Air particulate matter and cardiovascular disease: the epidemiological, biomedical and clinical evidence

Lung-deposited dose of particulate matter from residential exposure to smoke from wood burning

Residential settings are of utmost importance for human exposure, as it is where people spend most of their time. Residential wood combustion is a widespread practice known as a source of indoor particulate matter (PM). Nevertheless, research on the risks of exposure associated with this source is scarce, and a better understanding of respiratory deposition of smoke particles is needed. The dosimetry model ExDoM2 was applied to determine the deposited dose of inhalable particulate matter (PM₁₀) from residential biomass combustion in the human respiratory tract (HRT) of adults and children. The dose was estimated using PM₁₀ exposure concentrations obtained from a field campaign carried out in two households during the operation of an open fireplace and a woodstove. Simultaneously, PM₁₀ levels were monitored outside to investigate the outdoor dose in a rural area strongly impacted by biomass burning emissions. Indoors, the 8-h average PM₁₀ concentrations ranged from 88.3 to 489 μg m^-3 and from 69.4 to 122 μg m^-3 for the operation of the fireplace and the woodstove, respectively, while outdoor average PM₁₀ concentrations ranged from 17.3 to 94.2 μg m^-3. The highest amount of the deposited particles was recorded in the extrathoracic region (68-79%), whereas the deposition was much lower in the tracheobronchial tree (5-6%) and alveolar-interstitial region (16-21%). The total dose received while using the fireplace was more than twofold the one received in the room with a woodstove and more than 10 times higher than in the absence of the source. Overall, indoor doses were higher than the ones received by a subject exposed outdoors, especially at the alveolar-interstitial region. After 24 h of exposure, it was estimated that approximately 35 to 37% of the particles deposited in the HRT were transferred to the gastrointestinal tract, while approximately 2.0-2.5% were absorbed into the blood. The results from exposure and dose of indoor particles gathered in this work suggest that homeowners should be encouraged to upgrade the wood burning technology to reduce the PM levels inside their residences. This study also provides biologically relevant results on the lung deposition of particles from residential biomass burning that can be used as a reference for future research.

Association between particulate matter air pollution and heart attacks in San Diego County

Air pollution is one of the major risk factors contributing to adverse public health outcomes worldwide. Fine particulate matter (PM_2.5) has been repeatedly associated with increased risk of cardiovascular events, including heart attacks. Because PM_2.5 is unequally distributed with elevated concentrations near high-traffic and industrial zones, PM_2.5 is an environmental justice issue of major public health concern. In this study, we reviewed the relationship between PM_2.5, emergency visits due to heart attacks, and environmental justice in San Diego County using data from CalEnviroScreen 3.0. Our results indicate that PM_2.5, diesel PM emissions, and emergency visits due to heart attacks are weakly, but positively correlated (r = 0.3, R² < 0.1). Areas classified as environmental justice communities, communities comprised more dominantly of nonwhite populations, and communities closer to the San Diego-Tijuana border are exposed disproportionately to air pollution in San Diego County. Overall, this work demonstrates that there is an association between elevated local PM concentrations in San Diego County communities with emergency hospital visits due to heart attacks, and that these associations are an environmental justice issue disproportionally affecting disadvantaged communities.Implications: Particulate matter is an adverse contributor to overall health throughout the lifespan, contributing to diseases such as asthma, hypertension, stroke, and increased risk of cardiovascular events. Here, we assess the relationship between particulate matter and heart attacks in San Diego County using CalEnviroScreen3.0. Using these tools, we also examine correlations between this relationship and different sociodemographic indicators such as age, race, income, and proximity to the high-traffic U.S.-Mexico border. Overall, we show that specific communities around San Diego are more highly exposed to particulate matter, and that these relationships may be disproportionately contributing to heart attacks in disadvantaged communities.

An Air Particulate Pollutant Induces Neuroinflammation and Neurodegeneration in Human Brain Models

Fine particulate matter (PM2.5), a major component among air pollutants, highlights as a global health concern. Several epidemiological studies show the correlation between chronical PM2.5 exposure and incidents of neurological disorders including Alzheimer's disease. However, the mechanisms have not been well understood, partly due to the lack of model systems that reflect the physiologically relevant innate immunity in human brains. Here, PM2.5-polluted human brain models (PMBs) are created in a 3D microfluidic platform reconstituting key aspects of human brain immunity under the PM2.5 exposure. PM2.5 penetration across a blood-brain barrier (BBB) model and accumulation in the brain tissue side of the model are first validated. Second, the PMB model shows that the BBB-penetrating PM2.5 initiates astrogliosis, resulting in slight neuronal loss and microglial infiltration. Third, it is demonstrated that the infiltrating microglia obtain M1 phenotype induced by interleukin-1β and interferon-γ from neurons and reactive astrocytes under the PM2.5 exposure. Finally, it is observed that additional proinflammatory mediators and nitric oxide released from the M1 microglia exacerbate neuronal damages, such as synaptic impairment, phosphoric tau accumulation, and neuronal death. This study suggests that PM2.5 can be a potential environmental risk factor for dementia mediated by the detrimental neuroinflammation.

Ecosystem services and impact of industrial pollution on urban health: evidence from Durgapur, West Bengal, India

Industrialization, urbanization, and rapid socioeconomic growth are the prime factors regarding development of an urban city. These activities deteriorate the environment slowly by increasing harmful pollutants and the impact of which will be observed in near future in terms of several natural calamities, disease, and ecological consequences. Various urban ecosystems like urban forestry, wetland, grassland, parks/gardens etc. are the main criteria of urban health in respect to delivering multiple of benefits to the surrounding biota. But these regulatory systems have been affected severely through different industrial pollution stresses resulting into deterioration of their physicochemical quality and biotic diversity. The study revealed that the annual average air pollution index (API) exceeded the higher threshold value (i.e. >100) during the study period and recognized Durgapur as the severely polluted region in West Bengal, India. The characteristics of major air pollutants like SO₂, NOx, and suspended particulate matter (SPM) and their temporal trends have been evaluated. The objective of this study was to detect the effect of industrial pollution on the aforesaid urban ecosystems in terms of variable ecological services such as purification of polluted air, atmospheric regulation, reduction of noise, proper drainage of rainwater, and sewage treatment. The outcome of this review work was to evaluate thoroughly the physiological, biochemical, and morphological symptoms of plant species under air pollution stress. On the other hand, the effect of air pollution on human and animal populations regarding various diseases (like bronchitis, cardiopulmonary arrest, cancer, liver and kidney dysfunction) has also been discussed.

Comparison of PM10 Sources at Traffic and Urban Background Sites Based on Elemental, Chemical and Isotopic Composition: Case Study from Krakow, Southern Poland

In large urban agglomerations, car traffic is one of the main sources of particulate matter. It consists of particulate matter directly generated in the process of incomplete liquid fuel burning in vehicle engine, secondary aerosols formed from exhaust gaseous pollutants (NOx, SO2) as well as products of tires, brake pads and pavement abrasion. Krakow is one of the cities in Europe with the highest concentrations of particulate matter. The article presents the results of combined elemental, chemical and isotopic analyses of particulate matter PM10 at two contrasting urban environments during winter and summer seasons. Daily PM10 samples were collected during the summer and winter seasons of 2018/2019 at two stations belonging to the network monitoring air quality in the city. Mean PM10 concentrations at traffic-dominated stations were equal to 35 ± 7 µg/m3 and 76 ± 28 µg/m3 in summer and winter, respectively, to be compared with 25.6 ± 5.7 µg/m3 and 51 ± 25 µg/m3 in summer and winter, respectively, recorded at the urban background station. The source attribution of analyzed PM10 samples was carried out using two modeling approaches: (i) The Positive Matrix Factorization (PMF) method for elemental and chemical composition (concentrations of elements, ions, as well as organic and elemental carbon in daily PM10 samples), and (ii) Isotope Mass Balance (IMB) for 13C and 14C carbon isotope composition of carbonaceous fraction of PM10. For PMF application, five sources of particulate matter were identified for each station: fossil fuel combustion, secondary inorganic aerosols, traffic exhaust, soil, and the fifth source which included road dust, industry, construction work. The IMB method allowed the partitioning of the total carbon reservoir of PM10 into carbon originating from coal combustion, from biogenic sources (natural emissions and biomass burning) and from traffic. Both apportionment methods were applied together for the first time in the Krakow agglomeration and they gave consistent results.

Dose-Dependent Blood-Feeding Activity and Ovarian Alterations to PM2.5 in Aedes aegypti

Simple Summary

Aedes aegypti (Ae. aegypti) is a mosquito that transmits arboviruses and responds to various biological and environmental stressors, including temperature, rainfall, and humidity. However, there is a lack of knowledge about fine particulate matter (PM_2.5) effects on arbovirus vectors. We hypothesized that fine particulate matter (PM_2.5) may affect Ae. aegypti blood-feeding rate and organs. We set up an environmental chamber that could adjust the concentration of PM_2.5 and observed their blood-feeding activity. We observed a dose–response relationship between PM_2.5 level and blood-feeding rate in adult female Ae. aegypti mosquitoes. In addition, histopathological study showed some changes in the ovaries. Vacuolated or vacuolar degeneration characterized by a formation of non-lipid small droplets in the cytoplasm was observed. This demonstrated the degenerative stage of the cells before developing hydropic degeneration or another advanced stage of cellular damage. The present study explored the effects of PM_2.5 exposure on the blood-feeding rate and organ integrity in the major arboviral vector Ae. Aegypti, providing information on the potential but indirect operational impact of PM_2.5 exposure on the survival and transmission capabilities of this major vector. Our findings may contribute towards the conceptualization and implementation of mosquito control measures with due consideration of the effects of ambient PM_2.5 on their populations.

