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Forastiere F, Spadaro JV, Ancona C, Jovanovic Andersen Z, Cozzi I, Gumy S, Loncar D, Mudu P, Medina S, Perez Velasco R, Walton H, Zhang J, Krzyzanowski M. Choices of morbidity outcomes and concentration-response functions for health risk assessment of long-term exposure to air pollution. Environ Epidemiol 2024; 8:e314. [PMID: 39045486 PMCID: PMC11265782 DOI: 10.1097/ee9.0000000000000314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 05/14/2024] [Indexed: 07/25/2024] Open
Abstract
Background Air pollution health risk assessment (HRA) has been typically conducted for all causes and cause-specific mortality based on concentration-response functions (CRFs) from meta-analyses that synthesize the evidence on air pollution health effects. There is a need for a similar systematic approach for HRA for morbidity outcomes, which have often been omitted from HRA of air pollution, thus underestimating the full air pollution burden. We aimed to compile from the existing systematic reviews and meta-analyses CRFs for the incidence of several diseases that could be applied in HRA. To achieve this goal, we have developed a comprehensive strategy for the appraisal of the systematic reviews and meta-analyses that examine the relationship between long-term exposure to particulate matter with an aerodynamic diameter smaller than 2.5 µm (PM2.5), nitrogen dioxide (NO2), or ozone (O3) and incidence of various diseases. Methods To establish the basis for our evaluation, we considered the causality determinations provided by the US Environmental Protection Agency Integrated Science Assessment for PM2.5, NO2, and O3. We developed a list of pollutant/outcome pairs based on these assessments and the evidence of a causal relationship between air pollutants and specific health outcomes. We conducted a comprehensive literature search using two databases and identified 75 relevant systematic reviews and meta-analyses for PM2.5 and NO2. We found no relevant reviews for long-term exposure to ozone. We evaluated the reliability of these studies using an adaptation of the AMSTAR 2 tool, which assesses various characteristics of the reviews, such as literature search, data extraction, statistical analysis, and bias evaluation. The tool's adaptation focused on issues relevant to studies on the health effects of air pollution. Based on our assessment, we selected reviews that could be credible sources of CRF for HRA. We also assessed the confidence in the findings of the selected systematic reviews and meta-analyses as the sources of CRF for HRA. We developed specific criteria for the evaluation, considering factors such as the number of included studies, their geographical distribution, heterogeneity of study results, the statistical significance and precision of the pooled risk estimate in the meta-analysis, and consistency with more recent studies. Based on our assessment, we classified the outcomes into three lists: list A (a reliable quantification of health effects is possible in an HRA), list B+ (HRA is possible, but there is greater uncertainty around the reliability of the CRF compared to those included on list A), and list B- (HRA is not recommended because of the substantial uncertainty of the CRF). Results In our final evaluation, list A includes six CRFs for PM2.5 (asthma in children, chronic obstructive pulmonary disease, ischemic heart disease events, stroke, hypertension, and lung cancer) and three outcomes for NO2 (asthma in children and in adults, and acute lower respiratory infections in children). Three additional outcomes (diabetes, dementia, and autism spectrum disorders) for PM2.5 were included in list B+. Recommended CRFs are related to the incidence (onset) of the diseases. The International Classification of Diseases, 10th revision codes, age ranges, and suggested concentration ranges are also specified to ensure consistency and applicability in an HRA. No specific suggestions were given for ozone because of the lack of relevant systematic reviews. Conclusion The suggestions formulated in this study, including CRFs selected from the available systematic reviews, can assist in conducting reliable HRAs and contribute to evidence-based decision-making in public health and environmental policy. Future research should continue to update and refine these suggestions as new evidence becomes available and methodologies evolve.
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Affiliation(s)
- Francesco Forastiere
- National Research Council, IFT, Palermo, Italy
- Environmental Research Group, Imperial College, London, United Kingdom
| | - Joseph V. Spadaro
- World Health Organization, Headquarters, Geneva, Switzerland
- Spadaro Environmental Research Consultants (SERC), Philadelphia, Pennsylvania
| | - Carla Ancona
- Department of Epidemiology, Lazio Regional Health Service, Local Health Unit Roma 1, Rome, Italy
| | | | - Ilaria Cozzi
- Department of Epidemiology, Lazio Regional Health Service, Local Health Unit Roma 1, Rome, Italy
| | - Sophie Gumy
- World Health Organization, Headquarters, Geneva, Switzerland
| | - Dejan Loncar
- World Health Organization, Headquarters, Geneva, Switzerland
| | - Pierpaolo Mudu
- World Health Organization (WHO), European Center for Environment and Health, Bonn, Germany
| | | | - Roman Perez Velasco
- World Health Organization (WHO), European Center for Environment and Health, Bonn, Germany
| | - Heather Walton
- Environmental Research Group, Imperial College, London, United Kingdom
- National Institute of Health Research Health Protection Research Unit on Environmental Exposures and Health at Imperial College London, London, United Kingdom
| | - Jiawei Zhang
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Hantrakool S, Sriwichai M, Shaengkhamnang B, Leetrakool N, Niprapan P, Kawichai S, Wannakul S, Panyasit N, Tuntivate P, Wongtagan O, Natesirinilkul R, Koonyosying P, Phinyo P, Punnachet T, Hantrakun N, Piriyakhuntorn P, Rattanathammethee T, Chai-Adisaksopha C, Rattarittamrong E, Tantiworawit A, Norasetthada L, Srichairatanakool S. The effects of ambient particulate matter air pollution on platelets and hemostasis. Front Public Health 2024; 12:1410406. [PMID: 39091522 PMCID: PMC11292950 DOI: 10.3389/fpubh.2024.1410406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Accepted: 07/08/2024] [Indexed: 08/04/2024] Open
Abstract
Introduction Elevated ambient pollution exposure is potentially linked to thromboembolism. However, the mechanisms by which particulate matter (PM) interferes with the balance of hemostatic system remain unclear. This study investigates PM-mediated hemostatic changes in individuals across unique seasonal variations of ambient pollution. Methods This prospective study was conducted between February and July 2020 during alterations in ambient pollution in Chiang Mai, Thailand. Blood tests from 30 healthy subjects were assessed at four-week intervals, four times in total. Various coagulation tests, including prothrombin time (PT), activated partial thromboplastin time (aPTT), von Willebrand factor (vWF), platelet count, and platelet functions, were evaluated. A mixed-effects model was used to analyze the impact of high PM2.5 and PM10 on hemostatic parameters. Results Thirty male subjects with mean age of 38.9 ± 8.2 years, were included. High levels of PM2.5 and PM10 were significantly associated with PT shortening, with no such effect observed in aPTT. PM2.5 and PM10 values also positively correlated with vWF function, while vWF antigen levels remained unchanged. Soluble P-selectin showed a strong positive association with PM2.5 and PM10 levels. Platelet function analysis revealed no correlation with PM values. Conclusion Short-term exposure to elevated PM2.5 and PM10 concentrations was linked to shortened PT and enhanced vWF function in healthy individuals. Exploring the impact of these changes on clinically relevant thrombosis is crucial. Additional studies on the pathogenesis of pollution-related thrombosis are warranted for maintaining good health.
