Temporal trends in respiratory mortality and short-term effects of air pollutants in Shenyang, China

Cancer mortality risk from short-term PM2.5 exposure and temporal variations in Brazil

Although some studies have found that short-term PM2.5 exposure is associated with lung cancer deaths, its impact on other cancer sites is unclear. To answer this research question, this time-stratified case-crossover study used individual cancer death data between January 1, 2000, and December 31, 2019, extracted from the Brazilian mortality information system to quantify the associations between short-term PM2.5 exposure and cancer mortality from 25 common cancer sites. Daily PM2.5 concentration was aggregated at the municipality level as the key exposure. The study included a total of 34,516,120 individual death records, with the national daily mean PM2.5 exposure 15.3 (SD 4.3) μg/m3. For every 10-μg/m3 increase in three-day average PM2.5 exposure, the odds ratio (OR) for all-cancer mortality was 1.04 (95% CI 1.03-1.04). Apart from all-cancer deaths, PM2.5 exposure may impact cancers of oesophagus (1.04, 1.00-1.08), stomach (1.05, 1.02-1.08), colon-rectum (1.04, 1.01-1.06), lung (1.04, 1.02-1.06), breast (1.03, 1.00-1.06), prostate (1.07, 1.04-1.10), and leukaemia (1.05, 1.01-1.09). During the study period, acute PM2.5 exposure contributed to an estimated 1,917,994 cancer deaths, ranging from 0 to 6,054 cases in each municipality. Though there has been a consistent downward trend in PM2.5-related all-cancer mortality risks from 2000 to 2019, the impact remains significant, indicating the continued importance of cancer patients avoiding PM2.5 exposure. This nationwide study revealed a notable association between acute PM2.5 exposure and heightened overall and site-specific cancer mortality for the first time to our best knowledge. The findings suggest the importance of considering strategies to minimize such exposure in cancer care guidelines. ENVIRONMENTAL IMPLICATION: The 20-year analysis of nationwide death records in Brazil revealed that heightened short-term exposure to PM2.5 is associated with increased cancer mortality at various sites, although this association has gradually decreased over time. Despite the declining impact, the research highlights the persistent adverse effects of PM2.5 on cancer mortality, emphasizing the importance of continued research and preventive measures to address the ongoing public health challenges posed by air pollution.

Short-term ozone exposure and cancer mortality in Brazil: A nationwide case-crossover study

Exposure to ambient ozone (O3) is linked to increased mortality risks from various diseases, but epidemiological investigations delving into its potential implications for cancer mortality are limited. We aimed to examine the association between short-term O3 exposure and site-specific cancer mortality and investigate vulnerable subgroups in Brazil. In total 3,459,826 cancer death records from 5570 Brazilian municipalities between 2000 and 2019, were included. Municipal average daily O3 concentration was calculated from a global estimation at 0.25°×0.25° spatial resolution. The time-stratified case-crossover design was applied to assess the O3-cancer mortality association. Subgroup analyses by age, sex, season, time-period, region, urban hierarchy, climate classification, quantiles of GDP per capita and illiteracy rates were performed. A linear and non-threshold exposure-response relationship was observed for short-term exposure to O3 with cancer mortality, with a 1.00% (95% CI: 0.79%-1.20%) increase in all-cancer mortality risks for each 10-μg/m3 increment of three-day average O3. Kidney cancer was most strongly with O3 exposure, followed by cancers of the prostate, stomach, breast, lymphoma, brain and lung. The associated cancer risks were relatively higher in the warm season and in southern Brazil, with a decreasing trend over time. When restricting O3 concentration to the national minimum value during 2000-2019, a total of 147,074 (116,690-177,451) cancer deaths could be avoided in Brazil, which included 17,836 (7014-28,653) lung cancer deaths. Notably, these associations persisted despite observed adaptation within the Brazilian population, highlighting the need for a focus on incorporating specific measures to mitigate O3 exposure into cancer care recommendations.

Source apportionment of fine aerosol particles of water-soluble and carbonaceous species measured in semi-urban (Kharagpur) and megacity (Kolkata) atmospheres over the eastern Indo-Gangetic plain: Chemical characterisation, relative abundance and anthropogenic contributions

We conducted the source apportionment of fine aerosol particles (aerodynamic diameter ≤1.6μm) collected with the indigenously designed-fabricated submicron aerosol sampler (SAS) in the eastern Indo-Gangetic plain (IGP) semi-urban (Kharagpur, KGP) and megacity (Kolkata, KOL) atmospheres, examining the chemical characteristics at KGP (January 2015-February 2016), and accentuating their abundance and the sources of anthropogenic pollution relative to KOL. The fine water-soluble inorganic ions (WSII) at KGP predominantly constituted Ca2+ (52 %) and equivalent amounts (12 % each) of Cl-, Mg2+ and secondary inorganic aerosols (sum of SO42-, NO3- and NH4+). The annual mean of SO42- at KGP was twice (thrice) larger than NO3- (NH4+); this of organic carbon (OC) was thrice elemental carbon (EC), with secondary OC being 37 % of the total OC. The concordance in peaks of OC with K+ concentrations was identified during the seasonal open biomass burning at KGP (November and May). While the annual mean of OC (EC) concentration at KGP was slightly lower than (nearly equivalent to) KOL; K+, NO3-, NH4+ and F- concentrations at KOL were twice larger than KGP. Source quantification using Positive Matrix Factorization (PMF) revealed the regional dust with crustal elements marked as clean (polluted) at KGP (KOL) constituted the largest fractional contribution among the six identified factors at both KGP and KOL. The combustion-derived anthropogenic pollution comprising about 60 % (50 %) of fine particles at KOL (KGP) was predominantly from the transportation sector (in vehicular emissions and regional dust), coal combustion (industries) and open biomass burning at KOL; it was from brick kilns, residential biofuel combustion, and open biomass burning at KGP. The source-wide distribution of measured aerosol species showed their emergence from largely different sources at KGP and KOL; thereby suggesting a prioritised strategy for sustainable emissions mitigation considering the prominent sources of combustion-derived anthropogenic pollution and aerosol species for megacity and semi-urban atmospheres.

