oxides at 5 and 6 days prior to delivery (OR=1.17, 99% CI 1.04 to 1.30 and OR=1.15, 1.03 to 1.28, respectively). High exposure to toxic air pollution species such as ethylbenzene (OR=1.50, 1.08 to 2.09), m-xylene (OR=1.54, 1.11 to 2.13), o-xylene (OR=1.51, 1.09 to 2.09), p-xylene (OR=1.43, 1.03 to 1.99) and toluene (OR=1.42, 1.02 to 1.97) at 5 days prior to delivery were also associated with cardiovascular events. Decreased odds of events were observed with exposure to ozone. CONCLUSIONS Air pollution in the days prior to delivery, especially nitrogen oxides and some toxic air pollution species, was associated with increased risk of cardiovascular events during the labour/delivery admission.
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Affiliation(s)
- Tuija Männistö
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Rockville, Maryland, USA
- Northern Finland Laboratory Centre NordLab, Oulu, Finland
- Department of Clinical Chemistry, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Department of Chronic Disease Prevention, National Institute for Health and Welfare, Oulu, Finland
| | - Pauline Mendola
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Rockville, Maryland, USA
| | - Katherine Laughon Grantz
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Rockville, Maryland, USA
| | - Kira Leishear
- Glotech Inc., Rockville, Maryland, USA
- US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Rajeshwari Sundaram
- Biostatistics and Bioinformatics Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Rockville, Maryland, USA
| | | | - Qi Ying
- Zachry Department of Civil Engineering, Texas A&M University, College Station, Texas, USA
| | - Danping Liu
- Biostatistics and Bioinformatics Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Rockville, Maryland, USA
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84
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Thiering E, Heinrich J. Epidemiology of air pollution and diabetes. Trends Endocrinol Metab 2015; 26:384-94. [PMID: 26068457 DOI: 10.1016/j.tem.2015.05.002] [Citation(s) in RCA: 88] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Revised: 04/28/2015] [Accepted: 05/07/2015] [Indexed: 02/04/2023]
Abstract
Air pollution affects a large proportion of the global population. Air pollutants are hypothesized to exert their effects via impaired endothelial function, elevated systemic inflammation, mitochondrial dysfunction, and oxidative stress, all of which are hallmarks of type 2 diabetes (T2D). Here we review epidemiological studies aimed at answering whether diabetes patients are more vulnerable to ambient (outdoor) air pollution exposure and whether air pollution is associated with diabetes development or other predisposing conditions for T2D. Current evidence suggests an association between air pollution exposure and T2D, but more critical analysis is warranted. Understanding the associations between air pollution exposure and the development of T2D is critical in our efforts to control sources of air pollution and their impact on the disease.
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Affiliation(s)
- Elisabeth Thiering
- Institute of Epidemiology I, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany; Division of Metabolic and Nutritional Medicine, Dr von Hauner Children's Hospital, University of Munich Medical Center, Munich, Germany.
| | - Joachim Heinrich
- Institute of Epidemiology I, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany; Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Inner City Clinic, University Hospital Munich, Ludwig Maximilian University of Munich, Munich, Germany
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85
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Emergency hospital visits in association with volcanic ash, dust storms and other sources of ambient particles: a time-series study in Reykjavík, Iceland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:4047-59. [PMID: 25872017 PMCID: PMC4410232 DOI: 10.3390/ijerph120404047] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Revised: 03/17/2015] [Accepted: 04/02/2015] [Indexed: 11/16/2022]
Abstract
Volcanic ash contributed significantly to particulate matter (PM) in Iceland following the eruptions in Eyjafjallajökull 2010 and Grímsvötn 2011. This study aimed to investigate the association between different PM sources and emergency hospital visits for cardiorespiratory causes from 2007 to 2012. Indicators of PM10 sources; “volcanic ash”, “dust storms”, or “other sources” (traffic, fireworks, and re-suspension) on days when PM10 exceeded the daily air quality guideline value of 50 µg/m3 were entered into generalized additive models, adjusted for weather, time trend and co-pollutants. The average number of daily emergency hospital visits was 10.5. PM10 exceeded the air quality guideline value 115 out of 2191 days; 20 days due to volcanic ash, 14 due to dust storms (two days had both dust storm and ash contribution) and 83 due to other sources. High PM10 levels from volcanic ash tended to be significantly associated with the emergency hospital visits; estimates ranged from 4.8% (95% Confidence Interval (CI): 0.6, 9.2%) per day of exposure in unadjusted models to 7.3% (95% CI: −0.4, 15.5%) in adjusted models. Dust storms were not consistently associated with daily emergency hospital visits and other sources tended to show a negative association. We found some evidence indicating that volcanic ash particles were more harmful than particles from other sources, but the results were inconclusive and should be interpreted with caution.
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Goldberg MS, Wheeler AJ, Burnett RT, Mayo NE, Valois MF, Brophy JM, Giannetti N. Physiological and perceived health effects from daily changes in air pollution and weather among persons with heart failure: a panel study. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2015; 25:187-199. [PMID: 24938511 DOI: 10.1038/jes.2014.43] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2013] [Accepted: 04/16/2014] [Indexed: 06/03/2023]
Abstract
We carried out this daily diary panel study in Montreal, Quebec, to determine whether oxygen saturation, pulse rate, blood pressure, self-rated health, and shortness of breath at night were associated with concentrations of indoor carbon monoxide (CO), and indoor and outdoor fine particles (PM2.5), temperature, and relative humidity. Over a 2-month consecutive period between 2008 and 2010, we measured daily indoor and outdoor levels of the air pollutants and weather variables and 55 subjects measured their daily health and other variables. To estimate the associations between the health outcomes and the environmental exposures, we used a mixed effects regression model using an autoregressive model of order-one and we adjusted for month and day and personal variables. The general pattern of associations can be summarized as follows: oxygen saturation was reduced for increases in indoor- and outdoor-PM2.5 and temperature. Pulse rate increased on the concurrent day for increases in indoor CO and PM2.5. Diastolic blood pressure increased with increasing indoor and outdoor PM2.5 and relative humidity. Systolic blood pressure increased with indoor PM2.5 and decreased with increasing indoor and outdoor temperature. Self-rated health diminished with increases in outdoor PM2.5 and indoor and outdoor temperature. Self-reported shortness of breath at night increased with increasing indoor and outdoor temperatures. Health in heart failure is affected in the short term by personal and environmental conditions that are manifest in intermediate physiological parameters.
