101
|
Li A, Zhou Q, Xu Q. Prospects for ozone pollution control in China: An epidemiological perspective. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2021; 285:117670. [PMID: 34380231 DOI: 10.1016/j.envpol.2021.117670] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 06/17/2021] [Accepted: 06/26/2021] [Indexed: 06/13/2023]
Abstract
Severe surface ozone pollution has become widespread in China. To protect public health, Chinese scientific communities and government agencies have striven to mitigate ozone pollution. However, makers of pollution mitigation policies rarely consider epidemiological research, and communication between epidemiological researchers and the government is poor. Therefore, this article reviews the current mitigation policies and the National Ambient Air Quality Standard (NAAQS) for ozone from an epidemiological perspective and proposes recommendations for researchers and policy makers on the basis of epidemiological evidence. We review current nationwide ozone control measures for mitigating ozone pollution from four dimensions: the integration of ozone and particulate matter control, ozone precursors control, ozone control in different seasons, and regional cooperation on the prevention of ozone pollution. In addition, we present environmental and epidemiological evidence and propose recommendations and discuss relevant ozone metrics and the criteria values of the NAAQS. We finally conclude that the disease burden attributable to ozone exposure in China may be underestimated and that the epidemiological research regarding the health effects of integrating ozone and particulate matter control is insufficient. Furthermore, atmospheric volatile organic compounds are severely detrimental to health, and related control policies are urgently required in China. We recommend a greater focus on winter ozone pollution and conclude that the health benefits of regional cooperation on ozone control and prevention are salient. We argue that daily average ozone concentration may be a more biologically relevant ozone metric than those currently used by the NAAQS, and accumulating epidemiological evidence supports revision of the standards. This review provides new insight for ozone mitigation policies and related epidemiological studies in China.
Collapse
Affiliation(s)
- Ang Li
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100005, China
| | - Quan Zhou
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100005, China
| | - Qun Xu
- Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, 100005, China; Center of Environmental and Health Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100005, China.
| |
Collapse
|
102
|
The Impact of Air Pollutants and Meteorological Factors on Chronic Obstructive Pulmonary Disease Exacerbations: A Nationwide Study. Ann Am Thorac Soc 2021; 19:214-226. [PMID: 34499589 DOI: 10.1513/annalsats.202103-298oc] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
RATIONALE Chronic obstructive lung disease (COPD) is a chronic progressive disease. Although smoking is the most important risk factor, 30% of COPD patients are never smokers, and environmental agents are also influential. The effects of air pollutants and meteorological factors on COPD exacerbations have not been studied extensively. OBJECTIVE We aimed to investigate the air pollutants and meteorological factors that impact the incidence of COPD exacerbations. METHODS We obtained clinical data of COPD exacerbation cases from The National Health Insurance Service (NHIS) and merged it with 24-hour average values of air pollutants and meteorological factors from national databases. Patients who reside in eight metropolitan cities, where observatory stations are densely located, were selected for analysis. RESULTS In 1,404,505 COPD patients between 2013 and 2018, 15,282 COPD exacerbations leading to hospitalization or emergency room visits were identified. Among the various air pollutants and meteorological factors, particulate matter (PM)2.5, PM10, NO2, SO2, CO, O3, average temperature and diurnal temperature range (DTR) were associated with COPD exacerbations. GAM model analysis with cubic splines showed an inverted U-shaped relationship with PM2.5, PM10, CO, NO2, SO2, O3, DTR and humidity, while it displayed a U-shaped pattern with the average temperature. Distinct patterns were found from 2015-2016 to 2017-2018. CONCLUSIONS PM2.5, PM10, CO, NO2, O3, SO2, average temperature, humidity, and DTR affected the incidence of COPD exacerbations in various patterns, up to 10 lag days.
Collapse
|
103
|
Müller L, Usemann J, Alves MP, Latzin P. Diesel exposure increases susceptibility of primary human nasal epithelial cells to rhinovirus infection. Physiol Rep 2021; 9:e14994. [PMID: 34542243 PMCID: PMC8451029 DOI: 10.14814/phy2.14994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 07/14/2021] [Accepted: 07/15/2021] [Indexed: 11/30/2022] Open
Abstract
Nasal epithelial cells (NECs) are among the first cells to be exposed to air pollutants and respiratory viruses. Although it is known that air pollution exposure and rhinovirus infections increase the risk for asthma development independently, it is unclear how these risk factors interact on a cellular level. Therefore, we aimed to investigate how exposure to diesel particulate matter (DPM) modifies the response of primary NECs to rhinovirus (RV) infection in vitro. Exposure of re-differentiated, primary NECs (49 healthy children [0-7 years], 12 adults) to DPM modified the mRNA expression of viral cell-surface receptors, pattern recognition receptors, and pro-inflammatory response (also protein levels). After exposure to DPM, we additionally infected the NECs with RV-1b and RV-16. Viral loads (assessed by titration assays) were significantly higher in DPM-exposed compared with non-exposed NECs. Exposure to DPM prior to RV infection resulted in a significant upregulation of pro-inflammatory cytokines (mRNA and protein level) and β-defensins mRNA, and significant downregulation of pattern recognition receptors mRNA and CXCL10 (mRNA and protein levels). There was no difference between all outcomes of NECs from children and adults. We can conclude that exposure to DPM prior to RV infection increases viral loads by downregulation of viral defense receptors and upregulation of pro-inflammatory cytokines. Our findings indicate a strong interaction between air pollution and the antiviral response to RV infection in NECs. We provide mechanistic evidence that exposure to air pollution increases susceptibility to RV infection.
Collapse
Affiliation(s)
- Loretta Müller
- Division of Paediatric Respiratory Medicine and AllergologyDepartment of Paediatrics, InselspitalBern University HospitalUniversity of BernBernSwitzerland
- Department for BioMedical Research (DBMR)University of BernBernSwitzerland
- University Children's Hospital Basel (UKBB)BaselSwitzerland
| | - Jakob Usemann
- Division of Paediatric Respiratory Medicine and AllergologyDepartment of Paediatrics, InselspitalBern University HospitalUniversity of BernBernSwitzerland
- Department for BioMedical Research (DBMR)University of BernBernSwitzerland
- University Children's Hospital Basel (UKBB)BaselSwitzerland
- Division of Respiratory MedicineUniversity Children's Hospital ZurichZurichSwitzerland
| | - Marco P. Alves
- Institute of Virology and ImmunologyBernSwitzerland
- Department of Infectious Diseases and PathobiologyVetsuisse FacultyUniversity of BernBernSwitzerland
| | - Philipp Latzin
- Division of Paediatric Respiratory Medicine and AllergologyDepartment of Paediatrics, InselspitalBern University HospitalUniversity of BernBernSwitzerland
- Department for BioMedical Research (DBMR)University of BernBernSwitzerland
- University Children's Hospital Basel (UKBB)BaselSwitzerland
| |
Collapse
|
104
|
Majumder N, Goldsmith WT, Kodali VK, Velayutham M, Friend SA, Khramtsov VV, Nurkiewicz TR, Erdely A, Zeidler-Erdely PC, Castranova V, Harkema JR, Kelley EE, Hussain S. Oxidant-induced epithelial alarmin pathway mediates lung inflammation and functional decline following ultrafine carbon and ozone inhalation co-exposure. Redox Biol 2021; 46:102092. [PMID: 34418598 PMCID: PMC8385153 DOI: 10.1016/j.redox.2021.102092] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 08/02/2021] [Accepted: 08/04/2021] [Indexed: 11/29/2022] Open
Abstract
Environmental inhalation exposures are inherently mixed (gases and particles), yet regulations are still based on single toxicant exposures. While the impacts of individual components of environmental pollution have received substantial attention, the impact of inhalation co-exposures is poorly understood. Here, we mechanistically investigated pulmonary inflammation and lung function decline after inhalation co-exposure and individual exposures to ozone (O3) and ultrafine carbon black (CB). Environmentally/occupationally relevant lung deposition levels in mice were achieved after inhalation of stable aerosols with similar aerodynamic and mass median distributions. X-ray photoemission spectroscopy detected increased surface oxygen contents on particles in co-exposure aerosols. Compared with individual exposures, co-exposure aerosols produced greater acellular and cellular oxidants detected by electron paramagnetic resonance (EPR) spectroscopy, and in vivo immune-spin trapping (IST), as well as synergistically increased lavage neutrophils, lavage proteins and inflammation related gene/protein expression. Co-exposure induced a significantly greater respiratory function decline compared to individual exposure. A synthetic catalase-superoxide dismutase mimetic (EUK-134) significantly blunted lung inflammation and respiratory function decline confirming the role of oxidant imbalance. We identified a significant induction of epithelial alarmin (thymic stromal lymphopoietin-TSLP)-dependent interleukin-13 pathway after co-exposure, associated with increased mucin and interferon gene expression. We provided evidence of interactive outcomes after air pollution constituent co-exposure and identified a key mechanistic pathway that can potentially explain epidemiological observation of lung function decline after an acute peak of air pollution. Developing and studying the co-exposure scenario in a standardized and controlled fashion will enable a better mechanistic understanding of how environmental exposures result in adverse outcomes. Interaction with O3 mediates free radical production on the surface of carbon black (CB) particles. Oxidants mediate co-exposure (CB + O3)-induced lung function decline. EUK-134 (a synthetic superoxide-catalase mimetic) abrogates CB + O3-induced lung inflammation. CB + O3 co-exposure induces greater lung inflammation than individual exposures. Epithelial alarmin (TSLP) contributes significantly to the CB + O3 toxicity.
Collapse
Affiliation(s)
- Nairrita Majumder
- Department of Physiology and Pharmacology, School of Medicine, West Virginia University, USA; Center for Inhalation Toxicology (iTOX), School of Medicine, West Virginia University, USA
| | - William T Goldsmith
- Department of Physiology and Pharmacology, School of Medicine, West Virginia University, USA; Center for Inhalation Toxicology (iTOX), School of Medicine, West Virginia University, USA
| | - Vamsi K Kodali
- Department of Physiology and Pharmacology, School of Medicine, West Virginia University, USA; Center for Inhalation Toxicology (iTOX), School of Medicine, West Virginia University, USA; National Institute for Occupational Safety and Health, USA
| | | | - Sherri A Friend
- Center for Inhalation Toxicology (iTOX), School of Medicine, West Virginia University, USA; National Institute for Occupational Safety and Health, USA
| | - Valery V Khramtsov
- Department of Biochemistry, School of Medicine, West Virginia University, USA
| | - Timothy R Nurkiewicz
- Department of Physiology and Pharmacology, School of Medicine, West Virginia University, USA; Center for Inhalation Toxicology (iTOX), School of Medicine, West Virginia University, USA
| | - Aaron Erdely
- Department of Physiology and Pharmacology, School of Medicine, West Virginia University, USA; Center for Inhalation Toxicology (iTOX), School of Medicine, West Virginia University, USA; National Institute for Occupational Safety and Health, USA
| | - Patti C Zeidler-Erdely
- Department of Physiology and Pharmacology, School of Medicine, West Virginia University, USA; Center for Inhalation Toxicology (iTOX), School of Medicine, West Virginia University, USA; National Institute for Occupational Safety and Health, USA
| | - Vince Castranova
- Department of Physiology and Pharmacology, School of Medicine, West Virginia University, USA
| | - Jack R Harkema
- Department of Pathobiology and Diagnostic Investigation, School of Veterinary Medicine, Michigan State University, USA
| | - Eric E Kelley
- Department of Physiology and Pharmacology, School of Medicine, West Virginia University, USA; Center for Inhalation Toxicology (iTOX), School of Medicine, West Virginia University, USA
| | - Salik Hussain
- Department of Physiology and Pharmacology, School of Medicine, West Virginia University, USA; Center for Inhalation Toxicology (iTOX), School of Medicine, West Virginia University, USA.
| |
Collapse
|
105
|
Liu Y, Pan J, Fan C, Xu R, Wang Y, Xu C, Xie S, Zhang H, Cui X, Peng Z, Shi C, Zhang Y, Sun H, Zhou Y, Zhang L. Short-Term Exposure to Ambient Air Pollution and Mortality From Myocardial Infarction. J Am Coll Cardiol 2021; 77:271-281. [PMID: 33478650 DOI: 10.1016/j.jacc.2020.11.033] [Citation(s) in RCA: 89] [Impact Index Per Article: 29.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 10/22/2020] [Accepted: 11/13/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Short-term exposure to ambient air pollution has been linked to occurrence of myocardial infarction (MI); however, only a limited number of studies investigated its association with death from MI, and the results remain inconsistent. OBJECTIVES This study sought to investigate the association of short-term exposure to air pollution across a wide range of concentrations with MI mortality. METHODS A time-stratified case-crossover study was conducted to investigate 151,608 MI death cases in Hubei province (China) from 2013 to 2018. Based on each case's home address, exposure to particulate matter with an aerodynamic diameter ≤2.5 μm (PM2.5), particulate matter with an aerodynamic diameter ≤10 μm (PM10), sulfur dioxide, nitrogen dioxide (NO2), carbon monoxide, and ozone on each of the case and control days was assessed as the inverse distance-weighted average concentration at neighboring air quality monitoring stations. Conditional logistic regression models were implemented to quantify exposure-response associations. RESULTS Exposure to PM2.5, PM10, and NO2 (mean exposure on the same day of death and 1 day prior) was significantly associated with increased odds of MI mortality. The odds associated with PM2.5 and PM10 exposures increased steeply before a breakpoint (PM2.5, 33.3 μg/m3; PM10, 57.3 μg/m3) and flattened out at higher exposure levels, while the association for NO2 exposure was almost linear. Each 10-μg/m3 increase in exposure to PM2.5 (<33.3 μg/m3), PM10 (<57.3 μg/m3), and NO2 was significantly associated with a 4.14% (95% confidence interval [CI]: 1.25% to 7.12%), 2.67% (95% CI: 0.80% to 4.57%), and 1.46% (95% CI: 0.76% to 2.17%) increase in odds of MI mortality, respectively. The association between NO2 exposure and MI mortality was significantly stronger in older adults. CONCLUSIONS Short-term exposure to PM2.5, PM10, and NO2 was associated with increased risk of MI mortality.
