Triggering of cardiovascular hospital admissions by fine particle concentrations in New York state: Before, during, and after implementation of multiple environmental policies and a recession

A case-crossover study of ST-elevation myocardial infarction and organic carbon and source-specific PM2.5 concentrations in Monroe County, New York

Background

Previous work reported increased rates of cardiovascular hospitalizations associated with increased source-specific PM2.5 concentrations in New York State, despite decreased PM2.5 concentrations. We also found increased rates of ST elevation myocardial infarction (STEMI) associated with short-term increases in concentrations of ultrafine particles and other traffic-related pollutants in the 2014-2016 period, but not during 2017-2019 in Rochester. Changes in PM2.5 composition and sources resulting from air quality policies (e.g., Tier 3 light-duty vehicles) may explain the differences. Thus, this study aimed to estimate whether rates of STEMI were associated with organic carbon and source-specific PM2.5 concentrations.

Methods

Using STEMI patients treated at the University of Rochester Medical Center, compositional and source-apportioned PM2.5 concentrations measured in Rochester, a time-stratified case-crossover design, and conditional logistic regression models, we estimated the rate of STEMI associated with increases in mean primary organic carbon (POC), secondary organic carbon (SOC), and source-specific PM2.5 concentrations on lag days 0, 0-3, and 0-6 during 2014-2019.

Results

The associations of an increased rate of STEMI with interquartile range (IQR) increases in spark-ignition emissions (GAS) and diesel (DIE) concentrations in the previous few days were not found from 2014 to 2019. However, IQR increases in GAS concentrations were associated with an increased rate of STEMI on the same day in the 2014-2016 period (Rate ratio [RR] = 1.69; 95% CI = 0.98, 2.94; 1.73 μg/m3). In addition, each IQR increase in mean SOC concentration in the previous 6 days was associated with an increased rate of STEMI, despite imprecision (RR = 1.14; 95% CI = 0.89, 1.45; 0.42 μg/m3).

Conclusion

Increased SOC concentrations may be associated with increased rates of STEMI, while there seems to be a declining trend in adverse effects of GAS on triggering of STEMI. These changes could be attributed to changes in PM2.5 composition and sources following the Tier 3 vehicle introduction.

PM2.5 and its components and respiratory disease healthcare encounters - Unanticipated increased exposure-response relationships in recent years after environmental policies

Prior studies reported excess rates (ERs) of cardiorespiratory events associated with short-term increases in PM2.5 concentrations, despite implementation of pollution-control policies. In 2017, Federal Tier 3 light-duty vehicle regulations began, and to-date there have been no assessments of population health effects of the policy. Using the NYS Statewide Planning and Research Cooperative System (SPARCS) database, we obtained hospitalizations and ED visits with a principal diagnosis of asthma or chronic obstructive pulmonary disease (COPD) for residents living within 15 miles of six urban PM2.5 monitoring sites in NYS (2014-2019). We used a time-stratified case-crossover design and conditional logistic regression (adjusting for ambient temperature, relative humidity, and weekday) to estimate associations between PM2.5, POC (primary organic carbon), SOC (secondary organic carbon), and rates of respiratory disease hospitalizations and emergency department (ED) visits from 2014 to 2019. We evaluated demographic disparities in these relative rates and compared changes in ERs before (2014-2016) and after Tier 3 implementation (2017-2019). Each interquartile range increase in PM2.5 was associated with increased ERs of asthma or COPD hospitalizations and ED visits in the previous 7 days (ERs ranged from 1.1%-3.1%). Interquartile range increases in POC were associated with increased rates of asthma ED visits (lag days 0-6: ER = 2.1%, 95% CI = 0.7%, 3.6%). Unexpectedly, the ERs of asthma admission and ED visits associated with PM2.5, POC, and SOC were higher during 2017-2019 (after Tier 3) than 2014-2016 (before Tier-3). Chronic obstructive pulmonary disease analyses showed similar patterns. Excess Rates were higher in children (<18 years; asthma) and seniors (≥65 years; COPD), and Black, Hispanic, and NYC residents. In summary, unanticipated increases in asthma and COPD ERs after Tier-3 implementation were observed, and demographic disparities in asthma/COPD and PM2.5, POC, and SOC associations were also observed. Future work should confirm findings and investigate triggering of respiratory events by source-specific PM.

Major source categories of PM2.5 oxidative potential in wintertime Beijing and surroundings based on online dithiothreitol-based field measurements

Fine particulate matter (PM2.5) causes millions of premature deaths each year worldwide. Oxidative potential (OP) has been proposed as a better metric for aerosol health effects than PM2.5 mass concentration alone. In this study, we report for the first time online measurements of PM2.5 OP in wintertime Beijing and surroundings based on a dithiothreitol (DTT) assay. These measurements were combined with co-located PM chemical composition measurements to identify the main source categories of aerosol OP. In addition, we highlight the influence of two distinct pollution events on aerosol OP (spring festival celebrations including fireworks and a severe regional dust storm). Source apportionment coupled with multilinear regression revealed that primary PM and oxygenated organic aerosol (OOA) were both important sources of OP, accounting for 41 ± 12 % and 39 ± 10 % of the OPvDTT (OP normalized by the sampled air volume), respectively. The small remainder was attributed to fireworks and dust, mainly resulting from the two distinct pollution events. During the 3.5-day spring festival period, OPvDTT spiked to 4.9 nmol min-1 m-3 with slightly more contribution from OOA (42 ± 11 %) and less from primary PM (31 ± 15 %). During the dust storm, hourly-averaged PM2.5 peaked at a very high value of 548 μg m-3 due to the dominant presence of dust-laden particles (88 % of total PM2.5). In contrast, only mildly elevated OPvDTT values (up to 1.5 nmol min-1 m-3) were observed during this dust event. This observation indicates that variations in OPvDTT cannot be fully explained using PM2.5 alone; one must also consider the chemical composition of PM2.5 when studying aerosol health effects. Our study highlights the need for continued pollution control strategies to reduce primary PM emissions, and more in-depth investigations into the source origins of OOA, to minimize the health risks associated with PM exposure in Beijing.

Long-term PM1 exposure and hypertension hospitalization: A causal inference study on a large community-based cohort in South China

Limited evidence exists on the effect of submicronic particulate matter (PM1) on hypertension hospitalization. Evidence based on causal inference and large cohorts is even more scarce. In 2015, 36,271 participants were enrolled in South China and followed up through 2020. Each participant was assigned single-year, lag0-1, and lag0-2 moving average concentration of PM1 and fine inhalable particulate matter (PM2.5) simulated based on satellite data at a 1-km resolution. We used an inverse probability weighting approach to balance confounders and utilized a marginal structural Cox model to evaluate the underlying causal links between PM1 exposure and hypertension hospitalization, with PM2.5-hypertension association for comparison. Several sensitivity studies and the analyses of effect modification were also conducted. We found that a higher hospitalization risk from both overall (HR: 1.13, 95% CI: 1.05-1.22) and essential hypertension (HR: 1.15, 95% CI: 1.06-1.25) was linked to each 1 µg/m3 increase in the yearly average PM1 concentration. At lag0-1 and lag0-2, we observed a 17%-21% higher risk of hypertension associated with PM1. The effect of PM1 was 6%-11% higher compared with PM2.5. Linear concentration-exposure associations between PM1 exposure and hypertension were identified, without safety thresholds. Women and participants that engaged in physical exercise exhibited higher susceptibility, with 4%-22% greater risk than their counterparts. This large cohort study identified a detrimental relationship between chronic PM1 exposure and hypertension hospitalization, which was more pronounced compared with PM2.5 and among certain groups.

The impact of long-term PM1 exposure on all-cause mortality and its interaction with BMI: A nationwide prospective cohort study in China

BACKGROUND

China has a serious air pollution problem and a high prevalence of obesity. The interaction between the two and its impact on all-cause mortality is a public health issue of great concern.

OBJECTIVES

This study aimed to investigate the association between long-term exposure to particulate matter with aerodynamic diameter ≤ 1 μm (PM1) and all-cause mortality, as well as the interaction effect of body mass index (BMI) in the association.

METHODS

A total of 33,087 participants from 162 counties in 25 provinces in China were included, with annual average PM1 exposure being estimated based on the county address. The PM1-mortality relation was evaluated using the time-varying Cox proportional hazards models, with the dose-response relationship being fitted using the penalized splines. Besides, the potential interaction effect of BMI in the PM1-mortality relation was evaluated.

RESULTS

The incidence of all-cause deaths was 76.99 per 10,000 person-years over a median of 8.2 years of follow-up. After controlling for potential confounders, the PM1-mortality relation was approximately J-shaped. The full-adjustment analysis observed the hazard ratio (HR) of all-cause mortality was 1.114 [95 % confidence interval (CI): 1.017-1.220] corresponding to a 10 μg/m3 rise in PM1 concentration. Further stratified analyses suggested the adverse effects of PM1 might be more pronounced among the underweight.

DISCUSSION

Higher PM1 concentrations were associated with an increase in all-cause mortality. The BMI might further alter the relation, and the underweight population was the sensitive subgroup of the population that needed to be protected.

Toxicity Risk Assessment Due to Particulate Matter Pollution from Regional Health Data: Case Study from Central Romania

Air pollution poses one of the greatest dangers to public well-being. This article outlines a study conducted in the Central Romania Region regarding the health risks associated with particulate matter (PM) of two sizes, viz., PM10 and PM2.5. The methodology used consists of the following: (i) an analysis of the effects of PM pollutants, (ii) an analysis of total mortality and cardiovascular-related mortality, and (iii) a general health risk assessment. The Central Region of Romania is situated in the Carpathian Mountains' inner arch (consisting of six counties). The total population of the region under investigation is about 2.6 million inhabitants. Health risk assessment is calculated based on the relative risk (RR) formula. During the study period, our simulations show that reducing these pollutants' concentrations below the new WHO guidelines (2021) will prevent over 172 total fatalities in Brasov alone, as an example. Furthermore, the potential benefit of reducing annual PM2.5 levels on total cardiovascular mortality is around 188 persons in Brasov. Although health benefits may also depend upon other physiological parameters, all general health indicators point towards a significant improvement in overall health by a general reduction in particulate matter, as is shown by the toxicity assessment of the particulate matter in the region of interest. The modality can be applied to other locations for similar studies.

