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Borge R, Requia WJ, Yagüe C, Jhun I, Koutrakis P. Impact of weather changes on air quality and related mortality in Spain over a 25 year period [1993-2017]. ENVIRONMENT INTERNATIONAL 2019; 133:105272. [PMID: 31675571 DOI: 10.1016/j.envint.2019.105272] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 10/02/2019] [Accepted: 10/14/2019] [Indexed: 05/02/2023]
Abstract
Climate change is a major public health concern. In addition to its direct impacts on temperature patterns and extreme weather events, climate change affects public health indirectly through its influence on air quality. Pollution trends are not only affected by emissions changes but also by weather changes. In this paper we analyze air quality trends in Spain of important air pollutants (C6H6, CO, NO2, NOx, O3, PM10, PM2.5, and SO2) recorded during the last 25 years, from 1993 to 2017. We found substantial reductions in ambient concentration levels for all the pollutants studied except for O3. To assess the influence of recent weather changes on air quality trends we applied generalized additive models (GAMs) using nonparametric smoothing; with and without adjusting for weather parameters including temperature, wind speed, humidity and precipitation frequency. The difference of annual slopes estimated by the models without and with adjusting for these meteorological variables represents the impact of weather changes on pollutant trends, i.e. the 'weather penalty'. The analyses were seasonally and geographically stratified to account for temporal and regional differences across Spain. The results were meta-analyzed to estimate weather penalties on ambient concentration trends at a national level as well as the impact on mortality for the most relevant pollutants. We found significant penalties for most pollutants, implying that air quality would have improved even more during our study period if weather conditions had remained constant. The largest weather influences were found for PM10, with seasonal penalties up to 22 μg⋅m-3 accumulated over the 25-year period in some regions. The national meta-analysis shows penalties of 0.060 μg⋅m-3 per year (95% Confidence Interval, CI: 0.004, 0.116) in cold months and 0.127 μg⋅m-3 per year (95% CI: 0.089, 0.164) in warm months. Penalties of this magnitude would correspond to 129 annual deaths (95% CI: 25, 233), i.e. approximately 3200 deaths over the 25-year period in Spain. According to our results, the health benefits of recent emission abatements for this pollutant in Spain would have been up to 10% greater if weather conditions had remained constant during the last 25 years.
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Affiliation(s)
- Rafael Borge
- Harvard University, School of Public Health, 401 Park Drive, Landmark Center 4th Floor West, Boston, MA 02115, United States; Universidad Politécnica de Madrid (UPM), Environmental Modelling Laboratory, Department of Chemical & Environmental Engineering, C/ José Gutiérrez Abascal 2, 28006 Madrid, Spain.
| | - Weeberb J Requia
- Harvard University, School of Public Health, 401 Park Drive, Landmark Center 4th Floor West, Boston, MA 02115, United States
| | - Carlos Yagüe
- Department of Earth Physics and Astrophysics, University Complutense of Madrid, Faculty of Physical Sciences, E-28040 Madrid, Spain
| | - Iny Jhun
- Harvard Medical School, 25 Shattuck Street, Boston, MA 02215, United States
| | - Petros Koutrakis
- Harvard University, School of Public Health, 401 Park Drive, Landmark Center 4th Floor West, Boston, MA 02115, United States
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102
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A Case-Crossover Study to Investigate the Effects of Atmospheric Particulate Matter Concentrations, Season, and Air Temperature on Accident and Emergency Presentations for Cardiovascular Events in Northern Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16234627. [PMID: 31766396 PMCID: PMC6926530 DOI: 10.3390/ijerph16234627] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 11/11/2019] [Accepted: 11/15/2019] [Indexed: 12/05/2022]
Abstract
