Fine particulate matter constituents and cardiopulmonary mortality in a heavily polluted Chinese city

Spatiotemporal patterns of particulate matter (PM) and associations between PM and mortality in Shenzhen, China

Background

Most studies on air pollution exposure and its associations with human health in China have focused on the heavily polluted industrial areas and/or mega-cities, and studies on cities with comparatively low air pollutant concentrations are still rare. Only a few studies have attempted to analyse particulate matter (PM) for the vibrant economic centre Shenzhen in the Pearl River Delta. So far no systematic investigation of PM spatiotemporal patterns in Shenzhen has been undertaken and the understanding of pollution exposure in urban agglomerations with comparatively low pollution is still limited.

Methods

We analyze daily and hourly particulate matter concentrations and all-cause mortality during 2013 in Shenzhen, China. Temporal patterns of PM (PM_2.5 and PM₁₀) with aerodynamic diameters of 2.5 (10) μm or less (or less (including particles with a diameter that equals to 2.5 (10) μm) are studied, along with the ratio of PM_2.5 to PM₁₀. Spatial distributions of PM₁₀ and PM_2.5 are addressed and associations of PM₁₀ or PM_2.5 and all-cause mortality are analyzed.

Results

Annual average PM₁₀ and PM_2.5 concentrations were 61.3 and 39.6 μg/m³ in 2013. PM_2.5 failed to meet the Class 2 annual limit of the National Ambient Air Quality Standard. PM_2.5 was the primary air pollutant, with 8.8 % of days having heavy PM_2.5 pollution. The daily PM_2.5/PM₁₀ ratios were high. Hourly PM_2.5 concentrations in the tourist area were lower than downtown throughout the day. PM₁₀ and PM_2.5 concentrations were higher in western parts of Shenzhen than in eastern parts. Excess risks in the number of all-cause mortality with a 10 μg/m³ increase of PM were 0.61 % (95 % confidence interval [CI]: 0.50–0.72) for PM₁₀, and 0.69 % (95 % CI: 0.55–0.83) for PM_2.5, respectively. The greatest ERs of PM₁₀ and PM_2.5 were in 2-day cumulative measures for the all-cause mortality, 2-day lag for females and the young (0–65 years), and L02 for males and the elder (>65 years). PM_2.5 had higher risks on all-cause mortality than PM₁₀. Effects of high PM pollution on mortality were stronger in the elder and male.

Conclusions

Our findings provide additional relevant information on air quality monitoring and associations of PM and human health, valuable data for further scientific research in Shenzhen and for the on-going discourse on improving environmental policies.

Association of urban particle numbers and sources with lung function among children with asthma or allergies

Previous studies have reported sources of particle number pollution in urban air, but have not evaluated relationships between respiratory health and these sources. We compared, among children with asthma or allergies, the associations of spirometric lung functions with increased exposure to source-specific versus size-segregated particle number concentrations (PNC). Hourly measurements of PNC were acquired from the aerosol Supersite in New Taipei, Taiwan. Spirometry (FVC, FEV1, and FEF) was recorded monthly for 59 children with asthma or allergies at five schools during 2007-2008. After co-pollutant adjustment for ozone, we found a 0.21 and 0.17 L decrease in FVC [95% confidence interval (CI): -0.35, -0.06 L] and FEV1 (95% CI: -0.32, -0.03 L), respectively, with an interquartile range increase (1879.7#/cm(3)) in secondary aerosol contribution observed on the previous day. In addition, we found no significant associations of FVC with accumulation mode (0.1 μm<aerodynamic diameter<2.5 μm) PNC. Our findings suggest that PNC of secondary origin is most responsible for pollution-related respiratory effects among children living in urban Taipei. Studies that rely on exposure to size-segregated PNC may underestimate PM health impacts.

Ambient particulate air pollution and circulating antioxidant enzymes: A repeated-measure study in healthy adults in Beijing, China

The association of systemic antioxidant activity with ambient air pollution has been unclear. A panel of 40 healthy college students underwent repeated blood collection for 12 occasions under three exposure scenarios before and after relocating from a suburban area to an urban area in Beijing, China in 2010-2011. We measured various air pollutants including fine particles (PM2.5) and determined circulating levels of antioxidant enzymes extracellular superoxide dismutase (EC-SOD) and glutathione peroxidase 1 (GPX1) in the laboratory. An interquartile range increase of 63.4 μg/m(3) at 3-d PM2.5 moving average was associated with a 6.3% (95% CI: 0.6, 12.4) increase in EC-SOD and a 5.5% (95% CI: 1.3, 9.8) increase in GPX1. Several PM2.5 chemical constituents, including negative ions (nitrate and chloride) and metals (e.g., iron and strontium), were consistently associated with increases in EC-SOD and GPX1. Our results support activation of circulating antioxidant enzymes following exposure to particulate air pollution.

Particle size and chemical constituents of ambient particulate pollution associated with cardiovascular mortality in Guangzhou, China

Though significant associations between particulate matter (PM) air pollution and cardiovascular diseases have been widely reported, it remains unclear what characteristics, such as particle size and chemical constituents, may be responsible for the effects. A time-series model was applied to examine the cardiovascular effects of particle size (for the period of 2009-2011) and chemical constituents (2007-2010) in Guangzhou, we controlled for potential confounders in the model, such as time trends, day of the week, public holidays, meteorological factors and influenza epidemic. We found significant associations of cardiovascular mortality with PM10, PM2.5 and PM1; the excess risk (ER) was 6.10% (95% CI: 1.76%, 10.64%), 6.11% (95% CI: 1.76%, 10.64%) and 6.48% (95% CI: 2.10%, 11.06%) for per IQR increase in PM10, PM2.5 and PM1 at moving averages for the current day and the previous 3 days (lag03), respectively. We did not find significant effects of PM2.5-10 and PM1-2.5. For PM2.5 constituents, we found that organic carbon, elemental carbon, sulfate, nitrate and ammonium were significantly associated with cardiovascular mortality, the corresponding ER for an IQR concentration increase at lag03 was 1.13% (95% CI: 0.10%, 2.17%), 2.77% (95% CI: 0.72%, 4.86%), 2.21% (95% CI: 1.05%, 3.38%), 1.98% (95% CI: 0.54%, 3.44%), and 3.38% (95% CI: 1.56%, 5.23%), respectively. These results were robust to adjustment of other air pollutants and they remained consistent in various sensitivity analyses by changing model parameters. Our study suggests that PM1 and constituents from combustion and secondary aerosols might be important characteristics of PM pollution associated with cardiovascular mortality in Guangzhou.