Characterizing the sources of ambient PM10 organic aerosol in urban and rural Catalonia, Spain

Organic aerosols (OA) have recently been shown to be the dominant contributor to the oxidative potential of airborne particulate matter in northeastern Spain. We collected PM10 filter samples every fourth day from January 2017 to March 2018 at two sampling stations located in Barcelona city and Montseny Natural Park, representing urban and rural areas, respectively. The chemical composition of PM10 was analyzed offline using a broad set of analytical instruments, including high-resolution time-of-flight mass spectrometry (HR-ToF-AMS), a total organic carbon analyzer (TCA), inductively coupled plasma atomic emission spectrometry (ICP-AES), inductively coupled plasma mass spectrometry (ICP-MS), ion chromatography (IC), and thermal-optical carbon analyzer. Source apportionment analysis of the water-soluble organic content of the samples measured via HR-ToF-AMS revealed two primary and two secondary sources of OA, which included biomass-burning OA (BBOA), sulfur-containing OA (SCOA), as well as summer- and winter‑oxygenated OA (SOOA and WOOA). The presence of hydrocarbon-like water-insoluble OA was also identified based on concentration trends in black carbon and nitrogen oxides. The results from the source apportionment analysis of the inorganic composition were correlated with different OA factors to assess potential source contributors. Barcelona showed significantly higher average water-soluble OA concentrations (5.63 ± 0.56 μg m-3) than Montseny (3.27 ± 0.37 μg m-3) over the sampling period. WOOA accounted for nearly 27 % of the averaged OA in Barcelona compared to only 7 % in Montseny. In contrast, SOOA had a greater contribution to OA in Montseny (47 %) than in Barcelona (24 %). SCOA and BBOA were responsible for 15-28 % of the OA at both sites. There were also seasonal variations in the relative contributions of different OA sources. Our overall results showed that local anthropogenic sources were primarily responsible for up to 70 % of ambient soluble OA in Barcelona, and regulating local-scale emissions could significantly improve air quality in urban Spain.

Long-term particulate matter exposure and the risk of neurological hospitalization: Evidence from causal inference of a large longitudinal cohort in South China

With limited evidence on the neurological impact of particulate matter (PM) exposure in China, particularly for PM1 which is smaller but more toxic, we conducted a large Chinese cohort study using causal inference approaches to comprehensively clarify such impact. A total of 36,271 participants in southern China were recruited in 2015 and followed up through 2020. We obtained the neurological hospitalizations records by linking the cohort data to the electronic reports from 418 medical institutions across the study area. By using high-resolution PM concentrations from satellite-based spatiotemporal models and the cohort data, we performed marginal structural Cox models under causal assumptions to assess the potential causal links between time-varying PM exposure and neurological hospitalizations. Our findings indicated that increasing PM1, PM2.5, and PM10 concentrations by 1 μg/m³ were associated with higher overall neurological hospitalization risks, with hazard ratios (HRs) of 1.10 (95% confidence interval (CI) 1.04-1.16), 1.09 (95% CI 1.04-1.14), and 1.03 (95% CI 1.00-1.06), respectively. PM1 appeared to have a stronger effect on neurological hospitalization, with a 1% and 7% higher impact compared to PM2.5 and PM10, respectively. Additionally, each 1-μg/m3 increase in the annual PM1 concentration was associated with an elevated risk of hospitalizations for ischemic stroke (HR: 1.15; 95% CI, 1.06-1.26), which tended to be larger than the estimates for PM2.5 (HR: 1.13, 95% CI, 1.04-1.23) and PM10 (HR: 1.05, 95% CI, 1.00-1.09). Furthermore, never-married or female individuals tended be at a greater risk compared with their counterparts. Our study provides important insights into the health impact of particles, particularly smaller particles, on neurological hospitalization risk and highlights the need for clean-air policies that specifically target these particles.

[Effect of Short-Term Exposure to Air Pollutants on Hospital Admissions for End-Stage Renal Disease Patients Undergoing Hemodialysis]

Objective

To evaluate the association between short-term exposure to air pollutants of end-stage renal disease (ESRD) patients on maintenance hemodialysis and the number of daily hospital admissions.

Methods

The data on hospitalizations were obtained from the database of the municipal Urban Employees' Basic Medical Insurance and Urban Residents' Basic Medical Insurance of a city in Southwest China. Single and multiple pollutant generalized additive models were utilized to estimate the effect of air pollutants (CO, NO2, O3, PM10, PM2.5, and SO2) on patient admissions after the lag time of different numbers of days. In addition, subgroup analyses stratified by sex, age, PM2.5 and PM10 concentration thresholds, seasonality, and comorbidity status for cardiovascular diseases and hypertension were conducted.

Results

In the single pollutant models, the pollutants significantly associated with patient admissions and the corresponding lag time of the strongest association were as follows, every time CO increased by 0.1 mg/m3, there was a 2.39% increase (95% confidence interval [CI]: 0.96%-3.83%) in patient admissions after 7 days of lag time; every time NO2, O3, PM2.5, PM10, and SO2 increased by 10 μg/m3, patient admissions increased by 4.02% (95% CI: 1.21%-6.91%) after 7 days of lag time, 3.57% (95% CI: 0.78%-6.44%) after 0-4 days of lag time, 2.00% (95% CI: 1.07%-2.93%) after 6 days of lag time, 1.19% (95% CI: 0.51%-1.88%) after 7 days of lag time, and 8.37% (95% CI: 3.08%-13.93%) after 7 days of lag time, respectively. In the multiple pollutant model, every time O3 and PM2.5 increased by 10 μg/m3, there was an increase of 3.18% (95% CI: 0.34%-6.09%) in daily patient admissions after 0-4 days of lag time and an increase of 1.85% (95% CI: 0.44%-3.28%) after 7 days of lag time. Furthermore, subgroup analyses showed that seasonality, the severity of air pollution, and patients' comorbidities might be the effect modifiers for the association between ambient air pollution and hospital admissions in ESRD patients receiving maintenance hemodialysis.

Conclusion

Air pollution is closely associated with hospital admissions in ESRD patients undergoing maintenance hemodialysis and the strength of this association varies according to seasonality, the severity of air pollution, and patients' status of comorbidities.

Associations between short-term exposure to fine particulate matter and acute myocardial infarction: A case-crossover study

BACKGROUND

Previous studies evaluated the impact of particle matters (PM) on the risk of acute myocardial infarction (AMI) based on local registries.

HYPOTHESIS

This study aimed to evaluate possible short term effect of air pollutants on occurrence of AMI based on a specific case report sheet that was designed for this purpose.

METHODS

AMI was documented among 982 patients who referred to the emergency departments in Tehran, Iran, between July 2017 to March 2019. For each patient, case period was defined as 24 hour period preceding the time of emergency admission and referent periods were defined as the corresponding time in 1, 2, and 3 weeks before the admission. The associations of particulate matter with an aerodynamic diameter ≤2.5 μm (PM2 .5 ) and particulate matter with an aerodynamic diameter ≤10 μm (PM10 ) with AMI were analyzed using conditional logistic regression in a case-crossover design.

RESULT

Increase in PM2.5 and PM10 was significantly associated with the occurrence of AMI with and without adjustment for the temperature and humidity. In the adjusted model each 10 μg/m3 increase of PM10 and PM2.5 in case periods was significantly associated with increase myocardial infarction events (95% CI = 1.041-1.099, OR = 1.069 and 95% CI = 1.073-1.196, and OR = 1.133, respectively). Subgroup analysis showed that increase in PM10 did not increase AMI events in diabetic subgroup, but in all other subgroups PM10 and PM2 .5 concentration showed positive associations with increased AMI events.

CONCLUSION

Acute exposure to ambient air pollution was associated with increased risk of AMI irrespective of temperature and humidity.

Effect of Air Pollution Particulate Matter on Ischemic and Hemorrhagic Stroke: A Scoping Review

Air pollution particulate matter (PM) exposure has been established as a risk factor for stroke. However, few studies have investigated the effects of PM exposure on stroke subtypes (ischemic and hemorrhagic stroke). Ischemic (IS) and hemorrhagic strokes (HS) involve distinctive pathophysiological pathways and may be differentially influenced by PM exposure. This review aims to characterize the effects of PM exposure on ischemic and hemorrhagic strokes. It also identifies subpopulations that may be uniquely vulnerable to PM toxicity. Pubmed was queried from 2000 to 2023 to identify clinical and epidemiological studies examining the association between PM exposure and stroke subtypes (ischemic and hemorrhagic stroke). Inclusion criteria were: 1) articles written in English 2) clinical and epidemiological studies 3) studies with a clear definition of stroke, IS, HS, and air pollution 4) studies reporting the effects of PM and 5) studies that included distinct analyses per stroke subtype. Two independent reviewers screened the literature for applicable studies. A total of 50 articles were included in this review. Overall, PM exposure increases ischemic stroke risk in both lightly and heavily polluted countries. The association between PM exposure and hemorrhagic stroke is variable and may be influenced by a country's ambient air pollution levels. A stronger association between PM exposure and stroke is demonstrated in older individuals and those with pre-existing diabetes. There is no clear effect of sex or hypertension on PM-associated stroke risk. Current literature suggests PM exposure increases ischemic stroke risk, with an unclear effect on hemorrhagic stroke risk. Older patients and those with pre-existing diabetes may be the most vulnerable to PM toxicity. Future investigations are needed to characterize the influence of sex and hypertension on PM-associated stroke risk.

Research progress of different components of PM2.5 and ischemic stroke

PM2.5 is a nonhomogeneous mixture of complex components produced from multiple sources, and different components of this mixture have different chemical and biological toxicities, which results in the fact that the toxicity and hazards of PM2.5 may vary even for the same mass of PM2.5. Previous studies on PM2.5 and ischemic stroke have reached different or even opposing conclusions, and considering the heterogeneity of PM2.5 has led researchers to focus on the health effects of specific PM2.5 components. However, due to the complexity of PM2.5 constituents, assessing the association between exposure to specific PM2.5 constituents and ischemic stroke presents significant challenges. Therefore, this paper reviews and analyzes studies related to PM2.5 and its different components and ischemic stroke, aiming to understand the composition of PM2.5 and identify its harmful components, elucidate their relationship with ischemic stroke, and thus provide some insights and considerations for studying the biological mechanisms by which they affect ischemic stroke and for the prevention and treatment of ischemic stroke associated with different components of PM2.5.