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Affiliation(s)
- Sasinee Hantrakool
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Maitree Sriwichai
- Blood Bank Section, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | | | - Nipapan Leetrakool
- Blood Bank Section, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Piangrawee Niprapan
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Sawaeng Kawichai
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Sitapak Wannakul
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Noppamas Panyasit
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Pakinee Tuntivate
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Ornkamon Wongtagan
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Rungrote Natesirinilkul
- Division of Hematology/Oncology, Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Pimpisid Koonyosying
- Department of Biochemistry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Phichayut Phinyo
- Center for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Teerachat Punnachet
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Nonthakorn Hantrakun
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Pokpong Piriyakhuntorn
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Thanawat Rattanathammethee
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Chatree Chai-Adisaksopha
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Ekarat Rattarittamrong
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Adisak Tantiworawit
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Lalita Norasetthada
- Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Jiang Z, Zhang S, Gao T, Chen K, Liu Y, Liu Y, Wang T, Zeng P. Co-exposure to multiple air pollutants, genetic susceptibility, and the risk of myocardial infarction onset: a cohort analysis of the UK Biobank participants. Eur J Prev Cardiol 2024; 31:698-706. [PMID: 38085043 DOI: 10.1093/eurjpc/zwad384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 11/18/2023] [Accepted: 12/06/2023] [Indexed: 04/19/2024]
Abstract
AIMS The relationship between the long-term joint exposure to ambient air pollution and incidence of myocardial infarction (MI) and modification by genetic susceptibility remain inconclusive. METHODS AND RESULTS We analysed 329 189 UK Biobank participants without MI at baseline. Exposure concentrations to particulate matter (PM2.5 and PM10), nitrogen dioxide (NO2), and nitrogen oxides (NOx) were obtained. Air pollution score assessing the joint exposure was calculated, and its association with MI was evaluated via Cox model under the P value aggregation framework. Genetic susceptibility to MI was evaluated by incorporating polygenic risk score (PRS) into models. Risk prediction models were also established. During a median follow-up of 13.4 years, 9993 participants developed MI. Per interquartile range increase of PM2.5, PM10, NO2, and NOx resulted in 74% [95% confidence intervals (CIs) 69%-79%], 67% (63%-72%), 46% (42%-49%), and 38% (35%-41%) higher risk of MI. Compared with the lowest quartile (Q1) of air pollution score, the multivariable adjusted hazard ratio (HR) (95%CIs) of Q4 (the highest cumulative air pollution) was 3.50 (3.29-3.72) for MI. Participants with the highest PRS and air pollution score possessed the highest risk of incident MI (HR = 4.88, 95%CIs 4.35-5.47). Integrating PRS, air pollution exposure, and traditional factors substantially improved risk prediction of MI. CONCLUSION Long-term joint exposure to air pollutants including PM2.5, PM10, NO2, and NOx is substantially associated with increased risk of MI. Genetic susceptibility to MI strengthens such adverse joint association. Air pollutions together with genetic and traditional factors enhance the accuracy of MI risk prediction.
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Affiliation(s)
- Zhou Jiang
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, Jiangsu 221004, China
| | - Shuo Zhang
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, Jiangsu 221004, China
| | - Tongyu Gao
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, Jiangsu 221004, China
| | - Keying Chen
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, Jiangsu 221004, China
| | - Yuxin Liu
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, Jiangsu 221004, China
| | - Ying Liu
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, Jiangsu 221004, China
| | - Ting Wang
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, Jiangsu 221004, China
| | - Ping Zeng
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, Jiangsu 221004, China
- Center for Medical Statistics and Data Analysis, Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, Jiangsu 221004, China
- Key Laboratory of Human Genetics and Environmental Medicine, Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, Jiangsu 221004, China
- Key Laboratory of Environment and Health, Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, Jiangsu 221004, China
- Xuzhou Engineering Research Innovation Center of Biological Data Mining and Healthcare Transformation, Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, Jiangsu 221004, China
- Jiangsu Engineering Research Center of Biological Data Mining and Healthcare Transformation, Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, Jiangsu 221004, China
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Cao Y, Feng Y, Xia N, Zhang J. Causal associations of particulate matter 2.5 and cardiovascular disease: A two-sample mendelian randomization study. PLoS One 2024; 19:e0301823. [PMID: 38578766 PMCID: PMC10997086 DOI: 10.1371/journal.pone.0301823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 03/20/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND According to epidemiological studies, particulate matter 2.5 (PM2.5) is a significant contributor to cardiovascular disease (CVD). However, making causal inferences is difficult due to the methodological constraints of observational studies. In this study, we used two-sample Mendelian randomization (MR) to examine the causal relationship between PM 2.5 and the risk of CVD. METHODS Genome-wide association study (GWAS) statistics for PM2.5 and CVD were collected from the FinnGen and UK Biobanks. Mendelian randomization analyses were applied to explore the causal effects of PM2.5 on CVD by selecting single-nucleotide polymorphisms(SNP) as instrumental variables. RESULTS The results revealed that a causal effect was observed between PM2.5 and coronary artery disease(IVW: OR 2.06, 95% CI 1.35, 3.14), and hypertension(IVW: OR 1.07, 95% CI 1.03, 1.12). On the contrary, no causal effect was observed between PM2.5 and myocardial infarction(IVW: OR 0.73, 95% CI 0.44, 1.22), heart failure(IVW: OR 1.54, 95% CI 0.96, 2.47), atrial fibrillation(IVW: OR 1.03, 95% CI 0.71, 1.48), and ischemic stroke (IS)(IVW: OR 0.98, 95% CI 0.54, 1.77). CONCLUSION We discovered that there is a causal link between PM2.5 and coronary artery disease and hypertension in the European population, using MR methods. Our discovery may have the significance of public hygiene to improve the understanding of air quality and CVD risk.
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Affiliation(s)
- Ye Cao
- Department of Cardiology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, P. R. China
- Department of Cardiology, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, P. R. China
| | - Yi Feng
- Department of Cardiology, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, P. R. China
| | - Nan Xia
- Department of Cardiology, Renmin Hospital, Hubei University of Medicine, Shiyan, Hubei, P. R. China
| | - Jiancheng Zhang
- Department of Cardiology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, P. R. China
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Shen H, Gong M, Zhang M, Sun S, Zheng R, Yan Q, Hu J, Xie X, Wu Y, Yang J, Wu J, Yang J. Effects of PM 2.5 exposure on clock gene BMAL1 and cell cycle in human umbilical vein endothelial cells. Toxicol Res (Camb) 2024; 13:tfae022. [PMID: 38419835 PMCID: PMC10898333 DOI: 10.1093/toxres/tfae022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 02/02/2024] [Accepted: 02/07/2024] [Indexed: 03/02/2024] Open
Abstract
Background Fine particulate matter (PM2.5) exposure has been closely associated with cardiovascular diseases, which are relevant to cell cycle arrest. Brain and muscle aryl-hydrocarbon receptor nuclear translocator-like protein 1 (BMAL1) not only participates in regulating the circadian clock but also plays a role in modulating cell cycle. However, the precise contribution of the circadian clock gene BMAL1 to PM2.5-induced cell cycle change remains unclear. This study aims to explore the impact of PM2.5 exposure on BMAL1 expression and the cell cycle in human umbilical vein endothelial cells (HUVECs). Methods HUVECs was exposed to PM2.5 for 24 hours at different concentrations ((0, 12.5, 25, 75 and 100 μg.mL-1) to elucidate the potential toxic mechanism. Following exposure to PM2.5, cell viability, ROS, cell cycle, and the expression of key genes and proteins were detected. Results A remarkable decrease in cell viability is observed in the PM2.5-exposed HUVECs, as well as a significant increase in ROS production. In addition, PM2.5-exposed HUVECs have cycle arrest in G0/G1 phase, and the gene expression of p27 is also markedly increased. The protein expression of BMAL1 and the gene expression of BMAL1 are increased significantly. Moreover, the protein expressions of p-p38 MAPK and p-ERK1/2 exhibit a marked increase in the PM2.5-exposed HUVECs. Furthermore, following the transfection of HUVECs with siBMAL1 to suppress BMAL1 expression, we observed a reduction in both the protein and gene expression of the MAPK/ERK pathway in HUVECs exposed to PM2.5. Conclusions Overall, our results indicate that PM2.5 exposure significantly upregulates the circadian clock gene expression of BMAL1 and regulates G0/G1 cell cycle arrest in HUVECs through the MAPK/ERK pathway, which may provide new insights into the potential molecular mechanism regarding BMAL1 on PM2.5-induced cardiovascular diseases.
