Association between PM2.5 and mortality of stomach and colorectal cancer in Xi'an: a time-series study

Long-term exposure to air pollution and incidence of gastric and the upper aerodigestive tract cancers in a pooled European cohort: The ELAPSE project

Air pollution has been shown to significantly impact human health including cancer. Gastric and upper aerodigestive tract (UADT) cancers are common and increased risk has been associated with smoking and occupational exposures. However, the association with air pollution remains unclear. We pooled European subcohorts (N = 287,576 participants for gastric and N = 297,406 for UADT analyses) and investigated the association between residential exposure to fine particles (PM2.5), nitrogen dioxide (NO2), black carbon (BC) and ozone in the warm season (O3w) with gastric and UADT cancer. We applied Cox proportional hazards models adjusting for potential confounders at the individual and area-level. During 5,305,133 and 5,434,843 person-years, 872 gastric and 1139 UADT incident cancer cases were observed, respectively. For gastric cancer, we found no association with PM2.5, NO2 and BC while for UADT the hazard ratios (95% confidence interval) were 1.15 (95% CI: 1.00-1.33) per 5 μg/m3 increase in PM2.5, 1.19 (1.08-1.30) per 10 μg/m3 increase in NO2, 1.14 (1.04-1.26) per 0.5 × 10-5 m-1 increase in BC and 0.81 (0.72-0.92) per 10 μg/m3 increase in O3w. We found no association between long-term ambient air pollution exposure and incidence of gastric cancer, while for long-term exposure to PM2.5, NO2 and BC increased incidence of UADT cancer was observed.

The association between ambient air pollution and colorectal cancer: a Mendelian randomization study

Mounting epidemiology studies have reported the potential associations between ambient air pollution exposure and colorectal cancer (CRC). However, the genetic association between ambient air pollution and CRC remains unclear. Using the Genome-wide association study (GWAS) data from UK biobank, we explored the genetic association of CRC (5,657 cases and 372,016 controls) with four ambient air pollutants (PM2.5, PM10, NO2, NOx; n = 423,796 to 456,380) under the framework of Mendelian randomization (MR). Our results revealed a significant association between long-term NO2 exposure (per 10 µg/m3) and increased CRC risk, with an odds ratio (OR) of 1.02 (95% confidence interval [CI]: 1.00-1.03), while no statistical association was found between CRC risk and the other air pollutants. Sensitivity analysis confirmed the robustness of the results. It is imperative to consider the impact of air pollution, particularly NO2, in mitigating the risk of CRC.

Correlation between socioeconomic indices and epidemiological indices of thyroid cancer from 1990 to 2019 year: a global ecologic study

BACKGROUND

The incidence of thyroid cancer as the most common type of endocrine gland malignancy has risen more significantly than any malignancies in recent years. Estimated new cases of thyroid cancer in the United States in 2024 were 12,500 and 31,520 for men and women, respectively, and estimated deaths were 1,180 for women and 990 for men. Indices of socio-economic have been commonly used to measure the development of countries. Therefore, this study aimed to examine the correlation between indices of socioeconomic status and epidemiological indices of thyroid cancer throughout the world. In addition, this study has compared two indices of human development and a socio-demographic index.

METHOD

This worldwide ecological study used data on thyroid cancer incidence, mortality, human development index (HDI), and sociodemographic index (SDI) between 1990 and 2019 from the Global Burden of Disease (GBD). We evaluated the correlation between incidence and mortality rates with socioeconomic indices by using Pearson's correlation coefficient. Furthermore, for the first time, the generalized additive model (GAM) was employed for modeling. The statistical software R, version 4.2.2, was used to conduct all statistical analyses.

RESULTS

The correlation between the incidence of thyroid cancer and the HDI was significant and positive (r = 0.47, p-value < 0.001). While the correlation between thyroid cancer mortality and HDI was not statistically significant (r = 0.01, p-value = 0.076). Besides, the incidence of thyroid cancer was significantly positively correlated with SDI (r = 0.48, p-value < 0.001). The multiple GAM showed that for one unit increase in HDI, the risk of thyroid cancer was increased by 2.1 times (RR = 2.1, 95%CI = 2.04 to 2.19), and for one unit increase in SDI, the risk of thyroid cancer was shown to increase by 2.2 times. (RR = 2.2, 95%CI = 2.19 to 2.35).

CONCLUSION

It has been evident that countries with higher incidence of thyroid cancer display higher socioeconomic indices. While, countries with higher socioeconomic indices, report lower mortality rates. However, based on the modeling results, it can be concluded that the SDI is slightly more useful in this regard. Therefore, examining the epidemiological indices of thyroid cancer by socio-economic indices can be useful to reflect a clear image of the distribution of this cancer in each country, and can be used for planning cancer prevention strategies.

The Effectiveness of a Mechanical Ventilation System for Indoor PM2.5 in Residential Houses

The mechanical ventilation systems used in houses are designed to reduce carbon dioxide emissions while minimizing the energy loss resulting from ventilation. However, the increase in indoor fine particulate (PM2.5) concentration because of external PM2.5 influx through the ventilation system poses a problem. Here, we analyzed the changes in indoor PM2.5 concentration, distinguishing between cases of high and low outdoor PM2.5 concentrations and considering the efficiency of the filters used in residential mechanical ventilation systems. When using filters with the minimum efficiency reporting value (MERV) of 10 in the ventilation system, the outdoor PM2.5 concentration was 5 μg/m³; compared to the initial concentration, the indoor PM2.5 concentration after 60 min decreased to 73%. When the outdoor PM2.5 concentration was 30-40 μg/m³, the indoor PM2.5 concentration reached 91%. However, when MERV 13 filters were used, the indoor PM2.5 concentration consistently dropped to 73-76%, regardless of the outdoor PM2.5 concentration. Furthermore, by comparing the established equation with the mass balance model, the error was confirmed to be within 5%, indicating a good fit. This allows for the prediction of indoor PM2.5 under various conditions when using mechanical ventilation systems, enabling the formulation of strategies for maintaining indoor PM2.5, as recommended by the World Health Organization.