Collapse
Affiliation(s)
- Yuewei Liu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.
| | - Jingju Pan
- Institute of Chronic Noncommunicable Disease Control and Prevention, Hubei Provincial Center for Disease Control and Prevention, Wuhan, China
| | - Chuangang Fan
- Institute of Health Surveillance, Analysis and Protection, Hubei Provincial Center for Disease Control and Prevention, Wuhan, China
| | - Ruijun Xu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yaqi Wang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Chang Xu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Shuguang Xie
- Institute of Health Surveillance, Analysis and Protection, Hubei Provincial Center for Disease Control and Prevention, Wuhan, China
| | - Hai Zhang
- Institute of Health Surveillance, Analysis and Protection, Hubei Provincial Center for Disease Control and Prevention, Wuhan, China
| | - Xiuqing Cui
- Institute of Health Surveillance, Analysis and Protection, Hubei Provincial Center for Disease Control and Prevention, Wuhan, China
| | - Zhe Peng
- Institute of Health Surveillance, Analysis and Protection, Hubei Provincial Center for Disease Control and Prevention, Wuhan, China
| | - Chunxiang Shi
- Meteorological Data Laboratory, National Meteorological Information Center, Beijing, China
| | - Yunquan Zhang
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Hong Sun
- Department of Environmental and Health, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Yun Zhou
- State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China; Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Lan Zhang
- Institute of Chronic Noncommunicable Disease Control and Prevention, Hubei Provincial Center for Disease Control and Prevention, Wuhan, China.
| |
Collapse
|
106
|
Pekince Md B, Baccioglu Md A. Allergic and non-allergic asthma phenotypes and exposure to air pollution. J Asthma 2021; 59:1509-1520. [PMID: 34254843 DOI: 10.1080/02770903.2021.1955133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Although harmful effects of air pollution on airway diseases are well-established, its effect on allergy still remains unclear. The aim of this study was to examine changes on asthma clinic and oxidant homeostasis due to air pollution between allergic asthma (AA) and non-allergic asthma (NA) phenotypes. METHODS This prospective, case-control study included patients with well-controlled asthma under regular treatment (n = 57) and healthy individuals (n = 51). Of asthma patients, 22 had AA and 35 had NA phenotypes. Respiratory symptoms, pulmonary function tests, serum total antioxidant status (TAS) and total oxidant status (TOS), and thiol/disulfide levels were compared between the most (V1) and least (V2) air-polluted times. RESULTS High air pollution exposure resulted to an increase in the frequency of respiratory symptoms and serum inflammation markers in both asthmatic and healthy individuals. Frequency of dyspnea and cough in AA and rhinitis in NA decreased from V1 to V2. Hospitalization due to asthma exacerbation, systemic corticosteroid use, and eosinophil counts were more frequent in NA group than AA in V1. An increase of blood eosinophil counts was observed in AA group at the same visit. Mean TAS and TOS levels were higher in asthma group than control group, and the decline in TAS and TOS levels from V1 to V2 was seen only in NA. All thiols decreased and SH/total SH ratios significantly increased from V1 to V2 in all groups. CONCLUSION This study demonstrates that air pollution affects both asthma patients and healthy individuals. Through oxidant-antioxidant and thiol pathways, however, it adversely affects respiratory system of asthma patients, at a greater extent, than healthy individuals.
Collapse
Affiliation(s)
- Busra Pekince Md
- Division of Critical Care, Department of Pulmonary Diseases, School of Medicine, Selcuk University, Konya, Turkey
| | - Ayse Baccioglu Md
- Division of Immunology and Allergy, Department of Pulmonary Diseases, School of Medicine, Kirikkale University, Kirikkale, Turkey
| |
Collapse
|
107
|
Abstract
Since the industrial revolution, air pollution has become a major problem causing several health problems involving the airways as well as the cardiovascular, reproductive, or neurological system. According to the WHO, about 3.6 million deaths every year are related to inhalation of polluted air, specifically due to pulmonary diseases. Polluted air first encounters the airways, which are a major human defense mechanism to reduce the risk of this aggressor. Air pollution consists of a mixture of potentially harmful compounds such as particulate matter, ozone, carbon monoxide, volatile organic compounds, and heavy metals, each having its own effects on the human body. In the last decades, a lot of research investigating the underlying risks and effects of air pollution and/or its specific compounds on the airways, has been performed, involving both in vivo and in vitro experiments. The goal of this review is to give an overview of the recent data on the effects of air pollution on healthy and diseased airways or models of airway disease, such as asthma or chronic obstructive pulmonary disease. Therefore, we focused on studies involving pollution and airway symptoms and/or damage both in mice and humans.
Collapse
|
108
|
Zhu F, Chen L, Qian ZM, Liao Y, Zhang Z, McMillin SE, Wang X, Lin H. Acute effects of particulate matter with different sizes on respiratory mortality in Shenzhen, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:37195-37203. [PMID: 33715123 DOI: 10.1007/s11356-021-13118-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 02/18/2021] [Indexed: 06/12/2023]
Abstract
There are relatively few studies that focus on the health effects of exposure to size-specific particles on respiratory mortality in China. We aimed to examine the association between different particle sizes and mortality from cause-specific respiratory diseases. We used a time series model with a quasi-Poisson link to investigate the relationship between different particle sizes and mortality from respiratory diseases, chronic obstructive pulmonary diseases (COPD), pneumonia, and asthma in Shenzhen during 2014-2017. A total of 3716 mortalities due to respiratory diseases were collected. Both PM1 and PM2.5 were associated with mortality of overall respiratory diseases, COPD, and pneumonia. An interquartile range (IQR) increase in PM1 at lag03 was associated with a 12.21% (95% CI: 2.59%, 22.75%) increase in respiratory mortality, and each IQR increase in PM2.5 at lag03 corresponded to a 12.09% (95% CI: 2.52%, 22.56%) increase in respiratory mortality. PM1-2.5 was not associated with mortality from all-cause or cause-specific respiratory diseases. This study suggests that both PM1 and PM2.5 may increase the risk of mortality due to respiratory diseases in Shenzhen, China.
Collapse
Affiliation(s)
- Feng Zhu
- Nanshan District Center for Disease Control and Prevention, Shenzhen, 518054, China
| | - Lan Chen
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Zhengmin Min Qian
- Department of Epidemiology and Biostatistics, College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO, 63104, USA
| | - Yuxue Liao
- Shenzhen Center for Disease Control and Prevention, Shenzhen, 518055, China
| | - Zhen Zhang
- Shenzhen Center for Disease Control and Prevention, Shenzhen, 518055, China
| | - Stephen Edward McMillin
- School of Social Work, College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO, 63103, USA
| | - Xiaojie Wang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
| |
Collapse
|
109
|
Cao D, Li D, Wu Y, Qian ZM, Liu Y, Liu Q, Sun J, Guo Y, Zhang S, Jiao G, Yang X, Wang C, McMillin SE, Zhang X, Lin H. Ambient PM 2.5 exposure and hospital cost and length of hospital stay for respiratory diseases in 11 cities in Shanxi Province, China. Thorax 2021; 76:thoraxjnl-2020-215838. [PMID: 34088786 DOI: 10.1136/thoraxjnl-2020-215838] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 04/09/2021] [Accepted: 05/04/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND Few studies have examined the effects of ambient particulate matter with an aerodynamic diameter less than or equal to 2.5 μm (PM2.5) on hospital cost and length of hospital stay for respiratory diseases in China. METHODS We estimated ambient air pollution exposure for respiratory cases through inverse distance-weighted averages of air monitoring stations based on their residential address and averaged at the city level. We used generalised additive models to quantify city-specific associations in 11 cities in Shanxi and a meta-analysis to estimate the overall effects. We further estimated respiratory burden attributable to PM2.5 using the standards of WHO (25 µg/m3) and China (75 µg/m3) as reference. RESULTS Each 10 µg/m3 increase in lag03 PM2.5 corresponded to 0.53% (95% CI: 0.33% to 0.73%) increase in respiratory hospitalisation, an increment of 3.75 thousand RMB (95% CI: 1.84 to 5.670) in hospital cost and 4.13 days (95% CI: 2.51 to 5.75) in length of hospital stay. About 9.7 thousand respiratory hospitalisations, 132 million RMB in hospital cost and 145 thousand days of hospital stay could be attributable to PM2.5 exposures using WHO's guideline as reference. We estimated that 193 RMB (95% CI: 95 to 292) in hospital cost and 0.21 days (95% CI: 0.13 to 0.30) in hospital stay could be potentially avoidable for an average respiratory case. CONCLUSION Significant respiratory burden could be attributable to PM2.5 exposures in Shanxi Province, China. The results need to be factored into impact assessment of air pollution policies to provide a more complete indication of the burden addressed by the policies.
Collapse
Affiliation(s)
- Dawei Cao
- Department of Respiration, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Dongyan Li
- Department of Respiration, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Yinglin Wu
- Department of Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Zhengmin Min Qian
- Department of Epidemiology and Biostatistics, College for Public Health and Social Justice, Saint Louis University, Saint Louis, Missouri, USA
| | - Yi Liu
- Department of Respiration, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Qiyong Liu
- Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jimin Sun
- Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China
| | - Yuming Guo
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Shiyu Zhang
- Department of Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Guangyuan Jiao
- Department of Ideological and Political Education, School of Marxism, Capital Medical University, Beijing, China
| | - Xiaoran Yang
- Department of Standards and Evaluation, Beijing Municipal Health Commission Policy Research Center, Beijing Municipal health Commission Information Center, Beijing, China
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Stephen Edward McMillin
- School of Social Work, College for Public Health and Social Justice, Saint Louis University, Saint Louis, Missouri, USA
| | - Xinri Zhang
- Department of Respiration, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong, China
| |
Collapse
|
110
|
Lim YH, Oh J, Han C, Bae HJ, Kim S, Jang Y, Ha E, Hong YC. Long-term exposure to moderate fine particulate matter concentrations and cause-specific mortality in an ageing society. Int J Epidemiol 2021; 49:1792-1801. [PMID: 33079997 DOI: 10.1093/ije/dyaa146] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Long-term exposure to particulate matter <2.5 μm in size (PM2.5) is considered a risk factor for premature death. However, only a few studies have been conducted in areas with moderate PM2.5 concentrations. Moreover, an ageing society may be more susceptible to environmental exposure and future burden of mortality due to PM2.5. METHODS This study estimates hazard ratios (HRs) for all-cause and cause-specific mortality from long-term exposure to moderate PM2.5 concentrations in the elderly populations of seven cities in South Korea. We also projected nationwide elderly mortality caused by long-term exposure to PM2.5, accounting for population ageing until 2045. Mortality in 1 720 230 elderly adults aged ≥65 years in 2008 was monitored across 2009-16 and linked to modelled PM2.5 concentrations. RESULTS A total of 421 100 deaths occurred in 2009-16, and the mean of annual PM2.5 concentration ranged between 21.1 and 31.9 μg/m3 in most regions. The overall HR for a 10 μg/m3 increase in a 36-month PM2.5 moving average was 1.024 (95% confidence intervals: 1.009, 1.039). We estimated that 11 833 all-cause nationwide elderly deaths were attributable to PM2.5 exposure. Annual death tolls may increase to 17 948 by 2045. However, if PM2.5 is reduced to 5 μg/m3 by 2045, the tolls may show a lower increase to 3646. CONCLUSIONS Long-term exposure to moderately high levels of PM2.5 was associated with increased mortality risk among the elderly. Thus, PM2.5 reduction in response to the projected ageing-associated mortality in South Korea is critical.
Collapse
Affiliation(s)
- Youn-Hee Lim
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea
| | - Jongmin Oh
- Department of Occupational and Environmental Medicine, School of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Changwoo Han
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hyun-Joo Bae
- Korea Environment Institute, Sejong, Republic of Korea
| | - Soontae Kim
- Department of Environmental and Safety Engineering, Ajou University, Suwon, Republic of Korea
| | - Yoonyoung Jang
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Eunhee Ha
- Department of Occupational and Environmental Medicine, School of Medicine, Ewha Womans University, Seoul, Republic of Korea
| | - Yun-Chul Hong
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea.,Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| |
Collapse
|
111
|
Federico MJ, Denlinger LC, Corren J, Szefler SJ, Fuhlbrigge AL. Exacerbation-Prone Asthma: A Biological Phenotype or a Social Construct. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2021; 9:2627-2634. [PMID: 34051392 DOI: 10.1016/j.jaip.2021.05.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 05/17/2021] [Accepted: 05/19/2021] [Indexed: 12/14/2022]
Abstract
Asthma is a complex syndrome with multiple phenotypes and endotypes. Asthma exacerbations are not only the clearest indictor of the morbidity of asthma and of the risk for mortality due to asthma, but also comprise a significant amount of the cost to care for poorly controlled asthma. There continues to be significant disparity in the prevalence, mortality, and morbidity due to asthma. Patients with asthma who suffer recurrent exacerbations are considered to have exacerbation-prone asthma (EPA). Efforts to characterize patients with frequent exacerbations show that the etiology is likely multifactorial. Research to determine the intrinsic risk factors for EPA include studies of both genetic and inflammatory biomarkers. External factors contributing to exacerbations have been extensively reviewed and include viral infection, environmental exposures, air pollution, and psychosocial and economic barriers to optimizing health. It is likely that EPA occurs when patients who have an increased underlying intrinsic/biological risk are placed in a given exposome (environments with a variety of exposures and triggers including allergens, pollution, stress, barriers, and occupational exposures). It is the social construct combined with underlying biology that frequently drives an EPA phenotype.