Effect of Air Pollution on Heart Failure: Systematic Review and Meta-Analysis

BACKGROUND

Heart failure (HF) poses a significant global disease burden. The current evidence on the impact of air pollution on HF remains inconsistent.

OBJECTIVES

We aimed to conduct a systematic review of the literature and meta-analysis to provide a more comprehensive and multiperspective assessment of the associations between short- and long-term air pollution exposure and HF from epidemiological evidences.

METHODS

Three databases were searched up to 31 August 2022 for studies investigating the association between air pollutants (PM 2.5 , PM 10 , NO 2 , SO 2 , CO, O 3 ) and HF hospitalization, incidence, or mortality. A random effects model was used to derive the risk estimations. Subgroup analysis was conducted by geographical location, age of participants, outcome, study design, covered area, the methods of exposure assessment, and the length of exposure window. Sensitivity analysis and adjustment for publication bias were performed to test the robustness of the results.

RESULTS

Of 100 studies covering 20 countries worldwide, 81 were for short-term and 19 were for long-term exposure. Almost all air pollutants were adversely associated with the risk of HF in both short- and long-term exposure studies. For short-term exposures, we found the risk of HF increased by 1.8% [relative risk ( RR ) = 1.018 , 95% confidence interval (CI): 1.011, 1.025] and 1.6% (RR = 1.016 , 95% CI: 1.011, 1.020) per 10 - μ g / m 3 increment of PM 2.5 and PM 10 , respectively. HF was also significantly associated with NO 2 , SO 2 , and CO, but not O 3 . Positive associations were stronger when exposure was considered over the previous 2 d (lag 0-1) rather than on the day of exposure only (lag 0). For long-term exposures, there were significant associations between several air pollutants and HF with RR (95% CI) of 1.748 (1.112, 2.747) per 10 - μ g / m 3 increment in PM 2.5 , 1.212 (1.010, 1.454) per 10 - μ g / m 3 increment in PM 10 , and 1.204 (1.069, 1.356) per 10 -ppb increment in NO 2 , respectively. The adverse associations of most pollutants with HF were greater in low- and middle-income countries than in high-income countries. Sensitivity analysis demonstrated the robustness of our results.

DISCUSSION

Available evidence highlighted adverse associations between air pollution and HF regardless of short- and long-term exposure. Air pollution is still a prevalent public health issue globally and sustained policies and actions are called for to reduce the burden of HF. https://doi.org/10.1289/EHP11506.

Long-term exposure to particulate matter and COPD mortality: Insights from causal inference methods based on a large population cohort in southern China

BACKGROUND

Evidence of the association between long-term exposure to particulate matter (PM) and chronic obstructive pulmonary disease (COPD) mortality from large population-based cohort study is limited and often suffers from residual confounding issues with traditional statistical methods. We hereby assessed the casual relationship between long-term PM (PM_2.5, PM₁₀ and PM_10-2.5) exposure and COPD mortality in a large cohort of Chinese adults using state-of-the-art causal inference approaches.

METHODS

A total of 580,757 participants in southern China were enrolled in a prospective cohort study from 2009 to 2015 and followed up until December 2020. Exposures to PM at each residential address were obtained from the Long-term Gap-free High-resolution Air Pollutant Concentration dataset. Marginal structural Cox models were used to investigate the association between COPD mortality and annual average exposure levels of PM exposure.

RESULTS

During an average follow-up of 8.0 years, 2250 COPD-related deaths occurred. Under a set of causal inference assumptions, the hazard ratio (HR) for COPD mortality was estimated to be 1.046 (95 % confidence interval: 1.034-1057), 1.037 (1.028-1.047), and 1.032 (1.006-1.058) for each 1-μg/m³ increase in annual average concentrations of PM_2.5, PM₁₀, and PM_10-2.5 respectively. Additionally, the detrimental effects appeared to be more pronounced among the elderly (age ≥ 65) and inactive participants. The effect estimates of PM_2.5, PM₁₀, and PM_10-2.5 tend to be greater among participants who were generally exposed to PM₁₀ concentrations below 70 μg/m³ than that among the general population.

CONCLUSION

Our results support causal links between long-term PM exposure and COPD mortality, highlighting the urgency for more effective strategies to reduce PM exposure, with particular attention on protecting potentially vulnerable groups.

Ambient Air Pollution and Stroke: An Updated Review

Despite recent advances in treatment and prevention, stroke remains a leading cause of morbidity and mortality. There is a critical need to identify novel modifiable risk factors for disease, including environmental agents. A body of evidence has accumulated suggesting that elevated levels of ambient air pollutants may not only trigger cerebrovascular events in susceptible people (short-term exposures) but also increase the risk of future events (long-term average exposures). This review assesses the updated evidence for both short and long-term exposure to ambient air pollution as a risk factor for stroke incidence and outcomes. It discusses the potential pathophysiologic mechanisms and makes recommendations to mitigate exposure on a personal and community level. The evidence indicates that reduction in air pollutant concentrations represent a significant population-level opportunity to reduce risk of cerebrovascular disease.

Association between short-term exposure to ambient air pollution and heart failure: An updated systematic review and meta-analysis of more than 7 million participants

Introduction

Exposure to air pollution has been linked to the mortality of heart failure. In this study, we sought to update the existing systematic review and meta-analysis, published in 2013, to further assess the association between air pollution and acute decompensated heart failure, including hospitalization and heart failure mortality.

Methods

PubMed, Web of Science, EMBASE, and OVID databases were systematically searched till April 2022. We enrolled the studies regarding air pollution exposure and heart failure and extracted the original data to combine and obtain an overall risk estimate for each pollutant.

Results

We analyzed 51 studies and 7,555,442 patients. Our results indicated that heart failure hospitalization or death was associated with increases in carbon monoxide (3.46% per 1 part per million; 95% CI 1.0233-1.046, P < 0.001), sulfur dioxide (2.20% per 10 parts per billion; 95% CI 1.0106-1.0335, P < 0.001), nitrogen dioxide (2.07% per 10 parts per billion; 95% CI 1.0106-1.0335, P < 0.001), and ozone (0.95% per 10 parts per billion; 95% CI 1.0024-1.0166, P < 0.001) concentrations. Increases in particulate matter concentration were related to heart failure hospitalization or death (PM_2.5 1.29% per 10 μg/m³, 95% CI 1.0093-1.0165, P < 0.001; PM₁₀ 1.30% per 10 μg/m³, 95% CI 1.0102-1.0157, P < 0.001).

Conclusion

The increase in the concentration of all pollutants, including gases (carbon monoxide, sulfur dioxide, nitrogen dioxide, ozone) and particulate matter [(PM_2.5), (PM₁₀)], is positively correlated with hospitalization rates and mortality of heart failure.

Systematic review registration

https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42021256241.

Discovering oxidative potential (OP) drivers of atmospheric PM10, PM2.5, and PM1 simultaneously in North-Eastern Spain

Ambient particulate matter (PM) is a major contributor to air pollution, leading to adverse health effects on the human population. It has been suggested that the oxidative potential (OP, as a tracer of oxidative stress) of PM is a possible determinant of its health impact. In this study, samples of PM₁₀, PM_2.5, and PM₁ were collected roughly every four days from January 2018 until March 2019 at a Barcelona urban background site and Montseny rural background site in northeastern Spain. We determined the chemical composition of samples, allowing us to perform source apportionment using positive matrix factorization. The OP of PM was determined by measuring reactive oxygen species using dithiothreitol and ascorbic acid assays. Finally, to link the sources with the measured OP, both a Pearson's correlation and a multiple linear regression model were applied to the dataset. The results showed that in Barcelona, the OP of PM₁₀ was much higher than those of PM_2.5 and PM₁, whereas in Montseny results for all PM sizes were in the same range, but significantly lower than in Barcelona. In Barcelona, several anthropogenic sources were the main drivers of OP in PM₁₀ (Combustion + Road Dust + Heavy Oil + OC-rich) and PM_2.5 (Road Dust + Combustion). In contrast, PM₁ -associated OP was driven by Industry, with a much lower contribution to PM₁₀ and PM_2.5 mass. Meanwhile, Montseny exhibited no clear drivers for OP evolution, likely explaining the lack of a significant difference in OP between PM₁₀, PM_2.5, and PM₁. Overall, this study indicates that size fraction matters for OP, as a function of the environment typology. In an urban context, OP is driven by the PM₁₀ and PM₁ size fractions, whereas only the PM₁ fraction is involved in rural environments.

The association between wind speed and the risk of injuries among preschool children: New insight from a sentinel-surveillance-based study

BACKGROUND

Injuries among preschool children are an important public health concern worldwide. Significant gaps remain in understanding the potential impact of wind speed on injuries among preschoolers. We aimed to clarify the association and its variation across subgroups to capture the vulnerability features.

METHODS

Using a case-crossover design and conditional logistic regression model, we compared the exposure to wind speed right before the injury events (case period) with that of control periods to determine the excess rate (ER) of injury on each of 0-3 lag days in Guangzhou, 2016-2020. Results were also stratified by sociodemographic characteristics of patients, basic characteristics of injury events, and clinical features of injuries to identify the most vulnerable subgroups of preschoolers.

RESULTS

Higher wind speed was significantly associated with an increased risk of injuries among preschoolers on lag 0, reaching an ER of 2.93 % (95 % confidence interval [CI] = 0.87, 5.03), but not on other lag days. The results of the stratified analyses showed that children under 3-year-old (3.41 %; 95 % CI = 0.36, 6.55), boys (3.66 %; 95 % CI = 1.04, 6.35), and non-locally registered children (3.65; 95 % CI = 0.02, 7.40) were more prone to wind-related injuries. Falls (2.67 %; 95 % CI = 0.11, 5.30) were the main cause of wind-related injuries, and taking transportation was the main activity when injuries occurred (13.16 %; 95 % CI = 4.45, 22.60). Additionally, injuries involving buildings/grounds/obstacles (4.69 %; 95 % CI = 1.66, 7.81) and the occurrence of sprain/strain (7.60 %; 95 % CI = 0.64, 15.04) showed a positive association with wind speed.

