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Zhang Z, Luan C, Wang C, Li T, Wu Y, Huang X, Jin B, Zhang E, Gong Q, Zhou X, Li X. Insulin resistance and its relationship with long-term exposure to ozone: Data based on a national population cohort. JOURNAL OF HAZARDOUS MATERIALS 2024; 472:134504. [PMID: 38704910 DOI: 10.1016/j.jhazmat.2024.134504] [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: 03/06/2024] [Revised: 04/14/2024] [Accepted: 04/30/2024] [Indexed: 05/07/2024]
Abstract
The relationship of ozone (O3), particularly the long-term exposure, with impacting metabolic homeostasis in population was understudied and under-recognised. Here, we used data from ChinaHEART, a nationwide, population-based cohort study, combined with O3 and PM2.5 concentration data with high spatiotemporal resolution, to explore the independent association of exposure to O3 with the prevalence of insulin resistance (IR). Among the 271 540 participants included, the crude prevalence of IR was 39.1%, while the age and sex standardized prevalence stood at 33.0%. Higher IR prevalence was observed with each increase of 10.0 μg/m3 in long-term O3 exposure, yielding adjusted odds ratios (OR) of 1.084 (95% CI: 1.079-1.089) in the one-pollutant model and 1.073 (95% CI: 1.067-1.079) in the two-pollutant model. Notably, a significant additive interaction between O3 and PM2.5 on the prevalence of IR was observed (P for additive interaction < 0.001). Our main findings remained consistent and robust in the sensitivity analyses. Our study suggests long-term exposure to O3 was independently and positively associated with prevalence of IR. It emphasized the benefits of policy interventions to reduce O3 and PM2.5 exposure jointly, which could ultimately alleviate the health and economic burden related to DM.
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Affiliation(s)
- Zenglei Zhang
- National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China; Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Cheng Luan
- Unit of Islet Pathophysiology, Department of Clinical Sciences Malmö, Lund University Diabetes Centre, Lund University, Malmö 21428, Sweden
| | - Chunqi Wang
- National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Tiantian Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
| | - Yi Wu
- National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Xin Huang
- National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Bolin Jin
- National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Enming Zhang
- Unit of Islet Pathophysiology, Department of Clinical Sciences Malmö, Lund University Diabetes Centre, Lund University, Malmö 21428, Sweden
| | - Qiuhong Gong
- Center of Endocrinology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Xianliang Zhou
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.
| | - Xi Li
- National Clinical Research Center of Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China; Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, Shenzhen, People's Republic of China; Central China Sub-center of the National Center for Cardiovascular Diseases, Zhengzhou, People's Republic of China.
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Liu C, Zhang B, Liu C, Zhang Y, Zhao K, Zhang P, Tian M, Lu Z, Guo X, Jia X. Association of ambient ozone exposure and greenness exposure with hemorrhagic stroke mortality at different times: A cohort study in Shandong Province, China. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 278:116356. [PMID: 38678691 DOI: 10.1016/j.ecoenv.2024.116356] [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: 01/04/2024] [Revised: 04/17/2024] [Accepted: 04/19/2024] [Indexed: 05/01/2024]
Abstract
Evidence on the association between long-term ozone exposure and greenness exposure and hemorrhagic stroke (HS) is limited, with mixed results. One potential source of this inconsistency is the difference in exposure time metrics. This study aimed to investigate the association between long-term exposure to ambient ozone, greenness, and mortality from HS using exposure metrics at different times. We also examined whether greenness exposure modified the relationship between ozone exposure and mortality due to HS. The study population consisted of 45771 participants aged ≥40 y residing in 20 counties in Shandong Province who were followed up from 2013 to 2019. Ozone exposure metrics (annual mean and warm season) and the normalized difference a measure of greenness exposure, were calculated. The relationship between environmental exposures (ozone and greenness exposures) and mortality from HS was assessed using time-dependent Cox proportional hazards models, and the modification of greenness exposure was examined using stratified analysis with interaction terms. The person-years at the end of follow-up were 90,663. With full adjustments, the risk of death from hemorrhagic stroke increased by 5% per interquartile range increase in warm season ozone [hazard ratio =1.05; 95 % confidence interval: 1.01-1.08]. No clear association was observed between annual ozone and mortality HS. Both the annual and summer NDVI were found to reduce the risk of HS mortality. The relationships were influenced by age, sex, and residence (urban or rural). Furthermore, greenness exposure was shown to have a modifying effect on the relationship between ozone exposure and the occurrence of HS mortality (P for interaction = 0.001). Long-term exposure to warm season O3 was positively associated with HS mortality, while greenness exposure was inversely associated with HS mortality. Greenness exposure may mitigate the negative effects of warm season ozone exposure on HS mortality.
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Affiliation(s)
- Chengrong Liu
- Department of Epidemiology and Statistics, Bengbu Medical University, Bengbu, China
| | - Bingyin Zhang
- Shandong Center for Disease Control and Prevention, Jinan, China
| | - Chao Liu
- Department of Epidemiology and Statistics, Bengbu Medical University, Bengbu, China
| | - Yingying Zhang
- Department of Epidemiology and Statistics, Bengbu Medical University, Bengbu, China
| | - Ke Zhao
- Department of Epidemiology and Statistics, Bengbu Medical University, Bengbu, China
| | - Peiyao Zhang
- Department of Epidemiology and Statistics, Bengbu Medical University, Bengbu, China
| | - Meihui Tian
- Department of Epidemiology and Statistics, Bengbu Medical University, Bengbu, China
| | - Zilong Lu
- Shandong Center for Disease Control and Prevention, Jinan, China
| | - Xiaolei Guo
- Shandong Center for Disease Control and Prevention, Jinan, China.
| | - Xianjie Jia
- Department of Epidemiology and Statistics, Bengbu Medical University, Bengbu, China.
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Zhu L, Fang J, Yao Y, Yang Z, Wu J, Ma Z, Liu R, Zhan Y, Ding Z, Zhang Y. Long-term ambient ozone exposure and incident cardiovascular diseases: National cohort evidence in China. JOURNAL OF HAZARDOUS MATERIALS 2024; 471:134158. [PMID: 38636234 DOI: 10.1016/j.jhazmat.2024.134158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 03/07/2024] [Accepted: 03/27/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND Long-term ozone (O3) exposure has been associated with cardiovascular disease (CVD) mortality in mounting cohort evidence, yet its relationship with incident CVD was poorly understood, especially in low- and middle-income countries (LMICs) experiencing high ambient air pollution. METHODS We carried out a nationwide perspective cohort study from 2010 through 2018 by dynamically enrolling 36948 participants across Chinese mainland. Warm-season (April-September) O3 concentrations were estimated using satellite-based machine-learning models with national coverage. Cox proportional hazards model with time-varying exposures was employed to evaluate the association of long-term O3 exposure with incident CVD (overall CVD, hypertension, stroke, and coronary heart disease [CHD]). Assuming causality, a counterfactual framework was employed to estimate O3-attributable CVD burden based on the exposure-response (E-R) relationship obtained from this study. Decomposition analysis was utilized to quantify the contributions of four key direct driving factors (O3 exposure, population size, age structure, and incidence rate) to the net change of O3-related CVD cases between 2010 and 2018. RESULTS A total of 4428 CVD, 2600 hypertension, 1174 stroke, and 337 CHD events were reported during 9-year follow-up. Each 10-μg/m³ increase in warm-season O3 was associated with an incident risk of 1.078 (95% confidence interval [CI]: 1.050-1.106) for overall CVD, 1.098 (95% CI: 1.062-1.135) for hypertension, 1.073 (95% CI: 1.019-1.131) for stroke, and 1.150 (95% CI: 1.038-1.274) for CHD, respectively. We observed no departure from linear E-R relationships of O3 exposure with overall CVD (Pnonlinear= 0.22), hypertension (Pnonlinear= 0.19), stroke (Pnonlinear= 0.70), and CHD (Pnonlinear= 0.44) at a broad concentration range of 60-160 µg/m3. Compared with rural dwellers, those residing in urban areas were at significantly greater O3-associated incident risks of overall CVD, hypertension, and stroke. We estimated 1.22 million (10.6% of overall CVD in 2018) incident CVD cases could be attributable to ambient O3 pollution in 2018, representing an overall 40.9% growth (0.36 million) compared to 2010 (0.87 million, 9.7% of overall CVD in 2010). This remarkable rise in O3-attributable CVD cases was primary driven by population aging (+24.0%), followed by increase in O3 concentration (+10.5%) and population size (+6.7%). CONCLUSIONS Long-term O3 exposure was associated with an elevated risk and burden of incident CVD in Chinese adults, especially among urban dwellers. Our findings underscored policy priorities of implementing joint control measures for fine particulate matter and O3 in the context of accelerated urbanization and population aging in China.
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Affiliation(s)
- Lifeng Zhu
- Institute of Social Development and Health Management, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Jiaying Fang
- Huadu District People's Hospital of Guangzhou, Guangzhou 510800, China
| | - Yao Yao
- China Center for Health Development Studies, Peking University, Beijing 100871, China
| | - Zhiming Yang
- School of Economics and Management, University of Science and Technology Beijing, Beijing 100083, China
| | - Jing Wu
- China Center for Health Development Studies, Peking University, Beijing 100871, China
| | - Zongwei Ma
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing 210023, China
| | - Riyang Liu
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing 210023, China
| | - Yu Zhan
- Department of Environmental Science and Engineering, Sichuan University, Chengdu 610065, China
| | - Zan Ding
- Baoan Central Hospital of Shenzhen, Shenzhen 518102, China.
| | - Yunquan Zhang
- Institute of Social Development and Health Management, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China.
