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Clark SN, Kulka R, Buteau S, Lavigne E, Zhang JJY, Riel-Roberge C, Smargiassi A, Weichenthal S, Van Ryswyk K. High-resolution spatial and spatiotemporal modelling of air pollution using fixed site and mobile monitoring in a Canadian city. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 356:124353. [PMID: 38866318 DOI: 10.1016/j.envpol.2024.124353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Revised: 05/20/2024] [Accepted: 06/08/2024] [Indexed: 06/14/2024]
Abstract
The development of high-resolution spatial and spatiotemporal models of air pollutants is essential for exposure science and epidemiological applications. While fixed-site sampling has conventionally provided input data for statistical predictive models, the evolving mobile monitoring method offers improved spatial resolution, ideal for measuring pollutants with high spatial variability such as ultrafine particles (UFP). The Quebec Air Pollution Exposure and Epidemiology (QAPEE) study measured and modelled the spatial and spatiotemporal distributions of understudied pollutants, such as UFPs, black carbon (BC), and brown carbon (BrC), along with fine particulate matter (PM2.5), nitrogen dioxide (NO2), and ozone (O3) in Quebec City, Canada. We conducted a combined fixed-site (NO2 and O3) and mobile monitoring (PM2.5, BC, BrC, and UFPs) campaign over 10-months. Mobile monitoring routes were monitored on a weekly basis between 8am-10am and designed using location/allocation modelling. Seasonal fixed-site sampling campaigns captured continuous 24-h measurements over two-week periods. Generalized Additive Models (GAMs), which combined data on pollution concentrations with spatial, temporal, and spatiotemporal predictor variables were used to model and predict concentration surfaces. Annual models for PM2.5, NO2, O3 as well as seven of the smallest size fractions in the UFP range, had high out of sample predictive accuracy (range r2: 0.54-0.86). Varying spatial patterns were observed across UFP size ranges measured as Particle Number Counts (PNC). The monthly spatiotemporal models for PM2.5 (r2 = 0.49), BC (r2 = 0.27), BrC (r2 = 0.29), and PNC (r2 = 0.49) had moderate or moderate-low out of sample predictive accuracy. We conducted a sensitivity analysis and found that the minimum number of 'n visits' (mobile monitoring sessions) required to model annually representative air pollution concentrations was between 24 and 32 visits dependent on the pollutant. This study provides a single source of exposure models for a comprehensive set of air pollutants in Quebec City, Canada. These exposure models will feed into epidemiological research on the health impacts of ambient UFPs and other pollutants.
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Affiliation(s)
- Sierra Nicole Clark
- Environmental and Social Epidemiology Section, Population Health Research Institute, St. George's, University of London, London, UK; Air Pollution Exposure Science Section, Water and Air Quality Bureau, Healthy Environments and Consumer Safety Branch, Health Canada, Government of Canada, Ottawa, Ontario, Canada
| | - Ryan Kulka
- Air Pollution Exposure Science Section, Water and Air Quality Bureau, Healthy Environments and Consumer Safety Branch, Health Canada, Government of Canada, Ottawa, Ontario, Canada
| | - Stephane Buteau
- Institut National de sante publique du Quebec (INSPQ), Quebec, Canada; École de santé publique, Département de santé environnementale et santé au travail, Université de Montréal, Québec, Canada; Centre of Public Health Research, University of Montreal and CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, Canada
| | - Eric Lavigne
- Populations Studies Division, Environmental Health Science and Research Bureau, Health Canada, Ottawa, Canada
| | - Joyce J Y Zhang
- Air Pollution Exposure Science Section, Water and Air Quality Bureau, Healthy Environments and Consumer Safety Branch, Health Canada, Government of Canada, Ottawa, Ontario, Canada
| | - Christian Riel-Roberge
- Direction de santé publique, Centre intégré universitaire de santé et de services sociaux (CIUSSS) de la Capitale-Nationale, Quebec City, Quebec, Canada
| | - Audrey Smargiassi
- Institut National de sante publique du Quebec (INSPQ), Quebec, Canada; École de santé publique, Département de santé environnementale et santé au travail, Université de Montréal, Québec, Canada; Centre of Public Health Research, University of Montreal and CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, Canada
| | - Scott Weichenthal
- Air Pollution Exposure Science Section, Water and Air Quality Bureau, Healthy Environments and Consumer Safety Branch, Health Canada, Government of Canada, Ottawa, Ontario, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Keith Van Ryswyk
- Air Pollution Exposure Science Section, Water and Air Quality Bureau, Healthy Environments and Consumer Safety Branch, Health Canada, Government of Canada, Ottawa, Ontario, Canada.
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Raab H, Moyer J, Afrin S, Garcia-Menendez F, Ward-Caviness CK. Prescribed fires, smoke exposure, and hospital utilization among heart failure patients. Environ Health 2023; 22:86. [PMID: 38087300 PMCID: PMC10717133 DOI: 10.1186/s12940-023-01032-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 11/08/2023] [Indexed: 12/18/2023]
Abstract
BACKGROUND Prescribed fires often have ecological benefits, but their environmental health risks have been infrequently studied. We investigated associations between residing near a prescribed fire, wildfire smoke exposure, and heart failure (HF) patients' hospital utilization. METHODS We used electronic health records from January 2014 to December 2016 in a North Carolina hospital-based cohort to determine HF diagnoses, primary residence, and hospital utilization. Using a cross-sectional study design, we associated the prescribed fire occurrences within 1, 2, and 5 km of the patients' primary residence with the number of hospital visits and 7- and 30-day readmissions. To compare prescribed fire associations with those observed for wildfire smoke, we also associated zip code-level smoke density data designed to capture wildfire smoke emissions with hospital utilization amongst HF patients. Quasi-Poisson regression models were used for the number of hospital visits, while zero-inflated Poisson regression models were used for readmissions. All models were adjusted for age, sex, race, and neighborhood socioeconomic status and included an offset for follow-up time. The results are the percent change and the 95% confidence interval (CI). RESULTS Associations between prescribed fire occurrences and hospital visits were generally null, with the few associations observed being with prescribed fires within 5 and 2 km of the primary residence in the negative direction but not the more restrictive 1 km radius. However, exposure to medium or heavy smoke (primarily from wildfires) at the zip code level was associated with both 7-day (8.5% increase; 95% CI = 1.5%, 16.0%) and 30-day readmissions (5.4%; 95% CI = 2.3%, 8.5%), and to a lesser degree, hospital visits (1.5%; 95% CI: 0.0%, 3.0%) matching previous studies. CONCLUSIONS Area-level smoke exposure driven by wildfires is positively associated with hospital utilization but not proximity to prescribed fires.
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Affiliation(s)
- Henry Raab
- Center for Public Health and Environmental Assessment, US Environmental Protection Agency, Human Studies Building, 104 Mason Farm Rd, Chapel Hill, NC, 27514, USA
| | - Joshua Moyer
- Center for Public Health and Environmental Assessment, US Environmental Protection Agency, Human Studies Building, 104 Mason Farm Rd, Chapel Hill, NC, 27514, USA
| | - Sadia Afrin
- Department of Civil, Construction, and Environmental Engineering, North Carolina State University, Raleigh, NC, 27606, USA
- Present address: MIT Laboratory for Aviation and the Environment, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Fernando Garcia-Menendez
- Department of Civil, Construction, and Environmental Engineering, North Carolina State University, Raleigh, NC, 27606, USA
| | - Cavin K Ward-Caviness
- Center for Public Health and Environmental Assessment, US Environmental Protection Agency, Human Studies Building, 104 Mason Farm Rd, Chapel Hill, NC, 27514, USA.
