101
|
Bei Y, Yang T, Xiao J. Cardiovascular medicine in China: what can we do to achieve the Healthy China 2030 plan? BMC Med 2018; 16:132. [PMID: 30139358 PMCID: PMC6107941 DOI: 10.1186/s12916-018-1133-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 07/23/2018] [Indexed: 02/06/2023] Open
Abstract
Cardiovascular diseases (CVDs) represent the leading cause of death in China. The Chinese government approved the Healthy China 2030 plan (jiànkāng zhōngguó 2030), emphasizing the strategic role of health in China's development. As morbidity and mortality from CVDs are constantly increasing in China, the prevention and treatment of CVDs are vital to achieve this plan. Following the major principles of health priority, science and technology innovation, scientific development, and balanced medical resource allocation outlined in the Healthy China 2030 plan, this Commentary briefly introduces the current status of CVDs in China and marks the important events undertaken to achieve this plan.
Collapse
Affiliation(s)
- Yihua Bei
- Institute of Cardiovascular Sciences, Shanghai University, 381 Nan Chen Road, Shanghai, 200444, China
| | - Tingting Yang
- Institute of Cardiovascular Sciences, Shanghai University, 381 Nan Chen Road, Shanghai, 200444, China
| | - Junjie Xiao
- Institute of Cardiovascular Sciences, Shanghai University, 381 Nan Chen Road, Shanghai, 200444, China.
| |
Collapse
|
102
|
Yu Y, Yao S, Dong H, Ji M, Chen Z, Li G, Yao X, Wang SL, Zhang Z. Short-term effects of ambient air pollutants and myocardial infarction in Changzhou, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2018; 25:22285-22293. [PMID: 29808399 DOI: 10.1007/s11356-018-2250-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 05/07/2018] [Indexed: 05/06/2023]
Abstract
Ambient air pollution had been shown strongly associated with cardiovascular diseases. However, the association between air pollution and myocardial infarction (MI) is inconsistent. In the present study, we conducted a time-series study to investigate the association between air pollution and MI. Daily air pollutants, weather data, and MI data were collected from January 2015 to December 2016 in Changzhou, China. Generalized linear model (GLM) was used to assess the immediate effects of air pollutants (PM2.5, PM10, NO2, SO2, and O3) on MI. We identified a total of 5545 cases for MI, and a 10-μg/m3 increment in concentrations of PM2.5 and PM10 was associated with respective increases of 1.636% (95% confidence interval [CI] 0.537-2.740%) and 0.805% (95% CI 0.037-1.574%) for daily MI with 2-day cumulative effects. The associations were more robust among males and in the warm season versus the cold one. No significant effect was found in SO2, NO2, or O3. This study suggested that short-term exposure to PM2.5 and PM10 was associated with the increased MI risks. Our results might be useful for the primary prevention of MI exacerbated by air pollutants.
Collapse
Affiliation(s)
- Yongquan Yu
- Department of Occupational Medicine and Environmental Health, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing, Jiangsu, 211166, People's Republic of China
| | - Shen Yao
- Department of Occupational Medicine and Environmental Health, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing, Jiangsu, 211166, People's Republic of China
| | - Huibin Dong
- Department of Chronic Disease Control and Prevention, Changzhou Center for Disease Control and Prevention, 203 Taishan Road, Changzhou, Jiangsu, 213022, People's Republic of China
| | - Minghui Ji
- Department of Occupational Medicine and Environmental Health, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing, Jiangsu, 211166, People's Republic of China
| | - Zhiyong Chen
- Department of Chronic Disease Control and Prevention, Changzhou Center for Disease Control and Prevention, 203 Taishan Road, Changzhou, Jiangsu, 213022, People's Republic of China
| | - Guiying Li
- Department of Chronic Disease Control and Prevention, Changzhou Center for Disease Control and Prevention, 203 Taishan Road, Changzhou, Jiangsu, 213022, People's Republic of China
| | - Xingjuan Yao
- Department of Chronic Disease Control and Prevention, Changzhou Center for Disease Control and Prevention, 203 Taishan Road, Changzhou, Jiangsu, 213022, People's Republic of China
| | - Shou-Lin Wang
- Department of Occupational Medicine and Environmental Health, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing, Jiangsu, 211166, People's Republic of China
| | - Zhan Zhang
- Department of Hygiene Analysis and Detection, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing, Jiangsu, 211166, People's Republic of China.
| |
Collapse
|
103
|
Dong H, Yu Y, Yao S, Lu Y, Chen Z, Li G, Yao Y, Yao X, Wang SL, Zhang Z. Acute effects of air pollution on ischaemic stroke onset and deaths: a time-series study in Changzhou, China. BMJ Open 2018; 8:e020425. [PMID: 30037864 PMCID: PMC6059268 DOI: 10.1136/bmjopen-2017-020425] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 05/10/2018] [Accepted: 06/05/2018] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE To investigate the acute effect of air pollutants on ischaemic stroke (IS) and IS-related death. SETTING Five urban districts in Changzhou, China, between 9 January 2015 and 31 December 2016. PARTICIPANTS A total of 32 840 IS cases and 4028 IS deaths were enrolled. MAIN OUTCOME MEASURES A time-series design, generalised additive model and multivariable regression model were used to examine the percentage change (95% CI) in daily IS counts and deaths with an IQR increase in air pollutant levels for different single or multiple lag days in single-pollutant and two-pollutant models. RESULTS Daily IS counts increased 0.208% (95% CI 0.036% to 0.381%) with an IQR increment in the levels of nitrogen dioxide (NO2). The estimated risk of NO2 was more robust in males and in the cold season. For daily IS counts, the estimated effects of NO2 and sulfur dioxide (SO2) were more significant when adjusted for particulate matter with aerodynamic diameters <2.5 µm (PM2.5) and PM10. An IQR increment in the concentration of PM10, SO2 and NO2 significantly increased IS deaths with 6 days of cumulative effects (0.268%, 95% CI 0.007% to 1.528%; 0.34%, 0.088% to 0.592%; and 0.263%, 0.004% to 0.522%, respectively). Young individuals (<65 years old) had a higher IS mortality risk for PM2.5, PM10, NO2 and CO. For IS death, the effect estimates of SO2 in the elderly, females and the cold season were more pronounced; statistical significance was also identified for SO2 when adjusted for carbon monoxide (CO). CONCLUSIONS This study suggested that short-term exposure to ambient NO2 was associated with increased IS risk. In addition, SO2 was associated with increased IS onset and death.
Collapse
Affiliation(s)
- Huibin Dong
- Department of Chronic Disease Control and Prevention, Changzhou Center for Disease Control and Prevention, Changzhou, China
| | - Yongquan Yu
- Department of Occupational Medicine and Environmental Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Shen Yao
- Department of Occupational Medicine and Environmental Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Yan Lu
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Zhiyong Chen
- Department of Chronic Disease Control and Prevention, Changzhou Center for Disease Control and Prevention, Changzhou, China
| | - Guiying Li
- Department of Chronic Disease Control and Prevention, Changzhou Center for Disease Control and Prevention, Changzhou, China
| | - Yao Yao
- Department of Chronic Disease Control and Prevention, Changzhou Center for Disease Control and Prevention, Changzhou, China
| | - Xingjuan Yao
- Department of Chronic Disease Control and Prevention, Changzhou Center for Disease Control and Prevention, Changzhou, China
| | - Shou-Lin Wang
- Department of Occupational Medicine and Environmental Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Zhan Zhang
- Department of Hygiene Analysis and Detection, School of Public Health, Nanjing Medical University, Nanjing, China
| |
Collapse
|
104
|
Cytotoxicity of Air Pollutant 9,10-Phenanthrenequinone: Role of Reactive Oxygen Species and Redox Signaling. BIOMED RESEARCH INTERNATIONAL 2018; 2018:9523968. [PMID: 29984252 PMCID: PMC6015725 DOI: 10.1155/2018/9523968] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Accepted: 04/30/2018] [Indexed: 01/22/2023]
Abstract
Atmospheric pollution has been a principal topic recently in the scientific and political community due to its role and impact on human and ecological health. 9,10-phenanthrenequinone (9,10-PQ) is a quinone molecule found in air pollution abundantly in the diesel exhaust particles (DEP). This compound has studied extensively and has been shown to develop cytotoxic effects both in vitro and in vivo. 9, 10-PQ has been proposed to play a critical role in the development of cytotoxicity via generation of reactive oxygen species (ROS) through redox cycling. This compound also reduces expression of glutathione (GSH), which is critical in Phase II detoxification reactions. Understanding the underlying cellular mechanisms involved in cytotoxicity can allow for the development of therapeutics designed to target specific molecules significantly involved in the 9,10-PQ-induced ROS toxicity. This review highlights the developments in the understanding of the cytotoxic effects of 9, 10-PQ with special emphasis on the possible mechanisms involved.
Collapse
|
105
|
Qiu H, Tan K, Long F, Wang L, Yu H, Deng R, Long H, Zhang Y, Pan J. The Burden of COPD Morbidity Attributable to the Interaction between Ambient Air Pollution and Temperature in Chengdu, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018. [PMID: 29534476 PMCID: PMC5877037 DOI: 10.3390/ijerph15030492] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Evidence on the burden of chronic obstructive pulmonary disease (COPD) morbidity attributable to the interaction between ambient air pollution and temperature has been limited. This study aimed to examine the modification effect of temperature on the association of ambient air pollutants (including particulate matter (PM) with aerodynamic diameter <10 μm (PM10) and <2.5 μm (PM2.5), nitrogen dioxide (NO2), sulfur dioxide (SO2), carbon monoxide (CO) and ozone (O3)) with risk of hospital admissions (HAs) for COPD, as well as the associated morbidity burden in urban areas of Chengdu, China, from 2015 to 2016. Based on the generalized additive model (GAM) with quasi-Poisson link, bivariate response surface model and stratification parametric model were developed to investigate the potential interactions between ambient air pollution and temperature on COPD HAs. We found consistent interactions between ambient air pollutants (PM2.5, PM10 and SO2) and low temperature on COPD HAs, demonstrated by the stronger associations between ambient air pollutants and COPD HAs at low temperatures than at moderate temperatures. Subgroup analyses showed that the elderly (≥80 years) and males were more vulnerable to this interaction. The joint effect of PM and low temperature had the greatest impact on COPD morbidity burden. Using WHO air quality guidelines as reference concentration, about 17.30% (95% CI: 12.39%, 22.19%) and 14.72% (95% CI: 10.38%, 19.06%) of COPD HAs were attributable to PM2.5 and PM10 exposures on low temperature days, respectively. Our findings suggested that low temperature significantly enhanced the effects of PM and SO2 on COPD HAs in urban Chengdu, resulting in increased morbidity burden. This evidence has important implications for developing interventions to reduce the risk effect of COPD morbidity.
Collapse
Affiliation(s)
- Hang Qiu
- Health Big Data Research Institute, Big Data Research Center, University of Electronic Science and Technology of China, Chengdu 611731, China.
| | - Kun Tan
- Health and Family Planning Information Center of Sichuan Province, Chengdu 610041, China.
- Sichuan Health Information Association, Chengdu 610041, China.
| | - Feiyu Long
- School of Electronic and Information Engineering, Beijing Jiaotong University, Beijing 100044, China.
| | - Liya Wang
- Health Big Data Research Institute, Big Data Research Center, University of Electronic Science and Technology of China, Chengdu 611731, China.
| | - Haiyan Yu
- Health Big Data Research Institute, Big Data Research Center, University of Electronic Science and Technology of China, Chengdu 611731, China.
- School of Economics and Management, Chongqing University of Posts and Telecommunications, Chongqing 400065, China.
- Department of Statistics, The Pennsylvania State University, University Park, PA 16802-2111, USA.
| | - Ren Deng
- Health and Family Planning Information Center of Sichuan Province, Chengdu 610041, China.
- Sichuan Health Information Association, Chengdu 610041, China.
| | - Hu Long
- Health and Family Planning Information Center of Sichuan Province, Chengdu 610041, China.
- Sichuan Health Information Association, Chengdu 610041, China.
| | - Yanlong Zhang
- Chengdu Shulianyikang Technology Co., Ltd., Chengdu 610041, China.
| | - Jingping Pan
- Health and Family Planning Information Center of Sichuan Province, Chengdu 610041, China.
- Sichuan Health Information Association, Chengdu 610041, China.
| |
Collapse
|
106
|
Liang F, Xiao Q, Wang Y, Lyapustin A, Li G, Gu D, Pan X, Liu Y. MAIAC-based long-term spatiotemporal trends of PM 2.5 in Beijing, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 616-617:1589-1598. [PMID: 29055576 DOI: 10.1016/j.scitotenv.2017.10.155] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 10/15/2017] [Accepted: 10/15/2017] [Indexed: 06/07/2023]
Abstract
Satellite-driven statistical models have been proven to be able to provide spatially resolved PM2.5 estimates worldwide. The North China Plain has been suffering from severe PM2.5 pollution in recent years. An accurate assessment of the spatiotemporal characteristics of PM2.5 levels in this region is crucial to design effective air pollution control policy. Our objective is to estimate daily PM2.5 concentrations at 1km spatial resolution from 2004 to 2014 in Beijing and its surrounding areas using the Multi-angle implementation of atmospheric correction (MAIAC) aerosol optical depth (AOD). A high-performance three-stage model was developed with AOD, meteorological, demographic and land use variables as predictors, which includes a custom-designed PM2.5 gap-filling method. The 11-year average annual coverage increased from 177days to 279days and annual PM2.5 prediction error decreased from 14.1μg/m3 to 8.3μg/m3 after gap-filling techniques were applied. Results show that the 11-year overall mean of predicted PM2.5 was 67.1μg/m3 in our study domain. The cross-validation R2 value of our model is 0.82 in 2013 and 0.79 in 2014. In addition, the models predicted historical PM2.5 concentrations with relatively high accuracy at the seasonal and annual levels (R2 ranged from 0.78 to 0.86). Our long-term PM2.5 prediction filled the gaps left by ground monitors, which would be beneficial to PM2.5 related epidemiological studies in Beijing.
