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Chen Y, Zang L, Chen J, Xu D, Yao D, Zhao M. Characteristics of ambient ozone (O 3) pollution and health risks in Zhejiang Province. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2017; 24:27436-27444. [PMID: 28980116 DOI: 10.1007/s11356-017-0339-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 09/25/2017] [Indexed: 06/07/2023]
Abstract
Troposphere ozone, which is from secondary formation processes, has been increasing dramatically during the last decades in China, inducing high health risks. In this study, temporal and spatial distribution of O3 was studied among 13 sites of three cities during 2014-2016. The objectives were to clarify the characteristics of the ambient pollution of O3 under the influence from other pollutants and meteorological parameters and the health outcomes from exposure to O3. The concentrations of O3 during summer were much higher than those during winter, and the concentrations in downtown areas were higher than in rural or mountain areas. PM2.5, NO2, SO2, and wind speed (WS) were negatively correlated with O3, and CO, temperature (T), and relative humidity (RH) were positively correlated with O3. In multivariable analysis, two separate factors-solar radiation and atmospheric diffusion status, affected the O3 levels. The concentrations of O3 reached the highest level at 15:00 and the lowest value at about 6:00-8:00, with the similar trend to T and WS, and opposite to RH. According to the dose-response model, relative risks (RRs) and population attributable fractions (PAFs) with confidence intervals (CIs) for chronic obstructive pulmonary disease (COPD) from exposure to O3 were 1.0612 (CI 1.0607-1.0616) and 5.32% (CI 5.29-5.36%), respectively, attributable to 2000 deaths in Zhejiang Province in 2014.
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Affiliation(s)
- Yuanchen Chen
- College of Environment, Research Center of Environmental Science, Key Laboratory of Microbial Technology for Industrial Pollution Control of Zhejiang Province, Zhejiang University of Technology, Hangzhou, 310014, China
| | - Lu Zang
- College of Environment, Research Center of Environmental Science, Key Laboratory of Microbial Technology for Industrial Pollution Control of Zhejiang Province, Zhejiang University of Technology, Hangzhou, 310014, China
| | - Jinyuan Chen
- College of Environment, Research Center of Environmental Science, Key Laboratory of Microbial Technology for Industrial Pollution Control of Zhejiang Province, Zhejiang University of Technology, Hangzhou, 310014, China
| | - Da Xu
- Zhejiang Province Environmental Monitoring Center, Hangzhou, 310012, China
| | - Defei Yao
- Zhejiang Province Environmental Monitoring Center, Hangzhou, 310012, China
| | - Meirong Zhao
- College of Environment, Research Center of Environmental Science, Key Laboratory of Microbial Technology for Industrial Pollution Control of Zhejiang Province, Zhejiang University of Technology, Hangzhou, 310014, China.
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Global Associations between Air Pollutants and Chronic Obstructive Pulmonary Disease Hospitalizations. A Systematic Review. Ann Am Thorac Soc 2017; 13:1814-1827. [PMID: 27314857 DOI: 10.1513/annalsats.201601-064oc] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
RATIONALE Exacerbations are key events in chronic obstructive pulmonary disease (COPD), affecting lung function decline and quality of life. The effect of exposure to different air pollutants on COPD exacerbations is not clear. OBJECTIVES To carry out a systematic review, examining associations between air pollutants and hospital admissions for COPD exacerbations. METHODS MEDLINE, Embase, BIOSIS, Science Citation Index, and the Air Pollution Epidemiology Database were searched for publications published between 1980 and September 2015. Inclusion criteria were focused on studies presenting solely a COPD outcome defined by hospital admissions and a measure of gaseous air pollutants and particle fractions. The association between each pollutant and COPD admissions was investigated in metaanalyses using random effects models. Analyses were stratified by geographical clusters for investigation of the consistency of the evidence worldwide. MEASUREMENTS AND MAIN RESULTS Forty-six studies were included, and results for all the pollutants under investigation showed marginal positive associations; however, the number of included studies was small, the studies had high heterogeneity, and there was evidence of small-study bias. Geographical clustering of the effects of pollution on COPD hospital admissions was evident and reduced heterogeneity significantly. CONCLUSIONS The most consistent association was between a 1-mg/m3 increase in carbon monoxide level and COPD-related admissions (odds ratio, 1.02; 95% confidence interval, 1.01-1.03). The heterogeneity was moderate, and there was a consistent positive association in both Europe and North America, although levels were clearly below World Health Organization guideline values. There is mixed evidence on the effects of environmental pollution on COPD exacerbations. Limitations of previous studies included the low spatiotemporal resolution of pollutants, inadequate control for confounding factors, and the use of aggregated health data that ignored personal characteristics. The need for more targeted exposure estimates in a large number of geographical locations is evident.
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Masoumi K, Haddadzadeh Shoushtari M, Forouzan A, Asgari Darian A, Dastoorpoor M, Ebrahimzadeh P, Aghababaeian H. Rainfall-Associated Bronchospasm Epidemics: The Epidemiological Effects of Air Pollutants and Weather Variables. Can Respir J 2017; 2017:9252069. [PMID: 29089817 PMCID: PMC5635285 DOI: 10.1155/2017/9252069] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 07/20/2017] [Accepted: 08/14/2017] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND This study compares different risk factors in patients visiting a hospital during five rainfall-associated bronchospasm epidemics in Ahvaz and those visiting on other occasions. METHODS This case-control study was conducted on 5307 patients with bronchospasm admitted to the Emergency Department of Imam Khomeini Hospital in Ahvaz (Iran) from late October to December (as the epidemic) and 916 patients admitted from late January to March (as the nonepidemic) in 2011 to 2015. RESULTS A total of the 41.7% of the cases and 48.8% of the controls had episodes of bronchospasm, suggesting a significant difference between the two groups (P < 0.001). The mean concentrations of PM10, NO, NO2, and NO x pollutants (except O3) were significantly higher in the nonepidemic periods (P < 0.05). The adjusted analysis showed a direct significant relationship between emergency respiratory admissions and each unit of increase in NO and SO2 concentration during the epidemic periods and NO2 concentration during the nonepidemic periods. During the epidemic periods, a direct and significant relationship was also observed between respiratory admissions and each unit of increase in relative humidity and evaporation. CONCLUSION The results suggest that certain pollutants and weather variables are associated with the risk of emergency respiratory admissions during epidemic periods.
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Affiliation(s)
- Kambiz Masoumi
- Department of Emergency Medicine, Imam Khomeini General Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Maryam Haddadzadeh Shoushtari
- Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Arash Forouzan
- Department of Emergency Medicine, Imam Khomeini General Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ali Asgari Darian
- Department of Emergency Medicine, Imam Khomeini General Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Maryam Dastoorpoor
- Department of Epidemiology and Biostatistics, Faculty of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Pegah Ebrahimzadeh
- Department of Emergency Medicine, Imam Khomeini General Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Khaniabadi YO, Daryanoosh SM, Hopke PK, Ferrante M, De Marco A, Sicard P, Oliveri Conti G, Goudarzi G, Basiri H, Mohammadi MJ, Keishams F. Acute myocardial infarction and COPD attributed to ambient SO2 in Iran. ENVIRONMENTAL RESEARCH 2017; 156:683-687. [PMID: 28477578 DOI: 10.1016/j.envres.2017.04.028] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Revised: 04/15/2017] [Accepted: 04/21/2017] [Indexed: 06/07/2023]
Abstract
Acute myocardial infarction (MI) and chronic obstructive pulmonary disease (COPD) are important diseases worldwide. Inhalation is the major route of short-term exposure to air sulfur dioxide (SO2) that negatively affect human health. The objective of this study was to estimate the health effects of short-term exposure to SO2 in Khorramabad, Iran using the AirQ software developed by the World Health Organization (WHO). Daily mean SO2 concentrations were used as the estimates of human short-term exposure and allow calculation of the attributable excess relative risk of an acute MI and hospital admissions due to COPD (HACOPD). The annual mean SO2 concentration in Khorramabad was 51.33µg/m3. Based on the relative risk (RR) and baseline incidence (BI) approach of WHO, an increased risk of 2.7% (95% CI: 1.1-4.2%) of acute MI and 2.0% (95% CI: 0-4.6%) of HACOPD, respectively, were attributed to a 10µg/m3 SO2 increase. Since the geographic, demographic, and climatic characteristics are different from the areas in which the risk relationships were developed and not evaluated here, further investigations will be needed to fully quantify other health impacts of SO2. A decreased risk for MIs and COPD attributable to SO2 could be achieved if mitigation strategies and measures are implemented to reduce the exposure.
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Affiliation(s)
- Yusef Omidi Khaniabadi
- Health Care System of Karoon, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | | | - Philip K Hopke
- Center for Air Resources Engineering and Science, Clarkson University, Potsdam, NY 13699, USA; Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, NY 14619, USA
| | - Margherita Ferrante
- Environmental and Food Hygiene Laboratories (LIAA) of Department of Medical Sciences, Surgical and Advanced Technologies "G.F. Ingrassia", Hygiene and Public Health. University of Catania, Italy.
| | - Alessandra De Marco
- Italian National Agency for New Technologies, Energy and Sustainable Economic Development (ENEA), Lungotevere Thaon de Revel, Rome, Italy
| | - Pierre Sicard
- ACRI-HE, route du Pin Montard, Sophia Antipolis, France
| | - Gea Oliveri Conti
- Environmental and Food Hygiene Laboratories (LIAA) of Department of Medical Sciences, Surgical and Advanced Technologies "G.F. Ingrassia", Hygiene and Public Health. University of Catania, Italy
| | - Gholamreza Goudarzi
- Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Hassan Basiri
- Department of Environmental Health Engineering, School of Health, Lorestan University of Medical Sciences, Khorramabad, Iran
| | | | - Fariba Keishams
- Department of Environmental Health Engineering, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
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Affiliation(s)
- S Jouneau
- Service de pneumologie, hôpital Pontchaillou, IRSET UMR 1085, université de Rennes 1, 2, rue Henri-le-Guilloux, 35033 Rennes, France.
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Khaniabadi YO, Goudarzi G, Daryanoosh SM, Borgini A, Tittarelli A, De Marco A. Exposure to PM 10, NO 2, and O 3 and impacts on human health. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2017; 24:2781-2789. [PMID: 27837472 DOI: 10.1007/s11356-016-8038-6] [Citation(s) in RCA: 79] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 11/01/2016] [Indexed: 05/20/2023]
Abstract
Air pollution is emerging as a risk factor for human health like cancer and other health outcomes in developing countries, especially Iran where air pollutant concentrations are elevated. Additionally, some of the crucial environmental problems are caused by air pollution. Nevertheless, the data on health effects of air pollution are limited. The main objective of this study was to assess the health impacts attributed to particulate matter less than 10 μg/m3 (PM10), nitrogen dioxide (NO2), and ozone (O3) in Kermanshah City (Iran). The diurnal averages of PM10 and NO2 levels and 1-h averages of O3 concentrations were applied to assess the cardiovascular mortality due to exposure to these pollutants during the years 2014 and 2015. The excess number of cardiovascular mortality was estimated by relative risk (RR) and baseline incidence (BI) defined by the World Health Organization (WHO). The excess in mortality risk for cardiovascular diseases is of 188 premature deaths related to PM10, 33 related to NO2, and 83 related to O3, respectively. The results indicate that a 10-μg/m3 change in PM10, NO2, and O3 generates a relative risk of 1.066, 1.012, and 1.020, respectively. The excess of relative risk is of 6.6, 1.2, and 2.0%, respectively. Immediate policies and actions are needed to reduce the various sources of these pollutants from transport and energy manufacture facilities in Kermanshah.
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Affiliation(s)
- Yusef Omidi Khaniabadi
- Health Care System of Karoon, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Gholamreza Goudarzi
- Environmental Technologies Research Center (ETRC), Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | | | - Alessandro Borgini
- Cancer Registry and Environmental Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, Milan, Italy
| | - Andrea Tittarelli
- Cancer Registry and Environmental Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, Milan, Italy
| | - Alessandra De Marco
- Department of Territorial and Production Systems Sustainability, SSPT-MET-INAT, ENEA, CR Casaccia, Via Anguillarese 301, 00123, Rome, Italy.
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Vahedian M, Khanjani N, Mirzaee M, Koolivand A. Associations of short-term exposure to air pollution with respiratory hospital admissions in Arak, Iran. JOURNAL OF ENVIRONMENTAL HEALTH SCIENCE & ENGINEERING 2017; 15:17. [PMID: 28725443 PMCID: PMC5514473 DOI: 10.1186/s40201-017-0277-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 06/14/2017] [Indexed: 05/03/2023]
Abstract
BACKGROUND Ambient air pollution, is one of the most frequently stated environmental problems. Many epidemiological studies have documented adverse health effects for ambient air pollution. This study aimed to investigate the association between ambient air pollution and respiratory hospital admissions. METHODS In this ecological time series study data about air pollutant concentrations including CO, NO2, O3, PM2.5, PM10 and SO2 and, respiratory hospital admissions in the urban population of Arak, from January 1st 2010 to December 31st 2015; were inquired, from the Arak Department of Environment, and two major hospitals, respectively. Meteorological data were inquired for the same period as well. Time-series regression analysis with a distributed lag model, controlled for seasonality long-time trends, weather and day of the week, was used for data analysis. RESULTS Every 10 μg/m3 increase in NO2, and PM10 and every 1 mg/m3 increase in CO at lag 0 corresponded to a RR = 1.032 (95%CI, 1.003-1.06), RR = 1.01 (95%CI, 1.004-1.017) and RR = 1.09 (95%CI, 1.04-1.14), increase in respiratory disease hospitalizations, respectively. Males and the elderly were found to be more susceptible than females and other age groups to air pollutants in regard to respiratory disease admissions. CONCLUSIONS The results of this study showed that outdoor air pollutants significantly increase respiratory hospital admissions; especially among the men and elders in Arak.