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Affiliation(s)
- Mark S Goldberg
- 1] Department of Medicine, McGill University, Montreal, Quebec, Canada [2] Division of Clinical Epidemiology, Department of Medicine, Research Institute, McGill University Health Centre, Montreal, Quebec, Canada
| | - Amanda J Wheeler
- 1] Centre for Ecosystem Management, School of Natural Sciences, Edith Cowan University, Perth, Western Australia, Australia [2] Air Health Science Division, Health Canada, Ottawa, Ontario, Canada
| | - Richard T Burnett
- Biostatistics and Epidemiology Division, Safe Environments Directorate, Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, Ontario, Canada
| | - Nancy E Mayo
- 1] Department of Medicine, McGill University, Montreal, Quebec, Canada [2] Division of Clinical Epidemiology, Department of Medicine, Research Institute, McGill University Health Centre, Montreal, Quebec, Canada
| | - Marie-France Valois
- 1] Department of Medicine, McGill University, Montreal, Quebec, Canada [2] Division of Clinical Epidemiology, Department of Medicine, Research Institute, McGill University Health Centre, Montreal, Quebec, Canada
| | - James M Brophy
- 1] Department of Medicine, McGill University, Montreal, Quebec, Canada [2] Division of Clinical Epidemiology, Department of Medicine, Research Institute, McGill University Health Centre, Montreal, Quebec, Canada
| | - Nadia Giannetti
- Department of Medicine, McGill University, Montreal, Quebec, Canada
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Simoni M, Baldacci S, Maio S, Cerrai S, Sarno G, Viegi G. Adverse effects of outdoor pollution in the elderly. J Thorac Dis 2015; 7:34-45. [PMID: 25694816 DOI: 10.3978/j.issn.2072-1439.2014.12.10] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Accepted: 01/10/2015] [Indexed: 01/17/2023]
Abstract
With fewer newborns and people living longer, older people are making up an increasing fraction of the total population. Epidemiological evidence shows that older-age-related health problems affect a wide and expanding proportion of the world population. One of the major epidemiological trends of this century is the rise of chronic diseases that affect more elderly than younger people. A total of 3.7 million premature deaths worldwide in 2012 are attributable to outdoor air pollution; the susceptibility to adverse effects of air pollution is expected to differ widely between people and within the same person, and also over time. Frailty history, a measure of multi-system decline, modifies cumulative associations between air pollution and lung function. Moreover, pre-existing diseases may determine susceptibility. In the elderly, due to comorbidity, exposure to air pollutants may even be fatal. Rapid and not-well-planned urbanization is associated with high level of ambient air pollution, mainly caused by vehicular exhausts. In general, there is sufficient evidence of the adverse effects related to short-term exposure, while fewer studies have addressed the longer-term health effects. Increased pollution exposures have been associated with increased mortality, hospital admissions/emergency-room visits, mainly due to exacerbations of chronic diseases or to respiratory tract infections (e.g., pneumonia). These effects may also be modulated by ambient temperature and many studies show that the elderly are mostly vulnerable to heat waves. The association between heat and mortality in the elderly is well-documented, while less is known regarding the associations with hospital admissions. Chronic exposure to elevated levels of air pollution has been related to the incidence of chronic obstructive pulmonary disease (COPD), chronic bronchitis (CB), asthma, and emphysema. There is also growing evidence suggesting adverse effects on lung function related to long-term exposure to ambient air pollution. Few studies have assessed long-term mortality in the elderly. It is still unclear what are the pollutants most damaging to the health of the elderly. It seems that elderly subjects are more vulnerable to particulate matter (PM) than to other pollutants, with particular effect on daily cardio-respiratory mortality and acute hospital admissions. Not many studies have targeted elderly people specifically, as well as specific respiratory morbidity. Most data have shown higher risks in the elderly compared to the rest of the population. Future epidemiological cohort studies need to keep investigating the health effects of air pollutants (mainly cardiopulmonary diseases) on the elderly.