Associations Between Fine Particulate Matter Components and Daily Mortality in Nagoya, Japan

BACKGROUND

Seasonal variation and regional heterogeneity have been observed in the estimated effect of fine particulate matter (PM2.5) mass on mortality. Differences in the chemical compositions of PM2.5 may cause this variation. We investigated the association of the daily concentration of PM2.5 components with mortality in Nagoya, Japan.

METHODS

We combined daily mortality counts for all residents aged 65 years and older with concentration data for PM2.5 mass and components in Nagoya from April 2003 to December 2007. A time-stratified case-crossover design was used to examine the association of daily mortality with PM2.5 mass and each component (chloride, nitrate, sulfate, sodium, potassium, calcium, magnesium, ammonium, elemental carbon [EC], and organic carbon [OC]).

RESULTS

We found a stronger association between mortality and PM2.5 mass in transitional seasons. In analysis for each PM2.5 component, sulfate, nitrate, chloride, ammonium, potassium, EC, and OC were significantly associated with mortality in a single-pollutant model. In a multi-pollutant model, an interquartile range increase in the concentration of sulfate was marginally associated with an increase in all-cause mortality of 2.1% (95% confidence interval, -0.1 to 4.4).

CONCLUSIONS

These findings suggest that some specific PM components have a more hazardous effect than others and contribute to seasonal variation in the health effects of PM2.5.

Characterizing multi-pollutant air pollution in China: Comparison of three air quality indices

Multi-pollutant air pollution (i.e., several pollutants reaching very high concentrations simultaneously) frequently occurs in many regions across China. Air quality index (AQI) is used worldwide to inform the public about levels of air pollution and associated health risks. The current AQI approach used in China is based on the maximum value of individual pollutants, and does not consider the combined health effects of exposure to multiple pollutants. In this study, two novel alternative indices--aggregate air quality index (AAQI) and health-risk based air quality index (HAQI)--were calculated based on data collected in six megacities of China (Beijing, Shanghai, Guangzhou, Shjiazhuang, Xi'an, and Wuhan) during 2013 to 2014. Both AAQI and HAQI take into account the combined health effects of various pollutants, and the HAQI considers the exposure (or concentration)-response relationships of pollutants. AAQI and HAQI were compared to AQI to examine the effectiveness of the current AQI in characterizing multi-pollutant air pollution in China. The AAQI and HAQI values are higher than the AQI on days when two or more pollutants simultaneously exceed the Chinese Ambient Air Quality Standards (CAAQS) 24-hour Grade II standards. The results of the comparison of the classification of risk categories based on the three indices indicate that the current AQI approach underestimates the severity of health risk associated with exposure to multi-pollutant air pollution. For the AQI-based risk category of 'unhealthy', 96% and 80% of the days would be 'very unhealthy' or 'hazardous' if based on AAQI and HAQI, respectively; and for the AQI-based risk category of 'very unhealthy', 67% and 75% of the days would be 'hazardous' if based on AAQI and HAQI, respectively. The results suggest that the general public, especially sensitive population groups such as children and the elderly, should take more stringent actions than those currently suggested based on the AQI approach during high air pollution events. Sensitivity studies were conducted to examine the assumptions used in the AAQI and HAQI approaches. Results show that AAQI is sensitive to the choice of pollutant irrelevant constant. HAQI is sensitive to the choice of both threshold values and pollutants included in total risk calculation.

Fine Particulate Matter Constituents, Nitric Oxide Synthase DNA Methylation and Exhaled Nitric Oxide

It remains unknown how fine particulate matter (PM2.5) constituents affect differently the fractional concentration of exhaled nitric oxide (FeNO, a biomarker of airway inflammation) and the DNA methylation of its encoding gene (NOS2A). We aimed to investigate the short-term effects of PM2.5 constituents on NOS2A methylation and FeNO. We designed a longitudinal study among chronic obstructive pulmonary disease (COPD) patients with six repeated health measurements in Shanghai, China. We applied linear mixed-effect models to evaluate the associations. We observed that the inverse association between PM2.5 and methylation at position 1 was limited within 24 h, and the positive association between PM2.5 and FeNO was the strongest at lag 1 day. Organic carbon, element carbon, NO3(-) and NH4(+) were robustly and significantly associated with decreased methylation and elevated FeNO. An interquartile range increase in total PM2.5 and the four constituents was associated with decreases of 1.19, 1.63, 1.62, 1.17, and 1.14 in percent methylation of NOS2A, respectively, and increases of 13.30%,16.93%, 8.97%, 18.26%, and 11.42% in FeNO, respectively. Our results indicated that organic carbon, element carbon, NO3(-) and NH4(+) might be mainly responsible for the effects of PM2.5 on the decreased NOS2A DNA methylation and elevated FeNO in COPD patients.

Analysing the health effects of simultaneous exposure to physical and chemical properties of airborne particles

BACKGROUND

Airborne particles are a complex mix of organic and inorganic compounds, with a range of physical and chemical properties. Estimation of how simultaneous exposure to air particles affects the risk of adverse health response represents a challenge for scientific research and air quality management. In this paper, we present a Bayesian approach that can tackle this problem within the framework of time series analysis.

METHODS

We used Dirichlet process mixture models to cluster time points with similar multipollutant and response profiles, while adjusting for seasonal cycles, trends and temporal components. Inference was carried out via Markov Chain Monte Carlo methods. We illustrated our approach using daily data of a range of particle metrics and respiratory mortality for London (UK) 2002-2005. To better quantify the average health impact of these particles, we measured the same set of metrics in 2012, and we computed and compared the posterior predictive distributions of mortality under the exposure scenario in 2012 vs 2005.

RESULTS

The model resulted in a partition of the days into three clusters. We found a relative risk of 1.02 (95% credible intervals (CI): 1.00, 1.04) for respiratory mortality associated with days characterised by high posterior estimates of non-primary particles, especially nitrate and sulphate. We found a consistent reduction in the airborne particles in 2012 vs 2005 and the analysis of the posterior predictive distributions of respiratory mortality suggested an average annual decrease of -3.5% (95% CI: -0.12%, -5.74%).