Air pollution and cancer daily mortality in Hangzhou, China: an ecological research

BACKGROUND

Long-term exposure to air pollution has been linked to cancer incidence. However, the evidence is limited regarding the effect of short-term exposure to air pollution on cancer mortality.

OBJECTIVES

This study aimed to investigate associations between short-term exposure to air pollutants (sulfur dioxide (SO2), nitrogen dioxide (NO2), particulate matter with an aerodynamic diameter <10 mm (PM10) and PM2.5) and cancer daily mortality.

METHODS

This study used air quality, meteorological and daily cancer death data from 2014 to 2019 in Hangzhou, China. Generalised additive models (GAM) with quasi-Poisson regression were used to analyse the associations between air pollutants and cancer mortality with adjustment for confounding factors including time trends, day of week, temperature and humidity. Then, we conducted stratified analyses by sex, age, season and education. In addition, stratified analyses of age, season and education were performed within each sex to determine whether sex difference was modified by such factors.

RESULTS

After adjusting for potential confounders, the GAM results indicated a statistically significant relationship between increased cancer mortality and elevated air pollution concentrations, but only in the female population. For every 10 μg/m3 rise in pollutant concentration, the increased risk of cancer death in females was 6.82% (95% CI 3.63% to 10.10%) for SO2 on lag 03, and 2.02% (95% CI 1.12% to 2.93%) for NO2 on lag 01 and 0.89% (95% CI 0.46% to 1.33%) for PM10 on lag 03 and 1.29% (95% CI 0.64% to 1.95%) for PM2.5 on lag 03. However, no statistically significant association was found among males. Moreover, the differences in effect sizes between males and females were more pronounced during the cold season, among the elderly and among subjects with low levels of education.

CONCLUSIONS

Increased cancer mortality was only observed in females with rising concentrations of air pollutants. Further research is required to confirm this sex difference. Advocate for the reduction of air pollutant emissions to protect vulnerable groups.

Potential impact of ambient temperature on maternal blood pressure and hypertensive disorders of pregnancy: A nationwide multicenter study based on the China birth cohort

Limited evidence exists regarding the association between ambient temperature and blood pressure (BP) level of pregnant women. To investigate the associations of ambient temperature with maternal BP and hypertensive disorders of pregnancy (HDP), we studied 105,063 participants in 38 centers of 17 provinces from November 2017 to December 2021. BP was measured with standardized automated digital sphygmomanometers. Ambient temperature was classified into five classes as very hot, moderate hot, mild, moderate cold, and very cold. Generalized linear mixed models were used to investigate the ambient temperature-BP/HDP associations, controlling for multiple covariates. No significant associations of first-trimester ambient temperature with maternal BP and HDP prevalence were observed. Compared with mild temperature, second-trimester very cold and second-trimester moderate cold were statistically associated with the increase of 1.239 mmHg (95% CI: 0.908, 1.569) and 0.428 mmHg (95% CI: 0.099, 0.757) for second-trimester systolic blood pressure (SBP), respectively. Similar trends were also observed in the association between second-trimester cold exposure and second-trimester diastolic blood pressure (DBP), in the association between second-trimester cold exposure and third-trimester SBP/DBP as well as in the association between third-trimester cold exposure and third-trimester SBP/DBP although some estimates were not statistically significant. Furthermore, in the second and third trimester, very cold [second trimester: adjusted odds ratio (aOR) = 1.298; third trimester: aOR = 1.236) and moderate cold (second trimester: aOR = 1.208; third trimester: aOR = 1.146) exposures also increased the odds of HDP, and these associations were stronger among participants aged ≥35 years or from North China. The second and third trimesters are the critical exposure windows for ambient temperature exposure-BP/HDP associations. During this period, exposure to cold ambient temperature was associated with elevated BP as well as increased HDP prevalence among most Chinese pregnant women, those aged ≥35 years or from North China being more vulnerable.

Mortality burden based on the associations of ambient PM2.5 with cause-specific mortality in China: Evidence from a death-spectrum wide association study (DWAS)

Although studies have estimated the associations of PM_2.5 with total mortality or cardiopulmonary mortality, few have comprehensively examined cause-specific mortality risk and burden caused by ambient PM_2.5. Thus, this study investigated the association of short-term exposure to PM_2.5 with cause-specific mortality using a death-spectrum wide association study (DWAS). Individual information of 5,450,764 deaths during 2013-2018 were collected from six provinces in China. Daily PM_2.5 concentration in the case and control days were estimated by a random forest model. A time-stratified case-crossover study design was applied to estimate the associations (access risk, ER) of PM_2.5 with cause-specific mortality, which was then used to calculate the population-attributable fraction (PAF) of mortality and the corresponding mortality burden caused by PM_2.5. Each 10 μg/m³ increase in PM_2.5 concentration (lag03) was associated with a 0.80 % [95 % confidence interval (CI): 0.73 %, 0.86 %] rise in total mortality. We found greater mortality effect at PM_2.5 concentrations < 50 μg/m³. Stratified analyses showed greater ERs in females (1.01 %, 95 %CI: 0.91 %, 1.11 %), children ≤ 5 years (2.17 %, 95 %CI: 0.85 %, 3.51 %), and old people ≥ 70 years. We identified 33 specific causes (level 2) of death which had significant associations with PM_2.5, including 16 circulatory diseases, 9 respiratory diseases, and 8 other causes. The PAF estimated based on the overall association between PM_2.5 and total mortality was 3.16 % (95 %CI: 2.89 %, 3.40 %). However, the PAF was reduced to 2.88 % (95 %CI: 1.88 %, 3.81 %) using the associations of PM_2.5 with 33 level 2 causes of death, based on which 250.15 (95 %CI: 163.29, 330.93) thousand deaths were attributable to short-term PM_2.5 exposure across China in 2019. Overall, this study provided a comprehensive picture on the death-spectrum wide association between PM_2.5 and morality in China. We observed robust positive cause-specific associations of PM_2.5 with mortality risk, which may provide more precise basis in assessing the mortality burden of air pollution.