Collapse
Affiliation(s)
- Monica J Federico
- The Breathing Institute, Children's Hospital Colorado, and Department of Pediatrics, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colo.
| | - Loren C Denlinger
- Division of Allergy, Pulmonary, and Critical Care Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wis
| | - Jonathan Corren
- Departments of Medicine and Pediatrics, Divisions of Allergy and Clinical Immunology, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, Calif
| | - Stanley J Szefler
- The Breathing Institute, Children's Hospital Colorado, and Department of Pediatrics, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colo
| | - Anne L Fuhlbrigge
- Pulmonary Sciences and Critical Care, Department of Medicine, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colo
| |
Collapse
|
112
|
Sex and Gender Differences in Lung Disease. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1304:227-258. [PMID: 34019273 DOI: 10.1007/978-3-030-68748-9_14] [Citation(s) in RCA: 60] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Sex differences in the anatomy and physiology of the respiratory system have been widely reported. These intrinsic sex differences have also been shown to modulate the pathophysiology, incidence, morbidity, and mortality of several lung diseases across the life span. In this chapter, we describe the epidemiology of sex differences in respiratory diseases including neonatal lung disease (respiratory distress syndrome, bronchopulmonary dysplasia) and pediatric and adult disease (including asthma, cystic fibrosis, idiopathic pulmonary fibrosis, chronic obstructive pulmonary disease, lung cancer, lymphangioleiomyomatosis, obstructive sleep apnea, pulmonary arterial hypertension, and respiratory viral infections such as respiratory syncytial virus, influenza, and SARS-CoV-2). We also discuss the current state of research on the mechanisms underlying the observed sex differences in lung disease susceptibility and severity and the importance of considering both sex and gender variables in research studies' design and analysis.
Collapse
|
113
|
Zhang Y. All-Cause Mortality Risk and Attributable Deaths Associated with Long-Term Exposure to Ambient PM 2.5 in Chinese Adults. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2021; 55:6116-6127. [PMID: 33870687 DOI: 10.1021/acs.est.0c08527] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Several recent studies in China have associated raised mortality risks with chronic exposure to ambient PM2.5. However, cohort evidence covering general populations and more homogeneous regions is extensively scarce. We conceived a nationwide perspective cohort study from 2010 through 2018, by enrolling 30 946 adult men and women aged 16-110 years from 25 provincial regions in mainland China. Cox proportional hazards models with time-varying exposures were adopted to quantify longitudinal association of PM2.5 exposure with all-cause mortality. A total of 1762 death events occurred during a median follow-up of 8.1 years. Participants were exposed to a broad range of annual mean PM2.5 concentrations (2.4-112 μg/m3), with an average estimate of 47.5 μg/m3. A 10-μg/m3 increase in annual average of PM2.5 exposure was associated with an hazard ratio of 1.055 (95% confidence interval: 1.022-1.088, p < 0.001) for all-cause mortality. We estimated totally 2.68 million deaths attributable to ambient PM2.5 in 2015, yielding a remarkable reduction of 36.7 thousand compared to the estimate in 2010 (2.72 million deaths). This study added nationally representative evidence regarding concentration-response function for long-term PM2.5-mortality association in Chinese adults, which may significantly contribute to national and global assessments of PM2.5-attributable death burden.
Collapse
Affiliation(s)
- Yunquan Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan 430065, China
| |
Collapse
|
114
|
Byrwa-Hill BM, Presto AA, Wenzel S, Fabisiak JP. Impact of a pollution breach at a coke oven factory on asthma control in nearby vulnerable adults. J Allergy Clin Immunol 2021; 148:225-233. [PMID: 33894208 DOI: 10.1016/j.jaci.2021.04.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 03/29/2021] [Accepted: 04/08/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Previous studies have related sulfur dioxide (SO2) exposure to asthma exacerbations. We utilized the University of Pittsburgh Asthma Institute registry to study associations of asthma exacerbations between 2 geographically distinct populations of adults with asthma. OBJECTIVE Our objective was to examine whether asthma symptoms worsened following a significant fire event that destroyed pollution control equipment at the largest coke works in the United States. METHODS Two groups of patients with asthma, namely, those residing within 10 miles of the coke works fire (the proximal group [n = 39]) and those residing beyond that range (the control group [n = 44]), were geocoded by residential address. Concentrations of ambient air SO2 were generated by using local University of Pittsburgh Asthma Institute registry air monitoring data. Factory emissions were also evaluated. Data from a patient historical acute exposure survey and in-person follow-up data were evaluated. Inferential statistics were used to compare the groups. RESULTS In the immediate postfire period (6-8 weeks), the level of emissions of SO2 from the factory emissions increased to 25 times more than the typical level. Following the pollution control breach, the proximal cohort self-reported an increase in medication use (risk ratio = 1.76; 95% CI = 1.1-2.8; P < .01) and more exacerbations. In a small subset of the follow-up cohort of those who completed the acute exposure survey only, asthma control metrics improved. CONCLUSIONS Real-world exposure to a marked increase in ambient levels of SO2 from a pollution control breach was associated with worsened asthma control in patients proximal to the event, with the worsened control improving following repair of the controls. Improved spatial resolution of air pollutant measurements would enable better examination of exposures and subsequent health impacts.
Collapse
Affiliation(s)
- Brandy M Byrwa-Hill
- Department of Environmental and Occupational Health, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pa
| | - Albert A Presto
- Center for Atmospheric Particle Studies, Department of Mechanical Engineering, Carnegie Mellon University, Pittsburgh, Pa
| | - Sally Wenzel
- Department of Environmental and Occupational Health, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pa; University of Pittsburgh Asthma Institute, University of Pittsburgh Medical Center, Pittsburgh, Pa.
| | - James P Fabisiak
- Department of Environmental and Occupational Health, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pa.
| |
Collapse
|
115
|
Annesi-Maesano I, Forastiere F, Balmes J, Garcia E, Harkema J, Holgate S, Kelly F, Khreis H, Hoffmann B, Maesano CN, McConnell R, Peden D, Pinkerton K, Schikowski T, Thurston G, Van Winkle LS, Carlsten C. The clear and persistent impact of air pollution on chronic respiratory diseases: a call for interventions. Eur Respir J 2021; 57:57/3/2002981. [PMID: 33737377 DOI: 10.1183/13993003.02981-2020] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 11/09/2020] [Indexed: 12/13/2022]
Affiliation(s)
- Isabella Annesi-Maesano
- Sorbonne Université and INSERM, Epidemiology of Allergic and Respiratory Diseases Dept, Institut Pierre Louis of Epidemiology and Public Health, Paris, France
| | | | - John Balmes
- University of California Berkeley-University of California San Francisco Joint Medical Program, Berkeley, CA, USA.,School of Public Health, University of California, Berkeley, CA, USA.,Dept of Medicine, School of Medicine, University of California, San Francisco, CA, USA
| | - Erika Garcia
- Dept of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Jack Harkema
- Dept of Pathobiology and Diagnostic Investigation, College of Veterinary Medicine, Michigan State University, East Lansing, MI, USA
| | - Stephen Holgate
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Frank Kelly
- Environmental Research Group, King's College, London, UK
| | - Haneen Khreis
- Center for Advancing Research in Transportation Emissions, Energy, and Health (CARTEEH), Texas A&M Transportation Institute (TTI), College Station, TX, USA
| | - Barbara Hoffmann
- Institute for Occupational, Social and Environmental Medicine, Center for Health and Society, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany
| | - Cara Nichole Maesano
- Sorbonne Université and INSERM, Epidemiology of Allergic and Respiratory Diseases Dept, Institut Pierre Louis of Epidemiology and Public Health, Paris, France
| | - Rob McConnell
- University of Southern California, Preventive Medicine, Los Angeles, CA, USA
| | - David Peden
- Center for Environmental Medicine, Asthma and Lung Biology and Division of Allergy, Immunology and Rheumatology, Dept of Pediatrics, the School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kent Pinkerton
- Center for Health and the Environment, John Muir Institute of the Environment, University of California, Davis, CA, USA
| | - Tamara Schikowski
- IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany
| | - George Thurston
- New York University School of Medicine, Dept of Environmental Medicine, New York, NY, USA
| | - Laura S Van Winkle
- Dept of Anatomy, Physiology and Cell Biology, School of Veterinary Medicine, University of California, Davis, Davis, CA, USA
| | - Christopher Carlsten
- Air Pollution Exposure Laboratory, Dept of Medicine, Division of Respiratory Medicine, The University of British Columbia, Vancouver, BC, Canada
| |
Collapse
|
116
|
Zhang Y, Wei J, Shi Y, Quan C, Ho HC, Song Y, Zhang L. Early-life exposure to submicron particulate air pollution in relation to asthma development in Chinese preschool children. J Allergy Clin Immunol 2021; 148:771-782.e12. [PMID: 33684436 DOI: 10.1016/j.jaci.2021.02.030] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 01/27/2021] [Accepted: 02/16/2021] [Indexed: 01/15/2023]
Abstract
BACKGROUND Emerging research suggested an association of early-life particulate air pollution exposure with development of asthma in childhood. However, the potentially differential effects of submicron particulate matter (PM; PM with aerodynamic diameter ≤1 μm [PM1]) remain largely unknown. OBJECTIVE This study primarily aimed to investigate associations of childhood asthma and wheezing with in utero and first-year exposures to size-specific particles. METHODS We conducted a large cross-sectional survey among 5788 preschool children aged 3 to 5 years in central China. In utero and first-year exposures to ambient PM1, PM with aerodynamic diameter less than or equal to 2.5 μm, and PM with aerodynamic diameter less than or equal to 10 μm at 1 × 1-km resolution were assessed using machine learning-based spatiotemporal models. A time-to-event analysis was performed to examine associations between residential PM exposures and childhood onset of asthma and wheezing. RESULTS Early-life size-specific PM exposures, particularly during pregnancy, were significantly associated with increased risk of asthma, whereas no evident PM-wheezing associations were observed. Each 10-μg/m3 increase in in utero and first-year PM1 exposure was accordingly associated with an asthma's hazard ratio in childhood of 1.618 (95% CI, 1.159-2.258; P = .005) and 1.543 (0.822-2.896; P = .177). Subgroup analyses suggest that short breast-feeding duration may aggravate PM-associated risk of childhood asthma. Each 10-μg/m3 increase in in utero exposure to PM1, for instance, was associated with a hazard ratio of 2.260 (1.393-3.666) among children with 0 to 5 months' breast-feeding and 1.156 (0.721-1.853) among those longer breast-fed. CONCLUSIONS Our study added comparative evidence for increased risk of childhood asthma in relation to early-life PM exposures, highlighting stronger associations with ambient PM1 than with PM with aerodynamic diameter less than or equal to 2.5 μm and PM with aerodynamic diameter less than or equal to 10 μm.
Collapse
Affiliation(s)
- Yunquan Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University of Science and Technology, Wuhan, China; Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, China.
| | - Jing Wei
- Department of Chemical and Biochemical Engineering, Iowa Technology Institute, The University of Iowa, Iowa City, Iowa
| | - Yuqin Shi
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, China; Department of Environmental Hygiene and Occupational Medicine, School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Chao Quan
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, China; Department of Environmental Hygiene and Occupational Medicine, School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Hung Chak Ho
- Department of Urban Planning and Design, The University of Hong Kong, Hong Kong, China
| | - Yimeng Song
- Department of Land Surveying and Geo-Informatics, The Hong Kong Polytechnic University, Hong Kong, China; Smart Cities Research Institute, The Hong Kong Polytechnic University, Hong Kong, China
| | - Ling Zhang
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, China; Department of Environmental Hygiene and Occupational Medicine, School of Public Health, Wuhan University of Science and Technology, Wuhan, China.
| |
Collapse
|
117
|
Shin HH, Parajuli RP, Gogna P, Maquiling A, Dehghani P. Pollutant-sex specific differences in respiratory hospitalization and mortality risk attributable to short-term exposure to ambient air pollution. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 755:143135. [PMID: 33168238 DOI: 10.1016/j.scitotenv.2020.143135] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 09/11/2020] [Accepted: 10/13/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Many studies have reported associations of individual pollutants with respiratory hospitalization and mortality based on different populations, which makes it difficult to directly compare adverse health effects among multiple air pollutants. OBJECTIVES The study goal is to compare acute respiratory-related hospitalization and mortality associated with short-term exposure to three ambient air pollutants and analyze differences in health risks by season, age and sex. METHODS Hourly measurements of air pollutants (ozone, NO2, PM2.5) and temperature were collected from ground-monitors for 24 cities along with daily hospitalization (1996-2012) and mortality (1984-2012) data. National associations between air pollutant and health outcome were estimated for season (warm, cold vs. year-round), age (base ≥ 1, seniors > 65), and sex (females ≥ 1 and males ≥ 1) using Bayesian hierarchical models. RESULTS Overall, the three air pollutants were significantly associated with acute respiratory health outcomes at different lag-days. For respiratory hospitalization, the increased risks in percent changes with 95% posterior intervals for a 10-unit increase in each pollutant were: ozone (lag1, 0.7% (0.4, 0.9)), NO2 (lag0, 0.7% (0.1, 1.4)), and PM2.5 (lag1, 1.3% (0.7, 1.9)). For respiratory mortality: ozone (lag2, 1.2% (0.4, 1.9)), NO2 (lag1, 2.1% (0.6, 3.5)), and PM2.5 (lag1, 0.6% (-1.0, 2.2)). While some differences in risk were observed by season and age group, sex-specific differences were more pronounced. Compared with males, females had a higher respiratory mortality risk (1.8% (0.6, 2.9) vs 0.5% (-0.3, 1.3)) from ozone, a higher respiratory hospitalization risk (0.9% (0.0, 1.8) vs 0.6% (-0.3, 1.4)) but lower mortality risk (1.4% (-1.0, 3.7) vs 2.2% (0.4, 4.0)) from NO2, and a lower hospitalization risk (0.7% (-0.2, 1.7) vs 1.8% (1.0, 2.6)) from PM2.5. CONCLUSION This study reports significant health effects of short-term exposure to three ambient air pollutants on respiratory hospitalization (ozone≈NO2 < PM2.5 per-10 unit; ozone>NO2 ≈ PM2.5 per-IQR) and mortality (ozone≈NO2 > PM2.5) in Canada. Pollutant-sex-specific differences were found, but inconclusive due to limited biological and physiological explanations. Further studies are warranted to understand the pollutant-sex specific differences.
