Air particulate matter and cardiovascular disease: a narrative review

Haze Influencing Factors: A Data Envelopment Analysis Approach

This paper investigates the meteorological factors and human activities that influence PM_2.5 pollution by employing the data envelopment analysis (DEA) approach to a chance constrained stochastic optimization problem. This approach has the two advantages of admitting random input and output, and allowing the evaluation unit to exceed the front edge under the given probability constraint. Furthermore, by utilizing the meteorological observation data incorporated with the economic and social data for Jiangsu Province, the chance constrained stochastic DEA model was solved to explore the relationship between the meteorological elements and human activities and PM_2.5 pollution. The results are summarized by the following: (1) Among all five primary indexes, social progress, energy use and transportation are the most significant for PM_2.5 pollution. (2) Among our selected 14 secondary indexes, coal consumption, population density and civil car ownership account for a major portion of PM_2.5 pollution. (3) Human activities are the main factor producing PM_2.5 pollution. While some meteorological elements generate PM_2.5 pollution, some act as influencing factors on the migration of PM_2.5 pollution. These findings can provide a reference for the government to formulate appropriate policies to reduce PM_2.5 emissions and for the communities to develop effective strategies to eliminate PM_2.5 pollution.

Attributable risk of hospital admissions for overall and specific mental disorders due to particulate matter pollution: A time-series study in Chengdu, China

The associations of particulate matter (PM) pollution with the morbidity of overall and subtypes of mental disorders (MDs), as well as the corresponding morbidity burden, remain understudied, especially in developing countries. This study aimed to evaluate the short-term effects of PM_2.5 (diameters ≤ 2.5 µm), PM₁₀ (diameters ≤ 10 µm) and PM_C (diameters between 2.5 and 10 µm) on hospital admissions (HAs) for MDs in Chengdu, China, during 2015-2016, and calculate corresponding attributable risks. A generalized additive model (GAM) with controlling for time trend, meteorological conditions, holidays and day of the week was used to estimate the associations. Stratified analyses were also performed by age, gender and season. We further estimated the burden of HAs for MDs attributable to PM exposure. During the study period, a total of 10,947 HAs for MDs were collected. PM_2.5, PM₁₀ and PM_C were significantly associated with elevated risks of MDs hospitalizations. Each 10 μg/m³ increase in PM_2.5, PM₁₀ and PM_C at lag06 corresponded to an increase of 2.89% (95% CI: 0.75-5.08%), 1.91% (95% CI: 0.57-3.28%) and 3.95% (95% CI: 0.84-7.15%) in daily HAs for MDs, respectively. The risk estimates of PM on MDs hospitalizations were generally robust after adjustment for gaseous pollutants in two-pollutant models. We found stronger associations between PM pollution and MDs in males and in cool seasons than in females and in warm seasons. For specific subtypes of MDs, significant associations of PM pollution with dementia,schizophrenia and depression were observed. Using WHO's air quality guidelines as the reference concentrations, 9.53% (95% CI: 2.67-15.58%), 9.17% (95% CI: 2.91-14.70%) and 6.10% (95% CI: 1.40-10.32%) of HAs for MDs could be attributable to PM_2.5, PM₁₀ and PM_C, respectively. Our results suggested that PM exposure might be an important trigger of hospitalizations for MDs in Chengdu, China, and account for substantial morbidity burden.

Fine particulate matter and incidence of metabolic syndrome in non-CVD patients: A nationwide population-based cohort study

BACKGROUND

It has been reported that particulate matter (PM) is associated with cardiovascular diseases (CVD) while metabolic syndrome is also an important risk factor for CVD. However, few studies have investigated the epidemiological association between PM and metabolic syndrome.

OBJECTIVE

To investigate the association between one-year exposure to PM with an aerodynamic diameter <2.5 μm (PM_2.5) and the risk of metabolic syndrome in Korean adults without CVD.

METHODS

Exposure to PM_2.5 was assessed using a Community Multiscale Air Quality (CMAQ) model. Metabolic syndrome was defined by National Cholesterol Education Program Adult Treatment Panel III. Andersen and Gill model with time-varying covariates, considering recurrent events, was used to investigate the association between one-year average PM_2.5 and the risk of incident metabolic syndrome in 119,998 adults from the national health screening cohort provided by Korea National Health Insurance from 2009 to 2013.

RESULTS

Higher risk of metabolic syndrome, waist-based obesity, hypertension, hypertriglyceridemia, low HDL cholesterol, and hyperglycemia were significantly associated with a 10-μg/m³ increase in PM_2.5 [adjusted hazard ratio (HR): 1.070, 1.510, 1.499, 1.468, 1.627 and 1.380, respectively]. In addition, the risk of metabolic syndrome associated with PM_2.5 exposure was significant in the consistently obese group (obese at baseline and endpoint).

CONCLUSION

Exposure to one-year average PM_2.5 is associated with an increased risk of metabolic syndrome and its components in adults without CVD. These associations are particularly prominent in the consistently obese group (obese at baseline and endpoint). Our findings indicate that PM_2.5 affects the onset of MS and its components which may lead to increase the risk of CVD.

Preparedness components of health systems in the Eastern Mediterranean Region for effective responses to dust and sand storms: a systematic review

Background: Dust and Sand Storm (DSS), according to estimates by global reports, will increase dramatically in the Eastern Mediterranean Region (EMR). Numerous health problems caused by DSS will be severely affected regions and vulnerable groups. This study aimed to identify the components of the preparedness of health systems for the DSS phenomenon in EMR. Methods: In this systematic review, the peer-reviewed papers in four electronic databases, including Medline through PubMed, Scopus, ISI Web of Science and the Cochrane library, as well as available grey literature, were searched and selected. The research process was carried out by including papers whose results were related to the potential health effects caused by desert dusts in EMR. Was used the combination of three groups of keywords: the exposure factor, health effects as outcomes, and the countries located in EMR. The focus was on the PRISMA checklist, with no time limitations until December 2017. Finally, through 520 related citations, 30 articles were included. Descriptive and thematic content analyses were evaluated. Results: The preparedness components were divided into three and ten main categories and subcategories, respectively. The three categories covered the areas of DSS hazard identification, planning and policy-making, and risk assessment. Conclusions: Recognition of the health system preparedness factors for DSS in EMR will help policy-makers and managers perform appropriate measures when dealing with this hazard. More studies should be conducted to understand these factors in other parts of the world. Registration: PROSPERO registration number CRD42018093325.

Indoor nanoscale particulate matter-induced coagulation abnormality based on a human 3D microvascular model on a microfluidic chip

BACKGROUND

A growing body of evidence shows that indoor concentrations of airborne particles are often higher than is typically encountered outdoors. Since exposure to indoor PM2.5 is thought to be associated with cardiovascular disease, the health impacts of indoor air pollution need to be explored. Based on animal models, ambient particulate matter has been proved to promote coagulation which is very likely involved in the pathogenic development of cardiovascular disease. However, animal models are insufficient to predict what will happen with any certainty in humans. For this reason, the precise pathogenic mechanisms behind the development of cardiovascular disease in humans have not yet been determined.

RESULTS

We generated a 3D functional human microvascular network in a microfluidic device. This model enables human vascular endothelial cells to form tissue-like microvessels that behave very similarly to human blood vessels. The perfusable microvasculature allows the delivery of particles introduced into these generated human-like microvessels to follow the fluid flow. This exposure path effectively simulates the dynamic movement of airborne nanoscale particles (ANPs) within human vessels. In this study, we first identified the existence of ANPs in indoor air pollution. We then showed that ANPs could activate endothelial cells via ROS induced inflammation, and further resulted in abnormal expression of the coagulation factors (TF, TM and t-PA) involved in coagulation cascades. In addition, we found that a protein could cover ANPs, and this biointeraction could interfere with heparan sulfate (HS). Human organotypic 3D microvessel models provide a bridge for how research outcomes can translate to humans.

