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Kaspersen KA, Antonsen S, Horsdal HT, Kjerulff B, Brandt J, Geels C, Christensen JH, Frohn LM, Sabel CE, Dinh KM, Hertel O, Sigsgaard T, Pedersen CB, Erikstrup C. Exposure to air pollution and risk of respiratory tract infections in the adult Danish population-a nationwide study. Clin Microbiol Infect 2024; 30:122-129. [PMID: 37858866 DOI: 10.1016/j.cmi.2023.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 09/22/2023] [Accepted: 10/12/2023] [Indexed: 10/21/2023]
Abstract
OBJECTIVES The association between air pollution and risk of respiratory tract infection (RTI) in adults needs to be clarified in settings with low to moderate levels of air pollution. We investigated this in the Danish population between 2004 and 2016. METHODS We included 3 653 490 persons aged 18-64 years in a nested case-control study. Exposure was defined as the average daily concentration at the individual's residential address of CO, NOX, NO2, O3, SO2, NH3, PPM2.5, black carbon, organic carbon, mineral dust, sea salt, secondary inorganic aerosols, SO42-, NO3-, NH4+, secondary organic aerosols, PM2.5, and PM10 during a 3-month exposure window. RTIs were defined by hospitalization for RTIs. Incidence rate ratios (IRRs) and 95% CIs were estimated comparing highest with lowest decile of exposure using conditional logistic regression models. RESULTS In total, 188 439 incident cases of RTI were identified. Exposure to most air pollutants was positively associated with risk of RTI. For example, NO2 showed an IRR of 1.52 (CI: 1.48-1.55), and PM2.5 showed an IRR of 1.45 (CI: 1.40-1.50). In contrast, exposure to sea salt, PM10, NH3, and O3 was negatively associated with a risk of RTIs. DISCUSSION In this nationwide study comprising adults, exposure to air pollution was associated with risk of RTIs and subgroups hereof. Sea salt, PM10, NH3, and O3 may be proxies for rural areas, as the levels of these species in Denmark are higher near the western coastlines and/or in rural areas with fewer combustion sources.
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Affiliation(s)
- Kathrine A Kaspersen
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus N, Denmark; Danish Big Data Centre for Environment and Health (BERTHA), Aarhus University, Aarhus C, Denmark.
| | - Sussie Antonsen
- Danish Big Data Centre for Environment and Health (BERTHA), Aarhus University, Aarhus C, Denmark; National Centre for Register-based Research, Aarhus BSS, Aarhus University, Aarhus V, Denmark; Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark
| | - Henriette T Horsdal
- Danish Big Data Centre for Environment and Health (BERTHA), Aarhus University, Aarhus C, Denmark; National Centre for Register-based Research, Aarhus BSS, Aarhus University, Aarhus V, Denmark
| | - Bertram Kjerulff
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus N, Denmark; Danish Big Data Centre for Environment and Health (BERTHA), Aarhus University, Aarhus C, Denmark
| | - Jørgen Brandt
- Department of Environmental Science, Aarhus University, Roskilde, Denmark; iClimate - Interdisciplinary Centre for Climate Change, Aarhus University, Roskilde, Denmark
| | - Camilla Geels
- Department of Environmental Science, Aarhus University, Roskilde, Denmark; iClimate - Interdisciplinary Centre for Climate Change, Aarhus University, Roskilde, Denmark
| | | | - Lise M Frohn
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Clive E Sabel
- Danish Big Data Centre for Environment and Health (BERTHA), Aarhus University, Aarhus C, Denmark; Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark; Department of Public Health, Aarhus University, Aarhus, Denmark; Health Research Institute, University of Canberra, Canberra, ACT, Australia
| | - Khoa M Dinh
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus N, Denmark
| | - Ole Hertel
- Danish Big Data Centre for Environment and Health (BERTHA), Aarhus University, Aarhus C, Denmark; Department of Ecoscience, Aarhus University, Roskilde, Denmark
| | - Torben Sigsgaard
- Danish Big Data Centre for Environment and Health (BERTHA), Aarhus University, Aarhus C, Denmark; Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark; Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Carsten B Pedersen
- Danish Big Data Centre for Environment and Health (BERTHA), Aarhus University, Aarhus C, Denmark; National Centre for Register-based Research, Aarhus BSS, Aarhus University, Aarhus V, Denmark; Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark
| | - Christian Erikstrup
- Department of Clinical Immunology, Aarhus University Hospital, Aarhus N, Denmark; Danish Big Data Centre for Environment and Health (BERTHA), Aarhus University, Aarhus C, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus C, Denmark
