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Lee S, Ku H, Hyun C, Lee M. Machine Learning-Based Analyses of the Effects of Various Types of Air Pollutants on Hospital Visits by Asthma Patients. TOXICS 2022; 10:644. [PMID: 36355936 PMCID: PMC9696060 DOI: 10.3390/toxics10110644] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 10/20/2022] [Accepted: 10/25/2022] [Indexed: 06/16/2023]
Abstract
Asthma is a chronic respiratory disorder defined by airway inflammation, chest pains, wheezing, coughing, and difficulty breathing that affects an estimated 300 million individuals globally. Although various studies have shown an association between air pollution and asthma, few studies have used statistical and machine learning algorithms to investigate the effect of each individual air pollutant on asthma. The purpose of this research was to assess the association between air pollutants and the frequency of hospital visits by asthma patients using three analysis methods: linear correlation analyses were performed by Pearson correlation coefficients, and least absolute shrinkage and selection operator (LASSO) and random forest (RF) models were used for machine learning-based analyses to investigate the effect of air pollutants. This research studied asthma patients using the hospital visit database in Seoul, South Korea, collected between 2013 and 2017. The data set included outpatient hospital visits (n = 17,787,982), hospital admissions (n = 215,696), and emergency department visits (n = 85,482). The daily atmospheric environmental information from 2013 to 2017 at 25 locations in Seoul was evaluated. The three analysis models revealed that NO2 was the most significant pollutant on average in outpatient hospital visits by asthma patients. For example, NO2 had the greatest impact on outpatient hospital visits, resulting in a positive association (r=0.331). In hospital admissions of asthma patients, CO was the most significant pollutant on average. It was observed that CO exhibited the most positive association with hospital admissions (I = 3.329). Additionally, a significant time lag was found between both NO2 and CO and outpatient hospital visits and hospital admissions of asthma patients in the linear correlation analysis. In particular, NO2 and CO were shown to increase hospital admissions at lag 4 in the linear correlation analysis. This study provides evidence that PM2.5, PM10, NO2, CO, SO2, and O3 are associated with the frequency of hospital visits by asthma patients.
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Affiliation(s)
- Soyeon Lee
- School of Electrical and Electronics Engineering, Chung-Ang University, Seoul 06974, Korea
| | - Hyeeun Ku
- School of Electrical and Electronics Engineering, Chung-Ang University, Seoul 06974, Korea
| | - Changwan Hyun
- Department of Urology, Korea University College of Medicine, Seoul 02841, Korea
| | - Minhyeok Lee
- School of Electrical and Electronics Engineering, Chung-Ang University, Seoul 06974, Korea
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Salimi F, Stasinska A, Morgan GG, Hankey GJ, Almeida O, Yeap B, Flicker L, Heyworth J. Long-term exposure to low air pollutant concentrations and hospitalisation for respiratory diseases in older men: A prospective cohort study in Perth, Australia. Heliyon 2022; 8:e10905. [PMID: 36276719 PMCID: PMC9578981 DOI: 10.1016/j.heliyon.2022.e10905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 05/22/2022] [Accepted: 09/27/2022] [Indexed: 11/06/2022] Open
Abstract
Background Acute exposure to ambient air pollution even at low concentrations has been associated with increased hospitalisation for respiratory diseases but the effects of long-term exposure are less certain. In this study, we investigated the associations between long-term exposures to PM2.5, PM2.5 absorbance and NO2 and hospitalisation for asthma, chronic obstructive pulmonary disease and pneumonia in a cohort of older men living in Perth, Western Australia, a city where the levels of air pollutants are well below the world standards. Materials and methods The study population of 11,156 men with no prior hospitalisation for respiratory disease was drawn from the Health in Men Study (HIMS) cohort of men aged >65 years living in Perth, Western Australia between 1996-1999. PM2.5, PM2.5 absorbance (PM2.5a) and NO2 were measured across the Perth metropolitan area over three seasons in 2012. Land use regression (LUR) models were used to estimate annual concentrations of PM2.5, PM2.5 absorbance and NO2 at the residential address of each participant from inception (1996) to 2015. Hospitalisation for respiratory disease between inception and 2015 was ascertained using the Western Australian Data Linkage System. The association between exposure to air pollution with hospitalisation for respiratory disease was examined using Cox regression analysis. Results No statistically significant associations were observed in the fully adjusted models. However, positive associations were observed with first hospitalisation for pneumonia (HR 1.08, 95% CI: 1.01–1.16) when adjusted for age, year of enrolment, smoking status, education, BMI and physical activity. Conclusions In this longitudinal study of older men we found no evidence of associations between increased long-term exposure to low-level air pollution with increased risk of hospitalisation for respiratory diseases in Perth, Australia. More studies on respiratory morbidity associated with exposure to low levels of air pollution are needed for more comprehensive understanding of the overall risk.
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Affiliation(s)
- Farhad Salimi
- University Centre for Rural Health, Faculty of Medicine and Health, The University of Sydney, Australia Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Australia,Occupational and Environmental Health Sciences, Public Health and Preventive Medicine, Monash University, Australia,Corresponding author.
| | - Ania Stasinska
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Geoffrey G. Morgan
- University Centre for Rural Health, Faculty of Medicine and Health, The University of Sydney, Australia Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Australia
| | - Graeme J. Hankey
- Medical School, The University of Western Australia, Perth, Western Australia, Australia
| | - Osvaldo Almeida
- Medical School, The University of Western Australia, Perth, Western Australia, Australia
| | - Bu Yeap
- Medical School, The University of Western Australia, Perth, Western Australia, Australia
| | - Leon Flicker
- Medical School, The University of Western Australia, Perth, Western Australia, Australia
| | - Jane Heyworth
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
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Zhou J, Lei R, Xu J, Peng L, Ye X, Yang D, Yang S, Yin Y, Zhang R. The Effects of Short-Term PM 2.5 Exposure on Pulmonary Function among Children with Asthma-A Panel Study in Shanghai, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11385. [PMID: 36141658 PMCID: PMC9517124 DOI: 10.3390/ijerph191811385] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 09/05/2022] [Accepted: 09/07/2022] [Indexed: 06/16/2023]
Abstract
Fine particulate matter (PM2.5) has been reported to be an important risk factor for asthma. This study was designed to evaluate the relationship between PM2.5 and lung function among children with asthma in Shanghai, China. From 2016 to 2019, a total of 70 Chinese children aged 4 to 14 in Shanghai were recruited for this panel study. The questionnaire was used to collect baseline information, and the lung function covering forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1) and peak expiratory flow (PEF) were carried out for each child more than twice during follow-up. Meanwhile, the simultaneous daily air atmospheric pollutants and meteorological data were collected. The linear mixed effect (LME) model was used to assess the relationship between air pollutants and lung function. A significantly negative association was found between PM2.5 and lung function in children with asthma. In the single-pollutant model, the largest effects of PM2.5 on lung function were found for lag 0-2, with FVC and FEV1 decreasing by 0.91% [95% confidence interval (CI): -1.75, -0.07] and 1.05% (95% CI: -2.09, 0.00), respectively, for each 10 μg/m3 increase in PM2.5. In the multi-pollution model (adjusted PM2.5 + SO2 + O3), the maximum effects of PM2.5 on FVC and FEV1 also appeared for lag 0-2, with FVC and FEV1 decreasing by 1.57% (95% CI: -2.69, -0.44) and 1.67% (95% CI: -3.05, -0.26), respectively, for each 10 μg/m3 increase in PM2.5. In the subgroup analysis, boys, preschoolers (<6 years old) and hot seasons (May to September) were more sensitive to changes. Our findings may contribute to a better understanding of the short-term exposure effects of PM2.5 on lung function in children with asthma.
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Affiliation(s)
- Ji Zhou
- Department of Atmospheric and Oceanic Sciences & Institute of Atmospheric Sciences, Fudan University, Shanghai 200437, China
- Shanghai Typhoon Institute, China Meteorological Administration (CMA), Shanghai 200030, China
- Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Bureau, Shanghai 200030, China
| | - Ruoyi Lei
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou 730000, China
| | - Jianming Xu
- Shanghai Typhoon Institute, China Meteorological Administration (CMA), Shanghai 200030, China
- Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Bureau, Shanghai 200030, China
| | - Li Peng
- Shanghai Typhoon Institute, China Meteorological Administration (CMA), Shanghai 200030, China
- Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Bureau, Shanghai 200030, China
| | - Xiaofang Ye
- Shanghai Typhoon Institute, China Meteorological Administration (CMA), Shanghai 200030, China
- Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Bureau, Shanghai 200030, China
| | - Dandan Yang
- Shanghai Typhoon Institute, China Meteorological Administration (CMA), Shanghai 200030, China
- Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Bureau, Shanghai 200030, China
| | - Sixu Yang
- Shanghai Typhoon Institute, China Meteorological Administration (CMA), Shanghai 200030, China
- Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Bureau, Shanghai 200030, China
| | - Yong Yin
- Department of Respiratory, School of Medicine, Shanghai Children’s Medical Center, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Renhe Zhang
- Department of Atmospheric and Oceanic Sciences & Institute of Atmospheric Sciences, Fudan University, Shanghai 200437, China
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Luo J, Liu H, Hua S, Song L. The Correlation of PM2.5 Exposure with Acute Attack and Steroid Sensitivity in Asthma. BIOMED RESEARCH INTERNATIONAL 2022; 2022:2756147. [PMID: 36033576 PMCID: PMC9410784 DOI: 10.1155/2022/2756147] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/05/2022] [Accepted: 08/08/2022] [Indexed: 11/17/2022]
Abstract
Bronchial asthma is a common chronic inflammatory disease of the respiratory system. Asthma primarily manifests in reversible airflow limitation and airway inflammation, airway remodeling, and persistent airway hyperresponsiveness. PM2.5, also known as fine particulate matter, is the main component of air pollution and refers to particulate matter with an aerodynamic diameter of ≤2.5 μm. PM2.5 can be suspended in the air for an extensive time and, in addition, can contain or adsorb heavy metals, toxic gases, polycyclic aromatic hydrocarbons, bacterial viruses, and other harmful substances. Epidemiological studies have demonstrated that, in addition to increasing the incidence of asthma, PM2.5 exposure results in a significant increase in the incidence of hospital visits and deaths due to acute asthma attacks. Furthermore, PM2.5 was reported to induce glucocorticoid resistance in asthmatic individuals. Although various countries have implemented strict control measures, due to the wide range of PM2.5 sources, complex components, and unknown pathogenic mechanisms involving the atmosphere, environment, chemistry, and toxicology, PM2.5 damage to human health still cannot be effectively controlled. In this present review, we summarized the current knowledge base regarding the relationship between PM2.5 toxicity and the onset, acute attack prevalence, and steroid sensitivity in asthma.
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Affiliation(s)
- Jingjing Luo
- Department of Respiratory Medicine, Center for Pathogen Biology and Infectious Diseases, Key Laboratory of Organ Regeneration and Transplantation of the Ministry of Education, The First Hospital of Jilin University, Changchun 130021, China
| | - Han Liu
- Department of Respiratory Medicine, Center for Pathogen Biology and Infectious Diseases, Key Laboratory of Organ Regeneration and Transplantation of the Ministry of Education, The First Hospital of Jilin University, Changchun 130021, China
| | - Shucheng Hua
- Department of Respiratory Medicine, Center for Pathogen Biology and Infectious Diseases, Key Laboratory of Organ Regeneration and Transplantation of the Ministry of Education, The First Hospital of Jilin University, Changchun 130021, China
| | - Lei Song
- Department of Respiratory Medicine, Center for Pathogen Biology and Infectious Diseases, Key Laboratory of Organ Regeneration and Transplantation of the Ministry of Education, The First Hospital of Jilin University, Changchun 130021, China
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Makiabadi B, Zakarianezhad M, Zeydabadi E. The role of hydrogen bonds on the stability of anticancer drug compounds TG/uracil, TG/5-fluorouracil and TG/gimeracil. Struct Chem 2022. [DOI: 10.1007/s11224-022-02028-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Markozannes G, Pantavou K, Rizos EC, Sindosi OΑ, Tagkas C, Seyfried M, Saldanha IJ, Hatzianastassiou N, Nikolopoulos GK, Ntzani E. Outdoor air quality and human health: An overview of reviews of observational studies. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 306:119309. [PMID: 35469927 DOI: 10.1016/j.envpol.2022.119309] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 03/15/2022] [Accepted: 04/12/2022] [Indexed: 06/14/2023]
Abstract
The epidemiological evidence supporting putative associations between air pollution and health-related outcomes continues to grow at an accelerated pace with a considerable heterogeneity and with varying consistency based on the outcomes assessed, the examined surveillance system, and the geographic region. We aimed to evaluate the strength of this evidence base, to identify robust associations as well as to evaluate effect variation. An overview of reviews (umbrella review) methodology was implemented. PubMed and Scopus were systematically screened (inception-3/2020) for systematic reviews and meta-analyses examining the association between air pollutants, including CO, NOX, NO2, O3, PM10, PM2.5, and SO2 and human health outcomes. The quality of systematic reviews was evaluated using AMSTAR. The strength of evidence was categorized as: strong, highly suggestive, suggestive, or weak. The criteria included statistical significance of the random-effects meta-analytical estimate and of the effect estimate of the largest study in a meta-analysis, heterogeneity between studies, 95% prediction intervals, and bias related to small study effects. Seventy-five systematic reviews of low to moderate methodological quality reported 548 meta-analyses on the associations between outdoor air quality and human health. Of these, 57% (N = 313) were not statistically significant. Strong evidence supported 13 associations (2%) between elevated PM2.5, PM10, NO2, and SO2 concentrations and increased risk of cardiorespiratory or pregnancy/birth-related outcomes. Twenty-three (4%) highly suggestive associations were identified on elevated PM2.5, PM10, O3, NO2, and SO2 concentrations and increased risk of cardiorespiratory, kidney, autoimmune, neurodegenerative, cancer or pregnancy/birth-related outcomes. Sixty-seven (12%), and 132 (24%) meta-analyses were graded as suggestive, and weak, respectively. Despite the abundance of research on the association between outdoor air quality and human health, the meta-analyses of epidemiological studies in the field provide evidence to support robust associations only for cardiorespiratory or pregnancy/birth-related outcomes.
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Affiliation(s)
- Georgios Markozannes
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece; Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | | | - Evangelos C Rizos
- Department of Internal Medicine, University Hospital of Ioannina, Ioannina, Greece; School of Medicine, European University Cyprus, Nicosia, Cyprus; Hellenic Open University, Patra, Greece
| | - Ourania Α Sindosi
- Laboratory of Meteorology, Department of Physics, University of Ioannina, Ioannina, Greece
| | - Christos Tagkas
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Maike Seyfried
- Faculty of Medicine, University of Tuebingen, Tuebingen, Germany
| | - Ian J Saldanha
- Center for Evidence Synthesis in Health, Department of Health Services, Policy, and Practice, and Department of Epidemiology, School of Public Health, Brown University, RI, USA
| | - Nikos Hatzianastassiou
- Laboratory of Meteorology, Department of Physics, University of Ioannina, Ioannina, Greece
| | | | - Evangelia Ntzani
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece; Center for Evidence Synthesis in Health, Department of Health Services, Policy, and Practice, and Department of Epidemiology, School of Public Health, Brown University, RI, USA.
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57
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Zhou Q, Kang SL, Lin X, Zhang XY. Impact of air pollutants on hospital visits for pediatric asthma in Fuzhou city, southeast China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:58664-58674. [PMID: 35366721 DOI: 10.1007/s11356-022-19928-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 03/22/2022] [Indexed: 06/14/2023]
Abstract
Rapid social development in China has resulted in severe air pollution and adverse impacts on people's health. Although studies have been conducted on the relationship between exposure to air pollutants and asthma exacerbation, most studies were performed in relatively heavily polluted areas, while little is known about the effect of air pollutants in less polluted areas. We assessed the effects of air pollutants on the risk of asthma-related outpatient and emergency visits of infants and children aged from 0 to 13 years during 2018 to 2020 in Fuzhou city, southeast China. Data of six air pollutants: sulfur dioxide (SO2), nitrogen dioxides (NO2), carbon monoxide (CO), daily maximum 8-h average ozone (O3-8 h), particulate matter with an aerodynamic diameter ≤ 10 μm (PM10), and particulate matter with an aerodynamic diameter ≤ 2.5 μm (PM2.5), were obtained from the Environmental Protection Administration of Fuzhou. Data of temperature, humidity, and wind speed were provided by the Meteorological Bureau of Fuzhou. Results revealed that on lag day 6, NO2, SO2, and CO were positively associated with the number of outpatient and emergency visits. Among the pollutants, SO2 had the highest effects on both outpatient visits (RR = 1.672, 95%CI 1.545, 1.809) and emergency visits (RR = 1.495, 95%CI 1.241, 1.800), and its effect on outpatient visits was stronger in children aged 0-4 years than in those aged 5-13 years (RR = 2.331 vs. 1.439). In conclusion, SO2 contributes substantially to the adverse effects of air pollutants on pediatric respiratory health in Fuzhou. Younger children were more affected by air pollution than their older counterparts.
