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Anbari K, Sicard P, Omidi Khaniabadi Y, Raja Naqvi H, Rashidi R. Assessing the effect of COVID-19 pandemic on air quality change and human health outcomes in a capital city, southwestern Iran. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2023; 33:1716-1727. [PMID: 36099327 DOI: 10.1080/09603123.2022.2120967] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 08/30/2022] [Indexed: 06/15/2023]
Abstract
The aimsof this study were to assess the spatial variation of PM2.5, NO2, and O3 between 2019 (before) and 2020 (during COVID-19 pandemic); and calculation the health outcomes of exposure to these pollutants. The daily PM2.5, NO2, and O3 concentrations were applied to assess health effects by relative risk, and baseline incidence. The annual PM2.5 and NO2 mean concentrations exceeded the WHO guideline values, while O3 did not exceed. The restrictive measures associated to COVID-19 led to reduction at the annual means of PM2.5 and NO2 by -25.5% and -23.1%, respectively, while the annual mean of O3 increased by +7.9%. The number of M-CVD and M-RD (-25.6%, -26.1%) related to PM2.5 exposure, and HA-COPD and HA-RD >65 years old (-21% and -3.84%) related to NO2 exposure were reduced in 2020, and O3 exposure-related M-CVD (+30.1%) and HA-RD >65 years old (+23.4%) increased compared to the previous year 2019.
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Affiliation(s)
- Khatereh Anbari
- Social Determinants of Health Research Center, School of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| | | | - Yusef Omidi Khaniabadi
- Occupational and Environmental Health Research Center, Petroleum Industry Health Organization (PIHO), Ahvaz, Iran
| | - Hasan Raja Naqvi
- Department of Geography, Faculty of Natural Sciences, Jamia Millia Islamia, New Delhi, India
| | - Rajab Rashidi
- Department of Occupational Health, Nutritional Health Research Center, School of Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran
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Liu Y, You J, Dong J, Wang J, Bao H. Ambient carbon monoxide and relative risk of daily hospital outpatient visits for respiratory diseases in Lanzhou, China. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2023; 67:1913-1925. [PMID: 37726554 DOI: 10.1007/s00484-023-02550-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 08/03/2023] [Accepted: 08/29/2023] [Indexed: 09/21/2023]
Abstract
At present, evidence of the associations between carbon monoxide (CO) and respiratory diseases (RD) in Northwest China is limited and controversial. The aim of this study is to evaluate the impact of ambient CO on outpatient visits for RD in Lanzhou, China. The daily amount of outpatient visits for total and cause-specific RD, air pollutant, and weather variables were collected in Lanzhou, China from 1st January 2013 to 31st December 2019. A generalized additive model and distributed lag nonlinear model were used to assess associations between CO and outpatient visits for RD. During the study period, a total of 1,623,361 RD outpatient visits were recorded. For each interquartile range (IQR) (0.77 mg/m3) increase in CO, the relative risk (RR) was 1.163 (95% CI: 1.138, 1.188) for total RD at lag07, 1.153 (95% CI: 1.128,1.179) for upper respiratory tract infection (URTI) at lag07, 1.379 (95% CI: 1.338,1.422) for pneumonia at lag07, 1.029 (95% CI: 0.997,1.062) for chronic obstructive pulmonary disease (COPD) lag04, 1.068 (95% CI: 1.028,1.110) for asthma lag03, and 1.212 (95% CI: 1.178,1.247) for bronchitis lag07, respectively. In the subgroup analyses, the impacts of CO were more pronounced on total RD, pneumonia, COPD, and bronchitis in males than females, while the opposite was true in URTI and asthma. The impact of CO on RD was the strongest for children under 15 years-of-age. We also found significantly stronger effects during cold seasons compared to warm seasons. In addition, we observed a roughly linear exposure-response curve between CO and RD with no threshold effect. This study in Lanzhou revealed a remarkable association between CO level and an elevated risk of total and cause-specific RD outpatient visits, especially for pneumonia.
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Affiliation(s)
- Yaocong Liu
- School of Public Health, Lanzhou University, Lanzhou, 730000, People's Republic of China
| | - Jianhua You
- School of Public Health, Lanzhou University, Lanzhou, 730000, People's Republic of China
| | - Jiyuan Dong
- School of Public Health, Lanzhou University, Lanzhou, 730000, People's Republic of China.
| | - Jiancheng Wang
- Gansu Provincial Hospital, Lanzhou, 730050, People's Republic of China
| | - Hairong Bao
- Department of Gerontal Respiratory Medicine, The First Hospital of Lanzhou University, Lanzhou, 730000, China
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Aranburu-Imatz A, Jiménez-Hornero JE, Morales-Cané I, López-Soto PJ. Environmental pollution in North-Eastern Italy and its influence on chronic obstructive pulmonary disease: time series modelling and analysis using visibility graphs. AIR QUALITY, ATMOSPHERE, & HEALTH 2023; 16:793-804. [PMID: 36714016 PMCID: PMC9875196 DOI: 10.1007/s11869-023-01310-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 01/16/2023] [Indexed: 06/01/2023]
Abstract
The impact on human health from environmental pollution is receiving increasing attention. In the case of respiratory diseases such as chronic obstructive pulmonary disease (COPD), the relationship is now well documented. However, few studies have been carried out in areas with low population density and low industrial production, such as the province of Belluno (North-Eastern Italy). The aim of the study was to analyze the effect of exposure to certain pollutants on the temporal dynamics of hospital admissions for COPD in the province of Belluno. Daily air pollution concentration, humidity, precipitations, and temperature were collected from the air monitoring stations in Belluno. Generalized additive mixed models (GAMM) and visibility graphs were used to determine the effects of the short-term exposure to environmental agents on hospital admissions associated to COPD. In the case of the city of Belluno, the GAMM showed that hospital admissions were associated with NO2, PM10, date, and temperature, while for the city of Feltre, GAMM produced no associated variables. Several visibility graph indices (average edge overlap and interlayer mutual information) showed a significant overlap between environmental agents and hospital admission for both cities. Our study has shown that visibility graphs can be useful in establishing associations between environmental agents and COPD hospitalization in sparsely populated areas.
