Ambient particulate air pollution, heart rate variability, and blood markers of inflammation in a panel of elderly subjects

Association between a urinary biomarker for exposure to PAH and blood level of the acute phase protein serum amyloid A in coke oven workers

BACKGROUND

Coke oven workers are exposed to both free and particle bound PAH. Through this exposure, the workers may be at increased risk of cardiovascular diseases. Systemic levels of acute phase response proteins have been linked to cardiovascular disease in epidemiological studies, suggesting it as a marker of these conditions. The aim of this study was to assess whether there was association between PAH exposure and the blood level of the acute phase inflammatory response marker serum amyloid A (SAA) in coke oven workers.

METHODS

A total of 87 male Polish coke oven workers from two different plants comprised the study population. Exposure was assessed by means of the individual post-shift urinary excretion of 1-hydroxypyrene, as internal dose of short-term PAH exposure, and by anti-benzo[a]pyrene diolepoxide (anti-B[a]PDE)-DNA), as a biomarker of long-term PAH exposure. Blood levels of acute phase proteins SAA and CRP were measured by immunoassay. C-reactive protein (CRP) levels were included to adjust for baseline levels of SAA.

RESULTS

Multiple linear regression showed that the major determinants of increased SAA levels were urinary 1-hydroxypyrene (beta = 0.56, p = 0.030) and serum CRP levels (beta = 7.08; p < 0.0001) whereas anti-B[a]PDE-DNA, the GSTM1 detoxifying genotype, diet, and smoking were not associated with SAA levels.

CONCLUSIONS

Urinary 1-hydroxypyrene as biomarker of short-term PAH exposure and serum levels of CRP were predictive of serum levels of SAA in coke oven workers. Our data suggest that exposure of coke oven workers to PAH can lead to increased systemic acute response and therefore potentially increased risk of cardiovascular disease.

Ambient Air Pollution and the Risk of Atrial Fibrillation and Stroke: A Population-Based Cohort Study

BACKGROUND

Although growing evidence links air pollution to stroke incidence, less is known about the effect of air pollution on atrial fibrillation (AF), an important risk factor for stroke.

OBJECTIVES

We assessed the associations between air pollution and incidence of AF and stroke. We also sought to characterize the shape of pollutant-disease relationships.

METHODS

The population-based cohort comprised 5,071,956 Ontario residents, age 35–85 y and without the diagnoses of both outcomes on 1 April 2001 and was followed up until 31 March 2015. AF and stroke cases were ascertained using health administrative databases with validated algorithms. Based on annual residential postal codes, we assigned 5-y running average concentrations of fine particulate matter ([Formula: see text]), nitrogen dioxide ([Formula: see text]), and ozone ([Formula: see text]) from satellite-derived data, a land-use regression model, and a fusion-based method, respectively, as well as redox-weighted averages of [Formula: see text] and [Formula: see text] ([Formula: see text]) for each year. Using Cox proportional hazards models, we estimated the hazard ratios (HRs) and 95% confidence intervals (95% CIs) of AF and stroke with each of these pollutants, adjusting for individual- and neighborhood-level variables. We used newly developed nonlinear risk models to characterize the shape of pollutant–disease relationships.

RESULTS

Between 2001 and 2015, we identified 313,157 incident cases of AF and 122,545 cases of stroke. Interquartile range increments of [Formula: see text], [Formula: see text], [Formula: see text], and [Formula: see text] were associated with increases in the incidence of AF [HRs (95% CIs): 1.03 (1.01, 1.04), 1.02 (1.01, 1.03), 1.01 (1.00, 1.02), and 1.01 (1.01, 1.02), respectively] and the incidence of stroke [HRs (95% CIs): 1.05 (1.03, 1.07), 1.04 (1.01, 1.06), 1.05 (1.03, 1.06), and 1.05 (1.04, 1.06), respectively]. Associations of similar magnitude were found in various sensitivity analyses. Furthermore, we found a near-linear association for stroke with [Formula: see text], whereas [Formula: see text], [Formula: see text]-, and [Formula: see text] relationships exhibited sublinear shapes.

CONCLUSIONS

Air pollution was associated with stroke and AF onset, even at very low concentrations. https://doi.org/10.1289/EHP4883.

Impacts of In-Cabin Exposure to Size-Fractionated Particulate Matters and Carbon Monoxide on Changes in Heart Rate Variability for Healthy Public Transit Commuters

To evaluate the cardiovascular impact of traffic-related pollutant exposure on healthy young adults, the research team has collected the primary data of in-cabin exposure to air pollutants and heart rate variability (HRV). Twenty young healthy college students were recruited in Taipei metropolitan area. In addition to electrocardiogram, personal exposure to air pollutants, i.e., particulate matter (PM) and carbon monoxide (CO), and weather conditions, including temperature and relative humidity (RH), on campus, bus, and mass rapid transit were monitored continuously. The following HRV parameters were evaluated using generalized additive mixed model to adjust for personal and meteorological variables: heart rate (HR), the square root of the mean of the sum of the squares of differences between adjacent normal-to-normal (NN) intervals (r-MSSD), the standard deviation of all NN intervals (SDNN), the percentage of successive NN interval differences greater than 50 ms (pNN50), low-frequency power (LF), high-frequency power (HF), total power (TP), and LF/HF. They were assessed to find out the association between in-cabin exposure and HRV parameters. Compared with the HRV parameters measured on campus, the percent changes in r-MSSD, SDNN, pNN50+1, LF, HF, and TP decreased when the participants were in public transits. After adjusting for all locations, 5 min moving averages of PM2.5–10 and PM1 were significantly associated with the increase in the percent changes in HR and SDNN. Additionally, 5 min moving averages of PM2.5–10 exposure were significantly associated with the decrease in the percent change in HF, while it was significantly associated with the increase of the percent change in LF/HF. The reduction of the percent change in HR was also found to be significantly associated with 5 min CO moving averages. To conclude, current analyses have shown that size-fractionated PMs and CO exposure in public transits might lead to significant changes of HRV parameters for healthy young adults.

Cold storage conditions modify microRNA expressions for platelet transfusion

MicroRNAs (miRNAs) are small RNA molecules that modulate gene and protein expression in hematopoiesis. Platelets are known to contain a fully functional miRNA machinery. While platelets used for transfusion are normally stored at room temperature, recent evidence suggests more favorable effects under a cold-storage condition, including higher adhesion and aggregation properties. Thus, we sought to determine whether functional differences in platelets are associated with the differential profiling of platelet miRNA expressions. To obtain the miRNA expression profile, next-generation sequencing was performed on human platelets obtained from 10 healthy subjects. The miRNAs were quantified after being stored in three different conditions: 1) baseline (before storage), 2) stored at 22°C with agitation for 72 h, and 3) stored at 4°C for 72 h. Following the identification of miRNAs by sequencing, the results were validated at the level of mature miRNAs from 18 healthy subjects, by using quantitative polymerase chain reaction (qPCR). Differential expression was observed for 125 miRNAs that were stored at 4°C and 9 miRNAs stored at 22°C as compared to the baseline. The validation study by qPCR confirmed that storage at 4°C increased the expression levels (fold change 95% CI) of mir-20a-5p (1.87, p<0.0001), mir-10a-3p (1.88, p<0.0001), mir-16-2-3p (1.54, p<0.01), and mir-223-5p (1.38, p<0.05), compared with those of the samples stored at 22°C. These results show that miRNAs correlate with platelet quality under specific storage conditions. The data indicate that miRNAs could be potentially used as biomarkers of platelet quality.

Association between incidence of fatal intracerebral hemorrhagic stroke and fine particulate air pollution

Objective

Few studies investigating associations between fine particulate air pollution and hemorrhagic stroke have considered subtypes. Additionally, less is known about the modification of such association by factors measured at the individual level. We aimed to investigate the risk of fatal intracerebral hemorrhage (ICH) incidence in case of PM_2.5 (particles ≤ 2.5 μm in aerodynamic diameter) exposure.

Methods

Data on incidence of fatal ICH from 1 June 2012 to 31 May 2014 were extracted from the acute stroke mortality database in Shanghai Municipal Center for Disease Control and Prevention (SCDC). We used the time-stratified case-crossover approach to assess the association between daily concentrations of PM_2.5 and fatal ICH incidence in Shanghai, China.

