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The application of meta-analytic (multi-level) models with multiple random effects: A systematic review. Behav Res Methods 2020; 52:2031-2052. [DOI: 10.3758/s13428-020-01373-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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202
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Ortega-García JA, Martínez-Hernández I, Boldo E, Cárceles-Álvarez A, Solano-Navarro C, Ramis R, Aguilar-Ros E, Sánchez-Solis M, López-Hernández F. [Urban air pollution and hospital admissions for asthma and acute respiratory disease in Murcia city (Spain)]. An Pediatr (Barc) 2020; 93:95-102. [PMID: 32115374 DOI: 10.1016/j.anpedi.2020.01.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 01/15/2020] [Accepted: 01/16/2020] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Urban air pollution is a major threat to child and adolescent health. Children are more vulnerable to its effects, being associated with higher morbidity and mortality due to acute and chronic diseases, especially respiratory ones. A study is performed on the relationship between urban air pollution and the rate of hospital admissions due to acute respiratory diseases. PATIENTS AND METHODS An ecological study was conducted on young people under 17 years-old in the city of Murcia, who had visited hospital emergency departments due to respiratory diseases (ICD-9) during 2015. A logistic regression was performed on the risk of hospital admission that included consultations in relation to the average daily levels of environmental pollutants (NO2, O3, PM10, SO2) obtained from the Air Quality Surveillance and Control network of the Region of Murcia. Other control variables, such as gender, age, average daily ambient temperature, and season of the year. RESULTS A total of 12,354 (56% boys and 44% girls) children consulted in the emergency department for respiratory disease. Of those, 3.5% were admitted, with a mean age of 2.54 (95% CI; 2.16-2.91) years. The odds ratio (OR) of hospital admission for respiratory diseases: NO2 1.02 (95% CI; 1.01-1.04; P<.01), O3 1.01 (95% CI; 1.00-1.03; P<.01) male 1.4 (95% CI 1.11-1.79; P<.01) and winter 2.10 (95% CI 1.40-3.21; P<.01). Admissions for asthma: PM10 1.02 (95% CI; 1.01-1.04; P<.05), O3 1.04 (95% CI; 1.01-1.06; P<.01). Admissions for bronchiolitis: Age 0.69 (95% CI; 0.48-0.99; P<.05); NO2 1.03 (95% CI; 1.01-1.05; P<.01). CONCLUSIONS Urban air pollution increases hospital admissions in children due to acute respiratory diseases, especially asthma and bronchiolitis. Implementing preventive measures, expanding time series and collaborative studies with open data, would help improve public health and air quality in the cities.
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Affiliation(s)
- Juan Antonio Ortega-García
- Comité de Salud Medioambiental, Asociación Española de Pediatría (AEP); Unidad de Salud Medioambiental, Servicio de Pediátria, Hospital Clínico Universitario Virgen de la Arrixaca, Salud y Ambiente Lab, IMIB-Arrixaca, Universidad de Murcia, Murcia, España.
| | - Indra Martínez-Hernández
- Unidad de Salud Medioambiental, Servicio de Pediátria, Hospital Clínico Universitario Virgen de la Arrixaca, Salud y Ambiente Lab, IMIB-Arrixaca, Universidad de Murcia, Murcia, España
| | - Elena Boldo
- Unidad de Epidemiología Ambiental y del Cáncer, Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, España. CIBER en Epidemiología y Salud Pública-CIBERESP, Madrid, España
| | - Alberto Cárceles-Álvarez
- Unidad de Salud Medioambiental, Servicio de Pediátria, Hospital Clínico Universitario Virgen de la Arrixaca, Salud y Ambiente Lab, IMIB-Arrixaca, Universidad de Murcia, Murcia, España
| | - Carmen Solano-Navarro
- Sección de Urgencias, Servicio de Pediatría, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España
| | - Rebeca Ramis
- Unidad de Epidemiología Ambiental y del Cáncer, Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, España. CIBER en Epidemiología y Salud Pública-CIBERESP, Madrid, España
| | - Estefanía Aguilar-Ros
- Unidad de Salud Medioambiental, Servicio de Pediátria, Hospital Clínico Universitario Virgen de la Arrixaca, Salud y Ambiente Lab, IMIB-Arrixaca, Universidad de Murcia, Murcia, España
| | - Manuel Sánchez-Solis
- Sección de Neumología Pediátrica, Servicio de Pediatría, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, España
| | - Fernando López-Hernández
- Departamento de Métodos Cuantitativos, Universidad Politécnica de Cartagena, Cartagena, Murcia, España
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203
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Urban-level environmental factors related to pediatric asthma. Porto Biomed J 2020; 5:e57. [PMID: 33299939 PMCID: PMC7722407 DOI: 10.1097/j.pbj.0000000000000057] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 01/06/2020] [Indexed: 01/22/2023] Open
Abstract
During the 20th century, urbanization has increasing and represented a major demographic and environmental change in developed countries. This ever-changing urban environment has an impact on disease patterns and prevalence, namely on noncommunicable diseases, such as asthma and allergy, and poses many challenges to understand the relationship between the changing urban environment and the children health. The complex interaction between human beings and urbanization is dependent not only on individual determinants such as sex, age, social or economic resources, and lifestyles and behaviors, but also on environment, including air pollution, indoors and outdoors, land use, biodiversity, and handiness of green areas. Therefore, the assessment and identification of the impact of urban environment on children's health have become a priority and many recent studies have been conducted with the goal of better understanding the impacts related to urbanization, characterizing indoor air exposure, identifying types of neighborhoods, or characteristics of neighborhoods that promote health benefits. Thus, this review focuses on the role of urban environmental factors on pediatric asthma.
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204
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Lu P, Zhang Y, Lin J, Xia G, Zhang W, Knibbs LD, Morgan GG, Jalaludin B, Marks G, Abramson M, Li S, Guo Y. Multi-city study on air pollution and hospital outpatient visits for asthma in China. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2020; 257:113638. [PMID: 31812526 DOI: 10.1016/j.envpol.2019.113638] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Revised: 11/11/2019] [Accepted: 11/16/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND The proportion of asthma patients with mild to moderate exacerbations is far greater than the number who experience episodes that are severe enough to require emergency room visits or hospital admission. However the routinely collected data from hospitals is absent in the past. OBJECTIVE To evaluate associations between short-term exposures to air pollutants and hospital outpatient visits for asthma in China. METHODS We obtained data for 143,057 asthma outpatient visits from the largest hospitals in 17 Chinese cities, between Jan 01 2013 and Dec 31 2015. We used daily concentrations of air pollutants measured by the China National Environmental Monitoring Centre. We used a time-stratified case-crossover design, and fitted conditional logistic regression models to determine the associations. RESULTS Particulate matter ≤10μm in diameter (PM10) and nitrogen dioxide (NO2) were associated with increased risks of hospital outpatient visits for asthma on the same day, while the effects were delayed for particulate matter ≤2.5μm in diameter (PM2.5) and sulphur dioxide (SO2). For the cumulative effect model at lag05 days, 10 μg/m3 increase in air pollutants concentrations were correlated with hospital outpatient visits for asthma with odds ratios (ORs) and 95% confidence intervals 1.004 (1.000-1.008) for PM2.5, 1.005 (1.002-1.008) for PM10, 1.030 (1.021-1.040) for NO2, and 1.015 (1.008-1.021) for SO2. Almost one in nine (10.9%; 7.7, 13.9%) hospital outpatient visits for asthma were attributable to NO2. CONCLUSION Short-term exposures to PM2.5, PM10, NO2 and SO2 were associated with hospital outpatient visits for asthma in China.
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Affiliation(s)
- Peng Lu
- Department of Epidemiology, School of Public Health and Management, Binzhou Medical University, Yantai, Shandong, China; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - 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
| | - Jiangtao Lin
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, China-Japan Friendship Hospital, National Clinical Research Center for Respiratory Diseases, Beijing, China.
| | - Guoxin Xia
- School of Medicine, Binzhou Medical University, Yantai, Shandong, China
| | - Wenyi Zhang
- Center for Disease Surveillance and Research, Institute for Disease Control and Prevention of Chinese People's Liberation Army, Beijing, China
| | - Luke D Knibbs
- School of Public Health, University of Queensland, Brisbane, Queensland, Australia
| | - Geoffrey G Morgan
- School of Public Health, University Centre for Rural Health, University of Sydney, Sydney, New South Wales, Australia
| | - Bin Jalaludin
- School of Public Health and Community Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Guy Marks
- South Western Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia
| | - Michael Abramson
- 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.
| | - Yuming Guo
- Department of Epidemiology, School of Public Health and Management, Binzhou Medical University, Yantai, Shandong, China; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
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205
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Hopke PK, Croft DP, Zhang W, Lin S, Masiol M, Squizzato S, Thurston SW, van Wijngaarden E, Utell MJ, Rich DQ. Changes in the hospitalization and ED visit rates for respiratory diseases associated with source-specific PM 2.5 in New York State from 2005 to 2016. ENVIRONMENTAL RESEARCH 2020; 181:108912. [PMID: 31753467 PMCID: PMC6982568 DOI: 10.1016/j.envres.2019.108912] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Revised: 11/08/2019] [Accepted: 11/08/2019] [Indexed: 05/24/2023]
Abstract
Prior work found increased rates for emergency department (ED) visits for asthma and hospitalizations for chronic obstructive pulmonary disease per unit mass of PM2.5 across New York State (NYS) during 2014-2016 after significant reductions in ambient PM2.5 concentrations had occurred following implementation of various policy actions and major economic disruptions. The associations of source-specific PM2.5 concentrations with these respiratory diseases were assessed with a time-stratified case-cossover design and logistic regression models to identify the changes in the PM2.5 that have led to the apparently increased toxicity per unit mass. The rates of ED visits and hospitalizations for asthma and COPD associated with increases in source-specific PM2.5 concentrations in the prior 1, 4, and 7 days were estimated for 6 urban sites in New York State. Overall, there were similar numbers of significantly increased (n = 9) and decreased rates (n = 8) of respiratory events (asthma and COPD hospitalizations and ED visits) associated with increased source-specific PM2.5 concentrations in the previous 1, 4, and 7 days. Associations of source-specific PM2.5 concentrations with excess rates of hospitalizations for COPD for spark- and compression ignition vehicles increased in the 2014-2016 period, but the values were not statistically significant. Other source types showed inconsistent patterns of excess rates. For asthma ED visits, only biomass burning and road dust showed consistent positive associations with road dust having significant values for most lag times. Secondary nitrate also showed significant positive associations with asthma ED visits in the AFTER period compared to no associations in the prior periods. These results suggest that the relationships of asthma and COPD exacerbation with source-specific PM2.5 are not well defined and further work will be needed to determine the causes of the apparent increases in the per unit mass toxicity of PM2.5 in New York State in the 2014-16 period.
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Affiliation(s)
- Philip K Hopke
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA; Center for Air Resources Engineering and Science, Clarkson University, Potsdam, NY, USA.
| | - Daniel P Croft
- Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Wangjian Zhang
- Department of Environmental Health Sciences. University at Albany, The State University of New York, Albany, NY, USA
| | - Shao Lin
- Department of Environmental Health Sciences. University at Albany, The State University of New York, Albany, NY, USA
| | - Mauro Masiol
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - Stefania Squizzato
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA
| | - Sally W Thurston
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, USA
| | - Edwin van Wijngaarden
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA; Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Mark J Utell
- Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA; Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - David Q Rich
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA; Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA; Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, USA
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206
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Liu K, Li S, Qian ZM, Dharmage SC, Bloom MS, Heinrich J, Jalaludin B, Markevych I, Morawska L, Knibbs LD, Hinyard L, Xian H, Liu S, Lin S, Leskinen A, Komppula M, Jalava P, Roponen M, Hu LW, Zeng XW, Hu W, Chen G, Yang BY, Guo Y, Dong GH. Benefits of influenza vaccination on the associations between ambient air pollution and allergic respiratory diseases in children and adolescents: New insights from the Seven Northeastern Cities study in China. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2020; 256:113434. [PMID: 31672350 DOI: 10.1016/j.envpol.2019.113434] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 10/16/2019] [Accepted: 10/17/2019] [Indexed: 05/22/2023]
Abstract
BACKGROUND Little information exists on interaction effects between air pollution and influenza vaccination on allergic respiratory diseases. We conducted a large population-based study to evaluate the interaction effects between influenza vaccination and long-term exposure to ambient air pollution on allergic respiratory diseases in children and adolescents. METHODS A cross-sectional study was investigated during 2012-2013 in 94 schools from Seven Northeastern Cities (SNEC) in China. Questionnaires surveys were obtained from 56 137 children and adolescents aged 2-17 years. Influenza vaccination was defined as receipt of the influenza vaccine. We estimated air pollutants exposure [nitrogen dioxide (NO2) and particulate matter with aerodynamic diameters ≤1 μm (PM1), ≤2.5 μm (PM2.5) and ≤10 μm (PM10)] using machine learning methods. We employed two-level generalized linear mix effects model to examine interactive effects between influenza vaccination and air pollution exposure on allergic respiratory diseases (asthma, asthma-related symptoms and allergic rhinitis), after controlling for important covariates. RESULTS We found statistically significant interactions between influenza vaccination and air pollutants on allergic respiratory diseases and related symptoms (doctor-diagnosed asthma, current wheeze, wheeze, persistent phlegm and allergic rhinitis). The adjusted ORs for doctor-diagnosed asthma, current wheeze and allergic rhinitis among the unvaccinated group per interquartile range (IQR) increase in PM1 and PM2.5 were significantly higher than the corresponding ORs among the vaccinated group [For PM1, doctor-diagnosed asthma: OR: 1.89 (95%CI: 1.57-2.27) vs 1.65 (95%CI: 1.36-2.00); current wheeze: OR: 1.50 (95%CI: 1.22-1.85) vs 1.10 (95%CI: 0.89-1.37); allergic rhinitis: OR: 1.38 (95%CI: 1.15-1.66) vs 1.21 (95%CI: 1.00-1.46). For PM2.5, doctor-diagnosed asthma: OR: 1.81 (95%CI: 1.52-2.14) vs 1.57 (95%CI: 1.32-1.88); current wheeze: OR: 1.46 (95%CI: 1.21-1.76) vs 1.11 (95%CI: 0.91-1.35); allergic rhinitis: OR: 1.35 (95%CI: 1.14-1.60) vs 1.19 (95%CI: 1.00-1.42)]. The similar patterns were observed for wheeze and persistent phlegm. The corresponding p values for interactions were less than 0.05, respectively. We assessed the risks of PM1-related and PM2.5-related current wheeze were decreased by 26.67% (95%CI: 1.04%-45.66%) and 23.97% (95%CI: 0.21%-42.08%) respectively, which was attributable to influenza vaccination (both p for efficiency <0.05). CONCLUSIONS Influenza vaccination may play an important role in mitigating the detrimental effects of long-term exposure to ambient air pollution on childhood allergic respiratory diseases. Policy targeted at increasing influenza vaccination may yield co-benefits in terms of reduced allergic respiratory diseases.