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Affiliation(s)
- Mostafa Vahedian
- Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Narges Khanjani
- Environmental Health Engineering Research Center, Kerman University of Medical Sciences, Kerman, Iran
- Department of Epidemiology and Biostatistics, School of Public Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Moghaddameh Mirzaee
- Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Ali Koolivand
- Department of Environmental Health Engineering, Faculty of Health, Arak University of Medical Sciences, Arak, Iran
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Curti S, Gori D, Di Gregori V, Farioli A, Baldasseroni A, Fantini MP, Christiani DC, Violante FS, Mattioli S. PubMed search filters for the study of putative outdoor air pollution determinants of disease. BMJ Open 2016; 6:e013092. [PMID: 28003291 PMCID: PMC5223690 DOI: 10.1136/bmjopen-2016-013092] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVES Several PubMed search filters have been developed in contexts other than environmental. We aimed at identifying efficient PubMed search filters for the study of environmental determinants of diseases related to outdoor air pollution. METHODS We compiled a list of Medical Subject Headings (MeSH) and non-MeSH terms seeming pertinent to outdoor air pollutants exposure as determinants of diseases in the general population. We estimated proportions of potentially pertinent articles to formulate two filters (one 'more specific', one 'more sensitive'). Their overall performance was evaluated as compared with our gold standard derived from systematic reviews on diseases potentially related to outdoor air pollution. We tested these filters in the study of three diseases potentially associated with outdoor air pollution and calculated the number of needed to read (NNR) abstracts to identify one potentially pertinent article in the context of these diseases. Last searches were run in January 2016. RESULTS The 'more specific' filter was based on the combination of terms that yielded a threshold of potentially pertinent articles ≥40%. The 'more sensitive' filter was based on the combination of all search terms under study. When compared with the gold standard, the 'more specific' filter reported the highest specificity (67.4%; with a sensitivity of 82.5%), while the 'more sensitive' one reported the highest sensitivity (98.5%; with a specificity of 47.9%). The NNR to find one potentially pertinent article was 1.9 for the 'more specific' filter and 3.3 for the 'more sensitive' one. CONCLUSIONS The proposed search filters could help healthcare professionals investigate environmental determinants of medical conditions that could be potentially related to outdoor air pollution.
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Affiliation(s)
- Stefania Curti
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Davide Gori
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Valentina Di Gregori
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Andrea Farioli
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Alberto Baldasseroni
- Tuscany Regional Centre for Occupational Injuries and Diseases (CeRIMP), Florence, Italy
| | - Maria Pia Fantini
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - David C Christiani
- Department of Environmental Health, Harvard School of Public Health, Harvard University, Boston, Massachusetts, USA
| | - Francesco S Violante
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Stefano Mattioli
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
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Li J, Sun S, Tang R, Qiu H, Huang Q, Mason TG, Tian L. Major air pollutants and risk of COPD exacerbations: a systematic review and meta-analysis. Int J Chron Obstruct Pulmon Dis 2016; 11:3079-3091. [PMID: 28003742 PMCID: PMC5161337 DOI: 10.2147/copd.s122282] [Citation(s) in RCA: 152] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Short-term exposure to major air pollutants (O3, CO, NO2, SO2, PM10, and PM2.5) has been associated with respiratory risk. However, evidence on the risk of chronic obstructive pulmonary disease (COPD) exacerbations is still limited. The present study aimed at evaluating the associations between short-term exposure to major air pollutants and the risk of COPD exacerbations. Methods After a systematic search up until March 30, 2016, in both English and Chinese electronic databases such as PubMed, EMBASE, and CNKI, the pooled relative risks and 95% confidence intervals were estimated by using the random-effects model. In addition, the population-attributable fractions (PAFs) were also calculated, and a subgroup analysis was conducted. Heterogeneity was assessed by I2. Results In total, 59 studies were included. In the single-pollutant model, the risks of COPD were calculated by each 10 μg/m3 increase in pollutant concentrations, with the exception of CO (100 μg/m3). There was a significant association between short-term exposure and COPD exacerbation risk for all the gaseous and particulate pollutants. The associations were strongest at lag0 and lag3 for gaseous and particulate air pollutants, respectively. The subgroup analysis not only further confirmed the overall adverse effects but also reduced the heterogeneities obviously. When 100% exposure was assumed, PAFs ranged from 0.60% to 4.31%, depending on the pollutants. The adverse health effects of SO2 and NO2 exposure were more significant in low-/middle-income countries than in high-income countries: SO2, relative risk: 1.012 (95% confidence interval: 1.001, 1.023); and NO2, relative risk: 1.019 (95% confidence interval: 1.014, 1.024). Conclusion Short-term exposure to air pollutants increases the burden of risk of COPD acute exacerbations significantly. Controlling ambient air pollution would provide benefits to COPD patients.
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Affiliation(s)
- Jinhui Li
- Shenzhen Institute of Research and Innovation, Nanshan, The University of Hong Kong, Shenzhen, People's Republic of China; School of Public Health, The University of Hong Kong, Pok Fu Lam, Hong Kong Special Administrative Region
| | - Shengzhi Sun
- Shenzhen Institute of Research and Innovation, Nanshan, The University of Hong Kong, Shenzhen, People's Republic of China; School of Public Health, The University of Hong Kong, Pok Fu Lam, Hong Kong Special Administrative Region
| | - Robert Tang
- Shenzhen Institute of Research and Innovation, Nanshan, The University of Hong Kong, Shenzhen, People's Republic of China; School of Public Health, The University of Hong Kong, Pok Fu Lam, Hong Kong Special Administrative Region
| | - Hong Qiu
- School of Public Health, The University of Hong Kong, Pok Fu Lam, Hong Kong Special Administrative Region
| | - Qingyuan Huang
- Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Minhang, Shanghai, People's Republic of China
| | - Tonya G Mason
- School of Public Health, The University of Hong Kong, Pok Fu Lam, Hong Kong Special Administrative Region
| | - Linwei Tian
- Shenzhen Institute of Research and Innovation, Nanshan, The University of Hong Kong, Shenzhen, People's Republic of China; School of Public Health, The University of Hong Kong, Pok Fu Lam, Hong Kong Special Administrative Region
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Seow WJ, Downward GS, Wei H, Rothman N, Reiss B, Xu J, Bassig BA, Li J, He J, Hosgood HD, Wu G, Chapman RS, Tian L, Wei F, Caporaso NE, Vermeulen R, Lan Q. Indoor concentrations of nitrogen dioxide and sulfur dioxide from burning solid fuels for cooking and heating in Yunnan Province, China. INDOOR AIR 2016; 26:776-83. [PMID: 26340585 PMCID: PMC6800159 DOI: 10.1111/ina.12251] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Accepted: 08/31/2015] [Indexed: 05/03/2023]
Abstract
The Chinese national pollution census has indicated that the domestic burning of solid fuels is an important contributor to nitrogen dioxide (NO2 ) and sulfur dioxide (SO2 ) emissions in China. To characterize indoor NO2 and SO2 air concentrations in relation to solid fuel use and stove ventilation in the rural counties of Xuanwei and Fuyuan, in Yunnan Province, China, which have among the highest lung cancer rates in the nation, a total of 163 participants in 30 selected villages were enrolled. Indoor 24-h NO2 and SO2 samples were collected in each household over two consecutive days. Compared to smoky coal, smokeless coal use was associated with higher NO2 concentrations [geometric mean (GM) = 132 μg/m(3) for smokeless coal and 111 μg/m(3) for smoky coal, P = 0.065] and SO2 [limit of detection = 24 μg/m(3) ; percentage detected (%Detect) = 86% for smokeless coal and 40% for smoky coal, P < 0.001]. Among smoky coal users, significant variation of NO2 and SO2 air concentrations was observed across different stove designs and smoky coal sources in both counties. Model construction indicated that the measurements of both pollutants were influenced by stove design. This exposure assessment study has identified high levels of NO2 and SO2 as a result of burning solid fuels for cooking and heating.
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Affiliation(s)
- W J Seow
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA.
| | - G S Downward
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, IRAS, Utrecht University, Utrecht, The Netherlands
| | - H Wei
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - N Rothman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - B Reiss
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, IRAS, Utrecht University, Utrecht, The Netherlands
| | - J Xu
- Division of Epidemiology and Biostatistics, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - B A Bassig
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - J Li
- Qujing Centers for Disease Control and Prevention, Qujing, China
| | - J He
- Qujing Centers for Disease Control and Prevention, Qujing, China
| | - H D Hosgood
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - G Wu
- China National Environmental Monitoring Center, Beijing, China
| | - R S Chapman
- College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand
| | - L Tian
- Division of Epidemiology and Biostatistics, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - F Wei
- China National Environmental Monitoring Center, Beijing, China
| | - N E Caporaso
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - R Vermeulen
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, IRAS, Utrecht University, Utrecht, The Netherlands
| | - Q Lan
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
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Miravitlles M, D'Urzo A, Singh D, Koblizek V. Pharmacological strategies to reduce exacerbation risk in COPD: a narrative review. Respir Res 2016; 17:112. [PMID: 27613392 PMCID: PMC5018159 DOI: 10.1186/s12931-016-0425-5] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 08/20/2016] [Indexed: 01/17/2023] Open
Abstract
Identifying patients at risk of exacerbations and managing them appropriately to reduce this risk represents an important clinical challenge. Numerous treatments have been assessed for the prevention of exacerbations and their efficacy may differ by patient phenotype. Given their centrality in the treatment of COPD, there is strong rationale for maximizing bronchodilation as an initial strategy to reduce exacerbation risk irrespective of patient phenotype. Therefore, in patients assessed as frequent exacerbators (>1 exacerbation/year) we propose initial bronchodilator treatment with a long-acting muscarinic antagonist (LAMA)/ long-acting β2-agonist (LABA). For those patients who continue to experience >1 exacerbation/year despite maximal bronchodilation, we advocate treating according to patient phenotype. Based on currently available data on adding inhaled corticosteroids (ICS) to a LABA, ICS might be added to a LABA/LAMA combination in exacerbating patients who have an asthma-COPD overlap syndrome or high blood eosinophil counts, while in exacerbators with chronic bronchitis, consideration should be given to treating with a phosphodiesterase (PDE)-4 inhibitor (roflumilast) or high-dose mucolytic agents. For those patients who experience frequent bacterial exacerbations and/or bronchiectasis, addition of mucolytic agents or a macrolide antibiotic (e.g. azithromycin) should be considered. In all patients at risk of exacerbations, pulmonary rehabilitation should be included as part of a comprehensive management plan.
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Affiliation(s)
- Marc Miravitlles
- Pneumology Department, Hospital General Universitari Vall d'Hebron, Pg. Vall d'Hebron 119-129, 08035, Barcelona, Spain.
| | - Anthony D'Urzo
- Department of Family and Community Medicine, University of Toronto, 1670 Dufferin Street, Suite 107, Toronto, ON, M6H 3M2, Canada
| | - Dave Singh
- University of Manchester, Medicines Evaluation Unit, University Hospital of South Manchester Foundation Trust, Southmoor Road, Manchester, M23 9QZ, UK
| | - Vladimir Koblizek
- Department of Pneumology, Charles University in Prague, Faculty of Medicine in Hradec Kralove, Simkova 870, Hradec Kralove 1, 500 38, Czech Republic
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Ji X, Zhang Y, Ku T, Yun Y, Li G, Sang N. MicroRNA-338-5p modulates pulmonary hypertension-like injuries caused by SO 2, NO 2 and PM 2.5 co-exposure through targeting the HIF-1α/Fhl-1 pathway. Toxicol Res (Camb) 2016; 5:1548-1560. [PMID: 30090456 DOI: 10.1039/c6tx00257a] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Accepted: 09/06/2016] [Indexed: 01/26/2023] Open
Abstract
The role of ambient air pollution is considered to be important in the development of chronic obstructive pulmonary disease (COPD), and pulmonary hypertension (PH) is a common clinical manifestation of COPD. However, many studies have mainly focused on the adverse health effects of a single air pollutant, ignoring the combined toxicity of multiple pollutants. In the present study, we co-exposed mice to coal-burning air pollutants (SO2, NO2 and PM2.5), and confirmed PH-like injury occurrence by airflow limitation, marked abnormal endothelin-1 (ET-1) and endothelial nitric oxide synthase (eNOS) expression, and histopathological and ultrastructural alteration. Global microRNA (miRNA) arrays identified three significantly changed miRNAs homologous with humans (miR-338-5p, miR-450b-3p and miR-142-5p), and we targeted miR-338-5p based on real-time reverse transcription-PCR (RT-PCR) validation. Furthermore, bioinformatic and dual-luciferase reporter gene analyses indicated that miR-338-5p bound to 3'-UTR of hypoxia-inducible factor 1α (HIF-1α) mRNA and down-regulation of miR-338-5p led to the increased expression of HIF-1α and its related gene four-and-a-half LIM (Lin-11, Isl-1 and Mec-3) domain 1 (Fhl-1) and contributed to PH. This study provides evidence for the role of miRNAs in PH through targeting HIF-1α/Fhl-1 pathway after air pollutants co-exposure and implies new insights into the molecular markers for COPD caused by air pollution.