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Dong Z, Jiang Y, Wang S, Xing J, Ding D, Zheng H, Wang H, Huang C, Yin D, Song Q, Zhao B, Hao J. Spatially and Temporally Differentiated NO x and VOCs Emission Abatement Could Effectively Gain O 3-Related Health Benefits. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2024; 58:9570-9581. [PMID: 38781138 DOI: 10.1021/acs.est.4c01345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
The increasing level of O3 pollution in China significantly exacerbates the long-term O3 health damage, and an optimized health-oriented strategy for NOx and VOCs emission abatement is needed. Here, we developed an integrated evaluation and optimization system for the O3 control strategy by merging a response surface model for the O3-related mortality and an optimization module. Applying this system to the Yangtze River Delta (YRD), we evaluated driving factors for mortality changes from 2013 to 2017, quantified spatial and temporal O3-related mortality responses to precursor emission abatement, and optimized a health-oriented control strategy. Results indicate that insufficient NOx emission abatement combined with deficient VOCs control from 2013 to 2017 aggravated O3-related mortality, particularly during spring and autumn. Northern YRD should promote VOCs control due to higher VOC-limited characteristics, whereas fastening NOx emission abatement is more favorable in southern YRD. Moreover, promotion of NOx mitigation in late spring and summer and facilitating VOCs control in spring and autumn could further reduce O3-related mortality by nearly 10% compared to the control strategy without seasonal differences. These findings highlight that a spatially and temporally differentiated NOx and VOCs emission control strategy could gain more O3-related health benefits, offering valuable insights to regions with severe ozone pollution all over the world.
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Affiliation(s)
- Zhaoxin Dong
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, School of Environment, Tsinghua University, Beijing 100084, China
- State Environmental Protection Key Laboratory of Formation and Prevention of the Urban Air Pollution Complex, Shanghai Academy of Environment Sciences, Shanghai 200233, China
- State Environmental Protection Key Laboratory of Sources and Control of Air Pollution Complex, Beijing 100084, China
| | - Yueqi Jiang
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, School of Environment, Tsinghua University, Beijing 100084, China
- State Environmental Protection Key Laboratory of Sources and Control of Air Pollution Complex, Beijing 100084, China
| | - Shuxiao Wang
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, School of Environment, Tsinghua University, Beijing 100084, China
- State Environmental Protection Key Laboratory of Sources and Control of Air Pollution Complex, Beijing 100084, China
| | - Jia Xing
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, School of Environment, Tsinghua University, Beijing 100084, China
- State Environmental Protection Key Laboratory of Sources and Control of Air Pollution Complex, Beijing 100084, China
| | - Dian Ding
- Institute for Atmospheric and Earth System Research/Physics, Faculty of Science, University of Helsinki, 00014 Helsinki, Finland
| | - Haotian Zheng
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, School of Environment, Tsinghua University, Beijing 100084, China
- State Environmental Protection Key Laboratory of Sources and Control of Air Pollution Complex, Beijing 100084, China
| | - Hongli Wang
- State Environmental Protection Key Laboratory of Formation and Prevention of the Urban Air Pollution Complex, Shanghai Academy of Environment Sciences, Shanghai 200233, China
| | - Cheng Huang
- State Environmental Protection Key Laboratory of Formation and Prevention of the Urban Air Pollution Complex, Shanghai Academy of Environment Sciences, Shanghai 200233, China
| | - Dejia Yin
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, School of Environment, Tsinghua University, Beijing 100084, China
- State Environmental Protection Key Laboratory of Sources and Control of Air Pollution Complex, Beijing 100084, China
| | - Qian Song
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, School of Environment, Tsinghua University, Beijing 100084, China
- State Environmental Protection Key Laboratory of Sources and Control of Air Pollution Complex, Beijing 100084, China
| | - Bin Zhao
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, School of Environment, Tsinghua University, Beijing 100084, China
- State Environmental Protection Key Laboratory of Sources and Control of Air Pollution Complex, Beijing 100084, China
| | - Jiming Hao
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, School of Environment, Tsinghua University, Beijing 100084, China
- State Environmental Protection Key Laboratory of Sources and Control of Air Pollution Complex, Beijing 100084, China
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Du X, Chen R, Kan H. Challenges of Air Pollution and Health in East Asia. Curr Environ Health Rep 2024; 11:89-101. [PMID: 38321318 DOI: 10.1007/s40572-024-00433-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2024] [Indexed: 02/08/2024]
Abstract
PURPOSE OF REVIEW Air pollution has been a serious environmental and public health issue worldwide, particularly in Asian countries. There have been significant increases in epidemiological studies on fine particulate matter (PM2.5) and ozone pollution in East Asia, and an in-depth review of epidemiological evidence is urgent. Thus, we carried out a systematic review of the epidemiological research on PM2.5 and ozone pollution in East Asia released in recent years. RECENT FINDINGS Recent studies have indicated that PM2.5 and ozone are the most detrimental air pollutants to human health, resulting in substantial disease burdens for Asian populations. Many epidemiological studies of PM2.5 and ozone have been mainly performed in three East Asian countries (China, Japan, and South Korea). We derived the following summary findings: (1) both short-term and long-term exposure to PM2.5 and ozone could raise the risks of mortality and morbidity, emphasizing the need for continuing improvements in air quality in East Asia; (2) the long-term associations between PM2.5 and mortality in East Asia are comparable to those observed in Europe and North America, whereas the short-term associations are relatively smaller in magnitude; and (3) further cohort and intervention studies are required to yield robust and precise evidence that can promote evidence-based policymaking in East Asia. This updated review presented an outline of the health impacts of PM2.5 and ozone in East Asia, which may be beneficial for the development of future regulatory policies and standards, as well as for designing subsequent investigations.
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Affiliation(s)
- Xihao Du
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, 200032, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, 200032, China.
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Shanghai Institute of Infectious Disease and Biosecurity, Fudan University, Shanghai, 200032, China.
- Children's Hospital of Fudan University, National Center for Children's Health, Shanghai, China.
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Karim N, Hod R, Wahab MIA, Ahmad N. Projecting non-communicable diseases attributable to air pollution in the climate change era: a systematic review. BMJ Open 2024; 14:e079826. [PMID: 38719294 PMCID: PMC11086555 DOI: 10.1136/bmjopen-2023-079826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 04/16/2024] [Indexed: 05/12/2024] Open
Abstract
OBJECTIVES Climate change is a major global issue with significant consequences, including effects on air quality and human well-being. This review investigated the projection of non-communicable diseases (NCDs) attributable to air pollution under different climate change scenarios. DESIGN This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 flow checklist. A population-exposure-outcome framework was established. Population referred to the general global population of all ages, the exposure of interest was air pollution and its projection, and the outcome was the occurrence of NCDs attributable to air pollution and burden of disease (BoD) based on the health indices of mortality, morbidity, disability-adjusted life years, years of life lost and years lived with disability. DATA SOURCES The Web of Science, Ovid MEDLINE and EBSCOhost databases were searched for articles published from 2005 to 2023. ELIGIBILITY CRITERIA FOR SELECTING STUDIES The eligible articles were evaluated using the modified scale of a checklist for assessing the quality of ecological studies. DATA EXTRACTION AND SYNTHESIS Two reviewers searched, screened and selected the included studies independently using standardised methods. The risk of bias was assessed using the modified scale of a checklist for ecological studies. The results were summarised based on the projection of the BoD of NCDs attributable to air pollution. RESULTS This review included 11 studies from various countries. Most studies specifically investigated various air pollutants, specifically particulate matter <2.5 µm (PM2.5), nitrogen oxides and ozone. The studies used coupled-air quality and climate modelling approaches, and mainly projected health effects using the concentration-response function model. The NCDs attributable to air pollution included cardiovascular disease (CVD), respiratory disease, stroke, ischaemic heart disease, coronary heart disease and lower respiratory infections. Notably, the BoD of NCDs attributable to air pollution was projected to decrease in a scenario that promotes reduced air pollution, carbon emissions and land use and sustainable socioeconomics. Contrastingly, the BoD of NCDs was projected to increase in a scenario involving increasing population numbers, social deprivation and an ageing population. CONCLUSION The included studies widely reported increased premature mortality, CVD and respiratory disease attributable to PM2.5. Future NCD projection studies should consider emission and population changes in projecting the BoD of NCDs attributable to air pollution in the climate change era. PROSPERO REGISTRATION NUMBER CRD42023435288.
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Affiliation(s)
- Norhafizah Karim
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bandar Tun Razak, Kuala lumpur, Malaysia
| | - Rozita Hod
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bandar Tun Razak, Kuala lumpur, Malaysia
| | - Muhammad Ikram A Wahab
- Center of Toxicology and Health Risk Studies (CORE), Universiti Kebangsaan Malaysia Fakulti Sains Kesihatan, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Norfazilah Ahmad
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bandar Tun Razak, Kuala lumpur, Malaysia
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Hu X, Knibbs LD, Zhou Y, Ou Y, Dong GH, Dong H. The role of lifestyle in the association between long-term ambient air pollution exposure and cardiovascular disease: a national cohort study in China. BMC Med 2024; 22:93. [PMID: 38439026 PMCID: PMC10913402 DOI: 10.1186/s12916-024-03316-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 02/23/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) caused by air pollution poses a considerable burden on public health. We aim to examine whether lifestyle factors mediate the associations of air pollutant exposure with the risk of CVD and the extent of the interaction between lifestyles and air pollutant exposure regarding CVD outcomes. METHODS We included 7000 participants in 2011-2012 and followed up until 2018. The lifestyle evaluation consists of six factors as proxies, including blood pressure, blood glucose, blood lipids, body mass index, tobacco exposure, and physical activity, and the participants were categorized into three lifestyle groups according to the number of ideal factors (unfavorable, 0-1; intermediate, 2-4; and favorable, 5-6). Satellite-based spatiotemporal models were used to estimate exposure to ambient air pollutants (including particles with diameters ≤ 1.0 μm [PM1], ≤ 2.5 μm [PM2.5], ≤ 10 μm [PM10], nitrogen dioxide [NO2], and ozone [O3]). Cox regression models were used to examine the associations between air pollutant exposure, lifestyles and the risk of CVD. The mediation and modification effects of lifestyle categories on the association between air pollutant exposure and CVD were analyzed. RESULTS After adjusting for covariates, per 10 μg/m3 increase in exposure to PM1 (HR: 1.09, 95% CI: 1.05-1.14), PM2.5 (HR: 1.04, 95% CI: 1.00-1.08), PM10 (HR: 1.05, 95% CI: 1.03-1.08), and NO2 (HR: 1.11, 95% CI: 1.05-1.18) was associated with an increased risk of CVD. Adherence to a healthy lifestyle was associated with a reduced risk of CVD compared to an unfavorable lifestyle (HR: 0.65, 95% CI: 0.56-0.76 for intermediate lifestyle and HR: 0.41, 95% CI: 0.32-0.53 for favorable lifestyle). Lifestyle played a significant partial mediating role in the contribution of air pollutant exposure to CVD, with the mediation proportion ranging from 7.4% for PM10 to 14.3% for PM2.5. Compared to an unfavorable lifestyle, the relative excess risk due to interaction for a healthier lifestyle to reduce the effect on CVD risk was - 0.98 (- 1.52 to - 0.44) for PM1, - 0.60 (- 1.05 to - 0.14) for PM2.5, - 1.84 (- 2.59 to - 1.09) for PM10, - 1.44 (- 2.10 to - 0.79) for NO2, and - 0.60 (- 1.08, - 0.12) for O3. CONCLUSIONS Lifestyle partially mediated the association of air pollution with CVD, and adherence to a healthy lifestyle could protect middle-aged and elderly people from the adverse effects of air pollution regarding CVD.