Short-term association of air pollution with lung cancer mortality in Osaka, Japan

Long-term air pollution exposure has been linked to increased lung cancer mortality. However, little is known about whether day-to-day fluctuations in air pollution levels are in relation to lung cancer mortality, particularly in low-exposure settings. This study aimed to evaluate the short-term associations between air pollution and lung cancer mortality. Daily data on lung cancer mortality, fine particulate matter (PM_2.5), nitrogen dioxide (NO₂), sulfur dioxide (SO₂), carbon monoxide (CO), and weather conditions were collected from Osaka Prefecture, Japan, from 2010 to 2014. Generalized linear models were combined with quasi-Poisson regression were applied to evaluate the associations between each air pollutant and lung cancer mortality after adjusting for potential confounders. Mean (standard deviation) concentrations of PM_2.5, NO₂, SO₂, and CO were 16.7 (8.6) μg/m³, 36.8 (14.2) μg/m³, 11.1 (4.0) μg/m³, and 0.51 (0.16) mg/m³, respectively. Interquartile range increases in concentrations of PM_2.5, NO₂, SO₂, and CO (2-d moving average) were associated with 2.65% (95% confidence intervals [CIs]: 0.96%-4.37%), 4.28% (95% CIs: 2.24%-6.36%), 3.35% (95% CIs: 1.03%-5.73%), and 4.60% (95% CIs: 2.19%-7.05%) increased risk of lung cancer mortality, respectively. Stratified analyses showed that the associations were strongest in the older population and men. Exposure‒response curves showed a continuously increasing mortality risk from lung cancer with elevation of air pollution levels, without discernible thresholds. In summary, we found evidence of increased lung cancer mortality in relation to short-term elevations in ambient air pollution. These findings may merit further research to better understand this issue.

Effects of short-term PM2.5 exposure on blood lipids among 197,957 people in eastern China

Globally, air pollution is amongst the most significant causes of premature death. Nevertheless, studies on the relationship between fine particulate matter (PM_2.5) exposure and blood lipids have typically not been population-based. In a large, community-based sample of residents in Yixing city, we assessed the relationship between short-term outdoor PM_2.5 exposure and blood lipid concentrations. Participants who attended the physical examination were enrolled from Yixing People's hospital from 2015 to 2020. We collected general characteristics of participants, including gender and age, as well as test results of indicators of blood lipids. Data on daily meteorological factors were collected from the National Meteorological Data Sharing Center ( http://data.cma.cn/ ) and air pollutant concentrations were collected from the China Air Quality Online Monitoring and Analysis Platform ( https://www.aqistudy.cn/ ) during this period. We applied generalized additive models to estimate short-term effects of ambient PM_2.5 exposure on each measured blood lipid-related indicators and converted these indicators into dichotomous variables (non- hyperlipidemia and hyperlipidemia) to calculate risks of hyperlipidemia associated with PM_2.5 exposure. A total of 197,957 participants were included in the analysis with mean age 47.90 years (± SD, 14.28). The increase in PM_2.5 was significantly associated with hyperlipidemia (odds ratio (OR) 1.003, 95% CI 1.001-1.004), and it was still significant in subgroups of males and age < 60 years. For every 10 μg/m³ increase in PM_2.5, triglyceride levels decreased by 0.5447% (95% CI - 0.7873, - 0.3015), the low-density lipoprotein cholesterol concentration increased by 0.0127 mmol/L (95% CI 0.0099, 0.0156), the total cholesterol concentration increased by 0.0095 mmol/L (95% CI 0.0053, 0.0136), and no significant association was observed between PM_2.5 and the high-density lipoprotein cholesterol concentration. After excluding people with abnormal blood lipid concentrations, the associations remained significant except for the high-density lipoprotein cholesterol concentration. PM_2.5 was positively correlated with low-density lipoprotein cholesterol and total cholesterol, and negatively correlated with triglyceride, indicating PM_2.5 can potentially affect health through blood lipid levels.

Long-term trends in mortality risk associated with short-term exposure to air pollution in 10 Japanese cities between 1977 and 2015

BACKGROUND AND AIM

Short-term associations between air pollution and mortality have been well reported in Japan, but the historical changes in mortality risk remain unknown. We examined temporal changes in the mortality risks associated with short-term exposure to four criteria air pollutants in selected Japanese cities.

METHODS

We collected daily mortality data for non-accidental causes (n = 5,748,206), cardiovascular (n = 1,938,743) and respiratory diseases (n = 777,266), and air pollutants (sulfur dioxide [SO₂], nitrogen dioxide [NO₂], suspended particulate matter [SPM], and oxidants [Ox]) in 10 cities from 1977 to 2015. We performed two-stage analysis with 5-year stratification to estimate the relative risk (RR) of mortality per 10-unit increase in the 2-day moving average of air pollutant concentrations. In the first stage, city-specific associations were assessed using a quasi-Poisson generalized linear regression model. In the second stage, city-specific estimates were pooled using a random-effects meta-analysis. Linear trend and ratio of relative risks (RRR) were computed to examine temporal changes.

RESULTS

When stratifying the analysis by every 5 years, average concentrations in each sub-period decreased for SO₂, NO₂, and SPM (14.2-2.3 ppb, 29.4-17.5 ppb, 52.1-20.6 μg/m³, respectively) but increased for Ox (29.1-39.1 ppb) over the study period. We found evidence of a negative linear trend in the risk of cardiovascular mortality associated with SPM across sub-periods. However, the risks of non-accidental and respiratory mortality per 10-unit increase in SPM concentration were significantly higher in the most recent period than in the earliest period. Other gaseous pollutants did not show such temporal risk change. The risks posed by these pollutants were slightly to moderately heterogeneous in the different cities.

CONCLUSIONS

The mortality risks associated with short-term exposure to SPM changed, with different trends by cause of death, in 10 cities over 39 years whereas the risks for other gaseous pollutants were relatively stable.

The PM2.5 concentration reduction improves survival rate of lung cancer in Beijing

INTRODUCTION

Long-term exposure to ambient fine particulate matter (PM_2.5) has been linked to increases in the incidence of lung cancer. However, more evidence is needed to conclude its effects on lung cancer survival.

OBJECTIVES

The study aimed to explore the relationship between long-term PM_2.5 exposure and lung cancer survival and evaluated the benefits of clean air actions in Beijing.

METHODS

A whole-population cohort study was conducted on lung cancer patients diagnosed between 2001 and 2017. An atmospheric chemical transport model was used to estimate exposure under a counterfactual scenario without the policy and then quantified the effect of the policy. Cox regression models were used with the seasonality-adjusted PM_2.5 as the main effect.