Abstract

High levels of fine particulate matter (PM_2.5) air pollution are a concern for human health. Several studies have examined the effects of air pollution on human and animal health. However, there is a lack of knowledge about its effects on arbovirus vectors. Thus, we investigated whether PM_2.5 concentration alters the blood-feeding activity of Ae. aegypti mosquitoes. We investigated the effect on the females’ propensity to blood feed at eight concentrations of PM_2.5 ranging from 100 to 1000 μg/m³. Correlation analysis showed blood-feeding activity had a significant strong negative correlation with concentration of PM_2.5 (r_p = −0.85; p ≤ 0.00001). Exploratory linear and non-linear models showed an exponential decay relationship was the best fitting model (corrected Akaike’s information criterion, 193.0; Akaike’s weight, 0.766; adjusted R², 0.780). Ultrastructural study demonstrated PM_2.5 did not obstruct the respiratory system, but some fine particles were present on the antenna and abdominal body parts. Ovaries showed a dose–response relationship between PM_2.5 level and vacuolated degeneration. In conclusion, the blood-feeding behavior of Ae. aegypti females may have an exponential decay relationship with PM_2.5 level, and their ovaries may demonstrate dose-dependent degeneration. These findings may be important in understanding the vector’s biology and disease transmission in settings with high PM_2.5 levels. These results are important to understand blood-feeding and feeding pattern of mosquitoes during PM_2.5 pollution, which is important for disease transmission and vector control.

Pharmacological inhibition of PAI-1 alleviates cardiopulmonary pathologies induced by exposure to air pollutants PM2.5

Numerous studies have established that acute or chronic exposure to environmental pollutants like particulate matter (PM) leads to the development of accelerated aging related pathologies including pulmonary and cardiovascular diseases, and thus air pollution is one of the major global threats to human health. Air pollutant particulate matter 2.5 (PM_2.5)-induced cellular dysfunction impairs tissue homeostasis and causes vascular and cardiopulmonary damage. To test a hypothesis that elevated plasminogen activator inhibitor-1 (PAI-1) levels play a pivotal role in air pollutant-induced cardiopulmonary pathologies, we examined the efficacy of a drug-like novel inhibitor of PAI-1, TM5614, in treating PM_2.5-induced vascular and cardiopulmonary pathologies. Results from biochemical, histological, and immunohistochemical studies revealed that PM_2.5 increases the circulating levels of PAI-1 and thrombin and that TM5614 treatment completely abrogates these effects in plasma. PM_2.5 significantly augments the levels of pro-inflammatory cytokine interleukin-6 (IL-6) in bronchoalveolar lavage fluid (BALF), and this also can be reversed by TM5614, indicating its efficacy in amelioration of PM_2.5-induced increases in inflammatory and pro-thrombotic factors. TM5614 reduces PM_2.5-induced increased levels of inflammatory markers cluster of differentiation 107 b (Mac3) and phospho-signal transducer and activator of transcription-3 (pSTAT3), adhesion molecule vascular cell adhesion molecule 1 (VCAM1), and apoptotic marker cleaved caspase 3. Longer exposure to PM_2.5 induces pulmonary and cardiac thrombosis, but TM5614 significantly ameliorates PM_2.5-induced vascular thrombosis. TM5614 also reduces PM_2.5-induced increased blood pressure and heart weight. In vitro cell culture studies revealed that PM_2.5 induces the levels of PAI-1, type I collagen, fibronectin (Millipore), and sterol regulatory element binding protein-1 and 2 (SREBP-1 and SREBP-2), transcription factors that mediate profibrogenic signaling, in cardiac fibroblasts. TM5614 abrogated that stimulation, indicating that it may block PM_2.5-induced PAI-1 and profibrogenic signaling through suppression of SREBP-1 and 2. Furthermore, TM5614 blocked PM_2.5-mediated suppression of nuclear factor erythroid related factor 2 (Nrf2), a major antioxidant regulator, in cardiac fibroblasts. Pharmacological inhibition of PAI-1 with TM5614 is a promising therapeutic approach to control air pollutant PM_2.5-induced cardiopulmonary and vascular pathologies.

Adverse Impact of Environmental Chemicals on Developmental Origins of Kidney Disease and Hypertension

Chronic kidney disease (CKD) and hypertension are becoming a global health challenge, despite developments in pharmacotherapy. Both diseases can begin in early life by so-called "developmental origins of health and disease" (DOHaD). Environmental chemical exposure during pregnancy can affect kidney development, resulting in renal programming. Here, we focus on environmental chemicals that pregnant mothers are likely to be exposed, including dioxins, bisphenol A (BPA), phthalates, per- and polyfluoroalkyl substances (PFAS), polycyclic aromatic hydrocarbons (PAH), heavy metals, and air pollution. We summarize current human evidence and animal models that supports the link between prenatal exposure to environmental chemicals and developmental origins of kidney disease and hypertension, with an emphasis on common mechanisms. These include oxidative stress, renin-angiotensin system, reduced nephron numbers, and aryl hydrocarbon receptor signaling pathway. Urgent action is required to identify toxic chemicals in the environment, avoid harmful chemicals exposure during pregnancy and lactation, and continue to discover other potentially harmful chemicals. Innovation is also needed to identify kidney disease and hypertension in the earliest stage, as well as translating effective reprogramming interventions from animal studies into clinical practice. Toward DOHaD approach, prohibiting toxic chemical exposure and better understanding of underlying mechanisms, we have the potential to reduce global burden of kidney disease and hypertension.

Correlation between Exposure to Fine Particulate Matter (PM2.5) during Pregnancy and Congenital Anomalies: Its Surgical Perspectives

BACKGROUND

Fine particulate matter (PM_2.5) can easily penetrate blood vessels and tissues through the human respiratory tract and cause various health problems. Some studies reported that particular matter (PM) exposure during pregnancy is associated with low birth weight or congenital cardiovascular anomalies. This study aimed to investigate the correlation between the degree of exposure to PM ≤ 2.5 μm (PM_2.5) during pregnancy and congenital anomalies relevant to the field of pediatric surgery.

METHODS

Mother-infant dyads with registered addresses in the Metropolitan City were selected during 3 years. The electronic medical records of mothers and neonates were retrospectively analyzed, with a focus on maternal age at delivery, date of delivery, gestation week, presence of diabetes mellitus (DM) or hypertension, parity, the residence of the mother and infant, infant sex, birth weight, Apgar score, and presence of congenital anomaly. The monthly PM_2.5 concentration from the first month of pregnancy to the delivery was computed based on the mothers' residences.

RESULTS

PM_2.5 exposure concentration in the second trimester was higher in the congenital anomaly group than in the non-congenital anomaly group (24.82 ± 4.78 µg/m³, P = 0.023). PM_2.5 exposure concentration did not affect the incidence of nervous, cardiovascular, and gastrointestinal anomalies. While statistically insignificant, the groups with nervous, cardiovascular, gastrointestinal, musculoskeletal, and other congenital anomalies were exposed to higher PM_2.5 concentrations in the first trimester compared with their respective counterparts. The effect of PM_2.5 concentration on the incidence of congenital anomalies was significant even after adjusting for the mother's age, presence of DM, hypertension, and parity. The incidence of congenital anomalies increased by 26.0% (95% confidence interval of 4.3% and 49.2%) per 7.23 µg/m³ elevation of PM_2.5 interquartile range in the second trimester.

CONCLUSIONS

The congenital anomaly group was exposed to a higher PM_2.5 concentration in the second trimester than the non-congenital anomaly group. The PM_2.5 exposure concentration level in the first trimester tended to be higher in groups with anomalies than those without anomalies. This suggests that continuous exposure to a high PM_2.5 concentration during pregnancy influences the incidence of neonatal anomalies in surgical respects.

Predictors of Limited Access to Dental Health Care Among NYC Taxi/FHV Drivers

Taxi and for-hire vehicle (FHV) drivers are a largely immigrant, low-income occupational group at increased cardiovascular disease (CVD) risk. Poor dental health is a CVD risk factor, and dental care access is an unexamined taxi/FHV driver CVD risk factor. A cross-sectional survey was administered to 422 taxi/FHV drivers (2016-2017) to identify predictors of access to dental health care among drivers. One-third (n = 128, 30.3%) reported needing dental care/tests/treatment within the past six months, and nearly one-half (n = 61, 48%) were delayed/unable to obtain care. Only 57.6% (n = 241) had past-year dental cleanings. Not having enough money to cover household expenses was a significant predictor of being delayed/unable to obtain needed dental care/tests/treatment in the prior six months (0.5 OR; 95% CI, 0.28-0.89; p < .05). Lack of dental insurance coverage (2.72 OR; 95% CI, 1.60-4.63; p < .001) or lack of primary care provider (2.72 OR; 95% CI, 1.60-4.63; p < .001) were associated with lack of past-year dental cleaning. Seventeen percent of drivers with Medicaid were unaware of their dental coverage, which was associated with both inability to access needed dental care/tests/treatment in the past 6 months (p = .026) and no past-year dental cleaning (p < .001). Limited understanding of dental coverage was associated with both an inability to access needed dental care/tests/treatment in the past 6 months (p = .028) and lack of past-year dental cleaning (p = .014). Our findings can inform targeted intervention development to increase taxi/FHV driver dental care access/uptake, potentially improving their CVD risk.

CC16-TNF-α negative feedback loop formed between Clara cells and normal airway epithelial cells protects against diesel exhaust particles exposure-induced inflammation

CC16 is almost exclusively expressed in non-ciliated epithelial Clara cells, and widely used as a Clara cell marker. Diesel exhaust particles (DEPs), the fine particulate matters produced by diesel engines, cause or exacerbate airway-related diseases. Our previous study documented that DEP inhibits the CC16 expression in the immortalized mouse Clara cell line through methylation of C/EBPα promoter. However, the molecular mechanism by which DEP regulates CC16 secretion is unclear. Here, we isolated CC16 containing Clara cells (CC16⁺) from human distal lung, and found that DEP inhibited CC16 secretion from CC16⁺ cells via methylation of C/EBPα and inhibition of Munc18b transcription. CC16⁺ cell conditioned media containing different concentrations of CC16 was prepared and used for culture of airway epithelial cells BEAS-2B with no expression of CC16. A positive correlation was observed between CC16 level and DEP-induced autophagy activity, and a negative correlation between CC16 level and DEP-induced pro-inflammatory cytokine TNF-α, IL-6, and IL-8 level, suggesting that CC16 might mitigate DEP-induced inflammation via promoting autophagy in BEAS-2B cells. This result was further confirmed by adding recombinant CC16 to BEAS-2B cells exposed to DEP. Moreover, CC16 level was significantly increased when CC16⁺ cells were cultured in BEAS-2B cell conditioned medium containing TNF-α or the normal medium supplemented with recombinant TNF-α, suggesting that TNF-α induced CC16 production and secretion from CC16⁺ cells. Collectively, these data point that CC16 and TNF-α form a negative feedback loop, and this negative feedback loop between Clara cells and normal airway epithelial cells protects against DEP exposure-induced inflammation.