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Affiliation(s)
- Alejandra Aranburu-Imatz
- Department of Nursing, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Av. Menéndez Pidal S/N., 14004 Córdoba, Spain
- Department of Nursing, Pharmacology and Physiotherapy, University of Cordoba, Córdoba, Spain
- Outpatient Clinic, Hospital Giovanni Paolo II, ULSS1 Dolomiti, Veneto, Italy
| | | | - Ignacio Morales-Cané
- Department of Nursing, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Av. Menéndez Pidal S/N., 14004 Córdoba, Spain
- Department of Nursing, Pharmacology and Physiotherapy, University of Cordoba, Córdoba, Spain
- Department of Nursing, Hospital Universitario Reina Sofía de Córdoba, Córdoba, Spain
| | - Pablo Jesús López-Soto
- Department of Nursing, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Av. Menéndez Pidal S/N., 14004 Córdoba, Spain
- Department of Nursing, Pharmacology and Physiotherapy, University of Cordoba, Córdoba, Spain
- Department of Nursing, Hospital Universitario Reina Sofía de Córdoba, Córdoba, Spain
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Jiang YX, Zhou LX, Yang LL, Huang QS, Xiao H, Li DW, Zhou YM, Hu YG, Tang EJ, Li YF, Ji AL, Luo P, Cai TJ. The association between short-term exposure to ambient carbon monoxide and hospitalization costs for bronchitis patients: A hospital-based study. ENVIRONMENTAL RESEARCH 2022; 210:112945. [PMID: 35202627 DOI: 10.1016/j.envres.2022.112945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 12/28/2021] [Accepted: 02/09/2022] [Indexed: 06/14/2023]
Abstract
Ambient carbon monoxide (CO) is associated with bronchitis morbidity, but there is no evidence concerning its correlation with hospitalization costs for bronchitis patients. This study aimed to investigate the relationship between short-term ambient CO exposure and hospitalization costs for bronchitis patients in Chongqing, China. Baseline data for 3162 hospitalized bronchitis patients from November 2013 to December 2019 were collected. Multiple linear regression analysis was used to determine the association, delayed and cumulative, between short-term CO exposure and hospitalization costs. Additionally, subgroup analyses were performed by gender, age, season, and comorbidity. Positive association between CO and hospitalization costs for bronchitis patients was observed. The strongest association was observed at lag 015 days, with per 1 mg/m3 increase of CO concentrations corresponded to 5834.40 Chinese Yuan (CNY) (95% CI: 2318.71, 9350.08; P < 0.001) (845.97 US dollars) increment in hospitalization costs. Stratified analysis results showed that the association was more obvious among those males, elderly, with comorbidities, and in warm seasons. More importantly, there was strongest correlation between CO and bronchitis patients with coronary heart disease. In summary, short-term exposure to ambient CO, even lower than Chinese and WHO standards, can be associated with increased hospitalization costs for bronchitis. Controlling CO exposure can be helpful to reduce medical burden associated with bronchitis patients. The results also suggest that when setting air quality standards and formulating preventive measures, susceptible subpopulations ought to be considered.
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Affiliation(s)
- Yue-Xu Jiang
- Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China; Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Lai-Xin Zhou
- Medical Department, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, 400037, China
| | - Li-Li Yang
- Department of Information, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, 400037, China
| | - Qing-Song Huang
- Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China; Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Hua Xiao
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Da-Wei Li
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Yu-Meng Zhou
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Yue-Gu Hu
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - En-Jie Tang
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Ya-Fei Li
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Ai-Ling Ji
- Department of Preventive Medicine, Chongqing Medical and Pharmaceutical College, Chongqing, 401331, China.
| | - Peng Luo
- Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China.
| | - Tong-Jian Cai
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China.
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Silva Rodriguez ME, Silveyra P. Air Pollution Exposure as a Relevant Risk Factor for Chronic Obstructive Pulmonary Disease Exacerbations in Male and Female Patients. EUROPEAN MEDICAL JOURNAL 2022. [DOI: 10.33590/emj/21-00228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a multifactorial lung inflammatory disease that affects 174 million people worldwide, with a recently reported increased incidence in female patients. Patients with COPD are especially vulnerable to the detrimental effects of environmental exposures, especially from air particulate and gaseous pollutants; exposure to air pollution severely influences COPD outcomes, resulting in acute exacerbations, hospitalisations, and death. Here, a literature review of the recent work addressing air pollution-induced acute exacerbations of COPD (AECOPD) was conducted in order to determine whether sex was considered as a biological variable in these studies, and whether air pollution exposure affected patients with COPD in a sex-specific manner. It was found that, while the majority of studies enrolled both male and female patients, only a few reported results were disaggregated by sex. Most studies had a higher enrolment of male patients, only four compared AECOPD outcomes between sexes, and only one study identified sex differences in AECOPD, with females displaying higher rates. Overall, this analysis of the literature confirmed that air pollution exposure is a trigger for AECOPD hospitalisations and revealed a significant gap in the knowledge of sex-specific effects of air pollutants on COPD outcomes, highlighting the need for more studies to consider sex as a biological variable.
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Affiliation(s)
| | - Patricia Silveyra
- School of Public Health, Indiana University Bloomington, Indiana, USA
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Wine O, Osornio Vargas A, Campbell SM, Hosseini V, Koch CR, Shahbakhti M. Cold Climate Impact on Air-Pollution-Related Health Outcomes: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1473. [PMID: 35162495 PMCID: PMC8835073 DOI: 10.3390/ijerph19031473] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/14/2022] [Accepted: 01/24/2022] [Indexed: 01/05/2023]
Abstract
In cold temperatures, vehicles idle more, have high cold-start emissions including greenhouse gases, and have less effective exhaust filtration systems, which can cause up to ten-fold more harmful vehicular emissions. Only a few vehicle technologies have been tested for emissions below -7 °C (20 °F). Four-hundred-million people living in cities with sub-zero temperatures may be impacted. We conducted a scoping review to identify the existing knowledge about air-pollution-related health outcomes in a cold climate, and pinpoint any research gaps. Of 1019 papers identified, 76 were selected for review. The papers described short-term health impacts associated with air pollutants. However, most papers removed the possible direct effect of temperature on pollution and health by adjusting for temperature. Only eight papers formally explored the modifying effect of temperatures. Five studies identified how extreme cold and warm temperatures aggravated mortality/morbidity associated with ozone, particles, and carbon-monoxide. The other three found no health associations with tested pollutants and temperature. Additionally, in most papers, emissions could not be attributed solely to traffic. In conclusion, evidence on the relationship between cold temperatures, traffic-related pollution, and related health outcomes is lacking. Therefore, targeted research is required to guide vehicle regulations, assess extreme weather-related risks in the context of climate change, and inform public health interventions.
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Affiliation(s)
- Osnat Wine
- Department of Mechanical Engineering, Faculty of Engineering, University of Alberta, Edmonton, AB T6G 1H9, Canada; (O.W.); (C.R.K.)
| | - Alvaro Osornio Vargas
- Department of Paediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB T6G 1C9, Canada;
| | - Sandra M. Campbell
- Health Sciences Library, University of Alberta, Edmonton, AB T6G 2R7, Canada;
| | - Vahid Hosseini
- School of Sustainable Energy Engineering, Simon Fraser University, Surrey, BC V3T 0N1, Canada;
| | - Charles Robert Koch
- Department of Mechanical Engineering, Faculty of Engineering, University of Alberta, Edmonton, AB T6G 1H9, Canada; (O.W.); (C.R.K.)
| | - Mahdi Shahbakhti
- Department of Mechanical Engineering, Faculty of Engineering, University of Alberta, Edmonton, AB T6G 1H9, Canada; (O.W.); (C.R.K.)