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Affiliation(s)
- Quan Zhou
- Fuzhou Center for Disease Control and Prevention, Fuzhou, 350004, Fujian, China
- Fuzhou Center for Disease Control and Prevention affiliated to Fujian Medical University, Fuzhou, China
| | - Shu-Ling Kang
- Fuzhou Center for Disease Control and Prevention, Fuzhou, 350004, Fujian, China
- Fuzhou Center for Disease Control and Prevention affiliated to Fujian Medical University, Fuzhou, China
| | - Xin Lin
- Fuzhou Center for Disease Control and Prevention, Fuzhou, 350004, Fujian, China.
- Fuzhou Center for Disease Control and Prevention affiliated to Fujian Medical University, Fuzhou, China.
| | - Xiao-Yang Zhang
- Fuzhou Center for Disease Control and Prevention, Fuzhou, 350004, Fujian, China.
- Fuzhou Center for Disease Control and Prevention affiliated to Fujian Medical University, Fuzhou, China.
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Oluwasanya PW, Carey T, Samad YA, Occhipinti LG. Unencapsulated and washable two-dimensional material electronic-textile for NO 2 sensing in ambient air. Sci Rep 2022; 12:12288. [PMID: 35853965 PMCID: PMC9296651 DOI: 10.1038/s41598-022-16617-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 07/12/2022] [Indexed: 11/17/2022] Open
Abstract
Materials adopted in electronic gas sensors, such as chemiresistive-based NO2 sensors, for integration in clothing fail to survive standard wash cycles due to the combined effect of aggressive chemicals in washing liquids and mechanical abrasion. Device failure can be mitigated by using encapsulation materials, which, however, reduces the sensor performance in terms of sensitivity, selectivity, and therefore utility. A highly sensitive NO2 electronic textile (e-textile) sensor was fabricated on Nylon fabric, which is resistant to standard washing cycles, by coating Graphene Oxide (GO), and GO/Molybdenum disulfide (GO/MoS2) and carrying out in situ reduction of the GO to Reduced Graphene Oxide (RGO). The GO/MoS2 e-textile was selective to NO2 and showed sensitivity to 20 ppb NO2 in dry air (0.05%/ppb) and 100 ppb NO2 in humid air (60% RH) with a limit of detection (LOD) of ~ 7.3 ppb. The selectivity and low LOD is achieved with the sensor operating at ambient temperatures (~ 20 °C). The sensor maintained its functionality after undergoing 100 cycles of standardised washing with no encapsulation. The relationship between temperature, humidity and sensor response was investigated. The e-textile sensor was embedded with a microcontroller system, enabling wireless transmission of the measurement data to a mobile phone. These results show the potential for integrating air quality sensors on washable clothing for high spatial resolution (< 25 cm2)—on-body personal exposure monitoring.
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Affiliation(s)
- Pelumi W Oluwasanya
- Cambridge Graphene Centre, Department of Engineering, University of Cambridge, Cambridge, UK
| | - Tian Carey
- Cambridge Graphene Centre, Department of Engineering, University of Cambridge, Cambridge, UK. .,CRANN and AMBER Research Centres, Trinity College Dublin, Dublin, Ireland.
| | - Yarjan Abdul Samad
- Cambridge Graphene Centre, Department of Engineering, University of Cambridge, Cambridge, UK.
| | - Luigi G Occhipinti
- Cambridge Graphene Centre, Department of Engineering, University of Cambridge, Cambridge, UK.
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Mueller W, Wilkinson P, Milner J, Loh M, Vardoulakis S, Petard Z, Cherrie M, Puttaswamy N, Balakrishnan K, Arvind DK. The relationship between greenspace and personal exposure to PM 2.5 during walking trips in Delhi, India. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 305:119294. [PMID: 35436507 DOI: 10.1016/j.envpol.2022.119294] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 04/08/2022] [Accepted: 04/09/2022] [Indexed: 06/14/2023]
Abstract
The presence of urban greenspace may lead to reduced personal exposure to air pollution via several mechanisms, for example, increased dispersion of airborne particulates; however, there is a lack of real-time evidence across different urban contexts. Study participants were 79 adolescents with asthma who lived in Delhi, India and were recruited to the Delhi Air Pollution and Health Effects (DAPHNE) study. Participants were monitored continuously for exposure to PM2.5 (particulate matter with an aerodynamic diameter of less than 2.5 μm) for 48 h. We isolated normal day-to-day walking journeys (n = 199) from the personal monitoring dataset and assessed the relationship between greenspace and personal PM2.5 using different spatial scales of the mean Normalised Difference Vegetation Index (NDVI), mean tree cover (TC), and proportion of surrounding green land use (GLU) and parks or forests (PF). The journeys had a mean duration of 12.7 (range 5, 53) min and mean PM2.5 personal exposure of 133.9 (standard deviation = 114.8) μg/m3. The within-trip analysis showed weak inverse associations between greenspace markers and PM2.5 concentrations only in the spring/summer/monsoon season, with statistically significant associations for TC at the 25 and 50 m buffers in adjusted models. Between-trip analysis also indicated inverse associations for NDVI and TC, but suggested positive associations for GLU and PF in the spring/summer/monsoon season; no overall patterns of association were evident in the autumn/winter season. Associations between greenspace and personal PM2.5 during walking trips in Delhi varied across metrics, spatial scales, and season, but were most consistent for TC. These mixed findings may partly relate to journeys being dominated by walking along roads and small effects on PM2.5 of small pockets of greenspace. Larger areas of greenspace may, however, give rise to observable spatial effects on PM2.5, which vary by season.
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Affiliation(s)
- William Mueller
- Research, Institute of Occupational Medicine, Edinburgh, UK; Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK.
| | - Paul Wilkinson
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK; Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
| | - James Milner
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK; Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Miranda Loh
- Research, Institute of Occupational Medicine, Edinburgh, UK
| | - Sotiris Vardoulakis
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australia
| | - Zoë Petard
- Centre for Speckled Computing, School of Informatics, University of Edinburgh, Scotland, UK
| | - Mark Cherrie
- Research, Institute of Occupational Medicine, Edinburgh, UK
| | - Naveen Puttaswamy
- Department of Environmental Health Engineering, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | - Kalpana Balakrishnan
- Department of Environmental Health Engineering, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | - D K Arvind
- Centre for Speckled Computing, School of Informatics, University of Edinburgh, Scotland, UK
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Impact Of Covid-19 Transport Restrictions On Ambient Air Pollutant Concentrations And Asthma-Related Hospital Admissions. Public Health 2022; 211:66-71. [PMID: 36029546 PMCID: PMC9289007 DOI: 10.1016/j.puhe.2022.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 07/06/2022] [Accepted: 07/08/2022] [Indexed: 11/22/2022]
Abstract
Objectives Exposure to air pollution is a known risk factor for asthma exacerbations and hospitalisations. This study aimed to identify if COVID-19 transport restrictions led to improvements in air quality in Dublin and if this had an impact on asthma-related hospital admissions. Study design This was a population-based retrospective cohort study. Methods Daily concentration levels of particulate matter (PM2.5 and PM10) and nitrogen dioxide (NO2) were obtained from the Environmental Protection Agency (EPA). The Hospital In-Patient Enquiry (HIPE) system provided the daily number of asthma-related hospital admissions in Dublin. The figures for 2018–2019 were compared with the period of transport restrictions (from March 2020). Results During the period of transport restrictions, there was a significant decrease in mean daily concentrations in both PM2.5 (8.9 vs 7.8 μg/m3, P = 0.002) and NO2 (24.0 vs 16.7 μg/m3, P < 0.001). There was also a significant reduction in the mean number of daily asthma admissions (4.5 vs 2.8 admissions, P < 0.001). Only NO2 showed a statistically significant correlation with asthma admissions (r = 0.132, P < 0.001). Conclusion Transport restrictions introduced to mitigate against COVID-19 led to lower pollutant levels and improved air quality. Previously described associations between pollutants and asthma would indicate that these improvements in air quality contributed to the reduction in asthma-related admissions. The complex nature of PM is the likely explanation for the lack of correlation between its concentration and asthma admissions, unlike NO2 whose primary source is vehicular emissions. Public Health needs to advocate for transport policies, which can improve air quality and hence improve human health.
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Short-Term Associations between PM 10 and Respiratory Health Effects in Visby, Sweden. TOXICS 2022; 10:toxics10060333. [PMID: 35736941 PMCID: PMC9227158 DOI: 10.3390/toxics10060333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/12/2022] [Accepted: 06/16/2022] [Indexed: 11/26/2022]
Abstract
The old Swedish city Visby, located on the island Gotland, has, for several years, reported higher PM10 concentrations than any other city in Sweden. In Visby, local limestone is used, both in road paving and as sand used for anti-slip measures, resulting in a clear annual pattern of PM10 with the highest concentrations during winter/spring when studded tires are allowed. This study analyzes the short-term associations between PM10 and daily number of patients with acute respiratory problems (ICD–10 diagnoses: J00–J99) seeking care at the hospital or primary healthcare units in Visby during the period of 2013–2019. The daily mean of PM10 was on average 45 µg m−3 during winter/spring and 18 µg m−3 during summer/autumn. Four outcome categories were analyzed using quasi-Poisson regression models, stratifying for period and adjusting for calendar variables and weather. An increase in respiratory visits was associated with increasing concentrations in PM10 during the summer/autumn period, most prominent among children, where asthma visits increased by 5% (95% CI: 2–9%) per 10 µg m−3 increase in PM10. For the winter/spring period, no significant effects were observed, except for the diagnose group ‘upper airways’ in adults, where respiratory visits increased by 1% (95% CI: 0.1–1.9%) per 10 µg m−3 increase. According to the results, limestone in particles seem to be relatively harmless at the exposure concentrations observed in Visby, and this is in line with the results from a few experimental and occupational studies.
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Hua Y, Yuan X, Wang J, Zeng K, Zhi S, Liu L. Association between air pollution and hospital admissions for chronic respiratory disease in people aged over 65 years: a time series analysis in Ningbo, China, 2015-2017. Int Arch Occup Environ Health 2022; 95:1293-1304. [PMID: 35661917 DOI: 10.1007/s00420-022-01887-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 05/16/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE To provide essential information of environmental triggers leading to CRD. METHODS We investigated the short-term effects of ambient air pollutants on CRD-related hospitalizations in people aged ≥ 65 years in Ningbo. Data on 23,610 cases of CRD requiring hospitalization were collected from January 2015 to August 2017. After adjusting for temporal trends, seasonality, meteorological conditions, day of week (DOW), and public holidays, we used generalized additive Poisson distribution models to calculate the excess risks (ERs) and 95% confidence intervals (95% CIs) of CRD related hospitalizations. RESULTS Our results showed that fine particulate matter (PM2.5), inhalable particulate matter (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), and carbon monoxide (CO) were associated with CRD-related hospitalizations in people aged ≥ 65 years. We observed that each 10 μg/m3 increase (except for each 0.1 mg/m3 increase in CO) in the concentration of air pollutants, the percentage of CRD-related hospitalizations due to PM2.5, PM10, and SO2 exposure at lag 07, NO2 exposure at lag 03, and CO exposure at lag 0 increased by 2.13% (95% CI: 0.55%, 3.74%), 1.76% (95% CI: 0.70%, 2.83%), 8.24% (95% CI: 0.92%, 16.09%), 2.16% (95% CI: 0.26%, 4.05%), and 1.19% (95% CI: 0.26%, 2.12%), respectively. In addition, we found stronger effects of particulate matter in 75-84 years age group, on warmer days, and in asthmatics. CONCLUSION In conclusion, air pollution may have adverse effects on CRD-related hospitalizations among people aged ≥ 65 years in Ningbo. Therefore, public health measures should be taken to improve air quality.
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Affiliation(s)
- Yuzhe Hua
- School of Medicine, Ningbo University, Ningbo, China
| | - Xiaoqi Yuan
- Ningbo Women and Children Hospital, Ningbo, China
| | - Jichao Wang
- The Affiliated Hospital of Medical School, Ningbo, China
| | - Ke Zeng
- The Affiliated Hospital of Medical School, Ningbo, China
| | - Shuai Zhi
- School of Medicine, Ningbo University, Ningbo, China
| | - Liya Liu
- School of Medicine, Ningbo University, Ningbo, China.
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Lee M, Ohde S, Ishimatsu S. Photochemical oxidants and ambulance dispatches for asthmatic symptoms in Tokyo. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2022; 32:1220-1230. [PMID: 33941000 DOI: 10.1080/09603123.2020.1866753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 12/15/2020] [Indexed: 06/12/2023]
Abstract
While photochemical oxidants (Ox = O3+ NO2) are known to increase asthma flare-ups, there is a paucity of studies of the Japanese population, especially for Tokyo residents. We used data on asthma cases (n = 7,455) from ambulance dispatches in Tokyo, 2015-2016. Variables included date and time of incidence, age, sex, occurrence location at the ward (ku) level, and the symptom/cause of dispatch as recorded by paramedics. Ox data were obtained from the nearest air quality monitoring station to the occurrence location, then linked them with the outcomes based on occurrence date. We directly incorporated a distributed lag model into a bi-directional case-crossover study design controlling for ambient temperature and day of week. A 10-ppb increase in Ox for lag days 0-3 was associated with a 5.51% (95% CI: 0.13 to 11.18) increase in ambulance dispatches related to asthma. The association was strongest on lag day 1 (4.67%, 95% CI: 0.51 to 9.00). Exposure to high levels of Ox was associated with increased ambulance dispatches related to asthma exacerbations in Tokyo, Japan.
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Affiliation(s)
- Mihye Lee
- School of Public Health, St. Luke's International University, Tokyo, Japan
| | - Sachiko Ohde
- School of Public Health, St. Luke's International University, Tokyo, Japan
| | - Shinichi Ishimatsu
- Emergency and Critical Care Medicine, St. Luke's International Hospital, Tokyo, Japan
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Eghomwanre AF, Oguntoke O, Taiwo AM. Levels of indoor particulate matter and association with asthma in children in Benin City, Nigeria. ENVIRONMENTAL MONITORING AND ASSESSMENT 2022; 194:467. [PMID: 35648237 DOI: 10.1007/s10661-022-10135-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 05/23/2022] [Indexed: 06/15/2023]
Abstract
The relationship between indoor particulate matter and asthma in children was assessed in this study. Forty-five (45) locations were randomly selected across the five local government areas in Benin City, Edo State, for air quality assessment. Indoor and outdoor particulates (PM1.0, PM2.5, and PM10) were monitored monthly using a handheld BLATN particulate sampler (Br-Smart-126S series). Reported clinical cases of asthma in children from 2008 to 2017 were collected from two major hospitals in the metropolis. The data obtained were analysed with SPSS for Windows version 21.0. The average concentrations of indoor and ambient PM ranged between 10.7-26.2 and 19.0-49.4 µg/m3 (PM1.0), 27.4-59.6 and 45.6-93.0 µg/m3 (PM2.5), and 33.5-67.9 and 60.9-106.1 µg/m3 (PM10) in the wet and dry seasons. PM2.5 and PM10 concentrations were observed above the WHO standards. Indoor particulate concentration was significantly (p = 0.001-0.012) higher in the dry season across the locations. Outdoor PM correlated positively (R = 0.568-0.855, p < 0.05; R2 = 0.322-0.724, p < 0.001) with their corresponding indoor PM concentration. The hazard ratio (HR) values of PM2.5 and PM10 exceeded 1 in all the sampling locations during the dry season, while the mean total hazard ratio (THR) of both PM metrics was considerably higher during the dry season than in the wet season. Indoor PM concentrations showed a significant positive correlation with reported cases of asthma (R = 0.498-0.542, p < 0.001) and accounted for 40.6% of the asthma cases during the dry season. The study showed that children in the selected households are at risk of increased asthma exacerbation due to exposure to particulate matter pollution.