CONCLUSIONS

The 3D human microvessel model was used to determine the physiological responses of human vessels to ANP stimulation. Based on the obtained data, we concluded that ANPs not only disrupts normal coagulation functions, but also act directly on anticoagulant factors in human vessels. These experimental observations provide a potential biological explanation for the epidemiologically established link between ANPs and coagulation abnormality. This organ-on-chip model may provide a bridge from in vitro results to human responses.

Metabolic Syndrome and Air Pollution: A Narrative Review of Their Cardiopulmonary Effects

Particulate matter (PM) exposure and metabolic syndrome (MetSyn) are both significant global health burdens. PM exposure has been implicated in the pathogenesis of MetSyn and cardiopulmonary diseases. Individuals with pre-existing MetSyn may be more susceptible to the detrimental effects of PM exposure. Our aim was to provide a narrative review of MetSyn/PM-induced systemic inflammation in cardiopulmonary disease, with a focus on prior studies of the World Trade Center (WTC)-exposed Fire Department of New York (FDNY). We included studies (1) published within the last 16-years; (2) described the epidemiology of MetSyn, obstructive airway disease (OAD), and vascular disease in PM-exposed individuals; (3) detailed the known mechanisms of PM-induced inflammation, MetSyn and cardiopulmonary disease; and (4) focused on the effects of PM exposure in WTC-exposed FDNY firefighters. Several investigations support that inhalation of PM elicits pulmonary and systemic inflammation resulting in MetSyn and cardiopulmonary disease. Furthermore, individuals with these preexisting conditions are more sensitive to PM exposure-related inflammation, which can exacerbate their conditions and increase their risk for hospitalization and chronic disease. Mechanistic research is required to elucidate biologically plausible therapeutic targets of MetSyn- and PM-induced cardiopulmonary disease.

Particulate Matter Exposure of Passengers at Bus Stations: A Review

This review clarifies particulate matter (PM) pollution, including its levels, the factors affecting its distribution, and its health effects on passengers waiting at bus stations. The usual factors affecting the characteristics and composition of PM include industrial emissions and meteorological factors (temperature, humidity, wind speed, rain volume) as well as bus-station-related factors such as fuel combustion in vehicles, wear of vehicle components, cigarette smoking, and vehicle flow. Several studies have proven that bus stops can accumulate high PM levels, thereby elevating passengers' exposure to PM while waiting at bus stations, and leading to dire health outcomes such as cardiovascular disease (CVD), respiratory effects, and diabetes. In order to accurately predict PM pollution, an artificial neural network (ANN) and adaptive neuro-fuzzy inference systems (ANFIS) have been developed. ANN is a data modeling method of proven effectiveness in solving complex problems in the fields of alignment, prediction, and classification, while the ANFIS model has several advantages including non-requirement of a mathematical model, simulation of human thinking, and simple interpretation of results compared with other predictive methods.

Acute effect of fine and coarse particular matter on cardiovascular visits in Ningbo, China

Although a growing number of epidemiological studies have been conducted on size-specific health effects of particulate matter in China, results remain inconsistent. In this study, we investigated acute effect of fine and coarse particular matter on cardiovascular hospital visits in Ningbo, China. We used generalized additive models to examine short-term effects of PM_2.5 and PM_10-2.5 on cardiovascular hospital visits by adjustment for temporal, seasonal, and meteorological effects. Subgroup analyses were conducted by age, sex, and season. We also examined the stability of their effects in multi-pollutant models. We found that PM_2.5 were associated with cardiovascular hospital visits (RR = 1.006; 95% CI 1.000, 1.011) and results remained similar after adjustment for PM_10-2.5 (RR = 1.005; 95% CI 0.998, 1.013). There was a borderline association between PM_10-2.5 and cardiovascular hospital visits (RR = 1.007; 95% CI 0.997, 1.016), which disappeared after controlling for PM_2.5 (RR = 1.000; 95% CI 0.988, 1.013). The associations appeared to be stronger in the cold season and among the elderly (≥ 75 years). The findings of this study suggested significant adverse effects of PM_2.5, but no independent effects of PM_10-2.5 on cardiovascular hospital visits. Additional studies are needed to confirm these findings.

Editor's Highlight: Modifying Role of Endothelial Function Gene Variants on the Association of Long-Term PM2.5 Exposure With Blood DNA Methylation Age: The VA Normative Aging Study

Recent studies have reported robust associations of long-term PM2.5 exposure with DNA methylation-based measures of aging; yet, the molecular implications of these relationships remain poorly understood. We evaluated if genetic variation in 3 biological pathways implicated in PM2.5-related disease-oxidative stress, endothelial function, and metal processing-could modify the effect of PM2.5 on DNAm-age, one prominent DNA methylation-based measure of biological age. This analysis was based on 552 individuals from the Normative Aging Study with at least one visit between 2000 and 2011 (n = 940 visits). A genetic-score approach was used to calculate aging-risk variant scores for endothelial function, oxidative stress, and metal processing pathways. One-year PM2.5 and PM2.5 component (sulfate and ammonium) levels at participants' addresses were estimated using the GEOS-chem transport model. Blood DNAm-age was calculated using CpG sites on the Illumina HumanMethylation450 BeadChip. In fully-adjusted linear mixed-effects models, the effects of sulfate on DNAm-age (in years) were greater in individuals with high aging-risk endothelial function variant scores when compared with individuals with low aging-risk endothelial function variant scores (Pinteraction = 0.0007; βHigh = 1.09, 95% CIHigh: 0.70, 1.48; βLow = 0.40, 95% CILow: 0.14, 0.67). Similar trends were observed in fully adjusted models of ammonium and total PM2.5 alone. No effect modification was observed by oxidative stress and metal processing variant scores. Secondary analyses revealed significant associations of serum endothelial markers, intercellular adhesion molecule-1 (β = 0.01, 95% CI: 0.002, 0.012) and vascular cell adhesion molecule-1 (β = 0.002, 95% CI: 0.0005, 0.0026), with DNAm-age. Our results add novel evidence that endothelial physiology may be important to DNAm-age relationships, but further research is required to establish their generalizability.

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

Background

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

Methods and Results

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

Conclusions

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

Lung health in era of climate change and dust storms

Dust storms are strong winds which lead to particle exposure over extensive areas. These storms influence air quality on both a local and global scale which lead to both short and long-term effects. The frequency of dust storms has been on the rise during the last decade. Forecasts suggest that their incidence will increase as a response to the effects of climate change and anthropogenic activities. Elderly people, young children, and individuals with chronic cardiopulmonary diseases are at the greatest risk for health effects of dust storms. A wide variety of infectious and non-infectious diseases have been associated with dust exposure. Influenza A virus, pulmonary coccidioidomycosis, bacterial pneumonia, and meningococcal meningitis are a few examples of dust-related infectious diseases. Among non-infectious diseases, chronic obstructive pulmonary disease, asthma, sarcoidosis and pulmonary fibrosis have been associated with dust contact. Here, we review two molecular mechanisms of dust induced lung disease for asthma and sarcoidosis. We can also then further understand the mechanisms by which dust particles disturb airway epithelial and immune cells.

Cardiovascular and Cerebrovascular Emergency Department Visits Associated With Wildfire Smoke Exposure in California in 2015

BACKGROUND

Wildfire smoke is known to exacerbate respiratory conditions; however, evidence for cardiovascular and cerebrovascular events has been inconsistent, despite biological plausibility.