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Affiliation(s)
- Kangkang Liu
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Zhengmin Min Qian
- Department of Epidemiology, College for Public Health and Social Justice, Saint Louis University, Saint Louis, 63104, USA
| | - Shyamali C Dharmage
- Allergy and Lung Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, 3052, Australia
| | - Michael S Bloom
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China; Department of Environmental Health Sciences and Epidemiology and Biostatistics, University at Albany, State University of New York, Rensselaer, NY, 12144, USA
| | - Joachim Heinrich
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, Ludwig-Maximilian-University, Munich, 80336, Germany
| | - Bin Jalaludin
- School of Public Health and Community Medicine, The University of New South Wales, Kensington, NSW, 2052, Australia
| | - Iana Markevych
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health, Ingolstädter Landstraße 1, Neuherberg, 85764, Germany; Division of Metabolic and Nutritional Medicine, Dr. von Hauner Children's Hospital, Munich, Ludwig-Maximilians-University of Munich, Munich, 80336, Germany; Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, Ludwig-Maximilian-University, Munich, 80336, Germany
| | - Lidia Morawska
- International Laboratory for Air Quality & Health (ILAQH), Science and Engineering Faculty, Institute of Health Biomedical Innovation (IHBI), Queensland University of Technology, Brisbane, 4059, Australia
| | - Luke D Knibbs
- School of Public Health, The University of Queensland, Herston, Queensland, 4006, Australia
| | - Leslie Hinyard
- Center for Health Outcomes Research, Saint Louis University, Saint Louis, 63104, USA
| | - Hong Xian
- Department of Epidemiology, College for Public Health and Social Justice, Saint Louis University, Saint Louis, 63104, USA
| | - Shan Liu
- NHC Key Laboratory of Food Safety Risk Assessment, China National Center for Food Safety Risk Assessment, Beijing, 100021, China
| | - Shao Lin
- Department of Environmental Health Sciences and Epidemiology and Biostatistics, University at Albany, State University of New York, Rensselaer, NY, 12144, USA
| | - Ari Leskinen
- Finnish Meteorological Institute, Kuopio, 70211, Finland; Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, 70211, Finland
| | - Mika Komppula
- Finnish Meteorological Institute, Kuopio, 70211, Finland
| | - Pasi Jalava
- Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, 70211, Finland
| | - Marjut Roponen
- Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, 70211, Finland
| | - Li-Wen Hu
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Xiao-Wen Zeng
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Wenbiao Hu
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, 4059, Australia
| | - Gongbo Chen
- Department of Global Health, School of Health Sciences, Wuhan University, Wuhan, 430000, China
| | - Bo-Yi Yang
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Guang-Hui Dong
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
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207
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Hauptman M, Gaffin JM, Petty CR, Sheehan WJ, Lai PS, Coull B, Gold DR, Phipatanakul W. Proximity to major roadways and asthma symptoms in the School Inner-City Asthma Study. J Allergy Clin Immunol 2020; 145:119-126.e4. [PMID: 31557500 PMCID: PMC6949366 DOI: 10.1016/j.jaci.2019.08.038] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 07/31/2019] [Accepted: 08/22/2019] [Indexed: 01/28/2023]
Abstract
BACKGROUND Traffic proximity has been associated with adverse respiratory health outcomes. Less is known about the combined impact of residential and school exposures on pediatric asthma. OBJECTIVE We sought to use spatial analysis methodology to analyze residential and school proximity to major roadways and pediatric asthma morbidity. METHODS The School Inner-City Asthma Study (n = 350) recruited school-aged children with asthma. Each participant's school and home addresses were geocoded, and distances from major roadways were measured to calculate a composite measure accounting for both home and school traffic exposure. Generalized estimating equation models were clustered by subject and adjusted for age, race/ethnicity, sex, income, environmental tobacco smoke, controller medication, upper respiratory tract infections, and seasonality. RESULTS The majority of participants (62%) attended schools within 100 m from major roadways, and 40% also resided within 100 m of major roadways. In multivariate analyses major roadway proximity was independently associated with increased asthma symptom days. At greater than the threshold of 100 m, children had 29% less odds of a symptom day over the past 2 weeks for each 100-m increase in distance from a major roadway (odds ratio, 0.71; 95% CI, 0.58-0.87; P < .01). Children farther from a major roadway also had significantly less reported health care use (odds ratio, 0.63; 95% CI, 0.47-0.85; P < .01) and were significantly less likely to have poor asthma control (odds ratio, 0.80; 95% CI, 0.69-0.94; P < .01). There was not a meaningful association between distance to a major roadway and lung function outcomes. CONCLUSIONS Proximity to a major roadway, a composite measure of home and school exposure but primarily driven by home exposure, was associated with greater asthma morbidity. More studies are needed to evaluate the independent effect of school distance to a roadway on asthma morbidity.
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Affiliation(s)
- Marissa Hauptman
- Division of General Pediatrics, Boston Children's Hospital, Boston, Mass; Region 1 New England Pediatric Environmental Health Specialty Unit, Boston, Mass; Harvard Medical School, Boston, Mass
| | - Jonathan M Gaffin
- Harvard Medical School, Boston, Mass; Division of Respiratory Diseases, Boston Children's Hospital, Boston, Mass
| | - Carter R Petty
- Institutional Centers for Clinical and Translational Research, Boston Children's Hospital, and the Department of Pediatrics, Harvard Medical School, Boston, Mass
| | - William J Sheehan
- Harvard Medical School, Boston, Mass; Division of Allergy and Immunology, Boston Children's Hospital, Boston, Mass
| | - Peggy S Lai
- Harvard Medical School, Boston, Mass; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Mass; Division of Pulmonary and Critical Care, Massachusetts General Hospital, Boston, Mass
| | - Brent Coull
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Mass
| | - Diane R Gold
- Harvard Medical School, Boston, Mass; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Mass; Division of Respiratory Epidemiology, Channing Laboratory, Brigham and Women's Hospital, Boston, Mass
| | - Wanda Phipatanakul
- Harvard Medical School, Boston, Mass; Division of Allergy and Immunology, Boston Children's Hospital, Boston, Mass.
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208
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Mack SM, Madl AK, Pinkerton KE. Respiratory Health Effects of Exposure to Ambient Particulate Matter and Bioaerosols. Compr Physiol 2019; 10:1-20. [PMID: 31853953 PMCID: PMC7553137 DOI: 10.1002/cphy.c180040] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Researchers have been studying the respiratory health effects of ambient air pollution for more than 70 years. While air pollution as a whole can include gaseous, solid, and liquid constituents, this article focuses only on the solid and liquid fractions, termed particulate matter (PM). Although PM may contain anthropogenic, geogenic, and/or biogenic fractions, in this article, particles that originate from microbial, fungal, animal, or plant sources are distinguished from PM as bioaerosols. Many advances have been made toward understanding which particle and exposure characteristics most influence deposition and clearance processes in the respiratory tract. These characteristics include particle size, shape, charge, and composition as well as the exposure concentration and dose rate. Exposure to particles has been directly associated with the exacerbation and, under certain circumstances, onset of respiratory disease. The circumstances of exposure leading to disease are dependent on stressors such as human activity level and changing particle composition in the environment. Historically, researchers assumed that bioaerosols were too large to be inhaled into the deep lung, and thus, not applicable for study in conjunction with PM2.5 (the 2.5-μm and below size fraction that can reach the deep lung); however, this concept is beginning to be challenged. While there is extensive research on the health effects of PM and bioaerosols independent of each other, only limited work has been performed on their coexposure. Studying these two particle types as dual stressors to the respiratory system may aid in more thoroughly understanding the etiology of respiratory injury and disease. © 2020 American Physiological Society. Compr Physiol 10:1-20, 2020.
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Affiliation(s)
- Savannah M. Mack
- Center for Health and the Environment, John Muir Institute of the Environment, University of California, Davis, California, USA
| | - Amy K. Madl
- Center for Health and the Environment, John Muir Institute of the Environment, University of California, Davis, California, USA
| | - Kent E. Pinkerton
- Center for Health and the Environment, John Muir Institute of the Environment, University of California, Davis, California, USA
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209
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Abstract
Childhood asthma affects many children placing them at significant risk for health care utilization and school absences. Several new developments relevant to the field of pediatric asthma have occurred over the last 5 years; yet, there is much more to learn. It is poorly understood how to prevent the disease, optimally address environmental challenges, or effectively manage poor adherence. Moreover, it is not clear how to customize therapy by asthma phenotype, age group, high risk groups, or severity of disease. Highlights of advances in pediatric asthma are reviewed and multiple essential areas for further exploration and research are discussed.
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210
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Jung EJ, Na W, Lee KE, Jang JY. Elderly Mortality and Exposure to Fine Particulate Matter and Ozone. J Korean Med Sci 2019; 34:e311. [PMID: 31833266 PMCID: PMC6911868 DOI: 10.3346/jkms.2019.34.e311] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 10/15/2019] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND The effects on particulate matter (PM) and ozone on health are being reported by a number of studies. The effects of these air pollutants are likely to be stronger in the elderly population, but studies in this regard are scarce. The purpose of this study was to study the effects of PM ≤ 2.5 μ and ozone on chronic health effects of the elderly population. METHODS In order to analyze the health status of the elderly population, National Statistical Office Mortality records were used. In this study, we calculated the number of deaths in Seoul of people who were 60 years or older between 2002 and 2012. The current study analyzed each disorder separately and the lag effect. PM and ozone were analyzed using the single exposure model, as well as the adjusted multi exposure model. RESULTS In the single exposure analysis with PM2.5 as the exposure variable, with the increase of 10 μ/m³, the number of deaths increased by 1.0039 fold, and vascular disease 1.0053 fold. In the multi exposure model adjusting for ozone, the number of deaths increased by 1.0037 fold, and vascular disease 1.0049 fold. In the single exposure analysis with ozone as the exposure variable, with the increase of 10 ppb, the number of deaths increased by 1.0038 fold, and in the multi exposure model adjusting for PM2.5, the number of deaths increased by 1.0027 fold. These results differed depending on the period or season. There was a 5-day lag effect between PM2.5 and deaths in the multi exposure model, and 1.0028 fold when adjusted for ozone. There was a 1-day lag effect in single exposure models with ozone as the main variable, and 1.0027 fold increase in deaths. CONCLUSION In our study, an increase in the number of deaths in the elderly population in accordance with the increase in the PM2.5 and ozone was found. The association found in our study could also influence socioeconomic burden. Future studies need to be performed in regards to younger population, as well as other air pollutants.
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Affiliation(s)
- En Joo Jung
- Department of Preventive Medicine, Ajou University School of Medicine, Suwon, Korea.
| | | | - Kyung Eun Lee
- Occupational Safety and Health Research Institute, Korea Occupational Safety and Health Agency, Ulsan, Korea
| | - Jae Yeon Jang
- Department of Preventive Medicine, Ajou University School of Medicine, Suwon, Korea
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211
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The Impacts of Different Air Pollutants on Domestic and Inbound Tourism in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16245127. [PMID: 31847502 PMCID: PMC6950462 DOI: 10.3390/ijerph16245127] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 12/01/2019] [Accepted: 12/06/2019] [Indexed: 12/17/2022]
Abstract
Previous studies have reported that air pollution negatively affects the tourism industry. This paper attempted to answer the following question: among different air pollutants, which one acts as the most adverse factor? The study was based on a sample of panel data covering 337 Chinese cities for the period between 2007 and 2016. Four pollutant indicators were inspected: PM 2 . 5 (particulate matter 2.5 micrometers or less in size), PM 10 (particulate matter 10 micrometers or less in size), SO 2 (sulfur dioxide), and NO 2 (nitrogen dioxide). It was found that PM 2 . 5 had a significantly negative impact on both domestic and inbound tourist arrivals. Regarding the other three pollutant indicators, except for the negative influence of NO 2 on inbound tourist arrivals, no statistically significant impact was found. This study suggests that tourism policy makers should primarily focus on PM 2 . 5 , when considering the nexus between air quality and tourism development. According to our estimates, the negative impact of PM 2 . 5 on tourism is substantial. If the PM 2 . 5 concentration in the ambient air increases by 1 μ g/m 3 (=0.001 mg/m 3 ), domestic and inbound tourist arrivals will decline by 0.482% and 1.227%, respectively. These numbers imply an average reduction of 81,855 person-times in annual domestic tourist arrivals and 12,269 in inbound tourist arrivals in each city.
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212
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Turkeltaub PC, Lockey RF, Holmes K, Friedmann E. Asthma and/or hay fever as predictors of fertility/impaired fecundity in U.S. women: National Survey of Family Growth. Sci Rep 2019; 9:18711. [PMID: 31822754 PMCID: PMC6904488 DOI: 10.1038/s41598-019-55259-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 11/26/2019] [Indexed: 01/25/2023] Open
Abstract
This study addresses whether asthma and/or hay fever predict fertility and impaired fecundity. The lifetime number of pregnancies (fertility) and spontaneous pregnancy losses (impaired fecundity) in 10,847 women representative of the U.S. population 15 to 44 years of age with histories of diagnosed asthma and/or hay fever are analyzed in the 1995 National Survey of Family Growth using multivariable Poisson regression with multiple covariates and adjustments for complex sampling. Smokers have significantly increased fertility compared to nonsmokers. Smokers with asthma only have significantly increased fertility compared to other smokers. Higher fertility is associated with impaired fecundity (ectopic pregnancy, miscarriage, stillbirth). Women with asthma (with and without hay fever) have significantly higher pregnancy losses than women without asthma. With increasing number of pregnancies, smokers have increased pregnancy losses compared to nonsmokers. Smokers, especially those with asthma only, have increased fertility and require special attention as to their family planning needs, reproductive health, and smoking cessation. Women with asthma, regardless of number of pregnancies, and smokers with higher numbers of pregnancies have high risk pregnancies that require optimal asthma/medical management prenatally and throughout pregnancy. Whether a proinflammatory asthma endotype underlies both the increased fertility and impaired fecundity associated with age and smoking is discussed.