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Affiliation(s)
- Marzia Simoni
- 1 Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa (Italy), Via Trieste 41, 56126, Pisa, Italy ; 2 CNR Institute of Biomedicine and Molecular Immunology "A. Monroy", Via U. La Malfa 153, 90146, Palermo, Italy
| | - Sandra Baldacci
- 1 Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa (Italy), Via Trieste 41, 56126, Pisa, Italy ; 2 CNR Institute of Biomedicine and Molecular Immunology "A. Monroy", Via U. La Malfa 153, 90146, Palermo, Italy
| | - Sara Maio
- 1 Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa (Italy), Via Trieste 41, 56126, Pisa, Italy ; 2 CNR Institute of Biomedicine and Molecular Immunology "A. Monroy", Via U. La Malfa 153, 90146, Palermo, Italy
| | - Sonia Cerrai
- 1 Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa (Italy), Via Trieste 41, 56126, Pisa, Italy ; 2 CNR Institute of Biomedicine and Molecular Immunology "A. Monroy", Via U. La Malfa 153, 90146, Palermo, Italy
| | - Giuseppe Sarno
- 1 Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa (Italy), Via Trieste 41, 56126, Pisa, Italy ; 2 CNR Institute of Biomedicine and Molecular Immunology "A. Monroy", Via U. La Malfa 153, 90146, Palermo, Italy
| | - Giovanni Viegi
- 1 Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa (Italy), Via Trieste 41, 56126, Pisa, Italy ; 2 CNR Institute of Biomedicine and Molecular Immunology "A. Monroy", Via U. La Malfa 153, 90146, Palermo, Italy
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Franck U, Leitte AM, Suppan P. Multifactorial airborne exposures and respiratory hospital admissions--the example of Santiago de Chile. THE SCIENCE OF THE TOTAL ENVIRONMENT 2015; 502:114-21. [PMID: 25244038 DOI: 10.1016/j.scitotenv.2014.08.093] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Revised: 07/18/2014] [Accepted: 08/25/2014] [Indexed: 05/05/2023]
Abstract
UNLABELLED Our results provide evidence for respiratory effects of combined exposure to airborne pollutants in Santiago de Chile. Different pollutants account for varying adverse effects. Ozone was not found to be significantly associated with respiratory morbidity. BACKGROUND High concentrations of various air pollutants have been associated with hospitalization due to development and exacerbation of respiratory diseases. The findings of different studies vary in effect strength and are sometimes inconsistent. OBJECTIVES We aimed to assess associations between airborne exposures by particulate matter as well as gaseous air pollutants and hospital admissions due to respiratory disease groups under the special orographic and meteorological conditions of 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 respiratory illnesses. RESULTS We found for CO, NO2, PM10 and PM2.5 adverse relationships to respiratory 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 CO and PM10 followed by PM2.5, while in 2-pollutant models effects of NO2 persisted in most cases whereas other effects weakened and significant effects remain for PM2.5, only. In addition the strongest effects seemed to be immediate or with a delay of up to one day, but effects were found until day 7, too. Adverse effects of ozone could not be detected. CONCLUSIONS Taking case numbers and effect strength of all cardiovascular diseases into account, mitigation measures should address all pollutants especially CO, NO2, and PM10.
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Affiliation(s)
- Ulrich Franck
- Core Facility Studies, Helmholtz Centre for Environmental Research - UFZ, Leipzig, Germany.
| | - Arne Marian Leitte
- Core Facility Studies, Helmholtz Centre for Environmental Research - UFZ, Leipzig, Germany.
| | - Peter Suppan
- Institute of Meteorology and Climate Research (IMK-IFU), Karlsruhe Institute of Technology (KIT), Garmisch-Partenkirchen, Germany.
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Pope CA, Turner MC, Burnett RT, Jerrett M, Gapstur SM, Diver WR, Krewski D, Brook RD. Relationships between fine particulate air pollution, cardiometabolic disorders, and cardiovascular mortality. Circ Res 2014; 116:108-15. [PMID: 25348167 DOI: 10.1161/circresaha.116.305060] [Citation(s) in RCA: 249] [Impact Index Per Article: 24.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
RATIONALE Growing evidence suggests that long-term exposure to fine particulate matter (PM2.5) air pollution contributes to risk of cardiovascular disease (CVD) morbidity and mortality. There is uncertainty about who are most susceptible. Individuals with underlying cardiometabolic disorders, including hypertension, diabetes mellitus, and obesity, may be at greater risk. PM2.5 pollution may also contribute to cardiometabolic disorders, augmenting CVD risk. OBJECTIVE This analysis evaluates relationships between long-term PM2.5 exposure and cardiometabolic disease on risk of death from CVD and cardiometabolic conditions. METHODS AND RESULTS Data on 669 046 participants from the American Cancer Society Cancer Prevention Study II cohort were linked to modeled PM2.5 concentrations at geocoded home addresses. Cox proportional hazards regression models were used to estimate adjusted hazards ratios for death from CVD and cardiometabolic diseases based on death-certificate information. Effect modification by pre-existing cardiometabolic risk factors on the PM2.5-CVD mortality association was examined. PM2.5 exposure was associated with CVD mortality, with the hazards ratios (95% confidence interval) per 10 μg/m(3) increase in PM2.5 equal to 1.12 (1.10-1.15). Deaths linked to hypertension and diabetes mellitus (mentioned on death certificate as either primary or contributing cause of death) were also associated with PM2.5. There was no consistent evidence of effect modification by cardiometabolic disease risk factors on the PM2.5-CVD mortality association. CONCLUSIONS Pollution-induced CVD mortality risk is observed for those with and without existing cardiometabolic disorders. Long-term exposure may also contribute to the development or exacerbation of cardiometabolic disorders, increasing risk of CVD, and cardiometabolic disease mortality.
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Affiliation(s)
- C Arden Pope
- From the Department of Economics, Brigham Young University, Provo, UT (C.A.P.); McLaughlin Centre for Population Health Risk Assessment, Institute of Population Health (M.C.T., D.K.) and Department of Epidemiology and Community Medicine, Faculty of Medicine (D.K.), University of Ottawa, Ottawa, Ontario, Canada; Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain (M.C.T.); CIBER Epidemiologia y Salud Publica (CIBERESP), Barcelona, Spain (M.C.T.); Universitat Pompeu Fabra, Barcelona, Spain (M.C.T.); Health Canada, Ottawa, Ontario, Canada (R.T.B.); Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley (M.J.); Epidemiology Research Program, American Cancer Society, Atlanta, GA (S.M.G., W.R.D.); Risk Sciences International, Ottawa, Ontario, Canada (D.K.); and Division of Cardiovascular Medicine, University of Michigan Medical School, Ann Arbor (R.D.B.).