Collapse
Affiliation(s)
- Fengchao Liang
- Department of Occupational and Environmental Health, School of Public Health, Peking University, Beijing 100191, China; Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA; Department of Epidemiology, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China
| | - Qingyang Xiao
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA.
| | - Yujie Wang
- NASA Goddard Space Flight Center, Greenbelt, MD, USA; University of Maryland Baltimore County, Baltimore, MD, USA.
| | | | - Guoxing Li
- Department of Occupational and Environmental Health, School of Public Health, Peking University, Beijing 100191, China.
| | - Dongfeng Gu
- Department of Epidemiology, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China
| | - Xiaochuan Pan
- Department of Occupational and Environmental Health, School of Public Health, Peking University, Beijing 100191, China.
| | - Yang Liu
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA.
| |
Collapse
|
107
|
Tan C, Wang Y, Lin M, Wang Z, He L, Li Z, Li Y, Xu K. Long-term high air pollution exposure induced metabolic adaptations in traffic policemen. ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2018; 58:156-162. [PMID: 29346078 DOI: 10.1016/j.etap.2018.01.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 01/04/2018] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To assess the adverse physiological changes induced by long-term exposure to PM2.5. METHODS Totally 183 traffic policemen and 88 office policemen as the control group, were enrolled in this study. The concentrations of PM2.5 in both the working places of traffic and office policemen were obtained. Detailed personal questionnaires and conventional laboratory tests including hematology, fasting blood glucose, blood lipids, liver, kidney, immunity and tumor-related markers were conducted on all participants of this study. RESULTS A dose-response relationship between the FBG, HDL-c and CEA values and the PM2.5 exposure duration was observed. Multivariate analysis confirmed that one hour on duty outdoor per day for one year was associated with an increase in FBG of 0.005% (95% CI: 0.0004% to 0.009%), CEA of 0.012% (95% CI: 0.006% to 0.017%), and a decrease in HDL-C of 0.001% (95% CI: 0.00034% to 0.002%). CONCLUSION Long-term high air pollution exposure may lead to metabolism adaptation and it is likely involved in the development of cardiovascular disease and diabetes mellitus.
Collapse
Affiliation(s)
- Chaochao Tan
- Department of Laboratory Medicine, Xiangya School of Medicine, Central South University, Changsha 410013, P.R. China
| | - Yupeng Wang
- Department of Laboratory Medicine, Xiangya School of Medicine, Central South University, Changsha 410013, P.R. China
| | - Mingyue Lin
- Department of Laboratory Medicine, Xiangya School of Medicine, Central South University, Changsha 410013, P.R. China
| | - Zhu Wang
- Department of Laboratory Medicine, Xiangya School of Medicine, Central South University, Changsha 410013, P.R. China
| | - Li He
- Department of Laboratory Medicine, Xiangya School of Medicine, Central South University, Changsha 410013, P.R. China
| | - Zhiyi Li
- Department of Laboratory Medicine, Xiangya School of Medicine, Central South University, Changsha 410013, P.R. China
| | - Yu Li
- Department of Laboratory Medicine, Xiangya School of Medicine, Central South University, Changsha 410013, P.R. China
| | - Keqian Xu
- Department of Laboratory Medicine, Xiangya School of Medicine, Central South University, Changsha 410013, P.R. China.
| |
Collapse
|
108
|
Tian Y, Xiang X, Juan J, Song J, Cao Y, Huang C, Li M, Hu Y. Short-term effects of ambient fine particulate matter pollution on hospital visits for chronic obstructive pulmonary disease in Beijing, China. Environ Health 2018; 17:21. [PMID: 29482552 PMCID: PMC6389038 DOI: 10.1186/s12940-018-0369-y] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 02/20/2018] [Indexed: 05/25/2023]
Abstract
BACKGROUND Little is known about the effect of ambient fine particulate matter (PM2.5) on chronic obstructive pulmonary disease (COPD) in China. The objective of this study was to explore the short-term effects of PM2.5 on outpatient and inpatient visits for COPD in Beijing, China. METHODS A total of 3,503,313 outpatient visits and 126,982 inpatient visits for COPD between January 1, 2010, and June 30, 2012, were identified from the Beijing Medical Claim Data for Employees. A generalized additive Poisson model was applied to estimate the percentage change with 95% confidence interval (CI) in hospital visits for COPD in relation to an interquartile range (IQR) (90.8 μg/m3) increase in PM2.5 concentrations. RESULTS Short-term exposure to PM2.5 was significantly associated with increased use of COPD-related health services. There were clear exposure-response associations of PM2.5 with COPD outpatient and inpatient visits. An IQR increase in the concurrent day PM2.5 concentrations was significantly associated with a 2.38% (95% CI, 2.22%-2.53%) and 6.03% (95% CI, 5.19%-6.87%) increase in daily outpatient visits and inpatient visits, respectively. Elderly people were more sensitive to the adverse effects. The estimated risk was higher during the warm season compared to the cool season. CONCLUSIONS Short-term exposure to PM2.5 was associated with increased risk of hospital visits for COPD. Our findings contributed to the limited evidence concerning the effects of ambient PM2.5 on COPD morbidity in developing countries.
Collapse
Affiliation(s)
- Yaohua Tian
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, Beijing, 100191, China
| | - Xiao Xiang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, Beijing, 100191, China
| | - Juan Juan
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, Beijing, 100191, China
| | - Jing Song
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, Beijing, 100191, China
| | - Yaying Cao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, Beijing, 100191, China
| | - Chao Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, Beijing, 100191, China
| | - Man Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, Beijing, 100191, China
| | - Yonghua Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, Beijing, 100191, China.
| |
Collapse
|
109
|
Liu H, Tian Y, Cao Y, Song J, Huang C, Xiang X, Li M, Hu Y. Fine particulate air pollution and hospital admissions and readmissions for acute myocardial infarction in 26 Chinese cities. CHEMOSPHERE 2018; 192:282-288. [PMID: 29107880 DOI: 10.1016/j.chemosphere.2017.10.123] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 10/23/2017] [Accepted: 10/23/2017] [Indexed: 05/25/2023]
Abstract
Monitoring data on fine particulate matter (PM2.5) level in China's major cities were available since 2013. We conducted a time-stratified case-crossover study to evaluate the association between short-term exposure to PM2.5 and hospital admissions for acute myocardial infarction (AMI), as well as subsequent cardiac and AMI readmissions among AMI survivors. Hospital admissions for ST-elevation myocardial infarction (STEMI) and non ST-elevation myocardial infarction (NSTEMI) from 1 January 2014 through 31 December 2015 were identified from electronic Hospitalization Summary Reports. Conditional logistic regression was used to explore the relation between PM2.5 and hospital admissions for AMI. Individuals discharged alive following STEMI in 2014 were followed up for subsequent readmissions through 31 December 2015. We used the Cox proportional hazards model to evaluate the effect of PM2.5 pollution on subsequent cardiac and STEMI readmissions. Hospital admissions for STEMI (n = 106,467) and NSTEMI (n = 12,719) were examined separately. Exposure to an interquartile range (IQR) increase in PM2.5 concentration (47.5 μg/m3) at lags 2, 3, 4 and 0-5 days corresponded with 0.6% (95% CI, 0.1%-1.1%), 0.8 (95% CI, 0.3%-1.3%), 0.6% (95% CI, 0.1%-1.1%) and 0.9% (95% CI, 0-1.8%) increases in STEMI admissions, respectively. For NSTEMI, no significant association was observed with PM2.5. We also observed significant associations of PM2.5 concentration with both subsequent cardiac and STEMI readmissions among STEMI survivors. In conclusion, short-term elevations in PM2.5 concentration may increase the risk of STEMI but not NSTEMI, and the association appeared to be more evident among STEMI survivors.
Collapse
Affiliation(s)
- Hui Liu
- Medical Informatics Center, Peking University, No.38 Xueyuan Road, 100191, Beijing, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191, Beijing, China
| | - Yaohua Tian
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191, Beijing, China
| | - Yaying Cao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191, Beijing, China
| | - Jing Song
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191, Beijing, China
| | - Chao Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191, Beijing, China
| | - Xiao Xiang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191, Beijing, China
| | - Man Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191, Beijing, China
| | - Yonghua Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191, Beijing, China.
| |
Collapse
|
110
|
Thurston GD, Newman JD. Walking to a pathway for cardiovascular effects of air pollution. Lancet 2018; 391:291-292. [PMID: 29221647 PMCID: PMC7944650 DOI: 10.1016/s0140-6736(17)33078-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 10/24/2017] [Indexed: 01/27/2023]
Affiliation(s)
- George D Thurston
- New York University School of Medicine, Department of Environmental Medicine, Tuxedo, NY 10987-5007, USA.
| | - Jonathan D Newman
- New York University School of Medicine, Department of Medicine, Division of Cardiology, New York, NY, USA
| |
Collapse
|
111
|
Sinharay R, Gong J, Barratt B, Ohman-Strickland P, Ernst S, Kelly FJ, Zhang JJ, Collins P, Cullinan P, Chung KF. Respiratory and cardiovascular responses to walking down a traffic-polluted road compared with walking in a traffic-free area in participants aged 60 years and older with chronic lung or heart disease and age-matched healthy controls: a randomised, crossover study. Lancet 2018; 391:339-349. [PMID: 29221643 PMCID: PMC5803182 DOI: 10.1016/s0140-6736(17)32643-0] [Citation(s) in RCA: 230] [Impact Index Per Article: 38.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 09/19/2017] [Accepted: 09/21/2017] [Indexed: 12/15/2022]
Abstract
BACKGROUND Long-term exposure to pollution can lead to an increase in the rate of decline of lung function, especially in older individuals and in those with chronic obstructive pulmonary disease (COPD), whereas shorter-term exposure at higher pollution levels has been implicated in causing excess deaths from ischaemic heart disease and exacerbations of COPD. We aimed to assess the effects on respiratory and cardiovascular responses of walking down a busy street with high levels of pollution compared with walking in a traffic-free area with lower pollution levels in older adults. METHODS In this randomised, crossover study, we recruited men and women aged 60 years and older with angiographically proven stable ischaemic heart disease or stage 2 Global initiative for Obstructive Lung Disease (GOLD) COPD who had been clinically stable for 6 months, and age-matched healthy volunteers. Individuals with ischaemic heart disease or COPD were recruited from existing databases or outpatient respiratory and cardiology clinics at the Royal Brompton & Harefield NHS Foundation Trust and age-matched healthy volunteers using advertising and existing databases. All participants had abstained from smoking for at least 12 months and medications were taken as recommended by participants' doctors during the study. Participants were randomly assigned by drawing numbered disks at random from a bag to do a 2 h walk either along a commercial street in London (Oxford Street) or in an urban park (Hyde Park). Baseline measurements of participants were taken before the walk in the hospital laboratory. During each walk session, black carbon, particulate matter (PM) concentrations, ultrafine particles, and nitrogen dioxide (NO2) concentrations were measured. FINDINGS Between October, 2012, and June, 2014, we screened 135 participants, of whom 40 healthy volunteers, 40 individuals with COPD, and 39 with ischaemic heart disease were recruited. Concentrations of black carbon, NO2, PM10, PM2.5, and ultrafine particles were higher on Oxford Street than in Hyde Park. Participants with COPD reported more cough (odds ratio [OR] 1·95, 95% CI 0·96-3·95; p<0·1), sputum (3·15, 1·39-7·13; p<0·05), shortness of breath (1·86, 0·97-3·57; p<0·1), and wheeze (4·00, 1·52-10·50; p<0·05) after walking down Oxford Street compared with Hyde Park. In all participants, irrespective of their disease status, walking in Hyde Park led to an increase in lung function (forced expiratory volume in the first second [FEV1] and forced vital capacity [FVC]) and a decrease in pulse wave velocity (PWV) and augmentation index up to 26 h after the walk. By contrast, these beneficial responses were attenuated after walking on Oxford Street. In participants with COPD, a reduction in FEV1 and FVC, and an increase in R5-20 were associated with an increase in during-walk exposure to NO2, ultrafine particles and PM2.5, and an increase in PWV and augmentation index with NO2 and ultrafine particles. In healthy volunteers, PWV and augmentation index were associated both with black carbon and ultrafine particles. INTERPRETATION Short-term exposure to traffic pollution prevents the beneficial cardiopulmonary effects of walking in people with COPD, ischaemic heart disease, and those free from chronic cardiopulmonary diseases. Medication use might reduce the adverse effects of air pollution in individuals with ischaemic heart disease. Policies should aim to control ambient levels of air pollution along busy streets in view of these negative health effects. FUNDING British Heart Foundation.