CONCLUSIONS

We proposed an effective approach that enabled the better understanding of hidden structures in multipollutant health effects within time series analysis. It allowed the identification of exposure metrics associated with respiratory mortality and provided a tool to assess the changes in health effects from various policies to control the ambient particle matter mixtures.

Assessing the role of chemical components in cellular responses to atmospheric particle matter (PM) through chemical fractionation of PM extracts

In order to further our understanding of the influence of chemical components and ultimately specific sources of atmospheric particulate matter (PM) on pro-inflammatory and other adverse cellular responses, we promulgate and apply a suite of chemical fractionation tools to aqueous aerosol extracts of PM samples for analysis in toxicity assays. We illustrate the approach with a study that used water extracts of quasi-ultrafine PM (PM0.25) collected in the Los Angeles Basin. Filtered PM extracts were fractionated using Chelex, a weak anion exchanger diethylaminoethyl (DEAE), a strong anion exchanger (SAX), and a hydrophobic C18 resin, as well as by desferrioxamine (DFO) complexation that binds iron. The fractionated extracts were then analyzed using high-resolution sector field inductively coupled plasma mass spectrometry (SF-ICPMS) to determine elemental composition. Cellular responses to the fractionated extracts were probed in an in vitro rat alveolar macrophages model with measurement of reactive oxygen species (ROS) production and the cytokine tumor necrosis factor-α (TNF-α). The DFO treatment that chelates iron was very effective at reducing the cellular ROS activity but had only a small impact on the TNF-α production. In contrast, the hydrophobic C18 resin treatment had a small impact on the cellular ROS activity but significantly reduced the TNF-α production. The use of statistical methods to integrate the results across all treatments led to the conclusion that sufficient iron must be present to participate in the chemistry needed for ROS activity, but the amount of ROS activity is not proportional to the iron solution concentration. ROS activity was found to be most related to cationic mono- and divalent metals (i.e., Mn and Ni) and oxyanions (i.e., Mo and V). Although the TNF-α production was not significantly affected by the chelexation of iron, it was greatly impacted by the removal of organics with the C18 resin and all other metal removal methods, suggesting that iron is not a critical pathway leading to TNF-α production, but a wide range of soluble metals and organic compounds in particulate matter play a role. Although the results are specific to the Los Angeles Basin, where the samples used in the study were collected, the method employed in the study can be widely employed to study the role of components of particulate matter in in vitro or in vivo assays.

Associations between long-term exposure to chemical constituents of fine particulate matter (PM2.5) and mortality in Medicare enrollees in the eastern United States

BACKGROUND

Several epidemiological studies have reported that long-term exposure to fine particulate matter (PM2.5) is associated with higher mortality. Evidence regarding contributions of PM2.5 constituents is inconclusive.

OBJECTIVES

We assembled a data set of 12.5 million Medicare enrollees (≥ 65 years of age) to determine which PM2.5 constituents are a) associated with mortality controlling for previous-year PM2.5 total mass (main effect); and b) elevated in locations exhibiting stronger associations between previous-year PM2.5 and mortality (effect modification).

METHODS

For 518 PM2.5 monitoring locations (eastern United States, 2000-2006), we calculated monthly mortality rates, monthly long-term (previous 1-year average) PM2.5, and 7-year averages (2000-2006) of major PM2.5 constituents [elemental carbon (EC), organic carbon matter (OCM), sulfate (SO42-), silicon (Si), nitrate (NO3-), and sodium (Na)] and community-level variables. We applied a Bayesian hierarchical model to estimate location-specific mortality rates associated with previous-year PM2.5 (model level 1) and identify constituents that contributed to the spatial variability of mortality, and constituents that modified associations between previous-year PM2.5 and mortality (model level 2), controlling for community-level confounders.

RESULTS

One-standard deviation (SD) increases in 7-year average EC, Si, and NO3- concentrations were associated with 1.3% [95% posterior interval (PI): 0.3, 2.2], 1.4% (95% PI: 0.6, 2.4), and 1.2% (95% PI: 0.4, 2.1) increases in monthly mortality, controlling for previous-year PM2.5. Associations between previous-year PM2.5 and mortality were stronger in combination with 1-SD increases in SO42- and Na.

CONCLUSIONS

Long-term exposures to PM2.5 and several constituents were associated with mortality in the elderly population of the eastern United States. Moreover, some constituents increased the association between long-term exposure to PM2.5 and mortality. These results provide new evidence that chemical composition can partly explain the differential toxicity of PM2.5.

Estimating mortality derived from indoor exposure to particles of outdoor origin

Following an extensive review of the literature, we further analyze the published data to examine the health effects of indoor exposure to particulate matter (PM) of outdoor origin. We obtained data on all-cause, cardiovascular, and respiratory mortality per 10 μg/m³ increase in outdoor PM₁₀ or PM_2.5; the infiltration factors for buildings; and estimated time spent outdoors by individuals in the United States, Europe, China, and globally. These data were combined log-linear exposure–response model to estimate the all-cause, cardiovascular, and respiratory mortality of exposure to indoor PM pollution of outdoor origin. Indoor PM pollution of outdoor origin is a cause of considerable mortality, accounting for 81% to 89% of the total increase in mortality associated with exposure to outdoor PM pollution for the studied regions. The findings suggest that enhancing the capacity of buildings to protect occupants against exposure to outdoor PM pollution has significant potential to improve public health outcomes.

Impact of ambient fine particulate matter carbon measurement methods on observed associations with acute cardiorespiratory morbidity

Elemental carbon (EC) and organic carbon (OC) represent a substantial portion of particulate matter <2.5 μm in diameter (PM2.5), and have been associated with adverse health effects. EC and OC are commonly measured using the National Institute of Occupational Safety and Health (NIOSH) method or the Interagency Monitoring of Protected Visual Environments (IMPROVE) method. Measurement method differences could have an impact on observed epidemiologic associations. Daily speciated PM2.5 data were obtained from the St Louis-Midwest Supersite, and St Louis emergency department (ED) visit data were obtained from the Missouri Hospital Association for the period June 2001 to April 2003. We assessed acute associations between cardiorespiratory ED visits and EC and OC from NIOSH and IMPROVE methods using Poisson generalized linear models controlling for temporal trends and meteorology. Associations were generally similar for EC and OC from the different measurement methods. The most notable difference between methods was observed for congestive heart failure and EC (for example, warm season rate ratios (95% confidence intervals) per interquartile range change in EC concentration were: NIOSH=1.06 (0.99-1.13), IMPROVE=1.01 (0.96-1.07)). Overall, carbon measurement method had little impact on acute associations between EC, OC, and ED visits. Some specific differences were observed, however, which may be related to particle composition.