Phytosampling-a supplementary tool for particulate matter (PM) speciation characterization

Ambient air particulate matter (PM) and PM-associated environmentally persistent free radicals (EPFRs) have been documented to contribute to pollution-related health effects. Studies of ambient air PM potentially bear artifacts stemming from the collection methods. We have investigated the applicability of PM phytosampling (PHS) as a supplementary tool to a classic PM sampler in respect of achieving better PM chemical composition assessment (primarily organic fraction). Phytosampling is a static PM collection method relying on the particle entrapment by the plant's leaf through electrostatic forces and surface trichomes. We have investigated the differences in the EPFR and polycyclic aromatic hydrocarbon (PAH) speciation and concentration on ambient air PM for PHS and high-volume PM sampler (HVS). The advantages of PHS are easy particle recovery from the matrix, collection under natural environmental conditions, and the ability to apply a dense collection network to accurately represent spatial pollutant distribution. The experimental results show that the PHS can provide valuable speciation information, sometimes different from that observed for HVS. For PM collected by PHS, we detected the larger contribution of oxygen-centered EPFRs, different decay behavior, and more consistent PAH distribution between different PM sizes compared to the PM from HVS. These results indicate that the isolation of samples from the ambient during HVS sampling and exposure to high-volume airflow may alter the chemical composition of the samples, while the PHS method could provide details on the original speciation and concentration and be more representative of the PM surface. However, PHS cannot evaluate an absolute air concentration of PM, so it serves as an excellent supplementary tool to work in conjunction with the standard PM collection method.

Analysis of Mineral Aerosol in the Surface Layer over the Caspian Lowland Desert by the Data of 12 Summer Field Campaigns in 2002–2020

In-situ knowledge on characteristics of mineral aerosols is important for weather and climate prediction models, particularly for modeling such processes as the entrainment, transport and deposition of aerosols. However, field measurements of the dust emission flux, dust size distribution and its chemical composition under realistic wind conditions remain rare. In this study, we present experimental data over annual expeditions in the arid and semi-arid zones of the Caspian Lowland Desert (Kalmykia, south of Russia); we evaluate characteristics of mineral aerosol concentration and fluxes, estimate its chemical composition and calculate its long-distance transport characteristics. The mass concentration in different years ranges from several tens to several hundred of μg m−3. The significant influence of wind velocity on the value of mass and counting concentration and on the proposed entrainment mechanisms is confirmed. An increased content of anthropogenic elements (S, Sn, Pb, Bi, Mo, Ag, Cd, Hg, etc.), which is characteristic for all observation points in the south of the European Russia, is found. The trajectory analysis show that long-range air particles transport from the Caspian Lowland Desert to the central regions of European Russia tends to increase in the recent decades.

Particulate Matter and Premature Mortality: A Bayesian Meta-Analysis

BACKGROUND

We present a systematic review of studies assessing the association between ambient particulate matter (PM) and premature mortality and the results of a Bayesian hierarchical meta-analysis while accounting for population differences of the included studies.

METHODS

The review protocol was registered in the PROSPERO systematic review registry. Medline, CINAHL and Global Health databases were systematically searched. Bayesian hierarchical meta-analysis was conducted using a non-informative prior to assess whether the regression coefficients differed across observations due to the heterogeneity among studies.

RESULTS

We identified 3248 records for title and abstract review, of which 309 underwent full text screening. Thirty-six studies were included, based on the inclusion criteria. Most of the studies were from China (n = 14), India (n = 6) and the USA (n = 3). PM_2.5 was the most frequently reported pollutant. PM was estimated using modelling techniques (22 studies), satellite-based measures (four studies) and direct measurements (ten studies). Mortality data were sourced from country-specific mortality statistics for 17 studies, Global Burden of Disease data for 16 studies, WHO data for two studies and life tables for one study. Sixteen studies were included in the Bayesian hierarchical meta-analysis. The meta-analysis revealed that the annual estimate of premature mortality attributed to PM_2.5 was 253 per 1,000,000 population (95% CI: 90, 643) and 587 per 1,000,000 population (95% CI: 1, 39,746) for PM₁₀.

CONCLUSION

253 premature deaths per million population are associated with exposure to ambient PM_2.5. We observed an unstable estimate for PM₁₀, most likely due to heterogeneity among the studies. Future research efforts should focus on the effects of ambient PM₁₀ and premature mortality, as well as include populations outside Asia. Key messages: Ambient PM_2.5 is associated with premature mortality. Given that rapid urbanization may increase this burden in the coming decades, our study highlights the urgency of implementing air pollution mitigation strategies to reduce the risk to population and planetary health.

Social Susceptibility to Multiple Air Pollutants in Cardiovascular Disease

INTRODUCTION

Cardiovascular disease (CVD) is the leading cause of death in the United States, and substantial research has linked ambient air pollution to elevated rates of CVD etiology and events. Much of this research identified increased effects of air pollution in lower socioeconomic position (SEP) communities, where pollution exposures are also often higher. The complex spatial confounding between air pollution and SEP makes it very challenging, however, to disentangle the impacts of these very different exposure types and to accurately assess their interactions. The specific causal components (i.e., specific social stressors) underlying this SEP-related susceptibility remain unknown, because there are myriad pathways through which poverty and/or lower-SEP conditions may influence pollution susceptibility - including diet, smoking, coexposures in the home and occupational environments, health behaviors, and healthcare access. Growing evidence suggests that a substantial portion of SEP-related susceptibility may be due to chronic psychosocial stress - given the known wide-ranging impacts of chronic stress on immune, endocrine, and metabolic function - and to a higher prevalence of unpredictable chronic stressors in many lower-SEP communities, including violence, job insecurity, and housing instability. As such, elucidating susceptibility to pollution in the etiology of CVD, and in the risk of CVD events, has been identified as a research priority. This interplay among social and environmental conditions may be particularly relevant for CVD, because pollution and chronic stress both impact inflammation, metabolic function, oxidative stress, hypertension, atherosclerosis, and other processes relevant to CVD etiology. Because pollution exposures are often spatially patterned by SEP, disentangling their effects - and quantifying any interplay - is especially challenging. Doing so, however, would help to improve our ability to identify and characterize susceptible populations and to improve our understanding of how community stressors may alter responses to multiple air pollutants. More clearly characterizing susceptible populations will improve our ability to design and target interventions more effectively (and cost-effectively) and may reveal greater benefits of pollution reduction in susceptible communities, strengthening cost-benefit and accountability analyses, ultimately reducing the disproportionate burden of CVD and reducing health disparities.

METHODS

In the current study, we aimed to quantify combined effects of multiple pollutants and stressor exposures on CVD events, using a number of unique datasets we have compiled and verified, including the following. 1. Poverty metrics, violent crime rates, a composite socioeconomic deprivation index (SDI), an index of racial and economic segregation, noise disturbance metrics, and three composite spatial factors produced from a factor analysis of 27 community stressors. All indicators have citywide coverage and were verified against individual reports of stress and stressor exposure, in citywide focus groups and surveys. 2. Spatial surfaces for multiple pollutants from the New York City (NYC) Community Air Survey (NYCCAS), which monitored multiple pollutants year-round at 150 sites and used land use regression (LUR) modeling to estimate fine-scale (100-m) intra-urban spatial variance in fine particles (PM2.5), nitrogen dioxide (NO2), sulfur dioxide (SO2), and ozone (O3). 3. Daily data and time-trends derived from all U.S. Environmental Protection Agency (EPA) Air Quality System (AQS) monitors in NYC for 2005-2011, which we combined with NYCCAS surfaces to create residence- and day-specific spatiotemporal exposure estimates. 4. Complete data on in- and out-patient unscheduled CVD events presented in NYC hospitals for 2005-2011 (n = 1,113,185) from the New York State (NYS) Department of Health's Statewide Planning and Research Cooperative System (SPARCS). In the study, we quantified relationships between multiple pollutant exposures and both community CVD event rates and individual risk of CVD events in NYC and tested whether pollution-CVD associations varied by community SEP and social stressor exposures. We hypothesized (1) that greater chronic community-level SEP, stressor, and pollution exposures would be associated with higher community CVD rates; (2) that spatiotemporal variations in multiple pollutants would be associated with excess risk of CVD events; and (3) that pollution-CVD associations would be stronger in communities of lower SEP or higher stressor exposures.

RESULTS

To first understand the separate and combined associations with CVD for both stressors and pollutants measured at the same spatial and temporal scale of resolution, we used ecological cross-sectional models to examine spatial relationships between multiple chronic pollutant and stressor exposures and age-adjusted community CVD rates. Using census-tract-level annual averages (n = 2,167), we compared associations with CVD rates for multiple pollutant concentrations and social stressors. We found that associations with community CVD rates were consistently stronger for social stressors than for pollutants, in terms of both magnitude and significance. We note, however, that this result may be driven by the relatively greater variation (on a proportional basis) for stressors than for pollutants in NYC. We also tested effect modification of pollutant-CVD associations by each social stressor and found evidence of stronger associations for NO2, PM2.5, and wintertime SO2 with CVD rates, particularly across quintiles of increasing community violence or assault rates (P trend < 0.0001). To examine individual-level associations between spatiotemporal exposures to multiple pollutants and the risk of CVD events, across multiple lag days, we examined the combined effects of multiple pollutant exposures, using spatiotemporal (day- and residence-specific) pollution exposure estimates and hospital data on individual CVD events in case-crossover models, which inherently adjust for nontime-varying individual confounders (e.g., sex and race) and comorbidities. We found consistent significant relationships only for same-day pollutant exposures and the risk of CVD events, suggesting very acute impacts of pollution on CVD risk. Associations with CVD were positive for NO2, PM2.5, and SO2, as hypothesized, and we found inverse associations for O3 (a secondary pollutant chemically decreased ["scavenged"] by fresh emissions that, in NYC, displays spatial and temporal patterns opposite those of NO2). Finally, to test effect modification by chronic community social stressors on the relationships between spatiotemporal pollution measures and the risk of CVD events, we used individual-level case-crossover models, adding interaction terms with categorical versions of each social stressor. We found that associations between NO2 and the risk of CVD events were significantly elevated only in communities with the highest exposures to social stressors (i.e., in the highest quintiles of poverty, socioeconomic deprivation, violence, or assault). The largest positive associations for PM2.5 and winter SO2 were generally found in the highest-stressor communities but were not significant in any quintile. We again found inverse associations for O3, which were likewise stronger for individuals living in communities with greater stressor exposures.