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Youssim I, Erez O, Novack L, Nevo D, Kloog I, Raz R. Ambient temperature and preeclampsia: A historical cohort study. ENVIRONMENTAL RESEARCH 2023; 238:117107. [PMID: 37696321 DOI: 10.1016/j.envres.2023.117107] [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: 06/04/2023] [Revised: 08/21/2023] [Accepted: 09/08/2023] [Indexed: 09/13/2023]
Abstract
Previous studies found inconsistent associations between ambient temperature during pregnancy and the risk of preeclampsia. If such associations are causal, they may impact the future burden of preeclampsia in the context of climate change. We used a historical cohort of 129,009 pregnancies (5074 preeclampsia cases) from southern Israel that was merged with temperature assessments from a hybrid satellite-based exposure model. Distributed-lag and cause-specific hazard models were employed to study time to all preeclampsia cases, followed by stratification according to early (≤34 weeks) and late (>34 weeks) onset disease and identify critical exposure periods. We found a positive association between temperature and preeclampsia during gestation, which was stronger in the 3rd trimester. For example, during week 33, compared to the reference temperature of 22.4 °C, the cause-specific hazard ratio (HRCS) of preeclampsia was 1.01 (95% confidence interval (CI): 1.01-1.02) when exposed to 30 °C, 1.05 (95%CI: 1.03-1.08) at 35 °C, and 1.07 (95%CI: 1.04-1.10) at 37 °C. The associations existed with both early- and late-onset preeclampsia; however, the associations with the early-onset disease were somewhat stronger, limited to the first weeks of pregnancy and the third trimester, and with larger confidence intervals. The HRCS for early preeclampsia onset, when exposed to 37 °C compared to 22.4 °C during week 33, was 1.12 (95%CI: 0.96-1.30), and for late-onset preeclampsia, the HRCS was 1.09 (95%CI: 1.05-1.13). To conclude, exposure to high temperatures at the beginning and, particularly, the end of gestation is associated with an increased risk of preeclampsia in southern Israel.
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Affiliation(s)
- Iaroslav Youssim
- Braun School of Public Health and Community Medicine, The Hebrew University of Jerusalem, Israel.
| | - Offer Erez
- Division of Obstetrics and Gynecology, Soroka University Medical Center, Israel; Department of Obstetrics and Gynecology, Hutzel Women's Hospital, Wayne State University, Detroit, MI, USA
| | - Lena Novack
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Israel; Soroka University Medical Center, Israel, Ben-Gurion University of the Negev, Israel
| | - Daniel Nevo
- Department of Statistics and Operations Research, Tel Aviv University, Tel Aviv, Israel
| | - Itai Kloog
- The Department of Geography and Environmental Development, Ben-Gurion University of the Negev, Israel
| | - Raanan Raz
- Braun School of Public Health and Community Medicine, The Hebrew University of Jerusalem, Israel
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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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Lei J, Chen R, Liu C, Zhu Y, Xue X, Jiang Y, Shi S, Gao Y, Kan H, Xuan J. Fine and coarse particulate air pollution and hospital admissions for a wide range of respiratory diseases: a nationwide case-crossover study. Int J Epidemiol 2023; 52:715-726. [PMID: 37159523 DOI: 10.1093/ije/dyad056] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 04/20/2023] [Indexed: 05/11/2023] Open
Abstract
BACKGROUND The associations between fine and coarse particulate matter (PM2.5 and PM2.5-10) air pollution and hospital admissions for full-spectrum respiratory diseases were rarely investigated, especially for age-specific associations. We aim to estimate the age-specific associations of short-term exposures to PM2.5 and PM2.5-10 with hospital admissions for full-spectrum respiratory diseases in China. METHODS We conducted an individual-level case-crossover study based on a nationwide hospital-based registry including 153 hospitals across 20 provincial regions in China in 2013-20. We applied conditional logistic regression models and distributed lag models to estimate the exposure- and lag-response associations. RESULTS A total of 1 399 955 hospital admission records for various respiratory diseases were identified. The associations of PM2.5 and PM2.5-10 with total respiratory hospitalizations lasted for 4 days, and an interquartile range increase in PM2.5 (34.5 μg/m3) and PM2.5-10 (26.0 μg/m3) was associated with 1.73% [95% confidence interval (95% CI): 1.34%, 2.12%)] and 1.70% (95% CI: 1.31%, 2.10%) increases, respectively, in total respiratory hospitalizations over lag 0-4 days. Acute respiratory infections (i.e. pneumonia, bronchitis and bronchiolitis) were consistently associated with PM2.5 or PM2.5-10 exposure across different age groups. We found the disease spectrum varied by age, including rarely reported findings (i.e. acute laryngitis and tracheitis, and influenza) among children and well-established associations (i.e. chronic obstructive pulmonary disease, asthma, acute bronchitis and emphysema) among older populations. Besides, the associations were stronger in females, children and older populations. CONCLUSIONS This nationwide case-crossover study provides robust evidence that short-term exposure to both PM2.5 and PM2.5-10 was associated with increased hospital admissions for a wide range of respiratory diseases, and the spectra of respiratory diseases varied by age. Females, children and older populations were more susceptible.
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Affiliation(s)
- Jian Lei
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Renjie Chen
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Cong Liu
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Yixiang Zhu
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Xiaowei Xue
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Yixuan Jiang
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Su Shi
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Ya Gao
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Haidong Kan
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
- National Center for Children's Health, Children's Hospital of Fudan University, Shanghai, China
| | - Jianwei Xuan
- Health Economic Research Institute, School of Pharmacy, Sun Yat-Shen University, Guangzhou, China
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Niu L, Girma B, Liu B, Schinasi LH, Clougherty JE, Sheffield P. Temperature and mental health-related emergency department and hospital encounters among children, adolescents and young adults. Epidemiol Psychiatr Sci 2023; 32:e22. [PMID: 37066768 PMCID: PMC10130844 DOI: 10.1017/s2045796023000161] [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: 06/06/2022] [Revised: 02/08/2023] [Accepted: 03/23/2023] [Indexed: 04/18/2023] Open
Abstract
AIMS We examine the association between high ambient temperature and acute mental health-related healthcare encounters in New York City for children, adolescents and young adults. METHODS This case-crossover study included emergency department (ED) visits and hospital encounters with a primary diagnosis of any mental health disorder during warm-season months (June-August) in New York City from 2005 to 2011 from patients of three age groups (6-11, 12-17 and 18-25 years). Using a distributed lag non-linear model over 0-5 lag days, by fitting a conditional logistic regression for each age group, we calculated the cumulative odds ratios of mental health encounters associated with an elevated temperature. Analyses were stratified by race/ethnicity, payment source and mental health categories to elucidate vulnerable subpopulations. RESULTS In New York City, there were 82,982 mental health-related encounters for young people aged 6 to 25 years during our study period months. Elevated temperature days were associated with higher risk of mental health-related ED and hospital encounters for the 6- to 11-year-olds (odds ratio [OR]: 1.28, 95% confidence interval [CI]: 1.13-1.46), for the 12- to 17-year-olds (OR: 1.17, 95% CI: 1.09-1.25) and for the 18- to 25-year-olds (OR: 1.09, 95% CI: 1.04-1.15). Children with reaction disorders, adolescents with anxiety and bipolar disorders, young adults with psychosis and reaction disorders and Black and non-Hispanic children and adolescents showed vulnerability to elevated temperature. CONCLUSIONS We found that elevated ambient temperatures were associated with acute mental health ED or hospital encounters across childhood, adolescence and young adulthood.