METHODS AND RESULTS

A population-based epidemiologic analysis was conducted for daily cardiovascular and cerebrovascular emergency department (ED) visits and wildfire smoke exposure in 2015 among adults in 8 California air basins. A quasi-Poisson regression model was used for zip code-level counts of ED visits, adjusting for heat index, day of week, seasonality, and population. Satellite-imaged smoke plumes were classified as light, medium, or dense based on model-estimated concentrations of fine particulate matter. Relative risk was determined for smoky days for lag days 0 to 4. Rates of ED visits by age- and sex-stratified groups were also examined. Rates of all-cause cardiovascular ED visits were elevated across all lags, with the greatest increase on dense smoke days and among those aged ≥65 years at lag 0 (relative risk 1.15, 95% confidence interval [1.09, 1.22]). All-cause cerebrovascular visits were associated with smoke, especially among those 65 years and older, (1.22 [1.00, 1.49], dense smoke, lag 1). Respiratory conditions were also increased, as anticipated (1.18 [1.08, 1.28], adults >65 years, dense smoke, lag 1). No association was found for the control condition, acute appendicitis. Elevated risks for individual diagnoses included myocardial infarction, ischemic heart disease, heart failure, dysrhythmia, pulmonary embolism, ischemic stroke, and transient ischemic attack.

CONCLUSIONS

Analysis of an extensive wildfire season found smoke exposure to be associated with cardiovascular and cerebrovascular ED visits for all adults, particularly for those over aged 65 years.

The effects of autophagy on vascular endothelial cells induced by airborne PM2.5

The purpose of this study was to examine the direct toxicity of PM2.5 collected from Beijing on human umbilical vein endothelial cells (HUVEC). A Cell Counting Kit 8 (CCK8) assay demonstrated that PM2.5 exposure decreased the proliferation of HUVECs in a dose-dependent manner. We also found that PM2.5 exposure induced autophagy in HUVECs, as evidenced by: (1) an increased number of double-membrane vesicles; (2) enhanced conversion and punctuation of the microtubule-associated protein light chain 3 (LC3); and (3) decreased levels of the selective autophagy substrate p62 in a time-dependent manner. Furthermore, promoting autophagy in PM2.5-exposed HUVECs with rapamycin increased the cell survival rate, whereas inhibiting autophagy via 3-methyladenine significantly decreased cell survival. These results demonstrate that PM2.5 exposure can induce cytotoxicity and autophagy in HUVECs and that autophagy play a protective role against PM2.5-induced cytotoxicity. The findings of the present study imply a direct toxic effect of PM2.5 on HUVECs and provide novel insight into the mechanism of cardiovascular diseases caused by PM2.5 exposure.

Development of a high-throughput in vivo screening platform for particulate matter exposures

Particulate matter (PM) exposure is a public health burden with poorly understood health effect mechanisms and lacking an efficient model to compare the vast diversity of PM exposures. Zebrafish (Danio rerio) are amenable to high-throughput screening (HTS), but few studies have investigated PM toxicity in zebrafish, despite the multitude of advantages. To develop standardized exposure procedures, the urban PM standard reference material (SRM) 1649b was used to systematically determine sample preparation methods, design experimental controls, determine concentration ranges and evaluation procedures. Embryos (n = 32/treatment) were dechorionated and placed into 96-well plates containing SRM1649b (0-200 μg/mL) at 6 h post fertilization (hpf). Developmental toxicity was assessed at 24 and 120 hpf by evaluating morphological changes, embryonic/larval photomotor behavior, and mortality. Differences from blank medium and particle controls were observed for all biological responses measured. Differences due to SRM1649b concentration and preparation method were also observed. Exposure to SRM1649b from DMSO extraction was associated with changes in morphology and mortality and hypoactivity in photomotor responses compared to the DMSO control for the whole particle suspension (76, 68%) and soluble fraction (59, 54%) during the embryonic and larval stages, respectively. Changes in behavioral responses were not observed following exposure to the insoluble fraction of SRM1649b from DMSO extraction. The toxicity bias from PM preparation provided further impetus to select a single HTS exposure method. Based on the biological activity results, the soluble fraction of SRM1649b from DMSO extraction was selected and shown to have concentration dependent cyp1a/GFP expression. This rapid, sensitive and consistently scalable model is a potentially cost-effective vertebrate approach to study the toxicology of PM from diverse locations, and provides a path to identifying the toxic material(s) in these samples, and discover the mechanisms of toxicity.

Hypertension prevalence and living conditions related to air pollution: results of a national epidemiological study in Lebanon

Hypertension is a risk factor of several diseases, linked to high mortality and morbidity, particularly in developing countries. Some studies have linked indoor and outdoor pollution exposure items to hypertension, but results were inconsistent. Our objective was to assess the association of living conditions related to air pollution to hypertension in Lebanon, a Middle Eastern country. A national cross-sectional study was conducted all over Lebanon. Blood pressure and its related medications were assessed to be able to classify participants as hypertensive or not. Moreover, in addition to living conditions related to air pollution exposure, we assessed potential predictors of hypertension, including sociodemographic characteristics, self-reported health information and biological measurements. Furthermore, we assessed dose-effect relationship of air pollution items in relation with hypertension. Living conditions related to indoor and outdoor air pollution exposures were associated with hypertension, with or without taking biological values into account. Moreover, we found a dose-effect relationship of exposure with risk of disease (15% increase in risk of disease for every additional pollution exposure item), after adjustment for sociodemographics and biological characteristics (Ora = 1.15 [1.03-1.28]). Although additional studies would be necessary to confirm these findings, interventions should start to sensitize the population about the effect of air pollution on chronic diseases. The work on reducing pollution and improving air quality should be implemented to decrease the disease burden on the population and health system.

Combining Community Engagement and Scientific Approaches in Next-Generation Monitor Siting: The Case of the Imperial County Community Air Network

Air pollution continues to be a global public health threat, and the expanding availability of small, low-cost air sensors has led to increased interest in both personal and crowd-sourced air monitoring. However, to date, few low-cost air monitoring networks have been developed with the scientific rigor or continuity needed to conduct public health surveillance and inform policy. In Imperial County, California, near the U.S./Mexico border, we used a collaborative, community-engaged process to develop a community air monitoring network that attains the scientific rigor required for research, while also achieving community priorities. By engaging community residents in the project design, monitor siting processes, data dissemination, and other key activities, the resulting air monitoring network data are relevant, trusted, understandable, and used by community residents. Integration of spatial analysis and air monitoring best practices into the network development process ensures that the data are reliable and appropriate for use in research activities. This combined approach results in a community air monitoring network that is better able to inform community residents, support research activities, guide public policy, and improve public health. Here we detail the monitor siting process and outline the advantages and challenges of this approach.

Monitoring of airborne particulates near industrial silica sand mining and processing facilities

To quantify risk of ambient exposure to airborne particulates around industrial silica sand operations, this study used EPA-certified federal reference method monitors to measure the levels of PM₁₀ and PM_2.5 particulate matter. The monitoring sites were chosen based upon EPA siting criteria, dichotomous samplers were calibrated before and after sampling, and pre- and post-weight filter weights were recorded. PM_2.5 levels were significantly higher (paired t-tests) at both sites - averages of 7.70 ± 6.15 and 22.7 ± 31.714;µg/m³ - than concurrent background levels of 5.11 and 6.57µg/m³ respectively; and 98^th percentile values were 24.9 and 111 µg/m³, respectively. Average PM₁₀ levels were 24.2 and 49.0 µg/m³, and second-highest annual levels were 45.5 and 69.1 µg/m³ (two years) and 62.9 ug/m³ (2015) and 61.5 ug/m³ (2016), respectively for the two sites. Neither precipitation nor wind speed or direction appeared to affect PM_2.5 or PM₁₀ concentrations.