Collapse
Affiliation(s)
- Hwashin Hyun Shin
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, ON, Canada; Department of Mathematics and Statistics, Queen's University, Kingston, ON, Canada.
| | | | - Priyanka Gogna
- Department of Public Health Sciences, Queen's University, Kingston, ON, Canada.
| | - Aubrey Maquiling
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, ON, Canada.
| | - Parvin Dehghani
- Environmental Health Science and Research Bureau, Health Canada, Ottawa, ON, Canada.
| |
Collapse
|
118
|
Wang H, Lu F, Guo M, Fan W, Ji W, Dong Z. Associations between PM 1 exposure and daily emergency department visits in 19 hospitals, Beijing. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 755:142507. [PMID: 33032134 DOI: 10.1016/j.scitotenv.2020.142507] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 09/16/2020] [Accepted: 09/16/2020] [Indexed: 05/06/2023]
Abstract
Although the adverse health effects caused by PM2.5 (particulate matter (PM) with an aerodynamic diameter <2.5 μm) and PM10 (PM with an aerodynamic diameter <10 μm) have been examined in numeric studies, far less scientific evidence is available for PM with an aerodynamic diameter <1 μm (PM1). We performed a time series analysis to elucidate the associations between PM1 exposure and emergency department visits (EDVs) in 19 hospitals within Beijing. During the study period from January 2016 to December 2017, the average PM1 (mean ± standard deviation) was determined to be 39 ± 39 μg/m3, which was approximately 36% lower than that of 61 ± 56 μg/m3 for PM2.5. Results based on meta-analysis suggest that non-accidental and respiratory EDVs increased by 0.47% (95% confidence interval, CI: 0.35, 0.59%) and 0.59% (95%CI: 0.38, 0.8%) per 10 μg/m3 uptick in PM1 exposure. By comparison, the magnitude downgraded to 0.27% (95%CI: 0.15, 0.39%) in non-accidental and 0.32% (95%CI: 0.18, 0.47%) in respiratory EDVs for PM2.5 exposure, indicating that PMs of a smaller size may be a higher risk factor for EDVs. No significant differences in PM-associated EDV effects were noted between males and females, while stratified analysis by age and season illustrated that stronger effects were found for a warm season and young population. Our analysis reinforces the notion that PM1 exhibited a higher risk for EDVs, suggesting more efforts may be required to mitigate PM1 pollution.
Collapse
Affiliation(s)
- Hao Wang
- School of Space and Environment, Beihang University, Beijing 100191, China
| | - Feng Lu
- Beijing Municipal Health Commission Information Center, Beijing 100034, China
| | - Moning Guo
- Beijing Municipal Health Commission Information Center, Beijing 100034, China
| | - Wenhong Fan
- School of Space and Environment, Beihang University, Beijing 100191, China; Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Beihang University, Beijing 100191, China
| | - Wei Ji
- State Environmental Protection Key Laboratory of Regional Eco-process and Function Assessment, Chinese Research Academy of Environmental Sciences, Beijing 100012, China
| | - Zhaomin Dong
- School of Space and Environment, Beihang University, Beijing 100191, China; Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, Beihang University, Beijing 100191, China.
| |
Collapse
|
119
|
Santos UDP, Arbex MA, Braga ALF, Mizutani RF, Cançado JED, Terra-Filho M, Chatkin JM. Environmental air pollution: respiratory effects. J Bras Pneumol 2021; 47:e20200267. [PMID: 33567063 PMCID: PMC7889311 DOI: 10.36416/1806-3756/e20200267] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 12/06/2020] [Indexed: 12/25/2022] Open
Abstract
Environmental air pollution is a major risk factor for morbidity and mortality worldwide. Environmental air pollution has a direct impact on human health, being responsible for an increase in the incidence of and number of deaths due to cardiopulmonary, neoplastic, and metabolic diseases; it also contributes to global warming and the consequent climate change associated with extreme events and environmental imbalances. In this review, we present articles that show the impact that exposure to different sources and types of air pollutants has on the respiratory system; we present the acute effects-such as increases in symptoms and in the number of emergency room visits, hospitalizations, and deaths-and the chronic effects-such as increases in the incidence of asthma, COPD, and lung cancer, as well as a rapid decline in lung function. The effects of air pollution in more susceptible populations and the effects associated with physical exercise in polluted environments are also presented and discussed. Finally, we present the major studies on the subject conducted in Brazil. Health care and disease prevention services should be aware of this important risk factor in order to counsel more susceptible individuals about protective measures that can facilitate their treatment, as well as promoting the adoption of environmental measures that contribute to the reduction of such emissions.
Collapse
Affiliation(s)
- Ubiratan de Paula Santos
- . Divisão de Pneumologia, Instituto do Coração - InCor - Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP) Brasil
| | - Marcos Abdo Arbex
- . Faculdade de Medicina, Universidade de Araraquara - UNIARA - Araraquara (SP) Brasil
- . Núcleo de Estudos em Epidemiologia Ambiental, Laboratório de Poluição Atmosférica Experimental - NEEA-LPAE - Departamento de Patologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP) Brasil
| | - Alfésio Luis Ferreira Braga
- . Núcleo de Estudos em Epidemiologia Ambiental, Laboratório de Poluição Atmosférica Experimental - NEEA-LPAE - Departamento de Patologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP) Brasil
- . Grupo de Avaliação de Exposição e Risco Ambiental, Programa de Pós-Graduação em Saúde Coletiva, Universidade Católica de Santos - UNISANTOS - Santos (SP) Brasil
| | - Rafael Futoshi Mizutani
- . Grupo de Doenças Respiratórias Ambientais, Ocupacionais e de Cessação de Tabagismo, Divisão de Pneumologia, Instituto do Coração - InCor - Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP) Brasil
| | | | - Mário Terra-Filho
- . Departamento de Cardiopneumologia, Divisão de Pneumologia, Instituto do Coração - InCor - Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP) Brasil
| | - José Miguel Chatkin
- . Disciplina de Medicina Interna/Pneumologia, Escola de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS - Porto Alegre (RS), Brasil
- . Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS - Porto Alegre (RS), Brasil
| |
Collapse
|
120
|
Zhang Y, Wu Z, Gou K, Wang R, Wang J. The Impact of Air Pollution on Outpatient Visits of Children with Asthma in Xi'an, China. Wilderness Environ Med 2021; 32:47-54. [PMID: 33518497 DOI: 10.1016/j.wem.2020.11.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 11/04/2020] [Accepted: 11/12/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The number of children with asthma has increased significantly in China. In recent years, there has been a steady increase in outpatient visits of children with asthma, attributed to poor air quality and environmental pollution reported regionally and at our institution. This study aimed to assess the association between air pollution and the number of outpatient visits of children with asthma in Xi'an, the largest city in northwest China. METHODS We searched the database of the largest children's hospital in Xi'an for related information from 2014 to 2018 and then acquired data on air pollution, including the daily average concentrations of fine particles (PM2.5), inhalable particles (PM10), nitrogen dioxide (NO2), and sulfur dioxide (SO2) of that same time period. Time-series generalized additive models were used to analyze the relationships. RESULTS Our results revealed that air pollution was very serious in Xi'an, with elevated average concentrations of PM2.5, PM10, and NO2 from 2015 to 2018. The relative risk of outpatient visits due to asthma associated with PM2.5, PM10, and SO2 pollution rose significantly and reached 1.11 (1.02-1.21), 1.25 (1.01-1.55), and 1.71 (1.31-2.25), respectively, when there was a 10 ug·m-3 increase in concentration, during a lag of 21 d. CONCLUSIONS A high concentration of particulate matter (PM2.5 and PM10) was the prominent feature of air pollution in Xi'an. Exposure to air pollutant (PM2.5, PM10, SO2) was positively associated with an increased risk of children's outpatient visits for asthma in Xi'an.
Collapse
Affiliation(s)
- Yaozu Zhang
- Department of Stomatology, The Affiliated Children Hospital of Xi'an Jiaotong University, Shanxi, Xi'an, China
| | - Zonghui Wu
- Department of Stomatology, The Affiliated Children Hospital of Xi'an Jiaotong University, Shanxi, Xi'an, China
| | - Kaihua Gou
- Department of Otolaryngology-Head and Neck Surgery, The Affiliated Children Hospital of Xi'an Jiaotong University, Shanxi, Xi'an, China
| | - Ruifang Wang
- Department of Stomatology, The Affiliated Children Hospital of Xi'an Jiaotong University, Shanxi, Xi'an, China
| | - Jie Wang
- Department of Otolaryngology-Head and Neck Surgery, The Affiliated Children Hospital of Xi'an Jiaotong University, Shanxi, Xi'an, China.
| |
Collapse
|
121
|
Asthma and air pollution: recent insights in pathogenesis and clinical implications. Curr Opin Pulm Med 2021; 26:10-19. [PMID: 31724961 DOI: 10.1097/mcp.0000000000000644] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE OF REVIEW Air pollution has adverse effects on the onset and morbidity of respiratory diseases, including asthma. In this review, we discuss recent insights into the effects of air pollution on the incidence and exacerbation of asthma. We focus on epidemiological studies that describe the association between air pollution exposure and development, mortality, persistence and exacerbations of asthma among different age groups. Moreover, we also provide an update on translational studies describing the mechanisms behind this association. RECENT FINDINGS Mechanisms linking air pollutants such as particulate matter, nitrogen dioxide (NO2) and ozone to the development and exacerbation of asthma include the induction of both eosinophilic and neutrophilic inflammation driven by stimulation of airway epithelium and increase of pro-inflammatory cytokine production, oxidative stress and DNA methylation changes. Although exposure during foetal development is often reported as a crucial timeframe, exposure to air pollution is detrimental in people of all ages, thus influencing asthma onset as well as increase in asthma prevalence, mortality, persistence and exacerbation. SUMMARY In conclusion, this review highlights the importance of reducing air pollution levels to avert the progressive increase in asthma incidence and morbidity.
Collapse
|
122
|
Analysis of Single Nucleotide Variants (SNVs) Induced by Exposure to PM 10 in Lung Epithelial Cells Using Whole Genome Sequencing. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031046. [PMID: 33503946 PMCID: PMC7908261 DOI: 10.3390/ijerph18031046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/20/2021] [Accepted: 01/21/2021] [Indexed: 11/23/2022]
Abstract
There are many epidemiological studies asserting that fine dust causes lung cancer, but the biological mechanism is not clear. This study was conducted to investigate the effect of PM10 (particulate matter less than 10 μm) on single nucleotide variants through whole genome sequencing in lung epithelial cancer cell lines (HCC-827, NCI-H358) that have been exposed to PM10. The two cell lines were exposed to PM10 for 15 days. We performed experimental and next generation sequencing analyses on experimental group that had been exposed to PM10 as well as an unexposed control group. After exposure to PM10, 3005 single nucleotide variants were newly identified in the NCI-H358 group, and 4402 mutations were identified in the HCC-827 group. We analyzed these single nucleotide variants with the Mutalisk program. We observed kataegis in chromosome 1 in NCI-H358 and chromosome 7 in HCC-827. In mutational signatures analysis, the COSMIC mutational signature 5 was highest in both HCC-827 and NCI-H358 groups, and each cosine similarity was 0.964 in HCC-827 and 0.979 in the NCI-H358 group. The etiology of COSMIC mutational signature 5 is unknown at present. Well-designed studies are needed to determine whether environmental factors, such as PM10, cause COSMIC mutational signature 5.
Collapse
|
123
|
Chatkin J, Correa L, Santos U. External Environmental Pollution as a Risk Factor for Asthma. Clin Rev Allergy Immunol 2021; 62:72-89. [PMID: 33433826 PMCID: PMC7801569 DOI: 10.1007/s12016-020-08830-5] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2020] [Indexed: 12/12/2022]
Abstract
Air pollution is a worrisome risk factor for global morbidity and mortality and plays a special role in many respiratory conditions. It contributes to around 8 million deaths/year, with outdoor exposure being responsible for more than 4.2 million deaths throughout the world, while more than 3.8 million die from situations related to indoor pollution. Pollutant agents induce several respiratory symptoms. In addition, there is a clear interference in numerous asthma outcomes, such as incidence, prevalence, hospital admission, visits to emergency departments, mortality, and asthma attacks, among others. The particulate matter group of pollutants includes coarse particles/PM10, fine particles/PM2.5, and ultrafine particles/PM0.1. The gaseous components include ground-level ozone, nitrogen dioxide, sulfur dioxide, and carbon monoxide. The timing, load, and route of allergen exposure are other items affecting allergic disease phenotypes. The complex interaction between pollutant exposures and human host factors has an implication in the development and rise of asthma as a public health problem. However, there are hiatuses in the understanding of the pathways in this disease. The routes through which pollutants induce asthma are multiple, and include the epigenetic changes that occur in the respiratory tract microbiome, oxidative stress, and immune dysregulation. In addition, the expansion of the modern Westernized lifestyle, which is characterized by intense urbanization and more time spent indoors, resulted in greater exposure to polluted air. Another point to consider is the different role of the environment according to age groups. Children growing up in economically disadvantaged neighborhoods suffer more important negative health impacts. This narrative review highlights the principal polluting agents, their sources of emission, epidemiological findings, and mechanistic evidence that links environmental exposures to asthma.