Collapse
Affiliation(s)
- Rudy Sinharay
- National Heart and Lung Institute and MRC-PHE Centre for Environment and Health, Imperial College, London, UK; NIHR Biomedical Research Unit, Royal Brompton & Harefield NHS Trust, London, UK
| | - Jicheng Gong
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing China; Nicholas School of Environment & Duke Global Health Institute, Duke University, Durham, USA; Duke Kunshan University, Kunshan, China
| | - Benjamin Barratt
- MRC-PHE Centre for Environment and Health, King's College London, London, UK
| | - Pamela Ohman-Strickland
- Rutgers School of Public Health, Rutgers, The State University of New Jersey, New Jersey, USA
| | - Sabine Ernst
- NIHR Biomedical Research Unit, Royal Brompton & Harefield NHS Trust, London, UK
| | - Frank J Kelly
- MRC-PHE Centre for Environment and Health, King's College London, London, UK
| | - Junfeng Jim Zhang
- BIC-ESAT and SKL-ESPC, College of Environmental Sciences and Engineering, Peking University, Beijing China; Nicholas School of Environment & Duke Global Health Institute, Duke University, Durham, USA; Duke Kunshan University, Kunshan, China
| | - Peter Collins
- National Heart and Lung Institute and MRC-PHE Centre for Environment and Health, Imperial College, London, UK; NIHR Biomedical Research Unit, Royal Brompton & Harefield NHS Trust, London, UK
| | - Paul Cullinan
- National Heart and Lung Institute and MRC-PHE Centre for Environment and Health, Imperial College, London, UK; NIHR Biomedical Research Unit, Royal Brompton & Harefield NHS Trust, London, UK
| | - Kian Fan Chung
- National Heart and Lung Institute and MRC-PHE Centre for Environment and Health, Imperial College, London, UK; NIHR Biomedical Research Unit, Royal Brompton & Harefield NHS Trust, London, UK.
| |
Collapse
|
112
|
Yu Y, Dong H, Yao S, Ji M, Yao X, Zhang Z. Protective Effects of Ambient Ozone on Incidence and Outcomes of Ischemic Stroke in Changzhou, China: A Time-Series Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14121610. [PMID: 29261153 PMCID: PMC5751026 DOI: 10.3390/ijerph14121610] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 11/22/2017] [Accepted: 12/19/2017] [Indexed: 12/16/2022]
Abstract
The potential beneficial effect of ozone (O3) on stroke had been identified experimentally and clinically, but these effects remain controversial in population-based studies. This study aimed to explore the epidemiological association between O3 and risk of ischemic stroke. Ischemic stroke related health data and air pollution data were obtained from the Center for Disease Control and Prevention and Environmental Monitoring Center in Changzhou between 2015 and 2016, respectively. The associations between the short-term exposure to O3 and daily ischemic stroke onsets and deaths were examined based on time-series generalized additive Poisson model. During the study period, daily ischemic stroke onsets and deaths decreased 0.340% (95% confidence interval (CI) −0.559% to −0.120%) and 0.697% (95% CI −1.103% to −0.290%) with an interquartile range (IQR) (41.1 µg/m3) increase in levels of ambient O3, respectively. The protective effects of O3 were more significant in men and elders and in the cool season than those in women and young people and in the warm season, respectively. The negative association was independent of PM2.5, PM10, SO2, NO2 or CO exposure. Acute O3 exposure was associated with decreased risk of ischemic stroke. These findings will help provide new insights into the relationship between ischemic stroke and ambient O3 concentrations.
Collapse
Affiliation(s)
- Yongquan Yu
- Department of Occupational Medicine and Environmental Health, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing 211166, China.
| | - Huibin Dong
- Department of Chronic Disease Control and Prevention, Changzhou Center for Disease Control and Prevention, 203 Taishan Road, Changzhou 213022, China.
| | - Shen Yao
- Department of Occupational Medicine and Environmental Health, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing 211166, China.
| | - Minghui Ji
- Department of Occupational Medicine and Environmental Health, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing 211166, China.
| | - Xingjuan Yao
- Department of Chronic Disease Control and Prevention, Changzhou Center for Disease Control and Prevention, 203 Taishan Road, Changzhou 213022, China.
| | - Zhan Zhang
- Department of Hygiene Analysis and Detection, School of Public Health, Nanjing Medical University, 101 Longmian Avenue, Nanjing 211166, China.
| |
Collapse
|
113
|
Brook RD, Newby DE, Rajagopalan S. Air Pollution and Cardiometabolic Disease: An Update and Call for Clinical Trials. Am J Hypertens 2017; 31:1-10. [PMID: 28655143 DOI: 10.1093/ajh/hpx109] [Citation(s) in RCA: 98] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 06/15/2017] [Indexed: 12/13/2022] Open
Abstract
Fine particulate matter <2.5 µm (PM2.5) air pollution is a leading cause of global morbidity and mortality. The largest portion of deaths is now known to be due to cardiovascular disorders. Several air pollutants can trigger acute events (e.g., myocardial infarctions, strokes, heart failure). However, mounting evidence additionally supports that longer-term exposures pose a greater magnified risk to cardiovascular health. One explanation may be that PM2.5 has proven capable of promoting the development of chronic cardiometabolic conditions including atherosclerosis, hypertension, and diabetes mellitus. Here, we provide an updated overview of recent major studies regarding the impact of PM2.5 on cardiometabolic health and outline key remaining scientific questions. We discuss the relevance of emerging trials evaluating personal-level strategies (e.g., facemasks) to prevent the harmful effects of PM2.5, and close with a call for large-scale outcome trials to allow for the promulgation of formal evidence-base recommendations regarding their appropriate usage in the global battle against air pollution.
Collapse
Affiliation(s)
- Robert D Brook
- Division of Cardiovascular Medicine, University of Michigan, USA
| | - David E Newby
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, United Kingdom
| | - Sanjay Rajagopalan
- Division of Cardiovascular Medicine, Harrington Heart and Vascular Institute, University Hospitals, USA
| |
Collapse
|
114
|
Li G, Xue M, Zeng Q, Cai Y, Pan X, Meng Q. Association between fine ambient particulate matter and daily total mortality: An analysis from 160 communities of China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2017; 599-600:108-113. [PMID: 28472694 DOI: 10.1016/j.scitotenv.2017.04.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Revised: 03/31/2017] [Accepted: 04/02/2017] [Indexed: 05/22/2023]
Abstract
Short-term exposure to outdoor fine particulate matter air pollution is associated with adverse health effects. However, existing literature have been limited in size and scope in countries with high air pollution level, especially in China. The study aims to examine the association of fine particulate matter with daily total mortality in 160 Chinese communities between 2013 and 2014. Two-stage analyses were used to assess the relationship between fine particulate matter (PM2.5) and mortality. Firstly, Poisson regression model was used to estimate the community-specific PM2.5-mortalty association. Secondly, a meta-analysis was used to pool the effect estimates within each region. During the study period, a total of 1.4 million deaths were recorded in 160 communities. There was a significant association between PM2.5 and mortality. Specifically, a 10μg/m3 increase in 2-day moving average PM2.5 concentration on total morality corresponded to a 0.17% (95% confidence interval (CI): 0.10, 0.23) in national level. The estimate of PM2.5 on morality in Pearl Delta River was highest among Beijing-Tianjin-Hebei regions, Pearl River Delta, and Yangtze River Delta. Females, older population and widowed population appeared to be more vulnerable to particulate matter exposure. Conclusively, this largest epidemiologic study of fine particulate matter in China suggests that PM2.5 is associated with increased mortality risk.
Collapse
Affiliation(s)
- Guoxing Li
- Department of Occupational and Environmental Health, School of Public Health, Peking University, Beijing, China.
| | - Ming Xue
- Center for Health Statistics and Information, National Health and Family Planning Commission, China.
| | - Qiang Zeng
- Tianjin Center for Diseases Prevention and Control, China.
| | - Yue Cai
- Center for Health Statistics and Information, National Health and Family Planning Commission, China.
| | - Xiaochuan Pan
- Department of Occupational and Environmental Health, School of Public Health, Peking University, Beijing, China.
| | - Qun Meng
- Center for Health Statistics and Information, National Health and Family Planning Commission, China.
| |
Collapse
|
115
|
Newell K, Kartsonaki C, Lam KBH, Kurmi OP. Cardiorespiratory health effects of particulate ambient air pollution exposure in low-income and middle-income countries: a systematic review and meta-analysis. Lancet Planet Health 2017; 1:e368-e380. [PMID: 29851649 DOI: 10.1016/s2542-5196(17)30166-3] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2017] [Revised: 10/17/2017] [Accepted: 11/20/2017] [Indexed: 05/21/2023]
Abstract
BACKGROUND Most prospective studies on the health effects of particulate ambient air pollution exposure have focused on high-income countries, which have much lower pollutant concentrations than low-income and middle-income countries (LMICs) and different sources of pollution. We aimed to investigate the cardiorespiratory health effects of particulate ambient air pollution exposure in LMICs exclusively. METHODS For this systematic review and meta-analysis, we searched PubMed, Web of Science, Embase, LILACS, Global Health, and Proquest for studies published between database inception and Nov 28, 2016, investigating the cardiorespiratory health effects of particulate ambient air pollution exposure in LMICs. Data were extracted from published studies by one author, and then checked and verified by all authors independently. We pooled estimates by pollutant type (particulate matter with a diameter of <2·5 μm [PM2·5] or 2·5-10 μm [PM10]), lag, and outcome, and presented them as excess relative risk per 10 μg/m3 increase in particulate ambient air pollution. We used a random-effects model to derive overall excess risk. The study protocol is registered with PROSPERO, number CRD42016051733. FINDINGS Of 1553 studies identified, 91 met the full eligibility criteria. Only four long-term exposure studies from China were identified and not included in the meta-analysis. A 10 μg/m3 increase in same-day PM2·5 was associated with a 0·47% (95% CI 0·34-0·61) increase in cardiovascular mortality and a 0·57% (0·28-0·86) increase in respiratory mortality. A 10 μg/m3 increase in same-day PM10 was associated with a 0·27% (0·11-0·44) increase in cardiovascular mortality and a 0·56% (0·24-0·87) increase in respiratory mortality. INTERPRETATION Short-term exposure to particulate ambient air pollution is associated with increases in cardiorespiratory morbidity and mortality in LMIC's, with apparent regional-specific variations. FUNDING None.
Collapse
Affiliation(s)
- Katherine Newell
- Clinical Trial Service Unit & Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
| | - Christiana Kartsonaki
- Clinical Trial Service Unit & Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK; Medical Research Council Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Kin Bong Hubert Lam
- Clinical Trial Service Unit & Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Om P Kurmi
- Clinical Trial Service Unit & Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| |
Collapse
|
116
|
Liu H, Tian Y, Xu Y, Huang Z, Huang C, Hu Y, Zhang J. Association between ambient air pollution and hospitalization for ischemic and hemorrhagic stroke in China: A multicity case-crossover study. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2017; 230:234-241. [PMID: 28654881 DOI: 10.1016/j.envpol.2017.06.057] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Revised: 06/15/2017] [Accepted: 06/17/2017] [Indexed: 05/19/2023]
Abstract
There is growing interest in the association between ambient air pollution and stroke, but few studies have investigated the association in developing countries. The primary objective of this study was to examine the association between levels of ambient air pollutants and hospital admission for stroke in China. A time-stratified case-crossover analysis was conducted between 2014 and 2015 in 14 large Chinese cities among 200,958 ischemic stroke and 41,746 hemorrhagic stroke hospitalizations. We used conditional logistic regression to estimate the percentage changes in stroke admissions in relation to interquartile range increases in air pollutants. Air pollution was positively associated with ischemic stroke. A difference of an interquartile range of the 6-day average for particulate matter less than 10 μm in aerodynamic diameter, sulfur dioxide, nitrogen dioxide, carbon monoxide, and ozone corresponded to 0.7% (95% CI: 0%, 1.4%), 1.6% (95% CI: 1.0%, 2.3%), 2.6% (95% CI: 1.8%, 3.5%), 0.5% (95% CI: -0.2%, 1.1%), and 1.3% (95% CI: 0.3%, 2.3%) increases in ischemic stroke admissions, respectively. For hemorrhagic stroke, we observed the only significant association in relation to nitrogen dioxide on the current day (percentage change: 1.6%; 95% CI: 0.3%, 2.9%). Our findings contribute to the limited scientific literature concerning the effect of ambient air pollution on stroke in developing countries. Our findings may have significant public health implications for primary prevention of stroke in China.
Collapse
Affiliation(s)
- Hui Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191 Beijing, China; Medical Informatics Center, Peking University, No.38 Xueyuan Road, 100191 Beijing, China
| | - Yaohua Tian
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191 Beijing, China
| | - Yan Xu
- Department of Neurology, Peking University People's Hospital, No.11 South Xizhimen Street, 100044 Beijing, China
| | - Zhe Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191 Beijing, China
| | - Chao Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191 Beijing, China
| | - Yonghua Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191 Beijing, China.
| | - Jun Zhang
- Department of Neurology, Peking University People's Hospital, No.11 South Xizhimen Street, 100044 Beijing, China.
| |
Collapse
|
117
|
Tian Y, Xiang X, Juan J, Sun K, Song J, Cao Y, Hu Y. Fine particulate air pollution and hospital visits for asthma in Beijing, China. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2017; 230:227-233. [PMID: 28654880 DOI: 10.1016/j.envpol.2017.06.029] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 06/12/2017] [Accepted: 06/12/2017] [Indexed: 06/07/2023]
Abstract
Data on fine particulate matter (PM2.5) in China were first announced in 2013. The primary objective of this study was to evaluate the acute effects of PM2.5 on asthma morbidity in Beijing, China. A total of 978,658 asthma hospital visits consisting of 928,607 outpatient visits, 40,063 emergency room visits and 9988 hospital admissions from January 1, 2010, to June 30, 2012, were identified from the Beijing Medical Claim Data for Employees. A generalized additive Poisson model was applied to explore the association between PM2.5 and health service use. The mean daily PM2.5 concentration was 99.5 μg/m3 with a range from 7.2 μg/m3 to 492.8 μg/m3. Ambient PM2.5 concentration was significantly associated with increased use of asthma-related health services. Every 10 μg/m3 increase in PM2.5 concentration on the same day was significantly associated with a 0.67% (95% CI, 0.53%-0.81%), 0.65% (95% CI, 0.51%-0.80%), and 0.49% (95% CI, 0.35%-0.64%) increase in total hospital visits, outpatient visits and emergency room visits, respectively. The exposure-response association between PM2.5 concentration and hospital visits for asthma exacerbations was approximately linear. In conclusion, this study found that short-term elevations in PM2.5 concentration may increase the risk of asthma exacerbations. Our findings contribute to the limited scientific literature concerning the acute effects of PM2.5 on asthma morbidity outcomes in developing countries.