Results

A total of 5286 fatal ICH cases occurred during our study period. The averaged concentration of PM_2.5 was 77.45 μg/m³. The incidence of fatal ICH was significantly associated with PM_2.5 concentration. Substantial differences were observed among subjects with diabetes compared with those without; following the increase of PM_2.5 in lag2, the OR (95% CI) for subjects with diabetes was 1.26 (1.09–1.46) versus 1.05 (0.98–1.12) for those without. We did not find evidence of effect modification by hypertension and cigarette smoking.

Conclusions

Fatal ICH incidence was associated with PM_2.5 exposure. Our results also suggested that diabetes may increase the risk for ICH incidence in relation to PM_2.5.

Electronic supplementary material

The online version of this article (10.1186/s12199-019-0793-9) contains supplementary material, which is available to authorized users.

Does short-term air pollution exposure have effects on blood pressure and heart rate in healthy women in the city of Niš, Serbia?

OBJECTIVE

Epidemiological research has shown that air pollution is associated with cardiovascular events, but little is known about short-term effects on blood pressure (BP) and heart rate (HR) in Serbian population. The present study assessed the short-term association between black smoke (BS) and sulphur dioxide (SO₂) levels in urban air and the daily values of blood pressure and heart rate in 98 healthy nonsmoking female volunteers.

METHODS

Generalized regression model was fitted controlling for temperature, relative humidity, air pressure, season, and the day of the week.

RESULTS

There was no association between short-term air pollution exposure and BP and HR, the exposure showed a tendency toward a decrease of diastolic BP and HR, but with no statistical significance.

CONCLUSION

The present findings did not support the conclusion that current levels of ambient BS and SO₂ may have an effect on blood pressure and heart rate in women.

Impacts of air pollution, temperature, and relative humidity on leukocyte distribution: An epigenetic perspective

BACKGROUND

Exploring the associations of air pollution and weather variables with blood leukocyte distribution is critical to understand the impacts of environmental exposures on the human immune system.

OBJECTIVES

As previous analyses have been mainly based on data from cell counters, which might not be feasible in epidemiologic studies including large populations of long-stored blood samples, we aimed to expand the understanding of this topic by employing the leukocyte distribution estimated by DNA methylation profiles.

METHODS

We measured DNA methylation profiles in blood samples using Illumina HumanMethylation450 BeadChip from 1519 visits of 774 Caucasian males participating in the Normative Aging Study. Leukocyte distribution was estimated using Houseman's and Horvath's algorithms. Data on air pollution exposure, temperature, and relative humidity within 28 days before each blood draw was obtained.

RESULTS

After fully adjusting for potential covariates, PM_2.5, black carbon, particle number, carbon monoxide, nitrogen dioxide, sulfur dioxide, temperature, and relative humidity were associated with the proportions of at least one subtype of leukocytes. Particularly, an interquartile range-higher 28-day average exposure of PM_2.5 was associated with 0.147-, 0.054- and 0.101-unit lower proportions (z-scored) of plasma cells, naïve CD8+ T cells, and natural killers, respectively, and 0.059- and 0.161-unit higher proportions (z-scored) of naïve CD4+ T cells and CD8+ T cells, respectively.

CONCLUSIONS

Our study suggests that short-term air pollution exposure, temperature, and relative humidity are associated with leukocyte distribution. Our study further provides a successful attempt to use epigenetic patterns to assess the influences of environmental exposures on human immune profiles.

Cross-sectional associations between long-term exposure to particulate matter and depression in China: The mediating effects of sunlight, physical activity, and neighborly reciprocity

BACKGROUND

Although numerous studies have speculated about the direct and indirect linkage between long-term air pollution (i.e., PM_2.5) concentrations and mental health in developed countries, evidence for developing countries is limited. Our aim was to examine the mediation effects of sunlight, physical activity, and neighborly reciprocity on the association between air pollution and depression.

METHODS

In a sample of 20,861 individuals in China in 2016, depression was measured using the Center for Epidemiological Studies Depression screener (CES-D) and linked to annual city-wide PM_2.5 data. We used multilevel regression models to assess the associations between depressive symptoms and PM_2.5 and tested the mediation of sunlight, physical activity, and neighborly reciprocity in this association. Propensity score matching was used to evaluate whether selection bias may affect the association between CES-D scores and PM_2.5.

RESULTS

PM_2.5 concentration was positively associated with depression symptoms. All mediators were significantly and negatively associated with PM_2.5. Our mediation analyses indicated that physical activity, neighborly reciprocity, and exposure to sunlight are important mechanisms through which PM_2.5 affects depressive symptoms.

LIMITATIONS

The limitations of the present study were the cross-sectional nature of the data and modifiable areal unit problem.

CONCLUSIONS

Our findings suggest not only that PM_2.5 is directly associated with depression, but also that this association seems to be partially mediated by physical activity, neighborly reciprocity, and sunlight.

Adverse Effects of Fine-Particle Exposure on Joints and Their Surrounding Cells and Microenvironment

Current understanding of the health risks and adverse effects upon exposure to fine particles is premised on the direct association of particles with target organs, particularly the lung; however, fine-particle exposure has also been found to have detrimental effects on sealed cavities distant to the portal-of-entry, such as joints. Moreover, the fundamental toxicological issues have been ascribed to the direct toxic mechanisms, in particular, oxidative stress and proinflammatory responses, without exploring the indirect mechanisms, such as compensated, adaptive, and secondary effects. In this Review, we recapitulate the current findings regarding the detrimental effects of fine-particle exposure on joints, the surrounding cells, and microenvironment, as well as their deteriorating impact on the progression of arthritis. We also elaborate the likely molecular mechanisms underlying the particle-induced detrimental influence on joints, not limited to direct toxicity, but also considering the other indirect mechanisms. Because of the similarities between fine air particles and engineered nanomaterials, we compare the toxicities of engineered nanomaterials to those of fine air particles. Arthritis and joint injuries are prevalent, particularly in the elderly population. Considering the severity of global exposure to fine particles and limited studies assessing the detrimental effects of fine-particle exposure on joints and arthritis, this Review aims to appeal to a broad interest and to promote more research efforts in this field.

The Acute Effects of Age and Particulate Matter Exposure on Heart Rate and Heart Rate Variability in Mice

Exposure to ambient particulate matter (PM) is associated with increased cardiac morbidity and mortality with the elderly considered to be the most susceptible. The purpose of this study was to determine if exposure to PM would cause a greater impact on heart regulation in older DBA/2 (D2) male mice as determined by changes in heart rate (HR) and heart rate variability (HRV). D2 mice at the ages of 4, 12, and 19 months were instilled with 100 µg of PM or saline by aspiration. Before and after the aspiration, 3-min echocardiogram (ECG) samples for HR and HRV were recorded at 15-min intervals for 3 h along with corresponding measurements of homeostasis, such as temperature, metabolism, and ventilation. PM exposure resulted in an increase in HRV, declines in HR, and altered measures of homeostasis for a subset of the 12-mo mice. The PM aspiration did not affect cardiac or homeostasis parameters in the 4- or 19-mo mice. Our results suggest that a select group of middle-age mice are more susceptible to alterations in their heart rhythm after PM exposure and highlight that there are acute age-related differences in heart rhythm following PM exposure.

Child's buccal cell mitochondrial DNA content modifies the association between heart rate variability and recent air pollution exposure at school

BACKGROUND

Studies investigating short-term exposure to ambient air pollution and heart rate variability (HRV) suggest that particulate matter (PM) exposure is associated with reductions in measures of HRV. Mitochondria are sensitive to PM exposure and may represent a biologically relevant underlying mechanism. However, evidence in children is lacking.

OBJECTIVES

Here we examine whether PM has an influence on children's HRV and evaluate whether mitochondrial DNA content (mtDNAc) reflects individual susceptibility.

METHODS

Within a panel study in primary school children (aged 9-12 years), we measured HRV in a subset of 60 children on three different days during school-time using four indicators: normal-to-normal intervals (SDNN), square root of mean squared difference of normal-to-normal intervals (rMSSD), high frequency (HF), and low frequency (LF). This resulted in a total number of 150 visits (median number of visits per child: 2.5/child). MtDNAc was measured using qPCR in buccal cells. We measured recent PM exposure at the school. Residential 24-hour mean exposure to PM was modelled with a high resolution spatial temporal model. Mixed-effects models were used to estimate the association between HRV and recent PM exposure and potential effect-modification by mtDNAc.