Analysis of the spatio-temporal evolution of sustainable land use in China under the carbon emission trading scheme: A measurement idea based on the DID model

Sustainable development is the theme of world economic development in the 21st century. As a key part of sustainable development, sustainable land use (SLU) encompasses economic development and environmentally friendly and social progress. In recent decades, China has formulated many environmental regulatory policies to achieve sustainable development and "carbon peaking and carbon neutrality (double-carbon)" goals, among which the carbon emission trading scheme (CETS) is the most representative and provides valuable research. In this paper, we aimed to reflect the spatio-temporal evolution of SLU in China under the influence of environmental regulatory policies through an indicator measurement strategy based on the DID estimation method. The study conclusions are as follows: (1) The CETS can effectively improve SLU from the perspectives of economic development and environmentally friendly progress, and the impact has primarily been in the pilot areas. And, its effectiveness is closely linked to local locational factors. (2) With respect to the dimension of economic development, the CETS has not changed the provincial distribution patterns of SLU; rather, it continues to remain "high to low, east to west". However, regarding the environmentally friendly progress dimension, the CETS has significantly changed the provincial distribution patterns of SLU, which are characterized by spatial agglomeration with urban agglomerations such as the Pearl River Delta (PRD) and the Yangtze River Delta (YRD) as the core. (3) The screening results of the SLU indicators based on economic development showed that the CETS primarily improved the innovation capacities of pilot regions, and the impacts on economic levels were relatively small. Similarly, the screening results of the SLU indicators based on environmentally friendly progress showed that the CETS had primarily acted on reducing pollution emission intensity and strengthening greening construction, revealing only short-term effects on improving energy use efficiency. Based on the above, this paper explored the meaning and role of the CETS in more detail, with a view to providing insight into the implementation and formulation of environmental regulation policies.

Reconsidering the effects of urban form on PM2.5 concentrations: an urban shrinkage perspective

The phenomenon of urban shrinkage is currently occurring worldwide; however, the "growth-oriented" planning paradigm is not suitable for these shrinking cities. Reconsidering the relationship between urban form and PM_2.5 concentrations from the perspective of urban shrinkage can help provide a research reference for controlling air pollution and optimizing the spatial layout of shrinking cities. This study takes shrinking areas in China as the research subject, which are divided into four research groups according to their shrinkage degree. The empirical results indicate that the average PM_2.5 concentrations decrease with the aggravation of urban shrinkage. In terms of the effect of urban form on PM_2.5 concentrations, the urban size is always positively related to PM_2.5 concentrations, while the impact of urban fragmentation on PM_2.5 concentrations is negligible. Further, urban shape positively affects PM_2.5 concentrations only in moderately and severely shrinking cities. Cities with sprawling urban forms have higher PM_2.5 concentrations, except for those facing severe shrinking trends. This study suggests that governments in shrinking cities should reasonably adjust both the urban form and land use to improve air quality based on the degree of urban shrinkage.

Associations between fine particulate matter and colorectal cancer: a systematic review and meta-analysis

Colorectal cancer (CRC) is the second deadliest cancer worldwide. The impact of fine particulate matter (PM2.5) on many diseases is a global concern, yet its association with CRC is unclear. This study aimed to assess the effect of PM2.5 exposure on CRC. We searched PubMed, Web of Science, and Google Scholar databases for population-based articles published before September 2022, providing risk estimates with 95% confidence intervals (CI). Among 85,743 articles, we identified 10 eligible studies across multiple countries and regions in North America and Asia. We calculated the overall risk, incidence and mortality and performed subgroup analyses according to countries and regions. The results revealed an association between PM2.5 and increased risk of CRC (total risk, 1.19 [95% CI 1.12-1.28]; incidence, OR=1.18 [95% CI 1.09-1.28]; mortality, OR=1.21 [95% CI 1.09-1.35]). The elevated risks of CRC associated with PM2.5 were different across countries and regions, at 1.34 [95% CI 1.20-1.49], 1.00 [95% CI 1.00-1.00], 1.08 [95% CI 1.06-1.10], 1.18 [95% CI 1.07-1.29], 1.01 [95% CI 0.79-1.30], in the United States, China, Taiwan, Thailand, and Hong Kong, respectively. Incidence and mortality risks were higher in North America than those in Asia. In particular, the incidence and mortality were highest in the United States (1.61 [95% CI 1.38-1.89] and 1.29 [95% CI 1.17-1.42], respectively) than those in other countries. This study is the first comprehensive meta-analysis to find a strong association between PM2.5 exposure and increased CRC risk.

Association between ambient cold exposure and mortality risk in Shandong Province, China: Modification effect of particulate matter size

Introduction

Numerous studies have reported the modification of particulate matters (PMs) on the association between cold temperature and health. However, it remains uncertain whether the modification effect may vary by size of PMs, especially in Shandong Province, China where the disease burdens associated with cold temperature and PMs are both substantial. This study aimed to examine various interactive effects of cold exposure and ambient PMs with diameters ≤1/2.5 μm (PM1 and PM2.5) on premature deaths in Shandong Province, China.