Organic extracts from African dust storms stimulate oxidative stress and induce inflammatory responses in human lung cells through Nrf2 but not NF-κB

The health impact of the global African dust event (ADE) phenomenon in the Caribbean has been vaguely investigated. Heavy metals in ADE and non-ADE extracts were evaluated for the formation of reactive oxygen species (ROS) and antioxidant capacity by cells using, deferoxamine mesylate (DF) and N-acetyl-l-cysteine (NAC). Results show that ADE particulate matter 2.5 (PM2.5) induces ROS and stimulates oxidative stress. Pre-treatment with DF reduces ROS in ADE and Non-ADE extracts and in lung cells demonstrating that heavy metals are of utmost importance. Glutathione-S-transferase and Heme Oxygenase 1 mRNA levels are induced with ADE PM and reduced by DF and NAC. ADE extracts induced Nrf2 activity and IL-8 mRNA levels significantly more than Non-ADE. NF-κB activity was not detected in any sample. Trace elements and organic constituents in ADE PM2.5 enrich the local environment load, inducing ROS formation and activating antioxidant-signaling pathways increasing pro-inflammatory mediator expressions in lung cells.

Systematic review and meta-analysis of the adverse health effects of ambient PM2.5 and PM10 pollution in the Chinese population

INTRODUCTION

As the largest developing country, China has some of the worst air quality in the world. Heavy smog in January 2013 led to unprecedented public concern about the health impact of exposure to particulate matter. Conducting health impact assessments of particulate matter has thus become an urgent task for public health practitioners. Combined estimates of the health effects of exposure to particulate matter from quantitative reviews could provide vital information for epidemiology-based health impact assessments, but estimates for the Chinese population are limited.

METHODS

On December 31, 2013, we systematically searched the PubMed, Web of Science, and China National Knowledge Infrastructure databases using as keywords names of 127 major cities in Mainland China, Hong Kong, and Taiwan. From among the 1464 articles identified, 59 studies were manually screened. Random-effects or fixed-effects models were used to combine their risk estimates, the funnel plots with Egger test were performed to evaluate the publication bias and Meta regression were run to explore the association between exposure to particulate matter with aerodynamic diameters less than 10 and 2.5 µm (PM10 and PM2.5) and the resulting health effects by the Comprehensive Meta Analysis.

RESULTS

In terms of short-term effects, the combined excess risks of total non-accidental mortality, mortality due to cardiovascular disease, and mortality due to respiratory disease were 0.36% (95% confidence interval [95%CI]: 0.26%, 0.46%), 0.36% (95%CI: 0.24%, 0.49%), and 0.42% (95%CI: 0.28%, 0.55%), for each 10 μg/m(3) increase in PM10. A 10 μg/m(3) increase in PM2.5 was associated with a 0.40% (95%CI: 0.22%, 0.59%) increase in total non-accidental mortality, a 0.63% (95%CI: 0.35%, 0.91%) increase in mortality due to cardiovascular disease, and a 0.75% (95%CI: 01.39%, 1.11%) increase in mortality due to respiratory disease. For constituent-specific mortality, increases of 0.40-3.11% were associated with an increase of 10 ng/m(3) for nickel in PM. The summary estimate ranges of hospital utilization were 0.08% ~ 0.72% and -0.58% ~ 1.32% for a 10 μg/m(3) increase in PM10 and PM2.5. In terms of long-term effects, a 10 μg/m(3) increase of PM10 corresponded to 23-67% increase in the risk of mortality.

CONCLUSION

Short exposures to PM10 and PM2.5 are associated with increases in mortality, but evidence of constituent-associated health effects, long-term effects and morbidity in China is still inadequate.

Association of fine particles with respiratory disease mortality: a meta-analysis

Short-time exposure to high levels of fine particles (particulate matter with an aerodynamic diameter≤2.5 μm; PM2.5) may trigger respiratory disease, but this association has not been determined. The objective of this study was to evaluate and quantify the short-time exposure to fine particles on respiratory disease mortality. Published articles were obtained from electronic databases and a validity assessment was used. The meta-analysis was conducted with the incorporation of good-quality studies. After applying the inclusion criteria, 9 articles were included in the study. The methodological qualities of the published studies were good, and every study achieved a score of 3. Fine particles were significantly associated with an increase in respiratory mortality risk (for every 10 μg/m3 increment, rate difference [RD]=1.32%, 95% confidence interval [CI]: 0.95%-1.68%; p=.000). These findings indicate that short-time exposure to fine particles could increase the risk of respiratory disease mortality.

Chemical characteristics of water-soluble ions in particulate matter in three metropolitan areas in the North China Plain

PM_2.5 and PM₁₀ samples were collected simultaneously in each season in Beijing, Tianjin and Shijiazhuang to identify the characteristics of water-soluble ion compositions in the North China Plain. The water-soluble ions displayed significant seasonal variation. The dominant ions were NO₃⁻, SO₄²⁻, NH₄⁺ and Cl⁻, accounting for more than 90% and 86% to the mass of total water-soluble ions in PM_2.5 and PM₁₀, respectively. The anion/cation ratio indicated that the ion acidity of each city varied both between sites and seasonally. Over 50% of the ion species were enriched in small particles ≤1 µm in diameter. The [NO₃⁻]/[SO₄²⁻] ratio indicated that vehicles accounted for the majority of the particulate pollution in Beijing. Shijiazhuang, a city highly reliant on coal combustion, had a higher SO₄²⁻ concentration.

Global chemical composition of ambient fine particulate matter for exposure assessment

Epidemiologic and health impact studies are inhibited by the paucity of global, long-term measurements of the chemical composition of fine particulate matter. We inferred PM2.5 chemical composition at 0.1° × 0.1° spatial resolution for 2004-2008 by combining aerosol optical depth retrieved from the MODIS and MISR satellite instruments, with coincident profile and composition information from the GEOS-Chem global chemical transport model. Evaluation of the satellite-model PM2.5 composition data set with North American in situ measurements indicated significant spatial agreement for secondary inorganic aerosol, particulate organic mass, black carbon, mineral dust, and sea salt. We found that global population-weighted PM2.5 concentrations were dominated by particulate organic mass (11.9 ± 7.3 μg/m(3)), secondary inorganic aerosol (11.1 ± 5.0 μg/m(3)), and mineral dust (11.1 ± 7.9 μg/m(3)). Secondary inorganic PM2.5 concentrations exceeded 30 μg/m(3) over East China. Sensitivity simulations suggested that population-weighted ambient PM2.5 from biofuel burning (11 μg/m(3)) could be almost as large as from fossil fuel combustion sources (17 μg/m(3)). These estimates offer information about global population exposure to the chemical components and sources of PM2.5.