Atmospheric particulate matter (PM) has multiple adverse effects on human health, high temperatures are also associated with adverse health outcomes, and the frequency of cardiovascular events (CVEs) varies with season. We investigated a hypothesized increase in PM-related accident and emergency (A&E) presentations for CVE with high temperature, warm season, days of high influenza incidence, and in people with a cancer diagnosis, using a time-stratified case-crossover study design. Outcomes were associations of A&E presentation for CVE with atmospheric PM ≤ 10 μm (PM10), season, and air temperature. PM10 levels in the municipality of residence (exposure variable) were estimated by modeling data from local monitoring stations. Conditional logistic regression models estimated odds ratios (OR) with 95% confidence intervals (CI) for presentations in relation to supposed influencers, adjusting for confounders. Study participants were all who presented at the A&E of a large hospital near Milan, Italy, for a CVE (ICD-9: 390–459) from 1st January 2014 to 31st December 2015. There were 1349 A&E presentations for CVE in 2014–2015 and 5390 control days. Risk of A&E presentation was significantly increased on hot days with OR 1.34 (95%CI 1.05–1.71) per 10 μg/m3 PM10 increment (as mean PM10 on day of presentation, and 1 and 2 days before (lags 0–2)), and (for lag 0) in autumn (OR 1.23, 95%CI 1.09–1.37) and winter (OR 1.18, 95%CI 1.01–1.38). Risks were also significantly increased when PM10 was on lag 1, in people with a cancer diagnosis in the spring and summer months (1.88, 95%CI 1.05–3.37), and on days (lags 0–2) of high influenza incidence (OR 2.34, 95%CI 1.01–5.43). PM10 levels exceeded the 50 μg/m3 “safe” threshold recommended by the WHO and Italian legislation for only 3.8% of days during the warm periods of 2014–2015. Greater risk of A&E presentation for CVE in periods of high PM10 and high temperature suggests that “safe” thresholds for PM10 should be temperature-dependent and that the adverse effects of PM10 will increase as temperatures increase due to climate change.
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103
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Silveira IH, Oliveira BFA, Cortes TR, Junger WL. The effect of ambient temperature on cardiovascular mortality in 27 Brazilian cities. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 691:996-1004. [PMID: 31326821 DOI: 10.1016/j.scitotenv.2019.06.493] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 06/17/2019] [Accepted: 06/28/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND There is limited evidence on the relationship between temperature and cardiovascular mortality in middle and low-income countries, particularly in Latin America. In this study, we investigated the total effect of temperature on cardiovascular mortality in 27 Brazilian cities, and the effect modification by geographic, socioeconomic, demographic and infrastructure characteristics within cities. METHODS In the city-specific analysis, we used time-series analyses to estimate the relationship between mean temperature and daily cardiovascular mortality using quasi-Poisson generalized linear models combined with distributed lag non-linear models. In the second stage, a meta-analysis was used to pool the effects of temperature on cardiovascular mortality for Brazil and its five regions (Central-West, North, Northeast, South, and Southeast). We used a meta-regression to examine the effect modification of city-specific geographic, socioeconomic, demographic and infrastructure-related variables. RESULTS The risks associated with temperature varied across the locations. Higher cardiovascular mortality was associated with low and high temperatures in most of the cities, Brazil and the Central-West, North, South, and Southeast regions. The overall relative risk (RR) for Brazil was 1.26 (95% confidence interval [CI]: 1.17-1.35) for the 1st percentile of temperature and 1.07 (95% CI: 1.01-1.13) for the 99th percentile of temperature versus the 79th percentile (27.7 °C), where RR was lowest. The temperature range was the variable that best explained the variation in effects among the cities, with greater effects in locations having a broader range. CONCLUSIONS The results indicate effects of low and high temperatures on the risk of cardiovascular mortality in most of Brazil's capital cities, besides a pooled effect for Brazil and the Central-West, North, South, and Southeast regions. These findings can help inform public policies addressing the health impact of temperature extremes, especially in the context of climate change.
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Affiliation(s)
- Ismael Henrique Silveira
- Institute of Social Medicine, State University of Rio de Janeiro, Rua São Francisco Xavier, 524, Sala 7013-D, Maracanã, Rio de Janeiro Cep: 20550-013, RJ, Brazil.