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Affiliation(s)
- Xiangming Hu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China
| | - Luke D Knibbs
- School of Public Health, The University of Sydney, Camperdown, NSW, 2006, Australia
- Public Health Research Analytics and Methods for Evidence, Public Health Unit, Sydney Local Health District, Camperdown, NSW, 2050, Australia
| | - Yingling Zhou
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China
| | - Yanqiu Ou
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China.
| | - Guang-Hui Dong
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China.
| | - Haojian Dong
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China.
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8
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Huang M, Tao S, Zhu K, Feng H, Lu X, Hang J, Wang X. Applicability of evaluation metrics/schemes for human health burden attributable to regional ozone pollution: A case study in the Guangdong-Hong Kong-Macao Greater Bay Area (GBA), South China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 914:169910. [PMID: 38185177 DOI: 10.1016/j.scitotenv.2024.169910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 12/28/2023] [Accepted: 01/02/2024] [Indexed: 01/09/2024]
Abstract
This is a study to identify the applicable/preferable short- and long-term metrics/schemes to evaluate the premature mortality attributable to the ozone pollution in the Guangdong-Hong Kong-Macao Greater Bay Area (GBA), one of the most representative populous ozone pollution regions in China, by comprehensively accounting the uncertainty sources. The discrepancy between the observation and the CAQRA reanalysis datasets (2013-2019) was investigated in terms of the concentration variation pattern, which determines the exposure metric change. A set of domestic short-term C-R coefficients for the all-age population were integrated using the meta-analysis respectively corresponding to the metrics of MDA1, MDA8, and Daily average. The dataset-based deviations of the short-term attributable factors (AFs) and their corresponding premature mortalities were respectively about 16.9 ± 13.3 % and <5 % based on MDA8, much smaller than other two metrics; and the MDA8-based evaluation results were the most sensitive to the deteriorative ozone pollution, with the maximum upward trends of 0.095-0.129 %/year. Accordingly, MDA8 was recognized as the most applicable short-term metric. For the long-term exposure, the domestic summer metric SMDA8 could not exactly represent the peak-season ozone maximum level in the GBA, with the deviation from 6MMDA8 as much as 30 %. By considering the ability of metric to represent the peak-season ozone, the relatively smaller dataset-based discrepancies of AFs (6MMDA8-WHO2021: 23.3 ± 16.9 %, AMDA8-T2016: 20.7 ± 15.8 %) and the attributable premature mortalities (6MMDA8-WHO2021: 5 %, AMDA8-T2016: 8 %), and the higher sensitivity of the evaluation results to the deteriorative ozone pollution (6MMDA8-WHO2021: 0.13 %;year, p = 0.01; AMDA8-T2016: 0.15 %/year, p = 0.03), the schemes of 6MMDA8-WHO2021 and AMDA8-T2016 were recognized relatively more preferable for the adult (≥25-year) long-term evaluation. Based on the recognized metric/schemes, the central and the eastern PRE areas of higher NO2 level in the GBA were experiencing the highest health burdens from 2013 to 2019.
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Affiliation(s)
- Minjuan Huang
- School of Atmospheric Sciences, Sun Yat-sen University, and Southern Marine Science and Engineering Guangdong Laboratory (Zhuhai), Zhuhai 519082, PR China; Guangdong Province Key Laboratory for Climate Change and Natural Disaster Studies, Sun Yat-sen University, Zhuhai 519082, PR China; Guangdong Provincial Field Observation and Research Station for Climate Environment and Air Quality Change in the Pearl River Estuary, Zhuhai 519082, PR China.
| | - Song Tao
- School of Atmospheric Sciences, Sun Yat-sen University, and Southern Marine Science and Engineering Guangdong Laboratory (Zhuhai), Zhuhai 519082, PR China
| | - Ke Zhu
- School of Atmospheric Sciences, Sun Yat-sen University, and Southern Marine Science and Engineering Guangdong Laboratory (Zhuhai), Zhuhai 519082, PR China
| | - Huiran Feng
- School of Atmospheric Sciences, Sun Yat-sen University, and Southern Marine Science and Engineering Guangdong Laboratory (Zhuhai), Zhuhai 519082, PR China
| | - Xiao Lu
- School of Atmospheric Sciences, Sun Yat-sen University, and Southern Marine Science and Engineering Guangdong Laboratory (Zhuhai), Zhuhai 519082, PR China; Guangdong Province Key Laboratory for Climate Change and Natural Disaster Studies, Sun Yat-sen University, Zhuhai 519082, PR China; Guangdong Provincial Field Observation and Research Station for Climate Environment and Air Quality Change in the Pearl River Estuary, Zhuhai 519082, PR China
| | - Jian Hang
- School of Atmospheric Sciences, Sun Yat-sen University, and Southern Marine Science and Engineering Guangdong Laboratory (Zhuhai), Zhuhai 519082, PR China; Guangdong Province Key Laboratory for Climate Change and Natural Disaster Studies, Sun Yat-sen University, Zhuhai 519082, PR China; Guangdong Provincial Field Observation and Research Station for Climate Environment and Air Quality Change in the Pearl River Estuary, Zhuhai 519082, PR China
| | - Xuemei Wang
- Guangdong-Hongkong-Macau Joint Laboratory of Collaborative Innovation for Environmental Quality, Institute for Environmental and Climate Research, Jinan University, Guangzhou 510632, PR China
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9
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Peng M, Zhang F, Yuan Y, Yang Z, Wang K, Wang Y, Tang Z, Zhang Y. Long-term ozone exposure and all-cause mortality: Cohort evidence in China and global heterogeneity by region. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 270:115843. [PMID: 38141337 DOI: 10.1016/j.ecoenv.2023.115843] [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: 10/09/2023] [Revised: 12/05/2023] [Accepted: 12/14/2023] [Indexed: 12/25/2023]
Abstract
BACKGROUND Cohort evidence linking long-term ozone (O3) exposure to mortality remained largely mixed worldwide and was extensively deficient in densely-populated Asia. This study aimed to assess the long-term effects of O3 exposure on all-cause mortality among Chinese adults, as well as to examine potential regional heterogeneity across the globe. METHODS A national dynamic cohort of 42153 adults aged 16+ years were recruited from 25 provinces across Chinese mainland and followed up during 2010-2018. Annual warm-season (April-September) O3 and year-round co-pollutants (i.e., nitrogen dioxide [NO2] and fine particulate matter [PM2.5]) were simulated through validated spatial-temporal prediction models and were assigned to each enrollee in each calendar year. Cox proportional hazards models with time-varying exposures were employed to assess the O3-mortality association. Concentration-response (C-R) curves were fitted by natural cubic spline function to investigate the potential nonlinear association. Both single-pollutant model and co-pollutant models additionally adjusting for PM2.5 and/or NO2 were employed to examine the robustness of the estimated association. The random-effect meta-analysis was adopted to pool effect estimates from the current and prior population-based cohorts (n = 29), and pooled C-R curves were fitted through the meta-smoothing approach by regions. RESULTS The study population comprised of 42153 participants who contributed 258921.5 person-years at risk (median 6.4 years), of whom 2382 death events occurred during study period. Participants were exposed to an annual average of 51.4 ppb (range: 22.7-74.4 ppb) of warm-season O3 concentration. In the single-pollutant model, a significantly increased hazard ratio (HR) of 1.098 (95% confidence interval [CI]: 1.023-1.179) was associated with a 10-ppb rise in O3 exposure. Associations remained robust to additional adjustments of co-pollutants, with HRs of 1.099 (95% CI: 1.023-1.180) in bi-pollutant model (+PM2.5) and 1.093 (95% CI: 1.018-1.174) in tri-pollutant model (+PM2.5+NO2), respectively. A J-shaped C-R relationship was identified among Chinese general population, suggesting significant excess mortality risk at high ozone exposure only. The combined C-R curves from Asia (n = 4) and North America (n = 17) demonstrated an overall increased risk of all-cause mortality with O3 exposure, with pooled HRs of 1.124 (95% CI: 0.966-1.307) and 1.023 (95% CI: 1.007-1.039) per 10-ppb rise, respectively. Conversely, an opposite association was observed in Europe (n = 8, HR: 0.914 [95% CI: 0.860-0.972]), suggesting significant heterogeneity across regions (P < 0.01). CONCLUSIONS This study provided national evidence that high O3 exposure may curtail long-term survival of Chinese general population. Great between-region heterogeneity of pooled O3-mortality was identified across North America, Europe, and Asia.
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Affiliation(s)
- Minjin Peng
- Department of Outpatient, Taihe Hospital, Hubei University of Medicine, Shiyan 442000, China
| | - Faxue Zhang
- Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan 430072, China
| | - Yang Yuan
- Institute of Social Development and Health Management, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China.
| | - Zhiming Yang
- School of Economics and Management, University of Science and Technology Beijing, Beijing 100083, China
| | - Kai Wang
- Institute of Social Development and Health Management, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Yaqi Wang
- Institute of Social Development and Health Management, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Ziqing Tang
- Institute of Social Development and Health Management, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Yunquan Zhang
- Institute of Social Development and Health Management, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China.