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Affiliation(s)
- Xiaotong Ji
- College of Environment and Resource , Research Center of Environment and Health , Shanxi University , Taiyuan , Shanxi 030006 , PR China . ; ; Tel: +86-351-7011932
| | - Yingying Zhang
- College of Environment and Resource , Research Center of Environment and Health , Shanxi University , Taiyuan , Shanxi 030006 , PR China . ; ; Tel: +86-351-7011932
| | - Tingting Ku
- College of Environment and Resource , Research Center of Environment and Health , Shanxi University , Taiyuan , Shanxi 030006 , PR China . ; ; Tel: +86-351-7011932
| | - Yang Yun
- College of Environment and Resource , Research Center of Environment and Health , Shanxi University , Taiyuan , Shanxi 030006 , PR China . ; ; Tel: +86-351-7011932
| | - Guangke Li
- College of Environment and Resource , Research Center of Environment and Health , Shanxi University , Taiyuan , Shanxi 030006 , PR China . ; ; Tel: +86-351-7011932
| | - Nan Sang
- College of Environment and Resource , Research Center of Environment and Health , Shanxi University , Taiyuan , Shanxi 030006 , PR China . ; ; Tel: +86-351-7011932
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63
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DeVries R, Kriebel D, Sama S. Outdoor Air Pollution and COPD-Related Emergency Department Visits, Hospital Admissions, and Mortality: A Meta-Analysis. COPD 2016; 14:113-121. [PMID: 27564008 DOI: 10.1080/15412555.2016.1216956] [Citation(s) in RCA: 108] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
A systematic literature review was performed to identify all peer-reviewed literature quantifying the association between short-term exposures of particulate matter <2.5 microns (PM2.5), nitrogen dioxide (NO2), and sulfur dioxide (SO2) and COPD-related emergency department (ED) visits, hospital admissions (HA), and mortality. These results were then pooled for each pollutant through meta-analyses with a random effects model. Subgroup meta-analyses were explored to study the effects of selected lag/averaging times and health outcomes. A total of 37 studies satisfied our inclusion criteria, contributing to a total of approximately 1,115,000 COPD-related acute events (950,000 HAs, 80,000 EDs, and 130,000 deaths) to our meta-estimates. An increase in PM2.5 of 10 ug/m3 was associated with a 2.5% (95% CI: 1.6-3.4%) increased risk of COPD-related ED and HA, an increase of 10 ug/m3 in NO2 was associated with a 4.2% (2.5-6.0%) increase, and an increase of 10 ug/m3 in SO2 was associated with a 2.1% (0.7-3.5%) increase. The strength of these pooled effect estimates, however, varied depending on the selected lag/averaging time between exposure and outcome. Similar pooled effects were estimated for each pollutant and COPD-related mortality. These results suggest an ongoing threat to the health of COPD patients from both outdoor particulates and gaseous pollutants. Ambient outdoor concentrations of PM2.5, NO2, and SO2 were significantly and positively associated with both COPD-related morbidity and mortality.
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Affiliation(s)
| | - David Kriebel
- a Department of Work Environment , University of Massachusetts Lowell , Lowell , Massachusetts , USA
| | - Susan Sama
- a Department of Work Environment , University of Massachusetts Lowell , Lowell , Massachusetts , USA
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64
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Colao A, Muscogiuri G, Piscitelli P. Environment and Health: Not Only Cancer. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:E724. [PMID: 27447654 PMCID: PMC4962265 DOI: 10.3390/ijerph13070724] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 07/12/2016] [Indexed: 01/07/2023]
Abstract
The Hippocratic tradition emphasized environmental causes of diseases and the need for harmony between the individual and the natural environment as the right philosophy to maintain a good health status. Public awareness and scientific attention concerning environmental pollution is usually focused on the consequent increased risk of developing cancer. Air pollution has been recognized by the World Health Organization (WHO) to cause cardiovascular and respiratroy diseases, as well as lung cancer, after acute/chronic exposure to fine particulates (PM2.5 and PM10) even at concentrations which are 50% lower than those accepted as legal limits in many developed countries. An increase of 10 µg/m³ of PM2.5 produces a +4%-6% of overall mortality, a +10% of cardiovascular disease prevalence (arithmyas, acute myocardial infarctions, and heart failure) and a +22% of lung cancer prevalence. In addition to these chronic effects, acute hospitalizations are also affected, especially among susceptible populations such as children and diabetic patients. Water and soil contamination also have an additional detrimental effect on people's health. Other issues concerning environment contamination and human health include male/female fertility, metabolic and thyroid conditions, but also professional exposures resulting in occupational diseases. Moreover, in the perspective of "gender medicine", different acute or chronic effects of environmental pollution should be specifically assessed both in men and in women. This special issue on "Environmental Diseases" is aimed at providing a global overview about different threats to human health possibily originating from environmental contamination.
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Affiliation(s)
- Annamaria Colao
- Department of Clinical Medicine and Surgery, University Federico II School of Medicine, Via Pansini 5, Naples 80131, Italy.
| | - Giovanna Muscogiuri
- Southern Italy Hospital Institute (IOS), Medicina Futura Research, Naples 80143, Italy.
| | - Prisco Piscitelli
- Southern Italy Hospital Institute (IOS), Medicina Futura Research, Naples 80143, Italy.
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65
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Burchette JE, Campbell GD, Geraci SA. Preventing Hospitalizations From Acute Exacerbations of Chronic Obstructive Pulmonary Disease. Am J Med Sci 2016; 353:31-40. [PMID: 28104101 DOI: 10.1016/j.amjms.2016.06.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 05/27/2016] [Accepted: 06/09/2016] [Indexed: 01/01/2023]
Abstract
Chronic obstructive lung disease is among the leading causes of adult hospital admissions and readmissions in the United States. Preventing acute exacerbations is the primary approach in therapy. Combinations of smoking cessation, pulmonary rehabilitation, vaccinations and inhaled and oral medications may all reduce the overall risk of acute exacerbations. When prevention is unsuccessful, treatment of exacerbations often does not require hospitalization but can be safely executed in the outpatient setting. In the patient who does not require mechanical ventilation or who manifests respiratory acidosis, oxygen supplementation, frequent short-acting inhaled bronchodilators, oral corticosteroids and often antibiotics can abort the decompensation and sometimes return the patient to his or her pre-attack baseline lung function. Several models exist for delivering this care in the ambulatory setting. Follow-up care after an exacerbation has resolved is important, though there are few hard data suggesting which approach is best in this setting.
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Affiliation(s)
- Jessica E Burchette
- Department of Pharmacy Practice, Gatton College of Pharmacy, East Tennessee State University, Johnson City, Tennessee.
| | - G Douglas Campbell
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Mississippi School of Medicine, Jackson, Mississippi; G.V. (Sonny) Montgomery Veterans Affairs Medical Center, Jackson, Mississippi
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66
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Zhang S, Li G, Tian L, Guo Q, Pan X. Short-term exposure to air pollution and morbidity of COPD and asthma in East Asian area: A systematic review and meta-analysis. ENVIRONMENTAL RESEARCH 2016; 148:15-23. [PMID: 26995350 DOI: 10.1016/j.envres.2016.03.008] [Citation(s) in RCA: 94] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Revised: 03/02/2016] [Accepted: 03/04/2016] [Indexed: 05/28/2023]
Abstract
BACKGROUND The association between short-term exposure to air pollution and morbidity of COPD and asthma has been observed in many studies. However, there is a lack of systematic review of the overall risk ratios in East Asian area to provide scientific evidence for health risk assessment. METHODS A systematic literature retrieval was conducted in December 2014. The results from eligible studies were stratified by pollutants, diseases, types of hospital utilization, and age groups of the subject. For each pollutant-outcome pair, meta-analysis was conducted to calculate the pooled risk ratios (RR) with 95% confidence intervals for every 10μg/m(3) increase in pollutants (1mg/m(3) in CO). We also performed meta-regression to explore the source of heterogeneity and funnel plots to detect publication bias. RESULTS Based on results from 26 studies, statistically significant pooled RRs of different pollutants and age groups ranged from 1.007 (SO2 in all ages) to 1.028 (O3 in all ages) for COPD general hospital admissions, 1.011 (SO2 in all ages) to 1.028 (O3 in all ages) for COPD emergency hospital admissions, 1.013 (PM10 in all ages) to 1.141 (CO in children) for all-type asthma hospital utilization, 1.010 (PM10 in all ages) to 1.141 (CO in children) for asthma general hospital admissions, and 1.009 (SO2 in all ages) to 1.040 (NO2 in children) for asthma emergency hospital admissions. The association between air pollution and asthma morbidity was generally stronger in children, but not significant in people aged 15-64. CONCLUSIONS Evidence was found that short-term exposure to air pollution was associated with increasing risk of hospital utilization for COPD and asthma in the whole population, the elderly and children, but not in people aged 15-64. Children tended to be more susceptible to the effect of air pollution on asthma morbidity.
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Affiliation(s)
- Siqi Zhang
- Department of Occupational and Environmental Health, Peking University School of Public Health, No 38, Xueyuan Road, Haidian District, Beijing 100191, China.
| | - Guoxing Li
- Department of Occupational and Environmental Health, Peking University School of Public Health, No 38, Xueyuan Road, Haidian District, Beijing 100191, China.
| | - Lin Tian
- Department of Occupational and Environmental Health, Peking University School of Public Health, No 38, Xueyuan Road, Haidian District, Beijing 100191, China.
| | - Qun Guo
- Department of Occupational and Environmental Health, Peking University School of Public Health, No 38, Xueyuan Road, Haidian District, Beijing 100191, China.
| | - Xiaochuan Pan
- Department of Occupational and Environmental Health, Peking University School of Public Health, No 38, Xueyuan Road, Haidian District, Beijing 100191, China.
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67
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Zychowski KE, Lucas SN, Sanchez B, Herbert G, Campen MJ. Hypoxia-induced pulmonary arterial hypertension augments lung injury and airway reactivity caused by ozone exposure. Toxicol Appl Pharmacol 2016; 305:40-45. [PMID: 27286659 DOI: 10.1016/j.taap.2016.06.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 05/10/2016] [Accepted: 06/03/2016] [Indexed: 11/29/2022]
Abstract
Ozone (O3)-related cardiorespiratory effects are a growing public health concern. Ground level O3 can exacerbate pre-existing respiratory conditions; however, research regarding therapeutic interventions to reduce O3-induced lung injury is limited. In patients with chronic obstructive pulmonary disease, hypoxia-associated pulmonary hypertension (HPH) is a frequent comorbidity that is difficult to treat clinically, yet associated with increased mortality and frequency of exacerbations. In this study, we hypothesized that established HPH would confer vulnerability to acute O3 pulmonary toxicity. Additionally, we tested whether improvement of pulmonary endothelial barrier integrity via rho-kinase inhibition could mitigate pulmonary inflammation and injury. To determine if O3 exacerbated HPH, male C57BL/6 mice were subject to either 3 weeks continuous normoxia (20.9% O2) or hypoxia (10.0% O2), followed by a 4-h exposure to either 1ppm O3 or filtered air (FA). As an additional experimental intervention fasudil (20mg/kg) was administered intraperitoneally prior to and after O3 exposures. As expected, hypoxia significantly increased right ventricular pressure and hypertrophy. O3 exposure in normoxic mice caused lung inflammation but not injury, as indicated by increased cellularity and edema in the lung. However, in hypoxic mice, O3 exposure led to increased inflammation and edema, along with a profound increase in airway hyperresponsiveness to methacholine. Fasudil administration resulted in reduced O3-induced lung injury via the enhancement of pulmonary endothelial barrier integrity. These results indicate that increased pulmonary vascular pressure may enhance lung injury, inflammation and edema when exposed to pollutants, and that enhancement of pulmonary endothelial barrier integrity may alleviate such vulnerability.
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Affiliation(s)
- Katherine E Zychowski
- Department of Pharmaceutical Sciences, University of New Mexico College of Pharmacy, Albuquerque, NM 87131, United States
| | - Selita N Lucas
- Department of Pharmaceutical Sciences, University of New Mexico College of Pharmacy, Albuquerque, NM 87131, United States
| | - Bethany Sanchez
- Department of Pharmaceutical Sciences, University of New Mexico College of Pharmacy, Albuquerque, NM 87131, United States
| | - Guy Herbert
- Department of Pharmaceutical Sciences, University of New Mexico College of Pharmacy, Albuquerque, NM 87131, United States
| | - Matthew J Campen
- Department of Pharmaceutical Sciences, University of New Mexico College of Pharmacy, Albuquerque, NM 87131, United States.