| | - Michelle C Turner
- From the Department of Economics, Brigham Young University, Provo, UT (C.A.P.); McLaughlin Centre for Population Health Risk Assessment, Institute of Population Health (M.C.T., D.K.) and Department of Epidemiology and Community Medicine, Faculty of Medicine (D.K.), University of Ottawa, Ottawa, Ontario, Canada; Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain (M.C.T.); CIBER Epidemiologia y Salud Publica (CIBERESP), Barcelona, Spain (M.C.T.); Universitat Pompeu Fabra, Barcelona, Spain (M.C.T.); Health Canada, Ottawa, Ontario, Canada (R.T.B.); Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley (M.J.); Epidemiology Research Program, American Cancer Society, Atlanta, GA (S.M.G., W.R.D.); Risk Sciences International, Ottawa, Ontario, Canada (D.K.); and Division of Cardiovascular Medicine, University of Michigan Medical School, Ann Arbor (R.D.B.)
| | - Richard T Burnett
- From the Department of Economics, Brigham Young University, Provo, UT (C.A.P.); McLaughlin Centre for Population Health Risk Assessment, Institute of Population Health (M.C.T., D.K.) and Department of Epidemiology and Community Medicine, Faculty of Medicine (D.K.), University of Ottawa, Ottawa, Ontario, Canada; Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain (M.C.T.); CIBER Epidemiologia y Salud Publica (CIBERESP), Barcelona, Spain (M.C.T.); Universitat Pompeu Fabra, Barcelona, Spain (M.C.T.); Health Canada, Ottawa, Ontario, Canada (R.T.B.); Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley (M.J.); Epidemiology Research Program, American Cancer Society, Atlanta, GA (S.M.G., W.R.D.); Risk Sciences International, Ottawa, Ontario, Canada (D.K.); and Division of Cardiovascular Medicine, University of Michigan Medical School, Ann Arbor (R.D.B.)
| | - Michael Jerrett
- From the Department of Economics, Brigham Young University, Provo, UT (C.A.P.); McLaughlin Centre for Population Health Risk Assessment, Institute of Population Health (M.C.T., D.K.) and Department of Epidemiology and Community Medicine, Faculty of Medicine (D.K.), University of Ottawa, Ottawa, Ontario, Canada; Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain (M.C.T.); CIBER Epidemiologia y Salud Publica (CIBERESP), Barcelona, Spain (M.C.T.); Universitat Pompeu Fabra, Barcelona, Spain (M.C.T.); Health Canada, Ottawa, Ontario, Canada (R.T.B.); Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley (M.J.); Epidemiology Research Program, American Cancer Society, Atlanta, GA (S.M.G., W.R.D.); Risk Sciences International, Ottawa, Ontario, Canada (D.K.); and Division of Cardiovascular Medicine, University of Michigan Medical School, Ann Arbor (R.D.B.)
| | - Susan M Gapstur
- From the Department of Economics, Brigham Young University, Provo, UT (C.A.P.); McLaughlin Centre for Population Health Risk Assessment, Institute of Population Health (M.C.T., D.K.) and Department of Epidemiology and Community Medicine, Faculty of Medicine (D.K.), University of Ottawa, Ottawa, Ontario, Canada; Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain (M.C.T.); CIBER Epidemiologia y Salud Publica (CIBERESP), Barcelona, Spain (M.C.T.); Universitat Pompeu Fabra, Barcelona, Spain (M.C.T.); Health Canada, Ottawa, Ontario, Canada (R.T.B.); Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley (M.J.); Epidemiology Research Program, American Cancer Society, Atlanta, GA (S.M.G., W.R.D.); Risk Sciences International, Ottawa, Ontario, Canada (D.K.); and Division of Cardiovascular Medicine, University of Michigan Medical School, Ann Arbor (R.D.B.)
| | - W Ryan Diver
- From the Department of Economics, Brigham Young University, Provo, UT (C.A.P.); McLaughlin Centre for Population Health Risk Assessment, Institute of Population Health (M.C.T., D.K.) and Department of Epidemiology and Community Medicine, Faculty of Medicine (D.K.), University of Ottawa, Ottawa, Ontario, Canada; Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain (M.C.T.); CIBER Epidemiologia y Salud Publica (CIBERESP), Barcelona, Spain (M.C.T.); Universitat Pompeu Fabra, Barcelona, Spain (M.C.T.); Health Canada, Ottawa, Ontario, Canada (R.T.B.); Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley (M.J.); Epidemiology Research Program, American Cancer Society, Atlanta, GA (S.M.G., W.R.D.); Risk Sciences International, Ottawa, Ontario, Canada (D.K.); and Division of Cardiovascular Medicine, University of Michigan Medical School, Ann Arbor (R.D.B.)
| | - Daniel Krewski
- From the Department of Economics, Brigham Young University, Provo, UT (C.A.P.); McLaughlin Centre for Population Health Risk Assessment, Institute of Population Health (M.C.T., D.K.) and Department of Epidemiology and Community Medicine, Faculty of Medicine (D.K.), University of Ottawa, Ottawa, Ontario, Canada; Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain (M.C.T.); CIBER Epidemiologia y Salud Publica (CIBERESP), Barcelona, Spain (M.C.T.); Universitat Pompeu Fabra, Barcelona, Spain (M.C.T.); Health Canada, Ottawa, Ontario, Canada (R.T.B.); Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley (M.J.); Epidemiology Research Program, American Cancer Society, Atlanta, GA (S.M.G., W.R.D.); Risk Sciences International, Ottawa, Ontario, Canada (D.K.); and Division of Cardiovascular Medicine, University of Michigan Medical School, Ann Arbor (R.D.B.)
| | - Robert D Brook
- From the Department of Economics, Brigham Young University, Provo, UT (C.A.P.); McLaughlin Centre for Population Health Risk Assessment, Institute of Population Health (M.C.T., D.K.) and Department of Epidemiology and Community Medicine, Faculty of Medicine (D.K.), University of Ottawa, Ottawa, Ontario, Canada; Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain (M.C.T.); CIBER Epidemiologia y Salud Publica (CIBERESP), Barcelona, Spain (M.C.T.); Universitat Pompeu Fabra, Barcelona, Spain (M.C.T.); Health Canada, Ottawa, Ontario, Canada (R.T.B.); Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley (M.J.); Epidemiology Research Program, American Cancer Society, Atlanta, GA (S.M.G., W.R.D.); Risk Sciences International, Ottawa, Ontario, Canada (D.K.); and Division of Cardiovascular Medicine, University of Michigan Medical School, Ann Arbor (R.D.B.)
