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Zhao Y, Wang S, Lang L, Huang C, Ma W, Lin H. Ambient fine and coarse particulate matter pollution and respiratory morbidity in Dongguan, China. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2017; 222:126-131. [PMID: 28041838 DOI: 10.1016/j.envpol.2016.12.070] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 12/23/2016] [Accepted: 12/24/2016] [Indexed: 06/06/2023]
Abstract
We estimated the short-term effects of particulate matter (PM) pollution with aerodynamic diameters ≤2.5 μm (PM2.5) and between 2.5 and 10 μm (PMc) on hospital outpatient visits due to overall and specific respiratory diseases, as well as the associated morbidity burden in Dongguan, a subtropical city in South China. A time-series model with quasi-Poisson link was used to examine the association between PM pollution and morbidities from respiratory diseases, COPD, asthma and pneumonia in Dongguan during 2013-2015. We further estimated the morbidity burden (population attributable fraction and attributable morbidity) due to ambient PM pollution. A total of 44,801 hospital outpatient visits for respiratory diseases were recorded during the study period. Both PM2.5 and PMc were found to be significantly associated with morbidity of overall respiratory diseases, COPD, and asthma. An IQR (interquartile range) increase in PM2.5 at lag03 day was associated with 15.41% (95% CI: 10.99%, 20.01%) increase in respiratory morbidity, and each IQR increase in PMc at lag03 corresponded to 7.24% (95% CI: 4.25%, 10.32%) increase in respiratory morbidity. We did not find significant effects of PM2.5 and PMc on pneumonia. Using WHO's guideline (25 μg/m3) as reference concentration, about 8.32% (95% CI: 5.90%, 10.86%) of respiratory morbidity (3727, 95% CI: 2642, 4867, in morbidity number) were estimated to be attributed to PM2.5, and 0.86% (95% CI: 0.50%, 1.23%) of respiratory morbidity, representing 385 (95% CI: 225, 551) hospital outpatient visits, could be attributed to coarse particulate pollutant. Our study suggests that both fine and coarse particulate pollutants are an important trigger of hospital outpatient visits for respiratory diseases, and account for substantial respiratory morbidity in Dongguan, China.
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Affiliation(s)
- Yiju Zhao
- Department of Respirator Medicine, The Fifth People's Hospital of Dongguan, Dongguan, China
| | | | - Lingling Lang
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Caiyan Huang
- Department of Respirator Medicine, The Fifth People's Hospital of Dongguan, Dongguan, China
| | - Wenjun Ma
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China.
| | - Hualiang Lin
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China.
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52
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Huang F, Luo Y, Tan P, Xu Q, Tao L, Guo J, Zhang F, Xie X, Guo X. Gaseous Air Pollution and the Risk for Stroke Admissions: A Case-Crossover Study in Beijing, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14020189. [PMID: 28216595 PMCID: PMC5334743 DOI: 10.3390/ijerph14020189] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Revised: 01/15/2017] [Accepted: 01/27/2017] [Indexed: 01/11/2023]
Abstract
Background: Though increasing evidence supports association between gaseous air pollution and stroke, it remains unclear whether the effects differ in season, sex and age. The aim of this study was to examine the associations of gaseous air pollution with stroke admissions in Beijing, 2013–2014 in different subgroups. Methods: Case-crossover design and conditional logistic regression were used to perform the analyses. We examined the exposure-response relationship between air pollution and stroke. Stratified analyses were performed in different seasons, sex, and age groups. Results: There were 147,624 stroke admissions during the study period. In the whole study period, percent changes of stroke admissions were 0.82% (95% CI: 0.52% to 1.13%) and 0.73% (95% CI: 0.44% to 1.03%) per 10 μg/m3 increase in the same day conentration of nitrogen dioxide (NO2) and sulfur dioxide (SO2). The positive associations were higher in warm seasons and with patients >65 years (p < 0.05). Contrary effects of carbon monoxide (CO) and ozone on stroke admissions were observed in different seasons. Conclusions: NO2 and SO2 were positively associated with stroke admissions, with stronger effects in warm seasons and with patients >65 years. The associations of CO and ozone with stroke admissions differed across seasons.
