1
|
Lian X, Wang Y, Guo J, Wan X, Ye X, Zhou J, Han R, Yu H, Huang S, Li J. The short-term effects of individual and mixed ambient air pollutants on suicide mortality: A case-crossover study. JOURNAL OF HAZARDOUS MATERIALS 2024; 472:134505. [PMID: 38703689 DOI: 10.1016/j.jhazmat.2024.134505] [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: 01/29/2024] [Revised: 04/14/2024] [Accepted: 04/30/2024] [Indexed: 05/06/2024]
Abstract
It is critical to explore intervenable environmental factors in suicide mortality. Based on 30,688 suicide cases obtained from the Mortality Surveillance System of the Jiangsu Provincial Centre for Disease Control and Prevention, we utilized a case-crossover design, and found that the OR of suicide deaths increased by a maximum of 0.71 % (95 % CI: 0.09 %, 1.32 %), 0.68 % (95 % CI: 0.12 %, 1.25 %), 0.77 % (95 % CI: 0.19 %, 1.37 %), 2.95 % (95 % CI: 1.62 %, 4.29 %), 4.18 % (95 % CI: 1.55 %, 6.88 %), and 0.93 % (95 % CI: 0.10 %, 1.77 %), respectively, for per 10 μg/m3 increase in the particulate matter (PM) with diameters ≤ 2.5 µm (PM2.5), PM with diameters ≤ 10 µm (PM10), ozone (O3), nitrogen dioxide (NO2), sulfur dioxide (SO2), and per 0.1 mg/m3 increase in carbon monoxide (CO) concentrations with the conditional logistic regression analysis. People living in county-level cities were more susceptible. Particularly, a significant positive association was found between air pollutant mixture exposure and suicide deaths (OR=1.04,95 % CI: 1.01, 1.06). The excess fraction of suicide deaths due to air pollution reached a maximum of 8.07 %. In conclusion, we found associations between individual and mixed ambient air pollutants and suicide deaths, informing the development of integrated air pollution management and targeted measures for suicide prevention and intervention. ENVIRONMENTAL IMPLICATION: As a major contributor to the global burden of disease, air pollution was confirmed by accumulating studies to have adverse impact on mental health, and potentially lead to suicide deaths. However, systematic studies on the association between air pollution and suicide mortality are lacking. We explored the associations of multiple air pollutants and pollution mixtures with suicide deaths and assessed excess suicide mortality due to air pollution, emphasizing the importance of air pollution control on suicide prevention. Our study provides evidence to support mechanistic studies on the association between air pollution and suicide, and informs comprehensive air pollution management.
Collapse
Affiliation(s)
- Xinyao Lian
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China
| | - Yaqi Wang
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China
| | - Jianhui Guo
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China
| | - Xiaoyu Wan
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China
| | - Xinyao Ye
- School of Public Health, Peking University, Beijing 100191, China
| | - Jinyi Zhou
- Non-Communicable Chronic Disease Control and Prevention Institute, Jiangsu Provincial Center for Disease Control and Prevention, Jiangsu 210009, China
| | - Renqiang Han
- Non-Communicable Chronic Disease Control and Prevention Institute, Jiangsu Provincial Center for Disease Control and Prevention, Jiangsu 210009, China
| | - Hao Yu
- Non-Communicable Chronic Disease Control and Prevention Institute, Jiangsu Provincial Center for Disease Control and Prevention, Jiangsu 210009, China.
| | - Shaodan Huang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China.
| | - Jing Li
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China.
| |
Collapse
|
2
|
Hasnain MG, Garcia-Esperon C, Tomari YK, Walker R, Saluja T, Rahman MM, Boyle A, Levi CR, Naidu R, Filippelli G, Spratt NJ. Bushfire-smoke trigger hospital admissions with cerebrovascular diseases: Evidence from 2019-20 bushfire in Australia. Eur Stroke J 2024; 9:468-476. [PMID: 38258746 DOI: 10.1177/23969873231223307] [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] [Indexed: 01/24/2024] Open
Abstract
INTRODUCTION Exposure to ambient air pollution is strongly associated with increased cerebrovascular diseases. The 2019-20 bushfire season in Australia burnt 5.4 million hectares of land in New South Wales alone, with smoke so severe it affected cities in Argentina, 11,000 km away. The smoke emitted by bushfires consists of both gaseous and particle components. It is important to note that exposure to particulate matter has been shown to be linked to a heightened risk of stroke, which is the primary kind of cerebrovascular illness, as well as an increased likelihood of hospitalisations and mortality. However, the available data is inadequate in terms of documenting the response of patients diagnosed with a proven cerebrovascular illness to bushfire smoke. Additionally, there is a lack of information about the health effects associated with particulate matter throughout the bushfire season and on days when smoke was present in 2019 and 2020.Therefore, we aimed to determine the effects of (i) short-term air pollution triggered by bushfires and (ii) high smoke days in increasing the daily number of hospital admissions with cerebrovascular diseases. MATERIALS AND METHODS Hospitalisation data were accessed from the admitted patient dataset from seven local Government areas of Hunter New England Local Health District. The bushfire period was defined from 1 October 2019 to 10 February 2020, and a same period from 2018-19 as the control. High bushfire smoke days were days when the average daily concentration of particulate matter was higher than the 95th percentile of the control period. Poisson regression models and fixed effect meta-analysis were used to analyse the data. RESULTS In total, 275 patients with cerebrovascular admissions were identified, with 147 (53.5%) during the bushfire (2019-20) and 128 (46.5%) in the control period (2018-19). There was no significant increase in daily admissions for cerebrovascular disease (Incidence Rate Ratio, IRR: 1.04; 95% CI: 0.81-1.34; p-value: 0.73), acute stroke (IRR: 1.15; 95% CI: 0.88-1.50; p-value: 0.29) or acute ischaemic stroke (IRR: 1.18; 95% CI: 0.87-1.59; p-value: 0.28), over the entire bushfire period. However, the high bushfire smoke days were associated with increased acute ischaemic stroke-related hospital admissions across lead 0-3 and the highest cumulative effect was observed with lead 0 (IRR:1.52; 95% CI: 1.01-2.29; p-value: 0.04). In addition, during the bushfire period, particulate matter, both PM10 and PM2.5 (defined as particulates that have an effective aerodynamic diameter of 10, and 2.5 microns, respectively), were also associated with increased acute ischaemic stroke admissions with a lag of 0-3 days. DISCUSSION AND CONCLUSION The results suggested a possible association between particulate matter and high smoke days with increased hospital admissions due to acute ischaemic stroke during the recent Australian bushfire season.