| | - Beatriz Fátima Alves Oliveira
- Institute of Social Medicine, State University of Rio de Janeiro, Rua São Francisco Xavier, 524, Sala 7013-D, Maracanã, Rio de Janeiro Cep: 20550-013, RJ, Brazil
| | - Taísa Rodrigues Cortes
- Institute of Social Medicine, State University of Rio de Janeiro, Rua São Francisco Xavier, 524, Sala 7013-D, Maracanã, Rio de Janeiro Cep: 20550-013, RJ, Brazil
| | - Washington Leite Junger
- Institute of Social Medicine, State University of Rio de Janeiro, Rua São Francisco Xavier, 524, Sala 7013-D, Maracanã, Rio de Janeiro Cep: 20550-013, RJ, Brazil
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104
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Lee W, Choi HM, Kim D, Honda Y, Leon Guo YL, Kim H. Synergic effect between high temperature and air pollution on mortality in Northeast Asia. ENVIRONMENTAL RESEARCH 2019; 178:108735. [PMID: 31539825 DOI: 10.1016/j.envres.2019.108735] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 08/09/2019] [Accepted: 09/06/2019] [Indexed: 06/10/2023]
Abstract
High temperature and air pollutants have been reported as potential risk factors of mortality. Previous studies investigated interaction between the two variables; however, the excess death risk due to the synergic effect (i.e. interaction on the additive scale) between the two variables has not been investigated adequately on a multi-country scale. This study aimed to assess the excess death risk due to the synergism between high temperature and air pollution on mortality using a multicity time-series analysis. We collected time-series data on mortality, weather variables, and four air pollutants (PM10, O3, NO2, and CO) for 16 metropolitan cities of three countries (Japan, Korea, and Taiwan) in Northeast Asia (1979-2015). Quasi-Poisson time-series regression and meta-analysis were used to estimate the additive interaction between high temperature and air pollution. The additive interaction was measured by relative excess risk due to interaction (RERI) index. We calculated RERI with relative risks (RR) of the 99th/10th, 90th/90th, and 99th/90th percentiles of temperature/air pollution metrics, where risk at the 90th/10th percentiles of temperature/air pollution metrics was the reference category. This study showed that there may exist positive and significant excess death risks due to the synergism between high temperature and air pollution in the total population for all pollutants (95% lower confidence intervals of all RERIs>0 or near 0). In final, we measured quantitatively the excess death risks due to synergic effect between high temperature and air pollution, and the synergism should be considered in public health interventions and a composite warning system.
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Affiliation(s)
- Whanhee Lee
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Hayon Michelle Choi
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Dahye Kim
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Yasushi Honda
- Faculty of Health and Sports Sciences, University of Tsukuba, Tsukuba, Japan
| | - Yue-Liang Leon Guo
- Environmental and Occupational Medicine, National Taiwan University (NTU) College of Medicine and NTU Hospital, Taipei, Taiwan; National Institute of Environmental Health Sciences, National Health Research Institutes, Zhunan, Taiwan
| | - Ho Kim
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea.
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105
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Vicedo-Cabrera AM, Chen K. Living in a highly polluted and warmer environment: Challenges for cardiovascular prevention. Eur J Prev Cardiol 2019; 27:511-512. [PMID: 31438724 DOI: 10.1177/2047487319871708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Ana M Vicedo-Cabrera
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Kai Chen
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA
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106
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Mortality Related to Cold Temperatures in Two Capitals of the Baltics: Tallinn and Riga. ACTA ACUST UNITED AC 2019; 55:medicina55080429. [PMID: 31382432 PMCID: PMC6723676 DOI: 10.3390/medicina55080429] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 07/24/2019] [Accepted: 08/01/2019] [Indexed: 11/17/2022]
Abstract
Background and objectives: Despite global warming, the climate in Northern Europe is generally cold, and the large number of deaths due to non-optimal temperatures is likely due to cold temperatures. The aim of the current study is to investigate the association between cold temperatures and all-cause mortality, as well as cause-specific mortality, in Tallinn and Riga in North-Eastern Europe. Materials and Methods: We used daily information on deaths from state death registries and minimum temperatures from November to March over the period 1997-2015 in Tallinn and 2009-2015 in Riga. The relationship between the daily minimum temperature and mortality was investigated using the Poisson regression, combined with a distributed lag non-linear model considering lag times of up to 21 days. Results: We found significantly higher all-cause mortality owing to cold temperatures both in Tallinn (Relative Risk (RR) = 1.28, 95% Confidence Interval (CI) 1.01-1.62) and in Riga (RR = 1.41, 95% CI 1.11-1.79). In addition, significantly increased mortality due to cold temperatures was observed in the 75+ age group (RR = 1.64, 95% CI 1.17-2.31) and in cardiovascular mortality (RR = 1.83, 95% CI 1.31-2.55) in Tallinn and in the under 75 age group in Riga (RR = 1.58, 95% CI 1.12-2.22). In this study, we found no statistically significant relationship between mortality due to respiratory or external causes and cold days. The cold-related attributable fraction (AF) was 7.4% (95% CI -3.7-17.5) in Tallinn and 8.3% (95% CI -0.5-16.3) in Riga. This indicates that a relatively large proportion of deaths in cold periods can be related to cold in North-Eastern Europe, where winters are relatively harsh.
