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Chen P, Yuan Z, Miao L, Yang L, Wang H, Xu D, Lin Z. Acute cardiorespiratory response to air quality index in healthy young adults. ENVIRONMENTAL RESEARCH 2022; 214:113983. [PMID: 35948148 DOI: 10.1016/j.envres.2022.113983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 06/27/2022] [Accepted: 07/22/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Little is known about the acute health impacts of air quality index (AQI) on cardiorespiratory risk factors. OBJECTIVES To assess the short-term links of AQI with cardiorespiratory risk factors in young healthy adults. METHODS We performed a longitudinal panel study with 4 repeated visits in 40 healthy young adults in Hefei, Anhui Province, China from August to October 2021. Cardiorespiratory factors included systolic blood pressure (BP), diastolic BP (DBP), mean arterial pressure (MAP) and fractional exhaled nitric oxide (FeNO). We collected hourly AQI data from a nearby air quality monitoring site. Linear mixed-effects model was applied to assess the effects of AQI on BP and FeNO. RESULTS The study participants (75.0% females) provided 160 pairs of valid health measurements with average age of 24 years. The mean AQI level was 44.43 during the study period. There were significant positive associations of AQI with three BP parameters and FeNO at different lag periods. For example, an interquartile range increase in AQI (26.54 unit) over lag 0-24 h was associated with increments of 6.69 mmHg (95%CI: 2.95-10.44), 5.71 mmHg (95%CI: 3.30-8.13), 6.04 mmHg (95%CI: 3.46-8.62) and 5.67% (95%CI: 1.05%-16.05%) in SBP, DBP, MAP and FeNO, respectively. The results were robust after controlling for PM1. We did not find effect modifications by gender, BMI, physical activity, or AQI category level on the associations. CONCLUSIONS The current findings on associations of AQI with cardiorespiratory factors might add evidence of the acute adverse cardiorespiratory consequences following air pollution.
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Affiliation(s)
- Ping Chen
- Department of Toxicology, School of Public Health, Anhui Medical University, Hefei, 230032, China
| | - Zhi Yuan
- Department of Toxicology, School of Public Health, Anhui Medical University, Hefei, 230032, China
| | - Lin Miao
- Department of Toxicology, School of Public Health, Anhui Medical University, Hefei, 230032, China
| | - Liyan Yang
- Department of Toxicology, School of Public Health, Anhui Medical University, Hefei, 230032, China
| | - Hua Wang
- Department of Toxicology, School of Public Health, Anhui Medical University, Hefei, 230032, China; Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Anhui Medical University, Hefei, 230032, China
| | - Dexiang Xu
- Department of Toxicology, School of Public Health, Anhui Medical University, Hefei, 230032, China; Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Anhui Medical University, Hefei, 230032, China.
| | - Zhijing Lin
- Department of Toxicology, School of Public Health, Anhui Medical University, Hefei, 230032, China; Key Laboratory of Environmental Toxicology of Anhui Higher Education Institutes, Anhui Medical University, Hefei, 230032, China.
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Concentration–Response Functions as an Essence of the Results from Lags. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19138116. [PMID: 35805772 PMCID: PMC9265718 DOI: 10.3390/ijerph19138116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 06/21/2022] [Accepted: 06/29/2022] [Indexed: 02/04/2023]
Abstract
Among various aspects of environmental epidemiology, one is to assess the relationships between ambient air pollution and health outcomes. The goal of this work is to estimate the associations in the form of the parametric concentration–response functions (C-RF). Various forms of the C-RFs are proposed in this short-term health effect study. Emergency department (ED) visits for all respiratory health problems are analyzed as an illustrative example. A case-crossover (CC) technique is applied as a study design. Daily cases are organized as daily counts by the same day of the week in one common month. A conditional Poisson regression is used in the constructed statistical models. Temperature and relative humidity are included in the statistical models in the form of natural splines. Ground-level ozone concentration is considered an exposure. Ozone concentration values are transformed and submitted to the statistical models. The parameters of the transformation are determined by using the goodness of fit criterion. Counts of ED visits are analyzed in relation to a sequence of lagged exposure to ozone. The C-RF shapes are constructed for each individual lag. In a final step, the set of the estimated C-RF shapes is used to create a pooled C-RF shape. The results are positive and statistically significant for nine lagged exposures, from 0 to 8 days. The following relative risks (RR) were estimated from the constructed C-RFs at 30 ppb concentration of ozone: RR = 1.0531 (95% confidence interval: 1.0231, 1.0718), 1.0462 (1.0253, 1.0677), and 1.0387, (1.0240, 1.0531), realizing the CC method, CC method + transformation, and CC method + flexible transformation, respectively. The pooled C-RF shape gives a summary of the associations between ED visits for respiratory conditions and ambient ozone. The estimated shapes indicate lower air health effects than the standard CC methods. Among three considered statistical models, the CC method + flexible transformation is the most appropriate to use according to the goodness of fit criterion.
