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Makra L, Matyasovszky I, Bálint B, Csépe Z. Association of allergic rhinitis or asthma with pollen and chemical pollutants in Szeged, Hungary, 1999-2007. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2014; 58:753-68. [PMID: 23558448 DOI: 10.1007/s00484-013-0656-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2012] [Revised: 02/26/2013] [Accepted: 02/26/2013] [Indexed: 05/23/2023]
Abstract
The effect of biological (pollen) and chemical air pollutants on respiratory hospital admissions for the Szeged region in Southern Hungary is analysed. A 9-year (1999-2007) database includes--besides daily number of respiratory hospital admissions--daily mean concentrations of CO, PM10, NO, NO2, O3 and SO2. Two pollen variables (Ambrosia and total pollen excluding Ambrosia) are also included. The analysis was performed for patients with chronic respiratory complaints (allergic rhinitis or asthma bronchiale) for two age categories (adults and the elderly) of males and females. Factor analysis was performed to clarify the relative importance of the pollutant variables affecting respiratory complaints. Using selected low and high quantiles corresponding to probability distributions of respiratory hospital admissions, averages of two data sets of each air pollutant variable were evaluated. Elements of these data sets were chosen according to whether actual daily patient numbers were below or above their quantile value. A nonparametric regression technique was applied to discriminate between extreme and non-extreme numbers of respiratory admissions using pollen and chemical pollutants as explanatory variables. The strongest correlations between extreme patient numbers and pollutants can be observed during the pollen season of Ambrosia, while the pollen-free period exhibits the weakest relationships. The elderly group with asthma bronchiale is characterised by lower correlations between extreme patient numbers and pollutants compared to adults and allergic rhinitis, respectively. The ratio of the number of correct decisions on the exceedance of a quantile resulted in similar conclusions as those obtained by using multiple correlations.
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Affiliation(s)
- László Makra
- Department of Climatology and Landscape Ecology, University of Szeged, POB 653, 6701, Szeged, Hungary,
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Bell ML, Zanobetti A, Dominici F. Evidence on vulnerability and susceptibility to health risks associated with short-term exposure to particulate matter: a systematic review and meta-analysis. Am J Epidemiol 2013; 178:865-76. [PMID: 23887042 DOI: 10.1093/aje/kwt090] [Citation(s) in RCA: 217] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Although there is strong evidence that short-term exposure to particulate matter is associated with health risks, less is known about whether some subpopulations face higher risks. We identified 108 papers published after 1995 and summarized the scientific evidence regarding effect modification of associations between short-term exposure to particulate matter and the risk of death or hospitalization. We performed a meta-analysis of estimated mortality associations by age and sex. We found strong, consistent evidence that the elderly experience higher risk of particular matter--associated hospitalization and death, weak evidence that women have higher risks of hospitalization and death, and suggestive evidence that those with lower education, income, or employment status have higher risk of death. Meta-analysis showed a statistically higher risk of death of 0.64% (95% confidence interval (CI): 0.50, 0.78) for older populations compared with 0.34% (95% CI: 0.25, 0.42) for younger populations per 10 μg/m3 increase of particulate matter with aerodynamic diameter ≤10 μm. Women had a slightly higher risk of death of 0.55% (95% CI: 0.41, 0.70) compared with 0.50% (95% CI: 0.34, 0.54) for men, but these 2 risks were not statistically different. Our synthesis on modifiers for risks associated with particulate matter can aid the design of air quality policies and suggest directions for future research. Studies of biological mechanisms could be informed by evidence of differential risks by population, such as by sex and preexisting conditions.
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Qiu H, Yu ITS, Wang X, Tian L, Tse LA, Wong TW. Cool and dry weather enhances the effects of air pollution on emergency IHD hospital admissions. Int J Cardiol 2013; 168:500-5. [DOI: 10.1016/j.ijcard.2012.09.199] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2012] [Accepted: 09/26/2012] [Indexed: 10/27/2022]
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Richmond-Bryant J, Meng Q, Davis JA, Cohen J, Svendsgaard D, Brown JS, Tuttle L, Hubbard H, Rice J, Kirrane E, Vinikoor-Imler L, Kotchmar D, Hines E, Ross M. A multi-level model of blood lead as a function of air lead. THE SCIENCE OF THE TOTAL ENVIRONMENT 2013; 461-462:207-13. [PMID: 23727994 DOI: 10.1016/j.scitotenv.2013.05.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Revised: 04/27/2013] [Accepted: 05/03/2013] [Indexed: 05/04/2023]
Abstract
National and local declines in lead (Pb) in blood (PbB) over the past several years coincide with the decline in ambient air Pb (PbA) concentrations. The objective of this work is to evaluate how the relationship between PbB levels and PbA levels has changed following the phase out of leaded gasoline and tightened controls on industrial Pb emissions over the past 30 years among a national population sample. Participant-level data from the National Health and Nutrition Examination Survey (NHANES) were employed for two time periods (1988-1994 and 1999-2008), and the model was corrected for housing, demographic, socioeconomic, and other covariates present in NHANES. NHANES data for PbB and covariates were merged with PbA data from the U.S. Environmental Protection Agency. Linear mixed effects models (LMEs) were run to assess the relationship of PbB with PbA; sample weights were omitted, given biases encountered with the use of sample weights in LMEs. The 1988-1994 age-stratified results found that ln(PbB) was statistically significantly associated with ln(PbA) for all age groups. The consistent influence of PbA on PbB across age groups for the years 1988-1994 suggests a ubiquitous exposure unrelated to age of the sample population. The comparison of effect estimates for ln(PbA) shows a statistically significant effect estimate and ANOVA results for ln(PbB) for the 6- to 11-year and 12- to 19-year age groups during 1999-2008. The more recent finding suggests that PbA has less consistent influence on PbB compared with other factors.
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Affiliation(s)
- Jennifer Richmond-Bryant
- National Center for Environmental Assessment, U.S. Environmental Protection Agency, 109 TW Alexander Drive, B243-01, Research Triangle Park, NC 27711, USA
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Bhaskaran K, Gasparrini A, Hajat S, Smeeth L, Armstrong B. Time series regression studies in environmental epidemiology. Int J Epidemiol 2013; 42:1187-95. [PMID: 23760528 PMCID: PMC3780998 DOI: 10.1093/ije/dyt092] [Citation(s) in RCA: 693] [Impact Index Per Article: 63.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Time series regression studies have been widely used in environmental epidemiology, notably in investigating the short-term associations between exposures such as air pollution, weather variables or pollen, and health outcomes such as mortality, myocardial infarction or disease-specific hospital admissions. Typically, for both exposure and outcome, data are available at regular time intervals (e.g. daily pollution levels and daily mortality counts) and the aim is to explore short-term associations between them. In this article, we describe the general features of time series data, and we outline the analysis process, beginning with descriptive analysis, then focusing on issues in time series regression that differ from other regression methods: modelling short-term fluctuations in the presence of seasonal and long-term patterns, dealing with time varying confounding factors and modelling delayed (‘lagged’) associations between exposure and outcome. We finish with advice on model checking and sensitivity analysis, and some common extensions to the basic model.
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Affiliation(s)
- Krishnan Bhaskaran
- Department of Non-Communicable Diseases Epidemiology, London School of Hygiene and Tropical Medicine, London, UK, Medical Statistics Department, London School of Hygiene and Tropical Medicine, London, UK and Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, UK
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Tamayo Uria I, Mateu Mahiques J, Mughini Gras L. Temporal distribution and weather correlates of Norway rat (Rattus norvegicus) infestations in the city of Madrid, Spain. ECOHEALTH 2013; 10:137-144. [PMID: 23539128 DOI: 10.1007/s10393-013-0829-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2012] [Revised: 03/11/2013] [Accepted: 03/15/2013] [Indexed: 06/02/2023]
Abstract
Urban Norway rats are challenging pests, posing significant health and economic threats. Implementing ecologically based integrated rodent management (EBIRM) programmes relies primarily on the understanding of ecological relationships between rodents and their environments, with emphasis on the processes influencing rodent populations in the target ecosystem. We investigated the temporal distribution of urban Norway rat infestations in Madrid, Spain, and tested for the association of such infestations with temperature, relative humidity and precipitation by fitting a multivariate Poisson generalized linear model to a 3-year (2006-2008) daily time series of 4,689 Norway rat sightings. Norway rat infestations showed a marked seasonality, peaking in the summer. Most Norway rat sightings were reported on Mondays. Minimum temperature and relative humidity were positively associated with Norway rat infestation, whereas the association with precipitation was negative. The time series was adequately explained by the model. We identified previously unrecognized time periods that are more prone to Norway rat infestation than others and generated hypotheses about the association between weather, human outdoor activity, resource availability, rodent activity and population size. This provided local authorities engaged in preserving urban ecosystem health with basic research information to predict future rodent outbreaks and support the implementation of EBIRM programmes in urban areas.
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Affiliation(s)
- Ibon Tamayo Uria
- Department of Health and Consumer Affairs, Government of the Basque Country, Donostia-San Sebastian, Spain.
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Khafaie MA, Salvi SS, Ojha A, Khafaie B, Gore SS, Yajnik CS. Systemic inflammation (C-reactive protein) in type 2 diabetic patients is associated with ambient air pollution in Pune City, India. Diabetes Care 2013; 36:625-30. [PMID: 23172977 PMCID: PMC3579327 DOI: 10.2337/dc12-0388] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To study the association between ambient air pollutants and serum C-reactive protein (CRP) concentration in 1,392 type 2 diabetic patients in Pune, India. RESEARCH DESIGN AND METHODS A cross-sectional study was conducted that linked daily time series of ambient air pollution data (obtained from central monitoring sites) and plasma CRP concentration in type 2 diabetic patients from the Wellcome Trust Genetic (WellGen) Study, recruited between March 2005 and May 2007. Air pollution effects on CRP concentration were investigated with delays (lags) of 0-7 days and multiday averaging spans of 7, 14, and 30 days before blood collection adjusted for age, sex, BMI, hemoglobin, fasting plasma glucose, treatment with agents with anti-inflammatory action, season, air temperature, and relative humidity. RESULTS Median CRP concentration was 3.49 mg/L. For 1 SD increase in SO(2) and oxides of nitrogen (NO(x)) concentrations in ambient air, a day before blood collection (lag(1)), we observed a significant increase in CRP (9.34 and 7.77%, respectively). The effect was higher with lag(2) (12.42% for SO(2) and 11.60% for NO(x)) and wore off progressively thereafter. We also found a significant association with multiday averaging times of up to 30 and 7 days for SO(2) and NO(x), respectively. No significant associations were found between particulate matter with an aerodynamic profile ≤10 µm (PM(10)) and CRP concentration except in summer. The association was significantly higher among patients with a shorter duration of diabetes, and in those not on statin and thiazolidinedione treatment. CONCLUSIONS We demonstrate, for the first time, a possible contribution of ambient air pollution to systemic inflammation in Indian type 2 diabetic patients. This may have implications for vascular complications of diabetes.