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The Impact of Air Pollutants and Meteorological Factors on Chronic Obstructive Pulmonary Disease Exacerbations: A Nationwide Study. Ann Am Thorac Soc 2021; 19:214-226. [PMID: 34499589 DOI: 10.1513/annalsats.202103-298oc] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
RATIONALE Chronic obstructive lung disease (COPD) is a chronic progressive disease. Although smoking is the most important risk factor, 30% of COPD patients are never smokers, and environmental agents are also influential. The effects of air pollutants and meteorological factors on COPD exacerbations have not been studied extensively. OBJECTIVE We aimed to investigate the air pollutants and meteorological factors that impact the incidence of COPD exacerbations. METHODS We obtained clinical data of COPD exacerbation cases from The National Health Insurance Service (NHIS) and merged it with 24-hour average values of air pollutants and meteorological factors from national databases. Patients who reside in eight metropolitan cities, where observatory stations are densely located, were selected for analysis. RESULTS In 1,404,505 COPD patients between 2013 and 2018, 15,282 COPD exacerbations leading to hospitalization or emergency room visits were identified. Among the various air pollutants and meteorological factors, particulate matter (PM)2.5, PM10, NO2, SO2, CO, O3, average temperature and diurnal temperature range (DTR) were associated with COPD exacerbations. GAM model analysis with cubic splines showed an inverted U-shaped relationship with PM2.5, PM10, CO, NO2, SO2, O3, DTR and humidity, while it displayed a U-shaped pattern with the average temperature. Distinct patterns were found from 2015-2016 to 2017-2018. CONCLUSIONS PM2.5, PM10, CO, NO2, O3, SO2, average temperature, humidity, and DTR affected the incidence of COPD exacerbations in various patterns, up to 10 lag days.
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The effect of nitrogen dioxide and atmospheric pressure on hospitalization risk for chronic obstructive pulmonary disease in Guangzhou, China. Respir Med 2021; 182:106424. [PMID: 33932714 DOI: 10.1016/j.rmed.2021.106424] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 04/13/2021] [Accepted: 04/16/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND The relationship between air pollution and meteorological factors on diseases has become a research hotspot recently. Nevertheless, few studies have touched the inferences of nitrogen dioxide (NO2) and atmospheric pressure (AP) on hospitalization risk for chronic obstructive pulmonary disease (COPD). OBJECTIVES To investigate the short-term impact of particulate air pollutants and meteorology factors on hospitalizations for COPD and quantify the corresponding risk burden of hospital admission. METHODS In our study, COPD cases were collected from Guangzhou Panyu Central Hospital (n = 11,979) from Dec of 2013 to Jun 2019. The 24-h average temperature, relative humidity (RH), wind speed (V), AP and other meteorological data were obtained from Guangzhou Meteorological Bureau. Air pollution data were collected from Guangzhou Air Monitoring Station. The influence of different NO2 and AP values on COPD risk was quantified by a distributed lag nonlinear model (DLNM) combined with Poisson Regression and Time Series analysis. RESULTS We found that NO2 had a non-linear relationship with the incidence of COPD, with an approximate "M" type, appearing at the peaks of 126 μg/m³ (RR = 1.32, 95%CI, 1.07 to 1.64) and 168 μg/m³ (RR = 1.21, 95%CI, 0.94 to 1.55), respectively. And the association between AP and COPD incidence exhibited an approximate J-shape with a peak occurring at 1035 hPa (RR = 1.16, 95% CI, 1.02 to 1.31). CONCLUSIONS The nonlinear relationship of NO2 and AP on COPD admission risk in different periods of lag can be used to establish an early warning system for diseases and reduce the possible outbreaks and burdens of COPD in a sensitive population.
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Wang Z, Zhou Y, Zhang Y, Huang X, Duan X, Chen D, Ou Y, Tang L, Liu S, Hu W, Liao C, Zheng Y, Wang L, Xie M, Zheng J, Liu S, Luo M, Wu F, Deng Z, Tian H, Peng J, Yang H, Xiao S, Wang X, Zhong N, Ran P. Association of change in air quality with hospital admission for acute exacerbation of chronic obstructive pulmonary disease in Guangdong, China: A province-wide ecological study. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2021; 208:111590. [PMID: 33396113 DOI: 10.1016/j.ecoenv.2020.111590] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 10/27/2020] [Accepted: 10/30/2020] [Indexed: 06/12/2023]
Abstract
AIMS To assess possible effect of air quality improvements, we investigated the temporal change in hospital admissions for acute exacerbations of chronic obstructive pulmonary disease (AECOPD) associated with pollutant concentrations. METHODS We collected daily concentrations of particulate matter (i.e., PM2.5, PM10 and PMcoarse), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), ozone (O3), and admissions for AECOPD for 21 cities in Guangdong from 2013 to 2017. We examined the association of air pollution with AECOPD admissions using two-stage time-series analysis, and estimated the annual attributable fractions, numbers, and direct hospitalization costs of AECOPD admissions with principal component analysis. RESULTS From 2013-2017, mean daily concentrations of SO2, PM10 and PM2.5 declined by nearly 40%, 30%, and 26% respectively. As the average daily 8 h O3 concentration increased considerably, the number of days exceeding WHO target (i.e.,100 μg/m³) increased from 103 in 2015-152 in 2017. For each interquartile range increase in pollutant concentration, the relative risks of AECOPD admission at lag 0-3 were 1.093 (95% CI 1.06-1.13) for PM2.5, 1.092 (95% CI 1.08-1.11) for O3, and 1.092 (95% CI 1.05-1.14) for SO2. Attributable fractions of AECOPD admission advanced by air pollution declined from 9.5% in 2013 to 4.9% in 2016, then increased to 6.0% in 2017. A similar declining trend was observed for direct AECOPD hospitalization costs. CONCLUSION Declined attributable hospital admissions for AECOPD may be associated with the reduction in concentrations of PM2.5, PM10 and SO2 in Guangdong, while O3 has emerged as an important risk factor. Summarizes the main finding of the work: Reduction in PM may result in declined attributable hospitalizations for AECOPD, while O3 has emerged as an important risk factor following an intervention.
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Affiliation(s)
- Zihui Wang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Yumin Zhou
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Yongbo Zhang
- Department of Environmental Protection of Guangdong Province, Guangdong Provincial Academy of Environmental Science, Guangzhou, China
| | - Xiaoliang Huang
- Department of Health of Guangdong Province, Government Affairs Service Center of Health Commission of Guangdong Province, Guangzhou, China
| | - Xianzhong Duan
- Department of Environmental Protection of Guangdong Province, Department of Ecology and Environment of Guangdong Province, Guangzhou, China
| | - Duohong Chen
- Department of Environmental Protection of Guangdong Province, Guangdong Environmental Monitoring Center, Key Laboratory of Regional Air Quality Monitoring, Ministry of Environmental Protection, Guangzhou, China
| | - Yubo Ou
- Department of Environmental Protection of Guangdong Province, Guangdong Environmental Monitoring Center, Key Laboratory of Regional Air Quality Monitoring, Ministry of Environmental Protection, Guangzhou, China
| | - Longhui Tang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Shiliang Liu
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China; Center for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Canada
| | - Wei Hu
- Department of Health of Guangdong Province, Government Affairs Service Center of Health Commission of Guangdong Province, Guangzhou, China
| | - Chenghao Liao
- Department of Environmental Protection of Guangdong Province, Guangdong Provincial Academy of Environmental Science, Guangzhou, China
| | - Yijia Zheng
- Department of Environmental Protection of Guangdong Province, Guangdong Provincial Academy of Environmental Science, Guangzhou, China
| | - Long Wang
- Department of Environmental Protection of Guangdong Province, Guangdong Provincial Academy of Environmental Science, Guangzhou, China
| | - Min Xie
- Department of Environmental Protection of Guangdong Province, Guangdong Environmental Monitoring Center, Key Laboratory of Regional Air Quality Monitoring, Ministry of Environmental Protection, Guangzhou, China
| | - Jinzhen Zheng
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Sha Liu
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Ming Luo
- School of Geography and Planning, Sun Yat Sen University, Guangzhou, China
| | - Fan Wu
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Zhishan Deng
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Heshen Tian
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Jieqi Peng
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Huajing Yang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Shan Xiao
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Xinwang Wang
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Nanshan Zhong
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Pixin Ran
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China.