Collapse
Affiliation(s)
- Md Golam Hasnain
- College of Health, Medicine, and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia
- John Hunter Hospital, Hunter New England Local Health District, New Lambton Heights, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Carlos Garcia-Esperon
- College of Health, Medicine, and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia
- John Hunter Hospital, Hunter New England Local Health District, New Lambton Heights, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Yumi Kashida Tomari
- College of Health, Medicine, and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia
- John Hunter Hospital, Hunter New England Local Health District, New Lambton Heights, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Rhonda Walker
- John Hunter Hospital, Hunter New England Local Health District, New Lambton Heights, NSW, Australia
| | - Tarunpreet Saluja
- College of Health, Medicine, and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia
- John Hunter Hospital, Hunter New England Local Health District, New Lambton Heights, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Md Mijanur Rahman
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Sydney, Australia
| | - Andrew Boyle
- College of Health, Medicine, and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia
- John Hunter Hospital, Hunter New England Local Health District, New Lambton Heights, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Christopher R Levi
- College of Health, Medicine, and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia
- John Hunter Hospital, Hunter New England Local Health District, New Lambton Heights, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| | - Ravi Naidu
- Global Centre for Environmental Remediation, College of Engineering Science and Environment, The University of Newcastle, Callaghan, NSW, Australia
- CRC for Contamination Assessment and Remediation of the Environment (crcCARE), The University of Newcastle, Callaghan, NSW, Australia
| | | | - Neil J Spratt
- College of Health, Medicine, and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia
- John Hunter Hospital, Hunter New England Local Health District, New Lambton Heights, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
| |
Collapse
|
3
|
Byun G, Kim S, Choi Y, Kim A, Team AC, Lee JT, Bell ML. Long-term exposure to PM 2.5 and mortality in a national cohort in South Korea: effect modification by community deprivation, medical infrastructure, and greenness. BMC Public Health 2024; 24:1266. [PMID: 38720292 PMCID: PMC11080206 DOI: 10.1186/s12889-024-18752-y] [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: 09/28/2023] [Accepted: 04/30/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Long-term exposure to PM2.5 has been linked to increased mortality risk. However, limited studies have examined the potential modifying effect of community-level characteristics on this association, particularly in Asian contexts. This study aimed to estimate the effects of long-term exposure to PM2.5 on mortality in South Korea and to examine whether community-level deprivation, medical infrastructure, and greenness modify these associations. METHODS We conducted a nationwide cohort study using the National Health Insurance Service-National Sample Cohort. A total of 394,701 participants aged 30 years or older in 2006 were followed until 2019. Based on modelled PM2.5 concentrations, 1 to 3-year and 5-year moving averages of PM2.5 concentrations were assigned to each participant at the district level. Time-varying Cox proportional-hazards models were used to estimate the association between PM2.5 and non-accidental, circulatory, and respiratory mortality. We further conducted stratified analysis by community-level deprivation index, medical index, and normalized difference vegetation index to represent greenness. RESULTS PM2.5 exposure, based on 5-year moving averages, was positively associated with non-accidental (Hazard ratio, HR: 1.10, 95% Confidence Interval, CI: 1.01, 1.20, per 10 µg/m3 increase) and circulatory mortality (HR: 1.22, 95% CI: 1.01, 1.47). The 1-year moving average of PM2.5 was associated with respiratory mortality (HR: 1.33, 95% CI: 1.05, 1.67). We observed higher associations between PM2.5 and mortality in communities with higher deprivation and limited medical infrastructure. Communities with higher greenness showed lower risk for circulatory mortality but higher risk for respiratory mortality in association with PM2.5. CONCLUSIONS Our study found mortality effects of long-term PM2.5 exposure and underlined the role of community-level factors in modifying these association. These findings highlight the importance of considering socio-environmental contexts in the design of air quality policies to reduce health disparities and enhance overall public health outcomes.
Collapse
Affiliation(s)
- Garam Byun
- School of the Environment, Yale University, New Haven, CT, 06511, USA
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, 02841, Republic of Korea
| | - Sera Kim
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, 02841, Republic of Korea
| | - Yongsoo Choi
- School of the Environment, Yale University, New Haven, CT, 06511, USA
| | - Ayoung Kim
- Department of Public Health Sciences, Graduate School of Public health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826, Republic of Korea
| | - AiMS-Create Team
- Ai-Machine learning Statistics Collaborative Research Ensemble for Air pollution, Temperature, and all types of Environmental exposures, Seoul National University and Pusan National University, Seoul, Republic of Korea
| | - Jong-Tae Lee
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, 02841, Republic of Korea.
- School of Health Policy and Management, College of Health Sciences, Korea University, Hana Science Hall, 145, Anam-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea.
| | - Michelle L Bell
- School of the Environment, Yale University, New Haven, CT, 06511, USA
- School of Health Policy and Management, College of Health Sciences, Korea University, Hana Science Hall, 145, Anam-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea
| |
Collapse
|
4
|
Shen Y, de Hoogh K, Schmitz O, Clinton N, Tuxen-Bettman K, Brandt J, Christensen JH, Frohn LM, Geels C, Karssenberg D, Vermeulen R, Hoek G. Monthly average air pollution models using geographically weighted regression in Europe from 2000 to 2019. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 918:170550. [PMID: 38320693 DOI: 10.1016/j.scitotenv.2024.170550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 01/02/2024] [Accepted: 01/27/2024] [Indexed: 02/12/2024]
Abstract
Detailed spatial models of monthly air pollution levels at a very fine spatial resolution (25 m) can help facilitate studies to explore critical time-windows of exposure at intermediate term. Seasonal changes in air pollution may affect both levels and spatial patterns of air pollution across Europe. We built Europe-wide land-use regression (LUR) models to estimate monthly concentrations of regulated air pollutants (NO2, O3, PM10 and PM2.5) between 2000 and 2019. Monthly average concentrations were collected from routine monitoring stations. Including both monthly-fixed and -varying spatial variables, we used supervised linear regression (SLR) to select predictors and geographically weighted regression (GWR) to estimate spatially-varying regression coefficients for each month. Model performance was assessed with 5-fold cross-validation (CV). We also compared the performance of the monthly LUR models with monthly adjusted concentrations. Results revealed significant monthly variations in both estimates and model structure, particularly for O3, PM10, and PM2.5. The 5-fold CV showed generally good performance of the monthly GWR models across months and years (5-fold CV R2: 0.31-0.66 for NO2, 0.4-0.79 for O3, 0.4-0.78 for PM10, 0.46-0.87 for PM2.5). Monthly GWR models slightly outperformed monthly-adjusted models. Correlations between monthly GWR model were generally moderate to high (Pearson correlation >0.6). In conclusion, we are the first to develop robust monthly LUR models for air pollution in Europe. These monthly LUR models, at a 25 m spatial resolution, enhance epidemiologists to better characterize Europe-wide intermediate-term health effects related to air pollution, facilitating investigations into critical exposure time windows in birth cohort studies.
Collapse
Affiliation(s)
- Youchen Shen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands.
| | - Kees de Hoogh
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands; Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Oliver Schmitz
- Department of Physical Geography, Faculty of Geosciences, Utrecht University, Utrecht, the Netherlands
| | - Nick Clinton
- Google, Inc, Mountain View, California, United States
| | | | - Jørgen Brandt
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | | | - Lise M Frohn
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Camilla Geels
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Derek Karssenberg
- Department of Physical Geography, Faculty of Geosciences, Utrecht University, Utrecht, the Netherlands
| | - Roel Vermeulen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands; Julius Centre for Health Sciences and Primary Care, University Medical Centre, Utrecht University, Utrecht, the Netherlands
| | - Gerard Hoek
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| |
Collapse
|
5
|
Hasnain MG, Garcia-Esperon C, Tomari YK, Walker R, Saluja T, Rahman MM, Boyle A, Levi CR, Naidu R, Filippelli G, Spratt NJ. Effect of short-term exposure to air pollution on daily cardio- and cerebrovascular hospitalisations in areas with a low level of air pollution. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:102438-102445. [PMID: 37668781 PMCID: PMC10567850 DOI: 10.1007/s11356-023-29544-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 08/23/2023] [Indexed: 09/06/2023]
Abstract
Exposure to air pollution is associated with increased cardio- and cerebrovascular diseases. However, the evidence regarding the short-term effect of air pollution on cardio- and cerebrovascular hospitalisations in areas with relatively low air pollution levels is limited. This study aims to examine the effect of short-term exposure to different air pollutants on hospital admissions due to cardio- and cerebrovascular diseases in rural and regional Australia with low air pollution. The study was conducted in five local Government areas of Hunter New England Local Health District (HNE-LHD). Hospitalisation data from January 2018 to February 2020 (820 days) were accessed from the HNE-LHD admitted patients' dataset. Poisson regression model was used to examine the association between the exposure (air pollutants) and outcome variables (hospitalisation due to cardio- and cerebrovascular disease). The concentrations of gaseous air pollutants, Sulphur Dioxide (SO2), Nitrogen Dioxide (NO2), Ozone (O3), Carbon Monoxide (CO), and Ammonia (NH3) were below national benchmark concentrations for every day of the study period. In single pollutant models, SO2 and NO2 significantly increased the daily number of cardio- and cerebrovascular hospitalisations. The highest cumulative effect for SO2 was observed across lag 0-3 days (Incidence Rate Ratio, IRR: 1.77; 95% Confidence Interval, CI: 1.18-2.65; p-value: 0.01), and for NO2, it was across lag 0-2 days (IRR: 1.13; 95% CI: 1.02-1.25; p-value: 0.02). In contrast, higher O3 was associated with decreased cardio- and cerebrovascular hospitalisations, with the largest effect observed at lag 0 (IRR: 0.94; 95% CI: 0.89-0.98; p-value: 0.02). In the multi-pollutant model, the effect of NO2 remained significant at lag 0 and corresponded to a 21% increase in cardio- and cerebrovascular hospitalisation (95% CI: 1-44%; p-value = 0.04). Thus, the study revealed that gaseous air pollutants, specifically NO2, were positively related to increased cardio- and cerebrovascular hospitalisations, even at concentrations below the national standards.
