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Brzezińska-Pawłowska OE, Rydzewska AD, Łuczyńska M, Majkowska-Wojciechowska B, Kowalski ML, Makowska JS. Environmental factors affecting seasonality of ambulance emergency service visits for exacerbations of asthma and COPD. J Asthma 2015; 53:139-45. [PMID: 26369434 DOI: 10.3109/02770903.2015.1075547] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The aim of this study was to assess the association of severe exacerbations of asthma and Chronic Obstructive Pulmonary Disease (COPD) requiring ambulance emergency service (AES) visits with meteorological parameters and influenza outbreaks. METHODS The records of patients calling the AES in 2007 and 2008 in the urban area of Lodz due to dyspnea were analyzed. Information on 25 daily reported meteorological parameters was obtained from the local meteorological service and data on influenza outbreaks obtained from the national surveillance service. RESULTS During the winter months, a significantly higher mean daily number of AES visits for both COPD and asthma were noticed when compared to the summer. Interestingly, the number of daily AES visits correlated with several weather parameters, and the multiple regression analysis confirmed a negative correlation with minimum temperature, mean temperature and the dew point for both diseases (R = 0.526; p < 0.01; R = 0.577; p < 0.01 and R = 0.589; p < 0.01). Furthermore, the increased number of AES visits also correlated with a new number of cases of influenza infections as reported by local influenza surveillance system (rs = 77.6%; p < 0.001 and rs = 80.8%; p < 0.001 for asthma and COPD, respectively). CONCLUSION Seasonality of AES visits for asthma and COPD are similar and seems to be related to specific weather conditions and to influenza outbreaks.
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Affiliation(s)
- Olga E Brzezińska-Pawłowska
- a Department of Immunology , Rheumatology and Allergy, Chair of Clinical Immunology and Microbiology, Medical University of Lodz , Łódź , Poland
| | - Anna D Rydzewska
- a Department of Immunology , Rheumatology and Allergy, Chair of Clinical Immunology and Microbiology, Medical University of Lodz , Łódź , Poland
| | - Marta Łuczyńska
- a Department of Immunology , Rheumatology and Allergy, Chair of Clinical Immunology and Microbiology, Medical University of Lodz , Łódź , Poland
| | - Barbara Majkowska-Wojciechowska
- a Department of Immunology , Rheumatology and Allergy, Chair of Clinical Immunology and Microbiology, Medical University of Lodz , Łódź , Poland
| | - Marek L Kowalski
- a Department of Immunology , Rheumatology and Allergy, Chair of Clinical Immunology and Microbiology, Medical University of Lodz , Łódź , Poland
| | - Joanna S Makowska
- a Department of Immunology , Rheumatology and Allergy, Chair of Clinical Immunology and Microbiology, Medical University of Lodz , Łódź , Poland
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102
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Marino E, Caruso M, Campagna D, Polosa R. Impact of air quality on lung health: myth or reality? Ther Adv Chronic Dis 2015; 6:286-98. [PMID: 26336597 DOI: 10.1177/2040622315587256] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The respiratory system is a primary target of the harmful effects of key air pollutants of health concern. Several air pollutants have been implicated including particulate matter (PM), ozone (O3), nitrogen dioxide (NO2) polycyclic aromatic hydrocarbons (PAHs) and volatile organic compounds (VOCs). It is well known that episodes of exposure to high concentrations of outdoor air pollutants can cause acute respiratory exacerbations. However, there is now increasing evidence suggesting that significant exposure to outdoor air pollutants may be also associated with development of lung cancer and with incident cases of chronic obstructive pulmonary disease (COPD) and respiratory allergies. Here we provide a critical appraisal of the impact of air pollution on respiratory diseases and discuss strategies for preventing excessive exposure to harmful air pollutants. However, the evidence that significant exposure to air pollutants is causing COPD, lung cancer or respiratory allergies is not conclusive and therefore regulators must be aware that execution of clean air policies may not be that cost-effective and may lead to unintended consequences. Addressing the lung health effects of air pollution must be considered work in progress.
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Affiliation(s)
- Elisa Marino
- Dipartimento di Medicina Clinica e Sperimentale, and UOC di Medicina Interna e Immunologia Clinica, Università di Catania, Italy
| | - Massimo Caruso
- Dipartimento di Medicina Clinica e Sperimentale, and UOC di Medicina Interna e Immunologia Clinica, Università di Catania, Italy
| | - Davide Campagna
- Dipartimento di Medicina Clinica e Sperimentale, and UOC di Medicina Interna e Immunologia Clinica, Università di Catania, Italy
| | - Riccardo Polosa
- UOC di Medicina Interna e Immunologia Clinica, Policlinico Universitario, University of Catania, Via S. Sofia 78, 95100, Catania, Italy
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103
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Wu S, Yang D, Wei H, Wang B, Huang J, Li H, Shima M, Deng F, Guo X. Association of chemical constituents and pollution sources of ambient fine particulate air pollution and biomarkers of oxidative stress associated with atherosclerosis: A panel study among young adults in Beijing, China. CHEMOSPHERE 2015; 135:347-353. [PMID: 25981523 DOI: 10.1016/j.chemosphere.2015.04.096] [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: 02/03/2015] [Revised: 04/27/2015] [Accepted: 04/28/2015] [Indexed: 06/04/2023]
Abstract
Ambient particulate air pollution has been associated with increased oxidative stress and atherosclerosis, but the chemical constituents and pollution sources behind the association are unclear. We investigated the associations of various chemical constituents and pollution sources of ambient fine particles (PM2.5) with biomarkers of oxidative stress in a panel of 40 healthy university students. Study participants underwent repeated blood collections for 12 times before and after relocating from a suburban campus to an urban campus with high air pollution levels in Beijing, China. Air pollution data were obtained from central air-monitoring stations, and plasma levels of oxidized low-density lipoprotein (Ox-LDL) and soluble CD36 (sCD36) were determined in the laboratory (n=464). Linear mixed-effects models were used to estimate the changes in biomarkers in association with exposure variables. PM2.5 iron and nickel were positively associated with Ox-LDL (p<0.05). For each interquartile range increase in iron (1-day, 0.51 μg/m(3)) and nickel (2-day, 2.5 ng/m(3)), there were a 1.9% [95% confidence interval (CI): 0.2%, 3.7%] increase and a 1.8% (95% CI: 0.2%, 3.4%) increase in Ox-LDL, respectively. We also found that each interquartile range increase in calcium (1-day, 0.7 μg/m(3)) was associated with a 4.8% (95% CI: 0.7%, 9.1%) increase in sCD36. Among the pollution sources, PM2.5 from traffic emissions and coal combustion were suggestively and positively associated with Ox-LDL. Our findings suggest that a subset of metals in airborne particles may be the major air pollution components that contribute to the increased oxidative stress associated with atherosclerosis.
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Affiliation(s)
- Shaowei Wu
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing, China
| | - Di Yang
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing, China
| | - Hongying Wei
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing, China
| | - Bin Wang
- Institute of Reproductive & Child Health, Peking University School of Public Health, Beijing, China
| | - Jing Huang
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing, China
| | - Hongyu Li
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing, China
| | - Masayuki Shima
- Department of Public Health, Hyogo College of Medicine, Hyogo, Japan
| | - Furong Deng
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing, China.
| | - Xinbiao Guo
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, Beijing, China
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104
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Pirozzi C, Sturrock A, Carey P, Whipple S, Haymond H, Baker J, Weng HY, Greene T, Scholand MB, Kanner R, Paine R. Respiratory effects of particulate air pollution episodes in former smokers with and without chronic obstructive pulmonary disease: a panel study. ACTA ACUST UNITED AC 2015. [DOI: 10.1186/s40749-015-0004-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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105
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Respiratory Tract Deposition of Inhaled Wood Smoke Particles in Healthy Volunteers. J Aerosol Med Pulm Drug Deliv 2015; 28:237-46. [DOI: 10.1089/jamp.2014.1122] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
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106
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Pirozzi C, Sturrock A, Weng HY, Greene T, Scholand MB, Kanner R, Paine R. Effect of naturally occurring ozone air pollution episodes on pulmonary oxidative stress and inflammation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:5061-75. [PMID: 25985308 PMCID: PMC4454954 DOI: 10.3390/ijerph120505061] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 05/06/2015] [Accepted: 05/07/2015] [Indexed: 11/29/2022]
Abstract
This study aimed to determine if naturally occurring episodes of ozone air pollution in the Salt Lake Valley in Utah, USA, during the summer are associated with increased pulmonary inflammation and oxidative stress, increased respiratory symptoms, and decreased lung function in individuals with chronic obstructive pulmonary disease (COPD) compared to controls. We measured biomarkers (nitrite/nitrate (NOx), 8-isoprostane) in exhaled breath condensate (EBC), spirometry, and respiratory symptoms in 11 former smokers with moderate-to-severe COPD and nine former smokers without airflow obstruction during periods of low and high ozone air pollution. High ozone levels were associated with increased NOx in EBC in both COPD (8.7 (±8.5) vs. 28.6 (±17.6) μmol/L on clean air vs. pollution days, respectively, p < 0.01) and control participants (7.6 (±16.5) vs. 28.5 (±15.6) μmol/L on clean air vs. pollution days, respectively, p = 0.02). There was no difference in pollution effect between COPD and control groups, and no difference in EBC 8-isoprostane, pulmonary function, or respiratory symptoms between clean air and pollution days in either group. Former smokers both with and without airflow obstruction developed airway oxidative stress and inflammation in association with ozone air pollution episodes.