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107
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Wang C, Feng L, Chen K. The impact of ambient particulate matter on hospital outpatient visits for respiratory and circulatory system disease in an urban Chinese population. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 666:672-679. [PMID: 30812001 DOI: 10.1016/j.scitotenv.2019.02.256] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 01/26/2019] [Accepted: 02/16/2019] [Indexed: 05/27/2023]
Abstract
There are limited evidence on the association between short-term exposure to ambient particulate matter (PM) and overall hospital outpatient visits for respiratory system disease (RESD) and cardio-cerebrovascular system disease (CCD) in high-polluted countries like China. Though previous epidemiological studies of RESD and CCD generally applied a linear relationship of the acute PM effects, it is unclear whether this linear exposure-response relationship holds in high pollution area. In this study, a time-series study during 2013 through 2016 was conducted to investigate 245,442 and 430,486 hospital visits for RESD and CCD respectively from Nanjing city, China. A combination of logistic generalized additive model (GAM) was used to evaluate the exposure-response associations. The results disclosed that a 10 μg/m3 increase in PM2.5 and PM10 concentration on the current day of exposure (lag 0) was associated with 0.36% (95% CI: -0.02%-0.73%) and 0.33% (0.07%-0.60%) increase in RESD; and 0.42% (0.00%-0.85%) and 0.37% (0.08%-0.67%) increase in CCD. The exposure-response association was approximately linear within 0-150 μg/m3 of PM concentration and non-linear across the full range of exposures. The effects of PM on RESD and CCD were sensitive to additional adjustment for co-pollutants, indicating the health effects of air pollution mixture in Nanjing city. There was no evidence of potential effect modification of RESD and CCD by season (cold and warm), age (5-64, 65-74, ≧75 years) and sex (male and female) groups. Though not statistically significant, the estimated risks in warm season were higher than those in cold season, suggesting potential synergistic effects of ambient PM pollution and temperature on triggering RESD and CCD.
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Affiliation(s)
- Ce Wang
- School of Energy and Environment, Southeast University, Nanjing, 210096, PR China; State Key Laboratory of Environmental Medicine Engineering, Ministry of Education, Southeast University, Nanjing, 210096, PR China.
| | - Lan Feng
- National-Provincial Joint Engineering Research Center of Electromechanical Product Packaging, College of Civil Engineering, Nanjing Forestry University, Nanjing, 210037, PR China.
| | - Kai Chen
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany.
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108
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Wu R, Song X, Chen D, Zhong L, Huang X, Bai Y, Hu W, Ye S, Xu H, Feng B, Wang T, Zhu Y, Fang J, Liu S, Chen J, Wang X, Zhang Y, Huang W. Health benefit of air quality improvement in Guangzhou, China: Results from a long time-series analysis (2006-2016). ENVIRONMENT INTERNATIONAL 2019; 126:552-559. [PMID: 30852442 DOI: 10.1016/j.envint.2019.02.064] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Revised: 02/25/2019] [Accepted: 02/25/2019] [Indexed: 05/22/2023]
Abstract
Numerous epidemiologic studies on adverse health effects of air pollution have been well documented; however, assessment on health benefits of air quality improvement from air pollution control measures has been limited in developing countries. We assessed the mortality benefits associated with air pollution improvement over 11 years in Guangzhou, China (2006-2016). A time series analysis with Generalized additive Poisson models was used to estimate mortality effects of ozone (O3) and nitrogen dioxide (NO2), adjusting for time trend, day of week, public holiday, temperature and relative humidity. We further estimated the changes in mortality burden of O3 and NO2, including attributable fraction (AF, in %) and attributable mortality (AM, in number of death) during study period. We lastly estimated mortality effects during the 2010 Asian Games (November 12 to December 18, 2010) compared to a baseline period consisting of 4-week before and 4-week after the game. During the study period, average annual concentrations of NO2 decreased from 42.3 μg/m3 in 2006 to 33.8 μg/m3 in 2016; while O3 levels remained stable over time. We observed significant increases in mortality of O3 and NO2, with approximately linear exposure-response relationships. In specific, each