RESULTS

Children were on average [SD] 9.9 [1.2] years and comprised 39 girls. Median [25th-75th] recent outdoor PM_2.5 and PM₁₀ exposure at school was 6.20 [2.8-12.8] μg/m³ and 29.3 [24.7-42.0] μg/m³, respectively. In children with low mtDNAc (25th percentile), we observed for each 10 μg/m³ increment in recent PM_2.5 exposure a lowering in the LF parameter with 9.76% (95% CI: -16.9 to -1.99%, p = 0.02; p_int = 0.007). Children with high mtDNAc did not show this association. For PM₁₀ exposure, we observed an inverse association with three HRV indicators in children with low mtDNAc: -2.24% (95% CI: -4.27 to -0.16%; p = 0.04; p_int = 0.02) for SDNN, -5.67% (95% CI: -10.5 to -0.59%; p = 0.03; p_int = 0.04) for HF and -6.64% (95% CI: -10.7 to -2.38%; p = 0.003; p_int = 0.005) for LF.

CONCLUSIONS

HRV is inversely associated with recent PM air pollution, especially in children with low mtDNAc. Our data revealed that mtDNAc determines susceptibility to adverse autonomic effects of recent PM exposure in children.

Roadside Exposure and Inflammation Biomarkers among a Cohort of Traffic Police in Kathmandu, Nepal

Air pollution is a major environmental problem in the Kathmandu Valley. Specifically, roadside and traffic-related air pollution exposure levels were found at very high levels exceeding Nepal air quality standards for daily PM_2.5. In an exposure study involving traffic police officers, we collected 78 blood samples in a highly polluted spring season (16 February 2014–4 April 2014) and 63 blood samples in the less polluted summer season (20 July 2014–22 August 2014). Fourteen biomarkers, i.e., C-reactive protein (CRP), serum amyloid A (SAA), intracellular adhesion molecule (ICAM-1), vascular cell adhesion molecule (VCAM-1), interferon gamma (IFN-γ), interleukins (IL1-β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-12, IL-13), and tumor necrosis factor (TNF-α) were analyzed in collected blood samples using proinflammatory panel 1 kits and vascular injury panel 2 kits. All the inflammatory biomarker levels were higher in the summer season than in the spring season, while particulate levels were higher in the spring season than in the summer season. We did not find significant association between 24-hour average PM_2.5 or black carbon (BC) exposure levels with most of analyzed biomarkers for the traffic volunteers working and residing near busy roads in Kathmandu, Nepal, during 2014. Inflammation and vascular injury marker concentrations were generally higher in females, suggesting the important role of gender in inflammation biomarkers. Because of the small sample size of female subjects, further investigation with a larger sample size is required to confirm the role of gender in inflammation biomarkers.

The Exposome and Asthma

This article on exposome and asthma focuses on the interaction of patients and their environments in various parts of their growth, development, and stages of life. Indoor and outdoor environments play a role in pathogenesis via levels and duration of exposure, with genetic susceptibility as a crucial factor that alters the initiation and trajectory of common conditions such as asthma. Knowledge of environmental exposures globally and changes that are occurring is necessary to function effectively as medical professionals and health advocates.

A unifying conceptual framework of factors associated to cardiac vagal control

Cardiac vagal control (CVC) reflects the activity of the vagus nerve regulating cardiac functioning. CVC can be inferred via heart rate variability measurement, and it has been positively associated to a broad range of cognitive, emotional, social, and health outcomes. It could then be considered as an indicator for effective self-regulation, and given this role, one should understand the factors increasing and decreasing CVC. The aim of this paper is to review the broad range of factors influencing CVC, and to provide a unifying conceptual framework to integrate comprehensively those factors. The structure of the unifying conceptual framework is based on the theory of ecological rationality, while its functional aspects are based on the neurovisceral integration model. The structure of this framework distinguishes two broad areas of associations: person and environment, as this reflects adequately the role played by CVC regarding adaptation. The added value of this framework lies at different levels: theoretically, it allows integrating findings from a variety of scientific disciplines and refining the predictions of the neurovisceral integration model; methodologically, it helps identifying factors that increase and decrease CVC; and lastly at the applied level, it can play an important role for society regarding health policies and for the individual to empower one's flourishing.

Changing places to study short-term effects of air pollution on cardiovascular health: a panel study

BACKGROUND

Short-term exposure to ambient air pollution triggers acute cardiovascular events. Here, we evaluate the association of exposure to ambient air pollution with two intermediate cardiovascular endpoints: blood pressure and carotid stiffness.

METHODS

In a one-year panel study, we included 20 healthy volunteers (10 male-female couples aged 59-75 years) with air pollution and health parameters measured every two months at their region of residence (Leuven, Belgium) and twice during two ten-day periods in two locations, one with higher (Milan, Italy) and one with lower (Vindeln, Sweden) air pollution levels (220 observations). We measured blood pressure, carotid arterial stiffness, personal exposure to NO₂, and ambient concentrations of PM₁₀, PM_2.5, and NO₂. We used linear mixed models to evaluate the associations between the health outcomes and the air pollutants.

RESULTS

Compared with Leuven, exposure to pollutants was higher in Milan and lower in Vindeln, with the highest contrast for NO₂ (median 20.7 μg/m³ (IQR:7.4) vs 65.1 μg/m³ (9.0) and 4.5 mg/m³ (0.8), respectively). We did not observe significant associations between either systolic or diastolic blood pressure and variations in air pollution. However, we found significant associations between arterial stiffness and 5 day average exposure to the studied pollutants. The strongest associations were observed for PM₁₀ with carotid distensibility (DC) and compliance (CC) coefficients, and the young elastic modulus (YEM): 4.3% (95%CI:7.0;1.5) increase in DC, 4.7% (95%CI:7.1;2.3) increase in CC and 4.2% (95%CI:1.1;7.3) decrease in YEM for each 10 μg/m³ decreases in PM₁₀.

CONCLUSIONS

Our study suggests that short-term exposure to air pollution results in reductions in carotid elasticity among elderly population.

Diesel exhaust particles induce autophagy and citrullination in Normal Human Bronchial Epithelial cells

A variety of environmental agents has been found to influence the development of autoimmune diseases; in particular, the studies investigating the potential association of systemic autoimmune rheumatic diseases with environmental micro and nano-particulate matter are very few and contradictory. In this study, the role of diesel exhaust particles (DEPs), one of the most important components of environment particulate matter, emitted from Euro 4 and Euro 5 engines in altering the Normal Human Bronchial Epithelial (NHBE) cell biological activity was evaluated. NHBE cells were exposed in vitro to Euro 4 and Euro 5 particle carbon core, sampled upstream of the typical emission after-treatment systems (diesel oxidation catalyst and diesel particulate filter), whose surfaces have been washed from well-assessed harmful species, as polycyclic aromatic hydrocarbons (PAHs) to: (1) investigate their specific capacity to affect cell viability (flow cytometry); (2) stimulate the production of the pro-inflammatory cytokine IL-18 (Enzyme-Linked ImmunoSorbent Assay -ELISA-); (3) verify their specific ability to induce autophagy and elicit protein citrullination and peptidyl arginine deiminase (PAD) activity (confocal laser scanning microscopy, immunoprecipitation, Sodium Dodecyl Sulphate-PolyAcrylamide Gel Electrophoresis -SDS-PAGE- and Western blot, ELISA). In this study we demonstrated, for the first time, that both Euro 4 and Euro 5 carbon particles, deprived of PAHs possibly adsorbed on the soot surface, were able to: (1) significantly affect cell viability, inducing autophagy, apoptosis and necrosis; (2) stimulate the release of the pro-inflammatory cytokine IL-18; (3) elicit protein citrullination and PAD activity in NHBE cells. In particular, Euro 5 DEPs seem to have a more marked effect with respect to Euro 4 DEPs.