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10
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Yan Q, Xiao Z, Zhang X, Wang G, Zhong C, Qiu D, Huang S, Zheng L, Gao Z. Association of organophosphate flame retardants with all-cause and cause-specific mortality among adults aged 40 years and older. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 268:115690. [PMID: 37976933 DOI: 10.1016/j.ecoenv.2023.115690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 11/09/2023] [Accepted: 11/11/2023] [Indexed: 11/19/2023]
Abstract
The longitudinal associations of urinary concentrations of diphenyl phosphate (DPHP), bis(2-chloroethyl) phosphate (BCEP), and bis(1,3-dichloro-2-propyl) phosphate (BDCPP) with all-cause, cardiovascular, and cancer mortality in a population of adults aged 40 years and older are still unclear. A total of 3238 participants were included in this cohort study. Urinary BCEP levels were positively associated with all-cause mortality and cardiovascular mortality. Specifically, a logarithmic increase in BCEP concentration was related to a 26 % higher risk of all-cause mortality and a 32 % higher risk of cardiovascular mortality. No significant associations were observed for DPHP and BDCPP in relation to mortality. Doseresponse analysis confirmed the linear associations of BCEP with all-cause and cardiovascular mortality and the nonlinear inverted U-shaped association between DPHP exposure and all-cause mortality. Notably, the economic burden associated with BCEP exposure was estimated, and it was shown that concentrations in the third tertile of BCEP exposure incurred approximately 507 billion dollars of financial burden for all-cause mortality and approximately 717 billion dollars for cardiovascular mortality. These results highlight the importance of addressing exposure to BCEP and its potential health impacts on the population. More research is warranted to explore the underlying mechanisms and develop strategies for reducing exposure to this harmful chemical.
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Affiliation(s)
- Qing Yan
- Department of Neurosurgery, Children's Hospital of Nanjing Medical University, Nanjing, People's Republic of China
| | - Zhihao Xiao
- School of Public Health, Nanjing Medical University, Nanjing, People's Republic of China
| | - Xianli Zhang
- Department of Neurosurgery, Children's Hospital of Nanjing Medical University, Nanjing, People's Republic of China
| | - Gang Wang
- Department of Neurosurgery, Children's Hospital of Nanjing Medical University, Nanjing, People's Republic of China
| | - Chunyu Zhong
- Department of Neurosurgery, Children's Hospital of Nanjing Medical University, Nanjing, People's Republic of China
| | - Dezhi Qiu
- Department of Neurosurgery, Children's Hospital of Nanjing Medical University, Nanjing, People's Republic of China
| | - Songming Huang
- Department of Nephrology, Children's Hospital of Nanjing Medical University, Nanjing, People's Republic of China.
| | - Lei Zheng
- Department of Neurosurgery, Children's Hospital of Nanjing Medical University, Nanjing, People's Republic of China.
| | - Zhe Gao
- Department of Neurosurgery, Children's Hospital of Nanjing Medical University, Nanjing, People's Republic of China.
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11
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Sun HZ, Zhao J, Liu X, Qiu M, Shen H, Guillas S, Giorio C, Staniaszek Z, Yu P, Wan MW, Chim MM, van Daalen KR, Li Y, Liu Z, Xia M, Ke S, Zhao H, Wang H, He K, Liu H, Guo Y, Archibald AT. Antagonism between ambient ozone increase and urbanization-oriented population migration on Chinese cardiopulmonary mortality. Innovation (N Y) 2023; 4:100517. [PMID: 37822762 PMCID: PMC10562756 DOI: 10.1016/j.xinn.2023.100517] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 09/17/2023] [Indexed: 10/13/2023] Open
Abstract
Ever-increasing ambient ozone (O3) pollution in China has been exacerbating cardiopulmonary premature deaths. However, the urban-rural exposure inequity has seldom been explored. Here, we assess population-scale O3 exposure and mortality burdens between 1990 and 2019 based on integrated pollution tracking and epidemiological evidence. We find Chinese population have been suffering from climbing O3 exposure by 4.3 ± 2.8 ppb per decade as a result of rapid urbanization and growing prosperity of socioeconomic activities. Rural residents are broadly exposed to 9.8 ± 4.1 ppb higher ambient O3 than the adjacent urban citizens, and thus urbanization-oriented migration compromises the exposure-associated mortality on total population. Cardiopulmonary excess premature deaths attributable to long-term O3 exposure, 373,500 (95% uncertainty interval [UI]: 240,600-510,900) in 2019, is underestimated in previous studies due to ignorance of cardiovascular causes. Future O3 pollution policy should focus more on rural population who are facing an aggravating threat of mortality risks to ameliorate environmental health injustice.
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Affiliation(s)
- Haitong Zhe Sun
- Yusuf Hamied Department of Chemistry, University of Cambridge, Cambridge CB2 1EW, UK
- Department of Earth Sciences, University of Cambridge, Cambridge CB2 3EQ, UK
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Junchao Zhao
- State Key Joint Laboratory of ESPC, State Environmental Protection Key Laboratory of Sources and Control of Air Pollution Complex, School of Environment, Tsinghua University, Beijing 100084, China
| | - Xiang Liu
- School of Atmospheric Sciences, Nanjing University, Nanjing 210023, China
| | - Minghao Qiu
- Department of Earth System Science, Stanford University, Stanford, CA 94305, USA
| | - Huizhong Shen
- School of Environmental Science and Engineering, Southern University of Science and Technology, Shenzhen 518055, China
| | - Serge Guillas
- Department of Statistical Science, University College London, London WC1E 6BT, UK
- The Alan Turing Institute, London NW1 2DB, UK
| | - Chiara Giorio
- Yusuf Hamied Department of Chemistry, University of Cambridge, Cambridge CB2 1EW, UK
| | - Zosia Staniaszek
- Yusuf Hamied Department of Chemistry, University of Cambridge, Cambridge CB2 1EW, UK
| | - Pei Yu
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Michelle W.L. Wan
- Yusuf Hamied Department of Chemistry, University of Cambridge, Cambridge CB2 1EW, UK
| | - Man Mei Chim
- Yusuf Hamied Department of Chemistry, University of Cambridge, Cambridge CB2 1EW, UK
| | - Kim Robin van Daalen
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge CB1 8RN, UK
- Heart and Lung Research Institute, University of Cambridge, Cambridge CB2 0BD, UK
- Barcelona Supercomputing Center, Department of Earth Sciences, 08034 Barcelona, Spain
| | - Yilin Li
- Yusuf Hamied Department of Chemistry, University of Cambridge, Cambridge CB2 1EW, UK
| | - Zhenze Liu
- School of Environmental Science and Engineering, Nanjing University of Information Science and Technology, Nanjing 210044, China
| | - Mingtao Xia
- Department of Mathematics, University of California, Los Angeles, Los Angeles, CA 90095, USA
| | - Shengxian Ke
- State Key Laboratory of New Ceramics and Fine Processing, Key Laboratory of Advanced Materials of Ministry of Education, School of Materials Science and Engineering, Tsinghua University, Beijing 100084, China
| | - Haifan Zhao
- Department of Engineering, University of Cambridge, Cambridge CB2 1PZ, UK
| | - Haikun Wang
- School of Atmospheric Sciences, Nanjing University, Nanjing 210023, China
| | - Kebin He
- State Key Joint Laboratory of ESPC, State Environmental Protection Key Laboratory of Sources and Control of Air Pollution Complex, School of Environment, Tsinghua University, Beijing 100084, China
| | - Huan Liu
- State Key Joint Laboratory of ESPC, State Environmental Protection Key Laboratory of Sources and Control of Air Pollution Complex, School of Environment, Tsinghua University, Beijing 100084, China
| | - Yuming Guo
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Alexander T. Archibald
- Yusuf Hamied Department of Chemistry, University of Cambridge, Cambridge CB2 1EW, UK
- National Centre for Atmospheric Science, Cambridge CB2 1EW, UK
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12
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Li Y, Ma L, Ni M, Bai Y, Li C. Drivers of ozone-related premature mortality in China: Implications for historical and future scenarios. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2023; 345:118663. [PMID: 37487454 DOI: 10.1016/j.jenvman.2023.118663] [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: 05/03/2023] [Revised: 07/15/2023] [Accepted: 07/19/2023] [Indexed: 07/26/2023]
Abstract
Long-term exposure to ambient ozone (O3) poses a severe public health threat in China. However, the drivers of premature mortality caused by O3 pollution are still poorly constrained, despite being prerequisites for addressing the threat. Here, we demonstrate the contributions of historical and future changes in peak-season O3, population size, age structure, and baseline mortality to China's O3-related mortality using decomposition analysis. From 2013 to 2021, O3-related mortality decreased dramatically from 78.8 (40.8-124.6) to 68.7 (36.0-107.2) thousand, especially in densely populated areas with high pollution. Variations in peak-season O3, population size, age structure, and baseline mortality led to changes in O3-related mortality of +27.3 (14.8-41.3), +2.6 (1.4-4.1), +22.3 (11.5-35.2), and -40.3 (20.9-63.7) thousand, respectively. The influence of peak-season O3 on O3-related mortality shifted from positive during 2013-2019 (+8.4% per year) to negative during 2019-2021 (-8.8% per year), which highly regulated the interannual trend of mortality. From 2021 to 2035, O3-related mortality is expected to increase by 31% in the current context of peak-season O3 levels, primarily caused by increased aging. Even reducing peak-season O3 to the WHO interim target 1 (IT-1) would only reduce O3-related mortality by 3.9%, while a more rigorous standard (IT-2) would prevent 83.7% of mortality. These findings suggest that improving ambient O3 can lead to significant health benefits, but substantial mitigation strategies are merited given the future trend of population aging.
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Affiliation(s)
- Yong Li
- Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, School of Public Health, Guizhou Medical University, Guiyang, 550025, China
| | - Lu Ma
- Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, School of Public Health, Guizhou Medical University, Guiyang, 550025, China.
| | - Maofei Ni
- College of Eco-Environmental Science and Engineering, Guizhou Minzu University, Guiyang, 550025, China
| | - Yun Bai
- School of Management Science and Engineering, Chongqing Technology and Business University, Chongqing, 400067, China
| | - Chuan Li
- School of Management Science and Engineering, Chongqing Technology and Business University, Chongqing, 400067, China.