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Affiliation(s)
- Cheryl Pirozzi
- Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, University of Utah, 26 North 1900 East, Salt Lake City, UT 84132, USA.
| | - Anne Sturrock
- Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, University of Utah, 26 North 1900 East, Salt Lake City, UT 84132, USA.
| | - Hsin-Yi Weng
- Department of Pediatrics, University of Utah, Salt Lake City, UT 84132, USA.
| | - Tom Greene
- Department of Internal Medicine, Division of Epidemiology, University of Utah, Salt Lake City, UT 84132, USA.
| | - Mary Beth Scholand
- Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, University of Utah, 26 North 1900 East, Salt Lake City, UT 84132, USA.
| | - Richard Kanner
- Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, University of Utah, 26 North 1900 East, Salt Lake City, UT 84132, USA.
| | - Robert Paine
- Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, University of Utah, 26 North 1900 East, Salt Lake City, UT 84132, USA.
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107
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Simoni M, Baldacci S, Maio S, Cerrai S, Sarno G, Viegi G. Adverse effects of outdoor pollution in the elderly. J Thorac Dis 2015; 7:34-45. [PMID: 25694816 DOI: 10.3978/j.issn.2072-1439.2014.12.10] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Accepted: 01/10/2015] [Indexed: 01/17/2023]
Abstract
With fewer newborns and people living longer, older people are making up an increasing fraction of the total population. Epidemiological evidence shows that older-age-related health problems affect a wide and expanding proportion of the world population. One of the major epidemiological trends of this century is the rise of chronic diseases that affect more elderly than younger people. A total of 3.7 million premature deaths worldwide in 2012 are attributable to outdoor air pollution; the susceptibility to adverse effects of air pollution is expected to differ widely between people and within the same person, and also over time. Frailty history, a measure of multi-system decline, modifies cumulative associations between air pollution and lung function. Moreover, pre-existing diseases may determine susceptibility. In the elderly, due to comorbidity, exposure to air pollutants may even be fatal. Rapid and not-well-planned urbanization is associated with high level of ambient air pollution, mainly caused by vehicular exhausts. In general, there is sufficient evidence of the adverse effects related to short-term exposure, while fewer studies have addressed the longer-term health effects. Increased pollution exposures have been associated with increased mortality, hospital admissions/emergency-room visits, mainly due to exacerbations of chronic diseases or to respiratory tract infections (e.g., pneumonia). These effects may also be modulated by ambient temperature and many studies show that the elderly are mostly vulnerable to heat waves. The association between heat and mortality in the elderly is well-documented, while less is known regarding the associations with hospital admissions. Chronic exposure to elevated levels of air pollution has been related to the incidence of chronic obstructive pulmonary disease (COPD), chronic bronchitis (CB), asthma, and emphysema. There is also growing evidence suggesting adverse effects on lung function related to long-term exposure to ambient air pollution. Few studies have assessed long-term mortality in the elderly. It is still unclear what are the pollutants most damaging to the health of the elderly. It seems that elderly subjects are more vulnerable to particulate matter (PM) than to other pollutants, with particular effect on daily cardio-respiratory mortality and acute hospital admissions. Not many studies have targeted elderly people specifically, as well as specific respiratory morbidity. Most data have shown higher risks in the elderly compared to the rest of the population. Future epidemiological cohort studies need to keep investigating the health effects of air pollutants (mainly cardiopulmonary diseases) on the elderly.
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Affiliation(s)
- Marzia Simoni
- 1 Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa (Italy), Via Trieste 41, 56126, Pisa, Italy ; 2 CNR Institute of Biomedicine and Molecular Immunology "A. Monroy", Via U. La Malfa 153, 90146, Palermo, Italy
| | - Sandra Baldacci
- 1 Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa (Italy), Via Trieste 41, 56126, Pisa, Italy ; 2 CNR Institute of Biomedicine and Molecular Immunology "A. Monroy", Via U. La Malfa 153, 90146, Palermo, Italy
| | - Sara Maio
- 1 Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa (Italy), Via Trieste 41, 56126, Pisa, Italy ; 2 CNR Institute of Biomedicine and Molecular Immunology "A. Monroy", Via U. La Malfa 153, 90146, Palermo, Italy
| | - Sonia Cerrai
- 1 Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa (Italy), Via Trieste 41, 56126, Pisa, Italy ; 2 CNR Institute of Biomedicine and Molecular Immunology "A. Monroy", Via U. La Malfa 153, 90146, Palermo, Italy
| | - Giuseppe Sarno
- 1 Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa (Italy), Via Trieste 41, 56126, Pisa, Italy ; 2 CNR Institute of Biomedicine and Molecular Immunology "A. Monroy", Via U. La Malfa 153, 90146, Palermo, Italy
| | - Giovanni Viegi
- 1 Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa (Italy), Via Trieste 41, 56126, Pisa, Italy ; 2 CNR Institute of Biomedicine and Molecular Immunology "A. Monroy", Via U. La Malfa 153, 90146, Palermo, Italy
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108
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Ghozikali MG, Mosaferi M, Safari GH, Jaafari J. Effect of exposure to O₃ , NO₂, and SO₂ on chronic obstructive pulmonary disease hospitalizations in Tabriz, Iran. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2015; 22:2817-23. [PMID: 25217280 DOI: 10.1007/s11356-014-3512-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 08/24/2014] [Indexed: 05/28/2023]
Abstract
Air pollution in cities is a serious environmental problem especially in the developing countries. We examined the associations between gaseous pollutants and hospitalizations for chronic obstructive pulmonary diseases (COPD) among people living in Tabriz, a city in north western of Iran. We used the approach proposed by the World Health Organization (WHO) using the AirQ 2.2.3 software developed by the WHO European Center for Environment and Health, Bilthoven Division. To assess human exposure and health effect, data were used for ozone as a1h average; for nitrogen dioxide and sulfur dioxide as daily average concentrations. The association between air pollution and chronic obstructive pulmonary disease (COPD) was assessed using AirQ 2.2.3 model. The results of this study showed that 3 % (95 % CI 1.2-4.8 %) of HA COPD were attributed to O3 concentrations over 10 μg/m(3). Also, 0.9 % (95 % CI 0.1-2.2 %) and 0.4 % (95 % CI 0-1.1 %) of HA COPD were attributed to NO2 and SO2 concentrations over 10 μg/m(3), respectively. For every 10 μg/m(3) increase in O3, NO2, and SO2 concentrations, the risk of HA COPD increase to about 0.58, 0.38, and 0.44 %, respectively. We found significant positive associations between the levels of all air pollution and hospital admissions COPD. Otherwise, O3, NO2, and SO2 have a significant impact on COPD hospitalization.
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Affiliation(s)
- Mohammad Ghanbari Ghozikali
- Environmental Health Department of East Azerbaijan Province Health Center, Tabriz University of Medical Sciences, Tabriz, Iran,
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109
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Wang W, Ying Y, Wu Q, Zhang H, Ma D, Xiao W. A GIS-based spatial correlation analysis for ambient air pollution and AECOPD hospitalizations in Jinan, China. Respir Med 2015; 109:372-8. [PMID: 25682544 DOI: 10.1016/j.rmed.2015.01.006] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Revised: 12/02/2014] [Accepted: 01/17/2015] [Indexed: 11/17/2022]
Abstract
BACKGROUND Acute exacerbations of COPD (AECOPD) are important events during disease procedure. AECOPD have negative effect on patients' quality of life, symptoms and lung function, and result in high socioeconomic costs. Though previous studies have demonstrated the significant association between outdoor air pollution and AECOPD hospitalizations, little is known about the spatial relationship utilized a spatial analyzing technique- Geographical Information System (GIS). OBJECTIVE Using GIS to investigate the spatial association between ambient air pollution and AECOPD hospitalizations in Jinan City, 2009. METHODS 414 AECOPD hospitalization cases in Jinan, 2009 were enrolled in our analysis. Monthly concentrations of five monitored air pollutants (NO2, SO2, PM10, O3, CO) during January 2009-December 2009 were provided by Environmental Protection Agency of Shandong Province. Each individual was geocoded in ArcGIS10.0 software. The spatial distribution of five pollutants and the temporal-spatial specific air pollutants exposure level for each individual was estimated by ordinary Kriging model. Spatial autocorrelation (Global Moran's I) was employed to explore the spatial association between ambient air pollutants and AECOPD hospitalizations. A generalized linear model (GLM) using a Poisson distribution with log-link function was used to construct a core model. RESULTS At residence, concentrations of SO2, PM10, NO2, CO, O3 and AECOPD hospitalization cases showed statistical significant spatially clustered. The Z-score of SO2, PM10, CO, O3, NO2 at residence is 15.88, 13.93, 12.60, 4.02, 2.44 respectively, while at workplace, concentrations of PM10, SO2, O3, CO and AECOPD hospitalization cases showed statistical significant spatially clustered. The Z-score of PM10, SO2, O3, CO at workplace is 11.39, 8.07, 6.10, and 5.08 respectively. After adjusting for potential confounders in the model, only the PM10 concentrations at workplace showed statistical significance, with a 10 μg/m(3) increase of PM10 at workplace associated with a 7% (95%CI: [3.3%, 10%]) increase of hospitalizations due to AECOPD. CONCLUSIONS Ambient air pollution is correlated with AECOPD hospitalizations spatially. A 10 μg/m(3) increase of PM10 at workplace was associated with a 7% (95%CI: [3.3%, 10%]) increase of hospitalizations due to AECOPD in Jinan, 2009. As a spatial data processing tool, GIS has novel and great potential on air pollutants exposure assessment and spatial analysis in AECOPD research.