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68
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Tamayo-Uria I, Altzibar JM, Mughini-Gras L, Dorronsoro M. Exacerbations of Chronic Obstructive Pulmonary Disease (COPD): An Ecological Study in the Basque Country, Spain (2000-2011). COPD 2016; 13:726-733. [PMID: 27232203 DOI: 10.1080/15412555.2016.1182145] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Chronic obstructive pulmonary disease (COPD) is a prevalent condition in adults aged ≥40 years characterized by progressive airflow limitation associated with chronic inflammatory response to noxious particles in the airways and lungs. Smoking, genetics, air pollution, nutrition and other factors may influence COPD development. Most hospitalizations and deaths for COPD are caused by its acute exacerbations, which greatly affect the health and quality of life of COPD patients and pose a high burden on health services. The aims of this project were to identify trends, geographic patterns and risk factors for COPD exacerbations, as revealed by hospitalizations and deaths, in the Basque Country, Spain, over a period of 12 years (2000-2011). Hospitalization and mortality rates for COPD were 262 and 18 per 100,000 population, respectively, with clusters around the biggest cities. Hospital mortality was 7.4%. Most hospitalized patients were male (77.4%) and accounted for 72.1% of hospital mortality. Hospitalizations decreased during the study period, except for 50-64 year-old women, peaking significantly. Using a multivariate modeling approach it was shown that hospitalizations were positively correlated with increased atmospheric concentrations of NO2, CO, PM10, and SO2, and increased influenza incidence, but were negatively associated with increased temperatures and atmospheric O3 concentration. COPD exacerbations decreased in the Basque Country during 2000-2011, but not among 50-64-year-old women, reflecting the high smoking prevalence among Spanish women during the 1970-1990s. The main metropolitan areas were those with the highest risk for COPD exacerbations, calling attention to the role of heavy car traffic. Influenza virus, cold temperatures, and increased atmospheric NO2, CO, PM10, and SO2 (but decreased O3) concentrations were identified as potential contributors to the burden of COPD exacerbations in the community. These findings are important for both the understanding of the disease process and in providing potential targets for COPD-reducing initiatives and new avenues for research.
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Affiliation(s)
- Ibon Tamayo-Uria
- a ISGlobal, Centre for Research in Environmental Epidemiology (CREAL) , Barcelona , Spain.,b Universitat Pompeu Fabra (UPF) , Barcelona , Spain.,c CIBER Epidemiología y Salud Pública (CIBERESP) , Spain
| | - Jone M Altzibar
- c CIBER Epidemiología y Salud Pública (CIBERESP) , Spain.,d Public Health Division of Gipuzkoa, BioDonostia Research Institute , San Sebastian , Spain
| | - Lapo Mughini-Gras
- e Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands Department of Infectious Diseases and Immunology, Utrecht University, Faculty of Veterinary Medicine , the Netherlands
| | - Miren Dorronsoro
- c CIBER Epidemiología y Salud Pública (CIBERESP) , Spain.,f Public Health Direction , Basque Regional Health Department , Vitoria-Gasteiz , Spain
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69
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Aloui R, Magne F, Devouassoux G, Deverchere J, Ritter P, Bentaher A, Pacheco Y. [Effects of fine particulate matter from on bronchial epithelial cells]. Rev Mal Respir 2016; 33:767-774. [PMID: 27157066 DOI: 10.1016/j.rmr.2016.02.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Accepted: 02/01/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Ambient air contains a variety of pollutants including solid particles. Human bronchial epithelial cells (HBEC) play a key role following inhalation of these toxic particles. In a cell culture system of HBEC, we investigated the effects of several fractions of Lyons air-derived particles on cell viability/proliferation and production of the inflammatory mediators IL-8 and TGF-β. METHODS Air particles were collected in Lyon (France) by filtration of the air and impaction on filters located on a tapered element oscillating microbalance. Several diameter-based fractions of particles were prepared. HBEC were then exposed to different concentrations of these fractions. RESULTS HBEC survival was not altered after 48hours of culture in the presence of particles regardless of their diameter and concentration. A dose-dependent inhibitory effect on cell growth was observed for all fractions. The particles caused an increase of both TGF-ß and Il-8 protein levels as a function of their diameters and/or concentrations. CONCLUSION Air-derived particle fractions exhibit both an inhibitory effect on cell proliferation and a pro-inflammatory activity on HBEC.
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Affiliation(s)
- R Aloui
- Service de pneumologie, centre hospitalier Lyon Sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite cedex, France
| | - F Magne
- Inserm U1111, CNRS UMR5308, inflammation et immunité de l'épithélium respiratoire, faculté de médecine et de Maïeutique Lyon Sud - Charles-Mérieux, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France; Service de pneumologie, hôpital de la Croix-Rousse, 69000 Lyon, France
| | - G Devouassoux
- Inserm U1111, CNRS UMR5308, inflammation et immunité de l'épithélium respiratoire, faculté de médecine et de Maïeutique Lyon Sud - Charles-Mérieux, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France; Service de pneumologie, hôpital de la Croix-Rousse, 69000 Lyon, France
| | - J Deverchere
- Inserm U1111, CNRS UMR5308, inflammation et immunité de l'épithélium respiratoire, faculté de médecine et de Maïeutique Lyon Sud - Charles-Mérieux, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France
| | - P Ritter
- Direction de l'écologie urbaine, mairie de Lyon, 69205 Lyon cedex 01, France
| | - A Bentaher
- Inserm U1111, CNRS UMR5308, inflammation et immunité de l'épithélium respiratoire, faculté de médecine et de Maïeutique Lyon Sud - Charles-Mérieux, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France
| | - Y Pacheco
- Inserm U1111, CNRS UMR5308, inflammation et immunité de l'épithélium respiratoire, faculté de médecine et de Maïeutique Lyon Sud - Charles-Mérieux, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France; Service de pneumologie, centre hospitalier Lyon Sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite cedex, France.
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70
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Liu Y, Yan S, Poh K, Liu S, Iyioriobhe E, Sterling DA. Impact of air quality guidelines on COPD sufferers. Int J Chron Obstruct Pulmon Dis 2016; 11:839-72. [PMID: 27143874 PMCID: PMC4846081 DOI: 10.2147/copd.s49378] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Background COPD is one of the leading causes of morbidity and mortality in both high- and low-income countries and a major public health burden worldwide. While cigarette smoking remains the main cause of COPD, outdoor and indoor air pollution are important risk factors to its etiology. Although studies over the last 30 years helped reduce the values, it is not very clear if the current air quality guidelines are adequately protective for COPD sufferers. Objective This systematic review was to summarize the up-to-date literature on the impact of air pollution on the COPD sufferers. Methods PubMed and Google Scholar were utilized to search for articles related to our study’s focus. Search terms included “COPD exacerbation”, “air pollution”, “air quality guidelines”, “air quality standards”, “COPD morbidity and mortality”, “chronic bronchitis”, and “air pollution control” separately and in combination. We focused on articles from 1990 to 2015. We also used articles prior to 1990 if they contained relevant information. We focused on articles written in English or with an English abstract. We also used the articles in the reference lists of the identified articles. Results Both short-term and long-term exposures to outdoor air pollution around the world are associated with the mortality and morbidity of COPD sufferers even at levels below the current air quality guidelines. Biomass cooking in low-income countries was clearly associated with COPD morbidity in adult nonsmoking females. Conclusion There is a need to continue to improve the air quality guidelines. A range of intervention measures could be selected at different levels based on countries’ socioeconomic conditions to reduce the air pollution exposure and COPD burden.
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Affiliation(s)
- Youcheng Liu
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Shuang Yan
- Department of Endocrinology and Metabolism, Fourth Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang Province, People's Republic of China
| | - Karen Poh
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Suyang Liu
- Epidemiology, Human Genetics & Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Emanehi Iyioriobhe
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - David A Sterling
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
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71
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Snow SJ, Gordon CJ, Bass VL, Schladweiler MC, Ledbetter AD, Jarema KA, Phillips PM, Johnstone AF, Kodavanti UP. Age-related differences in pulmonary effects of acute and subchronic episodic ozone exposures in Brown Norway rats. Inhal Toxicol 2016; 28:313-23. [PMID: 27097751 DOI: 10.3109/08958378.2016.1170910] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Ozone (O3) is known to induce adverse pulmonary and systemic health effects. Importantly, children and older persons are considered at-risk populations for O3-induced dysfunction, yet the mechanisms accounting for the age-related pulmonary responses to O3 are uncertain. In this study, we examined age-related susceptibility to O3 using 1 mo (adolescent), 4 mo (young adult), 12 mo (adult) and 24 mo (senescent) male Brown Norway rats exposed to filtered air or O3 (0.25 and 1.00 ppm), 6 h/day, two days/week for 1 week (acute) or 13 weeks (subchronic). Ventilatory function, assessed by whole-body plethysmography, and bronchoalveolar lavage fluid (BALF) biomarkers of injury and inflammation were used to examine O3-induced pulmonary effects. Relaxation time declined in all ages following the weekly exposures; however, this effect persisted only in the 24 mo rats following a five days recovery, demonstrating an inability to induce adaptation commonly seen with repeated O3 exposures. PenH was increased in all groups with an augmented response in the 4 mo rats following the subchronic O3 exposures. O3 led to increased breathing frequency and minute volume in the 1 and 4 mo animals. Markers of pulmonary permeability were increased in all age groups. Elevations in BALF γ-glutamyl transferase activity and lung inflammation following an acute O3 exposure were noted in only the 1 and 4 mo rats, which likely received an increased effective O3 dose. These data demonstrate that adolescent and young adult animals are more susceptible to changes in ventilation and pulmonary injury/inflammation caused by acute and episodic O3 exposure.
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Affiliation(s)
- Samantha J Snow
- a Environmental Public Health Division and NHEERL, US Environmental Protection Agency, Research Triangle Park , NC , USA
| | - Christopher J Gordon
- b Toxicity Assessment Division, NHEERL, US Environmental Protection Agency, Research Triangle Park , NC , USA , and
| | - Virginia L Bass
- a Environmental Public Health Division and NHEERL, US Environmental Protection Agency, Research Triangle Park , NC , USA .,c Environmental Sciences and Engineering, School of Public Health, University of North Carolina at Chapel Hil , Chapel Hill , NC , USA
| | - Mette C Schladweiler
- a Environmental Public Health Division and NHEERL, US Environmental Protection Agency, Research Triangle Park , NC , USA
| | - Allen D Ledbetter
- a Environmental Public Health Division and NHEERL, US Environmental Protection Agency, Research Triangle Park , NC , USA
| | - Kimberly A Jarema
- b Toxicity Assessment Division, NHEERL, US Environmental Protection Agency, Research Triangle Park , NC , USA , and
| | - Pamela M Phillips
- b Toxicity Assessment Division, NHEERL, US Environmental Protection Agency, Research Triangle Park , NC , USA , and
| | - Andrew F Johnstone
- b Toxicity Assessment Division, NHEERL, US Environmental Protection Agency, Research Triangle Park , NC , USA , and
| | - Urmila P Kodavanti
- a Environmental Public Health Division and NHEERL, US Environmental Protection Agency, Research Triangle Park , NC , USA
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72
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Ni Y, Wu S, Ji W, Chen Y, Zhao B, Shi S, Tu X, Li H, Pan L, Deng F, Guo X. The exposure metric choices have significant impact on the association between short-term exposure to outdoor particulate matter and changes in lung function: Findings from a panel study in chronic obstructive pulmonary disease patients. THE SCIENCE OF THE TOTAL ENVIRONMENT 2016; 542:264-70. [PMID: 26519586 DOI: 10.1016/j.scitotenv.2015.10.114] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2015] [Revised: 10/18/2015] [Accepted: 10/23/2015] [Indexed: 05/25/2023]
Abstract
BACKGROUND The use of ambient air pollution data obtained from central air-monitoring stations as surrogates for participants' exposures to outdoor air pollutants in previous studies may have introduced bias in the estimation of exposure-response associations. OBJECTIVES We investigated and compared the effects of short-term exposure to outdoor particulate matter (PMout) and outdoor-originated equivalent personal PM (PMeq) on lung function in chronic obstructive pulmonary disease (COPD) patients. METHODS A total of 33 doctor-diagnosed stable COPD patients were recruited and repeatedly measured for lung function (totally 170 measurements) in 2013-2014. Daily PMout concentrations were obtained from central-monitoring stations, and daily time-weighted average PMeq concentrations were estimated based on PMout over the study. Associations of PM with lung function were estimated using mixed-effects models. RESULTS Interquartile range increases in PM2.5out (111.0 μg/m(3), 5-day) and PM10out (112.0 μg/m(3), 3-day) were associated with a 3.3% (95% confidence interval [CI]: -5.8%, -0.8%) reduction and a 2.1% (95%CI: -3.9%, -0.3%) reduction in forced vital capacity (FVC), respectively. Similar results were found for forced expiratory volume in 1s (FEV1). An interquartile range increase in PM2.5eq (45.3 μg/m(3), 3-day), but not PM10eq, was still associated with a 1.7% (95%CI: -3.3%, -0.1%) reduction in FVC. CONCLUSIONS Our study may provide a novel approach to assess the association of ambient PM with health observations with improved accuracy.