Enhancing cardiac vagal activity: Factors of interest for sport psychology

Self-regulation plays a critical role in sport performance. An objective, psychophysiological marker of self-regulation is cardiac vagal activity, the activity of the vagus nerve regulating cardiac functioning. The aim of this paper is to provide an overview of factors influencing cardiac vagal activity, which can be useful for athletes. Specifically, we organize this overview in two main domains: personal factors and environmental factors. Among the personal factors, we discuss the behavioral strategies that can be used by athletes: nutrition, non-ingestive oral habits, water immersion, body temperature reduction, sleeping habits, relaxation methods, cognitive techniques, praying, music, and exercise. Among environmental factors, we discuss those linked to the social (i.e., contact with humans and animals) and physical (i.e., aromas, lights, sounds, temperature, outdoor, altitude) environment. Future research directions are given, as well as practical implications for athletes and coaches.

Effect of Portable Air Filtration Systems on Personal Exposure to Fine Particulate Matter and Blood Pressure Among Residents in a Low-Income Senior Facility: A Randomized Clinical Trial

IMPORTANCE

Fine particulate matter (smaller than 2.5 μm) (PM2.5) air pollution is a major global risk factor for cardiovascular (CV) morbidity and mortality. Few studies have tested the benefits of portable air filtration systems in urban settings in the United States.

OBJECTIVE

To investigate the effectiveness of air filtration at reducing personal exposures to PM2.5 and mitigating related CV health effects among older adults in a typical US urban location.

DESIGN, SETTING, AND PARTICIPANTS

This randomized, double-blind crossover intervention study was conducted from October 21, 2014, through November 4, 2016, in a low-income senior residential building in Detroit, Michigan. Forty nonsmoking older adults were enrolled, with daily CV health outcome and PM2.5 exposure measurements.

INTERVENTIONS

Participants were exposed to the following three 3-day scenarios separated by 1-week washout periods: unfiltered air (sham filtration), low-efficiency (LE) high-efficiency particulate arrestance (HEPA)-type filtered air, and high-efficiency (HE) true-HEPA filtered air using filtration systems in their bedroom and living room.

MAIN OUTCOMES AND MEASURES

The primary outcome was brachial blood pressure (BP). Secondary outcomes included aortic hemodynamics, pulse-wave velocity, and heart rate variability. Exposures to PM2.5 were measured in the participants' residences and by personal monitoring.

RESULTS

The 40 participants had a mean (SD) age of 67 (8) years (62% men). Personal PM2.5 exposures were significantly reduced by air filtration from a mean (SD) of 15.5 (10.9) μg/m3 with sham filtration to 10.9 (7.4) μg/m3 with LE fitration and 7.4 (3.3) μg/m3 with HE filtration. Compared with sham filtration, any filtration for 3 days decreased brachial systolic and diastolic BP by 3.2 mm Hg (95% CI, -6.1 to -0.2 mm Hg) and 1.5 mm Hg (95% CI, -3.3 to 0.2 mm Hg), respectively. A continuous decrease occurred in systolic and diastolic BP during the 3-day period of LE filtration, with a mean of 3.4 mm Hg (95% CI, -6.8 to -0.1 mm Hg) and 2.2 mm Hg (95% CI, -4.2 to -0.3 mm Hg), respectively. For HE filtration, systolic and diastolic BP decreased by 2.9 mm Hg (95% CI, -6.2 to 0.5 mm Hg) and 0.8 mm Hg (95% CI, -2.8 to 1.2 mm Hg), respectively. Most secondary outcomes were not significantly improved.

CONCLUSIONS AND RELEVANCE

Results of this study showed that short-term use of portable air filtration systems reduced personal PM2.5 exposures and systolic BP among older adults living in a typical US urban location. The use of these relatively inexpensive systems is potentially cardioprotective against PM2.5 exposures and warrants further research.

TRIAL REGISTRATION

ClinicalTrials.gov identifier: NCT03334565.

Differential Expression Profile of MicroRNAs During Prolonged Storage of Platelet Concentrates As a Quality Measurement Tool in Blood Banks

Platelet concentrate (PC) is a key blood component, which even in good storage conditions, susceptible to cellular damage over time. Hence, blood banks discard unused PC bags after 5 days of storage. Biomarkers of PC quality are therefore highly sought after in blood bank governance. We used the data (Gene Expression Omnibus: GSE61856) generated with next-generation sequencing to examine the expression profiles of microRNAs (miRNAs) from PCs that were stored for 6 days in a blood bank, that is, 1 day longer than is normally stored PC. We identified the 14 most differentially expressed miRNAs by comparing a control PC on the first day of storage with the PCs on each of the subsequent 5 days of storage from day 1 to 6. In all, we identified nine miRNAs with the downregulated profile (miR-145-5p, miR-150-5p, miR-183-5p, miR-26a-5p, miR-331-3p, miR-338-5p, miR-451a, miR-501-3p, and miR-99b-5p) and five upregulated miRNAs (miR-1304-3p, miR-411-5p, miR-432-5p, miR-668-3p, and miR-939-5p). These miRNAs were validated by real-time quantitative PCR in 100 PC units. As each PC unit is composed of platelets of five individuals, the validation was thus performed in 500 individuals (250 men and 250 women, comprised 18-40 years old adults). The data were analyzed with hierarchical clustering and principal component analysis, which revealed the variation of mean relative expression and the instability of miRNAs half-life on the fourth day of PC storage, which coincides with time of onset of platelet storage lesions. These new observations can usefully inform future decision-making and governance in blood banks concerning PC quality.

Maternal air pollution exposure and preterm birth in Wuxi, China: Effect modification by maternal age

BACKGROUND

Numerous studies have investigated prenatal air pollution and shown that air pollutants have adverse effect on birth outcomes. However, which trimester was the most sensitive and whether the effect was related to maternal age is still ambiguous.

OBJECTIVES

This study aims to explore the association between maternal air pollution exposure during pregnancy and preterm birth, and if this relationship is modified by maternal age.

METHODS

In this retrospective cohort study, we examine the causal relationship of prenatal exposure to air pollutants including particulate matters, which are less than 10 µm (PM₁₀), and ozone (O₃), which is one of the gaseous pollutants, on preterm birth by gestational age. A total of 6693 pregnant women were recruited from Wuxi Maternal and Child Health Care Hospital. The participants were dichotomized into child-bearing age group (< 35 years old) and advanced age group (> = 35 years old) in order to analyze the effect modification by maternal age. Logistic and linear regression models were performed to assess the risk for preterm birth (gestational age < 37 weeks) caused by prenatal air pollution exposure.

RESULTS

With adjustment for covariates, the highest level of PM₁₀ exposure significantly increased the risk of preterm birth by 1.42-fold (95% CI: 1.10, 1.85) compared those with the lowest level in the second trimester. Trimester-specific PM₁₀ exposure was positively associated with gestational age, whereas O₃ exposure was associated with gestational age in the early pregnancy. When stratified by maternal age, PM₁₀ exposure was significantly associated with an increased risk of preterm birth only in the advanced age group during pregnancy (OR:2.15, 95% CI: 1.13, 4.07). The results suggested that PM₁₀ exposure associated with preterm birth was modified by advanced maternal age (OR _interaction = 2.00, 95% CI: 1.02, 3.91, P_interaction = 0.032).

CONCLUSION

Prenatal air pollution exposure would increase risk of preterm birth and reduced gestational age. Thus, more attention should be paid to the effects of ambient air pollution exposure on preterm birth especially in pregnant women with advanced maternal age.

The effect of ambient particle matters on hospital admissions for cardiac arrhythmia: a multi-city case-crossover study in China

BACKGROUND

The relationship between particle matters (PMs) and cardiac arrhythmia has been investigated in numerous studies. However, evidence from developing countries is limited. The aim of this study was to evaluate the association between ambient PMs and hospital admissions for cardiac arrhythmia in China and to examine the potential effect modifiers.

METHODS

A time-stratified case-crossover analysis was conducted in 26 large Chinese cities. In total, we identified 175,265 hospital admissions for cardiac arrhythmia between January 2014 and December 2015 from electronic hospitalization summary reports. Conditional logistic regression was performed to estimate the percentage changes in cardiac arrhythmia admissions in relation to interquartile range increases in air pollutants. Age, gender and prespecified comorbid health conditions including hypertension, diabetes, congestive heart failure and hyperlipidemia were stratified to evaluate susceptibility factors.