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Affiliation(s)
- Morteza A Khafaie
- Department of Health, Jondi-Shapour University of Medical Sciences, Ahvaz, Iran
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Gianicolo EAL, Bruni A, Mangia C, Cervino M, Vigotti MA. Acute effects of urban and industrial pollution in a government-designated "Environmental risk area": the case of Brindisi, Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2013; 23:446-460. [PMID: 23317293 DOI: 10.1080/09603123.2012.755154] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Exposure to air pollutants has been associated with increased hospital admissions (HAs) for respiratory and cardiovascular diseases. This work describes a short-term epidemiological study in Brindisi, a highly industrialized town in Southern Italy. The effects of daily exposure to PM10 and NO2 on daily HAs for cardiac, respiratory, and cerebrovascular diseases were investigated by means of a case-crossover design in the period 2001-2007. Results showed positive associations between PM10 and HAs for cardiac and respiratory diseases and between NO2 and HAs for all the categories of diseases considered, particularly among females. Although not statistically significant, increased risk was observed for wind blowing from the port and the industrial area. Findings confirm the health risks associated with ambient air pollution exposure, even though NO2 and PM10 concentrations were below the legal limits. This may be due to the complex scenario of emissions in the area, which should be better investigated.
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Acute myocardial infarctions, strokes and influenza: seasonal and pandemic effects. Epidemiol Infect 2013; 141:735-44. [PMID: 23286343 DOI: 10.1017/s0950268812002890] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
The incidence of myocardial infarctions and influenza follow similar seasonal patterns. To determine if acute myocardial infarctions (AMIs) and ischaemic strokes are associated with influenza activity, we built time-series models using data from the Nationwide Inpatient Sample. In these models, we used influenza activity to predict the incidence of AMI and ischaemic stroke. We fitted national models as well as models based on four geographical regions and five age groups. Across all models, we found consistent significant associations between AMIs and influenza activity, but not between ischaemic strokes and influenza. Associations between influenza and AMI increased with age, were greatest in those aged >80 years, and were present in all geographical regions. In addition, the natural experiment provided by the second wave of the influenza pandemic in 2009 provided further evidence of the relationship between influenza and AMI, because both series peaked in the same non-winter month.
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Wang Z, Liu Y, Hu M, Pan X, Shi J, Chen F, He K, Koutrakis P, Christiani DC. Acute health impacts of airborne particles estimated from satellite remote sensing. ENVIRONMENT INTERNATIONAL 2013; 51:150-159. [PMID: 23220016 PMCID: PMC3711510 DOI: 10.1016/j.envint.2012.10.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2012] [Revised: 10/27/2012] [Accepted: 10/28/2012] [Indexed: 05/28/2023]
Abstract
Satellite-based remote sensing provides a unique opportunity to monitor air quality from space at global, continental, national and regional scales. Most current research focused on developing empirical models using ground measurements of the ambient particulate. However, the application of satellite-based exposure assessment in environmental health is still limited, especially for acute effects, because the development of satellite PM(2.5) model depends on the availability of ground measurements. We tested the hypothesis that MODIS AOD (aerosol optical depth) exposure estimates, obtained from NASA satellites, are directly associated with daily health outcomes. Three independent healthcare databases were used: unscheduled outpatient visits, hospital admissions, and mortality collected in Beijing metropolitan area, China during 2006. We use generalized linear models to compare the short-term effects of air pollution assessed by ground monitoring (PM(10)) with adjustment of absolute humidity (AH) and AH-calibrated AOD. Across all databases we found that both AH-calibrated AOD and PM(10) (adjusted by AH) were consistently associated with elevated daily events on the current day and/or lag days for cardiovascular diseases, ischemic heart diseases, and COPD. The relative risks estimated by AH-calibrated AOD and PM(10) (adjusted by AH) were similar. Additionally, compared to ground PM(10), we found that AH-calibrated AOD had narrower confidence intervals for all models and was more robust in estimating the current day and lag day effects. Our preliminary findings suggested that, with proper adjustment of meteorological factors, satellite AOD can be used directly to estimate the acute health impacts of ambient particles without prior calibrating to the sparse ground monitoring networks.
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Affiliation(s)
- Zhaoxi Wang
- Harvard School of Public Health, Massachusetts General Hospital/Harvard Medical School, Boston, MA 02115, USA.
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Modeling respiratory illnesses with change point: A lesson from the SARS epidemic in Hong Kong. Comput Stat Data Anal 2013; 57:589-599. [PMID: 32362698 PMCID: PMC7185837 DOI: 10.1016/j.csda.2012.07.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2012] [Revised: 05/24/2012] [Accepted: 07/31/2012] [Indexed: 11/23/2022]
Abstract
It is generally agreed that respiratory disease is closely related to ambient air quality and weather conditions. Besides, hygiene related factors such as the public health measures by the government and possible personal awareness in the community can also affect the spread of infectious respiratory diseases. However, there is no quantitative support for this conclusion, because of lack of quality data. The severe acute respiratory syndrome (or SARS) outbreak in 2003 triggered strict public health measures and personal awareness in the prevention of infectious respiratory diseases, providing us an opportunity to quantify the impact of hygiene related factors in the spread of the disease. In this paper, we model the number of the respiratory illnesses by a semiparametric model which models the environmental and weather impacts using a multiple index model and the impact of other public health measures and possible personal awareness using a growth curve with jump. Using data from Hong Kong, we found that public health measures contributed to about 39% of reduction in the number of respiratory illnesses during the SARS period. However, the impact of hygienically related factors eventually fades as time passes. The results provide indirect quantitative support to the usefulness of governmental campaigns to arouse the awareness of the public in staying away from transmission of respiratory diseases during the full outbreak of the disease. The results also show the fast fading of alertness of Hong Kong people towards the epidemic. Furthermore, our model also offers a way to model the impacts of environmental factors on respiratory diseases, when the data contains the effect of human intervention, by introducing the change point and growth curve to remove such an effect.
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Ambient air pollution exposure and respiratory, cardiovascular and cerebrovascular mortality in Cape Town, South Africa: 2001–2006. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2012. [PMID: 23202828 PMCID: PMC3524609 DOI: 10.3390/ijerph9113978] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Little evidence is available on the strength of the association between ambient air pollution exposure and health effects in developing countries such as South Africa. The association between the 24-h average ambient PM10, SO2 and NO2 levels and daily respiratory (RD), cardiovascular (CVD) and cerebrovascular (CBD) mortality in Cape Town (2001–2006) was investigated with a case-crossover design. For models that included entire year data, an inter-quartile range (IQR) increase in PM10 (12 mg/m3) and NO2 (12 mg/m3) significantly increased CBD mortality by 4% and 8%, respectively. A significant increase of 3% in CVD mortality was observed per IQR increase in NO2 and SO2 (8 mg/m3). In the warm period, PM10 was significantly associated with RD and CVD mortality. NO2 had significant associations with CBD, RD and CVD mortality, whilst SO2 was associated with CVD mortality. None of the pollutants were associated with any of the three outcomes in the cold period. Susceptible groups depended on the cause-specific mortality and air pollutant. There is significant RD, CVD and CBD mortality risk associated with ambient air pollution exposure in South Africa, higher than reported in developed countries.
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Canova C, Dunster C, Kelly FJ, Minelli C, Shah PL, Caneja C, Tumilty MK, Burney P. PM10-induced hospital admissions for asthma and chronic obstructive pulmonary disease: the modifying effect of individual characteristics. Epidemiology 2012; 23:607-15. [PMID: 22531667 DOI: 10.1097/ede.0b013e3182572563] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND Evidence suggests that oxidative stress is a unifying feature underlying the toxic actions of particulate matter (PM). We have investigated whether individual plasma antioxidant concentrations (uric acid and vitamins C, A, and E) and 10 antioxidant genes modify the response to PM with respect to hospital admissions for chronic obstructive pulmonary disease (COPD) or asthma. METHODS Using a bidirectional, hospital-based, case-crossover study, 209 patients admitted for asthma or COPD to the Chelsea and Westminster Hospital (London), with 234 admissions, were recruited between May 2008 and July 2010. PM10 levels in the area of Kensington and Chelsea at the time of admission were compared with the levels 14 days before and 14 days after the event. Conditional logistic regression was used to estimate the effect of PM10 at several temporal lags, while controlling for confounders. RESULTS An increase in asthma/COPD admission rate was related to a 10 μg/m increase in PM10, with the highest effect noted 0-3 days before the exacerbation (for lag 0-3, odds ratio = 1.35 [95% confidence interval = 1.04-1.76]). Serum vitamin C modified the effect of PM10 on asthma/COPD exacerbations. A similar (although weaker) influence was observed for low levels of uric acid and vitamin E, whereas vitamin A showed no effect modification. GSTP1 (rs1695), SOD2 (rs4880), and Nrf2 (rs1806649) were associated with a trend toward an increased risk of hospital admissions during periods of high PM10 levels. CONCLUSIONS Our study suggests that the concentration of antioxidants in patients' serum modifies the short-term effects of PM10 on asthma and COPD exacerbations.
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Affiliation(s)
- Cristina Canova
- MRC-HPA Centre for Environment and Health, Imperial College, London, United Kingdom.