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Affiliation(s)
- Yang Ni
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Shaowei Wu
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Wenjing Ji
- Department of Building Science, School of Architecture, Tsinghua University, Beijing, China
| | - Yahong Chen
- Respiratory Department, Peking University Third Hospital, Beijing, China
| | - Bin Zhao
- Department of Building Science, School of Architecture, Tsinghua University, Beijing, China
| | - Shanshan Shi
- Department of Building Science, School of Architecture, Tsinghua University, Beijing, China
| | - Xingying Tu
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Hongyu Li
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Lu Pan
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Furong Deng
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China.
| | - Xinbiao Guo
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
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73
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Ghanbari Ghozikali M, Heibati B, Naddafi K, Kloog I, Oliveri Conti G, Polosa R, Ferrante M. Evaluation of Chronic Obstructive Pulmonary Disease (COPD) attributed to atmospheric O3, NO2, and SO2 using Air Q Model (2011-2012 year). ENVIRONMENTAL RESEARCH 2016; 144:99-105. [PMID: 26599588 DOI: 10.1016/j.envres.2015.10.030] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 09/29/2015] [Accepted: 10/28/2015] [Indexed: 05/28/2023]
Abstract
Chronic obstructive pulmonary disease (COPD) is an important disease worldwide characterized by chronically poor airflow. The economic burden of COPD on any society can be enormous if not managed. We applied the approach proposed by the World Health Organization (WHO) using the AirQ2.2.3 software developed by the WHO European Center for Environment and Health on air pollutants in Tabriz (Iran) (2011-2012 year). A 1h average of concentrations of ozone (O3), daily average concentrations of nitrogen dioxide (NO2) and sulfur dioxide (SO2) were used to assess human exposure and health effect in terms of attributable proportion of the health outcome and annual number of excess cases of Hospital Admissions for COPD (HA COPD). The results of this study showed that 2% (95% CI: 0.8-3.1%) of HA COPD were attributed to O3 concentrations over 10 μg/m(3). In addition, 0.7 % (95% CI: 0.1-1.8%) and 0.5% (95% CI: 0-1%) of HA COPD were attributed to NO2 and SO2 concentrations over 10 μg/m(3) respectively. In this study, we have shown that O3, NO2 and SO2 have a significant impact on COPD hospitalization. Given these results the policy decisions are needed in order to reduce the chronic pulmonary diseases caused by air pollution and furthermore better quantification studies are recommended.
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Affiliation(s)
- Mohammad Ghanbari Ghozikali
- Tabriz Health Services Management Research Center, Department of Environmental Health Engineering, East Azerbaijan Province Health Center, Tabriz University of Medical Sciences, Tabriz, Iran; Department of Environmental Health Engineering, School of Public Health and Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran
| | - Behzad Heibati
- Department of Occupational Health Engineering, Faculty of Health and Health Sciences Research Center, Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Kazem Naddafi
- Department of Environmental Health Engineering, School of Public Health and Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran
| | - Itai Kloog
- Department of Environmental Health, Harvard University, 665 Huntington Avenue, Landmark Center Room 415, Boston, MA 0211, United States
| | - Gea Oliveri Conti
- Environmental and Food Hygiene Laboratories (LIAA), Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Hygiene and Public Health, University of Catania, Via S. Sofia 87, 95123 Catania, Italy.
| | - Riccardo Polosa
- Department of Internal and Emergency Medicine, Teaching Hospital-Policlinico-V. Emanuele II, University of Catania, Catania 95123, Italy
| | - Margherita Ferrante
- Environmental and Food Hygiene Laboratories (LIAA), Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Hygiene and Public Health, University of Catania, Via S. Sofia 87, 95123 Catania, Italy
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74
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Pandis SN, Skyllakou K, Florou K, Kostenidou E, Kaltsonoudis C, Hasa E, Presto AA. Urban particulate matter pollution: a tale of five cities. Faraday Discuss 2016; 189:277-90. [DOI: 10.1039/c5fd00212e] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Five case studies (Athens and Paris in Europe, Pittsburgh and Los Angeles in the United States, and Mexico City in Central America) are used to gain insights into the changing levels, sources, and role of atmospheric chemical processes in air quality in large urban areas as they develop technologically. Fine particulate matter is the focus of our analysis. In all cases reductions of emissions by industrial and transportation sources have resulted in significant improvements in air quality during the last few decades. However, these changes have resulted in the increasing importance of secondary particulate matter (PM) which dominates over primary in most cases. At the same time, long range transport of secondary PM from sources located hundreds of kilometres from the cities is becoming a bigger contributor to the urban PM levels in all seasons. “Non-traditional” sources including cooking, and residential and agricultural biomass burning contribute an increasing fraction of the now reduced fine PM levels. Atmospheric chemistry is found to change the chemical signatures of a number of these sources relatively fast both during the day and night, complicating the corresponding source apportionment.
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Affiliation(s)
- Spyros N. Pandis
- Dept. of Chemical Engineering
- University of Patras
- Patras
- Greece
- Dept. of Chemical Engineering
| | | | - Kalliopi Florou
- Dept. of Chemical Engineering
- University of Patras
- Patras
- Greece
| | | | | | - Erion Hasa
- Dept. of Chemical Engineering
- University of Patras
- Patras
- Greece
| | - Albert A. Presto
- Center of Atmospheric Particle Studies
- Carnegie Mellon University
- Pittsburgh
- USA
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75
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Marino E, Caruso M, Campagna D, Polosa R. Impact of air quality on lung health: myth or reality? Ther Adv Chronic Dis 2015; 6:286-98. [PMID: 26336597 DOI: 10.1177/2040622315587256] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The respiratory system is a primary target of the harmful effects of key air pollutants of health concern. Several air pollutants have been implicated including particulate matter (PM), ozone (O3), nitrogen dioxide (NO2) polycyclic aromatic hydrocarbons (PAHs) and volatile organic compounds (VOCs). It is well known that episodes of exposure to high concentrations of outdoor air pollutants can cause acute respiratory exacerbations. However, there is now increasing evidence suggesting that significant exposure to outdoor air pollutants may be also associated with development of lung cancer and with incident cases of chronic obstructive pulmonary disease (COPD) and respiratory allergies. Here we provide a critical appraisal of the impact of air pollution on respiratory diseases and discuss strategies for preventing excessive exposure to harmful air pollutants. However, the evidence that significant exposure to air pollutants is causing COPD, lung cancer or respiratory allergies is not conclusive and therefore regulators must be aware that execution of clean air policies may not be that cost-effective and may lead to unintended consequences. Addressing the lung health effects of air pollution must be considered work in progress.
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Affiliation(s)
- Elisa Marino
- Dipartimento di Medicina Clinica e Sperimentale, and UOC di Medicina Interna e Immunologia Clinica, Università di Catania, Italy
| | - Massimo Caruso
- Dipartimento di Medicina Clinica e Sperimentale, and UOC di Medicina Interna e Immunologia Clinica, Università di Catania, Italy
| | - Davide Campagna
- Dipartimento di Medicina Clinica e Sperimentale, and UOC di Medicina Interna e Immunologia Clinica, Università di Catania, Italy
| | - Riccardo Polosa
- UOC di Medicina Interna e Immunologia Clinica, Policlinico Universitario, University of Catania, Via S. Sofia 78, 95100, Catania, Italy
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76
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Miron IJ, Linares C, Montero JC, Criado-Alvarez JJ, Díaz J. Changes in cause-specific mortality during heat waves in central Spain, 1975-2008. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2015; 59:1213-1222. [PMID: 25399358 DOI: 10.1007/s00484-014-0933-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Revised: 10/21/2014] [Accepted: 10/31/2014] [Indexed: 06/04/2023]
Abstract
The relationship between heat waves and mortality has been widely described, but there are few studies using long daily data on specific-cause mortality. This study is undertaken in central Spain and analysing natural causes, circulatory and respiratory causes of mortality from 1975 to 2008. Time-series analysis was performed using ARIMA models, including data on specific-cause mortality and maximum and mean daily temperature and mean daily air pressure. The length of heat waves and their chronological number were analysed. Data were stratified in three decadal stages: 1975-1985, 1986-1996 and 1997-2008. Heat-related mortality was triggered by a threshold temperature of 37 °C. For each degree that the daily maximum temperature exceeded 37 °C, the percentage increase in mortality due to circulatory causes was 19.3 % (17.3-21.3) in 1975-1985, 30.3 % (28.3-32.3) in 1986-1996 and 7.3 % (6.2-8.4) in 1997-2008. The increase in respiratory cause ranged from 12.4 % (7.8-17.0) in the first period, to 16.3 % (14.1-18.4) in the second and 13.7 % (11.5-15.9) in the last. Each day of heat-wave duration explained 5.3 % (2.6-8.0) increase in respiratory mortality in the first period and 2.3 % (1.6-3.0) in the last. Decadal scale differences exist for specific-causes mortality induced by extreme heat. The impact on heat-related mortality by natural and circulatory causes increases between the first and the second period and falls significantly in the last. For respiratory causes, the increase is no reduced in the last period. These results are of particular importance for the estimation of future impacts of climate change on health.
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Affiliation(s)
- Isidro Juan Miron
- Torrijos Public Health District, Castile-La Mancha Regional Health & Social Affairs Authority, Torrijos, Toledo, Spain,
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77
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Hemming J, Hughes BR, Rennie AR, Tomas S, Campbell RA, Hughes AV, Arnold T, Botchway SW, Thompson KC. Environmental Pollutant Ozone Causes Damage to Lung Surfactant Protein B (SP-B). Biochemistry 2015; 54:5185-97. [PMID: 26270023 PMCID: PMC4571829 DOI: 10.1021/acs.biochem.5b00308] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Revised: 07/30/2015] [Indexed: 11/28/2022]
Abstract
Lung surfactant protein B (SP-B) is an essential protein found in the surfactant fluid at the air-water interface of the lung. Exposure to the air pollutant ozone could potentially damage SP-B and lead to respiratory distress. We have studied two peptides, one consisting of the N-terminus of SP-B [SP-B(1-25)] and the other a construct of the N- and C-termini of SP-B [SP-B(1-25,63-78)], called SMB. Exposure to dilute levels of ozone (~2 ppm) of monolayers of each peptide at the air-water interface leads to a rapid reaction, which is evident from an increase in the surface tension. Fluorescence experiments revealed that this increase in surface tension is accompanied by a loss of fluorescence from the tryptophan residue at the interface. Neutron and X-ray reflectivity experiments show that, in contrast to suggestions in the literature, the peptides are not solubilized upon oxidation but rather remain at the interface with little change in their hydration. Analysis of the product material reveals that no cleavage of the peptides occurs, but a more hydrophobic product is slowly formed together with an increased level of oligomerization. We attributed this to partial unfolding of the peptides. Experiments conducted in the presence of phospholipids reveal that the presence of the lipids does not prevent oxidation of the peptides. Our results strongly suggest that exposure to low levels of ozone gas will damage SP-B, leading to a change in its structure. The implication is that the oxidized protein will be impaired in its ability to interact at the air-water interface with negatively charged phosphoglycerol lipids, thus compromising what is thought to be its main biological function.
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Affiliation(s)
- Joanna
M. Hemming
- Department of Biological Sciences
and Institute of Structural and Molecular Biology, Birkbeck College, University of London, Malet Street, London WC1E
7HX, U.K.
| | - Brian R. Hughes
- Department of Biological Sciences
and Institute of Structural and Molecular Biology, Birkbeck College, University of London, Malet Street, London WC1E
7HX, U.K.
| | - Adrian R. Rennie
- Materials Physics, Department
of
Physics and Astronomy, Uppsala University, 75120 Uppsala, Sweden
| | - Salvador Tomas
- Department of Biological Sciences
and Institute of Structural and Molecular Biology, Birkbeck College, University of London, Malet Street, London WC1E
7HX, U.K.
| | - Richard A. Campbell
- Institut Laue-Langevin, 71 Avenue des Martyrs, CS20156, 38042 Grenoble Cedex 09, France
| | - Arwel V. Hughes
- ISIS Pulsed Neutron and Muon Source, STFC Rutherford Appleton Laboratory,
Harwell Oxford, Didcot, Oxfordshire OX11 0QX, U.K.
| | - Thomas Arnold
- Diamond
Light Source, Harwell
Science and Innovation Campus, Didcot OX11 0DE, U.K.
| | - Stanley W. Botchway
- STFC, Lasers
for Science Facility,
Central Laser Facility, Research Complex at Harwell, STFC Rutherford Appleton Laboratory,
Harwell Oxford, Didcot, Oxfordshire OX11 0FA, U.K.
| | - Katherine C. Thompson
- Department of Biological Sciences
and Institute of Structural and Molecular Biology, Birkbeck College, University of London, Malet Street, London WC1E
7HX, U.K.