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Affiliation(s)
- Fangfang Huang
- School of Public Health, Capital Medical University, Beijing 100069, China.
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China.
| | - Yanxia Luo
- School of Public Health, Capital Medical University, Beijing 100069, China.
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China.
| | - Peng Tan
- Beijing Public Health Information Center, Beijing 100050, China.
| | - Qin Xu
- School of Public Health, Capital Medical University, Beijing 100069, China.
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China.
| | - Lixin Tao
- School of Public Health, Capital Medical University, Beijing 100069, China.
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China.
| | - Jin Guo
- School of Public Health, Capital Medical University, Beijing 100069, China.
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China.
| | - Feng Zhang
- School of Public Health, Capital Medical University, Beijing 100069, China.
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China.
| | - Xueqin Xie
- Beijing Public Health Information Center, Beijing 100050, China.
| | - Xiuhua Guo
- School of Public Health, Capital Medical University, Beijing 100069, China.
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China.
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53
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Li R, Jiang N, Liu Q, Huang J, Guo X, Liu F, Gao Z. Impact of Air Pollutants on Outpatient Visits for Acute Respiratory Outcomes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14010047. [PMID: 28067786 PMCID: PMC5295298 DOI: 10.3390/ijerph14010047] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2016] [Revised: 12/24/2016] [Accepted: 01/03/2017] [Indexed: 12/14/2022]
Abstract
The air pollution in China is a severe problem. The aim of our study was to investigate the impact of air pollutants on acute respiratory outcomes in outpatients. Outpatient data from 2 December 2013 to 1 December 2014 were collected, as well as air pollutant data including ozone (O₃), nitrogen dioxide (NO₂), carbon monoxide (CO), sulfur dioxide (SO₂), and particulate matter (PM2.5 and PM10). We screened six categories of acute respiratory outcomes and analyzed their associations with different air pollutant exposures, including upper respiratory tract infection (URTI), acute bronchitis (AB), community-acquired pneumonia (CAP), acute exacerbation of chronic obstructive pulmonary disease (AECOPD), acute exacerbation of asthma (AE-asthma), and acute exacerbation of bronchiectasis (AEBX). A case-crossover design with a bidirectional control sampling approach was used for statistical analysis. A total of 57,144 patients were enrolled for analysis. PM2.5, PM10, NO₂, SO₂, and CO exposures were positively associated with outpatient visits for URTI, AB, CAP, and AEBX. PM10, SO₂, and CO exposures were positively associated with outpatient visits for AECOPD. Exposure to O₃ was positively associated with outpatient visits for AE-asthma, but negatively associated with outpatient visits for URTI, CAP, and AEBX. In conclusion, air pollutants had acute effects on outpatient visits for acute respiratory outcomes, with specific outcomes associated with specific pollutants.
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Affiliation(s)
- Ran Li
- Department of Respiratory and Critical Care Medicine, Peking University People's Hospital, Beijing 100044, China.
| | - Ning Jiang
- Department of Respiratory and Critical Care Medicine, Peking University People's Hospital, Beijing 100044, China.
| | - Qichen Liu
- School of Public Health, Peking University, Beijing 100871, China.
| | - Jing Huang
- School of Public Health, Peking University, Beijing 100871, China.
| | - Xinbiao Guo
- School of Public Health, Peking University, Beijing 100871, China.
| | - Fan Liu
- Department of Respiratory and Critical Care Medicine, Peking University People's Hospital, Beijing 100044, China.
| | - Zhancheng Gao
- Department of Respiratory and Critical Care Medicine, Peking University People's Hospital, Beijing 100044, China.