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Makra L, Matyasovszky I, Bálint B. Association of allergic asthma emergency room visits with the main biological and chemical air pollutants. THE SCIENCE OF THE TOTAL ENVIRONMENT 2012; 432:288-96. [PMID: 22750174 DOI: 10.1016/j.scitotenv.2012.05.088] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2012] [Revised: 05/27/2012] [Accepted: 05/28/2012] [Indexed: 05/20/2023]
Abstract
Joint effect of biological (pollen) and chemical air pollutants on asthma emergency room (ER) visits was analyzed for Szeged region of Southern Hungary. Our database of a nine-year period (1999-2007) includes daily number of asthma emergency room (ER) visits, and daily mean concentrations of CO, PM(10), NO, NO(2), O(3) and SO(2), furthermore two pollen variables (Ambrosia and total pollen excluding Ambrosia), as well. The analysis was performed for ER visits of asthma bronchiale using two age groups (adults and the elderly) of males and females for three seasons. Factor analysis was performed in order to clarify the relative importance of the pollutant variables affecting asthma ER visits. Asthma ER visits denote notably stronger associations with the pollutants in adult male than in adult female patients both for the pollen season of Ambrosia and the pollen-free season. Furthermore, adults are substantially more sensitive to severe asthma attack than the elderly for the season of total pollen excluding Ambrosia pollen. The joint effect of the chemical and pollen variables is the highest for the asthma ER cases in the pollen season of Ambrosia, basically due to the extra impact of the total pollen excluding Ambrosia pollen and partly due to Ambrosia pollen. A nonparametric regression technique was applied to discriminate between events of ER visit-no ER visit using pollen and chemical pollutants as explaining variables. Based on multiple correlations, the strongest relationships between ER visits and pollutants are observed during the pollen-free season. The elderly group with asthma bronchiale is characterized by weaker relationships between ER visits and pollutants compared to adults. Ratio of the number of correct decisions on the events of ER visit-no ER visit is lowest for the season of total pollen excluding Ambrosia pollen. Otherwise, similar conclusions hold as those received by multiple correlations.
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Affiliation(s)
- László Makra
- Department of Climatology and Landscape Ecology, University of Szeged, HU-6701 Szeged, P.O.B. 653, Hungary.
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Temporal variation in air pollution concentrations and preterm birth-a population based epidemiological study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2012; 9:272-85. [PMID: 22470291 PMCID: PMC3315074 DOI: 10.3390/ijerph9010272] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2011] [Revised: 01/09/2012] [Accepted: 01/13/2012] [Indexed: 02/05/2023]
Abstract
There is growing evidence of adverse birth outcomes due to exposure to air pollution during gestation. However, recent negative studies are also reported. The aim of this study was to assess the effect of ozone and vehicle exhaust exposure (NO(2)) on the length of the gestational period and risk of preterm delivery. We used data from the Swedish Medical Birth Registry on all vaginally delivered singleton births in the Greater Stockholm area who were conceived during 1987-1995 (n = 115,588). Daily average levels of NO(2) (from three measuring stations) and ozone (two stations) were used to estimate trimester and last week of gestation average exposures. Linear regression models were used to assess the association between the two air pollutants and three exposure windows, while logistic regression models were used when analyzing associations with preterm delivery (<37 weeks gestation). Five percent were born preterm. The median gestational period was 40 weeks. Higher levels of ozone during the first trimester were associated with shorter gestation as well as with an elevated risk of preterm delivery, the odds ratio from the most complex model was 1.06 (95% CI: 1.00-1.13) per 10 μg/m(3) increase in the mean daily 8-h maximum concentration. Higher levels of ozone during the second trimester were associated with shorter gestation but the elevated risk of preterm delivery was not statistically significant. Higher levels of ozone and NO(2) during the last week of gestation were associated with a shorter duration of gestation and NO(2) also with preterm delivery. There were no significant associations between first and second trimester NO(2) exposure estimates and studied outcomes. The effect of first trimester ozone exposure, known to cause oxidative stress, was smallest among women who conceived during autumn when vitamin D status, important for fetal health, in Scandinavian women is the highest.
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Rückerl R, Schneider A, Breitner S, Cyrys J, Peters A. Health effects of particulate air pollution: A review of epidemiological evidence. Inhal Toxicol 2012; 23:555-92. [PMID: 21864219 DOI: 10.3109/08958378.2011.593587] [Citation(s) in RCA: 311] [Impact Index Per Article: 25.9] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Regina Rückerl
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology II, Neuherberg, Germany.
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Reyna MA, Bravo ME, López R, Nieblas EC, Nava ML. Relative risk of death from exposure to air pollutants: a short-term (2003-2007) study in Mexicali, Baja California, México. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2012; 22:370-86. [PMID: 22420489 DOI: 10.1080/09603123.2011.650153] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Studies have shown associations between respiratory diseases and air pollutants in Mexicali, México; however, none have addressed relative risk (RR) of death. By using Poisson regression models, we quantified the RR by exposure for: particulate matter (PM(10), PM(2.5)), carbon monoxide (CO), nitrogen dioxide (NO(2)), ozone (O(3)), and sulfur dioxide (SO(2)) over a 5-year period and by climate (winter or summer). RRs were estimated utilizing each pollutant (single-pollutant model) on the same day as pollutant concentration were measured (lag 0) and up to 7 days later to the pollutant measurements (lag 7). Significant associations were found in RRs for one interquartile range increment of the corresponding pollutant, such as: PM(2.5) lagged 5 days in winter and for the 5-year period (RR, 1.041 and 1.028, respectively); CO lagged 1 day in winter and for the 5-year period (RR, 1.044 and 1.032, respectively); NO(2) on the current day (lag 0) in summer (RR = 1.037); and SO(2) lagged one day for the 5-year period (RR = 1.023).
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Affiliation(s)
- Marco A Reyna
- Bioengineering and Environmental Health, Autonomous University of Baja California, Blvd. Benito Juarez y Calle Normal s/n, Col. Insurgentes Este, Mexicali, México.
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Lim D, Ikeda A, Vu KKT, Yamaguchi KT, Tyner TR, Hasson AS. Method development for the measurement of quinone levels in urine. J Chromatogr B Analyt Technol Biomed Life Sci 2011; 879:3592-8. [PMID: 22024390 DOI: 10.1016/j.jchromb.2011.09.051] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2011] [Revised: 09/20/2011] [Accepted: 09/28/2011] [Indexed: 11/30/2022]
Abstract
A method was developed for the quantification of 1-4 ring quinones in urine samples using liquid-liquid extraction followed by analysis with gas chromatography-mass spectrometry. Detection limits for the ten quinones analyzed are in the range 1-2 nmol dm(-3). The potential use of this approach to monitor urinary quinone levels was then evaluated in urine samples from both Sprague-Dawley rats and human subjects. Rats were exposed to 9,10-phenanthraquinone (PQ) by both injection and ingestion (mixed with solid food and dissolved in drinking water). Urinary levels of PQ were found to increase by up to a factor of ten compared to control samples, and the levels were found to depend on both the dose and duration of exposure. Samples were also collected and analyzed periodically from human subjects over the course of six months. Eight quinones were detected in the samples, with levels varying from below the detection limit up to 3 μmol dm(-3).
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Affiliation(s)
- Dianne Lim
- Department of Chemistry, California State University, Fresno, CA 93740, USA
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Mallone S, Stafoggia M, Faustini A, Gobbi GP, Marconi A, Forastiere F. Saharan dust and associations between particulate matter and daily mortality in Rome, Italy. ENVIRONMENTAL HEALTH PERSPECTIVES 2011; 119:1409-1414. [PMID: 21970945 DOI: 10.12989/eph.1003026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/28/2010] [Accepted: 06/17/2011] [Indexed: 05/27/2023]
Abstract
BACKGROUND Outbreaks of Saharan-Sahel dust over Euro-Mediterranean areas frequently induce exceedances of the Europen Union's 24-hr standard of 50 μg/m3 for particulate matter (PM) with aerodynamic diameter ≤ than 10 μm (PM10). OBJECTIVES We evaluated the effect of Saharan dust on the association between different PM fractions and daily mortality in Rome, Italy. METHODS In a study of 80,423 adult residents who died in Rome between 2001 and 2004, we performed a time-series analysis to explore the effects of PM2.5, PM2.5-10, and PM10 on natural, cardiac, cerebrovascular, and respiratory mortality. We defined Saharan dust days by combining light detection and ranging (LIDAR) observations and analyses from operational models. We tested a Saharan dust-PM interaction term to evaluate the hypothesis that the effects of PM, especially coarse PM (PM2.5-10), on mortality would be enhanced on dust days. RESULTS Interquartile range increases in PM2.5-10 (10.8 μg/m3) and PM10 (19.8 μg/m3) were associated with increased mortality due to natural, cardiac, cerebrovascular, and respiratory causes, with estimated effects ranging from 2.64% to 12.65% [95% confidence interval (CI), 1.18-25.42%] for the association between PM2.5-10 and respiratory mortality (0- to 5-day lag). Associations of PM2.5-10 with cardiac mortality were stronger on Saharan dust days (9.73%; 95% CI, 4.25-15.49%) than on dust-free days (0.86%; 95% CI, -2.47% to 4.31%; p = 0.005). Saharan dust days also modified associations between PM10 and cardiac mortality (9.55% increase; 95% CI, 3.81-15.61%; vs. dust-free days: 2.09%; 95% CI, -0.76% to 5.02%; p = 0.02). CONCLUSIONS We found evidence of effects of PM2.5-10 and PM10 on natural and cause-specific mortality, with stronger estimated effects on cardiac mortality during Saharan dust outbreaks. Toxicological and biological effects of particles from desert sources need to be further investigated and taken into account in air quality standards.