RESULTS

PMs levels were positively associated with the number of hospital admissions for cardiac arrhythmia. Both PM_2.5 and PM₁₀ had the strongest impact on lag 2 days. An interquartile range increase in PM_2.5 (47.5 μg/m³) and PM₁₀ (76.9 μg/m³) concentrations on lag 2 days was associated with increments of 2.09% (95%CI, 1.58-2.60%) and 2.33% (95%CI, 1.68-2.97%) in hospital admission for cardiac arrhythmia, respectively. Evidence of effect modification by age and comorbid diabetes was observed. The elderly (> 65 years) and patients with comorbid diabetes were more likely to be hospitalized for cardiac arrhythmia following exposure to high levels of PMs.

CONCLUSIONS

This study found an increased risk of arrhythmia admissions associated with PM_2.5 and PM₁₀ levels among 26 Chinese cities. The associations of PMs with arrhythmia admissions were stronger in aged population and people with diabetes.

Development of Ahmedabad's Air Information and Response (AIR) Plan to Protect Public Health

Indian cities struggle with some of the highest ambient air pollution levels in the world. While national efforts are building momentum towards concerted action to reduce air pollution, individual cities are taking action on this challenge to protect communities from the many health problems caused by this harmful environmental exposure. In 2017, the city of Ahmedabad launched a regional air pollution monitoring and risk communication project, the Air Information and Response (AIR) Plan. The centerpiece of the plan is an air quality index developed by the Indian Institute of Tropical Meteorology’s System for Air Quality and Weather Forecasting and Research program that summarizes information from 10 new continuous air pollution monitoring stations in the region, each reporting data that can help people avoid harmful exposures and inform policy strategies to achieve cleaner air. This paper focuses on the motivation, development, and implementation of Ahmedabad’s AIR Plan. The project is discussed in terms of its collaborative roots, public health purpose in addressing the grave threat of air pollution (particularly to vulnerable groups), technical aspects in deploying air monitoring technology, and broader goals for the dissemination of an air quality index linked to specific health messages and suggested actions to reduce harmful exposures. The city of Ahmedabad is among the first cities in India where city leaders, state government, and civil society are proactively working together to address the country’s air pollution challenge with a focus on public health. The lessons learned from the development of the AIR Plan serve as a template for other cities aiming to address the heavy burden of air pollution on public health. Effective working relationships are vital since they form the foundation for long-term success and useful knowledge sharing beyond a single city.

The role of air pollution on ST-elevation myocardial infarction: a narrative mini review

ST-elevation myocardial infarction (STEMI) is one of the potential causes of death worldwide. In spite of substantial advances in its diagnosis and treatment, STEMI is still considered as a major public health dilemma in developed and particularly developing countries. One of the triggering factors of STEMI is supposed to be air pollutants like gaseous pollutants including, sulfur dioxide, nitric dioxide, carbon monoxide, ozone and particulate matters (PM) including, PM under 2.5 µm (PM_2.5) and PM under 10 µm (PM₁₀). Air pollution can trigger STEMI with various mechanisms such as increasing inflammatory factors and changing the heart rate or blood viscosity. In this article, we aimed to explore research in the field and discuss the relationship between air pollution and STEMI.

Association of ultrafine particles with cardiopulmonary health among adult subjects in the urban areas of northern Taiwan

The association between short-term exposure to particulate air pollution, especially fine particles, and cardiopulmonary health has been well-established in previous studies. However, previous findings regarding the effect of ultrafine particles (UFPs) on cardiopulmonary health are inconsistent. We repeatedly measured the mass concentrations of UFPs using a Micro-Orifice Uniform Deposit Impactor (MOUDI) in the apartments of 100 adult participants and collected the participants' health data from the pulmonary outpatient unit of Shuang-Ho Hospital to investigate the association between short-term exposure to UFPs and cardiopulmonary health using mixed-effects models from January 1, 2014 to August 31, 2017. We also collected ambient air pollution monitoring data from the Taiwan Environmental Protection Administration for data analysis. We observed that an interquartile range increase in the 24-hour mean UFPs (0.97 μg/m³) was associated with a 6.3% [95% confidence interval (CI) = 2.9, 9.7], 5.6% (95% CI = 4.1, 7.1) and 8.5% (95% CI = 3.9, 13.1) increase in systolic blood pressure, diastolic blood pressure and high sensitivity-C-reactive protein, respectively. We also observed the association of particulate matter less than or equal to 2.5 μm in diameter and nitrogen dioxide with increased blood pressure and ozone with decreased lung function. A negative trend between UFPs and forced expiratory volume in the first second was observed. We concluded that short-term exposure to UFPs was associated with cardiovascular health in adult subjects in the urban areas of northern Taiwan.

Impact of Obesity and Ozone on the Association Between Particulate Air Pollution and Cardiovascular Disease and Stroke Mortality Among US Adults

Background

Cardiovascular diseases (CVDs) and stroke are the highest and third highest causes of death, respectively, in the whole United States. It is well established that both long‐ and short‐term exposure to particulate air pollution (particulate matter with diameters <2.5 μm [PM_2.5]) increases the risks of both CVD and stroke mortality.

Methods and Results

We combined county‐level data for CVD and stroke mortality, and prevalence of hypertension and obesity, with spatial patterns of PM_2.5 and ozone in a cross‐sectional ecological study. We found significant positive associations between both CVD (β=15.4, P<0.001) and stroke (β=2.7, P<0.001) mortality with PM_2.5. Ozone had significant link with just CVD (β=1372.1, P<0.001). Once poverty, ethnicity, and education were taken into account, there were still significant positive associations between PM_2.5 and both CVD (β=1.2, P<0.001) and stroke (β=1.1, P<0.001) mortality. Moreover, the association between CVD and ozone remained after adjustment for these factors (β=21.8, P<0.001). PM_2.5 and ozone were independent risk factors. The impact of PM_2.5 on CVD and stroke mortality was strongly dependent on the prevalence of obesity. Hypertension partially mediated the associations of PM_2.5 and mortality from CVD and stroke.

Conclusions

There was a spatial association between PM_2.5 exposure and the leading causes of death and disability in United States. The effect of PM_2.5 was considerably greater in areas where obesity is more prevalent. Hypertension is a possible mediator of the association of PM_2.5 and both CVD and stroke.

Association of fine particulate air pollution with cardiopulmonary morbidity in Western Coast of Saudi Arabia

Objectives:

To assess cardiopulmonary morbidity associated with daily exposures to PM_2.5 in Western Coast of Saudi Arabia.

Methods:

We monitored 24-h PM_2.5 and its constituents including black carbon (BC), particulate sulfate (p-SO₄^2–), nitrate (p-NO₃^–), ammonium (p-NH₄⁺) and trace elements (TEs) at a site in Rabigh, Saudi Arabia from May to June 2013 with simultaneous collection of hospital data (N=2513). Cardiopulmonary morbidity risk was determined in a generalized linear time-series model.

Results:

Exposure to PM_2.5 was associated with a 7.6% (p=0.056) increase in risk of respiratory disease (RD) in females. Black carbon increased RD morbidity risk by 68.1% (p=0.056) in females. Exposure to p-SO₄^2– increased the cardiovascular disease (CVD) risk by up to 5.3% (p=0.048) in males; and RD by 2.9% (p=0.037) in females and 2.5% (p=0.022) in males. The p-NH₄⁺ increased CVD risk by up to 20.3% (p=0.033) in males; and RD by 10.7% (p=0.014) in females and 8% (p=0.031) in males. No statistically significant association was observed for p-NO₃^– and TEs exposure.

Conclusion:

Overall, results show an increased risk for cardiopulmonary morbidity following exposure to air pollution.