increase of 10 μg/m3 in O3 and NO2 at 2 prior days was associated with increases of 0.60% (95% confidence interval (CI): 0.47, 0.74) and 1.89% (95%CI: 1.49, 2.29) in total mortality, respectively. We further estimated that AF on total mortality attributed to NO2 decreased from 1.38% (95%CI: 1.09, 1.68) in 2006-2010 to 0.43% (95%CI: 0.34, 0.52) in 2011-2016, corresponding to AM on total mortality of 2496 deaths (95%CI: 1964, 3033) to 1073 deaths (95%CI: 846, 1301). During the 2010 Asian Games, we observed decrease in total mortality of 9.3% (95%CI: -15.0, -3.2) in comparison with that observed in the baseline period. Similar mortality benefits in cardiovascular diseases were also observed. Our results showed reduced mortality burden from air pollution improvement in Guangzhou in recent years, which provide strong rationale for continuing to reduce air pollution through comprehensive and rigorous air quality management in the area.
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Affiliation(s)
- Rongshan Wu
- Department of Occupational and Environmental Health, Peking University School of Public Health, Beijing, China; Key Laboratory of Molecular Cardiovascular Sciences of Ministry of Education, Peking University Institute of Environmental Medicine, Beijing, China
| | - Xiaoming Song
- Department of Occupational and Environmental Health, Peking University School of Public Health, Beijing, China; Key Laboratory of Molecular Cardiovascular Sciences of Ministry of Education, Peking University Institute of Environmental Medicine, Beijing, China
| | - Duohong Chen
- Environmental Monitoring Center of Guangdong Province, Guangzhou, Guangdong Province, China
| | - Liuju Zhong
- Guangdong Polytechnic of Environmental Protection Engineering, Foshan, Guangdong Province, China.
| | - Xiaoliang Huang
- Government Affairs Service Center of Health Department of Guangdong Province, China
| | - Yingchen Bai
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, China
| | - Wei Hu
- Government Affairs Service Center of Health Department of Guangdong Province, China
| | - Siqi Ye
- Environmental Monitoring Center of Guangdong Province, Guangzhou, Guangdong Province, China
| | - Hongbing Xu
- Department of Occupational and Environmental Health, Peking University School of Public Health, Beijing, China; Key Laboratory of Molecular Cardiovascular Sciences of Ministry of Education, Peking University Institute of Environmental Medicine, Beijing, China
| | - Baihuan Feng
- Department of Occupational and Environmental Health, Peking University School of Public Health, Beijing, China; Key Laboratory of Molecular Cardiovascular Sciences of Ministry of Education, Peking University Institute of Environmental Medicine, Beijing, China
| | - Tong Wang
- Department of Occupational and Environmental Health, Peking University School of Public Health, Beijing, China; Key Laboratory of Molecular Cardiovascular Sciences of Ministry of Education, Peking University Institute of Environmental Medicine, Beijing, China
| | - Yutong Zhu
- Department of Occupational and Environmental Health, Peking University School of Public Health, Beijing, China; Key Laboratory of Molecular Cardiovascular Sciences of Ministry of Education, Peking University Institute of Environmental Medicine, Beijing, China
| | - Jiakun Fang
- Department of Occupational and Environmental Health, Peking University School of Public Health, Beijing, China; Key Laboratory of Molecular Cardiovascular Sciences of Ministry of Education, Peking University Institute of Environmental Medicine, Beijing, China
| | - Shuo Liu
- Department of Occupational and Environmental Health, Peking University School of Public Health, Beijing, China; Key Laboratory of Molecular Cardiovascular Sciences of Ministry of Education, Peking University Institute of Environmental Medicine, Beijing, China
| | - Jie Chen
- Department of Occupational and Environmental Health, Peking University School of Public Health, Beijing, China; Key Laboratory of Molecular Cardiovascular Sciences of Ministry of Education, Peking University Institute of Environmental Medicine, Beijing, China
| | - Xuemei Wang
- Institute for Environmental and Climate Research, Jinan University, Guangzhou, Guangdong Province, China
| | - Yuanhang Zhang
- Department of Environmental Sciences, Peking University College of Environmental Science and Engineering, Beijing, China
| | - Wei Huang
- Department of Occupational and Environmental Health, Peking University School of Public Health, Beijing, China; Key Laboratory of Molecular Cardiovascular Sciences of Ministry of Education, Peking University Institute of Environmental Medicine, Beijing, China.