RESULTS

A 10 μg/m³ increase in PM_2.5 was estimated to be with a 6.5 % (95 % CI: 4.8 %, 8.2 %) increase in the mortality rates. The association was heterogeneous and modified by individual-level characteristics. The clean air actions were estimated to have prevented 3548 (95 % CI: 3280, 3825) premature deaths and to have prolonged survival time by 4.29 months (95 % CI: 0.01, 25.11).

CONCLUSION

Our findings suggest that PM_2.5 exposure lowers the survival rate for lung cancer. The clean air actions implemented in Beijing can protect lung cancer patients by increasing their survival time.

SYNOPSIS

Long-term exposure to PM_2.5 can lower lung patients' survival rates whereas the clean air actions in Beijing have prolonged these patients' survival time by reducing PM_2.5 level.

Association between out-patient visits and air pollution in Chiang Mai, Thailand: Lessons from a unique situation involving a large data set showing high seasonal levels of air pollution

Chiang Mai is one of the most known cities of Northern Thailand, representative for various cities in the East and South-East Asian region exhibiting seasonal smog crises. While a few studies have attempted to address smog crises effects on human health in that geographic region, research in this regard is still in its infancy. We exploited a unique situation based on two factors: large pollutant concentration variations due to the Chiang Mai smog crises and a relatively large sample of out-patient visits. About 216,000 out-patient visits in the area of Chiang Mai during the period of 2011 to 2014 for upper (J30-J39) and lower (J44) respiratory tract diseases were evaluated with respect to associations with particulate matter (PM10), ozone (O3), and nitrogen dioxide (NO2) concentrations using single-pollutant and multiple-pollutants Poisson regression models. All three pollutants were found to be associated with visits due to upper respiratory tract diseases (with relative risks RR = 1.023 at cumulative lag 05, 95% CI: 1.021–1.025, per 10 μg/m3 PM10 increase, RR = 1.123 at lag 05, 95% CI: 1.118–1.129, per 10 ppb O3 increase, and RR = 1.110 at lag 05, 95% CI: 1.102–1.119, per 10 ppb NO2 increase). Likewise, all three pollutants were found to be associated with visits due to lower respiratory tract diseases (with RR = 1.016 at lag 06, 95% CI: 1.015–1.017, per 10 μg/m3 PM10 increase, RR = 1.073 at lag 06, 95% CI: 1.070–1.076, per 10 ppb O3 increase, and RR = 1.046 at lag 06, 95% CI: 1.040–1.051, per 10 ppb NO2 increase). Multi-pollutants modeling analysis identified O3 as a relatively independent risk factor and PM10-NO2 pollutants models as promising two-pollutants models. Overall, these results demonstrate the adverse effects of all three air pollutants on respiratory morbidity and call for air pollution reduction and control.

The effects of air pollution on the lung cancer mortality in rural areas of eastern China: a multi-region study

Recently, the burden of lung cancer (LC) has attracted global attention. Meanwhile, LC has become the leading cause of death in China. Many studies found a strong link between air pollutants and the risk of LC mortality in some large cities, but the results have been inconsistent, and most studies have only focused on the daily effects of six pollutants in large cities, ignoring their potential cumulative effects. This study was to investigate the weekly effects of six air pollutants (CO, NO₂, O₃, PM_2.5, PM₁₀, and SO₂) on LC mortality in rural areas of eastern China and to further clarify which population groups were susceptible to air pollution and seasonal trends. First, a generalized additive model was combined with a distributed lag nonlinear model to evaluate the individual impact of air pollution on LC deaths in each area. The random-effect model was then used to pool the associations between air pollutants and LC mortality risk in ten counties or districts. The results showed that six air pollutants had a statistically significant effect on the risk of LC mortality at different lag weeks. The effects of NO₂, PM₁₀, and CO on weekly LC mortality were strongest at a cumulative lag of 1, 0, and 1 week, respectively, the maximum cumulative risk ratio (RR) of 1.37 (95%CI: 1.23 to 1.52), 1.30 (95%CI: 1.15 to 1.46), and 1.30 (95%CI: 1.17 to 1.43), with interquartile concentrations increasing. In summary, air pollution was an important factor in LC mortality, and the effect was stronger on males, the elderly, and during cold season. It was suggested that relevant departments should formulate air pollution management measures for the elderly, males, and in different seasons in rural areas and reduce the burden of lung cancer caused by air pollution.

Systematic review and meta-analysis of studies between short-term exposure to ambient carbon monoxide and non-accidental, cardiovascular, and respiratory mortality in China

Although a growing number of original epidemiological studies imply a link between ambient pollution exposure and mortality risk, the findings associated with carbon monoxide (CO) exposure are inconsistent. Thus, we conducted a systematic review and meta-analysis of epidemiological studies to evaluate the correlations between ambient CO and non-accidental, cardiovascular, and respiratory mortality in China. Eight databases were searched from inception to 15 May 2021. A random-effect model was used to calculate the pooled relative risks (RRs) and 95% confidence intervals (CIs). Subgroup analyses as well as sensitivity analyses were performed. The I square value (I²) was used to assess heterogeneity among different studies. The assessment of publication bias on included studies was examined by funnel plot and Egger's test. The influence of a potential publication bias on findings was explored by using the trim-and-fill procedure. Ultimately, a total of 19 studies were included in our analysis. The pooled relative risk for each 1 mg/m³ increase of ambient carbon monoxide was 1.0220 (95%CI: 1.0102-1.0339) for non-accidental mortality, 1.0304 (95%CI:1.0154-1.0457) for cardiovascular mortality, and 1.0318 (95%CI:1.0132-1.0506) for respiratory mortality. None of subgroup analyses could explain the source of heterogeneity. Exclusion of any single study did not materially alter the pooled effect estimates. Although it was suggestive of publication bias, findings were generally similar with principal findings when we explored the influence of a potential publication bias using the trim-and-fill method. Our meta-analysis demonstrated that exposure to ambient CO was positive with risk of deaths from all non-accidental causes, total cardiovascular, and respiratory diseases. Based on these findings, tougher intervention policies and initiatives to reduce the health effects of CO exposure should be established.