Collapse
Affiliation(s)
- Jose Chatkin
- Pulmonology Division, School of Medicine, Pontifical Catholic University Rio Grande Do Sul (PUCRS), Hospital São Lucas da PUCRS, Porto Alegre, Brazil.
| | - Liana Correa
- Health Sciences Doctorate Program, School of Medicine, Pontifical Catholic University Rio Grande Do Sul (PUCRS), Pulmonologist Hospital São Lucas da PUCRS, Porto Alegre, Brazil
| | - Ubiratan Santos
- Pulmonology Division of Instituto Do Coração, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil
| |
Collapse
|
124
|
Liu L, Liu C, Chen R, Zhou Y, Meng X, Hong J, Cao L, Lu Y, Dong X, Xia M, Ding B, Qian L, Wang L, Zhou W, Gui Y, Zhang X. Associations of short-term exposure to air pollution and emergency department visits for pediatric asthma in Shanghai, China. CHEMOSPHERE 2021; 263:127856. [PMID: 32822929 DOI: 10.1016/j.chemosphere.2020.127856] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 06/13/2020] [Accepted: 07/27/2020] [Indexed: 05/08/2023]
Abstract
There is limited evidence regarding the relationship between air pollution and pediatric asthma in developing countries. This study aimed to investigate the association between short-term exposure to ambient air pollutants and pediatric asthma emergency department (ED) visits in Shanghai, China. We collected data on six criteria air pollutants (PM2.5, PM10, NO2, SO2, CO, and O3) and daily ED visits for pediatric asthma patients from 66 hospitals in Shanghai from 2016 to 2018. The generalized additive model combined with polynomial distributed lag model was applied to explore the associations. We fitted two-pollutant models and stratified the analyses by sex, age, and season. In total, we identified 108,817 emergency department visits for pediatric asthma. A 10 μg/m3 increase in the concentrations of PM2.5, NO2, SO2, and O3 was significantly associated with increased risks of pediatric asthma ED visits, with relative risk of pediatric asthma of 1.011 [95% confidence interval (CI): 1.002, 1.021], 1.030 (95%CI: 1.017, 1.043), 1.106 (95%CI: 1.041, 1.174), and 1.009 (95%CI: 1.001, 1.017), respectively. The associations of NO2 remained robust in the two-pollutant models. There were stronger associations for older children (6-18 years) and in warm seasons. The concentration-response curves for pediatric asthma and PM2.5, NO2, SO2, and O3 were steeper at lower and moderate concentrations but became flatter at higher concentrations. This analysis provided evidence that short-term exposure to air pollutants (PM2.5, NO2, SO2, and O3) could increase the risk of asthma exacerbations among children, and health benefits would be gained from improved air quality.
Collapse
Affiliation(s)
- Lijuan Liu
- Department of Respiratory Medicine, Children's Hospital of Fudan University, Shanghai, 201102, China
| | - Cong Liu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, 200032, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, 200032, China
| | - Yufeng Zhou
- Institute of Pediatrics, Children's Hospital of Fudan University, Shanghai, 201102, China; Institutes of Biomedical Sciences, Fudan University, Shanghai, 200032, China
| | - Xia Meng
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, 200032, China
| | - Jianguo Hong
- Department of Pediatrics, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai, 200080, China
| | - Lanfang Cao
- Department of Pediatrics, Renji Hospital, Shanghai Jiao Tong University, Shanghai, 200127, China
| | - Yanming Lu
- Department of Pediatrics, South Campus, Renji Hospital, Shanghai Jiao Tong University, Shanghai, 201112, China
| | - Xiaoyan Dong
- Department of Respiratory Medicine, Children's Hospital of Shanghai Jiaotong University, Shanghai, 200040, China
| | - Min Xia
- Department of Pediatrics, Renji Hospital, Shanghai Jiao Tong University, Shanghai, 200127, China
| | - Bo Ding
- Department of Pediatrics, South Campus, Renji Hospital, Shanghai Jiao Tong University, Shanghai, 201112, China
| | - Liling Qian
- Department of Respiratory Medicine, Children's Hospital of Fudan University, Shanghai, 201102, China
| | - Libo Wang
- Department of Respiratory Medicine, Children's Hospital of Fudan University, Shanghai, 201102, China
| | - Wenhao Zhou
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, 201102, China
| | - Yonghao Gui
- Cardiovascular Center, Children's Hospital of Fudan University, Shanghai, 201102, China
| | - Xiaobo Zhang
- Department of Respiratory Medicine, Children's Hospital of Fudan University, Shanghai, 201102, China.
| |
Collapse
|
125
|
He J, Ghorveh MG, Hurst JH, Tang M, Alhanti B, Lang JE, Goldstein BA. Evaluation of associations between asthma exacerbations and distance to roadways using geocoded electronic health records data. BMC Public Health 2020; 20:1626. [PMID: 33121457 PMCID: PMC7599107 DOI: 10.1186/s12889-020-09731-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 10/19/2020] [Indexed: 11/10/2022] Open
Abstract
Background Asthma exacerbations in children often require medications, urgent care, and hospitalization. Multiple environmental triggers have been associated with asthma exacerbations, including particulate matter 2.5 (PM2.5) and ozone, which are primarily generated by motor vehicle exhaust. There is mixed evidence as to whether proximity to highways increases risk of asthma exacerbations. Methods To evaluate the impact of highway proximity, we assessed the association between asthma exacerbations and the distance of child’s primary residence to two types of roadways in Durham County, North Carolina, accounting for other patient-level factors. We abstracted data from the Duke University Health System electronic health record (EHR), identifying 6208 children with asthma between 2014 and 2019. We geocoded each child’s distance to roadways (both 35 MPH+ and 55 MPH+). We classified asthma exacerbation severity into four tiers and fitted a recurrent event survival model to account for multiple exacerbations. Results There was a no observed effect of residential distance from 55+ MPH highway (Hazard Ratio: 0.98 (95% confidence interval: 0.94, 1.01)) and distance to 35+ MPH roadway (Hazard Ratio: 0.98 (95% confidence interval: 0.83, 1.15)) and any asthma exacerbation. Even those children living closest to highways (less 0.25 miles) had no increased risk of exacerbation. These results were consistent across different demographic strata. Conclusions While the results were non-significant, the characteristics of the study sample – namely farther distance to roadways and generally good ambient environmental pollution may contribute to the lack of effect. Compared to previous studies, which often relied on self-reported measures, we were able to obtain a more objective assessment of outcomes. Overall, this work highlights the opportunity to use EHR data to study environmental impacts on disease. Supplementary Information Supplementary information accompanies this paper at 10.1186/s12889-020-09731-0.
Collapse
Affiliation(s)
- Jingyi He
- Department of Biostatistics & Bioinformatics, Duke University, 2424 Erwin Road, Durham, NC, 27705, USA
| | | | - Jillian H Hurst
- Children's Health & Discovery Initiative, Duke University, Durham, NC, USA.,Department of Pediatrics, Duke University, Durham, USA
| | - Monica Tang
- Department of Medicine, University California, San Francisco, USA
| | | | - Jason E Lang
- Duke Clinical Research Institute, Durham, NC, USA.,Department of Pediatrics, Duke University, Durham, USA
| | - Benjamin A Goldstein
- Department of Biostatistics & Bioinformatics, Duke University, 2424 Erwin Road, Durham, NC, 27705, USA. .,Duke Clinical Research Institute, Durham, NC, USA. .,Children's Health & Discovery Initiative, Duke University, Durham, NC, USA. .,Department of Pediatrics, Duke University, Durham, USA.
| |
Collapse
|
126
|
Montgomery MT, Sajuthi SP, Cho SH, Everman JL, Rios CL, Goldfarbmuren KC, Jackson ND, Saef B, Cromie M, Eng C, Medina V, Elhawary JR, Oh SS, Rodriguez-Santana J, Vladar EK, Burchard EG, Seibold MA. Genome-Wide Analysis Reveals Mucociliary Remodeling of the Nasal Airway Epithelium Induced by Urban PM 2.5. Am J Respir Cell Mol Biol 2020; 63:172-184. [PMID: 32275839 DOI: 10.1165/rcmb.2019-0454oc] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Air pollution particulate matter <2.5 μm (PM2.5) exposure is associated with poor respiratory outcomes. Mechanisms underlying PM2.5-induced lung pathobiology are poorly understood but likely involve cellular and molecular changes to the airway epithelium. We extracted and chemically characterized the organic and water-soluble components of air pollution PM2.5 samples, then determined the whole transcriptome response of human nasal mucociliary airway epithelial cultures to a dose series of PM2.5 extracts. We found that PM2.5 organic extract (OE), but not water-soluble extract, elicited a potent, dose-dependent transcriptomic response from the mucociliary epithelium. Exposure to a moderate OE dose modified the expression of 424 genes, including activation of aryl hydrocarbon receptor signaling and an IL-1 inflammatory program. We generated an OE-response gene network defined by eight functional enrichment groups, which exhibited high connectivity through CYP1A1, IL1A, and IL1B. This OE exposure also robustly activated a mucus secretory expression program (>100 genes), which included transcriptional drivers of mucus metaplasia (SPDEF and FOXA3). Exposure to a higher OE dose modified the expression of 1,240 genes and further exacerbated expression responses observed at the moderate dose, including the mucus secretory program. Moreover, the higher OE dose significantly increased the MUC5AC/MUC5B gel-forming mucin expression ratio and strongly downregulated ciliated cell expression programs, including key ciliating cell transcription factors (e.g., FOXJ1 and MCIDAS). Chronic OE stimulation induced mucus metaplasia-like remodeling characterized by increases in MUC5AC+ secretory cells and MUC5AC mucus secretions. This epithelial remodeling may underlie poor respiratory outcomes associated with high PM2.5 exposure.
Collapse
Affiliation(s)
| | | | - Seung-Hyun Cho
- RTI International, Research Triangle Park, North Carolina
| | | | | | | | | | | | | | | | - Vivian Medina
- Centro de Neumología Pediátrica, San Juan, Puerto Rico; and
| | | | | | | | - Eszter K Vladar
- Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine and.,Department of Cell and Developmental Biology, University of Colorado School of Medicine, Aurora, Colorado
| | - Esteban G Burchard
- Department of Medicine and.,Department of Bioengineering and Therapeutic Sciences, University of California San Francisco, San Francisco, California
| | - Max A Seibold
- Center for Genes, Environment, and Health, and.,Department of Pediatrics, National Jewish Health, Denver, Colorado.,Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine and
| |
Collapse
|
127
|
Rouadi PW, Idriss SA, Naclerio RM, Peden DB, Ansotegui IJ, Canonica GW, Gonzalez-Diaz SN, Rosario Filho NA, Ivancevich JC, Hellings PW, Murrieta-Aguttes M, Zaitoun FH, Irani C, Karam MR, Bousquet J. Immunopathological features of air pollution and its impact on inflammatory airway diseases (IAD). World Allergy Organ J 2020; 13:100467. [PMID: 33042360 PMCID: PMC7534666 DOI: 10.1016/j.waojou.2020.100467] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 08/31/2020] [Accepted: 09/11/2020] [Indexed: 12/14/2022] Open
Abstract
Air pollution causes significant morbidity and mortality in patients with inflammatory airway diseases (IAD) such as allergic rhinitis (AR), chronic rhinosinusitis (CRS), asthma, and chronic obstructive pulmonary disease (COPD). Oxidative stress in patients with IAD can induce eosinophilic inflammation in the airways, augment atopic allergic sensitization, and increase susceptibility to infection. We reviewed emerging data depicting the involvement of oxidative stress in IAD patients. We evaluated biomarkers, outcome measures and immunopathological alterations across the airway mucosal barrier following exposure, particularly when accentuated by an infectious insult.