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Dondi A, Manieri E, Betti L, Dormi A, Carbone C, Biagi C, Pierantoni L, Zama D, Paglione M, Lanari M. Exposure to outdoor air pollution and risk of hospitalization for bronchiolitis in an urban environment: A 9-year observational study. Pediatr Pulmonol 2023; 58:2786-2794. [PMID: 37378432 DOI: 10.1002/ppul.26583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 06/13/2023] [Accepted: 06/20/2023] [Indexed: 06/29/2023]
Abstract
BACKGROUND Outdoor air pollution is supposed to influence the course of bronchiolitis, but the evidence is limited. The present study aimed at evaluating the role of outdoor air pollutants on hospitalization for bronchiolitis. METHODS Infants aged ≤12 months referred for bronchiolitis to our Pediatric Emergency Department in Bologna, Italy, from 1 October 2011 to 16 March 2020 (nine epidemic seasons) were retrospectively included. Daily concentrations of benzene (C6 H6 ), nitrogen dioxide (NO2 ), particulate matter ≤2.5 μm (PM2.5 ), and ≤10 μm (PM10 ), and the mean values of individual patient exposure in the week and the 4 weeks before hospital access were calculated. The association between air pollutants exposure and hospitalization was evaluated through logistic regression analysis. RESULTS A total of 2902 patients were enrolled (59.9% males; 38.7% hospitalized). Exposure to PM2.5 in the 4 weeks preceding bronchiolitis was identified as the main parameter significantly driving the risk of hospitalization (odds ratio [95% confidence interval]: 1.055 [1.010-1.102]). After stratifying by season, higher values of other outdoor air pollutants were found to significantly affect hospitalization: 4-week exposure to C6 H6 (Season 2011-2012, 4.090 [1.184-14.130]) and PM2.5 (Season 2017-2018, 1.282 [1.032-1.593]), and 1-week exposure to C6 H6 (Season 2012-2013, 6.193 [1.552-24.710]), NO2 (Season 2013-2014, 1.064 [1.009-1.122]), PM2.5 (Season 2013-2014, 1.080 [1.023-1.141]), and PM10 (Season 2018-2019, 1.102 [0.991-1.225]). CONCLUSION High levels of PM2.5 , C6 H6 , NO2 , and PM10 may increase the risk of hospitalization in children affected by bronchiolitis. Open-air exposure of infants during rush hours and in the most polluted areas should be avoided.
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Affiliation(s)
- Arianna Dondi
- Pediatric Emergency Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Elisa Manieri
- Specialty School of Paediatrics, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Ludovica Betti
- Specialty School of Paediatrics, Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Ada Dormi
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Claudio Carbone
- Italian National Agency for New Technologies, Energy and Sustainable Economic Development (ENEA), Bologna, Italy
| | - Carlotta Biagi
- Pediatric Emergency Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Luca Pierantoni
- Pediatric Emergency Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Daniele Zama
- Pediatric Emergency Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Marco Paglione
- Italian National Research Council-Institute of Atmospheric Sciences and Climate (CNR-ISAC), Bologna, Italy
| | - Marcello Lanari
- Pediatric Emergency Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
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Ünal E, Özdemir A, Khanjani N, Dastoorpoor M, Özkaya G. Air pollution and pediatric respiratory hospital admissions in Bursa, Turkey: A time series study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2022; 32:2767-2780. [PMID: 34641701 DOI: 10.1080/09603123.2021.1991282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 10/06/2021] [Indexed: 06/13/2023]
Abstract
We aimed to investigate the relation between air pollution and the number of daily hospitalizations due to pneumonia, asthma, bronchitis in children aged 0-18 in Bursa city of Turkey, between the years 2013-2018. The daily values of air pollutants (PM10, SO2, NO2, NOx, CO, and O3) from 2013 until 2018, were obtained. Adjusted Quasi-Poisson regression models including distributed lags, controlled for climate variables were used for data analysis. Increases in SO2, ozone, PMs, and nitrogen oxides were associated with pneumonia hospitalizations, increases in SO2 NOx and PMs were associated with asthma hospitalizations, and increases in SO2 and ozone were associated with bronchitis hospitalizations. Male hospitalization was related with SO2, ozone, and NOx; while female hospitalization was only related with SO2. This study showed that short-term exposure to air pollution is associated with an increased risk of pneumonia, asthma, and bronchitis hospitalization among children in Bursa.