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Affiliation(s)
- Li Niu
- Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Blean Girma
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Bian Liu
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Leah H. Schinasi
- Department of Environmental and Occupational Health and Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Jane E. Clougherty
- Department of Environmental and Occupational Health and Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Perry Sheffield
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Zheng D, Huang X, Guo Y. Spatiotemporal variation of ozone pollution and health effects in China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:57808-57822. [PMID: 35355182 DOI: 10.1007/s11356-022-19935-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 03/23/2022] [Indexed: 06/14/2023]
Abstract
With the rapid urbanization and industrialization in China, ozone pollution has become increasingly serious and poses a greater threat to human health. In this study, the spatiotemporal distribution of ozone pollution in China's cities and urban agglomerations from 2015 to 2019 was analyzed. The health effects and health economic costs of ozone pollution in China were estimated by applying the environmental Benefits Mapping and Analysis Program-Community Edition (BenMAP-CE) model. The results are as follows: (1) ozone pollution was more serious in Chinese urban agglomerations from 2015 to 2019; (2) the hot spots of ozone concentration mainly distributed in the North China Plain, expanding from north to south; the cold spots decreased year by year and were located in the northeast, northwest, and southwest of China, shifting from northwest to southwest; (3) the seasonal average of ozone concentration in China was the highest in summer, followed by spring and autumn, and the lowest in winter; (4) the number of all-cause premature deaths of ozone pollution in China increased slowly from 2015 to 2019, and the average of urban agglomerations was significantly higher than cities, with similar spatial distribution characteristics as ozone concentration; (5) the health economic costs of ozone pollution from 2015 to 2019 slowly expanded to surrounding cities with Beijing, Shanghai, Xi'an, and Chongqing as the centers of high values, while the low value areas decreased year by year and were mainly concentrated in southwest and northeast China. The health economic costs of ozone pollution at urban agglomerations scale were higher in the eastern coastal regions and lower in the northwest inland regions. Thus, this study presents policy recommendations to provide decision-making reference for realizing the inter-regional prevention and control of ozone pollution.
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Affiliation(s)
- Dianyuan Zheng
- College of Urban and Environmental Sciences, Northwest University, Xi'an, 710127, China
| | - Xiaojun Huang
- College of Urban and Environmental Sciences, Northwest University, Xi'an, 710127, China.
- Shaanxi Key Laboratory of Earth Surface System and Environmental Carrying Capacity, Xi'an, 710127, China.
- Shaanxi Xi'an Urban Forest Ecosystem Research Station, Xi'an, 710127, China.
| | - Yuhui Guo
- College of Urban and Environmental Sciences, Northwest University, Xi'an, 710127, China
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Karimi B, Moradzadeh R, Samadi S. Air pollution and COVID-19 mortality and hospitalization: An ecological study in Iran. ATMOSPHERIC POLLUTION RESEARCH 2022; 13:101463. [PMID: 35664828 PMCID: PMC9154086 DOI: 10.1016/j.apr.2022.101463] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 05/21/2022] [Accepted: 05/22/2022] [Indexed: 05/07/2023]
Abstract
Exposure to air pollution can exacerbate the severe COVID-19 conditions, subsequently causing an increase in the death rate. In this study, we investigated the association between long-term exposure to air pollution and risks of COVID-19 hospitalization and mortality in Arak, Iran. Air pollution data was obtained from air quality monitoring stations located in Arak, including particulate matter (PM), nitrogen dioxide (NO2), sulfur dioxide (SO2), ozone (O3) and carbon monoxide (CO). Daily numbers of Covid-19 cases including hospital admissions (hospitalization) and deaths (mortality) were obtained from a national data registry recorded by Arak University of Medical Sciences. A Poisson regression model with natural spline functions was applied to set the effects of air pollution on COVID-19 hospitalization and mortality. The percent change of COVID-19 hospitalization per 10 μg/m3 increase in PM2.5 and PM10 were 8.5% (95% CI 7.6 to 11.5) and 4.8% (95% CI 3 to 6.5), respectively. An increase of 10 μg/m3 in PM2.5 resulting in 5.6% (95% CI: 3.1-8.3%) increase in COVID-19 mortality. The percent change of hospitalization (7.7%, 95% CI 2.2 to 13.3) and mortality (4.5%, 95% CI 0.3 to 9.5) were positively significant per one ppb increment in SO2, while NO2, O3 and CO were inversely associated with hospitalization and mortality. Our findings strongly suggesting that a small increase in long-term exposure to PM2.5, PM10 and SO2 elevating risks of hospitalization and mortality related to COVID-19.
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Affiliation(s)
- Behrooz Karimi
- Department of Environmental Health Engineering, Health Faculty, Arak University of Medical Sciences, Arak, Iran
| | - Rahmatollah Moradzadeh
- Department of Epidemiology, Health Faculty, Arak University of Medical Sciences, Arak, Iran
| | - Sadegh Samadi
- Department of Occupational Health and Safety Engineering, Health Faculty, Arak University of Medical Sciences, Arak, Iran
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Niu L, Herrera MT, Girma B, Liu B, Schinasi L, Clougherty JE, Sheffield PE. High ambient temperature and child emergency and hospital visits in New York City. Paediatr Perinat Epidemiol 2022; 36:36-44. [PMID: 34164839 PMCID: PMC8957707 DOI: 10.1111/ppe.12793] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 04/16/2021] [Accepted: 04/18/2021] [Indexed: 02/01/2023]
Abstract
BACKGROUND Emerging literature has documented heat-related impacts on child health, yet few studies have evaluated the effects of heat among children of different age groups and comparing emergency department (ED) and hospitalisation risks. OBJECTIVES To examine the differing associations between high ambient temperatures and risk of ED visits and hospitalisations among children by age group in New York City (NYC). METHODS We used New York Statewide Planning and Research Cooperative System (SPARCS) data on children aged 0-18 years admitted to NYC EDs (n = 2,252,550) and hospitals (n = 228,006) during the warm months (May-September) between 2005 and 2011. Using a time-stratified, case-crossover design, we estimated the risk of ED visits and hospitalisations associated with daily maximum temperature (Tmax) for children of all ages and by age group. RESULTS The average Tmax over the study period was 80.3°F (range 50°, 104°F). Tmax conferred the greatest risk of ED visits for children aged 0-4, with a 6-day cumulative excess risk of 2.4% (95% confidence interval [CI] 1.7, 3.0) per 13°F (ie interquartile range) increase in temperature. Children and adolescents 5-12 years (0.8%, 95% CI 0.1, 1.6) and 13-18 years (1.4%, 95% CI 0.6, 2.3) are also sensitive to heat. For hospitalisations, only adolescents 13-18 years had increased heat-related risk, with a cumulative excess risk of 7.9% (95% CI 2.0, 14.2) per 13°F increase in Tmax over 85°F. CONCLUSIONS This urban study in NYC reinforces that young children are particularly vulnerable to effects of heat, but also demonstrates the sensitivity of older children and adolescents as well. These findings underscore the importance of focussing on children and adolescents in targeting heat illness prevention and emergency response activities, especially as global temperatures continue to rise.