Influence of airborne particulates on respiratory tract deposition of inhaled toluene and naphthalene in the rat

OBJECTIVE

Most studies report that inhaled volatile and semivolatile organic compounds (VOCs/SVOCs) tend to deposit in the upper respiratory tract, while ultrafine (or near ultrafine) particulate matter (PM) (∼100 nm) reaches the lower airways. The objective of this study was to determine whether carbon particle co-exposure carries VOCs/SVOCs deeper into the lungs where they are deposited.

MATERIALS AND METHODS

Male Sprague-Dawley rats were exposed by inhalation (nose-only) to radiolabeled toluene (20 ppm) or naphthalene (20 ppm) on a single occasion for 1 h, with or without concurrent carbon particle exposure (∼5 mg/m³). The distribution of radiolabel deposited within the respiratory tract of each animal was determined after sacrifice. The extent of adsorption of toluene and naphthalene to airborne carbon particles under the exposure conditions of the study was also assessed.

RESULTS

We found that in the absence of particles, the highest deposition of both naphthalene and toluene was observed in the upper respiratory tract. Co-exposure with carbon particles tended to increase naphthalene deposition slightly throughout the respiratory tract, whereas slight decreases in toluene deposition were observed. Few differences were statistically significant. Naphthalene showed greater adsorption to the particles compared to toluene, but overall the particle-adsorbed concentration of each of these compounds was a small fraction of the total inspired concentration.

CONCLUSIONS

These studies imply that at the concentrations used for the exposures in this study, inhaled carbon particles do not substantially alter the deposition of naphthalene and toluene within the respiratory tract.

Self-reported history of stroke and long-term living conditions near air pollution sources: results of a national epidemiological study in Lebanon

Stroke is a disease related to high mortality and morbidity, particularly in developing countries. Some studies have linked self-reported indoor and outdoor pollution to stroke and mini-stroke, while some others showed no association. Our objective was to assess this association in Lebanon, a Middle Eastern developing country. A national cross-sectional study was conducted all over Lebanon. In addition to self-reported items of pollution exposure, we assessed potential predictors of stroke and mini-stroke, including sociodemographic characteristics, self-reported health information, and biological measurements. Moreover, we assessed dose-effect relationship of pollution items in relation with stroke. Self-reported indoor pollution exposure was associated with stroke and mini-stroke, with or without taking biological values into account. Moreover, we found a dose-effect relationship of exposure with risk of disease, but this effect did not reach statistical significance after adjustment for sociodemographics and biological characteristics. No association was found for any outdoor pollution item. Although additional studies would be necessary to confirm these findings, sensitizing the population about the effect of pollution on chronic diseases, working on reducing pollution, and improving air quality should be implemented to decrease the burden of the disease on the population and health system.

Desert Dust and Health: A Central Asian Review and Steppe Case Study

In Asian deserts environmental and anthropomorphic dust is a significant health risk to rural populations. Natural sources in dry landscapes are exacerbated by human activities that increase the vulnerability to dust and dust-borne disease vectors. Today in Central and Inner Asian drylands, agriculture, mining, and rapid development contribute to dust generation and community exposure. Thorough review of limited dust investigation in the region implies but does not quantify health risks. Anthropogenic sources, such as the drying of the Aral Sea, highlight the shifting dust dynamics across the Central EurAsian steppe. In the Gobi Desert, our case study in Khanbogd, Mongolia addressed large-scale mining’s potential dust risk to the health of the local population. Dust traps showed variable exposure to particulates among herder households and town residents; dust density distribution indicated that sources beyond the mine need to be considered when identifying particulate sources. Research suggests that atmospheric dust from multiple causes may enhance human particulate exposure. Greater awareness of dust in greater Central Asia reflects community concern about related health implications. Future human well-being in the region will require more thorough information on dust emissions in the changing environment.

Bioaerosol exposure and circulating biomarkers in a panel of elderly subjects and healthy young adults

Numerous studies have found that risk of cardiovascular diseases is associated with increased blood levels of circulating markers of systemic inflammation. We investigated associations of acute exposure to bioaerosols (bacteria and fungi) with blood markers of inflammation and coagulation using panels of elderly subjects and healthy young adults. We conducted a panel study of 44 nonsmoker elderly subjects in a retirement communities and a panel study of 40 healthy young adults living in a school dormitory within Tehran city, Iran. Blood sample biomarkers were measured weekly over 6weeks and including high sensitive C-reactive protein (hsCRP), tumor necrosis factor-soluble receptor-II (sTNF-RII), von Willebrand factor (vWF), white blood cells (WBC) count and interleukin-6 (IL-6). We found significant positive associations for IL-6 and WBC with exposure to Aspergillus spp. (As), Cladosporium spp. (Cl), Penicillium spp. (Pe), total fungi (TF) and Micrococcus spp. (MI); vWF with Cl and MI; sTNF-RII with Staphylococcus spp. (ST) in healthy young adults from the current-day and multiday averages. For elderly subjects, we observed significant positive associations for hsCRP, sTNF-RII and WBC with exposure to MI, but not with ST and total bacteria (TB). Our results showed the strongest significant positive associations for IL-6 with MI, ST and TB in elderly people. In addition, IL-6 was also positively associated with As, Cl and Pe in elderly. Also, the results showed that increase of vWF was significantly associated with bacterial and fungal aerosols, except Bacillus spp. (BA) at some lags in elderly subjects. Pooled results support the pivotal role of bioaerosols in increasing the level of some of inflammatory biomarkers, especially IL-6 and WBC in healthy young adults but possibly also in elderly people.

Gene expression profiles and bioinformatics analysis of human umbilical vein endothelial cells exposed to PM2.5

Cardiovascular system is demonstrated the main target of PM_2.5 and the objective of this study was to explore the toxic effect and molecular mechanisms caused by PM_2.5 in primary human umbilical vein endothelial cells (HUVECs) using microarray and bioinformatics analysis. The results showed that 591 genes were differentially expressed triggered by PM_2.5, of which 174 genes were down-regulated, while 417 genes were up-regulated. Gene ontology analysis revealed that PM_2.5 caused significant changes in gene expression patterns, including response to stimuli, immune response, and cellular processes. Pathway analysis and Signal-net analysis suggested that endocytosis, chemokine signaling pathway, RNA transport, protein processing in endoplasmic reticulum (ER) and autophagy regulation were the most critical pathways in PM_2.5-induced toxicity in HUVECs. Moreover, gene expression confirmation of LIF, BCL2L1, CSF3, HMOX1, RPS6, PFKFB, CAPN1, HSPBP1, MOGS, PREB, TUBB2A, GABARAP by qRT-PCR indicated that endocytosis might be involved in the cellular uptake of PM_2.5 by forming phagosomes, and subsequently inflammation, hypoxia and ER stress was occurred, which finally activated autophagy after PM_2.5 exposure in HUVECs. In summary, our data can serve as fundamental research clues for further studies of PM_2.5-induced toxicity in HUVECs.