Methods

In the 2013-2018 cold seasons, data on daily mortality, PM1 and PM2.5, and weather conditions were collected from the 1822 sub-districts of Shandong Province. A time-stratified case-crossover study design was performed to quantify the cumulative association between ambient cold and mortality over lag 0-12 days, with a linear interactive term between temperature and PM1 and PM2.5 additionally added into the model.

Results

The mortality risk increased with temperature decline, with the cumulative OR of extreme cold (-16.9°C, the 1st percentile of temperature range) being 1.83 (95% CI: 1.66, 2.02), compared with the minimum mortality temperature. The cold-related mortality risk was 2.20 (95%CI: 1.83, 2.64) and 2.24 (95%CI: 1.78, 2.81) on high PM1 and PM2.5 days, which dropped to 1.60 (95%CI: 1.39, 1.84) and 1.60 (95%CI: 1.37, 1.88) on low PM1 and PM2.5 days. PM1 showed greater modification effect for per unit concentration increase than PM2.5. For example, for each 10?g/m3 increase in PM1 and PM2.5, the mortality risk associated with extreme cold temperature increased by 7.6% (95% CI: 1.3%, 14.2%) and 2.6% (95% CI: -0.7%, 5.9%), respectively.

Discussion

The increment of smaller PMs' modification effect varied by population subgroups, which was particularly strong in the elderly aged over 75 years and individuals with middle school education and below. Specific health promotion strategies should be developed towards the greater modification effect of smaller PMs on cold effect.

A bibliometric and visualization analysis on the association between chronic exposure to fine particulate matter and cancer risk

INTRODUCTION

As one of the major pollutants in ambient air pollution, fine particulate matter (PM_2.5) has attracted public attention. A large body of laboratory and epidemiological research has shown that PM_2.5 exposure is harmful to human health.

METHODS

To investigate its association with the commonly observed PM-related cancer, a bibliometric study was performed on related publications from 2012 to 2021 from a macroscopic perspective with the help of the Web of Science database and scientometric software VOSviewer, CiteSpace V, HistCite, and Biblioshiny.

RESULTS

The results indicated that of the 1,948 enrolled documents, scientific productions increased steadily and peaked in 2020 with 348 publications. The most prolific authors, journals, organizations, and countries were Raaschou-Nielsen O, Science of the Total Environment, the Chinese Academy of Sciences, and China, respectively. The top five keywords in frequency order were "air pollution," "particulate matter," "lung cancer," "exposure," and "mortality."

DISCUSSION

The toxic mechanism of carcinogenicity was explained and is worthy of further investigation. China and the US collaborated most closely, and it is hoped the two countries can strengthen their collaboration to combat air pollution. There is also a need to identify the components of PM_2.5 and refine the models to assess the global burden of disease attributed to PM_2.5 exposure.

A comprehensive understanding of ambient particulate matter and its components on the adverse health effects based from epidemiological and laboratory evidence

The impacts of air pollution on public health have become a great concern worldwide. Ambient particulate matter (PM) is a major air pollution that comprises a heterogeneous mixture of different particle sizes and chemical components. The chemical composition and physicochemical properties of PM change with space and time, which may cause different impairments. However, the mechanisms of the adverse effects of PM on various systems have not been fully elucidated and systematically integrated. The Adverse Outcome Pathway (AOP) framework was used to comprehensively illustrate the molecular mechanism of adverse effects of PM and its components, so as to clarify the causal mechanistic relationships of PM-triggered toxicity on various systems. The main conclusions and new insights of the correlation between public health and PM were discussed, especially at low concentrations, which points out the direction for further research in the future. With the deepening of the study on its toxicity mechanism, it was found that PM can still induce adverse health effects with low-dose exposure. And the recommended Air Quality Guideline level of PM_2.5 was adjusted to 5 μg/m³ by World Health Organization, which meant that deeper and more complex mechanisms needed to be explored. Traditionally, oxidative stress, inflammation, autophagy and apoptosis were considered the main mechanisms of harmful effects of PM. However, recent studies have identified several emerging mechanisms involved in the toxicity of PM, including pyroptosis, ferroptosis and epigenetic modifications. This review summarized the comprehensive evidence on the health effects of PM and the chemical components of it, as well as the combined toxicity of PM with other air pollutants. Based on the AOP Wiki and the mechanisms of PM-induced toxicity at different levels, we first constructed the PM-related AOP frameworks on various systems.

PM2.5 exposure and cervical cancer survival in Liaoning Province, northeastern China

Particulate matter with a diameter of 2.5 μm or less (PM_2.5) has frequently been reported to be associated with an increased incidence of cancer, but few studies have explored the association between PM_2.5 exposure and cancer survival. We retrospectively analyzed the association between PM_2.5 exposure and the overall survival (OS) of cervical cancer patients residing in 14 urban areas of Liaoning Province, northeastern China, during January 2014-October 2021. Patients from urban areas who completed the recommended treatments with complete follow-up information were included. The PM_2.5 monitoring data of each urban area of Liaoning Province were retrieved, and individual exposure to PM_2.5 after diagnosis was calculated as the average daily concentration in the city of residence from the date of discharge to the date of death or the last follow-up. Log-rank tests and Cox regression were performed to examine the relationship between PM_2.5 exposure and cervical cancer survival. A total of 1753 cervical cancer patients were finally included, among whom 804 (45.9%) were from Shenyang City, the capital of Liaoning Province. The median average daily concentration of PM_2.5 to which the patients were exposed was 45.0 (interquartile range 38.2-50.0) μg/m³. Both log-rank tests (grouped by quartiles, p < 0.001) and Cox regression (continuous, HR = 1.06, 95% CI 1.04-1.08) indicated that PM_2.5 was significantly associated with shorter OS. Sensitivity analysis also confirmed the robustness of our findings. From the subgroup analysis, only the OS of stage II and stage III patients was associated with PM exposure. Our findings provide the insight that PM_2.5 exposure might be associated with shorter OS of cervical cancer patients.