DNA Methylome Marks of Exposure to Particulate Matter at Three Time Points in Early Life

Maternal exposure to airborne particulate matter (PM) has been associated with restricted fetal growth and reduced birthweight. Here, we performed methylome-wide analyses of cord and children's blood DNA in relation to residential exposure to PM smaller than 10 μm (PM10). This study included participants of the Avon Longitudinal Study of Pregnancy and Childhood (ALSPAC, cord blood, n = 780; blood at age 7, n = 757 and age 15-17, n = 850) and the EXPOsOMICS birth cohort consortium including cord blood from ENVIR ONAGE ( n = 197), INMA ( n = 84), Piccolipiù ( n = 99) and Rhea ( n = 75). We could not identify significant CpG sites, by meta-analyzing associations between maternal PM10 exposure during pregnancy and DNA methylation in cord blood, nor by studying DNA methylation and concordant annual exposure at 7 and 15-17 years. The CpG cg21785536 was inversely associated with PM10 exposure using a longitudinal model integrating the three studied age groups (-1.2% per 10 μg/m3; raw p-value = 3.82 × 10-8). Pathway analyses on the corresponding genes of the 100 strongest associated CpG sites of the longitudinal model revealed enriched pathways relating to the GABAergic synapse, p53 signaling and NOTCH1. We provided evidence that residential PM10 exposure in early life affects methylation of the CpG cg21785536 located on the EGF Domain Specific O-Linked N-Acetylglucosamine Transferase gene.

Cardio-Respiratory Effects of Air Pollution in a Panel Study of Outdoor Physical Activity and Health in Rural Older Adults

Objective:

To examine cardio-respiratory effects of air pollution in rural older adults exercising outdoors.

Methods:

Adults 55 and over completed measurements of blood pressure, peak expiratory flow and oximetry daily, and of heart rate variability, endothelial function, spirometry, fraction of exhaled nitric oxide and urinary oxidative stress markers weekly, before and after outdoor exercise, for 10 weeks. Data were analyzed using linear mixed effect models.

Results:

Pooled estimates combining 2013 (n = 36 participants) and 2014 (n = 41) indicated that an interquartile increase in the air quality health index (AQHI) was associated with a significant (P < 0.05) increase in heart rate (2.1%) and significant decreases in high frequency power (−19.1%), root mean square of successive differences (−9.5%), and reactive hyperemia index (−6.5%).

Conclusions:

We observed acute subclinical adverse effects of air pollution in rural older adults exercising outdoors.

Biomarkers of Human Cardiopulmonary Response After Short-Term Exposures to Medical Laser-Generated Particulate Matter From Simulated Procedures: A Pilot Study

OBJECTIVE

We conducted an exposure chamber study in humans using a simulated clinical procedure lasing porcine tissue to demonstrate evidence of effects of exposure to laser-generated particulate matter (LGPM).

METHODS

We measured pre- and post-exposure changes in exhaled nitric oxide (eNO), spirometry, heart rate variability (HRV), and blood markers of inflammation in five volunteers.

RESULTS

Change in pre- and post-exposure measurements of eNO and spirometry was unremarkable. Neutrophil and lymphocyte counts increased and fibrinogen levels decreased in four of the five subjects. Measures of HRV showed decreases in the standard deviation of normal between beat intervals and sequential 5-minute intervals.

CONCLUSION

These data represent the first evidence of human physiologic response to LGPM exposure. Further exploration of coagulation effects and HRV is warranted.

Early-Life Persistent Vitamin D Deficiency Alters Cardiopulmonary Responses to Particulate Matter-Enhanced Atmospheric Smog in Adult Mice

Early life nutritional deficiencies can lead to increased cardiovascular susceptibility to environmental exposures. Thus, the purpose of this study was to examine the effect of early life persistent vitamin D deficiency (VDD) on the cardiopulmonary response to a particulate matter-enhanced photochemical smog. Mice were fed a VDD or normal diet (ND) after weaning. At 17 weeks of age, mice were implanted with radiotelemeters to monitor electrocardiogram, heart rate (HR), and heart rate variability (HRV). Ventilatory function was measured throughout the diet before and after smog exposure using whole-body plethysmography. VDD mice had lower HR, increased HRV, and decreased tidal volume compared with ND. Regardless of diet, HR decreased during air exposure; this response was blunted by smog in ND mice and to a lesser degree in VDD. When compared with ND, VDD increased HRV during air exposure and more so with smog. However, smog only increased cardiac arrhythmias in ND mice. This study demonstrates that VDD alters the cardiopulmonary response to smog, highlighting the possible influence of nutritional factors in determining responses to air pollution. The mechanism of how VDD induces these effects is currently unknown, but modifiable factors should be considered when performing risk assessment of complex air pollution atmospheres.

Impact of Particulate Air Pollution on Cardiovascular Health

PURPOSE OF REVIEW

Air pollution is established as an independent risk factor for cardiovascular diseases (CVDs). Ambient particulate matter (PM), a principal component of air pollutant, has been considered as a main culprit of the adverse effects of air pollution on human health.

RECENT FINDINGS

Extensive epidemiological and toxicological studies have demonstrated particulate air pollution is positively associated with the development of CVDs. Short-term PM exposure can trigger acute cardiovascular events while long-term exposure over years augments cardiovascular risk to an even greater extent and can reduce life expectancy by a few years. Inhalation of PM affects heart rate variability, blood pressure, vascular tone, blood coagulability, and the progression of atherosclerosis. The potential molecular mechanisms of PM-caused CVDs include direct toxicity to the cardiovascular system or indirect injury by inducing systemic inflammation and oxidative stress in circulation. This review mainly focuses on the acute and chronic effects of ambient PM exposure on the development of cardiovascular diseases and the possible mechanisms for PM-induced increases in cardiovascular morbidity and mortality. Additionally, we summarized some appropriate interventions to attenuate PM air pollution-induced cardiovascular adverse effects, which may promote great benefits to public health.

Short-term effects of fine particulate matter on acute myocardial infraction mortality and years of life lost: A time series study in Hong Kong

Previous studies have applied years of life lost (YLL) as a complementary indicator to assess the short-term effect of the air pollution on the health burden from all-cause mortality, but sparsely focused on individual diseases such as acute myocardial infraction (AMI). In this study, we aimed to conduct a time-series analysis to evaluate short-term effects of fine particulate matter (PM_2.5) on mortality and YLL from AMI in Hong Kong from 2011 to 2015, and explore the potential effect modifiers including sex and age by subgroup analysis. We applied generalized additive Poisson and Gaussian regression model for daily death count and YLL, respectively. We found that 10μg/m³ increment in concentration of PM_2.5 lasting for two days (lag₀₁) was associated with a 2.35% (95% CI 0.38% to 4.36%) increase in daily mortality count and a 1.69 (95% CI 0.01 to 3.37) years increase in YLL from AMI. The association between PM_2.5 and AMI mortality count was stronger among women and older people than men and young people, respectively. We concluded that acute exposure to PM_2.5 may increase the risk of mortality and YLL from AMI in Hong Kong and this effect can be modified by age and gender. These findings add to the evidence base for public health policy formulation and resource allocation.

Long-term exposure to air pollution is associated with biological aging

Long-term exposure to air pollution is associated with age-related diseases. We explored the association between accelerated biological aging and air pollution, a potential mechanism linking air pollution and health. We estimated long-term exposure to PM₁₀, PM_2.5, PM_2.5 absorbance/black carbon (BC), and NO_x via land-use regression models in individuals from the KORA F4 cohort. Accelerated biological aging was assessed using telomere length (TeloAA) and three epigenetic measures: DNA methylation age acceleration (DNAmAA), extrinsic epigenetic age acceleration (correlated with immune cell counts, EEAA), and intrinsic epigenetic age acceleration (independent of immune cell counts, IEAA). We also investigated sex-specific associations between air pollution and biological aging, given the published association between sex and aging measures. In KORA an interquartile range (0.97 μg/m³) increase in PM_2.5 was associated with a 0.33 y increase in EEAA (CI = 0.01, 0.64; P = 0.04). BC and NO_x (indicators or traffic exposure) were associated with DNAmAA and IEAA in women, while TeloAA was inversely associated with BC in men. We replicated this inverse BC-TeloAA association in the Normative Aging Study, a male cohort based in the USA. A multiple phenotype analysis in KORA F4 combining all aging measures showed that BC and PM₁₀ were broadly associated with biological aging in men. Thus, we conclude that long-term exposure to air pollution is associated with biological aging measures, potentially in a sex-specific manner. However, many of the associations were relatively weak and further replication of overall and sex-specific associations is warranted.