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Eze IC, Schaffner E, Fischer E, Schikowski T, Adam M, Imboden M, Tsai M, Carballo D, von Eckardstein A, Künzli N, Schindler C, Probst-Hensch N. Long-term air pollution exposure and diabetes in a population-based Swiss cohort. ENVIRONMENT INTERNATIONAL 2014; 70:95-105. [PMID: 24912113 DOI: 10.1016/j.envint.2014.05.014] [Citation(s) in RCA: 126] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Revised: 04/22/2014] [Accepted: 05/16/2014] [Indexed: 05/23/2023]
Abstract
Air pollution is an important risk factor for global burden of disease. There has been recent interest in its possible role in the etiology of diabetes mellitus. Experimental evidence is suggestive, but epidemiological evidence is limited and mixed. We therefore explored the association between air pollution and prevalent diabetes, in a population-based Swiss cohort. We did cross-sectional analyses of 6392 participants of the Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults [SAPALDIA], aged between 29 and 73 years. We used estimates of average individual home outdoor PM10 [particulate matter <10μm in diameter] and NO2 [nitrogen dioxide] exposure over the 10 years preceding the survey. Their association with diabetes was modeled using mixed logistic regression models, including participants' study area as random effect, with incremental adjustment for confounders. There were 315 cases of diabetes (prevalence: 5.5% [95% confidence interval (CI): 2.8, 7.2%]). Both PM10 and NO2 were associated with prevalent diabetes with respective odds ratios of 1.40 [95% CI: 1.17, 1.67] and 1.19 [95% CI: 1.03, 1.38] per 10μg/m(3) increase in the average home outdoor level. Associations with PM10 were generally stronger than with NO2, even in the two-pollutant model. There was some indication that beta blockers mitigated the effect of PM10. The associations remained stable across different sensitivity analyses. Our study adds to the evidence that long term air pollution exposure is associated with diabetes mellitus. PM10 appears to be a useful marker of aspects of air pollution relevant for diabetes. This association can be observed at concentrations below air quality guidelines.
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Affiliation(s)
- Ikenna C Eze
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Emmanuel Schaffner
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Evelyn Fischer
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Tamara Schikowski
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; IUF - Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany
| | - Martin Adam
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Medea Imboden
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Ming Tsai
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - David Carballo
- Division of Cardiology, Geneva University Hospital, Geneva, Switzerland
| | | | - Nino Künzli
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Christian Schindler
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Nicole Probst-Hensch
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
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91
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Bai L, Woodward A, Chen B, Liu Q. Temperature, hospital admissions and emergency room visits in Lhasa, Tibet: a time-series analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2014; 490:838-48. [PMID: 24907619 DOI: 10.1016/j.scitotenv.2014.05.024] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Revised: 04/30/2014] [Accepted: 05/06/2014] [Indexed: 05/16/2023]
Abstract
BACKGROUND Tibet of China, with an average altitude of over 4000 m, has experienced noticeable changes in its climate over the last 50 years. The association between temperature and morbidity (most commonly represented by hospital admissions) has been documented mainly in developed countries. Little is known about patterns in China; nor have the health effects of temperature variations been closely studied in highland areas, worldwide. OBJECTIVE We investigated the temperature-morbidity association in Lhasa, the capital city of Tibet, using sex- and age-specific hospitalizations, excluding those due to external causes. METHODS A distributed lag non-linear model (DLNM) was applied to assess the nonlinear and delayed effects of temperature on morbidity (including total emergency room visits, total and cause-specific hospital admissions, sex- and age-specific non-external admissions). RESULTS High temperatures are associated with increases in morbidity, to a greater extent than low temperatures. Lag effects of high and low temperatures were cause-specific. The relative risks (RR) of high temperature for total emergency room visits and non-external hospitalizations were 1.162 (95% CI: 1.002-1.349) and 1.161 (95% CI: 1.007-1.339) respectively, for lag 0-14 days. The strongest cumulative effect of heat for lag 0-27 days was on admissions for infectious diseases (RR: 2.067, 95% CI: 1.026-4.027). Acute heat effects at lag 0 were related with increases of renal (RR: 1.478, 95% CI: 1.005-2.174) and respiratory diseases (RR: 1.119, 95% CI: 1.010-1.240), whereas immediate cold effects increased admission for digestive diseases (RR: 1.132, 95% CI: 1.002-1.282). Those ≥65 years of age and males were more vulnerable to high temperatures. CONCLUSION We provide a first look at the temperature-morbidity relationship in Tibet. Exposure to both hot and cold temperatures resulted in increased admissions to hospital, but the immediate causes varied. We suggest that initiatives should be taken to reduce the adverse effects of temperature extremes in Tibet.
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Affiliation(s)
- Li Bai
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing 102206, PR China.
| | - Alistair Woodward
- School of Population Health, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand.
| | - Bin Chen
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing 102206, PR China.
| | - Qiyong Liu
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing 102206, PR China; Shandong University Climate Change and Health Center, 44 Wenhua Road, Jinan, Shangdong 250012, PR China; Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou 310003, PR China.