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Xu C, Fan YN, Liang Z, Xiao SH, Huang L, Kan HD, Chen RJ, Liu XL, Yao CY, Luo G, Zhang Y, Li YF, Ji AL, Cai TJ. Unexpected association between increased levels of ambient carbon monoxide and reduced daily outpatient visits for vaginitis: A hospital-based study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 723:137923. [PMID: 32220730 DOI: 10.1016/j.scitotenv.2020.137923] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 02/16/2020] [Accepted: 03/12/2020] [Indexed: 06/10/2023]
Abstract
Carbon monoxide (CO) is a well-known "toxic gas". It represents a toxic inhalation hazard at high concentration and is commonly found in polluted air. However, a series of recent studies have suggested that low concentration of CO can also produce protective functions. This study was performed to investigate the association between ambient CO exposure and vaginitis outpatient visits. Daily baseline outpatient data of vaginitis from January 1, 2013 to December 31, 2015 were obtained from Xi'an, a heavily-polluted metropolis in China. The over-dispersed Poisson generalized additive model was applied to discover the relations between short-term ambient CO exposure and the number of vaginitis outpatient visits by adjusting day of the week and weather conditions. A total of 16,825 outpatient hospital visits for vaginitis were recorded. The mean daily concentration of carbon monoxide (CO) was well below Chinese and WHO guidelines. During the study period, increased levels of ambient CO was associated with reduced outpatient-visits through concurrent to lag 5 days, and the most significant association was evidenced at lag 05. A 0.1 mg/m3 increase in daily average CO at lag 05 corresponded to -1.25% (95%CI: -1.85%, -0.65%) change in outpatient-visits for vaginitis. Moreover, the association was more significant in those women aged 20-29 years. After adjustment for PM10, PM2.5, SO2, and NO2, and O3, the negative associations of CO with vaginitis kept significant, suggesting relative stability of effect estimates. In summary, this is the first evidence that increased ambient CO exposure can be related to reduced daily outpatient visits for vaginitis. The results of our study may not only help to establish more comprehensive understanding of the health effects of ambient air on vaginitis and other gynecological diseases, but also provide a clue to new potential interventions.
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Affiliation(s)
- Chen Xu
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, China; Troop 94498 of PLA, Nanyang, China
| | - Yan-Ni Fan
- Medical Record Room of Information Department, Tangdu Hospital, Air Force Medical University (Fourth Military Medical University), Xi'an, China
| | - Zhen Liang
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, China; Department of Obstetrics and Gynecology, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | | | | | - Hai-Dong Kan
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai, China
| | - Ren-Jie Chen
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai, China
| | - Xiao-Ling Liu
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, China
| | - Chun-Yan Yao
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, China
| | - Gan Luo
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, China
| | - Yao Zhang
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, China
| | - Ya-Fei Li
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, China
| | - Ai-Ling Ji
- Department of Preventive Medicine & Chongqing Engineering Research Center of Pharmaceutical Sciences, Chongqing Medical and Pharmaceutical College, Chongqing, China.
| | - Tong-Jian Cai
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, China.
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11
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Gao H, Wang K, W. Au W, Zhao W, Xia ZL. A Systematic Review and Meta-Analysis of Short-Term Ambient Ozone Exposure and COPD Hospitalizations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17062130. [PMID: 32210080 PMCID: PMC7143242 DOI: 10.3390/ijerph17062130] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 03/16/2020] [Accepted: 03/20/2020] [Indexed: 02/05/2023]
Abstract
Chronic obstructive pulmonary disease (COPD) is the third leading cause of death globally and ozone exposure is a main cause of its disease burden. However, studies on COPD hospitalizations from short-term ambient level ozone exposure have not generated consensus results. To address the knowledge gap, comprehensive and systematic searches in several databases were conducted using specific keywords for publications up to February 14, 2020. Random-effect models were used to derive overall excess risk estimates between short-term ambient-level ozone exposure and COPD hospitalizations. The influence analyses were used to test the robustness of the results. Both meta-regression and subgroup analyses were used to explore the sources of heterogeneity and potential modifying factors. Based on the results from 26 eligible studies, the random-effect model analyses show that a 10 µg/m3 increase in maximum 8-h ozone concentration was associated with 0.84% (95% CI: 0.09%, 1.59%) higher COPD hospitalizations. The estimates were higher for warm season and multiple-day lag but lower for old populations. Results from subgroup analyses also indicate a multiple-day lag trend and bigger significant health effects during longer day intervals. Although characteristics of individual studies added modest heterogeneity to the overall estimates, the results remained robust during further analyses and exhibited no evidence of publication bias. Our systematic review and meta-analysis indicate that short-term ambient level ozone exposure was associated with increased risk of COPD hospitalizations. The significant association with multiple-day lag trend indicates that a multiple-day exposure metric should be considered for establishing ambient ozone quality and exposure standards for improvement of population health. Future investigations and meta-analysis studies should include clinical studies as well as more careful lag selection protocol.
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Affiliation(s)
- Hui Gao
- Changning Center for Disease Control and Prevention, Shanghai 200051, China;
| | - Kan Wang
- School of Public Health, & Key Laboratory of Public Health Safety of Ministry of Education of China, Fudan University, Shanghai 200032, China;
- Department of Epidemiology, Erasmus Medical Center, 3000CA Rotterdam, The Netherlands
| | - William W. Au
- University of Medicine, Pharmacy, Science and Techonology, 540142 Tirgu Mures, Romania;
- Faculty of Preventive Medicine and MPH Education Center, Shantou University Medical College, Shantou 515041, China
| | - Wensui Zhao
- Changning Center for Disease Control and Prevention, Shanghai 200051, China;
- Correspondence: (W.Z.); (Z.-l.X.); Tel./Fax: +86-21-520-641-06 (W.Z.); +86-21-542-370-90 (Z.-l.X.)
| | - Zhao-lin Xia
- School of Public Health, & Key Laboratory of Public Health Safety of Ministry of Education of China, Fudan University, Shanghai 200032, China;
- Correspondence: (W.Z.); (Z.-l.X.); Tel./Fax: +86-21-520-641-06 (W.Z.); +86-21-542-370-90 (Z.-l.X.)