Cardiotoxicity and Mechanism of Particulate Matter 2.5 (PM2.5) Exposure in Offspring Rats During Pregnancy

BACKGROUND The aim of this study was to investigate the cardiotoxicity and mechanism of particulate matter 2.5 (PM2.5) exposure on offspring rats during pregnancy. MATERIAL AND METHODS Wistar rats were used to establish a PM2.5 exposure animal model during pregnancy, and they were divided into a control group, a low-dose group, a middle-dose group, and a high-dose group according to PM2.5 exposure dose. The pathological changes of heart tissue, the rate of myocardial cell apoptosis, the levels of LDH, AST, and CM-KB in serum, and the difference in mitochondrial fusion genes (OPA1 and Mfn1) and mitochondrial genes (Drp1 and Fis1) were compared among groups. RESULTS The arrangement of myocardial fibers in offspring mice of PM2.5 exposure groups became disordered, the shape of some cardiomyocytes became irregular, and some staining darker nuclei appeared. The apoptotic rates of myocardium in offspring rats exposed to PM2.5 were (12.61±0.93)% in the low-dose group, (25.14±1.53)% in the middle-dose group, and (30.13±1.50)% in the high-dose group, which were all significantly higher than in the control group (9.12±0.80)% (P<0.05). The levels of LDH, AST, and CM-KB and the expression of OPA1, Mfn1, Drp1, and Fis1 in offspring mice of PM2.5 exposure groups increased with the increase of PM2.5 exposure dose, and were significantly higher than that of the control group (P<0.05). CONCLUSIONS The mitochondria of the offspring mice were damaged due to the abnormal expression of mitochondrial fusion/splicing gene by PM2.5 exposure during pregnancy, and the hearts of offspring mice were damaged due to damaged mitochondria.

Association between air pollution and cardiovascular mortality in China: a systematic review and meta-analysis

Air pollutant levels in many Chinese cities remained significantly higher than the upper limits stated in World Health Organization guidelines. In light of limited evidence in China, we conducted a meta-analysis summarizing the association between acute exposure of air pollution and cardiovascular mortality. We searched PubMed, and CNKI databases etc. for literature published in English or Chinese up to January 2017. Outcomes were pooled and compared using random-effects model. Excess risks (ERs) per 10 μg/m³ increase in PM_2.5, PM₁₀, NO₂, SO₂ and O₃ were evaluated. Subgroup analysis was conducted according to lag patterns (lags 0, 1, 2, 0–1, 0–2 days), gender (male vs. female), temperature (cool vs. warm) and age (< 65 vs. ≥ 65). Study bias was detected using Begg’s and Egger’s test. Of 299 articles identified, 30 met inclusion criteria. Each 10 μg/m³ increase in the concentration was associated with a higher incidence of cardiovascular mortality for PM_2.5 (0.68%, 95% CI: 0.39–0.97%), PM₁₀ (0.39%, 95% CI: 0.26–0.53%), NO₂ (1.12%, 95% CI: 0.76–1.48%), SO₂ (0.75%, 95% CI: 0.42–1.09%), and O₃ (0.62%, 95% CI: 0.33–0.92%), respectively. Air pollution conferred greater adverse impacts on cardiovascular mortality for longer duration of exposures. Strongest associations were seen for lag 0–1 day of exposure among all pollutants. Female, lower temperature, and age > 65 years were associated with greater risks of cardiovascular mortality for all pollutants. Higher concentrations of air pollutants correlated with a greater short-term increase in cardiovascular mortality. Further high-quality studies in China are urgently warranted to determine the susceptible population, which would offer reference for policy-making to minimize adverse health effects.

Associations between long-term exposure to PM2.5 component species and blood DNA methylation age in the elderly: The VA normative aging study

BACKGROUND

Long-term PM_2.5 exposure and aging have been implicated in multiple shared diseases; studying their relationship is a promising strategy to further understand the adverse impact of PM_2.5 on human health.

OBJECTIVE

We assessed the relationship of major PM_2.5 component species (ammonium, elemental carbon, organic carbon, nitrate, and sulfate) with Horvath and Hannum DNA methylation (DNAm) age, two DNA methylation-based predictors of chronological age.

METHODS

This analysis included 552 participants from the Normative Aging Study with multiple visits between 2000 and 2011 (n=940 visits). We estimated 1-year PM_2.5 species levels at participants' addresses using the GEOS-chem transport model. Blood DNAm-age was calculated using CpG sites on the Illumina HumanMethylation450 BeadChip. We fit linear mixed-effects models, controlling for PM_2.5 mass and lifestyle/environmental factors as fixed effects, with the adaptive LASSO penalty to identify PM_2.5 species associated with DNAm-age.

RESULTS

Sulfate and ammonium were selected by the LASSO in the Horvath DNAm-age models. In a fully-adjusted multiple-species model, interquartile range increases in both 1-year sulfate (95%CI: 0.28, 0.74, P<0.0001) and ammonium (95%CI: 0.02, 0.70, P=0.04) levels were associated with at least a 0.36-year increase in Horvath DNAm-age. No PM_2.5 species were selected by the LASSO in the Hannum DNAm-age models. Our findings persisted in sensitivity analyses including only visits with 1-year PM_2.5 levels within US EPA national ambient air quality standards.

CONCLUSION

Our results demonstrate that sulfate and ammonium were most associated with Horvath DNAm-age and suggest that DNAm-age measures differ in their sensitivity to ambient particle exposures and potentially disease.

Genome-wide transcriptional analysis of cardiovascular-related genes and pathways induced by PM2.5 in human myocardial cells

Air pollution has been a major environment-related health threat. Most of the studies on PM_2.5 toxicity have verified on the cardiovascular system and endothelial cells. However, researches on PM_2.5-induced myocardial-related toxicity are limited. This study aims to fully understand the toxic effects of PM_2.5 on human myocardial cell (AC16) and explore its molecular mechanism based on microarray analysis and bioinformatics analysis. Microarray data analysis manifested that PM_2.5-induced toxicity affected expression of 472 genes compared with the control group, including 166 upregulated genes and 306 downregulated genes in human myocardial (AC16) cells. GO analysis showed that cellular processes such as immune response, cell maturation, embryonic heart tube morphogenesis, cellular response to electrical stimulus, skeletal muscle tissue regeneration, and negative regulation of signal transduction were upregulated, while regulation of transcription (DNA-dependent), rhythmic process, protein destabilization apoptotic process, and innate immune response were downregulated. The pathway analysis indicates that cell signaling pathways such as cytokine-cytokine receptor interaction, NF-κB signaling pathway, chemokine signaling pathway, endocrine and other factor-regulated calcium reabsorption, HTLV-I infection, and cell adhesion molecules (CAMs) were upregulated, while the TGF-β signaling pathway was downregulated. In addition, Signal-net showed that the TUBA4A, ADRBK2, BRIX1, SMC4, EIF5B, PRMT1, ATG4B, and NDC80 genes were significantly decreased, while the expression of the KRT6B gene was markedly increased compared with the control group. All the genes were verified by qRT-PCR. This study had provided new bioinformatics evidences in PM_2.5-induced myocardial tissue toxicity which is necessary for further cardiovascular system toxicity studies.

Systemic effects of controlled exposure to diesel exhaust: a meta-analysis from randomized controlled trials

INTRODUCTION

Ambient air pollution is associated with adverse cardiovascular events. This meta-analysis aimed to investigate the short-term association between air pollution and cardiovascular effects on healthy volunteers.

METHODS

We searched databases to identify randomized trials with controlled human exposures to either of two models for studying ambient particulate matter: diesel-exhaust or concentrated ambient particles. Estimates of size effect were performed using standardized mean difference (SMD). Heterogeneity was assessed with I₂ statistics. Outcomes were vascular function estimated by forearm blood flow (FBF), blood pressure, heart rate, and blood analysis.

RESULTS

Database searches yielded 17 articles (n = 342) with sufficient information for meta-analyses. High levels of heterogeneity for the some outcomes were analyzed using random-effects model. The pooled effect estimate showed that short-term exposure to air pollution impaired FBF response from 2.7 to 2.5 mL/100 mL tissue/min (SMD 0.404; p = .006). There was an increase in 5000 platelet/mm³ following pollution exposure (SMD 0.390; p = .050) but no significant differences for other outcomes.

CONCLUSION

Controlled human exposures to air pollution are associated with the surrogates of vascular dysfunction and increase in platelet count, which might be related to adverse cardiovascular events. Given the worldwide prevalence of exposure to air pollution, these findings are relevant for public health. KEY MESSAGES Controlled exposure to air pollution impairs vasomotor response, which is a surrogate for adverse cardiovascular events. This is the first meta-analysis from randomized clinical trials showing short-term association between air pollution and cardiovascular effects on healthy volunteers. Given the worldwide prevalence of exposure to air pollution, this finding is important for public health.