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Affiliation(s)
- Li Niu
- Department of Environmental Medicine and Public HealthIcahn School of Medicine at Mount SinaiNew YorkNYUSA
| | - Maria Teresa Herrera
- Department of Environmental Medicine and Public HealthIcahn School of Medicine at Mount SinaiNew YorkNYUSA
| | - Blean Girma
- Department of Environmental Medicine and Public HealthIcahn School of Medicine at Mount SinaiNew YorkNYUSA
| | - Bian Liu
- Department of Population Health Science and PolicyIcahn School of Medicine at Mount SinaiNew YorkNYUSA
| | - Leah Schinasi
- Department of Environmental and Occupational Health and Urban Health CollaborativeDornsife School of Public HealthDrexel UniversityPhiladelphiaPAUSA
| | - Jane E. Clougherty
- Department of Environmental and Occupational Health and Urban Health CollaborativeDornsife School of Public HealthDrexel UniversityPhiladelphiaPAUSA
| | - Perry E. Sheffield
- Department of Environmental Medicine and Public HealthIcahn School of Medicine at Mount SinaiNew YorkNYUSA
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Saucy A, de Hoogh K, Vienneau D, Tangermann L, Schäffer B, Wunderli JM, Probst-Hensch N, Röösli M. Mutual effects of fine particulate matter, nitrogen dioxide, and fireworks on cause-specific acute cardiovascular mortality: A case-crossover study in communities affected by aircraft noise. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2021; 291:118066. [PMID: 34536646 DOI: 10.1016/j.envpol.2021.118066] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 08/19/2021] [Accepted: 08/27/2021] [Indexed: 06/13/2023]
Abstract
Ambient air pollution is the leading cause of environmental mortality and morbidity worldwide. However, the individual contributions to acute mortality of traffic-related air pollutants such as nitrogen dioxide (NO2) and fine particulate matter (PM2.5) are still debated. We conducted a time-stratified case-crossover study for a population located around Zurich airport in Switzerland, including 24,886 adult cardiovascular deaths from the Swiss National Cohort. We estimated the risk of cause-specific cardiovascular mortality associated with daily NO2 and PM2.5 concentrations at home using distributed lag models up to 7 days preceding death, adjusted for daily temperature, precipitation, acute night-time aircraft noise, firework celebrations, and holidays. Cardiovascular mortality was associated with NO2, whereas the association with PM2.5 disappeared upon adjustment for NO2. The strongest association was observed between NO2 and ischemic stroke mortality (odds ratio = 1.55 per 10 μg/m3, 95% confidence intervals = 1.20-2.00). Cause-specific mortality analyses showed differences in terms of delayed effect: odds ratios were highest at 1-3 days after exposure for most outcomes but at lags of 3-5 days for heart failure. Individual vulnerabilities to NO2 associated cardiovascular mortality also varied by cause of death, possibly highlighting the role of different behaviours and risk factors in the most susceptible groups. The risk of cardiovascular mortality was also increased on firework days and after public holidays, independent from NO2 and PM2.5 concentrations. This study confirms the association between ambient NO2, as a marker for primary emissions, and acute cardiovascular mortality in a specific setting around a major airport. Future research should clarify the role of additional air pollutants including ultra-fine particles on cardiovascular diseases to inform most efficient control measures.
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Affiliation(s)
- Apolline Saucy
- Swiss Tropical and Public Health Institute (SwissTPH), Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute (SwissTPH), Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Danielle Vienneau
- Swiss Tropical and Public Health Institute (SwissTPH), Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Louise Tangermann
- Swiss Tropical and Public Health Institute (SwissTPH), Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Beat Schäffer
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Dübendorf, Switzerland
| | - Jean-Marc Wunderli
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Dübendorf, Switzerland
| | - Nicole Probst-Hensch
- Swiss Tropical and Public Health Institute (SwissTPH), Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Martin Röösli
- Swiss Tropical and Public Health Institute (SwissTPH), Basel, Switzerland; University of Basel, Basel, Switzerland.
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11
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Saucy A, Ragettli MS, Vienneau D, de Hoogh K, Tangermann L, Schäffer B, Wunderli JM, Probst-Hensch N, Röösli M. The role of extreme temperature in cause-specific acute cardiovascular mortality in Switzerland: A case-crossover study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 790:147958. [PMID: 34098271 DOI: 10.1016/j.scitotenv.2021.147958] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 05/07/2021] [Accepted: 05/17/2021] [Indexed: 06/12/2023]
Abstract
Since the 2003 heatwave in Europe, evidence has been rapidly increasing on the association between extreme temperature and all-cause mortality. Little is known, however, about cause-specific cardiovascular mortality, effect modification by air pollution and aircraft noise, and which population groups are the most vulnerable to extreme temperature. We conducted a time-stratified case-crossover study in Zurich, Switzerland, including all adult cardiovascular deaths between 2000 and 2015 with precise individual exposure estimates at home location. We estimated the risk of 24,884 cardiovascular deaths associated with heat and cold using distributed non-linear lag models. We investigated potential effect modification of temperature-related mortality by fine particles, nitrogen dioxide, and night-time aircraft noise and performed stratified analyses across individual and social characteristics. We found increased risk of mortality for heat (odds ratio OR = 1.28 [95% confidence interval: 1.11-1.49] for 99th percentile of daily Tmean (24 °C) versus optimum temperature at 20 °C) and cold (OR = 1.15 [0.95-1.39], 5th percentile of daily Tmean (-3 °C) versus optimum temperature at 20 °C). Heat-related mortality was particularly strong for myocardial infarctions and hypertension related deaths, and among older women (>75 years). Analysis of effect modification also indicated that older women with lower socio-economic position and education are at higher risk for heat-related mortality. PM2.5 increased the risk of heat-related mortality for heart failure, but not all-cause cardiovascular mortality. This study provides useful information for preventing cause-specific cardiovascular temperature-related mortality in moderate climate zones comparable to Switzerland.
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Affiliation(s)
- Apolline Saucy
- Swiss Tropical and Public Health Institute (SwissTPH), Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Martina S Ragettli
- Swiss Tropical and Public Health Institute (SwissTPH), Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Danielle Vienneau
- Swiss Tropical and Public Health Institute (SwissTPH), Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute (SwissTPH), Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Louise Tangermann
- Swiss Tropical and Public Health Institute (SwissTPH), Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Beat Schäffer
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Dübendorf, Switzerland
| | - Jean-Marc Wunderli
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Dübendorf, Switzerland
| | - Nicole Probst-Hensch
- Swiss Tropical and Public Health Institute (SwissTPH), Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Martin Röösli
- Swiss Tropical and Public Health Institute (SwissTPH), Basel, Switzerland; University of Basel, Basel, Switzerland.