PM2.5 constituents and hospital emergency-room visits in Shanghai, China

Although ambient PM2.5 has been linked to adverse health effects, the chemical constituents that cause harm are largely unclear. Few prior studies in a developing country have reported the health impacts of PM2.5 constituents. In this study, we examined the short-term association between PM2.5 constituents and emergency room visits in Shanghai, China. We measured daily concentrations of PM2.5, organic carbon (OC), elemental carbon (EC), and eight water-soluble ions between January 1, 2011 and December 31, 2012. We analyzed the data using overdispersed generalized linear Poisson models. During our study period, the mean daily average concentration of PM2.5 in Shanghai was 55 μg/m(3). Major contributors to PM2.5 mass included OC, EC, sulfate, nitrate, and ammonium. For a 1-day lag, an interquartile range increment in PM2.5 mass (36.47 μg/m(3)) corresponded to 0.57% [95% confidence interval (CI): 0.13%, 1.01%] increase of emergency room visits. In all the three models used, we found significant positive associations of emergency room visits with OC and EC. Our findings suggest that PM2.5 constituents from the combustion of fossil fuel (e.g., OC and EC) may have an appreciable influence on the health impact attributable to PM2.5.

Short-term associations of cause-specific emergency hospitalizations and particulate matter chemical components in Hong Kong

Despite an increasing number of recent studies, the overall epidemiologic evidence associating specific particulate matter chemical components with health outcomes has been mixed. The links between components and hospitalizations have rarely been examined in Asia. We estimated associations between exposures to 18 chemical components of particulate matter with aerodynamic diameter less than 10 μm (PM10) and daily emergency cardiorespiratory hospitalizations in Hong Kong, China, between 2001 and 2007. Carbonaceous particulate matter, sulfate, nitrate, and ammonium accounted for two-thirds of the PM10 mass. After adjustment for time-varying confounders, a 3.4-μg/m(3) increment in 2-day moving average of same-day and previous-day nitrate concentrations was associated with the largest increase of 1.32% (95% confidence interval: 0.73, 1.92) in cardiovascular hospitalizations; elevation in manganese level (0.02 μg/m(3)) was linked to a 0.91% (95% confidence interval: 0.19, 1.64) increase in respiratory hospitalizations. Upon further adjustment for gaseous copollutants, nitrate, sodium ion, chloride ion, magnesium, and nickel remained significantly associated with cardiovascular hospitalizations, whereas sodium ion, aluminum, and magnesium, components abundantly found in coarser PM10, were associated with respiratory hospitalizations. Most positive links were seen during the cold season. These findings lend support to the growing body of literature concerning the health associations of particulate matter composition and provide important insight into the differential health risks of components found in fine and coarse modes of PM10.

Long-term exposure to elemental constituents of particulate matter and cardiovascular mortality in 19 European cohorts: results from the ESCAPE and TRANSPHORM projects

BACKGROUND

Associations between long-term exposure to ambient particulate matter (PM) and cardiovascular (CVD) mortality have been widely recognized. However, health effects of long-term exposure to constituents of PM on total CVD mortality have been explored in a single study only.

AIMS

The aim of this study was to examine the association of PM composition with cardiovascular mortality.

METHODS

We used data from 19 European ongoing cohorts within the framework of the ESCAPE (European Study of Cohorts for Air Pollution Effects) and TRANSPHORM (Transport related Air Pollution and Health impacts--Integrated Methodologies for Assessing Particulate Matter) projects. Residential annual average exposure to elemental constituents within particle matter smaller than 2.5 and 10 μm (PM2.5 and PM10) was estimated using Land Use Regression models. Eight elements representing major sources were selected a priori (copper, iron, potassium, nickel, sulfur, silicon, vanadium and zinc). Cohort-specific analyses were conducted using Cox proportional hazards models with a standardized protocol. Random-effects meta-analysis was used to calculate combined effect estimates.

RESULTS

The total population consisted of 322,291 participants, with 9545 CVD deaths. We found no statistically significant associations between any of the elemental constituents in PM2.5 or PM10 and CVD mortality in the pooled analysis. Most of the hazard ratios (HRs) were close to unity, e.g. for PM10 Fe the combined HR was 0.96 (0.84-1.09). Elevated combined HRs were found for PM2.5 Si (1.17, 95% CI: 0.93-1.47), and S in PM2.5 (1.08, 95% CI: 0.95-1.22) and PM10 (1.09, 95% CI: 0.90-1.32).

CONCLUSION

In a joint analysis of 19 European cohorts, we found no statistically significant association between long-term exposure to 8 elemental constituents of particles and total cardiovascular mortality.

The effects of dust-haze on mortality are modified by seasons and individual characteristics in Guangzhou, China

This study aimed to investigate the effects of dust-haze on mortality and to estimate the seasonal and individual-specific modification effects in Guangzhou, China. Mortality, air pollution and meteorological data were collected for 2006-2011. A dust-haze day was defined as daily visibility <10 km with relative humidity <90%. This definition was further divided into light (8-10 km), medium (5-8 km) and heavy dust-haze (<5 km). A distributed lag linear model (DLM) was employed. Light, medium and heavy dust-haze days were associated with increased mortality of 3.4%, 6.8% and 10.4% respectively, at a lag of 0-6 days. This effect was more pronounced during the cold season, for cardiovascular mortality (CVD), respiratory mortality (RESP), in males and people ≥60years. These effects became insignificant after adjustment for PM10. We concluded that dust-haze significantly increased mortality risk in Guangzhou, China, and this effect appears to be dominated by particulate mass and modified by season and individual-specific factors.