Collapse
Affiliation(s)
- Md Golam Hasnain
- College of Health, Medicine, and Wellbeing, The University of Newcastle, University Drive, Callaghan, New South Wales, 2308, Australia.
- John Hunter Hospital, Hunter New England Local Health District, Lookout Road, New Lambton Heights, New South Wales, 2305, Australia.
- Hunter Medical Research Institute, Lookout Road, New Lambton Heights, New South Wales, 2305, Australia.
| | - Carlos Garcia-Esperon
- College of Health, Medicine, and Wellbeing, The University of Newcastle, University Drive, Callaghan, New South Wales, 2308, Australia
- John Hunter Hospital, Hunter New England Local Health District, Lookout Road, New Lambton Heights, New South Wales, 2305, Australia
- Hunter Medical Research Institute, Lookout Road, New Lambton Heights, New South Wales, 2305, Australia
| | - Yumi Kashida Tomari
- College of Health, Medicine, and Wellbeing, The University of Newcastle, University Drive, Callaghan, New South Wales, 2308, Australia
- John Hunter Hospital, Hunter New England Local Health District, Lookout Road, New Lambton Heights, New South Wales, 2305, Australia
- Hunter Medical Research Institute, Lookout Road, New Lambton Heights, New South Wales, 2305, Australia
| | - Rhonda Walker
- John Hunter Hospital, Hunter New England Local Health District, Lookout Road, New Lambton Heights, New South Wales, 2305, Australia
| | - Tarunpreet Saluja
- College of Health, Medicine, and Wellbeing, The University of Newcastle, University Drive, Callaghan, New South Wales, 2308, Australia
- John Hunter Hospital, Hunter New England Local Health District, Lookout Road, New Lambton Heights, New South Wales, 2305, Australia
- Hunter Medical Research Institute, Lookout Road, New Lambton Heights, New South Wales, 2305, Australia
| | - Md Mijanur Rahman
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Sydney, Australia
| | - Andrew Boyle
- College of Health, Medicine, and Wellbeing, The University of Newcastle, University Drive, Callaghan, New South Wales, 2308, Australia
- John Hunter Hospital, Hunter New England Local Health District, Lookout Road, New Lambton Heights, New South Wales, 2305, Australia
- Hunter Medical Research Institute, Lookout Road, New Lambton Heights, New South Wales, 2305, Australia
| | - Christopher R Levi
- College of Health, Medicine, and Wellbeing, The University of Newcastle, University Drive, Callaghan, New South Wales, 2308, Australia
- John Hunter Hospital, Hunter New England Local Health District, Lookout Road, New Lambton Heights, New South Wales, 2305, Australia
- Hunter Medical Research Institute, Lookout Road, New Lambton Heights, New South Wales, 2305, Australia
| | - Ravi Naidu
- Global Centre for Environmental Remediation, College of Engineering Science and Environment, The University of Newcastle, University Drive, Callaghan, New South Wales, 2308, Australia
- CRC for Contamination Assessment and Remediation of the Environment (crcCARE), The University of Newcastle, University Drive, Callaghan, New South Wales, 2308, Australia
| | - Gabriel Filippelli
- Department of Earth Sciences, Indiana University, Indianapolis, IN, 46202, USA
| | - Neil J Spratt
- College of Health, Medicine, and Wellbeing, The University of Newcastle, University Drive, Callaghan, New South Wales, 2308, Australia
- John Hunter Hospital, Hunter New England Local Health District, Lookout Road, New Lambton Heights, New South Wales, 2305, Australia
- Hunter Medical Research Institute, Lookout Road, New Lambton Heights, New South Wales, 2305, Australia
| |
Collapse
|
6
|
Oak YJ, Park RJ, Lee JT, Byun G. Future air quality and premature mortality in Korea. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 865:161134. [PMID: 36587681 DOI: 10.1016/j.scitotenv.2022.161134] [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: 10/11/2022] [Revised: 11/22/2022] [Accepted: 12/19/2022] [Indexed: 06/17/2023]
Abstract
We simulate air quality in Korea for the present, the near-term, and the long-term future conditions under the Shared Socioeconomic Pathways (SSP1: most sustainable pathway with strong emissions control, SSP3: most challenging pathway with mild emissions control) using a chemical transport model. Simulated future concentrations of NO2, SO2, and fine particulate matter (PM2.5), show, in general, lower values compared to the present with varying degrees depending on SSP scenarios. Significant reductions in precursor emissions result in a decrease in O3 concentrations under a NOx-limited environment in the long-term future under SSP1. Under SSP3, O3 increases in the future under a VOC-limited regime, driven by increased CH4 levels and biogenic VOC emissions under the warming climate. Concentrations of PM2.5 and its components, including sulfate, nitrate, ammonium, and organic aerosols (OA), generally decrease in the long-term future under both scenarios. However, the contribution of biogenic secondary OA (BSOA) to PM2.5 will increase in the future. Simulated results are used to estimate cardiorespiratory mortality changes with concentration-response factors from epidemiologic studies in Korea based on national health surveys and Korean cohorts, using projected population structures from the SSP database. The cardiorespiratory health burden of long-term exposure to O3, NO2, SO2, and PM2.5 is estimated to be 10,419 (95 % confidence interval: 1271-17,142), 8630 (0-18,713), 3958 (0-9272), and 10,431 (1411-20,643) deaths in 2019. We find that the total cardiorespiratory excess mortality due to air pollutants under SSP1 decreases by 8 % and 95 % in 2045 and 2095, respectively. Under SSP3, excess mortality increases by 80 % in 2045, and decreases by 22 % in 2095, resulting in a substantial difference in the health outcomes depending on the emission scenario. We also find that the BSOA contribution to total PM2.5 will differ by region, emphasizing the potential health impact of BSOA on a local scale in the future.