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Affiliation(s)
- Haochong Shen
- Department of Toxicology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, 199 Renai Road, Suzhou Industrial Park, Suzhou, Jiangsu 215123, China
| | - Meidi Gong
- Department of Toxicology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, 199 Renai Road, Suzhou Industrial Park, Suzhou, Jiangsu 215123, China
| | - Minghao Zhang
- Department of Toxicology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, 199 Renai Road, Suzhou Industrial Park, Suzhou, Jiangsu 215123, China
| | - Shikun Sun
- Department of Toxicology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, 199 Renai Road, Suzhou Industrial Park, Suzhou, Jiangsu 215123, China
| | - Rao Zheng
- Department of Toxicology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, 199 Renai Road, Suzhou Industrial Park, Suzhou, Jiangsu 215123, China
| | - Qing Yan
- Department of Toxicology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, 199 Renai Road, Suzhou Industrial Park, Suzhou, Jiangsu 215123, China
| | - Juan Hu
- Department of Toxicology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, 199 Renai Road, Suzhou Industrial Park, Suzhou, Jiangsu 215123, China
| | - Xiaobin Xie
- Department of Toxicology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, 199 Renai Road, Suzhou Industrial Park, Suzhou, Jiangsu 215123, China
| | - Yan Wu
- Department of Toxicology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, 199 Renai Road, Suzhou Industrial Park, Suzhou, Jiangsu 215123, China
| | - Junjie Yang
- Department of Toxicology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, 199 Renai Road, Suzhou Industrial Park, Suzhou, Jiangsu 215123, China
| | - Jing Wu
- Department of Toxicology, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, 199 Renai Road, Suzhou Industrial Park, Suzhou, Jiangsu 215123, China
| | - Jing Yang
- School of Basic Medicine and Forensic Medicine, Baotou Medical College, Inner Mongolia University of Science and Technology, 31 Jianshe Road, Donghe District, Baotou, Inner Mongolia 014040, China
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Wathanavasin W, Banjongjit A, Phannajit J, Eiam-Ong S, Susantitaphong P. Association of fine particulate matter (PM 2.5) exposure and chronic kidney disease outcomes: a systematic review and meta-analysis. Sci Rep 2024; 14:1048. [PMID: 38200164 PMCID: PMC10781728 DOI: 10.1038/s41598-024-51554-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 01/06/2024] [Indexed: 01/12/2024] Open
Abstract
Several studies have reported an increased risk of chronic kidney disease (CKD) outcomes after long-term exposure (more than 1 year) to particulate matter with an aerodynamic diameter of ≤ 2.5 µm (PM2.5). However, the conclusions remain inconsistent. Therefore, we conducted this meta-analysis to examine the association between long-term PM2.5 exposure and CKD outcomes. A literature search was conducted in PubMed, Scopus, Cochrane Central Register of Controlled trials, and Embase for relevant studies published until August 10, 2023. The main outcomes were incidence and prevalence of CKD as well as incidence of end-stage kidney disease (ESKD). The random-effect model meta-analyses were used to estimate the risk of each outcome among studies. Twenty two studies were identified, including 14 cohort studies, and 8 cross-sectional studies, with a total of 7,967,388 participants. This meta-analysis revealed that each 10 μg/m3 increment in PM2.5 was significantly associated with increased risks of both incidence and prevalence of CKD [adjusted odds ratio (OR) 1.31 (95% confidence interval (CI) 1.24 to 1.40), adjusted OR 1.31 (95% CI 1.03 to 1.67), respectively]. In addition, the relationship with ESKD incidence is suggestive of increased risk but not conclusive (adjusted OR 1.16; 95% CI 1.00 to 1.36). The incidence and prevalence of CKD outcomes had a consistent association across all subgroups and adjustment variables. Our study observed an association between long-term PM2.5 exposure and the risks of CKD. However, more dedicated studies are required to show causation that warrants urgent action on PM2.5 to mitigate the global burden of CKD.
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Affiliation(s)
- Wannasit Wathanavasin
- Nephrology Unit, Department of Medicine, Charoenkrung Pracharak Hospital, Bangkok Metropolitan Administration, Bangkok, Thailand
| | - Athiphat Banjongjit
- Nephrology Unit, Department of Medicine, Vichaiyut Hospital, Bangkok, Thailand
| | - Jeerath Phannajit
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
- Division of Clinical Epidemiology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
- Center of Excellence for Metabolic Bone Disease in CKD Patients, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Somchai Eiam-Ong
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Paweena Susantitaphong
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand.
- Center of Excellence for Metabolic Bone Disease in CKD Patients, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
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Supphapipat K, Leurcharusmee P, Chattipakorn N, Chattipakorn SC. Impact of air pollution on postoperative outcomes following organ transplantation: Evidence from clinical investigations. Clin Transplant 2024; 38:e15180. [PMID: 37987510 DOI: 10.1111/ctr.15180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 11/22/2023]
Abstract
INTRODUCTION Air pollution is a worldwide problem affecting human health via various body systems, resulting in numerous significant adverse events. Air pollutants, including particulate matter < or = 2.5 microns (PM2.5), particulate matter < or = 10 microns (PM10), ozone (O3 ), nitrogen dioxide (NO2 ), and traffic-related air pollution (TRAP), have demonstrated the negative effects on human health (e.g., increased cerebrovascular, cardiovascular, and respiratory diseases, malignancy, and mortality). Organ transplant patients, who are taking immunosuppressive agents, are especially vulnerable to the adverse effects of air pollutants. The evidence from clinical investigation has shown that exposure to air pollution after organ transplantation is associated with organ rejection, cardiovascular disease, coronary heart disease, cerebrovascular disease, infection-related mortality, and vitamin D deficiency. OBJECTIVES AND METHOD This review aims to summarize and discuss the association of exposure to air pollutants and serum 25-hydroxyvitamin D level and outcomes after transplantation. Controversial findings are also included and discussed. CONCLUSION All of the findings suggest that air pollution results in a hazardous environment, which not only impacts human health worldwide but also affects post-transplant outcomes.
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Affiliation(s)
- Kittitorn Supphapipat
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Department of Anesthesiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Prangmalee Leurcharusmee
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Department of Anesthesiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Nipon Chattipakorn
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, Thailand
| | - Siriporn C Chattipakorn
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, Thailand
- Department of Oral Biology and Diagnostic Sciences, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
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Liu N, Deng Q, Hu P, Chang J, Li Y, Zhang Y, Su Y, Liu J, Long Y. Associations between urban exposome and recurrence risk among survivors of acute myocardial infarction in Beijing, China. ENVIRONMENTAL RESEARCH 2023; 238:117267. [PMID: 37776939 PMCID: PMC7615203 DOI: 10.1016/j.envres.2023.117267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 09/24/2023] [Accepted: 09/27/2023] [Indexed: 10/02/2023]
Abstract
Few previous studies have investigated the impacts of coexposure to multiple urban environmental factors on the prognosis of acute myocardial infarction (AMI) events. This study aimed to evaluate the associations between the urban exposome and AMI recurrence. We used data from 88,509 AMI patients from a large cohort obtained from the Beijing Cardiovascular Disease Surveillance System between 2013 and 2019. Twenty-six types of urban exposures were assessed within 300-m, 500-m, and 1000-m buffers of patients' home addresses in the baseline and cumulative average levels. We used the Cox proportional hazard model along with the Elastic Net (ENET) algorithm to estimate the hazard ratios (HRs) of recurrent AMI per interquartile range increase in each selected urban exposure. The increased risk of AMI recurrence was significantly associated with lower urban function diversity in the 500-m buffer, longer distance to subway stations and higher PM2.5 for both baseline and cumulative average exposure. The cumulative averages of two urban factors, including the distance to parks, and the density of fruit and vegetable shops in the 1000-m buffer, were also identified as significant factors affecting the risk of AMI recurrence. These findings can help improve the urban design for promoting human cardiovascular health.