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54
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Lin H, Liu T, Xiao J, Zeng W, Li X, Guo L, Zhang Y, Xu Y, Tao J, Xian H, Syberg KM, Qian ZM, Ma W. Mortality burden of ambient fine particulate air pollution in six Chinese cities: Results from the Pearl River Delta study. ENVIRONMENT INTERNATIONAL 2016; 96:91-97. [PMID: 27639206 DOI: 10.1016/j.envint.2016.09.007] [Citation(s) in RCA: 125] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 08/17/2016] [Accepted: 09/07/2016] [Indexed: 05/12/2023]
Abstract
BACKGROUND Epidemiological studies have reported significant association between ambient fine particulate matter air pollution (PM2.5) and mortality, however, few studies have investigated the relationship of mortality with PM2.5 and associated mortality burden in China, especially in a multicity setting. METHODS We investigated the PM2.5-mortality association in six cities of the Pearl River Delta region from 2013 to 2015. We used generalized additive Poisson models incorporating penalized smoothing splines to control for temporal trend, temperature, and relative humidity. We applied meta-analyses using random-effects models to pool the effect estimates in the six cities. We also examined these associations in stratified analyses by sex, age group, education level and location of death. We further estimated the mortality burden (attributable fraction and attributable mortality) due to ambient PM2.5 exposures. RESULTS During the study period, a total of 316,305 deaths were recorded in the study area. The analysis revealed a significant association between PM2.5 and mortality. Specifically, a 10μg/m3 increase in 4-day averaged (lag03) PM2.5 concentration corresponded to a 1.76% (95% confidence interval (CI): 1.47%, 2.06%) increase in total mortality, 2.19% (95% CI: 1.80%, 2.59%) in cardiovascular mortality, and 1.68% (95% CI: 1.00%, 2.37%) in respiratory mortality. The results were generally robust to model specifications and adjustment of gaseous air pollutants. We estimated that 0.56% (95% CI: 0.47%, 0.66%) and 3.79% (95% CI: 3.14%, 4.45%) of all-cause mortalities were attributable to PM2.5 using China's and WHO's air quality standards as the reference, corresponding to 1661 (95% CI: 1379, 1946) and 11,176 (95% CI: 9261, 13,120) attributable premature mortalities, respectively. CONCLUSION This analysis adds to the growing body of evidence linking PM2.5 with daily mortality, and mortality burdens, particularly in one Chinese region with high levels of air pollution.
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Affiliation(s)
- Hualiang Lin
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Tao Liu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Jianpeng Xiao
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Weilin Zeng
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Xing Li
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Lingchuan Guo
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Yonghui Zhang
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Yanjun Xu
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Jun Tao
- South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou, China
| | - Hong Xian
- College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO 63104, USA
| | - Kevin M Syberg
- College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO 63104, USA
| | - Zhengmin Min Qian
- College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO 63104, USA.
| | - Wenjun Ma
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China.
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55
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Weitzman M, Yusufali AH, Bali F, Vilcassim MJR, Gandhi S, Peltier R, Nadas A, Sherman S, Lee L, Hong Z, Shearston J, Park SH, Gordon T. Effects of hookah smoking on indoor air quality in homes. Tob Control 2016; 26:586-591. [PMID: 27798320 DOI: 10.1136/tobaccocontrol-2016-053165] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 08/24/2016] [Accepted: 09/07/2016] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Hookahs (water pipes) are rapidly increasing in popularity worldwide. Evidence suggests that although perceived as safer than cigarette smoke, hookah smoke may be as, or even more, dangerous as cigarette smoke. METHODS Air samples from 33 homes-11 where only hookah-smoking occurred, 12 with only cigarettes and 10 with no smoking-were collected to analyse concentrations of particulate matter (PM2.5), black carbon, elemental and organic carbon and carbon monoxide (CO). Air quality was assessed in rooms where smoking occurred and in an adjacent room. RESULTS Hookah and cigarette smoking impaired home air quality. The rooms in which hookahs were smoked showed the highest concentrations for all pollutants. CO was significantly greater in the rooms where hookahs were smoked than in the cigarette-smoking rooms and the non-smoking households (p<0.05). In addition, CO levels in the rooms adjacent to where hookah was smoked were 2.5-fold to 4-fold greater than those in the smoking and non-smoking rooms of the cigarette homes (p<0.05). PM2.5 levels were also elevated in hookah homes compared to cigarette and non-smoking homes, although not significantly different. CONCLUSIONS This study, the first of its kind, demonstrates potentially hazardous levels of home air pollution in rooms where hookahs are being smoked as well as in adjacent rooms. These levels were greater than those in cigarette smoking homes, raising concerns about potential negative health effects on all individuals living in homes where hookahs are smoked.