CONCLUSIONS

In ecological models, we found stronger relationships with community CVD rates for social stressors than for pollutant exposures. In case-crossover analyses, higher exposures to NO2, PM2.5, and SO2 were associated with greater excess risk of CVD events but only on the case day (there were no consistent significant lagged-day effects). In effect-modification analyses at both the community and individual level, we found evidence of stronger pollution-CVD associations in communities with higher stressor exposures. Given substantial spatial confounding across multiple social stressors, further research is needed to disentangle these effects in order to identify the predominant social stressors driving this observed differential susceptibility.

High Levels of Fine Particulate Matter (PM2.5) Concentrations from Burning Solid Fuels in Rural Households of Butajira, Ethiopia

The use of solid fuel, known to emit pollutants which cause damage to human health, is the primary energy option in Ethiopia. Thus, the aim of this study was to measure the level of household air pollution by using the 24-h mean concentration of fine particulate matter (PM_2.5) in 150 randomly recruited households in rural Butajira, Ethiopia. Data relating to household and cooking practices were obtained by conducting face-to-face interviews with the mothers. The 24-h mean (standard deviation) and median PM_2.5 concentrations were 410 (220) and 340 µg/m³, respectively. Households using only traditional stoves and those who did not open the door or a window during cooking had a significantly higher mean concentration compared with their counterparts. There is a statistically significant correlation between the mean concentration of PM_2.5 and the self-reported cooking duration. The pollution level was up to 16 times higher than the WHO 24-h guideline limit of 25 μg/m^3, thus leaving the mothers and children who spend the most time at the domestic hearth at risk of the adverse health effects from solid fuel use in Ethiopia. Thus, effective short- and long-term interventions are urgently needed.

Marathon race performance increases the amount of particulate matter deposited in the respiratory system of runners: an incentive for "clean air marathon runs"

Background

In the last decades, marathon running has become a popular form of physical activity among people around the world. It should be noticed that the main marathon races are performed in large cities, where air quality varies considerably. It is well established that breathing polluted air results in a number of harmful effects to the human body. However, there have been no studies to show the impact of marathon run performance on the amount of the deposition of varied fractions of airborne particulate matter (PM) in the respiratory tract of runners. This is why the present study sought to determine the impact of marathon run performance in the air of varying quality on the deposition of the PM₁, PM_2.5, PM₁₀ in the respiratory tract in humans.

Methods

The PM₁, PM_2.5 and PM₁₀ deposition was determined in an “average runner” (with marathon performance time 4 h: 30 min) and in an “elite marathon runner” (with marathon performance time 2 h: 00 min) at rest, and during a marathon race, based on own measurements of the PM content in the air and the size-resolved DF(d) profile concept.

Results

We have shown that breathing air containing 50 µg m⁻³ PM₁₀ (a borderline value according to the 2006 WHO standard - still valid) at minute ventilation (V_E) equal to 8 L min⁻¹ when at rest, resulted in PM₁₀deposition rate of approximately 9 µg h⁻¹, but a marathon run of an average marathon runner with the V_E = 62 L min⁻¹ increased the deposition rate up to 45 µg h⁻¹. In the elite runner, marathon run with the V_E= 115 L min⁻¹ increased PM₁₀ deposition rate to 83 µg h⁻¹. Interestingly, breathing the air containing 50 µg m⁻³of PM₁₀ at the V_E = 115 L min⁻¹by the elite marathon runner during the race resulted in the same PM₁₀deposition rate as the breathing highly polluted air containing as much as 466 µg m⁻³ of PM₁₀ when at rest. Furthermore, the total PM₁₀ deposition in the respiratory tract during a marathon race in average runners is about 22% greater (203 / 166 = 1.22) than in elite runners. According to our calculations, the concentration of PM₁₀in the air during a marathon race that would allow one not to exceed the PM₁₀ deposition rate of 9 µg h⁻¹should be lower than 10 µg m⁻³ in the case of an average runner, and it should be lower than 5.5 µg m⁻³ in the case of an elite runner.

Conclusions

We conclude that a marathon run drastically increases the rate of deposition of the airborne PM in the respiratory tract of the runners, as a consequence of the huge V_E generated during the race. A decrease of the PM content in the air attenuates this rate. Based on our calculations, we postulate that the PM₁₀ content in the air during a “clean air marathon run”, involving elite marathon runners, should be below 5.5 µg m⁻³.

The influence of urban, socio-economic, and eco-environmental aspects on COVID-19 cases, deaths and mortality: A multi-city case in the Atlantic Forest, Brazil

Urban, socio-economic and eco-environmental influences on people's health are widely studied and well-known. Their relation to COVID-19, however, is still a novel research topic. Thus, we investigated if COVID-19 parameters are higher in cities with higher urbanization, worst socio-economic conditions, and less vegetation cover, considering 3,052 municipalities in the Atlantic Forest, Brazil. Brazil is the second country most affected by COVID-19, and the Atlantic Forest is its most urbanized, populous, and deforested region. Indexes were created through multivariate principal components analysis using secondary official data: population, demographic density, absolute built area, and relative built area as urbanization parameters; average per capita income, relative people vulnerable to poverty, illiteracy rate of the population aged 18 or over, and human development index (HDI) as socio-economic parameters; and absolute and relative vegetation cover, absolute and relative forest cover as eco-environmental parameters. These indexes were correlated with absolute and relative confirmed COVID-19 cases, absolute and relative confirmed deaths, and mortality rate via Spearman's and Kendall's coefficients. Strong correlations (>0.50) were found between COVID-19 and urbanization. Socio-economic and eco-environmental aspects, although weaker predictors of COVID-19, presented meaningful relations with the health parameters. This study contributes to the evidence regarding COVID-19 incidence in the Brazilian population.

Particulate Matter-Induced Cardiovascular Dysfunction: A Mechanistic Insight

Air pollution and particulate matter (PM) are significant factors for adverse health effects most prominently cardiovascular disease (CVD). PM is produced from various sources, which include both natural and anthropogenic. It is composed of biological components, organic compounds, minerals, and metals, which are responsible for inducing inflammation and adverse health effects. However, the adverse effects are related to PM size distribution. Finer particles are a significant cause of cardiovascular events. This review discusses the direct and indirect mechanisms of PM-induced CVD like myocardial infarction, the elevation of blood pressure, cardiac arrhythmias, atherosclerosis, and thrombosis. The two potential mechanisms are oxidative stress and systemic inflammation. Prenatal exposure has also been linked with cardiovascular outcomes later in life. Moreover, we also mentioned the epidemiological studies that strongly associate PM with CVD.

Influence of fine particulate matter and its pure particulate fractions on pulmonary immune cells and cytokines in mice

Particulate matter with a diameter ≤2.5 µm (PM^2.5) has a complex composition and has been associated with the incidence of cardiopulmonary disease and premature death in humans. However, whether pure particulate fractions of PM^2.5 (PPP^2.5), which are composed primarily of carbon, are responsible for the toxicity caused by ambient particulate matter (original PM^2.5 particles, OPP^2.5) is currently unclear. The present study assessed the acute toxic effects of OPP^2.5 sampled in Beijing, China and of its PPP^2.5 fraction in male BALB/c mice. The mice were intratracheally instilled with a single dose of aerosolized OPP^2.5 or PPP^2.5. Blood, lungs and bronchoalveolar lavage fluid were collected after 24 h for histopathology, flow cytometry and the measurement of pro-inflammatory cytokines/chemokines and other biochemical factors. Both OPP^2.5 and PPP^2.5 caused acute toxicity, particularly inflammatory responses, including an increase in the levels of pro-inflammatory cytokines and an accumulation of numerous immune cells in the lungs. OPP^2.5 induced a stronger inflammatory response than PPP^2.5. The complex components adsorbed into the solid core granules of OPP^2.5 and the granules themselves contributed to the toxic effects.

Evaluation of the Toxicity on Lung Cells of By-Products Present in Naphthalene Secondary Organic Aerosols

In 2018, seven million people died prematurely due to exposure to pollution. Polycyclic aromatic hydrocarbons (PAHs) are a significant source of secondary organic aerosol (SOA) in urban areas. We investigated the toxic effects of by-products of naphthalene SOA on lung cells. These by-products were 1,4-naphthoquinone (1,4-NQ), 2-hydroxy-1,4-naphthoquinone (2-OH-NQ), phthalic acid (PA) and phthaldialdehyde (OPA). Two different assessment methodologies were used to monitor the toxic effects: real-time cell analysis (RTCA) and the Holomonitor, a quantitative phase contrast microscope. The chemicals were tested in concentrations of 12.5 to 100 µM for 1,4-NQ and 1 to 10 mM for 2-OH-NQ, PA and OPA. We found that 1,4-NQ is toxic to cells from 25 to 100 µM (EC50: 38.7 µM ± 5.2); 2-OH-NQ is toxic from 1 to 10mM (EC50: 5.3 mM ± 0.6); PA is toxic from 5 to 10 mM (EC50: 5.2 mM ± 0.3) and OPA is toxic from 2.5 to 10 mM (EC50: 4.2 mM ± 0.5). Only 1,4-NQ and OPA affected cell parameters (migration, motility, motility speed and optical volume). Furthermore, 1,4-NQ is the most toxic by-product of naphthalene, with an EC50 value that was one hundred times higher than those of the other compounds. RTCA and Holomonitor analysis showed a complementarity when studying the toxicity induced by chemicals.