Collapse
Key Words
- AR, Allergic rhinitis
- Air pollution
- Antioxidant
- COPD, Chronic obstructive pulmonary disease
- CRS, Chronic rhinosinusitis
- DEP, Diesel exhaust particles
- IAD, Inflammatory airway diseases
- IL, Interleukin
- ILC, Innate lymphoid cells
- Inflammatory airway disease
- NOx, Nitrogen oxides
- Oxidative stress biomarkers
- PAH, Polycyclic aromatic hydrocarbons
- PM, Particulate matter
- ROS, Reactive oxygen species
- TBS, Tobacco smoke
- TLR, Toll-like receptors
- Tobacco smoke
- Treg, Regulatory T cell
- VOCs, Volatile organic compounds
Collapse
Affiliation(s)
- Philip W. Rouadi
- Department of Otolaryngology-Head and Neck Surgery, Eye and Ear University Hospital, Beirut, Lebanon
| | - Samar A. Idriss
- Department of Otolaryngology-Head and Neck Surgery, Eye and Ear University Hospital, Beirut, Lebanon
| | - Robert M. Naclerio
- Johns Hopkins University Department of Otolaryngology - Head and Neck Surgery, Baltimore, MD, USA
| | - David B. Peden
- UNC Center for Environmental Medicine, Asthma, and Lung Biology, Division of Allergy, Immunology and Rheumatology, Department of Pediatrics UNS School of Medicine, USA
| | - Ignacio J. Ansotegui
- Department of Allergy and Immunology, Hospital Quironsalud Bizkaia, Bilbao, Spain
| | | | - Sandra Nora Gonzalez-Diaz
- University Autonoma de Nuevo Leon Facultad de Medicina y Hospital Universitario U.A.N.L, Monterrey, NL, c.p. 64460, México
| | | | - Juan Carlos Ivancevich
- Faculty of Medicine, Universidad del Salvador, Buenos Aires, Argentina and Head of Allergy and Immunology at the Santa Isabel Clinic, Buenos Aires, Argentina
| | - Peter W. Hellings
- Department of Otorhinolaryngology, University Hospitals Leuven, Leuven, Belgium
- Department of Otorhinolaryngology, Academic Medical Center Amsterdam, The Netherlands - Department Otorhinolaryngology, University Hospital Ghent, Belgium
| | | | - Fares H. Zaitoun
- LAUMC Rizk Hospital, Otolaryngology-Allergy Department, Beirut, Lebanon
| | - Carla Irani
- Department of Internal Medicine and Infectious Diseases, St Joseph University, Hotel Dieu de France Hospital, Beirut, Lebanon
| | - Marilyn R. Karam
- Division of Rheumatology, Allergy and Clinical Immunology, Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
| | - Jean Bousquet
- INSERM U 1168, VIMA: Ageing and Chronic Diseases Epidemiological and Public Health Approaches, Villejuif, France
- University Versailles St-Quentin-en-Yvelines, France
- Allergy-Centre-Charité, Charité–Universitätsmedizin Berlin, Berlin, Germany
| |
Collapse
|
128
|
Saglani S, Wisnivesky JP, Charokopos A, Pascoe CD, Halayko AJ, Custovic A. Update in Asthma 2019. Am J Respir Crit Care Med 2020; 202:184-192. [PMID: 32338992 DOI: 10.1164/rccm.202003-0596up] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Sejal Saglani
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Juan P Wisnivesky
- Division of General Internal Medicine and.,Division of Pulmonary and Critical Care Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Antonios Charokopos
- Division of Pulmonary and Critical Care Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Christopher D Pascoe
- Department of Physiology and Pathophysiology, University of Manitoba, Winnipeg, Manitoba, Canada; and.,Biology of Breathing Group, Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
| | - Andrew J Halayko
- Department of Physiology and Pathophysiology, University of Manitoba, Winnipeg, Manitoba, Canada; and.,Biology of Breathing Group, Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
| | - Adnan Custovic
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| |
Collapse
|
129
|
Li Z, Ma J, Lin Y, Shen J, Wu Z, Chan MTV, Wu WKK. Embryonic gene expression altered by maternal exposure to air pollution in rats. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:31699-31705. [PMID: 32500497 DOI: 10.1007/s11356-020-09413-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Accepted: 05/21/2020] [Indexed: 06/11/2023]
Abstract
Exposure to air pollution is known to increase the risks for cardiovascular, pulmonary and metabolic diseases. Growing evidences also indicated that air pollution exposure during pregnancy could negatively impact on early embryonic development and children's health. We performed RNA sequencing to identify deregulated mRNAs in air pollution-exposed rat embryos. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses were used to analyse the potential cellular functions of deregulated mRNAs. Our analysis indicated that a total of 1678 mRNAs were differentially expressed on gestation day 9 upon in utero exposure to fine particulate matter of > 200 μg/m3, among which 1098 mRNAs were downregulated and 580 mRNAs were upregulated. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses revealed gap junction, cell adhesion, axon guidance and the neurotrophin signalling pathway as key biological processes perturbed by air pollution exposure. Furthermore, reconstruction of the mRNA regulatory network highlighted the central roles of Tbx4, Bmp4, Sox10, Wnt9b, Bmp7 and Foxc2. These data suggested that embryonic mRNA deregulation may underlie the formation of air pollution-associated congenital defects.
Collapse
Affiliation(s)
- Zheng Li
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100042, China
| | - Jianqing Ma
- Department of Orthopedic Surgery, The General Hospital of Xingtai Mining Industry Bloc.,Orthopaedic Hospital of Xingtai, Xingtai, 054000, Hebei, China
| | - Youxi Lin
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100042, China
| | - Jianxiong Shen
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100042, China.
| | - Zhanyong Wu
- Department of Orthopedic Surgery, The General Hospital of Xingtai Mining Industry Bloc.,Orthopaedic Hospital of Xingtai, Xingtai, 054000, Hebei, China.
| | - Matthew T V Chan
- Department of Anaesthesia and Intensive Care and Peter Hung Pain Research Institute, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - William K K Wu
- Department of Anaesthesia and Intensive Care and Peter Hung Pain Research Institute, The Chinese University of Hong Kong, Hong Kong, Hong Kong
- State Key Laboratory of Digestive Diseases, Centre for Gut Microbiota Research, Institute of Digestive Diseases and LKS Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| |
Collapse
|
130
|
Huang G, Zhang Q, Wu H, Wang Q, Chen Y, Guo P, Zhao Q. Sperm quality and ambient air pollution exposure: A retrospective, cohort study in a Southern province of China. ENVIRONMENTAL RESEARCH 2020; 188:109756. [PMID: 32531526 DOI: 10.1016/j.envres.2020.109756] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 05/26/2020] [Accepted: 05/27/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND Abnormal semen quality is one of the common causes of infertility. The relationship between exposure to air pollutants and semen quality is unclear. OBJECTIVES To evaluate the impact of ambient air pollutant exposures on semen quality. METHODS We analyzed 3797 semen samples from Guangdong Human Sperm Bank between May 28, 2018 and March 31, 2019. The inverse distance weighted interpolation method was used to estimate the personal exposures to CO, SO2, NO2, O3, PM10 and PM2.5 during the entire period (0-90 lag days) and key periods (0-9, 10-14, 70-90 lag days) of sperm development. Linear mixed models were used to evaluate the exposure-response relationships between air pollutants and semen quality, including sperm concentration, sperm count and sperm motility, after adjusting for other covariates. The regression coefficients and 95% confidence intervals (CIs) associated with each interquartile range (IQR) increase in pollutant concentrations were estimated for each semen quality parameter. RESULTS Overall, we observed a significant association of decreased sperm count with the exposure to PM10 (-0.2466; -0.4443, -0.0489) and PM2.5 (-0.2910; -0.5401, -0.0419). Among the sperm quality parameters assessed, sperm count was observed more frequently to be negatively associated with ambient air pollutants (CO, NO2, O3, PM10 and PM2.5), especially for the period during 10-14 lag days. In addition, motility decline was significantly associated with O3 in the late stage of sperm development. Sensitivity analyses for subgroup population yielded similar results. No significant association was found between all pollutants and sperm concentration (all P > 0.05). CONCLUSIONS Our results indicate that ambient air pollutants exposures during sperm development may have an adverse effect on semen quality, especially for sperm count and motility. The findings emphasize the potential to improve semen quality by reducing ambient air pollutant exposures, and the importance of taking into account the critical period of sperm development when protective measures are implemented.
Collapse
Affiliation(s)
- Guanhao Huang
- Department of Healthcare, Guangdong Women and Children's Hospital, Guangzhou Medical University, Guangzhou, 511442, China
| | - Qin Zhang
- Good Clinical Practice Office, Cancer Hospital of Shantou University Medical College, Shantou, 515041, China
| | - Haisheng Wu
- Department of Preventive Medicine, Shantou University Medical College, Shantou, 515041, China
| | - Qiling Wang
- Epidemiological Research Office of Key Laboratory of Male Reproduction and Genetics, National Health Commission of PR China, Family Planning Special Hospital of Guangdong Province, Guangzhou, 510600, China
| | - Yuliang Chen
- Department of Preventive Medicine, Shantou University Medical College, Shantou, 515041, China
| | - Pi Guo
- Department of Preventive Medicine, Shantou University Medical College, Shantou, 515041, China.
| | - Qingguo Zhao
- Epidemiological Research Office of Key Laboratory of Male Reproduction and Genetics, National Health Commission of PR China, Family Planning Special Hospital of Guangdong Province, Guangzhou, 510600, China.
| |
Collapse
|
131
|
Tiotiu AI, Novakova P, Nedeva D, Chong-Neto HJ, Novakova S, Steiropoulos P, Kowal K. Impact of Air Pollution on Asthma Outcomes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176212. [PMID: 32867076 PMCID: PMC7503605 DOI: 10.3390/ijerph17176212] [Citation(s) in RCA: 189] [Impact Index Per Article: 47.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 08/20/2020] [Accepted: 08/25/2020] [Indexed: 12/15/2022]
Abstract
Asthma is a chronic respiratory disease characterized by variable airflow obstruction, bronchial hyperresponsiveness, and airway inflammation. Evidence suggests that air pollution has a negative impact on asthma outcomes in both adult and pediatric populations. The aim of this review is to summarize the current knowledge on the effect of various outdoor and indoor pollutants on asthma outcomes, their burden on its management, as well as to highlight the measures that could result in improved asthma outcomes. Traffic-related air pollution, nitrogen dioxide and second-hand smoking (SHS) exposures represent significant risk factors for asthma development in children. Nevertheless, a causal relation between air pollution and development of adult asthma is not clearly established. Exposure to outdoor pollutants can induce asthma symptoms, exacerbations and decreases in lung function. Active tobacco smoking is associated with poorer asthma control, while exposure to SHS increases the risk of asthma exacerbations, respiratory symptoms and healthcare utilization. Other indoor pollutants such as heating sources and molds can also negatively impact the course of asthma. Global measures, that aim to reduce exposure to air pollutants, are highly needed in order to improve the outcomes and management of adult and pediatric asthma in addition to the existing guidelines.
Collapse
Affiliation(s)
- Angelica I. Tiotiu
- Department of Pulmonology, University Hospital of Nancy, 54395 Nancy, France
- Development of Adaptation and Disadvantage, Cardiorespiratory Regulations and Motor Control (EA 3450 DevAH), University of Lorraine, 54395 Nancy, France
- Correspondence: ; Tel.: +33-383-154-299
| | - Plamena Novakova
- Clinic of Clinical Allergy, Medical University, 1000 Sofia, Bulgaria;
| | | | - Herberto Jose Chong-Neto
- Division of Allergy and Immunology, Department of Pediatrics, Federal University of Paraná, Curitiba 80000-000, Brazil;
| | - Silviya Novakova
- Allergy Unit, Internal Consulting Department, University Hospital “St. George”, 4000 Plovdiv, Bulgaria;
| | - Paschalis Steiropoulos
- Department of Respiratory Medicine, Medical School, Democritus University of Thrace, University General Hospital Dragana, 68100 Alexandroupolis, Greece;
| | - Krzysztof Kowal
- Department of Allergology and Internal Medicine, Medical University of Bialystok, 15-037 Bialystok, Poland;
| |
Collapse
|
132
|
Zhu R, Fang H, Chen M, Hu X, Cao Y, Yang F, Xia K. Screen time and sleep disorder in preschool children: identifying the safe threshold in a digital world. Public Health 2020; 186:204-210. [PMID: 32861085 DOI: 10.1016/j.puhe.2020.07.028] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 06/23/2020] [Accepted: 07/19/2020] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Sleep disorder is a common problem in children that can jeopardize their health and well-being. With the popularity of electronic devices such as portable tablets and smartphones in the 21st century, children are spending much more time on screen, but the impact of such change on children's sleep disorder has been less investigated so far. This study aims to examine the dose-response association between time spent on different electronic devices and children's sleep disorder. STUDY DESIGN The design of this study is a cross-sectional study. METHODS We randomly selected 2278 children aged 3-6 years from 15 kindergartens in Tongling, China. The potentially non-linear association between screen-viewing time (i.e. television [TV], computer, iPad, Phone) and the risk of sleep disorder was examined using a logistic generalized additive model. RESULTS We observed a J-shaped association between TV viewing time and the risk of sleep disorder, with a threshold of 1 h/day. For each 1 h/day increment in TV viewing time over the threshold, the risk of sleep disorder increased by 12.35% (95% confidence interval: 1.87-23.92%). This association seemed to be greater for girls than boys and for TV viewing at weekend than on weekdays, but the difference was not statistically significant (P-value>0.05). We did not find adequate evidence of an adverse effect of more time spent on computer, iPad and Phone. CONCLUSIONS This study suggests a positive but non-linear relationship between time spent on watching TV and sleep disorder in Chinese preschool children. Setting the TV viewing time limit less than 1 h/day may help reduce the risk of developing sleep disorder. Further investigation is also needed to examine and compare the effects of heavy use of other electronic devices on sleep disorder.