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Affiliation(s)
- Ningrui Liu
- School of Architecture, Tsinghua University, Beijing, China
| | - Qiuju Deng
- Center for Clinical and Epidemiologic Research, Beijing An Zhen Hospital, Capital Medical University; Beijing Institute of Heart, Lung, and Blood Vessel Diseases; National Clinical Research Center of Cardiovascular Diseases, Beijing, China
| | - Piaopiao Hu
- Center for Clinical and Epidemiologic Research, Beijing An Zhen Hospital, Capital Medical University; Beijing Institute of Heart, Lung, and Blood Vessel Diseases; National Clinical Research Center of Cardiovascular Diseases, Beijing, China
| | - Jie Chang
- Center for Clinical and Epidemiologic Research, Beijing An Zhen Hospital, Capital Medical University; Beijing Institute of Heart, Lung, and Blood Vessel Diseases; National Clinical Research Center of Cardiovascular Diseases, Beijing, China
| | - Yan Li
- School of Architecture, Tsinghua University, Beijing, China
| | - Yuyang Zhang
- School of Architecture, Tsinghua University, Beijing, China
| | - Yuwei Su
- School of Architecture, Tsinghua University, Beijing, China; School of Urban Design, Wuhan University, Wuhan, China
| | - Jing Liu
- Center for Clinical and Epidemiologic Research, Beijing An Zhen Hospital, Capital Medical University; Beijing Institute of Heart, Lung, and Blood Vessel Diseases; National Clinical Research Center of Cardiovascular Diseases, Beijing, China.
| | - Ying Long
- School of Architecture, Tsinghua University, Beijing, China; Hang Lung Center for Real Estate, Key Laboratory of Eco Planning & Green Building, Ministry of Education, Tsinghua University, Beijing, China.
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9
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Wang Y, Qiu X, Wei Y, Schwartz JD. Long-Term Exposure to Ambient PM 2.5 and Hospitalizations for Myocardial Infarction Among US Residents: A Difference-in-Differences Analysis. J Am Heart Assoc 2023; 12:e029428. [PMID: 37702054 PMCID: PMC10547266 DOI: 10.1161/jaha.123.029428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 08/02/2023] [Indexed: 09/14/2023]
Abstract
Background Air pollution has been recognized as an untraditional risk factor for myocardial infarction (MI). However, the MI risk attributable to long-term exposure to fine particulate matter ≤2.5 μm in aerodynamic diameter (PM2.5) is unclear, especially in younger populations, and few studies have represented the general population or had power to examine comorbidities. Methods and Results We applied the difference-in-differences approach to estimate the relationship between annual PM2.5 exposure and hospitalizations for MI among US residents and further identified potential susceptible subpopulations. All hospital admissions for MI in 10 US states over the period 2002 to 2016 were obtained from the Healthcare Cost and Utilization Project State Inpatient Database. In total, 1 914 684 MI hospital admissions from 8106 zip codes were included in this study. We observed a 1.35% (95% CI, 1.11-1.59) increase in MI hospitalization rate for 1-μg/m3 increase in annual PM2.5 exposure. The estimate was robust to adjustment for surface pressure, relative humidity, and copollutants. In the population exposed to ≤12 μg/m3, there was a larger increment of 2.17% (95% CI, 1.79-2.56) in hospitalization rate associated with 1-μg/m3 increase in PM2.5. Young people (0-34 years of age) and elderly people (≥75 years of age) were the 2 most susceptible age groups. Residents living in more densely populated or poorer areas and individuals with comorbidities were observed to be at a greater risk. Conclusions This study indicates long-term residential exposure to PM2.5 could increase risk of MI among the general US population, people with comorbidities, and poorer individuals. The association persists below current standards.
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Affiliation(s)
- Yichen Wang
- Department of Environmental HealthHarvard T.H. Chan School of Public HealthBostonMA
| | - Xinye Qiu
- Department of Environmental HealthHarvard T.H. Chan School of Public HealthBostonMA
| | - Yaguang Wei
- Department of Environmental HealthHarvard T.H. Chan School of Public HealthBostonMA
| | - Joel D. Schwartz
- Department of Environmental HealthHarvard T.H. Chan School of Public HealthBostonMA
- Department of EpidemiologyHarvard T.H. Chan School of Public HealthBostonMA
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10
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Jia Y, Lin Z, He Z, Li C, Zhang Y, Wang J, Liu F, Li J, Huang K, Cao J, Gong X, Lu X, Chen S. Effect of Air Pollution on Heart Failure: Systematic Review and Meta-Analysis. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:76001. [PMID: 37399145 PMCID: PMC10317211 DOI: 10.1289/ehp11506] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 02/15/2023] [Accepted: 06/06/2023] [Indexed: 07/05/2023]
Abstract
BACKGROUND Heart failure (HF) poses a significant global disease burden. The current evidence on the impact of air pollution on HF remains inconsistent. OBJECTIVES We aimed to conduct a systematic review of the literature and meta-analysis to provide a more comprehensive and multiperspective assessment of the associations between short- and long-term air pollution exposure and HF from epidemiological evidences. METHODS Three databases were searched up to 31 August 2022 for studies investigating the association between air pollutants (PM 2.5 , PM 10 , NO 2 , SO 2 , CO, O 3 ) and HF hospitalization, incidence, or mortality. A random effects model was used to derive the risk estimations. Subgroup analysis was conducted by geographical location, age of participants, outcome, study design, covered area, the methods of exposure assessment, and the length of exposure window. Sensitivity analysis and adjustment for publication bias were performed to test the robustness of the results. RESULTS Of 100 studies covering 20 countries worldwide, 81 were for short-term and 19 were for long-term exposure. Almost all air pollutants were adversely associated with the risk of HF in both short- and long-term exposure studies. For short-term exposures, we found the risk of HF increased by 1.8% [relative risk ( RR ) = 1.018 , 95% confidence interval (CI): 1.011, 1.025] and 1.6% (RR = 1.016 , 95% CI: 1.011, 1.020) per 10 - μ g / m 3 increment of PM 2.5 and PM 10 , respectively. HF was also significantly associated with NO 2 , SO 2 , and CO, but not O 3 . Positive associations were stronger when exposure was considered over the previous 2 d (lag 0-1) rather than on the day of exposure only (lag 0). For long-term exposures, there were significant associations between several air pollutants and HF with RR (95% CI) of 1.748 (1.112, 2.747) per 10 - μ g / m 3 increment in PM 2.5 , 1.212 (1.010, 1.454) per 10 - μ g / m 3 increment in PM 10 , and 1.204 (1.069, 1.356) per 10 -ppb increment in NO 2 , respectively. The adverse associations of most pollutants with HF were greater in low- and middle-income countries than in high-income countries. Sensitivity analysis demonstrated the robustness of our results. DISCUSSION Available evidence highlighted adverse associations between air pollution and HF regardless of short- and long-term exposure. Air pollution is still a prevalent public health issue globally and sustained policies and actions are called for to reduce the burden of HF. https://doi.org/10.1289/EHP11506.