Gaseous Air Pollution and the Risk for Stroke Admissions: A Case-Crossover Study in Beijing, China

Background: Though increasing evidence supports association between gaseous air pollution and stroke, it remains unclear whether the effects differ in season, sex and age. The aim of this study was to examine the associations of gaseous air pollution with stroke admissions in Beijing, 2013–2014 in different subgroups. Methods: Case-crossover design and conditional logistic regression were used to perform the analyses. We examined the exposure-response relationship between air pollution and stroke. Stratified analyses were performed in different seasons, sex, and age groups. Results: There were 147,624 stroke admissions during the study period. In the whole study period, percent changes of stroke admissions were 0.82% (95% CI: 0.52% to 1.13%) and 0.73% (95% CI: 0.44% to 1.03%) per 10 μg/m³ increase in the same day conentration of nitrogen dioxide (NO₂) and sulfur dioxide (SO₂). The positive associations were higher in warm seasons and with patients >65 years (p < 0.05). Contrary effects of carbon monoxide (CO) and ozone on stroke admissions were observed in different seasons. Conclusions: NO₂ and SO₂ were positively associated with stroke admissions, with stronger effects in warm seasons and with patients >65 years. The associations of CO and ozone with stroke admissions differed across seasons.

Blueberry Anthocyanin-Enriched Extracts Attenuate Fine Particulate Matter (PM2.5)-Induced Cardiovascular Dysfunction

Blueberry anthocyanin-enriched extracts (BAE) at three doses (0.5, 1.0, and 2.0 g/kg) were administered by oral gavage to rats exposed to 10 mg/kg fine particulate matter (PM_2.5) three times a week. A positive control group was exposed to PM_2.5 without BAE treatment. We analyzed heart rate (HR), electrocardiogram (ECG), and histopathology, and biomarkers of cardiovascular system injuries, systemic inflammation, oxidative stress, endothelial function, and apoptosis. Results indicated that BAE, particularly at 1.0 g/kg, improved ECG and decreased cytokine levels in PM_2.5-exposed rats. These changes were accompanied by an increase in interleukin 10 levels and superoxide dismutase activity in heart tissue and Bcl-2 protein expression, as well as a decrease in interleukin 6, malondialdehyde, endothelin 1, and angiotensin II levels and a reduction in Bax protein expression. This study demonstrates that BAE at certain doses can protect the cardiovascular system from PM_2.5-induced damage.

Impact of air pollution and temperature on adverse birth outcomes: Madrid, 2001-2009

BACKGROUND/OBJECTIVES

Low birth weight (<2500 g) (LBW), premature birth (<37 weeks of gestation) (PB), and late foetal death (<24 h of life) (LFD) are causes of perinatal morbi-mortality, with short- and long-term social and economic health impacts. This study sought to identify gestational windows of susceptibility during pregnancy and to analyse and quantify the impact of different air pollutants, noise and temperature on the adverse birth outcomes.

METHODS

Time-series study to assess the impact of mean daily PM_2.5, NO₂ and O₃ (μg/m³), mean daily diurnal (Leqd) and nocturnal (Leqn) noise levels (dB(A)), maximum and minimum daily temperatures (°C) on the number of births with LBW, PB or LFD in Madrid across the period 2001-2009. We controlled for linear trend, seasonality and autoregression. Poisson regression models were fitted for quantification of the results. The final models were expressed as relative risk (RR) and population attributable risk (PAR).

RESULTS

Leqd was observed to have the following impacts in LBW: at onset of gestation, in the second trimester and in the week of birth itself. NO₂ had an impact in the second trimester. In the case of PB, the following: Leqd in the second trimester, Leqn in the week before birth and PM_2.5 in the second trimester. In the case of LFD, impacts were observed for both PM_2.5 in the third trimester, and minimum temperature. O₃ proved significant in the first trimester for LBW and PB, and in the second trimester for LFD.

CONCLUSIONS

Pollutants concentrations, noise and temperature influenced the weekly average of new-borns with LBW, PB and LFD in Madrid. Special note should be taken of the effect of diurnal noise on LBW across the entire pregnancy. The exposure of pregnant population to the environmental factors analysed should therefore be controlled with a view to reducing perinatal morbi-mortality.

Toxicological effects of particulate matter (PM2.5) on rats: Bioaccumulation, antioxidant alterations, lipid damage, and ABC transporter activity

Previous studies have demonstrated the harmful effects of atmospheric pollutants on cardiac systems because of the presence of particulate matter (PM), a complex mixture of numerous substances including trace metals. In this study, the toxicity of PM2.5 from two regions, rural (PM2.5 level of 8.5 ± 4.0 μg m(-3)) and industrial (PM2.5 level of 14.4 ± 4.1 μg m(-3)) in Brazil, was investigated through in vivo experiments in rats. Metal accumulation and biochemical responses were evaluated after rats were exposed to three different concentrations of PM2.5 in saline extract (10× dilution, 5× dilution, and concentrated). The experimental data showed the bioaccumulation of diverse trace metals in the hearts of groups exposed to PM2.5 from both regions. Furthermore, mobilization of the antioxidant defenses and an increase in lipid peroxidation of the cardiac tissue was observed in response to the industrial and rural area PM2.5. Glutathione-S-transferase activity was increased in groups exposed to the 5× and concentrated rural PM2.5. Additionally, ATP-binding cassette (ABC) transporter activity in the cardiac tissue exposed to PM2.5 was reduced in response to the 5× dilution of the rural and industrial region PM2.5. Histological analysis showed a decrease in the percentage of cardiac cells in the heart at all tested concentrations. The results indicate that exposure to different concentrations of PM2.5 from both sources causes biochemical and histological changes in the heart with consequent damage to biological structures; these factors can favor the development of cardiac diseases.

Effect of Environmental Factors on Low Weight in Non-Premature Births: A Time Series Analysis

OBJECTIVE

Exposure to pollutants during pregnancy has been related to adverse birth outcomes. LBW can give rise to lifelong impairments. Prematurity is the leading cause of LBW, yet few studies have attempted to analyse how environmental factors can influence LBW in infants who are not premature. This study therefore sought to analyse the influence of air pollution, noise levels and temperature on LBW in non-premature births in Madrid during the period 2001-2009.

METHODS

Ecological time-series study to assess the impact of PM2.5, NO2 and O3 concentrations, noise levels, and temperatures on LBW among non-premature infants across the period 2001-2009. Our analysis extended to infants having birth weights of 1,500 g to 2,500 g (VLBW) and less than 1,500 g (ELBW). Environmental variables were lagged until 37 weeks with respect to the date of birth, and cross-correlation functions were used to identify explaining lags. Results were quantified using Poisson regression models.

RESULTS

Across the study period 298,705 births were registered in Madrid, 3,290 of which had LBW; of this latter total, 1,492 were non-premature. PM2.5 was the only pollutant to show an association with the three variables of LBW in non-premature births. This association occurred at around the third month of gestation for LBW and VLBW (LBW: lag 23 and VLBW: lag 25), and at around the eighth month of gestation for ELBW (lag 6). Leqd was linked to LBW at lag zero. The RR of PM2.5 on LBW was 1.01 (1.00 1.03). The RR of Leqd on LBW was 1.09 (0.99 1.19)(p<0.1).

CONCLUSIONS

The results obtained indicate that PM2.5 had influence on LBW. The adoption of measures aimed at reducing the number of vehicles would serve to lower pregnant women's exposure. In the case of noise should be limited the exposure to high levels during the final weeks of pregnancy.