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Affiliation(s)
- A F Eghomwanre
- Department of Environmental Management and Toxicology, Faculty of Life Sciences, University of Benin, Benin City, Nigeria.
- Department of Environmental Management and Toxicology, College of Environmental Resources Management, Federal University of Agriculture, Abeokuta, Nigeria.
| | - O Oguntoke
- Department of Environmental Management and Toxicology, College of Environmental Resources Management, Federal University of Agriculture, Abeokuta, Nigeria
| | - A M Taiwo
- Department of Environmental Management and Toxicology, College of Environmental Resources Management, Federal University of Agriculture, Abeokuta, Nigeria
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De Roos AJ, Kenyon CC, Yen YT, Moore K, Melly S, Hubbard RA, Maltenfort M, Forrest CB, Diez Roux AV, Schinasi LH. Does Living near Trees and Other Vegetation Affect the Contemporaneous Odds of Asthma Exacerbation among Pediatric Asthma Patients? J Urban Health 2022; 99:533-548. [PMID: 35467328 PMCID: PMC9187838 DOI: 10.1007/s11524-022-00633-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/18/2022] [Indexed: 02/02/2023]
Abstract
Vegetation may influence asthma exacerbation through effects on aeroallergens, localized climates, air pollution, or children's behaviors and stress levels. We investigated the association between residential vegetation and asthma exacerbation by conducting a matched case-control study based on electronic health records of asthma patients, from the Children's Hospital of Philadelphia (CHOP). Our study included 17,639 exacerbation case events and 34,681 controls selected from non-exacerbation clinical visits for asthma, matched to cases by age, sex, race/ethnicity, public payment source, and residential proximity to the CHOP main campus ED and hospital. Overall greenness, tree canopy, grass/shrub cover, and impervious surface were assessed near children's homes (250 m) using satellite imagery and high-resolution landcover data. We used generalized estimating equations to estimate odds ratios (OR) and 95% confidence intervals (CI) for associations between each vegetation/landcover measure and asthma exacerbation, with adjustment for seasonal and sociodemographic factors-for all cases, and for cases defined by diagnosis setting and exacerbation frequency. Lower odds of asthma exacerbation were observed in association with greater levels of tree canopy near the home, but only for children who experienced multiple exacerbations in a year (OR = 0.94 per 10.2% greater tree canopy coverage, 95% CI = 0.90-0.99). Our findings suggest possible protection for asthma patients from tree canopy, but differing results by case frequency suggest that potential benefits may be specific to certain subpopulations of asthmatic children.
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Affiliation(s)
- Anneclaire J De Roos
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA. .,Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA.
| | - Chén C Kenyon
- Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Yun-Ting Yen
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Kari Moore
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Steven Melly
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Rebecca A Hubbard
- Department of Biostatistics, Epidemiology & Informatics, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Mitchell Maltenfort
- Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Christopher B Forrest
- Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Ana V Diez Roux
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA.,Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Leah H Schinasi
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA.,Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
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Acito M, Fatigoni C, Villarini M, Moretti M. Cytogenetic Effects in Children Exposed to Air Pollutants: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:6736. [PMID: 35682315 PMCID: PMC9180689 DOI: 10.3390/ijerph19116736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/17/2022] [Accepted: 05/25/2022] [Indexed: 12/03/2022]
Abstract
The aim of this systematic review and meta-analysis was to assess the association between exposure to ambient air pollutants and micronuclei (MN) frequency in children. This work was performed according to the Cochrane Collaboration and the PRISMA guidelines and recommendations. Articles published before November 2021 were identified by an advanced search on PubMed/MEDLINE, Scopus and Web of Science databases. A critical appraisal using a specific tool was conducted to assess the quality of each included study. All analyses were carried out by using the Review Manager (RevMan) 5.4 software (The Cochrane Collaboration, London, UK). One hundred and forty-five references were firstly identified, and, at the end of selection process, 13 studies met the inclusion criteria. Six studies carried out a direct evaluation through the use of air samplers, whereas the other ones accessed environmental databases (n = 2) or used other tools (n = 3). In two cases, exposure was not directly investigated, with children sampled in two different areas with well-known different levels of pollution. The overall effect size (ES) was 1.57 ((95% CI = 1.39; 1.78), p-value < 0.00001) (total evaluated subjects: 4162), which highlighted a statistically significant association between outdoor air pollution and MN frequency in children. As a high MN frequency has been associated with a number of pathological states and a higher risk of developing chronic degenerative diseases, our results should be taken into consideration by policy makers to design and implement interventions aimed at reducing the introduction of pollutants in the atmosphere as well as at minimizing the exposure extent, particularly in children.
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Affiliation(s)
| | | | | | - Massimo Moretti
- Unit of Public Health, Department of Pharmaceutical Sciences, University of Perugia, Via del Giochetto, 06122 Perugia, Italy; (M.A.); (C.F.); (M.V.)
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Dąbrowiecki P, Chciałowski A, Dąbrowiecka A, Badyda A. Ambient Air Pollution and Risk of Admission Due to Asthma in the Three Largest Urban Agglomerations in Poland: A Time-Stratified, Case-Crossover Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19105988. [PMID: 35627528 PMCID: PMC9140383 DOI: 10.3390/ijerph19105988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 05/04/2022] [Accepted: 05/11/2022] [Indexed: 11/16/2022]
Abstract
Ambient air pollution in urban areas may trigger asthma exacerbations. We carried out a time-series analysis of the association between the concentrations of various air pollutants and the risk of hospital admission due to asthma over 7 days from exposure. We used distributed lag nonlinear models to analyze data gathered between 2010 and 2018 in the three largest urban agglomerations in Poland. Overall, there were 31,919 asthma hospitalizations. Over 7 days since exposure, the rate ratio (95%CI) for admission per 10 µg/m3 was 1.013 (1.002–1.024) for PM10; 1.014 (1.000–1.028) for PM2.5; 1.054 (1.031–1.078) for NO2; and 1.044 for SO2 (95%CI: 0.986–1.104). For all pollutants, the risk of admission was the greatest on the day of exposure (day 0), decreased below baseline on days 1 and 2, and then increased gradually up to day 6. The proportions (95%CI) of hospitalizations attributable to air pollution were 4.52% (0.80%–8.14%) for PM10; 3.74% (0.29%–7.11%) for PM2.5; 16.4% (10.0%–21.8%) for NO2; and 2.50% (−0.75%–5.36%) for SO2. In conclusion, PM2.5, PM10, NO2, and SO2 pollution was associated with an increased risk of hospital admission due to asthma in the three largest urban agglomerations in Poland over nine years.
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Affiliation(s)
- Piotr Dąbrowiecki
- Department of Allergology and Infectious Diseases, Military Institute of Medicine, 04-141 Warsaw, Poland; (P.D.); (A.C.)
- Polish Federation of Asthma Allergy and COPD Patients Associations, 01-604 Warsaw, Poland
| | - Andrzej Chciałowski
- Department of Allergology and Infectious Diseases, Military Institute of Medicine, 04-141 Warsaw, Poland; (P.D.); (A.C.)
| | | | - Artur Badyda
- Polish Federation of Asthma Allergy and COPD Patients Associations, 01-604 Warsaw, Poland
- Faculty of Building Services, Hydro and Environmental Engineering, Warsaw University of Technology, 00-653 Warsaw, Poland
- Correspondence:
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Zhao Y, Kong D, Fu J, Zhang Y, Chen Y, Liu Y, Chang Z, Liu Y, Liu X, Xu K, Jiang C, Fan Z. Increased Risk of Hospital Admission for Asthma in Children From Short-Term Exposure to Air Pollution: Case-Crossover Evidence From Northern China. Front Public Health 2022; 9:798746. [PMID: 34976938 PMCID: PMC8718688 DOI: 10.3389/fpubh.2021.798746] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 11/22/2021] [Indexed: 11/23/2022] Open
Abstract
Background: Previous studies suggested that exposure to air pollution could increase risk of asthma attacks in children. The aim of this study is to investigate the short-term effects of exposure to ambient air pollution on asthma hospital admissions in children in Beijing, a city with serious air pollution and high-quality medical care at the same time. Methods: We collected hospital admission data of asthma patients aged ≤ 18 years old from 56 hospitals from 2013 to 2016 in Beijing, China. Time-stratified case-crossover design and conditional Poisson regression were applied to explore the association between risk of asthma admission in children and the daily concentration of six air pollutants [particulate matter ≤ 2.5 μm (PM2.5), particulate matter ≤ 10 μm (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and ozone (O3)], adjusting for meteorological factors and other pollutants. Additionally, stratified analyses were performed by age, gender, and season. Results: In the single-pollutant models, higher levels of PM2.5, SO2, and NO2 were significantly associated with increased risk of hospital admission for asthma in children. The strongest effect was observed in NO2 at lag06 (RR = 1.25, 95%CI: 1.06-1.48), followed by SO2 at lag05 (RR = 1.17, 95%CI: 1.05–1.31). The robustness of effects of SO2 and NO2 were shown in two-pollutant models. Stratified analyses further indicated that pre-school children (aged ≤ 6 years) were more susceptible to SO2. The effects of SO2 were stronger in the cold season, while the effects of NO2 were stronger in the warm season. No significant sex-specific differences were observed. Conclusions: These results suggested that high levels of air pollution had an adverse effect on childhood asthma, even in a region with high-quality healthcare. Therefore, it will be significant to decrease hospital admissions for asthma in children by controlling air pollution emission and avoiding exposure to air pollution.
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Affiliation(s)
- Yakun Zhao
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Dehui Kong
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Jia Fu
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Yongqiao Zhang
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Yuxiong Chen
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Yanbo Liu
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Zhen'ge Chang
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Yijie Liu
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Xiaole Liu
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Kaifeng Xu
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Chengyu Jiang
- National Key Laboratory of Medical Molecular Biology, Department of Biochemistry, Institute of Basic Medical Sciences, Peking Union Medical Colleges, Chinese Academy of Medical Sciences, Beijing, China
| | - Zhongjie Fan
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
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Hurst JH, Zhao C, Hostetler HP, Ghiasi Gorveh M, Lang JE, Goldstein BA. Environmental and clinical data utility in pediatric asthma exacerbation risk prediction models. BMC Med Inform Decis Mak 2022; 22:108. [PMID: 35459216 PMCID: PMC9034565 DOI: 10.1186/s12911-022-01847-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 04/13/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Asthma exacerbations are triggered by a variety of clinical and environmental factors, but their relative impacts on exacerbation risk are unclear. There is a critical need to develop methods to identify children at high-risk for future exacerbation to allow targeted prevention measures. We sought to evaluate the utility of models using spatiotemporally resolved climatic data and individual electronic health records (EHR) in predicting pediatric asthma exacerbations. METHODS We extracted retrospective EHR data for 5982 children with asthma who had an encounter within the Duke University Health System between January 1, 2014 and December 31, 2019. EHR data were linked to spatially resolved environmental data, and temporally resolved climate, pollution, allergen, and influenza case data. We used xgBoost to build predictive models of asthma exacerbation over 30-180 day time horizons, and evaluated the contributions of different data types to model performance. RESULTS Models using readily available EHR data performed moderately well, as measured by the area under the receiver operating characteristic curve (AUC 0.730-0.742) over all three time horizons. Inclusion of spatial and temporal data did not significantly improve model performance. Generating a decision rule with a sensitivity of 70% produced a positive predictive value of 13.8% for 180 day outcomes but only 2.9% for 30 day outcomes. CONCLUSIONS EHR data-based models perform moderately wellover a 30-180 day time horizon to identify children who would benefit from asthma exacerbation prevention measures. Due to the low rate of exacerbations, longer-term models are likely to be most clinically useful. TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Jillian H. Hurst
- grid.26009.3d0000 0004 1936 7961Department of Pediatrics, Division of Infectious Diseases, Duke University School of Medicine, Durham, NC USA ,grid.26009.3d0000 0004 1936 7961Department of Pediatrics, Children’s Health and Discovery Initiative, Duke University School of Medicine, Durham, NC USA
| | - Congwen Zhao
- grid.26009.3d0000 0004 1936 7961Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC USA
| | - Haley P. Hostetler
- grid.26009.3d0000 0004 1936 7961Department of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, Duke University School of Medicine, Durham, NC USA
| | - Mohsen Ghiasi Gorveh
- grid.26009.3d0000 0004 1936 7961Duke Clinical Research Institute, Duke University, Durham, NC USA
| | - Jason E. Lang
- grid.26009.3d0000 0004 1936 7961Department of Pediatrics, Division of Pulmonary and Sleep Medicine, Duke University School of Medicine, Durham, NC USA
| | - Benjamin A. Goldstein
- grid.26009.3d0000 0004 1936 7961Department of Pediatrics, Children’s Health and Discovery Initiative, Duke University School of Medicine, Durham, NC USA ,grid.26009.3d0000 0004 1936 7961Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC USA ,grid.26009.3d0000 0004 1936 7961Duke Clinical Research Institute, Duke University, Durham, NC USA
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PM2.5 Exposure and Asthma Development: The Key Role of Oxidative Stress. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:3618806. [PMID: 35419163 PMCID: PMC9001082 DOI: 10.1155/2022/3618806] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 03/24/2022] [Indexed: 12/21/2022]
Abstract
Oxidative stress is defined as the imbalance between reactive oxygen species (ROS) production and the endogenous antioxidant defense system, leading to cellular damage. Asthma is a common chronic inflammatory airway disease. The presence of asthma tends to increase the production of reactive oxygen species (ROS), and the antioxidant system in the lungs is insufficient to mitigate it. Therefore, asthma can lead to an exacerbation of airway hyperresponsiveness and airway inflammation. PM2.5 exposure increases ROS levels. Meanwhile, the accumulation of ROS will further enhance the oxidative stress response, resulting in DNA, protein, lipid, and other cellular and molecular damage, leading to respiratory diseases. An in-depth study on the relationship between oxidative stress and PM2.5-related asthma is helpful to understand the pathogenesis and progression of the disease and provides a new direction for the treatment of the disease. This paper reviews the research progress of oxidative stress in PM2.5-induced asthma as well as highlights the therapeutic potentials of antioxidant approaches in treatment of asthma.
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Chen L, Wang X, Qian ZM, Sun L, Qin L, Wang C, Howard SW, Aaron HE, Lin H. Ambient gaseous pollutants and emergency ambulance calls for all-cause and cause-specific diseases in China: a multicity time-series study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:28527-28537. [PMID: 34988821 DOI: 10.1007/s11356-021-18337-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 12/21/2021] [Indexed: 06/14/2023]
Abstract
Much attention has been paid to the health effects of ambient particulate matter pollution; the effects of gaseous air pollutants have not been well studied. Emergency ambulance calls (EACs) may provide a better indicator of the acute health effects than the widely used health indicators, such as mortality and hospital admission. We estimated the short-term associations between gaseous air pollutants [nitrogen dioxide (NO2), sulfur dioxide (SO2), and ozone (O3)] and EACs for all-cause, cardiovascular, and respiratory diseases in seven Chinese cities from 2014 to 2019. We used generalized additive models and random-effects meta-analysis to examine the city-specific and pooled associations. Stratified analyses were conducted by age, sex, and season. A total of 1,626,017 EACs were observed for all-cause EACs, including 230,537 from cardiovascular diseases, and 96,483 from respiratory diseases. Statistically significant associations were observed between NO2 and EACs for all-cause diseases, while the effects of SO2 were positive, but not statistically significant in most models. No significant relationship was found between O3 and EACs. Specifically, each 10 μg/m3 increase in the 2-day moving average concentration of NO2 was associated with a 1.07% [95% confidence interval (CI): 0.40%, 1.76%], 0.76% (95% CI: 0.19%, 1.34%) and 0.06% (95% CI: -1.57%, 1.73%) increase in EACs due to all-cause, cardiovascular and respiratory diseases, respectively. Stratified analysis showed a larger effect of NO2 on all-cause EACs in the cold season [excess relative risk (ERR): 0.33% (95% CI: 0.05%, 0.60%) for warm season, ERR: 0.77% (95% CI: 0.31%, 1.23%) for cold season]. Our study indicates that acute exposures to NO2 might be an important trigger of the emergent occurrence of all-cause, cardiovascular and respiratory diseases, and this effect should be of particular concern in the cold season. Further policy development for controlling gaseous air pollution is warranted to reduce the emergent occurrence of cardiopulmonary diseases.