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Affiliation(s)
- Eda Ünal
- Department of Nursing, Bursa Uludag University Institute of Health Sciences, Bursa, Turkey
| | - Aysel Özdemir
- Department of Public Health Nursing, Bursa Uludag University, Faculty of Health Sciences, Bursa, Turkey
| | - Narges Khanjani
- Environmental Health Engineering Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Maryam Dastoorpoor
- Department of Biostatistics and Epidemiology, Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Güven Özkaya
- Department of Biostatistics, Bursa Uludag University Medical Faculty, Bursa, Turkey
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Gheissari R, Liao J, Garcia E, Pavlovic N, Gilliland FD, Xiang AH, Chen Z. Health Outcomes in Children Associated with Prenatal and Early-Life Exposures to Air Pollution: A Narrative Review. TOXICS 2022; 10:toxics10080458. [PMID: 36006137 PMCID: PMC9415268 DOI: 10.3390/toxics10080458] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 07/25/2022] [Accepted: 08/03/2022] [Indexed: 06/04/2023]
Abstract
(1) Background: The developmental origins of health and disease (DOHaD) hypothesis links adverse fetal exposures with developmental mal-adaptations and morbidity later in life. Short- and long-term exposures to air pollutants are known contributors to health outcomes; however, the potential for developmental health effects of air pollution exposures during gestation or early-childhood have yet to be reviewed and synthesized from a DOHaD lens. The objective of this study is to summarize the literature on cardiovascular and metabolic, respiratory, allergic, and neuropsychological health outcomes, from prenatal development through early childhood, associated with early-life exposures to outdoor air pollutants, including traffic-related and wildfire-generated air pollutants. (2) Methods: We conducted a search using PubMed and the references of articles previously known to the authors. We selected papers that investigated health outcomes during fetal or childhood development in association with early-life ambient or source-specific air pollution exposure. (3) Results: The current literature reports that prenatal and early-childhood exposures to ambient and traffic-related air pollutants are associated with a range of adverse outcomes in early life, including cardiovascular and metabolic, respiratory and allergic, and neurodevelopmental outcomes. Very few studies have investigated associations between wildfire-related air pollution exposure and health outcomes during prenatal, postnatal, or childhood development. (4) Conclusion: Evidence from January 2000 to January 2022 supports a role for prenatal and early-childhood air pollution exposures adversely affecting health outcomes during development. Future studies are needed to identify both detrimental air pollutants from the exposure mixture and critical exposure time periods, investigate emerging exposure sources such as wildfire, and develop feasible interventional tools.
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Affiliation(s)
- Roya Gheissari
- Department of Population and Public Health Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, CA 90033, USA
| | - Jiawen Liao
- Department of Population and Public Health Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, CA 90033, USA
| | - Erika Garcia
- Department of Population and Public Health Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, CA 90033, USA
| | - Nathan Pavlovic
- Sonoma Technology Inc., 1450 N. McDowell Blvd., Suite 200, Petaluma, CA 94954, USA
| | - Frank D. Gilliland
- Department of Population and Public Health Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, CA 90033, USA
| | - Anny H. Xiang
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA 91107, USA
| | - Zhanghua Chen
- Department of Population and Public Health Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, CA 90033, USA
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Ormeño Illanes JCR, Quevedo Langenegger I. Higher latitude and lower solar radiation influence on hip fracture admissions in Chilean older population. Osteoporos Int 2021; 32:2033-2041. [PMID: 33818634 DOI: 10.1007/s00198-021-05910-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 03/03/2021] [Indexed: 12/25/2022]
Abstract