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12
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Personal Interventions for Reducing Exposure and Risk for Outdoor Air Pollution: An Official American Thoracic Society Workshop Report. Ann Am Thorac Soc 2021; 18:1435-1443. [PMID: 34468284 PMCID: PMC8489863 DOI: 10.1513/annalsats.202104-421st] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Poor air quality affects the health and wellbeing of large populations around the globe. Although source controls are the most effective approaches for improving air quality and reducing health risks, individuals can also take actions to reduce their personal exposure by staying indoors, reducing physical activity, altering modes of transportation, filtering indoor air, and using respirators and other types of face masks. A synthesis of available evidence on the efficacy, effectiveness, and potential adverse effects or unintended consequences of personal interventions for air pollution is needed by clinicians to assist patients and the public in making informed decisions about use of these interventions. To address this need, the American Thoracic Society convened a workshop in May of 2018 to bring together a multidisciplinary group of international experts to review the current state of knowledge about personal interventions for air pollution and important considerations when helping patients and the general public to make decisions about how best to protect themselves. From these discussions, recommendations were made regarding when, where, how, and for whom to consider personal interventions. In addition to the efficacy and safety of the various interventions, the committee considered evidence regarding the identification of patients at greatest risk, the reliability of air quality indices, the communication challenges, and the ethical and equity considerations that arise when discussing personal interventions to reduce exposure and risk from outdoor air pollution.
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13
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Zhang F, Zhang Y, Liu L, Jiao A, Chen D, Xiang Q, Fang J, Ding Z, Zhang Y. Assessing PM 2.5-associated risk of hospitalization for COPD: an application of daily excessive concentration hours. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:30267-30277. [PMID: 33590391 DOI: 10.1007/s11356-021-12655-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 01/20/2021] [Indexed: 06/12/2023]
Abstract
Existing PM2.5-morbidity studies using daily mean concentration as exposure metric may fail to capture intra-day variations of PM2.5 concentrations, resulting in underestimated health impacts to some extent. This study introduced a novel indicator, daily excessive concentration hours (DECH), defined as sums of per-hourly excessive concentrations of PM2.5 against a specific threshold within a day. PM2.5 DECHs were separately calculated as daily concentration-hours >8, 10, 15, 20, and 25 μg/m3 (abbreviations: DECH-8, DECH-10, DECH-15, DECH-20, and DECH-25). We adopted a time-stratified case-crossover design with conditional logistic regression models to compare risks of hospitalizations for chronic obstructive pulmonary disease (COPD) associated with PM2.5 mean and DECHs in Shenzhen, China. We observed highly comparable PM2.5-COPD associations using exposure metrics of daily mean and DECHs with above-defined thresholds. For instance, PM2.5 mean and DECHs showed similar increases in risks of COPD hospitalization for an interquartile range rise in exposure, with odds ratio estimates of 1.26 (95% confidence interval: 1.06-1.50) for PM2.5 mean, 1.24 (1.05-1.46) for DECH-10 and 1.21 (1.06-1.39) for DECH-25, respectively. Findings remained robust after further adjusting for gaseous pollutants (e.g., SO2, NO2, CO, and O3) and meteorologic factors (e.g., wind speed and air pressure). Our study strengthened the evidence that DECHs could come be as a novel exposure metric in health risk assessments associated with short-term exposure to ambient PM2.5.
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Affiliation(s)
- Faxue Zhang
- Center of Health Administration and Development Studies, Hubei University of Medicine, Shiyan, 442000, China
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, Wuhan, 430071, China
| | - Yuanyuan Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University of Science and Technology, Wuhan, 430065, China
| | - Linjiong Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University of Science and Technology, Wuhan, 430065, China
| | - Anqi Jiao
- Department of Preventive Medicine, School of Health Sciences, Wuhan University, Wuhan, 430071, China
| | - Dieyi Chen
- Department of Global Health, School of Health Sciences, Wuhan University, Wuhan, 430071, China
| | - Qianqian Xiang
- Hubei Provincial Center for Disease Control and Prevention, Wuhan, 430079, China
| | - Jiaying Fang
- Medical Department, Huadu District People's Hospital of Guangzhou, Guangzhou, 510800, China
| | - Zan Ding
- The Institute of Metabolic Diseases, Baoan Central Hospital of Shenzhen, The Fifth Affiliated Hospital of Shenzhen University, Shenzhen, 518102, Guangdong, China
| | - Yunquan Zhang
- Center of Health Administration and Development Studies, Hubei University of Medicine, Shiyan, 442000, China.
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University of Science and Technology, Wuhan, 430065, China.
- Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan, 430065, China.
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14
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Lopez PD, Cativo-Calderon EH, Otero D, Rashid M, Atlas S, Rosendorff C. The Impact of Environmental Factors on the Mortality of Patients With Chronic Heart Failure. Am J Cardiol 2021; 146:48-55. [PMID: 33577810 DOI: 10.1016/j.amjcard.2021.01.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 12/30/2020] [Accepted: 01/05/2021] [Indexed: 10/22/2022]
Abstract
Outcomes of acute heart failure hospitalizations are worse during the winter than the rest of the year. Seasonality data are more limited for outcomes in chronic heart failure and the effect of environmental variables is unknown. In this population-level study, we merged 20-year data for 555,324 patients with heart failure from the national Veterans Administration database with data on climate from the National Oceanic and Atmospheric Administration and air pollutants by the Environmental Protection Agency. The outcome was the all-cause mortality rate, stratified by geographical location and each month. The impact of environmental factors was assessed through Pearson's correlation and multiple regression with a family-wise α = 0.05. The monthly all-cause mortality was 13.9% higher in the winter than the summer, regardless of gender, age group, and heart failure etiology. Winter season, lower temperatures, and higher concentrations of nitrogen dioxide were associated with a higher mortality rate in multivariate analysis of the overall population. Different environmental factors were associated in regions with similar patterns of temperature and precipitation. The only environmental factor associated with the mortality rate of patients dwelling in large urban centers was the air quality index. In conclusion, the mortality in chronic heart failure exhibits a seasonal pattern, regardless of latitude or climate. In this group of patients, particularly those of male gender, a higher mortality was associated with environmental factors and incorporating these factors in treatment plans and recommendations could have a favorable cost-benefit ratio.
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15
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Yao J, Brauer M, Wei J, McGrail KM, Johnston FH, Henderson SB. Sub-Daily Exposure to Fine Particulate Matter and Ambulance Dispatches during Wildfire Seasons: A Case-Crossover Study in British Columbia, Canada. ENVIRONMENTAL HEALTH PERSPECTIVES 2020; 128:67006. [PMID: 32579089 PMCID: PMC7313403 DOI: 10.1289/ehp5792] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 05/06/2020] [Accepted: 05/14/2020] [Indexed: 05/24/2023]
Abstract
BACKGROUND Exposure to fine particulate matter (PM2.5) during wildfire seasons has been associated with adverse health outcomes. Previous studies have focused on daily exposure, but PM2.5 levels in smoke events can vary considerably within 1 d. OBJECTIVES We aimed to assess the immediate and lagged relationship between sub-daily exposure to PM2.5 and acute health outcomes during wildfire seasons in British Columbia. METHODS We used a time-stratified case-crossover study design to evaluate the association between modeled hourly PM2.5 and ambulance dispatches during wildfire seasons from 2010 to 2015. Distributed lag nonlinear models were used to estimate the lag-specific and cumulative odds ratios (ORs) at lags from 1 to 48 h. We examined the relationship for all dispatches and dispatches related to respiratory, circulatory, and diabetic conditions, identified by codes for ambulance dispatch (AD), paramedic assessment (PA) or hospital diagnosis (HD). RESULTS Increased respiratory health outcomes were observed within 1 h of exposure to a 10-μg/m3 increase in PM2.5. The 48-h cumulative OR [95% confidence interval (CI)] was 1.038 (1.009, 1.067) for the AD code Breathing Problems and 1.098 (1.013, 1.189) for PA code Asthma/COPD. The point estimates were elevated within 1 h for the PA code for Myocardial Infarction and HD codes for Ischemic Heart Disease, which had 24-h cumulative ORs of 1.104 (0.915, 1.331) and 1.069 (0.983, 1.162), respectively. The odds of Diabetic AD and PA codes increased over time to a cumulative 24-h OR of 1.075 (1.001, 1.153) and 1.104 (1.015, 1.202) respectively. CONCLUSIONS We found increased PM2.5 during wildfire seasons was associated with some respiratory and cardiovascular outcomes within 1 h following exposure, and its association with diabetic outcomes increased over time. Cumulative effects were consistent with those reported elsewhere in the literature. These results warrant further investigation and may have implications for the appropriate time scale of public health actions. https://doi.org/10.1289/EHP5792.