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Affiliation(s)
- Lan Chen
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Xiaojie Wang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Zhengmin Min Qian
- Department of Epidemiology and Biostatistics, College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO, 63104, USA
| | - Liwen Sun
- Huairou District Center for Disease Control and Prevention, Beijing, 101400, China
| | - Lijie Qin
- Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, China
| | - Steven W Howard
- Department of Epidemiology and Biostatistics, College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO, 63104, USA
| | - Hannah E Aaron
- Department of Epidemiology and Biostatistics, College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO, 63104, USA
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
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Review of Ground-Level Ozone Impact in Respiratory Health Deterioration for the Past Two Decades. ATMOSPHERE 2022. [DOI: 10.3390/atmos13030434] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Background: Ground-level ozone has been gaining notoriety with increasing evidence of its nefarious effects on health, especially respiratory diseases. Where do we stand on the solidity of this data and is there room for improvement? Objectives: Evaluate this evidence for incongruities or heterogeneity in this field of research. How is the exposure assessment conducted, where does Portugal stand in this field, and what can be improved? Health deterioration concerning asthma, chronic obstructive pulmonary disease (COPD), and acute respiratory distress syndrome (ARDS) are analysed. Methods: A review of 1735 studies was conducted through PubMed and Google Scholar engines for the past two decades. We identified 59 eligible studies and included an array of variables, including O3 measurements, number of air-quality monitoring stations used, relative risks, odds ratios, hazard ratios, number of hospital admissions, visits, or mortality, and size of population dataset used. Results: Approximately 83% of data in this review presents significant correlations of ozone with asthma, COPD, and ARDS. Studies that report negative or not significant associations mention a lack of data or topographic differences as the main issue with these divergent results. Studies consistently report summer as a period of particular concern. Portuguese data in this field is lacking. Conclusions: This research field is growing in interest and there is evidence that ozone plays a non-negligible role in health deterioration. The few Portuguese studies in this field seem aligned with the literature reviewed but more research is needed. Suggested improvements are more and better data through denser air-quality networks to accurately depict personal exposure to ozone. Homogenization of the exposure assessment concerning averaging times of ozone to daily maximum 8 h averages whenever possible. Risk increments based on 10 ppb instead of interquartile ranges. Lastly, contrary to some studies in this review, the topographic effect on concentrations and health deterioration should not be underestimated and seasonality should always be checked.
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Li J, Hu Y, Li H, Lin Y, Tong S, Li Y. Assessing the impact of air pollutants on clinical visits for childhood allergic respiratory disease induced by house dust mite in Shanghai, China. Respir Res 2022; 23:48. [PMID: 35248029 PMCID: PMC8897928 DOI: 10.1186/s12931-022-01967-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 02/21/2022] [Indexed: 01/16/2023] Open
Abstract
Background The prevalence of allergic respiratory disease (ARD) is increasing worldwide during the last few decades, causing a great disease burden especially for children. Air pollution has been increasingly considered as a potential contributor to this trend, but its role in ARD induced by house dust mite (HDM-ARD) remains unclear, especially in time-series study. Methods A positive reporting of respiratory allergy to named allergens was included by serum specific IgE testing. A time series Quasi-Poisson regression with distributed lag non-linear model, combined with generalized linear model was used to examine the effects of air pollutants on ARD, HDM-ARD and ARD induced by non-house dust mite (NHDM-ARD). Results A total of 16,249 cases of ARD, including 8,719 HDM-ARD and 8,070 NHDM-ARD from 1 Jan 2013 to 31 Dec 2017 were involved in this study. Air pollutants were significantly associated with clinical visits for childhood ARD and HDM-ARD. Exposure to higher O3 and interquartile range (IQR) increment in O3 (40.6 µg/m3) increased the risks of clinical visits for childhood HDM-ARD (RRlag0-5 for the 95th percentile of O3: 1.26, 95% confidence interval (CI): 1.03, 1.55; RRlag0-5 for IQR increment (40.6 µg/m3): 1.09, 95% CI: 1.01, 1.17) and ARD (RRlag0-5 for the 95th percentile of O3: 1.19, 95% CI: 1.03, 1.38; RRlag0-5 for IQR increment (40.6 µg/m3): 1.06, 95% CI: 1.01, 1.12). In addition, higher O3 was associated with increased RR of boys with ARD (RRlag0-5 for the 95th percentile: 1.26, 95% CI: 1.05, 1.51; RRlag0-5 for IQR increment (40.6 µg/m3): 1.09, 95% CI: 1.02, 1.16) and HDM-ARD (RRlag0-5 for the 95th percentile: 1.36, 95% CI: 1.06, 1.75; RRlag0-5 for IQR increment (40.6 µg/m3): 1.11, 95% CI: 1.02, 1.22), but not in girls. Conclusions Exposure to O3 appeared to be a trigger of clinical visits for childhood ARD, especially for HDM-ARD and boys. These findings provide novel evidence on the impact of air pollution on HDM-ARD, which may have significant implications for designing effective intervention programs to control and prevent childhood ARD, especially HDM-ARD, in China and other similar developing countries. Supplementary Information The online version contains supplementary material available at 10.1186/s12931-022-01967-1.
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Nishida C, Yatera K. The Impact of Ambient Environmental and Occupational Pollution on Respiratory Diseases. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:2788. [PMID: 35270479 PMCID: PMC8910713 DOI: 10.3390/ijerph19052788] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 02/22/2022] [Accepted: 02/25/2022] [Indexed: 11/16/2022]
Abstract
Ambient pollutants and occupational pollutants may cause and exacerbate various lung and respiratory diseases. This review describes lung and respiratory diseases in relation to ambient pollutants, particularly particulate matter (PM2.5), and occupational air pollutants, excluding communicable diseases and indoor pollutants, including tobacco smoke exposure. PM2.5 produced by combustion is an important ambient pollutant. PM2.5 can cause asthma attacks and exacerbations of chronic obstructive pulmonary disease in the short term. Further, it not only carries a risk of lung cancer and death, but also hinders the development of lung function in children in the long term. It has recently been suggested that air pollution, such as PM2.5, is a risk factor for severe coronavirus disease (COVID-19). Asbestos, which causes asbestosis, lung cancer, and malignant mesothelioma, and crystalline silica, which cause silicosis, are well-known traditional occupational pollutants leading to pneumoconiosis. While work-related asthma (WRA) is the most common occupational lung disease in recent years, many different agents cause WRA, including natural and synthetic chemicals and irritant gases. Primary preventive interventions that increase awareness of pollutants and reduce the development and exacerbation of diseases caused by air pollutants are paramount to addressing ambient and occupational pollution.
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Affiliation(s)
| | - Kazuhiro Yatera
- Department of Respiratory Medicine, University of Occupational and Environmental Health, Fukuoka 807-8555, Japan;
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Renzi M, Scortichini M, Forastiere F, De' Donato F, Michelozzi P, Davoli M, Gariazzo C, Viegi G, Stafoggia M, Ancona C, Bucci S, De' Donato F, Michelozzi P, Renzi M, Scortichini M, Stafoggia M, Bonafede M, Gariazzo C, Marinaccio A, Argentini S, Sozzi R, Bonomo S, Fasola S, Forastiere F, La Grutta S, Viegi G, Cernigliaro A, Scondotto S, Baldacci S, Maio S, Licitra G, Moro A, Angelini P, Bonvicini L, Broccoli S, Ottone M, Rossi PG, Colacci A, Parmagnani F, Ranzi A, Galassi C, Migliore E, Bisceglia L, Chieti A, Brusasca G, Calori G, Finardi S, Nanni A, Pepe N, Radice P, Silibello C, Tinarelli G, Uboldi F, Carlino G. A nationwide study of air pollution from particulate matter and daily hospitalizations for respiratory diseases in Italy. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 807:151034. [PMID: 34666080 DOI: 10.1016/j.scitotenv.2021.151034] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 10/05/2021] [Accepted: 10/13/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND/AIM The relationship between air pollution and respiratory morbidity has been widely addressed in urban and metropolitan areas but little is known about the effects in non-urban settings. Our aim was to assess the short-term effects of PM10 and PM2.5 on respiratory admissions in the whole country of Italy during 2006-2015. METHODS We estimated daily PM concentrations at the municipality level using satellite data and spatiotemporal predictors. We collected daily counts of respiratory hospital admissions for each Italian municipality. We considered five different outcomes: all respiratory diseases, asthma, chronic obstructive pulmonary disease (COPD), lower and upper respiratory tract infections (LRTI and URTI). Meta-analysis of province-specific estimates obtained by time-series models, adjusting for temperature, humidity and other confounders, was applied to extrapolate national estimates for each outcome. At last, we tested for effect modification by sex, age, period, and urbanization score. Analyses for PM2.5 were restricted to 2013-2015 cause the goodness of fit of exposure estimation. RESULTS A total of 4,154,887 respiratory admission were registered during 2006-2015, of which 29% for LRTI, 12% for COPD, 6% for URTI, and 3% for asthma. Daily mean PM10 and PM2.5 concentrations over the study period were 23.3 and 17 μg/m3, respectively. For each 10 μg/m3 increases in PM10 and PM2.5 at lag 0-5 days, we found excess risks of total respiratory diseases equal to 1.20% (95% confidence intervals, 0.92, 1.49) and 1.22% (0.76, 1.68), respectively. The effects for the specific diseases were similar, with the strongest ones for asthma and COPD. Higher effects were found in the elderly and in less urbanized areas. CONCLUSIONS Short-term exposure to PM is harmful for the respiratory system throughout an entire country, especially in elderly patients. Strong effects can be found also in less urbanized areas.
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Affiliation(s)
- Matteo Renzi
- Department of Epidemiology, ASL Rome 1, Local Health Authority, Lazio Region, Italy.
| | - Matteo Scortichini
- Department of Epidemiology, ASL Rome 1, Local Health Authority, Lazio Region, Italy
| | - Francesco Forastiere
- CNR Institute of Biomedical Research and Innovation (IRIB), Palermo, Italy; Environmental Research Group, School of Public Health, Imperial College, London, UK
| | - Francesca De' Donato
- Department of Epidemiology, ASL Rome 1, Local Health Authority, Lazio Region, Italy
| | - Paola Michelozzi
- Department of Epidemiology, ASL Rome 1, Local Health Authority, Lazio Region, Italy
| | - Marina Davoli
- Department of Epidemiology, ASL Rome 1, Local Health Authority, Lazio Region, Italy
| | - Claudio Gariazzo
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Compensation Authority (INAIL), Monteporzio Catone (RM), Italy
| | - Giovanni Viegi
- CNR Institute of Biomedical Research and Innovation (IRIB), Palermo, Italy; CNR Institute of Clinical Physiology (IFC), Pisa, Italy
| | - Massimo Stafoggia
- Department of Epidemiology, ASL Rome 1, Local Health Authority, Lazio Region, Italy
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Fishe J, Zheng Y, Lyu T, Bian J, Hu H. Environmental effects on acute exacerbations of respiratory diseases: A real-world big data study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 806:150352. [PMID: 34555607 PMCID: PMC8627495 DOI: 10.1016/j.scitotenv.2021.150352] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 09/11/2021] [Accepted: 09/11/2021] [Indexed: 05/06/2023]
Abstract
BACKGROUND The effects of weather periods, race/ethnicity, and sex on environmental triggers for respiratory exacerbations are not well understood. This study linked the OneFlorida network (~15 million patients) with an external exposome database to analyze environmental triggers for asthma, bronchitis, and COPD exacerbations while accounting for seasonality, sex, and race/ethnicity. METHODS This is a case-crossover study of OneFlorida database from 2012 to 2017 examining associations of asthma, bronchitis, and COPD exacerbations with exposures to heat index, PM 2.5 and O 3. We spatiotemporally linked exposures using patients' residential addresses to generate average exposures during hazard and control periods, with each case serving as its own control. We considered age, sex, race/ethnicity, and neighborhood deprivation index as potential effect modifiers in conditional logistic regression models. RESULTS A total of 1,148,506 exacerbations among 533,446 patients were included. Across all three conditions, hotter heat indices conferred increasing exacerbation odds, except during November to March, where the opposite was seen. There were significant differences when stratified by race/ethnicity (e.g., for asthma in April, May, and October, heat index quartile 4, odds were 1.49 (95% confidence interval (CI) 1.42-1.57) for Non-Hispanic Blacks and 2.04 (95% CI 1.92-2.17) for Hispanics compared to 1.27 (95% CI 1.19-1.36) for Non-Hispanic Whites). Pediatric patients' odds of asthma and bronchitis exacerbations were significantly lower than adults in certain circumstances (e.g., for asthma during June - September, pediatric odds 0.71 (95% CI 0.68-0.74) and adult odds 0.82 (95% CI 0.79-0.85) for the highest quartile of PM 2.5). CONCLUSION This study of acute exacerbations of asthma, bronchitis, and COPD found exacerbation risk after exposure to heat index, PM 2.5 and O 3 varies by weather period, age, and race/ethnicity. Future work can build upon these results to alert vulnerable populations to exacerbation triggers.
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Affiliation(s)
- Jennifer Fishe
- Department of Emergency Medicine, University of Florida College of Medicine - Jacksonville, United States of America; Center for Data Solutions, University of Florida College of Medicine - Jacksonville, United States of America.
| | - Yi Zheng
- Department of Epidemiology, University of Florida College of Medicine & College of Public Health and Health Professions, United States of America
| | - Tianchen Lyu
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, United States of America
| | - Jiang Bian
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, United States of America
| | - Hui Hu
- Department of Epidemiology, University of Florida College of Medicine & College of Public Health and Health Professions, United States of America
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DZIARZHYNSKAYA NADZEYA, HINDZIUK ANDREY, HINDZIUK LARISA, SYSOEVA IRINA, KRUPSKAYA DARYA, URBAN ULIA, CHERNIAVSKAYA NATALYA, VISHNEVSKAYA ALEXANDRA, MAKAROVA ELENA, ERMAK SVETLANA, HINDZIUK NELLI. Airborne chemical pollution and children's asthma incidence rate in Minsk. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2022; 62:E871-E878. [PMID: 35603254 PMCID: PMC9104677 DOI: 10.15167/2421-4248/jpmh2021.62.4.1568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 10/28/2021] [Indexed: 11/12/2022]
Abstract
Introduction Asthma manifestations are closely connected with air pollution. Discovering interconnection between concentrations of air pollutants and asthma incidence rate among children provides information for developing effective measures to reduce air pollution and improve population health. Study purpose was to carry out hygienic analysis of the influence of atmospheric air quality on the incidence rate of bronchial asthma of children in Minsk in 2009-2018. Methods During 2019 retrospective health cohort study was conducted, data from stationary air quality monitoring posts were collected. Correlation analysis was conducted by determining the Pearson coefficient. Results Ten-year levels of asthma incidence rate had a moderate downward trend; the highest levels were registered among 5-9-year-old children. 74.7% of all cases of asthma were registered among children under 10 years: 33,61% among 1-4-year-old and 41.09% - among 5-9-year-old. Results of the study showed that concentrations of ammonia, particulate matter (dust/aerosol undifferentiated in composition) and lead in Minsk were characterized by downward trend, carbon oxide and nitrogen dioxide concentrations remained unstable, elevated levels of formaldehyde remained near highways with heavy traffic. Strong evidence was found for concentrations of particulate matter (dust/aerosol undifferentiated in composition) (R = 0.76-0.85, p < 0.05), lead (R = 0.69-0.97, p < 0.05), ammonia (R = 0.64-0.72, p < 0.05) nitrogen dioxide (R = 0.63-0.8, p < 0.05) and children's asthma incidence rate. Conclusions Obtained results indicate that particulate matter, lead, ammonia and nitrogen dioxide concentrations hesitation causes changes in children's asthma incidence levels. Not being the initial cause of the disease, they influence epidemic process and can be the target for preventive measures.