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Affiliation(s)
- Wenqiao Wang
- Department of Respiratory Medicine, Qilu Hospital, Shandong University, No. 107, Wenhua Xi Road, Jinan, Shandong, 250012, PR China; Department of Respiratory Diseases, China-Japan Friendship Hospital, Peking University, Beijing, PR China.
| | - Yangyang Ying
- Department of Respiratory Medicine, Qilu Hospital, Shandong University, No. 107, Wenhua Xi Road, Jinan, Shandong, 250012, PR China.
| | - Quanyuan Wu
- College of Population, Resources and Environment, Shandong Normal University, No. 88, Wenhua Dong Road, Jinan, Shandong, 250012, PR China.
| | - Haiping Zhang
- College of Population, Resources and Environment, Shandong Normal University, No. 88, Wenhua Dong Road, Jinan, Shandong, 250012, PR China.
| | - Dedong Ma
- Department of Respiratory Medicine, Qilu Hospital, Shandong University, No. 107, Wenhua Xi Road, Jinan, Shandong, 250012, PR China.
| | - Wei Xiao
- Department of Respiratory Medicine, Qilu Hospital, Shandong University, No. 107, Wenhua Xi Road, Jinan, Shandong, 250012, PR China.
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110
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Hu G, Zhong N, Ran P. Air pollution and COPD in China. J Thorac Dis 2015; 7:59-66. [PMID: 25694818 PMCID: PMC4311081 DOI: 10.3978/j.issn.2072-1439.2014.12.47] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2014] [Accepted: 12/24/2014] [Indexed: 11/14/2022]
Abstract
Recently, many researchers paid more attentions to the association between air pollution and chronic obstructive pulmonary disease (COPD). Haze, a severe form of outdoor air pollution, affected most parts of northern and eastern China in the past winter. In China, studies have been performed to evaluate the impact of outdoor air pollution and biomass smoke exposure on COPD; and most studies have focused on the role of air pollution in acutely triggering symptoms and exacerbations. Few studies have examined the role of air pollution in inducing pathophysiological changes that characterise COPD. Evidence showed that outdoor air pollution affects lung function in both children and adults and triggers exacerbations of COPD symptoms. Hence outdoor air pollution may be considered a risk factor for COPD mortality. However, evidence to date has been suggestive (not conclusive) that chronic exposure to outdoor air pollution increases the prevalence and incidence of COPD. Cross-sectional studies showed biomass smoke exposure is a risk factor for COPD. A long-term retrospective study and a long-term prospective cohort study showed that biomass smoke exposure reductions were associated with a reduced decline in forced expiratory volume in 1 second (FEV1) and with a decreased risk of COPD. To fully understand the effect of air pollution on COPD, we recommend future studies with longer follow-up periods, more standardized definitions of COPD and more refined and source-specific exposure assessments.
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111
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Uh ST, Koo SM, Jang AS, Park SW, Choi JS, Kim YH, Park CS. Proteomic differences with and without ozone-exposure in a smoking-induced emphysema lung model. Korean J Intern Med 2015; 30:62-72. [PMID: 25589837 PMCID: PMC4293566 DOI: 10.3904/kjim.2015.30.1.62] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Revised: 07/25/2014] [Accepted: 09/25/2014] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND/AIMS Acute exacerbations in chronic obstructive pulmonary disease may be related to air pollution, of which ozone is an important constituent. In this study, we investigated the protein profiles associated with ozone-induced exacerbations in a smoking-induced emphysema model. METHODS Mice were divided into the following groups: group I, no smoking and no ozone (NS + NO); group II, no smoking and ozone (NS + O); group III, smoking and no ozone (S + NO); and group IV, smoking and ozone (S + O). Bronchoalveolar lavage, the mean linear intercept (MLI) on hematoxylin and eosin staining, nano-liquid chromatography-tandem mass spectrometry (LC-MS/MS), and Western blotting analyses were performed. RESULTS The MLIs of groups III (S + NO) and IV (S + O) (45 ± 2 and 44 ± 3 µm, respectively) were significantly higher than those of groups I (NS + NO) and II (NS + O) (26 ± 2 and 23 ± 2 µm, respectively; p < 0.05). Fourteen spots that showed significantly different intensities on image analyses of two-dimensional (2D) protein electrophoresis in group I (NS + NO) were identified by LC-MS/MS. The levels of six proteins were higher in group IV (S + O). The levels of vimentin, lactate dehydrogenase A, and triose phosphate isomerase were decreased by both smoking and ozone treatment in Western blotting and proteomic analyses. In contrast, TBC1 domain family 5 (TBC1D5) and lamin A were increased by both smoking and ozone treatment. CONCLUSIONS TBC1D5 could be a biomarker of ozone-induced lung injury in emphysema.
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Affiliation(s)
- Soo-Taek Uh
- Division of Allergy and Respiratory Medicine, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - So-My Koo
- Division of Allergy and Respiratory Medicine, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - An Soo Jang
- Genome Research Center for Allergy and Respiratory Disease, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Sung Woo Park
- Genome Research Center for Allergy and Respiratory Disease, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Jae Sung Choi
- Division of Respiratory Medicine, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Yong-Hoon Kim
- Division of Respiratory Medicine, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Choon Sik Park
- Genome Research Center for Allergy and Respiratory Disease, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
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112
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Tian L, Ho KF, Wang T, Qiu H, Pun VC, Chan CS, Louie PKK, Yu ITS. Ambient carbon monoxide and the risk of hospitalization due to chronic obstructive pulmonary disease. Am J Epidemiol 2014; 180:1159-67. [PMID: 25480818 DOI: 10.1093/aje/kwu248] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Data from recent experimental and clinical studies have indicated that lower concentrations of inhaled carbon monoxide might have beneficial antiinflammatory effects. Inhaled carbon monoxide has the potential to be a therapeutic agent for chronic obstructive pulmonary diseases (COPD). However, population-based epidemiologic studies of environmentally relevant carbon monoxide exposure have generated mixed findings. We conducted a time-series study in Hong Kong to estimate the association of short-term exposure to ambient carbon monoxide with emergency hospitalizations for COPD. We collected daily emergency hospital admission data and air pollution data from January 2001 to December 2007. We used log-linear Poisson models to estimate the associations between daily hospital admissions for COPD and the average daily concentrations of carbon monoxide while controlling for the traffic-related co-pollutants nitrogen dioxide and particulate matter with an aerodynamic diameter less than 2.5 μm. Results showed that ambient carbon monoxide was negatively associated with the risk of hospitalizations for COPD. After adjustment for levels nitrogen dioxide or particulate matter with an aerodynamic diameter less than 2.5 μm, the negative associations of carbon monoxide with COPD hospitalizations became stronger. The risk estimates were similar for female and male subjects. In conclusion, short-term exposure to ambient carbon monoxide was associated with a decreased risk of hospitalization for COPD, which suggests that carbon monoxide exposure provides some acute protection of against exacerbation of COPD.
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113
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Donaldson GC, Wedzicha JA. The causes and consequences of seasonal variation in COPD exacerbations. Int J Chron Obstruct Pulmon Dis 2014; 9:1101-10. [PMID: 25336941 PMCID: PMC4199860 DOI: 10.2147/copd.s54475] [Citation(s) in RCA: 84] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The time of year when patients experience exacerbations of chronic obstructive pulmonary disease is a much-overlooked feature of the disease. The higher incidence of exacerbations in winter has important consequences for patients in terms of increased morbidity and mortality. The seasonality also imposes a considerable burden on already-overloaded health care services, with both primary care consultations and hospital admissions increasing in number. The seasonality of exacerbations varies with latitude, and is greater in more temperate climates, where there may be less protection from outdoor and indoor cold exposure. The precise causes of the seasonality are unknown, but thought to be partly due to the increased prevalence of respiratory viral infections circulating in cold, damp conditions. Increased susceptibility to viral infection may also be a mechanism mediated through increased airway inflammation or possibly reduced vitamin D levels. The seasonality of exacerbations informs us about the triggers of exacerbations and suggests possible strategies to reduce their number.
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Affiliation(s)
- Gavin C Donaldson
- Airways Disease Section, National Heart and Lung Institute, Imperial College London, London, UK
| | - Jadwiga A Wedzicha
- Airways Disease Section, National Heart and Lung Institute, Imperial College London, London, UK
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114
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Rice MB, Thurston GD, Balmes JR, Pinkerton KE. Climate change. A global threat to cardiopulmonary health. Am J Respir Crit Care Med 2014; 189:512-9. [PMID: 24400619 DOI: 10.1164/rccm.201310-1924pp] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Recent changes in the global climate system have resulted in excess mortality and morbidity, particularly among susceptible individuals with preexisting cardiopulmonary disease. These weather patterns are projected to continue and intensify as a result of rising CO2 levels, according to the most recent projections by climate scientists. In this Pulmonary Perspective, motivated by the American Thoracic Society Committees on Environmental Health Policy and International Health, we review the global human health consequences of projected changes in climate for which there is a high level of confidence and scientific evidence of health effects, with a focus on cardiopulmonary health. We discuss how many of the climate-related health effects will disproportionally affect people from economically disadvantaged parts of the world, who contribute relatively little to CO2 emissions. Last, we discuss the financial implications of climate change solutions from a public health perspective and argue for a harmonized approach to clean air and climate change policies.