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Mallone S, Stafoggia M, Faustini A, Gobbi GP, Marconi A, Forastiere F. Saharan dust and associations between particulate matter and daily mortality in Rome, Italy. ENVIRONMENTAL HEALTH PERSPECTIVES 2011; 119:1409-14. [PMID: 21970945 DOI: 10.1289/ehp.1003026] [Citation(s) in RCA: 98] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2010] [Accepted: 06/17/2011] [Indexed: 05/22/2023]
Abstract
BACKGROUND Outbreaks of Saharan-Sahel dust over Euro-Mediterranean areas frequently induce exceedances of the Europen Union's 24-hr standard of 50 μg/m3 for particulate matter (PM) with aerodynamic diameter ≤ than 10 μm (PM10). OBJECTIVES We evaluated the effect of Saharan dust on the association between different PM fractions and daily mortality in Rome, Italy. METHODS In a study of 80,423 adult residents who died in Rome between 2001 and 2004, we performed a time-series analysis to explore the effects of PM2.5, PM2.5-10, and PM10 on natural, cardiac, cerebrovascular, and respiratory mortality. We defined Saharan dust days by combining light detection and ranging (LIDAR) observations and analyses from operational models. We tested a Saharan dust-PM interaction term to evaluate the hypothesis that the effects of PM, especially coarse PM (PM2.5-10), on mortality would be enhanced on dust days. RESULTS Interquartile range increases in PM2.5-10 (10.8 μg/m3) and PM10 (19.8 μg/m3) were associated with increased mortality due to natural, cardiac, cerebrovascular, and respiratory causes, with estimated effects ranging from 2.64% to 12.65% [95% confidence interval (CI), 1.18-25.42%] for the association between PM2.5-10 and respiratory mortality (0- to 5-day lag). Associations of PM2.5-10 with cardiac mortality were stronger on Saharan dust days (9.73%; 95% CI, 4.25-15.49%) than on dust-free days (0.86%; 95% CI, -2.47% to 4.31%; p = 0.005). Saharan dust days also modified associations between PM10 and cardiac mortality (9.55% increase; 95% CI, 3.81-15.61%; vs. dust-free days: 2.09%; 95% CI, -0.76% to 5.02%; p = 0.02). CONCLUSIONS We found evidence of effects of PM2.5-10 and PM10 on natural and cause-specific mortality, with stronger estimated effects on cardiac mortality during Saharan dust outbreaks. Toxicological and biological effects of particles from desert sources need to be further investigated and taken into account in air quality standards.
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Mallone S, Stafoggia M, Faustini A, Gobbi GP, Marconi A, Forastiere F. Saharan dust and associations between particulate matter and daily mortality in Rome, Italy. ENVIRONMENTAL HEALTH PERSPECTIVES 2011; 119:1409-1414. [PMID: 21970945 PMCID: PMC3230430 DOI: 10.12989/ehp.1003026] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/28/2010] [Accepted: 06/17/2011] [Indexed: 05/18/2023]
Abstract
BACKGROUND Outbreaks of Saharan-Sahel dust over Euro-Mediterranean areas frequently induce exceedances of the Europen Union's 24-hr standard of 50 μg/m3 for particulate matter (PM) with aerodynamic diameter ≤ than 10 μm (PM10). OBJECTIVES We evaluated the effect of Saharan dust on the association between different PM fractions and daily mortality in Rome, Italy. METHODS In a study of 80,423 adult residents who died in Rome between 2001 and 2004, we performed a time-series analysis to explore the effects of PM2.5, PM2.5-10, and PM10 on natural, cardiac, cerebrovascular, and respiratory mortality. We defined Saharan dust days by combining light detection and ranging (LIDAR) observations and analyses from operational models. We tested a Saharan dust-PM interaction term to evaluate the hypothesis that the effects of PM, especially coarse PM (PM2.5-10), on mortality would be enhanced on dust days. RESULTS Interquartile range increases in PM2.5-10 (10.8 μg/m3) and PM10 (19.8 μg/m3) were associated with increased mortality due to natural, cardiac, cerebrovascular, and respiratory causes, with estimated effects ranging from 2.64% to 12.65% [95% confidence interval (CI), 1.18-25.42%] for the association between PM2.5-10 and respiratory mortality (0- to 5-day lag). Associations of PM2.5-10 with cardiac mortality were stronger on Saharan dust days (9.73%; 95% CI, 4.25-15.49%) than on dust-free days (0.86%; 95% CI, -2.47% to 4.31%; p = 0.005). Saharan dust days also modified associations between PM10 and cardiac mortality (9.55% increase; 95% CI, 3.81-15.61%; vs. dust-free days: 2.09%; 95% CI, -0.76% to 5.02%; p = 0.02). CONCLUSIONS We found evidence of effects of PM2.5-10 and PM10 on natural and cause-specific mortality, with stronger estimated effects on cardiac mortality during Saharan dust outbreaks. Toxicological and biological effects of particles from desert sources need to be further investigated and taken into account in air quality standards.
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Kraus U, Breitner S, Schnelle-Kreis J, Cyrys J, Lanki T, Rückerl R, Schneider A, Brüske I, Gu J, Devlin R, Wichmann HE, Zimmermann R, Peters A. Particle-associated organic compounds and symptoms in myocardial infarction survivors. Inhal Toxicol 2011; 23:431-47. [PMID: 21639711 DOI: 10.3109/08958378.2011.580471] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONTEXT The aerosol components responsible for the adverse health effects of the exposure to particulate matter (PM) have not been conclusively identified, and there is especially little information on the role of particulate organic compounds (POC). OBJECTIVE This study evaluated the role of PM and POC with regard to daily symptoms. METHODS One hundred and fifty-three myocardial infarction survivors from Augsburg, Germany, recorded daily occurrence of different symptoms in winter 2003/2004. Ambient concentrations of PM with a diameter <2.5 μm (PM(2.5)), particle number concentration (PNC), PM(2.5)-bound hopanes, and polycyclic aromatic hydrocarbons (PAH) were quantified. Data were analyzed using generalized estimating equations adjusting for meteorological and other time-variant confounders. RESULTS The odds for avoidance of physically demanding activities due to heart problems increased immediately associated with most POC measures (e.g. 5% per 1.08 ng/m(3) increase in benzo[a]pyrene, 95%-confidence interval (CI):1-9%) and tended to a delayed decrease. After a 2-day delayed decrease associated with hopanes, the odds for shortness of breath increased consistently after 3 days with almost all POC measures (e.g. 4% per 0.21 ng/m(3) increase in 17α(H), 21β(H)-hopane, CI: 1-8%). The odds for heart palpitations marginally increased immediately in association with PNC (8% per 8146 cm(-3) increase in PNC, CI: 0-16%). CONCLUSIONS The study showed an association between PM, particle-bound POC, and daily symptoms. The organic compounds may be causally related with cardiovascular health or act rather as indicators for traffic- and combustion-related particles.
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Affiliation(s)
- Ute Kraus
- Institute of Epidemiology II, Helmholtz Zentrum München-German Research Center for Environmental Health, Neuherberg, Germany
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Meteorological factors and El Niño Southern Oscillation are independently associated with dengue infections. Epidemiol Infect 2011; 140:1244-51. [PMID: 21906411 DOI: 10.1017/s095026881100183x] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Our objective was to determine the association between temperature, humidity, rainfall and dengue activity in Singapore, after taking into account lag periods as well as long-term climate variability such as the El Niño Southern Oscillation Index (SOI). We used a Poisson model which allowed for autocorrelation and overdispersion in the data. We found weekly mean temperature and mean relative humidity as well as SOI to be significantly and independently associated with dengue notifications. There was an interaction effect by periods of dengue outbreaks, but periods where El Niño was present did not moderate the relationship between humidity and temperature with dengue notifications. Our results help to understand the temporal trends of dengue in Singapore, and further reinforce the findings that meteorological factors are important in the epidemiology of dengue.
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Zauli Sajani S, Hänninen O, Marchesi S, Lauriola P. Comparison of different exposure settings in a case--crossover study on air pollution and daily mortality: counterintuitive results. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2011; 21:385-94. [PMID: 20571526 DOI: 10.1038/jes.2010.27] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2009] [Accepted: 03/25/2010] [Indexed: 05/22/2023]
Abstract
Because of practical problems associated with measurement of personal exposures to air pollutants in larger populations, almost all epidemiological studies assign exposures based on fixed-site ambient air monitoring stations. In the presence of multiple monitoring stations at different locations, the selection of them may affect the observed epidemiological concentration--response (C-R) relationships. In this paper, we quantify these impacts in an observational ecologic case--crossover study of air pollution and mortality. The associations of daily concentrations of PM(10), O(3), and NO(2) with daily all-cause non-violent mortality were investigated using conditional logistic regression to estimate percent increase in the risk of dying for an increase of 10 μg/m(3) in the previous day air pollutant concentrations (lag 1). The study area covers the six main cities in the central-western part of Emilia-Romagna region (population of 1.1 million). We used four approaches to assign exposure to air pollutants for each individual considered in the study: nearest background station; city average of all stations available; average of all stations in a macro-area covering three cities and average of all six cities in the study area (50 × 150 km(2)). Odds ratios generally increased enlarging the spatial dimension of the exposure definition and were highest for six city-average exposure definition. The effect is especially evident for PM(10), and similar for NO(2), whereas for ozone, we did not find any change in the C-R estimates. Within a geographically homogeneous region, the spatial aggregation of monitoring station data leads to higher and more robust risk estimates for PM(10) and NO(2), even if monitor-to-monitor correlations showed a light decrease with distance. We suggest that the larger aggregation improves the representativity of the exposure estimates by decreasing exposure misclassification, which is more profound when using individual stations vs regional averages.
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Affiliation(s)
- Stefano Zauli Sajani
- Regional Center for Environment and Health, ARPA Emilia-Romagna, Via Begarelli, 13, Modena 41121, Italy.
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Namdeo A, Tiwary A, Farrow E. Estimation of age-related vulnerability to air pollution: assessment of respiratory health at local scale. ENVIRONMENT INTERNATIONAL 2011; 37:829-837. [PMID: 21420174 DOI: 10.1016/j.envint.2011.02.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2010] [Revised: 02/01/2011] [Accepted: 02/02/2011] [Indexed: 05/30/2023]
Abstract
This paper demonstrates association of short-term variation in pollution and health outcomes within the same geographical area for a typical urban setting in the northern part of the UK from time series analysis. It utilises publicly available datasets for regulated air pollutants (PM₁₀, NO₂, SO₂, CO and O₃), meteorology and respiratory hospital admissions (and mortality) between April 2002 and December 2005 to estimate the respiratory health effect of pollution exposure, mainly in the elderly. Our results show that PM₁₀ and O₃ are positively associated with respiratory hospital admissions in the elderly, specifically in the age group 70-79. CO effects seem to be concentrated on the most elderly age group (80+) whereas NO₂ seems to have the opposite age-related effect, with lower effects on the more elderly.