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Affiliation(s)
| | - Richard F Lockey
- Division of Allergy & Immunology, University of South Florida College of Medicine, 13000 Bruce B. Downs Blvd, Tampa, Florida, 33613, USA
| | - Katie Holmes
- Organizational Systems and Adult Health, University of Maryland School of Nursing, 655 W. Lombard St., Baltimore, Maryland, 21201, USA
- The Hilltop Institute, University of Maryland Baltimore County, 1000 Hilltop Circle, Baltimore, Maryland, 21250, USA
| | - Erika Friedmann
- Organizational Systems and Adult Health, University of Maryland School of Nursing, 655 W. Lombard St., Baltimore, Maryland, 21201, USA
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213
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Review of the effect of air pollution exposure from industrial point sources on asthma-related effects in childhood. Environ Epidemiol 2019; 3:e077. [PMID: 33778345 PMCID: PMC7939412 DOI: 10.1097/ee9.0000000000000077] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 10/10/2019] [Indexed: 01/01/2023] Open
Abstract
We reviewed epidemiologic studies of the association between exposure to air pollution from industries and asthma-related outcomes in childhood. We searched bibliographic databases and reference lists of relevant articles to identify studies examining the association between children's exposure to air pollution from industrial point-sources and asthma-related outcomes, including asthma, asthma-like symptoms, wheezing, and bronchiolitis. We extracted key characteristics of each study and when appropriate we performed a random-effects meta-analysis of results and quantified heterogeneity (I 2). Thirty-six studies were included in this review. Meta-analysis was generally not possible and limited to a few studies because of substantial variation across design characteristics and methodologies. In case-crossover studies using administrative health data, pooled odds ratio (OR) of hospitalization for asthma and bronchiolitis in children <5 years were 1.02 [95% confidence intervals (CI): 0.96, 1.08; I 2 = 56%] and 1.01 (95% CI: 0.97, 1.05; I 2 = 64%) per 10 ppb increase in the daily mean and hourly maximum concentration of sulfur dioxide (SO2), respectively. For PM2.5, pooled ORs were 1.02 (95% CI: 0.93, 1.10; I 2 = 56%) and 1.01 (95% CI: 0.98, 1.03 I 2 = 33%) per 10 μg/m3 increment in the daily mean and hourly maximum concentration. In cross-sectional studies using questionnaires, pooled ORs for the prevalence of asthma and wheezing in relation to residential proximity to industry were 1.98 (95% CI: 0.87, 3.09; I 2 =71%) and 1.33 (95% CI: 0.86, 1.79; I 2= 65%), respectively. In conclusion, this review showed substantial heterogeneity across study designs and methods. Meta-analysis results suggested no evidence of an association for short-term asthma-related effects and an indication for long-term effects, but heterogeneity between results and limitations in terms of design and exposure assessment preclude drawing definite conclusions. Further well-conducted studies making use of a longitudinal design and of refined exposure assessment methods are needed to improve risk estimates.
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214
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Borchers Arriagada N, Horsley JA, Palmer AJ, Morgan GG, Tham R, Johnston FH. Association between fire smoke fine particulate matter and asthma-related outcomes: Systematic review and meta-analysis. ENVIRONMENTAL RESEARCH 2019; 179:108777. [PMID: 31593836 DOI: 10.1016/j.envres.2019.108777] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 09/25/2019] [Accepted: 09/25/2019] [Indexed: 05/20/2023]
Abstract
BACKGROUND Asthma-related outcomes are regularly used by studies to investigate the association between human exposure to landscape fire smoke and health. Robust summary effect estimates are required to inform health protection policy for fire smoke exposure. OBJECTIVE To conduct a systematic review and meta-analysis to estimate the association between short-term exposure to landscape fire smoke (LFS) fine particulate matter (PM2.5) and asthma-related outcomes. METHODS We conducted a systematic review and meta-analysis following PRISMA guidelines. Four databases (PubMed, Medline, EMBASE and Scopus) and reference lists of recent fire smoke and health reviews were searched. The Newcastle-Ottawa Scale was used to evaluate the quality of case-crossover studies, and a previously validated quality assessment framework was used for observational studies lacking control groups. Publication bias was assessed using funnel plots and Egger's Test. The trim and fill method was used when there was evidence of publication bias. Sensitivity and influence analyses were conducted on all endpoints to test the robustness of estimates. Summary estimates were obtained for hospitalisations and emergency department (ED) visits. A descriptive analysis was conducted for physician visits, medication use, and salbutamol dispensations. RESULTS From an initial 181 articles (after duplicate removal), 20 studies were included for quantitative assessment and descriptive synthesis. LFS PM2.5 levels were positively associated with asthma hospitalisations (RR = 1.06, 95% CI: 1.02-1.09) and emergency department visits (RR = 1.07, 95% CI: 1.04-1.09). Subgroup analyses found that females were more susceptible than males for ED visits, and that there was an increasing association by age groups for hospital admissions and ED visits. High heterogeneity between studies was observed, but results were robust to sensitivity analysis. CONCLUSIONS Females and all adults aged over 65 years appear to be the population groups most sensitive to asthma-related outcomes when exposed to LFS PM2.5. Overall, results were higher than those obtained for a typical PM2.5 mixture.
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Affiliation(s)
- Nicolas Borchers Arriagada
- Menzies Institute for Medical Research, University of Tasmania, Tasmania, Australia; New South Wales Bushfire Risk Management Research Hub, University of Tasmania, Tasmania, Australia.
| | - Joshua A Horsley
- Sydney School of Public Health, University Centre for Rural Health, University of Sydney, Sydney, New South Wales, Australia
| | - Andrew J Palmer
- Menzies Institute for Medical Research, University of Tasmania, Tasmania, Australia; Centre for Health Policy, School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Geoffrey G Morgan
- Sydney School of Public Health, University Centre for Rural Health, University of Sydney, Sydney, New South Wales, Australia
| | - Rachel Tham
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - Fay H Johnston
- Menzies Institute for Medical Research, University of Tasmania, Tasmania, Australia.
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215
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Li X, Chen Q, Zheng X, Li Y, Han M, Liu T, Xiao J, Guo L, Zeng W, Zhang J, Ma W. Effects of ambient ozone concentrations with different averaging times on asthma exacerbations: A meta-analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 691:549-561. [PMID: 31325855 DOI: 10.1016/j.scitotenv.2019.06.382] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 06/10/2019] [Accepted: 06/23/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Mounting evidence suggests that short-term exposure to ozone increases the risk of asthma exacerbations. However, ozone exposures have been assessed using ambient ozone concentrations averaged over different time periods in different studies. OBJECTIVE To evaluate the risks for asthma exacerbations related to ambient ozone measured as 1-hour or 8-hour daily maximum and 24-hour average concentrations. METHODS Based on a literature search in PubMed, EMBASE and Web of Science, we identified all time-series studies as of December 4th, 2018 and included 47 eligible studies in our analyses. Asthma exacerbation is defined as the risk for emergency room visits or hospital admissions. Pooled relative risks (RRs) and 95% confidence intervals (95%CIs) for a 10 μg/m3 increase in daily ozone concentration were estimated using random effect models. Subgroup analyses and sensitivity analyses were also performed to examine the risks for different seasons, regions and age groups and for the robustness of our main findings. RESULTS Significant and similar associations were found for O3-1 h max (RR,1.012; 95%CI, 1.005-1.019) and O3-8 h max (RR, 1.011; 95%CI, 1.007-1.014), while marginal effect was identified for O3-24 h average (RR, 1.005; 95%CI, 0.996-1.014). No significant publication bias but high heterogeneities were observed. During the warm season, ozone was significantly associated with asthma exacerbation. O3-1 h max had the highest RR of 1.014 (95%CI, 1.005-1.024), followed by O3-8 h max (RR, 1.012; 95%CI, 1.009-1.016), while marginal association was identified for O3-24 h avg (RR, 1.008; 95%CI, 0.998-1.017). During the cold season, null associations were identified for all the three averaging times. Variations were also observed in region and age. CONCLUSION Ozone exposure measured as 1-hour or 8-hour daily max were more consistently associated with asthma exacerbations than 24-hour average exposure during the warm season.
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Affiliation(s)
- Xing Li
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, Guangdong Province 511430, China; Department of Epidemiology, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou, Guangdong Province 510515, China
| | - Qing Chen
- Department of Epidemiology, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou, Guangdong Province 510515, China
| | - Xueyan Zheng
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, Guangdong Province 511430, China
| | - Yongzhi Li
- Department of Epidemiology, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou, Guangdong Province 510515, China
| | - Min Han
- Department of Epidemiology, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou, Guangdong Province 510515, China
| | - Tao Liu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, Guangdong Province 511430, China
| | - Jianpeng Xiao
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, Guangdong Province 511430, China
| | - Lingchuan Guo
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, Guangdong Province 511430, China
| | - Weilin Zeng
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, Guangdong Province 511430, China
| | - Junfeng Zhang
- Nicholas School of the Environment, Duke Global Health Institute, Duke University, Durham, NC 27705, USA; Duke Kunshan University, Kunshan, Jiangsu Province 215316, China.
| | - Wenjun Ma
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, Guangdong Province 511430, China.
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216
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Annesi-Maesano I, Forastiere F. Doubts about the adverse effects of air pollution on asthma? Eur Respir J 2019; 54:54/4/1901900. [PMID: 31672909 DOI: 10.1183/13993003.01900-2019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 09/26/2019] [Indexed: 11/05/2022]
Affiliation(s)
- Isabella Annesi-Maesano
- Sorbonne Université and INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP UMRS 1136), Epidemiology of Allergic and Respiratory Diseases Dept (EPAR), Medical School Saint-Antoine, Paris, France
| | - Francesco Forastiere
- Institute of Biomedicine and Molecular Immunology (IBIM), National Research Council, Palermo, Italy.,Environmental Research Group, King's College, London, UK
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217
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Haahtela T, von Hertzen L, Anto JM, Bai C, Baigenzhin A, Bateman ED, Behera D, Bennoor K, Camargos P, Chavannes N, de Sousa JC, Cruz A, Do Céu Teixeira M, Erhola M, Furman E, Gemicioğlu B, Gonzalez Diaz S, Hellings PW, Jousilahti P, Khaltaev N, Kolek V, Kuna P, La Grutta S, Lan LTT, Maglakelidze T, Masjedi MR, Mihaltan F, Mohammad Y, Nunes E, Nyberg A, Quel J, Rosado-Pinto J, Sagara H, Samolinski B, Schraufnagel D, Sooronbaev T, Tag Eldin M, To T, Valiulis A, Varghese C, Vasankari T, Viegi G, Winders T, Yañez A, Yorgancioğlu A, Yusuf O, Bousquet J, Billo NE. Helsinki by nature: The Nature Step to Respiratory Health. Clin Transl Allergy 2019; 9:57. [PMID: 31695865 PMCID: PMC6822361 DOI: 10.1186/s13601-019-0295-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Accepted: 10/17/2019] [Indexed: 12/21/2022] Open
Abstract
Background The Nature Step to Respiratory Health was the overarching theme of the 12th General Meeting of the Global Alliance against Chronic Respiratory Diseases (GARD) in Helsinki, August 2018. New approaches are needed to improve respiratory health and reduce premature mortality of chronic diseases by 30% till 2030 (UN Sustainable Development Goals, SDGs). Planetary health is defined as the health of human civilization and the state of the natural systems on which it depends. Planetary health and human health are interconnected, and both need to be considered by individuals and governments while addressing several SDGs. Results The concept of the Nature Step has evolved from innovative research indicating, how changed lifestyle in urban surroundings reduces contact with biodiverse environments, impoverishes microbiota, affects immune regulation and increases risk of NCDs. The Nature Step calls for strengthening connections to nature. Physical activity in natural environments should be promoted, use of fresh vegetables, fruits and water increased, and consumption of sugary drinks, tobacco and alcohol restricted. Nature relatedness should be part of everyday life and especially emphasized in the care of children and the elderly. Taking “nature” to modern cities in a controlled way is possible but a challenge for urban planning, nature conservation, housing, traffic arrangements, energy production, and importantly for supplying and distributing food. Actions against the well-known respiratory risk factors, air pollution and smoking, should be taken simultaneously. Conclusions In Finland and elsewhere in Europe, successful programmes have been implemented to reduce the burden of respiratory disorders and other NCDs. Unhealthy behaviour can be changed by well-coordinated actions involving all stakeholders. The growing public health concern caused by NCDs in urban surroundings cannot be solved by health care alone; a multidisciplinary approach is mandatory.