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12
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Qu F, Liu F, Zhang H, Chao L, Guan J, Li R, Yu F, Yan X. Comparison of air pollutant-related hospitalization burden from AECOPD in Shijiazhuang, China, between heating and non-heating season. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:31225-31233. [PMID: 31463744 DOI: 10.1007/s11356-019-06242-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 08/16/2019] [Indexed: 06/10/2023]
Abstract
Few researches have been investigated on the effects of ambient air pollutants from coal combustion on acute exacerbation of chronic obstructive pulmonary disease (AECOPD) hospitalizations. The whole time series was split into heating season and non-heating season. We used a quasi-Poisson generalized linear regression model combined with distributed lag non-linear models (DLNMs) to estimate the relative cumulative risk and calculate the air pollutant hospitalization burden of AECOPD for lag 0-7 days in heating season and non-heating season. There were higher PM2.5, PM10, NO2, SO2, and CO concentrations in heating seasons than non-heating season in Shijiazhuang; however, O3 was higher in non-heating season than heating season. The AECOPD-associated relative cumulative risks for PM2.5, PM10, NO2, and SO2 for lag 0-7 days were significantly positively associated with hospitalization in heating and non-heating season; we found that the cumulative relative risk of NO2 was the greatest in every 1 unit of air pollutants during the heating season and the cumulative relative risk of SO2 was the greatest during the non-heating season. The results showed that 17.8%, 12.9%, 1.7%, 16.7%, and 10.5% of AECOPD hospitalizations could be attributable to PM2.5, PM10, SO2, NO2, and CO exposure in heating season, respectively. However, the results showed that 19.5%, 22.4%, 15%, 8.3%, and 10.4% of AECOPD hospitalizations could be attributable to PM2.5, PM10, SO2, NO2, and O3 exposure in non-heating season, respectively. The attributable burden of AECOPD hospitalization in heating season and non-heating season are different. PM2.5, PM10, NO2, and CO are the main factors of heating season, while PM10, PM2.5, SO2, and O3 are the main factors of non-heating season. In conclusions, the centralized heating can change the influence of attributable risk. When government departments formulate interventions to reduce the risk of acute hospitalization of chronic obstructive pulmonary disease (COPD), the influence of heating on disease burden should be considered.
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Affiliation(s)
- Fangfang Qu
- Department of Respiratory and Critical Care Medicine, The Second Hospital of HeBei Medical University, No. 215 Heping West Road, Shijiazhuang, Hebei Province, China
- HeBei institute of Respiratory Disease, Shijiazhuang, China
| | - Feifei Liu
- Department of Respiratory and Critical Care Medicine, The Second Hospital of HeBei Medical University, No. 215 Heping West Road, Shijiazhuang, Hebei Province, China
- HeBei institute of Respiratory Disease, Shijiazhuang, China
| | - Huiran Zhang
- Department of Respiratory and Critical Care Medicine, The Second Hospital of HeBei Medical University, No. 215 Heping West Road, Shijiazhuang, Hebei Province, China
- HeBei institute of Respiratory Disease, Shijiazhuang, China
| | - Lingshan Chao
- Department of Respiratory and Critical Care Medicine, The Second Hospital of HeBei Medical University, No. 215 Heping West Road, Shijiazhuang, Hebei Province, China
- HeBei institute of Respiratory Disease, Shijiazhuang, China
| | - Jitao Guan
- Department of Respiratory and Critical Care Medicine, The Second Hospital of HeBei Medical University, No. 215 Heping West Road, Shijiazhuang, Hebei Province, China
- HeBei institute of Respiratory Disease, Shijiazhuang, China
| | - Rongqin Li
- Department of Central Laboratory, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, China
| | - Fengxue Yu
- Department of Central Laboratory, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei Province, China
| | - Xixin Yan
- Department of Respiratory and Critical Care Medicine, The Second Hospital of HeBei Medical University, No. 215 Heping West Road, Shijiazhuang, Hebei Province, China.
- HeBei institute of Respiratory Disease, Shijiazhuang, China.
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13
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Zhao Y, Hu J, Tan Z, Liu T, Zeng W, Li X, Huang C, Wang S, Huang Z, Ma W. Ambient carbon monoxide and increased risk of daily hospital outpatient visits for respiratory diseases in Dongguan, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 668:254-260. [PMID: 30852202 DOI: 10.1016/j.scitotenv.2019.02.333] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 02/21/2019] [Accepted: 02/21/2019] [Indexed: 04/13/2023]
Abstract
BACKGROUND The toxicity of high-concentration carbon monoxide (CO) on human health has previously been documented. However, the epidemiological evidence on the association between acute exposure to ambient CO and respiratory diseases is relatively lacking and controversial. OBJECTIVES To examine the short-term association between ambient CO and hospital outpatient visits for respiratory diseases in Dongguan, China. METHODS The number of daily hospital outpatient visits for respiratory diseases, and air pollution and meteorological data were collected from January 2013 to August 2017. A generalized additive model with a quasi-Poisson link was used to estimate the association between ambient CO concentration and the total number of hospital outpatient visits for all respiratory diseases and those for asthma, bronchiectasis, chronic obstructive pulmonary disease (COPD) and pneumonia. We further analyzed the effect of ambient CO by gender and age. RESULTS Over the study period, a 24-h mean concentration of ambient CO of 0.88 mg/m3 (below the limit for CO in China) and a total of 89,484 hospital outpatient visits for respiratory diseases were recorded. Ambient CO was found to increase the risk for asthma, bronchiectasis, pneumonia and the total number of respiratory diseases. The per interquartile range (IQR) increase in ambient CO at lag03 day corresponded to a 5.62% (95% confidence interval (CI): 3.24%, 8.05%), 8.86% (95% CI: 4.89%, 12.98%), 6.67% (95% CI: 0.87%, 12.81%) and 7.20% (95% CI: 2.35%, 12.29%) increased risk in outpatient visits for all respiratory diseases, asthma, bronchiectasis and pneumonia, respectively. Each association was partially weakened after adjusting for co-pollutants. The effect of ambient CO on respiratory diseases appeared to be greater for females and the elderly. CONCLUSIONS Short-term exposure to ambient CO was associated with increased risk of outpatient visits for respiratory diseases. Our analysis may help to understand the health effects of low-levels of CO and provide evidence for the creation of air quality standards.
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Affiliation(s)
- Yiju Zhao
- Department of Respirator Medicine, The Fifth People's Hospital of Dongguan, Dongguan 523905, China
| | - Jianxiong Hu
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou 510220, China
| | - Zhenwei Tan
- Record Room, The Fifth People's Hospital of Dongguan, Dongguan 523905, China
| | - Tao Liu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Weilin Zeng
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Xing Li
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China
| | - Caiyan Huang
- Department of Respirator Medicine, The Fifth People's Hospital of Dongguan, Dongguan 523905, China
| | - Shengyong Wang
- Medical College, Jinan University, Guangzhou 510632, China
| | - Zhao Huang
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou 510220, China
| | - Wenjun Ma
- School of Public Health, Southern Medical University, Guangzhou 510515, China; Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China.