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Affiliation(s)
- Michael Weitzman
- Department of Pediatrics, New York University, School of Medicine, New York, New York, USA.,College of Global Public Health, New York University, New York, New York, USA.,Department of Environmental Medicine, New York University, School of Medicine, New York, New York, USA.,New York University/Abu Dhabi Public Health Research Center, Abu Dhabi, UAE
| | - Afzal Hussein Yusufali
- New York University/Abu Dhabi Public Health Research Center, Abu Dhabi, UAE.,Hatta Hospital, Dubai Health Authority, Dubai, UAE
| | - Fatma Bali
- New York University/Abu Dhabi Public Health Research Center, Abu Dhabi, UAE.,Hatta Hospital, Dubai Health Authority, Dubai, UAE
| | - M J Ruzmyn Vilcassim
- Department of Environmental Medicine, New York University, School of Medicine, New York, New York, USA
| | - Shashank Gandhi
- Department of Biology, New York University, New York, New York, USA
| | - Richard Peltier
- Department of Environmental Health Sciences, University of Massachusetts, Amherst, Massachusetts, USA
| | - Arthur Nadas
- Department of Environmental Medicine, New York University, School of Medicine, New York, New York, USA
| | - Scott Sherman
- New York University/Abu Dhabi Public Health Research Center, Abu Dhabi, UAE.,College of Global Public Health, New York University, New York, New York, USA.,Department of Population Health, New York University, School of Medicine, New York, New York, USA
| | - Lily Lee
- Department of Pediatrics, New York University, School of Medicine, New York, New York, USA.,Brooklyn College, Brooklyn, New York, USA
| | - Zhang Hong
- Department of Pediatrics, New York University, School of Medicine, New York, New York, USA
| | - Jenni Shearston
- Department of Population Health, New York University, School of Medicine, New York, New York, USA
| | - Su Hyun Park
- Department of Pediatrics, New York University, School of Medicine, New York, New York, USA
| | - Terry Gordon
- College of Global Public Health, New York University, New York, New York, USA.,Department of Environmental Medicine, New York University, School of Medicine, New York, New York, USA.,New York University/Abu Dhabi Public Health Research Center, Abu Dhabi, UAE
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56
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Lin H, Ma W, Qiu H, Vaughn MG, Nelson EJ, Qian Z, Tian L. Is standard deviation of daily PM2.5 concentration associated with respiratory mortality? ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2016; 216:208-214. [PMID: 27262134 DOI: 10.1016/j.envpol.2016.05.068] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 05/09/2016] [Accepted: 05/24/2016] [Indexed: 06/05/2023]
Abstract
Studies on health effects of air pollution often use daily mean concentration to estimate exposure while ignoring daily variations. This study examined the health effects of daily variation of PM2.5. We calculated daily mean and standard deviations of PM2.5 in Hong Kong between 1998 and 2011. We used a generalized additive model to estimate the association between respiratory mortality and daily mean and variation of PM2.5, as well as their interaction. We controlled for potential confounders, including temporal trends, day of the week, meteorological factors, and gaseous air pollutants. Both daily mean and standard deviation of PM2.5 were significantly associated with mortalities from overall respiratory diseases and pneumonia. Each 10 μg/m(3) increment in daily mean concentration at lag 2 day was associated with a 0.61% (95% CI: 0.19%, 1.03%) increase in overall respiratory mortality and a 0.67% (95% CI: 0.14%, 1.21%) increase in pneumonia mortality. And a 10 μg/m(3) increase in standard deviation at lag 1 day corresponded to a 1.40% (95% CI: 0.35%, 2.46%) increase in overall respiratory mortality, and a 1.80% (95% CI: 0.46%, 3.16%) increase in pneumonia mortality. We also observed a positive but non-significant synergistic interaction between daily mean and variation on respiratory mortality and pneumonia mortality. However, we did not find any significant association with mortality from chronic obstructive pulmonary diseases. Our study suggests that, besides mean concentration, the standard deviation of PM2.5 might be one potential predictor of respiratory mortality in Hong Kong, and should be considered when assessing the respiratory effects of PM2.5.