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109
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Olstrup H, Johansson C, Forsberg B, Åström C. Association between Mortality and Short-Term Exposure to Particles, Ozone and Nitrogen Dioxide in Stockholm, Sweden. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16061028. [PMID: 30901873 PMCID: PMC6466204 DOI: 10.3390/ijerph16061028] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 03/19/2019] [Accepted: 03/19/2019] [Indexed: 01/19/2023]
Abstract
In this study, the effects on daily mortality in Stockholm associated with short-term exposure to ultrafine particles (measured as number of particles with a diameter larger than 4 nm, PNC4), black carbon (BC) and coarse particles (PM2.5–10) have been compared with the effects from more common traffic-pollution indicators (PM10, PM2.5 and NO2) and O3 during the period 2000–2016. Air pollution exposure was estimated from measurements at a 20 m high building in central Stockholm. The associations between daily mortality lagged up to two days (lag 02) and the different air pollutants were modelled by using Poisson regression. The pollutants with the strongest indications of an independent effect on daily mortality were O3, PM2.5–10 and PM10. In the single-pollutant model, an interquartile range (IQR) increase in O3 was associated with an increase in daily mortality of 2.0% (95% CI: 1.1–3.0) for lag 01 and 1.9% (95% CI: 1.0–2.9) for lag 02. An IQR increase in PM2.5–10 was associated with an increase in daily mortality of 0.8% (95% CI: 0.1–1.5) for lag 01 and 1.1% (95% CI: 0.4–1.8) for lag 02. PM10 was associated with a significant increase only at lag 02, with 0.8% (95% CI: 0.08–1.4) increase in daily mortality associated with an IQR increase in the concentration. NO2 exhibits negative associations with mortality. The significant excess risk associated with O3 remained significant in two-pollutant models after adjustments for PM2.5–10, BC and NO2. The significant excess risk associated with PM2.5–10 remained significant in a two-pollutant model after adjustment for NO2. The significantly negative associations for NO2 remained significant in two-pollutant models after adjustments for PM2.5–10, O3 and BC. A potential reason for these findings, where statistically significant excess risks were found for O3, PM2.5–10 and PM10, but not for NO2, PM2.5, PNC4 and BC, is behavioral factors that lead to misclassification in the exposure. The concentrations of O3 and PM2.5–10 are in general highest during sunny and dry days during the spring, when exposure to outdoor air tend to increase, while the opposite applies to NO2, PNC4 and BC, with the highest concentrations during the short winter days with cold weather, when people are less exposed to outdoor air.
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Affiliation(s)
- Henrik Olstrup
- Atmospheric Science Unit, Department of Environmental Science and Analytical Chemistry, Stockholm University, 11418 Stockholm, Sweden.
| | - Christer Johansson
- Atmospheric Science Unit, Department of Environmental Science and Analytical Chemistry, Stockholm University, 11418 Stockholm, Sweden.
- Environment and Health Administration, SLB, Box 8136, 104 20 Stockholm, Sweden.
| | - Bertil Forsberg
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, 90187 Umeå, Sweden.
| | - Christofer Åström
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, 90187 Umeå, Sweden.