CONCLUSIONS

Higher wind speed was associated with a significantly elevated rate of injuries among preschoolers without delayed effects, where children under 3-year-old, boys, and non-locally registered subgroups were more susceptible to wind-related injuries. This study may provide new insights for refining the prevention measures against wind-related injuries among preschoolers.

The risk of injuries during work and its association with precipitation: New insight from a sentinel-based surveillance and a case-crossover design

Background

Injuries during work are often exogenous and can be easily influenced by environmental factors, especially weather conditions. Precipitation, a crucial weather factor, has been linked to unintentional injuries, yet evidence of its effect on work-related injuries is limited. Therefore, we aimed to clarify the impact of precipitation on injuries during work as well as its variation across numerous vulnerability features.

Methods

Records on the work-related injury during 2016-2020 were obtained from four sentinel hospitals in Guangzhou, China, and were matched with the daily weather data during the same period. We applied a time-stratified case-crossover design followed by a conditional logistic regression to evaluate the association between precipitation and work-related injuries. Covariates included wind speed, sunlight, temperature, SO ₂, NO ₂, and PM _2.5. Results were also stratified by multiple factors to identify the most vulnerable subgroups.

Results

Daily precipitation was a positive predictor of work-related injuries, with each 10 mm increase in precipitation being associated with an increase of 1.57% in the rate of injuries on the same day and 1.47-1.14% increase of injuries on subsequent 3 days. The results revealed that precipitation had a higher effect on work-related injuries in winter (4.92%; 95%CI: 1.77-8.17%). The elderly (2.07%; 95%CI: 0.64-3.51%), male (1.81%; 95%CI: 0.96-2.66%) workers or those with lower educational levels (2.58%; 95%CI: 1.59-3.54%) were more likely to suffer from injuries on rainy days. There was a higher risk for work-related injuries caused by falls (2.63%; 95%CI: 0.78-4.52%) or the use of glass products (1.75%; 95%CI: 0.49-3.02%) on rainy days.

Conclusions

Precipitation was a prominent risk factor for work-related injury, and its adverse effect might endure for 3 days. Certain sub-groups of workers were more vulnerable to injuries in the rain.

Triggering of ST-elevation myocardial infarction by ultrafine particles in New York: Changes following Tier 3 vehicle introduction

BACKGROUND

Previously, we found increased rates of ST-elevation myocardial infarction (STEMI) associated with increased ultrafine particle (UFP; <100 nm) concentrations in the previous few hours in Rochester, New York. Relative rates were higher after air quality policies and a recession reduced pollutant concentrations (2014-2016 versus 2005-2013), suggesting PM composition had changed and the same PM mass concentration had become more toxic. Tier 3 light duty vehicles, which should produce less primary organic aerosols and oxidizable gaseous compounds, likely making PM less toxic, were introduced in 2017. Thus, we hypothesized we would observe a lower relative STEMI rate in 2017-2019 than 2014-2016.

METHODS

Using STEMI events treated at the University of Rochester Medical Center (2014-2019), UFP and other pollutants measured in Rochester, a case-crossover design, and conditional logistic regression models, we estimated the rate of STEMI associated with increased UFP and other pollutants in the previous hours and days in the 2014-2016 and 2017-2019 periods.

RESULTS

An increased rate of STEMI was associated with each 3111 particles/cm³ increase in UFP concentration in the previous hour in 2014-2016 (lag hour 0: OR = 1.22; 95% CI = 1.06, 1.39), but not in 2017-2019 (OR = 0.94; 95% CI = 0.80, 1.10). There were similar patterns for black carbon, UFP_11-50nm, and UFP_51-100nm. In contrast, increased rates of STEMI were associated with each 0.6 ppb increase in SO₂ concentration in the previous 120 h in both periods (2014-2016: OR = 1.26, 95% CI = 1.03, 1.55; 2017-2019: OR = 1.21, 95% CI = 0.87, 1.68).

CONCLUSIONS

Greater rates of STEMI were associated with short term increases in concentrations of UFP and other motor vehicle related pollutants before Tier 3 introduction (2014-2016), but not afterwards (2017-2019). This change may be due to changes in PM composition after Tier 3 introduction, as well as to increased exposure misclassification and greater underestimation of effects from 2017 to 2019.

How neighborhood environment modified the effects of power outages on multiple health outcomes in New York state?

Background

Although power outage (PO) is one of the most important consequences of increasing weather extremes and the health impact of POs has been reported previously, studies on the neighborhood environment underlying the population vulnerability in such situations are limited. This study aimed to identify dominant neighborhood environmental predictors which modified the impact of POs on multiple health outcomes in New York State.

Methods

We applied a two-stage approach. In the first stage, we used time series analysis to determine the impact of POs (versus non-PO periods) on multiple health outcomes in each power operating division in New York State, 2001-2013. In the second stage, we classified divisions as risk-elevated and non-elevated, then developed predictive models for the elevation status based on 36 neighborhood environmental factors using random forest and gradient boosted trees.

Results

Consistent across different outcomes, we found predictors representing greater urbanization, particularly, the proportion of residents having access to public transportation (importance ranging from 4.9-15.6%), population density (3.3-16.1%), per capita income (2.3-10.7%), and the density of public infrastructure (0.8-8.5%), were associated with a higher possibility of risk elevation following power outages. Additionally, the percent of minority (-6.3-27.9%) and those with limited English (2.2-8.1%), the percent of sandy soil (6.5-11.8%), and average soil temperature (3.0-15.7%) were also dominant predictors for multiple outcomes. Spatial hotspots of vulnerability generally were located surrounding New York City and in the northwest, the pattern of which was consistent with socioeconomic status.

Conclusion

Population vulnerability during power outages was dominated by neighborhood environmental factors representing greater urbanization.

Associations Between Ambient Extreme Heat Exposure and Emergency Department Visits Related to Kidney Disease

RATIONALE & OBJECTIVE

Extreme heat exposure is associated with multiple diseases. However, our current understanding of the specific impact of extreme heat exposure on kidney disease is limited.

STUDY DESIGN

Case-crossover study.

SETTING & PARTICIPANTS

1,114,322 emergency department (ED) visits with a principal diagnosis of kidney disease were identified in New York state, 2005-2013.

EXPOSURE

Extreme heat exposure was defined as when the daily temperature exceeded the 90th percentile temperature of that month during the study period in the county.

OUTCOME

ED visits with a principal diagnosis of kidney disease and its subtypes (ICD-9 [International Classification of Diseases, Ninth Revision] codes 580-599, 788).

ANALYTICAL APPROACH

Extreme heat exposure on the ED visit days was compared with extreme heat exposure on control days using a conditional logistic regression model, controlling for humidity, air pollutants, and holidays. The excess risk of kidney disease was calculated for a week (lag days 0-6) after extreme heat exposure during the warm season (May through September). We also stratified our estimates by sociodemographic characteristics.

RESULTS

Extreme heat exposure was associated with a 1.7% (lag day 0) to 3.1% (lag day 2) higher risk of ED visits related to kidney disease; this association was stronger with a greater number of extreme heat exposure days in the previous week. The association with extreme heat exposure lasted for an entire week and was stronger in the transitional months (ie, May and September; excess rates ranged from 1.8% to 5.1%) rather than the summer months (June through August; excess rates ranged from 1.5% to 2.7%). The strength of association was greater among those with ED visits related to acute kidney injury, kidney stones, and urinary tract infections. Age and sex may modify the association between extreme heat exposure and ED visits.

LIMITATIONS

Individual exposure to heat-how long people were outside or whether they had access to air conditioning-was unknown.

CONCLUSIONS

Extreme heat exposure was significantly associated with a dose-dependent greater risk of ED visits for kidney disease.

Particle surface area, ultrafine particle number concentration, and cardiovascular hospitalizations

While the health impacts of larger particulate matter, such as PM₁₀ and PM_2.5, have been studied extensively, research regarding ultrafine particles (UFPs or PM_0.1) and particle surface area concentration (PSC) is lacking. This case-crossover study assessed the associations between exposure to PSC and UFP number concentration (UFPnc) and hospital admissions for cardiovascular diseases (CVDs) in New York State (NYS), 2013-2018. We used a time-stratified case-crossover design to compare the PSC and UFPnc levels between hospitalization days and control days (similar days without admissions) for each CVD case. We utilized NYS hospital discharge data to identify all CVD cases who resided in NYS. UFP simulation data from GEOS-Chem-APM, a state-of-the-art chemical transport model, was used to define PSC and UFPnc. Using a multi-pollutant model and conditional logistic regression, we assessed excess risk (ER)% per inter-quartile change of PSC and UFPnc after controlling for meteorological factors, co-pollutants, and time-varying variables. We found immediate and lasting associations between PSC and overall CVDs (lag0-lag0-6: ERs% (95% CI%) ranges: 0.4 (0.1,0.7) - 0.9 (0.7-1.2), and delayed and prolonged ERs%: 0.1-0.3 (95% CIs: 0.1-0.5) between UFPnc and CVDs (lag0-3-lag0-6). Exposure to larger PSC was associated with immediate ER increases in stroke, hypertension, and ischemic heart diseases (1.1%, 0.7%, 0.8%, respectively, all p < 0.05). The adverse effects of PSC on CVDs were highest among children (5-17 years old), in the fall and winter, and during cold temperatures. In conclusion, we found an immediate, lasting effects of PSC on overall CVDs and a delayed, prolonged impact of UFPnc. PSC was a more sensitive indicator than UFPnc. The PSC effects were higher among certain CVD subtypes, in children, in certain seasons, and during cold days. Further studies are needed to validate our findings and evaluate the long-term effects.