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14
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de Miguel-Díez J, Hernández-Vázquez J, López-de-Andrés A, Álvaro-Meca A, Hernández-Barrera V, Jiménez-García R. Analysis of environmental risk factors for chronic obstructive pulmonary disease exacerbation: A case-crossover study (2004-2013). PLoS One 2019; 14:e0217143. [PMID: 31120946 PMCID: PMC6532877 DOI: 10.1371/journal.pone.0217143] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 05/07/2019] [Indexed: 12/14/2022] Open
Abstract
Purpose We aim to assess if air pollution levels and climatological factors are associated with hospital admissions for exacerbation of chronic obstructive pulmonary disease (COPD) in Spain from 2004 to 2013. Methods We conducted a retrospective study. Information on pollution level and climatological factors were obtained from the Spanish Meteorological Agency and hospitalizations from the Spanish hospital discharge database. A case-crossover design was used to identify factors associated with hospitalizations and in hospital mortality. Postal codes were used to assign climatic and pollutant factors to each patient. Results We detected 162,338 hospital admissions for COPD exacerbation. When seasonal effects were evaluated we observed that hospital admissions and mortality were more frequent in autumn and winter. In addition, we found significant associations of temperature, humidity, ozone (O3), carbon monoxide (CO), particulate matter up to 10 μm in size (PM10) and nitrogen dioxide (NO2) with hospital admissions. Lower temperatures at admission with COPD exacerbation versus 1, 1.5, 2 and 3 weeks prior to hospital admission for COPD exacerbation, were associated with a higher probability of dying in the hospital. Other environmental factors that were related to in-hospital mortality were NO2, O3, PM10 and CO. Conclusions Epidemiology of hospital admissions by COPD exacerbation was negatively affected by colder climatological factors (seasonality and absolute temperature) and short-term exposure to major air pollution (NO2, O3, CO and PM10).
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Affiliation(s)
- Javier de Miguel-Díez
- Pneumology Department, Hospital General Universitario Gregorio Marañón, Universidad Complutense de Madrid, Madrid, Spain
| | | | - Ana López-de-Andrés
- Preventive Medicine and Public Health Teaching and Research Unit, Department of Health Sciences, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
- * E-mail:
| | - Alejandro Álvaro-Meca
- Preventive Medicine and Public Health Teaching and Research Unit, Department of Health Sciences, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Valentín Hernández-Barrera
- Preventive Medicine and Public Health Teaching and Research Unit, Department of Health Sciences, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Rodrigo Jiménez-García
- Preventive Medicine and Public Health Teaching and Research Unit, Department of Health Sciences, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
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15
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Soleimani Z, Darvishi Boloorani A, Khalifeh R, Griffin DW, Mesdaghinia A. Short-term effects of ambient air pollution and cardiovascular events in Shiraz, Iran, 2009 to 2015. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:6359-6367. [PMID: 30617889 DOI: 10.1007/s11356-018-3952-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Accepted: 12/07/2018] [Indexed: 06/09/2023]
Abstract
Air pollution and dust storms are associated with increased cardiovascular hospital admissions. The aim of this study was to investigate the association between short-term exposure to ambient air pollutants and CVD (cardiovascular disease) events in a long-term observational period. The study included the events of cardiovascular diseases (namely coronary artery disease, ischemic heart disease, myocardial infarction, and pneumo thrombo embolism) within the population of Shiraz, from March 21, 2009 to March 20, 2015. Also, each patient's demographics were recorded. Main meteorological variables and five ambient pollutants (CO, O3, SO2, NO2, and PM10) were recorded. Statistical analysis was performed using linear regression (GLM) and a generalized additive model (GAM) estimating Poisson distribution and adjusted for the main risk factors and ambient meteorological variables. A mild prevalence (51.5%) of coronary artery disease (CAD) was registered in 6425 events. In GLM analysis, we observed an association among the pollutants with the coronary artery disease hospital admissions which was in the order of CO, NO2, and PM10. The highest association of each pollutant with hospital admission was observed as PM10 at lag 4 (RR = 1.08; 95% CI 1.02, 1.14 and p < 0.05), NO2 at lag 0 (RR = 1.22; 95% CI 1.00, 1.48), and CO at lag 0 (RR = 1.52 95% CI = (1.16, 1.99)). However, on dusty days, there were significantly higher numbers of referrals of cardiovascular patients (mean = 7.54 ± 4.44 and p = 0.002,) than on non-dusty days. According to these data, dust storms and some types of pollutants in the air are responsible for more admissions to hospitals for cardiovascular problems.
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Affiliation(s)
- Zahra Soleimani
- Department of Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Department of Environmental Health Engineering, School of Public Health, Semnan University of Medical Sciences, Semnan, Iran
| | - Ali Darvishi Boloorani
- Department of Remote Sensing and GIS, Faculty of Geography, University of Tehran, Tehran, Iran
| | - Reza Khalifeh
- Department of Statistics, Mathematical Science and Computer School, Tehran University, Tehran, Iran
| | - Dale W Griffin
- US Geological Survey, 600 4th St. South, St. Petersburg, FL, 33701, USA
| | - Alireza Mesdaghinia
- Department of Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
- Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran.
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16
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Khaniabadi YO, Daryanoosh M, Sicard P, Takdastan A, Hopke PK, Esmaeili S, De Marco A, Rashidi R. Chronic obstructive pulmonary diseases related to outdoor PM 10, O 3, SO 2, and NO 2 in a heavily polluted megacity of Iran. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2018; 25:17726-17734. [PMID: 29671231 DOI: 10.1007/s11356-018-1902-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 03/27/2018] [Indexed: 05/22/2023]
Abstract
This study was conducted to quantify, by an approach proposed by the World Health Organization (WHO), the daily hospital admissions for chronic obstructive pulmonary disease (COPD) related to exposure to particulate matter (PM10) and oxidants such as ozone (O3), sulfur dioxide (SO2), and nitrogen dioxide (NO2) in a heavily polluted city in Iran. For the health impact assessment, in terms of COPD, the current published relative risk (RR) and baseline incidence (BI) values, suggested by the WHO, and the 1-h O3 concentrations and daily PM10, NO2, and SO2 concentrations were compiled. The results showed that 5.9, 4.1, 1.2, and 1.9% of the COPD daily hospitalizations in 2011 and 6.6, 1.9, 2.3, and 2.1% in 2012 were attributed to PM10, O3, SO2, and NO2 concentrations exceeding 10 μg/m3, respectively. This study indicates that air quality and the high air pollutant levels have an effect on COPD morbidity. Air pollution is associated with visits to emergency services and hospital admissions. A lower relative risk can be achieved if some stringent control strategies for reducing air pollutants or emission precursors are implemented.
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Affiliation(s)
- Yusef Omidi Khaniabadi
- Department of Environmental Health, Health Care System of Karoon, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohammad Daryanoosh
- Department of Environmental Health, Health Center of Hendijan, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | | | - Afshin Takdastan
- Environmental Technologies Research Center (ETRC), Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Department of Environmental Health Engineering, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Philip K Hopke
- Center for Air Resources Engineering and Science, Clarkson University, Potsdam, NY, 13699, USA
- Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, NY, 14619, USA
| | - Shirin Esmaeili
- Department of Environmental Health Engineering, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Alessandra De Marco
- Department of Territorial and Production Systems Sustainability, ENEA, Rome, Italy
| | - Rajab Rashidi
- Nutrition Health Research Center, Department of Occupational Health Engineering, School of Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran.