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110
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Yang BY, Guo Y, Markevych I, Qian Z(M, Bloom MS, Heinrich J, Dharmage SC, Rolling CA, Jordan SS, Komppula M, Leskinen A, Bowatte G, Li S, Chen G, Liu KK, Zeng XW, Hu LW, Dong GH. Association of Long-term Exposure to Ambient Air Pollutants With Risk Factors for Cardiovascular Disease in China. JAMA Netw Open 2019; 2:e190318. [PMID: 30848806 PMCID: PMC6484675 DOI: 10.1001/jamanetworkopen.2019.0318] [Citation(s) in RCA: 141] [Impact Index Per Article: 28.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
IMPORTANCE Which cardiometabolic risk factors (eg, hypertension, type 2 diabetes, overweight or obesity, and dyslipidemia) are more sensitive to long-term exposure to ambient air pollution and whether participants with these conditions are more susceptible to the cardiovascular effects of air pollution remain unclear. OBJECTIVES To evaluate the associations among long-term exposure to air pollutants, cardiometabolic risk factors, and cardiovascular disease (CVD) prevalence. DESIGN, SETTING, AND PARTICIPANTS This population-based cross-sectional study was conducted from April 1 through December 31, 2009, in 3 cities in Northeastern China. Participants were adults aged 18 to 74 years who had lived in study area for 5 years or longer. Data analysis was performed from May 1 through December 31, 2018. EXPOSURES Long-term (2006-2008) exposure to air pollutants was measured using a spatiotemporal statistical model (particulate matter with an aerodynamic diameter of ≤2.5 μm [PM2.5] and ≤1.0 μm [PM1.0]) and data from air monitoring stations (particulate matter with an aerodynamic diameter of ≤10.0 μm [PM10.0], sulfur dioxide [SO2], nitrogen dioxide [NO2], and ozone [O3]). MAIN OUTCOMES AND MEASURES Cardiovascular disease was determined by self-report of physician-diagnosed CVD. Blood pressure, body mass index, and levels of triglycerides and low-density lipoprotein cholesterol were measured using standard methods. RESULTS Participants included 15 477 adults (47.3% women) with a mean (SD) age of 45.0 (13.5) years. The prevalence of CVD was 4.8%, and the prevalence of cardiometabolic risk factors ranged from 8.6% (hyperbetalipoproteinemia) to 40.5% (overweight or obesity). Mean (SD) air pollutant concentrations ranged from 35.3 (5.5) μg/m3 (for NO2) to 123.1 (14.6) μg/m3 (for PM10.0). Associations with air pollutants were identified for individuals with hyperbetalipoproteinemia (eg, odds ratio [OR], 1.36 [95% CI, 1.03-1.78] for a 10-μg/m3 increase in PM1.0) and the weakest association for those with for overweight or obesity (eg, OR, 1.06 [95% CI, 1.02-1.09] for a 10-μg/m3 increase in PM1.0). Cardiometabolic risk factors only partially mediated associations between air pollution and CVD. However, they modified the associations such that greater associations were found in participants with these cardiometabolic conditions (eg, ORs for CVD and per 10-μg/m3 increase in PM1.0, 1.22 [95% CI, 1.12-1.33] in participants with hyperbetalipoproteinemia and 1.07 [95% CI, 0.98-1.16] in participants without hyperbetalipoproteinemia). CONCLUSIONS AND RELEVANCE In this population-based study of Chinese adults with CVD, long-term exposure to air pollution was associated with a higher prevalence of cardiometabolic risk factors, and the strongest associations were observed for hyperbetalipoproteinemia. In addition, participants with cardiometabolic risk factors may have been more vulnerable to the effects of air pollution on CVD.