Collapse
Affiliation(s)
- Yaohua Tian
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191 Beijing, China
| | - Xiao Xiang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191 Beijing, China
| | - Juan Juan
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191 Beijing, China
| | - Kexin Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191 Beijing, China
| | - Jing Song
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191 Beijing, China
| | - Yaying Cao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191 Beijing, China
| | - Yonghua Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191 Beijing, China.
| |
Collapse
|
118
|
Liu H, Tian Y, Xiang X, Sun K, Juan J, Song J, Cao Y, Xu B, Hu Y. Air Pollution and Hospitalization for Acute Myocardial Infarction in China. Am J Cardiol 2017; 120:753-758. [PMID: 28705380 DOI: 10.1016/j.amjcard.2017.06.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Revised: 05/16/2017] [Accepted: 06/01/2017] [Indexed: 11/26/2022]
Abstract
There is growing interest in the association between ambient air pollution and acute myocardial infarction (AMI). The objective of this study was to explore the association in 14 Chinese cities using a time-stratified case-crossover design. We identified 80,787 hospital admissions for AMI between January 1, 2014 and December 31, 2015 from electronic hospitalization summary reports. Conditional logistic regression was used to estimate the percent changes with 95% confidence intervals (CIs) in AMI admissions in relation to an interquartile range increase in ambient air pollutant concentrations. All analyzed air pollutants, with the exception of ozone, were positively associated with daily AMI admissions on lag2 and lag3 days. An interquartile range increase in particulate matter <10 µm in aerodynamic diameter, sulfur dioxide, nitrogen dioxide, and carbon monoxide concentrations on lag2 day was significantly associated with a 0.8% (95% CI 0.1%, 1.6%), 2.0% (95% CI 1.2%, 2.9%), 2.2% (95% CI 1.4%, 3.1%), and 1.1% (95% CI 0.4%, 1.8%) increase in AMI admissions, respectively. We also observed a significant association in relation to ozone on lag4 day (percent change: 1.3%; 95% CI 0.2%, 2.4%). Subgroup analyses indicated no effect modification of risk by age (≥65 years and <65 years) or gender. In conclusion, this is the first multicity study in China, or even in other developing countries, to report the short-term effects of air pollution on AMI morbidity. Our findings contribute to the limited scientific data on the effects of ambient air pollution on AMI in developing countries.
Collapse
|
119
|
Tian Y, Xiang X, Wu Y, Cao Y, Song J, Sun K, Liu H, Hu Y. Fine Particulate Air Pollution and First Hospital Admissions for Ischemic Stroke in Beijing, China. Sci Rep 2017; 7:3897. [PMID: 28634403 PMCID: PMC5478610 DOI: 10.1038/s41598-017-04312-5] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 05/15/2017] [Indexed: 12/26/2022] Open
Abstract
The primary objective of this study was to assess the association between short-term changes in ambient fine particulate matter (PM2.5) and first hospital admissions for ischemic stroke. We identified 63,956 first hospital admissions for ischemic stroke from the Beijing Medical Claim Data for Employees from January 1, 2010, through June 30, 2012. A generalized additive Poisson model was applied to explore the association between PM2.5 and admissions for ischemic stroke. We also explore the effect modification of risk by age and gender. The exposure-response relationship between PM2.5 and admissions for ischemic stroke was approximately linear, with a relatively stable response at lower concentrations (<100 μg/m3) and a steeper response at higher concentrations. A 10 μg/m3 increase in the same-day PM2.5 concentration was associated with 0.31% (95% CI, 0.17-0.45%, P < 1.57 × 10-5) increase in the daily admissions for ischemic stroke. The association was also statistically significant at lag 1, 2, 3, 0-2 and 0-4 days. Subgroup analyses showed that the association was not different between patients ≥65 years and <65 years old or between males and females. In conclusion, short-term exposure to PM2.5 was positively associated with first hospital admissions for ischemic stroke in Beijing, China.
Collapse
Affiliation(s)
- Yaohua Tian
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, 100191, Beijing, China
| | - Xiao Xiang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, 100191, Beijing, China
| | - Yiqun Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, 100191, Beijing, China
| | - Yaying Cao
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, 100191, Beijing, China
| | - Jing Song
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, 100191, Beijing, China
| | - Kexin Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, 100191, Beijing, China
| | - Hui Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, 100191, Beijing, China
- Medical Informatics Center, Peking University, No. 38 Xueyuan Road, 100191, Beijing, China
| | - Yonghua Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38 Xueyuan Road, 100191, Beijing, China.
| |
Collapse
|
120
|
Perret JL, Bowatte G, Lodge CJ, Knibbs LD, Gurrin LC, Kandane-Rathnayake R, Johns DP, Lowe AJ, Burgess JA, Thompson BR, Thomas PS, Wood-Baker R, Morrison S, Giles GG, Marks G, Markos J, Tang MLK, Abramson MJ, Walters EH, Matheson MC, Dharmage SC. The Dose-Response Association between Nitrogen Dioxide Exposure and Serum Interleukin-6 Concentrations. Int J Mol Sci 2017; 18:ijms18051015. [PMID: 28481326 PMCID: PMC5454928 DOI: 10.3390/ijms18051015] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 04/26/2017] [Accepted: 04/28/2017] [Indexed: 12/04/2022] Open
Abstract
Systemic inflammation is an integral part of chronic obstructive pulmonary disease (COPD), and air pollution is associated with cardiorespiratory mortality, yet the interrelationships are not fully defined. We examined associations between nitrogen dioxide (NO2) exposure (as a marker of traffic-related air pollution) and pro-inflammatory cytokines, and investigated effect modification and mediation by post-bronchodilator airflow obstruction (post-BD-AO) and cardiovascular risk. Data from middle-aged participants in the Tasmanian Longitudinal Health Study (TAHS, n = 1389) were analyzed by multivariable logistic regression, using serum interleukin (IL)-6, IL-8 and tumor necrosis factor-α (TNF-α) as the outcome. Mean annual NO2 exposure was estimated at residential addresses using a validated satellite-based land-use regression model. Post-BD-AO was defined by post-BD forced expiratory ratio (FEV1/FVC) < lower limit of normal, and cardiovascular risk by a history of either cerebrovascular or ischaemic heart disease. We found a positive association with increasing serum IL-6 concentration (geometric mean 1.20 (95% CI: 1.1 to 1.3, p = 0.001) per quartile increase in NO2). This was predominantly a direct relationship, with little evidence for either effect modification or mediation via post-BD-AO, or for the small subgroup who reported cardiovascular events. However, there was some evidence consistent with serum IL-6 being on the causal pathway between NO2 and cardiovascular risk. These findings raise the possibility that the interplay between air pollution and systemic inflammation may differ between post-BD airflow obstruction and cardiovascular diseases.
Collapse
Affiliation(s)
- Jennifer L Perret
- Allergy and Lung Health Unit, Center for Epidemiology and Biostatistics, the University of Melbourne, Melbourne, Victoria 3010, Australia.
- Institute for Breathing and Sleep (IBAS), Heidelberg, Melbourne, Victoria 3084, Australia.
| | - Gayan Bowatte
- Allergy and Lung Health Unit, Center for Epidemiology and Biostatistics, the University of Melbourne, Melbourne, Victoria 3010, Australia.
| | - Caroline J Lodge
- Allergy and Lung Health Unit, Center for Epidemiology and Biostatistics, the University of Melbourne, Melbourne, Victoria 3010, Australia.
| | - Luke D Knibbs
- School of Public Health, the University of Queensland, Herston, Queensland 4006, Australia.
| | - Lyle C Gurrin
- Allergy and Lung Health Unit, Center for Epidemiology and Biostatistics, the University of Melbourne, Melbourne, Victoria 3010, Australia.
| | - Rangi Kandane-Rathnayake
- School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria 3004, Australia.
| | - David P Johns
- School of Medicine, University of Tasmania, Hobart, Tasmania 7001, Australia.
- "Breathe Well" Center of Research Excellence for Chronic Respiratory Disease and Lung Ageing, School of Medicine, University of Tasmania, Hobart, Tasmania 7005, Australia.
| | - Adrian J Lowe
- Allergy and Lung Health Unit, Center for Epidemiology and Biostatistics, the University of Melbourne, Melbourne, Victoria 3010, Australia.
| | - John A Burgess
- Allergy and Lung Health Unit, Center for Epidemiology and Biostatistics, the University of Melbourne, Melbourne, Victoria 3010, Australia.
| | - Bruce R Thompson
- Allergy, Immunology and Respiratory Medicine, the Alfred Hospital, Melbourne, Victoria 3004, Australia.
| | - Paul S Thomas
- Prince of Wales' Hospital Clinical School and School of Medicine Sciences, Faculty of Medicine, University of New South Wales, Sydney, NSW 2052, Australia.
| | - Richard Wood-Baker
- School of Medicine, University of Tasmania, Hobart, Tasmania 7001, Australia.
| | - Stephen Morrison
- Department of Medicine, University of Queensland, Brisbane, Queensland 4072, Australia.
| | - Graham G Giles
- Cancer Epidemiological Center, Cancer Council Victoria, Melbourne, Victoria 3053, Australia.
| | - Guy Marks
- South West Sydney Clinical School, the University of NSW, Liverpool, NSW 2170, Australia.
| | - James Markos
- Department of Respiratory Medicine, Launceston General Hospital, Launceston, Tasmania 7250, Australia.
| | - Mimi L K Tang
- Department of Allergy and Immunology, Royal Children's Hospital, Parkville, Victoria 3052, Australia.
- Allergy and Immune Disorders, Murdoch Children's Research Institute, Parkville, Victoria 3052, Australia.
- Department of Paediatrics, the University of Melbourne, Victoria 3010, Australia.
| | - Michael J Abramson
- School of Public Health & Preventive Medicine, Monash University, Melbourne, Victoria 3004, Australia.
| | - E Haydn Walters
- Allergy and Lung Health Unit, Center for Epidemiology and Biostatistics, the University of Melbourne, Melbourne, Victoria 3010, Australia.
- School of Medicine, University of Tasmania, Hobart, Tasmania 7001, Australia.
- "Breathe Well" Center of Research Excellence for Chronic Respiratory Disease and Lung Ageing, School of Medicine, University of Tasmania, Hobart, Tasmania 7005, Australia.
| | - Melanie C Matheson
- Allergy and Lung Health Unit, Center for Epidemiology and Biostatistics, the University of Melbourne, Melbourne, Victoria 3010, Australia.
| | - Shyamali C Dharmage
- Allergy and Lung Health Unit, Center for Epidemiology and Biostatistics, the University of Melbourne, Melbourne, Victoria 3010, Australia.
| |
Collapse
|
121
|
Onozuka D, Hagihara A. Out-of-hospital cardiac arrest attributable to sunshine: a nationwide, retrospective, observational study. EUROPEAN HEART JOURNAL. QUALITY OF CARE & CLINICAL OUTCOMES 2017; 3:107-113. [PMID: 28927170 DOI: 10.1093/ehjqcco/qcw056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 11/02/2016] [Indexed: 11/15/2022]
Abstract
Aims To investigate the population attributable risk of out-of-hospital cardiac arrest (OHCA) from non-optimal sunshine duration and the relative contribution of daily sunshine hours. Methods and Results National registry data of all cases of OHCA occurred between 2005 and 2014 in the 47 Japanese prefectures were obtained. We examined the relationship between daily duration of sunshine and OHCA risk for each prefecture in Japan using a Poisson regression model combined with a distributed lag non-linear model, adjusting for confounding factors. The estimated associations for each prefecture were pooled at the nationwide level using a multivariate random-effects meta-analysis. A total of 658 742 cases of OHCA of presumed cardiac origin met our inclusion criteria. The minimum morbidity sunshine duration varied from the 21st percentile in Okayama to the 99th percentile in Hokkaido, Gifu, and Hyogo. Overall, 5.78% [95% empirical confidence interval (eCI): 3.57-7.16] of the OHCA cases were attributable to daily sunshine duration. The attributable fraction for short sunshine duration (below the minimum morbidity sunshine duration) was 4.18% (95% eCI: 2.64-5.38), whereas that for long sunshine duration (above the minimum morbidity sunshine duration) was 1.59% (95% eCI: 0.81-2.21). Conclusions Daily sunshine duration was responsible for OHCA burden, and a greater number of OHCA cases occurred in patients who were only exposed to sunshine for short periods of time each day. Our findings suggest that public health efforts to reduce OHCA burden should take sunshine level into account.