Respiratory Filter Reduces the Cardiovascular Effects Associated With Diesel Exhaust Exposure: A Randomized, Prospective, Double-Blind, Controlled Study of Heart Failure: The FILTER-HF Trial

OBJECTIVES

The goal of this study was to test the effects of a respiratory filter intervention (filter) during controlled pollution exposure.

BACKGROUND

Air pollution is considered a risk factor for heart failure (HF) decompensation and mortality.

METHODS

This study was a double-blind, randomized to order, controlled, 3-way crossover, single-center clinical trial. It enrolled 26 patients with HF and 15 control volunteers. Participants were exposed in 3 separate sessions to clean air, unfiltered diesel exhaust exposure (DE), or filtered DE. Endpoints were endothelial function assessed by using the reactive hyperemia index (RHi), arterial stiffness, serum biomarkers, 6-min walking distance, and heart rate variability.

RESULTS

In patients with HF, DE was associated with a worsening in RHi from 2.17 (interquartile range [IQR]: 1.8 to 2.5) to 1.72 (IQR: 1.5 to 2.2; p = 0.002) and an increase in B-type natriuretic peptide (BNP) from 47.0 pg/ml (IQR: 17.3 to 118.0 pg/ml) to 66.5 pg/ml (IQR: 26.5 to 155.5 pg/ml; p = 0.004). Filtration reduced the particulate concentration (325 ± 31 μg/m(3) vs. 25 ± 6 μg/m(3); p < 0.001); in the group with HF, filter was associated with an improvement in RHi from 1.72 (IQR: 1.5 to 2.2) to 2.06 (IQR: 1.5 to 2.6; p = 0.019) and a decrease in BNP from 66.5 pg/ml (IQR: 26.5 to 155.5 pg/ml) to 44.0 pg/ml (IQR: 20.0 to 110.0 pg/ml; p = 0.015) compared with DE. In both groups, DE decreased the 6-min walking distance and arterial stiffness, although filter did not change these responses. DE had no effect on heart rate variability or exercise testing.

CONCLUSIONS

To our knowledge, this trial is the first to show that a filter can reduce both endothelial dysfunction and BNP increases in patients with HF during DE. Given these potential benefits, the widespread use of filters in patients with HF exposed to traffic-derived air pollution may have beneficial public health effects and reduce the burden of HF. (Effects of Air Pollution Exposure Reduction by Filter Mask on Heart Failure; NCT01960920).

Impact of pulmonary exposure to gold core silver nanoparticles of different size and capping agents on cardiovascular injury

BACKGROUND

The uses of engineered nanomaterials have expanded in biomedical technology and consumer manufacturing. Furthermore, pulmonary exposure to various engineered nanomaterials has, likewise, demonstrated the ability to exacerbate cardiac ischemia reperfusion (I/R) injury. However, the influence of particle size or capping agent remains unclear. In an effort to address these influences we explored response to 2 different size gold core nanosilver particles (AgNP) with two different capping agents at 2 different time points. We hypothesized that a pulmonary exposure to AgNP induces cardiovascular toxicity influenced by inflammation and vascular dysfunction resulting in expansion of cardiac I/R Injury that is sensitive to particle size and the capping agent.

METHODS

Male Sprague-Dawley rats were exposed to 200 μg of 20 or 110 nm polyvinylprryolidone (PVP) or citrate capped AgNP. One and 7 days following intratracheal instillation serum was analyzed for concentrations of selected cytokines; cardiac I/R injury and isolated coronary artery and aorta segment were assessed for constrictor responses and endothelial dependent relaxation and endothelial independent nitric oxide dependent relaxation.

RESULTS

AgNP instillation resulted in modest increase in selected serum cytokines with elevations in IL-2, IL-18, and IL-6. Instillation resulted in a derangement of vascular responses to constrictors serotonin or phenylephrine, as well as endothelial dependent relaxations with acetylcholine or endothelial independent relaxations by sodium nitroprusside in a capping and size dependent manner. Exposure to both 20 and 110 nm AgNP resulted in exacerbation cardiac I/R injury 1 day following IT instillation independent of capping agent with 20 nm AgNP inducing marginally greater injury. Seven days following IT instillation the expansion of I/R injury persisted but the greatest injury was associated with exposure to 110 nm PVP capped AgNP resulted in nearly a two-fold larger infarct size compared to naïve.

CONCLUSIONS

Exposure to AgNP may result in vascular dysfunction, a potentially maladaptive sensitization of the immune system to respond to a secondary insult (e.g., cardiac I/R) which may drive expansion of I/R injury at 1 and 7 days following IT instillation where the extent of injury could be correlated with capping agents and AgNP size.

Preterm birth and air pollution: Critical windows of exposure for women with asthma

BACKGROUND

Ambient air pollutants may increase preterm birth (PTB) risk, but critical exposure windows are uncertain. The interaction of asthma and pollutant exposure is rarely studied.

OBJECTIVE

We sought to assess the interaction of maternal asthma and air pollutant exposures in relation to PTB risk.

METHODS

Electronic medical records for 223,502 US deliveries were linked with modified Community Multiscale Air Quality model outputs. Logistic regression with generalized estimating equations estimated the odds ratio and 95% CIs for PTB on the basis of the interaction of maternal asthma and particulate matter with aerodynamic diameter of less than 2.5 microns and particulate matter with aerodynamic diameter of less than 10 microns, ozone (O3), nitrogen oxides (NOx), sulfur dioxide (SO2), and carbon monoxide (CO) per interquartile range. For each gestational week 23 to 36, exposures among women who delivered were compared with those remaining pregnant. Three-month preconception, whole pregnancy, weeks 1 to 28, and the last 6 weeks of gestation averages were also evaluated.

RESULTS

On assessing PTB by gestational week, we found that significant asthma interactions were sporadic before 30 weeks but more common during weeks 34 to 36, with higher risk among mothers with asthma for NOx, CO, and SO2 exposure and an inverse association with O3 in week 34. Odds of PTB were significantly higher among women with asthma for CO and NOx exposure preconception and early in pregnancy. In the last 6 weeks of pregnancy, PTB risk associated with particulate matter with aerodynamic diameter of less than 10 microns was higher among women with asthma.

CONCLUSIONS

Mothers with asthma may experience a higher risk for PTB after exposure to traffic-related pollutants such as CO and NOx, particularly for exposures 3-months preconception and in the early weeks of pregnancy.

Evaluation of a spatially resolved forest fire smoke model for population-based epidemiologic exposure assessment

Exposure to forest fire smoke (FFS) is associated with multiple adverse health effects, mostly respiratory. Findings for cardiovascular effects have been inconsistent, possibly related to the limitations of conventional methods to assess FFS exposure. In previous work, we developed an empirical model to estimate smoke-related fine particulate matter (PM2.5) for all populated areas in British Columbia (BC), Canada. Here, we evaluate the utility of our model by comparing epidemiologic associations between modeled and measured PM2.5. For each local health area (LHA), we used Poisson regression to estimate the effects of PM2.5 estimates and measurements on counts of medication dispensations and outpatient physician visits. We then used meta-regression to estimate the overall effects. A 10 μg/m(3) increase in modeled PM2.5 was associated with increased sabutamol dispensations (RR=1.04, 95% CI 1.03-1.06), and physician visits for asthma (1.06, 1.04-1.08), COPD (1.02, 1.00-1.03), lower respiratory infections (1.03, 1.00-1.05), and otitis media (1.05, 1.03-1.07), all comparable to measured PM2.5. Effects on cardiovascular outcomes were only significant using model estimates in all LHAs during extreme fire days. This suggests that the exposure model is a promising tool for increasing the power of epidemiologic studies to detect the health effects of FFS via improved spatial coverage and resolution.