The influence of socioeconomic and environmental determinants on acute myocardial infarction (AMI) mortality from the spatial epidemiological perspective

Plenty of epidemiological approaches have been explored to detect the effects of environmental and socioeconomic factors on acute myocardial infarction (AMI) mortality. Whereas, identifying the influence of potential affecting factors on AMI mortality based on a spatial epidemiological perspective was strongly desired. Moreover, the interaction effects of two potential factors on the diseases were always neglected previously. Here, the Geodetector and geographically & temporally weighted regression model (GTWR) combined with multi-source spatiotemporal datasets were introduced to quantitatively determine the relationship between AMI mortality and potential influencing factors across Xi'an during 2014-2016. Besides, Moran's I was adopted to diagnose the spatial autocorrelation of AMI mortality. Some findings were achieved. The number of AMI mortality cases increased from 5075 in 2014 to 6774 in 2016. Air pollutants, meteorological factors, economic status, and topography factors exhibited a significant effect on AMI mortality. The AMI mortality demonstrated an obvious spatial autocorrelation feature during 2014-2016. POP and PE represented the most obvious impact on AMI mortality, respectively. Moreover, the interaction of any two factors was larger than that of the single factor on AMI mortality, and the factors with the strongest interaction vary according to lag groups and ages. The effects of factors on AMI mortality were POP (- 628.925) > PE (140.102) > RD (79.145) > O₃ (- 58.438) > E_NH₃ (42.370) for male, and POP (- 751.206) > RD (132.935) > E_NH₃ (58.758) > PE (- 45.434) > O₃ (- 21.256) for female, respectively. This work reminds the local government to continuously control air pollution, strengthen urban planning, and improve the health care of the rural areas for alleviating AMI mortality. Meanwhile, the scheme of the current study supplies a scientific reference for examining the effects of potential impact factors on related diseases using the spatial epidemiological perspective.

A prospective cohort study on the association between waterpipe tobacco smoking and gastric cancer mortality in Northern Vietnam

Tobacco consumption, as a worldwide problem, is a risk factor for several types of cancer. In Vietnam, tobacco consumption in the form of waterpipe tobacco smoking is common. This prospective cohort study aimed to study the association between waterpipe tobacco smoking and gastric cancer mortality in Northern Vietnam. A total of 25,619 eligible participants were followed up between 2008 and 2019. Waterpipe tobacco and cigarette smoking data were collected; semi-quantitative food frequency and lifestyle questionnaires were also utilized. Gastric cancer mortality was determined via medical records available at the state health facilities. A Cox proportional hazards model was used to estimate hazard ratios (HR) and 95% confidence intervals (95% CI). During 314,992.8 person-years of follow-up, 55 men and 25 women deaths due to gastric cancer were identified. With never-smokers as the reference, the risk of gastric cancer mortality was significantly increased in participants who were ever-smoking (HR = 2.43, 95% CI = 1.35–4.36). The positive risk was also observed in men but was not significantly increased in women. By types of tobacco use, exclusive waterpipe smokers showed a significantly increased risk of gastric cancer mortality (HR = 3.22, 95% CI = 1.67–6.21) but that was not significantly increased in exclusive cigarette smokers (HR = 1.90, 95% CI = 0.88–4.07). There was a significant positive association between tobacco smoking and gastric cancer death for indicators of longer smoking duration, higher frequency per day, and cumulative frequency of both waterpipe and cigarette smoking. Waterpipe tobacco smoking would significantly increase the risk of gastric cancer mortality in the Vietnamese population. Further studies are required to understand the waterpipe tobacco smoking-driven gastric cancer burden and promote necessary interventions.

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.

Clinical Research on Gastrointestinal Surgery Based on Smart Medicine

Smart medical technology uses the medical information platform, with the help of current technical means, so that the information between medical staff and medical equipment can be shared. The combination of current technology and the medical field has become the norm. In the future, more artificial intelligence technologies will be incorporated in the medical field to promote the development of medical undertakings. At present, the information on the Internet is very large and complex, and general search engines often do not have knowledge in certain professional fields and can only perform shallow keyword searches, so it is difficult to meet people's medical diagnostic needs. Smart medical technology can solve the problem of these needs. Surgery, commonly known as operation, refers to the process of entering the body to change the condition of the disease through technical means and under the guidance of professionals. Earlier operations only performed cutting on the body surface. With the continuous maturity of surgical operations, operations can now be performed on any part, but manual operations are still the main one. In addition to manual surgery, there are many machine surgeries, such as laser surgeries. Clinical research takes the diagnosis and treatment of diseases as the main content, takes patients as the research object, and is a scientific research activity involving multiple personnel. This article aimed to study the clinical research of gastrointestinal surgery based on smart medicine and hoped to use smart medical technology to improve the clinical research level of gastrointestinal surgery and provide technical support for surgery. This study proposes to apply natural language processing technology to the medical field, build an intelligent diagnostic auxiliary system, and use the existing medical record data to realize the corresponding medical auxiliary function. The research measures and analyzes the basic information of medical students, the incidence of functional gastrointestinal disease, the incidence of common symptoms of functional gastrointestinal disease, and the differential distribution of various symptoms in different professions, genders, and ages. The experimental results of this article show that there are 27 cases of gastrointestinal bleeding, accounting for 18%; 10 cases of dysphagia, accounting for 7%; 78 cases of abdominal pain and bloating, accounting for 53%; and 19 cases of melena, accounting for 13%. Abdominal pain and bloating are the most common clinical manifestations of the gastrointestinal tract and require more attention.