Collapse
|
122
|
Onozuka D, Hagihara A. Spatiotemporal variation in heat-related out-of-hospital cardiac arrest during the summer in Japan. THE SCIENCE OF THE TOTAL ENVIRONMENT 2017; 583:401-407. [PMID: 28117163 DOI: 10.1016/j.scitotenv.2017.01.081] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Revised: 01/13/2017] [Accepted: 01/13/2017] [Indexed: 05/25/2023]
Abstract
BACKGROUND Although several studies have reported the impacts of extremely high temperature on cardiovascular diseases, few studies have investigated the spatiotemporal variation in the incidence of out-of-hospital cardiac arrest (OHCA) due to extremely high temperature in Japan. METHODS Daily OHCA data from 2005 to 2014 were acquired from all 47 prefectures of Japan. We used time-series Poisson regression analysis combined with a distributed lag non-linear model to assess the temporal variability in the effects of extremely high temperature on OHCA incidence in each prefecture, adjusted for time trends. Spatial variability in the relationships between extremely high temperature and OHCA between prefectures was estimated using a multivariate random-effects meta-analysis. RESULTS We analyzed 166,496 OHCA cases of presumed cardiac origin occurring during the summer (June to September) that met the inclusion criteria. The minimum morbidity percentile (MMP) was the 51st percentile of temperature during the summer in Japan. The overall cumulative relative risk at the 99th percentile vs. the MMP over lags 0-10days was 1.21 (95% CI: 1.12-1.31). There was also a strong low temperature effect during the summer periods. No substantial difference in spatial or temporal variability was observed over the study period. CONCLUSIONS Our study demonstrated spatiotemporal homogeneity in the risk of OHCA during periods of extremely high temperature between 2005 and 2014 in Japan. Our findings suggest that public health strategies for OHCA due to extremely high temperatures should be finely adjusted and should particularly account for the unchanging risk during the summer.
Collapse
Affiliation(s)
- Daisuke Onozuka
- Department of Health Communication, Kyushu University Graduate School of Medical Sciences, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
| | - Akihito Hagihara
- Department of Health Communication, Kyushu University Graduate School of Medical Sciences, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
| |
Collapse
|
123
|
Onozuka D, Hagihara A. Within-summer variation in out-of-hospital cardiac arrest due to extremely long sunshine duration. Int J Cardiol 2017; 231:120-124. [DOI: 10.1016/j.ijcard.2016.12.179] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 12/18/2016] [Accepted: 12/21/2016] [Indexed: 12/30/2022]
|
124
|
He MZ, Zeng X, Zhang K, Kinney PL. Fine Particulate Matter Concentrations in Urban Chinese Cities, 2005-2016: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14020191. [PMID: 28216601 PMCID: PMC5334745 DOI: 10.3390/ijerph14020191] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2017] [Revised: 02/07/2017] [Accepted: 02/08/2017] [Indexed: 12/22/2022]
Abstract
Background: Particulate matter pollution has become a growing health concern over the past few decades globally. The problem is especially evident in China, where particulate matter levels prior to 2013 are publically unavailable. We conducted a systematic review of scientific literature that reported fine particulate matter (PM2.5) concentrations in different regions of China from 2005 to 2016. Methods: We searched for English articles in PubMed and Embase and for Chinese articles in the China National Knowledge Infrastructure (CNKI). We evaluated the studies overall and categorized the collected data into six geographical regions and three economic regions. Results: The mean (SD) PM2.5 concentration, weighted by the number of sampling days, was 60.64 (33.27) μg/m³ for all geographic regions and 71.99 (30.20) μg/m³ for all economic regions. A one-way ANOVA shows statistically significant differences in PM2.5 concentrations between the various geographic regions (F = 14.91, p < 0.0001) and the three economic regions (F = 4.55, p = 0.01). Conclusions: This review identifies quantifiable differences in fine particulate matter concentrations across regions of China. The highest levels of fine particulate matter were found in the northern and northwestern regions and especially Beijing. The high percentage of data points exceeding current federal regulation standards suggests that fine particulate matter pollution remains a huge problem for China. As pre-2013 emissions data remain largely unavailable, we hope that the data aggregated from this systematic review can be incorporated into current and future models for more accurate historical PM2.5 estimates.
Collapse
Affiliation(s)
- Mike Z He
- Department of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD 21205, USA.
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY 10032, USA.
| | - Xiange Zeng
- Program in Public Health Studies, Johns Hopkins University Krieger School of Arts and Sciences, Baltimore, MD 21218, USA.
| | - Kaiyue Zhang
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210000, Jiangsu, China.
- Yangzhou Center for Disease Control and Prevention, Yangzhou 225000, Jiangsu, China.
| | - Patrick L Kinney
- Department of Environmental Health, School of Public Health, Boston University, Boston, MD 02118, USA.
| |
Collapse
|
125
|
Wang Z, Pang W, He C, Li Y, Jiang Y, Guo C. Blueberry Anthocyanin-Enriched Extracts Attenuate Fine Particulate Matter (PM 2.5)-Induced Cardiovascular Dysfunction. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2017; 65:87-94. [PMID: 27996266 DOI: 10.1021/acs.jafc.6b04603] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
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 (PM2.5) three times a week. A positive control group was exposed to PM2.5 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 PM2.5-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 PM2.5-induced damage.
Collapse
Affiliation(s)
- Ziyu Wang
- School of Public Health, Guangxi Medical University , Nanning 530021, China
- Department of Nutrition, Tianjin Institute of Health and Environmental Medicine , Tianjin 300050, China
| | - Wei Pang
- Department of Nutrition, Tianjin Institute of Health and Environmental Medicine , Tianjin 300050, China
| | - Congcong He
- Department of Nutrition, Tianjin Institute of Health and Environmental Medicine , Tianjin 300050, China
| | - Yibo Li
- Department of Nutrition, Tianjin Institute of Health and Environmental Medicine , Tianjin 300050, China
| | - Yugang Jiang
- Department of Nutrition, Tianjin Institute of Health and Environmental Medicine , Tianjin 300050, China
| | - Changjiang Guo
- School of Public Health, Guangxi Medical University , Nanning 530021, China
- Department of Nutrition, Tianjin Institute of Health and Environmental Medicine , Tianjin 300050, China
| |
Collapse
|
126
|
Chang J, Li B, Li J, Sun Y. The Effects of Age, Period, and Cohort on Mortality from Ischemic Heart Disease in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14010050. [PMID: 28067846 PMCID: PMC5295301 DOI: 10.3390/ijerph14010050] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2016] [Revised: 12/10/2016] [Accepted: 12/22/2016] [Indexed: 12/12/2022]
Abstract
In contrast with most developed countries, mortality due to ischemic heart disease (IHD) continues to rise in China. We examined the effects of age, period, and cohort on IHD mortality in urban and rural populations from 1987 to 2013 to identify the drivers of this trend. Region-specific data on annual IHD mortality among adults aged 20 to 84 years and corresponding population statistics were collected. We then tested for age, period, and cohort effects using the Intrinsic Estimator approach. Our results indicated that IHD mortality in China increased significantly over the three decades studied. There was a log-linear increase in the age effect on IHD mortality as those aged 80–84 showed 277 and 161 times greater IHD mortality risk than those aged 20–24 in urban and rural populations, respectively. While there was an upward trend in the period effect in both populations, the influence of the cohort effect on mortality decreased over time for those born from 1904 to 1993. The age, period, and cohort effects on mortality in China were generally comparable between urban and rural populations. The results suggest that population aging is a major driver behind the rapid rise in IHD mortality. Increased exposure to air pollution may also have played a role in driving the period effect
Collapse
Affiliation(s)
- Jie Chang
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an 710061, China.
- Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an 710061, China.
| | - Boyang Li
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
| | - Jingjing Li
- Department of Behavior Science and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA.
- Department of Epidemiology, School of Public Health, Wuhan University, Wuhan 430071, China.
| | - Yang Sun
- Department of Public Affairs and Management, School of Political Science and Public Administration, Wuhan University, 299 Bayi Road, Wuchang District, Wuhan 430072, China.
| |
Collapse
|
127
|
Out-of-hospital cardiac arrest risk attributable to temperature in Japan. Sci Rep 2017; 7:39538. [PMID: 28045031 PMCID: PMC5206734 DOI: 10.1038/srep39538] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 11/24/2016] [Indexed: 02/02/2023] Open
Abstract
Several studies have estimated the associations between extreme temperatures and mortality and morbidity; however, few have investigated the attributable fraction for a wide range of temperatures on the risk of out-of-hospital cardiac arrest (OHCA). We obtained daily records of OHCA cases in the 47 Japanese prefectures between 2005 and 2014. We examined the relationship between OHCA and temperature for each prefecture using a Poisson regression model combined with a distributed lag non-linear model. The estimated prefecture-specific associations were pooled at the nationwide level using a multivariate random-effect meta-analysis. A total of 659,752 cases of OHCA of presumed-cardiac origin met the inclusion criteria. Overall, 23.93% (95% empirical confidence interval [eCI]: 20.15–26.19) of OHCA was attributable to temperature. The attributable fraction to low temperatures was 23.64% (95% eCI: 19.76–25.87), whereas that of high temperatures was 0.29% (95% eCI: 0.21–0.35). The attributable fraction for OHCA was related to moderate low temperature with an overall estimate of 21.86% (95% eCI: 18.10–24.21). Extreme temperatures were responsible for a small fraction. The majority of temperature-related OHCAs were attributable to lower temperatures. The attributable risk of extremely low and high temperatures was markedly lower than that of moderate temperatures.
Collapse
|
128
|
Xu Q, Wang S, Guo Y, Wang C, Huang F, Li X, Gao Q, Wu L, Tao L, Guo J, Wang W, Guo X. Acute exposure to fine particulate matter and cardiovascular hospital emergency room visits in Beijing, China. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2017; 220:317-327. [PMID: 27697383 DOI: 10.1016/j.envpol.2016.09.065] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 09/20/2016] [Accepted: 09/20/2016] [Indexed: 05/06/2023]
Abstract
Fine particulate matter (PM2.5) air pollution outbreaks have recently occurred frequently in China. However, evidence of the associations between short-term exposure to PM2.5 and cardiovascular morbidity is still limited in China. This study aimed to evaluate the associations between PM2.5 and hospital emergency room visits (ERVs) for cardiovascular diseases in urban areas in Beijing. Daily counts of cardiovascular ERVs were collected from ten large general hospitals from Jan 1 to Dec 31, 2013. Air pollution data were obtained from the Beijing Environmental Protection Bureau including 17 monitoring stations. A generalized additive Poisson model was used to examine the associations between PM2.5 and cardiovascular ERVs after controlling for seasonality, day of the week, public holidays, influenza outbreaks, and weather conditions. In total, there were 56,221 cardiovascular ERVs during the study period. The daily mean PM2.5 concentration was 102.1 μg/m3, ranging from 6.7 μg/m3 to 508.5 μg/m3. Per 10 μg/m3 increase in PM2.5 was associated with a 0.14% (95% confidence interval [CI]: 0.01%-0.27%) increase in cardiovascular ERVs at lag3. Cumulative delayed estimates were greatest at lag0-5 (0.30%, 95% CI: 0.09%-0.52%). The estimates of percentage change in daily ERVs per 10 μg/m3 increase in PM2.5 were 0.56% (95%CI: 0.16%-0.95%) for ischemic heart disease (IHD) at lag0-1, 0.81% (95%CI: 0.05%-1.57%) for heart rhythm disturbances (HRD) at lag0-1 and 1.21% (95%CI: 0.27%-2.15%) for heart failure (HF) at lag0, respectively. The effects of PM2.5 on IHD ERVs during high temperature days (>11.01 °C) were significantly higher than that on low temperature days (≤11.01 °C) at lag0, lag0-1, lag0-3 and lag0-5 (P < 0.05). The study suggests that PM2.5 has acute impacts on cardiovascular ERVs in Beijing, especially on IHD, HRD and HF. The effects of PM2.5 on IHD ERVs vary by temperature.
Collapse
Affiliation(s)
- Qin Xu
- School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Shuo Wang
- Beijing Chao-yang Hospital, Capital Medical University, Beijing, China
| | - Yuming Guo
- Division of Epidemiology and Biostatistics, School of Public Health, University of Queensland, Brisbane, Australia
| | - Chao Wang
- School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Fangfang Huang
- School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Xia Li
- School of Public Health, Capital Medical University, Beijing, China; Graduate Entry Medical School, University of Limerick, Limerick, Ireland
| | - Qi Gao
- School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Lijuan Wu
- School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Lixin Tao
- School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Jin Guo
- School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Wei Wang
- School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China; School of Medical Sciences, Edith Cowan University, Perth, Australia
| | - Xiuhua Guo
- School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China.
| |
Collapse
|
129
|
Tian L, Sun S. Comparison of Health Impact of Air Pollution Between China and Other Countries. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 1017:215-232. [PMID: 29177964 DOI: 10.1007/978-981-10-5657-4_9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Air pollution is the world's largest single environmental risk according to the World Health Organization (WHO), which caused around seven million deaths in 2012. Extensive epidemiological studies have been carried out worldwide to examine the health impacts of ambient air pollution, consistently demonstrating significant health impacts of ambient air pollution. Air pollution problem in China is especially serious; it has become the fourth biggest threat to the health of the Chinese people. In this review, we summarized existing literature, compared health impact of air pollution between China and other countries, and found substantial heterogeneity in the risk estimates of air pollution. The effect heterogeneities may be due to the differences in the characteristics of populations (e.g., the proportion of the elder population and people with preexisting diseases), exposure profile (e.g., air pollution concentrations and composition), and regional climate. Although the magnitude of relative risk estimates of air pollution is generally similar with that in other parts of the world, air pollution is one of China's most serious environmental health problems given the huge number of people exposed to high concentration levels of air pollution in China.