Collapse
Affiliation(s)
- Yujin J Oak
- School of Earth and Environmental Sciences, Seoul National University, Seoul, South Korea
| | - Rokjin J Park
- School of Earth and Environmental Sciences, Seoul National University, Seoul, South Korea.
| | - Jong-Tae Lee
- School of Health Policy and Management, College of Health Science, Korea University, Seoul, South Korea; Interdisciplinary Program in Precision Public Health, Korea University, Seoul, South Korea
| | - Garam Byun
- Interdisciplinary Program in Precision Public Health, Korea University, Seoul, South Korea
| |
Collapse
|
7
|
Tan S, Xie D, Ni C, Zhao G, Shao J, Chen F, Ni J. Spatiotemporal characteristics of air pollution in Chengdu-Chongqing urban agglomeration (CCUA) in Southwest, China: 2015-2021. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2023; 325:116503. [PMID: 36274306 DOI: 10.1016/j.jenvman.2022.116503] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 10/04/2022] [Accepted: 10/09/2022] [Indexed: 06/16/2023]
Abstract
Studying the spatiotemporal characteristics of air pollutants in urban agglomerations and their response factors will help to improve the quality of urban living. In combining air quality monitoring data and wavelet analysis from the Chengdu-Chongqing urban agglomeration (CCUA), this study assessed the spatiotemporal distribution characteristics and influential factors of air pollutants on daily, monthly and annual scales. The results showed that the concentration of air pollutants in the CCUA has decreased year by year, and air quality has improved. Except for O3, pollutants in autumn and winter were higher than those in summer. The spatial distribution of air pollutants was obvious distributed in Chengdu, Chongqing, Zigong and Dazhou. Pollution incidents were mainly concentrated in winter. The 6 air pollutants and air quality index (AQI) have dominant periods on multiple time scales. AQI showed positive coherence with PM2.5 and PM10 on multiple time scales, and obvious positive coherence with SO2, CO, NO2 and O3 in the short term scale. AQI was not strongly correlated with the fire point, but exhibited obvious negative coherence in the long term scale. In addition, AQI showed an obvious positive correlation with temperature and sunshine hours in short term, and a clear negative correlation with humidity and rainfall. The research results of this paper will provide a reference for pollution prevention and control in the CCUA.
Collapse
Affiliation(s)
- Shaojun Tan
- College of Resources and Environment, Southwest University, Chongqing, 400715, China.
| | - Deti Xie
- College of Resources and Environment, Southwest University, Chongqing, 400715, China.
| | - Chengsheng Ni
- College of Resources and Environment, Southwest University, Chongqing, 400715, China.
| | - Guangyao Zhao
- College of Resources and Environment, Southwest University, Chongqing, 400715, China.
| | - Jingan Shao
- College of Geography and Tourism, Chongqing Normal University, Chongqing, 401331, China.
| | - Fangxin Chen
- College of Resources and Environment, Southwest University, Chongqing, 400715, China.
| | - Jiupai Ni
- College of Resources and Environment, Southwest University, Chongqing, 400715, China.
| |
Collapse
|
8
|
Lagged acute respiratory outcomes among children related to ambient pollutant exposure in a high exposure setting in South Africa. Environ Epidemiol 2022; 6:e228. [PMID: 36530932 PMCID: PMC9746739 DOI: 10.1097/ee9.0000000000000228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 09/05/2022] [Indexed: 02/05/2023] Open
Abstract
UNLABELLED Acute ambient air pollution impacts on the respiratory health of children may be lagged across time. We determined the short-term lagged effects of particulate matter (PM2.5), sulphur dioxide (SO2), and oxides of nitrogen (NOx) on the respiratory health of children living in low-income communities. METHODS A school-based study was conducted using a repeated measures design, across summer and winter, in four schools in each of four suburbs in the Vaal Triangle, South Africa. Data for PM2.5, NOx, and SO2 were obtained from monitoring stations within close proximity of the schools. Over 10 school days in each phase, grade 4 children completed a symptoms log and lung function tests. Parents completed a child respiratory questionnaire. Generalized estimation equations models adjusted for covariates of interest in relation to lung function outcomes and air pollutants including lag effects of 1-5 days. RESULTS Daily PM2.5, NOx, and SO2 median concentration levels were frequently higher than international standards. Among the 280 child participants (mean age 9 years), the prevalence of symptoms based on probable asthma was 9.6%. There was a consistent increased pollutant-related risk for respiratory symptoms, except for NOx and shortness of breath. Lung function, associated with pollutant fluctuations across the different lags, was most pronounced for peak expiratory flow rate (PEFR) for PM2.5 and SO2. A preceding 5-day average SO2 exposure had the largest loss (7.5 L/minute) in PEFR. CONCLUSIONS Lagged declines in daily lung function and increased odds of having respiratory symptoms were related to increases in PM2.5 and SO2 among a school-based sample of children.
Collapse
|
9
|
Kim H, Samet JM, Bell ML. Association between Short-Term Exposure to Air Pollution and COVID-19 Mortality: A Population-Based Case-Crossover Study Using Individual-Level Mortality Registry Confirmed by Medical Examiners. ENVIRONMENTAL HEALTH PERSPECTIVES 2022; 130:117006. [PMID: 36367781 PMCID: PMC9651183 DOI: 10.1289/ehp10836] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 09/21/2022] [Accepted: 10/11/2022] [Indexed: 05/25/2023]
Abstract
BACKGROUND Studies have suggested links between ambient air pollution and coronavirus 2019 (COVID-19) mortality, yet confirmation by well-designed epidemiological studies with individual data is needed. OBJECTIVES We aimed to examine whether short-term exposure to air pollution is associated with risk of mortality from COVID-19 for those infected with COVID-19. METHODS The Cook County Medical Examiner's Office reports individual-level data for deaths from COVID-19 that occur in its jurisdiction, which includes all confirmed COVID-19 deaths in Cook County, Illinois. Case-crossover analysis was conducted to estimate the associations of estimated short-term exposures to particulate matter (PM) with aerodynamic diameter ≤2.5μm (PM2.5) and ozone (O3) on the day of death and up to 21 d before death at location of death with COVID-19. A total of 7,462 deaths from COVID-19 that occurred up to 28 February 2021 were included in the final analysis. We adjusted for potential confounders by time-stratified case-crossover design and by covariate adjustments (i.e., time-invariant factors, meteorological factors, viral transmission, seasonality, and time trend). RESULTS Of the 7,462 case and 25,457 self-control days, almost all were days with exposure levels below the PM2.5 24-h National Ambient Air Quality Standard (NAAQS) (35 μg/m3); 98.9% had O3 levels below the maximum 8-h NAAQS (35.7 μg/m3 or 70 parts per billion). An interquartile range (IQR) increase (5.2 μg/m3) in cumulative 3-wk PM2.5 exposure was associated with a 69.6% [95% confidence interval (CI): 34.6, 113.8] increase in risk of COVID-19 mortality. An IQR increase (8.2 μg/m3) in 3-d O3 exposure was associated with a 29.0% (95% CI: 9.9, 51.5) increase in risk of COVID-19 mortality. The associations differed by demographics or race/ethnicity. There was indication of modification of the associations by some comorbid conditions. DISCUSSION Short-term exposure to air pollution below the NAAQS may increase the mortality burden from COVID-19. https://doi.org/10.1289/EHP10836.