Foliar dust particle retention and metal accumulation of five garden tree species in Hangzhou: Seasonal changes

As particulate matter and heavy metals in the atmosphere affect the atmospheric quality, they pose a threat to human health through the respiratory system. Vegetation can remove airborne particles and purify the atmosphere. Plant leaves are capable of effectively absorbing heavy metals contained by particulates. To evaluate the effects of different garden plants on the particulate matter retention and heavy metal accumulation, the seasonal changes of dust retention of five typical garden plants were compared in the industrial and non-industrial zones in Hangzhou. Results revealed that these species differed in dust retention with the descending order of Loropetalum chinense > Osmanthus fragrans > Pittosporum tobira > Photinia × fraseri > Cinnamomum camphora, which were related to the microstructure feature of the leaf. These species also showed seasonal variation in dust retention, with the highest in summer, followed by winter, autumn, and spring, respectively. The total suspended particle per unit leaf area was higher in the industrial site (80.54 g m^-2) than in the non-industrial site (19.77 g m^-2). Leaf particles in different size fractions differed among species, while coarse particles (d > ten μm) predominated in most cases. The L. chinense and C. camphora plants accumulated the greatest Pb and Ni compared to other plants. Overall, L. chinense was the best suitable plant species to improve the air quality.

Elucidating sources of VOCs in the Capital Region of New York State: Implications to secondary transformation and public health exposure

Exposure to ambient volatile organic compounds (VOCs) in urban areas is of interest because of their potential adverse effects to public health. A study was carried out to elucidate ambient sources of VOCs in the Capital Region of New York State for the period 2015-2019. A combined dataset of VOCs and PM_2.5 species was used in positive matrix factorization (PMF) model to better interpret the complex nature of different sources. Ten sources were revealed, where background source (3.8 μg/m³, 30%) was the largest contributor to VOCs, followed by petroleum-related emissions (2.9 μg/m³, 22%) and pyrolyzed oxygen (OP)-Elemental Carbon (EC2)-aldehydes-rich (2.7 μg/m³, 21%). Other notable VOC sources included methyl ethyl ketone (MEK)-rich, vehicular traffic, and biomass burning. Both OP-EC2-aldehydes-rich and petroleum-related emissions showed notable contribution to ozone (O₃) and secondary organic aerosol (SOA) formation, respectively. Observed mean carcinogenic risk values of benzene and formaldehyde and 95th percentiles risk values of 1,3-butadiene and acetaldehyde were above the USEPA acceptable level of 1x10^-6 but below a tolerable risk of 1x10^-4. Estimated carcinogenic risk values of OP-EC2-aldehydes-rich, vehicular traffic, background and petroleum-related emissions were above the USEPA acceptable cancer risk and posed greater risk to public health (more than 80% of total carcinogenic risk) compared to other sources. Due to lack of some VOC species data (e.g., alkanes, alkenes, terpenes, alcohols), other urban VOC sources e.g., fugitive emissions, fuel evaporation, unburned fuel were not identified. More work is needed to better understand the contribution of VOC sources to O₃ and SOA formation in Albany and surrounding region. Findings can support policy makers in developing appropriate air quality management initiatives for the Capital Region in New York State.

Long-term PM0.1 exposure and human blood lipid metabolism: New insight from the 33-community study in China

Ambient particles with aerodynamic diameter <0.1 μm (PM_0.1) have been suggested to have significant health impact. However, studies on the association between long-term PM_0.1 exposure and human blood lipid metabolism are still limited. This study was aimed to evaluate such association based on multiple lipid biomarkers and dyslipidemia indicators. We matched the 2006-2009 average PM_0.1 concentration simulated using the neural-network model following the WRF-Chem model with the clinical and questionnaire data of 15,477 adults randomly recruited from 33 communities in Northeast China in 2009. After controlling for social demographic and behavior confounders, we assessed the association of PM_0.1 concentration with multiple lipid biomarkers and dyslipidemia indicators using generalized linear mixed-effect models. Effect modification by various social demographic and behavior factors was examined. We found that each interquartile range increase in PM_0.1 concentration was associated with a 5.75 (95% Confidence interval, 3.24-8.25) mg/dl and a 6.05 (2.85-9.25) mg/dl increase in the serum level of total cholesterol and LDL-C, respectively. This increment was also associated with an odds ratio of 1.25 (1.10-1.42) for overall dyslipidemias, 1.41 (1.16, 1.73) for hypercholesterolemia, and 1.90 (1.39, 2.61) for hyperbetalipoproteinemia. Additionally, we found generally greater effect estimates among the younger participants and those with lower income or with certain behaviors such as high-fat diet. The deleterious effect of long-term PM_0.1 exposure on lipid metabolism may make it an important toxic chemical to be targeted by future preventive strategies.

Effects of ambient air pollutants on hospital admissions and deaths for cardiovascular diseases: a time series analysis in Tehran

Short-term exposures to air pollution have been associated with various adverse health effects. In this study, we investigated the associations between ambient air pollutants with the number of hospital admissions and mortality from cardiovascular diseases (CVDs). This time series study was conducted in Tehran for the years 2014-2017 (1220 day). We collected the ambient air pollutant concentration data from the regulatory monitoring stations. The health data were obtained from the Ministry of Health and Medical Education. A distributed lag non-linear model (DLNM) was used for the analyses. Total CVDs and ischemic heart disease (IHD) admissions were associated with CO for each 1 mg/m³ increase at lags of 6 and 7 days. Also, there was a positive association between total CVDs (RR 1.01; 1.001 to 1.03), IHD (RR 1.04; 1.006 to 1.07), and cerebrovascular diseases (RR 1.03; 1.005 to 1.07) mortality with SO₂ at a lag of 4 days. PM_2.5 and PM₁₀ were associated with cerebrovascular disease admissions in females aged 16-65 years and 16 years and younger for each 10 µg/m³ increase, respectively. Short-term exposure to SO₂, NO₂, and CO was associated with hospital admissions and mortality for CVDs, IHD, cerebrovascular diseases, and other cardiovascular diseases at different lags. Moreover, females were more affected by ambient air pollutants than males in terms of their burden of CVDs. Therefore, identifying the likely harmful effects of pollutants given their current concentrations requires the planning and implementation of strategies to reduce air pollution.

Changing Emissions Results in Changed PM2.5 Composition and Health Impacts

In the period of 2005 to 2016, multiple air pollution control regulations have entered into effect in the United States at both the Federal and state level. In addition, economic changes have also occurred primarily in the electricity generation sector that substantially changed the emissions from this sector. This combination of policy implementations and economics has led to substantial reductions in PM2.5, its major constituents, and source specific PM2.5 concentrations across the New York State, particularly those of sulfate, nitrate, and primary organic carbon. However, secondary organic carbon and spark-ignition vehicular emission contributions have increased. Related studies of changes in health outcomes, the excess rates of emergency department visits and hospitalizations for a variety of cardiovascular and respiratory diseases and respiratory infections have increased per unit mass of PM2.5. It appears that the increased toxicity per unit mass was due to the reduction in low toxicity constituents such that the remaining mass had greater impacts on public health.

Secondary organic aerosol association with cardiorespiratory disease mortality in the United States

Fine particle pollution, PM2.5, is associated with increased risk of death from cardiorespiratory diseases. A multidecadal shift in the United States (U.S.) PM2.5 composition towards organic aerosol as well as advances in predictive algorithms for secondary organic aerosol (SOA) allows for novel examinations of the role of PM2.5 components on mortality. Here we show SOA is strongly associated with county-level cardiorespiratory death rates in the U.S. independent of the total PM2.5 mass association with the largest associations located in the southeastern U.S. Compared to PM2.5, county-level variability in SOA across the U.S. is associated with 3.5× greater per capita county-level cardiorespiratory mortality. On a per mass basis, SOA is associated with a 6.5× higher rate of mortality than PM2.5, and biogenic and anthropogenic carbon sources both play a role in the overall SOA association with mortality. Our results suggest reducing the health impacts of PM2.5 requires consideration of SOA.

The individual and synergistic impacts of windstorms and power outages on injury ED visits in New York State

BACKGROUND

There is little work in assessing the impact of storm events combined with power outage (PO). In this study, we evaluated the individual and synergistic impacts of wind events and PO on overall and subtypes of injuries in New York State (NYS) and by demographics.

METHODS

The emergency department (ED) visit data were obtained from the NYS Department of Health from November-April 2005-2013 to identify injury cases, length of stay and care costs. Wind event was defined according to high wind, strong wind or thunderstorm wind defined by NOAA. PO occurrence was defined when PO coverage exceeded the 50th percentile of its distribution. By comparing non-event days, we used distributed lag nonlinear models to evaluate the impacts of wind events, PO, and their combined effect on injuries during the cold season over a 0-3-day lag period, while controlling for time-varying confounders. The differences in critical care indicators between event and non-event days were also evaluated.

RESULTS

Overall injuries ED visits (16,628,812) significantly increased during the wind events (highest Risk Ratio (RR): 1.05; 95% CI: 1.02-1.08), and were highest when wind events cooccurred with PO (highest RR: 1.14; 95% CI: 1.10-1.18), but not during PO alone (RR: 1.00; 95%CI: 0.96-1.04). The increase was also observed with all subgroups through Day 2 after the event. Greater risks exist for older adults (≥65 years) and those on Medicaid. After the joint occurrences of wind events and PO, average visits are 0.2 days longer, and cost 13% more, compared to no wind/no PO days.

CONCLUSION

There is a significant increase in ED visits, length of stay and cost of injuries during wind events, especially when they coupled with PO and especially among older cases and Medicaid holders. Our findings may be used for planning disaster preparedness and recovery efforts.

Compositional changes of PM2.5 in NE Spain during 2009-2018: A trend analysis of the chemical composition and source apportionment

In this work, time-series analyses of the chemical composition and source contributions of PM_2.5 from an urban background station in Barcelona (BCN) and a rural background station in Montseny (MSY) in northeastern Spain from 2009 to 2018 were investigated and compared. A multisite positive matrix factorization analysis was used to compare the source contributions between the two stations, while the trends for both the chemical species and source contributions were studied using the Theil-Sen trend estimator. Between 2009 and 2018, both stations showed a statistically significant decrease in PM_2.5 concentrations, which was driven by the downward trends of levels of chemical species and anthropogenic source contributions, mainly from heavy oil combustion, mixed combustion, industry, and secondary sulfate. These source contributions showed a continuous decrease over the study period, signifying the continuing success of mitigation strategies, although the trends of heavy oil combustion and secondary sulfate have flattened since 2016. Secondary nitrate also followed a significant decreasing trend in BCN, while secondary organic aerosols (SOA) very slightly decreased in MSY. The observed decreasing trends, in combination with the absence of a trend for the organic aerosols (OA) at both stations, resulted in an increase in the relative proportion of OA in PM_2.5 by 12% in BCN and 9% in MSY, mostly from SOA, which increased by 7% in BCN and 4% in MSY. Thus, at the end of the study period, OA accounted for 40% and 50% of the annual mean PM_2.5 at BCN and MSY, respectively. This might have relevant implications for air quality policies aiming at abating PM_2.5 in the study region and for possible changes in toxicity of PM_2.5 due to marked changes in composition and source apportionment.