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Affiliation(s)
- Anil Namdeo
- Transport Operations Research Group, Civil Engineering and Geosciences, Cassie Building, Newcastle University, Newcastle upon Tyne, UK
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Brüske I, Hampel R, Baumgärtner Z, Rückerl R, Greven S, Koenig W, Peters A, Schneider A. Ambient air pollution and lipoprotein-associated phospholipase A₂ in survivors of myocardial infarction. ENVIRONMENTAL HEALTH PERSPECTIVES 2011; 119:921-6. [PMID: 21356620 PMCID: PMC3223011 DOI: 10.1289/ehp.1002681] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2010] [Accepted: 02/28/2011] [Indexed: 05/08/2023]
Abstract
BACKGROUND Increasing evidence suggests a proatherogenic role for lipoprotein-associated phospholipase A₂ (Lp-PLA2). A meta-analysis of published cohorts has shown that Lp-PLA2 is an independent predictor of coronary heart disease events and stroke. OBJECTIVE In this study, we investigated whether the association between air pollution and cardiovascular disease might be partly explained by increased Lp-PLA2 mass in response to exposure. METHODS A prospective longitudinal study of 200 patients who had had a myocardial infarction was performed in Augsburg, Germany. Up to six repeated clinical examinations were scheduled every 4-6 weeks between May 2003 and March 2004. Supplementary to the multicenter AIRGENE protocol, we assessed repeated plasma Lp-PLA2 concentrations. Air pollution data from a fixed monitoring site representing urban background concentrations were collected. We measured hourly means of particle mass [particulate matter (PM) < 10 µm (PM₁₀) and PM < 2.5 µm (PM(2.5)) in aerodynamic diameter] and particle number concentrations (PNCs), as well as the gaseous air pollutants carbon monoxide (CO), sulfur dioxide (SO₂), ozone (O₃), nitric oxide (NO), and nitrogen dioxide (NO₂). Data were analyzed using mixed models with random patient effects. RESULTS Lp-PLA2 showed a positive association with PM₁₀, PM(2.5), and PNCs, as well as with CO, NO₂, NO, and SO₂ 4-5 days before blood withdrawal (lag 4-5). A positive association with O₃ was much more immediate (lag 0). However, inverse associations with some pollutants were evident at shorter time lags. CONCLUSION These preliminary findings should be replicated in other study populations because they suggest that the accumulation of acute and subacute effects or the chronic exposure to ambient particulate and gaseous air pollution may result in the promotion of atherosclerosis, mediated, at least in part, by increased levels of Lp-PLA2.
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Affiliation(s)
- Irene Brüske
- Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany.
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Abstract
Genetic susceptibility is likely to play a role in response to air pollution. Hence, gene-environment interaction studies can be a tool for exploring the mechanisms and the importance of the pathway in the association between air pollution and a cardiovascular outcome. In this article, we present a systematic review of the studies that have examined gene-environment interactions in relation to the cardiovascular health effects of air pollutants. We identified 16 articles meeting our search criteria. Of these studies, most have focused on individual functional polymorphisms or individual candidate genes. Moreover, they were all based on 3 study populations that have been extensively investigated in relation to air pollution effects: the Normative Aging Study, Air Pollution and Inflammatory Response in Myocardial Infarction Survivors: Gene-Environment Interaction in a High Risk Group, and Multiethnic Study of Atherosclerosis. In conclusions, the studies differed substantially in both the cardiovascular outcomes examined and the polymorphisms examined, so there is little confirmation of results across cohorts. Gene-environment interaction studies can help explore the mechanisms and the potential pathway in the association between air pollution and a cardiovascular outcome; replication of findings and studies involving multiple cohorts would be needed to draw stronger conclusions.
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Affiliation(s)
- Antonella Zanobetti
- Department of Environmental Health, Exposure Epidemiology and Risk Program, Harvard School of Public Health, Boston, MA 02115, USA.
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Tramuto F, Cusimano R, Cerame G, Vultaggio M, Calamusa G, Maida CM, Vitale F. Urban air pollution and emergency room admissions for respiratory symptoms: a case-crossover study in Palermo, Italy. Environ Health 2011; 10:31. [PMID: 21489245 PMCID: PMC3096899 DOI: 10.1186/1476-069x-10-31] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2010] [Accepted: 04/13/2011] [Indexed: 05/20/2023]
Abstract
BACKGROUND Air pollution from vehicular traffic has been associated with respiratory diseases. In Palermo, the largest metropolitan area in Sicily, urban air pollution is mainly addressed to traffic-related pollution because of lack of industrial settlements, and the presence of a temperate climate that contribute to the limited use of domestic heating plants. This study aimed to investigate the association between traffic-related air pollution and emergency room admissions for acute respiratory symptoms. METHODS From January 2004 through December 2007, air pollutant concentrations and emergency room visits were collected for a case-crossover study conducted in Palermo, Sicily. Risk estimates of short-term exposures to particulate matter and gaseous ambient pollutants including carbon monoxide, nitrogen dioxide, and sulfur dioxide were calculated by using a conditional logistic regression analysis. RESULTS Emergency departments provided data on 48,519 visits for respiratory symptoms. Adjusted case-crossover analyses revealed stronger effects in the warm season for the most part of the pollutants considered, with a positive association for PM10 (odds ratio = 1.039, 95% confidence interval: 1.020 - 1.059), SO2 (OR = 1.068, 95% CI: 1.014 - 1.126), nitrogen dioxide (NO2: OR = 1.043, 95% CI: 1.021 - 1.065), and CO (OR = 1.128, 95% CI: 1.074 - 1.184), especially among females (according to an increase of 10 μg/m3 in PM10, NO2, SO2, and 1 mg/m3 in CO exposure). A positive association was observed either in warm or in cold season only for PM10. CONCLUSIONS Our findings suggest that, in our setting, exposure to ambient levels of air pollution is an important determinant of emergency room (ER) visits for acute respiratory symptoms, particularly during the warm season. ER admittance may be considered a good proxy to evaluate the adverse effects of air pollution on respiratory health.
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Affiliation(s)
- Fabio Tramuto
- Department for Health Promotion Sciences "G. D'Alessandro" - Hygiene section, University of Palermo, Via del Vespro 133, 90127 Palermo, Italy
| | - Rosanna Cusimano
- Department of Public Health, Epidemiology and Preventive Medicine - ASP6 Palermo, Via Siracusa 45, 90141 Palermo, Italy
- Palermo Province Cancer Registry, Department for Health Promotion Sciences "G. D'Alessandro" - Hygiene section, University of Palermo, Via del Vespro 133, 90127 Palermo, Italy
| | - Giuseppe Cerame
- Department for Health Promotion Sciences "G. D'Alessandro" - Hygiene section, University of Palermo, Via del Vespro 133, 90127 Palermo, Italy
| | | | - Giuseppe Calamusa
- Department for Health Promotion Sciences "G. D'Alessandro" - Hygiene section, University of Palermo, Via del Vespro 133, 90127 Palermo, Italy
| | - Carmelo M Maida
- Department for Health Promotion Sciences "G. D'Alessandro" - Hygiene section, University of Palermo, Via del Vespro 133, 90127 Palermo, Italy
| | - Francesco Vitale
- Department for Health Promotion Sciences "G. D'Alessandro" - Hygiene section, University of Palermo, Via del Vespro 133, 90127 Palermo, Italy
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Krmpotic D, Luzar-Stiffler V, Rakusic N, Stipic Markovic A, Hrga I, Pavlovic M. Effects of traffic air pollution and hornbeam pollen on adult asthma hospitalizations in Zagreb. Int Arch Allergy Immunol 2011; 156:62-8. [PMID: 21447960 DOI: 10.1159/000322177] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2010] [Accepted: 10/18/2010] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Environmental factors play an important role in asthma morbidity, although the contribution of individual pollutants or pollens in exacerbating asthma is not completely elucidated. Despite the evidence of importance of the hornbeam pollen in inducing allergic sensitization, its role in provoking asthma exacerbation has not been evaluated. The aim of the present study was to investigate effects of traffic pollutants on adult asthma hospitalization adjusting for pollens including hornbeam. METHODS During a 3-year period, health and environmental data were collected and analyzed. Daily asthma hospitalizations were regressed on pollutants and potential confounding variables using an autoregressive Poisson model. RESULTS The risk of asthma hospitalization was associated significantly with the 95th to 99th percentile increase in levels of nitrogen dioxide (RR = 1.22; 95% CI: 1.05-1.40), carbon monoxide (RR = 1.25; 95% CI: 1.01-1.55) and hornbeam pollen (RR = 1.21; 95% CI: 1.11-1.30). The effect of nitrogen dioxide was delayed by 5 days. No statistically significant increase in the risk of asthma hospitalization was found for PM(10) particles. A comparison among the standardized regression coefficients and their respective p values indicates that the most important risk factor for asthma hospitalization is associated with hornbeam pollen levels. No statistically significant interactions between pollutants and pollens were detected. CONCLUSIONS The current results suggest that traffic-related air pollution is associated with increased risk of adult asthma hospitalization. Nonetheless, the most significant risk for asthma hospitalization is associated with hornbeam pollen levels in the city of Zagreb.
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Affiliation(s)
- Diana Krmpotic
- University Hospital Centre Zagreb, Clinic for Lung Diseases Jordanovac, University of Zagreb School of Medicine, Zagreb, Croatia. krmpotic @ vip.hr
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Silva AMCD, Mattos IE, Freitas SR, Longo KM, Hacon SS. Material particulado (PM2.5) de queima de biomassa e doenças respiratórias no sul da Amazônia brasileira. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2010. [DOI: 10.1590/s1415-790x2010000200015] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJETIVOS: Analisar espacialmente o efeito da exposição ao material particulado (PM2.5) na ocorrência de doenças do aparelho respiratório de crianças de um a quatro anos e de idosos com sessenta e cinco anos ou mais nos municípios do Estado de Mato Grosso em 2004. MÉTODOS: Trata-se de um estudo ecológico em duas etapas. A primeira foi uma investigação da autocorrelação espacial global da prevalência de internações por doenças respiratórias e do percentual de horas críticas de concentração do material particulado nos municípios do estado de Mato Grosso, empregando-se o método bayesiano empírico para minimização das flutuações aleatórias dos indicadores e a estatística Moran "global". A segunda, uma regressão múltipla espacial, teve como variáveis resposta a prevalência de internações por doenças respiratórias, e como variável de exposição o percentual de horas críticas anuais. Para ajuste, foram utilizadas variáveis proxies de poluição do ar, variáveis de atenção à saúde e de condições de vida da população. RESULTADOS: Não foram observados padrões espaciais globais de prevalência de doenças respiratórias em grupos sensíveis nos municípios, mas evidenciou-se elevada dependência espacial do percentual de horas críticas anuais de concentração do material particulado. Na regressão múltipla, foram observadas associações estatisticamente significativas entre a prevalência de internações por doenças respiratórias e o percentual de horas críticas anuais de material particulado. CONCLUSÕES: As emissões de material particulado originadas de queimadas na Amazônia Legal estão relacionadas à prevalência de internações por doenças respiratórias em grupos populacionais sensíveis nos municípios do Estado de Mato Grosso.