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Affiliation(s)
- Mary B Rice
- 1 Pulmonary and Critical Care Unit, Massachusetts General Hospital, Boston, Massachusetts
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115
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Rice MB, Ljungman PL, Wilker EH, Gold DR, Schwartz JD, Koutrakis P, Washko GR, O'Connor GT, Mittleman MA. Short-term exposure to air pollution and lung function in the Framingham Heart Study. Am J Respir Crit Care Med 2014; 188:1351-7. [PMID: 24200465 DOI: 10.1164/rccm.201308-1414oc] [Citation(s) in RCA: 131] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
RATIONALE Short-term exposure to ambient air pollution has been associated with lower lung function. Few studies have examined whether these associations are detectable at relatively low levels of pollution within current U.S. Environmental Protection Agency (EPA) standards. OBJECTIVES To examine exposure to ambient air pollutants within EPA standards and lung function in a large cohort study. METHODS We included 3,262 participants of the Framingham Offspring and Third Generation cohorts living within 40 km of the Harvard Supersite monitor in Boston, Massachusetts (5,358 examinations, 1995-2011) who were not current smokers, with previous-day pollutant levels in compliance with EPA standards. We compared lung function (FEV1 and FVC) after previous-day exposure to particulate matter less than 2.5 μm in diameter (PM2.5), nitrogen dioxide (NO2), and ozone (O3) in the "moderate" range of the EPA Air Quality Index to exposure in the "good" range. We also examined linear relationships between moving averages of pollutant concentrations 1, 2, 3, 5, and 7 days before spirometry and lung function. MEASUREMENTS AND MAIN RESULTS Exposure to pollutant concentrations in the "moderate" range of the EPA Air Quality Index was associated with a 20.1-ml lower FEV1 for PM2.5 (95% confidence interval [CI], -33.4, -6.9), a 30.6-ml lower FEV1 for NO2 (95% CI, -60.9, -0.2), and a 55.7-ml lower FEV1 for O3 (95% CI, -100.7, -10.8) compared with the "good" range. The 1- and 2-day moving averages of PM2.5, NO2, and O3 before testing were negatively associated with FEV1 and FVC. CONCLUSIONS Short-term exposure to PM2.5, NO2, and O3 within current EPA standards was associated with lower lung function in this cohort of adults.
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Affiliation(s)
- Mary B Rice
- 1 Cardiovascular Epidemiology Research Unit, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
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116
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Callaly E, Mikulich O, Silke B. Increased winter mortality: the effect of season, temperature and deprivation in the acutely ill medical patient. Eur J Intern Med 2013; 24:546-51. [PMID: 23481129 DOI: 10.1016/j.ejim.2013.02.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2012] [Revised: 02/08/2013] [Accepted: 02/09/2013] [Indexed: 11/19/2022]
Abstract
BACKGROUND Studies examining seasonal mortality have found excess winter mortality, particularly in the elderly. We examined the seasonal mortality variations for all emergency medical admissions to St James' Hospital, Dublin, over 10 years (2002-2011). We explored the effects of ambient temperature, deprivation markers, case-mix, co-morbidity and illness severity on seasonal mortality. METHODS All emergency admissions to an acute hospital were categorised by season. We examined season as a predictor of 30-day hospital mortality. RESULTS 30-day in-hospital mortality was lowest in autumn (7.5%) and highest in winter (9.6%). Winter admission had 17% (p=0.009) increased unadjusted risk of a death by day 30 (OR 1.17: 95% CI 1.07, 1.28). A clinical classification system identified that chronic obstructive disease, pneumonia, epilepsy/seizures and congestive heart failure had more presentations in the winter. Multivariate analysis found that winter was not an independent predictor (OR 1.08: 95% CI 0.97, 1.19). Predictors including illness severity and the Charlson Index accounted for the increased risk of winter admission. The minimum daily temperature independently predicted outcome; there was a 20% increased in-hospital death rate when it was colder (OR 1.20: 95% CI 1.09, 1.33; p<0.001). Deprivation was a univariate and multivariate (OR 1.22 95%CI 1.07, 1.39; p=0.002) predictor of mortality, but did not show marked seasonal variation. CONCLUSION Patients admitted in the winter have an approximate 17% increased risk of an in-hospital death by 30 days; this is related to cold along with increased illness severity and co-morbidity burden. The disease profile is different with winter admissions.
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Affiliation(s)
- Elizabeth Callaly
- Division of Internal Medicine St James's Hospital, Dublin 8, Ireland.
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117
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Ecological study on hospitalizations for cancer, cardiovascular, and respiratory diseases in the industrial area of Etang-de-Berre in the South of France. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2013; 2013:328737. [PMID: 23864868 PMCID: PMC3706020 DOI: 10.1155/2013/328737] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2013] [Revised: 04/15/2013] [Accepted: 05/07/2013] [Indexed: 01/31/2023]
Abstract
The Etang-de-Berre area is a large industrialized area in the South of France, exposing 300,000 inhabitants to the plumes of its industries. The possible associated health risks are of the highest concern to the population, who asked for studies investigating their health status. A geographical ecological study based on standardized hospitalizations ratios for cancer, cardiovascular, and respiratory diseases was carried out over the 2004–2007 period. Exposure to air pollution was assessed using dispersion models coupled with a geographic information system to estimate an annual mean concentration of sulfur dioxide (SO2) for each district. Results showed an excess risk of hospitalization for myocardial infarction in women living in districts with medium or high SO2 exposure, respectively, 38% [CI 95% 4 : 83] and 54% [14 : 110] greater than women living in districts at the reference level exposure. A 26% [2 : 57] excess risk of hospitalization for myocardial infarction was also observed in men living in districts with high SO2 levels. No excess risk of hospitalization for respiratory diseases or for cancer was observed, except for acute leukemia in men only. Results illustrate the impact of industrial air pollution on the cardiovascular system and call for an improvement of the air quality in the area.
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118
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Lin YK, Chang SC, Lin C, Chen YC, Wang YC. Comparing ozone metrics on associations with outpatient visits for respiratory diseases in Taipei Metropolitan area. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2013; 177:177-84. [PMID: 23333210 PMCID: PMC7127381 DOI: 10.1016/j.envpol.2012.12.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2012] [Revised: 12/09/2012] [Accepted: 12/14/2012] [Indexed: 05/05/2023]
Abstract
This study reported cumulative 6-day (lag 0-5 days) relative risks (RR) and confidence intervals (CI) of daily outpatient visits for total respiratory disease (RD), asthma, and chronic airway obstruction not otherwise classified (CAO) associated with three ozone metrics (daily 1-h maximum (O3, 1 h max), 8-h average maximum (O3, 8 h max), 24-h average (O3, 24 h avg)), and an alternative oxidant indicator (Ox) in Taipei Metropolitan, using distributed lag non-linear models after controlling for potential confounders. The Ox showed the strongest association with outpatient visits for total RD (RR = 1.10, 95% CI: 1.10, 1.11) and asthma (RR = 1.18, 95% CI: 1.00, 1.39) in the cold season. The O3, 24 h avg appeared to be the optimal ozone metric associating with total RD than O3, 1 h max and O3, 8 h max based on model selection. In conclusion, outpatient visits for total RD associated with ozone vary with ozone metrics, disease and season.
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Affiliation(s)
- Yu-Kai Lin
- Institute of Environmental Health, College of Public Health, National Taiwan University, 17 Xu-Zhou Road, Taipei 10055, Taiwan
- Harvard School of Public Health, Department of Environmental Health, Environmental and Occupational Medicine and Epidemiology Program, 677 Huntington Ave, Boston, MA 02115, USA
| | - Shuenn-Chin Chang
- Taiwan Environmental Protection Administration, 83, Sec. 1, Jhonghua Road, Taipei City 10042, Taiwan
- School of Public Health, National Defense Medical Center, 161, Sec. 6, Min-Chuan East Road, Taipei 114, Taiwan
| | - ChitSan Lin
- Department of Marine Environmental Engineering, National Kaohsiung Marine University, 142 Haijhuan Road, Nanzih District, Kaohsiung City 811, Taiwan
| | - Yi-Chun Chen
- Department of Health Management, I-Shou University, Kaohsiung 824, Taiwan
| | - Yu-Chun Wang
- Department of Bioenvironmental Engineering, College of Engineering, Chung Yuan Christian University, 200 Chung-Pei Road, Chung Li 320, Taiwan
- Corresponding author.
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119
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Barreno RX, Richards JB, Schneider DJ, Cromar KR, Nadas AJ, Hernandez CB, Hallberg LM, Price RE, Hashmi SS, Blackburn MR, Haque IU, Johnston RA. Endogenous osteopontin promotes ozone-induced neutrophil recruitment to the lungs and airway hyperresponsiveness to methacholine. Am J Physiol Lung Cell Mol Physiol 2013; 305:L118-29. [PMID: 23666750 DOI: 10.1152/ajplung.00080.2013] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Inhalation of ozone (O₃), a common environmental pollutant, causes pulmonary injury, pulmonary inflammation, and airway hyperresponsiveness (AHR) in healthy individuals and exacerbates many of these same sequelae in individuals with preexisting lung disease. However, the mechanisms underlying these phenomena are poorly understood. Consequently, we sought to determine the contribution of osteopontin (OPN), a hormone and a pleiotropic cytokine, to the development of O₃-induced pulmonary injury, pulmonary inflammation, and AHR. To that end, we examined indices of these aforementioned sequelae in mice genetically deficient in OPN and in wild-type, C57BL/6 mice 24 h following the cessation of an acute (3 h) exposure to filtered room air (air) or O₃ (2 parts/million). In wild-type mice, O₃ exposure increased bronchoalveolar lavage fluid (BALF) OPN, whereas immunohistochemical analysis demonstrated that there were no differences in the number of OPN-positive alveolar macrophages between air- and O₃-exposed wild-type mice. O₃ exposure also increased BALF epithelial cells, protein, and neutrophils in wild-type and OPN-deficient mice compared with genotype-matched, air-exposed controls. However, following O₃ exposure, BALF neutrophils were significantly reduced in OPN-deficient compared with wild-type mice. When airway responsiveness to inhaled acetyl-β-methylcholine chloride (methacholine) was assessed using the forced oscillation technique, O₃ exposure caused hyperresponsiveness to methacholine in the airways and lung parenchyma of wild-type mice, but not OPN-deficient mice. These results demonstrate that OPN is increased in the air spaces following acute exposure to O₃ and functionally contributes to the development of O₃-induced pulmonary inflammation and airway and lung parenchymal hyperresponsiveness to methacholine.