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92
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Bai L, Ding G, Gu S, Bi P, Su B, Qin D, Xu G, Liu Q. The effects of summer temperature and heat waves on heat-related illness in a coastal city of China, 2011-2013. ENVIRONMENTAL RESEARCH 2014; 132:212-9. [PMID: 24815333 DOI: 10.1016/j.envres.2014.04.002] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Revised: 03/31/2014] [Accepted: 04/02/2014] [Indexed: 05/22/2023]
Abstract
BACKGROUND Devastating health effects from recent heat waves in China have highlighted the importance of understanding health consequences from extreme heat stress. Despite the increasing mortality from extreme heat, very limited studies have quantified the effects of summer extreme temperature on heat-related illnesses in China. METHODS The associations between extreme heat and daily heat-related illnesses that occurred in the summers of 2011-2013 in Ningbo, China, have been examined, using a distributed lag non-linear model (DLNM) based on 3862 cases. The excess morbidities of heat-related illness during each heat wave have been calculated separately and the cumulative heat wave effects on age-, sex-, and cause-specific illnesses in each year along lags have been estimated as well. RESULTS After controlling the effect of relative humidity, it is found that maximum temperature, rather than heat index, was a better predictor of heat-related illnesses in summers. A positive association between maximum temperatures and occurrence of heat-related diseases was apparent, especially at short lag effects. Six heat waves during the period of 2011-2013 were identified and all associated with excess heat-related illnesses. Relative to the average values for the corresponding periods in 2011 and 2012, a total estimated 679 extra heat-related illnesses occurred during three heat waves in 2013. The significant prolonged heat wave effects on total heat-related illnesses during heat waves in three study years have also been identified. The strongest cumulative effect of heat waves was on severe heat diseases in 2013, with a 10-fold increased risk. More males than females, individuals with more severe forms of illness, were more affected by the heat. However, all age groups were vulnerable. CONCLUSIONS Recent heat waves had a substantial and delayed effect on heat illnesses in Ningbo. Relevant active well-organized public health initiatives should be implemented to reduce the adverse effects of heat extremes on the illnesses.
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Affiliation(s)
- Li Bai
- State Key Laboratory for Infectious Diseases Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing 102206, China.
| | - Gangqiang Ding
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China.
| | - Shaohua Gu
- State Key Laboratory for Infectious Diseases Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing 102206, China.
| | - Peng Bi
- School of Population Health, University of Adelaide, South Australia 5005, Australia.
| | - Buda Su
- National Climate Center, Beijing 100081, China.
| | - Dahe Qin
- National Climate Center, Beijing 100081, China.
| | - Guozhang Xu
- Ningbo Center for Disease Control and Prevention, Ningbo 315010, China.
| | - Qiyong Liu
- State Key Laboratory for Infectious Diseases Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing 102206, China; Shandong University Climate Change and Health Center, Jinan 250100, China; Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou 310003, China.
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93
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Bai L, Woodward A, Liu Q. Temperature and mortality on the roof of the world: a time-series analysis in three Tibetan counties, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2014; 485-486:41-48. [PMID: 24704955 DOI: 10.1016/j.scitotenv.2014.02.094] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Revised: 02/06/2014] [Accepted: 02/21/2014] [Indexed: 05/17/2023]
Abstract
BACKGROUND Tibet, with an average altitude of more than 4,000 meters, is warming faster than anywhere else in China. However, there have been no studies in Tibet of the relation between ambient temperature and mortality. METHODS We examined mean temperature and daily mortality in three Tibetan counties (Chengguan, Jiangzi and Naidong) using a distributed lag non-linear model (DLNM) based on 5,610 deaths that occurred in 2008-2012. We separately investigated hot and cold effects on non-accidental deaths, cardiovascular deaths, out-of-hospital deaths and vulnerability factors including age, sex and education. RESULTS In all three counties, the effect of heat tended to be immediate, while the impact of cold lasted longer. The effects were consistent but modest in size and not statistically significant except for cumulative cold effects in Jiangzi (lag=0-14, RR=2.251, 95% CI=1.054-4.849). Those who were more vulnerable to temperature extremes tended to be men, the elderly (over 65 years) and illiterate persons. We found stronger temperature effects on cardiovascular deaths than on all-cause mortality, and we also observed an increase in out-of-hospital mortality in one county. CONCLUSIONS This is the first study to investigate the temperature-mortality relationship in Tibet, and the findings may guide public health programs and other interventions to protect the population against extreme temperatures in a developing Tibet.
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Affiliation(s)
- Li Bai
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing 102206, PR China.
| | - Alistair Woodward
- School of Population Health, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand.
| | - Qiyong Liu
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing 102206, PR China; Shandong University Climate Change and Health Center, 44 WenHua Road, JiNan, Shangdong 250012, PR China; Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou 310003, PR China.
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94
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Senthilkumar S, Manju A, Muthuselvam P, Shalini D, Indhumathi V, Kalaiselvi K, Palanivel M, Chandrasekar PP, Rajaguru P. Characterization and genotoxicity evaluation of particulate matter collected from industrial atmosphere in Tamil Nadu state, India. JOURNAL OF HAZARDOUS MATERIALS 2014; 274:392-8. [PMID: 24797908 DOI: 10.1016/j.jhazmat.2014.04.017] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Revised: 04/11/2014] [Accepted: 04/12/2014] [Indexed: 05/09/2023]
Abstract
Ambient particulate matter (PM) collected in the vicinity of five industries (Cement, Chemical, Thermal power plant, Sponge-iron and Steel) in Tamil Nadu state, India was characterized for size distribution, metals and polycyclic aromatic hydrocarbons (PAHs) content. Genotoxicity of PM and organic matter (OM) extracted from PM was measured in human lung cancer cell-line, A549 and in human liver carcinoma cell-line, HepG2, respectively, using the comet assay. PM values varied from 57.0 μg/m(3) of air at Cement industry upstream to 561.0 μg/m(3) of air at Sponge iron industry downstream samples. Their metal content varied from 5.758 μg/m(3) of air at Chemical industry to 46.144 μg/m(3) of air at Sponge iron industry and PAH concentration varied from 0.5 ng/m(3) air in upstream Thermal power plant to 3302.4 ng/m(3) air in downstream Sponge iron industry samples. While all PM samples induced DNA strand breaks at higher dose levels, downstream samples of Steel and Sponge iron industries which contained relatively higher concentrations of PAHs and metals and exhibited higher levels of pro-oxidant activity as measured by DTT activity induced significantly higher levels of DNA damage in HepG2 and A549 cells. Pretreatment of A549 cells with vitamin C or quercetin significantly reduced PM induced DNA strand breaks.