The state of science on severe air pollution episodes: Quantitative and qualitative analysis

Severe episodic air pollution blankets entire cities and regions and have a profound impact on humans and their activities. We compiled daily fine particle (PM_2.5) data from 100 cities in five continents, investigated the trends of number, frequency, and duration of pollution episodes, and compared these with the baseline trend in air pollution. We showed that the factors contributing to these events are complex; however, long-term measures to abate emissions from all anthropogenic sources at all times is also the most efficient way to reduce the occurrence of severe air pollution events. In the short term, accurate forecasting systems of such events based on the meteorological conditions favouring their occurrence, together with effective emergency mitigation of anthropogenic sources, may lessen their magnitude and/or duration. However, there is no clear way of preventing events caused by natural sources affected by climate change, such as wildfires and desert dust outbreaks.

Power outage mediates the associations between major storms and hospital admission of chronic obstructive pulmonary disease

BACKGROUND

Chronic obstructive pulmonary disease (COPD) is the third-leading cause of death worldwide with continuous rise. Limited studies indicate that COPD was associated with major storms and related power outages (PO). However, significant gaps remain in understanding what PO's role is on the pathway of major storms-COPD. This study aimed to examine how PO mediates the major storms-COPD associations.

METHODS

In this time-series study, we extracted all hospital admissions with COPD as the principal diagnosis in New York, 2001-2013. Using distributed lag nonlinear models, the hospitalization rate during major storms and PO was compared to non-major storms and non-PO periods to determine the risk ratios (RRs) for COPD at each of 0-6 lag days respectively after controlling for time-varying confounders and concentration of fine particulate matter (PM2.5). We then used Granger mediation analysis for time series to assess the mediation effect of PO on the major storms-COPD associations.

RESULTS

The RRs of COPD hospitalization following major storms, which mainly included flooding, thunder, hurricane, snow, ice, and wind, were 1.23 to 1.49 across lag 0-6 days. The risk was strongest at lag3 and lasted significantly for 4 days. Compared with non-outage periods, the PO period was associated with 1.23 to 1.61 higher risk of COPD admissions across lag 0-6 days. The risk lasted significantly for 2 days and was strongest at lag2. Snow, hurricane and wind were the top three contributors of PO among the major storms. PO mediated as much as 49.6 to 65.0% of the major storms-COPD associations.

CONCLUSIONS

Both major storms and PO were associated with increased hospital admission of COPD. PO mediated almost half of the major storms-COPD hospitalization associations. Preparation of surrogate electric system before major storms is essential to reduce major storms-COPD hospitalization.

Evaluation of regional transport of PM2.5 during severe atmospheric pollution episodes in the western Yangtze River Delta, China

During winter 2018, the 16 prefecture-level cities in Anhui Province, Western Yangtze River Delta region, China had very high PM_2.5 concentrations and prolonged pollution days. The impact of regional transport in the formation, accumulation, as well as dispersion of fine particulate matter (PM_2.5) in Anhui Province was very significant. This study quantified and analyzed the vertical transport of PM_2.5 in three major cities (Hefei, Fuyang, and Suzhou) of Anhui Province in January and July 2018 using the Weather Research and Forecasting (WRF) model coupled with the Community Multiscale Air Quality (CMAQ) model. The results of the inter-regional transport of PM_2.5 revealed the dominant transport pathways for the three cities. The flux mainly flowed into Fuyang from Henan (2.23 and 1.42 kt/day in January and July, respectively) and Bozhou (1.96 and 1.21 kt/day in January and July, respectively), while the main flux from Fuyang flowed into Henan (-2.15 kt/day) and Lu'an (-1.91 kt/day) in January and Henan (-0.34 kt/day) and Bozhou (-0.29 kt/day) in July. In addition, the dominant transport pathways and the heights at which they occurred were identified: the northwest-southeast and northeast-south pathways in both winter and summer at both lower (˂300 m) and higher (≥300 m) levels for Fuyang; the northwest-south and northeast-southwest pathways in winter (at both lower and upper levels) and northwest-east and northeast-southwest pathways in summer at lower and upper levels for Hefei; and the northwest-southeast and northeast-south pathways in both winter (from 50 m up to the top level) and summer (between 100 and 300 m) for Suzhou. Furthermore, the intensities of daily PM_2.5 transport fluxes in Fuyang during the atmospheric pollution episode (APE1) were stronger than the monthly average. These results show that joint emission controls across multiple cities along the identified pathways are urgently needed to reduce winter episodes.

Effect of upflow and downflow baffle configuration on particulate matter removal in a mirror-symmetrical multi-compartment scrubber

Control over particulate matter (PM) emission from grilling is required for improving public health and air quality. The performance of mirror-symmetrical multi-compartment scrubbers with an upflow (U-type) and downflow baffle (D-type) configuration was evaluated for PM emission control from grilling at a flow rate of 30 m³ min^-1. The PM removal efficiency of the U-type scrubber was the highest when the water level was 8 cm (95.6%), and the pressure drops recorded at the water levels of 6, 8 and 10 cm were 103, 122 and 153 mmH₂O, respectively. Although PM removal efficiency of the D-type scrubber was over 91.0% at the water levels of 8, 10 and 12 cm, the pressure drops were 124, 142 and 185 mmH₂O, respectively. A comprehensive evaluation of the water volume, pressure drop and PM removal performance, as well as device size, revealed that the U-type scrubber with a PM removal efficiency of 92% or higher and a pressure drop of 122 mmH₂O or lower at the water levels of 6-8 cm was more economical for removing PM from grilling gas than the D-type scrubber.

Ambient extreme heat exposure in summer and transitional months and emergency department visits and hospital admissions due to pregnancy complications

Although extreme heat exposure (EHE) was reported to be associated with increased risks of multiple diseases, little is known about the effects of EHE on pregnancy complications. We examined the EHE-pregnancy complications associations by lag days, subtypes, sociodemographic characteristics, and areas in New York State (NYS). We conducted a case-crossover analysis to assess the EHE-pregnancy complications associations in summer (June-August) and transitional months (May and September). All emergency department (ED) visits and hospital admissions due to pregnancy complications (ICD 9 codes: 630-649) from 2005 to 2013 in NYS were included. Daily mean temperature > 90th percentile of the monthly mean temperature in each county was defined as an EHE. We used conditional logistic regression while controlling for other weather factors, air pollutants and holidays to assess the EHE-pregnancy complications associations. EHE was significantly associated with increased ED visits for pregnancy complications in summer (ORs ranged: 1.01-1.04 from lag days 0-5). There was also a significant and stronger association in transitional months (ORs ranged: 1.02-1.06, Lag 0). Furthermore, we found EHE affected multiple subtypes of pregnancy complications, including threatened/spontaneous abortion, renal diseases, infectious diseases, diabetes, and hypertension (ORs range: 1.13-1.90) during transitional months. A significant concentration response effect between the number of consecutive days of EHE and ED visits in summer (P for trend <0.001), ED visits in September (P for trend =0.03), and hospital admission in May (P for trend<0.001) due to pregnancy complications was observed, respectively. African Americans and residents in lower socioeconomic position (SEP) counties were more susceptible to the effects of EHE. In conclusion, we found an immediate and prolonged effect of EHE on pregnancy complications in summer and a stronger, immediate effect in transitional months. These effects were stronger in African Americans and counties with lower SEP. Earlier warnings regarding extreme heat are recommended to decrease pregnancy complications.

Airborne particulate matter in Tehran's ambient air

In recent decades, particulate matter (PM) concentrations in Tehran have exceeded the World Health Organization's (WHO) guideline on most days. In this study, a search protocol was defined by identifying the keywords, to carry out a systematic review of the concentrations and composition of PM in Tehran's ambient air. For this purpose, searches were done in Scopus, PubMed, and Web of Science in 2019. Among the founded articles (197 in Scopus, 61 in PubMed, and 153 in Web of Science). The results show that in Tehran, the annual average PM₁₀ exceeded the WHO guidelines and for more than 50.0% of the days, the PM_2.5 concentration was more than WHO 24-h guidance value. The PM concentration in Tehran has two seasonal peaks due to poorer dispersion and suspension from dry land, respectively. Tehran has two daily PM peaks due to traffic and changes in boundary-layer heights; one just after midnight and the other during morning rush hour. Indoor concentrations of PM10 and PM2.5 in Tehran were 10.6 and 21.8 times higher than the corresponding values in ambient air. Tehran represents a unique case of problems of controlling PM because of its geographical setting, emission sources, and land use. This review provided a comprehensive assessment for decision makers to assist them in making appropriate policy decisions to improve the air quality. Considering factors such as diversity of resources, temporal and spatial variations, and urban location is essential in developing control plans. Also future studies should focus more on PM reduction plans.

The immediate effects of winter storms and power outages on multiple health outcomes and the time windows of vulnerability

BACKGROUND

While most prior research has focused on extreme heat, few assessed the immediate health effects of winter storms and associated power outages (PO), although severe storms have become more frequent. This study evaluates the joint and independent health effects of winter storms and PO, snow versus ice-storm, effects by time window (peak timing, winter/transitional months) and the impacts on critical care indicators including numbers of comorbidity, procedure, length of stay and cost.

METHODS

We use distributed lag nonlinear models to assess the impacts of winter storm/PO on hospitalizations due to cardiovascular, lower respiratory diseases (LRD), respiratory infections, food/water-borne diseases (FWBD) and injuries in New York State on 0-6 lag days following storm/PO compared with non-storm/non-PO periods (references), while controlling for time-varying factors and PM2.5. The storm-related hospitalizations are described by time window. We also calculate changes in critical care indicators between the storm/PO and control periods.