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Affiliation(s)
- Bo-Yi Yang
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Iana Markevych
- Institute of Epidemiology, Helmholtz Zentrum München–German Research Center for Environmental Health, Neuherberg, Germany
- Division of Metabolic and Nutritional Medicine, Dr von Hauner Children’s Hospital, Ludwig Maximilian University of Munich, Munich, Germany
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital of Munich, Munich, Germany
| | - Zhengmin (Min) Qian
- Department of Epidemiology and Biostatistics, College for Public Health and Social Justice, Saint Louis University, St Louis, Missouri
| | - Michael S. Bloom
- Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer, New York
- Department of Epidemiology and Biostatics, University at Albany, State University of New York, Rensselaer, New York
| | - Joachim Heinrich
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital of Munich, Munich, Germany
- Comprehensive Pneumology Center Munich, German Center for Lung Research, Munich, Germany
| | - Shyamali C. Dharmage
- Allergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, Melbourne, Australia
- Murdoch Children Research Institute, Melbourne, Australia
| | - Craig A. Rolling
- Department of Epidemiology and Biostatistics, College for Public Health and Social Justice, Saint Louis University, St Louis, Missouri
| | - Savannah S. Jordan
- Department of Epidemiology and Biostatistics, College for Public Health and Social Justice, Saint Louis University, St Louis, Missouri
| | | | - Ari Leskinen
- Finnish Meteorological Institute, Kuopio, Finland
| | - Gayan Bowatte
- The National Institute of Fundamental Studies, Kandy, Sri Lanka
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Gongbo Chen
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Kang-Kang Liu
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xiao-Wen Zeng
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Li-Wen Hu
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Guang-Hui Dong
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
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Tibuakuu M, Michos ED, Navas-Acien A, Jones MR. Air Pollution and Cardiovascular Disease: A Focus on Vulnerable Populations Worldwide. CURR EPIDEMIOL REP 2018; 5:370-378. [PMID: 30931239 DOI: 10.1007/s40471-018-0166-8] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Purpose of review Certain subgroups defined by sociodemographics (race/ethnicity, age, sex and socioeconomic status [SES]), geographic location (rural vs. urban), comorbid conditions and country economic conditions (developed vs. developing) may disproportionately suffer the adverse cardiovascular effects of exposure to ambient air pollution. Yet, previous reviews have had a broad focus on the general population without consideration of these potentially vulnerable populations. Recent findings Over the past decade, a wealth of epidemiologic studies have linked air pollutants including particulate matter, oxides of nitrogen, and carbon monoxide to cardiovascular disease (CVD) risk factors, subclinical CVD, clinical cardiovascular outcomes and cardiovascular mortality in certain susceptible populations. Highest risk for poor CVD outcomes from air pollution exist in racial/ethnic minorities, especially in blacks compared to whites in the U.S, those at low SES, elderly populations, women, those with certain comorbid conditions and developing countries compared to developed countries. However, findings are less consistent for urban compared to rural populations. Summary Vulnerable subgroups including racial/ethnic minorities, women, the elderly, smokers, diabetics and those with prior heart disease had higher risk for adverse cardiovascular outcomes from exposure to air pollution. There is limited data from developing countries where concentrations of air pollutants are more extreme and cardiovascular event rates are higher than that of developed countries. Further epidemiologic studies are needed to understand and address the marked disparities in CVD risk conferred by air pollution globally, particularly among these vulnerable subgroups.
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Affiliation(s)
- Martin Tibuakuu
- St. Luke's Hospital, Department of Medicine, Chesterfield, MO, USA.,Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Erin D Michos
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, MD, USA.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Columbia University School of Public Health, New York, NY, USA
| | - Miranda R Jones
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD, USA
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Synergistic Effects of Ambient Temperature and Air Pollution on Health in Europe: Results from the PHASE Project. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15091856. [PMID: 30154318 PMCID: PMC6163671 DOI: 10.3390/ijerph15091856] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 07/30/2018] [Accepted: 08/18/2018] [Indexed: 01/03/2023]
Abstract
We studied the potential synergy between air pollution and meteorology and their impact on mortality in nine European cities with data from 2004 to 2010. We used daily series of Apparent Temperature (AT), measurements of particulate matter (PM10), ozone (O₃), and nitrogen dioxide (NO₂) and total non-accidental, cardiovascular, and respiratory deaths. We applied Poisson regression for city-specific analysis and random effects meta-analysis to combine city-specific results, separately for the warm and cold seasons. In the warm season, the percentage increase in all deaths from natural causes per °C increase in AT tended to be greater during high ozone days, although this was only significant for all ages when all causes were considered. On low ozone days, the increase in the total daily number of deaths was 1.84% (95% CI 0.87, 2.82), whilst it was 2.20% (95% CI 1.28, 3.13) in the high ozone days per 1 °C increase in AT. Interaction with PM10 was significant for cardiovascular (CVD) causes of death for all ages (2.24% on low PM10 days (95% CI 1.01, 3.47) whilst it is 2.63% (95% CI 1.57, 3.71) on high PM10 days) and for ages 75+. In days with heat waves, no consistent pattern of interaction was observed. For the cold period, no evidence for synergy was found. In conclusion, some evidence of interactive effects between hot temperature and the levels of ozone and PM10 was found, but no consistent synergy could be identified during the cold season.
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