Associations between Weather, Air Quality and Moderate Extreme Cancer-Related Mortality Events in Augsburg, Southern Germany

While many authors have described the adverse health effects of poor air quality and meteorological extremes, there remain inconsistencies on a regional scale as well as uncertainty about the single and joint effects of atmospheric predictors. In this context, we investigated the short-term impacts of weather and air quality on moderate extreme cancer-related mortality events for the urban area of Augsburg, Southern Germany, during the period 2000–2017. First, single effects were uncovered by applying a case-crossover routine. The overall impact was assessed by performing a Mann–Whitney U testing scheme. We then compared the results of this procedure to extreme noncancer-related mortality events. In a second step, we found periods with contemporaneous significant predictors and carried out an in-depth analysis of these joint-effect periods. We were interested in the atmospheric processes leading to the emergence of significant conditions. Hence, we applied the Principal Component Analysis to large-scale synoptic conditions during these periods. The results demonstrate a strong linkage between high-mortality events in cancer patients and significantly above-average levels of nitrogen dioxide (NO₂) and particulate matter (PM_2.5) during the late winter through spring period. These were mainly linked to northerly to easterly weak airflow under stable, high-pressure conditions. Especially in winter and spring, this can result in low temperatures and a ground-level increase and the accumulation of air pollution from heating and traffic as well as eastern lateral advection of polluted air. Additionally, above-average temperatures were shown to occur on the days before mortality events from mid-summer through fall, which was also caused by high-pressure conditions with weak wind flow and intense solar radiation. Our approach can be used to analyse medical data with epidemiological as well as climatological methods while providing a more vivid representation of the underlying atmospheric processes.

Daily nonaccidental mortality associated with short-term PM2.5 exposures in Delhi, India

Supplemental Digital Content is available in the text.

Ambient particulate matter of aerodynamic diameter less than 2.5 microns PM_2.5) levels in Delhi routinely exceed World Health Organization (WHO) guidelines and Indian National Ambient Air Quality Standards (NAAQS) for acceptable levels of daily exposure. Only a handful of studies have examined the short-term mortality effects of PM in India, with none from Delhi examining the contribution of PM_2.5.

An investigation into the impact of variations of ambient air pollution and meteorological factors on lung cancer mortality in Yangtze River Delta

Lung cancer (LC) mortality, as one of the top cancer deaths in China, has been associated with increased levels of exposure to ambient air pollutants. In this study, different lag times on weekly basis were applied to study the association of air pollutants (PM2.5, PM10, and NO2) and LC mortality in Ningbo, and in subpopulations at different age groups and genders. Furthermore, seasonal variations of pollutant concentrations and meteorological variables (temperature, relative humidity, and wind speed) were analysed. A generalised additive model (GAM) using Poisson regression was employed to estimate the effect of single pollutant model on LC mortality in Yangtze River Delta using Ningbo as a case study. It was reported that there were statistically significant relationships between lung cancer mortality and air pollutants. Increases of 6.2% (95% confidence interval [CI]: 0.2% to 12.6%) and 4.3% (95% CI: 0.1% to 8.5%) weekly total LC mortality with a 3-week lag time were linked to each 10 μg/m³ increase of weekly average PM_2.5 and PM₁₀ respectively. The association of air pollutants (PM_2.5, PM₁₀ and NO₂) and LC mortality with a 3-week lag time was also found statistically significant during periods of low temperature (T < 18 °C), low relative humidity (H < 73.7%) and low wind speed (u < 2.8 m/s), respectively. The female population was found to be more susceptible to the exposure to air pollution than the male population. In addition, the population with an age of 50 years or above was shown to be more sensitive to ambient air pollutant. These outcomes indicated that increased risk of lung cancer mortality was evidently linked to exposure to ambient air pollutant on a weekly basis. The impact of weekly variation on the LC mortality and air pollutant levels should be considered in air pollution-related health burden analysis.

Respiratory mortality associated with ozone in China: A systematic review and meta-analysis

This systematic review and meta-analysis was performed to obtain updated evidence regarding the short-term effect of ozone on respiratory mortality in China. We systematically searched the Embase, PubMed, Scopus, Web of Science, China National Knowledge Internet, and Wanfang databases for relevant studies. After screening based on the inclusion criteria, 12 studies with 19 estimates were selected for further meta-analysis. The results revealed that respiratory mortality significantly increased by 0.55% (95% confidence interval: 0.24%-0.85%; Q = 39.47, I² = 54.4%, P = 0.002, tau² < 10^-5) for every 10-μg/m³ increase in the maximum 8-h average concentration of ozone. Furthermore, differences in combined estimates were observed between various regions and lag structures. The combined effect of single-day lags was generally larger than that of multiday lags; the estimate of mortality for the population in the north was larger than that for the population in the south. The sensitivity analysis demonstrated that the main findings were stable; funnel plots with Egger's and Begg's tests indicated no significant publication bias in our analysis.

Air pollution exposure-the (in)visible risk factor for respiratory diseases

There is increasing interest in understanding the role of air pollution as one of the greatest threats to human health worldwide. Nine of 10 individuals breathe air with polluted compounds that have a great impact on lung tissue. The nature of the relationship is complex, and new or updated data are constantly being reported in the literature. The goal of our review was to summarize the most important air pollutants and their impact on the main respiratory diseases (chronic obstructive pulmonary disease, asthma, lung cancer, idiopathic pulmonary fibrosis, respiratory infections, bronchiectasis, tuberculosis) to reduce both short- and the long-term exposure consequences. We considered the most important air pollutants, including sulfur dioxide, nitrogen dioxide, carbon monoxide, volatile organic compounds, ozone, particulate matter and biomass smoke, and observed their impact on pulmonary pathologies. We focused on respiratory pathologies, because air pollution potentiates the increase in respiratory diseases, and the evidence that air pollutants have a detrimental effect is growing. It is imperative to constantly improve policy initiatives on air quality in both high- and low-income countries.