Collapse
Affiliation(s)
- Honghyok Kim
- Division of Environmental and Occupational Health Sciences, School of Public Health, University of Illinois Chicago, Chicago, Illinois, USA
- School of the Environment, Yale University, New Haven, Connecticut, USA
| | - Jonathan M. Samet
- Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado, USA
- Department of Environmental & Occupational Health, Colorado School of Public Health, Aurora, Colorado, USA
| | - Michelle L. Bell
- School of the Environment, Yale University, New Haven, Connecticut, USA
| |
Collapse
|
10
|
Choi Y, Byun G, Lee JT. Temporal Heterogeneity of Short-Term Effects of Particulate Matter on Stroke Outpatients in Seven Major Cities of the Republic of Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12316. [PMID: 36231621 PMCID: PMC9566257 DOI: 10.3390/ijerph191912316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 09/23/2022] [Accepted: 09/24/2022] [Indexed: 06/16/2023]
Abstract
Although particulate matter (PM) is a major risk factor for stroke, its effects on hospital outpatients admitted for stroke have not been documented in Korea. In addition, recent studies have reported that the effects of PM10 on circulatory mortality changed over time. We aimed to estimate the effects of PM10 on stroke and their temporal heterogeneity in seven major cities of Korea during the period 2002-2015. The study period was divided into five years of moving time windows, and city-specific PM10 effects on ischemic and hemorrhagic stroke outpatients were calculated. We pooled the estimates using meta-analysis and plotted them into a sequence to identify their temporal trends. A 10 µg/m3 increase of PM10 was significantly associated with increments in hospital outpatients admitted for ischemic stroke (0.24%, 95% CI: 0.04%, 0.44%), but not for hemorrhagic stroke (0.33%, 95% CI: -0.06%, 0.73%). Effect estimates for strokes increased during the period 2003-2013 but decreased after. For the first time, we have estimated the effects of PM10 on hospital outpatients admitted for stroke in Korea. The observed temporal trend in PM10 effects was similar to patterns of circulatory mortality, suggesting that the temporal heterogeneity in PM10 effects might be due to systematic causes rather than random fluctuations.
Collapse
Affiliation(s)
- Yongsoo Choi
- School of Health Policy and Management, College of Health Science, Korea University, 145, Anam-ro, Seongbuk-gu, Seoul 02481, Korea
| | - Garam Byun
- Interdisciplinary Program in Precision Public Health, Korea University, 145, Anam-ro, Seongbuk-gu, Seoul 02481, Korea
| | - Jong-Tae Lee
- School of Health Policy and Management, College of Health Science, Korea University, 145, Anam-ro, Seongbuk-gu, Seoul 02481, Korea
- Interdisciplinary Program in Precision Public Health, Korea University, 145, Anam-ro, Seongbuk-gu, Seoul 02481, Korea
| |
Collapse
|
11
|
Associations between Long-Term Air Pollution Exposure and Risk of Osteoporosis-Related Fracture in a Nationwide Cohort Study in South Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042404. [PMID: 35206592 PMCID: PMC8872590 DOI: 10.3390/ijerph19042404] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 02/03/2022] [Accepted: 02/17/2022] [Indexed: 01/27/2023]
Abstract
Bone health is a major concern for aging populations globally. Osteoporosis and bone mineral density are associated with air pollution, but less is known about the impacts of air pollution on osteoporotic fracture. We aimed to assess the associations between long-term air pollution exposure and risk of osteoporotic fracture in seven large Korean cities. We used Cox proportional hazard models to estimate hazard rations (HRs) of time-varying moving window of past exposures of particulate matter (PM10), sulfur dioxide (SO2), carbon monoxide (CO), nitrogen dioxide (NO2), and ozone (O3) for osteoporotic fracture in Korean adults (age ≥ 50 years) in the National Health Insurance Service-National Sample Cohort data, followed 2002 to 2015. HRs were calculated for an interquartile range (IQR) increase. Comorbidity and prescription associated with osteoporosis, age, sex, body mass index, health behaviors, and income were adjusted in the models. Effect modification by age, sex, exercise, and income was examined. We assessed 56,467 participants over 535,481 person-years of follow up. Linear and positive exposure-response associations were found for SO2, while PM10 and NO2 showed nonlinear associations. SO2 was associated with osteoporosis-related fracture with marginal significance (HR for an IQR [2 ppb] increase = 1.04, 95% CI: 1.00, 1.09). The SO2 HR estimates were robust in analyses applying various moving windows of exposure (from one to three years of past exposure) and two-pollutant models. The central HR estimate of O3 implied positive associations but was not significant (HR for 0.007 ppm increase = 1.01, 95% CI: 0.97, 1.06). PM10, CO, and NO2 did not show associations. Vulnerable groups by sex, age, exercise, and income varied across air pollutants and there was no evidence of effect modifications. Long-term exposure to SO2, but not PM10, CO, NO2 and O3, was associated with increased osteoporotic fracture risks in Korean adults.
Collapse
|
12
|
Basagaña X, Barrera-Gómez J. Reflection on modern methods: visualizing the effects of collinearity in distributed lag models. Int J Epidemiol 2021; 51:334-344. [PMID: 34458914 DOI: 10.1093/ije/dyab179] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2021] [Indexed: 11/12/2022] Open
Abstract
Collinearity can be a problem in regression models. When examining the effects of an exposure at different time points, constrained distributed lag models can alleviate some of the problems caused by collinearity. Still, some consequences of collinearity may remain and they are often unexplored. We aimed to illustrate the effects of collinearity in the context of distributed lag models, and to provide a tool to assess whether the results of a study could be influenced by collinearity. We used simulations under different scenarios of hypothesized effects of an exposure to visualize the resulting curves of lagged effects. We analysed three real datasets: a cohort study looking for windows of vulnerability to air pollution, a time series study examining the linear association of air pollution with hospital admissions, and a time series study examining the non-linear association between temperature and mortality. We showed that collinearity could be the explanation for some unexpected results, e.g. for statistically significant associations in the opposite direction from that expected, or for wrongly suggesting that some periods are more important than others. We implemented the collin R package to explore the potential consequences of collinearity in the context of distributed lag models. Our visual tool can be a useful way to assess if the results of an analysis may be influenced by collinearity.
Collapse
Affiliation(s)
- Xavier Basagaña
- ISGlobal, Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Jose Barrera-Gómez
- ISGlobal, Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| |
Collapse
|
13
|
de Foy B, Heo J, Kang JY, Kim H, Schauer JJ. Source attribution of air pollution using a generalized additive model and particle trajectory clusters. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 780:146458. [PMID: 34030340 DOI: 10.1016/j.scitotenv.2021.146458] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 03/05/2021] [Accepted: 03/09/2021] [Indexed: 06/12/2023]
Abstract
Speciated hourly measurements of fine aerosols were made for more than two years at an urban, an industrial and a port site in Busan, Korea. A Generalized Additive Model (GAM) was designed to deconvolve factors contributing to the pollutant concentrations at multiple scales. The model yields estimates of source contributions to pollution by separately identifying the signals in the time series due to meteorology, vertical mixing, horizontal wind transport and temporal variations such as diurnal, weekly, seasonal and annual trends. The GAM model was expanded to include FLEXPART back trajectory clusters generated using fuzzy c-means clustering. This made it possible to quantify the impact of long-range transport using the Trajectory Cluster Contribution Function (TCCF). TCCF provides a development of methods such as Concentration Field Analysis and Potential Source Contribution Function by providing numerical estimates of concentration changes associated with different air mass transport patterns while accounting for possible confounding factors from meteorology. The GAM simulations identified the importance of local transport for primary pollutants and long-range transport from China for secondary pollutants. Local factors accounted for up to 72% of the variance in concentrations of NO2 and elemental carbon whereas large-scale/seasonal factors accounted for up to 56% of PM2.5 and 80% of inorganic species. The algorithm further identified the importance of the weekend effect and the holiday effect at the different sites in Busan. The residual from the analysis was used to estimate the impact of the COVID-19 pandemic. The signature of the pandemic was different between the pollutants as well as from site to site. The model was able to distinguish small impacts from local pollutants at the residential site; short-lived acute impacts from industrial changes; and longer-term changes due to the early pandemic response in China.