RESULTS

We found the joint effects of storm/PO are the strongest (risk ratios (RR) range: 1.01-1.90), followed by that of storm alone (1.02-1.39), but not during PO alone. Ice storms have stronger impacts (RRs: 1.04-3.15) than snowstorms (RRs: 1.03-2.21). The storm/PO-health associations, which occur immediately, and some last a whole week, are stronger in FWBD, October/November, and peak between 3:00-8:00 p.m. Comorbidity and medical costs significantly increase after storm/PO.

CONCLUSION

Winter storms increase multiple diseases, comorbidity and medical costs, especially when accompanied by PO or ice storms. Early warnings and prevention may be critical in the transitional months and afternoon rush hours.

Sources, variability and parameterizations of intra-city factors obtained from dispersion-normalized multi-time resolution factor analyses of PM2.5 in an urban environment

Ambient fine particulate matter (PM_2.5) data of similar continuously monitored species at two air monitoring sites with different characteristics within the City of Toronto were used to gauge the intra-city variations in the PM composition over a largely concurrent period spanning two years. One location was <8 m from the side of a major highway while the other was an urban background location. For the first time, multi-time resolution factor analysis was applied to dispersion-normalized concentrations to identify and quantify source contributions while reducing the influence of local meteorology. These factors were particulate sulphate (pSO4), particulate nitrate (pNO3), secondary organic aerosols (SOA), crustal matter (CrM) that were common to both sites, a hydrocarbon-like organic matter (HOM) exclusive to the urban background site, three black carbon related factors (BC, BC-HOM at the highway site, and a brown carbon rich factor (BC-BrC) at the urban background site), biomass burning organic matter (BBOM) and brake dust (BD) factors exclusive to the highway site. The PM_2.5 composition was different between these two locations, over only a 10 km distance. The sum of SOA, pSO4 and pNO3 at the urban background site averaged 57% of the PM_2.5 mass while the same species represented 43% of the average PM_2.5 mass at the highway site. Local or site-specific factors may be of greater interest for control policy design. Thus, regression analyses with potential explanatory, site-specific variables were performed for results from the highway site. Three model approaches were explored: multiple linear regression (MLR), regression with a generalized reduced gradient (GRG) algorithm, and a generalized additive model (GAM). GAM gave the largest fraction of variance for the locally-found factors at the highway site. Heavy-duty vehicles were most important for explaining the black carbon (BC and BC-HOM) factors. Light-duty vehicles were dominant for the brake dust (BD) factor. The auxiliary modelling for the local factors showed that the traffic-related factors likely originated along the main roadways at their respective sites while the more regional factors, - pSO4, pNO3, SOA, - had sources that were both regional and local in origin and with contributions that varied seasonally. These results will be useful in understanding ambient particulate matter sources on a city scale that will support air quality management planning.

Short and long term exposure to air pollution increases the risk of ischemic heart disease

Previous studies have suggested an increased risk of ischemic heart disease related to air pollution. This study aimed to explore both the short-term and long-term effects of air pollutants on the risk of ischemic heart disease after adjusting for meteorological factors. The Korean National Health Insurance Service-Health Screening Cohort from 2002 to 2013 was used. Overall, 2155 participants with ischemic heart disease and 8620 control participants were analyzed. The meteorological data and air pollution data, including SO₂ (ppm), NO₂ (ppm), O₃ (ppm), CO (ppm), and particulate matter (PM)₁₀ (μg/m³), were analyzed using conditional logistic regression. Subgroup analyses were performed according to age, sex, income, and region of residence. One-month exposure to SO₂ was related to 1.36-fold higher odds for ischemic heart disease (95% confidence interval [95% CI] 1.06–1.75). One-year exposure to SO₂, O₃, and PM₁₀ was associated with 1.58- (95% CI 1.01–2.47), 1.53- (95% CI 1.27–1.84), and 1.14 (95% CI 1.02–1.26)-fold higher odds for ischemic heart disease. In subgroup analyses, the ≥ 60-year-old group, men, individuals with low income, and urban groups demonstrated higher odds associated with 1-month exposure to SO₂. Short-term exposure to SO₂ and long-term exposure to SO_2, O₃, and PM₁₀ were related to ischemic heart disease.

COVID-19 pandemic in Wuhan: Ambient air quality and the relationships between criteria air pollutants and meteorological variables before, during, and after lockdown

As a result of the lockdown (LD) control measures enacted to curtail the COVID-19 pandemic in Wuhan, almost all non-essential human activities were halted beginning on January 23, 2020 when the total lockdown was implemented. In this study, changes in the concentrations of the six criteria air pollutants (PM_2.5, PM₁₀, SO₂, NO₂, CO, and O₃) in Wuhan were investigated before (January 1 to 23, 2020), during (January 24 to April 5, 2020), and after the COVID-19 lockdown (April 6 to June 20, 2020) periods. Also, the relationships between the air pollutants and meteorological variables during the three periods were investigated. The results showed that there was significant improvement in air quality during the lockdown. Compared to the pre-lockdown period, the concentrations of NO₂, PM_2.5, PM₁₀, and CO decreased by 50.6, 41.2, 33.1, and 16.6%, respectively, while O₃ increased by 149% during the lockdown. After the lockdown, the concentrations of PM_2.5, CO and SO₂ declined by an additional 19.6, 15.6, and 2.1%, respectively. However, NO₂, O₃, and PM₁₀ increased by 55.5, 25.3, and 5.9%, respectively, compared to the lockdown period. Except for CO and SO₂, WS had negative correlations with the other pollutants during the three periods. RH was inversely related with all pollutants. Positive correlations were observed between temperature and the pollutants during the lockdown. Easterly winds were associated with peak PM_2.5 concentrations prior to the lockdown. The highest PM_2.5 concentrations were associated with southwesterly wind during the lockdown, and northwesterly winds coincided with the peak PM_2.5 concentrations after the lockdown. Although, COVID-19 pandemic had numerous negative effects on human health and the global economy, the reductions in air pollution and significant improvement in ambient air quality likely had substantial short-term health benefits. This study improves the understanding of the mechanisms that lead to air pollution under diverse meteorological conditions and suggest effective ways of reducing air pollution in Wuhan.

Cardiovascular effects of air pollution: current evidence from animal and human studies

Air pollution is a global health concern. Particulate matter (PM)_2.5, a component of ambient air pollution, has been identified by the World Health Organization as one of the pollutants that poses the greatest threat to public health. Cardiovascular health effects have been extensively documented, and these effects are still being researched to provide an overview of recent literature regarding air pollution-associated cardiovascular morbidity and mortality in humans. Additionally, potential mechanisms through which air pollutants affect the cardiovascular system are discussed based on human and additional animal studies. We used the strategy of a narrative review to summarize the scientific literature of studies that were published in the past 7 yr. Searches were carried out on PubMed and Web of Science using predefined search queries. We obtained an initial set of 800 publications that were filtered to 78 publications that were relevant to include in this review. Analysis of the literature showed significant associations between air pollution, especially PM_2.5, and the risk of elevated blood pressure (BP), acute coronary syndrome, myocardial infarction (MI), cardiac arrhythmia, and heart failure (HF). Prominent mechanisms that underlie the adverse effects of air pollution include oxidative stress, systemic inflammation, endothelial dysfunction, autonomic imbalance, and thrombogenicity. The current review underscores the relevance of air pollution as a global health concern that affects cardiovascular health. More rigorous standards are needed to reduce the cardiovascular disease burden imposed by air pollution. Continued research on the health impact of air pollution is needed to provide further insight.

The impact on heart rate and blood pressure following exposure to ultrafine particles from cooking using an electric stove

Cooking is a major source of indoor particulate matter (PM), especially ultrafine particles (UFPs). Long-term exposure to fine and ultrafine particles (UFPs) has been associated with adverse human health effects. Toxicological studies have demonstrated that exposure to PM_2.5 (particles with aerodynamic diameter smaller than 2.5 μm) may result in increased blood pressure (BP). Some clinical studies have shown that acute exposure to PM_2.5 causes changes in systolic (SBP) and diastolic blood pressure (DBP), depending on the source of particles. Studies assessing the effect of exposure to cooking PM on BP and heart rate (HR) using electric or gas stoves are not well represented in the literature. The aim of this investigation was to perform controlled studies to quantify the exposure of 50 healthy volunteer participants to fine and ultrafine particles emitted from a low-emissions recipe for frying ground beef on an electric stove. The BP and heart rate (HR) of the volunteers were monitored during exposure and after the exposure (2 h post-exposure). Maximum UFP and PM_2.5 concentrations were 6.5 × 10⁴ particles/cm³ and 0.017 mg/m³, respectively. Exposure to UFPs from frying was associated with statistically significant increases in the SBP. The lack of food and drink during the 2 h post-cooking period was also associated with a statistically significant reduction in SBP. No statistically significant changes in DBP were observed. Physiological factors, including heat stress over the stove, movements and anxiety, could be responsible for an elevation in HR at the early stages of the experiments with a subsequent drop in HR after 90 min post-cooking, when study participants were relaxed in a living room.

Temporal changes in short-term associations between cardiorespiratory emergency department visits and PM2.5 in Los Angeles, 2005 to 2016

BACKGROUND

Emissions control programs targeting certain air pollution sources may alter PM_2.5 composition, as well as the risk of adverse health outcomes associated with PM_2.5.

OBJECTIVES

We examined temporal changes in the risk of emergency department (ED) visits for cardiovascular diseases (CVDs) and asthma associated with short-term increases in ambient PM_2.5 concentrations in Los Angeles, California.

METHODS

Poisson log-linear models with unconstrained distributed exposure lags were used to estimate the risk of CVD and asthma ED visits associated with short-term increases in daily PM_2.5 concentrations, controlling for temporal and meteorological confounders. The models were run separately for three predefined time periods, which were selected based on the implementation of multiple emissions control programs (EARLY: 2005-2008; MIDDLE: 2009-2012; LATE: 2013-2016). Two-pollutant models with individual PM_2.5 components and the remaining PM_2.5 mass were also considered to assess the influence of changes in PM_2.5 composition on changes in the risk of CVD and asthma ED visits associated with PM_2.5 over time.