Negative Air Ions Alleviate Particulate Matter-Induced Inflammation and Oxidative Stress in the Human Keratinocyte Cell Line HaCaT

Background

Recent studies have revealed that particulate matter induces inflammation, oxidative stress, and several skin diseases. Experimental results have also shown that negative air ions are highly effective in removing particulate matter-induced inflammation.

Objective

The present study aimed to investigate whether negative air ions can inhibit inflammatory responses and reduce oxidative stress in HaCaT cells exposed to particulate matters.

Methods

HaCaT cells were treated with particulate matter in the presence or absence of negative air ions and the viability was evaluated by the MTT assay. Reactive oxygen species (ROS) generation was quantified by the dichlorodihydrofluorescein diacetate assay. The expression of genes and proteins was analyzed by real-time polymerase chain reaction and Western blot. Levels of inflammatory cytokines were quantified by enzyme-linked immunosorbent assay.

Results

Negative air ions were observed to downregulate the mRNA and protein levels of particulate matter-induced pro-inflammatory cytokines in HaCaT cells. In addition, negative air ion treatment suppressed particulate matter-induced intracellular ROS generation, p38 mitogen-activated protein kinase activation, and activator protein 1 (c-Fos and c-Jun) activation.

Conclusion

Our findings indicate that negative air ions exert anti-inflammatory and antioxidant effects in HaCaT cells exposed to particulate matter. Therefore, negative air ions can be used for the prevention and treatment of particulate matter-related inflammatory skin diseases.

The Protective Effects of Shengmai Formula Against Myocardial Injury Induced by Ultrafine Particulate Matter Exposure and Myocardial Ischemia are Mediated by the PI3K/AKT/p38 MAPK/Nrf2 Pathway

Background and Purpose: Ultrafine particulate matter (UFPM) induces oxidative stress (OS) and is considered to be a risk factor of myocardial ischemia (MI). Shengmai formula (SMF) is a traditional Chinese medicine with antioxidant properties and has been used to treat cardiovascular diseases for a long time. The aim of this study was to explore the protective role of SMF and the mechanism by which it prevents myocardial injury in UFPM-exposed rats with MI. Methods: An MI rat model was established. Animals were randomly divided into five groups: sham, UFPM + MI, SMF (1.08 mg/kg⋅d) + UFPM + MI, SMF (2.16 mg/kg⋅d) + UFPM + MI, and SMF (4.32 mg/kg⋅d) + UFPM + MI. SMF or saline was administrated 7 days before UFPM instillation (100 μg/kg), followed by 24 h of ischemia. Physiological and biochemical parameters were measured, and histopathological examinations were conducted to evaluate myocardial damage. We also explored the potential mechanism of the protective role of SMF using a system pharmacology approach and an in vitro myoblast cell model with small molecule inhibitors. Results: UFPM produced myocardial injuries on myocardial infarct size; serum levels of LDH, CK-MB, and cardiac troponin; and OS responses in the rats with MI. Pretreatment with SMF significantly attenuated these damages via reversing the biomarkers. SMF also improved histopathology induced by UFPM and significantly altered the PI3K/AKT/MAPK and OS signaling pathways. The expression patterns of Cat, Gstk1, and Cyba in the UFPM model group were reversed in the SMF-treated group. In in vitro studies, SMF attenuated UFPM-induced reactive oxygen species production, mitochondrial damage, and OS responses. The PI3K/AKT/p38 MAPK/Nrf2 pathway was significantly changed in the SMF group compared with that in the UFPM group, whereas opposite results were obtained for pathway inhibition. Conclusion: These findings indicate that SMF prevents OS responses and exerts beneficial effects against myocardial injury induced by UFPM + MI in rats. Furthermore, the PI3K/AKT/p38 MAPK/Nrf2 signaling pathway might be involved in the protective effects of SMF.

Effects of PM10 and Weather on Respiratory and Cardiovascular Diseases in the Ciuc Basin (Romanian Carpathians)

This study presents the PM10 concentration, respiratory and cardiovascular disease hospital admissions evolution in the Ciuc basin for a period of 9 years (2008–2016), taking into consideration different meteorological conditions: boundary layer, lifting condensation level, temperature-humidity index, and wind chill equivalent chart index. The PM10 and hospital admissions evolution showed a very fluctuated hourly, weekly, monthly, yearly tendency. The PM10 concentration in winter (34.72 μg/m3) was 82% higher than the multiannual average (19.00 μg/m3), and almost three times higher than in summer (11.71 μg/m3). During the winter, PM10 concentration increased by an average of 9.36 μg/m3 due to the increased household heating. Climatological parameters have a demonstrable effect on the PM10 concentration variation. Children, the elderly and men are more sensitive to air pollution, the calculated relative risk for men was (RR = 1.45), and for women (RR = 1.37), respectively. A moderate correlation (0.51) was found between PM10 and pneumonia (P), while a relatively weak correlation (0.39) was demonstrated in the case of PM10 and upper respiratory tract infections (URTI). Furthermore, except thermal humidity index (THI), strong negative correlations were observed between the multiannual monthly mean PM10 and the meteorological data. The PM10 followed a moderate negative correlation with the boundary layer (−0.61). In the case of URTI and P, the highest number of hospital admissions occurred with a 5 to 7-day lag, while the 10 μg/m3 PM10 increase resulted in a 2.04% and 8.28% morbidity increase. For lung cancer (LC) and cardiovascular diseases (AMI, IHD, CCP), a maximum delay of 5–6 months was found. Three-month delay and an average growth of 1.51% was observed in the case of chronic obstructive pulmonary disease (COPD). Overall, these findings revealed that PM10 was and it is responsible for one-third of the diseases.

Climate change and antibiotic resistance: a deadly combination

Climate change is driven primarily by humanity's use of fossil fuels and the resultant greenhouse gases from their combustion. The effects of climate change on human health are myriad and becomingly increasingly severe as the pace of climate change accelerates. One relatively underreported intersection between health and climate change is that of infections, particularly antibiotic-resistant infections. In this perspective review, the aspects of climate change that have already, will, and could possibly impact the proliferation and dissemination of antibiotic resistance are discussed.

Circadian Deregulation as Possible New Player in Pollution-Induced Tissue Damage

Circadian rhythms are 24-h oscillations driven by a hypothalamic master oscillator that entrains peripheral clocks in almost all cells, tissues and organs. Circadian misalignment, triggered by industrialization and modern lifestyles, has been linked to several pathological conditions, with possible impairment of the quality or even the very existence of life. Living organisms are continuously exposed to air pollutants, and among them, ozone or particulate matters (PMs) are considered to be among the most toxic to human health. In particular, exposure to environmental stressors may result not only in pulmonary and cardiovascular diseases, but, as it has been demonstrated in the last two decades, the skin can also be affected by pollution. In this context, we hypothesize that chronodistruption can exacerbate cell vulnerability to exogenous damaging agents, and we suggest a possible common mechanism of action in deregulation of the homeostasis of the pulmonary, cardiovascular and cutaneous tissues and in its involvement in the development of pathological conditions.

High Vulnerability of Oligodendrocytes to Oxidative Stress Induced by Ultrafine Urban Particles

Oligodendrocytes, myelin-forming cells in the brain, are vulnerable to oxidative stress. Recent work indicates that air pollution causes demyelinating diseases such as multiple sclerosis. However, little is known about the mechanism of toxicity of ultrafine particulate matters (PMs) to oligodendrocytes. Here, we aimed to determine whether oligodendrocyte precursor cells (OPCs) and mature oligodendrocytes (mOLs) are more vulnerable to ultrafine urban PMs (uf-UPs) than other types of brain cells and damage to adult OPCs and mOLs in the mouse brain exposed to uf-UPs. For in vitro experiments, following exposure to various concentrations (2, 20, and 200 μg/mL) of uf-UPs, we measured survival rates, the amount of reactive oxygen species (ROS), and the total antioxidant capacities (TACs) of brain cells isolated from neonatal Sprague-Dawley rats. For animal experiments, after a four-week exposure to a uf-UP suspension (20 μL, 0.4 mg/mL), we enumerated the number of damaged cells and typed damaged cells in the white matter of the cerebellum of uf-UP-exposed mice. MTT assays and Hoechst staining demonstrated that OPCs and mOLs were more vulnerable to uf-UP-induced damage than astrocytes and cortical neurons at 2, 20, and 200 μg/mL of uf-UPs examined in this study (p < 0.05). Damage to OPCs and mOLs depended on uf-UP concentration. DCF assays and DHE staining indicated that the amount of ROS generated in OPCs and mOLs was significantly higher than in other brain cell types (p < 0.05). In contrast, TAC values in OPCs and mOLs were significantly lower than those of other brain cell types (p < 0.05). Fluoro-Jade B (FJB)-positive cells in the cerebellar white matter of the uf-UP-exposed group were significantly greater in number relative to the control group. Double immunofluorescence indicated that FJB-positive cells are NG2-positive adult OPCs and carbon anhydrase II-positive mOLs. Taken together, our findings suggest that oxidative stress induced by uf-UPs in the brain impairs adult OPCs and mOLs, causing demyelination and reducing the capacity for remyelination.

Prevention of Fine Dust-Induced Vascular Senescence by Humulus lupulus Extract and Its Major Bioactive Compounds

Both short- and long-term exposure to fine dust (FD) from air pollution has been linked to various cardiovascular diseases (CVDs). Endothelial cell (EC) senescence is an important risk factor for CVDs, and recent evidence suggests that FD-induced premature EC senescence increases oxidative stress levels. Hop plant (Humulus lupulus) is a very rich source of polyphenols known to have nutritional and therapeutic properties, including antioxidant behavior. The aims of this study were to evaluate whether Humulus lupulus extract prevents FD-induced vascular senescence and dysfunction and, if so, to characterize the underlying mechanisms and active components. Porcine coronary arteries and endothelial cells were treated with FD in the presence or absence of hop extract (HOP), and the senescence-associated-beta galactosidase (SA-β-gal) activity, cell-cycle progression, expression of senescence markers, oxidative stress level, and vascular function were evaluated. Results indicated that HOP inhibited FD-induced SA-β-gal activity, cell-cycle arrest, and oxidative stress, suggesting that HOP prevents premature induction of senescence by FD. HOP also ameliorated FD-induced vascular dysfunction. Additionally, xanthohumol (XN) and isoxanthohumol (IX) were found to produce the protective effects of HOP. Treatment with HOP and its primary active components XN and IX downregulated the expression of p22phox, p53, and angiotensin type 1 receptor, which all are known FD-induced redox-sensitive EC senescence inducers. Taken together, HOP and its active components protect against FD-induced endothelial senescence most likely via antioxidant activity and may be a potential therapeutic agent for preventing and/or treating air-pollution-associated CVDs.