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Affiliation(s)
- Ramon X Barreno
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, The University of Texas Medical School at Houston, Houston, TX 77030, USA
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120
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Lai HK, Tsang H, Wong CM. Meta-analysis of adverse health effects due to air pollution in Chinese populations. BMC Public Health 2013; 13:360. [PMID: 23594435 PMCID: PMC3698155 DOI: 10.1186/1471-2458-13-360] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2012] [Accepted: 04/11/2013] [Indexed: 11/16/2022] Open
Abstract
Background Pooled estimates of air pollution health effects are important drivers of environmental risk communications and political willingness. In China, there is a lack of review studies to provide such estimates for health impact assessments. Methods We systematically searched the MEDLINE database using keywords of 80 major Chinese cities in Mainland China, Hong Kong and Taiwan on 30 June 2012, yielding 350 abstracts with 48 non-duplicated reports either in English or Chinese after screening. We pooled the relative risks (RR) per 10 μg/m3 of particulate matter (PM10), nitrogen dioxide (NO2), sulphur dioxide (SO2) and ozone (O3). Results For short-term effects, the pooled RR (p < 0.05) ranges were: 1.0031 (PM10) to 1.0140 (NO2) for all-cause mortality, 1.0034 (cardiopulmonary, PM10) to 1.0235 (influenza and pneumonia, SO2) for 9 specific-causes mortality, 1.0021 (cardiovascular, PM10) to 1.0162 (asthma, O3) for 5 specific-causes hospital admissions. For birth outcomes, the RR (p < 0.05) ranged from 1.0051 (stillbirth, O3) to 1.1189 (preterm-birth, SO2) and for long-term effect on mortality from 1.0150 (respiratory, SO2) to 1.0297 (respiratory, NO2). Publication bias was absent (Egger test: p = 0.326 to 0.624). Annual PM10 and NO2 concentrations were inversely associated with RR of mortality (p = 0.017-0.028). Conclusions Evidence on short-term effects of air pollution is consistent and sufficient for health impact assessment but that on long-term effects is still insufficient.
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Affiliation(s)
| | | | - Chit-Ming Wong
- Department of Community Medicine, School of Public Health, The University of Hong Kong, Hong Kong, SAR, China.
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121
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Zhu R, Chen Y, Wu S, Deng F, Liu Y, Yao W. The Relationship between Particulate Matter (PM10) and Hospitalizations and Mortality Of Chronic Obstructive Pulmonary Disease: A Meta-Analysis. COPD 2013; 10:307-15. [DOI: 10.3109/15412555.2012.744962] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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122
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Zeng G, Sun B, Zhong N. Non-smoking-related chronic obstructive pulmonary disease: a neglected entity? Respirology 2013; 17:908-12. [PMID: 22845669 DOI: 10.1111/j.1440-1843.2012.02152.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Chronic obstructive pulmonary disease (COPD) is an increasing cause of morbidity and mortality worldwide, and it has been strongly correlated to tobacco smoking. While a number of studies have concentrated on smokers only, recent published data demonstrate that at least one fourth of patients with COPD are non-smokers, and that the burden of COPD in non-smokers is also higher than previously believed. Risk factors of COPD in non-smokers may include genetic factors, long-standing asthma, outdoor air pollution (from traffic and other sources), environmental smoke exposure (ETS), biomass smoke, occupational exposure, diet, recurrent respiratory infection in early childhood, tuberculosis and so on. In Asian region, indoor/outdoor air pollution and poor socioeconomic status may play important roles in the pathogenesis of non-smoking-related COPD. The prevalence of COPD among never smokers varies widely across nations. Such a variation may arise from several aspects, including study design, definition of COPD, diagnostic criteria, age and gender distribution of the studied population, local risk factors and socioeconomic status. More investigations and efforts are required to elucidate the involved factors and their shared contributions to non-smoking-related COPD so as to achieve better estimation and reduction of the burden of this neglected entity worldwide.
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Affiliation(s)
- Guangqiao Zeng
- State Key Laboratory of Respiratory Disease, First Affiliated Hospital, Guangzhou Medical College, Guangzhou, China
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123
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Arbex MA, Santos UDP, Martins LC, Saldiva PHN, Pereira LAA, Braga ALF. Air pollution and the respiratory system. J Bras Pneumol 2012; 38:643-55. [PMID: 23147058 DOI: 10.1590/s1806-37132012000500015] [Citation(s) in RCA: 103] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2012] [Accepted: 08/22/2012] [Indexed: 11/22/2022] Open
Abstract
Over the past 250 years-since the Industrial Revolution accelerated the process of pollutant emission, which, until then, had been limited to the domestic use of fuels (mineral and vegetal) and intermittent volcanic emissions-air pollution has been present in various scenarios. Today, approximately 50% of the people in the world live in cities and urban areas and are exposed to progressively higher levels of air pollutants. This is a non-systematic review on the different types and sources of air pollutants, as well as on the respiratory effects attributed to exposure to such contaminants. Aggravation of the symptoms of disease, together with increases in the demand for emergency treatment, the number of hospitalizations, and the number of deaths, can be attributed to particulate and gaseous pollutants, emitted by various sources. Chronic exposure to air pollutants not only causes decompensation of pre-existing diseases but also increases the number of new cases of asthma, COPD, and lung cancer, even in rural areas. Air pollutants now rival tobacco smoke as the leading risk factor for these diseases. We hope that we can impress upon pulmonologists and clinicians the relevance of investigating exposure to air pollutants and of recognizing this as a risk factor that should be taken into account in the adoption of best practices for the control of the acute decompensation of respiratory diseases and for maintenance treatment between exacerbations.
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Affiliation(s)
- Marcos Abdo Arbex
- Center for Environmental Epidemiology Studies, Air Pollution Laboratory, Department of Pathology, University of São Paulo School of Medicine, São Paulo, Brazil
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124
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Abstract
Limited data suggest that outdoor air pollution (such as ambient air pollution or traffic-related air pollution) and indoor air pollution (such as second-hand smoking and biomass fuel combustion exposure) are associated with the development of chronic obstructive pulmonary disease (COPD), but there is insufficient evidence to prove a causal relationship at this stage. It also appears that outdoor air pollution is a significant environmental trigger for acute exacerbation of COPD, leading to increasing symptoms, emergency department visits, hospital admissions and even mortality. Improving ambient air pollution and decreasing indoor biomass combustion exposure by improving home ventilation are effective measures that may substantially improve the health of the general public.
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Affiliation(s)
- Fanny W S Ko
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong.
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125
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Abstract
Although there are nonmodifiable genetic risk factors for COPD, most known risk factors for development and progression of COPD can be corrected. Continued efforts to encourage smoking cessation and measures to reduce exposure to SHS, outdoor air pollution, biomass smoke, and occupational and related amateur exposures will have a significant impact on worldwide health.
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Affiliation(s)
- Cheryl Pirozzi
- Pulmonary Division, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
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126
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Postolache O, Girão PS, Postolache G, Gabriel J. Cardio-respiratory and daily activity monitor based on FMCW Doppler radar embedded in a wheelchair. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2012; 2011:1917-20. [PMID: 22254706 DOI: 10.1109/iembs.2011.6090542] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Unobtrusive monitoring of the cardio-respiratory and daily activity for wheelchair users became nowadays an important challenge, considering population aging phenomena and the increasing of the elderly with chronic diseases that affect their motion capabilities. This work reports the utilization of FMCW (frequency modulated continuous wave) Doppler radar sensors embedded in a manual wheelchair to measure the cardiac and respiratory activities and the physical activity of the wheelchair user. Another radar sensor is included in the system in order to quantify the motor activity through the wheelchair traveled distance, when the user performs the manual operation of the wheelchair. A conditioning circuit including active filters and a microcontroller based primary processing module was designed and implemented to deliver the information through Bluetooth communication protocol to an Android OS tablet computer. The main capabilities of the software developed using Android SDK and Java were the signal processing of Doppler radar measurement channel signals, graphical user interface, data storage and Wi-Fi data synchronization with remote physiological and physical activity database.
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127
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Qiu H, Yu ITS, Tian L, Wang X, Tse LA, Tam W, Wong TW. Effects of coarse particulate matter on emergency hospital admissions for respiratory diseases: a time-series analysis in Hong Kong. ENVIRONMENTAL HEALTH PERSPECTIVES 2012; 120:572-6. [PMID: 22266709 PMCID: PMC3339455 DOI: 10.1289/ehp.1104002] [Citation(s) in RCA: 112] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2011] [Accepted: 01/20/2012] [Indexed: 05/02/2023]
Abstract
BACKGROUND Many epidemiological studies have linked daily counts of hospital admissions to particulate matter (PM) with an aerodynamic diameter ≤ 10 μm (PM10) and ≤ 2.5 μm (PM2.5), but relatively few have investigated the relationship of hospital admissions with coarse PM (PMc; 2.5-10 μm aerodynamic diameter). OBJECTIVES We conducted this study to estimate the health effects of PMc on emergency hospital admissions for respiratory diseases in Hong Kong after controlling for PM2.5 and gaseous pollutants. METHODS We conducted a time-series analysis of associations between daily emergency hospital admissions for respiratory diseases in Hong Kong from January 2000 to December 2005 and daily PM2.5 and PMc concentrations. We estimated PMc concentrations by subtracting PM2.5 from PM10 measurements. We used generalized additive models to examine the relationship between PMc (single- and multiday lagged exposures) and hospital admissions adjusted for time trends, weather conditions, influenza outbreaks, PM2.5, and gaseous pollutants (nitrogen dioxide, sulfur dioxide, and ozone). RESULTS A 10.9-μg/m(3) (interquartile range) increase in the 4-day moving average concentration of PMc was associated with a 1.94% (95% confidence interval: 1.24%, 2.64%) increase in emergency hospital admissions for respiratory diseases that was attenuated but still significant after controlling for PM2.5. Adjusting for gaseous pollutants and altering models assumptions had little influence on PMc effect estimates. CONCLUSION PMc was associated with emergency hospital admissions for respiratory diseases in Hong Kong independent of PM2.5 and gaseous pollutants. Further research is needed to evaluate health effects of different components of PMc.