Collapse
Affiliation(s)
- Benjamin de Foy
- Department of Earth and Atmospheric Sciences, Saint Louis University, St. Louis, MO, USA.
| | - Jongbae Heo
- Busan Development Institute, Busan, Republic of Korea
| | - Ji-Yoon Kang
- Busan Development Institute, Busan, Republic of Korea
| | - Hwajin Kim
- Center for Environment, Health and Welfare Research, Korea Institute of Science and Technology, Seoul, Republic of Korea
| | - James J Schauer
- University of Wisconsin - Madison, Environmental Chemistry and Technology Program, Madison, WI, USA; Wisconsin State Laboratory of Hygiene, Madison, WI, USA
| |
Collapse
|
14
|
Kim H, Lee JT. Inter-mortality displacement hypothesis and short-term effect of ambient air pollution on mortality in seven major cities of South Korea: a time-series analysis. Int J Epidemiol 2021; 49:1802-1812. [PMID: 33211858 DOI: 10.1093/ije/dyaa181] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Inter-mortality displacement (IMD) between cause-specific mortalities has not been introduced in air pollution epidemiology. Investigation into IMD would provide insights on the actual health burden of air pollution and interpretation of associations. We aimed to investigate IMD regarding short-term effect of air pollution on mortality. METHODS We illustrated manifestations and interpretations of lag-mortality associations. If IMD exists, a net increase of one cause-specific death can be offset by a net decrease of other cause-specific deaths. We conducted a time-series analysis to estimate associations of ambient particulate matter smaller than 10 µm (PM10), ozone (O3), sulphur dioxide (SO2), nitrogen dioxide (NO2) and carbon monoxide (CO) with mortality, considering lags up to the previous 45 days, for seven major cities of South Korea from 2006 to 2013. Attributable mortality cases were identified. RESULTS For O3, respiratory mortality [11 929 cases, 95% empirical confidence interval (eCI), 5358, 17 688 cases] was counterbalanced by cardiovascular mortality (-11 272 cases, 95% eCI: -22 444, -629 cases). All-cause mortality was 37 148 cases (95% eCI: 4448, 68 782 cases). For PM10, respiratory deaths were 9167 cases (95% eCI: 563, 16 521 cases), and cardiovascular deaths were 6929 cases (95% eCI: -11 793, 24 138 cases). Estimates for SO2 were comparable to those for PM10. All-cause mortality attributable to NO2 was explained by short-term mortality displacement. No associations with mortality were found for CO. CONCLUSIONS IMD may exist in the relationship between air pollution and mortality. The actual relationship between air pollution and cause-specific mortality may be masked by IMD.
Collapse
Affiliation(s)
- Honghyok Kim
- BK21PLUS Program in 'Embodiment: Health-Society Interaction', Department of Public Health Science, Graduate School, Korea University, Seoul, Republic of Korea.,School of the Environment, Yale University, New Haven, CT, USA
| | - Jong-Tae Lee
- BK21PLUS Program in 'Embodiment: Health-Society Interaction', Department of Public Health Science, Graduate School, Korea University, Seoul, Republic of Korea.,Department of Environmental Health, Korea University, Seoul, Republic of Korea.,School of Health Policy and Management, College of Health Science, Korea University, Seoul, Republic of Korea
| |
Collapse
|
15
|
Kim H, Bell ML, Lee JT. Multi-dimensional community characteristics in linking particulate matter pollution and cause-specific mortality: 72 communities of South Korea. ENVIRONMENTAL RESEARCH 2021; 196:110989. [PMID: 33689820 DOI: 10.1016/j.envres.2021.110989] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 02/04/2021] [Accepted: 03/04/2021] [Indexed: 05/18/2023]
Abstract
Concentration-response function for exposure to ambient particulate matter (PM) and mortality (i.e., relative risk, RR) may be inequal across communities by socioeconomic conditions. Investigation on specific mechanisms of this inequality regarding susceptibility to PM, beyond non-specific "socioeconomic conditions", would provide policy-relevant implications for tackling this inequality. However, such investigation via epidemiological studies is challenged by residual confounding by correlated mechanisms and different loss of life expectancy by PM exposures between communities. Here, we aimed to assess community characteristics including different aspects of socioeconomic deprivation, medical resources, health behaviors, air quality, and greenness in their relation to inequal RR for PM10 and cause-specific mortality in 72 municipalities in South Korea, 2006-2013, considering these challenges. We found that a 10 μg/m3 increase in PM10 on average across 46 days was associated with a 1.05% (95% CI: 0.24, 1.88) increase in all-cause mortality (ALL), 1.32% (95% CI: -0.29, 2.95) increase in cardiovascular mortality (CVD), and 6.47% (95% CI: 3.06, 10.00) increase in respiratory mortality (RES). The association between PM10 and mortality was higher in communities with higher ratio of SO2 to PM10 (ALL and RES), higher material deprivation (ALL, CVD, and RES), lower medical resources (CVD), higher prevalence of drinking (ALL and CVD), and lower prevalence of smoking (CVD and RES). Lag-structures showed smaller loss of life expectancy by PM exposures in communities with higher prevalence of smoking. Our findings suggest that PM-related health inequalities are shaped by a variety of mechanisms relating to susceptibility to PM exposures and different loss of life expectancy. Health policies controlling community characteristics may contribute to minimizing PM10-related health inequalities in those perspectives.
Collapse
Affiliation(s)
- Honghyok Kim
- Interdisciplinary Program in Precision Public Health, Korea University, Seoul, Republic of Korea; School of the Environment, Yale University, CT, USA
| | | | - Jong-Tae Lee
- Interdisciplinary Program in Precision Public Health, Korea University, Seoul, Republic of Korea; Department of Environmental Health, Korea University, Seoul, Republic of Korea; School of Health Policy and Management, College of Health Science, Korea University, Seoul, Republic of Korea.
| |
Collapse
|
16
|
Kim H, Lee JT, Fong KC, Bell ML. Alternative adjustment for seasonality and long-term time-trend in time-series analysis for long-term environmental exposures and disease counts. BMC Med Res Methodol 2021; 21:2. [PMID: 33397295 PMCID: PMC7780665 DOI: 10.1186/s12874-020-01199-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 12/21/2020] [Indexed: 11/17/2022] Open
Abstract
Background Time-series analysis with case-only data is a prominent method for the effect of environmental determinants on disease events in environmental epidemiology. In this analysis, adjustment for seasonality and long-term time-trend is crucial to obtain valid findings. When applying this analysis for long-term exposure (e.g., months, years) of which effects are usually studied via survival analysis with individual-level longitudinal data, unlike its application for short-term exposure (e.g., days, weeks), a standard adjustment method for seasonality and long-term time-trend can extremely inflate standard error of coefficient estimates of the effects. Given that individual-level longitudinal data are difficult to construct and often available to limited populations, if this inflation of standard error can be solved, rich case-only data over regions and countries would be very useful to test a variety of research hypotheses considering unique local contexts. Methods We discuss adjustment methods for seasonality and time-trend used in time-series analysis in environmental epidemiology and explain why standard errors can be inflated. We suggest alternative methods to solve this problem. We conduct simulation analyses based on real data for Seoul, South Korea, 2002–2013, and time-series analysis using real data for seven major South Korean cities, 2006–2013 to identify whether the association between long-term exposure and health outcomes can be estimated via time-series analysis with alternative adjustment methods. Results Simulation analyses and real-data analysis confirmed that frequently used adjustment methods such as a spline function of a variable representing time extremely inflate standard errors of estimates for associations between long-term exposure and health outcomes. Instead, alternative methods such as a combination of functions of variables representing time can make sufficient adjustment with efficiency. Conclusions Our findings suggest that time-series analysis with case-only data can be applied for estimating long-term exposure effects. Rich case-only data such as death certificates and hospitalization records combined with repeated measurements of environmental determinants across countries would have high potentials for investigating the effects of long-term exposure on health outcomes allowing for unique contexts of local populations. Supplementary Information The online version contains supplementary material available at 10.1186/s12874-020-01199-1.