Air Pollution and Emergency Hospital Admissions—Evidences from Lisbon Metropolitan Area, Portugal

The relevance of air pollution in the public health agenda has recently been reinforced—it is known that exposure to it has negative effects in the health of individuals, especially in big cities and metropolitan areas. In this article we observed the evolution of air pollutants (CO, NO, NO2, O3, PM10) emissions and we confront them with health vulnerabilities related to respiratory and circulatory diseases (all circulatory diseases, cardiac diseases, cerebrovascular disease, ischemic heart disease, all respiratory diseases, chronic lower respiratory diseases, acute upper respiratory infections). The study is supported in two databases, one of air pollutants and the other of emergency hospital admissions, in the 2005–2015 period, applied to the Lisbon Metropolitan Area. The analysis was conducted through Ordinary Least Squares (OLS) regression, while also using semi-elasticity to quantify associations. Results showed positive associations between air pollutants and admissions, tendentially higher in respiratory diseases, with CO and O3 having the highest number of associations, and the senior age group being the most impacted. We concluded that O3 is a good predictor for the under-15 age group and PM10 for the over-64 age group; also, there seems to exist a distinction between the urban city core and its suburban areas in air pollution and its relation to emergency hospital admissions.

Characterization of PM2.5 sources in a Belgrade suburban area: a multi-scale receptor-oriented approach

Designated as the most harmful for health, PM_2.5 aerosol fraction was a subject of our study. It was collected for all four seasons during 2014/15 in the suburban area of Belgrade (Serbia) and analysed for Al, Si, P, S, Cl, K, Ca, Ti, V, Cr, Mn, Fe, Ni, Cu, Zn, Br, As, Ba and Pb elements and for NH₄⁺, NO₃^- and SO₄^2- ions by particle-induced X-ray emission and ion chromatography techniques, respectively. Obtained concentrations have been treated by a combination of several receptor-oriented models to reveal source contributions to the suburban PM_2.5 at different spatial scales. Applied positive matrix factorization analysis indicated five main groups of emission sources: biomass burning (14.5%), traffic (3.9%), regional combustion/secondary sulphates (28.8%), local combustion/secondary nitrates (29.7%) and soil (5.4%). Local heating units had been pointed out as dominant contributors by long-range transport and ground-wind circulation analyses. Air masses circulating over the Balkan Peninsula denoted regional emissions as responsible for the high concentrations of secondary sulphates. Local and long-range transport analyses combined suggested that the BB and the LC/NO₃ originated from the wider urban area. Several Saharan dust episodes were detected as well. Presented results might be a basis for the development of air pollution mitigation strategies in the continental Balkan area, considered one of the most polluted and under-investigated European regions.

Association of ambient PM2·5 exposure with maternal bone strength in pregnant women from Mexico City: a longitudinal cohort study

BACKGROUND

Pregnancy is associated with deteriorations in maternal bone strength and heightened susceptibility to bone fractures. We aimed to investigate whether ambient particulate matter (PM)_2·5 concentrations were associated with bone strength during pregnancy.

METHODS

In this longitudinal cohort study, we analysed longitudinal data from women participating in the Programming Research in Obesity, Growth, Environment and Social Stressors (PROGRESS) cohort in Mexico City, Mexico. Eligible women were aged 18 years or older, at less than 20 weeks' gestation at the time of recruitment, planning to stay in Mexico City for the next 3 years, without heart or kidney disease, did not use steroids or anti-epileptic drugs, were not daily consumers of alcohol, and had access to a telephone. Daily ambient PM_2·5 concentrations were estimated from a spatio-temporal model that was based on the individual's address. Trabecular bone strength was measured using quantitative ultrasound from the radius of the middle finger and cortical bone strength from the proximal phalanx of the middle finger, during the second trimester, third trimester, and 1 and 6 months post partum. Bone strength T scores were modelled with PM_2·5 concentrations using linear mixed models and distributed lag models.

FINDINGS

Adjusting for multiple exposure windows, each 10 ug/m³ increase in PM_2·5 exposure concentrations in the first trimester was associated with a 0·18 SD decrease (95% CI -0·35 to -0·01; p=0·033) in ultrasound speed-of-sound (SOS) T score of trabecular bone strength from the second trimester until 6 months post partum. Similarly, each 10 μg/m³ increase in third trimester PM_2·5 exposure was associated with a 0·18 SD decrease (-0·36 to -0·01; p=0·044) in the SOS T score of trabecular bone strength from the third trimester until 6 months post partum. PM_2·5 exposure in the first month post partum was associated with a 0·20 SD decline (-0·39 to -0·01; p=0·043) in cortical bone strength until 6 months post partum.

INTERPRETATION

Ambient PM_2·5 exposure during and after pregnancy was associated with diminished trabecular and cortical bone strength. Early pregnancy PM_2·5 exposure was associated with a greater decline in bone strength later during pregnancy. Late pregnancy and early post-partum exposures adversely affected the post-partum bone strength recovery. Technological and policy solutions to reduce PM_2·5 pollution could improve public health by reducing bone fracture risk.

FUNDING

US National Institute of Environmental Health Sciences.

Effects of mild steel welding fume particles on pulmonary epithelial inflammation and endothelial activation

Welders have an increased risk for cardiovascular disease (CVD) following exposure to welding fumes. The underlying mechanisms are largely unknown; however, oxidative stress, systemic inflammation, and endothelial dysfunction have been suggested as contributing factors to particle-induced CVD. We investigated effects of mild steel welding fume (MSWF) on three target cell types: macrophages, pulmonary epithelial, and vascular endothelial cells. Cells were exposed to MSWF at nontoxic doses for 6 h/day, for five consecutive days. The expression of 40 genes involved in inflammation, fibrosis, and endothelial activation was analyzed. Moreover, changes in the reactive oxygen species production and migration capacity of cells were assessed. The expression of matrix metallopeptidase 1 (MMP1) was induced in both epithelial and endothelial cells following repeated exposure to MSWF. Although MMP1 is important in inflammatory responses in vivo, this effect was not concurrent with changes in the inflammatory status, cell proliferation, and migration capacities, nor did it induce oxidative stress in the cells. Thus, repeated exposure with low doses of MSWF was sufficient neither for inducing inflammatory stress in epithelial cells and macrophages nor for endothelial activation, and higher concentrations of MSWF or the nonparticle fraction of MSWF may be critical in causing the increased risk of CVD observed among welders.

An Assessment of Annual Mortality Attributable to Ambient PM2.5 in Bangkok, Thailand

Multiple studies indicate that PM2.5 is the most deleterious air pollutant for which there are ambient air quality standards. Daily concentrations of PM2.5 in Bangkok, Thailand, continuously exceed the World Health Organization (WHO) and the Thai National Ambient Air Quality Standards (NAAQSs). Bangkok has only recently begun to measure concentrations of PM2.5. To overcome this paucity of data, daily PM2.5/PM10 ratios were generated over the period 2012-2018 to interpolate missing values. Concentration-response coefficients (β values) for PM2.5 versus non-accidental, cardiopulmonary, and lung cancer mortalities were derived from the literature. Values were also estimated and were found to be comparable to those reported in the literature for a Chinese population, but considerably lower than those reported in the literature from the United States. These findings strongly suggest that specific regional β values should be used to accurately quantify the number of premature deaths attributable to PM2.5 in Asian populations. Health burden analysis using the Environmental Benefits Mapping and Analysis Program (BenMAP) showed that PM2.5 concentration in Bangkok contributes to 4240 non-accidental, 1317 cardiopulmonary, and 370 lung cancer mortalities annually. Further analysis showed that the attainment of PM2.5 levels to the NAAQSs and WHO guideline would reduce annual premature mortality in Bangkok by 33%and 75%, respectively.

Air Pollution across the Cancer Continuum: Extending Our Understanding of the Relationship between Environmental Exposures and Cancer

Previous studies of the environment and cancer have focused on etiology, showing that extrinsic factors in the environment contribute to 70% to 90% of cancers. Cancer patients and survivors often continue to live in the same neighborhoods they resided in before their cancer diagnosis. Thus, patients and survivors are exposed to the same environmental contexts that likely contributed to their original cancer, but little is known about the health effects of continued exposure to carcinogens after a cancer diagnosis. This commentary provides a summary of studies of the association between PM_2.5 and cancer mortality among patients and PM_2.5 and posttreatment morbidity among cancer survivors, and proposes new directions and opportunities for future research on such topics.See all articles in this CEBP Focus section, "Environmental Carcinogenesis: Pathways to Prevention."

Effects of ambient particulate matter on vascular tissue: a review

Fine and ultra-fine particulate matter (PM) are major constituents of urban air pollution and recognized risk factors for cardiovascular diseases. This review examined the effects of PM exposure on vascular tissue. Specific mechanisms by which PM affects the vasculature include inflammation, oxidative stress, actions on vascular tone and vasomotor responses, as well as atherosclerotic plaque formation. Further, there appears to be a greater PM exposure effect on susceptible individuals with pre-existing cardiovascular conditions.

Immunopathological features of air pollution and its impact on inflammatory airway diseases (IAD)

Air pollution causes significant morbidity and mortality in patients with inflammatory airway diseases (IAD) such as allergic rhinitis (AR), chronic rhinosinusitis (CRS), asthma, and chronic obstructive pulmonary disease (COPD). Oxidative stress in patients with IAD can induce eosinophilic inflammation in the airways, augment atopic allergic sensitization, and increase susceptibility to infection. We reviewed emerging data depicting the involvement of oxidative stress in IAD patients. We evaluated biomarkers, outcome measures and immunopathological alterations across the airway mucosal barrier following exposure, particularly when accentuated by an infectious insult.