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Affiliation(s)
- NADZEYA DZIARZHYNSKAYA
- Belarusian State Medical University, Minsk, Belarus
- Correspondence: Nadzeya Dziarzhynskaya, Belarusian State Medical University, Minsk, Belarus; 2 Minsk City Center of Hygiene and Epidemiology, Minsk, Belarus - E-mail:
| | | | | | | | - DARYA KRUPSKAYA
- Minsk City Center of Hygiene and Epidemiology, Minsk, Belarus
| | - ULIA URBAN
- Minsk City Center of Hygiene and Epidemiology, Minsk, Belarus
| | | | | | - ELENA MAKAROVA
- Minsk City Center of Hygiene and Epidemiology, Minsk, Belarus
| | - SVETLANA ERMAK
- Minsk City Center of Hygiene and Epidemiology, Minsk, Belarus
| | - NELLI HINDZIUK
- Minsk City Center of Hygiene and Epidemiology, Minsk, Belarus
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Clemons R, Kong M, Jawad K, Feygin Y, Caperell K. The Impact of Converting a Power Plant from Coal to Natural Gas on Pediatric Acute Asthma. J Asthma 2022; 59:2441-2448. [PMID: 35038390 DOI: 10.1080/02770903.2021.2022159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Background and Objectives: Air pollutants play a pivotal role in the frequency and severity of asthma symptoms. As cleaner air initiatives are increasingly being implemented, it is important to appraise how these changes relate to acute pediatric asthma. The objective of this study is to evaluate the effect of a Gas and Electric Company's transition from using coal to natural gas as their fuel source on pediatric asthma-related illnesses in Louisville, KY.Methods: Data were collected for children 2-17 years old from a large regional healthcare system, for which an asthma-related primary diagnosis was present between April 1, 2013 and April 1, 2018. Using an interrupted time series design, we analyzed monthly rates of asthma-related visits to urgent care (UC) and emergency departments (ED). Segmented Poisson regression models were used to assess whether the power company's transition was associated with changes in trends of asthma-related visits.Results: There were a total of 7,735 subjects who met inclusion criteria. Prior to the complete factory transition from coal to natural gas, the mean monthly rate for asthma-related visits was 163.9. After the transition, we observed a significant decrease to a mean monthly rate of 100.3 asthma-related visits (p < 0.001). In addition, the proportion of inpatient (23.7% vs. 30.5%, p < 0.001) visits significantly increased, while ED & UC (76.3 vs. 69.5%, p < 0.001) were significantly decreased.Conclusion: Converting an electrical power plant from coal to natural gas lead to a profound and sustained decrease in pediatric acute asthma exacerbation in Louisville, KY.
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Affiliation(s)
- Robert Clemons
- Pediatric Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, United States
| | - Maiying Kong
- Bioinformatics and Biostatistics, University of Louisville, Louisville, United States
| | - Kahir Jawad
- School of Public Health and Information Sciences, Biostatistics, University of Louisville, Louisville, United States
| | - Yana Feygin
- School of Public Health and Information Sciences, Biostatistics, University of Louisville, Louisville, United States
| | - Kerry Caperell
- Pediatric Emergency Medicine, University of Louisville School of Medicine, Louisville, United States
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Peng W, Li H, Peng L, Wang Y, Wang W. Effects of particulate matter on hospital admissions for respiratory diseases: an ecological study based on 12.5 years of time series data in Shanghai. Environ Health 2022; 21:12. [PMID: 35027064 PMCID: PMC8756174 DOI: 10.1186/s12940-021-00828-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 12/27/2021] [Indexed: 05/08/2023]
Abstract
BACKGROUND Previous epidemiological studies on the association between short-term exposure to particulate matter (PM) with hospital admission in major cities in China were limited to shorter study periods or a single hospital. The aim of this ecological study based on a 12.5-year time series was to investigate the association of short-term exposure to PM with aerodynamic diameter ≤ 2.5 μm (PM2.5) and aerodynamic diameter ≤ 10 μm (PM10) with hospital admissions for respiratory diseases. METHODS Daily hospital admissions data were from the Shanghai Medical Insurance System for the period January 1, 2008 to July 31, 2020. We estimated the percentage change with its 95% confidence interval (CI) for each 10 μg/m3 increase in the level of PM2.5 and PM10 after adjustment for calendar time, day of the week, public holidays, and meteorological factors applying a generalized additive model with a quasi-Poisson distribution. RESULTS There were 1,960,361 hospital admissions for respiratory diseases in Shanghai during the study period. A 10 μg/m3 increase in the level of each class of PM was associated with increased total respiratory diseases when the lag time was 0 day (PM2.5: 0.755%; 95% CI: 0.422, 1.089%; PM10: 0.250%; 95% CI: 0.042, 0.459%). The PM2.5 and PM10 levels also had positive associations with admissions for COPD, asthma, and pneumonia. Stratified analyses demonstrated stronger effects in patients more than 45 years old and during the cold season. Total respiratory diseases increased linearly with PM concentration from 0 to 100 μg/m3, and increased more slowly at higher PM concentrations. CONCLUSIONS This time-series study suggests that short-term exposure to PM increased the risk for hospital admission for respiratory diseases, even at low concentrations. These findings suggest that reducing atmospheric PM concentrations may reduce hospital admissions for respiratory diseases.
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Affiliation(s)
- Wenjia Peng
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, 200032, China
| | - Hao Li
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, 200032, China
| | - Li Peng
- Department of Epidemiology, Shanghai Key Laboratory of Meteorology and Health, Shanghai, 200032, China
| | - Ying Wang
- Key Laboratory of Health Technology Assessment, National Health and Family Planning Commission of the People's Republic of China, Fudan University, Shanghai, China.
- IRDR-ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, 200032, China.
| | - Weibing Wang
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, 200032, China.
- Department of Epidemiology, Shanghai Key Laboratory of Meteorology and Health, Shanghai, 200032, China.
- Department of Social Medicine, School of Public Health, Fudan University, Shanghai, 200032, China.
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Nassikas NJ, Chan EAW, Nolte CG, Roman HA, Micklewhite N, Kinney PL, Carter EJ, Fann NL. Modeling future asthma attributable to fine particulate matter (PM 2.5) in a changing climate: a health impact assessment. AIR QUALITY, ATMOSPHERE, & HEALTH 2022; 15:311-319. [PMID: 35173822 PMCID: PMC8842843 DOI: 10.1007/s11869-022-01155-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 01/04/2022] [Indexed: 06/14/2023]
Abstract
Exposure to fine particulate matter (PM2.5) is associated with asthma development as well as asthma exacerbation in children. PM2.5 can be directly emitted or can form in the atmosphere from pollutant precursors. PM2.5 emitted and formed in the atmosphere is influenced by meteorology; future changes in climate may alter the concentration and distribution of PM2.5. Our aim is to estimate the future burden of climate change and PM2.5 on new and exacerbated cases of childhood asthma. Projected concentrations of PM2.5 are based on the Geophysical Fluid Dynamics Laboratory Coupled Model version 3 climate model, the Representative Concentration Pathway 8.5 greenhouse gas scenario, and two air pollution emissions datasets: a 2011 emissions dataset and a 2040 emissions dataset that reflects substantial reductions in emissions of PM2.5 as compared to the 2011 inventory. We estimate additional PM2.5-attributable asthma as well as PM2.5-attributable albuterol inhaler use for four future years (2030, 2050, 2075, and 2095) relative to the year 2000. Exacerbations, regardless of the trigger, are counted as attributable to PM2.5 if the incident disease is attributable to PM2.5. We project 38 thousand (95% CI 36, 39 thousand) additional PM2.5-attributable incident childhood asthma cases and 29 million (95% CI 27, 31 million) additional PM2.5-attributable albuterol inhaler uses per year in 2030, increasing to 200 thousand (95% CI 190, 210 thousand) additional incident cases and 160 million (95% CI 150, 160 million) inhaler uses per year by 2095 relative to 2000 under the 2011 emissions dataset. These additional PM2.5-attributable incident asthma cases and albuterol inhaler use would cost billions of additional U.S. dollars per year by the late century. These outcomes could be mitigated by reducing air pollution emissions.
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Affiliation(s)
- Nicholas J. Nassikas
- Division of Pulmonary, Critical Care, and Sleep Medicine, Brown University, Providence, RI, USA
- Present Address: Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215, USA
| | - Elizabeth A. W. Chan
- Office of Air Quality Planning and Standards, Office of Air and Radiation, U.S. Environmental Protection Agency, Research Triangle Park, Durham, NC, USA
| | - Christopher G. Nolte
- Center for Environmental Measurement and Modeling, Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, Durham, NC, USA
| | | | | | | | - E. Jane Carter
- Division of Pulmonary, Critical Care, and Sleep Medicine, Brown University, Providence, RI, USA
| | - Neal L. Fann
- Office of Air Quality Planning and Standards, Office of Air and Radiation, U.S. Environmental Protection Agency, Research Triangle Park, Durham, NC, USA
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Lugogo N, Judson E, Haight E, Trudo F, Chipps BE, Trevor J, Ambrose CS. Severe asthma exacerbation rates are increased among female, Black, Hispanic, and younger adult patients: results from the US CHRONICLE study. J Asthma 2022; 59:2495-2508. [PMID: 35000529 DOI: 10.1080/02770903.2021.2018701] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To describe clinical outcomes in patients with severe asthma (SA) by common sociodemographic determinants of health: sex, race, ethnicity, and age. METHODS CHRONICLE is an observational study of subspecialist-treated, United States adults with SA receiving biologic therapy, maintenance systemic corticosteroids, or uncontrolled by high-dosage inhaled corticosteroids with additional controllers. For patients enrolled between February 2018 and February 2020, clinical characteristics and asthma outcomes were assessed by sex, race, ethnicity, age at enrollment, and age at diagnosis. Treating subspecialists reported exacerbations, exacerbation-related emergency department visits, and asthma hospitalizations from 12 months before enrollment through the latest data collection. Patients completed the St. George's Respiratory Questionnaire and the Asthma Control Test at enrollment. RESULTS Among 1884 enrolled patients, the majority were female (69%), reported White race (75%), non-Hispanic ethnicity (69%), and were diagnosed with asthma as adults (60%). Female, Black, Hispanic, and younger patients experienced higher annualized rates of exacerbations that were statistically significant compared with male, White, non-Hispanic, and older patients, respectively. Black, Hispanic, and younger patients also experienced higher rates of asthma hospitalizations. Female and Black patients exhibited poorer symptom control and poorer health-related quality of life. CONCLUSIONS In this contemporary, real-world cohort of subspecialist-treated adults with SA, female sex, Black race, Hispanic ethnicity, and younger age were important determinants of health, potentially attributable to physiologic and social factors. Knowledge of these disparities in SA disease burden among subspecialist-treated patients may help optimize care for all patients. Supplemental data for this article is available online at at www.tandfonline.com/ijas .
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Affiliation(s)
| | | | | | | | - Bradley E Chipps
- Capital Allergy & Respiratory Disease Center, Sacramento, CA, USA
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Zheng XY, Ma SL, Guan WJ, Xu YJ, Tang SL, Zheng YJ, Liao TT, Li C, Meng RL, Zeng ZP, Lin LF. Impact of polluting fuels for cooking on diabetes mellitus and glucose metabolism in south urban China. INDOOR AIR 2022; 32:e12960. [PMID: 34796997 DOI: 10.1111/ina.12960] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 11/01/2021] [Accepted: 11/06/2021] [Indexed: 05/26/2023]
Abstract
We hypothesized that exposure to polluting fuels for cooking was associated with abnormality of glucose metabolism and diabetes mellitus (DM) in south urban China. 3414 residents were surveyed in 14 urban areas of Guangdong Province in 2018. We recorded polluting fuels for cooking exposure, different DM status (DM, prediabetes), fasting blood glucose (FBG), oral glucose tolerance test (OGTT), glycated hemoglobin (HbA1c ), and other covariates by using a structured questionnaire. We conducted logistic regression model and multivariate linear regression model based on propensity-score method (inverse probability of weighting) to examine the effect of polluting fuels for cooking exposure on DM and glucose metabolism. Exposure to polluting fuels for cooking was associated with DM (odds ratio: 2.57, 95% confidence interval: 1.71 to 3.86) and prediabetes (odds ratio: 1.98, 95% confidence interval: 1.52 to 2.58) in both the adjusted and unadjusted models (all p < 0.05). Exposure to polluting fuels for cooking was significantly associated with an increase of FBG (β: 0.30 mmol/L, 95% confidence interval: 0.22 to 0.38 mmol/L). Sensitivity analysis showed that the results were not substantially changed. There was an increased risk of DM, prediabetes and high levels of FBG, OGTT, and HbA1c among participants aged ≥ 40 years with exposure to polluting fuels for cooking. We demonstrated that exposure to polluting fuels for cooking was associated with higher levels of FBG, which contributed to the increased risk of DM and prediabetes in middle-aged elderly Chinese population living in urban areas.
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Affiliation(s)
- Xue-Yan Zheng
- Guangdong provincial center for disease control and prevention, Guangdong, China
| | - Shu-Li Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Wei-Jie Guan
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Department of Thoracic Surgery, Guangzhou Institute for Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Yan-Jun Xu
- Guangdong provincial center for disease control and prevention, Guangdong, China
| | - Si-Li Tang
- School of Public Health, Southern Medical University, Guangzhou, China
| | - Yi-Jin Zheng
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | | | - Chuan Li
- Guangdong provincial center for disease control and prevention, Guangdong, China
| | - Rui-Lin Meng
- Guangdong provincial center for disease control and prevention, Guangdong, China
| | - Zhuan-Ping Zeng
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Li-Feng Lin
- Guangdong provincial center for disease control and prevention, Guangdong, China
- School of Public Health, Southern Medical University, Guangzhou, China
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83
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Kuo CY, Chan CK, Huang JL, Wu CY, Phan DV, Lo HY, Chan CL. Decline in hospitalization for childhood asthma in different air pollution regions in Taiwan, 2001-2012. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2022; 32:95-105. [PMID: 32073299 DOI: 10.1080/09603123.2020.1729964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Accepted: 02/11/2020] [Indexed: 06/10/2023]
Abstract
This study aimed to investigate the trends in childhood asthma hospitalization in regions with differing levels of air pollution in Taiwan, 2001-2012. Joinpoint regression was used to identify significant trend changes. The hospitalization rate varied according to gender, geographic region, and age. The incidence of childhood asthma hospitalization decreased from 127.99 to 76.67 (/100,000 population), with an average annual percentage change of around -4.1%; in the Yilan region, the average air pollution concentrations were 19.92 μg/m3, 39.47 μg/m3, 25.99 ppb, 2.19 ppb, and 11.23 ppb for PM2.5, PM10, O3, SO2, and NO2, respectively, which were lower than Taiwan's average values; however, the childhood asthma hospitalization rate was the highest (179.75/100,000 population). The national trend in childhood asthma hospitalization exhibited a significant decrease. The effects of air pollution on childhood asthma were greater in the higher-level air pollution regions, while less association was observed in the lower-level air pollution regions.