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Affiliation(s)
- Tari Haahtela
- 1Skin and Allergy Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Leena von Hertzen
- 2Department of Dermatology, Allergology and Venereology, Helsinki University Hospital, Helsinki, Finland
| | - Josep M Anto
- ISGlobAL, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
| | - Chunxue Bai
- Zhongshan Hospital, Fudan University, Shanghai Respiratory Research Institute, Shanghai, China
| | | | - Eric D Bateman
- 6Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Digambar Behera
- 7Dept. of Pulmonary Medicine, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Kazi Bennoor
- Department of Respiratory Medicine, National Institute of Diseases of the Chest and Hospital, Dhaka, Bangladesh
| | - Paulo Camargos
- 9Department of Pediatrics, Medical School, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Niels Chavannes
- 10Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - Jaime Correia de Sousa
- 11Life and Health Sciences Research Institute, ICVS, School of Medicine, University of Minho, Braga, Portugal
| | - Alvaro Cruz
- 12ProAR - Nucleo de Excelencia em Asma, Federal University of Bahia, Vitória Da Conquista, Brazil
| | | | - Marina Erhola
- 14National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Eeva Furman
- 15Environmental Policy Centre, Finnish Environment Institute, Helsinki, Finland
| | - Bilun Gemicioğlu
- 16Department of Pulmonary Diseases, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | | | - Peter W Hellings
- 18Laboratory of Clinical Immunology, Department of Microbiology and Immunology, KU Leuven, Louvain, Belgium
| | - Pekka Jousilahti
- 14National Institute for Health and Welfare (THL), Helsinki, Finland
| | - Nikolai Khaltaev
- Global Alliance Against Chronic Respiratory Diseases (GARD), Geneva, Switzerland
| | - Vitezslav Kolek
- 20Department of Respiratory Diseases and Tuberculosis, University Hospital Olomouc, Olomouc, Czech Republic
| | - Piotr Kuna
- 21Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
| | - Stefania La Grutta
- 22Istituto per la Ricerca e l'Innovazione Biomedica (IRIB), Consiglio Nazionale delle Ricerche (CNR), Palermo, Italy
| | - Le Thi Tuyet Lan
- Respiratory Care Center, University Medical Center, Ho Chi Minh City, Vietnam
| | - Tamaz Maglakelidze
- 24Pulmonology Department, Ivane Javakhishvili Tbilisi State University, Chapidze Emergency Cardiology Center, Tbilisi, Georgia
| | | | - Florin Mihaltan
- National Institute of Pneumology M. Nasta, Bucharest, Romania
| | - Yousser Mohammad
- 27National Center for Research in Chronic Respiratory Diseases, Tishreen University School of Medicine, Latakia, Syria
| | - Elizabete Nunes
- 28Pulmonology Department, Maputo Central Hospital, Maputo, Mozambique
| | - Arvid Nyberg
- 29FILHA, Finnish Lung Health Association, Helsinki, Finland
| | - Jorge Quel
- Hispanic American Allergy Asthma & Immunology Association, Marina Del Rey, California USA
| | - Jose Rosado-Pinto
- 31Immunoallergology Department, Hospital da Luz Lisboa, Lisbon, Portugal
| | - Hironori Sagara
- 32Division of Allergology & Respiratory Medicine, Showa University School of Medicine, Tokyo, Japan
| | - Boleslaw Samolinski
- 33Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - Dean Schraufnagel
- 34Department of Medicine, University of Illinois at Chicago, Chicago, USA
| | - Talant Sooronbaev
- Kyrgyzstan National Centre of Cardiology and Internal Medicine, Euro-Asian Respiratory Society, Bishkek, Kyrgyzstan
| | - Mohamed Tag Eldin
- 36Department of Thoracic Diseases, Ain Shams Faculty of Medicine, Abbassia, Cairo, Egypt
| | - Teresa To
- 37The Hospital for Sick Children, Research Institute and Della Lana School of Public Health, University of Toronto, Toronto, ON Canada
| | - Arunas Valiulis
- 38Clinic of Children's Diseases, Institute of Clinical Medicine, and Department of Public Health, Institute of Health Sciences, Vilnius University, Vilnius, Lithuania
| | | | | | - Giovanni Viegi
- 22Istituto per la Ricerca e l'Innovazione Biomedica (IRIB), Consiglio Nazionale delle Ricerche (CNR), Palermo, Italy.,40Istituto di Fisiologia Clinica CNR, Pisa, Italy
| | - Tonya Winders
- Allergy & Asthma Network, Vienna, VA USA.,Global Allergy & Asthma Patient Platform, Vienna, Austria
| | - Anahi Yañez
- Investigaciones en Alergia y Enfermedades Respiratorias (INAER), Buenos Aires, Argentina
| | - Arzu Yorgancioğlu
- 44Department of Pulmonary Diseases, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | - Osman Yusuf
- The Allergy and Asthma Institute, Islamabad, Pakistan
| | - Jean Bousquet
- MACVIA-France, Fondation Partenariale FMC VIA-LR, CHRU Arnaud de Villeneuve, Montpellier, France
| | - Nils E Billo
- 29FILHA, Finnish Lung Health Association, Helsinki, Finland.,Global Alliance Against Respiratory Diseases (GARD), Helsinki, Finland
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218
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Pinkerton KE, Chen CY, Mack SM, Upadhyay P, Wu CW, Yuan W. Cardiopulmonary Health Effects of Airborne Particulate Matter: Correlating Animal Toxicology to Human Epidemiology. Toxicol Pathol 2019; 47:954-961. [PMID: 31645209 DOI: 10.1177/0192623319879091] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The effects of particulate matter (PM) on cardiopulmonary health have been studied extensively over the past three decades. Particulate matter is the primary criteria air pollutant most commonly associated with adverse health effects on the cardiovascular and respiratory systems. The mechanisms by which PM exerts its effects are thought to be due to a variety of factors which may include, but are not limited to, concentration, duration of exposure, and age of exposed persons. Adverse effects of PM are strongly driven by their physicochemical properties, sites of deposition, and interactions with cells of the respiratory and cardiovascular systems. The direct translocation of particles, as well as neural and local inflammatory events, are primary drivers for the observed cardiopulmonary health effects. In this review, toxicological studies in animals, and clinical and epidemiological studies in humans are examined to demonstrate the importance of using all three approaches to better define potential mechanisms driving health outcomes upon exposure to airborne PM of diverse physicochemical compositions.
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Affiliation(s)
- Kent E Pinkerton
- Center for Health and the Environment, University of California, Davis, USA
| | - Chao-Yin Chen
- Department of Pharmacology, University of California, Davis, USA
| | - Savannah M Mack
- Center for Health and the Environment, University of California, Davis, USA
| | - Priya Upadhyay
- Center for Health and the Environment, University of California, Davis, USA
| | - Ching-Wen Wu
- Center for Health and the Environment, University of California, Davis, USA
| | - Wanjun Yuan
- Center for Health and the Environment, University of California, Davis, USA.,College of Environmental & Resource Sciences, Shanxi University, Taiyuan, Shanxi, China
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219
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Song DJ, Choi SH, Song WJ, Park KH, Jee YK, Cho SH, Lim DH. The Effects of Short-Term and Very Short-Term Particulate Matter Exposure on Asthma-Related Hospital Visits: National Health Insurance Data. Yonsei Med J 2019; 60:952-959. [PMID: 31538430 PMCID: PMC6753342 DOI: 10.3349/ymj.2019.60.10.952] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 08/13/2019] [Accepted: 08/14/2019] [Indexed: 12/21/2022] Open
Abstract
PURPOSE The purpose of this study was to investigate the effects of short-term and very short-term exposure to particulate matter (PM) exceeding the daily average environmental standards for Korea (≤100 μg/m³ for PM10 and ≤50 μg/m³ for PM2.5) on on asthma-related hospital visits. MATERIALS AND METHODS This was a population-based, case-crossover study using National Health Insurance and air pollution data between January 1, 2014 and December 31, 2016. The event day was defined as a day when PM exceeded the daily average environmental standard (short-term exposure) or daily average environmental standard for 2 hours (very short-term exposure). The control day was defined as the same day of the week at 1 week prior to the event day. RESULTS Compared with control days, asthma-related hospital visits on the 24-hr event days and 2-hr event days increased by 4.10% and 3.45% for PM₁₀ and 5.66% and 3.74% for PM2.5, respectively. Asthma-related hospital visits increased from the 24-hr event day for PM₁₀ to 4 days after the event day, peaking on the third day after the event day (1.26, 95% confidence interval, 1.22-1.30). Hospitalizations also increased on the third day after the event. While there was a difference in magnitude, PM2.5 exposure showed similar trends to PM₁₀ exposure. CONCLUSION We found a significant association between short-term and very short-term PM exposure exceeding the current daily average environmental standards of Korea and asthma-related hospital visits. These results are expected to aid in establishing appropriate environmental standards and relevant policies for PM.
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Affiliation(s)
- Dae Jin Song
- Department of Pediatrics, Korea University College of Medicine, Seoul, Korea
- Environmental Health Center for Asthma, Korea University Anam Hospital, Seoul, Korea
| | - Sun Hee Choi
- Department of Pediatrics, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Woo Jung Song
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kyung Hee Park
- Department of Internal Medicine, Institute of Allergy, Yonsei University College of Medicine, Seoul, Korea
| | - Young Koo Jee
- Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Korea
| | - Sang Heon Cho
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Institute of Allergy and Clinical Immunology, Medical Research Center, Seoul National University, Seoul, Korea.
| | - Dae Hyun Lim
- Department of Pediatrics, Inha University College of Medicine, Incheon, Korea
- Environmental Health Center for Allergic Diseases, Inha University Hospital, Incheon, Korea.
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220
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Effects of nanoparticles on neuroinflammation in a mouse model of asthma. Respir Physiol Neurobiol 2019; 271:103292. [PMID: 31542455 DOI: 10.1016/j.resp.2019.103292] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 09/16/2019] [Accepted: 09/19/2019] [Indexed: 01/01/2023]
Abstract
The interaction between chronic inflammation and neural dysfunction points to a link between the nervous and immune systems in the airways. In particular, environmental exposure to nanoparticles (NPs), defined as particulate matter having one dimension <100 nm, is associated with an enhanced risk of childhood and adult asthma. However, the impact of NPs on the neural response in asthma remains to be determined. This study determined the impact of NPs on neuroinflammation in a mouse model of allergic asthma. Ovalbumin (OVA) sensitized mice were treated with saline (Sham), OVA challenged and exposed to 200 μg/m3 NPs 1 h a day for 3 days on days 21-23 in a closed-system chamber attached to a ultrasonic nebulizer. The effect of NPs on the levels of neuropeptides, transient receptor potential vanilloid 1 (TRPV1), TRPV4, P2 × 4, and P2 × 7 was assessed by enzyme-linked immunosorbent assays, immunoblotting, and immunohistochemistry. NP exposure increased airway inflammation and responsiveness in OVA mice, and these increases were augmented in OVA plus NP-exposed mice. The lung tissue levels of TRPV1, TRPV4, P2 × 4, and P2 × 7 were increased in OVA mice, and these increases were augmented in OVA plus NP-exposed mice. The substance P, adenosine triphosphate (ATP), and calcitonin gene-related peptide (CGRP) levels in bronchoalveolar lavage fluid were increased in OVA mice, and these increases were augmented in OVA plus NP-exposed mice. Bradykinin, ATP, and CGRP were dose dependently increased in NP-exposed normal human bronchial epithelial (NHBE) cells. The calcium concentration was increased in NHBE cells exposed to NPs for 8 h. These results indicate that neuroinflammation can be involved in the pathogenesis of bronchial asthma and that NPs can exacerbate asthma via neuromediator release.
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221
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Lee SW, Yon DK, James CC, Lee S, Koh HY, Sheen YH, Oh JW, Han MY, Sugihara G. Short-term effects of multiple outdoor environmental factors on risk of asthma exacerbations: Age-stratified time-series analysis. J Allergy Clin Immunol 2019; 144:1542-1550.e1. [PMID: 31536730 DOI: 10.1016/j.jaci.2019.08.037] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 08/13/2019] [Accepted: 08/21/2019] [Indexed: 01/05/2023]
Abstract
BACKGROUND Although the different age groups had differences in sensitivity of asthma exacerbations (AEs) to environmental factors, no comprehensive study has examined the age-stratified effects of environmental factors on AEs. OBJECTIVE We sought to examine the short-term effects in age-stratified groups (infants, preschool children, school-aged children, adults, and the elderly) of outdoor environmental factors (air pollutants, weather conditions, aeroallergens, and respiratory viral epidemics) on AEs. METHODS We performed an age-stratified analysis of the short-term effects of 4 groups of outdoor environmental factors on AEs in Seoul Metropolitan City (Korea) from 2008 and 2012. The statistical analysis used a Poisson generalized linear regression model, with a distributed lag nonlinear model for identification of lagged and nonlinear effects and convergent cross-mapping for identification of causal associations. RESULTS Analysis of the total population (n = 10,233,519) indicated there were 28,824 AE events requiring admission to an emergency department during the study period. Diurnal temperature range had significant effects in pediatric (infants, preschool children, and school-aged children) and elderly (relative risk [RR], 1.056-1.078 and 1.016, respectively) subjects. Tree and weed pollen, human rhinovirus, and influenza virus had significant effects in school-aged children (RR, 1.014, 1.040, 1.042, and 1.038, respectively). Tree pollen and influenza virus had significant effects in adults (RR, 1.026 and 1.044, respectively). Outdoor air pollutants (particulate matter of ≤10 μm in diameter, nitrogen dioxide, ozone, carbon monoxide, and sulfur dioxide) had significant short-term effects in all age groups (except for carbon monoxide and sulfur dioxide in infants). CONCLUSION These findings provide a need for the development of tailored strategies to prevent AE events in different age groups.