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13
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Hu S, Xu X, Li C, Zhang L, Xing X, He J, Guo P, Zhang J, Niu Y, Chen S, Zhang R, Liu F, Ma S, Zhang M, Guo F, Zhang M. Long-term exposure to ambient ozone at workplace is positively and non-linearly associated with incident hypertension and blood pressure: longitudinal evidence from the Beijing-Tianjin-Hebei medical examination cohort. BMC Public Health 2023; 23:2011. [PMID: 37845647 PMCID: PMC10577958 DOI: 10.1186/s12889-023-16932-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 10/07/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND There is limited longitudinal evidence on the hypertensive effects of long-term exposure to ambient O3. We investigated the association between long-term O3 exposure at workplace and incident hypertension, diastolic blood pressure (DBP), systolic blood pressure (SBP), pulse pressure (PP), and mean arterial pressure (MAP) in general working adults. METHODS We conducted a cohort study by recruiting over 30,000 medical examination attendees through multistage stratified cluster sampling. Participants completed a standard questionnaire and comprehensive medical examination. Three-year ambient O3 concentrations at each employed participant's workplace were estimated using a two-stage machine learning model. Mixed-effects Cox proportional hazards models and linear mixed-effects models were used to examine the effect of O3 concentrations on incident hypertension and blood pressure parameters, respectively. Generalized additive mixed models were used to explore non-linear concentration-response relationships. RESULTS A total of 16,630 hypertension-free working participants at baseline finished the follow-up. The mean (SD) O3 exposure was 45.26 (2.70) ppb. The cumulative incidence of hypertension was 7.11 (95% CI: 6.76, 7.47) per 100 person-years. Long-term O3 exposure was independently, positively and non-linearly associated with incident hypertension (Hazard ratios (95% CI) for Q2, Q3, and Q4 were 1.77 (1.34, 2.36), 2.06 (1.42, 3.00) and 3.43 (2.46, 4.79), respectively, as compared with the first quartile (Q1)), DBP (β (95% CI) was 0.65 (0.01, 1.30) for Q2, as compared to Q1), SBP (β (95% CI) was 2.88 (2.00, 3.77), 2.49 (1.36, 3.61) and 2.61 (1.64, 3.58) for Q2, Q3, and Q4, respectively), PP (β (95% CI) was 2.12 (1.36, 2.87), 2.03 (1.18, 2.87) and 2.14 (1.38, 2.90) for Q2, Q3, and Q4, respectively), and MAP (β (95% CI) was 1.39 (0.76, 2.02), 1.04 (0.24, 1.84) and 1.12 (0.43, 1.82) for Q2, Q3, and Q4, respectively). The associations were robust across sex, age, BMI, and when considering PM2.5 and NO2. CONCLUSIONS To our knowledge, this is the first cohort study in the general population that demonstrates the non-linear hypertensive effects of long-term O3 exposure. The findings are particularly relevant for policymakers and researchers involved in ambient pollution and public health, supporting the integration of reduction of ambient O3 into public health interventions.
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Affiliation(s)
- Songhua Hu
- School of Statistics and Data Science, Nankai University, Tianjin, China
- Big Data Center for Children's Medical Care, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
| | - Ximing Xu
- Big Data Center for Children's Medical Care, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing, China
| | - Chunjun Li
- Tianjin Union Medical Center, Tianjin, China
| | - Li Zhang
- Tianjin First Central Hospital, Tianjin, China
| | - Xiaolong Xing
- School of Medicine, Nankai University, Tianjin, China
| | - Jiangshan He
- School of Medicine, Nankai University, Tianjin, China
| | - Pei Guo
- School of Medicine, Nankai University, Tianjin, China
| | - Jingbo Zhang
- Beijing Physical Examination Center, Beijing, China
| | - Yujie Niu
- Hebei Key Laboratory of Environment and Human Health, Shijiazhuang, China
- Department of Occupational Health and Environmental Health, Hebei Medical University, Shijiazhuang, China
| | - Shuo Chen
- Beijing Physical Examination Center, Beijing, China
| | - Rong Zhang
- Hebei Key Laboratory of Environment and Human Health, Shijiazhuang, China
- Department of Occupational Health and Environmental Health, Hebei Medical University, Shijiazhuang, China
| | - Feng Liu
- Beijing Physical Examination Center, Beijing, China
| | - Shitao Ma
- Hebei Key Laboratory of Environment and Human Health, Shijiazhuang, China
- Department of Occupational Health and Environmental Health, Hebei Medical University, Shijiazhuang, China
| | - Mianzhi Zhang
- Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
- Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin, China
| | - Fenghua Guo
- School of Medicine, Nankai University, Tianjin, China
| | - Minying Zhang
- School of Medicine, Nankai University, Tianjin, China.
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14
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Yuan Y, Zhou P, Peng M, Zhu L, Li Y, Wang K, Wang Y, Tang Z, Wang Y, Huang Y, Zhang J, Zhang Y. Residential greenness mitigates mortality risk from short-term airborne particulate exposure: An individual-level case-crossover study. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 264:115451. [PMID: 37703807 DOI: 10.1016/j.ecoenv.2023.115451] [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: 06/09/2023] [Revised: 08/26/2023] [Accepted: 09/04/2023] [Indexed: 09/15/2023]
Abstract
BACKGROUND Studies suggested that greenness could reduce death risks related to ambient exposure to particulate matter (PM), while the available evidence was mixed across the globe and substantially exiguous in low- and middle-income countries. By conceiving an individual-level case-crossover study in central China, this analysis primarily aimed to quantify PM-mortality associations and examined the modification effect of greenness on the relationship. METHODS We investigated a total of 177,058 nonaccidental death cases from 12 counties in central China, 2008-2012. Daily residential exposures to PM2.5 (aerodynamic diameter <2.5 µm), PMc (aerodynamic diameter between 2.5 and 10 µm), and PM10 (aerodynamic diameter <10 µm) were assessed at a 1 × 1-km resolution through satellite-derived machine-learning models. Residential surrounding greenness was assessed using satellite-derived enhanced vegetation index (EVI) and normalized difference vegetation index (NDVI) at multiple buffer sizes (250, 500, and 1000 m). To quantify the acute mortality risks associated with short-term exposure to PM2.5, PMc, and PM10, a time-stratified case-crossover design was utilized in conjunction with a conditional logistic regression model in our main analyses. To investigate the effect modification of greenness on PM-mortality associations, we grouped death cases into low, medium, and high greenness levels using cutoffs of 25th and 75th percentiles of NDVI or EVI exposure, and examined potential effect heterogeneity in PM-related mortality risks among these groups. RESULTS Mean concentrations (standard deviation) on the day of death were 73.8 (33.4) μg/m3 for PM2.5, 43.9 (17.3) μg/m3 for PMc, and 117.5 (44.9) μg/m3 for PM10. Size-fractional PM exposures were consistently exhibited significant associations with elevated risks of nonaccidental and circulatory mortality. For every increase of 10-μg/m3 in PM exposure, percent excess risks of nonaccidental and circulatory mortality were 0.271 (95% confidence interval [CI]: 0.010, 0.533) and 0.487 (95% CI: 0.125, 0.851) for PM2.5 at lag-01 day, 0.731 (95% CI: 0.108, 1.359) and 1.140 (95% CI: 0.267, 2.019) for PMc at lag-02 day, and 0.271 (95% CI: 0.010, 0.533) and 0.386 (95% CI: 0.111, 0.662) for PM10 at lag-01 day, respectively. Compared to participants in the low-level greenness areas, those being exposed to higher greenness were found to be at lower PM-associated risks of nonaccidental and circulatory mortality. Consistent evidence for alleviated risks in medium or high greenness group was observed in subpopulations of female and younger groups (age <75). CONCLUSIONS Short-term exposure to particulate air pollution was associated with elevated risks of nonaccidental and circulatory death, and individuals residing in higher neighborhood greenness possessed lower risk of PM-related mortality. These findings emphasized the potential public health advantages through incorporating green spaces into urban design and planning.
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Affiliation(s)
- Yang Yuan
- Institute of Social Development and Health Management, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Peixuan Zhou
- Institute of Social Development and Health Management, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Minjin Peng
- Department of Infection Control, Affiliated Taihe Hospital of Hubei University of Medicine, Shiyan 442000, China.
| | - Lifeng Zhu
- Institute of Social Development and Health Management, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Yachen Li
- Institute of Social Development and Health Management, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Kai Wang
- Institute of Social Development and Health Management, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Yaqi Wang
- Institute of Social Development and Health Management, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Ziqing Tang
- Institute of Social Development and Health Management, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Yixiang Wang
- Institute of Social Development and Health Management, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Yuqian Huang
- Institute of Social Development and Health Management, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Jingjing Zhang
- Institute of Social Development and Health Management, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Yunquan Zhang
- Institute of Social Development and Health Management, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China.
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15
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Liang S, Chen Y, Sun X, Dong X, He G, Pu Y, Fan J, Zhong X, Chen Z, Lin Z, Ma W, Liu T. Long-term exposure to ambient ozone and cardiovascular diseases: Evidence from two national cohort studies in China. J Adv Res 2023:S2090-1232(23)00226-6. [PMID: 37625570 DOI: 10.1016/j.jare.2023.08.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 08/15/2023] [Accepted: 08/16/2023] [Indexed: 08/27/2023] Open
Abstract
INTRODUCTION The health effects of ambient ozone have been investigated in many previous studies. However, the effects of long-term exposure to ambient ozone on the incidence of cardiovascular disease (CVD) remain inconclusive. OBJECTIVES To estimate the associations of long-term exposure to maximum daily 8-hours average ozone (MDA8 O3) with the incidence of total CVD, heart disease, hypertension, and stroke. METHODS This was a prospective cohort study, and the data was obtained from the China Health and Retirement Longitudinal Survey (CHARLS) implemented during 2011-2018 and the China Family Panel Studies (CFPS) implemented during 2010-2018. We applied a Cox proportional hazards regression model to evaluate the associations of MDA8 O3 with total CVD, heart disease, hypertension, and stroke risks, and the corresponding population-attributable fractions (PAF) attributable to MDA8 O3 were also calculated. All analyses were conducted by R software. RESULTS The mean MDA8 O3 concertation of all included participants in the CHARLS and CFPS were 51.03 part per billion (ppb) and 51.15 ppb, respectively. In the CHARLS including 18,177 participants, each 10 ppb increment in MDA8 O3 concentration was associated with a 31% increase [hazard ratio (HR) = 1.31, 95% confidence interval (CI): 1.22-1.42] in the risk of incident heart disease, and the corresponding population-attributable fractions (PAF) was 13.79% [10.12%-17.32%]. In the CFPS including 30,226 participants, each 10 ppb increment in MDA8 O3 concentration was associated with an increase in the risk of incident total CVD (1.07 [1.02-1.13]), and hypertension (1.10 [1.03-1.18]). The PAFs of total CVD, and hypertension attributable to MDA8 O3 were 3.53% [0.82%-6.16%], and 5.11% [1.73%-8.38%], respectively. Stratified analyses showed greater associations in males, urban areas, and Southern China. CONCLUSIONS Long-term exposure to MDA8 O3 may increase the incidence of CVD. Therefore, the policies that control O3 and related precursors are persistently needed.