Collapse
Affiliation(s)
- Linwei Tian
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
| | - Shengzhi Sun
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| |
Collapse
|
130
|
Ambient Fine Particulate Matter Exposure and Risk of Cardiovascular Mortality: Adjustment of the Meteorological Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13111082. [PMID: 27827945 PMCID: PMC5129292 DOI: 10.3390/ijerph13111082] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2016] [Revised: 10/04/2016] [Accepted: 10/21/2016] [Indexed: 11/17/2022]
Abstract
Few studies have explicitly explored the impacts of the extensive adjustment (with a lag period of more than one week) of temperature and humidity on the association between ambient fine particulate matter (PM2.5) and cardiovascular mortality. In a time stratified case-crossover study, we used a distributed lag nonlinear model to assess the impacts of extensive adjustments of temperature and humidity for longer lag periods (for 7, 14, 21, 28 and 40 days) on effects of PM2.5 on total cardiovascular mortality and mortality of cerebrovascular and ischemic heart disease and corresponding exposure-response relationships in Beijing, China, between 2008 and 2011. Compared with results only controlled for temperature and humidity for 2 days, the estimated effects of PM2.5 were smaller and magnitudes of exposure-response curves were decreased when longer lag periods of temperature and relative humidity were included for adjustments, but these changes varied across subpopulation, with marked decreases occurring in males and the elderly who are more susceptible to PM2.5-related mortalities. Our findings suggest that the adjustment of meteorological factors using lag periods shorter than one week may lead to overestimated effects of PM2.5. The associations of PM2.5 with cardiovascular mortality in susceptible populations were more sensitive to further adjustments for temperature and relative humidity.
Collapse
|
131
|
Onozuka D, Hagihara A. Associations of day-to-day temperature change and diurnal temperature range with out-of-hospital cardiac arrest. Eur J Prev Cardiol 2016; 24:204-212. [DOI: 10.1177/2047487316674818] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Daisuke Onozuka
- Department of Health Communication, Kyushu University Graduate School of Medical Sciences, Japan
| | - Akihito Hagihara
- Department of Health Communication, Kyushu University Graduate School of Medical Sciences, Japan
| |
Collapse
|
132
|
Zhang B, Zhao J, Yang R, Qian Z, Liang S, Bassig BA, Zhang Y, Hu K, Xu S, Dong G, Zheng T, Yang S. Ozone and Other Air Pollutants and the Risk of Congenital Heart Defects. Sci Rep 2016; 6:34852. [PMID: 27752048 PMCID: PMC5067649 DOI: 10.1038/srep34852] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Accepted: 09/21/2016] [Indexed: 11/09/2022] Open
Abstract
The objective of this study was to evaluate whether high levels of maternal exposure to O3, SO2, NO2, CO are related to increased risk of congenital heart defects (CHDs) in Wuhan, China. The study included mothers living in the central districts of Wuhan during pregnancy over the two-year period from June 10, 2011 to June 9, 2013. For each study participant, we assigned 1-month averages of O3, SO2, NO2 and CO exposure based on measurements obtained from the nearest exposure monitor to the living residence of mothers during their early pregnancy period. In one-pollutant model, we observed an increased risk of CHDs, ventricular septal defect (VSD), and tetralogy of fallot (TF) with increasing O3 exposure. In two-pollutant model, associations with all CHDs, VSD, and TF for O3 were generally consistent compared to the models that included only O3, with the strongest aORs observed for exposures during the third month of pregnancy. We also observed a positive association between CO exposures during the third month of pregnancy and VSD in two pollution model.Our results contribute to the small body of evidence regarding air pollution exposure and CHDs, but confirmation of these associations will be needed in future studies.
Collapse
Affiliation(s)
- Bin Zhang
- Wuhan Medical &Healthcare Center for Women and Children, Wuhan, Hubei Province 430030, China
| | - Jinzhu Zhao
- Wuhan Medical &Healthcare Center for Women and Children, Wuhan, Hubei Province 430030, China
| | - Rong Yang
- Wuhan Medical &Healthcare Center for Women and Children, Wuhan, Hubei Province 430030, China
| | - Zhengmin Qian
- College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO, USA
| | - Shengwen Liang
- Wuhan Environmental Monitoring Center, Wuhan, Hubei Province 430000, China
| | - Bryan A Bassig
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT 06510, USA
| | - Yiming Zhang
- Wuhan Medical &Healthcare Center for Women and Children, Wuhan, Hubei Province 430030, China
| | - Ke Hu
- Wuhan Environmental Monitoring Center, Wuhan, Hubei Province 430000, China
| | - Shunqing Xu
- Key Laboratory of Environment and Health, Ministry of Education &Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Guanghui Dong
- Department of Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China
| | - Tongzhang Zheng
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA
| | - Shaoping Yang
- Wuhan Medical &Healthcare Center for Women and Children, Wuhan, Hubei Province 430030, China
| |
Collapse
|
133
|
Network Analysis of Fine Particulate Matter (PM2.5) Emissions in China. Sci Rep 2016; 6:33227. [PMID: 27608625 PMCID: PMC5016853 DOI: 10.1038/srep33227] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Accepted: 08/23/2016] [Indexed: 11/30/2022] Open
Abstract
Specification of PM2.5 spatial and temporal characteristics is important for understanding PM2.5 adverse effects and policymaking. We applied network analysis to studying the dataset MIX, which contains PM2.5 emissions recorded from 2168 monitoring stations in China in 2008 and 2010. The results showed that for PM2.5 emissions from industrial sector 8 clusters were found in 2008 but they merged together into a huge cluster in 2010, suggesting that industrial sector underwent an integrating process. For PM2.5 emissions from electricity generation sector, strong locality of clusters was revealed, implying that each region had its own electricity generation system. For PM2.5 emissions from residential sector, the same pattern of 10 clusters was uncovered in both years, implicating the household energy consumption unchanged from 2008 to 2010. For PM2.5 emissions from transportation sector, the same pattern of 5 clusters with many connections in-between was unraveled, indicating the high-speed development of transportation nationalwidely. Except for the known elements, mercury (Hg) surfaced as an element for particle nucleation. To our knowledge, this is the first network study in this field.
Collapse
|
134
|
Gou H, Lu J, Li S, Tong Y, Xie C, Zheng X. Assessment of microbial communities in PM1 and PM10 of Urumqi during winter. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2016; 214:202-210. [PMID: 27086076 DOI: 10.1016/j.envpol.2016.03.073] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Revised: 03/30/2016] [Accepted: 03/30/2016] [Indexed: 05/14/2023]
Abstract
Recently, inhalable particulate matter has been reported to carry microorganisms responsible for human allergy and respiratory disease. The unique geographical environment and adverse weather conditions of Urumqi cause double pollution of dust and smog, but research on the microbial content of the atmosphere has not been commenced. In this study, 16S and 18S rRNA gene sequencing were conducted to investigate the microbial composition of Urumqi's PM1 and PM10 pollutants in winter. Results showed that the bacterial community is mainly composed of Proteobacteria, Firmicutes and Actinobacteria, Proteobacteria accounted for the most proportion which was significant difference in some aforementioned studies. Ascomycota and Basidiomycota constitute the main part of the fungal microbial community. The difference of bacterial relative abundance in sample point is greater than in particle sizes. The sequences of several pathogenic bacteria and opportunistic pathogens were also detected, such as Acinetobacter, Delftia, Serratia, Chryseobacterium, which may impact on immunocompromised populations (elderly, children and postoperative convalescence patients), and some fungal genera may cause several plant diseases. Our findings may serve an important reference value in the global air microbial propagation and air microbial research in desert.
Collapse
Affiliation(s)
- Huange Gou
- Key Laboratory for Green Processing of Chemical Engineering of Xinjiang Bingtuan, School of Chemistry and Chemical Engineering, Shihezi University, Shihezi, 832003, Xinjiang, PR China
| | - Jianjiang Lu
- Key Laboratory for Green Processing of Chemical Engineering of Xinjiang Bingtuan, School of Chemistry and Chemical Engineering, Shihezi University, Shihezi, 832003, Xinjiang, PR China.
| | - Shanman Li
- Key Laboratory for Green Processing of Chemical Engineering of Xinjiang Bingtuan, School of Chemistry and Chemical Engineering, Shihezi University, Shihezi, 832003, Xinjiang, PR China
| | - Yanbin Tong
- Key Laboratory for Green Processing of Chemical Engineering of Xinjiang Bingtuan, School of Chemistry and Chemical Engineering, Shihezi University, Shihezi, 832003, Xinjiang, PR China
| | - Chunbin Xie
- Key Laboratory for Green Processing of Chemical Engineering of Xinjiang Bingtuan, School of Chemistry and Chemical Engineering, Shihezi University, Shihezi, 832003, Xinjiang, PR China
| | - Xiaowu Zheng
- Key Laboratory for Green Processing of Chemical Engineering of Xinjiang Bingtuan, School of Chemistry and Chemical Engineering, Shihezi University, Shihezi, 832003, Xinjiang, PR China
| |
Collapse
|
135
|
Abstract
With one-fifth of the world's total population, China's prevention and control of cardiovascular disease (CVD) may affect the success of worldwide efforts to achieve sustainable CVD reduction. Understanding China's current cardiovascular epidemic requires awareness of the economic development in the past decades. The rapid economic transformations (industrialization, marketization, urbanization, globalization, and informationalization) contributed to the aging demography, unhealthy lifestyles, and environmental changes. The latter have predisposed to increasing cardiovascular risk factors and the CVD pandemic. Rising CVD rates have had a major economic impact, which has challenged the healthcare system and the whole society. With recognition of the importance of health, initial political steps and national actions have been taken to address the CVD epidemic. Looking to the future, we recommend that 4 priorities should be taken: pursue multisectorial government and nongovernment strategies targeting the underlying causes of CVD (the whole-of-government and whole-of-society policy); give priority to prevention; reform the healthcare system to fit the nature of noncommunicable diseases; and conduct research for evidence-based, low-cost, simple, sustainable, and scalable interventions. By pursuing the 4 priorities, the pandemic of CVD and other major noncommunicable diseases in China will be reversed and the global sustainable development goal achieved.
Collapse
Affiliation(s)
- Yangfeng Wu
- From Peking University School of Public Health and Clinical Research Institute, Beijing, China (Y.W.); The George Institute for Global Health at Peking University Health Science Center, Beijing, China (Y.W.); Boston University Schools of Medicine and Public Health, MA (E.J.B.); and The George Institute for Global Health, Sydney, Australia (S.M.).
| | - Emelia J Benjamin
- From Peking University School of Public Health and Clinical Research Institute, Beijing, China (Y.W.); The George Institute for Global Health at Peking University Health Science Center, Beijing, China (Y.W.); Boston University Schools of Medicine and Public Health, MA (E.J.B.); and The George Institute for Global Health, Sydney, Australia (S.M.)
| | - Stephen MacMahon
- From Peking University School of Public Health and Clinical Research Institute, Beijing, China (Y.W.); The George Institute for Global Health at Peking University Health Science Center, Beijing, China (Y.W.); Boston University Schools of Medicine and Public Health, MA (E.J.B.); and The George Institute for Global Health, Sydney, Australia (S.M.)
| |
Collapse
|
136
|
Xu Q, Li X, Wang S, Wang C, Huang F, Gao Q, Wu L, Tao L, Guo J, Wang W, Guo X. Fine Particulate Air Pollution and Hospital Emergency Room Visits for Respiratory Disease in Urban Areas in Beijing, China, in 2013. PLoS One 2016; 11:e0153099. [PMID: 27054582 PMCID: PMC4824441 DOI: 10.1371/journal.pone.0153099] [Citation(s) in RCA: 105] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2016] [Accepted: 03/23/2016] [Indexed: 11/18/2022] Open
Abstract
Background Heavy fine particulate matter (PM2.5) air pollution occurs frequently in China. However, epidemiological research on the association between short-term exposure to PM2.5 pollution and respiratory disease morbidity is still limited. This study aimed to explore the association between PM2.5 pollution and hospital emergency room visits (ERV) for total and cause-specific respiratory diseases in urban areas in Beijing. Methods Daily counts of respiratory ERV from Jan 1 to Dec 31, 2013, were obtained from ten general hospitals located in urban areas in Beijing. Concurrently, data on PM2.5 were collected from the Beijing Environmental Protection Bureau, including 17 ambient air quality monitoring stations. A generalized-additive model was used to explore the respiratory effects of PM2.5, after controlling for confounding variables. Subgroup analyses were also conducted by age and gender. Results A total of 92,464 respiratory emergency visits were recorded during the study period. The mean daily PM2.5 concentration was 102.1±73.6 μg/m3. Every 10 μg/m3 increase in PM2.5 concentration at lag0 was associated with an increase in ERV, as follows: 0.23% for total respiratory disease (95% confidence interval [CI]: 0.11%-0.34%), 0.19% for upper respiratory tract infection (URTI) (95%CI: 0.04%-0.35%), 0.34% for lower respiratory tract infection (LRTI) (95%CI: 0.14%-0.53%) and 1.46% for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) (95%CI: 0.13%-2.79%). The strongest association was identified between AECOPD and PM2.5 concentration at lag0-3 (3.15%, 95%CI: 1.39%-4.91%). The estimated effects were robust after adjusting for SO2, O3, CO and NO2. Females and people 60 years of age and older demonstrated a higher risk of respiratory disease after PM2.5 exposure. Conclusion PM2.5 was significantly associated with respiratory ERV, particularly for URTI, LRTI and AECOPD in Beijing. The susceptibility to PM2.5 pollution varied by gender and age.