Low-cost air pollution monitoring system-an opportunity for reducing the health risk associated with physical activity in polluted air

The issue of air pollution by particulate matter (PM) concerns many places in the world. At the same time, many residents undertake physical activity (recreation, rehabilitation, sport) in the open air. Generally, the amount of dust concentration depends on both the place (center or periphery of the city) and the time of day. In the present study we describe the outcome of monitoring of the state of air pollution by particle matter (PM₁₀) in the Kraków agglomeration area in order to show that it can provide information concerning air quality in the area where people practice varied kinds of sports in the open air. The measurements of PM₁₀ have been made by a few stations with identical construction working as one network. The details of the air pollution monitoring system and its data quality verification have been described. The network stations made multipoint observations across the Kraków Metropolitan Area during the year 2017 in eight locations. The locations selected represent a diverse spectrum of terrain conditions in which the Kraków agglomeration community undertakes physical activity. For most months of 2017, the minimum monthly average 4-hour PM₁₀ concentrations were recorded between 10–14 h, regardless of location, whereas the maximum was between 18–22. We also noticed a huge differences in the average monthly value of PM₁₀ in some locations within the Kraków agglomeration—ranging between 4.9–339.0 µg m⁻³. This indicates that some regions of the city are more suitable for performance of physical activity in the open air than others. In conclusion, we postulate that a low-cost air pollution monitoring system is capable of providing valuable information concerning air quality in a given region, which seems to be of importance also to people who practice varied sports activities in the open air.

Identification of Toxicity Parameters Associated with Combustion Produced Soot Surface Chemistry and Particle Structure by in Vitro Assays

Air pollution has become the world's single biggest environmental health risk of the past decade, causing millions of yearly deaths worldwide. One of the dominant air pollutants is fine particulate matter (PM2.5), which is a product of combustion. Exposure to PM2.5 has been associated with decreased lung function, impaired immunity, and exacerbations of lung disease. Accumulating evidence suggests that many of the adverse health effects of PM2.5 exposure are associated with lung inflammation and oxidative stress. While the physical structure and surface chemistry of PM2.5 are surrogate measures of particle oxidative potential, little is known about their contributions to negative health effects. In this study, we used functionalized carbon black particles as surrogates for atmospherically aged combustion-formed soot to assess the effects of PM2.5 surface chemistry in lung cells. We exposed the BEAS-2B lung epithelial cell line to different soot at a range of concentrations and assessed cell viability, inflammation, and oxidative stress. Our results indicate that exposure to soot with varying particle surface composition results in differential cell viability rates, the expression of pro-inflammatory and oxidative stress genes, and protein carbonylation. We conclude that particle surface chemistry, specifically oxygen content, in soot modulates lung cell inflammatory and oxidative stress responses.

Titanium dioxide nanoparticles exaggerate respiratory syncytial virus-induced airway epithelial barrier dysfunction

Respiratory syncytial virus (RSV) is the leading cause of lower respiratory tract infections in children worldwide. While most develop a mild, self-limiting illness, some develop severe acute lower respiratory infection and persistent airway disease. Exposure to ambient particulate matter has been linked to asthma, bronchitis, and viral infection in multiple epidemiological studies. We hypothesized that coexposure to nanoparticles worsens RSV-induced airway epithelial barrier dysfunction. Bronchial epithelial cells were incubated with titanium dioxide nanoparticles (TiO2-NP) or a combination of TiO2-NP and RSV. Structure and function of epithelial cell barrier were analyzed. Viral titer and the role of reactive oxygen species (ROS) generation were evaluated. In vivo, mice were intranasally incubated with TiO2-NP, RSV, or a combination. Lungs and bronchoalveolar lavage (BAL) fluid were harvested for analysis of airway inflammation and apical junctional complex (AJC) disruption. RSV-induced AJC disruption was amplified by TiO2-NP. Nanoparticle exposure increased viral infection in epithelial cells. TiO2-NP induced generation of ROS, and pretreatment with antioxidant, N-acetylcysteine, reversed said barrier dysfunction. In vivo, RSV-induced injury and AJC disruption were augmented in the lungs of mice given TiO2-NP. Airway inflammation was exacerbated, as evidenced by increased white blood cell infiltration into the BAL, along with exaggeration of peribronchial inflammation and AJC disruption. These data demonstrate that TiO2-NP exposure exacerbates RSV-induced AJC dysfunction and increases inflammation by mechanisms involving generation of ROS. Further studies are required to determine whether NP exposure plays a role in the health disparities of asthma and other lung diseases, and why some children experience more severe airway disease with RSV infection.

Increase of Cardiometabolic Biomarkers Among Vehicle Inspectors Exposed to PM0.25 and Compositions

Background

Exposure to particulate matter (PM) emitted from vehicle exhaust might disrupt systemic function and elevate the risk of cardiovascular disease. In this study, we examined the changes of cardiometabolic biomarkers among vehicle inspectors exposed daily to PM0.25 and components.

Methods

This cross-sectional study was conducted at two vehicle inspection centers, Pulogadung and Ujung Menteng, located in East Jakarta, Indonesia. The exposed respondents were 43 workers from vehicle inspection centers, and the unexposed group consisted of 22 staff officers working in the same locations. Vehicle exhaust particulate matter was measured for eight hours using a Leland Legacy personal pump attached to a Sioutas Cascade Impactor. The used filters were 25 and 37-mm quartz filters. The particulate matter concentration was analyzed using a gravimetric method, whereas trace elements were analyzed using energy dispersive X-ray fluorescence. An EEL Smoke Stain Reflectometer analyzed black carbon.

Results

The personal exposure concentrations of PM0.25 were 10.4-fold higher than those in unexposed groups. Calcium and sulfur were the major components in the obtained dust, and their levels were 3.3- and 7.2-fold higher, respectively, in the exposed group. Based on an independent-samples t-test, high-density lipoprotein, triglyceride, HbA1c, total immunoglobulin E, high-sensitivity C-reactive protein, tumor necrosis factor-alpha, and nitric oxide levels were significantly different between the groups.

Conclusions

In summary, it was suggested that PM0.25 exposure from vehicle exhaust might affect cardiometabolic biomarkers change.

Cardiovascular adaptations to particle inhalation exposure: molecular mechanisms of the toxicology

Ambient air, occupational settings, and the use and distribution of consumer products all serve as conduits for toxicant exposure through inhalation. While the pulmonary system remains a primary target following inhalation exposure, cardiovascular implications are exceptionally culpable for increased morbidity and mortality. The epidemiological evidence for cardiovascular dysfunction resulting from acute or chronic inhalation exposure to particulate matter has been well documented, but the mechanisms driving the resulting disturbances remain elusive. In the current review, we aim to summarize the cellular and molecular mechanisms that are directly linked to cardiovascular health following exposure to a variety of inhaled toxicants. The purpose of this review is to provide a comprehensive overview of the biochemical changes in the cardiovascular system following particle inhalation exposure and to highlight potential biomarkers that exist across multiple exposure paradigms. We attempt to integrate these molecular signatures in an effort to provide direction for future investigations. This review also characterizes how molecular responses are modified in at-risk populations, specifically the impact of environmental exposure during critical windows of development. Maternal exposure to particulate matter during gestation can lead to fetal epigenetic reprogramming, resulting in long-term deficits to the cardiovascular system. In both direct and indirect (gestational) exposures, connecting the biochemical mechanisms with functional deficits outlines pathways that can be targeted for future therapeutic intervention. Ultimately, future investigations integrating "omics"-based approaches will better elucidate the mechanisms that are altered by xenobiotic inhalation exposure, identify biomarkers, and guide in clinical decision making.

Mixed Vehicle Emissions Induces Angiotensin II and Cerebral Microvascular Angiotensin Receptor Expression in C57Bl/6 Mice and Promotes Alterations in Integrity in a Blood-Brain Barrier Coculture Model

Exposure to traffic-generated pollution is associated with alterations in blood-brain barrier (BBB) integrity and exacerbation of cerebrovascular disorders. Angiotensin (Ang) II signaling through the Ang II type 1 (AT1) receptor is known to promote BBB disruption. We have previously reported that exposure to a mixture of gasoline and diesel vehicle engine emissions (MVE) mediates alterations in cerebral microvasculature of C57Bl/6 mice, which is exacerbated through consumption of a high-fat (HF) diet. Thus, we investigated the hypothesis that inhalation exposure to MVE results in altered central nervous system microvascular integrity mediated by Ang II-AT1 signaling. Three-month-old male C57Bl/6 mice were placed on an HF or low-fat diet and exposed via inhalation to either filtered air (FA) or MVE (100 μg/m3 PM) 6 h/d for 30 days. Exposure to HF+MVE resulted in a significant increase in plasma Ang II and expression of AT1 in the cerebral microvasculature. Results from a BBB coculture study showed that transendothelial electrical resistance was decreased, associated with reduced expression of claudin-5 and occludin when treated with plasma from MVE+HF animals. These effects were attenuated through pretreatment with the AT1 antagonist, Losartan. Our BBB coculture showed increased levels of astrocyte AT1 and decreased expression of aryl hydrocarbon receptor and glutathione peroxidase-1, associated with increased interleukin-6 and transforming growth factor-β in the astrocyte media, when treated with plasma from MVE-exposed groups. Our results indicate that inhalation exposure to traffic-generated pollutants results in altered BBB integrity, mediated through Ang II-AT1 signaling and inflammation, which is exacerbated by an HF diet.