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Affiliation(s)
- Hong Qiu
- School of Public Health and Primary Care, Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
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128
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Abstract
With the rapid economic development occurring in the last decade in many countries of Asia, the level of air pollution has increased from both industrial and motor vehicle emissions. Compared with Europe and North America, the potential health effects of this increasing air pollution in Asia remain largely unmeasured. Recent data published by the Health Effects Institute from some major cities in India and China reveal that a 10 µg/m(3) increase in PM(10) was associated with an increase in mortality of 0.6% in daily all-natural cause mortality, with higher risks being found at extremes of high temperatures and in the lowest economically advantaged population. Other Asian studies have confirmed the link between hospital admissions for the worsening of COPD and the increase in asthma prevalence to levels of outdoor air pollutants. Although potential health effects appear to be similar to already-published Western data, it is important that further studies be carried out in Asia that will inform the public and the authorities of the necessity to curb levels of outdoor air pollutants to acceptable levels.
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Affiliation(s)
- Kian Fan Chung
- National Heart and Lung Institute, Imperial College, and NIHR Biomedical Research Unit, Royal Brompton Hospital, London, UK.
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129
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TAM WILSONW, WONG TZEWAI, WONG ANDROMEDAH, HUI DAVIDS. Effect of dust storm events on daily emergency admissions for respiratory diseases. Respirology 2011; 17:143-8. [DOI: 10.1111/j.1440-1843.2011.02056.x] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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130
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Tian L, Hossain SR, Lin H, Ho KF, Lee SC, Yu ITS. Increasing trend of primary NO(2) exhaust emission fraction in Hong Kong. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2011; 33:623-630. [PMID: 21331790 DOI: 10.1007/s10653-011-9375-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2010] [Accepted: 01/25/2011] [Indexed: 05/30/2023]
Abstract
Despite the successful reduction in roadside NO( x ) levels, no such decrease has been detected in roadside NO(2) concentration in Hong Kong. One underlying cause could be the rising primary NO(2) fraction of the total emission of NO( x ). Primary NO(2) can be particularly detrimental to Hong Kong because a large fraction of the population are exposed to the traffic-related primary pollutants in the street canyons formed by congested high-rise buildings. In this study, hourly mean concentration data for roadside nitrogen oxides (NO( x )), nitrogen dioxide (NO(2)), and background ozone (O(3)) were used to estimate the mean primary NO(2) fraction from vehicle exhausts in Hong Kong. An overall increasing trend was observed for the primary NO(2) fraction (f-NO(2)) values in all the three roadside air monitoring sites. The primary NO(2) as a fraction of total NO( x ) (f-NO(2)) increased approximately from 2% in 1998 to 13% in 2008 in Hong Kong. The two particular periods of rising f-NO(2) coincided with the two implementation periods of the diesel retrofit programs for the light-duty vehicles and heavy-duty vehicles. Future vehicle emission control strategies should target not only total NO( x ) but also primary NO(2). Health benefit or disease burden estimates should be taken into account and updated in the process of policy planning and evaluation.
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Affiliation(s)
- Linwei Tian
- School of Public Health and Primary Care, Chinese University of Hong Kong, China.
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131
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Yue GGL, Chan BCL, Kwok HF, To MH, Hon KL, Fung KP, Lau CBS, Leung PC. Screening for Anti-inflammatory and Bronchorelaxant Activities of 12 Commonly Used Chinese Herbal Medicines. Phytother Res 2011; 26:915-25. [PMID: 22105892 DOI: 10.1002/ptr.3659] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2011] [Revised: 06/16/2011] [Accepted: 08/29/2011] [Indexed: 11/11/2022]
Affiliation(s)
- Grace G. L. Yue
- Institute of Chinese Medicine; The Chinese University of Hong Kong; Shatin New Territories Hong Kong
- State Key Laboratory of Phytochemistry and Plant Resources in West China; The Chinese University of Hong Kong; Shatin New Territories Hong Kong
| | - Ben C. L. Chan
- Institute of Chinese Medicine; The Chinese University of Hong Kong; Shatin New Territories Hong Kong
- State Key Laboratory of Phytochemistry and Plant Resources in West China; The Chinese University of Hong Kong; Shatin New Territories Hong Kong
| | - Hin-Fai Kwok
- Institute of Chinese Medicine; The Chinese University of Hong Kong; Shatin New Territories Hong Kong
- State Key Laboratory of Phytochemistry and Plant Resources in West China; The Chinese University of Hong Kong; Shatin New Territories Hong Kong
| | - Ming-Ho To
- Institute of Chinese Medicine; The Chinese University of Hong Kong; Shatin New Territories Hong Kong
- State Key Laboratory of Phytochemistry and Plant Resources in West China; The Chinese University of Hong Kong; Shatin New Territories Hong Kong
| | - Kam-Lun Hon
- Department of Pediatrics; The Chinese University of Hong Kong; Shatin New Territories Hong Kong
| | - Kwok-Pui Fung
- Institute of Chinese Medicine; The Chinese University of Hong Kong; Shatin New Territories Hong Kong
- School of Biomedical Sciences; The Chinese University of Hong Kong; Shatin New Territories Hong Kong
- State Key Laboratory of Phytochemistry and Plant Resources in West China; The Chinese University of Hong Kong; Shatin New Territories Hong Kong
| | - Clara B. S. Lau
- Institute of Chinese Medicine; The Chinese University of Hong Kong; Shatin New Territories Hong Kong
- State Key Laboratory of Phytochemistry and Plant Resources in West China; The Chinese University of Hong Kong; Shatin New Territories Hong Kong
| | - Ping-Chung Leung
- Institute of Chinese Medicine; The Chinese University of Hong Kong; Shatin New Territories Hong Kong
- State Key Laboratory of Phytochemistry and Plant Resources in West China; The Chinese University of Hong Kong; Shatin New Territories Hong Kong
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132
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Liao CM, Hsieh NH, Chio CP. Fluctuation analysis-based risk assessment for respiratory virus activity and air pollution associated asthma incidence. THE SCIENCE OF THE TOTAL ENVIRONMENT 2011; 409:3325-33. [PMID: 21663946 PMCID: PMC7112072 DOI: 10.1016/j.scitotenv.2011.04.056] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2010] [Revised: 03/23/2011] [Accepted: 04/01/2011] [Indexed: 04/14/2023]
Abstract
Asthma is a growing epidemic worldwide. Exacerbations of asthma have been associated with bacterial and viral respiratory tract infections and air pollution. We correlated the asthma admission rates with fluctuations in respiratory virus activity and traffic-related air pollution, namely particulate matter with an aerodynamic diameter ≤ 10 μm (PM₁₀), nitrogen dioxide (NO₂), carbon monoxide (CO), sulfur dioxide (SO₂), and ozone (O₃). A probabilistic risk assessment framework was developed based on a detrended fluctuation analysis to predict future respiratory virus and air pollutant associated asthma incidence. Results indicated a strong association between asthma admission rate and influenza (r=0.80, p<0.05) and SO₂ level (r=0.73, p<0.05) in Taiwan in the period 2001-2008. No significant correlation was found for asthma admission and PM₁₀, O₃, NO₂, and CO. The proposed fluctuation analysis provides a simple correlation exponent describing the complex interactions of respiratory viruses and air pollutants with asthma. This study revealed that there was a 95% probability of having exceeded 2987 asthma admissions per 100,000 population. It was unlikely (30% probability) that the asthma admission rate exceeded 3492 per 100,000 population. The probability of asthma admission risk can be limited to below 50% by keeping the correlation exponent of influenza to below 0.9. We concluded that fluctuation analysis based risk assessment provides a novel predictor of asthma incidence.
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Affiliation(s)
- Chung-Min Liao
- Department of Bioenvironmental Systems Engineering, National Taiwan University, Taipei 10617, Taiwan, ROC.
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133
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Abstract
Epidemiological and toxicological research continues to support a link between urban air pollution and an increased incidence and/or severity of airway disease. Detrimental effects of ozone (O(3)), nitrogen dioxide (NO(2)) and particulate matter (PM), as well as traffic-related pollution as a whole, on respiratory symptoms and function are well documented. Not only do we have strong epidemiological evidence of a relationship between air pollution and exacerbation of asthma and respiratory morbidity and mortality in patients with chronic obstructive pulmonary disease (COPD), but recent studies, particularly in urban areas, have suggested a role for pollutants in the development of both asthma and COPD. Similarly, while prevalence and severity of atopic conditions appear to be more common in urban compared with rural communities, evidence is emerging that traffic-related pollutants may contribute to the development of allergy. Furthermore, numerous epidemiological and experimental studies suggest an association between exposure to NO(2) , O(3) , PM and combustion products of biomass fuels and an increased susceptibility to and morbidity from respiratory infection. Given the considerable contribution that traffic emissions make to urban air pollution researchers have sought to characterize the relative toxicity of traffic-related PM pollutants. Recent advances in mechanisms implicated in the association of air pollutants and airway disease include epigenetic alteration of genes by combustion-related pollutants and how polymorphisms in genes involved in antioxidant pathways and airway inflammation can modify responses to air pollution exposures. Other interesting epidemiological observations related to increased host susceptibility include a possible link between chronic PM exposure during childhood and vulnerability to COPD in adulthood, and that infants subjected to higher prenatal levels of air pollution may be at greater risk of developing respiratory conditions. While the characterization of pollutant components and sources promise to guide pollution control strategies, the identification of susceptible subpopulations will be necessary if targeted therapy/prevention of pollution-induced respiratory diseases is to be developed.