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Affiliation(s)
- Hualiang Lin
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Wenjun Ma
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Hong Qiu
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong, China
| | - Michael G Vaughn
- College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO 63104, USA
| | - Erik J Nelson
- College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO 63104, USA
| | - Zhengmin Qian
- College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO 63104, USA.
| | - Linwei Tian
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong, China.
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57
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Ko FW, Chan KP, Hui DS, Goddard JR, Shaw JG, Reid DW, Yang IA. Acute exacerbation of COPD. Respirology 2016; 21:1152-65. [PMID: 27028990 PMCID: PMC7169165 DOI: 10.1111/resp.12780] [Citation(s) in RCA: 204] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Revised: 12/18/2015] [Accepted: 01/20/2016] [Indexed: 01/14/2023]
Abstract
The literature of acute exacerbation of chronic obstructive pulmonary disease (COPD) is fast expanding. This review focuses on several aspects of acute exacerbation of COPD (AECOPD) including epidemiology, diagnosis and management. COPD poses a major health and economic burden in the Asia-Pacific region, as it does worldwide. Triggering factors of AECOPD include infectious (bacteria and viruses) and environmental (air pollution and meteorological effect) factors. Disruption in the dynamic balance between the 'pathogens' (viral and bacterial) and the normal bacterial communities that constitute the lung microbiome likely contributes to the risk of exacerbations. The diagnostic approach to AECOPD varies based on the clinical setting and severity of the exacerbation. After history and examination, a number of investigations may be useful, including oximetry, sputum culture, chest X-ray and blood tests for inflammatory markers. Arterial blood gases should be considered in severe exacerbations, to characterize respiratory failure. Depending on the severity, the acute management of AECOPD involves use of bronchodilators, steroids, antibiotics, oxygen and noninvasive ventilation. Hospitalization may be required, for severe exacerbations. Nonpharmacological interventions including disease-specific self-management, pulmonary rehabilitation, early medical follow-up, home visits by respiratory health workers, integrated programmes and telehealth-assisted hospital at home have been studied during hospitalization and shortly after discharge in patients who have had a recent AECOPD. Pharmacological approaches to reducing risk of future exacerbations include long-acting bronchodilators, inhaled steroids, mucolytics, vaccinations and long-term macrolides. Further studies are needed to assess the cost-effectiveness of these interventions in preventing COPD exacerbations.
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Affiliation(s)
- Fanny W Ko
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong.