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Affiliation(s)
- Ching-Yen Kuo
- Department of Information Management, Yuan Ze University, Taoyuan City, Taiwan
- Department of Medical Administration, Ministry of Health and Welfare, Taoyuan General Hospital, Taoyuan City, Taiwan
| | - Chin-Kan Chan
- Department of Pediatrics, Ministry of Health and Welfare, Taoyuan General Hospital, Taoyuan City, Taiwan
- Department of Biotechnology, Ming Chuan University, Taoyuan City, Taiwan
| | - Jing-Long Huang
- Department of Pediatrics, Division of Allergy, Asthma and Rheumatology, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taipei, Taiwan
| | - Chiung-Yi Wu
- Institute of Public Health, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Dinh-Van Phan
- Department of Information Management, Yuan Ze University, Taoyuan City, Taiwan
- University of Economics, The University of Danang, Da Nang, Vietnam
- Teaching and Research Team for Business Intelligence, University of Economics, the University of Danang, Da Nang, Vietnam
| | - Huei Yu Lo
- Department of Rehabilitation, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan City, Taiwan
- Department of Chemistry, Chung Yuan Christian University, Taoyuan City, Taiwan
| | - Chien Lung Chan
- Department of Information Management, Yuan Ze University, Taoyuan City, Taiwan
- Innovation Center for Big Data and Digital Convergence, Yuan Ze University, Taoyuan City, Taiwan
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84
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Cao D, Zheng D, Qian ZM, Shen H, Liu Y, Liu Q, Sun J, Zhang S, Jiao G, Yang X, Vaughn MG, Wang C, Zhang X, Lin H. Ambient sulfur dioxide and hospital expenditures and length of hospital stay for respiratory diseases: A multicity study in China. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 229:113082. [PMID: 34929503 DOI: 10.1016/j.ecoenv.2021.113082] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 12/03/2021] [Accepted: 12/10/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Ambient sulfur dioxide (SO2) has been associated with morbidity and mortality of respiratory diseases, however, its effect on length of hospital stays (LOS) and cost for these diagnoses remain unclear. METHODS We collected hospital admission information for respiratory diseases from all 11 cities in the Shanxi Province of China during 2017-2019. We assessed individual-level exposure by using an inverse distance weighting approach based on geocoded residential addresses. A generalized additive model was built to delineate city-specific effects of SO2 on hospitalization, hospital expenditure, and length of hospital stay for respiratory diseases. The overall effects were obtained by random-effects meta-analysis. We further estimated the respiratory burden attributable to SO2 by comparing different reference concentrations. RESULTS We observed significant effects of SO2 exposure on respiratory diseases. At the provincial level, each 10 μg/m3 increase in SO2 on lag03 was associated with a 0.63% (95% CI: 0.14-0.11) increase in hospital admission, an increase of 4.56 days (95% CI: 1.16-7.95) of hospital stay, and 3647.97 renminbi (RMB, Chinese money) (95% CI: 1091.05-6204.90) in hospital cost. We estimated about 6.13 (95% CI: 1.33-11.10) thousand hospital admissions, 65.77 million RMB (95% CI: 19.67-111.87) in hospital expenditure, and 82.13 (95% CI: 20.87-143.40) thousand days of hospital stay could have potentially been avoided had the daily SO2 concentrations been reduced to WHO's reference concentration (40 µg/m3). Variable values in correspondence with this reference concentration could reduce the hospital cost and LOS of each case by 52.67 RMB (95% CI: 15.75-89.59) and 0.07 days (95% CI: 0.02-0.117). CONCLUSION This study provides evidence that short-term ambient SO2 exposure is an important risk factor of respiratory diseases, indicating that continually tightening policies to reduce SO2 levels could effectively reduce respiratory disease burden in Shanxi Province.
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Affiliation(s)
- Dawei Cao
- Department of Respiration, Key Laboratory of Respiratory Disease Prevention and Control of Shanxi Department of Pulmonary and Critical Care Medicine, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Dashan Zheng
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong Province, China
| | - Zhengmin Min Qian
- Department of Epidemiology and Biostatistics, College for Public Health & Social Justice, Saint Louis University, 3545 Lafayette Avenue, Saint Louis, MO 63104, USA
| | - Huiqing Shen
- Department of Respiration, Key Laboratory of Respiratory Disease Prevention and Control of Shanxi Department of Pulmonary and Critical Care Medicine, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Yi Liu
- Department of Respiration, Key Laboratory of Respiratory Disease Prevention and Control of Shanxi Department of Pulmonary and Critical Care Medicine, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Qiyong Liu
- Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jimin Sun
- Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Shiyu Zhang
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong Province, China
| | - Guangyuan Jiao
- Department of Ideological and Political Education, School of Marxism, Capital Medical University, Beijing, China
| | - Xiaoran Yang
- Department of Standards and Evaluation, Beijing Municipal Health Commission Policy Research Center, Beijing Municipal health Commission Information Center, Beijing, China
| | - Michael G Vaughn
- School of Social Work, College for Public Health & Social Justice, Saint Louis University, Tegeler Hall, 3550 Lindell Boulevard, St. Louis, MO 631034, USA
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Xinri Zhang
- Department of Respiration, Key Laboratory of Respiratory Disease Prevention and Control of Shanxi Department of Pulmonary and Critical Care Medicine, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China.
| | - Hualiang Lin
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong Province, China.
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85
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Bagula H, Olaniyan T, de Hoogh K, Saucy A, Parker B, Leaner J, Röösli M, Dalvie MA. Ambient Air Pollution and Cardiorespiratory Outcomes amongst Adults Residing in Four Informal Settlements in the Western Province of South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413306. [PMID: 34948913 PMCID: PMC8707011 DOI: 10.3390/ijerph182413306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 12/09/2021] [Accepted: 12/15/2021] [Indexed: 11/16/2022]
Abstract
Few studies have investigated the relationship between ambient air pollution and cardiorespiratory outcomes in Africa. A cross-sectional study comprising of 572 adults from four informal settlements in the Western Cape, South Africa was conducted. Participants completed a questionnaire adapted from the European Community Respiratory Health Survey, and the National Health and Nutrition Examination Survey questionnaire. Exposure estimates were previously modelled using Land-Use Regression for Particulate Matter (PM2.5) and Nitrogen Dioxide (NO2) at participants' homes. The median age of the participants was 40.7 years, and 88.5% were female. The median annual NO2 level was 19.7 µg/m3 (interquartile range [IQR: 9.6-23.7]) and the median annual PM2.5 level was 9.7 µg/m3 (IQR: 7.3-12.4). Logistic regression analysis was used to assess associations between outcome variables and air pollutants. An interquartile range increase of 5.12 µg/m3 in PM2.5 was significantly associated with an increased prevalence of self-reported chest-pain, [Odds ratio: 1.38 (95% CI: 1.06-1.80)], adjusting for NO2, and other covariates. The study found preliminary circumstantial evidence of an association between annual ambient PM2.5 exposure and self-reported chest-pain (a crude proxy of angina-related pain), even at levels below the South African National Ambient Air Quality Standards.
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Affiliation(s)
- Herman Bagula
- Centre for Environmental and Occupational Health Research, School of Public Health and Family Medicine, University of Cape Town, Anzio Road, Observatory, Cape Town 7925, South Africa; (H.B.); (T.O.)
| | - Toyib Olaniyan
- Centre for Environmental and Occupational Health Research, School of Public Health and Family Medicine, University of Cape Town, Anzio Road, Observatory, Cape Town 7925, South Africa; (H.B.); (T.O.)
| | - Kees de Hoogh
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, CH-4002 Basel, Switzerland; (K.d.H.); (A.S.); (M.R.)
- Faculty of Science, University of Basel, CH-4003 Basel, Switzerland
| | - Apolline Saucy
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, CH-4002 Basel, Switzerland; (K.d.H.); (A.S.); (M.R.)
- Faculty of Science, University of Basel, CH-4003 Basel, Switzerland
- Barcelona Institute for Global Health, 08036 Barcelona, Spain
| | - Bhawoodien Parker
- Department of Environmental Affairs and Developmental Planning, Western Cape Government, Cape Town 7925, South Africa; (B.P.); (J.L.)
| | - Joy Leaner
- Department of Environmental Affairs and Developmental Planning, Western Cape Government, Cape Town 7925, South Africa; (B.P.); (J.L.)
| | - Martin Röösli
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, CH-4002 Basel, Switzerland; (K.d.H.); (A.S.); (M.R.)
- Faculty of Science, University of Basel, CH-4003 Basel, Switzerland
| | - Mohamed Aqiel Dalvie
- Centre for Environmental and Occupational Health Research, School of Public Health and Family Medicine, University of Cape Town, Anzio Road, Observatory, Cape Town 7925, South Africa; (H.B.); (T.O.)
- Correspondence: ; Tel.: +27-827863781
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86
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Huang J, Yang X, Fan F, Hu Y, Wang X, Zhu S, Ren G, Wang G. Outdoor air pollution and the risk of asthma exacerbations in single lag0 and lag1 exposure patterns: a systematic review and meta-analysis. J Asthma 2021; 59:2322-2339. [PMID: 34809505 DOI: 10.1080/02770903.2021.2008429] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Objective: To synthesize evidence regarding the relationship between outdoor air pollution and risk of asthma exacerbations in single lag0 and lag1 exposure patterns.Methods: We performed a systematic literature search using PubMed, Embase, Cochrane Library, Web of Science, ClinicalTrials, China National Knowledge Internet, Chinese BioMedical, and Wanfang databases. Articles published until August 1, 2020 and the reference lists of the relevant articles were reviewed. Two authors independently evaluated the eligible articles and performed structured extraction of the relevant information. Pooled relative risks (RRs) and 95% confidence intervals (CIs) of lag0 and lag1 exposure patterns were estimated using random-effect models.Results: Eighty-four studies met the eligibility criteria and provided sufficient information for meta-analysis. Outdoor air pollutants were associated with increased risk of asthma exacerbations in both single lag0 and lag1 exposure patterns [lag0: RR (95% CI) (pollutants), 1.057(1.011, 1.103) (air quality index, AQI), 1.007 (1.005, 1.010) (particulate matter of diameter ≤ 2.5 μm, PM2.5), 1.009 (1.005, 1.012) (particulate matter of diameter, PM10), 1.010 (1.006, 1.014) (NO2), 1.030 (1.011, 1.048) (CO), 1.005 (1.002, 1.009) (O3); lag1:1.064(1.022, 1.106) (AQI), 1.005 (1.002, 1.008) (PM2.5), 1.007 (1.004, 1.011) (PM10), 1.008 (1.004, 1.012) (NO2), 1.025 (1.007, 1.042) (CO), 1.010 (1.006, 1.013) (O3)], except SO2 [lag0: RR (95% CI), 1.004 (1.000, 1.007); lag1: RR (95% CI), 1.003 (0.999, 1.006)]. Subgroup analyses revealed stronger effects in children and asthma exacerbations associated with other events (including symptoms, lung function changes, and medication use).Conclusion: Outdoor air pollution increases the asthma exacerbation risk in single lag0 and lag1 exposure patterns.Trial registration: PROSPERO, CRD42020204097. https://www.crd.york.ac.uk/.Supplemental data for this article is available online at https://doi.org/10.1080/02770903.2021.2008429 .
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Affiliation(s)
- Junjun Huang
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, China
| | - Xiaoyu Yang
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, China
| | - Fangfang Fan
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Yan Hu
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, China
| | - Xi Wang
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, China
| | - Sainan Zhu
- Department of Biostatistics, Peking University First Hospital, Beijing, China
| | - Guanhua Ren
- Department of Library, Peking University First Hospital, Beijing, China
| | - Guangfa Wang
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, China
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Han CH, Pak H, Chung JH. Short-term effects of exposure to particulate matter and air pollution on hospital admissions for asthma and chronic obstructive pulmonary disease in Gyeonggi-do, South Korea, 2007-2018. JOURNAL OF ENVIRONMENTAL HEALTH SCIENCE & ENGINEERING 2021; 19:1535-1541. [PMID: 34900286 PMCID: PMC8617096 DOI: 10.1007/s40201-021-00709-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 07/10/2021] [Indexed: 06/02/2023]
Abstract
OBJECTIVES Research is lacking on the impacts of exposure to particulate matter (PM) and air pollution on patients with chronic obstructive pulmonary disease (COPD) or asthma. Therefore, we investigate the effects of various air pollution factors on hospitalization for asthma and COPD. METHODS We obtained data on pollutants-PM10, PM2.5, carbon monoxide (CO), ozone (O3), nitrogen dioxide (NO2), and sulfur dioxide (SO2)-in Gyeonggi-do, South Korea. We also extracted data from Korean National Health Insurance records and investigated asthma and COPD attacks that required hospitalization from January 2007 through February 2018. We used generalized additive models with Poisson distribution and log transformation to calculate adjusted risk. A time-stratified case-crossover design was used, and conditional logistic regression was performed to analyze these data. RESULTS Per-unit increases in concentrations of PM10, PM2.5, SO2, NO2, CO, and O3 on different best lag days were associated with increased risks for hospital admission for COPD and asthma. SO2 had the strongest effect on hospital admission for asthma (odds ratio [OR], 1.535; 95 % confidence interval [CI], 1.450-1.619). SO2 also had the strongest effect on hospital admission for COPD (OR, 1.659; 95 % CI, 1.541-1.786). Subgroup analyses showed that these relationships were stronger in seniors (≥ 65 years old) and women with asthma than in men and nonseniors with COPD. CONCLUSIONS Short-term exposure to PM10, PM2.5, CO, O3, NO2, and SO2 may result in hospitalization for asthma and COPD. Of these pollutants, SO2 has the strongest effects. Therefore, patients with COPD and asthma should be cautioned against performing outdoor activities when SO2 levels are high.
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Affiliation(s)
- Chang Hoon Han
- Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea
| | - Haeyong Pak
- Research and Analysis Team, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea
| | - Jae Ho Chung
- Department of Internal Medicine, International St. Mary`s Hospital, Catholic Kwandong University College of Medicine, Simgokro 100Gil 25 Seo-gu, 22711 Incheon, Republic of Korea
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Ayaz KM, Rajkumar R, Basma AG, Emad AJ, Abdullah AH, Hajar H, Mohammad OM, Al-Jahdali H. The effects of the COVID-19 lockdown on severe asthma in patients taking biologic therapy and air pollution in Riyadh. Ann Thorac Med 2021; 16:354-360. [PMID: 34820023 PMCID: PMC8588946 DOI: 10.4103/atm.atm_559_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 04/08/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND: The curfews and lockdowns imposed during the COVID-19 pandemic may decreased the volume of traffic and reduced air pollution. In addition, social distancing measures may contribute to reducing infection and asthma exacerbation. OBJECTIVE: The objective of this study was to assess asthma control and asthma medication use among severe asthmatics on biologics before and after the COVID-19 pandemic. METHODS: This is a cross-sectional survey study of patients with severe asthma receiving biologic therapy at King Abdulaziz Medical City-Riyadh, Saudi Arabia. We looked at the effects of the COVID-19 lockdown on this cohort of severe asthmatics on biologic therapy from March till June 2020 over a period of 12 weeks. We investigated changes in patients’ symptoms and asthma control using the asthma control test (ACT) score and other parameters including emergency department visits, hospitalizations, use of oral prednisolone, changes in inhaler therapy, frequency of bronchodilator use, and patient perception of their symptoms before and after the lockdown period. RESULTS: A total of 56, Female 39 (69%), mean age ± SD 47.4 ± 13.8 years. The duration of bronchial asthma since diagnosis ranged from 4 to 30 years. Most patients had been treated with omalizumab (47, 84%); the rest received mepolizumab (7, 12.5%) and dupilumab (2, 3.6%). All these patients had been on biologic therapy for 5 months, ranging from 5 to 120 months. Most of the patients (45, 80.4%) agreed that their symptoms of asthma had improved with biologic therapy. Most of the patients felt that overall asthma symptoms are better after curfew and lockdown 28 (50%). Less use of bronchodilators postcurfew was reported in 38% of the patients. Asthma control (≥20) using ACT score was significantly higher among patients in postcurfew and lockdown period compared to precurfew period 34 (61.7%) and 23 (41%) (P = 0.001), respectively. CONCLUSIONS: Asthma control was better postcurfew and lockdown. A decrease in air pollution and social distances may be a contributing factor.
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Affiliation(s)
- Khan Mohammad Ayaz
- Department of Medicine, College of Medicine, King Saud University for Health Sciences, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia.,Department of Medicine, Pulmonary Division, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
| | - Rajendram Rajkumar
- Department of Medicine, College of Medicine, King Saud University for Health Sciences, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia.,Department of Medicine, Internal Medicine Division, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
| | - Al-Ghamdi Basma
- Department of Medicine, Pulmonary Division, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
| | - Al-Jahdaly Emad
- Department of Occupational and Environmental Medicine, College of Medicine, Umm AlQura University, Makkah, Saudi Arabia
| | - Al-Harbi Abdullah
- Department of Medicine, College of Medicine, King Saud University for Health Sciences, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia.,Department of Medicine, Pulmonary Division, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
| | - Hayyan Hajar
- Department of Medicine, College of Medicine, King Saud University for Health Sciences, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia.,Department of Medicine, Pulmonary Division, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
| | - Obaidi Mostafa Mohammad
- Department of Medicine, College of Medicine, King Saud University for Health Sciences, Riyadh, Saudi Arabia.,Department of Medicine, Internal Medicine Division, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
| | - Hamdan Al-Jahdali
- Department of Medicine, College of Medicine, King Saud University for Health Sciences, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia.,Department of Medicine, Pulmonary Division, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
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89
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Martinez A, de la Rosa R, Mujahid M, Thakur N. Structural racism and its pathways to asthma and atopic dermatitis. J Allergy Clin Immunol 2021; 148:1112-1120. [PMID: 34743832 DOI: 10.1016/j.jaci.2021.09.020] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 09/03/2021] [Accepted: 09/20/2021] [Indexed: 12/31/2022]
Abstract
Black, Latinx, and Indigenous people in the United States experience a disproportionate burden of asthma and atopic dermatitis. The study of these disease disparities has focused on proximal socioenvironmental exposures and on the biomechanistic (including genetic) differences between racial and ethnic groups. Although biomedical research in allergy and immunology stands to benefit from the inclusion of diverse study populations, the narrow focus on biologic mechanisms disregards the complexity of interactions across biologic and structural factors, including the effects of structural racism. Structural racism is the totality of ways in which society fosters discrimination by creating and reinforcing inequitable systems through intentional policies and practices sanctioned by government and institutions. It is embedded across multiple levels, including the economic, educational, health care, and judicial systems, which are manifested in inequity in the physical and social environment. In this review, we present a conceptual framework and pull from the literature to demonstrate how structural racism is a root cause of atopic disease disparities by way of residential segregation, socioeconomic position, and mass incarceration, which may lead to aberrations in the innate and adaptive immune response and the augmentation of physiologic stress responses, contributing to a disproportionate disease burden for racial and ethnic populations.