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Affiliation(s)
- Shuru Liang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China; China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou 510632, China
| | - Yumeng Chen
- Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan 528000, China
| | - Xiaoli Sun
- Gynecology Department, Guangdong Women and Children Hospital, Guangzhou 511442, China
| | - Xiaomei Dong
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China; China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou 510632, China
| | - Guanhao He
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China; China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou 510632, China
| | - Yudong Pu
- Songshan Lake Central Hospital of Dongguan City, Dongguan 523808, China
| | - Jingjie Fan
- Department of Prevention and Health Care, Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen 518028, China
| | - Xinqi Zhong
- Department of Neonatology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, China
| | - Zhiqing Chen
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China; China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou 510632, China
| | - Ziqiang Lin
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China; China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou 510632, China
| | - Wenjun Ma
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China; China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou 510632, China
| | - Tao Liu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China; China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou 510632, China.
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Wei Y, Fei L, Wang Y, Zhang M, Chen Z, Guo H, Ge S, Zhu S, Dong P, Yang K, Xie N, Zhao G. A time-series analysis of short-term ambient ozone exposure and hospitalizations from acute myocardial infarction in Henan, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:93242-93254. [PMID: 37507564 PMCID: PMC10447277 DOI: 10.1007/s11356-023-28456-2] [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: 03/15/2023] [Accepted: 06/22/2023] [Indexed: 07/30/2023]
Abstract
Epidemiological studies in recent years have identified an association between exposure to air pollutants and acute myocardial infarction (AMI); however, the association between short-term ozone (O3) exposure and AMI hospitalization remains unclear, particularly in developing countries. Therefore, this study collected information on 24,489 AMI patients, including daily air pollutant and meteorological data in Henan, China, between 2016 and 2021. A distributed lagged nonlinear model combined with a Poisson regression model was used to estimate the nonlinear lagged effect of O3 on AMI hospitalizations. We also quantified the effects of O3 on the number of AMI hospitalizations, hospitalization days, and hospitalization costs. The results showed that single- and dual-pollution models of O3 at lag0, lag1, and lag (01-07) were risk factors for AMI hospitalizations, with the most significant effect at lag03 (RR = 1.132, 95% CI:1.083-1.182). Further studies showed that males, younger people (15-64 years), warm seasons, and long sunshine duration were more susceptible to O3. Hospitalizations attributable to O3 during the study period accounted for 11.66% of the total hospitalizations, corresponding to 2856 patients, 33,492 hospital days, and 90 million RMB. Maintaining O3 at 10-130 µg/m3 can prevent hundreds of AMI hospitalizations and save millions of RMB per year in Henan, China. In conclusion, we found that short-term exposure to O3 was significantly associated with an increased risk of hospitalization for AMI in Henan, China, and that further reductions in ambient O3 levels may have substantial health and economic benefits for patients and local healthcare facilities.
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Affiliation(s)
- Yulong Wei
- Department of Cardiology, The First Affiliated Hospital of Xinxiang Medical University, Weihui, 453100, China
| | - Lin Fei
- Department of Cardiology, The First Affiliated Hospital of Xinxiang Medical University, Weihui, 453100, China
- Life Science Research Center, The First Affiliated Hospital of Xinxiang Medical University, Weihui, 453100, China
| | - Yongbin Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Xinxiang Medical University, Xinxiang, 453003, China
| | - Min Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Xinxiang Medical University, Xinxiang, 453003, China
- School of Cardiovascular and Metabolic Medicine & Sciences, King's College London British Heart Foundation Centre of Research Excellence, London, SE5 9NU, UK
| | - Zhigang Chen
- Department of Cardiology, The First Affiliated Hospital of Xinxiang Medical University, Weihui, 453100, China
| | - Huige Guo
- Life Science Research Center, The First Affiliated Hospital of Xinxiang Medical University, Weihui, 453100, China
| | - Shiqi Ge
- Department of Cardiology, The First Affiliated Hospital of Xinxiang Medical University, Weihui, 453100, China
| | - Sen Zhu
- Department of Cardiology, The First Affiliated Hospital of Xinxiang Medical University, Weihui, 453100, China
| | - Pingshuan Dong
- Department of Cardiology, The First Affiliated Hospital of Henan University of Science and Technology, Luoyang, 471003, China
| | - Kan Yang
- Department of Cardiovascular Surgery, Nanyang Affiliated Hospital of Zhengzhou University, Nanyang Central Hospital, Nanyang, 473009, China
| | - Na Xie
- The Cardiology Department of the Third Affiliated Hospital of Xinxiang Medical University, Xinxiang, 453003, China
| | - Guoan Zhao
- Department of Cardiology, The First Affiliated Hospital of Xinxiang Medical University, Weihui, 453100, China.
- Life Science Research Center, The First Affiliated Hospital of Xinxiang Medical University, Weihui, 453100, China.
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Yao M, Niu Y, Liu S, Liu Y, Kan H, Wang S, Ji JS, Zhao B. Mortality Burden of Cardiovascular Disease Attributable to Ozone in China: 2019 vs 2050. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2023; 57:10985-10997. [PMID: 37466930 DOI: 10.1021/acs.est.3c02076] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
Due to a combination of lifestyle risk factors, the burden of cardiovascular disease (CVD) has been increasing in China, affecting an estimated 330 million people. Environmental risk factors can exacerbate these risks or independently contribute to CVD. Ozone is an overlooked and invisible risk factor, and it plays a significant role in the development of CVD. Our study provides a novel quantification of the ozone-attributable CVD mortality burden based on daily maximum 8-h average ozone concentration during May to October (6mDMA8) in Chinese adults in 2050, projected under Shared Socioeconomic Pathways 585 and 126, and using the updated WHO air quality guideline level. The study also considers the contributions made by changes in ozone exposure, population aging, population size, and baseline death rates of CVD between 2019 and 2050. While adopting a sustainable and green pathway (SSP 126) can reduce the projected magnitude of premature CVD deaths to 359,200 in 2050, it may not be sufficient to reduce the CVD mortality burden significantly. Therefore, it is crucial to implement strategies for stricter ozone control and reducing the baseline death rate of CVD to mitigate the impacts of ozone on Chinese adults.
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Affiliation(s)
- Mingyao Yao
- Department of Building Science, School of Architecture, Tsinghua University, Beijing 100084, China
| | - Yue Niu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and National Health Commission Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China
| | - Shuchang Liu
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, School of Environment, Tsinghua University, Beijing 100084, China
- Institute for Atmospheric and Climate Science, ETH Zurich, Zurich 8092, Switzerland
| | - Yumeng Liu
- Department of Building Science, School of Architecture, Tsinghua University, Beijing 100084, China
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and National Health Commission Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China
- Children's Hospital of Fudan University, National Center for Children's Health, Shanghai 200032, China
| | - Shuxiao Wang
- State Key Joint Laboratory of Environmental Simulation and Pollution Control, School of Environment, Tsinghua University, Beijing 100084, China
- State Environmental Protection Key Laboratory of Sources and Control of Air Pollution Complex, Beijing 100084, China
| | - John S Ji
- Vanke School of Public Health, Tsinghua University, Beijing 100084, China
| | - Bin Zhao
- Department of Building Science, School of Architecture, Tsinghua University, Beijing 100084, China
- Beijing Key Laboratory of Indoor Air Quality Evaluation and Control, Tsinghua University, Beijing 100084, China
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18
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Li M, Xue Y, Miao X, Ma P, Kong X, Jin Y, Li Y, Wang W, Zhang Q, Deng Q, Feng F. NLRP12 attenuates ozone-induced pulmonary inflammation by regulating canonical NF-κB Pathway. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 262:115275. [PMID: 37531929 DOI: 10.1016/j.ecoenv.2023.115275] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 07/04/2023] [Accepted: 07/17/2023] [Indexed: 08/04/2023]
Abstract
Ozone (O3) is an important urban air pollutant having strong correlations with respiratory diseases. Several lines of evidence suggest that O3 exposure causes airway hyperresponsiveness (AHR) and pulmonary inflammation. Inhibitory innate immune receptors, such as NLRP12, have been demonstrated to alleviate inflammation, but the functional role for NLRP12 in O3-induced lung inflammatory inflammation remains to be reported. Here, we determined whether NLRP12 took a protective role in O3-induced AHR and pulmonary inflammation via the suppression of canonical NF-κB. C57BL/6 J mice were exposed to filtered air (FA) or 0.25, 0.50 and 1.00 ppm (3 h/day for 5 consecutive days) followed by detection of airway resistance, white blood cells, total proteins, and cytokines. Meanwhile, NLRP12 in lung tissue were detected by real time PCR. Moreover, we also examined protein expression of NLRP12 and key biomarkers of NF-κB pathway. It was shown that 24 h post O3 exposure, AHR as wells as total cells, proteins, and cytokines contents in BALF of mice were increased compare to those of FA controls in a dose-dependent manner. Notably, O3-induced AHR and lung inflammation were associated with significant decrease in pulmonary NLRP12 and upregulation of phosphorylated IRAK1, p65 and IκBα in canonical NF-κB pathway. Intratracheal administration of NLRP12-overexpresing adenovirus 4 days prior to O3 exposure alleviated AHR and lung inflammation, and inhibited canonical NF-κB pathway activation. The findings from this study indicate that NLRP12 attenuates O3-induced AHR and pulmonary inflammation, possibly through regulating canonical NF-κB pathway. This provides a novel target for the prevention and treatment of lung diseases induced by O3 exposure.