Collapse
Affiliation(s)
- Qin Xu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Xia Li
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
- Graduate Entry Medical School, University of Limerick, Limerick, Ireland
| | - Shuo Wang
- Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Chao Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Fangfang Huang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Qi Gao
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Lijuan Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Lixin Tao
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Jin Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Wei Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
- School of Medical Sciences, Edith Cowan University, Perth, WA, Australia
- * E-mail: (XG); (WW)
| | - Xiuhua Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
- * E-mail: (XG); (WW)
| |
Collapse
|
137
|
Ye X, Peng L, Kan H, Wang W, Geng F, Mu Z, Zhou J, Yang D. Acute Effects of Particulate Air Pollution on the Incidence of Coronary Heart Disease in Shanghai, China. PLoS One 2016; 11:e0151119. [PMID: 26942767 PMCID: PMC4778855 DOI: 10.1371/journal.pone.0151119] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 02/22/2016] [Indexed: 12/21/2022] Open
Abstract
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.
Collapse
Affiliation(s)
- Xiaofang Ye
- Department of Environment Health, School of Public Health, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Service, Shanghai, China
| | - Li Peng
- Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Service, Shanghai, China
| | - Haidong Kan
- School of Public Health and Key Laboratory of Public Health Safety (Ministry of Education), Fudan University, Shanghai, China
| | - Weibing Wang
- School of Public Health and Key Laboratory of Public Health Safety (Ministry of Education), Fudan University, Shanghai, China
- Fudan Tyndall Centre, Shanghai, China
| | - Fuhai Geng
- Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Service, Shanghai, China
| | - Zhe Mu
- Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Service, Shanghai, China
| | - Ji Zhou
- Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Service, Shanghai, China
| | - Dandan Yang
- Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Service, Shanghai, China
| |
Collapse
|
138
|
Lin YK, Chen CF, Yeh HC, Wang YC. Emergency room visits associated with particulate concentration and Asian dust storms in metropolitan Taipei. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2016; 26:189-96. [PMID: 26531803 DOI: 10.1038/jes.2015.70] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Revised: 08/25/2015] [Accepted: 09/25/2015] [Indexed: 05/22/2023]
Abstract
This study evaluated risks of emergency room visits (ERV) for all causes, circulatory diseases, and respiratory diseases associated with concentrations of particulate matter (PM10 and PM2.5) and Asian dust storms (ADS) from 2000 to 2008 in metropolitan Taipei. Cumulative 4-day (lag 0-3) relative risks (RR) and confidence intervals (CI) of cause-specific ERV associated with daily concentrations of PM10 or PM2.5 and ADS based on study period (ADS frequently inflicted period: 2000-2004 and less-inflicted period: 2005-2008) were estimated using a distributed lag non-linear model with Poisson distribution. Risks associated with ADS-inflicted season (winter and spring), strength (ratio of stations with Pollutant Standard Index above 100 is < 0.5 or ≥ 0.5), and duration (ADS lasting for 1-3 days or ≥ 4 days) were especially evaluated. In non-linear models, an increase in PM10 from 10 μg/m(3) to 50 μg/m(3) was associated with increased risk of ERV for all causes and respiratory disease with cumulative 4- day RR of 1.18 (95% CI: 1.13, 1.24) and 1.37 (95% CI: 1.23, 1.54), respectively. From 2005 to 2008, the cumulative 4-day RR for an ERV related to an increase in PM2.5 from 5 μg/m(3) to 30 μg/m(3) is 1.21 (95% CI: 1.03, 1.41) for respiratory diseases, and 1.15 (95% CI: 1.08, 1.22) for all causes. In comparison with normal days, elevated ERV of all causes and respiratory diseases was also associated with winter ADS (with corresponding RRs of 1.10 (95% CI: 1.07, 1.13) and 1.14 (95% CI: 1.08, 1.21)) and shorter and less area-affected ADS (with corresponding RRs of 1.07 (95% CI: 1.01, 1.10) and 1.09 (95% CI: 1.03, 1.14)) from 2000 to 2004. Results of this study demonstrate that population health risk varies not only with PM concentration, but also with the ADS characteristics.
Collapse
Affiliation(s)
- Yu-Kai Lin
- Department of Health and Welfare, University of Taipei College of City Management, Taipei, Taiwan
| | - Chi-Feng Chen
- Department of Natural Resources, Chinese Culture University, Yang-Ming-Shan, Taipei, Taiwan
| | - Hui-Chung Yeh
- Department of Natural Resources, Chinese Culture University, Yang-Ming-Shan, Taipei, Taiwan
| | - Yu-Chun Wang
- Department of Environmental Engineering, College of Engineering, Chung Yuan Christian University, Zhongli, Taiwan
- Research Center for Environmental Risk Management, Chung Yuan Christian University, Zhongli, Taiwan
| |
Collapse
|
139
|
Zhang Q, Zhao D, Xie W, Xie X, Guo M, Wang M, Wang W, Liu W, Liu J. Recent Trends in Hospitalization for Acute Myocardial Infarction in Beijing: Increasing Overall Burden and a Transition From ST-Segment Elevation to Non-ST-Segment Elevation Myocardial Infarction in a Population-Based Study. Medicine (Baltimore) 2016; 95:e2677. [PMID: 26844503 PMCID: PMC4748920 DOI: 10.1097/md.0000000000002677] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Comparable data on trends of hospitalization rates for ST-segment elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI) remain unavailable in representative Asian populations.To examine the temporal trends of hospitalization for acute myocardial infarction (AMI) and its subtypes in Beijing.Patients hospitalized for AMI in Beijing from January 1, 2007 to December 31, 2012 were identified from the validated Hospital Discharge Information System. Trends in hospitalization rates, in-hospital mortality, length of stay (LOS), and hospitalization costs were analyzed by regression models for total AMI and for STEMI and NSTEMI separately. In total, 77,943 patients were admitted for AMI in Beijing during the 6 years, among whom 67.5% were males and 62.4% had STEMI. During the period, the rate of AMI hospitalization per 100,000 population increased by 31.2% (from 55.8 to 73.3 per 100,000 population) after age standardization, with a slight decrease in STEMI but a 3-fold increase in NSTEMI. The ratio of STEMI to NSTEMI decreased dramatically from 6.5:1.0 to 1.3:1.0. The age-standardized in-hospital mortality decreased from 11.2% to 8.6%, with a significant decreasing trend evident for STEMI in males and females (P < 0.001) and for NSTEMI in males (P = 0.02). The rate of percutaneous coronary intervention increased from 28.7% to 55.6% among STEMI patients. The total cost for AMI hospitalization increased by 56.8% after adjusting for inflation, although the LOS decreased by 1 day.The hospitalization burden for AMI has been increasing in Beijing with a transition from STEMI to NSTEMI. Diverse temporal trends in AMI subtypes from the unselected "real-world" data in Beijing may help to guide the management of AMI in China and other developing countries.
Collapse
Affiliation(s)
- Qian Zhang
- From the Department of Epidemiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases (QZ, DZ, WX, MW, WW, JL), and Beijing Public Health Information Center, Beijing, China (XX, MG, WL)
| | | | | | | | | | | | | | | | | |
Collapse
|
140
|
Madaniyazi L, Guo Y, Chen R, Kan H, Tong S. Predicting exposure-response associations of ambient particulate matter with mortality in 73 Chinese cities. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2016; 208:40-47. [PMID: 26452312 DOI: 10.1016/j.envpol.2015.09.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Revised: 08/29/2015] [Accepted: 09/03/2015] [Indexed: 06/05/2023]
Abstract
Estimating the burden of mortality associated with particulates requires knowledge of exposure-response associations. However, the evidence on exposure-response associations is limited in many cities, especially in developing countries. In this study, we predicted associations of particulates smaller than 10 μm in aerodynamic diameter (PM10) with mortality in 73 Chinese cities. The meta-regression model was used to test and quantify which city-specific characteristics contributed significantly to the heterogeneity of PM10-mortality associations for 16 Chinese cities. Then, those city-specific characteristics with statistically significant regression coefficients were treated as independent variables to build multivariate meta-regression models. The model with the best fitness was used to predict PM10-mortality associations in 73 Chinese cities in 2010. Mean temperature, PM10 concentration and green space per capita could best explain the heterogeneity in PM10-mortality associations. Based on city-specific characteristics, we were able to develop multivariate meta-regression models to predict associations between air pollutants and health outcomes reasonably well.
Collapse
Affiliation(s)
- Lina Madaniyazi
- School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia.
| | - Yuming Guo
- School of Public Health, University of Queensland, Herston QLD 4006, Australia.
| | - Renjie Chen
- School of Public Health, Fudan University, Shanghai, China.
| | - Haidong Kan
- School of Public Health, Fudan University, Shanghai, China.
| | - Shilu Tong
- School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia.
| |
Collapse
|
141
|
Spatz ES, Jiang X, Lu J, Masoudi FA, Spertus JA, Wang Y, Li X, Downing NS, Nasir K, Du X, Li J, Krumholz HM, Liu X, Jiang L. Qingdao Port Cardiovascular Health Study: a prospective cohort study. BMJ Open 2015; 5:e008403. [PMID: 26656011 PMCID: PMC4679897 DOI: 10.1136/bmjopen-2015-008403] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
PURPOSE In China, efforts are underway to respond to rapidly increasing rates of heart disease and stroke. Yet the epidemiology of cardiovascular disease in China may be different from that of other populations. Thus, there is a critical need for population-based studies that provide insight into the risk factors, incidence and outcomes of cardiovascular disease in China. The Qingdao Port Cardiovascular Health Study is designed to investigate the burden of cardiovascular disease and the sociodemographic, biological, environmental and clinical risk factors associated with disease onset and outcomes. PARTICIPANTS For this study, from 2000 through 2013, 32,404 employees aged 18 years or older were recruited from the Qingdao Port Group in China, contributing 221,923 annual health assessments. The mean age at recruitment was 43.4 (SD=12.9); 79% were male. In this ongoing study, annual health assessments, governed by extensive quality control mechanisms, include a questionnaire (capturing demographic and employment information, medical history, medication use, health behaviours and health outcomes), physical examination, ECG, and blood and urine analysis. Additional non-annual assessments include an X-ray, echocardiogram and carotid ultrasound; bio-samples will be collected for future genetic and proteomic analyses. Cardiovascular outcomes are accessed via self-report and are actively being verified with medical insurance claims; efforts are underway to adjudicate outcomes with hospital medical records. FINDINGS TO DATE Early findings reveal a significant increase in cardiovascular risk factors from 2000 to 2010 (hypertension: 26.4-39.4%; diabetes: 3.3-8.9%; hyperlipidaemia: 5.0-33.6%; body mass index >28 m/kg(2): 14.1-18.6%). FUTURE PLANS We aim to generate novel insights about the epidemiology and outcomes of cardiovascular disease in China, with specific emphasis on the potentially unique risk factor profiles of this Chinese population. Knowledge generated will be disseminated in the peer-reviewed literature, and will inform population-based strategies to improve cardiovascular health in China. TRIAL REGISTRATION NUMBER NCT02329886.
Collapse
Affiliation(s)
- Erica S Spatz
- Center for Outcomes Research and Evaluation, Yale University/Yale-New Haven Hospital, New Haven, Connecticut, USA
- Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Xianyan Jiang
- Section of Cardiovascular Medicine, Qingdao Fuwai Hospital, Qingdao, People's Republic of China
| | - Jiapeng Lu
- National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Frederick A Masoudi
- Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - John A Spertus
- Department of Health Outcomes Research, Saint Luke's Mid America Heart Institute/University of Missouri-Kansas City, Kansas City, Missouri, USA
| | - Yongfei Wang
- Center for Outcomes Research and Evaluation, Yale University/Yale-New Haven Hospital, New Haven, Connecticut, USA
- Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Xi Li
- National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Nicholas S Downing
- Center for Outcomes Research and Evaluation, Yale University/Yale-New Haven Hospital, New Haven, Connecticut, USA
| | - Khurram Nasir
- Center for Healthcare Advancement & Outcomes, Baptist Health South Florida, Miami, Florida, USA
- Miami Cardiac & Vascular Institute, Baptist Health South Florida, Miami, Florida, USA
| | - Xue Du
- National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Jing Li
- National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Harlan M Krumholz
- Center for Outcomes Research and Evaluation, Yale University/Yale-New Haven Hospital, New Haven, Connecticut, USA
- Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, Connecticut, USA
- The Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
- Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut, USA
| | - Xiancheng Liu
- Section of Cardiovascular Medicine, Qingdao Fuwai Hospital, Qingdao, People's Republic of China
- Qingdao Fuwai Hospital, Qingdao, People's Republic of China
| | - Lixin Jiang
- National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| |
Collapse
|
142
|
Onozuka D, Hagihara A. All-Cause and Cause-Specific Risk of Emergency Transport Attributable to Temperature: A Nationwide Study. Medicine (Baltimore) 2015; 94:e2259. [PMID: 26705208 PMCID: PMC4697974 DOI: 10.1097/md.0000000000002259] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Revised: 11/13/2015] [Accepted: 11/16/2015] [Indexed: 11/26/2022] Open
Abstract
Although several studies have estimated the associations between mortality or morbidity and extreme temperatures in terms of relative risk, few studies have investigated the risk of emergency transport attributable to the whole temperature range nationwide.We acquired data on daily emergency ambulance dispatches in all 47 prefectures of Japan from 2007 to 2010. We examined the relationship between emergency transport and temperature for each prefecture using a Poisson regression model in a distributed lag nonlinear model with adjustment for time trends. A random-effect multivariate meta-analysis was then applied to pool the estimates at the national level. Attributable morbidity was calculated for high and low temperatures, which were defined as those above or below the optimum temperature (ie, the minimum morbidity temperature) and for moderate and also extreme temperatures, which were defined using cutoffs at the 2.5th and 97.5th temperature percentiles.A total of 15,868,086 cases of emergency transport met the inclusion criteria. The emergency transport was attributable to nonoptimal temperature. The median minimum morbidity percentile was in the 79th percentile for all causes, the 96th percentile for cardiovascular disease, and the 92th percentile for respiratory disease. The fraction attributable to low temperature was 6.94% (95% eCI: 5.93-7.70) for all causes, 17.93% (95% eCI: 16.10-19.25) for cardiovascular disease, and 12.19% (95% eCI: 9.90-13.66) for respiratory disease, whereas the fraction attributable to high temperature was small (all causes = 1.01%, 95% eCI: 0.90-1.11; cardiovascular disease = 0.10%, 95% eCI: 0.04-0.14; respiratory disease = 0.29%, 95% eCI: 0.07-0.50). The all-cause morbidity risk that was attributable to temperature was related to moderate cold, with an overall estimate of 6.41% (95% eCI: 5.47-7.20). Extreme temperatures were responsible for a small fraction, which corresponded to 0.57% (95% eCI: 0.50-0.62) for extreme low temperature and 0.29% (95% eCI: 0.26-0.32) for extreme high temperature. The same trends were observed for cardiovascular and respiratory diseases.The majority of temperature-related emergency transport burden was attributable to lower temperature. The effect of extremely high or low temperatures was markedly lower than that attributable to moderately nonoptimal temperatures.