Collapse
Affiliation(s)
- R Zhu
- Department of Child Healthcare, Tongling Maternal and Child Healthcare Hospital, The 4th People's Hospital of Tongling, Tongling, China.
| | - H Fang
- Department of Child Healthcare, Tongling Maternal and Child Healthcare Hospital, The 4th People's Hospital of Tongling, Tongling, China
| | - M Chen
- Department of Child Healthcare, Tongling Maternal and Child Healthcare Hospital, The 4th People's Hospital of Tongling, Tongling, China
| | - X Hu
- Department of Child Healthcare, Tongling Maternal and Child Healthcare Hospital, The 4th People's Hospital of Tongling, Tongling, China
| | - Y Cao
- Department of Child Healthcare, Tongling Maternal and Child Healthcare Hospital, The 4th People's Hospital of Tongling, Tongling, China
| | - F Yang
- Department of Child Healthcare, Tongling Maternal and Child Healthcare Hospital, The 4th People's Hospital of Tongling, Tongling, China
| | - K Xia
- Department of Child Healthcare, Tongling Maternal and Child Healthcare Hospital, The 4th People's Hospital of Tongling, Tongling, China
| |
Collapse
|
133
|
A new once-daily long-acting β 2-adrenoceptor agonist-inhaled corticosteroid combination therapy for asthma. THE LANCET RESPIRATORY MEDICINE 2020; 8:936-937. [PMID: 32653076 DOI: 10.1016/s2213-2600(20)30305-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 05/13/2020] [Indexed: 11/24/2022]
|
134
|
Zhou Y, Ma J, Wang B, Liu Y, Xiao L, Ye Z, Fan L, Wang D, Mu G, Chen W. Long-term effect of personal PM 2.5 exposure on lung function: A panel study in China. JOURNAL OF HAZARDOUS MATERIALS 2020; 393:122457. [PMID: 32151939 DOI: 10.1016/j.jhazmat.2020.122457] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 01/19/2020] [Accepted: 03/02/2020] [Indexed: 06/10/2023]
Abstract
Exposure to fine particulate matter (PM2.5) have been associated with adverse respiratory outcomes, but long-term effect of personal exposure on lung function remains largely unknown. We conducted a panel study of 158 adult residents with 394 measurements of personal PM2.5 concentration and lung function within six years to investigate the long-term association. Linear mixed models were used to identify the associations between lung function changes in relation to different levels of persistent personal PM2.5 exposure in three or six years. We further attempted to validate resident areas (city) and smoking status as potential predictors of the long-term PM2.5 exposure levels (persistently high/ persistently low) by generating ROC curves. Compared with subjects who had persistently low exposure level, those with persistently high levels of personal PM2.5 exposure had an additional 3.63 % decline in FEV1/FVC in three years (-3.63 [-7.25, -0.02]), while 7.15 % decline in six years (-7.15 [-14.27, -0.03]). BMI can modify the association. The AUCs were 0.68 (95 %CI: 0.54, 0.82), 0.75 (0.64, 0.86), and 0.82 (0.71, 0.93) for models including smoking status, resident areas, and smoking status combining resident areas respectively. These findings provide new evidence for the long-term effect of personal PM2.5 exposure on lung function decline.
Collapse
Affiliation(s)
- Yun Zhou
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Jixuan Ma
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Bin Wang
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Yuewei Liu
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - Lili Xiao
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Zi Ye
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Lieyang Fan
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Dongming Wang
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Ge Mu
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China
| | - Weihong Chen
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China; Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China.
| |
Collapse
|
135
|
de Groot LES, Liu D, Dierdorp BS, Fens N, van de Pol MA, Sterk PJ, Kulik W, Gerlofs-Nijland ME, Cassee FR, Pinelli E, Lutter R. Ex vivo innate responses to particulate matter from livestock farms in asthma patients and healthy individuals. Environ Health 2020; 19:78. [PMID: 32620109 PMCID: PMC7333268 DOI: 10.1186/s12940-020-00632-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 06/24/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Asthma patients suffer from periodic acute worsening of symptoms (i.e. loss of asthma control or exacerbations), triggered by a variety of exogenous stimuli. With the growing awareness that air pollutants impact respiratory diseases, we investigated whether particulate matter (PM) derived from various livestock farms (BioPM) differentially affected innate and oxidative stress responses in asthma and health. METHODS Peripheral blood mononuclear cells (PBMCs), collected from patients sequentially before and during loss of asthma control and from healthy individuals, were exposed to BioPM collected from chicken, goat and pig farms (1 and 5 μg/ml), with or without pre-treatment with antioxidants. Cytokine release and oxidative stress were assessed. RESULTS PBMCs produced IFNγ, IL-1β, IL-10 and TNFα upon stimulation with BioPM, with that from pig farms inducing the highest cytokine levels. Overall, cytokine production was irrespective of the presence or state of disease. However, PBMCs from stable asthma patients upon exposure to the three BioPM showed more extreme TNFα responses than those from healthy subjects. Furthermore, PBMCs obtained during loss of asthma control that were exposed to BioPM from pig farms showed enhanced IFNγ release as well as decreased oxidative stress levels upon pre-treatment with N-acetylcysteine (NAC) compared to stable disease. NAC, but not superoxide dismutase and catalase, also counteracted BioPM-induced cytokine release, indicating the importance of intracellular reactive oxygen species in the production of cytokines. CONCLUSIONS BioPM triggered enhanced pro-inflammatory responses by PBMCs from both healthy subjects and asthma patients, with those from patients during loss of asthma control showing increased susceptibility to BioPM from pig farms in particular.
Collapse
Affiliation(s)
- Linsey E S de Groot
- Department of Respiratory Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
- Department of Experimental Immunology (Amsterdam Infection & Immunity Institute), Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
| | - Dingyu Liu
- Centre for Sustainability, Environment and Health, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Barbara S Dierdorp
- Department of Experimental Immunology (Amsterdam Infection & Immunity Institute), Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Niki Fens
- Department of Respiratory Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Marianne A van de Pol
- Department of Respiratory Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Peter J Sterk
- Department of Respiratory Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Wim Kulik
- Laboratory Genetic Metabolic Diseases, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Miriam E Gerlofs-Nijland
- Centre for Sustainability, Environment and Health, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Flemming R Cassee
- Centre for Sustainability, Environment and Health, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Elena Pinelli
- Centre for Immunology of Infectious Diseases and Vaccines, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - René Lutter
- Department of Respiratory Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Department of Experimental Immunology (Amsterdam Infection & Immunity Institute), Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
136
|
Ryu MH, Lau KSK, Wooding DJ, Fan S, Sin DD, Carlsten C. Particle depletion of diesel exhaust restores allergen-induced lung-protective surfactant protein D in human lungs. Thorax 2020; 75:640-647. [PMID: 32467339 DOI: 10.1136/thoraxjnl-2020-214561] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 05/02/2020] [Accepted: 05/04/2020] [Indexed: 02/06/2023]
Abstract
RATIONALE Exposure to air pollution is linked with increased asthma morbidity and mortality. To understand pathological processes linking air pollution and allergen exposures to asthma pathophysiology, we investigated the effect of coexposure to diesel exhaust (DE) and aeroallergen on immune regulatory proteins in human airways. METHODS Fourteen allergen-sensitised participants completed this randomised, double-blinded, cross-over, controlled exposure study. Each participant underwent four exposures (allergen-alone exposure, DE and allergen coexposure, particle-depleted DE (PDDE) and allergen coexposure, and sham exposure) on different order-randomised dates, each separated by a 4-week washout. Serum and bronchoalveolar lavage (BAL) were assayed for pattern recognition molecules, cytokines, chemokines and inflammatory mediators. RESULTS In human airways, allergen-alone exposure led to accumulation of surfactant protein D (SPD; p=0.02). Coexposure to allergen and DE did not elicit the same increase of SPD as did allergen alone; diesel particulate reduction restored allergen-induced SPD accumulation. Soluble receptor for advanced glycation end products was higher with particle reduction than without it. In the systemic circulation, there was a transient increase in SPD and club cell protein 16 (CC16) 4 hours after allergen alone. CC16 was augmented by PDDE, but not DE. % eosinophils in BAL (p<0.005), eotaxin-3 (p<0.0001), interleukin 5 (IL-5; p<0.0001) and thymus and activation regulated chemokine (p=0.0001) were each increased in BAL by allergen. IL-5, SPD and % eosinophils in BAL were correlated with decreased FEV1. CONCLUSION Short-term coexposure to aeroallergen and DE alters immune regulatory proteins in lungs; surfactant levels are dependent on particle depletion. TRIAL REGISTRATION NUMBER NCT02017431.
Collapse
Affiliation(s)
- Min Hyung Ryu
- Air Pollution Exposure Laboratory, Department of Medicine, Vancouver Coastal Health Research Institute, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
| | - Kevin Soon-Keen Lau
- Air Pollution Exposure Laboratory, Department of Medicine, Vancouver Coastal Health Research Institute, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
| | - Denise Jill Wooding
- Air Pollution Exposure Laboratory, Department of Medicine, Vancouver Coastal Health Research Institute, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
| | - Shuyu Fan
- Air Pollution Exposure Laboratory, Department of Medicine, Vancouver Coastal Health Research Institute, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
| | - Don D Sin
- Centre for Heart Lung Innovation, St. Paul's Hospital, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
| | - Christopher Carlsten
- Air Pollution Exposure Laboratory, Department of Medicine, Vancouver Coastal Health Research Institute, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada
| |
Collapse
|
137
|
Chen L, Zhang Y, Zhang W, Chen G, Lu P, Guo Y, Li S. Short-term effect of PM 1 on hospital admission for ischemic stroke: A multi-city case-crossover study in China. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2020; 260:113776. [PMID: 31962264 DOI: 10.1016/j.envpol.2019.113776] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 11/12/2019] [Accepted: 12/08/2019] [Indexed: 06/10/2023]
Abstract
This study aims to examine the association between short-term exposures to PM1, PM2.5 and PM10 (particulate matter with aerodynamic diameters ≤1 μm, ≤2.5 μm and ≤10 μm, respectively) and hospital admission for ischemic stroke in China. Daily counts of hospital admission for ischemic stroke were collected in 5 hospitals in China during November 2013 to October 2015. Daily concentrations of PM1, PM2.5 and PM10 were collected in 5 cities where the hospitals were located. A time-stratified case-crossover design was used to examine the hospital-specific PM-ischemic stroke association after controlling for potential confounders. Then the effect estimates were pooled using a random-effect meta-analysis. A total of 68,122 hospital admissions for ischemic stroke were identified from 5 hospitals during the study period. The pooled results showed that exposures to PM1, PM2.5 and PM10 were significantly associated with increased hospital admission for ischemic stroke on the current day and previous 1 day. The RRs (relative risk associated with per 10 μg/m3 increase in each pollutant) and 95%CIs (confidence intervals) for the cumulative effects of PM1, PM2.5 and PM10 on ischemic stroke during lag 0-1 days were 1.014 (1.005, 1.0023), 1.007 (1.000, 1.014) and 1.005 (1.001, 1.009), respectively. In total, 3.5%, 3.6% and 4.1% of hospital admissions for ischemic stroke could be attributable to PM1, PM2.5 and PM10, respectively. Exposures to ambient PM1, PM2.5 and PM10 pollution showed acute adverse effects on hospital admission for ischemic stroke. The health effects of PM1 should be considered by policy-makers.
Collapse
Affiliation(s)
- Lijun Chen
- Information Engineering College, Hubei University of Chinese Medicine, Wuhan, Hubei, China
| | - Yongming Zhang
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, National Clinical Research Center for Respiratory Diseases, Beijing, China.
| | - Wenyi Zhang
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Gongbo Chen
- Department of Global Health, School of Health Sciences, Wuhan University, Wuhan, Hubei, China
| | - Peng Lu
- Department of Epidemiology, School of Public Health and Management, Binzhou Medical University, Yantai, Shandong, China
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
| |
Collapse
|
138
|
Zhang Y, Fang J, Mao F, Ding Z, Xiang Q, Wang W. Age- and season-specific effects of ambient particles (PM 1, PM 2.5, and PM 10) on daily emergency department visits among two Chinese metropolitan populations. CHEMOSPHERE 2020; 246:125723. [PMID: 31887489 DOI: 10.1016/j.chemosphere.2019.125723] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 12/17/2019] [Accepted: 12/19/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Ambient PM2.5 has been identified as the top leading cause of risk-attributable deaths worldwide, particularly in China. Evidence suggested that PM1 contributed the most majority of PM2.5 concentrations in Chinese cities. However, epidemiologic knowledge to date is of wide lack regarding PM1-associated health effects. METHODS We collected daily records of all-cause emergency department visits (EDVs) and ground measurements of ambient air pollutants and meteorological factors in Guangzhou and Shenzhen, China, 2015-2016. Case-crossover design and conditional logistic regression models were used to comparatively assess the short-term effects of ambient PM1, PM2.5, and PM10 on EDVs. Stratified analyses by gender, age and season were performed to identify vulnerable groups and periods. RESULTS PM1, PM2.5 and PM10 were all significantly associated with increased EDVs in both cities. Population risks for EDVs increased by 2.2% [95% confidence interval, 1.8 to 2.6] in Guangzhou and 1.7% [1.0 to 2.4] in Shenzhen, for a 10 μg/m3 rise in PM1 at lag 0-1 days and lag 0-4 days, respectively. Relatively lower risks were found to be associated with PM2.5 and PM10. PM-EDVs associations exhibited no gender differences, but varied across age groups. Compared with adults and the elderly, children under 14 years-of-age suffered higher PM-induced risks. Results from both cities suggested greatly significant effect modification by season, with consistently stronger PM-EDVs associations during cold months. CONCLUSIONS Our study added comparative evidence for increased EDVs risks associated with short-term exposures to ambient PM1, PM2.5 and PM10. Besides, PM-associated effects were significantly stronger among children and during cold months.