Birth outcome racial disparities: A result of intersecting social and environmental factors

Adverse birth outcomes such as preterm birth, low-birth weight, and infant mortality continue to disproportionately affect black and poor infants in the United States. Improvements in healthcare quality and access have not eliminated these disparities. The objective of this review was to consider societal factors, including suboptimal education, income inequality, and residential segregation, that together lead to toxic environmental exposures and psychosocial stress. Many toxic chemicals, as well as psychosocial stress, contribute to the risk of adverse birth outcomes and black women often are more highly exposed than white women. The extent to which environmental exposures combine with stress and culminate in racial disparities in birth outcomes has not been quantified but is likely substantial. Primary prevention of adverse birth outcomes and elimination of disparities will require a societal approach to improve education quality, income equity, and neighborhoods.

Air Pollution and Other Environmental Modulators of Cardiac Function

Cardiovascular disease (CVD) is the leading cause of death in developed regions and a worldwide health concern. Multiple external causes of CVD are well known, including obesity, diabetes, hyperlipidemia, age, and sedentary behavior. Air pollution has been linked with the development of CVD for decades, though the mechanistic characterization remains unknown. In this comprehensive review, we detail the background and epidemiology of the effects of air pollution and other environmental modulators on the heart, including both short- and long-term consequences. Then, we provide the experimental data and current hypotheses of how pollution is able to cause the CVD, and how exposure to pollutants is exacerbated in sensitive states. Published 2017. Compr Physiol 7:1479-1495, 2017.

Association between weather seasonality and blood parameters in riverine populations of the Brazilian Amazon

OBJECTIVE

To analyze the seasonality of blood parameters related to iron homeostasis, inflammation, and allergy in two riverine populations from the Brazilian Amazon.

METHODS

This was a cross-sectional study of 120 children and adolescents of school age, living in riverine communities of Porto Velho, Rondonia, Brazil, describing the hematocrit, hemoglobin, ferritin, serum iron, total white blood cell count, lymphocytes, eosinophils, C-reactive protein, and immunoglobulin E levels in the dry and rainy seasons. The chi-squared test and the prevalence ratio were used for the comparison of proportions and mean analysis using paired Student's t-test.

RESULTS

Hemoglobin (13.3g/dL) and hematocrit (40.9%) showed higher average values in the dry season. Anemia prevalence was approximately 4% and 12% in the dry and rainy seasons, respectively. Serum iron was lower in the dry season, with a mean of 68.7 mcg/dL. The prevalence of iron deficiency was 25.8% in the dry season and 9.2% in the rainy season. Serum ferritin did not show abnormal values in both seasons; however, the mean values were higher in the dry season (48.5ng/mL). The parameters of eosinophils, lymphocytes, global leukocyte count, C-reactive protein and immunoglobulin E showed no seasonal differences. C-reactive protein and immunoglobulin E showed abnormal values in approximately 7% and 60% of the examinations, respectively.

CONCLUSION

Hematological parameters of the red cell series and blood iron homeostasis had seasonal variation, which coincided with the dry season in the region, in which an increase in atmospheric pollutants derived from fires is observed.

Air Pollution and Hospitalization for Acute Myocardial Infarction in China

There is growing interest in the association between ambient air pollution and acute myocardial infarction (AMI). The objective of this study was to explore the association in 14 Chinese cities using a time-stratified case-crossover design. We identified 80,787 hospital admissions for AMI between January 1, 2014 and December 31, 2015 from electronic hospitalization summary reports. Conditional logistic regression was used to estimate the percent changes with 95% confidence intervals (CIs) in AMI admissions in relation to an interquartile range increase in ambient air pollutant concentrations. All analyzed air pollutants, with the exception of ozone, were positively associated with daily AMI admissions on lag2 and lag3 days. An interquartile range increase in particulate matter <10 µm in aerodynamic diameter, sulfur dioxide, nitrogen dioxide, and carbon monoxide concentrations on lag2 day was significantly associated with a 0.8% (95% CI 0.1%, 1.6%), 2.0% (95% CI 1.2%, 2.9%), 2.2% (95% CI 1.4%, 3.1%), and 1.1% (95% CI 0.4%, 1.8%) increase in AMI admissions, respectively. We also observed a significant association in relation to ozone on lag4 day (percent change: 1.3%; 95% CI 0.2%, 2.4%). Subgroup analyses indicated no effect modification of risk by age (≥65 years and <65 years) or gender. In conclusion, this is the first multicity study in China, or even in other developing countries, to report the short-term effects of air pollution on AMI morbidity. Our findings contribute to the limited scientific data on the effects of ambient air pollution on AMI in developing countries.

Effects of exercise training intensity on cardiac autonomic regulation in habitual smokers

BACKGROUND

The sympathoexcitatory effects of cigarette smoking cause an autonomic imbalance that may lead to cardiovascular disease. Aerobic training improves autonomic function by developing cardiorespiratory fitness; however, it is still uncertain whether aerobic training ameliorates the compromised autonomic modulation in smokers. This study aimed to investigate the effects of 8 weeks' aerobic training at different exercise intensities on autonomic regulation in habitual smokers.

METHODS

Healthy males (n = 34) were randomly assigned to a moderate-intensity aerobic training (MAT, 60% of heart rate reserve [HRR]), a high-intensity training group (HAT, 75% HRR), or a control group (CG). Training groups performed 8 weeks' aerobic training on a treadmill (3 times/week), but all subjects continued to smoke cigarettes as usual. Heart rate variability was monitored to evaluate the effect of aerobic training on autonomic regulation.

RESULTS

Aerobic training improved autonomic balance despite the continued smoking. In the time domain, rMSSD and pNN50 were significantly increased in HAT than in CG. On spectral analysis, the absolute and normalized units of high frequency (HF) were significantly increased in HAT, whereas the LF/HF ratio and the normalized unit of LF were significantly decreased compared to that in CG. SD1 and the SD1/SD2 ratio of the Poincaré plot analysis were significantly increased compared to CG. Although MAT showed a similar tendency to HAT in nonlinear indexes, there were no significant differences compared to CG.

CONCLUSION

Aerobic training, particularly high-intensity training, increases the parasympathetic contribution to the sympathovagal system, leading to an improvement in autonomic balance despite continued cigarette smoking.

Variation in Tree Species Ability to Capture and Retain Airborne Fine Particulate Matter (PM2.5)

Human health risks caused by PM_2.5 raise awareness to the role of trees as bio-filters of urban air pollution, but not all species are equally capable of filtering the air. The objectives of this current study were: (1) to determine the foliar traits for effective PM_2.5-capture and (2) explore species-to-species differences in foliar PM_2.5-recapture capacity following a rain event. The study concluded that overall, the acicular needle shape made conifers more efficient with PM_2.5 accumulation and post-rainfall recapture than broadleaved species. The foliar shape and venation of broadleaved species did not appear to influence the PM_2.5 accumulation. However, the number of the grooves and trichomes of broadleaved species were positively related to foliar PM_2.5 accumulation, suggesting that they could be used as indicators for the effectiveness of tree PM_2.5 capture. Furthermore, the amount of PM_2.5 removal by rainfall was determined by the total foliar PM_2.5. Not all PM_2.5 remained on the foliage. In some species, PM_2.5 was resuspended during the growing season, and thus reduced the net particular accumulation for that species. These findings contribute to a better understanding of tree species potential for reducing PM_2.5 in urban environments.

Association of air pollution sources and aldehydes with biomarkers of blood coagulation, pulmonary inflammation, and systemic oxidative stress

Using data collected before, during, and after the 2008 Summer Olympic Games in Beijing, this study examines associations between biomarkers of blood coagulation (vWF, sCD62P and sCD40L), pulmonary inflammation (EBC pH, EBC nitrite, and eNO), and systemic oxidative stress (urinary 8-OHdG) with sources of air pollution identified utilizing principal component analysis and with concentrations of three aldehydes of health concern. Associations between the biomarkers and the air pollution source types and aldehydes were examined using a linear mixed effects model, regressing through seven lag days and controlling for ambient temperature, relative humidity, gender, and day of week for the biomarker measurements. The biomarkers for pulmonary inflammation, particularly EBC pH and eNO, were most consistently associated with vehicle and industrial combustion, oil combustion, and vegetative burning. The biomarkers for blood coagulation, particularly vWF and sCD62p, were most consistently associated with oil combustion. Systemic oxidative stress biomarker (8-OHdG) was most consistently associated with vehicle and industrial combustion. The associations of the biomarkers were generally not significant or consistent with secondary formation of pollutants and with the aldehydes. The findings support policies to control anthropogenic pollution sources rather than natural soil or road dust from a cardio-respiratory health standpoint.