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Affiliation(s)
- Adali Martinez
- School of Medicine, the University of California San Francisco, San Francisco, Calif
| | | | - Mahasin Mujahid
- School of Public Health, University of California Berkeley, Berkeley, Calif
| | - Neeta Thakur
- School of Medicine, the University of California San Francisco, San Francisco, Calif.
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Riederer AM, Krenz JE, Tchong-French MI, Torres E, Perez A, Younglove LR, Jansen KL, Hardie DC, Farquhar SA, Sampson PD, Metwali N, Thorne PS, Karr CJ. Effectiveness of portable HEPA air cleaners on reducing indoor endotoxin, PM 10, and coarse particulate matter in an agricultural cohort of children with asthma: A randomized intervention trial. INDOOR AIR 2021; 31:1926-1939. [PMID: 34288127 PMCID: PMC8577577 DOI: 10.1111/ina.12858] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 04/05/2021] [Accepted: 05/02/2021] [Indexed: 06/13/2023]
Abstract
We conducted a randomized trial of portable HEPA air cleaners in the homes of children age 6-12 years with asthma in the Yakima Valley, Washington. All families received asthma education while intervention families also received two HEPA cleaners (child's bedroom, living room). We collected 14-day integrated samples of endotoxin in settled dust and PM10 and PM10-2.5 in the air of the children's bedrooms at baseline and one-year follow-up, and used linear regression to compare follow-up levels, adjusting for baseline. Seventy-one families (36 HEPA, 35 control) completed the study. Baseline geometric mean (GSD) endotoxin loadings were 1565 (6.3) EU/m2 and 2110 (4.9) EU/m2 , respectively, in HEPA vs. control homes while PM10 and PM10-2.5 were 22.5 (1.9) μg/m3 and 9.5 (2.9) μg/m3 , respectively, in HEPA homes, and 19.8 (1.8) μg/m3 and 7.7 (2.0) μg/m3 , respectively, in control homes. At follow-up, HEPA families had 46% lower (95% CI, 31%-57%) PM10 on average than control families, consistent with prior studies. In the best-fit heterogeneous slopes model, HEPA families had 49% (95% CI, 6%-110%) and 89% lower (95% CI, 28%-177%) PM10-2.5 at follow-up, respectively, at 50th and 75th percentile baseline concentrations. Endotoxin loadings did not differ significantly at follow-up (4% lower, HEPA homes; 95% CI, -87% to 50%).
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Affiliation(s)
- Anne M. Riederer
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Jennifer E. Krenz
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Maria I. Tchong-French
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Elizabeth Torres
- Northwest Communities Education Center, Radio KDNA, Granger, WA, USA
| | - Adriana Perez
- Yakima Valley Farm Workers Clinic, Toppenish, WA, USA
| | - Lisa R. Younglove
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Karen L. Jansen
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - David C. Hardie
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Stephanie A. Farquhar
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - Paul D. Sampson
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Nervana Metwali
- Department of Occupational and Environmental Health, College of Public Health, University of Iowa, Iowa City, IA, USA
| | - Peter S. Thorne
- Department of Occupational and Environmental Health, College of Public Health, University of Iowa, Iowa City, IA, USA
| | - Catherine J. Karr
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
- Department of Pediatrics, University of Washington, Seattle, WA, USA
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91
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Franzin BT, Guizellini FC, Hojo O, Pastre IA, de Marchi MRR, Silva HF, Fertonani FL, Oliveira CM. Chemical and morpho-structural characterization of atmospheric aerosol (PM 10 and PM 2.5) in a city of São Paulo state, Brazil. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:59486-59498. [PMID: 33844139 DOI: 10.1007/s11356-021-13602-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 03/17/2021] [Indexed: 06/12/2023]
Abstract
To access the sources of air pollutants is crucial to control atmospheric pollution in urban areas, minimizing human exposure. Particulate matter is a pollutant of great concern making its chemical and morpho-structural characterization of enormous importance. The present work aims at the characterization of atmospheric PM10 and PM2.5. Data of the aerosol mass concentration was correlated by multivariate analysis with water-soluble ion fraction composition accessed by ion chromatography (IC), as well as with meteorological information and air mass backward trajectories. The gravimetric analysis presented average values 3 to 4 times higher than the guide values recommended by the World Health Organization (WHO). A morpho-structural analysis by SEM/FEG coupled to EDS was also carried out identifying the coarse fraction elements from minerals and from soil resuspension organic spherical particles that originated from combustion processes as well as Ti, associated with long-distance transportation. In the fine fraction, Zn with origin probably in tires and vehicle brakes was found. These origins were confirmed by the air masses' backward trajectories obtained by the HYSPLIT model (NOAA). This study contributes to a better understanding of the complex composition of the particulate material in the atmosphere of Araraquara City, resulting from the combination of local and long-distance sources, and serves as a basis for the comparison with future studies related to the air quality at this and other regions in Brazil and in the world.
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Affiliation(s)
- Bruno Trevizan Franzin
- São Paulo State University (Unesp), Institute of Chemistry, Araraquara, SP, 14800-060, Brazil.
- Centro de Química Estrutural, Faculdade de Ciências, Universidade de Lisboa, Edif. C8, Campo Grande, 1749-016, Lisbon, Portugal.
| | | | - Ossamu Hojo
- São Paulo State University (Unesp), Institute of Chemistry, Araraquara, SP, 14800-060, Brazil
| | - Iêda Aparecida Pastre
- São Paulo State University (Unesp), Biosciences, Languages and Exact Sciences Institute, Ibilce, São José do Rio Preto, SP, 15054-000, Brazil
| | | | - Hugo Félix Silva
- Centro de Química Estrutural, Faculdade de Ciências, Universidade de Lisboa, Edif. C8, Campo Grande, 1749-016, Lisbon, Portugal
- Área Departamental de Engenharia Química do Instituto Superior de Engenharia de Lisboa, ISEL-ADEQ, Rua Conselheiro Emídio Navarro, 1, 1059-007, Lisbon, Portugal
| | - Fernando Luis Fertonani
- São Paulo State University (Unesp), Institute of Chemistry, Araraquara, SP, 14800-060, Brazil
- São Paulo State University (Unesp), Biosciences, Languages and Exact Sciences Institute, Ibilce, São José do Rio Preto, SP, 15054-000, Brazil
| | - Cristina Maria Oliveira
- Centro de Química Estrutural, Faculdade de Ciências, Universidade de Lisboa, Edif. C8, Campo Grande, 1749-016, Lisbon, Portugal
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92
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Years of Life Lost (YLL) Due to Short-Term Exposure to Ambient Air Pollution in China: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111467. [PMID: 34769981 PMCID: PMC8582650 DOI: 10.3390/ijerph182111467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 10/28/2021] [Accepted: 10/29/2021] [Indexed: 11/16/2022]
Abstract
(1) Background: Years of life lost (YLL) as a surrogate of health is important for supporting ambient air pollution related policy decisions. However, there has been little comprehensive evaluation of the short-term impact of air pollution on cause-specific YLL, especially in China. Hence in this study, we selected China as sentinel region in order to conduct a meta-analysis to evaluate disease-specific YLL due to all the main ambient air pollutants. (2) Methods: A meta-analysis was conducted to evaluate disease-specific YLL due to the main ambient air pollutants in China, and 19 studies were included. We conducted methodological quality and risk of bias assessment for each included study as well as for heterogeneity and publication bias. Subgroup analysis and sensitivity analysis were also performed. (3) Results: Meta-analysis indicated that increases in PM2.5, PM10, SO2 and NO2 were associated with 1.99–5.84 years increase in YLL from non-accidental diseases. The increase in YLL to cardiovascular disease (CVD) was associated with PM10 and NO2, and the increase in YLL to respiratory diseases (RD) was associated with PM10. (4) Conclusions: Ambient air pollution was observed to be associated with several cause-specific YLL, increasing especially for elderly people and females.
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93
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Pacheco SE, Guidos G, Annesi-Maesano I, Pawankar R, Amato GD, Latour-Staffeld P, Urrutia-Pereira M, Kesic MJ, Hernandez ML. Climate Change and Global Issues in Allergy and Immunology. J Allergy Clin Immunol 2021; 148:1366-1377. [PMID: 34688774 DOI: 10.1016/j.jaci.2021.10.011] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 10/12/2021] [Accepted: 10/18/2021] [Indexed: 11/17/2022]
Abstract
The steady increase in global temperatures, resulting from the combustion of fossil fuels and the accumulation of greenhouse gases (GHG), continues to destabilize all ecosystems worldwide. Although annual emissions must halve by 2030 and reach net-zero by 2050 to limit some of the most catastrophic impacts associated with a warming planet, the world's efforts to curb GHG emissions fall short of the commitments made in the 2015 Paris Agreement (1). To this effect, July 2021 was recently declared the hottest month ever recorded in 142 years (2). The ramifications of these changes on global temperatures are complex and further promote outdoor air pollution, pollen exposure, and extreme weather events. Besides worsening respiratory health, air pollution, promotes atopy and susceptibility to infections. The GHG effects on pollen affect the frequency and severity of asthma and allergic rhinitis. Changes in temperature, air pollution, and extreme weather events exert adverse multisystemic health effects and disproportionally affect disadvantaged and vulnerable populations. This article is an update for allergists and immunologists about the health impacts of climate change, already evident in our daily practices. It is also a call to action and advocacy, including integrating climate change-related mitigation, education, and adaptation measures to protect our patients and avert further injury to our planet.
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Affiliation(s)
- Susan E Pacheco
- Professor of Pediatrics, University of Texas McGovern Medical School, MSB3.228, Houston, Texas 77030.
| | - Guillermo Guidos
- Professor of Immunology, School of Medicine, ENMH, Instituto Politecnico Nacional, Mexico City
| | - Isabella Annesi-Maesano
- Deputy Director of Institute Desbrest of Epiddemioloy and Public Health, INSERM and Montpellier University, Montpellier, France
| | - Ruby Pawankar
- Professor, Division of Allergy, Dept. of Pediatrics, Nippon Medical School, Tokyo, Japan
| | - Gennaro D' Amato
- Fellow and Honorary member of EAACI, FAAAAI, FERS. , Chairman Committee World Allergy Organization on "Aerobiology, Climate change, Biodiversity and Allergy"; Division of Respiratory Diseases and Allergy, High Specialty Hospital A. Cardarelli, Naples
| | - Patricia Latour-Staffeld
- Allergy and Clinical Immunology, Distinguished Graduate Universidad Nacional Pedro Henriquez Ureña, Medical director of Centro Avanzado De Alergia y Asma Santo Domingo, President Latin American Society of Allergy, Asthma and Immunology, Associate Professor School of Medicine Universidad Nacional Pedro Henriquez Ureña, Dominican Republic
| | | | - Matthew J Kesic
- Campbell University, Physician Assistant Program, College of Pharmacy and Health Sciences, 4150 US HWY 421 South, Lillington, NC 27546
| | - Michelle L Hernandez
- Professor of Pediatrics Division of Allergy & Immunology Director, Clinical Research Unit, Children's Research Institute, UNC School of Medicine, 5008C Mary Ellen Jones Building, 116 Manning Drive, CB #7231 Chapel Hill, NC 27599-7231
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94
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da Silveira Fleck A, Sadoine ML, Buteau S, Suarthana E, Debia M, Smargiassi A. Environmental and Occupational Short-Term Exposure to Airborne Particles and FEV 1 and FVC in Healthy Adults: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010571. [PMID: 34682321 PMCID: PMC8536058 DOI: 10.3390/ijerph182010571] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 10/02/2021] [Accepted: 10/04/2021] [Indexed: 11/29/2022]
Abstract
Background: No study has compared the respiratory effects of environmental and occupational particulate exposure in healthy adults. Methods: We estimated, by a systematic review and meta-analysis, the associations between short term exposures to fine particles (PM2.5 and PM4) and certain parameters of lung function (FEV1 and FVC) in healthy adults. Results: In total, 33 and 14 studies were included in the qualitative synthesis and meta-analyses, respectively. In environmental studies, a 10 µg/m3 increase in PM2.5 was associated with an FEV1 reduction of 7.63 mL (95% CI: −10.62 to −4.63 mL). In occupational studies, an increase of 10 µg/m3 in PM4 was associated with an FEV1 reduction of 0.87 mL (95% CI: −1.36 to −0.37 mL). Similar results were observed with FVC. Conclusions: Both occupational and environmental short-term exposures to fine particles are associated with reductions in FEV1 and FVC in healthy adults.
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Affiliation(s)
- Alan da Silveira Fleck
- Department of Environmental and Occupational Health, School of Public Health, University of Montreal, 2375 Chem. de la Côte-Sainte-Catherine, Montreal, QC H3T 1A8, Canada; (A.d.S.F.); (M.L.S.); (M.D.)
- Centre for Public Health Research (CReSP), 7101 Av du Parc, Montreal, QC H3N 1X9, Canada
| | - Margaux L. Sadoine
- Department of Environmental and Occupational Health, School of Public Health, University of Montreal, 2375 Chem. de la Côte-Sainte-Catherine, Montreal, QC H3T 1A8, Canada; (A.d.S.F.); (M.L.S.); (M.D.)
- Centre for Public Health Research (CReSP), 7101 Av du Parc, Montreal, QC H3N 1X9, Canada
| | - Stéphane Buteau
- Institut National de Sante Publique du Québec (INSPQ), 190 Boul Crémazie E, Montreal, QC H2P 1E2, Canada;
| | - Eva Suarthana
- Research Institute of the McGill University Health Center, 2155 Rue Guy, Montreal, QC H3H 2L9, Canada;
- Centre de Recherche de l’Hôpital du Sacré-Coeur de Montréal (CRHSCM), 5400 Boul Gouin O, Montreal, QC H4J 1C5, Canada
| | - Maximilien Debia
- Department of Environmental and Occupational Health, School of Public Health, University of Montreal, 2375 Chem. de la Côte-Sainte-Catherine, Montreal, QC H3T 1A8, Canada; (A.d.S.F.); (M.L.S.); (M.D.)
- Centre for Public Health Research (CReSP), 7101 Av du Parc, Montreal, QC H3N 1X9, Canada
| | - Audrey Smargiassi
- Department of Environmental and Occupational Health, School of Public Health, University of Montreal, 2375 Chem. de la Côte-Sainte-Catherine, Montreal, QC H3T 1A8, Canada; (A.d.S.F.); (M.L.S.); (M.D.)