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Sanhueza PA, Torreblanca MA, Diaz-Robles LA, Schiappacasse LN, Silva MP, Astete TD. Particulate air pollution and health effects for cardiovascular and respiratory causes in Temuco, Chile: a wood-smoke-polluted urban area. JOURNAL OF THE AIR & WASTE MANAGEMENT ASSOCIATION (1995) 2009; 59:1481-8. [PMID: 20066914 DOI: 10.3155/1047-3289.59.12.1481] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Temuco is one of the most highly wood-smoke-polluted cities in the world. Its population in 2004 was 340,000 inhabitants with 1587 annual deaths, of which 24% were due to cardiovascular and 11% to respiratory causes. For hospital admissions, cardiovascular diseases represented 6% and respiratory diseases 13%. Emergency room visits for acute respiratory infections represented 28%. The objective of the study presented here was to determine the relationship between air pollution from particulate matter less than or equal to 10 microm in aerodynamic diameter (PM10; mostly PM2.5, or particulate matter <2.5 microm in aerodynamic diameter) and health effects measured as the daily number of deaths, hospital admissions, and emergency room visits for cardiovascular, respiratory, and acute respiratory infection (ARI) diseases. The Air Pollution Health Effects European Approach (APHEA2) protocol was followed, and a multivariate Poisson regression model was fitted, controlling for trend, seasonality, and confounders for Temuco during 1998-2006. The results show that PM10 had a significant association with daily mortality and morbidity, with the elderly (population >65 yr of age) being the group that presented the greatest risk. The relative risk for respiratory causes, with an increase of 100 microg/m3 of PM10, was 1.163 with a 95% confidence interval (CI) of 1.057-1.279 for mortality, 1.137 (CI 1.096-1.178) for hospital admissions, and 1.162 for ARI (CI 1.144-1.181). There is evidence in Temuco of positive relationships between ambient particulate levels and mortality, hospital admissions, and ARI for cardiovascular and respiratory diseases. These results are consistent with those of comparable studies in other similar cities where wood smoke is the most important air pollution problem.
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Affiliation(s)
- Pedro A Sanhueza
- Department of Geographical Engineering, University of Santiago de Chile, Santiago, Chile.
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83
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Medina S, Le Tertre A, Saklad M. The Apheis project: Air Pollution and Health-A European Information System. AIR QUALITY, ATMOSPHERE, & HEALTH 2009; 2:185-198. [PMID: 20098507 PMCID: PMC2805804 DOI: 10.1007/s11869-009-0050-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2008] [Accepted: 08/23/2009] [Indexed: 05/25/2023]
Abstract
At a time when the Health Effects Institute, Centers for Disease Control, and Environmental Protection Agency are creating an Environmental Public Health Tracking Program on Air Pollution Effects in the USA, it seemed useful to share the experience acquired since 1999 by the Apheis project (Air Pollution and Health-A European Information System), which has tracked the effects of air pollution on health in 26 European cities and continues to do so as the new Aphekom project. In particular, this paper first describes the continuing impact of air pollution on health in Europe, how the Apheis project came to be and evolved, what its main objectives and achievements have been, and how the project benefited its participants. The paper then summarizes the main learnings of the Apheis project.
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84
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Orazzo F, Nespoli L, Ito K, Tassinari D, Giardina D, Funis M, Cecchi A, Trapani C, Forgeschi G, Vignini M, Nosetti L, Pigna S, Zanobetti A. Air pollution, aeroallergens, and emergency room visits for acute respiratory diseases and gastroenteric disorders among young children in six Italian cities. ENVIRONMENTAL HEALTH PERSPECTIVES 2009; 117:1780-5. [PMID: 20049132 PMCID: PMC2801171 DOI: 10.1289/ehp.0900599] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2009] [Accepted: 08/13/2009] [Indexed: 05/08/2023]
Abstract
BACKGROUND Past studies reported evidence of associations between air pollution and respiratory symptoms and morbidity for children. Few studies examined associations between air pollution and emergency room (ER) visits for wheezing, and even fewer for gastroenteric illness. We conducted a multicity analysis of the relationship between air pollution and ER visits for wheezing and gastroenteric disorder in children 0-2 years of age. METHODS We obtained ER visit records for wheezing and gastroenteric disorder from six Italian cities. A city-specific case-crossover analysis was applied to estimate effects of particulate matter (PM), nitrogen dioxide, sulfur dioxide, ozone, and carbon monoxide, adjusting for immediate and delayed effects of temperature. Lagged effects of air pollutants up to 6 prior days were examined. The city-specific results were combined using a random-effect meta-analysis. RESULTS CO and SO(2) were most strongly associated with wheezing, with a 2.7% increase [95% confidence interval (CI), 0.5-4.9] for a 1.04-microg/m(3) increase in 7-day average CO and a 3.4% (95% CI, 1.5-5.3) increase for an 8.0-microg/m(3) increase in SO(2). Positive associations were also found for PM with aerodynamic diameter < or = 10 microg and NO(2). We found a significant association between the 3-day moving average CO and gastroenteric disorders [3.8% increase (95% CI, 1.0-6.8)]. When data were stratified by season, the associations were stronger in summer for wheezing and in winter for gastroenteric disorders. CONCLUSION Air pollution is associated with triggering of wheezing and gastroenteric disorders in children 0-2 years of age; more work is needed to understand the mechanisms to help prevent wheezing in children.
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Affiliation(s)
- Flavia Orazzo
- Pediatric Emergency Room, Santobono’s Hospital, Naples, Italy
| | - Luigi Nespoli
- Pediatric Emergency Room, Pediatric Department, University of Varese, Varese, Italy
| | - Kazuhiko Ito
- Nelson Institute of Environmental Medicine, New York University School of Medicine, New York, New York, USA
| | - Davide Tassinari
- Pediatric Emergency Room, Pediatric Department, University of Bologna, Bologna, Italy
| | | | - Maurizio Funis
- Pediatric Emergency Room, Pediatric Department, Torre Galli, Florence, Italy
| | | | - Chiara Trapani
- Pediatric Emergency Room, Mayer Hospital, Florence, Italy
| | - Gisella Forgeschi
- Pediatric Emergency Room, Ponte a Niccheri Hospital, Florence, Italy
| | - Massimo Vignini
- Pediatric Emergency Room, Pediatric Department, Salesi Hospital, Ancona, Italy
| | - Luana Nosetti
- Pediatric Emergency Room, Pediatric Department, University of Varese, Varese, Italy
| | - Sabrina Pigna
- Pediatric Emergency Room, Gallarate Pediatric Hospital, Gallarate, Italy
| | - Antonella Zanobetti
- Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts, USA
- Address correspondence to A. Zanobetti, Department of Environmental Health, Exposure Epidemiology, and Risk Program, Harvard School of Public Health, 401 Park Drive, Landmark Center, Suite 415 West, P.O. Box 15698, Boston, MA 02215 USA. Telephone: (617) 384-8751. Fax: (617) 384-8745. E-mail:
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85
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Colbeck I, Lazaridis M. Aerosols and environmental pollution. Naturwissenschaften 2009; 97:117-31. [PMID: 19727639 DOI: 10.1007/s00114-009-0594-x] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2009] [Revised: 07/15/2009] [Accepted: 07/16/2009] [Indexed: 11/30/2022]
Abstract
The number of publications on atmospheric aerosols has dramatically increased in recent years. This review, predominantly from a European perspective, summarizes the current state of knowledge of the role played by aerosols in environmental pollution and, in addition, highlights gaps in our current knowledge. Aerosol particles are ubiquitous in the Earth's atmosphere and are central to many environmental issues; ranging from the Earth's radiative budget to human health. Aerosol size distribution and chemical composition are crucial parameters that determine their dynamics in the atmosphere. Sources of aerosols are both anthropogenic and natural ranging from vehicular emissions to dust resuspension. Ambient concentrations of aerosols are elevated in urban areas with lower values at rural sites. A comprehensive understanding of aerosol ambient characteristics requires a combination of measurements and modeling tools. Legislation for ambient aerosols has been introduced at national and international levels aiming to protect human health and the environment.
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Affiliation(s)
- Ian Colbeck
- Department of Biological Sciences, University of Essex, Colchester, CO4 3SQ, Essex, UK.
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86
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Wolf K, Schneider A, Breitner S, von Klot S, Meisinger C, Cyrys J, Hymer H, Wichmann HE, Peters A. Air temperature and the occurrence of myocardial infarction in Augsburg, Germany. Circulation 2009; 120:735-42. [PMID: 19687361 DOI: 10.1161/circulationaha.108.815860] [Citation(s) in RCA: 156] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Air temperature changes have been associated with cardiovascular mortality and morbidity. The objective of this study was to examine in detail the registry-based myocardial infarction (MI) rates and coronary deaths in relation to air temperature in the area of Augsburg, Germany. METHODS AND RESULTS Between 1995 and 2004, the Monitoring Trends and Determinants on Cardiovascular Diseases/Cooperative Health Research in the Region of Augsburg (MONICA/KORA) registry recorded 9801 cases of MI and coronary deaths. Over the same period, meteorological parameters and air pollutant concentrations were measured in the study region. Poisson regression analyses adjusting for time trend, relative humidity, season, and calendar effects were used to estimate immediate, delayed, and cumulative temperature effects on the occurrence of MIs. The daily rates of total MI, nonfatal and fatal events, and incident and recurrent events were analyzed. For the total MI cases, a 10 degrees C decrease in 5-day average temperature was associated with a relative risk of 1.10 (95% confidence interval, 1.04 to 1.15). The effect of temperature on the occurrence of nonfatal events showed a delayed pattern, whereas the association with fatal MI was more immediate. No association could be observed for recurrent events. The effects of temperature decreases on total MI cases were more pronounced in years with higher average temperatures and were visible in summer. CONCLUSIONS We observed an inverse relationship between temperature and MI occurrence not only during winter but also during summer. Thus, our results suggest not a pure "cold effect" but an influence of unusual temperature decreases.