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Affiliation(s)
- F J Kelly
- MRC-HPA Centre for Environment and Health, King's College, London, 150 Stamford Street, London SE1 9NH, UK.
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134
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Ji M, Cohan DS, Bell ML. Meta-analysis of the Association between Short-Term Exposure to Ambient Ozone and Respiratory Hospital Admissions. ENVIRONMENTAL RESEARCH LETTERS : ERL [WEB SITE] 2011; 6:024006. [PMID: 21779304 PMCID: PMC3138529 DOI: 10.1088/1748-9326/6/2/024006] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Ozone is associated with health impacts including respiratory outcomes; however, results differ across studies. Meta-analysis is an increasingly important approach to synthesizing evidence across studies. We conducted meta-analysis of short-term ozone exposure and respiratory hospitalizations to evaluate variation across studies and explore some of the challenges in meta-analysis. We identified 136 estimates from 96 studies and investigated how estimates differed by age, ozone metric, season, lag, region, disease category, and hospitalization type. Overall results indicate associations between ozone and various types of respiratory hospitalizations; however, study characteristics affected risk estimates. Estimates were similar, but higher, for the elderly compared to all ages and for previous day exposure compared to same day exposure. Comparison across studies was hindered by variation in definitions of disease categories, as some (e.g., asthma) were identified through ≥3 different sets of ICD codes. Although not all analyses exhibited evidence of publication bias, adjustment for publication bias generally lowered overall estimates. Emergency hospitalizations for total respiratory disease increased 4.47% (95% interval 2.48, 6.50%) per 10ppb 24-hr ozone among the elderly without adjustment for publication bias and 2.97% (1.05, 4.94%) with adjustment. Comparison of multi-city study results and meta-analysis based on single-city studies further suggested publication bias.
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Affiliation(s)
- Meng Ji
- School of Forestry and Environmental Studies, School of Public Health, Yale University, New Haven, CT, U.S.A
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135
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Ko FW, Tam W, Tung AH, Ngai J, Ng SS, Lai K, Au KF, Hui DS. A longitudinal study of serial BODE indices in predicting mortality and readmissions for COPD. Respir Med 2011; 105:266-73. [DOI: 10.1016/j.rmed.2010.06.022] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2010] [Revised: 06/28/2010] [Accepted: 06/29/2010] [Indexed: 11/16/2022]
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136
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Eisner MD, Blanc PD, Omachi TA, Yelin EH, Sidney S, Katz PP, Ackerson LM, Sanchez G, Tolstykh I, Iribarren C. Socioeconomic status, race and COPD health outcomes. J Epidemiol Community Health 2011; 65:26-34. [PMID: 19854747 PMCID: PMC3017471 DOI: 10.1136/jech.2009.089722] [Citation(s) in RCA: 159] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Although chronic obstructive pulmonary disease (COPD) is a common cause of death and disability, little is known about the effects of socioeconomic status (SES) and race-ethnicity on health outcomes. METHODS The aim of this study is to determine the independent impacts of SES and race-ethnicity on COPD severity status, functional limitations and acute exacerbations of COPD among patients with access to healthcare. Data were used from the Function, Living, Outcomes and Work cohort study of 1202 Kaiser Permanente Northern California Medical Care Plan members with COPD. RESULTS Lower educational attainment and household income were consistently related to greater disease severity, poorer lung function and greater physical functional limitations in cross-sectional analysis. Black race was associated with greater COPD severity, but these differences were no longer apparent after controlling for SES variables and other covariates (comorbidities, smoking, body mass index and occupational exposures). Lower education and lower income were independently related to a greater prospective risk of acute COPD exacerbation (HR 1.5; 95% CI 1.01 to 2.1; and HR 2.1; 95% CI 1.4 to 3.4, respectively). CONCLUSION Low SES is a risk factor for a broad array of adverse COPD health outcomes. Clinicians and disease management programs should consider SES as a key patient-level marker of risk for poor outcomes.
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Affiliation(s)
- M D Eisner
- Division of Occupational and Environmental Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA 94143-0111, USA.
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137
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Case-crossover design: Air pollution and health outcomes. Int J Occup Med Environ Health 2011; 24:249-55. [DOI: 10.2478/s13382-011-0034-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2011] [Accepted: 07/06/2011] [Indexed: 11/20/2022] Open
Abstract
Abstract
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138
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Fong KNK, Mui KW, Chan WY, Wong LT. Air quality influence on chronic obstructive pulmonary disease (COPD) patients' quality of life. INDOOR AIR 2010; 20:434-441. [PMID: 20590917 DOI: 10.1111/j.1600-0668.2010.00668.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
UNLABELLED Chronic obstructive pulmonary disease (COPD) is one of the leading causes of death. The relationship between urban air pollution and its short-term health effects on patients suffering from COPD is confirmed. However, information about the impact of air pollutants upon the quality of life (QOL) in patients with COPD is lacking. Through a cross-sectional survey, this study investigates such impact in terms of the scores of the (Chinese) chronic respiratory questionnaire (CCRQ) and the measurements of indoor air quality (IAQ), lung function and Moser's activities of daily living (ADL). Using Yule's Q statistic with a cutoff |Q|>0.7 to identify the strong relationships between environmental parameters and CRQ sub-scores, this study reveals that patient emotion is strongly associated with indoor environmental quality although the evidence of a causal relationship between them needs further research. PRACTICAL IMPLICATIONS As QOL in patients with COPD and indoor environmental parameters are strongly associated, indoor air pollutants must be monitored for related studies in the future.
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Affiliation(s)
- K N K Fong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
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139
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Impact of fine and ultrafine particles on emergency hospital admissions for cardiac and respiratory diseases. Epidemiology 2010; 21:414-23. [PMID: 20386174 DOI: 10.1097/ede.0b013e3181d5c021] [Citation(s) in RCA: 141] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Little is known about the short-term effects of ultrafine particles. METHODS We evaluated the effect of particulate matter with an aerodynamic diameter <or=10 microm (PM10), <or=2.5 microm (PM2.5), and ultrafine particles on emergency hospital admissions in Rome 2001-2005. We studied residents aged >or=35 years hospitalized for acute coronary syndrome, heart failure, lower respiratory tract infections, and chronic obstructive pulmonary disease (COPD). Information was available for factors indicating vulnerability, such as age and previous admissions for COPD. Particulate matter data were collected daily at one central fixed monitor. A case-crossover analysis was performed using a time-stratified approach. We estimated percent increases in risk per 14 microg/m PM10, per 10 microg/m PM2.5, and per 9392 particles/mL. RESULTS An immediate impact (lag 0) of PM2.5 on hospitalizations for acute coronary syndrome (2.3% [95% confidence interval = 0.5% to 4.2%]) and heart failure (2.4% [0.3% to 4.5%]) was found, whereas the effect on lower respiratory tract infections (2.8% [0.5% to 5.2%]) was delayed (lag 2). Particle number concentration showed an association only with admissions for heart failure (lag 0-5; 2.4% [0.2% to 4.7%]) and COPD (lag 0; 1.6% [0.0% to 3.2%]). The effects were generally stronger in the elderly and during winter. There was no clear effect modification with previous COPD. CONCLUSIONS We found sizeable acute health effects of fine and ultrafine particles. Although differential reliability in exposure assessment, in particular of ultrafine particles, precludes a firm conclusion, the study indicates that particulate matter of different sizes tends to have diverse outcomes, with dissimilar latency between exposure and health response.
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140
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Air pollution and daily emergency department visits for depression. Int J Occup Med Environ Health 2010; 22:355-62. [PMID: 20197262 DOI: 10.2478/v10001-009-0031-6] [Citation(s) in RCA: 123] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES To investigate the potential correlation between ambient air pollution exposure and emergency department (ED) visits for depression. MATERIALS AND METHODS A hierarchical clusters design was used to study 27 047 ED visits for depression in six cities in Canada. The data used in the analysis contain the dates of visits, daily numbers of diagnosed visits, and daily mean concentrations of air pollutants as well as the meteorological factors. The generalized linear mixed models technique was applied to data analysis. Poisson models were fitted to the clustered counts of ED visits with a single air pollutant, temperature and relative humidity. RESULTS Statistically significant positive correlations were observed between the number of ED visits for depression and the air concentrations of carbon monoxide (CO), nitrogen dioxide (NO2), sulphur dioxide (SO2) and particulate matter (PM10). The percentage increase in daily ED visits was 15.5% (95% CI: 8.0-23.5) for CO per 0.8 ppm and 20.0% (95% CI: 13.3-27.2) for NO2 per 20.1 ppb, for same day exposure in the warm weather period (April-September). For PM10, the largest increase, 7.2% (95% CI: 3.0-11.6) per 19.4 ug/m3, was observed for the cold weather period (October-March). CONCLUSIONS The results support the hypothesis that ED visits for depressive disorder correlate with ambient air pollution, and that a large majority of this pollution results from combustion of fossil fuels (e.g. in motor vehicles).