UNLABELLED Data linking solar radiation with fractures are lacking. We found that lower solar radiation was associated with higher hip fracture admission rates in men from Chile. This supports the idea that solar radiation, a surrogate of vitamin D, may be involved in the development of fractures in older population. INTRODUCTION : To explore the associations between solar radiation and latitude with hip fracture admission rates in people aged 65 years or older in Chile, the country with the greatest variation in solar radiation in the world. METHODS In this ecological study, we investigated the associations between regional solar radiation and latitude with hospitalizations due to hip fracture in population aged 65 years or older, by reviewing national records between 2013 and 2018. We also evaluated the role of sociodemographic factors such as poverty, education, indigenous ethnicity, and rurality rates. RESULTS Between 2013 and 2018, there were 44,328 admissions due to hip fracture in people aged 65 years or older; 77.5% were women and 65.1% were aged 80 years or older. The national admission rate was 389.3 per 100,000 inhabitants (95% CI: 382.4-396.2). The highest admission rate was registered in the Region IX (445.3 per 100,000, 95% CI: 398.3-492.4), which has the highest poverty rates, indigenous ethnicity rates, and rurality rates. We found a north-south increasing gradient of admission rates in men (β=1.5 [95% CI: 0 to 3], p=0.044) and a significant association between solar radiation and admission rates in men (β=-4.4 [95% CI: -8 to 0.8], p=0.02). Admission rates in men were also associated with sociodemographic variables such as poverty (β=2.4 [95% CI: 0 to 4.8], p=0.048) and rurality rates (β=1.2 [95% CI: 0.1 to 2.4], p=0.039). CONCLUSION Regional solar radiation and latitude were associated with hip fracture admission rates in men aged 65 years or older in Chile, with highest admission rates at higher latitudes and lower solar radiation.
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Affiliation(s)
| | - I Quevedo Langenegger
- Endocrinology Section, Department of Internal Medicine, School of Medicine, University of Concepción, Concepción, Chile
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Zaffanello M, Ferrante G, Fasola S, Piazza M, Piacentini G, La Grutta S. Personal and Environmental Risk Factors at Birth and Hospital Admission: Direct and Vitamin D-Mediated Effects on Bronchiolitis Hospitalization in Italian Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:E747. [PMID: 33477251 PMCID: PMC7829957 DOI: 10.3390/ijerph18020747] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/14/2021] [Accepted: 01/15/2021] [Indexed: 12/16/2022]
Abstract
Seasonal variations in UV-B radiation may influence vitamin D status, and this, in turn, may influence the risk of bronchiolitis hospitalization. The aim of this study was using a causal inference approach to investigate, simultaneously, the interrelationships between personal and environmental risk factors at birth/hospital admission (RFBH), serum vitamin D levels and bronchiolitis hospitalization. A total of 63 children (<2 years old) hospitalized for bronchiolitis (34 RSV-positive) and 63 controls were consecutively enrolled (2014-2016). Vitamin D levels and some RFBH (birth season, birth weight, gestational age, gender, age, weight, hospitalization season) were recorded. The discovered RFBH effects on the risk ok bronchiolitis hospitalization were decomposed into direct and vitamin-D mediated ones through Mediation Analysis. Winter-spring season (vs. summer-autumn) was significantly associated with lower vitamin D levels (mean difference -11.14 nmol/L). Increasing serum vitamin D levels were significantly associated with a lower risk of bronchiolitis hospitalization (OR = 0.84 for a 10-nmol/L increase). Winter-spring season and gestational age (one-week increase) were significantly and directly associated with bronchiolitis hospitalization (OR = 6.37 and OR = 0.78 respectively), while vitamin D-mediated effects were negligible (1.21 and 1.02 respectively). Using a comprehensive causal approach may enhance the understanding of the complex interrelationships among RFBH, vitamin D and bronchiolitis hospitalization.
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Affiliation(s)
- Marco Zaffanello
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, 37126 Verona, Italy; (M.Z.); (M.P.); (G.P.)
| | - Giuliana Ferrante
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90127 Palermo, Italy;
| | - Salvatore Fasola
- Institute for Biomedical Research and Innovation, National Research Council, 90146 Palermo, Italy;
| | - Michele Piazza
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, 37126 Verona, Italy; (M.Z.); (M.P.); (G.P.)
| | - Giorgio Piacentini
- Department of Surgery, Dentistry, Paediatrics and Gynaecology, University of Verona, 37126 Verona, Italy; (M.Z.); (M.P.); (G.P.)
| | - Stefania La Grutta
- Institute for Biomedical Research and Innovation, National Research Council, 90146 Palermo, Italy;
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