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Affiliation(s)
- Seung Won Lee
- Graduate School of Medicine, CHA University, Seongnam, Korea; Department of Data Science, Sejong University College of Software Convergence, Seoul, Korea
| | - Dong Keon Yon
- Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea; Medical Corps, Republic of Korea Army, Seongnam, Korea
| | - Chase C James
- Scripps Institution of Oceanography, University of California San Diego, San Diego, Calif
| | - Shinhae Lee
- Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Hyun Yong Koh
- F.M. Kirby Neurobiology Center, Boston Children's Hospital, Harvard Medical School, Boston, Mass
| | - Youn Ho Sheen
- Department of Pediatrics, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Korea
| | - Jae-Won Oh
- Department of Pediatrics, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
| | - Man Yong Han
- Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea.
| | - George Sugihara
- Scripps Institution of Oceanography, University of California San Diego, San Diego, Calif
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Almendros I, El-Merhie N, Jha A, Keir HR, Lykouras D, Mahmutovic Persson I, Ubags ND, Bartel S. Early Career Members at the Lung Science Conference and the Sleep and Breathing Conference 2019. Breathe (Sheff) 2019; 15:234-240. [PMID: 31508161 PMCID: PMC6717613 DOI: 10.1183/20734735.0203-2019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The European Respiratory Society (ERS) Lung Science Conference (LSC) is the basic science conference of the ERS and it takes place every March in Estoril, Portugal. It is important to note that, particularly at this conference, there is a lot of emphasis on the inclusion and development of Early Career Members. For example, each session is chaired by one Early Career Member together with a more senior scientist; there are 40 travel bursaries to enable abstract authors to attend the conference; there is a mentorship lunch session; and every year the Early Career Member Committee (ECMC) organises a specifically dedicated Early Career Member career development session on the Saturday afternoon. Thus, there are many reasons for Early Career Members to attend this conference but, for those who could not attend, we will describe here the scientific highlights of the LSC 2019 on the topic “Mechanisms of acute exacerbation of respiratory disease”. The Lung Science Conference and the Sleep and Breathing Conference 2019 brought together leading experts in the field to discuss the latest cutting-edge science, as well as various career development opportunities for early career membershttp://bit.ly/2XNX6V6
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Affiliation(s)
- Isaac Almendros
- Unitat de Biofísica i Bioenginyeria, Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Madrid, Spain
| | - Natalia El-Merhie
- Research Center Borstel, Leibniz Lung Center, Airway Research Center North (ARCN), Member of the German Center for Lung Research (DZL), Borstel, Germany
| | - Akhilesh Jha
- Dept of Medicine, University of Cambridge, Cambridge, UK.,National Heart and Lung Institute, Imperial College London, London, UK
| | - Holly R Keir
- Division of Molecular and Clinical Medicine, Ninewells Hospital, University of Dundee, Dundee, UK
| | - Dimosthenis Lykouras
- Dept of Respiratory Medicine, University Hospital of Patras, Rion Patras, Greece
| | - Irma Mahmutovic Persson
- Institution of Medical Radiation Physics, Dept of Translational Medicine, Lund University, Malmö, Sweden
| | - Niki D Ubags
- Faculty of Biology and Medicine, University of Lausanne, Service de Pneumologie, CHUV, Epalinges, Switzerland
| | - Sabine Bartel
- University of Groningen, University Medical Center Groningen, Dept of Pathology and Medical Biology, GRIAC Research Institute, Groningen, The Netherlands.,All authors are sorted alphabetically, except for S. Bartel
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223
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Maglione GA, Kurtz ML, Orona NS, Astort F, Busso IT, Mandalunis PM, Berra A, Tasat DR. Chronic exposure to urban air pollution from Buenos Aires: the ocular mucosa as an early biomarker. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:27444-27456. [PMID: 31327144 DOI: 10.1007/s11356-019-05966-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 07/11/2019] [Indexed: 06/10/2023]
Abstract
Air pollution represents a major health problem in megacities, bringing about 8 million deaths every year. The aim of the study was to evaluate in vivo the ocular and respiratory mucosa biological response after chronic exposure to urban air particles from Buenos Aires (UAP-BA). BALB/c mice were exposed to UAP-BA or filtered air for 1, 6, 9, and 12 months. After exposure, histology, histomorphometry, and IL-6 proinflammatory cytokine level were evaluated in the respiratory and ocular mucosa. Total cell number and differential cell count were determined in the brochoalveolar lavage fluid. In the lung, chronic exposure to UAP-BA induced reduction of the alveolar space, polymorhonuclear cell recruitment, and goblet cell hyperplasia. In the ocular surface, UAP-BA induced an initial mucin positive cells rise followed by a decline through time, while IL-6 level increased at the latest point-time assayed. Our results showed that the respiratory and the ocular mucosas respond differently to UAP-BA. Being that lung and ocular mucosa diseases may be triggered and/or exacerbated by chronic exposure to urban air PM, the inhabitants of Buenos Aires whom are chronically exposed to environmental urban air pollution may be considered a subpopulation at risk. Based on our results, we propose the ocular mucosa as a reliable and more accessible surrogate for pulmonary mucosa environmental toxicity that might also serve as an earlier biomarker for air pollution adverse impact on health.
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Affiliation(s)
- Guillermo A Maglione
- Center for the Studies in Health and Environment, School of Science and Technology, National University of San Martin, Martín de Irigoyen 3100, 1653, San Martín, Buenos Aires, Argentina
- Department of Histology and Embryology, School of Dentistry, University of Buenos Aires, Marcelo T. de Alvear 2142, C1122AAH, Autonomous City of Buenos Aires, Argentina
| | - Melisa L Kurtz
- Center for the Studies in Health and Environment, School of Science and Technology, National University of San Martin, Martín de Irigoyen 3100, 1653, San Martín, Buenos Aires, Argentina.
- National Research Council (CONICET), Godoy Cruz 2290, C1425FQB, Autonomous City of Buenos Aires, Argentina.
| | - Nadia S Orona
- Center for the Studies in Health and Environment, School of Science and Technology, National University of San Martin, Martín de Irigoyen 3100, 1653, San Martín, Buenos Aires, Argentina
- National Research Council (CONICET), Godoy Cruz 2290, C1425FQB, Autonomous City of Buenos Aires, Argentina
| | - Francisco Astort
- Center for the Studies in Health and Environment, School of Science and Technology, National University of San Martin, Martín de Irigoyen 3100, 1653, San Martín, Buenos Aires, Argentina
- National Research Council (CONICET), Godoy Cruz 2290, C1425FQB, Autonomous City of Buenos Aires, Argentina
| | - Iván Tavera Busso
- National Research Council (CONICET), Godoy Cruz 2290, C1425FQB, Autonomous City of Buenos Aires, Argentina
- Institute for Multidisciplinary Plant Biology, National University of Córdoba, Av. Vélez Sarsfield 299, X5000JJC, Córdoba City, Argentina
| | - Patricia M Mandalunis
- Department of Histology and Embryology, School of Dentistry, University of Buenos Aires, Marcelo T. de Alvear 2142, C1122AAH, Autonomous City of Buenos Aires, Argentina
| | - Alejandro Berra
- Department of Pathology, School of Medicine, University of Buenos Aires, Paraguay 2155, C1121ABG, Autonomous City of Buenos Aires, Argentina
| | - Deborah R Tasat
- Center for the Studies in Health and Environment, School of Science and Technology, National University of San Martin, Martín de Irigoyen 3100, 1653, San Martín, Buenos Aires, Argentina
- Department of Histology and Embryology, School of Dentistry, University of Buenos Aires, Marcelo T. de Alvear 2142, C1122AAH, Autonomous City of Buenos Aires, Argentina
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224
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Hopke PK, Croft D, Zhang W, Lin S, Masiol M, Squizzato S, Thurston SW, van Wijngaarden E, Utell MJ, Rich DQ. Changes in the acute response of respiratory diseases to PM 2.5 in New York State from 2005 to 2016. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 677:328-339. [PMID: 31059876 DOI: 10.1016/j.scitotenv.2019.04.357] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 04/21/2019] [Accepted: 04/24/2019] [Indexed: 04/14/2023]
Abstract
Prior studies reported that exposure to increased concentrations of fine particulate matter (PM2.5) were associated with increased rates of hospitalization and emergency department (ED) visits for asthma and chronic obstructive pulmonary disease (COPD). In this study, rates were examined from 2005 to 2016 using a case-crossover design to ascertain if there have been changes in the rates per unit mass exposure given substantial reductions in PM2.5 concentration and changes in its composition. PM2.5 concentrations were reduced through a combination of policies designed to improve air quality and economic drivers, including the 2008 economic recession and shifts in the relative costs of coal and natural gas. The study period was split into three periods reflecting that much of the emissions changes occurred between 2008 and 2013. Thus, the three periods were defined as: BEFORE (2005 to 2007), DURING (2008-2013), and AFTER (2014-2016). In general, the number of hospitalizations and ED visits declined with the decreased concentration of PM2.5. However, the rate of COPD hospitalizations and asthma ED visits associated with each interquartile range increase in ambient PM2.5 concentration was larger in the AFTER period than the DURING and BEFORE periods. For example, each 6.8 μg/m3 increase in PM2.5 on the same day was associated with 0.4% (0.0%, 0.8%), 0.3% (-0.2%, 0.7%), and 2.7% (1.9%, 3.5) increases in the rate of asthma emergency department visits in the BEFORE, DURING, and AFTER periods, respectively, suggesting the same mass concentration of PM2.5 was more toxic in the AFTER period.
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Affiliation(s)
- Philip K Hopke
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, United States of America; Center for Air Resources Engineering and Science, Clarkson University, Potsdam, NY, United States of America.
| | - Daniel Croft
- Department of Medicine, University of Rochester Medical Center, Rochester, NY, United States of America
| | - Wangjian Zhang
- Department of Environmental Health Sciences. University at Albany, the State University of New York, Albany, NY, United States of America
| | - Shao Lin
- Department of Environmental Health Sciences. University at Albany, the State University of New York, Albany, NY, United States of America
| | - Mauro Masiol
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, United States of America
| | - Stefania Squizzato
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, United States of America
| | - Sally W Thurston
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, United States of America
| | - Edwin van Wijngaarden
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, United States of America; Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, United States of America
| | - Mark J Utell
- Department of Medicine, University of Rochester Medical Center, Rochester, NY, United States of America; Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, United States of America
| | - David Q Rich
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, United States of America; Department of Medicine, University of Rochester Medical Center, Rochester, NY, United States of America; Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, United States of America
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225
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PM 10 Increases the Daily Outpatient Visits for Asthma: A Time Series Analysis from 2013-2016 in Shanghai, China. IRANIAN JOURNAL OF PUBLIC HEALTH 2019; 48:1539-1540. [PMID: 32292742 PMCID: PMC7145933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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226
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Rosa MJ, Perzanowski MS. Dietary Fat Intake, Particulate Matter Exposure, and Asthma Severity. Am J Respir Crit Care Med 2019; 199:1447-1448. [PMID: 30922061 PMCID: PMC6580673 DOI: 10.1164/rccm.201902-0296ed] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Maria José Rosa
- 1 Department of Environmental Medicine and Public Health Mt. Sinai School of Medicine New York, New York and
| | - Matthew S Perzanowski
- 2 Department of Environmental Health Sciences Columbia University New York, New York
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227
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Liu F, Qu F, Zhang H, Chao L, Li R, Yu F, Guan J, Yan X. The effect and burden modification of heating on adult asthma hospitalizations in Shijiazhuang: a time-series analysis. Respir Res 2019; 20:122. [PMID: 31200718 PMCID: PMC6570879 DOI: 10.1186/s12931-019-1092-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Accepted: 06/05/2019] [Indexed: 12/25/2022] Open
Abstract
Background Previous studies have found associations between asthma morbidity and air pollution especially in young population, (PLoS One 12:e0180522, 2017; Can J Public Health 103:4-8, 2012; Environ Health Perspect 118:449-57, 2010; Am J Respir Crit Care Med 182:307-16, 2010; J Allergy Clin Immunol 104:717-22, 2008; J Allergy Clin Immunol 104:717-22, 1999; Environ Res 111:1137-47, 2011) but most of them were conducted in areas with relatively low air pollutant level. Moreover, very few studies have investigated the effect and burden modification of heating season during which the ambient air pollution level is significantly different from that during non-heating season in north China. Objectives This study aimed to evaluate the effect and burden modification of heating on short-term associations between adult asthma hospitalizations and ambient air pollution in the north China city of Shijiazhuang. Methods Generalized additive models combined with penalized distributed lag nonlinear models were used to model associations between daily asthma hospitalizations and ambient air pollutants from 1 January 2013 to 16 December 2016 in Shijiazhuang city, adjusting for long-term and seasonality trend, day of week, statutory holiday, daily mean air pressure and temperature. Attributable risks were calculated to evaluate the burden of asthma hospitalizations due to air pollutants exposure. The effect of pollutants on hospitalization and the attributable measures were estimated in heating and non-heating season separately and the comparisons between the two seasons were conducted. Results All pollutants demonstrated positive and significant impacts on asthma hospitalizations both in heating season and non-heating season, except for O3 in heating season where a negative association was observed. However, the differences of the pollutant-specific effects between the two seasons were not significant. SO2 and NO2 exposure were associated with the heaviest burden among all pollutants in heating season; meanwhile, PM10 and PM2.5 were associated with the heaviest burden in heating season. Conclusions In conclusion, we found evidence of the effect of ambient air pollutants on asthma hospitalizations in Shijiazhuang. The central heating period could modify the effects in terms of attributable risks. The disease burden modification of heating should be taken into consideration when planning intervention measures to reduce the risk of asthma hospitalization.
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Affiliation(s)
- Feifei Liu
- The Second Hospital of Hebei Medical University, Shijiazhuang city, Hebei province, China
| | - Fangfang Qu
- The Second Hospital of Hebei Medical University, Shijiazhuang city, Hebei province, China
| | - Huiran Zhang
- The Second Hospital of Hebei Medical University, Shijiazhuang city, Hebei province, China
| | - Lingshan Chao
- The Second Hospital of Hebei Medical University, Shijiazhuang city, Hebei province, China
| | - Rongqin Li
- The Second Hospital of Hebei Medical University, Shijiazhuang city, Hebei province, China
| | - Fengxue Yu
- The Second Hospital of Hebei Medical University, Shijiazhuang city, Hebei province, China
| | - Jitao Guan
- The Second Hospital of Hebei Medical University, Shijiazhuang city, Hebei province, China
| | - Xixin Yan
- The Second Hospital of Hebei Medical University, Shijiazhuang city, Hebei province, China.
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228
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Baliatsas C, Smit LAM, Dückers MLA, van Dijk CE, Heederik D, Yzermans CJ. Patients with overlapping diagnoses of asthma and COPD: is livestock exposure a risk factor for comorbidity and coexisting symptoms and infections? BMC Pulm Med 2019; 19:105. [PMID: 31182085 PMCID: PMC6558812 DOI: 10.1186/s12890-019-0865-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 05/21/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Epidemiological research on health effects of livestock exposure in population subgroups with compromised respiratory health is still limited. The present study explored the association between livestock exposure and comorbid/concurrent conditions in patients with overlapping diagnoses of asthma and COPD. METHODS Electronic health record data from 23 general practices in the Netherlands were collected from 425 patients diagnosed with both asthma and COPD, living in rural areas with high livestock density ("study area"). Data of 341 patients with the same overlapping diagnoses, living in rural areas with lower livestock density ("control areas") were obtained from 19 general practices. First, the prevalence of comorbid disorders and symptoms/infections were compared between the study and control area. Second, the examined health outcomes were analyzed in relation to measures of individual livestock exposure. RESULTS Pneumonia was twice as common among patients living in areas with a high livestock density (OR 2.29, 99% CI 0.96-5.47); however, there were generally no statistically significant differences in the investigated outcomes between the study and control area. Significant associations were observed between presence of goats within 1000 m and allergic rhinitis (OR 5.71, 99% CI 1.11-29.3, p < 0.01), number of co-occurring symptoms (IRR 1.69, 99% CI 1.03-2.77, p < 0.01) and anxiety (OR 8.18, 99% 1.5-44.7, p < 0.01). Presence of cattle within 500 m was associated with pneumonia prevalence (OR 2.48, 99% CI 1.05-5.84, p < 0.01). CONCLUSION Livestock exposure is not associated with comorbid chronic conditions but appears to be a risk factor for symptomatic effects in patients with overlapping diagnoses of asthma and COPD.