Association of cardiopulmonary health effects with source-appointed ambient fine particulate in Beijing, China: a combined analysis from the Healthy Volunteer Natural Relocation (HVNR) study

Previous studies have associated ambient particulate chemical constituents with adverse cardiopulmonary health effects. However, specific pollution sources behind the cardiopulmonary health effects of ambient particles are uncertain. We examined the cardiopulmonary health effects of fine particles (PM2.5) from different pollution sources in Beijing, China, among a panel of 40 healthy university students. Study subjects were repeatedly examined for a series of cardiopulmonary health indicators during three 2-month-long study periods (suburban period, urban period 1, and urban period 2) in 2010-2011 before and after relocating from a suburban campus to an urban campus with changing air pollution levels and contents. Daily ambient PM2.5 mass samples were collected over the study and measured for 29 chemical constituents in the laboratory. Source appointment for ambient PM2.5 was performed using Positive Matrix Factorization, and mixed-effects models were used to estimate the cardiopulmonary effects associated with source-specific PM2.5 concentrations. Seven PM2.5 sources were identified as traffic emissions (12.0%), coal combustion (22.0%), secondary sulfate/nitrate (30.2%), metallurgical emission (0.4%), dust/soil (12.4%), industry (6.9%), and secondary organic aerosol (9.9%). Ambient PM2.5 in the suburban campus had larger contributions from secondary sulfate/nitrate (41.8% vs. 22.9%-26.0%) and metallurgical emission (0.7% vs. 0.3%) as compared to that in the urban campus), whereas PM2.5 in the urban campus had larger contributions from traffic emissions (13.0%-16.3% vs. 5.1%), coal combustion (21.0%-30.7% vs. 10.7%), and secondary organic aerosol (9.7%-12.0% vs. 8.7%) as compared to that in the suburban campus. Potential key sources were identified for PM2.5 effects on inflammatory biomarkers (secondary sulfate/nitrate and dust/soil), blood pressure (coal combustion and metallurgical emission), and pulmonary function (dust/soil and industry). Analyses using another source appointment tool Unmix yielded a similar pattern of source contributions and associated health effects. In conclusion, ambient PM2.5 in Beijing suburban and urban areas has two distinct patterns of source contributions, and PM2.5 from different sources may play important roles on different aspects of PM2.5-related cardiopulmonary health effects.

Day-night differences and seasonal variations of chemical species in PM₁₀ over Xi'an, northwest China

To investigate day-night differences and seasonal variations of PM10 and its chemical composition in an urban environment in Xi'an, northwest China, day- and nighttime PM10 mass and its chemical components including water-soluble ions (Na(+), NH4 (+), K(+), Mg(2+), Ca(2+), F(-), Cl(-), NO3 (-), and SO4 (2-)), organic carbon (OC), elemental carbon, and water-soluble organic carbon (WSOC) were measured on selected representative days from 20 December 2006 to 12 November 2007. Annual mean PM10 concentration in this city was five times of the China Ambient Air Quality Standard for annual average (70 μg m(-3)). Carbonaceous fractions and water-soluble ions accounted for nearly one third and 12.4 %, respectively, of the annual mean PM10 mass. No dramatic day-night differences were found in the loadings of PM10 or its chemical components. Spring samples were highlighted by abundance of Ca(2+), while the secondary aerosol species (SO4 (2-), NO3 (-), and NH4 (+)) and OC dominated in summer, autumn, and winter samples. Relatively low NO3 (-)/SO4 (2-) ratio suggested that stationary source emissions were more important than vehicle emissions in the source areas in this city. Strong relationships between WSOC and biomass markers (water-soluble K(+), OC1, and OP) were observed in winter and autumn, indicating that WSOC was derived mainly from biomass burning in these seasons. This was also supported by analysis results on the biomass burning events. In contrast, poor correlations between WSOC and biomass markers were demonstrated in summer and spring, implying that WSOC was mainly formed as secondary organic carbon through photochemical activities.

PM₂.₅-bound oxygenated PAHs, nitro-PAHs and parent-PAHs from the atmosphere of a Chinese megacity: seasonal variation, sources and cancer risk assessment

Polycyclic aromatic compounds (PACs) in air particulate matter contribute considerably to the health risk of air pollution. The objectives of this study were to assess the occurrence and variation in concentrations and sources of PM2.5-bound PACs [Oxygenated PAHs (OPAHs), nitro-PAHs and parent-PAHs] sampled from the atmosphere of a typical Chinese megacity (Xi'an), to study the influence of meteorological conditions on PACs and to estimate the lifetime excess cancer risk to the residents of Xi'an (from inhalation of PM2.5-bound PACs). To achieve these objectives, we sampled 24-h PM2.5 aerosols (once in every 6 days, from 5 July 2008 to 8 August 2009) from the atmosphere of Xi'an and measured the concentrations of PACs in them. The PM2.5-bound concentrations of Σcarbonyl-OPAHs, ∑hydroxyl+carboxyl-OPAHs, Σnitro-PAHs and Σalkyl+parent-PAHs ranged between 5-22, 0.2-13, 0.3-7, and 7-387 ng m(-3), respectively, being markedly higher than in most western cities. This represented a range of 0.01-0.4% and 0.002-0.06% of the mass of organic C in PM2.5 and the total mass of PM2.5, respectively. The sums of the concentrations of each compound group had winter-to-summer ratios ranging from 3 to 8 and most individual OPAHs and nitro-PAHs had higher concentrations in winter than in summer, suggesting a dominant influence of emissions from household heating and winter meteorological conditions. Ambient temperature, air pressure, and wind speed explained a large part of the temporal variation in PACs concentrations. The lifetime excess cancer risk from inhalation (attributable to selected PAHs and nitro-PAHs) was six fold higher in winter (averaging 1450 persons per million residents of Xi'an) than in summer. Our results call for the development of emission control measures.

Health impact assessment of exposure to fine particulate matter based on satellite and meteorological information

Air pollution in China, especially in the Pearl River Delta (PRD) region, has drastically increased in recent years. We modelled annual mean ground-level PM2.5 concentrations based on worldwide satellite information and meteorological data from 40 cities outside the PRD. The model of PM2.5 concentration (R = 0.845) was best explained by aerosol optical thickness (43.8%). We validated the spatial-temporal dimensions of the model and estimated that the annual mean PM2.5 concentration in PRD ranged between 22 and 65 μg m(-3). Then we used meta-analysis to obtain the pooled excess risks of mortality in China and assessed the health impacts. We found an inverse association between short-term excess risks of mortality and annual mean PM2.5 concentrations. Based on the above models and analyses, the associated excess deaths for all-cause and cardiopulmonary diseases were 3386 and 2639 respectively. The corresponding risk-standardized excess death rates were 2006 and 1069 per million people.