The Effects of PM2.5 from Asian Dust Storms on Emergency Room Visits for Cardiovascular and Respiratory Diseases

A case-crossover study examined how PM_2.5 from Asian Dust Storms (ADS) affects the number of emergency room (ER) admissions for cardiovascular diseases (CVDs) and respiratory diseases (RDs). Our data indicated that PM_2.5 concentration from ADS was highly correlated with ER visits for CVDs and RDs. The odds ratios (OR) increased by 2.92 (95% CI: 1.22–5.08) and 1.86 (95% CI: 1.30–2.91) per 10 µg/m³ increase in PM_2.5 levels, for CVDs and RDs, respectively. A 10 µg/m³ increase in PM_2.5 from ADSs was significantly associated with an increase in ER visits for CVDs among those 65 years of age and older (an increase of 2.77 in OR) and for females (an increase of 3.09 in OR). In contrast, PM_2.5 levels had a significant impact on RD ER visits among those under 65 years of age (OR = 1.77). The risk of ER visits for CVDs increased on the day when the ADS occurred in Taiwan and the day after (lag 0 and lag 1); the corresponding risk increase for RDs only increased on the fifth day after the ADS (lag 5). In Taiwan’s late winter and spring, the severity of ER visits for CVDs and RDs increases. Environmental protection agencies should employ an early warning system for ADS to reduce high-risk groups’ exposure to PM_2.5.

Particulate and gaseous pollutants on inflammation, thrombosis, and autonomic imbalance in subjects at risk for cardiovascular disease

This study examined effects of short-term urban air pollution exposures on inflammation, thrombosis, and autonomic imbalance in subjects at risk for cardiovascular disease (CVD). We enrolled 61 patients with multiple CVD risk factors and measured high sensitive C-reactive protein (hs-CRP), fibrinogen, D-dimer, and heart rate variability (HRV) indices. Two health examinations for each participant were performed during December 2002 through September 2003. Changes in inflammation and thrombotic markers and HRV indices with exposures to PM_2.5, organic carbon (OC), elemental carbon (EC), sulfur dioxide (SO₂), nitrogen dioxide (NO₂), and carbon monoxide (CO) at 1- to 3-day lags were analyzed using mixed models. The results showed inflammatory and thrombotic markers increased with 1- to 3-day lagged PM_2.5 components and gaseous pollutants exposures. hs-CRP maximally increased 0.19 [95% confidence interval (CI): 0.07-0.31] and 0.15 (95% CI: 0.05-0.24) mg/L for an interquartile range (IQR) of 1-day lagged SO₂ (2.3 ppb) and CO (0.5 ppm), respectively. D-dimer maximally increased 1.05 (95% CI: 0.13-1.75), 0.72 (95% CI: 0.09-1.21), 0.92 (95% CI: 0.13-1.50), and 0.90 (95% CI: 0.07-1.61) mg/dL for an IQR of 1-day lagged OC (3.9 μg/m³), EC (2.0 μg/m³), SO₂, and NO₂ (13.4 ppb), respectively. The HRV indices, including low frequency, very low frequency, and the ratio of low frequency to high frequency decreased 19.8 (95% CI: 4.4-32.7), 12.9 (95% CI: 0.8-23.4), and 17.6 (95% CI: 5.4-28.2)% for an IQR of 1-day lagged PM_2.5 (20.2 μg/m³), respectively. Our findings demonstrated PM_2.5 components and gaseous pollutants exert prolonged inflammatory and thrombotic reactions, while PM_2.5 exert an immediate autonomic imbalance.

Anemia prevalence and hemoglobin levels are associated with long-term exposure to air pollution in an older population

BACKGROUND

Anemia, a highly prevalent disorder in elderly populations, is associated with numerous adverse health outcomes, including increased mortality, impaired functional status and cognitive disorders. Approximately two-thirds of anemia in American elderly is caused by chronic inflammation or is unexplained. A potential contributing factor may include air pollution exposures, which have been shown to increase systemic inflammation and affect erythropoiesis. Few studies, however, have investigated the associations of air pollution on hemoglobin levels and anemia.

METHODS

We used linear regression models and modified Poisson regression with robust error variance to examine the associations of particulate matter (PM_2.5) and nitrogen dioxide (NO₂) on hemoglobin concentrations and prevalence of anemia, respectively, among 4121 older Americans enrolled in the National Social Life, Health, and Aging Project. We estimated participant-specific exposures to PM_2.5 using spatio-temporal models, and to NO₂ using nearest measurements from Environmental Protection Agency's Air Quality System. Hemoglobin levels were measured for participants in each of two data collection waves from dried blood spots. Anemia was defined using World Health Organization hemoglobin-based criteria of <13 and <12g/dL for men and women, respectively. Models were adjusted for age, sex, smoking status, race, income, education, neighborhood socioeconomic status, region, urbanicity and medication use. Mediation by C-reactive protein (CRP), a marker of systemic inflammation, was also investigated.

RESULTS

An inter-quartile range (IQR, 3.9μg/m³) increase in the one-year moving average PM_2.5 was positively associated with anemia prevalence (prevalence ratio, or PR 1.33, 95% CI: 1.23, 1.45) and decreases in average hemoglobin of 0.81g/dL (p<0.001). Similarly, an IQR (9.6ppb) increase in NO₂ was associated with anemia prevalence (PR 1.43, 95% CI: 1.25, 1.63) and a decrease in average hemoglobin of 0.81g/dL (p<0.001). Strong dose-response relationships were identified for both pollutants. Mediation of the effect of PM_2.5 by CRP was also identified (p=0.007).

CONCLUSIONS/INTERPRETATIONS

Air pollution exposures were significantly associated with increased prevalence of anemia and decreased hemoglobin levels in a cohort of older Americans. If causal, these associations could indicate that chronic air pollution exposure is an important risk factor for anemia in older adults.

Biomarkers of the health outcomes associated with ambient particulate matter exposure

Epidemiologic evidence supports the positive association of cardiopulmonary morbidity and mortality, and lung cancer risk with exposure to airborne particulate matter (PM). Oxidative stress and inflammation have been proposed to be the major causal factors involved in mediating PM effects on both cardiovascular and pulmonary health outcomes. However, the mechanism whereby PM causes the health effects is not fully elucidated. To evaluate and investigate human exposure to PM, it is essential to have a specific, sensitive and robust characterization of individual exposure to PM. Biomarkers may mark important intermediate steps leading to overt health effects after PM exposure. Thus biomarkers are promising indicators, which could serve as representative measures of the exposure to PM for assessing the health impacts and understanding the mechanism. Indeed, a number of biomarkers are already in use in the field of epidemiological studies and toxicological research. However, we are facing now the challenges to select robust, specific and sensitive biomarkers, which can be employed in large-scale of population to assess the health risk and to monitor the effectiveness of interventions. In this review, we describe a range of biomarkers that are associated with air pollution exposure, particularly markers of oxidative stress, inflammatory factors, and microRNAs, as well as markers of pollutants metabolites. Understanding the nature of the association of these biomarkers with PM exposure may shed some light on the process of selecting biomarkers for large-scale population studies, developing novel preventative and therapeutic strategies.

Are the Associations of Cardiac Acceleration and Deceleration Capacities With Fine Metal Particulate in Welders Mediated by Inflammation?

OBJECTIVE

The aim of this study was to investigate whether associations of acceleration capacity (AC) and deceleration capacity (DC) with metal-PM2.5 are mediated by inflammation.

METHODS

We obtained PM2.5, C-reactive protein, interleukin (IL)-6, 8, and 10, and electrocardiograms to compute AC and DC, from 45 male welders. Mediation analyses were performed using linear mixed models to assess associations between PM2.5 exposure, inflammatory mediator, and AC or DC, controlling for covariates.

RESULTS

The proportion of total effect of PM2.5 on AC or DC (indirect effect) mediated through IL-6 on AC was 4% at most. Controlling for IL-6 (direct effect), a 1 mg/m increase of PM2.5 was associated with a decrease of 2.16 (95% confidence interval -0.36 to 4.69) msec in AC and a decrease of 2.51 (95% confidence interval -0.90 to 5.93) msec in DC.

CONCLUSION

IL-6 may be mediating the effect of metal particulates on AC.