| | - Ka Pang Chan
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong
| | - David S Hui
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong
| | - John R Goddard
- School of Medicine, The University of Queensland, Brisbane, Australia.,Department of Thoracic Medicine, The Prince Charles Hospital, Metro North Hospital and Health District, Brisbane, Australia
| | - Janet G Shaw
- School of Medicine, The University of Queensland, Brisbane, Australia.,Department of Thoracic Medicine, The Prince Charles Hospital, Metro North Hospital and Health District, Brisbane, Australia
| | - David W Reid
- School of Medicine, The University of Queensland, Brisbane, Australia.,Department of Thoracic Medicine, The Prince Charles Hospital, Metro North Hospital and Health District, Brisbane, Australia.,Lung Infection and Inflammation Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Ian A Yang
- School of Medicine, The University of Queensland, Brisbane, Australia.,Department of Thoracic Medicine, The Prince Charles Hospital, Metro North Hospital and Health District, Brisbane, Australia
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Zhao Z, Chen R, Lin Z, Cai J, Yang Y, Yang D, Norback D, Kan H. Ambient carbon monoxide associated with alleviated respiratory inflammation in healthy young adults. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2016; 208:294-298. [PMID: 26282584 DOI: 10.1016/j.envpol.2015.07.029] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Revised: 07/08/2015] [Accepted: 07/18/2015] [Indexed: 06/04/2023]
Abstract
There is increasing controversy on whether acute exposure to ambient carbon monoxide (CO) is hazardous on respiratory health. We therefore performed a longitudinal panel study to evaluate the acute effects of ambient CO on fractional exhaled nitric oxide (FeNO), a well-established biomarker of airway inflammation. We completed 4-6 rounds of health examinations among 75 healthy young adults during April to June in 2013 in Shanghai, China. We applied the linear mixed-effect model to investigate the short-term associations between CO and FeNO. CO exposure during 2-72 h preceding health tests was significantly associated with decreased FeNO levels. For example, an interquartile range increase (0.3 mg/m(3)) of 2-h CO exposure corresponded to 10.6% decrease in FeNO. This association remained when controlling for the concomitant exposure to co-pollutants. This study provided support that short-term exposure to ambient CO might be related with reduced levels of FeNO, a biomarker of lower airway inflammation.
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Affiliation(s)
- Zhuohui Zhao
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China; Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP(3)), Fudan University, Shanghai, China
| | - Zhijing Lin
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China
| | - Jing Cai
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China; Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP(3)), Fudan University, Shanghai, China
| | - Yingying Yang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China
| | - Dandan Yang
- Shanghai Key Laboratory of Meteorology and Health, Shanghai, China
| | - Dan Norback
- Department of Environmental and Occupational Medicine, Uppsala University, Uppsala, Sweden
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China; Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP(3)), Fudan University, Shanghai, China.
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59
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Cai J, Chen R, Wang W, Xu X, Ha S, Kan H. Does ambient CO have protective effect for COPD patient? ENVIRONMENTAL RESEARCH 2015; 136:21-6. [PMID: 25460616 DOI: 10.1016/j.envres.2014.09.039] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Revised: 09/02/2014] [Accepted: 09/11/2014] [Indexed: 05/24/2023]
Abstract
BACKGROUND Existing studies found paradoxical effects of carbon monoxide (CO) on human health. Carbon monoxide (CO), at high concentrations, is a well-known toxicant, but recent studies suggest that CO at low concentrations may have protective health effects under certain conditions. OBJECTIVES To investigate the acute effect of ambient CO on hospital admission for chronic obstructive pulmonary disease (COPD) in Shanghai, China. METHODS Daily data on COPD admissions and CO concentrations between 2006 and 2008 were collected. We applied over-dispersed generalized additive Poisson models, adjusted for weather conditions, day of the week and public holidays, long-term and seasonal trends. RESULTS During the study period, the average CO concentration was 1.3mg/m(3), well below the international health-based standard. Negative associations were found between ambient CO concentration and daily COPD hospitalization. An interquartile range increase (0.6 mg/m(3)) in CO concentration at lag 3 day corresponded to -2.97% (95% confidence interval: -4.63%, -1.31%) change in COPD hospitalization. The negative associations were robust after adjustment for co-pollutants (PM10, NO2 and SO2). The protective effect of CO appeared to be more evident in the cool season. CONCLUSION Short-term exposure to CO at low ambient concentration may be associated with reduced risk of COPD hospitalization. Our results may contribute to a comprehensive understanding on the health effects of ambient CO.
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Affiliation(s)
- Jing Cai
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, & Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, & Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China; Global Health Institute, Fudan University, Shanghai, China; Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP3), Fudan University, Shanghai, China
| | - Weibing Wang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, & Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China
| | - Xiaohui Xu
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, USA
| | - Sandie Ha
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, USA
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, & Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China; Global Health Institute, Fudan University, Shanghai, China; Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP3), Fudan University, Shanghai, China.