Explore Regional PM2.5 Features and Compositions Causing Health Effects in Taiwan

Chemical compositions of atmospheric fine particles like PM2.5 prove harmful to human health, particularly to cardiopulmonary functions. Multifaceted health effects of PM2.5 have raised broader, stronger concerns in recent years, calling for comprehensive environmental health-risk assessments to offer new insights into air-pollution control. However, there have been few studies adopting local air-quality-monitoring datasets or local coefficients related to PM2.5 health-risk assessment. This study aims to assess health effects caused by PM2.5 concentrations and metal toxicity using epidemiological and toxicological methods based on long-term (2007-2017) hourly monitoring datasets of PM2.5 concentrations in four cities of Taiwan. The results indicated that (1) PM2.5 concentrations and hazardous substances varied substantially from region to region, (2) PM2.5 concentrations significantly decreased after 2013, which benefited mainly from two actions against air pollution, i.e., implementing air-pollution-control strategies and raising air-quality standards for certain emission sources, and (3) under the condition of low PM2.5 concentrations, high health risks occurred in eastern Taiwan on account of toxic substances adsorbed on PM2.5 surface. It appears that under the condition of low PM2.5 concentrations, the results of epidemiological and toxicological health-risk assessments may not agree with each other. This raises a warning that air-pollution control needs to consider toxic substances adsorbed in PM2.5 and region-oriented control strategies are desirable. We hope that our findings and the proposed transferable methodology can call on domestic and foreign authorities to review current air-pollution-control policies with an outlook on the toxicity of PM2.5.

Assessing the Impact of Lockdown on Atmospheric Ozone Pollution Amid the First Half of 2020 in Shenyang, China

During the eruption of COVID-19, a citywide lockdown was executed from 26 January to 23 March 2020, in Shenyang, in which the ozone pollution has recorded significant variations. This paper mainly anatomized the comprehensive characteristics and evolution trends of ozone pollution based on the lockdown period in the first half of 2020. Using the Hybrid Single Particle Lagrangian Integrated Trajectory (HYSPLIT) model and cluster analysis method to establish backward trajectories and channels, the spatial transport process of ozone in the preset period and the causation of typical ozone pollution events were investigated in depth. The results demonstrated that: The ozone concentration pollution in the first half of 2020 was increased than last year. During the lockdown period, the basic pollutants levels were lower than that in pre-lockdown under different proportions, except O₃ maximum 8-h moving average (MDA8) was increased by 69.7%, accompanied by the delay of daily peak value, increased pollution days and longer pollution cycle. The typical pollution events were highly consistent with the evolution path of fine aerosol compelled by extreme weather. The ozone concentration and the atmospheric oxidation capacity can be stably maintained at a low level when NO₂ concentration remained at 50–70 μg/m³, no matter how much the AQI was. Meanwhile, ozone concentration in the downwind suburban was as low as the central city and soared in few stations amid post-lockdown, simultaneous the correlation between ozone and other pollutants converted from negative to positive. The trajectory indicated that the pollution sources during the lockdown and pre-lockdown were basically Southern Russia, Inner Mongolia, and the three provinces of Northeast China, the pollution from the Bohai Sea provoked ozone pollutants in Shenyang to rebound briskly amid post-lockdown, the pollution of neighboring countries and areas would have a stronger impact on air quality under the effect of lockdown.

Particle-induced oxidative damage by indoor size-segregated particulate matter from coal-burning homes in the Xuanwei lung cancer epidemic area, Yunnan Province, China

Size-segregated samples of airborne particulate matter were collected at the coal-burning homes of the Hutou high lung cancer epidemic village and a comparison site Xize village of the Xuanwei County, Yuanan Province, by an Anderson Cascade Impact Sampler in winter and spring to study the toxicological characteristics of different-sized particles. The DNA damage caused by the water-soluble fractions of these size-segregated particles was analyzed by the plasmid scission assay, and the trace element compositions were determined by Inductively Coupled Plasma Mass Spectrometry. The DNA damage rate from the airborne particles in the high lung cancer incidence area was higher than that in Xize village. The different-sized particles have highly varying DNA damage rates, with the values being greater in the small size range than in the large size range. The particle-induced DNA damage rates had a significantly positive correlation with total water-soluble trace elements. Further analysis of the individual elements indicated that the water-soluble heavy metals Zn, Cu, Cd, Rb, Cs, and Sb had a positive correlation with the particle-induced DNA damage, implying that these water-soluble heavy metals played an important role in the DNA damage. The Sr had a negative correlation with the particle-induced DNA damage, suggesting that the water-soluble Sr might counter DNA damage. The mass concentrations of the total and individual water-soluble trace elements were mostly enriched in the small particle size ranges, thus implying the indoor airborne particles in the small size ranges would have a higher health risk.

The Gender-Based Differences in Vulnerability to Ambient Air Pollution and Cerebrovascular Disease Mortality: Evidences Based on 26781 Deaths

The gender-based differences in the vulnerability to ambient air pollution have not been widely explored. This study aimed to investigate vulnerability differences to the short-term effects of PM2.5, PM10 and O3 between cerebrovascular diseases (CEVD) deaths of men and women. The general additive models (GAMs) and distributed lag non-linear models (DLNMs) were adopted, and both single-pollutant and two-pollutant models were performed to analyze the associations between ambient air pollution and daily CEVD deaths. Both models indicated that O3 was the most suspicious pollutant that could induce excess CEVD deaths, and women tended to be more vulnerable to O3. These results were confirmed by seasonal analysis, in which we also found both genders were more vulnerable to O3 in winter. The exposure-response relationships revealed that women were usually more vulnerable to ambient air pollution than men, and the exposure-response curves differed significantly between genders. Our findings suggested that more attention should be paid on the adverse effects of ambient O3, and the protection of women CEVD population against air pollution should be emphasized.

Short-term association between ambient air pollution and lung cancer mortality

RATIONALE

Long-term exposure to air pollution has been associated with increased lung cancer incidence and mortality. However, the short-term association between air pollution and lung cancer mortality (LCM) remains largely unknown.

METHODS

We collected daily data on particulate matter with diameter <2.5 μm (PM_2.5), particulate matter with diameter < 10 μm (PM₁₀), sulfur dioxide (SO₂), and ozone (O₃), and LCM in three of the biggest cities in China, i.e. Beijing, Chongqing, and Guangzhou, from 2013 to 2015. We first estimated city-specific relationships between air pollutants and LCM using time-series generalized linear models, adjusting for potential confounders. A classification and regression tree (CART) model was used to stratify LCM risk based on combinations of air pollutants and meteorological factors in each city. Then we pooled the city-specific associations using random-effects meta-analysis. Meta regression was used to explore if city-specific characteristics modified the air pollution-LCM association. Finally, we stratified the analyses by season, age, and sex.