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Affiliation(s)
- Yanhui Jia
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China
| | - Zhennan Lin
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China
| | - Zhi He
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China
| | - Chenyang Li
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China
| | - Youjing Zhang
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China
| | - Jingyu Wang
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China
| | - Fangchao Liu
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China
| | - Jianxin Li
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China
| | - Keyong Huang
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China
| | - Jie Cao
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China
| | - Xinyuan Gong
- Department of Science and Education, Tianjin First Central Hospital, Tianjin, China
| | - Xiangfeng Lu
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China
| | - Shufeng Chen
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China
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11
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Teixeira J, Sousa G, Morais S, Delerue-Matos C, Oliveira M. Assessment of coarse, fine, and ultrafine particulate matter at different microenvironments of fire stations. CHEMOSPHERE 2023:139005. [PMID: 37245598 DOI: 10.1016/j.chemosphere.2023.139005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 05/17/2023] [Accepted: 05/20/2023] [Indexed: 05/30/2023]
Abstract
The concentrations of respirable particulate matter (PM) and the impact on indoor air quality in occupational settings remains poorly characterized. This study assesses, for the first time, the cumulative and non-cumulative concentrations of 14 fractions of coarse (3.65-9.88 μm), fine (0.156-2.47 μm), and ultrafine (0.015-0.095 μm) PM inside the garage of heavy vehicles, firefighting personal protective equipment' storage room, bar, and a common area of seven Portuguese fire stations. Sampling campaigns were performed during a regular work week at the fire stations. Levels of daily total cumulative PM ranged from 277.4 to 413.2 μg/m3 (maximum values of 811.4 μg/m3), with the bar (370.1 μg/m3) and the PPE' storage room (361.3 μg/m3) presenting slightly increased levels (p > 0.05) than the common area (324.8 μg/m3) and the garage (339.4 μg/m3). The location of the sampling site, the proximity to local industries and commercial activities, the layout of the building, the heating system used, and indoor sources influenced the PM concentrations. Fine (193.8-301.0 μg/m3) and ultrafine (41.3-78.2 μg/m3) particles were predominant in the microenvironments of all fire stations and accounted for 71.5% and 17.8% of daily total cumulative levels, respectively; coarse particles (23.3-47.1 μg/m3) represented 10.7% of total PM. The permissible exposure limit (5.0 mg/m3) defined by the Occupational Safety and Health Organization for respirable dust was not overcome in the evaluated fire stations. Results suggest firefighters' regular exposure to fine and ultrafine PM inside fire stations which will contribute to cardiorespiratory health burden. Further studies are needed to characterize firefighters' exposure to fine and ultrafine PM inside fire stations, identify main emission sources, and evaluate the contribution of exposures at fire stations to firefighters' occupational health risks.
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Affiliation(s)
- Joana Teixeira
- REQUIMTE/LAQV, Instituto Superior de Engenharia Do Porto, Instituto Politécnico Do Porto, R. Dr. António Bernardino de Almeida 431, 4249-015, Porto, Portugal
| | - Gabriel Sousa
- REQUIMTE/LAQV, Instituto Superior de Engenharia Do Porto, Instituto Politécnico Do Porto, R. Dr. António Bernardino de Almeida 431, 4249-015, Porto, Portugal
| | - Simone Morais
- REQUIMTE/LAQV, Instituto Superior de Engenharia Do Porto, Instituto Politécnico Do Porto, R. Dr. António Bernardino de Almeida 431, 4249-015, Porto, Portugal
| | - Cristina Delerue-Matos
- REQUIMTE/LAQV, Instituto Superior de Engenharia Do Porto, Instituto Politécnico Do Porto, R. Dr. António Bernardino de Almeida 431, 4249-015, Porto, Portugal
| | - Marta Oliveira
- REQUIMTE/LAQV, Instituto Superior de Engenharia Do Porto, Instituto Politécnico Do Porto, R. Dr. António Bernardino de Almeida 431, 4249-015, Porto, Portugal.
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12
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Rehman A, Kumari R, Kamthan A, Tiwari R, Srivastava RK, van der Westhuizen FH, Mishra PK. Cell-free circulating mitochondrial DNA: An emerging biomarker for airborne particulate matter associated with cardiovascular diseases. Free Radic Biol Med 2023; 195:103-120. [PMID: 36584454 DOI: 10.1016/j.freeradbiomed.2022.12.083] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 12/16/2022] [Accepted: 12/20/2022] [Indexed: 12/29/2022]
Abstract
The association of airborne particulate matter exposure with the deteriorating function of the cardiovascular system is fundamentally driven by the impairment of mitochondrial-nuclear crosstalk orchestrated by aberrant redox signaling. The loss of delicate balance in retrograde communication from mitochondria to the nucleus often culminates in the methylation of the newly synthesized strand of mitochondrial DNA (mtDNA) through DNA methyl transferases. In highly metabolic active tissues such as the heart, mtDNA's methylation state alteration impacts mitochondrial bioenergetics. It affects transcriptional regulatory processes involved in biogenesis, fission, and fusion, often accompanied by the integrated stress response. Previous studies have demonstrated a paradoxical role of mtDNA methylation in cardiovascular pathologies linked to air pollution. A pronounced alteration in mtDNA methylation contributes to systemic inflammation, an etiological determinant for several co-morbidities, including vascular endothelial dysfunction and myocardial injury. In the current article, we evaluate the state of evidence and examine the considerable promise of using cell-free circulating methylated mtDNA as a predictive biomarker to reduce the more significant burden of ambient air pollution on cardiovascular diseases.
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Affiliation(s)
- Afreen Rehman
- Department of Molecular Biology, ICMR-National Institute for Research in Environmental Health, Bhopal, India.
| | - Roshani Kumari
- Department of Molecular Biology, ICMR-National Institute for Research in Environmental Health, Bhopal, India.
| | - Arunika Kamthan
- Department of Molecular Biology, ICMR-National Institute for Research in Environmental Health, Bhopal, India.
| | - Rajnarayan Tiwari
- Department of Molecular Biology, ICMR-National Institute for Research in Environmental Health, Bhopal, India.
| | | | | | - Pradyumna Kumar Mishra
- Department of Molecular Biology, ICMR-National Institute for Research in Environmental Health, Bhopal, India.
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13
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Dwivedi AK, Vishwakarma D, Dubey P, Reddy SY. Air Pollution and the Heart: Updated Evidence from Meta-analysis Studies. Curr Cardiol Rep 2022; 24:1811-1835. [PMID: 36434404 DOI: 10.1007/s11886-022-01819-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/18/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE OF REVIEW Although environmental exposure such as air pollution is detrimental to cardiovascular disease (CVD), the effects of different air pollutants on different CVD endpoints produced variable findings. We provide updated evidence between air pollutants and CVD outcomes including mitigation strategies with meta-analytic evidence. RECENT FINDINGS An increased exposure to any class of air pollutants including particulate matter (PM), gas, toxic metals, and disruptive chemicals has been associated with CVD events. Exposure to PM < 2.5 μm has been consistently associated with most heart diseases and stroke as well as CVDs among at-risk individuals. Despite this, there is no clinical approach available for systemic evaluation of air pollution exposure and management. A large number of epidemiological evidence clearly suggests the importance of air pollution prevention and control for reducing the risk of CVDs and mortality. Cost-effective and feasible strategies for air pollution monitoring, screening, and necessary interventions are urgently required among at-risk populations and those living or working, or frequently commuting in polluted areas.
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Affiliation(s)
- Alok Kumar Dwivedi
- Division of Biostatistics & Epidemiology, Department of Molecular and Translational Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, 5001, El Paso Drive, El Paso, TX, 79905, USA. .,Biostatistics and Epidemiology Consulting Lab, Office of Research, Texas Tech University Health Sciences Center El Paso, El Paso, TX, USA.
| | - Deepanjali Vishwakarma
- Division of Biostatistics & Epidemiology, Department of Molecular and Translational Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, 5001, El Paso Drive, El Paso, TX, 79905, USA
| | - Pallavi Dubey
- Department of Obstetrics and Gynecology, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX, USA
| | - Sireesha Y Reddy
- Department of Obstetrics and Gynecology, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX, USA
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14
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Zhou CB, Hu YG, Fan YN, Wu N, Yao CY, Liu XL, Zhou YM, Xiao H, Tang EJ, Li DW, Cai TJ, Ji AL. More obvious association between short-term ambient nitrogen dioxide and atrial fibrillation outpatient visits in cool seasons: A hospital-based study in northwestern China. ENVIRONMENTAL RESEARCH 2022; 212:113220. [PMID: 35398083 DOI: 10.1016/j.envres.2022.113220] [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: 11/23/2021] [Revised: 03/12/2022] [Accepted: 03/28/2022] [Indexed: 06/14/2023]
Abstract
Atrial fibrillation (AF) is the most common sustained heart rhythm disorder associated with high mortality and morbidity. Limited studies have been conducted to assess the relationship between short-term exposure to ambient air pollution and AF attacks. This study aimed to explore the association between short-term ambient nitrogen dioxide (NO2) exposure and outpatient visits for AF in Xi'an, China. Data on daily AF outpatient visits and air pollutants from 2013 to 2019 (2555 days) were obtained. A time-series approach using over-dispersed Poisson generalized additive model (GAM) was employed, and stratified analyses were performed to investigate the potential modifying effects by season, age, and gender. A total of 8307 outpatient visits for AF were recorded. Increased levels of NO2 were associated with increased AF outpatient visits, and the most significant effect estimates were observed at lag 03: A 10 μg/m3 increase of NO2 at lag 03 was related to an elevation of 5.59% (95% CI: 2.67%, 8.51%) in daily outpatient visits for AF. Stratified analyses showed that there were no gender and age difference in the effect of NO2, while more obvious association was observed in cool seasons (October to March) than in warm seasons (April to September). In summary, short-term ambient NO2 exposure can be positively associated with daily outpatient visits for AF, especially in cool seasons. This work provided novel data that the association between air pollutants and AF can vary by seasons, further supporting that the prevention of cardiovascular health effects should be strengthened in winter.