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Affiliation(s)
- Jiayun Yao
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Michael Brauer
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Julie Wei
- British Columbia Emergency Health Services, Vancouver, British Columbia, Canada
| | - Kimberlyn M McGrail
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Fay H Johnston
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Sarah B Henderson
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
- Environmental Health Services, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
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16
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Do Ambient Ozone or Other Pollutants Modify Effects of Controlled Ozone Exposure on Pulmonary Function? Ann Am Thorac Soc 2020; 17:563-572. [DOI: 10.1513/annalsats.201908-597oc] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
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17
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Wang J, Cao H, Sun D, Qi Z, Guo C, Peng W, Sun Y, Xie Y, Liu X, Li B, Luo Y, Pan Y, Li Y, Zhang L. Associations between ambient air pollution and mortality from all causes, pneumonia, and congenital heart diseases among children aged under 5 years in Beijing, China: A population-based time series study. ENVIRONMENTAL RESEARCH 2019; 176:108531. [PMID: 31226628 DOI: 10.1016/j.envres.2019.108531] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 06/06/2019] [Accepted: 06/08/2019] [Indexed: 05/22/2023]
Abstract
BACKGROUND Previous studies have mainly focused on the associations between particulate matters and infant mortality. However, evidence regarding the associations between gaseous pollutants and mortality among children aged <5 years remains sparse. OBJECTIVES The aim of this study was to investigate the associations between ambient air pollution and death among children aged <5 years in Beijing, China, and explore the impact of age, gender and specific causes of death on these associations. METHODS Concentrations of ambient air pollution and the number of deaths among children aged <5 years in Beijing from January 2014 to September 2016 were extracted from authoritative electronic databases. The associations were estimated for a single-month lag from the current month up to the previous 5 months (lag0-lag5) and moving averages of the current and previous months (lag01-lag05) using generalized additive Poisson regression (adjusted for time trends, season, meteorological variables and holidays). Subgroup analyses related to age, gender and specific diseases were performed. Two-pollutant models were used to evaluate the possible role of single pollutants. RESULTS Sulfur dioxide (SO2), nitrogen dioxide (NO2) and carbon monoxide (CO) demonstrated the strongest associations with death among children aged <5 years at lag0, and the estimates decreased or even turned negative with the increasing lag periods. For an interquartile range increase in SO2, NO2 and CO at lag0, the odds ratios (OR) were 1.332 (95% CI 1.152-1.539), 1.383 (95% CI 1.113-1.718) and 1.273 (95% CI 1.028-1.575). However, CO lost significance after adjusting for SO2 and NO2, and PM2.5 gained significance (OR 1.548, 95% CI 1.061-2.258) after adjusting for PM10. The ORs for SO2 and NO2 remained the most stable across all two-pollutant models. The associations for children aged 1-5 years were stronger than those reported for infants at lag0 but lower at the other lag months. The pollutant associations were stronger for congenital heart disease-related death than overall and pneumonia-related death. We did not find significant differences in terms of gender. CONCLUSION Exposure to air pollution may increase the incidence of death among children aged <5 years. SO2 and NO2 may be the most stable pollutants reflecting associations between air pollution and death, deserving further attention. Children with congenital heart diseases are more susceptible to air pollution. Therefore, it is urgent to implement the clean air targets established by WHO and reduce the exposure of children to air pollution.
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Affiliation(s)
- Jing Wang
- Department of Children's Health Care, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, No. 251, Yaojiayuan Road, Chaoyang District, Beijing, 100026, China; Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, and Beijing Municipal Key Laboratory of Clinical Epidemiology, No. 10, Xi Toutiao You Anmenwai, Fengtai District, Beijing, 100069, China
| | - Han Cao
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, and Beijing Municipal Key Laboratory of Clinical Epidemiology, No. 10, Xi Toutiao You Anmenwai, Fengtai District, Beijing, 100069, China
| | - Dianqin Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, and Beijing Municipal Key Laboratory of Clinical Epidemiology, No. 10, Xi Toutiao You Anmenwai, Fengtai District, Beijing, 100069, China
| | - Zifan Qi
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, and Beijing Municipal Key Laboratory of Clinical Epidemiology, No. 10, Xi Toutiao You Anmenwai, Fengtai District, Beijing, 100069, China
| | - Chunyue Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, and Beijing Municipal Key Laboratory of Clinical Epidemiology, No. 10, Xi Toutiao You Anmenwai, Fengtai District, Beijing, 100069, China
| | - Wenjuan Peng
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, and Beijing Municipal Key Laboratory of Clinical Epidemiology, No. 10, Xi Toutiao You Anmenwai, Fengtai District, Beijing, 100069, China
| | - Yanyan Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, and Beijing Municipal Key Laboratory of Clinical Epidemiology, No. 10, Xi Toutiao You Anmenwai, Fengtai District, Beijing, 100069, China
| | - Yunyi Xie
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, and Beijing Municipal Key Laboratory of Clinical Epidemiology, No. 10, Xi Toutiao You Anmenwai, Fengtai District, Beijing, 100069, China
| | - Xiaohui Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, and Beijing Municipal Key Laboratory of Clinical Epidemiology, No. 10, Xi Toutiao You Anmenwai, Fengtai District, Beijing, 100069, China
| | - Bingxiao Li
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, and Beijing Municipal Key Laboratory of Clinical Epidemiology, No. 10, Xi Toutiao You Anmenwai, Fengtai District, Beijing, 100069, China
| | - Yanxia Luo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, and Beijing Municipal Key Laboratory of Clinical Epidemiology, No. 10, Xi Toutiao You Anmenwai, Fengtai District, Beijing, 100069, China
| | - Ying Pan
- Department of Children's Health Care, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, No. 251, Yaojiayuan Road, Chaoyang District, Beijing, 100026, China
| | - Yichen Li
- Department of Children's Health Care, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, No. 251, Yaojiayuan Road, Chaoyang District, Beijing, 100026, China.
| | - Ling Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, and Beijing Municipal Key Laboratory of Clinical Epidemiology, No. 10, Xi Toutiao You Anmenwai, Fengtai District, Beijing, 100069, China.