RESULTS

Over the entire period, the current-day concentrations of PM_2.5 and PM₁₀ in Chongqing and PM_2.5, PM₁₀, and SO₂ in Guangzhou were positively associated with LCM (Excess risk ranged from 0.72% (95% CI 0.27%-1.17%) to 6.06% (95% CI 0.76%-11.64%) with each 10 μg/m³ increment in different pollutants), but the association between current-day air pollution and LCM in Beijing was not significant (P > 0.05). When considering the environmental and weather factors simultaneously, current-day PM_2.5, relative humidity, and PM₁₀ were the most important factors associated with LCM in Beijing, Chongqing, and Guangzhou, respectively. LCM risk related with daily PM_2.5, PM₁₀, and SO₂ significantly increased with the increasing annual mean temperature and humidity of the city, while LCM risk related with daily O₃ significantly increased with the increases of latitude, annual mean O₃ concentration, and socioeconomic level. After stratification, the current-day PM_2.5, PM₁₀, and O₃ during the warm season in Beijing and PM_2.5, PM₁₀, and SO₂ during the cool season in Chongqing and Guangzhou were positively associated with LCM (Excess risk ranged from 0.93% (95% CI 0.42%-1.45%) to 7.16% (95% CI 0.64%-14.09%) with each 10 μg/m³ increment in different pollutants). Male and the elderly lung cancer patients were more sensitive to the short-term effect of air pollution.

CONCLUSIONS

Lung cancer patients should enhance protection measures against air pollution. More attentions should be paid for the high PM_2.5, PM₁₀, and O₃ during the warm season in Beijing, and high PM_2.5, PM₁₀, and SO₂ during the cool season in Chongqing and Guangzhou.

Ambient air pollution and respiratory mortality in Xi'an, China: a time-series analysis

Background

Although air pollution is a known fundamental problem in China, few studies have investigated the associations between ambient air pollution and respiratory mortality in non-metropolitan cities of China. The study aimed to investigate a potential relationship between short-term exposure to ambient air pollutants and respiratory mortality in Xi’an, China.

Methods

Daily averages of PM_2.5, SO₂, O₃, temperature, relative humidity and daily counts of respiratory mortality were obtained (2014–2016). Using a single and multi-pollutant approach in time-series analysis, the generalized additive model with natural splines was used for analysis. Subgroup analysis stratified by gender and age group (≤ 64 years and ≥ 65 years) was conducted.

Results

Seven thousand nine hundred sixty-five cases of respiratory mortality were assessed, with 62.9, 28.5, and 8.6% of mortality attributed to chronic lower respiratory diseases, influenza and pneumonia, as well as other forms of respiratory diseases, respectively. Observed pollutants were significantly associated with respiratory mortality. In the single pollutant model, 10 μg/m³ increase in a two-day moving average of PM_2.5, and SO₂ concentrations were significantly associated with relative risk 1.313(1.032, 1.708) and 1.4020(0.827, 2.854) of respiratory mortality, respectively. The effects of both air pollutants remained statistically significant after adjusting for collinearity in the multi-pollutant model. Ozone was only statistically associated with respiratory mortality in females at lag 0 [RR: 0.964(0.938, 0.991)].

Conclusion

This study provided evidence that respiratory mortality in Xi’an was significantly associated with exposure to ambient air pollutants from 2014 to 2016.

Soil high Cd exacerbates the adverse impact of elevated O3 on Populus alba 'Berolinensis' L

Pollution with both heavy metal and ground-level ozone (O₃) has been steadily increasing, especially in the cities with heavy industry. Little information is known about their combined impacts on urban tree. This study was aimed at characterizing the interactive effects of soil cadmium (Cd) addition and O₃ fumigation on visible injury and growth, photosynthesis, oxidative stress, antioxidant enzyme activities, abscisic acid (ABA) content and bioaccumulation of Cd in one-year-old Populus alba 'Berolinensis' saplings by using open top chambers in Shenyang city with developed heavy industry, Northeast China. In this study, poplar saplings were grown in the pots containing soil with different concentrations of Cd (0, 100 and 500 mg kg^-1) under ambient air (40 µg L^-1) and elevated O₃ (120 µg L^-1). The results showed that EO and its combination with high Cd (500 mg kg^-1) induced significant foliar injury symptoms, decreased root weight (by 41.6%) and total biomass (by 17.4%), inhibited net photosynthetic rate and stomatal conductance, and increased malondialdehyde and ABA contents after 4 weeks of O₃ exposure. Elevated O₃ exacerbated the accumulation of Cd in leaves and stems of poplar plants grown in the pots with high Cd-polluted soil. Our results also indicated that high Cd pollution in soil increased the susceptibility of plants to O₃ and exacerbated the adverse impact of elevated O₃ on physiological metabolisms of poplar species, which implied that it was very necessary to take into consideration for O₃-tolerance of tree species during phytoremediation of Cd-polluted soil in heavy industrial areas.

A study on the characteristics of pollutant release and transfer registers (PRTRs) and cancer incidence rates in Korea

This study aims to identify the past decade's trend of harmful chemical emissions, which have been disclosed on the website as open information. During the past 10 years, the number of places of business, examined for their harmful chemical emissions, increased about 1.3× and their emissions went up 1.1×. More than 50% of total emissions have occurred in the top three areas, and the largest emissions were from xylene and toluene for the past 10 years. Among the total emissions, the group 1 carcinogen decreased from 5.3 to 2.1%, and among group 1 in particular, trichloroethylene and benzene accounted for more than 80%. Although it was impossible to find out any relationship between major cancers' development and the results of carcinogen emissions, considering the features of carcinogens emitted in specific areas, more research is needed to find out relationship. And, it is necessary to come up with proactive policies to reduce harmful chemical substances which can affect human health through environmental pollution.