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78
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Nishinakagawa T, Senjyu H, Tanaka T, Asai M, Kotaki K, Yano Y, Miyamoto N, Yanagita Y, Kozu R, Tabusadani M, Honda S. Smoking aggravates the impaired pulmonary function of officially acknowledged female victims of air pollution of 40 years ago. TOHOKU J EXP MED 2015; 234:151-60. [PMID: 25274138 DOI: 10.1620/tjem.234.151] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Air pollution due to industrial waste and tobacco smoke is detrimental to pulmonary function. However, the combined effects of air pollution and smoking on pulmonary function have not been investigated. We examined the combined effect of air pollution of 40 years ago and concurrent smoking on the pulmonary function of officially acknowledged female victims in Japan, because females are more susceptible to the adverse effects of both irritants than males. The subjects comprised 655 female victims living in one of two areas with air pollution of 40 years ago and 572 females living in an area without air pollution. All victims have been prescribed standard respiratory medications. Pulmonary function was measured in 2000 for air-pollution groups (130 smokers and 525 non-smokers; mean age, 68.4 years) and during the period of 2004 to 2013 for non-air-pollution groups (113 smokers and 459 non-smokers; mean age, 69.0 years). The smokers included both current smokers and ex-smokers. The victims with a history of smoking had significantly lower forced expiratory volume in 1 second (FEV1 % predicted) (mean, 74%) and significantly lower FEV1/forced vital capacity (FVC) (mean, 70%) than the other groups (P<0.001). Thus, smoking aggravates the pulmonary function in officially acknowledged female victims, despite the improved air pollution and the continuous medical care provided by the government. In conclusion, exposure to air pollution of 40 years ago and cigarette smoking are associated with reduced pulmonary function. These results highlight the importance of measures aimed at smoking cessation and limiting air pollution.
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Affiliation(s)
- Tsuyoshi Nishinakagawa
- Department of Cardiopulmonary Rehabilitation Science, Nagasaki University Graduate School of Biomedical Sciences
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79
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Chow L, Parulekar AD, Hanania NA. Hospital management of acute exacerbations of chronic obstructive pulmonary disease. J Hosp Med 2015; 10:328-39. [PMID: 25820201 DOI: 10.1002/jhm.2334] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Revised: 02/04/2015] [Accepted: 02/04/2015] [Indexed: 11/09/2022]
Abstract
The course of chronic obstructive pulmonary disease (COPD) is often complicated by episodes of acute worsening of respiratory symptoms, which may lead to escalation of therapy and occasionally emergency department visits and hospitalization. Acute exacerbations of COPD (AECOPD) have a negative impact on quality of life and hasten the decline of lung function. They also significantly contribute to the direct and indirect healthcare costs of this disease. Severe exacerbations (those leading to hospital admission) have been associated with significant poor outcomes including an increased risk of readmissions and mortality. COPD is currently the fourth leading cause of hospital readmission in the United States. In this review, we will provide a broad overview on the etiology, assessment, management, discharge planning, and follow-up care of patients hospitalized with AECOPD.
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Affiliation(s)
- Leonard Chow
- Section of Pulmonary, Critical Care and Sleep Medicine, Baylor College of Medicine, Houston, Texas
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80
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Gao T, Wang XC, Chen R, Ngo HH, Guo W. Disability adjusted life year (DALY): a useful tool for quantitative assessment of environmental pollution. THE SCIENCE OF THE TOTAL ENVIRONMENT 2015; 511:268-287. [PMID: 25549348 DOI: 10.1016/j.scitotenv.2014.11.048] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2014] [Revised: 11/13/2014] [Accepted: 11/13/2014] [Indexed: 06/04/2023]
Abstract
Disability adjusted life year (DALY) has been widely used since 1990s for evaluating global and/or regional burden of diseases. As many environmental pollutants are hazardous to human health, DALY is also recognized as an indicator to quantify the health impact of environmental pollution related to disease burden. Based on literature reviews, this article aims to give an overview of the applicable methodologies and research directions for using DALY as a tool for quantitative assessment of environmental pollution. With an introduction of the methodological framework of DALY, the requirements on data collection and manipulation for quantifying disease burdens are summarized. Regarding environmental pollutants hazardous to human beings, health effect/risk evaluation is indispensable for transforming pollution data into disease data through exposure and dose-response analyses which need careful selection of models and determination of parameters. Following the methodological discussions, real cases are analyzed with attention paid to chemical pollutants and pathogens usually encountered in environmental pollution. It can be seen from existing studies that DALY is advantageous over conventional environmental impact assessment for quantification and comparison of the risks resulted from environmental pollution. However, further studies are still required to standardize the methods of health effect evaluation regarding varied pollutants under varied circumstances before DALY calculation.
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Affiliation(s)
- Tingting Gao
- Key Lab of Northwest Water Resources, Environment and Ecology, Ministry of Education, Xi'an University of Architecture and Technology, Xi'an 710055, China
| | - Xiaochang C Wang
- Key Lab of Northwest Water Resources, Environment and Ecology, Ministry of Education, Xi'an University of Architecture and Technology, Xi'an 710055, China.
| | - Rong Chen
- Key Lab of Northwest Water Resources, Environment and Ecology, Ministry of Education, Xi'an University of Architecture and Technology, Xi'an 710055, China
| | - Huu Hao Ngo
- School of Civil and Environmental Engineering, Faculty of Engineering and Information Technology, University of Technology Sydney, Broadway, NSW 2007, Australia.
| | - Wenshan Guo
- School of Civil and Environmental Engineering, Faculty of Engineering and Information Technology, University of Technology Sydney, Broadway, NSW 2007, Australia
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81
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Wang W, Ying Y, Wu Q, Zhang H, Ma D, Xiao W. A GIS-based spatial correlation analysis for ambient air pollution and AECOPD hospitalizations in Jinan, China. Respir Med 2015; 109:372-8. [PMID: 25682544 DOI: 10.1016/j.rmed.2015.01.006] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Revised: 12/02/2014] [Accepted: 01/17/2015] [Indexed: 11/17/2022]
Abstract
BACKGROUND Acute exacerbations of COPD (AECOPD) are important events during disease procedure. AECOPD have negative effect on patients' quality of life, symptoms and lung function, and result in high socioeconomic costs. Though previous studies have demonstrated the significant association between outdoor air pollution and AECOPD hospitalizations, little is known about the spatial relationship utilized a spatial analyzing technique- Geographical Information System (GIS). OBJECTIVE Using GIS to investigate the spatial association between ambient air pollution and AECOPD hospitalizations in Jinan City, 2009. METHODS 414 AECOPD hospitalization cases in Jinan, 2009 were enrolled in our analysis. Monthly concentrations of five monitored air pollutants (NO2, SO2, PM10, O3, CO) during January 2009-December 2009 were provided by Environmental Protection Agency of Shandong Province. Each individual was geocoded in ArcGIS10.0 software. The spatial distribution of five pollutants and the temporal-spatial specific air pollutants exposure level for each individual was estimated by ordinary Kriging model. Spatial autocorrelation (Global Moran's I) was employed to explore the spatial association between ambient air pollutants and AECOPD hospitalizations. A generalized linear model (GLM) using a Poisson distribution with log-link function was used to construct a core model. RESULTS At residence, concentrations of SO2, PM10, NO2, CO, O3 and AECOPD hospitalization cases showed statistical significant spatially clustered. The Z-score of SO2, PM10, CO, O3, NO2 at residence is 15.88, 13.93, 12.60, 4.02, 2.44 respectively, while at workplace, concentrations of PM10, SO2, O3, CO and AECOPD hospitalization cases showed statistical significant spatially clustered. The Z-score of PM10, SO2, O3, CO at workplace is 11.39, 8.07, 6.10, and 5.08 respectively. After adjusting for potential confounders in the model, only the PM10 concentrations at workplace showed statistical significance, with a 10 μg/m(3) increase of PM10 at workplace associated with a 7% (95%CI: [3.3%, 10%]) increase of hospitalizations due to AECOPD. CONCLUSIONS Ambient air pollution is correlated with AECOPD hospitalizations spatially. A 10 μg/m(3) increase of PM10 at workplace was associated with a 7% (95%CI: [3.3%, 10%]) increase of hospitalizations due to AECOPD in Jinan, 2009. As a spatial data processing tool, GIS has novel and great potential on air pollutants exposure assessment and spatial analysis in AECOPD research.
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Affiliation(s)
- Wenqiao Wang
- Department of Respiratory Medicine, Qilu Hospital, Shandong University, No. 107, Wenhua Xi Road, Jinan, Shandong, 250012, PR China; Department of Respiratory Diseases, China-Japan Friendship Hospital, Peking University, Beijing, PR China.
| | - Yangyang Ying
- Department of Respiratory Medicine, Qilu Hospital, Shandong University, No. 107, Wenhua Xi Road, Jinan, Shandong, 250012, PR China.
| | - Quanyuan Wu
- College of Population, Resources and Environment, Shandong Normal University, No. 88, Wenhua Dong Road, Jinan, Shandong, 250012, PR China.
| | - Haiping Zhang
- College of Population, Resources and Environment, Shandong Normal University, No. 88, Wenhua Dong Road, Jinan, Shandong, 250012, PR China.
| | - Dedong Ma
- Department of Respiratory Medicine, Qilu Hospital, Shandong University, No. 107, Wenhua Xi Road, Jinan, Shandong, 250012, PR China.
| | - Wei Xiao
- Department of Respiratory Medicine, Qilu Hospital, Shandong University, No. 107, Wenhua Xi Road, Jinan, Shandong, 250012, PR China.
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82
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Montes de Oca M, López Varela MV, Acuña A, Schiavi E, Rey MA, Jardim J, Casas A, Tokumoto A, Torres Duque CA, Ramírez-Venegas A, García G, Stirbulov R, Camelier A, Bergna M, Cohen M, Guzmán S, Sánchez E. ALAT-2014 Chronic Obstructive Pulmonary Disease (COPD) Clinical Practice Guidelines: questions and answers. Arch Bronconeumol 2015; 51:403-16. [PMID: 25596991 DOI: 10.1016/j.arbres.2014.11.017] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Revised: 11/10/2014] [Accepted: 11/17/2014] [Indexed: 11/17/2022]
Abstract
ALAT-2014 COPD Clinical Practice Guidelines used clinical questions in PICO format to compile evidence related to risk factors, COPD screening, disease prognosis, treatment and exacerbations. Evidence reveals the existence of risk factors for COPD other than tobacco, as well as gender differences in disease presentation. It shows the benefit of screening in an at-risk population, and the predictive value use of multidimensional prognostic indexes. In stable COPD, similar benefits in dyspnea, pulmonary function and quality of life are achieved with LAMA or LABA long-acting bronchodilators, whereas LAMA is more effective in preventing exacerbations. Dual bronchodilator therapy has more benefits than monotherapy. LAMA and combination LABA/IC are similarly effective, but there is an increased risk of pneumonia with LABA/IC. Data on the efficacy and safety of triple therapy are scarce. Evidence supports influenza vaccination in all patients and anti-pneumococcal vaccination in patients <65years of age and/or with severe airflow limitation. Antibiotic prophylaxis may decrease exacerbation frequency in patients at risk. The use of systemic corticosteroids and antibiotics are justified in exacerbations requiring hospitalization and in some patients managed in an outpatient setting.
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Affiliation(s)
- María Montes de Oca
- Hospital Universitario de Caracas, Universidad Central de Venezuela, Caracas, Venezuela.
| | | | - Agustín Acuña
- Hospital Universitario de Caracas, Universidad Central de Venezuela, y Centro Médico Docente La Trinidad, Caracas, Venezuela
| | - Eduardo Schiavi
- Hospital de Rehabilitación Respiratoria «María Ferrer», Buenos Aires, Argentina
| | | | - José Jardim
- Universidade Federal de São Paulo, São Paulo, Brasil
| | | | | | | | | | | | - Roberto Stirbulov
- Facultad de Ciencias Médicas, Santa Casa de San Pablo, São Paulo, Brasil
| | - Aquiles Camelier
- Universidade Federal da Bahia e Escola Bahiana de Medicina, Salvador, Brasil
| | - Miguel Bergna
- Hospital Dr. Antonio Cetrángolo, Vicente López, Buenos Aires, Argentina
| | - Mark Cohen
- Hospital Centro Médico, Guatemala, Guatemala
| | | | - Efraín Sánchez
- Hospital Universitario de Caracas, Universidad Central de Venezuela, y Centro Médico Docente La Trinidad, Caracas, Venezuela
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83
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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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84
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Donaldson GC, Wedzicha JA. The causes and consequences of seasonal variation in COPD exacerbations. Int J Chron Obstruct Pulmon Dis 2014; 9:1101-10. [PMID: 25336941 PMCID: PMC4199860 DOI: 10.2147/copd.s54475] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The time of year when patients experience exacerbations of chronic obstructive pulmonary disease is a much-overlooked feature of the disease. The higher incidence of exacerbations in winter has important consequences for patients in terms of increased morbidity and mortality. The seasonality also imposes a considerable burden on already-overloaded health care services, with both primary care consultations and hospital admissions increasing in number. The seasonality of exacerbations varies with latitude, and is greater in more temperate climates, where there may be less protection from outdoor and indoor cold exposure. The precise causes of the seasonality are unknown, but thought to be partly due to the increased prevalence of respiratory viral infections circulating in cold, damp conditions. Increased susceptibility to viral infection may also be a mechanism mediated through increased airway inflammation or possibly reduced vitamin D levels. The seasonality of exacerbations informs us about the triggers of exacerbations and suggests possible strategies to reduce their number.