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Affiliation(s)
- Christos Baliatsas
- Netherlands Institute for Health Services Research (NIVEL), Otterstraat 118-124, 3513 CR Utrecht, The Netherlands
| | - Lidwien A. M. Smit
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - Michel L. A. Dückers
- Netherlands Institute for Health Services Research (NIVEL), Otterstraat 118-124, 3513 CR Utrecht, The Netherlands
| | - Christel E. van Dijk
- Netherlands Institute for Health Services Research (NIVEL), Otterstraat 118-124, 3513 CR Utrecht, The Netherlands
| | - Dick Heederik
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - C. Joris Yzermans
- Netherlands Institute for Health Services Research (NIVEL), Otterstraat 118-124, 3513 CR Utrecht, The Netherlands
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229
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Tay TR, Lee JWY, Hew M. Diagnosis of severe asthma. Med J Aust 2019; 209:S3-S10. [PMID: 30453866 DOI: 10.5694/mja18.00125] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Accepted: 05/21/2018] [Indexed: 02/01/2023]
Abstract
Patients with asthma that is uncontrolled despite high intensity medication can present in both primary and specialist care. An increasing number of novel (and expensive) treatments are available for patients who fail conventional asthma therapy, but these may not be appropriate for all such patients. It is essential that a rigorous evaluation process be undertaken for these patients to identify those with biologically severe asthma who will require novel therapies, and those who may improve with control of contributory factors. In this article, we describe three key steps in the diagnostic evaluation process for severe asthma. The first step is confirmation of asthma diagnosis with objective evidence of variable airflow obstruction. The second involves management of contributory factors such as non-adherence, poor inhaler technique, ongoing asthma triggers, and comorbidities. The third step involves phenotyping and endotyping of patients with severe asthma. We provide a practical approach to implementing these measures in both primary and secondary care.
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Affiliation(s)
| | | | - Mark Hew
- The Alfred Hospital, Melbourne, VIC
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Shin SW, Bae DJ, Park CS, Lee JU, Kim RH, Kim SR, Chang HS, Park JS. Effects of air pollution on moderate and severe asthma exacerbations. J Asthma 2019; 57:875-885. [PMID: 31122089 DOI: 10.1080/02770903.2019.1611844] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Background: Few studies have evaluated the impact of air pollution levels on the severity of exacerbations. Thus, we compared the relative risks posed by air pollutant levels on moderate and severe exacerbations.Methods: Exacerbation episodes of 618 from 143 adult asthmatics were retrospectively collected between 2005 and 2015 in a tertiary hospital of Korea. Air pollution GPS data for the location closest to each patient's home were obtained from the national ambient monitoring station. The relative impacts of air pollutants on asthma exacerbations were evaluated via a time-trend controlled symmetrical, bidirectional, case-crossover design using conditional logistic regression models on the day of the exacerbation (T-0) and up to 3 days before the exacerbation (T-1-T-3).Results: Overall asthma exacerbation were associated with O3 levels in summer and winter (OR: 1.012[1.003-1.02] and 1.009[1.003-1.016]), SO2 levels in spring and summer (OR: 1.009[1-1.018] and 1.02[1.006-1.035]) and NO2 levels in winter (OR: 1.007[1.003-1.011]). Analyses of the temporal relationship between O3 concentrations and exacerbations demonstrated that 63.2% of episodes in the summer occurred when the O3 concentrations on T-1 were significantly higher than those on control days, while 51% of exacerbation episodes in the winter occurred. Severe and moderate exacerbations were similarly associated with O3 levels in winter (OR: 1.012 [1.003-1.02] vs. 1.01 [0.999-1.021], p > 0.05) and in summer (OR: 1.006 [1.002-1.009] vs. 1.009 [1.003-1.016], p > 0.05).Conclusions: Asthma exacerbations may be associated with the seasonal elevation of O3, SO2 and NO2 levels in summer and winter with the similar relative risk between moderate and severe exacerbations.
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Affiliation(s)
- Seung-Woo Shin
- Division of Allergy and Respiratory Medicine, Soonchunhyang Univ. Bucheon Hospital, Bucheon, South Korea
| | - Da-Jeong Bae
- Division of Allergy and Respiratory Medicine, Soonchunhyang Univ. Bucheon Hospital, Bucheon, South Korea
| | - Choon-Sik Park
- Division of Allergy and Respiratory Medicine, Soonchunhyang Univ. Bucheon Hospital, Bucheon, South Korea
| | - Jong-Uk Lee
- Division of Allergy and Respiratory Medicine, Soonchunhyang Univ. Bucheon Hospital, Bucheon, South Korea
| | - Ryun-Hee Kim
- Department of Medical Bioscience, Graduate School, Soonchunhyang University, Asan, South Korea
| | - Sung Roul Kim
- Department of Environmental Health Sciences, Soonchunhyang University, Asan, South Korea
| | - Hun-Soo Chang
- Department of Medical Bioscience, Graduate School, Soonchunhyang University, Asan, South Korea
| | - Jong Sook Park
- Division of Allergy and Respiratory Medicine, Soonchunhyang Univ. Bucheon Hospital, Bucheon, South Korea
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231
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Sun Z, Zhu D. Exposure to outdoor air pollution and its human health outcomes: A scoping review. PLoS One 2019; 14:e0216550. [PMID: 31095592 PMCID: PMC6522200 DOI: 10.1371/journal.pone.0216550] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Accepted: 04/10/2019] [Indexed: 12/17/2022] Open
Abstract
Despite considerable air pollution prevention and control measures that have been put into practice in recent years, outdoor air pollution remains one of the most important risk factors for health outcomes. To identify the potential research gaps, we conducted a scoping review focused on health outcomes affected by outdoor air pollution across the broad research area. Of the 5759 potentially relevant studies, 799 were included in the final analysis. The included studies showed an increasing publication trend from 1992 to 2008, and most of the studies were conducted in Asia, Europe, and North America. Among the eight categorized health outcomes, asthma (category: respiratory diseases) and mortality (category: health records) were the most common ones. Adverse health outcomes involving respiratory diseases among children accounted for the largest group. Out of the total included studies, 95.2% reported at least one statistically positive result, and only 0.4% showed ambiguous results. Based on our study, we suggest that the time frame of the included studies, their disease definitions, and the measurement of personal exposure to outdoor air pollution should be taken into consideration in any future research. The main limitation of this study is its potential language bias, since only English publications were included. In conclusion, this scoping review provides researchers and policy decision makers with evidence taken from multiple disciplines to show the increasing prevalence of outdoor air pollution and its adverse effects on health outcomes.
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Affiliation(s)
- Zhuanlan Sun
- Department of Management Science and Engineering, School of Economics and Management, Tongji University, Shanghai, China
| | - Demi Zhu
- Department of Comparative Politics, School of International and Public Affairs, Shanghai Jiaotong University, Shanghai, China
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Evaluation of Performance of Inexpensive Laser Based PM2.5 Sensor Monitors for Typical Indoor and Outdoor Hotspots of South Korea. APPLIED SCIENCES-BASEL 2019. [DOI: 10.3390/app9091947] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Inexpensive (<$300) real-time particulate matter monitors (IRMs), using laser as a light source, have been introduced for use with a Wi-Fi function enabling networking with a smartphone. However, the information of measurement error of these inexpensive but convenient IRMs are still limited. Using ESCORTAIR (ESCORT, Seoul, Korea) and PurpleAir (PA) (PurpleAir U.S.A.), we evaluated the performance of these two devices compared with the U.S. Environmental Protection Agency (EPA) Federal Equivalent Monitoring (FEM) devices, that is, GRIMM180 (GRIMM Aerosol, Germany) for the indoor measurement of pork panfrying or secondhand tobacco smoking (SHS) and Beta-ray attenuation monitor (BAM) (MetOne, Grants Pass, OR) for outdoor measurement at the national particulate matter (PM2.5) monitoring site near an urban traffic hotspot in Daejeon, South Korea, respectively. The PM2.5 concentrations measured by ESCORTAIR and PA were strongly correlated to FEM (r = 0.97 and 0.97 from indoor pan frying; 0.92 and 0.86 from indoor SHS; 0.85 and 0.88 from outdoor urban traffic hotspot). The two IRMs showed that PM2.5 mass concentrations were increased with increased outdoor relative humidity (RH) levels. However, after applying correction factors for RH, the Median (Interquartile range) of difference compared to FEM was (14.5 (6.1~23.5) %) for PA and 16.3 (8.5–28.0) % for ESCORTAIR, supporting their usage in the home or near urban hotspots.
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233
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Louisias M, Ramadan A, Naja AS, Phipatanakul W. The Effects of the Environment on Asthma Disease Activity. Immunol Allergy Clin North Am 2019; 39:163-175. [PMID: 30954168 PMCID: PMC6452888 DOI: 10.1016/j.iac.2018.12.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Asthma is highly prevalent and causes significant morbidity in children. The development of asthma depends on complex relationships between genetic predisposition and environmental modifiers of immune function. The biological and physical environmental factors include aeroallergens, microbiome, endotoxin, genetics, and pollutants. The psychosocial environment encompasses stress, neighborhood safety, housing, and discrimination. They all have been speculated to influence asthma control and the risk of developing asthma. Control of the factors that contribute to or aggravate symptoms, interventions to eliminate allergen exposure, guidelines-based pharmacologic therapy, and education of children and their caregivers are of paramount importance.
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Affiliation(s)
- Margee Louisias
- Division of Allergy and Immunology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Fegan Building, 6th floor, Boston, MA 02115, USA; Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Boston, MA, USA
| | - Amira Ramadan
- Division of Allergy and Immunology, Boston Children's Hospital, 300 Longwood Avenue, Fegan Building, 6th Floor, Boston, MA 02115, USA; Beth Israel Deaconess Medical Center, Boston, MA
| | - Ahmad Salaheddine Naja
- Division of Allergy and Immunology, Boston Children's Hospital, 300 Longwood Avenue, Fegan Building, 6th Floor, Boston, MA 02115, USA; Lebanese American University, Beirut, Lebanon
| | - Wanda Phipatanakul
- Division of Allergy and Immunology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Fegan Building, 6th floor, Boston, MA 02115, USA.
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Sánchez T, Gozal D, Smith DL, Foncea C, Betancur C, Brockmann PE. Association between air pollution and sleep disordered breathing in children. Pediatr Pulmonol 2019; 54:544-550. [PMID: 30719878 DOI: 10.1002/ppul.24256] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Accepted: 12/10/2018] [Indexed: 11/05/2022]
Abstract
BACKGROUND AND OBJECTIVE Similar to other respiratory diseases, sleep disordered breathing (SDB) may be exacerbated by air contaminants. Air pollution may have an impact on incidence and severity of SDB in children. The aims of this study were to examine potential associations between the exposure to different air pollutants and SDB symptoms in children. METHODS In this cross-sectional study, parents from first grade children of elementary schools throughout Chile were included. Data about clinical and family-related SDB risk factors, and the pediatric sleep questionnaire (PSQ) were obtained. Air pollution and meteorological data were obtained from the Chilean online air quality database. RESULTS A total of 564 children (44.9% males) aged (median) 6 years (5-9 year) were included. Prevalence of SDB based on PSQ was 17.7%. When examining air pollutants and conditions, only higher humidity (β = 0.005, 95%CI 0.001-0.009, P = 0.011) was significantly associated with higher PSQ scores after adjusting for demographic and household variables. Higher ozone (O3 ) levels (OR = 1.693, 95%CI 1.409-2.035, P < 0.001), higher humidity (OR = 1.161, 95%CI 1.041-2.035, P = 0.008) and higher dioxide sulfur (SO2 ) levels (OR = 1.16, 95%CI 1.07-1.94, P < 0.001]) were associated with increased odds of wheezing-related sleep disturbances after adjusting for confounders. Lower temperature was a significant predictor of snoring at least >3 nights/week, following adjustment (OR = 0.865, 95%CI 0.751-0.997, P < 0.05). CONCLUSION Sleep respiratory symptoms (wheezing and snoring) are significantly associated with air pollutants such as O3 and SO2 . In addition, meteorological conditions such as humidity and low temperatures may be also associated with SDB-related symptoms.
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Affiliation(s)
- Trinidad Sánchez
- Division of Pediatrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - David Gozal
- Section of Pediatric Sleep Medicine, Department of Pediatrics, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, Chicago, Illinois
| | - Dale L Smith
- Department of Public Health Sciences, Biological Sciences Division, The University of Chicago, Chicago, Illinois
| | | | - Carmen Betancur
- Department of Psychiatry and Mental Health, Universidad de Concepción, Concepción, Chile
| | - Pablo E Brockmann
- Pediatric Sleep Center, Department of Pediatric Cardiology and Pulmonology, Division of Pediatrics, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
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Toyinbo O, Phipatanakul W, Shaughnessy R, Haverinen-Shaughnessy U. Building and indoor environmental quality assessment of Nigerian primary schools: A pilot study. INDOOR AIR 2019; 29:510-520. [PMID: 30807666 PMCID: PMC6486416 DOI: 10.1111/ina.12547] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 01/12/2019] [Accepted: 02/25/2019] [Indexed: 06/09/2023]
Abstract
A total of 15 classrooms went through on-site assessments/inspections, including measurements of temperature (T), and concentrations of carbon monoxide (CO) and carbon dioxide (CO2 ). In addition, the level of surface biocontamination/cleaning effectiveness was assessed by measuring adenosine triphosphate (ATP) levels on students' desks. Based on the data, the quality of facilities in the buildings was low. Classroom occupancy exceeded ASHRAE 50 person/100 m2 standard in all cases indicating overcrowding. However, concentrations of CO2 remained below 1000 ppm in most classrooms. On the other hand, indoor T was above the recommended levels for thermal comfort in all classrooms. Maximum indoor CO was 6 ppm. Median ATP concentrations on the desk tops were moderately high in all schools. The use of open incinerators and power generator sets near classrooms, which was suspected to be the main source of CO, should be discouraged. Improved hygiene could be achieved by providing the students access to functioning bathroom facilities and cafeteria, and by effective cleaning of high contact surfaces such as desks. Although ventilation seems adequate based on CO2 concentrations, thermal comfort was not attained especially in the afternoon during extreme sunlight. Therefore, installing passive and/or mechanical cooling systems should be considered in this regard.