Collapse
Affiliation(s)
- Yunquan Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan, 430065, China; Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, 430065, China.
| | - Jiaying Fang
- Medical Department, Huadu District People's Hospital, Southern Medical University, Guangzhou, 510800, China
| | - Feiyue Mao
- School of Remote Sensing and Information Engineering, Wuhan University, Wuhan, 430071, China; State Key Laboratory of Information Engineering in Surveying, Mapping, and Remote Sensing, Wuhan University, Wuhan, 430071, China
| | - Zan Ding
- The Institute of Metabolic Diseases, Baoan Central Hospital of Shenzhen, The Fifth Affiliated Hospital of Shenzhen University, Shenzhen, 518102, China
| | - Qianqian Xiang
- Hubei Provincial Center for Disease Control and Prevention, Wuhan, 430079, China
| | - Wei Wang
- School of Geosciences and Info-Physics, Central South University, Changsha, China
| |
Collapse
|
139
|
Guo P, Chen Y, Wu H, Zeng J, Zeng Z, Li W, Zhang Q, Huo X, Feng W, Lin J, Miao H, Zhu Y. Ambient air pollution and markers of fetal growth: A retrospective population-based cohort study of 2.57 million term singleton births in China. ENVIRONMENT INTERNATIONAL 2020; 135:105410. [PMID: 31884132 DOI: 10.1016/j.envint.2019.105410] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Revised: 12/07/2019] [Accepted: 12/10/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUNDS Evidence is scarce on the relation between maternal exposure to ambient air pollution during pregnancy and fetal growth in developing countries. Moreover, the current evidence is inconsistent. We aimed to investigate the association of trimester-specific exposure to air pollution with risk of being born small for gestational age (SGA) and birth weight-markers of fetal growth-among Chinese term births. METHODS This retrospective population-based cohort study consisted of 2,567,457 singleton term live-births from January 1, 2014 to December 31, 2017 across 123 Chinese districts and counties. Personal exposure to ambient air pollutants including carbon monoxide (CO), sulfur dioxide (SO2), nitrogen dioxide (NO2), ozone (O3), particulate matter with aerodynamic diameter < 2.5 μm (PM2.5), and PM10 was assigned using the inverse distance weighting spatial interpolation algorithm. Generalized estimating equations (GEE) logistic regression models were performed to estimate the associations between trimester-specific exposure to air pollution and risk of SGA or low birth weight (LBW), and GEE linear regression to examine the associations between the exposure and term birth weight, adjusting for maternal demographics, maternal cigarette smoking status during pregnancy, mode of delivery, gravidity, gestational age, year and month of conception, neonate's sex, and meteorological factors. Stratified and sensitivity analyses were also performed. RESULTS When mother exposed to ambient air pollutants over the entire pregnancy, per IQR increment (0.122 mg/m3) in ambient CO concentrations was associated with higher risk of SGA (odds ratio (OR) = 1.04, 95% confidence interval (CI): 1.02, 1.05) and reduced birth weight among term births (-5.95 g, 95% CI: -8.01, -3.89). This association was also pronounced in the second and third trimesters. Term birth weight was negatively associated with per IQR increase of O3 (-3.52 g, 95% CI: -6.23, -0.81), PM2.5 (-5.93 g, 95% CI: -8.36, -3.49) and PM10 (-7.78 g, 95% CI: -10.41, -5.16) during the entire pregnancy, respectively. No significant association was detected between maternal exposure to air pollutants and term LBW. Effect estimates of heterogeneity suggested that maternal age and infant sex modified the impact of air pollution on birth weight. CONCLUSIONS The findings suggest that maternal exposure to air pollution during pregnancy is adversely affecting fetal growth. Further studies are warranted to integrate these findings and take clinical or public health interventions in pregnancy.
Collapse
Affiliation(s)
- Pi Guo
- Department of Preventive Medicine, Shantou University Medical College, Shantou 515041, China
| | - Yuliang Chen
- Department of Preventive Medicine, Shantou University Medical College, Shantou 515041, China
| | - Haisheng Wu
- Department of Preventive Medicine, Shantou University Medical College, Shantou 515041, China
| | - Jing Zeng
- Guangdong Women and Children Hospital, Guangzhou 511442, China
| | - Zhisheng Zeng
- Guangdong Women and Children Hospital, Guangzhou 511442, China
| | - Weiping Li
- Clinical Cohort Research Center, First Affiliated Hospital of Shantou University Medical College, Shantou 515041, China
| | - Qingying Zhang
- Department of Preventive Medicine, Shantou University Medical College, Shantou 515041, China
| | - Xia Huo
- Laboratory of Environmental Medicine and Developmental Toxicology, Guangzhou and Guangdong Key Laboratory of Environmental Pollution and Health, School of Environment, Jinan University, Guangzhou 510632, China
| | - Wenru Feng
- Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China
| | - Jiumin Lin
- Department of Hepatology and Infectious Diseases, the Second Affiliated Hospital, Shantou University Medical College, Shantou 515041, China
| | - Huazhang Miao
- Guangdong Women and Children Hospital, Guangzhou 511442, China.
| | - Yingxian Zhu
- Guangdong Women and Children Hospital, Guangzhou 511442, China.
| |
Collapse
|
140
|
Short-term effects of ambient PM 1 and PM 2.5 air pollution on hospital admission for respiratory diseases: Case-crossover evidence from Shenzhen, China. Int J Hyg Environ Health 2019; 224:113418. [PMID: 31753527 DOI: 10.1016/j.ijheh.2019.11.001] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 11/07/2019] [Accepted: 11/10/2019] [Indexed: 12/24/2022]
Abstract
BACKGROUND Ambient PM1 (particulate matter with aerodynamic diameter ≤1 μm) is an important contribution of PM2.5 mass. However, little is known worldwide regarding the PM1-associated health effects due to a wide lack of ground-based PM1 measurements from air monitoring stations. METHODS We collected daily records of hospital admission for respiratory diseases and station-based measurements of air pollution and weather conditions in Shenzhen, China, 2015-2016. Time-stratified case-crossover design and conditional logistic regression models were adopted to estimate hospitalization risks associated with short-term exposures to PM1 and PM2.5. RESULTS PM1 and PM2.5 showed significant adverse effects on respiratory disease hospitalizations, while no evident associations with PM1-2.5 were identified. Admission risks for total respiratory diseases were 1.09 (95% confidence interval: 1.04 to 1.14) and 1.06 (1.02 to 1.10), corresponding to per 10 μg/m3 rise in exposure to PM1 and PM2.5 at lag 0-2 days, respectively. Both PM1 and PM2.5 were strongly associated with increased admission for pneumonia and chronic obstructive pulmonary diseases, but exhibited no effects on asthma and upper respiratory tract infection. Largely comparable risk estimates were observed between male and female patients. Groups aged 0-14 years and 45-74 years were significantly affected by PM1- and PM2.5-associated risks. PM-hospitalization associations exhibited a clear seasonal pattern, with significantly larger risks in cold season than those in warm season among some subgroups. CONCLUSIONS Our study suggested that PM1 rather than PM1-2.5 contributed to PM2.5-induced risks of hospitalization for respiratory diseases and effects of PM1 and PM2.5 mainly occurred in cold season.
Collapse
|
141
|
Li Z, Ma J, Shen J, Chan MTV, Wu WKK, Wu Z. Differentially expressed circular RNAs in air pollution-exposed rat embryos. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:34421-34429. [PMID: 31637615 DOI: 10.1007/s11356-019-06489-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 09/10/2019] [Indexed: 06/10/2023]
Abstract
Circular RNAs (circRNAs) are an important class of non-coding RNAs partly by acting as microRNA sponges. Growing evidence indicates that air pollution exposure during pregnancy could lead to congenital defects in the offspring. In this study, using circRNAs sequencing, we profiled differentially expressed circRNAs in rat embryos exposed to a high concentration (> 200 μg/m3) of fine particulate matter (PM2.5) in utero. Compared with the control embryos whose mothers were reared in clean air, 25 and 55 circRNAs were found to be downregulated and upregulated, respectively, in the air pollution-exposed group. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses of circRNA-coexpressed genes indicated that segmentation, brain development, and system development together with lysine degradation, Rap1 signaling pathway, and adrenergic signaling were deregulated by in utero air pollution exposure. We also identified the central role of three circRNAs, namely circ_015003, circ_030724, and circ_127215 in the circRNA-microRNA interaction network. These data suggested that circRNA deregulation might play a crucial role in the development of air pollution-associated congenital malformations.
Collapse
Affiliation(s)
- Zheng Li
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jianqing Ma
- Department of Orthopedic Surgery, The General Hospital of Xingtai Mining Industry Bloc., Orthopaedic Hospital of Xingtai, Xingtai, Hebei, China
| | - Jianxiong Shen
- Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
| | - Matthew T V Chan
- Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Hong Kong, China
| | - William K K Wu
- Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Hong Kong, China
- State Key Laboratory of Digestive Diseases, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Zhanyong Wu
- Department of Orthopedic Surgery, The General Hospital of Xingtai Mining Industry Bloc., Orthopaedic Hospital of Xingtai, Xingtai, Hebei, China.
| |
Collapse
|
142
|
Sokolowska M, Quesniaux VFJ, Akdis CA, Chung KF, Ryffel B, Togbe D. Acute Respiratory Barrier Disruption by Ozone Exposure in Mice. Front Immunol 2019; 10:2169. [PMID: 31608051 PMCID: PMC6758598 DOI: 10.3389/fimmu.2019.02169] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 08/28/2019] [Indexed: 12/13/2022] Open
Abstract
Ozone exposure causes irritation, airway hyperreactivity (AHR), inflammation of the airways, and destruction of alveoli (emphysema), the gas exchange area of the lung in human and mice. This review focuses on the acute disruption of the respiratory epithelial barrier in mice. A single high dose ozone exposure (1 ppm for 1 h) causes first a break of the bronchiolar epithelium within 2 h with leak of serum proteins in the broncho-alveolar space, disruption of epithelial tight junctions and cell death, which is followed at 6 h by ROS activation, AHR, myeloid cell recruitment, and remodeling. High ROS levels activate a novel PGAM5 phosphatase dependent cell-death pathway, called oxeiptosis. Bronchiolar cell wall damage and inflammation upon a single ozone exposure are reversible. However, chronic ozone exposure leads to progressive and irreversible loss of alveolar epithelial cells and alveoli with reduced gas exchange space known as emphysema. It is further associated with chronic inflammation and fibrosis of the lung, resembling other environmental pollutants and cigarette smoke in pathogenesis of asthma, and chronic obstructive pulmonary disease (COPD). Here, we review recent data on the mechanisms of ozone induced injury on the different cell types and pathways with a focus on the role of the IL-1 family cytokines and the related IL-33. The relation of chronic ozone exposure induced lung disease with asthma and COPD and the fact that ozone exacerbates asthma and COPD is emphasized.
Collapse
Affiliation(s)
- Milena Sokolowska
- Swiss Institute of Allergy and Asthma Research, University of Zurich, Davos, Switzerland.,Christine Kühne - Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
| | - Valerie F J Quesniaux
- Laboratory of Experimental and Molecular Immunology and Neurogenetics (INEM), UMR 7355 CNRS-University of Orleans, Orléans, France
| | - Cezmi A Akdis
- Swiss Institute of Allergy and Asthma Research, University of Zurich, Davos, Switzerland.,Christine Kühne - Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
| | - Kian Fan Chung
- Airways Disease, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Bernhard Ryffel
- Laboratory of Experimental and Molecular Immunology and Neurogenetics (INEM), UMR 7355 CNRS-University of Orleans, Orléans, France
| | - Dieudonnée Togbe
- Laboratory of Experimental and Molecular Immunology and Neurogenetics (INEM), UMR 7355 CNRS-University of Orleans, Orléans, France.,ArtImmune SAS, Artinem, Orléans, France
| |
Collapse
|
143
|
Mumby S, Chung KF, Adcock IM. Transcriptional Effects of Ozone and Impact on Airway Inflammation. Front Immunol 2019; 10:1610. [PMID: 31354743 PMCID: PMC6635463 DOI: 10.3389/fimmu.2019.01610] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 06/27/2019] [Indexed: 12/24/2022] Open
Abstract
Epidemiological and challenge studies in healthy subjects and in individuals with asthma highlight the health impact of environmental ozone even at levels considered safe. Acute ozone exposure in man results in sputum neutrophilia in 30% of subjects particularly young children, females, and those with ongoing cardiopulmonary disease. This may be associated with systemic inflammation although not in all cases. Chronic exposure amplifies these effects and can result in the formation of asthma-like symptoms and immunopathology. Asthmatic patients who respond to ozone (responders) induce a greater number of genes in bronchoalveolar (BAL) macrophages than healthy responders with up-regulation of inflammatory and immune pathways under the control of cytokines and chemokines and the enhanced expression of remodeling and repair programmes including those associated with protease imbalances and cell-cell adhesion. These pathways are under the control of several key transcription regulatory factors including nuclear factor (NF)-κB, anti-oxidant factors such as nuclear factor (erythroid-derived 2)-like 2 NRF2, the p38 mitogen activated protein kinase (MAPK), and priming of the immune system by up-regulating toll-like receptor (TLR) expression. Murine and cellular models of acute and chronic ozone exposure recapitulate the inflammatory effects seen in humans and enable the elucidation of key transcriptional pathways. These studies emphasize the importance of distinct transcriptional networks in driving the detrimental effects of ozone. Studies indicate the critical role of mediators including IL-1, IL-17, and IL-33 in driving ozone effects on airway inflammation, remodeling and hyperresponsiveness. Transcription analysis and proof of mechanisms studies will enable the development of drugs to ameliorate the effects of ozone exposure in susceptible individuals.
Collapse
Affiliation(s)
- Sharon Mumby
- Respiratory Section, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Kian Fan Chung
- Respiratory Section, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Ian M Adcock
- Respiratory Section, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| |
Collapse
|
144
|
Affiliation(s)
- Paloma I Beamer
- 1 Asthma and Airway Disease Research Center and.,2 Mel and Enid Zuckerman College of Public Health University of Arizona Tucson, Arizona
| |
Collapse
|