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Szyszkowicz M, Lukina A, Dinu T. Urban Air Pollution and Emergency Department Visits for Neoplasms and Outcomes of Blood Forming and Metabolic Systems. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095603. [PMID: 35564996 PMCID: PMC9105125 DOI: 10.3390/ijerph19095603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 04/30/2022] [Accepted: 05/03/2022] [Indexed: 11/25/2022]
Abstract
This study focused on investigating possible associations between exposure to urban air pollution and the number of emergency department (ED) visits for various health outcomes. The outcomes were grouped into four chapters of the International Classification of Diseases Tenth Revision (ICD-10) system (i.e., Chapter II-IV: “Neoplasms”, “Diseases of the blood”, “Endocrine, nutritional and metabolic diseases”, and XVIII: “Symptoms, signs and abnormal clinical and laboratory findings“). The data were collected for the city of Toronto, Canada, (2004–2015, 4292 days). Four gaseous air pollutants (carbon monoxide (CO), nitrogen dioxide (NO2), ground level ozone (O3), and sulfur dioxide (SO2)) and fine particulate matter (PM2.5), and two calculated air quality health indexes (AQHI) based on Toronto were used. The statistical models were constructed by applying the conditional Poisson regression. The exposure was assessed over a maximum of 15 days (time lags 0–14 days). An analysis was performed with the following strata: sex, age, and seasons. Relative risks (RR) and their 95% confidence intervals (95%CI) were estimated for an increase in concentration by a one interquartile range (IQR). For the AQHI (composed of NO2, O3, and PM2.5), IQR = 1, the estimations for lag 1 and all patients, are RR = 1.023 (95%CI: 1.008, 1.038), 1.026 (1.012, 1.040), 1.013 (1.003, 1.024), and 1.007 (1.003, 1.010) for Chapters II–IV and XVIII, respectively. The results show that in the four large, analyzed health groups, the impact of air quality mainly occurs over a short period (from current day to a maximum of 3 days after exposure).
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Affiliation(s)
- Mieczysław Szyszkowicz
- Environmental Health Science & Research Bureau, Health Canada, Ottawa, ON K1A 0K9, Canada;
- Correspondence: or
| | - Anna Lukina
- Environmental Health Science & Research Bureau, Health Canada, Ottawa, ON K1A 0K9, Canada;
| | - Tatiana Dinu
- Water and Air Quality Bureau, Health Canada, Ottawa, ON K1A 0K9, Canada;
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Lin H, Long Y, Su Y, Song K, Li C, Ding N. Air pollution and hospital admissions for critical illness in emergency department: a tertiary-center research in Changsha, China, 2016-2020. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:21440-21450. [PMID: 34761317 DOI: 10.1007/s11356-021-17295-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 10/27/2021] [Indexed: 06/13/2023]
Abstract
We aimed to comprehensively investigate the associations of air pollutants with hospital admissions for critical illness in ED. Patients with critical illness including level 1 and level 2 of the Emergency Severity Index admitted in ED of Changsha Central Hospital from January 2016 to December 2020 were enrolled. Meteorological and air pollutants data source were collected from the National Meteorological Science Data Center. A Poisson generalized linear regression combined with a polynomial distributed lag model (PDLM) was utilized to explore the effect of air pollution on hospital admissions for critical illness in ED. Benchmarks as references (25th) were conducted for comparisons with high levels of pollutant concentrations (75th). At first, lagged effects of all different air pollutants were analyzed. Then, based on the most significant factor, analyses in subgroups were performed by gender (male and female), age (< 45, 45-65, and > 65), disorders (cardiovascular, neurological, respiratory), and seasons (spring, summer, autumn, and winter). A total of 47,290 patients with critical illness admitted in ED were included. The effects of air pollutants (PM2.5, PM10, SO2, NO2, O3 and CO) on critical illness ED visits were statistically significant. Strong collinearity between PM2.5 and PM10 (r = 0.862) was found. Both single-day lag and cumulative-day lag day models showed that PM2.5 had the strongest effects (lag 0, RR = 1.025, 95% CI 1.008-1.043, and lag 0-14, RR = 1.067, 95% CI 1.017-1.120, respectively). In both PM2.5 and PM10, the risks of critical illness in male, > 65 ages, respiratory diseases, and winter increased the most significant. Air pollutants, especially PM2.5 and PM10 exposure, could increase the risk of critical illness admission.