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18
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Li Z, Mao X, Liu Q, Song H, Ji Y, Xu D, Qiu B, Tian D, Wang J. Long-term effect of exposure to ambient air pollution on the risk of active tuberculosis. Int J Infect Dis 2019; 87:177-184. [PMID: 31374344 DOI: 10.1016/j.ijid.2019.07.027] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Revised: 07/25/2019] [Accepted: 07/25/2019] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES To explore the long-term effect of exposure to ambient air pollution on the risk of active tuberculosis (TB). METHODS We constructed a distributed-lag nonlinear model (DLNM) to evaluate the relatively long-term influence of outdoor PM2.5, PM10, SO2 and NO2 exposure on active TB risk in the city of Lianyungang in Jiangsu Province, China. RESULTS There were 7,282 TB cases reported in the study area during 2014-2017, with annual median (interquartile range) concentrations of PM2.5, PM10, SO2 and NO2 at 45.86 (34.57-64.14) μg/m3, 85.43 (62.86-116.14) μg/m3, 22.00 (15.71-30.86) μg/m3 and 30.00 (23.29-38.57) μg/m3, respectively. The single-pollutant model showed that for each 10 μg/m3 increase in concentration, the cumulative relative risk of TB was 1.12 (lag 0-24 weeks, 95% CI: 1.03-1.22) for PM2.5 with reference to 35 μg/m3; 1.11 (lag 0-21 weeks, 95% CI: 1.06-1.17) for PM10 with reference to 70 μg/m3; 1.37 (lag 0-20 weeks, 95% CI: 1.16-1.62) for SO2 with reference to 60 μg/m3; and 1.29 (lag 0-22 weeks, 95% CI: 1.11-1.49) for NO2 with reference to 40 μg/m3. In the multipollutant model considering both PM10 and NO2, the association remained significant. CONCLUSIONS Our results revealed a potential association between outdoor exposure to PM2.5, PM10, SO2, and NO2 and active TB. Considering that people from developing countries continue to be exposed to both severe outdoor air pollution and high rates of latent TB infection, the association between worsening air pollution and active TB deserves further attention.
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Affiliation(s)
- Zhongqi Li
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, People's Republic of China
| | - Xuhua Mao
- Department of Clinical Laboratory, Yixing People's Hospital, Wuxi, 214200, People's Republic of China
| | - Qiao Liu
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, People's Republic of China
| | - Huan Song
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, People's Republic of China
| | - Ye Ji
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, People's Republic of China
| | - Dian Xu
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, People's Republic of China
| | - Beibei Qiu
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, People's Republic of China
| | - Dan Tian
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, People's Republic of China
| | - Jianming Wang
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, People's Republic of China; Key Laboratory of Infectious Diseases, School of Public Health, Nanjing Medical University, Nanjing, 211166, People's Republic of China.
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Masselot P, Chebana F, Lavigne É, Campagna C, Gosselin P, Ouarda TBMJ. Toward an Improved Air Pollution Warning System in Quebec. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16122095. [PMID: 31200502 PMCID: PMC6617323 DOI: 10.3390/ijerph16122095] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 06/04/2019] [Accepted: 06/07/2019] [Indexed: 11/16/2022]
Abstract
The nature of pollutants involved in smog episodes can vary significantly in various cities and contexts and will impact local populations differently due to actual exposure and pre-existing sensitivities for cardiovascular or respiratory diseases. While regulated standards and guidance remain important, it is relevant for cities to have local warning systems related to air pollution. The present paper proposes indicators and thresholds for an air pollution warning system in the metropolitan areas of Montreal and Quebec City (Canada). It takes into account past and current local health impacts to launch its public health warnings for short-term episodes. This warning system considers fine particulate matter (PM2.5) as well as the combined oxidant capacity of ozone and nitrogen dioxide (Ox) as environmental exposures. The methodology used to determine indicators and thresholds consists in identifying extreme excess mortality episodes in the data and then choosing the indicators and thresholds to optimize the detection of these episodes. The thresholds found for the summer were 31 μg/m3 for PM2.5 and 43 ppb for Ox in Montreal, and 32 μg/m3 and 23 ppb in Quebec City. In winter, thresholds found were 25 μg/m3 and 26 ppb in Montreal, and 33 μg/m3 and 21 ppb in Quebec City. These results are in line with different guidelines existing concerning air quality, but more adapted to the cities examined. In addition, a sensitivity analysis is conducted which suggests that Ox is more determinant than PM2.5 in detecting excess mortality episodes.
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Affiliation(s)
- Pierre Masselot
- Institut National de la Recherche Scientifique, Centre Eau-Terre-Environnement, 490, rue de la Couronne, Québec, QC G1K 9A9, Canada.
| | - Fateh Chebana
- Institut National de la Recherche Scientifique, Centre Eau-Terre-Environnement, 490, rue de la Couronne, Québec, QC G1K 9A9, Canada.
| | - Éric Lavigne
- School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, ON K1G 5Z3, Canada.
- Air health Science Division, Health Canada, 269 Laurier Ave West, Ottawa, ON K1A 0K9, Canada.
| | - Céline Campagna
- Institut National de la Recherche Scientifique, Centre Eau-Terre-Environnement, 490, rue de la Couronne, Québec, QC G1K 9A9, Canada.
- Institut National de Santé Publique du Québec, 945 Avenue Wolfe, Québec, QC G1V 5B3, Canada.
| | - Pierre Gosselin
- Institut National de la Recherche Scientifique, Centre Eau-Terre-Environnement, 490, rue de la Couronne, Québec, QC G1K 9A9, Canada.
- Institut National de Santé Publique du Québec, 945 Avenue Wolfe, Québec, QC G1V 5B3, Canada.
- Ouranos, 550 Rue Sherbrooke Ouest, Montréal, QC H3A 1B9, Canada.
| | - Taha B M J Ouarda
- Institut National de la Recherche Scientifique, Centre Eau-Terre-Environnement, 490, rue de la Couronne, Québec, QC G1K 9A9, Canada.
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Shin SW, Bae DJ, Park CS, Lee JU, Kim RH, Kim SR, Chang HS, Park JS. Effects of air pollution on moderate and severe asthma exacerbations. J Asthma 2019; 57:875-885. [PMID: 31122089 DOI: 10.1080/02770903.2019.1611844] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Background: Few studies have evaluated the impact of air pollution levels on the severity of exacerbations. Thus, we compared the relative risks posed by air pollutant levels on moderate and severe exacerbations.Methods: Exacerbation episodes of 618 from 143 adult asthmatics were retrospectively collected between 2005 and 2015 in a tertiary hospital of Korea. Air pollution GPS data for the location closest to each patient's home were obtained from the national ambient monitoring station. The relative impacts of air pollutants on asthma exacerbations were evaluated via a time-trend controlled symmetrical, bidirectional, case-crossover design using conditional logistic regression models on the day of the exacerbation (T-0) and up to 3 days before the exacerbation (T-1-T-3).Results: Overall asthma exacerbation were associated with O3 levels in summer and winter (OR: 1.012[1.003-1.02] and 1.009[1.003-1.016]), SO2 levels in spring and summer (OR: 1.009[1-1.018] and 1.02[1.006-1.035]) and NO2 levels in winter (OR: 1.007[1.003-1.011]). Analyses of the temporal relationship between O3 concentrations and exacerbations demonstrated that 63.2% of episodes in the summer occurred when the O3 concentrations on T-1 were significantly higher than those on control days, while 51% of exacerbation episodes in the winter occurred. Severe and moderate exacerbations were similarly associated with O3 levels in winter (OR: 1.012 [1.003-1.02] vs. 1.01 [0.999-1.021], p > 0.05) and in summer (OR: 1.006 [1.002-1.009] vs. 1.009 [1.003-1.016], p > 0.05).Conclusions: Asthma exacerbations may be associated with the seasonal elevation of O3, SO2 and NO2 levels in summer and winter with the similar relative risk between moderate and severe exacerbations.