Collapse
Affiliation(s)
- Honghyok Kim
- School of the Environment, Yale University, 195 Prospect Street, New Haven, CT, 06511, USA.
| | - Jong-Tae Lee
- BK21PLUS Program in 'Embodiment: Health -Society Interaction', Department of Public Health Science, Graduate School, Korea University, Seoul, Republic of Korea.,School of Health Policy and Management, College of Health Science, Korea University, Seoul, Republic of Korea
| | - Kelvin C Fong
- School of the Environment, Yale University, 195 Prospect Street, New Haven, CT, 06511, USA
| | - Michelle L Bell
- School of the Environment, Yale University, 195 Prospect Street, New Haven, CT, 06511, USA
| |
Collapse
|
17
|
Kim H, Byun G, Choi Y, Kim S, Kim SY, Lee JT. Effects of long-term exposure to air pollution on all-cause mortality and cause-specific mortality in seven major cities of South Korea: Korean national health and nutritional examination surveys with mortality follow-up. ENVIRONMENTAL RESEARCH 2021; 192:110290. [PMID: 33027629 DOI: 10.1016/j.envres.2020.110290] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 09/09/2020] [Accepted: 09/24/2020] [Indexed: 06/11/2023]
Abstract
Evidence from cohort studies on the effects of long-term exposure to air pollution on mortality is limited in South Korea, which has high concentration of particles compared to North America, Western Europe, and Japan, and low exposure compared to China. To reduce knowledge gaps between other countries and South Korea, we investigated the association between all-cause, cardiovascular, and respiratory mortality and long-term exposure to PM10 and, as a surrogate for fine particles from local emission sources, SO2 and NO2. Participants comprised 18,220 subjects (97,114.4 person-years) residing in 73 districts of seven major cities of South Korea who were assigned to measurements of fixed-site monitoring stations and followed up. We applied Cox proportional hazard models with time-varying exposure up to three years average of air pollutants. We adjusted for individual and district-level covariates measured at baseline such as age, sex, socioeconomic positions, and health behaviors. We found that hazard ratios of PM10 and SO2 for all-cause mortality leveled off over approximately 5 ppb of SO2 and 35-50 μg/m3 of PM10. Interquartile range increases of PM10 (5.05 μg/m3), SO2 (2.09 ppb), and NO2 (11.41 ppb) were associated with 14.4% (95% CI: -0.4, 31.4), 18.1% (-4.5, 46.0), and 18.9% (-8.7, 54.7) increases in cardiovascular mortality, respectively. We did not find positive associations for respiratory mortality. The increase in cardiovascular mortality varied by sex (for PM10, in females, 27.4% (5.8, 53.5) increase), smoking (in non-smokers, 35.9% (12.7, 64.0) increase), drinking (in drinkers, 24.5% (2.1, 51.8) increase), marital status (in those not married, 23.1% (1.1, 49.9)), employment status (for SO2, in those employed, 79.4% (16.1, 177.3) increase), body mass index (in those ≥23, 47.6% (10.4, 97.3) increase), and community deprivation (for PM10, in less deprived communities, 21.0% (1.3, 44.4) increase). In summary, long-term exposure to air pollution is associated with mortality risk in South Korea. Our results suggest that the health effect of long-term exposure to air pollution may not be equal by sex, health behaviors and socioeconomic positions.
Collapse
Affiliation(s)
- Honghyok Kim
- BK21PLUS Program in "Embodiment: Health-Society Interaction," Department of Public Health Science, Graduate School, Korea University, Seoul, South Korea
| | - Garam Byun
- BK21PLUS Program in "Embodiment: Health-Society Interaction," Department of Public Health Science, Graduate School, Korea University, Seoul, South Korea
| | - Yongsoo Choi
- BK21PLUS Program in "Embodiment: Health-Society Interaction," Department of Public Health Science, Graduate School, Korea University, Seoul, South Korea
| | - Sera Kim
- BK21PLUS Program in "Embodiment: Health-Society Interaction," Department of Public Health Science, Graduate School, Korea University, Seoul, South Korea
| | - Soo-Yeon Kim
- BK21PLUS Program in "Embodiment: Health-Society Interaction," Department of Public Health Science, Graduate School, Korea University, Seoul, South Korea
| | - Jong-Tae Lee
- BK21PLUS Program in "Embodiment: Health-Society Interaction," Department of Public Health Science, Graduate School, Korea University, Seoul, South Korea; School of Health Policy and Management, College of Health Science, Korea University, Seoul, South Korea.
| |
Collapse
|
18
|
Zhang Y, Liu D, Liu Z. Fine Particulate Matter (PM 2.5) and Chronic Kidney Disease. REVIEWS OF ENVIRONMENTAL CONTAMINATION AND TOXICOLOGY 2021; 254:183-215. [PMID: 34529145 DOI: 10.1007/398_2020_62] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The impact of ambient particulate matter (PM) on public health has become a great global concern, which is especially prominent in developing countries. For health purposes, PM is typically defined by size, with the smaller particles having more health impacts. Particles with a diameter <2.5 μm are called PM2.5. Initial research studies have focused on the impact of PM2.5 on respiratory and cardiovascular diseases; nevertheless, an increasing number of data suggested that PM2.5 may affect every organ system in the human body, and the kidney is of no exception. The kidney is vulnerable to particulate matter because most environmental toxins are concentrated by the kidney during filtration. According to the high morbidity and mortality related to chronic kidney disease, it is necessary to determine the effect of PM2.5 on kidney disease and its mechanism that needs to be identified. To understand the current status of PM2.5 in the atmosphere and their potential harmful kidney effects in different regions of the world this review article was prepared based on peer-reviewed scientific papers, scientific reports, and database from government organizations published after the year 1998. In this review, we focus on the worldwide epidemiological evidence linking PM2.5 with chronic kidney disease and the effect of PM2.5 on the chronic kidney disease (CKD) progression. At the same time, we also discuss the possible mechanisms of PM2.5 exposure leading to kidney damage, in order to emphasize the contribution of PM2.5 to kidney damage. A global database on PM2.5 and kidney disease should be developed to provide new ideas for the prevention and treatment of kidney disease.
Collapse
Affiliation(s)
- Yilin Zhang
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, P. R. China
- Research Institute of Nephrology, Zhengzhou University, Zhengzhou, P. R. China
- Research Center for Kidney Disease, Zhengzhou, Henan Province, P. R. China
- Key Laboratory of Precision Diagnosis and Treatment for Chronic Kidney Disease in Henan Province, Zhengzhou, P. R. China
- Core Unit of National Clinical Medical Research Center of Kidney Disease, Zhengzhou, P. R. China
| | - Dongwei Liu
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, P. R. China.
- Research Institute of Nephrology, Zhengzhou University, Zhengzhou, P. R. China.
- Research Center for Kidney Disease, Zhengzhou, Henan Province, P. R. China.
- Key Laboratory of Precision Diagnosis and Treatment for Chronic Kidney Disease in Henan Province, Zhengzhou, P. R. China.
- Core Unit of National Clinical Medical Research Center of Kidney Disease, Zhengzhou, P. R. China.
| | - Zhangsuo Liu
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, P. R. China.
- Research Institute of Nephrology, Zhengzhou University, Zhengzhou, P. R. China.
- Research Center for Kidney Disease, Zhengzhou, Henan Province, P. R. China.
- Key Laboratory of Precision Diagnosis and Treatment for Chronic Kidney Disease in Henan Province, Zhengzhou, P. R. China.