Spatio-Temporal Evolution of Land Use Transition in the Background of Carbon Emission Trading Scheme Implementation: An Economic–Environmental Perspective

In the political context of “carbon peaking” and “carbon neutrality” proposed by the Chinese government, this paper investigates the spatio-temporal evolution of land use transition in China after the implementation of the carbon emission trading scheme (CETS). Based on the analysis of the spatio-temporal evolution, we discuss the spatial spillover of the policy effects. With the help of China’s CETS policy, this study explores the above issues with the main observation samples of the six provincial pilots included in CETS. Using the entropy weighting method, the indicator construction method, and local Moran’s I test, this paper takes 30 provincial areas in China from 2010 to 2017 as the full sample, and draws the following conclusions: (1) both the economic and environmental effects generated by CETS can optimize land use transition in the pilot areas, but the effective time points of the two are different; (2) the time for land use transition to be optimized by the two effects of CETS is different, among which the economic effect takes effect faster than the environmental effect; and (3) there is spatial spillover of the optimization effect of CETS on land use transition, but the specific effect depends on the industrial structure and development plan of the pilot areas.

Different Mortality Risks of Long-Term Exposure to Particulate Matter across Different Cancer Sites

Particulate matter (PM) air pollution has challenged the global community and the International Agency for Research on Cancer (IARC) classified airborne particulate matter as carcinogenic to humans. However, while most studies of cancer examined a single cancer type using different cohorts, few studies compared the associations of PM between different cancer types. We aimed to compare the association of long-term exposure to PM (PM₁₀ and PM_2.5) and cancer mortality across 17 different types of cancer using a population-based cohort in the Seoul Metropolitan Area (SMA), South Korea; Our study population includes 87,608 subjects (mean age: 46.58 years) residing in the SMA from the National Health Insurance Services-National Sample cohort (NHIS-NSC) and followed up for 2007-2015. We used the time-dependent Cox proportional hazards model to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs) of each cancer mortality per 10 μg/m³ increase in PM concentrations, after adjusting for individual and areal characteristics. During eight years of follow-up, 1487 people died with any of 17 cancer types. Lung cancer death was the highest, followed by liver and stomach cancer. Although we did not find the association for all cancer types, possibly because of limited cancer cases, HRs of PM_2.5 were relatively high for lung, stomach, pancreas, non-Hodgkin's lymphoma, prostate, esophagus, oral and pharynx, and brain cancer mortality (HRs = 1.44-7.14). High HRs for pancreas, non-Hodgkin's lymphoma, esophagus, and oral and pharynx cancer were also seen for PM₁₀; our findings suggest PM air pollution as a potential risk factor of cancer mortality for upper digestive tracts, mouth, pancreas, and non-Hodgkin's lymphoma in a highly urbanized population with high exposure to PM for a long time.

Environmental factors associated with gastric carcinogenesis

PURPOSE OF REVIEW

Gastric cancer is one of the leading causes of cancer-related deaths globally. Several modifiable environmental factors have been linked to gastric carcinogenesis but in many cases, evidence is either weak or fragmented. In this review, we interrogate the latest evidence implicating environmental factors in the development of gastric cancer.

RECENT FINDINGS

We are writing this review at a time when technological advancements are enabling scientists to effectively conduct large epidemiological studies with better tools for exposure estimations. We have highlighted risk factors that do not yet have enough evidence to be included as definite carcinogens in the International Agency for Research on Cancer monographs but have the potential for inclusion in the near future. Considered in our review are the links between gastric cancer and exposure to biomass smoke, particulate matter, occupational hazards and water contamination.

SUMMARY

This review illustrates the need for vigilance as evidence linking gastric cancer to various environmental factors is mounting. Many of these factors are modifiable, allowing for preventive strategies that could further decrease the global burden of gastric cancer.

Exposure to Outdoor Particulate Matter Air Pollution and Risk of Gastrointestinal Cancers in Adults: A Systematic Review and Meta-Analysis of Epidemiologic Evidence

BACKGROUND

Outdoor air pollution is a known lung carcinogen, but research investigating the association between particulate matter (PM) and gastrointestinal (GI) cancers is limited.

OBJECTIVES

We sought to review the epidemiologic literature on outdoor PM and GI cancers and to put the body of studies into context regarding potential for bias and overall strength of evidence.

METHODS

We conducted a systematic review and meta-analysis of epidemiologic studies that evaluated the association of fine PM [PM with an aerodynamic diameter of ≤2.5μm (PM2.5)] and PM10 (aerodynamic diameter ≤10μm) with GI cancer incidence or mortality in adults. We searched five databases for original research published from 1980 to 2021 in English and summarized findings for studies employing a quantitative estimate of exposure overall and by specific GI cancer subtypes. We evaluated the risk of bias of individual studies and the overall quality and strength of the evidence according to the Navigation Guide methodology, which is tailored for environmental health research.