Assessment of associations between ischaemic attacks in patients with type 2 diabetes mellitus and air concentrations of particulate matter <2.5 μm

Objective

To investigate the relationship between air concentrations of fine particulate matter <2.5 µm in diameter (PM2.5) and ischaemic attacks in high-risk elderly patients (aged ≥60 years).

Methods

This retrospective data analysis study extracted clinical data from an electronic medical chart system and environmental air quality data from the Ministry of the Environment Atmospheric Environmental Regional Observation System. Patients were stratified into four groups according to whether or not they had type 2 diabetes mellitus (T2DM) and/or an ischaemic attack (i.e. cerebral infarctions and myocardial infarctions) during the 2-year study period. Analysis of the combined clinical and environmental data produced the odds ratio for the likelihood of experiencing an ischaemic attack.

Results

Clinical data were collected from 94 647 patients. On days when the air temperature was ≥25℃ and PM2.5 concentration was ≥20µg/m³, an ischaemic attack was more likely to occur in the T2DM group than in the group without T2DM. An ischaemic attack was more likely to occur 2 days after an increase in the PM2.5 concentration compared with the same day as and 3–6 days after the increase.

Conclusion

The results of this study confirmed an association between PM2.5 and ischaemic attacks in high-risk patients.

Acute Effects of Particulate Air Pollution on the Incidence of Coronary Heart Disease in Shanghai, China

INTRODUCTION

Evidence based on ecological studies in China suggests that short-term exposure to particulate matter (PM) is associated with cardiovascular mortality. However, there is less evidence of PM-related morbidity for coronary heart disease (CHD) in China. This study aims to investigate the relationship between acute PM exposure and CHD incidence in people aged above 40 in Shanghai.

METHODS

Daily CHD events during 2005-2012 were identified from outpatient and emergency department visits. Daily average concentrations for particulate matter with aerodynamic diameter less than 10 microns (PM10) were collected over the 8-year period. Particulate matter with aerodynamic diameter less than 2.5 microns (PM2.5) were measured from 2009 to 2012. Analyses were performed using quasi-poisson regression models adjusting for confounders, including long-term trend, seasonality, day of the week, public holiday and meteorological factors. The effects were also examined by gender and age group (41-65 years, and >65 years).

RESULTS

There were 619928 CHD outpatient and emergency department visits. The average concentrations of PM10 and PM2.5 were 81.7 μg/m3 and 38.6 μg/m3, respectively. Elevated exposure to PM10 and PM2.5 was related with increased risk of CHD outpatients and emergency department visits in a short time course. A 10 μg/m3 increase in the 2-day PM10 and PM2.5 was associated with increase of 0.23% (95% CI: 0.12%, 0.34%) and 0.74% (95% CI: 0.44%, 1.04%) in CHD morbidity, respectively. The associations appeared to be more evident in the male and the elderly.

CONCLUSION

Short-term exposure to high levels of PM10 and PM2.5 was associated with increased risk of CHD outpatient and emergency department visits. Season, gender and age were effect modifiers of their association.

Effect of transient receptor potential vanilloid-1 on cough hypersensitivity induced by particulate matter 2.5

AIMS

The mechanism of cough hypersensitivity induced by particulate matter 2.5 (PM2.5) remains elusive. The current study was designed to explore the effect of transient receptor potential vanilloid-1 (TRPV1) on cough hypersensitivity in airway and central nervous system.

MAIN METHODS

The PM2.5-induced chronic cough model of guinea pig was established by exposure to different doses of PM2.5 for three weeks. After exposure, the animals were microinjected with TRPV1 agonist capsaicine, antagonist capsazepine in the dorsal vagal complex respectively. Cough sensitivity was measured by determining the provocative concentration of citric acid inducing 5 or more coughs (C5). Airway inflammation was detected by hematoxylin eosin (HE) staining and Evans blue fluorescence, and substance P (SP) and TRPV1 expressions in airway were observed by immunohistochemical staining. TRPV1 expressions in the dorsal vagal complex were observed by immunofluorescence. Retrograde tracing by pseudorabies virus-Bartha (PRV-Bartha) was conducted to confirm the regulatory pathway between airway and central nervous system.

KEY FINDINGS

PM2.5 induced TRPV1 expressions in both of airway and dorsal vagal complex and airway neurogenic inflammation. Airway vascular permeability increased after being exposed to PM2.5. The expressions of SP in the airway and airway inflammation was increased after microinjecting TRPV1 agonist, and decreased after microinjecting TRPV1 antagonist. PRV infected neurons in medulla oblongata mainly located in the dorsal vagal complex.

SIGNIFICANCE

These findings show that TRPV1 in the dorsal vagal complex could promote airway neurogenic inflammation and cough reflex sensitivity through neural pathways of vagal complex-airways, which indicate the therapeutic potential of specific inhibition of TRPV1 for chronic cough induced by PM2.5.

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

Air pollution is now becoming an independent risk factor for cardiovascular morbidity and mortality. Numerous epidemiological, biomedical and clinical studies indicate that ambient particulate matter (PM) in air pollution is strongly associated with increased cardiovascular disease such as myocardial infarction (MI), cardiac arrhythmias, ischemic stroke, vascular dysfunction, hypertension and atherosclerosis. The molecular mechanisms for PM-caused cardiovascular disease include directly toxicity to cardiovascular system or indirectly injury by inducing systemic inflammation and oxidative stress in peripheral circulation. Here, we review the linking between PM exposure and the occurrence of cardiovascular disease and discussed the possible underlying mechanisms for the observed PM induced increases in cardiovascular morbidity and mortality.

Estimation of surface-level PM concentration from satellite observation taking into account the aerosol vertical profiles and hygroscopicity

Surface-level PM10 distribution was estimated from the satellite aerosol optical depth (AOD) products, taking the account of vertical profiles and hygroscopicity of aerosols over Jeju, Korea during March 2008 and October 2009. In this study, MODIS AOD data from the Terra and Aqua satellites were corrected with aerosol extinction profiles and relative humidity data. PBLH (Planetary Boundary Layer Height) was determined from MPLNET lidar-derived aerosol extinction coefficient profiles. Through statistical analysis, better agreement in correlation (R = 0.82) between the hourly PM10 concentration and hourly average Sunphotometer AOD was the obtained when vertical fraction method (VFM) considering Haze Layer Height (HLH) and hygroscopic growth factor f(RH) was used. The validity of the derived relationship between satellite AOD and surface PM10 concentration clearly demonstrates that satellite AOD data can be utilized for remote sensing of spatial distribution of regional PM10 concentration.

Association between particulate air pollution and venous thromboembolism: A systematic literature review

Air pollution is a leading global problem for public health. A number of ambient pollutants have been involved, including carbon monoxide (CO), nitrogen dioxide (NO2), sulfur dioxide (SO2), ozone (O3) and particulate matter (PM). Although exposure to PM has been linked to a wide array of cardiovascular and respiratory disorders, its effect on venous thrombotic disorders is still uncertain. To elucidate this issue, we have performed a systematic review on the existing literature on the association between PM and venous thromboembolism (VTE), using MEDLINE, EMBASE and Cochrane electronic databases. Of the 158 reviewed studies, 11 of them (3 case-crossover studies, 2 time-series studies, 2 case-control studies, 2 prospective cohort studies, 2 retrospective studies) involving more than 500,000 events fulfilled the inclusion criteria and results are presented here. Because there was substantial heterogeneity in study design, duration of follow-up, statistical measure of effects, clinical outcomes and threshold, we refrained to perform a quantitative analysis of the available data and carried out only a systematic review. Overall, the literature data suggest a link between PM and VTE, but further trials on larger populations of patients with homogeneous study designs and outcomes are warranted.