RESULTS

The relative risk of CVD ED visits associated with a 10 μg/m³ increase in 4-day PM_2.5 concentration (lag 0-3) was higher in the LATE period (rate ratio = 1.020, 95% confidence interval = [1.010, 1.030]) compared to the EARLY period (1.003, [0.996, 1.010]). In contrast, for asthma, relative risk estimates were largest in the EARLY period (1.018, [1.006, 1.029]), but smaller in the following periods. Similar temporal differences in relative risk estimates for CVD and asthma were observed among different age and season groups. No single component was identified as an obvious contributor to the changing risk estimates over time, and some components exhibited different temporal patterns in risk estimates from PM_2.5 total mass, such as a decreased risk of CVD ED visits associated with sulfate over time.

CONCLUSIONS

Temporal changes in the risk of CVD and asthma ED visits associated with short-term increases in ambient PM_2.5 concentrations were observed. These changes could be related to changes in PM_2.5 composition (e.g., an increasing fraction of organic carbon and a decreasing fraction of sulfate in PM_2.5). Other factors such as improvements in healthcare and differential exposure misclassification might also contribute to the changes.

Deep learning for predicting the occurrence of cardiopulmonary diseases in Nanjing, China

The efficiency of disease prevention and medical care service necessitated the prediction of incidence. However, predictive accuracy and power were largely impeded in a complex system including multiple environmental stressors and health outcome of which the occurrence might be episodic and irregular in time. In this study, we established four different deep learning (DL) models to capture inherent long-term dependencies in sequences and potential complex relationships among constituents by initiating with the original input into a representation at a higher abstract level. We collected 504,555 and 786,324 hospital outpatient visits of grouped categories of respiratory (RESD) and circulatory system disease (CCD), respectively, in Nanjing from 2013 through 2018. The matched observations in time-series that might pose risk to cardiopulmonary health involved conventional air pollutants concentrations and metrological conditions. The results showed that a well-trained network architecture built upon long short-term memory block and a working day enhancer achieved optimal performance by three quantitative statistics, i.e., 0.879 and 0.902 of Nash-Sutcliffe efficiency, 0.921% and 0.667% of percent bias, and 0.347 and 0.312 of root mean square error-standard deviation ratio for RESD and CCD hospital visits, respectively. We observed the non-linear association of nitrogen dioxide and ambient air temperature with CCD hospital visits. Furthermore, these two environmental stressors were identified as the most sensitive predictive variables, and exerted synergetic effect for two health outcomes, particular in winter season. Our study indicated that high-quality surveillance data of atmospheric environments could provide novel opportunity for anticipating temporal trend of cardiopulmonary health outcomes based on DL model.

Neurodegenerative hospital admissions and long-term exposure to ambient fine particle air pollution

PURPOSE

Long-term exposure to ambient fine particle (PM_2.5) concentrations has been associated with an increased rate or risk of neurodegenerative conditions, but individual PM sources have not been previously examined in relation to neurodegenerative diseases.

METHODS

Using the Statewide Planning and Research Cooperative System database, we studied 63,287 hospital admissions with a primary diagnosis of either Alzheimer's disease, dementia, or Parkinson's disease for New York State residents living within 15 miles from six PM_2.5 monitoring sites. In addition to PM_2.5 concentrations, we studied seven specific PM_2.5 sources: secondary sulfate, secondary nitrate, biomass burning, diesel, spark-ignition emissions, pyrolyzed organic rich, and road dust. We estimated the rate of neurodegenerative hospital admissions associated with increased concentration of PM_2.5 and individual PM_2.5 sources average concentrations in the previous 0-29, 0-179, and 0-364 days.

RESULTS

Increases in ambient PM_2.5 concentrations were not consistently associated with increased hospital admissions rates. Increased source-specific PM2.5 concentrations were associated with both increased (e.g., secondary sulfates and diesel emissions) and decreased rates (e.g., secondary nitrate and spark-ignition vehicular emissions) of neurodegenerative admissions.

CONCLUSIONS

We did not observe clear associations between overall ambient PM_2.5 concentrations or source-apportioned ambient PM_2.5 contributions and rates of neurologic disease hospitalizations.

Sandstorm weather is a risk factor for mortality in ischemic heart disease patients in the Hexi Corridor, northwestern China

Ischemic heart disease (IHD) is one of the leading causes of mortality worldwide. Moreover, the effects of air pollution have been associated with several cardiovascular diseases (CVDs). The relationship between sandstorm weather and IHD is unknown. The Hexi Corridor is located in northwestern China and is a typical desert region comprising a large area of desert with a high incidence of sandstorms. This study aimed to explore the association between sandstorm weather and IHD-related mortality in this area. We acquired meteorological data of sandstorm weather from 2006 to 2015 from the Gansu Meteorological Bureau, and data regarding deaths due to IHD in five cities within the Hexi Corridor were collected from the death registration system of the Center for Disease Control of Gansu during the same period. Two other cities with few sandstorm events were selected as control regions. The time series method of the generalized additive model (GAM) was used to assess the association between sandstorm weather and IHD-related mortality in the Hexi Corridor. The results showed that the frequency of sandstorms in the Hexi Corridor was higher than that in the control regions (5.48% vs 1.64%, P < 0.01), and IHD-related mortality was correspondingly higher than that in the control regions (56.42/100,000 vs 45.62/100,000, P < 0.01). After stratification by gender, age, and urban/rural residence, a significant difference in IHD-related mortality was also noted (P < 0.05). Significant associations were found between sandstorm weather and IHD-related mortality, and the relative risk (RR) increased with an increasing number of days of sandstorm weather. According to the monthly and annual analyses, the mortality rate corresponded to sandstorm frequency. Our data suggest a positive association between sandstorm weather and IHD-related mortality in the Hexi Corridor of Gansu Province. The underlying mechanism requires further study.

Construction of polluted aerosol in accumulation that affects the incidence of lung cancer

Background

This model demonstrated the correlation between lung cancer incidences and the parts of ambient air pollution according to the National Aeronautics and Space Administration (NASA)'s high resolution technology satellites.

Methods

Chemical type of aerosols was investigated by the Aerosol Diagnostics Model such as black carbon, mineral dust, organic carbon, sea-salt and SO4. The model investigated associations between the six year accumulation of each aerosol and lung cancer incidence by Bayesian hierarchical spatio-temporal model. Which also represented integrated geophysical parameters.

Results

In analyses of accumulated chemical aerosol component from 2010 – 2016, the incidence rate ratio (IRR) of patients in 2017 were estimated. We observed a significant increasing risk for organic carbon exposure (IRR 1.021, 95%CI 1.020–1.022), SO₄, (IRR 1.026, 95% CI 1.025–1.028) and dust, (IRR 1.061, 95% CI 1.058–1.064). There was also suggestion of an increased risk with, every 1 ug/m³ increase in organic carbon compound is associated with 21% increased risk of lung cancer, whereas a 26% excess risk of cancer per 1 ug/m³ increase in mean SO₄ and 61% increased risk of lung cancer for dust levels. The other variables were the negative IRR which did not increase the risk of the exposed group.

Conclusion

With our results, this process can determine that organic carbon, SO₄ and dust was significantly associated with the elevated risk of lung cancer.

Changes in the hospitalization and ED visit rates for respiratory diseases associated with source-specific PM2.5 in New York State from 2005 to 2016

Prior work found increased rates for emergency department (ED) visits for asthma and hospitalizations for chronic obstructive pulmonary disease per unit mass of PM2.5 across New York State (NYS) during 2014-2016 after significant reductions in ambient PM2.5 concentrations had occurred following implementation of various policy actions and major economic disruptions. The associations of source-specific PM2.5 concentrations with these respiratory diseases were assessed with a time-stratified case-cossover design and logistic regression models to identify the changes in the PM2.5 that have led to the apparently increased toxicity per unit mass. The rates of ED visits and hospitalizations for asthma and COPD associated with increases in source-specific PM2.5 concentrations in the prior 1, 4, and 7 days were estimated for 6 urban sites in New York State. Overall, there were similar numbers of significantly increased (n = 9) and decreased rates (n = 8) of respiratory events (asthma and COPD hospitalizations and ED visits) associated with increased source-specific PM2.5 concentrations in the previous 1, 4, and 7 days. Associations of source-specific PM2.5 concentrations with excess rates of hospitalizations for COPD for spark- and compression ignition vehicles increased in the 2014-2016 period, but the values were not statistically significant. Other source types showed inconsistent patterns of excess rates. For asthma ED visits, only biomass burning and road dust showed consistent positive associations with road dust having significant values for most lag times. Secondary nitrate also showed significant positive associations with asthma ED visits in the AFTER period compared to no associations in the prior periods. These results suggest that the relationships of asthma and COPD exacerbation with source-specific PM2.5 are not well defined and further work will be needed to determine the causes of the apparent increases in the per unit mass toxicity of PM2.5 in New York State in the 2014-16 period.

Associations between Source-Specific Particulate Matter and Respiratory Infections in New York State Adults

The response of respiratory infections to source-specific particulate matter (PM) is an area of active research. Using source-specific PM_2.5 concentrations at six urban sites in New York State, a case-crossover design, and conditional logistic regression, we examined the association between source-specific PM and the rate of hospitalizations and emergency department (ED) visits for influenza or culture-negative pneumonia from 2005 to 2016. There were at most N = 14 764 influenza hospitalizations, N = 57 522 influenza ED visits, N = 274 226 culture-negative pneumonia hospitalizations, and N = 113 997 culture-negative pneumonia ED visits included in our analyses. We separately estimated the rate of respiratory infection associated with increased concentrations of source-specific PM_2.5, including secondary sulfate (SS), secondary nitrate (SN), biomass burning (BB), pyrolyzed organic carbon (OP), road dust (RD), residual oil (RO), diesel (DIE), and spark ignition vehicle emissions (GAS). Increased rates of ED visits for influenza were associated with interquartile range increases in concentrations of GAS (excess rate [ER] = 9.2%; 95% CI: 4.3%, 14.3%) and DIE (ER = 3.9%; 95% CI: 1.1%, 6.8%) for lag days 0-3. There were similar associations between BB, SS, OP, and RO, and ED visits or hospitalizations for influenza, but not culture-negative pneumonia hospitalizations or ED visits. Short-term increases in PM_2.5 from traffic and other combustion sources appear to be a potential risk factor for increased rates of influenza hospitalizations and ED visits.