The effects of firework regulation on air quality and public health during the Chinese Spring Festival from 2013 to 2017 in a Chinese megacity

Fireworks displays are a traditional form of celebration during the Chinese Spring Festival (Festival). In response to the heavy air pollution caused by fireworks, Shanghai, a megacity in China, has imposed regulatory measures on the use of fireworks in recent years. To investigate air quality trends before and after firework regulation was established and quantify its efficiency, gaseous pollutants, PM_2.5 levels, and PM_2.5 chemical composition were synchronously measured at 1 h time intervals at an urban site and a suburban site in Shanghai in the period during and around the Festival from 2013 to 2017. PM_2.5 concentrations at the urban site during the Festival over the five-year period were 79 (max: 524), 94 (290), 53 (163), 50 (146) and 32 (156) μg/m³, respectively, presenting a decreasing trend at a rate of -13.8 μg/m³/yr (p = 0.05). K⁺ concentrations, which serve as a tracer of fireworks, were 8.2 (max: 159.4), 2.5 (14.6), 2.2 (10.4), 4.3 (44.2) and 0.8 (4.5) μg/m³ during the Festival from 2013 to 2017, respectively, and thus decreased at a rate of -1.3 μg/m³/yr (p = 0.17). Accordingly, fireworks contributed 41 (51.9%), 38 (36.5%), 6 (10.3%), 21 (35.6%), and 4 μg/m³ (12.1%) to PM_2.5, respectively, implying the effectiveness of firework regulation in Shanghai. Health effects attributed to PM_2.5 pollution in Shanghai during the Festival were assessed based on Poisson regression. The number of premature deaths related to short-term PM_2.5 exposure in Shanghai during the Festival from 2013 to 2017 was 75 (95% CI: 27, 108), 92 (30, 129), 55 (18, 76), 49 (19, 70), and 31 (12, 45), respectively. Daily mortality due to PM_2.5 exposure during the Festival from 2013 to 2017 accounted for 1.4-3.8% of total daily mortality in Shanghai. This study provides scientific evidence of air quality improvement and the effectiveness of firework regulation in Shanghai.

Spatiotemporal patterns of recent PM2.5 concentrations over typical urban agglomerations in China

China experiences severe particulate matter pollution associated with rapid economic growth and accelerated urbanization. In this study, concentrations of PM_2.5 (fine particulate matter with an aerodynamic diameter ≤ 2.5 μm) throughout China, and specifically in nine typical urban agglomerations and one economic region, were statistically analyzed using high-resolution ground-based PM_2.5 observations from June 2014 to May 2018. The spatial variation of PM_2.5 was also explored via spatial autocorrelation analysis. High annual mean PM_2.5 concentrations were predominantly concentrated in the Beijing-Tianjin-Hebei, Central Plain, Northern Slope of Tianshan Mountain, and Cheng-Yu urban agglomerations, as well as the Huaihai Economic Region. The proportion of air quality nationwide monitoring sites where annual average PM_2.5 concentrations exceeded the Chinese Ambient Air Quality Standards (CAAQS) Grade II annual standard were 82.8%, 77.1%, and 70.8% in 2015, 2016, and 2017, respectively. Moreover, the frequency of PM_2.5 concentrations meeting the CAAQS Grade I 24-h standard increased in five national-level urban agglomerations, and the average annual PM_2.5 decreased from 2015 to 2017 with a reduction rate of over 20%. The southern Beijing-Tianjin-Hebei agglomeration and surrounding areas revealed the highest PM_2.5 pollution in four seasons. Monthly mean PM_2.5 typically exhibited a characteristic "U" shape. Diurnal mean PM_2.5 concentrations were generally consistent with typical urban agglomerations, with maximum and minimum PM_2.5 values occurring at approximately 08:00-12:00 and 15:00-17:00, respectively, except for the Northern Slope of Tianshan Mountain urban agglomeration (NSTM-UA) (14:00 and 08:00, respectively). A positive spatial autocorrelation of PM_2.5 concentrations was observed in all urban agglomerations (except NSTM-UA); high-high agglomeration centers of PM_2.5 pollution were located far inland with a circular distribution, and low-low agglomeration centers formed at the periphery of the high-high agglomeration region. This study is key for understanding the difference in PM_2.5 concentrations among urban agglomerations and region-oriented air pollution control strategies are highly suggested.

The burden of air pollution and weather condition on daily respiratory deaths among older adults in China, Jinan from 2011 to 2017

The health effects of short-term exposure to air pollutants on respiratory deaths and its modifiers such as meteorological indexes have been widely investigated. However, most of the previous studies are limited to single pollutants or total respiratory deaths, and their findings are inconsistent.To comprehensively examine the short-term effects of air pollutants on daily respiratory mortality.Our analysis included 16,931 nonaccidental respiratory deaths (except lung cancer and tuberculosis) among older adults (>65 years) from 2011 to 2017 in Jinan, China. We used a generalized additive Poisson models adjusted for meteorology and population dynamics to examine the associations between air pollutants (particulate matter with an aerodynamic diameter of b2.5μm [PM2.5], particulate matter with an aerodynamic diameter of b10μm [PM10], SO2, NO2, O3) and daily mortality for the total patients, males, females, chronic airway diseases, pneumonia patients, and rest patients in Jinan.Outdoor air pollution was significantly related to mortality from all respiratory diseases especially from chronic airway disease in Jinan, China. The effects of air pollutants had lag effects and harvesting effects, and the effects estimates usually reached a peak at lag 1 or 2 day. An increase of 10 μg/m or 10 ppb of PM2.5, PM10, SO2, NO2, and O3 corresponds to increments in mortality caused by chronic airway disease of 0.243% (95% confidence interval [CI]: -0.172-0.659) at lag 1 day, 0.127% (95% CI: -0.161-0.415) at lag 1 day, 0.603% (95% CI: 0.069-1.139) at lag 3 day, 0.649% (95% CI: -0.808-2.128) at lag 0 day and 0.944% (95% CI: 0.156-0.1598) at lag 1 day, respectively. The effects of air pollutants were usually greater in females and varied by respiratory subgroups. Spearman correlation analysis suggested that there was a significant association between meteorological indexes and air pollutants.Sex, age, temperature, humidity, pressure, and wind speed may modify the short-term effects of outdoor air pollution on mortality in Jinan. Compared with the other pollutants, O3 had a stronger effect on respiratory deaths among the elderly. Moreover, chronic airway diseases were more susceptible to air pollution. Our findings provided new evidence for new local environmental and health policies making.