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Affiliation(s)
- S Senthilkumar
- Department of Biotechnology, Anna University - BIT Campus, Tiruchirappalli 620024, Tamil Nadu, India.
| | - A Manju
- Department of Environmental Science, PSG College of Arts and Science, Coimbatore 641014, Tamil Nadu, India.
| | - P Muthuselvam
- Department of Biotechnology, Anna University - BIT Campus, Tiruchirappalli 620024, Tamil Nadu, India.
| | - D Shalini
- Department of Biotechnology, Anna University - BIT Campus, Tiruchirappalli 620024, Tamil Nadu, India.
| | - V Indhumathi
- Department of Biotechnology, Anna University - BIT Campus, Tiruchirappalli 620024, Tamil Nadu, India.
| | - K Kalaiselvi
- Department of Environmental Science, PSG College of Arts and Science, Coimbatore 641014, Tamil Nadu, India.
| | - M Palanivel
- Department of Environmental Science, PSG College of Arts and Science, Coimbatore 641014, Tamil Nadu, India.
| | - P P Chandrasekar
- Tamil Nadu Pollution Control Board, Salem 635004, Tamil Nadu, India.
| | - P Rajaguru
- Department of Biotechnology, Anna University - BIT Campus, Tiruchirappalli 620024, Tamil Nadu, India.
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95
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Park SK, Wang W. Ambient Air Pollution and Type 2 Diabetes: A Systematic Review of Epidemiologic Research. Curr Environ Health Rep 2014; 1:275-286. [PMID: 25170433 DOI: 10.1007/s40572-014-0017-9] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Recent experimental and epidemiologic studies have suggested air pollution as a new risk factor for type 2 diabetes mellitus (T2DM). We conducted a systematic review of the epidemiologic studies on the association of air pollution with T2DM and related outcomes published by December 2013. We identified 22 studies: 6 prospective studies on incident T2DM; 2 prospective study on diabetes mortality; 4 cross-sectional studies on prevalent T2DM; 7 ecological studies on mortality or morbidity from diabetes; and 3 studies on glucose or insulin levels. The evidence of the association between long-term exposure to fine particles (PM2.5) and the risk of T2DM is suggestive. The summary hazard ratio of the association between long-term PM2.5 exposure and incident T2DM was 1.11 (95% CI, 1.03-1.19) for a 10 μg/m3 increase. The evidence on the association between long-term traffic-related exposure (measured by nitrogen dioxide or nitrogen oxides) and the risk of T2DM was also suggestive although most studies were conducted in women. For short-term effects of air pollution on diabetes mortality or hospital/emergency admissions, we conclude that the evidence is not sufficient to infer a causal relationship. Because most studies were conducted in North America or in Europe where exposure levels are relatively low, more studies are needed in recently urbanized areas in Asia and Latin America where air pollution levels are much higher and T2DM is an emerging public health concern.
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Affiliation(s)
- Sung Kyun Park
- Departments of Epidemiology and Environmental Health Sciences, University of Michigan, School of Public Health, Ann Arbor, MI, U.S.A
| | - Weiye Wang
- Departments of Epidemiology and Environmental Health Sciences, University of Michigan, School of Public Health, Ann Arbor, MI, U.S.A
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96
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Samoli E, Stafoggia M, Rodopoulou S, Ostro B, Alessandrini E, Basagaña X, Díaz J, Faustini A, Gandini M, Karanasiou A, Kelessis AG, Le Tertre A, Linares C, Ranzi A, Scarinzi C, Katsouyanni K, Forastiere F. Which specific causes of death are associated with short term exposure to fine and coarse particles in Southern Europe? Results from the MED-PARTICLES project. ENVIRONMENT INTERNATIONAL 2014; 67:54-61. [PMID: 24657768 DOI: 10.1016/j.envint.2014.02.013] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Revised: 01/29/2014] [Accepted: 02/27/2014] [Indexed: 06/03/2023]
Abstract
We investigated the short-term effects of particles with aerodynamic diameter less than 2.5μm (PM2.5), between 2.5 and 10μm (PM2.5-10) and less than 10μm (PM10) on deaths from diabetes, cardiac and cerebrovascular causes, lower respiratory tract infections (LRTI) and chronic obstructive pulmonary disease (COPD) in 10 European Mediterranean metropolitan areas participating in the MED-PARTICLES project during 2001-2010. In the first stage of the analysis, data from each city were analyzed separately using Poisson regression models, whereas in the second stage, the city-specific air pollution estimates were combined to obtain overall estimates. We investigated the effects following immediate (lags 0-1), delayed (lags 2-5) and prolonged exposure (lags 0-5) and effect modification patterns by season. We evaluated the sensitivity of our results to co-pollutant exposures or city-specific model choice. We applied threshold models to investigate the pattern of selected associations. For a 10μg/m(3) increase in two days' PM2.5 exposure there was a 1.23% (95% confidence interval (95% CI): -1.63%, 4.17%) increase in diabetes deaths, while six days' exposure statistically significantly increased cardiac deaths by 1.33% (95% CI: 0.27, 2.40%), COPD deaths by 2.53% (95% CI: -0.01%, 5.14%) and LRTI deaths by 1.37% (95% CI: -1.94%, 4.78%). PM2.5 results were robust to co-pollutant adjustments and alternative modeling approaches. Stronger effects were observed in the warm season. Coarse particles displayed positive, even if not statistically significant, associations with mortality due to diabetes and cardiac causes that were more variable depending on exposure period, co-pollutant and seasonality adjustment. Our findings provide support for positive associations between PM2.5 and mortality due to diabetes, cardiac causes, COPD, and to a lesser degree to cerebrovascular causes, in the European Mediterranean region, which seem to drive the particles short-term health effects.