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Franck U, Leitte AM, Suppan P. Multifactorial airborne exposures and respiratory hospital admissions--the example of Santiago de Chile. THE SCIENCE OF THE TOTAL ENVIRONMENT 2015; 502:114-21. [PMID: 25244038 DOI: 10.1016/j.scitotenv.2014.08.093] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Revised: 07/18/2014] [Accepted: 08/25/2014] [Indexed: 05/05/2023]
Abstract
UNLABELLED Our results provide evidence for respiratory effects of combined exposure to airborne pollutants in Santiago de Chile. Different pollutants account for varying adverse effects. Ozone was not found to be significantly associated with respiratory morbidity. BACKGROUND High concentrations of various air pollutants have been associated with hospitalization due to development and exacerbation of respiratory diseases. The findings of different studies vary in effect strength and are sometimes inconsistent. OBJECTIVES We aimed to assess associations between airborne exposures by particulate matter as well as gaseous air pollutants and hospital admissions due to respiratory disease groups under the special orographic and meteorological conditions of Santiago de Chile. METHODS The study was performed in the metropolitan area of Santiago de Chile during 2004-2007. We applied a time-stratified case-crossover analysis taking temporal variation, meteorological conditions and autocorrelation into account. We computed associations between daily ambient concentrations of carbon monoxide (CO), nitrogen dioxide (NO2), particulate matter (PM10 and PM2.5 - particulate matter with aerodynamic diameters less than 10 or 2.5 μm, respectively) or ozone (O3) and hospital admissions for respiratory illnesses. RESULTS We found for CO, NO2, PM10 and PM2.5 adverse relationships to respiratory admissions while effect strength and lag depended on the pollutant and on the disease group. By trend, in 1-pollutant models most adverse pollutants were CO and PM10 followed by PM2.5, while in 2-pollutant models effects of NO2 persisted in most cases whereas other effects weakened and significant effects remain for PM2.5, only. In addition the strongest effects seemed to be immediate or with a delay of up to one day, but effects were found until day 7, too. Adverse effects of ozone could not be detected. CONCLUSIONS Taking case numbers and effect strength of all cardiovascular diseases into account, mitigation measures should address all pollutants especially CO, NO2, and PM10.
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Affiliation(s)
- Ulrich Franck
- Core Facility Studies, Helmholtz Centre for Environmental Research - UFZ, Leipzig, Germany.
| | - Arne Marian Leitte
- Core Facility Studies, Helmholtz Centre for Environmental Research - UFZ, Leipzig, Germany.
| | - Peter Suppan
- Institute of Meteorology and Climate Research (IMK-IFU), Karlsruhe Institute of Technology (KIT), Garmisch-Partenkirchen, Germany.
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Tian L, Ho KF, Wang T, Qiu H, Pun VC, Chan CS, Louie PKK, Yu ITS. Ambient carbon monoxide and the risk of hospitalization due to chronic obstructive pulmonary disease. Am J Epidemiol 2014; 180:1159-67. [PMID: 25480818 DOI: 10.1093/aje/kwu248] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Data from recent experimental and clinical studies have indicated that lower concentrations of inhaled carbon monoxide might have beneficial antiinflammatory effects. Inhaled carbon monoxide has the potential to be a therapeutic agent for chronic obstructive pulmonary diseases (COPD). However, population-based epidemiologic studies of environmentally relevant carbon monoxide exposure have generated mixed findings. We conducted a time-series study in Hong Kong to estimate the association of short-term exposure to ambient carbon monoxide with emergency hospitalizations for COPD. We collected daily emergency hospital admission data and air pollution data from January 2001 to December 2007. We used log-linear Poisson models to estimate the associations between daily hospital admissions for COPD and the average daily concentrations of carbon monoxide while controlling for the traffic-related co-pollutants nitrogen dioxide and particulate matter with an aerodynamic diameter less than 2.5 μm. Results showed that ambient carbon monoxide was negatively associated with the risk of hospitalizations for COPD. After adjustment for levels nitrogen dioxide or particulate matter with an aerodynamic diameter less than 2.5 μm, the negative associations of carbon monoxide with COPD hospitalizations became stronger. The risk estimates were similar for female and male subjects. In conclusion, short-term exposure to ambient carbon monoxide was associated with a decreased risk of hospitalization for COPD, which suggests that carbon monoxide exposure provides some acute protection of against exacerbation of COPD.