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17
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Zhang Z, Wang J, Lu W. Exposure to nitrogen dioxide and chronic obstructive pulmonary disease (COPD) in adults: a systematic review and meta-analysis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2018; 25:15133-15145. [PMID: 29558787 DOI: 10.1007/s11356-018-1629-7] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Accepted: 02/27/2018] [Indexed: 05/22/2023]
Abstract
Exposure to nitrogen dioxide (NO2) has long been linked to elevated mortality and morbidity from epidemiological evidences. However, questions remain unclear whether NO2 acts directly on human health or being an indicator of other ambient pollutants. In this study, random-effect meta-analyses were performed on examining exposure to nitrogen oxide (NOx) and its association with chronic obstructive pulmonary disease (COPD). The overall relative risk (RR) of COPD risk related to a 10 μg/m3 increase in NO2 exposure increased by 2.0%. The pooled effect on prevalence was 17% with an increase of 10 μg/m3 in NO2 concentration, and 1.3% on hospital admissions, and 2.6% on mortality. The RR of COPD cases related to NO2 long-term exposure was 2.5 and 1.4% in short-term exposure. The COPD effect related with a 10 μg/m3 increase in exposure to a general outdoor-sourced NO2 was 1.7 and 17.8% to exposure to an exclusively traffic-sourced NO2; importantly, we did observe the effect of NO2 on COPD mortality with a large majority in lag0. Long-term traffic exerted more severe impairments on COPD prevalence than long-term or short-term outdoor effect; long-term mortality effect on COPD was serious in single model from this meta-analysis. Overall, our study reported consistent evidence of the potential positive association between NO2 and COPD risk.
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Affiliation(s)
- Zili Zhang
- State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Jian Wang
- State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
- Division of Translational and Regenerative Medicine, Department of Medicine, The University of Arizona, Tucson, AZ, 85721-0202, USA
| | - Wenju Lu
- State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China.
- Division of Translational and Regenerative Medicine, Department of Medicine, The University of Arizona, Tucson, AZ, 85721-0202, USA.
- Department of Laboratory Medicine, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, 510120, China.
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18
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Milando CW, Batterman SA. Sensitivity analysis of the near-road dispersion model RLINE - an evaluation at Detroit, Michigan. ATMOSPHERIC ENVIRONMENT (OXFORD, ENGLAND : 1994) 2018; 181:135-144. [PMID: 29632433 PMCID: PMC5889051 DOI: 10.1016/j.atmosenv.2018.03.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The development of accurate and appropriate exposure metrics for health effect studies of traffic-related air pollutants (TRAPs) remains challenging and important given that traffic has become the dominant urban exposure source and that exposure estimates can affect estimates of associated health risk. Exposure estimates obtained using dispersion models can overcome many of the limitations of monitoring data, and such estimates have been used in several recent health studies. This study examines the sensitivity of exposure estimates produced by dispersion models to meteorological, emission and traffic allocation inputs, focusing on applications to health studies examining near-road exposures to TRAP. Daily average concentrations of CO and NOx predicted using the Research Line source model (RLINE) and a spatially and temporally resolved mobile source emissions inventory are compared to ambient measurements at near-road monitoring sites in Detroit, MI, and are used to assess the potential for exposure measurement error in cohort and population-based studies. Sensitivity of exposure estimates is assessed by comparing nominal and alternative model inputs using statistical performance evaluation metrics and three sets of receptors. The analysis shows considerable sensitivity to meteorological inputs; generally the best performance was obtained using data specific to each monitoring site. An updated emission factor database provided some improvement, particularly at near-road sites, while the use of site-specific diurnal traffic allocations did not improve performance compared to simpler default profiles. Overall, this study highlights the need for appropriate inputs, especially meteorological inputs, to dispersion models aimed at estimating near-road concentrations of TRAPs. It also highlights the potential for systematic biases that might affect analyses that use concentration predictions as exposure measures in health studies, e.g., to estimate health impacts.
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Global Associations between Air Pollutants and Chronic Obstructive Pulmonary Disease Hospitalizations. A Systematic Review. Ann Am Thorac Soc 2017; 13:1814-1827. [PMID: 27314857 DOI: 10.1513/annalsats.201601-064oc] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
RATIONALE Exacerbations are key events in chronic obstructive pulmonary disease (COPD), affecting lung function decline and quality of life. The effect of exposure to different air pollutants on COPD exacerbations is not clear. OBJECTIVES To carry out a systematic review, examining associations between air pollutants and hospital admissions for COPD exacerbations. METHODS MEDLINE, Embase, BIOSIS, Science Citation Index, and the Air Pollution Epidemiology Database were searched for publications published between 1980 and September 2015. Inclusion criteria were focused on studies presenting solely a COPD outcome defined by hospital admissions and a measure of gaseous air pollutants and particle fractions. The association between each pollutant and COPD admissions was investigated in metaanalyses using random effects models. Analyses were stratified by geographical clusters for investigation of the consistency of the evidence worldwide. MEASUREMENTS AND MAIN RESULTS Forty-six studies were included, and results for all the pollutants under investigation showed marginal positive associations; however, the number of included studies was small, the studies had high heterogeneity, and there was evidence of small-study bias. Geographical clustering of the effects of pollution on COPD hospital admissions was evident and reduced heterogeneity significantly. CONCLUSIONS The most consistent association was between a 1-mg/m3 increase in carbon monoxide level and COPD-related admissions (odds ratio, 1.02; 95% confidence interval, 1.01-1.03). The heterogeneity was moderate, and there was a consistent positive association in both Europe and North America, although levels were clearly below World Health Organization guideline values. There is mixed evidence on the effects of environmental pollution on COPD exacerbations. Limitations of previous studies included the low spatiotemporal resolution of pollutants, inadequate control for confounding factors, and the use of aggregated health data that ignored personal characteristics. The need for more targeted exposure estimates in a large number of geographical locations is evident.
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Çapraz Ö, Deniz A, Doğan N. Effects of air pollution on respiratory hospital admissions in İstanbul, Turkey, 2013 to 2015. CHEMOSPHERE 2017; 181:544-550. [PMID: 28463729 DOI: 10.1016/j.chemosphere.2017.04.105] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 04/01/2017] [Accepted: 04/22/2017] [Indexed: 05/25/2023]
Abstract
We examined the associations between the daily variations of air pollutants and hospital admissions for respiratory diseases in İstanbul, the largest city of Turkey. A time series analysis of counts of daily hospital admissions and outdoor air pollutants was performed using single-pollutant Poisson generalized linear model (GLM) while controlling for time trends and meteorological factors over a 3-year period (2013-2015) at different time lags (0-9 days). Effects of the pollutants (Excess Risk, ER) on current-day (lag 0) hospital admissions to the first ten days (lag 9) were determined. Data on hospital admissions, daily mean concentrations of air pollutants of PM10, PM2.5 and NO2 and daily mean concentrations of temperature and humidity of İstanbul were used in the study. The analysis was conducted among people of all ages, but also focused on different sexes and different age groups including children (0-14 years), adults (35-44 years) and elderly (≥65 years). We found significant associations between air pollution and respiratory related hospital admissions in the city. Our findings showed that the relative magnitude of risks for an association of the pollutants with the total respiratory hospital admissions was in the order of: PM2.5, NO2, and PM10. The highest association of each pollutant with total hospital admission was observed with PM2.5 at lag 4 (ER = 1.50; 95% CI = 1.09-1.99), NO2 at lag 4 (ER = 1.27; 95% CI = 1.02-1.53) and PM10 at lag 0 (ER = 0.61; 95% CI = 0.33-0.89) for an increase of 10 μg/m3 in concentrations of the pollutants. In conclusion, our study showed that short-term exposure to air pollution was positively associated with increased respiratory hospital admissions in İstanbul during 2013-2015. As the first air pollution hospital admission study using GLM in İstanbul, these findings may have implications for local environmental and social policies.