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Affiliation(s)
- Mengyuan Li
- Department of Toxicology, College of Public Health, Zhengzhou University, Zhengzhou, Henan Province, China
| | - Yuan Xue
- Department of Toxicology, College of Public Health, Zhengzhou University, Zhengzhou, Henan Province, China
| | - Xinyi Miao
- Department of Toxicology, College of Public Health, Zhengzhou University, Zhengzhou, Henan Province, China
| | - Pengwei Ma
- Department of Toxicology, College of Public Health, Zhengzhou University, Zhengzhou, Henan Province, China
| | - Xiangbing Kong
- Department of Toxicology, College of Public Health, Zhengzhou University, Zhengzhou, Henan Province, China
| | - Yuefei Jin
- Department of epidemiology, College of Public Health, Zhengzhou University, Zhengzhou, Henan Province, China
| | - Yan Li
- Synergetic Innovation Center of Kinesis and Health, School of Physical Education (Main Campus), Zhengzhou University, Zhengzhou, Henan, China
| | - Wei Wang
- Department of Occupational and Environmental Health, College of Public Health, Zhengzhou University, Zhengzhou, Henan Province, China
| | - Qiao Zhang
- Department of Toxicology, College of Public Health, Zhengzhou University, Zhengzhou, Henan Province, China
| | - Qihong Deng
- Department of Occupational and Environmental Health, College of Public Health, Zhengzhou University, Zhengzhou, Henan Province, China.
| | - Feifei Feng
- Department of Toxicology, College of Public Health, Zhengzhou University, Zhengzhou, Henan Province, China.
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Yuan Y, Wang K, Sun HZ, Zhan Y, Yang Z, Hu K, Zhang Y. Excess mortality associated with high ozone exposure: A national cohort study in China. ENVIRONMENTAL SCIENCE AND ECOTECHNOLOGY 2023; 15:100241. [PMID: 36761466 PMCID: PMC9905662 DOI: 10.1016/j.ese.2023.100241] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 01/18/2023] [Accepted: 01/18/2023] [Indexed: 05/24/2023]
Abstract
Emerging epidemiological studies suggest that long-term ozone (O3) exposure may increase the risk of mortality, while pre-existing evidence is mixed and has been generated predominantly in North America and Europe. In this study, we investigated the impact of long-term O3 exposure on all-cause mortality in a national cohort in China. A dynamic cohort of 20882 participants aged ≥40 years was recruited between 2011 and 2018 from four waves of the China Health and Retirement Longitudinal Study. A Cox proportional hazard regression model with time-varying exposures on an annual scale was used to estimate the mortality risk associated with warm-season (April-September) O3 exposure. The annual average level of participant exposure to warm-season O3 concentrations was 100 μg m-3 (range: 61-142 μg m-3). An increase of 10 μg m-3 in O3 was associated with a hazard ratio (HR) of 1.18 (95% confidence interval [CI]: 1.13-1.23) for all-cause mortality. Compared with the first exposure quartile of O3, HRs of mortality associated with the second, third, and highest exposure quartiles were 1.09 (95% CI: 0.95-1.25), 1.02 (95% CI: 0.88-1.19), and 1.56 (95% CI: 1.34-1.82), respectively. A J-shaped concentration-response association was observed, revealing a non-significant increase in risk below a concentration of approximately 110 μg m-3. Low-temperature-exposure residents had a higher risk of mortality associated with long-term O3 exposure. This study expands current epidemiological evidence from China and reveals that high-concentration O3 exposure curtails the long-term survival of middle-aged and older adults.
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Affiliation(s)
- Yang Yuan
- Institute of Social Development and Health Management, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan, 430065, China
| | - Kai Wang
- Institute of Social Development and Health Management, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan, 430065, China
| | - Haitong Zhe Sun
- Centre for Atmospheric Science, Yusuf Hamied Department of Chemistry, University of Cambridge, Cambridge, CB2 1EW, UK
- Department of Earth Sciences, University of Cambridge, Cambridge, CB2 3EQ, UK
| | - Yu Zhan
- Department of Environmental Science and Engineering, Sichuan University, Chengdu, Sichuan, 610065, China
| | - Zhiming Yang
- School of Economics and Management, University of Science and Technology Beijing, Beijing, 100083, China
| | - Kejia Hu
- Department of Big Data in Health Science, School of Public Health, Zhejiang University, Hangzhou, 310058, China
| | - Yunquan Zhang
- Institute of Social Development and Health Management, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan, 430065, China
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Huang W, Zhou Y, Chen X, Zeng X, Knibbs LD, Zhang Y, Jalaludin B, Dharmage SC, Morawska L, Guo Y, Yang X, Zhang L, Shan A, Chen J, Wang T, Heinrich J, Gao M, Lin L, Xiao X, Zhou P, Yu Y, Tang N, Dong G. Individual and joint associations of long-term exposure to air pollutants and cardiopulmonary mortality: a 22-year cohort study in Northern China. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2023; 36:100776. [PMID: 37547049 PMCID: PMC10398602 DOI: 10.1016/j.lanwpc.2023.100776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 04/11/2023] [Accepted: 04/14/2023] [Indexed: 08/08/2023]
Abstract
Background Evidence on the associations between long-term exposure to multiple air pollutants and cardiopulmonary mortality is limited, especially for developing regions with higher pollutant levels. We aimed to characterise the individual and joint (multi-pollutant) associations of long-term exposure to air pollutants with cardiopulmonary mortality, and to identify air pollutant that primarily contributes to the mortality risk. Methods We followed 37,442 participants with a mean age of 43.5 years in four cities in northern China (Tianjin, Shenyang, Taiyuan, and Rizhao) from January 1998 to December 2019. Annual particulate matter (PM) with diameters ≤2.5 μm (PM2.5), ≤10 μm (PM10), sulfur dioxide (SO2) and nitrogen dioxide (NO2) were estimated using daily average values from satellite-derived machine learning models and monitoring stations. Time-varying Cox proportional hazards model was used to evaluate the individual association between air pollutants and mortality from non-accidental causes, cardiovascular diseases (CVDs), non-malignant respiratory diseases (RDs) and lung cancer, accounting for demographic and socioeconomic factors. Effect modifications by age, sex, income and education level were also examined. Quantile-based g-Computation integrated with time-to-event data was additionally applied to evaluate the co-effects and the relative weight of contributions for air pollutants. Findings During 785,807 person-years of follow-up, 5812 (15.5%) died from non-accidental causes, among which 2932 (7.8%) were from all CVDs, 479 (1.3%) from non-malignant RDs, and 552 (1.4%) from lung cancer. Long-term exposure to PM10 (mean [baseline]: 136.5 μg/m3), PM2.5 (mean [baseline]: 70.2 μg/m3), SO2 (mean [baseline]: 113.0 μg/m3) and NO2 (mean [baseline]: 39.2 μg/m3) were adversely and consistently associated with all mortality outcomes. A 10 μg/m3 increase in PM2.5 was associated with higher mortality from non-accidental causes (hazard ratio 1.20; 95% confidence interval 1.17-1.23), CVDs (1.23; 1.19-1.28), non-malignant RDs (1.37; 1.25-1.49) and lung cancer (1.14; 1.05-1.23). A monotonically increasing curve with linear or supra-linear shape with no evidence of a threshold was observed for the exposure-response relationship of mortality with individual or joint exposure to air pollutants. PM2.5 consistently contributed most to the elevated mortality risks related to air pollutant mixture, followed by SO2 or PM10. Interpretation There was a strong and positive association of long-term individual and joint exposure to PM10, PM2.5, SO2, and NO2 with mortalities from non-accidental causes, CVDs, non-malignant RDs and lung cancer in high-exposure settings, with PM2.5 potentially being the main contributor. The shapes of associations were consistent with a linear or supra-linear exposure-response relationship, with no lower threshold observed within the range of concentrations in this study. Funding National Key Research and Development Program of China, the China Scholarship Council, the National Natural Science Foundation of China, Natural Science Foundation of Guangdong Province.
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Affiliation(s)
- Wenzhong Huang
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Yang Zhou
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou 510655, China
| | - Xi Chen
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin Medical University, Tianjin 300070, China
- Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin 300070, China
| | - Xiaowen Zeng
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Luke D. Knibbs
- Faculty of Medicine and Health, School of Public Health, The University of Sydney, NSW 2006, Australia
- Public Health Research Analytics and Methods for Evidence, Public Health Unit, Sydney Local Health District, Camperdown, NSW 2050, Australia
| | - Yunting Zhang
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Bin Jalaludin
- Centre for Air Quality and Health Research and Evaluation, Glebe, NSW 2037, Australia
- Ingham Institute for Applied Medial Research, Liverpool, NSW 2170, Australia
- School of Public Health and Community Medicine, The University of New South Wales, Kensington, NSW 2052, Australia
| | - Shyamali C. Dharmage
- Allergy and Lung Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC 3052, Australia
| | - Lidia Morawska
- International Laboratory for Air Quality and Health, Queensland University of Technology, Brisbane, QLD 4001, Australia
| | - Yuming Guo
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Xueli Yang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin Medical University, Tianjin 300070, China
- Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin 300070, China
| | - Liwen Zhang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin Medical University, Tianjin 300070, China
- Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin 300070, China
| | - Anqi Shan
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin Medical University, Tianjin 300070, China
- Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin 300070, China
| | - Jie Chen
- Department of Occupational and Environmental Health, School of Public Health, China Medical University, Shenyang 110122, China
| | - Tong Wang
- School of Public Health, Shanxi Medical University, Taiyuan 030001, China
| | - Joachim Heinrich
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich 80336, Germany
| | - Meng Gao
- Department of Geography, Hong Kong Baptist University, Hong Kong SAR, China
| | - Lizi Lin
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Xiang Xiao
- Department of Geography, Hong Kong Baptist University, Hong Kong SAR, China
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Peien Zhou
- Department of Public Health & Primary Care, University of Cambridge, Cambridge CB2 1TN, United Kingdom
| | - Yunjiang Yu
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou 510655, China
| | - Naijun Tang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Guanghui Dong
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
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Godoy ARL, da Silva AEA. Short-term relation between air pollutants and hospitalizations for respiratory diseases: analysis by temporal association rules. ENVIRONMENTAL MONITORING AND ASSESSMENT 2023; 195:854. [PMID: 37328713 DOI: 10.1007/s10661-023-11471-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 06/06/2023] [Indexed: 06/18/2023]
Abstract
This study investigates the relation between exposure to critical air pollution events with multipollutant (CO, PM10, PM2.5, NO2, O3, and SO2) and hospitalizations for respiratory diseases in the metropolitan area of São Paulo (RMSP) and in the countryside and coastline, from 2017 to 2021. Data mining analysis by temporal association rules searched for frequent patterns of respiratory diseases and multipollutants associated with time intervals. In the results, pollutants PM10, PM2.5, and O3 showed high concentration values in the three regions, SO2 on the coast, and NO2 in the RMSP. Seasonality was similar between pollutants and between cities and concentrations significantly higher in winter, except for O3, which was present in warm seasons. Hospitalizations were recurrent during the transition from summer to colder periods. In approximately 35% of the total days with hospitalization greater than the annual average, one or more pollutants had a high concentration. The rules showed that PM2.5, PM10, and O3 pollutants are strongly associated with increased hospitalizations in the RMSP (PM2.5 and PM10 with 38.5% support and 77% confidence) and in Campinas (PM2.5 with 66.1% support and 94% confidence) and the pollutant O3 with maximum support of 17.5%. On the coast, SO2 was related to high hospitalizations (43.85% support and 80% confidence). The pollutants CO and NO2 were not associated with the increase in hospitalizations. The ratio delay indicates the pollutants that were associated with hospitalizations, having concentration remained above the limit for three days, oscillating in smaller hospitalizations on the 1st day and again higher on the 2nd and 3rd days of delay, in a decreasing way. In conclusion, high pollutant exposure is significantly associated with daily hospitalization for respiratory problems. The cumulative effect of air pollutants increased hospitalization in the following days, in addition to identifying the pollutants and which pollutant combinations are most harmful to health in each region.