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Affiliation(s)
- Seung-Woo Shin
- Division of Allergy and Respiratory Medicine, Soonchunhyang Univ. Bucheon Hospital, Bucheon, South Korea
| | - Da-Jeong Bae
- Division of Allergy and Respiratory Medicine, Soonchunhyang Univ. Bucheon Hospital, Bucheon, South Korea
| | - Choon-Sik Park
- Division of Allergy and Respiratory Medicine, Soonchunhyang Univ. Bucheon Hospital, Bucheon, South Korea
| | - Jong-Uk Lee
- Division of Allergy and Respiratory Medicine, Soonchunhyang Univ. Bucheon Hospital, Bucheon, South Korea
| | - Ryun-Hee Kim
- Department of Medical Bioscience, Graduate School, Soonchunhyang University, Asan, South Korea
| | - Sung Roul Kim
- Department of Environmental Health Sciences, Soonchunhyang University, Asan, South Korea
| | - Hun-Soo Chang
- Department of Medical Bioscience, Graduate School, Soonchunhyang University, Asan, South Korea
| | - Jong Sook Park
- Division of Allergy and Respiratory Medicine, Soonchunhyang Univ. Bucheon Hospital, Bucheon, South Korea
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21
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Sun S, Tian L, Cao W, Lai PC, Wong PPY, Lee RSY, Mason TG, Krämer A, Wong CM. Urban climate modified short-term association of air pollution with pneumonia mortality in Hong Kong. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 646:618-624. [PMID: 30059922 DOI: 10.1016/j.scitotenv.2018.07.311] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 07/05/2018] [Accepted: 07/20/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND City is becoming warmer, especially in the process of urbanization and climate change. However, it is largely unknown whether this warming urban climate may modify the short-term effects of air pollution. OBJECTIVES To test whether warmer urban climates intensify the acute mortality effects of air pollution on pneumonia in Hong Kong. METHODS Participants who died of pneumonia from a prospective Chinese elderly cohort between 1998 and 2011 were selected as cases. Urban climatic (UC) classes of cases were determined by an established Urban Climatic Map according to their residential addresses. UC classes were first dichotomized into cool and warm climates and case-crossover analysis was used to estimate the short-term association of pneumonia mortality with air pollution. We further classified UC classes into climate quartiles and used case-only analysis to test the trend of urban climate modification on the short-term association of pneumonia mortality with air pollution. RESULTS Among 66,820 elders (≥65 years), 2208 pneumonia deaths (cases) were identified during the 11-14 years of follow-up. The effects of air pollution for cases residing in the warm climate were statistically significant (p < 0.05) higher than those living in the cool climate. There was an increasing linear trend of urban climate modification on the association of pneumonia mortality with NO2 (nitrogen dioxide) (p for trend = 0.035). Compared to climate Quartile 1 (the lowest), deaths resided in climate Quartile 2, 3, and 4 (the highest) were associated with an additional percent change of 9.07% (0.52%, 17.62%), 12.89% (4.34%, 21.43%), and 8.45% (-0.10%, 17.00%), respectively. CONCLUSIONS Warmer urban climate worsened the acute mortality effects of pneumonia associated with air pollutants in Hong Kong. Our findings suggest that warmer urban climate introduced by climate change and urbanization may increase the risks of air pollution-related pneumonia.
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Affiliation(s)
- Shengzhi Sun
- School of Public Health, The University of Hong Kong, Hong Kong SAR, China; Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Linwei Tian
- School of Public Health, The University of Hong Kong, Hong Kong SAR, China.
| | - Wangnan Cao
- Public Health and Healthy Ageing Research Group, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Poh-Chin Lai
- Department of Geography, Faculty of Social Sciences, The University of Hong Kong, Hong Kong SAR, China
| | | | - Ruby Siu-Yin Lee
- Elderly Health Service, Department of Health, Hong Kong Special Administrative Region, China
| | - Tonya G Mason
- School of Public Health, The University of Hong Kong, Hong Kong SAR, China
| | - Alexander Krämer
- Department of Public Health Medicine, School of Public Health, University of Bielefeld, Bielefeld, Germany
| | - Chit-Ming Wong
- School of Public Health, The University of Hong Kong, Hong Kong SAR, China
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22
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Loizeau M, Buteau S, Chaix B, McElroy S, Counil E, Benmarhnia T. Does the air pollution model influence the evidence of socio-economic disparities in exposure and susceptibility? ENVIRONMENTAL RESEARCH 2018; 167:650-661. [PMID: 30241004 DOI: 10.1016/j.envres.2018.08.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Revised: 06/27/2018] [Accepted: 08/01/2018] [Indexed: 06/08/2023]
Abstract
Studies assessing socio-economic disparities in air pollution exposure and susceptibility are usually based on a single air pollution model. A time stratified case-crossover study was designed to assess the impact of the type of model on differential exposure and on the differential susceptibility in the relationship between ozone exposure and daily mortality by socio-economic strata (SES) in Montreal. Non-accidental deaths along with deaths from cardiovascular and respiratory causes on the island of Montreal for the period 1991-2002 were included as cases. Daily ozone concentration estimates at partictaipants' residence were obtained from the five following air pollution models: Average value (AV), Nearest station model (NS), Inverse-distance weighting interpolation (IDW), Land-use regression model with back-extrapolation (LUR-BE) and Bayesian maximum entropy model combined with a land-use regression (BME-LUR). The prevalence of a low household income (< 20,000/year) was used as socio-economic variable, divided into two categories as a proxy for deprivation. Multivariable conditional logistic regressions were used considering 3-day average concentrations. Multiplicative and additive interactions (using Relative Excess Risk due to Interaction) as well as Cochran's tests were calculated and results were compared across the different air pollution models. Heterogeneity of susceptibility and exposure according to socio-economic status (SES) were found. Ratio of exposure across SES groups means ranged from 0.75 [0.74-0.76] to 1.01 [1.00-1.02], respectively for the LUR-BE and the BME-LUR models. Ratio of mortality odds ratios ranged from 1.01 [0.96-1.05] to 1.02 [0.97-1.08], respectively for the IDW and LUR-BE models. Cochran's test of heterogeneity between the air pollution models showed important heterogeneity regarding the differential exposure by SES, but the air pollution model was not found to influence heterogeneity regarding the differential susceptibility. The study showed air pollution models can influence the assessment of disparities in exposure according to SES in Montreal but not that of disparities in susceptibility.
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Affiliation(s)
- Maxime Loizeau
- Department of Family Medicine and Public Health & Scripps Institution of Oceanography University of California, San Diego, CA, USA; EHESP School of Public Health, Rennes, France
| | - Stéphane Buteau
- Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - Basile Chaix
- Inserm, UMR-S 1136, Pierre Louis Institute of Epidemiology and Public Health, Nemesis team, Paris, France
| | - Sara McElroy
- Department of Family Medicine and Public Health & Scripps Institution of Oceanography University of California, San Diego, CA, USA
| | | | - Tarik Benmarhnia
- Department of Family Medicine and Public Health & Scripps Institution of Oceanography University of California, San Diego, CA, USA
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