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Affiliation(s)
- Chun-Bei Zhou
- Chongqing Center for Disease Control and Prevention, Chongqing, 400042, China; Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Yue-Gu Hu
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Yan-Ni Fan
- Medical Record Room of Information Department, Second Affiliated Hospital, Air Force Medical University (Fourth Military Medical University), Xi'an, 710038, China
| | - Na Wu
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Chun-Yan Yao
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Xiao-Ling Liu
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Yu-Meng Zhou
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Hua Xiao
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - En-Jie Tang
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Da-Wei Li
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Tong-Jian Cai
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China.
| | - Ai-Ling Ji
- Department of Preventive Medicine, Chongqing Medical and Pharmaceutical College, Chongqing, 401331, China.
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15
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Khosravipour M, Safari-Faramani R, Rajati F, Omidi F. The long-term effect of exposure to respirable particulate matter on the incidence of myocardial infarction: a systematic review and meta-analysis study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:42347-42371. [PMID: 35355187 DOI: 10.1007/s11356-022-18986-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 01/27/2022] [Indexed: 06/14/2023]
Abstract
Although several studies have investigated the long-term association of respirable particulate matter (PM ≤ 10 µm) with the incidence of myocardial infarction (MI), this association is inconclusive or even contradictory. This systematic review and meta-analysis study aimed to quantify the long-term effect of exposure to respirable PM on the incidence of MI. To find relevant publications, online databases, including Scopus, PubMed, and Web of Science, were searched on October 10, 2021. A random-effect model was used to calculate the pooled hazard ratio (HR) and 95% confidence interval (95% CI) of MI across studies. Heterogeneity was presented with reporting I2 index. Of 4591 records found in the primary searching, the number of 24 prospective cohort studies with more than 70 million participants was included. The pooled HR (95% CI) of MI per 1 µg/m3 increment of respirable PM was estimated as 1.01 (1.00, 1.01). Subgroup analyses according to aerodynamic diameter of PM showed an only significant stronger risk of MI per 1 µg/m3 increase in PM with aerodynamic diameter < 2.5 µm (HR = 1.01, 95% CI = 1.00, 1.01). No sex difference was found in the association of respirable PM with MI incidence. There was only a significant association among studies defined MI as ICD-10: I21 code (HR = 1.01, 95% CI = 1.00, 1.01) and studies defined MI as ICD-10: I21-22 (HR = 1.02, 95% CI = 1.00, 1.04). No significant publication bias was observed across studies. In conclusion, this study confirms a significant association between long-term exposure to respirable PM air pollution and development of MI.
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Affiliation(s)
- Masoud Khosravipour
- Department of Occupational Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Safari-Faramani
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Department of Epidemiology, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Fatemeh Rajati
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Fariborz Omidi
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Department of Occupational Health Engineering, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
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16
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de Bont J, Jaganathan S, Dahlquist M, Persson Å, Stafoggia M, Ljungman P. Ambient air pollution and cardiovascular diseases: An umbrella review of systematic reviews and meta-analyses. J Intern Med 2022; 291:779-800. [PMID: 35138681 PMCID: PMC9310863 DOI: 10.1111/joim.13467] [Citation(s) in RCA: 150] [Impact Index Per Article: 75.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The available evidence on the effects of ambient air pollution on cardiovascular diseases (CVDs) has increased substantially. In this umbrella review, we summarized the current epidemiological evidence from systematic reviews and meta-analyses linking ambient air pollution and CVDs, with a focus on geographical differences and vulnerable subpopulations. We performed a search strategy through multiple databases including articles between 2010 and 31 January 2021. We performed a quality assessment and evaluated the strength of evidence. Of the 56 included reviews, the most studied outcomes were stroke (22 reviews), all-cause CVD mortality, and morbidity (19). The strongest evidence was found between higher short- and long-term ambient air pollution exposure and all-cause CVD mortality and morbidity, stroke, blood pressure, and ischemic heart diseases (IHD). Short-term exposures to particulate matter <2.5 μm (PM2.5 ), <10 μm (PM10 ), and nitrogen oxides (NOx ) were consistently associated with increased risks of hypertension and triggering of myocardial infarction (MI), and stroke (fatal and nonfatal). Long-term exposures of PM2.5 were largely associated with increased risk of atherosclerosis, incident MI, hypertension, and incident stroke and stroke mortality. Few reviews evaluated other CVD outcomes including arrhythmias, atrial fibrillation, or heart failure but they generally reported positive statistical associations. Stronger associations were found in Asian countries and vulnerable subpopulations, especially among the elderly, cardiac patients, and people with higher weight status. Consistent with experimental data, this comprehensive umbrella review found strong evidence that higher levels of ambient air pollution increase the risk of CVDs, especially all-cause CVD mortality, stroke, and IHD. These results emphasize the importance of reducing the alarming levels of air pollution across the globe, especially in Asia, and among vulnerable subpopulations.
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Affiliation(s)
- Jeroen de Bont
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Suganthi Jaganathan
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Centre for Environmental Health, Public Health Foundation of India, Delhi-NCR, India.,Centre for Chronic Disease Control, New Delhi, India
| | - Marcus Dahlquist
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Åsa Persson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Massimo Stafoggia
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Department of Epidemiology, Lazio Region Health Service, Rome, Italy
| | - Petter Ljungman
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Department of Cardiology, Danderyd University Hospital, Danderyd, Sweden
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Health Effects of Long-Term Exposure to Ambient PM 2.5 in Asia-Pacific: a Systematic Review of Cohort Studies. Curr Environ Health Rep 2022; 9:130-151. [PMID: 35292927 PMCID: PMC9090712 DOI: 10.1007/s40572-022-00344-w] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2022] [Indexed: 12/21/2022]
Abstract
Abstract Purpose of Review Health effects of long-term exposure to ambient PM2.5 vary with regions, and 75% of the deaths attributable to PM2.5 were estimated in Asia-Pacific in 2017. This systematic review aims to summarize the existing evidence from cohort studies on health effects of long-term exposure to ambient PM2.5 in Asia-Pacific. Recent Findings In Asia-Pacific, 60 cohort studies were conducted in Australia, Mainland China, Hong Kong, Taiwan, and South Korea. They consistently supported associations of long-term exposure to PM2.5 with increased all-cause/non-accidental and cardiovascular mortality as well as with incidence of cardiovascular diseases, type 2 diabetes mellitus, kidney diseases, and chronic obstructive pulmonary disease. Evidence for other health effects was limited. Inequalities were identified in PM2.5-health associations. Summary To optimize air pollution control and public health prevention, further studies need to assess the health effects of long-term PM2.5 exposure in understudied regions, the health effects of long-term PM2.5 exposure on mortality and risk of type 2 diabetes mellitus, renal diseases, dementia and lung cancer, and inequalities in PM2.5-health associations. Study design, especially exposure assessment methods, should be improved. Supplementary Information The online version contains supplementary material available at 10.1007/s40572-022-00344-w.