Circulating miRNAs as molecular markers of occupational grain dust exposure

Dust from grain and feed production may cause adverse health effects in exposed workers. In this study we explored circulating miRNAs as potential biomarkers of occupational grain dust exposure. Twenty-two serum miRNAs were analyzed in 44 grain dust exposed workers and 22 controls. Exposed workers had significantly upregulated miR-18a-5p, miR-124-3p and miR-574-3p, and downregulated miR-19b-3p and miR-146a-5p, compared to controls. Putative target genes for the differentially expressed miRNAs were involved in a range of Kyoto Encyclopedia of Genes and Genomes signaling pathways, and ‘Pathways in cancer’ and ‘Wnt signaling pathway’ were common for all the five miRNAs. MiRNA-diseases association analysis showed a link between the five identified miRNAs and several lung diseases terms. A positive correlation between miR-124-3p, miR-18a-5p, and miR-574-3p and IL-6 protein level was shown, while miR-19b-3p was inversely correlated with CC-16 and sCD40L protein levels. Receiver-operating characteristic analysis of the five miRNA showed that three miRNAs (miR-574-3p, miR-124-3p and miR-18a-5p) could distinguish the grain dust exposed group from the control group, with miR-574-3p as the strongest predictor of grain dust exposure. In conclusion, this study identified five signature miRNAs as potential novel biomarkers of grain dust exposure that may have potential as early disease markers.

Long-term exposure to outdoor and household air pollution and blood pressure in the Prospective Urban and Rural Epidemiological (PURE) study

Exposure to air pollution has been linked to elevated blood pressure (BP) and hypertension, but most research has focused on short-term (hours, days, or months) exposures at relatively low concentrations. We examined the associations between long-term (3-year average) concentrations of outdoor PM2.5 and household air pollution (HAP) from cooking with solid fuels with BP and hypertension in the Prospective Urban and Rural Epidemiology (PURE) study. Outdoor PM2.5 exposures were estimated at year of enrollment for 137,809 adults aged 35-70 years from 640 urban and rural communities in 21 countries using satellite and ground-based methods. Primary use of solid fuel for cooking was used as an indicator of HAP exposure, with analyses restricted to rural participants (n = 43,313) in 27 study centers in 10 countries. BP was measured following a standardized procedure and associations with air pollution examined with mixed-effect regression models, after adjustment for a comprehensive set of potential confounding factors. Baseline outdoor PM2.5 exposure ranged from 3 to 97 μg/m3 across study communities and was associated with an increased odds ratio (OR) of 1.04 (95% CI: 1.01, 1.07) for hypertension, per 10 μg/m3 increase in concentration. This association demonstrated non-linearity and was strongest for the fourth (PM2.5 > 62 μg/m3) compared to the first (PM2.5 < 14 μg/m3) quartiles (OR = 1.36, 95% CI: 1.10, 1.69). Similar non-linear patterns were observed for systolic BP (β = 2.15 mmHg, 95% CI: -0.59, 4.89) and diastolic BP (β = 1.35, 95% CI: -0.20, 2.89), while there was no overall increase in ORs across the full exposure distribution. Individuals who used solid fuels for cooking had lower BP measures compared to clean fuel users (e.g. 34% of solid fuels users compared to 42% of clean fuel users had hypertension), and even in fully adjusted models had slightly decreased odds of hypertension (OR = 0.93; 95% CI: 0.88, 0.99) and reductions in systolic (-0.51 mmHg; 95% CI: -0.99, -0.03) and diastolic (-0.46 mmHg; 95% CI: -0.75, -0.18) BP. In this large international multi-center study, chronic exposures to outdoor PM2.5 was associated with increased BP and hypertension while there were small inverse associations with HAP.

The association between short-term residential black carbon concentration on blood pressure in a general population sample

BACKGROUND

Exposure to black carbon indoors may be associated with blood pressure; however, evidence is limited to vulnerable subpopulations and highly exposed individuals. Our objective was to explore the relationship between indoor black carbon at various exposure windows on resting blood pressure in a general population sample.

METHODS

Black carbon was measured in the home of 76 individuals aged 10-71 in New Orleans, Louisiana. Exposure was measured every 1 minute for up to 120 hours using an AE51 microaethalometer. Systolic blood pressure and diastolic blood pressure were measured at the conclusion of exposure monitoring.

RESULTS

In adjusted models, at all exposure windows, increasing black carbon was associated with increased systolic blood pressure. The period 0-72 hours prior to blood pressure measurement showed the strongest effect; a 1 μg/m³ increase in black carbon was associated with a 7.55 mm Hg (P = .02) increase in systolic blood pressure. The relationship was stronger in participants reporting doctor-diagnosed hypertension (β = 6.47 vs β = 3.27). Black carbon was not associated with diastolic blood pressure.

CONCLUSION

Increasing black carbon concentration indoors is positively associated with increasing systolic blood pressure with the most relevant exposure window being 0-72 hours prior to blood pressure measurement. Individuals with hypertension may be a more susceptible population.

Relationship between different particle size fractions and all-cause and cause-specific emergency ambulance dispatches

BACKGROUND

Evidence on the relationship between different particle size fractions and emergency ambulance dispatches (EAD) remains limited and sparse.

METHODS

We collected daily data of EAD, ambient air pollution and meteorological data from 2014 to 2018 in Guangzhou, China. We used a generalized additive model with covariate adjustments to estimate the associations between different particle size fractions and EAD related to all-cause, cardiovascular diseases, and respiratory diseases. Several subgroup and sensitivity analyses were also performed.

RESULTS

Significant associations were observed between PM_2.5, PM_2.5-10, PM₁₀ and EADs. A 10 μg/m³ increase of PM_2.5, PM_2.5-10, and PM₁₀ was associated with an increase of 0.98% (95% CI: 0.67, 1.28%), 2.06% (95% CI: 1.44, 2.68%), and 0.75% (95%CI: 0.53, 0.96%) in all-cause EAD, with an increase of 0.69% (95% CI: 0.00, 1.39%), 2.04% (95% CI: 0.64, 3.45%), and 0.60% (95%CI: 0.11,1.10%) in cardiovascular-related EAD, and an increase of 1.14% (95% CI: 0.25, 2.04%), 2.52% (95% CI: 0.72, 4.35%), and 0.89% (95%CI: 0.25,1.52%) in respiratory-related EAD at lag03, respectively. The results were robust in subgroup and sensitivity analyses.

CONCLUSIONS

This study revealed that PM_2.5, PM_2.5-10 and PM₁₀ were significantly related with risks of all-cause and cause-specific EAD. More evidence of high quality may be needed to further support our results in this ecological study.

Oxygenated polycyclic aromatic hydrocarbons from ambient particulate matter induce electrophysiological instability in cardiomyocytes

Background

Epidemiologic studies have suggested that elevated concentrations of particulate matter (PM) are strongly associated with an increased risk of developing cardiovascular diseases, including arrhythmia. However, the cellular and molecular mechanisms by which PM exposure causes arrhythmia and the component that is mainly responsible for this adverse effect remains to be established. In this study, the arrhythmogenicity of mobilized organic matter from two different types of PM collected during summer (SPM) and winter (WPM) seasons in the Seoul metropolitan area was evaluated. In addition, differential effects between polycyclic aromatic hydrocarbons (PAHs) and oxygenated PAHs (oxy-PAHs) on the induction of electrophysiological instability were examined.

Results

We extracted the bioavailable organic contents of ambient PM, measuring 10 μm or less in diameter, collected from the Seoul metropolitan area using a high-volume air sampler. Significant alterations in all factors tested for association with electrophysiological instability, such as intracellular Ca²⁺ levels, reactive oxygen species (ROS) generation, and mRNA levels of the Ca²⁺-regulating proteins, sarcoplasmic reticulum Ca²⁺ATPase (SERCA2a), Ca²⁺/calmodulin-dependent protein kinase II (CaMK II), and ryanodine receptor 2 (RyR2) were observed in cardiomyocytes treated with PM. Moreover, the alterations were higher in WPM-treated cardiomyocytes than in SPM-treated cardiomyocytes. Three-fold more oxy-PAH concentrations were observed in WPM than SPM. As expected, electrophysiological instability was induced higher in oxy-PAHs (9,10-anthraquinone, AQ or 7,12-benz(a) anthraquinone, BAQ)-treated cardiomyocytes than in PAHs (anthracene, ANT or benz(a) anthracene, BaA)-treated cardiomyocytes; oxy-PAHs infusion of cells mediated by aryl hydrocarbon receptor (AhR) was faster than PAHs infusion. In addition, ROS formation and expression of calcium-related genes were markedly more altered in cells treated with oxy-PAHs compared to those treated with PAHs.

Conclusions

The concentrations of oxy-PAHs in PM were found to be higher in winter than in summer, which might lead to greater electrophysiological instability through the ROS generation and disruption of calcium regulation.

The association between long-term exposure to low-level PM2.5 and mortality in the state of Queensland, Australia: A modelling study with the difference-in-differences approach

BACKGROUND

To date, few studies have investigated the causal relationship between mortality and long-term exposure to a low level of fine particulate matter (PM2.5) concentrations.

METHODS AND FINDINGS

We studied 242,320 registered deaths in Queensland between January 1, 1998, and December 31, 2013, with satellite-retrieved annual average PM2.5 concentrations to each postcode. A variant of difference-in-differences (DID) approach was used to investigate the association of long-term PM2.5 exposure with total mortality and cause-specific (cardiovascular, respiratory, and non-accidental) mortality. We observed 217,510 non-accidental deaths, 133,661 cardiovascular deaths, and 30,748 respiratory deaths in Queensland during the study period. The annual average PM2.5 concentrations ranged from 1.6 to 9.0 μg/m3, which were well below the current World Health Organization (WHO) annual standard (10 μg/m3). Long-term exposure to PM2.5 was associated with increased total mortality and cause-specific mortality. For each 1 μg/m3 increase in annual PM2.5, we found a 2.02% (95% CI 1.41%-2.63%; p < 0.01) increase in total mortality. Higher effect estimates were observed in Brisbane than those in Queensland for all types of mortality. A major limitation of our study is that the DID design is under the assumption that no predictors other than seasonal temperature exhibit different spatial-temporal variations in relation to PM2.5 exposure. However, if this assumption is violated (e.g., socioeconomic status [SES] and outdoor physical activities), the DID design is still subject to confounding.

CONCLUSIONS

Long-term exposure to PM2.5 was associated with total, non-accidental, cardiovascular, and respiratory mortality in Queensland, Australia, where PM2.5 levels were measured well below the WHO air quality standard.