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Affiliation(s)
- Kathrin Wolf
- Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology, 85764 Neuherberg, Germany.
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87
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Abstract
More research on the effects of air pollutants on health is probably being done today than at any time in history. This is remarkable in view of the fact that, in many developed countries, concentrations of many air pollutants are now low in comparison with earlier periods. The position is much more alarming in the developing world: there pollutant concentrations are rising and effects on health are increasing. Present concerns about even low concentrations of air pollutants have been fuelled by developments in epidemiological techniques: time-series analysis has played a large part in demonstrating that even for common and non-carcinogenic air pollutants such as ozone and sulfur dioxide there may be no threshold of effect - at least, not at a population level. Findings from these studies are discussed in this chapter. Another remarkable advance has been the realisation that long-term exposure to the ambient aerosol increases the likelihood, at all adult ages, of death from cardiovascular disease. This effect may be due to an increased rate of development of atheromatous plaques in the coronary arteries with rupture of plaques leading to myocardial infarction. Time-series studies have revealed that even short-term exposure to particles increases the likelihood of cardiovascular “events” and abnormalities in the rhythm of the heart. It has been suggested that the ultrafine component of the ambient aerosol plays a large part in causing these effects. This has, in part, led to the current surge of interest in nano-toxicology. The suggestion remains unproven.
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88
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Milutinović S, Nikić D, Stosić L, Stanković A, Bogdanović D. Short-term association between air pollution and emergency room admissions for chronic obstructive pulmonary disease in Nis, Serbia. Cent Eur J Public Health 2009; 17:8-13. [PMID: 19418713 DOI: 10.21101/cejph.a3508] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The present study assesses the short-term association between black smoke (BS) and sulphur dioxide (SO2) levels in urban air and the daily number of emergency room admissions for chronic obstructive pulmonary disease (COPD) in Nis, Serbia. Generalised linear models extending Poisson regression were fitted controlling for time trend, seasonal variations, days of the week, temperature, relative humidity, air pressure, precipitation, rainfall, snowfall, overcast, and wind velocity. The emergency room admissions for all ages for COPD were significantly associated with previous-day level of BS and lag 0-2 (1,60% and 2,26% increase per 10 microg/m3, respectively). After controlling for SO2, single lagged (lag 1 and lag 2) as well as mean lagged values of BS (up to lag 0-3) were significantly associated with COPD emergencies. No effect was found for SO2, even after controlling for black smoke. The present findings support the conclusion that current levels of ambient BS may have an effect on the respiratory health of susceptible persons.
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89
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Lundbye-Christensen S, Dethlefsen C, Gorst-Rasmussen A, Fischer T, Schønheyder HC, Rothman KJ, Sørensen HT. Examining secular trends and seasonality in count data using dynamic generalized linear modelling: a new methodological approach illustrated with hospital discharge data on myocardial infarction. Eur J Epidemiol 2009; 24:225-30. [PMID: 19288215 DOI: 10.1007/s10654-009-9325-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2008] [Accepted: 03/03/2009] [Indexed: 01/14/2023]
Abstract
Time series of incidence counts often show secular trends and seasonal patterns. We present a model for incidence counts capable of handling a possible gradual change in growth rates and seasonal patterns, serial correlation, and overdispersion. The model resembles an ordinary time series regression model for Poisson counts. It differs in allowing the regression coefficients to vary gradually over time in a random fashion. During the 1983-1999 period, 17,989 incidents of acute myocardial infarction were recorded in the Hospital Discharge Registry for the county of North Jutland, Denmark. Records were updated daily. A dynamic model with a seasonal pattern and an approximately linear trend was fitted to the data, and diagnostic plots indicated a good model fit. The analysis conducted with the dynamic model revealed peaks coinciding with above-average influenza A activity. On average the dynamic model estimated a higher peak-to-trough ratio than traditional models, and showed gradual changes in seasonal patterns. Analyses conducted with this model provide insights not available from more traditional approaches.
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Affiliation(s)
- S Lundbye-Christensen
- Department of Cardiology, Center for Cardiovascular Research, Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark.
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90
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Zanobetti A, Bind MAC, Schwartz J. Particulate air pollution and survival in a COPD cohort. Environ Health 2008; 7:48. [PMID: 18847462 PMCID: PMC2572050 DOI: 10.1186/1476-069x-7-48] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2008] [Accepted: 10/10/2008] [Indexed: 05/07/2023]
Abstract
BACKGROUND Several studies have shown cross-sectional associations between long term exposure to particulate air pollution and survival in general population or convenience cohorts. Less is known about susceptibility, or year to year changes in exposure. We investigated whether particles were associated with survival in a cohort of persons with COPD in 34 US cities, eliminating the usual cross-sectional exposure and treating PM10 as a within city time varying exposure. METHODS Using hospital discharge data, we constructed a cohort of persons discharged alive with chronic obstructive pulmonary disease using Medicare data between 1985 and 1999. 12-month averages of PM10 were merged to the individual annual follow up in each city. We applied Cox's proportional hazard regression model in each city, with adjustment for individual risk factors. RESULTS We found significant associations in the survival analyses for single year and multiple lag exposures, with a hazard ratio for mortality for an increase of 10 microg/m(3) PM10 over the previous 4 years of 1.22 (95% CI: 1.17-1.27). CONCLUSION Persons discharged alive for COPD have substantial mortality risks associated with exposure to particles. The risk is evident for exposure in the previous year, and higher in a 4 year distributed lag model. These risks are significantly greater than seen in time series analyses.
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Affiliation(s)
- Antonella Zanobetti
- Department of Environmental Health, Harvard School of Public Health, Boston, USA
| | - Marie-Abele C Bind
- Department of Environmental Health, Harvard School of Public Health, Boston, USA
| | - Joel Schwartz
- Department of Environmental Health, Harvard School of Public Health, Boston, USA
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91
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Forastiere F, Stafoggia M, Berti G, Bisanti L, Cernigliaro A, Chiusolo M, Mallone S, Miglio R, Pandolfi P, Rognoni M, Serinelli M, Tessari R, Vigotti M, Perucci CA. Particulate matter and daily mortality: a case-crossover analysis of individual effect modifiers. Epidemiology 2008; 19:571-80. [PMID: 18467959 DOI: 10.1097/ede.0b013e3181761f8a] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Several time-series studies have established the relationship between particulate matter (PM10) and mortality. We adopted a case-crossover design to evaluate whether individual socio-demographic characteristics and chronic or acute medical conditions modify the PM10-mortality association. METHODS We selected all natural deaths (321,024 subjects) occurring among adult (aged 35+ years) residents of 9 Italian cities between 1997 and 2004. We had access to individual information on socio-demographic variables, location of death, and chronic conditions (hospital admissions in the preceding 2-year period). For in-hospital deaths, we collected information on treatment wards at time of death and acute medical conditions. In a case-crossover analysis we adjusted for time, population changes, and meteorological conditions. RESULTS PM10 was associated with mortality among subjects age 65 years and older (0.75% increase per 10 microg/m3 [95% confidence interval = 0.42% to 1.09%]), with a more pronounced effect among people age 85 and older. A weaker effect was found among the most affluent people. The effect was present for both out-of-hospital and in-hospital deaths, especially among those treated in general medicine and other less specialized wards. PM10 effects were stronger among people with diabetes (1.03% [0.28% to 1.79%]) and chronic obstructive pulmonary disease (0.84% [0.17% to 1.52%]). The acute conditions with the largest effect estimates were acute impairment of pulmonary circulation (4.56% [0.75% to 8.51%]) and heart failure (1.67% [0.30% to 3.04%]). CONCLUSIONS Several factors, including advanced age, type of hospital ward, and chronic and acute health conditions, modify the PM10-related risk of death. Altered pulmonary circulation and heart failure are important effect modifiers, suggesting that cardiac decompensation is a possible mechanism of the fatal PM10 effect.
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92
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Stafoggia M, Schwartz J, Forastiere F, Perucci CA. Does temperature modify the association between air pollution and mortality? A multicity case-crossover analysis in Italy. Am J Epidemiol 2008; 167:1476-85. [PMID: 18408228 DOI: 10.1093/aje/kwn074] [Citation(s) in RCA: 168] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Adverse health effects of particulate matter <10 microm in aerodynamic diameter (PM(10)) and high temperatures are well known, but the extent of their interaction on mortality is less clear. This paper describes effect modification of temperature in the PM(10)-mortality association and tests the hypothesis that higher PM(10) effects in summer are due to enhanced exposure to particles. All deaths of residents of nine Italian cities between 1997 and 2004 were selected. The case-crossover approach was adopted to estimate the effect of PM(10) on mortality by season and temperature level. Three strata of temperature corresponding to low, medium, and high "ventilation" were identified, and the interaction between PM(10) and temperature within each stratum was examined. Season and temperature levels strongly modified the PM(10)-mortality association: for a 10-microg/m(3) variation in PM(10), a 2.54% increase in risk of death in summer (95% confidence interval: 1.31, 3.78) compared with 0.20% (95% confidence interval: -0.08, 0.49) in winter. Analysis of the interaction between PM(10) and temperature within temperature strata resulted in positive but, in most cases, nonstatistically significant coefficients. The authors found much higher PM(10) effects on mortality during warmer days. The hypothesis that such an effect is attributable to enhanced exposure to particles in summer could not be rejected.
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Affiliation(s)
- M Stafoggia
- Department of Epidemiology, Rome E Health Authority, Rome, Italy.