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Affiliation(s)
- Hang Lin
- Department of Emergency Medicine, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, NO. 161 Shaoshan South Road, Changsha, Hunan, 410004, China
| | - Yong Long
- Department of Emergency Medicine, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, NO. 161 Shaoshan South Road, Changsha, Hunan, 410004, China
| | - Yingjie Su
- Department of Emergency Medicine, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, NO. 161 Shaoshan South Road, Changsha, Hunan, 410004, China
| | - Kun Song
- Department of Emergency Medicine, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, NO. 161 Shaoshan South Road, Changsha, Hunan, 410004, China
| | - Changluo Li
- Department of Emergency Medicine, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, NO. 161 Shaoshan South Road, Changsha, Hunan, 410004, China
| | - Ning Ding
- Department of Emergency Medicine, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, NO. 161 Shaoshan South Road, Changsha, Hunan, 410004, China.
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Yang X, Wang Y, Chen D, Tan X, Tian X, Shi L. Does the "Blue Sky Defense War Policy" Paint the Sky Blue?-A Case Study of Beijing-Tianjin-Hebei Region, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312397. [PMID: 34886123 PMCID: PMC8657255 DOI: 10.3390/ijerph182312397] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 11/22/2021] [Accepted: 11/22/2021] [Indexed: 11/16/2022]
Abstract
Improving air quality is an urgent task for the Beijing-Tianjin-Hebei (BTH) region in China. In 2018, utilizing 365 days' daily concentration data of six air pollutants (including PM2.5, PM10, SO2, NO2, CO and O3) at 947 air quality grid monitoring points of 13 cities in the BTH region and controlling the meteorological factors, this paper takes the implementation of the Blue Sky Defense War (BSDW) policy as a quasi-natural experiment to examine the emission reduction effect of the policy in the BTH region by applying the difference-in-difference method. Results show that the policy leads to the significant reduction of the daily average concentration of PM2.5, PM10, SO2, O3 by -1.951 μg/m3, -3.872 μg/m3, -1.902 μg/m3, -7.882 μg/m3 and CO by -0.014 mg/m3, respectively. The results of the robustness test support the aforementioned conclusions. However, this paper finds that the concentration of NO2 increases significantly (1.865 μg/m3). In winter heating seasons, the concentration of SO2, CO and O3 decrease but PM2.5, PM10 and NO2 increase significantly. Besides, resource intensive cities, non-key environmental protection cities and cities in the north of the region have great potential for air pollutant emission reduction. Finally, policy suggestions are recommended; these include setting specific goals at the city level, incorporating more cities into the list of key environmental protection cities, refining the concrete indicators of domestic solid fuel, and encouraging and enforcing clean heating diffusion.
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Affiliation(s)
- Xuan Yang
- School of Environment and Natural Resources, Renmin University of China, Beijing 100872, China; (X.Y.); (Y.W.); (D.C.); (X.T.)
| | - Yue Wang
- School of Environment and Natural Resources, Renmin University of China, Beijing 100872, China; (X.Y.); (Y.W.); (D.C.); (X.T.)
| | - Di Chen
- School of Environment and Natural Resources, Renmin University of China, Beijing 100872, China; (X.Y.); (Y.W.); (D.C.); (X.T.)
| | - Xue Tan
- Energy Strategy and Planning Research Department, State Grid Energy Research Institute Co., Ltd., Beijing 102209, China;
| | - Xue Tian
- School of Environment and Natural Resources, Renmin University of China, Beijing 100872, China; (X.Y.); (Y.W.); (D.C.); (X.T.)
| | - Lei Shi
- School of Environment and Natural Resources, Renmin University of China, Beijing 100872, China; (X.Y.); (Y.W.); (D.C.); (X.T.)