- Core Unit of National Clinical Medical Research Center of Kidney Disease, Zhengzhou, P. R. China.
| |
Collapse
|
19
|
Borsi SH, Khanjani N, Nejad HY, Riahi A, Sekhavatpour Z, Raji H, Dastoorpoor M. Air pollution and hospital admissions due to deep vein thrombosis (DVT) in Ahvaz, Iran. Heliyon 2020; 6:e04814. [PMID: 32913913 PMCID: PMC7472851 DOI: 10.1016/j.heliyon.2020.e04814] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 06/25/2020] [Accepted: 08/25/2020] [Indexed: 11/25/2022] Open
Abstract
There are limited studies on the relation between short-term exposure to air pollutants and the risk of deep venous thrombosis (DVT). The aim of this study was to determine the relation between the concentration of these pollutants and the risk of hospital admissions due to DVT in Ahvaz, which is one of the world's highly polluted cities. Daily data on pollutants including O3, NO, NO2, SO2, CO, PM10, and PM2.5and DVT hospital admissions were collected from2008until 2018. Quasi-Poisson regression combined with linear distributed lag models; adjusted for trend, seasonality, temperature, relative humidity, weekdays, and holidays were used to assess the relation between the daily average of air pollutants and hospital admission for DVT. The results showed that there was a significant increase in hospital admissions due to DVT in the total, men, women, and elderly populations in relation to NO and NO2. There was also a significant increase in DVT hospital admissions in the male and ≤60 years populations related to PM10; and among the female and ≤60 years old populations, related to PM2.5. Finally, the results showed that there were significant positive associations between SO2 and CO exposure and the incidence of DVT hospital admissions among men and women, respectively. The results of this study show the possible effect of short-term exposure to air pollution on the risk of DVT. Further studies are required to investigate whether direct interventions through industry and government policy may alter the impact of specific pollutants in order to alter the incidence of DVT and other identified health complications.
Collapse
Affiliation(s)
- Seyed Hamid Borsi
- Department of Internal Medicine, Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Narges Khanjani
- Environmental Health Engineering Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Hamid Yazdani Nejad
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Atefeh Riahi
- Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Zohreh Sekhavatpour
- Department of Anesthesiology, School of Paramedicine, Dezful University of Medical Sciences, Dezful, Iran
| | - Hanieh Raji
- Department of Internal Medicine, Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Maryam Dastoorpoor
- Department of Biostatistics and Epidemiology, Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| |
Collapse
|
20
|
Kim H, Yu S, Choi H. Effects of particulate air pollution on tuberculosis development in seven major cities of Korea from 2010 to 2016: methodological considerations involving long-term exposure and time lag. Epidemiol Health 2020; 42:e2020012. [PMID: 32164052 PMCID: PMC7285441 DOI: 10.4178/epih.e2020012] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 03/12/2020] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES Epidemiological evidence of associations between ambient particulate matter (PM) and tuberculosis (TB) risk is accumulating. Two previous studies in Korea found associations between air pollution—especially sulfur dioxide (SO2)—and TB. In this study, we conducted an annual time-series cross-sectional study to assess the effect of PM with an aerodynamic diameter less than 10 μm (PM10) on TB risk in seven major cities of Korea from 2010 to 2016, taking into account time lag and long-term cumulative exposure. METHODS Age-standardized TB notification rates were derived using the Korea National TB Surveillance System. Annual average PM10 concentrations were obtained from annual Korean air quality reports. We applied a generalized linear mixed model with unconstrained distributed lags of exposure to PM10. We adjusted for potential confounders such as age, health behaviors, and area-level characteristics. RESULTS Both average annual PM10 concentrations and age-standardized TB notification rates decreased over time. The association between cumulative exposure to PM10 and TB incidence became stronger as a longer exposure duration was considered. An increase of one standard deviation (5.63 μg/m3) in PM10 exposure for six years was associated with a 1.20 (95% confidence interval, 1.17 to 1.22) times higher TB notification rate. The marginal association of exposure duration with the TB notification rate was highest at four and five years prior to TB notification. This association remained consistent even after adjusting it for exposure to SO2. CONCLUSIONS The findings of this study suggest that cumulative exposure to PM10 may affect TB risk, with a potential lag effect.
Collapse
Affiliation(s)
- Honghyok Kim
- BK21Plus Program in Embodiment: Health-Society Interaction, Department of Public Health Sciences, Graduate School, Korea University, Seoul, Korea.,School of Forestry and Environmental Studies, Yale University, New Haven, CT, USA
| | - Sarah Yu
- BK21Plus Program in Embodiment: Health-Society Interaction, Department of Public Health Sciences, Graduate School, Korea University, Seoul, Korea.,Research Center, the Korean Institute of Tuberculosis, Korean National Tuberculosis Association, Seoul, Korea.,School of Health Policy and Management, Korea University College of Health Science, Seoul, Korea
| | - Hongjo Choi
- Research Center, the Korean Institute of Tuberculosis, Korean National Tuberculosis Association, Seoul, Korea.,Department of Preventive Medicine, Konyang University College of Medicine, Daejeon, Korea
| |
Collapse
|
21
|
Impact of Environmental Regulations on Environmental Quality and Public Health in China: Empirical Analysis with Panel Data Approach. SUSTAINABILITY 2020. [DOI: 10.3390/su12020623] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Achieving high-quality environmental development through environmental regulations and thus enhancing public health is a goal of the Chinese government. Based on the panel data of 30 Chinese provinces from 1998 to 2017, this study demonstrates the co-benefits of environmental regulations on air quality, water, and public health through a panel Granger causality model and mediation effect model. The findings indicate that environmental regulations have a Granger causal effect on public health costs and air and water pollution. Furthermore, the results from the mediation effect model suggest that waste gas treatment could improve air quality, thus reducing public health costs; wastewater treatments could not only reduce public health costs through improvement of the water environment but also increase social welfare. Additionally, air pollution exhibits a greater negative externality impact on health than water pollution. Thus, environmental regulation policies should pay more attention to air pollution control. The findings of this study indicate that environmental regulations have a significant co-benefit on high-quality environmental development and public health.
Collapse
|
22
|
Delay effect and burden of weather-related tuberculosis cases in Rajshahi province, Bangladesh, 2007-2012. Sci Rep 2019; 9:12720. [PMID: 31481739 PMCID: PMC6722246 DOI: 10.1038/s41598-019-49135-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 08/20/2019] [Indexed: 12/17/2022] Open
Abstract
Tuberculosis (TB) is a potentially fatal infectious disease that continues to be a public health problem in Bangladesh. Each year in Bangladesh an estimated 70,000 people die of TB and 300,000 new cases are projected. It is important to understand the association between TB incidence and weather factors in Bangladesh in order to develop proper intervention programs. In this study, we examine the delayed effect of weather variables on TB occurrence and estimate the burden of the disease that can be attributed to weather factors. We used generalized linear Poisson regression models to investigate the association between weather factors and TB cases reported to the Bangladesh National TB control program between 2007 and 2012 in three known endemic districts of North-East Bangladesh. The associated risk of TB in the three districts increases with prolonged exposure to temperature and rainfall, and persisted at lag periods beyond 6 quarters. The association between humidity and TB is strong and immediate at low humidity, but the risk decreases with increasing lag. Using the optimum weather values corresponding to the lowest risk of infection, the risk of TB is highest at low temperature, low humidity and low rainfall. Measures of the risk attributable to weather variables revealed that weather-TB cases attributed to humidity is higher than that of temperature and rainfall in each of the three districts. Our results highlight the high linearity of temporal lagged effects and magnitudes of the burden attributable to temperature, humidity, and rainfall on TB endemics. The results can hopefully advise the Bangladesh National TB control program and act as a practical reference for the early warning of TB cases.
Collapse
|