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93
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94
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Chen G, Song G, Jiang L, Zhang Y, Zhao N, Chen B, Kan H. Short‐term Effects of Ambient Gaseous Pollutants and Particulate Matter on Daily Mortality in Shanghai, China. J Occup Health 2008; 50:41-7. [DOI: 10.1539/joh.50.41] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Affiliation(s)
- Guohai Chen
- Shanghai Environmental Monitoring CenterChina
| | - Guixiang Song
- Shanghai Municipal Center of Disease Control and PreventionChina
| | - Lili Jiang
- Shanghai Municipal Center of Disease Control and PreventionChina
| | | | - Naiqing Zhao
- Department of Health StatisticsSchool of Public Health, Fudan UniversityChina
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95
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Bilancia M, Stea G. Timescale effect estimation in time-series studies of air pollution and health: A Singular Spectrum Analysis approach. Electron J Stat 2008. [DOI: 10.1214/07-ejs123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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96
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Samoli E, Touloumi G, Schwartz J, Anderson HR, Schindler C, Forsberg B, Vigotti MA, Vonk J, Kosnik M, Skorkovsky J, Katsouyanni K. Short-term effects of carbon monoxide on mortality: an analysis within the APHEA project. ENVIRONMENTAL HEALTH PERSPECTIVES 2007; 115:1578-83. [PMID: 18007988 PMCID: PMC2072841 DOI: 10.1289/ehp.10375] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2007] [Accepted: 08/15/2007] [Indexed: 05/19/2023]
Abstract
OBJECTIVES We investigated the short-term effects of carbon monoxide on total and cardiovascular mortality in 19 European cities participating in the APHEA-2 (Air Pollution and Health: A European Approach) project. METHODS We examined the association using hierarchical models implemented in two stages. In the first stage, data from each city were analyzed separately, whereas in the second stage the city-specific air pollution estimates were regressed on city-specific covariates to obtain overall estimates and to explore sources of possible heterogeneity. We evaluated the sensitivity of our results by applying different degrees of smoothing for seasonality control in the city-specific analysis. RESULTS We found significant associations of CO with total and cardiovascular mortality. A 1-mg/m(3) increase in the 2-day mean of CO levels was associated with a 1.20% [95% confidence interval (CI), 0.63-1.77%] increase in total deaths and a 1.25% (95% CI, 0.30-2.21%) increase in cardiovascular deaths. There was indication of confounding with black smoke and nitrogen dioxide, but the pollutant-adjusted effect of CO on mortality remained at least marginally statistically significant. The effect of CO on total and cardiovascular mortality was observed mainly in western and southern European cities and was larger when the standardized mortality rate was lower. CONCLUSIONS The results of this large study are consistent with an independent effect of CO on mortality. The heterogeneity found in the effect estimates among cities may be explained partly by specific city characteristics.
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Affiliation(s)
- Evangelia Samoli
- Department of Hygiene and Epidemiology, University of Athens Medical School, Athens, Greece.
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97
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Migliaretti G, Dalmasso P, Gregori D. Air pollution effects on the respiratory health of the resident adult population in Turin, Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2007; 17:369-379. [PMID: 17924265 DOI: 10.1080/09603120701628768] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
A case-control study was employed to investigate the relationship between atmospheric pollution and emergency hospital attendance for respiratory causes among adult and elderly patients resident in Turin in the period 1997 - 1999. Based on the primary diagnosis, adult (15 - 64 years) and elderly (>64 years) patients resident in Turin and admitted for respiratory causes were defined as Cases (n1 = 4.645); adult and elderly patients admitted for causes other than respiratory diseases or heart diseases were defined as Controls (n2 = 152.954). Sulfur dioxide (SO2 in microg/m3), total suspended particulate (TSP in microg/m3) and carbon monoxide (CO in mg/m3) were taken as indicators of urban air pollution; principal confounding factors were patient sex, age and education level; season, temperature, humidity, solar radiation; day of hospital admission. Statistical analysis was performed using logistic regression models. In accordance with Odds Ratio (OR) values and relative 95% Confidence Intervals (OR_95% CI) estimated by the models, associations are expressed as percent increase in risk (Increase%)1 and relative 95% Confidence Interval (95% CI) per 10 microg/m3 in SO2 and TSP, and per 1 mg/m3 in CO exposure. After adjusting for confounding factors, there was a mean increase in emergency hospital attendance of 2.20% (95% CI 1.70 - 2.60) and 2.55% (95% CI 1.79 - 3.32) per 10 microg/m3 increase in exposure to SO2 and TSP, respectively, and a mean increase of 5.30% (95% CI 3.00 - 7.70) per 1 mg/m3 increase in exposure to CO. A significant association was separately confirmed for SO2 and TSP in adult (15 - 64 years) and elderly (>64 years) patients, but for CO only among elderly patients. A significant association was found between the increase in emergency hospital attendance for respiratory causes and exposure to sulfur dioxide, total suspended particulate and carbon monoxide in Turin during the study period. This easy to use and manage case-control study produced results in line with those reported for other Italian and European cities.
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98
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Erbas B, Chang JH, Dharmage S, Ong EK, Hyndman R, Newbigin E, Abramson M. Do levels of airborne grass pollen influence asthma hospital admissions? Clin Exp Allergy 2007; 37:1641-7. [PMID: 17877763 DOI: 10.1111/j.1365-2222.2007.02818.x] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND The effects of environmental factors and ambient concentrations of grass pollen on allergic asthma are yet to be established. OBJECTIVE We sought to estimate the independent effects of grass pollen concentrations in the air over Melbourne on asthma hospital admissions for the 1992-1993 pollen season. METHODS Daily grass pollen concentrations were monitored over a 24-h period at three stations in Melbourne. The outcome variable was defined as all-age asthma hospital admissions with ICD9-493 codes. The ambient air pollutants were average daily measures of ozone, nitrogen dioxide and sulphur dioxide, and the airborne particle index representing fine particulate pollution. Semi-parametric Poisson regression models were used to estimate these effects, adjusted for air temperature, humidity, wind speed, rainfall, day-of-the-week effects and seasonal variation. RESULTS Grass pollen was a strong independent non-linear predictor of asthma hospital admissions in a multi-pollutant model (P=0.01). Our data suggest that grass pollen had an increasing effect on asthma hospital admissions up to a threshold of 30 grains/m3, and that the effect remains stable thereafter. CONCLUSION Our findings suggest that grass pollen levels influence asthma hospital admissions. High grass pollen days, currently defined as more than 50 grains/m3, are days when most sensitive individuals will experience allergic symptoms. However, some asthmatic patients may be at a significant risk even when airborne grass pollen levels are below this level. Patients with pollen allergies and asthma would be advised to take additional preventive medication at lower ambient concentrations.
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Affiliation(s)
- B Erbas
- Centre for Molecular Environmental Genetic Analytic Epidemiology, School of Population Health, University of Melbourne, Carlton, Vic., Australia.
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99
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Rückerl R, Greven S, Ljungman P, Aalto P, Antoniades C, Bellander T, Berglind N, Chrysohoou C, Forastiere F, Jacquemin B, von Klot S, Koenig W, Küchenhoff H, Lanki T, Pekkanen J, Perucci CA, Schneider A, Sunyer J, Peters A. Air pollution and inflammation (interleukin-6, C-reactive protein, fibrinogen) in myocardial infarction survivors. ENVIRONMENTAL HEALTH PERSPECTIVES 2007; 115:1072-80. [PMID: 17637925 PMCID: PMC1913563 DOI: 10.1289/ehp.10021] [Citation(s) in RCA: 207] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2006] [Accepted: 04/18/2007] [Indexed: 05/16/2023]
Abstract
BACKGROUND Numerous studies have found that ambient air pollution has been associated with cardiovascular disease exacerbation. OBJECTIVES Given previous findings, we hypothesized that particulate air pollution might induce systemic inflammation in myocardial infarction (MI) survivors, contributing to an increased vulnerability to elevated concentrations of ambient particles. METHODS A prospective longitudinal study of 1,003 MI survivors was performed in six European cities between May 2003 and July 2004. We compared repeated measurements of interleukin 6 (IL-6), fibrinogen, and C-reactive protein (CRP) with concurrent levels of air pollution. We collected hourly data on particle number concentrations (PNC), mass concentrations of particulate matter (PM) < 10 microm (PM(10)) and < 2.5 microm (PM(2.5)), gaseous pollutants, and meteorologic data at central monitoring sites in each city. City-specific confounder models were built for each blood marker separately, adjusting for meteorology and time-varying and time-invariant covariates. Data were analyzed with mixed-effects models. RESULTS Pooled results show an increase in IL-6 when concentrations of PNC were elevated 12-17 hr before blood withdrawal [percent change of geometric mean, 2.7; 95% confidence interval (CI), 1.0-4.6]. Five day cumulative exposure to PM(10) was associated with increased fibrinogen concentrations (percent change of arithmetic mean, 0.6; 95% CI, 0.1-1.1). Results remained stable for smokers, diabetics, and patients with heart failure. No consistent associations were found for CRP. CONCLUSIONS Results indicate an immediate response to PNC on the IL-6 level, possibly leading to the production of acute-phase proteins, as seen in increased fibrinogen levels. This might provide a link between air pollution and adverse cardiac events.
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Affiliation(s)
- Regina Rückerl
- GSF National Research Centre for Environment and Health, Institute of Epidemiology, Neuherberg, Germany.
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Zanobetti A, Schwartz J. Particulate air pollution, progression, and survival after myocardial infarction. ENVIRONMENTAL HEALTH PERSPECTIVES 2007; 115:769-75. [PMID: 17520066 PMCID: PMC1867961 DOI: 10.1289/ehp.9201] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2006] [Accepted: 02/20/2007] [Indexed: 05/03/2023]
Abstract
OBJECTIVE Several studies have examined the effect of particulate pollution (PM) on survival in general populations, but less is known about susceptible groups. Moreover, previous cohort studies have been cross-sectional and subject to confounding by uncontrolled differences between cities. DESIGN We investigated whether PM was associated with progression of disease or reduced survival in a study of 196,000 persons from 21 U.S. cities discharged alive following an acute myocardial infarction (MI), using within-city between-year exposure to PM. We constructed city-specific cohorts of survivors of acute MI using Medicare data between 1985 and 1999, and defined three outcomes on follow-up: death, subsequent MI, and a first admission for congestive heart failure (CHF). Yearly averages of PM(10) (particulate matter with aerodynamic diameter < 10 microm) were merged to the individual annual follow-up in each city. We applied Cox's proportional hazard regression model in each city, with adjustment for individual risk factors. In the second stage of the analysis, the city-specific results were combined using a meta-regression. RESULTS We found significant associations with a hazard ratio for the sum of the distributed lags of 1.3 [95% confidence interval (CI), 1.2-1.5] for mortality, a hazard ratio of 1.4 (95% CI, 1.2-1.7) for a hospitalization for CHF, and a hazard ratio of 1.4 (95% CI, 1.1-1.8) for a new hospitalization for MI per 10 microg/m(3) PM(10). CONCLUSIONS This is the first long-term study showing a significant association between particle exposure and adverse post-MI outcomes in persons who survived an MI.
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Affiliation(s)
- Antonella Zanobetti
- Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts 02215, USA.
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