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18
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Kriit HK, Andersson EM, Carlsen HK, Andersson N, Ljungman PLS, Pershagen G, Segersson D, Eneroth K, Gidhagen L, Spanne M, Molnar P, Wennberg P, Rosengren A, Rizzuto D, Leander K, Yacamán-Méndez D, Magnusson PKE, Forsberg B, Stockfelt L, Sommar JN. Using Distributed Lag Non-Linear Models to Estimate Exposure Lag-Response Associations between Long-Term Air Pollution Exposure and Incidence of Cardiovascular Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052630. [PMID: 35270332 PMCID: PMC8909720 DOI: 10.3390/ijerph19052630] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 02/18/2022] [Accepted: 02/23/2022] [Indexed: 12/23/2022]
Abstract
Long-term air pollution exposure increases the risk for cardiovascular disease, but little is known about the temporal relationships between exposure and health outcomes. This study aims to estimate the exposure-lag response between air pollution exposure and risk for ischemic heart disease (IHD) and stroke incidence by applying distributed lag non-linear models (DLNMs). Annual mean concentrations of particles with aerodynamic diameter less than 2.5 µm (PM2.5) and black carbon (BC) were estimated for participants in five Swedish cohorts using dispersion models. Simultaneous estimates of exposure lags 1-10 years using DLNMs were compared with separate year specific (single lag) estimates and estimates for lag 1-5- and 6-10-years using moving average exposure. The DLNM estimated no exposure lag-response between PM2.5 total, BC, and IHD. However, for PM2.5 from local sources, a 20% risk increase per 1 µg/m3 for 1-year lag was estimated. A risk increase for stroke was suggested in relation to lags 2-4-year PM2.5 and BC, and also lags 8-9-years BC. No associations were shown in single lag models. Increased risk estimates for stroke in relation to lag 1-5- and 6-10-years BC moving averages were observed. Estimates generally supported a greater contribution to increased risk from exposure windows closer in time to incident IHD and incident stroke.
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Affiliation(s)
- Hedi Katre Kriit
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, 90187 Umeå, Sweden; (B.F.); (J.N.S.)
- Correspondence: ; Tel.: +46-722-40-5220
| | - Eva M. Andersson
- Occupational and Environmental Medicine, Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden; (E.M.A.); (H.K.C.); (P.M.); (L.S.)
| | - Hanne K. Carlsen
- Occupational and Environmental Medicine, Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden; (E.M.A.); (H.K.C.); (P.M.); (L.S.)
| | - Niklas Andersson
- Institute of Environmental Medicine, Karolinska Institutet, 17177 Stockholm, Sweden; (N.A.); (P.L.S.L.); (G.P.); (K.L.)
| | - Petter L. S. Ljungman
- Institute of Environmental Medicine, Karolinska Institutet, 17177 Stockholm, Sweden; (N.A.); (P.L.S.L.); (G.P.); (K.L.)
- Department of Cardiology, Danderyd Hospital, 18233 Stockholm, Sweden
| | - Göran Pershagen
- Institute of Environmental Medicine, Karolinska Institutet, 17177 Stockholm, Sweden; (N.A.); (P.L.S.L.); (G.P.); (K.L.)
- Centre for Occupational and Environmental Medicine, Region Stockholm, 11365 Stockholm, Sweden
| | - David Segersson
- Swedish Meteorological and Hydrological Institute, 60176 Norrköping, Sweden; (D.S.); (L.G.)
| | - Kristina Eneroth
- SLB-Analys, Environment and Health Administration, 10420 Stockholm, Sweden;
| | - Lars Gidhagen
- Swedish Meteorological and Hydrological Institute, 60176 Norrköping, Sweden; (D.S.); (L.G.)
| | - Mårten Spanne
- Environmental Department of the City of Malmö, 20580 Malmo, Sweden;
| | - Peter Molnar
- Occupational and Environmental Medicine, Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden; (E.M.A.); (H.K.C.); (P.M.); (L.S.)
| | - Patrik Wennberg
- Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, 90187 Umeå, Sweden;
| | - Annika Rosengren
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Sahlgrenska University Hospital, 40530 Gothenburg, Sweden;
| | - Debora Rizzuto
- Ageing Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, 17177 Stockholm, Sweden;
- Stockholm Gerontology Research Center, 11346 Stockholm, Sweden
| | - Karin Leander
- Institute of Environmental Medicine, Karolinska Institutet, 17177 Stockholm, Sweden; (N.A.); (P.L.S.L.); (G.P.); (K.L.)
| | - Diego Yacamán-Méndez
- Department of Global Public Health, Karolinska Institutet, 17177 Stockholm, Sweden;
- Centre for Epidemiology and Community Medicine, Region Stockholm, 10431 Stockholm, Sweden
| | - Patrik K. E. Magnusson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, 17177 Stockholm, Sweden;
| | - Bertil Forsberg
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, 90187 Umeå, Sweden; (B.F.); (J.N.S.)
| | - Leo Stockfelt
- Occupational and Environmental Medicine, Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden; (E.M.A.); (H.K.C.); (P.M.); (L.S.)
| | - Johan N. Sommar
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, 90187 Umeå, Sweden; (B.F.); (J.N.S.)
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19
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Choi G, Kim Y, Shin G, Bae S. Projecting Lifetime Health Outcomes and Costs Associated with the Ambient Fine Particulate Matter Exposure among Adult Women in Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:2494. [PMID: 35270187 PMCID: PMC8909340 DOI: 10.3390/ijerph19052494] [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: 12/16/2021] [Revised: 02/03/2022] [Accepted: 02/17/2022] [Indexed: 02/05/2023]
Abstract
We sought to estimate the lifetime healthcare costs and outcomes associated with the exposure to the escalated concentration of fine particulate matter (particle size < 2.5 μm, PM2.5) among adult Korean women. We adapted a previously developed Markov model, and a hypothetical cohort composed of Korean women was exposed to either a standard (15 μg/m3) or increased (25 μg/m3) concentration of PM2.5. The time horizon of the analysis was 60 years, and the cycle length was 1 year. The outcomes were presented as direct healthcare costs and quality-adjusted life years (QALYs), and costs were discounted annually at 5%. Deterministic and probabilistic sensitivity analyses were performed. The model estimated that when the exposure concentration was increased by 10 μg/m3, the lifetime healthcare cost increased by USD 9309, which is an 11.3% increase compared to the standard concentration group. Women exposed to a higher concentration of PM2.5 were predicted to live 30.64 QALYs, compared to 32.08 QALYs for women who were exposed to the standard concentration of PM2.5. The tendency of a higher cost and shorter QALYs at increased exposure was consistent across a broad range of sensitivity analyses. The negative impact of PM2.5 was higher on cost than on QALYs and accelerated as the exposure time increased, emphasizing the importance of early intervention.
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Affiliation(s)
- Gyeyoung Choi
- College of Pharmacy, Ewha Womans University, Seoul 03760, Korea; (G.C.); (Y.K.); (G.S.)
| | - Yujeong Kim
- College of Pharmacy, Ewha Womans University, Seoul 03760, Korea; (G.C.); (Y.K.); (G.S.)
- Korean Health Insurance Review & Assessment Service, Wonju 26465, Korea
| | - Gyeongseon Shin
- College of Pharmacy, Ewha Womans University, Seoul 03760, Korea; (G.C.); (Y.K.); (G.S.)
| | - SeungJin Bae
- College of Pharmacy, Ewha Womans University, Seoul 03760, Korea; (G.C.); (Y.K.); (G.S.)