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Affiliation(s)
- Oluyemi Toyinbo
- National Institute for Health and Welfare, Kuopio FI-70701, Finland
- University of Eastern Finland, P.O. Box 1627, Kuopio 70211, Finland
| | - Wanda Phipatanakul
- Division of Allergy and Immunology, Boston Children’s Hospital, Harvard Medical School
| | | | - Ulla Haverinen-Shaughnessy
- National Institute for Health and Welfare, Kuopio FI-70701, Finland
- Indoor Air Program, the University of Tulsa, Tulsa, OK 74104, USA
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Poole JA, Barnes CS, Demain JG, Bernstein JA, Padukudru MA, Sheehan WJ, Fogelbach GG, Wedner J, Codina R, Levetin E, Cohn JR, Kagen S, Portnoy JM, Nel AE. Impact of weather and climate change with indoor and outdoor air quality in asthma: A Work Group Report of the AAAAI Environmental Exposure and Respiratory Health Committee. J Allergy Clin Immunol 2019; 143:1702-1710. [PMID: 30826366 PMCID: PMC10907958 DOI: 10.1016/j.jaci.2019.02.018] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 02/08/2019] [Accepted: 02/20/2019] [Indexed: 12/14/2022]
Abstract
Weather and climate change are constant and ever-changing processes that affect allergy and asthma. The purpose of this report is to provide information since the last climate change review with a focus on asthmatic disease. PubMed and Internet searches for topics included climate and weather change, air pollution, particulates, greenhouse gasses, traffic, insect habitat, and mitigation in addition to references contributed by the individual authors. Changes in patterns of outdoor aeroallergens caused by increasing temperatures and amounts of carbon dioxide in the atmosphere are major factors linked to increased duration of pollen seasons, increased pollen production, and possibly increased allergenicity of pollen. Indoor air pollution threats anticipated from climate changes include microbial and mold growth secondary to flooding, resulting in displacement of persons and need for respiratory protection of exposed workers. Air pollution from indoor burning of mosquito repellants is a potential anticipatory result of an increase in habitat regions. Air pollution from fossil fuel burning and traffic-related emissions can alter respiratory defense mechanisms and work synergistically with specific allergens to enhance immunogenicity to worsen asthma in susceptible subjects. Community efforts can significantly reduce air pollution, thereby reducing greenhouse gas emission and improving air quality. The allergist's approach to weather pattern changes should be integrated and anticipatory to protect at-risk patients.
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Affiliation(s)
- Jill A Poole
- Pulmonary, Critical Care, Sleep & Allergy Division, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Neb.
| | - Charles S Barnes
- Division of Allergy, Asthma and Immunology, Children's Mercy Hospital, University of Missouri-Kansas City School of Medicine, Kansas City, Mo
| | - Jeffrey G Demain
- Allergy Asthma & Immunology Center of Alaska, the Department of Pediatrics, University of Washington, and the WWAMI School of Medical Education, University of Alaska, Anchorage, Alaska
| | - Jonathan A Bernstein
- Division of Immunology, Allergy Section, Department of Internal Medicine, University of Cincinnati, Cincinnati, Ohio
| | - Mahesh A Padukudru
- Department of Respiratory Medicine, JSS Medical College, JSSAHER, Mysore, India
| | - William J Sheehan
- Division of Allergy, Children's National Medicine Center, Department of Pediatrics, George Washington School of Medicine and Health Sciences, Washington, DC
| | | | - James Wedner
- Division of Allergy & Immunology, John T. Milliken Department of Internal Medicine, Washington University, St Louis, Mo
| | - Rosa Codina
- Allergen Science & Consulting, Lenoir, NC; Division of Allergy and Immunology, Department of Internal Medicine, University of South Florida Morsani College of Medicine, Tampa, Fla
| | - Estelle Levetin
- Department of Biological Science, University of Tulsa, Tulsa, Okla
| | - John R Cohn
- Korman Respiratory Institute, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pa
| | - Steve Kagen
- Division of Allergy & Clinical Immunology, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wis
| | - Jay M Portnoy
- Division of Allergy, Asthma, & Immunology, Children's Mercy Hospital, University of Missouri-Kansas City, Kansas City, Mo
| | - Andre E Nel
- University of California Los Angeles, David Geffen School of Medicine and California NanoSystems Institute, Los Angeles, Calif
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Assessing the impact of air pollution on childhood asthma morbidity: how, when, and what to do. Curr Opin Allergy Clin Immunol 2019; 18:124-131. [PMID: 29493555 DOI: 10.1097/aci.0000000000000422] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE OF REVIEW Exposure to air pollutants is linked with poor asthma control in children and represents a potentially modifiable risk factor for impaired lung function, rescue medication use, and increased asthma-related healthcare utilization. Identification of the most relevant pollutants to asthma as well as susceptibility factors and strategies to reduce exposure are needed to improve child health. RECENT FINDINGS The current available literature supports the association between pollutants and negative asthma outcomes. Ethnicity, socioeconomic status, and presence of certain gene polymorphisms may impact susceptibility to the negative health effects of air pollution. Improved air quality standards were associated with better asthma outcomes. SUMMARY The link between air pollution and pediatric asthma morbidity is supported by the recent relevant literature. Continued efforts are needed to identify the most vulnerable populations and develop strategies to reduce exposures and improve air quality.
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Abstract
PURPOSE OF REVIEW Asthma attacks are frequent in children with asthma and can lead to significant adverse outcomes including time off school, hospital admission and death. Identifying children at risk of an asthma attack affords the opportunity to prevent attacks and improve outcomes. RECENT FINDINGS Clinical features, patient behaviours and characteristics, physiological factors, environmental data and biomarkers are all associated with asthma attacks and can be used in asthma exacerbation prediction models. Recent studies have better characterized children at risk of an attack: history of a severe exacerbation in the previous 12 months, poor adherence and current poor control are important features which should alert healthcare professionals to the need for remedial action. There is increasing interest in the use of biomarkers. A number of novel biomarkers, including patterns of volatile organic compounds in exhaled breath, show promise. Biomarkers are likely to be of greatest utility if measured frequently and combined with other measures. To date, most prediction models are based on epidemiological data and population-based risk. The use of digital technology affords the opportunity to collect large amounts of real-time data, including clinical and physiological measurements and combine these with environmental data to develop personal risk scores. These developments need to be matched by changes in clinical guidelines away from a focus on current asthma control and stepwise escalation in drug therapy towards inclusion of personal risk scores and tailored management strategies including nonpharmacological approaches. SUMMARY There have been significant steps towards personalized prediction models of asthma attacks. The utility of such models needs to be tested in the ability not only to predict attacks but also to reduce them.
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239
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IgE sensitization in a cohort of adolescents in southern Sweden and its relation to allergic symptoms. Clin Mol Allergy 2019; 17:6. [PMID: 30983886 PMCID: PMC6444864 DOI: 10.1186/s12948-019-0110-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 02/25/2019] [Indexed: 11/30/2022] Open
Abstract
Background There is a strong and consistent association between IgE sensitization and allergy, wheeze, eczema and food hypersensitivity. These conditions are also found in non-sensitized humans, and sensitization is found among individuals without allergy-related diseases. The aim of this study was to analyse the sensitization profile in a representative sample of the population, and to relate patterns of allergens and allergen components to allergic symptoms. Methods A population of 195 adolescents took part in this clinical study, which included a self-reported questionnaire and in vitro IgE testing. Results Sensitization to airborne allergens was significantly more common than sensitization to food allergens, 43% vs. 14%, respectively. IgE response was significantly higher in airborne allergens among adolescents with rhinitis (p < 0.001) and eczema (p < 0.01). Among 53 children with allergic symptoms according to the questionnaire, 60% were sensitized. Sensitization to food allergens was found among those with rhinitis, but only to PR-10 proteins. None of the participants had IgE to seed storage proteins. Conclusion The adolescents in this study, taken from a normal Swedish population, were mainly sensitized to grass pollen and rarely to specific food allergens. The major grass pollen allergen Phl p 1 was the main sensitizer, followed by Cyn d 1 and Phl p 2. Sixty-one percent reporting any allergic symptom were sensitized, and the allergen components associated with wheeze and rhinoconjunctivitis were Fel d 4, Der f 2 and Can f 5.
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Barbone F, Catelan D, Pistelli R, Accetta G, Grechi D, Rusconi F, Biggeri A. A Panel Study on Lung Function and Bronchial Inflammation among Children Exposed to Ambient SO₂ from an Oil Refinery. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16061057. [PMID: 30909566 PMCID: PMC6466338 DOI: 10.3390/ijerph16061057] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 03/12/2019] [Accepted: 03/15/2019] [Indexed: 11/16/2022]
Abstract
To determine the acute effects on respiratory function of children exposed to sulphur dioxide (SO2), we conducted two population-based longitudinal investigations near a major oil refinery. We enrolled 233 children, age 8–14, in Sarroch (Italy). The first study entailed five monthly spirometric visits (Panel 5). In a subgroup, children positive for history of respiratory symptoms were tested weekly (20 times) with spirometry and fractional exhaled nitric oxide (FeNO) measurement (Panel 20). Baseline questionnaires and daily diaries were recorded. SO2, NO2, PM10 and O3 were measured by monitoring stations. Multiple regression models were fitted. Using a multipollutant model, we found that a 10 µg/m3 SO2 increase at lag0–2 days determined a percent variation (PV) of −3.37 (90% confidence interval, CI: −5.39; −1.30) for forced expiratory volume after one second (FEV1) in Panel 5 and a PV = −3.51 (90% CI: −4.77; −2.23) in Panel 20. We found a strong dose-response relation: 1-h SO2 peaks >200 µg/m3 at lag2 days = FEV1 PV −2.49. For FeNO, we found a PV = 38.12 (90% CI: 12.88; 69.01) for each 10 µg/m3 SO2 increase at 8-h time lag and a strong dose-response relation. Exposure to SO2 is strongly associated with reduction of lung function and an increase in airway inflammation. This new evidence of harmful effects of SO2 peaks should induce regulatory intervention.
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Affiliation(s)
- Fabio Barbone
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, via dell'Istria 65/1, 34137 Trieste, Italy.
| | - Dolores Catelan
- Department of Statistics, Computer Science, Applications "G. Parenti" University of Florence, Viale Morgagni, 59, 50134 Firenze, Italy.
| | - Riccardo Pistelli
- School of Respiratory Medicine, Sacro Cuore University, Largo Francesco Vito 1, 00168 Rome, Italy.
| | - Gabriele Accetta
- Department of Statistics, Computer Science, Applications "G. Parenti" University of Florence, Viale Morgagni, 59, 50134 Firenze, Italy.
| | - Daniele Grechi
- Epidemiologia e Prevenzione, no profit social enterprise, via Ricciarelli 29, 20148 Milan, Italy.
| | - Franca Rusconi
- Unit of Epidemiology, "Anna Meyer" Children's University Hospital, Viale Pieraccini 24, 50139 Florence, Italy.
| | - Annibale Biggeri
- Department of Statistics, Computer Science, Applications "G. Parenti" University of Florence, Viale Morgagni, 59, 50134 Firenze, Italy.
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Williams AM, Phaneuf DJ, Barrett MA, Su JG. Short-term impact of PM 2.5 on contemporaneous asthma medication use: Behavior and the value of pollution reductions. Proc Natl Acad Sci U S A 2019; 116:5246-5253. [PMID: 30478054 PMCID: PMC6431208 DOI: 10.1073/pnas.1805647115] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Asthma ranks among the most costly of chronic diseases, accounting for over $50 billion annually in direct medical expenditures in the United States. At the same time, evidence has accumulated that fine particulate matter pollution can exacerbate asthma symptoms and generate substantial economic costs. To measure these costs, we use a unique nationwide panel dataset tracking asthmatic individuals' use of rescue medication and their exposure to PM2.5 (particulate matter with an aerodynamic diameter of <2.5 μm) concentration between 2012 and 2017, to estimate the causal relationship between pollution and inhaler use. Our sample consists of individuals using an asthma digital health platform, which relies on a wireless sensor to track the place and time of inhaler use events, as well as regular nonevent location and time indicators. These data provide an accurate measurement of inhaler use and allow spatially and temporally resolute assignment of pollution exposure. Using a high-frequency research design and individual fixed effects, we find that a 1 μg/m3 (12%) increase in weekly exposure to PM2.5 increases weekly inhaler use by 0.82%. We also show that there is seasonal, regional, and income-based heterogeneity in this response. Using our response prediction, and an estimate from the literature on the willingness to pay to avoid asthma symptoms, we show that a nationwide 1 μg/m3 reduction in particulate matter concentration would generate nearly $350 million annually in economic benefits.
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Affiliation(s)
- Austin M Williams
- Department of Agricultural and Applied Economics, University of Wisconsin-Madison, Madison, WI 53706
| | - Daniel J Phaneuf
- Department of Agricultural and Applied Economics, University of Wisconsin-Madison, Madison, WI 53706;
| | - Meredith A Barrett
- Clinical & Population Health Research, Propeller Health, San Francisco, CA 94108
| | - Jason G Su
- Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA 94720
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Air pollution in India and related adverse respiratory health effects: past, present, and future directions. Curr Opin Pulm Med 2019; 24:108-116. [PMID: 29300211 DOI: 10.1097/mcp.0000000000000463] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
PURPOSE OF REVIEW The review describes current status of air pollution in India, summarizes recent research on adverse health effects of ambient and household air pollution, and outlines the ongoing efforts and future actions required to improve air quality and reduce morbidity and mortality because of air pollution in India. RECENT FINDINGS Global burden of disease data analysis reveals more than one million premature deaths attributable to ambient air pollution in 2015 in India. More than one million additional deaths can be attributed to household air pollution. Particulate matter with diameter 2.5 μm or less has been causatively linked with most premature deaths. Acute respiratory tract infections, asthma, chronic obstructive pulmonary disease, exacerbations of preexisting obstructive airway disease and lung cancer are proven adverse respiratory effects of air pollution. Targeting air quality standards laid by WHO can significantly reduce morbidity and mortality because of air pollution in India. SUMMARY India is currently exposed to high levels of ambient and household air pollutants. Respiratory adverse effects of air pollution are significant contributors to morbidity and premature mortality in India. Substantial efforts are being made at legislative, administrative, and community levels to improve air quality. However, much more needs to be done to change the 'status quo' and attain the target air quality standards. VIDEO ABSTRACT: http://links.lww.com/COPM/A24.