RESULTS

Twenty studies met inclusion criteria and included participants from 14 countries; nearly all were of cohort design. All studies identified positive associations between PM exposure and risk of at least one GI cancer, although in 3 studies these relationships were not statistically significant. Three of 5 studies estimated associations with PM10 and satisfied inclusion criteria for meta-analysis, but each assessed a different GI cancer and were therefore excluded. In the random-effects meta-analysis of 13 studies, PM2.5 exposure was associated with an increased risk of GI cancer overall [risk ratio (RR)=1.12; 95% CI: 1.01, 1.24]. The most robust associations were observed for liver cancer (RR=1.31; 95% CI: 1.07, 1.56) and colorectal cancer (RR=1.35; 95% CI: 1.08, 1.62), for which all studies identified an increased risk. We rated most studies with "probably low" risk of bias and the overall body of evidence as "moderate" quality with "limited" evidence for this association. We based this determination on the generally positive, but inconsistently statistically significant, effect estimates reported across a small number of studies.

CONCLUSION

We concluded there is some evidence of associations between PM2.5 and GI cancers, with the strongest evidence for liver and colorectal cancers. Although there is biologic plausibility for these relationships, studies of any one cancer site were few and there remain only a small number overall. Studies in geographic areas with high GI cancer burden, evaluation of the impact of different PM exposure assessment approaches on observed associations, and investigation of cancer subtypes and specific chemical components of PM are important areas of interest for future research. https://doi.org/10.1289/EHP9620.

Contributing factors common to COVID‑19 and gastrointestinal cancer

The devastating complications of coronavirus disease 2019 (COVID-19) result from the dysfunctional immune response of an individual following the initial severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Multiple toxic stressors and behaviors contribute to underlying immune system dysfunction. SARS-CoV-2 exploits the dysfunctional immune system to trigger a chain of events, ultimately leading to COVID-19. The authors have previously identified a number of contributing factors (CFs) common to myriad chronic diseases. Based on these observations, it was hypothesized that there may be a significant overlap between CFs associated with COVID-19 and gastrointestinal cancer (GIC). Thus, in the present study, a streamlined dot-product approach was used initially to identify potential CFs that affect COVID-19 and GIC directly (i.e., the simultaneous occurrence of CFs and disease in the same article). The nascent character of the COVID-19 core literature (~1-year-old) did not allow sufficient time for the direct effects of numerous CFs on COVID-19 to emerge from laboratory experiments and epidemiological studies. Therefore, a literature-related discovery approach was used to augment the COVID-19 core literature-based ‘direct impact’ CFs with discovery-based ‘indirect impact’ CFs [CFs were identified in the non-COVID-19 biomedical literature that had the same biomarker impact pattern (e.g., hyperinflammation, hypercoagulation, hypoxia, etc.) as was shown in the COVID-19 literature]. Approximately 2,250 candidate direct impact CFs in common between GIC and COVID-19 were identified, albeit some being variants of the same concept. As commonality proof of concept, 75 potential CFs that appeared promising were selected, and 63 overlapping COVID-19/GIC potential/candidate CFs were validated with biological plausibility. In total, 42 of the 63 were overlapping direct impact COVID-19/GIC CFs, and the remaining 21 were candidate GIC CFs that overlapped with indirect impact COVID-19 CFs. On the whole, the present study demonstrates that COVID-19 and GIC share a number of common risk/CFs, including behaviors and toxic exposures, that impair immune function. A key component of immune system health is the removal of those factors that contribute to immune system dysfunction in the first place. This requires a paradigm shift from traditional Western medicine, which often focuses on treatment, rather than prevention.

Association of Ambient Fine Particulate Matter (PM2.5) with Elevated Fecal Hemoglobin Concentration and Colorectal Carcinogenesis: A Population-Based Retrospective Cohort Study

The roles of ambient fine particulate matter (PM_2.5) in the prevention of colorectal cancer (CRC) have been scarcely highlighted as there is short of empirical evidence regarding the influences of PM_2.5 on multistep carcinogenic processes of CRC. A retrospective cohort design with multistate outcomes was envisaged by linking monthly average PM_2.5 concentrations at 22 city/county level with large-scale cohorts of cancer-screened population to study the influences of PM_2.5 on short-term inflammatory process and multistep carcinogenic processes of CRC. Our study included a nationwide CRC screening cohort of 4,628,995 aged 50-69 years who attended first screen between 2004 and 2009 and continued periodical screens until 2016. We aimed to illustrate the carcinogenesis of PM_2.5 related to CRC by applying both hierarchical logistical and multistate Markov regression models to estimate the effects of air pollution on fecal immunochemical test (FIT) positive (a proxy of inflammatory marker) and pre-clinical and clinical states of CRC in the nationwide cohort. We found a significant association of high PM_2.5 exposure and FIT-positive by an increased risk of 11% [95% confidence interval (CI), 10-12]. PM_2.5 enhanced the risk of being preclinical state by 14% (95% CI, 10-18) and that of subsequent progression from pre-clinical to clinical state by 21% (95% CI, 14-28). Furthermore, the elevated risks for CRC carcinogenesis were significantly higher for people living in high PM_2.5 pollution areas in terms of yearly averages and the number days above 35 µg/m³ than those living in low PM_2.5 pollution areas. We concluded that both short-term and long-term PM_2.5 exposure were associated with multistep progression of CRC, which were useful to design precision primary and secondary prevention strategies of CRC for people who are exposed to high PM_2.5 pollution.