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20
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Shao L, Cao Y, Jones T, Santosh M, Silva LFO, Ge S, da Boit K, Feng X, Zhang M, BéruBé K. COVID-19 mortality and exposure to airborne PM 2.5: A lag time correlation. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 806:151286. [PMID: 34743816 PMCID: PMC8553633 DOI: 10.1016/j.scitotenv.2021.151286] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 10/07/2021] [Accepted: 10/23/2021] [Indexed: 05/05/2023]
Abstract
COVID-19 has escalated into one of the most serious crises in the 21st Century. Given the rapid spread of SARS-CoV-2 and its high mortality rate, here we investigate the impact and relationship of airborne PM2.5 to COVID-19 mortality. Previous studies have indicated that PM2.5 has a positive relationship with the spread of COVID-19. To gain insights into the delayed effect of PM2.5 concentration (μgm-3) on mortality, we focused on the role of PM2.5 in Wuhan City in China and COVID-19 during the period December 27, 2019 to April 7, 2020. We also considered the possible impact of various meteorological factors such as temperature, precipitation, wind speed, atmospheric pressure and precipitation on pollutant levels. The results from the Pearson's correlation coefficient analyses reveal that the population exposed to higher levels of PM2.5 pollution are susceptible to COVID-19 mortality with a lag time of >18 days. By establishing a generalized additive model, the delayed effect of PM2.5 on the death toll of COVID-19 was verified. A negative correction was identified between temperature and number of COVID-19 deaths, whereas atmospheric pressure exhibits a positive correlation with deaths, both with a significant lag effect. The results from our study suggest that these epidemiological relationships may contribute to the understanding of the COVID-19 pandemic and provide insights for public health strategies.
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Affiliation(s)
- Longyi Shao
- State Key Laboratory of Coal Resources and Safe Mining, College of Geoscience and Surveying Engineering, China University of Mining and Technology (Beijing), Beijing 100083, China.
| | - Yaxin Cao
- State Key Laboratory of Coal Resources and Safe Mining, College of Geoscience and Surveying Engineering, China University of Mining and Technology (Beijing), Beijing 100083, China
| | - Tim Jones
- School of Earth and Environmental Sciences, Cardiff University, Park Place, Cardiff CF10 3AT, UK
| | - M Santosh
- School of Earth Sciences and Resources, China University of Geoscience Beijing, Beijing 100083, China; Department of Earth Science, University of Adelaide, Adelaide, SA 5005, Australia
| | - Luis F O Silva
- Department of Civil and Environmental, Universidad de la Costa, Calle 58 #55-66, 080002 Barranquilla, Atlántico, Colombia
| | - Shuoyi Ge
- State Key Laboratory of Coal Resources and Safe Mining, College of Geoscience and Surveying Engineering, China University of Mining and Technology (Beijing), Beijing 100083, China
| | - Kátia da Boit
- Department of Civil and Environmental, Universidad de la Costa, Calle 58 #55-66, 080002 Barranquilla, Atlántico, Colombia
| | - Xiaolei Feng
- State Key Laboratory of Coal Resources and Safe Mining, College of Geoscience and Surveying Engineering, China University of Mining and Technology (Beijing), Beijing 100083, China
| | - Mengyuan Zhang
- State Key Laboratory of Coal Resources and Safe Mining, College of Geoscience and Surveying Engineering, China University of Mining and Technology (Beijing), Beijing 100083, China
| | - Kelly BéruBé
- School of Biosciences, Cardiff University, Museum Avenue, Cardiff CF10 3AX, Wales, UK
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21
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Marquès M, Correig E, Ibarretxe D, Anoro E, Antonio Arroyo J, Jericó C, Borrallo RM, Miret ML, Näf S, Pardo A, Perea V, Pérez-Bernalte R, Ramírez-Montesinos R, Royuela M, Soler C, Urquizu-Padilla M, Zamora A, Pedro-Botet J, Masana L, Domingo JL. Long-term exposure to PM 10 above WHO guidelines exacerbates COVID-19 severity and mortality. ENVIRONMENT INTERNATIONAL 2022; 158:106930. [PMID: 34678637 PMCID: PMC8519784 DOI: 10.1016/j.envint.2021.106930] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 09/28/2021] [Accepted: 10/07/2021] [Indexed: 05/04/2023]
Abstract
BACKGROUND Age, sex, race and comorbidities are insufficient to explain why some individuals remain asymptomatic after SARS-CoV-2 infection, while others die. In this sense, the increased risk caused by the long-term exposure to air pollution is being investigated to understand the high heterogeneity of the COVID-19 infection course. OBJECTIVES We aimed to assess the underlying effect of long-term exposure to NO2 and PM10 on the severity and mortality of COVID-19. METHODS A retrospective observational study was conducted with 2112 patients suffering COVID-19 infection. We built two sets of multivariate predictive models to assess the relationship between the long-term exposure to NO2 and PM10 and COVID-19 outcome. First, the probability of either death or severe COVID-19 outcome was predicted as a function of all the clinical variables together with the pollutants exposure by means of two regularized logistic regressions. Subsequently, two regularized linear regressions were constructed to predict the percentage of dead or severe patients. Finally, odds ratios and effects estimates were calculated. RESULTS We found that the long-term exposure to PM10 is a more important variable than some already stated comorbidities (i.e.: COPD/Asthma, diabetes, obesity) in the prediction of COVID-19 severity and mortality. PM10 showed the highest effects estimates (1.65, 95% CI 1.32-2.06) on COVID-19 severity. For mortality, the highest effect estimates corresponded to age (3.59, 95% CI 2.94-4.40), followed by PM10 (2.37, 95% CI 1.71-3.32). Finally, an increase of 1 µg/m3 in PM10 concentration causes an increase of 3.06% (95% CI 1.11%-4.25%) of patients suffering COVID-19 as a severe disease and an increase of 2.68% (95% CI 0.53%-5.58%) of deaths. DISCUSSION These results demonstrate that long-term PM10 burdens above WHO guidelines exacerbate COVID-19 health outcomes. Hence, WHO guidelines, the air quality standard established by the Directive 2008/50/EU, and that of the US-EPA should be updated accordingly to protect human health.
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Affiliation(s)
- Montse Marquès
- Universitat Rovira i Virgili, Laboratory of Toxicology and Environmental Health, School of Medicine, IISPV, Sant Llorenç 21, 43201 Reus, Catalonia, Spain.
| | - Eudald Correig
- Universitat Rovira i Virgili, Department of Biostatistics, Sant Llorenç 21, 43201 Reus, Catalonia, Spain
| | - Daiana Ibarretxe
- Universitat Rovira i Virgili, LIPIDCAS, University Hospital Sant Joan IISPV, CIBERDEM, Reus, Spain
| | - Eva Anoro
- LIPIDCAS, Pius Hospital Valls, Valls, Spain
| | - Juan Antonio Arroyo
- Lipid Unit, University Hospital Santa Creu i Sant Pau, Barcelona Autonomous University, Barcelona, Spain
| | - Carlos Jericó
- Lipid Unit, Hospital Moises Broggi. Consorci Sanitari Integral. Sant Joan Despí, Spain
| | - Rosa M Borrallo
- Internal Medicine Department. Terrasa Hospital. Consorci Sanitari Terrassa, Spain
| | - Marcel la Miret
- LIPIDCAS, Endocrinology Department, Hospital Verge de la Cinta, Tortosa, Spain
| | - Silvia Näf
- LIPIDCAS, Endocrinology Department, University Hospital Joan XXIII, IISPV. CIBERDEM. Universitat Rovira i Virgili. Tarragona, Spain
| | - Anna Pardo
- Internal Medicine Department, Hospital Delfos, Barcelona, Spain
| | | | | | | | - Meritxell Royuela
- Lipid Unit, ALTHAIA, Xarxa Assistencial Universitària de Manresa, Spain
| | | | - Maria Urquizu-Padilla
- Lipid Unit, University Hospital Vall d'Hebron, Barcelona Autonomous University, Barcelona, Spain
| | - Alberto Zamora
- Lipid Unit, Corporació de Salut del Maresme i la Selva, Hospital de Blanes, Spain
| | - Juan Pedro-Botet
- Lipid Unit, University Hospital del Mar, Barcelona Autonomous University, Barcelona, Spain
| | - Lluís Masana
- Universitat Rovira i Virgili, LIPIDCAS, University Hospital Sant Joan IISPV, CIBERDEM, Reus, Spain
| | - José L Domingo
- Universitat Rovira i Virgili, Laboratory of Toxicology and Environmental Health, School of Medicine, IISPV, Sant Llorenç 21, 43201 Reus, Catalonia, Spain
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