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141
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Relative contributions of geographic, socioeconomic, and lifestyle factors to quality of life, frailty, and mortality in elderly. PLoS One 2010. [PMID: 20098745 DOI: 10.1371/journal.pone.0008775.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND To date, few studies address disparities in older populations specifically using frailty as one of the health outcomes and examining the relative contributions of individual and environmental factors to health outcomes. METHODOLOGY/PRINCIPAL FINDINGS Using a data set from a health survey of 4,000 people aged 65 years and over living in all regions of Hong Kong, we examined regional variations in self-rated health, frailty, and four-year mortality, and analyzed the relative contributions of lifestyle, socioeconomic status, and geographical location of residence to these outcomes using path analysis. We hypothesize that lifestyle, socioeconomic status, and regional characteristics directly and indirectly through interactions contribute to self-rated physical and psychological health, frailty, and four-year mortality. District variations directly affect self-rated physical health, and also exert an effect through socioeconomic position as well as lifestyle factors. Socioeconomic position in turn directly affects self-rated physical health, as well as indirectly through lifestyle factors. A similar pattern of interaction is observed for self-rated mental health, frailty, and mortality, although there are differences in different lifestyle factors and district associations. Lifestyle factors also directly affect physical and mental components of health, frailty, and mortality. The magnitude of direct district effect is comparable to those of lifestyle and socioeconomic position. CONCLUSIONS/SIGNIFICANCE We conclude that district variations in health outcomes exist in the Hong Kong elderly population, and these variations result directly from district factors, and are also indirectly mediated through socioeconomic position as well as lifestyle. Provision and accessibility to health services are unlikely to play a significant role. Future studies on these district factors would be important in reducing health disparities in the older population.
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142
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Woo J, Chan R, Leung J, Wong M. Relative contributions of geographic, socioeconomic, and lifestyle factors to quality of life, frailty, and mortality in elderly. PLoS One 2010; 5:e8775. [PMID: 20098745 PMCID: PMC2808254 DOI: 10.1371/journal.pone.0008775] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2009] [Accepted: 12/18/2009] [Indexed: 11/25/2022] Open
Abstract
Background To date, few studies address disparities in older populations specifically using frailty as one of the health outcomes and examining the relative contributions of individual and environmental factors to health outcomes. Methodology/Principal Findings Using a data set from a health survey of 4,000 people aged 65 years and over living in all regions of Hong Kong, we examined regional variations in self-rated health, frailty, and four-year mortality, and analyzed the relative contributions of lifestyle, socioeconomic status, and geographical location of residence to these outcomes using path analysis. We hypothesize that lifestyle, socioeconomic status, and regional characteristics directly and indirectly through interactions contribute to self-rated physical and psychological health, frailty, and four-year mortality. District variations directly affect self-rated physical health, and also exert an effect through socioeconomic position as well as lifestyle factors. Socioeconomic position in turn directly affects self-rated physical health, as well as indirectly through lifestyle factors. A similar pattern of interaction is observed for self-rated mental health, frailty, and mortality, although there are differences in different lifestyle factors and district associations. Lifestyle factors also directly affect physical and mental components of health, frailty, and mortality. The magnitude of direct district effect is comparable to those of lifestyle and socioeconomic position. Conclusions/Significance We conclude that district variations in health outcomes exist in the Hong Kong elderly population, and these variations result directly from district factors, and are also indirectly mediated through socioeconomic position as well as lifestyle. Provision and accessibility to health services are unlikely to play a significant role. Future studies on these district factors would be important in reducing health disparities in the older population.
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Affiliation(s)
- Jean Woo
- Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, China.
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143
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Bibliography. Current world literature. Curr Opin Pulm Med 2009; 15:170-7. [PMID: 19225311 DOI: 10.1097/mcp.0b013e3283276f69] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This bibliography is compiled by clinicians from the journals listed at the end of this publication. It is based on literature entered into our database between 1 November 2007 and 31 October 2008 (articles are generally added to the database about two and a half months after publication). In addition, the bibliography contains every paper annotated by reviewers; these references were obtained from a variety of bibliographic databases and published between the beginning of the review period and the time of going to press. The bibliography has been grouped into topics that relate to the reviews in this issue.
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144
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Outdoor air pollution: impact on chronic obstructive pulmonary disease patients. Curr Opin Pulm Med 2009; 15:150-7. [DOI: 10.1097/mcp.0b013e32832185ee] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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145
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Raherison C. Epidémiologie de la bronchopneumopathie chronique obstructive. Presse Med 2009; 38:400-5. [DOI: 10.1016/j.lpm.2008.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2008] [Accepted: 12/30/2008] [Indexed: 10/21/2022] Open
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146
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Molfino NA, Coyle AJ. Gene-environment interactions in chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis 2009; 3:491-7. [PMID: 18990979 PMCID: PMC2629985 DOI: 10.2147/copd.s2528] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is one of the leading causes of death throughout the world and is largely associated with cigarette smoking. Despite the appreciation of the central role of smoking in the development of COPD, only a relatively small number of smokers (15%–20%) develop COPD. Recent studies depicting familial aggregation suggest that some subjects may have a genetic predisposition to developing COPD. In this respect, a number of single nucleotide polymorphisms have been reported in association with different COPD features (subphenotypes), although much of this data remains controversial. Classical genetic studies (including twin and family studies) assume an “equal-environment” scenario, but as gene-environment interactions occur in COPD, this assumption needs revision. Thus, new integrated models are needed to examine the major environmental factors associated with COPD which include smoking as well as air pollution, and respiratory infections, and not only genetic predisposition. Revisiting this area, may help answer the question of what has more bearing in the pathogenesis of COPD—the environment or the genomic sequence of the affected subjects. It is anticipated that an improved understanding of this interaction will both enable improved identification of individuals susceptible to developing this disease, as well as improved future treatments for this disease.
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147
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Tam WWS, Wong TW, Chair SY, Wong AHS. Diurnal temperature range and daily cardiovascular mortalities among the elderly in Hong Kong. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2009; 64:202-206. [PMID: 19864223 DOI: 10.1080/19338240903241192] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The authors aimed to examine the association between diurnal temperature range (DTR) and daily mortalities due to cardiovascular disease among people aged 65 years and older in Hong Kong, China. The authors used a generalized additive model to regress daily mortalities of the elderly due to cardiovascular disease on DTR and daily concentrations of air pollutants from 1997 to 2002. They also tested the effects of different lag days of DTR on mortality. Results indicate significant associations between cardiovascular mortality and DTR at lag day 1 and at lag days 0-1 to 0-5. The largest effect was at lag days 0-3 (relative risks = 1.017; 95% confidence interval = 1.003-1.031). The authors recommend that special attention be paid to the elderly population to protect them from excessive diurnal variations in temperature.
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148
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Bell ML, Ebisu K, Peng RD, Walker J, Samet JM, Zeger SL, Dominici F. Seasonal and regional short-term effects of fine particles on hospital admissions in 202 US counties, 1999-2005. Am J Epidemiol 2008; 168:1301-10. [PMID: 18854492 DOI: 10.1093/aje/kwn252] [Citation(s) in RCA: 210] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The authors investigated whether short-term effects of fine particulate matter with an aerodynamic diameter < or =2.5 microm (PM(2.5)) on risk of cardiovascular and respiratory hospitalizations among the elderly varied by region and season in 202 US counties for 1999-2005. They fit 3 types of time-series models to provide evidence for 1) consistent particulate matter effects across the year, 2) different particulate matter effects by season, and 3) smoothly varying particulate matter effects throughout the year. The authors found statistically significant evidence of seasonal and regional variation in estimates of particulate matter effect. Respiratory disease effect estimates were highest in winter, with a 1.05% (95% posterior interval: 0.29, 1.82) increase in hospitalizations per 10-microg/m(3) increase in same-day PM(2.5). Cardiovascular diseases estimates were also highest in winter, with a 1.49% (95% confidence interval: 1.09, 1.89) increase in hospitalizations per 10-microg/m(3) increase in same-day PM(2.5), with associations also observed in other seasons. The strongest evidence of a relation between PM(2.5) and hospitalizations was in the Northeast for both respiratory and cardiovascular diseases. Heterogeneity of PM(2.5) effects on hospitalizations may reflect seasonal and regional differences in emissions and in particles' chemical constituents. Results can help guide development of hypotheses and further epidemiologic studies on potential heterogeneity in the toxicity of constituents of the particulate matter mixture.
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149
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Murdoch DR, Jennings LC. Association of respiratory virus activity and environmental factors with the incidence of invasive pneumococcal disease. J Infect 2008; 58:37-46. [PMID: 19042025 DOI: 10.1016/j.jinf.2008.10.011] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2008] [Revised: 09/24/2008] [Accepted: 10/17/2008] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To correlate the incidence rate of invasive pneumococcal disease (IPD) with fluctuations in respiratory virus activity and environmental factors in Christchurch, New Zealand. METHODS Ecological study comparing incidence rates of IPD with incidence rates of respiratory virus detection, meteorologic and air pollution data during 1995-2006. The relationship between annualized monthly rates of IPD and annualized monthly rates of respiratory virus detection and monthly meteorologic recordings and air pollution data was assessed using Spearman's rank correlation coefficient and negative binomial regression analysis. RESULTS Incidence rates of IPD were statistically significantly correlated with increasing detection rates of influenza viruses, respiratory syncytial virus (RSV), adenovirus and parainfluenza virus 3. Furthermore, rates of IPD were statistically significantly correlated with decreasing daily temperature, sunshine hours and wind speed, and with increasing air pollution levels and humidity. After regression analysis, the only statistically significant associations in the total population were between influenza virus activity, parainfluenza virus 3 activity and air pollution levels and increased rates of IPD, although RSV activity was associated with increased rates of IPD in children <5 years old. CONCLUSIONS Incidence rates of IPD are associated with the increased activity of some respiratory viruses and with air pollution in Christchurch.
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Affiliation(s)
- David R Murdoch
- Department of Pathology, University of Otago Christchurch, P.O. Box 4345, Christchurch 8011, New Zealand.
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150
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CHAN-YEUNG M, LAI CK, CHAN KS, CHEUNG AH, YAO TJ, HO AS, KO FW, YAM LY, WONG PC, TSANG KW, LAM WK, HO JC, CHU CM, YU WC, CHAN HS, IP MS, HUI DS, TAM CY. The burden of lung disease in Hong Kong: A report from the Hong Kong Thoracic Society. Respirology 2008; 13 Suppl 4:S133-65. [DOI: 10.1111/j.1440-1843.2008.01394.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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