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Affiliation(s)
- Gavin C Donaldson
- Airways Disease Section, National Heart and Lung Institute, Imperial College London, London, UK
| | - Jadwiga A Wedzicha
- Airways Disease Section, National Heart and Lung Institute, Imperial College London, London, UK
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85
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Atkinson RW, Carey IM, Kent AJ, van Staa TP, Anderson HR, Cook DG. Long-term exposure to outdoor air pollution and the incidence of chronic obstructive pulmonary disease in a national English cohort. Occup Environ Med 2014; 72:42-8. [PMID: 25146191 PMCID: PMC4283678 DOI: 10.1136/oemed-2014-102266] [Citation(s) in RCA: 84] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Objectives The role of outdoor air pollution in the incidence of chronic obstructive pulmonary disease (COPD) remains unclear. We investigated this question using a large, nationally representative cohort based on primary care records linked to hospital admissions. Methods A cohort of 812 063 patients aged 40–89 years registered with 205 English general practices in 2002 without a COPD diagnosis was followed from 2003 to 2007. First COPD diagnoses recorded either by a general practitioner (GP) or on admission to hospital were identified. Annual average concentrations in 2002 for particulate matter with an aerodynamic diameter <10 µm (PM10) and <2.5 µm (PM2.5), nitrogen dioxide (NO2), ozone and sulfur dioxide (SO2) at 1 km2 resolution were estimated from emission-based dispersion models. Hazard ratios (HRs) per interquartile range change were estimated from Cox models adjusting for age, sex, smoking, body mass index and area-level deprivation. Results 16 034 participants (1.92%) received a COPD diagnosis from their GP and 2910 participants (0.35%) were admitted to hospital for COPD. After adjustment, HRs for GP recorded COPD and PM10, PM2.5 and NO2 were close to unity, positive for SO2 (HR=1.07 (95% CI 1.03 to 1.11) per 2.2 µg/m3) and negative for ozone (HR=0.94 (0.89 to 1.00) per 3 µg/m3). For admissions HRs for PM2.5 and NO2 remained positive (HRs=1.05 (0.98 to 1.13) and 1.06 (0.98 to 1.15) per 1.9 µg/m3 and 10.7 µg/m3, respectively). Conclusions This large population-based cohort study found limited, inconclusive evidence for associations between air pollution and COPD incidence. Further work, utilising improved estimates of air pollution over time and enhanced socioeconomic indicators, is required to clarify the association between air pollution and COPD incidence.
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Affiliation(s)
- R W Atkinson
- Population Health Research Institute and MRC-PHE Centre for Environment and Health, St George's, University of London, London, UK
| | - I M Carey
- Population Health Research Institute and MRC-PHE Centre for Environment and Health, St George's, University of London, London, UK
| | - A J Kent
- Ricardo-AEA Ltd., Harwell IBC, Didcot, Oxfordshire, UK
| | - T P van Staa
- London School of Hygiene and Tropical Medicine, London, UK Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
| | - H R Anderson
- Population Health Research Institute and MRC-PHE Centre for Environment and Health, St George's, University of London, London, UK MRC-PHE Centre for Environment and Health, King's College London, UK
| | - D G Cook
- Population Health Research Institute and MRC-PHE Centre for Environment and Health, St George's, University of London, London, UK
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86
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Abstract
Pulmonary rehabilitation (PR) is associated with improvements in exercise capacity, health related quality of life, psychological symptoms and response to utilization. Acute exacerbations threaten these improvements. An awareness of the clinical sequelae of acute exacerbation of chronic obstructive pulmonary disease enables approaches, such as early post exacerbation rehabilitation to mitigate its negative effects.
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87
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Kim KH, Kabir E, Ara Jahan S. A review of the consequences of global climate change on human health. JOURNAL OF ENVIRONMENTAL SCIENCE AND HEALTH. PART C, ENVIRONMENTAL CARCINOGENESIS & ECOTOXICOLOGY REVIEWS 2014; 32:299-318. [PMID: 25226222 DOI: 10.1080/10590501.2014.941279] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
The impact of climate change has been significant enough to endanger human health both directly and indirectly via heat stress, degraded air quality, rising sea levels, food and water security, extreme weather events (e.g., floods, droughts, earthquakes, volcano eruptions, tsunamis, hurricanes, etc.), vulnerable shelter, and population migration. The deterioration of environmental conditions may facilitate the transmission of diarrhea, vector-borne and infectious diseases, cardiovascular and respiratory illnesses, malnutrition, etc. Indirect effects of climate change such as mental health problems due to stress, loss of homes, economic instability, and forced migration are also unignorably important. Children, the elderly, and communities living in poverty are among the most vulnerable of the harmful effects due to climate change. In this article, we have reviewed the scientific evidence for the human health impact of climate change and analyzed the various diseases in association with changes in the atmospheric environment and climate conditions.
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Affiliation(s)
- Ki-Hyun Kim
- a Department of Civil and Environmental Engineering, Hanyang University , Seoul , Korea
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88
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Abstract
BACKGROUND There has been renewal of interest in the use of prophylactic antibiotics to reduce the frequency of exacerbations and improve quality of life in chronic obstructive pulmonary disease (COPD). OBJECTIVES To determine whether or not regular treatment of COPD patients with prophylactic antibiotics reduces exacerbations or affects quality of life. SEARCH METHODS We searched the Cochrane Airways Group Trials Register and bibliographies of relevant studies. The latest literature search was August 2013. SELECTION CRITERIA Randomised controlled trials (RCTs) that compared prophylactic antibiotics with placebo in patients with COPD. DATA COLLECTION AND ANALYSIS We used the standard methods of The Cochrane Collaboration. Data were extracted and analysed by two independent review authors. MAIN RESULTS Seven RCTs involving 3170 patients were included in this systematic review. All studies were published between 2001 and 2011. Five studies were of continuous antibiotics and two studies were of intermittent antibiotic prophylaxis (termed 'pulsed' for this review). The antibiotics investigated were azithromycin, erythromycin, clarithromycin and moxifloxacin. Azithromycin, erythromycin and clarithromycin are macrolides while moxifloxacin is a fourth-generation synthetic fluoroquinolone antibacterial agent. The study duration varied from three months to 36 months and all used intention-to-treat analysis. Most of the results were of moderate quality. The risk of bias of the included studies was generally low, and we did not downgrade the quality of evidence for risk of bias.The trials recruited participants with a mean age of 66 years and with at least a moderate severity of COPD. Three trials included participants with frequent exacerbations and two trials recruited participants requiring systemic steroids or antibiotics, or both, or who were at the end stage of their disease and required oxygen.The primary outcomes for this review were the number of exacerbations and quality of life.With use of continuous prophylactic antibiotics the number of patients experiencing an exacerbation was reduced (odds ratio (OR) 0.55; 95% confidence interval (CI) 0.39 to 0.77, 3 studies, 1262 participants, high quality). This represented a reduction from 69% of participants in the control group compared to 54% in the treatment group (95% CI 46% to 63%) and the number needed to treat to prevent one exacerbation (NNTb) was therefore 8 (95% CI 5 to 18). The frequency of exacerbations was also reduced with continuous prophylactic antibiotic treatment (rate ratio 0.73; 95% CI 0.58 to 0.91).Use of pulsed antibiotic treatment showed a non-significant reduction in the number of people with exacerbations (OR 0.87; 95% CI 0.69 to 1.09, 1 study, 1149 participants, moderate quality) and the test for interaction showed that this result was significantly different from the effect on exacerbations with continuous antibiotics.There was a statistically significant improvement in quality of life with both continuous and pulsed antibiotic treatment but this was smaller than the four unit improvement that is regarded as being clinically significant (MD -1.78; 95% CI -2.95 to -0.61, 2 studies, 1962 participants, moderate quality).Neither pulsed nor continuous antibiotics showed a significant effect on the secondary outcomes of frequency of hospital admissions, change in lung function, serious adverse events or all-cause mortality (moderate quality evidence).The adverse events that were recorded varied among the trials depending on the different antibiotics used. Azithromycin was associated with a significant hearing loss in the treatment group. The moxifloxacin pulsed study reported a significantly higher number of adverse events in the treatment arm due to the marked increase in gastrointestinal adverse events (P < 0.001). Some adverse events that led to drug discontinuation, such as development of long QTc or tinnitus, were not significantly more frequent in the treatment group than the placebo group but pose important considerations in clinical practice.The development of antibiotic resistance in the community is of major concern. One study found newly colonised patients to have higher rates of antibiotic resistance. Patients colonised with moxifloxacin-sensitive pseudomonas at initiation of therapy rapidly became resistant with the quinolone treatment. AUTHORS' CONCLUSIONS Use of continuous prophylactic antibiotics results in a clinically significant benefit in reducing exacerbations in COPD patients. All trials of continuous antibiotics used macrolides hence the noted benefit applies only to the use of continuous macrolide antibiotics. The impact of pulsed antibiotics remains uncertain and requires further research.The trials in this review included patients who were frequent exacerbators and needed treatment with antibiotics or systemic steroids, or who were on supplemental oxygen. There were also older individuals with a mean age of 66 years. The results of these trials apply only to the group of patients who were studied in these trials and may not be generalisable to other groups.Because of concerns about antibiotic resistance and specific adverse effects, consideration of prophylactic antibiotic use should be mindful of the balance between benefits to individual patients and the potential harms to society created by antibiotic overuse.
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Affiliation(s)
- Samantha C Herath
- Woolcock Institute of Medical Research, 431 Glebe Point Road, Sydney, New South Wales, Australia, 2037
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89
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Abstract
PURPOSE OF REVIEW Chronic obstructive pulmonary disease (COPD) is defined by airflow obstruction and is associated with an exaggerated inflammatory response to noxious stimuli, such as cigarette smoke. Inflammation and recruitment of immune cells drives the underlying pathophysiology; however, the roles of immune cells in the pathogenesis of COPD are evolving and this review will discuss the latest advancements in this field. RECENT FINDINGS Leukocytes including macrophages, neutrophils and lymphocytes are increased in the airways of COPD patients. Despite the presence of increased innate immune cells, COPD airways are often colonized with bacteria suggesting an underlying defect. Macrophages from COPD patients have reduced phagocytic ability which may drive the persistence of inflammation. Differing macrophage phenotypes have been associated with disease suggesting that the surrounding pulmonary environment in COPD may generate a specific phenotype that is permanently pro-inflammatory. COPD neutrophils are also aberrant with increased survival and motility, but lack direction which could lead to more widespread destruction during migration. Finally, an element of autoimmunity, driven by Th17 cells, and alterations in the ratios of lymphocyte subsets may also be involved in disease progression. SUMMARY COPD pathogenesis is complex with contributions from both the innate and adaptive immune systems, and the interaction of these cells with their environment mediates inflammation.
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90
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Hutchinson EJ, Pearson PJG. Vehicle exhaust catalysts in Great Britain: an environmental and economic analysis. ACTA ACUST UNITED AC 2013. [DOI: 10.1179/037174505x45522] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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91
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Lin YK, Chang SC, Lin C, Chen YC, Wang YC. Comparing ozone metrics on associations with outpatient visits for respiratory diseases in Taipei Metropolitan area. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2013; 177:177-84. [PMID: 23333210 PMCID: PMC7127381 DOI: 10.1016/j.envpol.2012.12.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2012] [Revised: 12/09/2012] [Accepted: 12/14/2012] [Indexed: 05/05/2023]
Abstract
This study reported cumulative 6-day (lag 0-5 days) relative risks (RR) and confidence intervals (CI) of daily outpatient visits for total respiratory disease (RD), asthma, and chronic airway obstruction not otherwise classified (CAO) associated with three ozone metrics (daily 1-h maximum (O3, 1 h max), 8-h average maximum (O3, 8 h max), 24-h average (O3, 24 h avg)), and an alternative oxidant indicator (Ox) in Taipei Metropolitan, using distributed lag non-linear models after controlling for potential confounders. The Ox showed the strongest association with outpatient visits for total RD (RR = 1.10, 95% CI: 1.10, 1.11) and asthma (RR = 1.18, 95% CI: 1.00, 1.39) in the cold season. The O3, 24 h avg appeared to be the optimal ozone metric associating with total RD than O3, 1 h max and O3, 8 h max based on model selection. In conclusion, outpatient visits for total RD associated with ozone vary with ozone metrics, disease and season.