Short-term exposure to particulate matter constituents and mortality in a national study of U.S. urban communities

BACKGROUND

Although the association between PM2.5 mass and mortality has been extensively studied, few national-level analyses have estimated mortality effects of PM2.5 chemical constituents. Epidemiologic studies have reported that estimated effects of PM2.5 on mortality vary spatially and seasonally. We hypothesized that associations between PM2.5 constituents and mortality would not vary spatially or seasonally if variation in chemical composition contributes to variation in estimated PM2.5 mortality effects.

OBJECTIVES

We aimed to provide the first national, season-specific, and region-specific associations between mortality and PM2.5 constituents.

METHODS

We estimated short-term associations between nonaccidental mortality and PM2.5 constituents across 72 urban U.S. communities from 2000 to 2005. Using U.S. Environmental Protection Agency (EPA) Chemical Speciation Network data, we analyzed seven constituents that together compose 79-85% of PM2.5 mass: organic carbon matter (OCM), elemental carbon (EC), silicon, sodium ion, nitrate, ammonium, and sulfate. We applied Poisson time-series regression models, controlling for time and weather, to estimate mortality effects.

RESULTS

Interquartile range increases in OCM, EC, silicon, and sodium ion were associated with estimated increases in mortality of 0.39% [95% posterior interval (PI): 0.08, 0.70%], 0.22% (95% PI: 0.00, 0.44), 0.17% (95% PI: 0.03, 0.30), and 0.16% (95% PI: 0.00, 0.32), respectively, based on single-pollutant models. We did not find evidence that associations between mortality and PM2.5 or PM2.5 constituents differed by season or region.

CONCLUSIONS

Our findings indicate that some constituents of PM2.5 may be more toxic than others and, therefore, regulating PM total mass alone may not be sufficient to protect human health.

The acute effects of fine particles on respiratory mortality and morbidity in Beijing, 2004-2009

Recent epidemiological and toxicological studies have shown associations between particulate matter and human health. However, the estimates of adverse health effects are inconsistent across many countries and areas. The stratification and interaction models were employed within the context of the generalized additive Poisson regression equation to examine the acute effects of fine particles on respiratory health and to explore the possible joint modification of temperature, humidity, and season in Beijing, China, for the period 2004-2009. The results revealed that the respiratory health damage threshold of the PM2.5 concentration was mainly within the range of 20-60 μg/m(3), and the adverse effect of excessively high PM2.5 concentration maintained a stable level. In the most serious case, an increase of 10 μg/m(3) PM2.5 results in an elevation of 4.60 % (95 % CI 3.84-4.60 %) and 4.48 % (95 % CI 3.53-5.41 %) with a lag of 3 days, values far higher than the average level of 0.69 % (95 % CI 0.54-0.85 %) and 1.32 % (95 % CI 1.02-1.61 %) for respiratory mortality and morbidity, respectively. There were strong seasonal patterns of adverse effects with the seasonal variation of temperature and humidity. The growth rates of respiratory mortality and morbidity were highest in winter. And, they increased 1.4 and 1.8 times in winter, greater than in the full year as PM2.5 increased 10 μg/m(3).

Associations between fine particle, coarse particle, black carbon and hospital visits in a Chinese city

China is one of the countries with the highest ambient particle levels in the world; however, there have been no epidemiologic studies examining the effects of fine particle (PM2.5), coarse particle (PM10-2.5) and black carbon (BC) simultaneously on morbidity outcomes. In this study, we conducted a time-series analysis to evaluate the acute effects of PM2.5, PM10-2.5, and BC on daily hospital visits in Shanghai, China. During our study period, the mean daily concentrations of PM2.5, PM10-2.5 and BC were 53.9 μg/m(3), 38.4 μg/m(3) and 3.9 μg/m(3), respectively. We found significant associations of PM2.5, PM 10-2.5, and BC with daily hospital visits. An inter-quartile range increase of the average concentrations of the current and previous days in PM2.5, PM10-2.5 and BC was associated with a 1.88% (95% CI: 0.69% to 3.06%), a 1.30% (95% CI: 0.25% to 2.34%) and a 1.33% (95% CI: 0.34% to 2.32%) increase in emergency-room visits, respectively. For outpatient visits, the corresponding estimated changes were -2.44% (95% CI: -6.62% to 1.74%), 1.09% (95% CI: -2.72% to 4.90%) and 3.34% (95% CI: 0.10% to 6.57%) respectively. The effects of BC were more robust than the effects of PM2.5 and PM10-2.5 in two-pollutant models. To our knowledge, this is the first study in China, or even in Asian developing countries, to report the effect of PM2.5, PM10-2.5, and BC simultaneously on morbidity. Our findings also suggest that BC could serve as a valuable air quality indicator that reflects the health risks of airborne particles.

Differentiating the associations of black carbon and fine particle with daily mortality in a Chinese city

There is only limited monitoring data of black carbon for epidemiologic analyses. In the current study, we used the distributed lag models to evaluate the association between mortality outcomes (both total and cause-specific) and exposure to black carbon and fine particle (PM(2.5)) in Shanghai, China. During our research period, the mean daily concentrations of black carbon and PM(2.5) were 3.9 μg/m3 and 53.9 μg/m3, respectively. The regression results showed that black carbon was significantly associated with total and cardiovascular mortality, but not with respiratory mortality. An inter-quartile range increase (2.7 μg/m3) of black carbon corresponded to a 2.3% (95% confidence interval [CI]: 0.6-4.1), 3.2% (95% CI: 0.6-5.7), and 0.6% (95% CI: -4.5 to 5.7) increase in total, cardiovascular and respiratory mortality, respectively. When adjusted for PM(2.5), the effects of black carbon increased and remained statistically significant; in contrast, the associations of PM(2.5) with daily mortality decreased and became statistically insignificant after adjustment for black carbon. To our knowledge, this is the first study in China, or even in Asian developing countries, to report the acute effect of black carbon and PM(2.5) on daily mortality simultaneously. Our findings suggest that black carbon is a valuable additional air quality indicator to evaluate the health risks of ambient particles.