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Assessment of Low-Level Air Pollution and Cardiovascular Incidence in Gdansk, Poland: Time-Series Cross-Sectional Analysis. J Clin Med 2023; 12:jcm12062206. [PMID: 36983207 PMCID: PMC10054494 DOI: 10.3390/jcm12062206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 03/03/2023] [Accepted: 03/04/2023] [Indexed: 03/18/2023] Open
Abstract
(1) Background: More than 1.8 million people in the European Union die every year as a result of CVD, accounting for 36% of all deaths with a large proportion being premature (before the age of 65). There are more than 300 different risk factors of CVD, known and air pollution is one of them. The aim of this study was to investigate whether daily cardiovascular mortality was associated with air pollutants and meteorological conditions in an urban environment with a low level of air pollution. (2) Methods: Data on daily incidence of strokes and myocardial infarctions in the city of Gdansk were obtained from the National Health Fund (NHF) and covered the period from 1 January 2014 to 31 December 2018. Data on the level of pollution, i.e., SO2, NO, NO2, NOx, CO, PM10, PM2.5, CO2, O3 and meteorological conditions came from the foundation: Agency of Regional Air Quality Monitoring in the Gdańsk metropolitan area (ARMAG). Using these data, we calculated mean values with standard deviation (SD) and derived the minimum and maximum values and interquartile range (IQR). Time series regression with Poisson distribution was used in statistical analysis. (4) Results: Stroke incidence is significantly affected by an increase in concentrations of NO, NO2 and NOx with RRs equal to 1.019 (95%CI: 1.001–1.036), 1.036 (95%CI: 1.008–1.064) and 1.017 (95%CI: 1.000–1.034) for every increase in IQR by 14.12, 14.62 and 22.62 μg/m3, respectively. Similarly, myocardial infarction incidence is significantly affected by an increase in concentrations of NO, NO2 and NOx with RRs equal to 1.030 (95%CI: 1.011–1.048), 1.053 (95%CI: 1.024–1.082) and 1.027 (95%CI: 1.010–1.045) for every increase in IQR by 14.12, 14.62 and 22.62 μg/m3, respectively. Both PM10 and PM2.5 were positively associated with myocardial infarction incidence. (5) Conclusions: In this time-series cross-sectional study, we found strong evidence that support the hypothesis that transient elevations in ambient PM2.5, PM10, NO2, SO2 and CO are associated with higher relative risk of ischemic stroke and myocardial infarction incidents.
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Keller K, Haghi SHR, Hahad O, Schmidtmann I, Chowdhury S, Lelieveld J, Münzel T, Hobohm L. Air pollution impacts on in-hospital case-fatality rate of ischemic stroke patients. Thromb Res 2023; 225:116-125. [PMID: 36990953 DOI: 10.1016/j.thromres.2023.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 03/15/2023] [Accepted: 03/17/2023] [Indexed: 03/29/2023]
Abstract
BACKGROUND A growing body of evidence suggests that air pollution exposure is associated with an increased risk for cardiovascular diseases. Data regarding the impact of long-term air pollution exposure on ischemic stroke mortality are sparse. METHODS The German nationwide inpatient sample was used to analyse all cases of hospitalized patients with ischemic stroke in Germany 2015-2019, which were stratified according to their residency. Data of the German Federal Environmental Agency regarding average values of air pollutants were assessed from 2015 to 2019 at district-level. Data were combined and the impact of different air pollution parameters on in-hospital case-fatality was analyzed. RESULTS Overall, 1,505,496 hospitalizations of patients with ischemic stroke (47.7% females; 67.4 % ≥70 years old) were counted in Germany 2015-2019, of whom 8.2 % died during hospitalization. When comparing patients with residency in federal districts with high vs. low long-term air pollution, enhanced levels of benzene (OR 1.082 [95%CI 1.034-1.132],P = 0.001), ozone (O3, OR 1.123 [95%CI 1.070-1.178],P < 0.001), nitric oxide (NO, OR 1.076 [95%CI 1.027-1.127],P = 0.002) and PM2.5 fine particulate matter concentrations (OR 1.126 [95%CI 1.074-1.180],P < 0.001) were significantly associated with increased case-fatality independent from age, sex, cardiovascular risk-factors, comorbidities, and revascularization treatments. Conversely, enhanced carbon monoxide, nitrogen dioxide, PM10, and sulphur dioxide (SO2) concentrations were not significantly associated with stroke mortality. However, SO2-concentrations were significantly associated with stroke-case-fatality rate of >8 % independent of residence area-type and area use (OR 1.518 [95%CI 1.012-2.278],P = 0.044). CONCLUSION Elevated long-term air pollution levels in residential areas in Germany, notably of benzene, O3, NO, SO2, and PM2.5, were associated with increased stroke mortality of patients. RESEARCH IN CONTEXT Evidence before this study: Besides typical, established risk factors, increasing evidence suggests that air pollution is an important and growing risk factor for stroke events, estimated to be responsible for approximately 14 % of all stroke-associated deaths. However, real-world data regarding the impact of long-term exposure to air pollution on stroke mortality are sparse. Added value of this study: The present study demonstrates that the long-term exposure to the air pollutants benzene, O3, NO, SO2 and PM2.5 are independently associated with increased case-fatality of hospitalized patients with ischemic stroke in Germany. Implications of all the available evidence: The results of our study support the urgent need to reduce the exposure to air pollution by tightening emission controls to reduce the stroke burden and stroke mortality.
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Wang J, Li J, Li X, Fang C. Characteristics of Air Pollutants Emission and Its Impacts on Public Health of Chengdu, Western China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192416852. [PMID: 36554731 PMCID: PMC9779229 DOI: 10.3390/ijerph192416852] [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: 10/13/2022] [Revised: 12/01/2022] [Accepted: 12/13/2022] [Indexed: 05/06/2023]
Abstract
Pollution caused by PM2.5 and O3 are common environmental problems which can easily affect human health. Chengdu is a major central city in Western China, and there is little research on the regional emissions and health effects of air pollution in Chengdu. According to the Multi-resolution Emissions Inventory of the Chinese Model, 2017 (MEIC v1.3), this study compiled the air pollutant emission inventory of Chengdu. The results show that the pollutant emission of Chengdu is generally higher in winter than in summer. The southeast area of Chengdu is the key area where emissions of residential and industrial sectors are dominant. Through air quality simulation with a Weather Research and Forecasting model, coupled with the Community Multiscale Air Quality (WRF-CMAQ), the health effects of PM2.5 and O3 in winter and summer in Chengdu of 2017 were investigated. The primary pollutant in winter is PM2.5 and O3 in summer. PM2.5 pollution accounted for 351 deaths in January and July 2017, and O3 pollution accounted for 328 deaths in the same period. There were 276 deaths in rural areas and 413 in urban areas. In January and July 2017, the health economic loss caused by PM2.5 accounted for 0.0974% of the gross regional product (GDP) of Chengdu in 2017, and the health economic loss caused by O3 accounted for 0.0910%.
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Affiliation(s)
- Ju Wang
- College of New Energy and Environment, Jilin University, Changchun 130012, China
- Key Laboratory of Groundwater Resources and Environment, Ministry of Education, Jilin University, Changchun 130012, China
- Jilin Province Key Laboratory of Water Resources and Environment, Jilin University, Changchun 130012, China
- Correspondence: ; Tel.: +86-131-0431-7228
| | - Juan Li
- College of New Energy and Environment, Jilin University, Changchun 130012, China
| | - Xinlong Li
- College of New Energy and Environment, Jilin University, Changchun 130012, China
| | - Chunsheng Fang
- College of New Energy and Environment, Jilin University, Changchun 130012, China
- Key Laboratory of Groundwater Resources and Environment, Ministry of Education, Jilin University, Changchun 130012, China
- Jilin Province Key Laboratory of Water Resources and Environment, Jilin University, Changchun 130012, China
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Niu Y, Chen R, Kan H, Zhou M. Regional effects unlikely to explain association between ozone and cardiovascular mortality in China - Authors' reply. Lancet Planet Health 2022; 6:e780-e781. [PMID: 36208640 DOI: 10.1016/s2542-5196(22)00224-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 09/06/2022] [Indexed: 06/16/2023]
Affiliation(s)
- Yue Niu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and National Health Commission Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and National Health Commission Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and National Health Commission Key Lab of Health Technology Assessment, Fudan University, Shanghai, China; Children's Hospital of Fudan University, National Center for Children's Health, Shanghai, China
| | - Maigeng Zhou
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
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