Collapse
Affiliation(s)
- Daisuke Onozuka
- From the Department of Health Communication, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | | |
Collapse
|
143
|
Abstract
Environmental exposure is an important but underappreciated risk factor contributing to the development and severity of cardiovascular disease (CVD). The heart and vascular system are highly vulnerable to a number of environmental agents--ambient air pollution and the metals arsenic, cadmium, and lead are widespread and the most-extensively studied. Like traditional risk factors, such as smoking and diabetes mellitus, these exposures advance disease and mortality via augmentation or initiation of pathophysiological processes associated with CVD, including blood-pressure control, carbohydrate and lipid metabolism, vascular function, and atherogenesis. Although residence in highly polluted areas is associated with high levels of cardiovascular risk, adverse effects on cardiovascular health also occur at exposure levels below current regulatory standards. Considering the widespread prevalence of exposure, even modest contributions to CVD risk can have a substantial effect on population health. Evidence-based clinical and public-health strategies aimed at reducing environmental exposures from current levels could substantially lower the burden of CVD-related death and disability worldwide.
Collapse
|
144
|
Li L, Lin GZ, Liu HZ, Guo Y, Ou CQ, Chen PY. Can the Air Pollution Index be used to communicate the health risks of air pollution? ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2015; 205:153-60. [PMID: 26057478 DOI: 10.1016/j.envpol.2015.05.038] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 05/10/2015] [Accepted: 05/11/2015] [Indexed: 05/22/2023]
Abstract
The validity of using the Air Pollution Index (API) to assess health impacts of air pollution and potential modification by individual characteristics on air pollution effects remain uncertain. We applied distributed lag non-linear models (DLNMs) to assess associations of daily API, specific pollution indices for PM10, SO2, NO2 and the weighted combined API (APIw) with mortality during 2003-2011 in Guangzhou, China. An increase of 10 in API was associated with a 0.88% (95% confidence interval (CI): 0.50, 1.27%) increase of non-accidental mortality at lag 0-2 days. Harvesting effects appeared after 2 days' exposure. The effect estimate of API over lag 0-15 days was statistically significant and similar with those of pollutant-specific indices and APIw. Stronger associations between API and mortality were observed in the elderly, females and residents with low educational attainment. In conclusion, the API can be used to communicate health risks of air pollution.
Collapse
Affiliation(s)
- Li Li
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou 510515, China
| | - Guo-Zhen Lin
- Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China
| | - Hua-Zhang Liu
- Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China
| | - Yuming Guo
- Division of Epidemiology and Biostatistics, School of Population Health, The University of Queensland, Brisbane, Queensland 4006, Australia
| | - Chun-Quan Ou
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou 510515, China.
| | - Ping-Yan Chen
- State Key Laboratory of Organ Failure Research, Department of Biostatistics, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou 510515, China.
| |
Collapse
|
145
|
Apte JS, Marshall JD, Cohen AJ, Brauer M. Addressing Global Mortality from Ambient PM2.5. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2015; 49:8057-66. [PMID: 26077815 DOI: 10.1021/acs.est.5b01236] [Citation(s) in RCA: 398] [Impact Index Per Article: 44.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Ambient fine particulate matter (PM2.5) has a large and well-documented global burden of disease. Our analysis uses high-resolution (10 km, global-coverage) concentration data and cause-specific integrated exposure-response (IER) functions developed for the Global Burden of Disease 2010 to assess how regional and global improvements in ambient air quality could reduce attributable mortality from PM2.5. Overall, an aggressive global program of PM2.5 mitigation in line with WHO interim guidelines could avoid 750 000 (23%) of the 3.2 million deaths per year currently (ca. 2010) attributable to ambient PM2.5. Modest improvements in PM2.5 in relatively clean regions (North America, Europe) would result in surprisingly large avoided mortality, owing to demographic factors and the nonlinear concentration-response relationship that describes the risk of particulate matter in relation to several important causes of death. In contrast, major improvements in air quality would be required to substantially reduce mortality from PM2.5 in more polluted regions, such as China and India. Moreover, forecasted demographic and epidemiological transitions in India and China imply that to keep PM2.5-attributable mortality rates (deaths per 100 000 people per year) constant, average PM2.5 levels would need to decline by ∼20-30% over the next 15 years merely to offset increases in PM2.5-attributable mortality from aging populations. An effective program to deliver clean air to the world's most polluted regions could avoid several hundred thousand premature deaths each year.
Collapse
Affiliation(s)
- Joshua S Apte
- †Department of Civil, Architectural and Environmental Engineering, University of Texas, 301 E. Dean Keeton St., Stop C1700, Austin, Texas 78712, United States
| | - Julian D Marshall
- ‡Department of Civil, Environmental, and Geo- Engineering, University of Minnesota, 500 Pillsbury Drive SE, Minneapolis, Minnesota 55455, United States
| | - Aaron J Cohen
- §Health Effects Institute, Suite 500, 101 Federal Street, Boston, Massachusetts 02110, United States
| | - Michael Brauer
- ∥School of Population and Public Health, The University of British Columbia, 2206 East Mall, Vancouver, British Columbia V6T1Z3, Canada
| |
Collapse
|
146
|
Li H, Chen R, Meng X, Zhao Z, Cai J, Wang C, Yang C, Kan H. Short-term exposure to ambient air pollution and coronary heart disease mortality in 8 Chinese cities. Int J Cardiol 2015; 197:265-70. [PMID: 26142971 DOI: 10.1016/j.ijcard.2015.06.050] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2015] [Revised: 05/11/2015] [Accepted: 06/18/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Coronary heart disease (CHD) accounted for a large fraction of death globally. The association between air pollution and CHD has been reported, but evidence from highly-polluted regions was scarce. We aimed to estimate the acute effects of outdoor air pollution on daily CHD mortality in China. METHODS We collected daily CHD deaths in 8 large Chinese cities from 1996 to 2008. We firstly obtained the city-specific effect estimates of air pollution using generalized additive models with quasi-Poisson regression, controlling for time trends, meteorological indicators and day of the week. The random-effect model in meta-analysis was used to pool the exposure-response relationships. RESULTS We identified a total of 0.13 million CHD deaths. On average, an increase of 10μg/m(3) in 2-day moving average concentrations of particulate matter≤10μm in aerodynamic diameter (PM10), sulfur dioxide (SO2) and nitrogen dioxide (NO2) was significantly associated with increases of 0.36% [95% confidence intervals (CIs): 0.12%, 0.61%], 0.86% (95% CIs: 0.30%,1.41%) and 1.30% (95% CIs: 0.45%, 2.14%) in daily CHD mortality over the 8 Chinese cities, respectively. The pooled exposure-response curves were almost linear and no apparent thresholds were identified. The effects were more pronounced in cities with lower levels of air pollution. The effects of PM10 and NO2 were more robust than SO2. CONCLUSION Our findings contributed to the very limited evidence regarding the hazardous effects of ambient air pollution on CHD mortality in highly-polluted regions such as China.
Collapse
Affiliation(s)
- Huichu Li
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, China; Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP3), Fudan University, Shanghai, China; Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China
| | - Xia Meng
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, China; Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP3), Fudan University, Shanghai, China; Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China
| | - Zhuohui Zhao
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, China
| | - Jing Cai
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, China
| | - Cuicui Wang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, China
| | - Changyuan Yang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, China
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, China; Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP3), Fudan University, Shanghai, China; Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China.
| |
Collapse
|
147
|
Liu Y, Goodson JM, Zhang B, Chin MT. Air pollution and adverse cardiac remodeling: clinical effects and basic mechanisms. Front Physiol 2015; 6:162. [PMID: 26042051 PMCID: PMC4438225 DOI: 10.3389/fphys.2015.00162] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2015] [Accepted: 05/04/2015] [Indexed: 11/13/2022] Open
Abstract
Exposure to air pollution has long been known to trigger cardiovascular events, primarily through activation of local and systemic inflammatory pathways that affect the vasculature. Detrimental effects of air pollution exposure on heart failure and cardiac remodeling have also been described in human populations. Recent studies in both human subjects and animal models have provided insights into the basic physiological, cellular and molecular mechanisms that play a role in adverse cardiac remodeling. This review will give a brief overview of the relationship between air pollution and cardiovascular disease, describe the clinical effects of air pollution exposure on cardiac remodeling, describe the basic mechanisms that affect remodeling as described in human and animal systems and will discuss future areas of investigation.
Collapse
Affiliation(s)
- Yonggang Liu
- Division of Cardiology, Department of Medicine, University of Washington Seattle, WA, USA
| | - Jamie M Goodson
- Department of Pathology, University of Washington Seattle, WA, USA
| | - Bo Zhang
- Division of Cardiology, Department of Medicine, University of Washington Seattle, WA, USA
| | - Michael T Chin
- Division of Cardiology, Department of Medicine, University of Washington Seattle, WA, USA ; Department of Pathology, University of Washington Seattle, WA, USA
| |
Collapse
|
148
|
Gerber A, Hofen-Hohloch AV, Schulze J, Groneberg DA. Tobacco smoke particles and indoor air quality (ToPIQ-II) - a modified study protocol and first results. J Occup Med Toxicol 2015; 10:5. [PMID: 25717342 PMCID: PMC4339475 DOI: 10.1186/s12995-015-0047-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2014] [Accepted: 02/03/2015] [Indexed: 12/02/2022] Open
Abstract
Background Environmental tobacco smoke (ETS)-associated particulate matter (PM) has to be seen as an independent health hazard and needs to be discussed separately from the already well-known toxic and carcinogenic compounds contained in cigarette smoke. We believe that brand-specific amounts of PM are of public interest and should be investigated. Methods An automatic environmental tobacco smoke emitter was developed and placed into a glass-chamber to generate cigarette smoke as reliably as possible. Cigarettes were smoked automatically according to a standardized protocol. Mean concentrations (Cmean) and area under the curve (AUC) of PM2.5 released by the brands P&S, Virginia (without filter) and the 3R4F standard research cigarette of the University of Kentucky, USA, were measured and compared with each other. Results Cmean PM2.5 of 3R4F reference was 1,725 μg/m3, for P&S: 1,982 μg/m3 and for Virginia without filter: 1,525 μg/m3. AUC PM2.5 for 3R4F reference was: 527,644 μg/m3×sec, for P&S: 606,171 μg/m3×sec, and for Virginia without filter: 464,788 μg/m3×sec. Conclusions Our modified ToPIQ-II study protocol shows significant brand-specific differences in the amounts of PM2.5 released by cigarettes into the environment, when compared to 3R4F reference cigarettes. We believe that information about PM-release of all relevant brands in relation to reference cigarettes should be published. In the light of PM as an independent risk factor for morbidity and mortality, this may serve as a basis for further epidemiologic investigations.
Collapse
Affiliation(s)
- Alexander Gerber
- Institute of Occupational, Social and Environmental Medicine, Goethe-University, Theodor-Stern-Kai 7, Haus 9b, 60590 Frankfurt am Main, Germany
| | - Alexander V Hofen-Hohloch
- Institute of Occupational, Social and Environmental Medicine, Goethe-University, Theodor-Stern-Kai 7, Haus 9b, 60590 Frankfurt am Main, Germany
| | - Johannes Schulze
- Institute of Occupational, Social and Environmental Medicine, Goethe-University, Theodor-Stern-Kai 7, Haus 9b, 60590 Frankfurt am Main, Germany
| | - David A Groneberg
- Institute of Occupational, Social and Environmental Medicine, Goethe-University, Theodor-Stern-Kai 7, Haus 9b, 60590 Frankfurt am Main, Germany
| |
Collapse
|
149
|
|