Chemical constituents of ambient particulate air pollution and biomarkers of inflammation, coagulation and homocysteine in healthy adults: a prospective panel study

Background

Ambient air pollution has been associated with activation of systemic inflammation and hypercoagulability and increased plasma homocysteine, but the chemical constituents behind the association are not well understood. We examined the relations of various chemical constituents of fine particles (PM_2.5) and biomarkers of inflammation, coagulation and homocysteine in the context of traffic-related air pollution.

Methods

A panel of 40 healthy college students underwent biweekly blood collection for 12 times before and after their relocation from a suburban campus to an urban campus with changing air pollution contents in Beijing. Blood samples were measured for circulatory biomarkers of high-sensitivity C reactive protein (hs-CRP), tumor necrosis factor alpha (TNF-α), fibrinogen, plasminogen activator inhibitor type 1 (PAI-1), tissue-type plasminogen activator (t-PA), von Willebrand factor (vWF), soluble platelet selectin (sP-selectin), and total homocysteine (tHcy). Various air pollutants were measured in a central air-monitoring station in each campus and 32 PM_2.5 chemical constituents were determined in the laboratory. We used three different mixed-effects models (single-constituent model, constituent-PM_2.5 joint model and constituent residual model) controlling for potential confounders to estimate the effects of PM_2.5 chemical constituents on circulatory biomarkers.

Results

We found consistent positive associations between the following biomarkers and PM_2.5 chemical constituents across different models: TNF-α with secondary organic carbon, chloride, zinc, molybdenum and stannum; fibrinogen with magnesium, iron, titanium, cobalt and cadmium; PAI-1 with titanium, cobalt and manganese; t-PA with cadmium and selenium; vWF with aluminum. We also found consistent inverse associations of vWF with nitrate, chloride and sodium, and sP-selectin with manganese. Two positive associations of zinc with TNF-α and of cobalt with fibrinogen, and two inverse associations of nitrate with vWF, and of manganese with sP-selectin, were independent of the other constituents in two-constituent models using constituent residual data. We only found weak air pollution effects on hs-CRP and tHcy.

Conclusions

Our results provide clues for the potential roles that PM_2.5 chemical constituents may play in the biological mechanisms through which air pollution may influence the cardiovascular system.

Immobilized transition metal ions stimulate contact activation and drive factor XII-mediated coagulation

BACKGROUND

Upon contact with an appropriate surface, factor XII (FXII) undergoes autoactivation or cleavage by kallikrein. Zn(2+) is known to facilitate binding of FXII and the cofactor, high molecular weight kininogen (HK), to anionic surfaces.

OBJECTIVES

To investigate whether transition metal ions immobilized on liposome surfaces can initiate coagulation via the contact pathway.

METHODS AND RESULTS

Liposomes containing a metal ion-chelating lipid, 1,2-dioleoyl-sn-glycero-3-{(N[5-amino-1-carboxypentyl]iminodiacetic acid)succinyl} ammonium salt (DOGS-NTA), were prepared by membrane extrusion (20% DOGS-NTA, 40% phosphatidylcholine, 10% phosphatidylserine, and 30% phosphatidylethanolamine). Ni(2+) immobilized on such liposomes accelerated clotting in normal plasma, but not factor XI (FXI)-deficient or FXII-deficient plasma. The results were similar to those obtained with a commercial activated partial thromboplastin time reagent. Charging such liposomes with other transition metal ions revealed differences in their procoagulant capacity, with Ni(2+) > Cu(2+) > Co(2+) and Zn(2+). Plasma could be depleted of FXI, FXII and HK by adsorption with Ni(2+) -containing beads, resulting in longer clot times. Consistent with this, FXI, FXII and HK bound to immobilized Ni(2+) or Cu(2+) with high affinity as determined by surface plasmon resonance. In the presence of Ni(2+) -bearing liposomes, K(m) and k(cat) values derived for autoactivation of FXII and prekallikrein, as well as for activation of FXII by kallikrein or prekallikrein by FXIIa, were similar to literature values obtained in the presence of dextran sulfate.

CONCLUSIONS

Immobilized Ni(2+) and Cu(2+) bind FXII, FXI and HK with high affinity and stimulate activation of the contact pathway, driving FXII-mediated coagulation. Activation of the contact system by immobilized transition metal ions may have implications during pathogenic infection or in individuals exposed to high levels of pollution.

Molecular distribution and stable carbon isotopic composition of dicarboxylic acids, ketocarboxylic acids, and α-dicarbonyls in size-resolved atmospheric particles from Xi'an City, China

Size-resolved airborne particles (9-stages) in urban Xi'an, China, during summer and winter were measured for molecular distributions and stable carbon isotopic compositions of dicarboxylic acids, ketocarboxylic acids, and α-dicarbonyls. To our best knowledge, we report for the first time the size-resolved differences in stable carbon isotopic compositions of diacids and related compounds in continental organic aerosols. High ambient concentrations of terephthalic (tPh, 379 ± 200 ng m(-3)) and glyoxylic acids (ωC(2), 235 ± 134 ng m(-3)) in Xi'an aerosols during winter compared to those in other Chinese cities suggest significant emissions from plastic waste burning and coal combustions. Most of the target compounds are enriched in the fine mode (<2.1 μm) in both seasons peaking at 0.7-2.1 μm. However, summertime concentrations of malonic (C(3)), succinic (C(4)), azelaic (C(9)), phthalic (Ph), pyruvic (Pyr), 4-oxobutanoic (ωC(4)), and 9-oxononanoic (ωC(9)) acids, and glyoxal (Gly) in the coarse mode (>2.1 μm) are comparable to and even higher than those in the fine mode (<2.1 μm). Stable carbon isotopic compositions of the major organics are higher in winter than in summer, except oxalic acid (C(2)), ωC(4), and Ph. δ(13)C of C(2) showed a clear difference in sizes during summer, with higher values in fine mode (ranging from -22.8‰ to -21.9‰) and lower values in coarse mode (-27.1‰ to -23.6‰). The lower δ(13)C of C(2) in coarse particles indicate that coarse mode of the compound originates from evaporation from fine mode and subsequent condensation/adsorption onto pre-existing coarse particles. Positive linear correlations of C(2), sulfate and ωC(2) and their δ(13)C values suggest that ωC(2) is a key intermediate, which is formed in aqueous-phase via photooxidation of precursors (e.g., Gly and Pyr), followed by a further oxidation to produce C(2).