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Affiliation(s)
- Yu-Kai Lin
- Institute of Environmental Health, College of Public Health, National Taiwan University, 17 Xu-Zhou Road, Taipei 10055, Taiwan
- Harvard School of Public Health, Department of Environmental Health, Environmental and Occupational Medicine and Epidemiology Program, 677 Huntington Ave, Boston, MA 02115, USA
| | - Shuenn-Chin Chang
- Taiwan Environmental Protection Administration, 83, Sec. 1, Jhonghua Road, Taipei City 10042, Taiwan
- School of Public Health, National Defense Medical Center, 161, Sec. 6, Min-Chuan East Road, Taipei 114, Taiwan
| | - ChitSan Lin
- Department of Marine Environmental Engineering, National Kaohsiung Marine University, 142 Haijhuan Road, Nanzih District, Kaohsiung City 811, Taiwan
| | - Yi-Chun Chen
- Department of Health Management, I-Shou University, Kaohsiung 824, Taiwan
| | - Yu-Chun Wang
- Department of Bioenvironmental Engineering, College of Engineering, Chung Yuan Christian University, 200 Chung-Pei Road, Chung Li 320, Taiwan
- Corresponding author.
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92
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Cengiz MA, Terzi Y. Comparing models of the effect of air pollutants on hospital admissions and symptoms for chronic obstructive pulmonary disease. Cent Eur J Public Health 2013; 20:282-6. [PMID: 23441395 DOI: 10.21101/cejph.a3757] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
There is an increasing interest in the use of hospital admission for Chronic obstructive pulmonary disease (COPD) in studies of short-term exposure effects attributed to air pollutants. However, little is known about the effect of air pollutants on COPD symptoms. This study was undertaken to determine whether there was an association between air pollutant levels and both hospital admissions and symptoms for COPD. For model comparison, we present Generalized Linear Model, Generalized Additive Model and a general approach for Bayesian inference via Markov chain Monte Carlo in generalized additive model. Furthermore, for comparing the predictive accuracy, Artificial Neural Networks (ANN) approach is given.
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Affiliation(s)
- Mehmet Ali Cengiz
- Department of Statistics, University of Ondokuz Mayis, Samsun, Turkey.
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93
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Hondula DM, Davis RE, Knight DB, Sitka LJ, Enfield K, Gawtry SB, Stenger PJ, Deaton ML, Normile CP, Lee TR. A respiratory alert model for the Shenandoah Valley, Virginia, USA. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2013; 57:91-105. [PMID: 22438053 DOI: 10.1007/s00484-012-0537-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2011] [Revised: 02/20/2012] [Accepted: 02/20/2012] [Indexed: 05/31/2023]
Abstract
Respiratory morbidity (particularly COPD and asthma) can be influenced by short-term weather fluctuations that affect air quality and lung function. We developed a model to evaluate meteorological conditions associated with respiratory hospital admissions in the Shenandoah Valley of Virginia, USA. We generated ensembles of classification trees based on six years of respiratory-related hospital admissions (64,620 cases) and a suite of 83 potential environmental predictor variables. As our goal was to identify short-term weather linkages to high admission periods, the dependent variable was formulated as a binary classification of five-day moving average respiratory admission departures from the seasonal mean value. Accounting for seasonality removed the long-term apparent inverse relationship between temperature and admissions. We generated eight total models specific to the northern and southern portions of the valley for each season. All eight models demonstrate predictive skill (mean odds ratio = 3.635) when evaluated using a randomization procedure. The predictor variables selected by the ensembling algorithm vary across models, and both meteorological and air quality variables are included. In general, the models indicate complex linkages between respiratory health and environmental conditions that may be difficult to identify using more traditional approaches.
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Affiliation(s)
- David M Hondula
- Department of Environmental Sciences, University of Virginia, Charlottesville, VA 22904, USA.
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94
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Kobayashi S, Hanagama M, Yamanda S, Satoh H, Tokuda S, Kobayashi M, Ueda S, Suzuki S, Yanai M. Impact of a large-scale natural disaster on patients with chronic obstructive pulmonary disease: the aftermath of the 2011 Great East Japan Earthquake. Respir Investig 2012; 51:17-23. [PMID: 23561254 DOI: 10.1016/j.resinv.2012.10.004] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2012] [Revised: 09/25/2012] [Accepted: 10/22/2012] [Indexed: 01/22/2023]
Abstract
BACKGROUND A large-scale natural disaster may exacerbate chronic respiratory diseases, such as chronic obstructive pulmonary disease (COPD). The aftermath of a natural disaster can include poor access to medication, medical equipment, and medical supplies. Little is known about the impact on patients with COPD. METHODS A retrospective cohort study was conducted at a regional medical center in Ishinomaki, the area affected most severely by the Great East Japan Earthquake in 2011. The study was performed 6 months after the disaster. The characteristics, clinical courses, and outcomes of COPD patients hospitalized after emergency visits during the study period were investigated and compared. RESULTS One hundred patients (112 episodes) were identified. Within a few days after the disaster, patients undergoing oxygen therapy at home came to the hospital to receive oxygen. In the subacute phase (from the third to the fifth week), the number of hospitalizations due to COPD exacerbations was significantly increased compared to the numbers observed before the earthquake (p<0.05). On admission, COPD patients reported significantly reduced participation in the activities of daily living (ADLs) after as compared to before the disaster. The incidence of cases of exacerbated COPD normalized 6 weeks after the earthquake. CONCLUSIONS The large-scale natural disaster that hit Japan in 2011 had a serious negative impact on the clinical outcomes of COPD patients in the disaster-affected area.
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Affiliation(s)
- Seiichi Kobayashi
- Department of Respiratory Medicine, Japanese Red Cross Ishinomaki Hospital, Ishinomaki 986-8522, Japan.
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95
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Mackay AJ, Hurst JR. COPD exacerbations: causes, prevention, and treatment. Immunol Allergy Clin North Am 2012; 33:95-115. [PMID: 23337067 DOI: 10.1016/j.iac.2012.10.006] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The mechanisms of chronic obstructive pulmonary disease exacerbation are complex. Respiratory viruses (in particular rhinovirus) and bacteria play a major role in the cause of these events. A distinct group of patients seems susceptible to frequent exacerbations, irrespective of disease severity, and this phenotype is stable over time. Many current therapeutic strategies help reduce exacerbation frequency. Further work is required to develop novel anti-inflammatory therapies for exacerbation prevention and treatment. This article focuses on the cause of chronic obstructive pulmonary disease exacerbations, and the current preventative and acute interventions available.
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Affiliation(s)
- Alex J Mackay
- Academic Unit of Respiratory Medicine, Royal Free Campus, UCL Medical School, Rowland Hill Street, London NW3 2PF, UK.
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96
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Matkovic Z, Miravitlles M. Chronic bronchial infection in COPD. Is there an infective phenotype? Respir Med 2012; 107:10-22. [PMID: 23218452 PMCID: PMC7126218 DOI: 10.1016/j.rmed.2012.10.024] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2012] [Revised: 09/13/2012] [Accepted: 10/30/2012] [Indexed: 02/06/2023]
Abstract
Microorganisms, particularly bacteria, are frequently found in the lower airways of COPD patients, both in stable state and during exacerbations. The host–pathogen relationship in COPD is a complex, dynamic process characterised by frequent changes in pathogens, their strains and loads, and subsequent host immune responses. Exacerbations are detrimental events in the course of COPD and evidence suggests that 70% may be caused by microorganisms. When considering bacterial exacerbations, recent findings based on molecular typing have demonstrated that the acquisition of new strains of bacteria or antigenic changes in pre-existing strains are the most important triggers for exacerbation onset. Even in clinically stable COPD patients the presence of microorganisms in their lower airways may cause harmful effects and induce chronic low-grade airway inflammation leading to increased exacerbation frequency, an accelerated decline in lung function and impaired health-related quality of life. Besides intraluminal localisation in the distal airways, bacteria can be found in the bronchial walls and parenchymal lung tissue of COPD patients. Therefore, the isolation of pathogenic bacteria in stable COPD should be considered as a form of chronic infection rather than colonisation. This new approach may have important implications for the management of patients with COPD.
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Affiliation(s)
- Zinka Matkovic
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Ciber de Enfermedades Respiratorias (CIBERES), Hospital Clínic, Barcelona, Spain
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97
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Santus P, Russo A, Madonini E, Allegra L, Blasi F, Centanni S, Miadonna A, Schiraldi G, Amaducci S. How air pollution influences clinical management of respiratory diseases. A case-crossover study in Milan. Respir Res 2012; 13:95. [PMID: 23078274 PMCID: PMC3511062 DOI: 10.1186/1465-9921-13-95] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2012] [Accepted: 10/15/2012] [Indexed: 12/31/2022] Open
Abstract
Background Environmental pollution is a known risk factor for multiple diseases and furthermore increases rate of hospitalisations. We investigated the correlation between emergency room admissions (ERAs) of the general population for respiratory diseases and the environmental pollutant levels in Milan, a metropolis in northern Italy. Methods We collected data from 45770 ERAs for respiratory diseases. A time-stratified case-crossover design was used to investigate the association between air pollution levels and ERAs for acute respiratory conditions. The effects of air pollutants were investigated at lag 0 to lag 5, lag 0–2 and lag 3–5 in both single and multi-pollutant models, adjusted for daily weather variables. Results An increase in ozone (O3) levels at lag 3–5 was associated with a 78% increase in the number of ERAs for asthma, especially during the warm season. Exposure to carbon monoxide (CO) proved to be a risk factor for pneumonia at lag 0–2 and in the warm season increased the risk of ERA by 66%. A significant association was found between ERAs for COPD exacerbation and levels of sulphur dioxide (SO2), CO, nitrate dioxide (NO2), and particulate matter (PM10 and PM2.5). The multipollutant model that includes all pollutants showed a significant association between CO (26%) and ERA for upper respiratory tract diseases at lag 0–2. For chronic obstructive pulmonary disease (COPD) exacerbations, only CO (OR 1.19) showed a significant association. Conclusions Exposure to environmental pollution, even at typical low levels, can increase the risk of ERA for acute respiratory diseases and exacerbation of obstructive lung diseases in the general population.
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Affiliation(s)
- Pierachille Santus
- Dipartimento di Scienze della Salute, Università degli Studi di Milano, Respiratory Unit, San Paolo Hospital, Milan, Italy
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98
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Djawe K, Levin L, Swartzman A, Fong S, Roth B, Subramanian A, Grieco K, Jarlsberg L, Miller RF, Huang L, Walzer PD. Environmental risk factors for Pneumocystis pneumonia hospitalizations in HIV patients. Clin Infect Dis 2012; 56:74-81. [PMID: 23042978 DOI: 10.1093/cid/cis841] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Pneumocystis pneumonia (PcP) is the second leading cause of morbidity and mortality in human immunodeficiency virus (HIV)-infected patients in the United States. Although the host risk factors for the development of PcP are well established, the environmental (climatological, air pollution) risk factors are poorly understood. The major goal of this study was to determine the environmental risk factors for admissions of HIV-positive patients with PcP to a single medical center. METHODS Between 1997 and 2008, 457 HIV-positive patients with microscopically confirmed PcP were admitted to the San Francisco General Hospital. A case-crossover design was applied to identify environmental risk factors for PcP hospitalizations. Climatological and air pollution data were collected from the Environmental Protection Agency and Weather Warehouse databases. Conditional logistic regression was used to evaluate the association of each environmental factor and PcP hospital admission. RESULTS Hospital admissions were significantly more common in the summer than in the other seasons. Increases in temperature and sulfur dioxide levels were independently associated with hospital admissions for PcP, but the effects of sulfur dioxide were modified by increasing carbon monoxide levels. CONCLUSIONS This study identifies both climatological and air pollution constituents as independent risk factors for hospitalization of HIV-positive patients with PcP in San Francisco. Thus, the environmental effects on PcP are more likely complex than previously thought. Further studies are needed to understand how these factors exert their effects and to determine if these factors are associated with PcP in other geographic locations.
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Affiliation(s)
- Kpandja Djawe
- Veterans Affairs Medical Center, Cincinnati, OH 45267-0560, USA
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99
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Abstract
Limited data suggest that outdoor air pollution (such as ambient air pollution or traffic-related air pollution) and indoor air pollution (such as second-hand smoking and biomass fuel combustion exposure) are associated with the development of chronic obstructive pulmonary disease (COPD), but there is insufficient evidence to prove a causal relationship at this stage. It also appears that outdoor air pollution is a significant environmental trigger for acute exacerbation of COPD, leading to increasing symptoms, emergency department visits, hospital admissions and even mortality. Improving ambient air pollution and decreasing indoor biomass combustion exposure by improving home ventilation are effective measures that may substantially improve the health of the general public.
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Affiliation(s)
- Fanny W S Ko
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong.
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100
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Abstract
The mechanisms of COPD exacerbation are complex. Respiratory viruses (in particular rhinovirus) and bacteria play a major role in the causative etiology of COPD exacerbations. In some patients, noninfective environmental factors may also be important. Data recently published from a large observational study identified a phenotype of patients more susceptible to frequent exacerbations. Many current therapeutic strategies can reduce exacerbation frequency. Future studies may target the frequent exacerbator phenotype, or those patients colonized with potential bacterial pathogens, for such therapies as long-term antibiotics, thus preventing exacerbations by decreasing bacterial load or preventing new strain acquisition in the stable state. Respiratory viral infections are also an important therapeutic target for COPD. Further work is required to develop new anti-inflammatory agents for exacerbation prevention, and novel acute treatments to improve outcomes at exacerbation.
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Affiliation(s)
- Alex J Mackay
- Academic Unit of Respiratory Medicine, Royal Free Campus, UCL Medical School, London, UK.
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