Environmental Regulations and Corporate Green Innovation in China: The Role of City Leaders' Promotion Pressure

China and other emerging market countries have suffered from the problem of environmental pollution while developing rapidly in the past few decades. In recent years, many countries have introduced strict environmental regulations in order to achieve sustainable development. This paper discusses the relationship between environmental regulations and corporate green innovation from the perspective of regional leaders' promotion pressure. The empirical results show that direct policy regulation within the region stimulates green innovation on the part of enterprises, and the promotion pressure of city leaders has a further positive moderating effect on the positive correlation between environmental regulations and enterprises' green innovation. The conclusion of the study proves that a strict environmental policy can promote the effectiveness of an environmental performance appraisal system in the sustainable development plans of cities and enterprises. This paper not only reveals the influence path of official promotion pressure on the sustainable development of enterprises in the administrative area from the micro perspective but also sheds some light that may improve government governance and promote the transformation of enterprises.

Should There Be Industrial Agglomeration in Sustainable Cities?: A Perspective Based on Haze Pollution

Haze pollution is a problem that cannot be ignored in the process of building sustainable cities, and while shifting industrial enterprises can solve the problem at the root, it is not conducive to the sustainable development of urban economies. This paper discusses the role of industrial agglomeration on urban pollution amelioration (haze pollution) using a sample of 253 prefecture-level cities in China. The highlight of this paper is the study of economic and environmental factors in the development of sustainable cities in the same framework and a series of econometric treatments that greatly increase the accuracy of the empirical evidence. Research intuitively shows that China’s haze pollution is clustered in spatial distribution and is spatially heterogeneous in concentration. With the passage of time, haze pollution has a tendency to move from an H–H concentration area to an L–L concentration area. The regression results show that an increase in the scale of local industrial agglomeration will lead to a decrease in local haze pollution; but an increase in the scale of local industrial agglomeration will lead to an increase in haze pollution in adjacent areas. Industrial agglomeration has significant spatial spillover effects, which are spatially heterogeneous. In addition, spillover effects between regions are greater than those within regions. After replacing the spatial weight matrix and controlling the endogenous problem using the instrumental variable method, the conclusion is still robust.

Risk of gastric cancer in the environs of industrial facilities in the MCC-Spain study

BACKGROUND

Gastric cancer is the fifth most frequent tumor worldwide. In Spain, it presents a large geographic variability in incidence, suggesting a possible role of environmental factors in its etiology. Therefore, epidemiologic research focused on environmental exposures is necessary.

OBJECTIVES

To assess the association between risk of gastric cancer (by histological type and tumor site) and residential proximity to industrial installations, according to categories of industrial groups and specific pollutants released, in the context of a population-based multicase-control study of incident cancer conducted in Spain (MCC-Spain).

METHODS

In this study, 2664 controls and 137 gastric cancer cases from 9 provinces, frequency matched by province of residence, age, and sex were included. Distances from the individuals' residences to the 106 industries located in the study areas were computed. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (95%CIs) for categories of distance (from 1 km to 3 km) to industries, adjusting for matching variables and potential confounders.

RESULTS

Overall, no excess risk of gastric cancer was observed in people living close to the industrial installations, with ORs ranging from 0.73 (at ≤2.5 km) to 0.93 (at ≤1.5 km). However, by industrial sector, excess risks (OR; 95%CI) were found near organic chemical industry (3.51; 1.42-8.69 at ≤2 km), inorganic chemical industry (3.33; 1.12-9.85 at ≤2 km), food/beverage sector (2.48; 1.12-5.50 at ≤2 km), and surface treatment using organic solvents (3.59; 1.40-9.22 at ≤3 km). By specific pollutant, a statistically significant excess risk (OR; 95%CI) was found near (≤3 km) industries releasing nonylphenol (6.43; 2.30-17.97) and antimony (4.82; 1.94-12.01).

CONCLUSIONS

The results suggest no association between risk of gastric cancer and living in the proximity to the industrial facilities as a whole. However, a few associations were detected near some industrial sectors and installations releasing specific pollutants.

The associations of air pollution and socioeconomic factors with esophageal cancer in China based on a spatiotemporal analysis

Rapid urbanization and industrialization in China have incurred serious air pollution and consequent health concerns. In this study, we examined the modifying effects of urbanization and socioeconomic factors on the association between PM_2.5 and incidence of esophageal cancer (EC) in 2000-2015 using spatiotemporal techniques and a quasi-Poisson generalized linear model. The results showed a downward trend of EC and high-risk areas aggregated in North China and Huai River Basin. In addition, a stronger association between PM_2.5 and incidence was observed in low urbanization group, and the association was stronger for females than males. When exposure time-windows were adjusted as 0, 5, 10, 15 years, the incidence risk increased by 2.48% (95% CI: 2.23%, 2.73%), 2.20% (95% CI: 1.91%, 2.49%), 2.18% (95% CI%: 1.92%, 2.43%), 1.87% (95% CI%:1.64, 2.10%) for males, respectively and 4.03% (95% CI: 3.63%, 4.43%), 2.20% (95% CI: 1.91%, 2.49%), 3.97% (95% CI: 3.54%, 4.41%), 3.06% (95% CI: 2.71%, 3.41%) for females, respectively. The findings indicated people in low urbanization group faced with a stronger EC risk caused by PM_2.5, which contributes to a more comprehensive understanding of combating EC challenges related to PM_2.5 pollution.