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Kuo CY, Chan CK, Wu CY, Phan DV, Chan CL. The Short-Term Effects of Ambient Air Pollutants on Childhood Asthma Hospitalization in Taiwan: A National Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16020203. [PMID: 30642061 PMCID: PMC6351918 DOI: 10.3390/ijerph16020203] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 01/05/2019] [Accepted: 01/08/2019] [Indexed: 12/27/2022]
Abstract
This investigation determined the effects of air pollution on childhood asthma hospitalization in regions with differing air pollution levels in Taiwan over a long time period. Data of childhood hospital admissions for asthma in patients aged 0–18 years and air quality in eight regions for the period 2001–2012 in Taiwan were collected. Poisson generalized linear regression analysis was employed to identify the relative risks of hospitalization due to asthma in children associated with exposure to varying levels of air pollutants with a change in the interquartile range after adjusting for temperature and relative humidity. Particulate matter ≤2.5 μm (PM2.5), particulate matter ≤10 μm (PM10), ozone (O3), sulfur dioxide (SO2), and nitrogen dioxide (NO2), were positively associated with childhood asthma hospitalization, while O3 was negatively associated with childhood asthma hospitalization. SO2 was identified as the most significant risk factor. The relative risks for asthma hospitalization associated with air pollutants were higher among children aged 0–5 years than aged 6–18 years and were higher among males than females. The effects of air pollution on childhood asthma were greater in the higher-level air pollution regions, while no association was observed in the lower-level air pollution regions. These findings may prove important for policymakers involved in implementing policies to reduce air pollution.
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Affiliation(s)
- Ching-Yen Kuo
- Department of Information Management, Yuan Ze University, 135 Yuan-Tung Road, Jung-Li, Taoyuan 320, Taiwan.
- Department of Medical Administration, Taoyuan General Hospital, Ministry of Health and Welfare, 1492 Zhongshan Road, Taoyuan Dist., Taoyuan 330, Taiwan.
| | - Chin-Kan Chan
- Department of Pediatrics, Taoyuan General Hospital, Ministry of Health and Welfare, 1492 Zhongshan Road, Taoyuan Dist., Taoyuan 330, Taiwan.
- Department of Biotechnology, Ming Chuan University, 5 De Ming Road, Gui Shan Dist., Taoyuan 333, Taiwan.
| | - Chiung-Yi Wu
- Department of Information Management, Yuan Ze University, 135 Yuan-Tung Road, Jung-Li, Taoyuan 320, Taiwan.
| | - Dinh-Van Phan
- Department of Information Management, Yuan Ze University, 135 Yuan-Tung Road, Jung-Li, Taoyuan 320, Taiwan.
- Innovation Center for Big Data and Digital Convergence, Yuan Ze University, 135 Yuan-Tung Road, Jung-Li, Taoyuan 320, Taiwan.
- University of Economics, The University of Danang, 71 Ngu Hanh Son Street, Danang 550000, Vietnam.
| | - Chien-Lung Chan
- Department of Information Management, Yuan Ze University, 135 Yuan-Tung Road, Jung-Li, Taoyuan 320, Taiwan.
- Innovation Center for Big Data and Digital Convergence, Yuan Ze University, 135 Yuan-Tung Road, Jung-Li, Taoyuan 320, Taiwan.
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245
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The Role of the Microbiome in Asthma: The Gut⁻Lung Axis. Int J Mol Sci 2018; 20:ijms20010123. [PMID: 30598019 PMCID: PMC6337651 DOI: 10.3390/ijms20010123] [Citation(s) in RCA: 144] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Revised: 12/22/2018] [Accepted: 12/27/2018] [Indexed: 12/14/2022] Open
Abstract
Asthma is one of the most common chronic respiratory diseases worldwide. It affects all ages but frequently begins in childhood. Initiation and exacerbations may depend on individual susceptibility, viral infections, allergen exposure, tobacco smoke exposure, and outdoor air pollution. The aim of this review was to analyze the role of the gut⁻lung axis in asthma development, considering all asthma phenotypes, and to evaluate whether microbe-based therapies may be used for asthma prevention. Several studies have confirmed the role of microbiota in the regulation of immune function and the development of atopy and asthma. These clinical conditions have apparent roots in an insufficiency of early life exposure to the diverse environmental microbiota necessary to ensure colonization of the gastrointestinal and/or respiratory tracts. Commensal microbes are necessary for the induction of a balanced, tolerogenic immune system. The identification of commensal bacteria in both the gastroenteric and respiratory tracts could be an innovative and important issue. In conclusion, the function of microbiota in healthy immune response is generally acknowledged, and gut dysbacteriosis might result in chronic inflammatory respiratory disorders, particularly asthma. Further investigations are needed to improve our understanding of the role of the microbiome in inflammation and its influence on important risk factors for asthma, including tobacco smoke and host genetic features.
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246
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Sakurai H, Morishima Y, Ishii Y, Yoshida K, Nakajima M, Tsunoda Y, Hayashi SY, Kiwamoto T, Matsuno Y, Kawaguchi M, Yamamoto M, Hizawa N. Sulforaphane ameliorates steroid insensitivity through an Nrf2-dependent pathway in cigarette smoke-exposed asthmatic mice. Free Radic Biol Med 2018; 129:473-485. [PMID: 30312763 DOI: 10.1016/j.freeradbiomed.2018.10.400] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 09/28/2018] [Accepted: 10/02/2018] [Indexed: 12/17/2022]
Abstract
Oxidative stress induced by cigarette smoke and other environmental pollutants contributes to refractory asthma. To better understand the role of smoking in asthma, we investigated the effects of cigarette smoke on allergic airway responses in mice and examined expression of nuclear factor-E2-related factor-2 (Nrf2) and its downstream factors, because Nrf2 is known to play a pivotal role in antioxidant responses. OVA-sensitized and challenged BALB/c mice were exposed to cigarette smoke and then treated with dexamethasone, sulforaphane (an activator of Nrf2), or their combination. Upon exposure to cigarette smoke, Nrf2 and associated transcripts were upregulated in response to oxidative stress, and asthmatic responses were steroid resistant. In OVA-sensitized and challenged mice exposed to cigarette smoke and treated with sulforaphane, Nrf2-mediated antioxidant responses were upregulated to a greater extent, and steroid sensitivity of asthmatic responses was restored. Moreover, the expression and activity of histone deacetylase 2 (HDAC2), a key regulator of steroid responsiveness, was reduced in mice exposed to cigarette smoke, but restored by sulforaphane treatment. No effects of sulforaphane were observed in Nrf2-deficient mice. These findings indicate that cigarette smoke induces steroid unresponsiveness in asthmatic airways, and that sulforaphane restores steroid sensitivity via upregulation of Nrf2 and enhancement of HDAC2 expression and activity. Thus, Nrf2 may serve as a potential molecular target for cigarette smoke-related refractory asthma resistant to steroid therapy.
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Affiliation(s)
- Hirofumi Sakurai
- Department of Pulmonary Medicine, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki 305-8575, Japan
| | - Yuko Morishima
- Department of Pulmonary Medicine, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki 305-8575, Japan.
| | - Yukio Ishii
- Department of Pulmonary Medicine, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki 305-8575, Japan
| | - Kazufumi Yoshida
- Department of Pulmonary Medicine, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki 305-8575, Japan
| | - Masayuki Nakajima
- Department of Pulmonary Medicine, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki 305-8575, Japan
| | - Yoshiya Tsunoda
- Department of Pulmonary Medicine, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki 305-8575, Japan
| | - Shih-Yuan Hayashi
- Department of Pulmonary Medicine, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki 305-8575, Japan
| | - Takumi Kiwamoto
- Department of Pulmonary Medicine, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki 305-8575, Japan
| | - Yosuke Matsuno
- Department of Pulmonary Medicine, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki 305-8575, Japan
| | - Mio Kawaguchi
- Department of Pulmonary Medicine, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki 305-8575, Japan
| | - Masayuki Yamamoto
- Department of Medical Biochemistry, Tohoku University Graduate School of Medicine, 2-1 Seiryo-cho, Aoba-ku, Sendai, Miyagi 980-8575, Japan
| | - Nobuyuki Hizawa
- Department of Pulmonary Medicine, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki 305-8575, Japan
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Esden J, Pesta-Walsh N. Diagnosis and Treatment of Asthma in Nonpregnant Women. J Midwifery Womens Health 2018; 64:18-27. [PMID: 30484945 DOI: 10.1111/jmwh.12907] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 08/07/2018] [Accepted: 08/08/2018] [Indexed: 11/28/2022]
Abstract
Asthma is a common condition affecting 8.3% of the adult population in the United States. The disease is characterized by chronic airway inflammation that leads to airway hyperresponsiveness and obstruction that results in coughing, wheezing, shortness of breath, and a feeling of chest tightness. The diagnosis and classification of asthma is based on reported symptoms, physical examination findings, and spirometry. Pharmacologic therapy is prescribed using a stepwise approach that begins with inhaled short-acting beta2 -agonists for intermittent asthma with the addition of daily inhaled corticosteroids for more persistent cases. Individuals with asthma are reevaluated on a regular basis to monitor symptoms, and pharmacologic treatments are adjusted as needed. Familiarity with the stepwise approach for asthma management and confidence in the efficacy and safety profiles of inhaled medications will assist clinicians in successful management of asthma in the primary care setting.
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248
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Hyphae fragments from A. fumigatus sensitize lung cells to silica particles (Min-U-Sil): Increased release of IL-1β. Toxicol In Vitro 2018; 55:1-10. [PMID: 30414920 DOI: 10.1016/j.tiv.2018.11.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 10/30/2018] [Accepted: 11/05/2018] [Indexed: 12/16/2022]
Abstract
Exposure to particulate matter (PM), such as mineral particles and biological particles/components may be linked to aggravation of respiratory diseases, including asthma. Here we report that exposure to Aspergillus fumigatus hyphae fragments (AFH) and lipopolysaccharide (LPS) induced both mRNA synthesis and release of pro-inflammatory interleukin-1 beta (IL-1β) in both human THP-1 monocytes (THP-1 Mo) and phorbol 12-myristate 13-acetate (PMA)-differentiated THP-1 monocytes (THP-1 macrophages; THP-1 Ma); while Min-U-Sil alone enhanced the release of IL-1β only in THP-1 Ma. Co-exposure to LPS or AFH with Min-U-Sil caused a synergistic release of IL-1β when compared to single exposures. In contrast, Min-U-Sil did not markedly change LPS- and AFH-induced release of tumor necrosis factor alpha (TNF-α). The combined exposures did not increase the LPS- and AFH-induced expression of IL-1β mRNA. Notably, the AFH- and LPS-induced IL-1β responses with and without co-exposure to Min-U-Sil in THP-1 Mo were found to be caspase-dependent as shown by inhibition with zYVAD-fmk. Furthermore, co-exposure with AFH and Min-U-Sil resulted in similar synergistic releases of IL-1β in primary human airway macrophages (AM; sputum), peripheral blood monocyte-derived macrophages (MDM) and in the human bronchial epithelial cell line (BEAS-2B). In conclusion, AFH induce both the synthesis and release of IL-1β. However, Min-U-Sil further enhanced the cleavage of the induced pro-IL-1β.
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249
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Yang SI. Particulate matter and childhood allergic diseases. KOREAN JOURNAL OF PEDIATRICS 2018; 62:22-29. [PMID: 30404430 PMCID: PMC6351801 DOI: 10.3345/kjp.2018.07045] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Accepted: 11/06/2018] [Indexed: 01/08/2023]
Abstract
Particulate matter (PM) is a ubiquitous air pollutant that is a growing public health concern. Previous studies have suggested that PM is associated with asthma development and exacerbation of asthma symptoms. Although several studies have suggested increased risks of atopic dermatitis, allergic rhinitis, and allergic sensitization in relation to PM exposure, the evidence remains inconsistent. The plausible mechanisms underlying these effects are related to oxidative stress, enhancement of sensitization to allergens, inflammatory and immunological responses, and epigenetics. This review discusses the effect of PM on childhood allergic diseases, along with plausible mechanisms. Further studies are required to understand the role of PM exposure on childhood allergic diseases, to reduce these diseases in children.
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Affiliation(s)
- Song-I Yang
- Department of Pediatrics, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea
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250
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Yu S, Park S, Park CS, Kim S. Association between the Ratio of FEV₁ to FVC and the Exposure Level to Air Pollution in Neversmoking Adult Refractory Asthmatics Using Data Clustered by Patient in the Soonchunhyang Asthma Cohort Database. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E2349. [PMID: 30356011 PMCID: PMC6266833 DOI: 10.3390/ijerph15112349] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 09/24/2018] [Accepted: 10/18/2018] [Indexed: 01/21/2023]
Abstract
Using real-world cases, asthma-related clinical data were clustered by patient; 5% of all asthmatics were found to have refractory asthma (RA) with a relatively low lung function (forced expiratory volume in 1 s/forced vital capacity (FEV₁/FVC) less than 80%). Using a multilevel study design for clustered spirometry data observed between 2005 and 2014, we evaluated the association between changes in the ratio of FEV₁ to FVC and variations in acute exposure to air pollution. We analyzed 2310 episodes of RA from 214 neversmoking patients. In spring, a 1 µg/m³ increase in concentration of particles ≤10 μm (PM10) on Lag 1 significantly reduced the ratio by 0.4% (95% confidence interval (CI): 0.1⁻0.7%) after adjusting for sex, age, body mass index (BMI), and total Immunoglobulin E (IgE) level. Unit (ppb) increase in SO₂ concentration on Lag 3 and 4 in fall and on Lag 6 in winter significantly reduced the ratio by 2 to 3% (p < 0.05). We found that acute exposure to PM10 in spring or SO₂ in fall or winter were positively associated with lung function drop indicating necessity of control strategies of target air pollutant source by season to protect susceptible population.
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Affiliation(s)
- Sol Yu
- Department of Environmental Sciences, Soonchunhyang University, Asan 31538, Korea.
- Division of Environmental Health Research, National Institute of Environmental Research, Incheon 22689, Korea.
| | - Sujung Park
- Department of Environmental Sciences, Soonchunhyang University, Asan 31538, Korea.
| | - Choon-Sik Park
- Department of Internal Medicine, Soonchunhyang Bocheon Hospital, Bucheon 22972, Korea.
| | - Sungroul Kim
- Department of Environmental Sciences, Soonchunhyang University, Asan 31538, Korea.
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