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Affiliation(s)
- Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, University of Athens, 75 Mikras Asias Str, 115 27 Athens, Greece.
| | - Massimo Stafoggia
- Department of Epidemiology of Lazio Region, 53 Santa Costanza Str, 00198 Rome, Italy
| | - Sophia Rodopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, University of Athens, 75 Mikras Asias Str, 115 27 Athens, Greece
| | - Bart Ostro
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona Biomedical Research Park, C/Doctor Aiguader, 88, E-08003 Barcelona, Spain
| | - Ester Alessandrini
- Department of Epidemiology of Lazio Region, 53 Santa Costanza Str, 00198 Rome, Italy
| | - Xavier Basagaña
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona Biomedical Research Park, C/Doctor Aiguader, 88, E-08003 Barcelona, Spain; Universitat Pompeu Fabra (UPF), Plaça de la Mercè, 10-12, 08002 Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), 3-5 Melchor Fernández Almagro, 28029 Madrid, Spain
| | - Julio Díaz
- Carlos III Institute of Health, 5 Avda. Monforte de Lemos, 28029 Madrid, Spain
| | - Annunziata Faustini
- Department of Epidemiology of Lazio Region, 53 Santa Costanza Str, 00198 Rome, Italy
| | - Martina Gandini
- Department of Epidemiology and Environmental Health, Regional Environmental Protection Agency, Piedmont, 9 Pio VII Str, 10127 Turin, Italy
| | - Angeliki Karanasiou
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona Biomedical Research Park, C/Doctor Aiguader, 88, E-08003 Barcelona, Spain
| | - Apostolos G Kelessis
- Environmental Department, Municipality of Thessaloniki, 7 Paparigopoulou Str, 54630 Thessaloniki, Greece
| | - Alain Le Tertre
- Environmental Health Department, French Institute for Public Health Surveillance (InVS), 12 du Val d'Osne Str, 94415 Saint-Maurice Cedex, France
| | - Cristina Linares
- Carlos III Institute of Health, 5 Avda. Monforte de Lemos, 28029 Madrid, Spain
| | - Andrea Ranzi
- Regional Centre for Environment and Health, Regional Agency for Environmental Prevention of Emilia-Romagna, 13 Begarelli Str, 41121 Modena, Italy
| | - Cecilia Scarinzi
- Department of Epidemiology and Environmental Health, Regional Environmental Protection Agency, Piedmont, 9 Pio VII Str, 10127 Turin, Italy
| | - Klea Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, University of Athens, 75 Mikras Asias Str, 115 27 Athens, Greece
| | - Francesco Forastiere
- Department of Epidemiology of Lazio Region, 53 Santa Costanza Str, 00198 Rome, Italy
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Lavigne E, Gasparrini A, Wang X, Chen H, Yagouti A, Fleury MD, Cakmak S. Extreme ambient temperatures and cardiorespiratory emergency room visits: assessing risk by comorbid health conditions in a time series study. Environ Health 2014; 13:5. [PMID: 24484632 PMCID: PMC3922624 DOI: 10.1186/1476-069x-13-5] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Accepted: 01/26/2014] [Indexed: 05/18/2023]
Abstract
BACKGROUND Extreme ambient temperatures are an increasing public health concern. The aim of this study was to assess if persons with comorbid health conditions were at increased risk of adverse cardiorespiratory morbidity during temperature extremes. METHODS A time series study design was applied to 292,666 and 562,738 emergency room (ER) visits for cardiovascular and respiratory diseases, respectively, that occurred in Toronto area hospitals between April 1st 2002 and March 31st 2010. Subgroups of persons with comorbid health conditions were identified. Relative risks (RRs) and their corresponding 95% confidence intervals (CIs) were estimated using a Poisson regression model with distributed lag non-linear model, and were adjusted for the confounding influence of seasonality, relative humidity, day-of-the-week, outdoor air pollutants and daily influenza ER visits. Effect modification by comorbid health conditions was tested using the relative effect modification (REM) index. RESULTS Stronger associations of cardiovascular disease ER visits were observed for persons with diabetes compared to persons without diabetes (REM = 1.12; 95% CI: 1.01 - 1.27) with exposure to the cumulative short term effect of extreme hot temperatures (i.e. 99th percentile of temperature distribution vs. 75th percentile). Effect modification was also found for comorbid respiratory disease (REM = 1.17; 95% CI: 1.02 - 1.44) and cancer (REM = 1.20; 95% CI: 1.02 - 1.49) on respiratory disease ER visits during short term hot temperature episodes. The effect of extreme cold temperatures (i.e. 1st percentile of temperature distribution vs. 25th percentile) on cardiovascular disease ER visits were stronger for individuals with comorbid cardiac diseases (REM = 1.47; 95% CI: 1.06 - 2.23) and kidney diseases (REM = 2.43; 95% CI: 1.59 - 8.83) compared to those without these conditions when cumulated over a two-week period. CONCLUSIONS The identification of those most susceptible to temperature extremes is important for public health officials to implement adaptation measures to manage the impact of extreme temperatures on population health.
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Affiliation(s)
- Eric Lavigne
- Environmental Issues Division, Public Health Agency of Canada, Ottawa, Canada
| | - Antonio Gasparrini
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - Xiang Wang
- Environmental Issues Division, Public Health Agency of Canada, Ottawa, Canada
| | - Hong Chen
- Public Health Ontario, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Institute for Clinical Evaluative Sciences, Toronto, Canada
| | | | - Manon D Fleury
- Environmental Issues Division, Public Health Agency of Canada, Ottawa, Canada
| | - Sabit Cakmak
- Population Studies Division, Health Canada, Ottawa, Canada
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98
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Affiliation(s)
- An-Soo Jang
- Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
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