- Centre for Public Health Research (CReSP), 7101 Av du Parc, Montreal, QC H3N 1X9, Canada
- Institut National de Sante Publique du Québec (INSPQ), 190 Boul Crémazie E, Montreal, QC H2P 1E2, Canada;
- Correspondence:
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95
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Aretz B, Janssen F, Vonk JM, Heneka MT, Boezen HM, Doblhammer G. Long-term exposure to fine particulate matter, lung function and cognitive performance: A prospective Dutch cohort study on the underlying routes. ENVIRONMENTAL RESEARCH 2021; 201:111533. [PMID: 34153335 DOI: 10.1016/j.envres.2021.111533] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 05/12/2021] [Accepted: 06/11/2021] [Indexed: 05/24/2023]
Abstract
BACKGROUND Exposure to fine particulate matter and black carbon is related to cognitive impairment and poor lung function, but less is known about the routes taken by different types of air pollutants to affect cognition. OBJECTIVES We tested two possible routes of fine particulate matter (PM2.5) and black carbon (BC) in impairing cognition, and evaluated their importance: a direct route over the olfactory nerve or the blood stream, and an indirect route over the lung. METHODS We used longitudinal observational data for 49,705 people aged 18+ from 2006 to 2015 from the Dutch Lifelines cohort study. By linking current home addresses to air pollution exposure data from ELAPSE in 2010, long-term average exposure to PM2.5 and BC was assessed. Lung function was measured by spirometry and Global Initiative (GLI) z-scores of forced expiratory volume in 1s (FEV1) and forced vital capacity (FVC) were calculated. Cognitive performance was measured by cognitive processing time (CPT) assessed by the Cogstate Brief Battery. Linear structural equation modeling was performed to test direct/indirect associations. RESULTS Higher exposure to PM2.5 but not BC was related to higher CPT and slower cognitive processing speed [Total Effect PM2.5: FEV1 model = 8.31 × 10-3 (95% CI: 5.71 × 10-3, 10.91 × 10-3), FVC model = 8.30 × 10-3 (95% CI: 5.69 × 10-3, 10.90 × 10-3)]. The direct association of PM2.5 constituted more than 97% of the total effect. Mediation by lung function was low for PM2.5 with a mediated proportion of 1.32% (FEV1) and 2.05% (FVC), but higher for BC (7.01% and 13.82% respectively). DISCUSSION Our results emphasise the importance of the lung acting as a mediator in the relationship between both exposure to PM2.5 and BC, and cognitive performance. However, higher exposure to PM2.5 was mainly directly associated with worse cognitive performance, which emphasises the health-relevance of fine particles due to their ability to reach vital organs directly.
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Affiliation(s)
- Benjamin Aretz
- Institute of Sociology and Demography, University of Rostock, Rostock, Germany; Population Research Centre, Faculty of Spatial Sciences, University of Groningen, Groningen, the Netherlands.
| | - Fanny Janssen
- Population Research Centre, Faculty of Spatial Sciences, University of Groningen, Groningen, the Netherlands; Netherlands Interdisciplinary Demographic Institute - KNAW/University of Groningen, The Hague, the Netherlands
| | - Judith M Vonk
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Michael T Heneka
- Department of Neurodegenerative Diseases and Gerontopsychiatry, University of Bonn, Bonn, Germany; Department of Infectious Diseases and Immunology, University of Massachusetts Medical School, Worcester, MA, USA; German Center for Neurodegenerative Diseases, Bonn, Germany
| | - H Marike Boezen
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Gabriele Doblhammer
- Institute of Sociology and Demography, University of Rostock, Rostock, Germany; German Center for Neurodegenerative Diseases, Bonn, Germany
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96
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Using Low-Cost Sensors to Assess Fine Particulate Matter Infiltration (PM 2.5) during a Wildfire Smoke Episode at a Large Inpatient Healthcare Facility. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189811. [PMID: 34574730 PMCID: PMC8468682 DOI: 10.3390/ijerph18189811] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 09/13/2021] [Accepted: 09/16/2021] [Indexed: 11/21/2022]
Abstract
Wildfire smoke exposure is associated with a range of acute health outcomes, which can be more severe in individuals with underlying health conditions. Currently, there is limited information on the susceptibility of healthcare facilities to smoke infiltration. As part of a larger study to address this gap, a rehabilitation facility in Vancouver, Canada was outfitted with one outdoor and seven indoor low-cost fine particulate matter (PM2.5) sensors in Air Quality Eggs (EGG) during the summer of 2020. Raw measurements were calibrated using temperature, relative humidity, and dew point derived from the EGG data. The infiltration coefficient was quantified using a distributed lag model. Indoor concentrations during the smoke episode were elevated throughout the building, though non-uniformly. After censoring indoor-only peaks, the average infiltration coefficient (range) during typical days was 0.32 (0.22–0.39), compared with 0.37 (0.31–0.47) during the smoke episode, a 19% increase on average. Indoor PM2.5 concentrations quickly reflected outdoor conditions during and after the smoke episode. It is unclear whether these results will be generalizable to other years due to COVID-related changes to building operations, but some of the safety protocols may offer valuable lessons for future wildfire seasons. For example, points of building entry and exit were reduced from eight to two during the pandemic, which likely helped to protect the building from wildfire smoke infiltration. Overall, these results demonstrate the utility of indoor low-cost sensors in understanding the impacts of extreme smoke events on facilities where highly susceptible individuals are present. Furthermore, they highlight the need to employ interventions that enhance indoor air quality in such facilities during smoke events.
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97
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Personal Interventions for Reducing Exposure and Risk for Outdoor Air Pollution: An Official American Thoracic Society Workshop Report. Ann Am Thorac Soc 2021; 18:1435-1443. [PMID: 34468284 PMCID: PMC8489863 DOI: 10.1513/annalsats.202104-421st] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Poor air quality affects the health and wellbeing of large populations around the globe. Although source controls are the most effective approaches for improving air quality and reducing health risks, individuals can also take actions to reduce their personal exposure by staying indoors, reducing physical activity, altering modes of transportation, filtering indoor air, and using respirators and other types of face masks. A synthesis of available evidence on the efficacy, effectiveness, and potential adverse effects or unintended consequences of personal interventions for air pollution is needed by clinicians to assist patients and the public in making informed decisions about use of these interventions. To address this need, the American Thoracic Society convened a workshop in May of 2018 to bring together a multidisciplinary group of international experts to review the current state of knowledge about personal interventions for air pollution and important considerations when helping patients and the general public to make decisions about how best to protect themselves. From these discussions, recommendations were made regarding when, where, how, and for whom to consider personal interventions. In addition to the efficacy and safety of the various interventions, the committee considered evidence regarding the identification of patients at greatest risk, the reliability of air quality indices, the communication challenges, and the ethical and equity considerations that arise when discussing personal interventions to reduce exposure and risk from outdoor air pollution.
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98
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Zheng XY, Tang SL, Guan WJ, Ma SL, Li C, Xu YJ, Meng RL, Lin LF. Exposure to biomass fuel is associated with high blood pressure and fasting blood glucose impairment in females in southern rural China. ENVIRONMENTAL RESEARCH 2021; 199:111072. [PMID: 33812878 DOI: 10.1016/j.envres.2021.111072] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 03/16/2021] [Accepted: 03/19/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVES We sought to investigate the association between household exposure to biomass fuel and metabolic syndrome (MetS) and its components including blood pressure, triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), fasting blood glucose (FBG) and waist circumference among females in southern rural China. METHODS We surveyed 1664 residents in the Chronic Disease and Risk Factors Surveillance, conducted in 14 districts of Guangdong province. We recorded the use of biomass fuel, MetS and its components, and other covariates by using a structured questionnaire. Logistic regression model and multivariate linear regression model were adopted for analysis. RESULTS Exposure to biomass fuel was significantly associated with an increase of systolic blood pressure (SBP) (β: 2.15, 95% confidence interval: 0.13 to 4.17) and FBG (β: 0.19, 95% confidence interval: 0.01 to 0.37) in the adjusted and unadjusted models (all P < 0.05). Among participants with exposure to biomass fuel, being overweight or obese was associated with an increased risk of having hypertension (odds ratio: 3.19, 95% confidence interval: 2.13 to 4.76) and higher FBG levels (odds ratio: 2.10, 95% confidence interval: 1.46 to 3.02). Exposure to biomass fuel was significantly associated with a decrease of the prevalence of central obesity (P < 0.05). However, exposure to biomass fuel was not associated with MetS, diastolic blood pressure and TG (all P > 0.05). CONCLUSIONS Exposure to biomass fuel is associated with an increase in blood pressure and FBG levels, but not MetS per se. Efforts should be made to protect females in southern rural China from the adverse effects associated with biomass fuel pollution.
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Affiliation(s)
- Xue-Yan Zheng
- Guangdong Provincial Center for Disease Control and Prevention, Guangdong, China
| | - Si-Li Tang
- School of Public Health, Southern Medical University, Guangzhou, China
| | - Wei-Jie Guan
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, China
| | - Shu-Li Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Chuan Li
- Guangdong Provincial Center for Disease Control and Prevention, Guangdong, China
| | - Yan-Jun Xu
- Guangdong Provincial Center for Disease Control and Prevention, Guangdong, China
| | - Rui-Lin Meng
- Guangdong Provincial Center for Disease Control and Prevention, Guangdong, China.
| | - Li-Feng Lin
- Guangdong Provincial Center for Disease Control and Prevention, Guangdong, China.
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99
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Vu BN, Tapia V, Ebelt S, Gonzales GF, Liu Y, Steenland K. The association between asthma emergency department visits and satellite-derived PM 2.5 in Lima, Peru. ENVIRONMENTAL RESEARCH 2021; 199:111226. [PMID: 33957138 PMCID: PMC8195863 DOI: 10.1016/j.envres.2021.111226] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 04/04/2021] [Accepted: 04/22/2021] [Indexed: 05/06/2023]
Abstract
BACKGROUND Asthma affects millions of people worldwide. Lima, Peru is one of the most polluted cities in the Americas but has insufficient ground PM2.5 (particulate matter that are 2.5 μm or less in diameter) measurements to conduct epidemiologic studies regarding air pollution. PM2.5 estimates from a satellite-driven model have recently been made, enabling a study between asthma and PM2.5. OBJECTIVE We conducted a daily time-series analysis to determine the association between asthma emergency department (ED) visits and estimated ambient PM2.5 levels in Lima, Peru from 2010 to 2016. METHODS We used Poisson generalized linear models to regress aggregated counts of asthma on district-level population weighted PM2.5. Indicator variables for hospitals, districts, and day of week were included to account for spatial and temporal autocorrelation while assessing same day, previous day, day before previous and average across all 3-day exposures. We also included temperature and humidity to account for meteorology and used dichotomous percent poverty and gender variables to assess effect modification. RESULTS There were 103,974 cases of asthma ED visits during the study period across 39 districts in Lima. We found a 3.7% (95% CI: 1.7%-5.8%) increase in ED visits for every interquartile range (IQR, 6.02 μg/m3) increase in PM2.5 same day exposure with no age stratification. For the 0-18 years age group, we found a 4.5% (95% CI: 2.2%-6.8%) increase in ED visits for every IQR increase in PM2.5 same day exposure. For the 19-64 years age group, we found a 6.0% (95% CI: 1.0%-11.0%) increase in ED visits for every IQR in average 3-day exposure. For the 65 years and up age group, we found a 16.0% (95% CI: 7.0%-24.0%) decrease in ED visits for every IQR increase in PM2.5 average 3-day exposure, although the number of visits in this age group was low (4,488). We found no effect modification by SES or gender. DISCUSSION Results from this study provide additional literature on use of satellite-driven exposure estimates in time-series analyses and evidence for the association between PM2.5 and asthma in a low- and middle-income (LMIC) country.
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Affiliation(s)
- Bryan N Vu
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States.
| | - Vilma Tapia
- Laboratory of Reproduction and Endocrinology, Laboratories of Investigation and Development (LID), Faculty of Sciences and Philosophy, Universidad Peruana, Cayetano Heredia, Lima, Peru; Department of Biological and Physiological Sciences, Faculty of Sciences and Philosophy, Universidad Peruana Cayetano Heredia, Lima, Peru; Instituto de Investigaciones de la Altura, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Stefanie Ebelt
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Gustavo F Gonzales
- Laboratory of Reproduction and Endocrinology, Laboratories of Investigation and Development (LID), Faculty of Sciences and Philosophy, Universidad Peruana, Cayetano Heredia, Lima, Peru; Department of Biological and Physiological Sciences, Faculty of Sciences and Philosophy, Universidad Peruana Cayetano Heredia, Lima, Peru; Instituto de Investigaciones de la Altura, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Yang Liu
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Kyle Steenland
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States
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Wu Y, Jin T, He W, Liu L, Li H, Liu C, Zhou Y, Hong J, Cao L, Lu Y, Dong X, Xia M, Ding B, Qian L, Wang L, Zhou W, Gui Y, Zhang X, Chen R. Associations of fine particulate matter and constituents with pediatric emergency room visits for respiratory diseases in Shanghai, China. Int J Hyg Environ Health 2021; 236:113805. [PMID: 34271373 DOI: 10.1016/j.ijheh.2021.113805] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 06/13/2021] [Accepted: 07/05/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Although ambient fine particulate matter (PM2.5) has been associated with adverse respiratory outcomes in children, few studies have examined PM2.5 constituents with respiratory diseases in children in China. OBJECTIVES To investigate the associations of short-term exposure to PM2.5 and its constituents with pediatric emergency room visits (ERVs) for respiratory diseases in Shanghai, China. METHODS We collected daily concentrations of PM2.5 and its constituents in urban Shanghai from January 1, 2016, to December 31, 2018. Daily pediatric ERVs for four major respiratory diseases, including upper respiratory tract infection, bronchitis, pneumonia, and asthma, were obtained from 66 hospitals in Shanghai during the same period. Associations of exposure to daily PM2.5 and constituents with respiratory ERVs were estimated using the over-dispersed generalized additive models. RESULT Short-term exposure to PM2.5 and its constituents were associated with increased pediatric ERVs for respiratory diseases. Specifically, an interquartile range increase in the 3-day average PM2.5 level (31 μg/m3) was associated with 1.86% (95%CI: 0.52, 3.22), 1.53% (95%CI: 0.01, 3.08), 1.90% (95%CI: 0.30, 3.52), and 2.67% (95%CI: 0.70, 4.68) increase of upper respiratory tract infection, bronchitis, pneumonia, and asthma ERVs, respectively. As for PM2.5 constituents, we found organic carbon, ammonium, nitrate, selenium, and zinc were associated with higher risk of respiratory ERVs in the single constituent and the constituent-PM2.5 models. CONCLUSION Short-term exposure to PM2.5 was associated with increased pediatric ERVs for respiratory diseases. Constituents related to anthropogenic combustion and traffic might be the dominant contributors of the observed associations.
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Affiliation(s)
- Yihan Wu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, 200032, China
| | - Tingting Jin
- Department of Respiratory Medicine, Children's Hospital of Fudan University, Shanghai, 201102, China
| | - Wen He
- Department of Respiratory Medicine, Children's Hospital of Fudan University, Shanghai, 201102, China
| | - Lijuan Liu
- Department of Respiratory Medicine, Children's Hospital of Fudan University, Shanghai, 201102, China
| | - Hongjin Li
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, 200032, China
| | - Cong Liu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, 200032, China
| | - Yufeng Zhou
- Institute of Pediatrics, Children's Hospital of Fudan University, Shanghai 201102, China; Institutes of Biomedical Sciences, Fudan University, Shanghai, 200032, China
| | - Jianguo Hong
- Department of Pediatrics, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai 200080, China
| | - Lanfang Cao
- Department of Pediatrics, Renji Hospital, Shanghai Jiao Tong University, Shanghai, 200127, China
| | - Yanming Lu
- Department of Pediatrics, South Campus, Renji Hospital, Shanghai Jiao Tong University, Shanghai, 201112, China
| | - Xiaoyan Dong
- Department of Respiratory Medicine, Children's Hospital of Shanghai Jiaotong University, Shanghai, 200040, China
| | - Min Xia
- Department of Pediatrics, Renji Hospital, Shanghai Jiao Tong University, Shanghai, 200127, China
| | - Bo Ding
- Department of Pediatrics, South Campus, Renji Hospital, Shanghai Jiao Tong University, Shanghai, 201112, China
| | - Liling Qian
- Department of Respiratory Medicine, Children's Hospital of Fudan University, Shanghai, 201102, China
| | - Libo Wang
- Department of Respiratory Medicine, Children's Hospital of Fudan University, Shanghai, 201102, China
| | - Wenhao Zhou
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, 201102, China
| | - Yonghao Gui
- Cardiovascular Center, Children's Hospital of Fudan University, Shanghai, 201102, China
| | - Xiaobo Zhang
- Department of Respiratory Medicine, Children's Hospital of Fudan University, Shanghai, 201102, China.
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, 200032, China.
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