- Correspondence: ; Tel.: +86-10-82502696
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Saygin H, Mercan Y, Yorulmaz F. The association between air pollution parameters and emergency department visits and hospitalizations due to cardiovascular and respiratory diseases: a time-series analysis. Int Arch Occup Environ Health 2021; 95:599-606. [PMID: 34617165 DOI: 10.1007/s00420-021-01769-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 09/27/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVE In this study, the association between cardiovascular and respiratory Emergency Department (ED) visits and hospitalizations and Sulfur Dioxide (SO2) and particulate matter with an aerodynamic diameter ≤ 10 µm (PM10) was determined. METHODS The records of a total of 632,223 people diagnosed with cardiovascular diseases (ICD-10 code I00-I99) and respiratory diseases (ICD-10 code J00-J99) at and over the age of 18 between 2012 and 2018 in three hospitals in Karaman in Turkey were examined in the present study. The daily 24-h averages for SO2 and PM10 concentrations were acquired in National Air Quality Monitoring. A time-series analysis with Poisson Generalized Linear Model was used. RESULTS Among the air pollution parameters, the mean ± standard deviation of SO2 and PM10 were 16.2 ± 22.1 and 75.8 ± 48.2 μg/m3, respectively. An increase of 10 μg/m3 in SO2 was associated with a 3% [Relative Risk (RR), 95% Confidence Interval (CI): 2-4)] increase in cardiovascular ED visit and 2% (RR, 95% CI 2-3) increase in respiratory ED visit, and 1% (RR, 95% CI 1-3) increase in respiratory hospitalizations. An increase of 10 μg/m3 in PM10 was associated with a 1% (RR, 95% CI 1-2) increase in cardiovascular hospitalizations. CONCLUSIONS Increases in SO2 are a risk factor for cardiovascular and respiratory ED visits, and respiratory hospitalizations. Increases in PM10 are a risk factor for cardiovascular hospitalizations.
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Affiliation(s)
- Hasan Saygin
- Department of Public Health, Kirklareli University Institute of Health Sciences, Kirklareli, Turkey.,Karaman Provincial Health Directorate Health Services Unit, 70110, Karaman, Turkey
| | - Yeliz Mercan
- Department of Public Health, Kirklareli University Institute of Health Sciences, Kirklareli, Turkey. .,Faculty of Health Science, Department of Health Management, Kirklareli University, 39000, Kirklareli, Turkey.
| | - Faruk Yorulmaz
- Faculty of Medicine, Department of Public Health, Trakya University, Edirne, Turkey
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Szyszkowicz M, Schoen S, de Angelis N. Air Pollution and Emergency Department Visits for Disease of the Genitourinary System. ENVIRONMENTAL HEALTH INSIGHTS 2021; 15:11786302211025360. [PMID: 34188483 PMCID: PMC8212373 DOI: 10.1177/11786302211025360] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 05/27/2021] [Indexed: 05/24/2023]
Abstract
The aim of this study is to determine associations between ambient air pollution and the number of emergency department (ED) visits for diseases of the genitourinary tract in Toronto, Canada. We used the National Ambulatory Care Reporting System (NACRS) database to obtain the related ED visits and developed statistical models using daily data on ED visits, temperature, relative humidity, and outdoor air pollution concentration levels. The NACRS database contains data on hospital-based and community-based ambulatory care. The environmental data were retrieved from the National Air Pollution Surveillance (NAPS) program. The NAPS is the main source of ambient air quality data in Canada. We considered 2 air quality health indexes and 6 air pollutants: daily means of fine particulate matter PM2.5, O3, CO, NO2, SO2, and also maximum 8-hour average ozone. For every air pollutant, we fit 270 models (15 lags × 18 strata). We found that same-day air pollution concentrations have the highest number of statistically significantly positive associations with ED visits for genitourinary health outcomes. A total of 133 positive associations were identified over the 14 days lag. In subgroup (strata) analysis, females older than 60 years of age were found to have the most positive associations. In particular, nitrogen dioxide was found to be highly associated with ED visits for females over 60; an increase in NO2 was associated with an increased relative risk (RR) of ED visits when lagged over 0, 1, and 2 days (RR = 1.040 [95% confidence interval: 1.028, 1.052], 1.020 [1.009, 1.032], and 1.025 [1.013, 1.036], respectively). The values of risks are reported for a 1 interquartile range increase in concentration (8.8 ppb). Our results suggest that urban ambient air pollution affect the number of ED visits due to genitourinary system conditions.
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Affiliation(s)
| | - Stephanie Schoen
- Environmental Health Science and
Research Bureau, Health Canada, Ottawa, ON, Canada
| | - Nicholas de Angelis
- Biomedical Program, Department of
Mechanical and Aerospace Engineering, Carleton University, Ottawa, ON, Canada
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