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Abstract
The Journal has been in the vanguard of publications of the respiratory microbiome, including a National Institutes of Health Workshop report, establishing the normal microbiome in patients with various risks, and in the correlation of microbiome changes with disease exacerbations and lung transplant. A new classification scheme for healthcare-associated pneumonia, risks for nosocomial Pseudomonas pneumonia, and associations between community-acquired pneumonia and risks or outcomes have been reported. The increasingly recognized role of viral respiratory tract infections was reflected in publications regarding incidence rates, risk factors, and associations with other respiratory diseases. Significant contributions to understanding and treating sepsis emerged in 2013. The role of tissue damage was highlighted in a series of publications. A much greater understanding of the importance of pathways that directly impact the pathogen at the site of infection and subsequent pathogen clearance has emerged. The Journal published important contributions across the spectrum of ineffective therapy (activated protein C), novel therapeutic ideas (statins and extracorporeal membrane oxygenation), and solidly beneficial approaches (early protocolized care). Biomarker development is maturing to include a wide array of molecular measurements increasingly aimed at aiding improved therapy.
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Affiliation(s)
- Richard G Wunderink
- 1 Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois; and
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Carlsten C, Georas SN. Update in environmental and occupational lung diseases 2013. Am J Respir Crit Care Med 2014; 189:1037-43. [PMID: 24787066 DOI: 10.1164/rccm.201401-0108up] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Chris Carlsten
- 1 Division of Respiratory Medicine, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; and
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Wang Q, Gao C, Wang H, Lang L, Yue T, Lin H. Ischemic stroke hospital admission associated with ambient temperature in Jinan, China. PLoS One 2013; 8:e80381. [PMID: 24260379 PMCID: PMC3833907 DOI: 10.1371/journal.pone.0080381] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Accepted: 10/08/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND This study estimated the effects of ambient temperature and relative humidity on hospital admissions for ischemic stroke during 1990-2009 in Jinan, China. METHODS To account for possible delayed effects and harvesting effect, we examined the impact of meteorological factors up to 30 days before each admission using a distributed lag non-linear model; we controlled for season, long-term trend, day of week and public holidays in the analysis. Stratified analyses were also done for summer and winter. RESULTS A total of 1,908 ischemic stroke hospital admissions were observed between 1990 and 2009. We found a strong non-linear acute effect of daily temperatures on ischemic stroke hospital admission. With the mean temperature 15°C as the reference, the relative risk (RR) was 1.43 (95% confidence interval (CI): 1.10-1.85) for 0°C daily temperature on the same day, and 0.43 (95% CI: 0.31-0.59) for 30°C daily temperature on the same day, respectively. The effect of ambient temperature was similar in summer and winter. No significant association was observed between relative humidity and ischemic stroke hospitalization. CONCLUSIONS Low temperature might be a risk factor for ischemic stroke, and high temperature might be protective factor of ischemic stroke occurrence in Jinan, China.
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Affiliation(s)
- Qinzhou Wang
- Department of Neurology, Qilu Hospital of Shandong University, Jinan, China
| | - Cuilian Gao
- Qilu Hospital of Shandong University, Jinan, China
| | | | - Lingling Lang
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Tao Yue
- Cadre Health Care Department, Zibo Center Hospital, Zibo, China
| | - Hualiang Lin
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
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Goldberg HJ, Holguin F. Carbon Monoxide in Small Doses—A Good Thing? Am J Respir Crit Care Med 2013; 188:1187-8. [DOI: 10.1164/rccm.201309-1615ed] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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