Air Pollution Status in 10 Mega-Cities in China during the Initial Phase of the COVID-19 Outbreak

Over the past decades, urbanization and industrialization have led to a change in air quality, bringing researchers to a full realization of the damaging effects of human activities on the environment. This study focused on describing air quality during the initial phase of the Novel Coronavirus disease (COVID-19) pandemic (since there were fewer anthropogenic activities) in 10 Chinese mega-cities. Using the independent t-test, the means of air quality index (AQI) scores and individual air pollutants concentration during the outbreak were compared with the means before the outbreak. Cohen’s d was estimated to quantify how much difference was observed. Based on the AQI score, the air quality in these 10 cities ranged from excellent (Shenzhen) to light pollution (Xi’an) with 44.8 μg m⁻³ and 119.7 μg m⁻³, respectively. In comparison to the 2019 air quality, Guangzhou and Wuhan noted major differences in air quality during the outbreak. Indicators of traffic pollution, particularly NO₂, were significantly lower during the outbreak in all cities. Particulate matter pollution varied, with some cities observing lower concentrations and other higher concentrations during the outbreak. There was a significant decrease in air pollution levels during the outbreak. More researchers should observe changes in air quality during peculiar or major events. Implementation of stringent regulation on vehicle use should be considered in mega-cities. Relevant findings should be employed in emphasizing the detrimental effects of anthropogenic activities and support the need for stringent emission control regulations.

Determining the effects of socioeconomic and environmental determinants on chronic obstructive pulmonary disease (COPD) mortality using geographically and temporally weighted regression model across Xi'an during 2014-2016

Numerous methods have been implemented to evaluate the relationship between environmental factors and respiratory mortality. However, the previous epidemiological studies seldom considered the spatial and temporal variation of the independent variables. The present study aims to detect the relations between respiratory mortality and related affecting factors across Xi'an during 2014-2016 based on a novel geographically and temporally weighted regression model (GTWR). Meanwhile, the ordinary least square (OLS) and the geographically weighted regression (GWR) models were developed for cross-comparison. Additionally, the spatial autocorrelation and Hot Spot analysis methods were conducted to detect the spatiotemporal dynamic of respiratory mortality. Some important outcomes were obtained. Socioeconomic and environmental determinants represented significant effects on respiratory diseases. The respiratory mortality exhibited an obvious spatial correlation feature, and the respiratory diseases tend to occur in winter and rural areas of the study area. The GTWR model outperformed OLS and GWR for determining the relations between respiratory mortality and socioeconomic as well as environmental determinants. The influence degree of anthropic factors on COPD mortality was higher than natural factors, and the effects of independent variables on COPD varied timely and locally. The results can supply a scientific basis for respiratory disease controlling and health facilities planning.

The Inducible Role of Ambient Particulate Matter in Cancer Progression via Oxidative Stress-Mediated Reactive Oxygen Species Pathways: A Recent Perception

Simple Summary

Particulate matter, especially the fine fraction PM2.5, is officially stated as carcinogenic to human. There are compelling evidences on the association between PM2.5 exposure and lung cancer, and there are also some preliminary data reporting the significant links between this fraction with non-lung cancers. The underlying mechanisms remain unclear. Further studies related to such scope are highly required. The purpose of this work is to systemically analyze recent findings concerning the relationship between PM2.5 and cancer, and to thoroughly present the oxidative stress pathways mediated by reactive oxygen species as the key mechanism for carcinogenesis induced by PM2.5. This will provide a more comprehensive and updated knowledge regarding carcinogenic capacity of PM2.5 to both clinicians and public health workers, contributing to preventive and therapeutic strategies to fight against cancer in human.

Abstract

Cancer is one of the leading causes of premature death and overall death in the world. On the other hand, fine particulate matter, which is less than 2.5 microns in aerodynamic diameter, is a global health problem due to its small diameter but high toxicity. Accumulating evidence has demonstrated the positive associations between this pollutant with both lung and non-lung cancer processes. However, the underlying mechanisms are yet to be elucidated. The present review summarizes and analyzes the most recent findings on the relationship between fine particulate matter and various types of cancer along with the oxidative stress mechanisms as its possible carcinogenic mechanisms. Also, promising antioxidant therapies against cancer induced by this poison factor are discussed.

Cancer mortality risk, fine particulate air pollution, and smoking in a large, representative cohort of US adults

PURPOSE

Air pollution and smoking are associated with various types of mortality, including cancer. The current study utilizes a publicly accessible, nationally representative cohort to explore relationships between fine particulate matter (PM2.5) exposure, smoking, and cancer mortality.

METHODS

National Health Interview Survey and mortality follow-up data were combined to create a study population of 635,539 individuals surveyed from 1987 to 2014. A sub-cohort of 341,665 never-smokers from the full cohort was also created. Individuals were assigned modeled PM2.5 exposure based on average exposure from 1999 to 2015 at residential census tract. Cox Proportional Hazard models were utilized to estimate hazard ratios for cancer-specific mortality controlling for age, sex, race, smoking status, body mass, income, education, marital status, rural versus urban, region, and survey year.

RESULTS

The risk of all cancer mortality was adversely associated with PM2.5 (per 10 µg/m3 increase) in the full cohort (hazard ratio [HR] 1.15, 95% confidence interval [CI] 1.08-1.22) and the never-smokers' cohort (HR 1.19, 95% CI 1.06-1.33). PM2.5-morality associations were observed specifically for lung, stomach, colorectal, liver, breast, cervix, and bladder, as well as Hodgkin lymphoma, non-Hodgkin lymphoma, and leukemia. The PM2.5-morality association with lung cancer in never-smokers was statistically significant adjusting for multiple comparisons. Cigarette smoking was statistically associated with mortality for many cancer types.

CONCLUSIONS

Exposure to PM2.5 air pollution contributes to lung cancer mortality and may be a risk factor for other cancer types. Cigarette smoking has a larger impact on cancer mortality than PM2.5 , but is associated with similar cancer types.