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Affiliation(s)
- Özkan Çapraz
- Marmara Clean Air Center, Şişli, İstanbul, Turkey.
| | - Ali Deniz
- İstanbul Technical University, Faculty of Aeronautics and Astronautics, Department of Meteorology, Maslak, İstanbul, Turkey.
| | - Nida Doğan
- İstanbul Technical University, Faculty of Aeronautics and Astronautics, Department of Meteorology, Maslak, İstanbul, Turkey.
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21
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Godbole R, Godbole VP, Alegaonkar PS, Bhagwat S. Effect of film thickness on gas sensing properties of sprayed WO3 thin films. NEW J CHEM 2017. [DOI: 10.1039/c7nj00963a] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
This study correlates thicknesses, morphology, electrical properties with gas-sensing capability of WO3 thin-film sensors which contributes to understanding of property-performance relationship.
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Affiliation(s)
| | - V. P. Godbole
- Department of Physics
- Savitribai Phule Pune University
- Pune 411 007
- India
| | - P. S. Alegaonkar
- Department of Applied Physics
- Defense Institute of Advanced Technology
- Pune 411 025
- India
| | - Sunita Bhagwat
- Department of Physics
- Abasaheb Garware College
- Pune 411 004
- India
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Li J, Sun S, Tang R, Qiu H, Huang Q, Mason TG, Tian L. Major air pollutants and risk of COPD exacerbations: a systematic review and meta-analysis. Int J Chron Obstruct Pulmon Dis 2016; 11:3079-3091. [PMID: 28003742 PMCID: PMC5161337 DOI: 10.2147/copd.s122282] [Citation(s) in RCA: 148] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Short-term exposure to major air pollutants (O3, CO, NO2, SO2, PM10, and PM2.5) has been associated with respiratory risk. However, evidence on the risk of chronic obstructive pulmonary disease (COPD) exacerbations is still limited. The present study aimed at evaluating the associations between short-term exposure to major air pollutants and the risk of COPD exacerbations. Methods After a systematic search up until March 30, 2016, in both English and Chinese electronic databases such as PubMed, EMBASE, and CNKI, the pooled relative risks and 95% confidence intervals were estimated by using the random-effects model. In addition, the population-attributable fractions (PAFs) were also calculated, and a subgroup analysis was conducted. Heterogeneity was assessed by I2. Results In total, 59 studies were included. In the single-pollutant model, the risks of COPD were calculated by each 10 μg/m3 increase in pollutant concentrations, with the exception of CO (100 μg/m3). There was a significant association between short-term exposure and COPD exacerbation risk for all the gaseous and particulate pollutants. The associations were strongest at lag0 and lag3 for gaseous and particulate air pollutants, respectively. The subgroup analysis not only further confirmed the overall adverse effects but also reduced the heterogeneities obviously. When 100% exposure was assumed, PAFs ranged from 0.60% to 4.31%, depending on the pollutants. The adverse health effects of SO2 and NO2 exposure were more significant in low-/middle-income countries than in high-income countries: SO2, relative risk: 1.012 (95% confidence interval: 1.001, 1.023); and NO2, relative risk: 1.019 (95% confidence interval: 1.014, 1.024). Conclusion Short-term exposure to air pollutants increases the burden of risk of COPD acute exacerbations significantly. Controlling ambient air pollution would provide benefits to COPD patients.
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Affiliation(s)
- Jinhui Li
- Shenzhen Institute of Research and Innovation, Nanshan, The University of Hong Kong, Shenzhen, People's Republic of China; School of Public Health, The University of Hong Kong, Pok Fu Lam, Hong Kong Special Administrative Region
| | - Shengzhi Sun
- Shenzhen Institute of Research and Innovation, Nanshan, The University of Hong Kong, Shenzhen, People's Republic of China; School of Public Health, The University of Hong Kong, Pok Fu Lam, Hong Kong Special Administrative Region
| | - Robert Tang
- Shenzhen Institute of Research and Innovation, Nanshan, The University of Hong Kong, Shenzhen, People's Republic of China; School of Public Health, The University of Hong Kong, Pok Fu Lam, Hong Kong Special Administrative Region
| | - Hong Qiu
- School of Public Health, The University of Hong Kong, Pok Fu Lam, Hong Kong Special Administrative Region
| | - Qingyuan Huang
- Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University, Minhang, Shanghai, People's Republic of China
| | - Tonya G Mason
- School of Public Health, The University of Hong Kong, Pok Fu Lam, Hong Kong Special Administrative Region
| | - Linwei Tian
- Shenzhen Institute of Research and Innovation, Nanshan, The University of Hong Kong, Shenzhen, People's Republic of China; School of Public Health, The University of Hong Kong, Pok Fu Lam, Hong Kong Special Administrative Region
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Milando CW, Martenies SE, Batterman SA. Assessing concentrations and health impacts of air quality management strategies: Framework for Rapid Emissions Scenario and Health impact ESTimation (FRESH-EST). ENVIRONMENT INTERNATIONAL 2016; 94:473-481. [PMID: 27318620 PMCID: PMC5609508 DOI: 10.1016/j.envint.2016.06.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 05/27/2016] [Accepted: 06/06/2016] [Indexed: 05/26/2023]
Abstract
In air quality management, reducing emissions from pollutant sources often forms the primary response to attaining air quality standards and guidelines. Despite the broad success of air quality management in the US, challenges remain. As examples: allocating emissions reductions among multiple sources is complex and can require many rounds of negotiation; health impacts associated with emissions, the ultimate driver for the standards, are not explicitly assessed; and long dispersion model run-times, which result from the increasing size and complexity of model inputs, limit the number of scenarios that can be evaluated, thus increasing the likelihood of missing an optimal strategy. A new modeling framework, called the "Framework for Rapid Emissions Scenario and Health impact ESTimation" (FRESH-EST), is presented to respond to these challenges. FRESH-EST estimates concentrations and health impacts of alternative emissions scenarios at the urban scale, providing efficient computations from emissions to health impacts at the Census block or other desired spatial scale. In addition, FRESH-EST can optimize emission reductions to meet specified environmental and health constraints, and a convenient user interface and graphical displays are provided to facilitate scenario evaluation. The new framework is demonstrated in an SO2 non-attainment area in southeast Michigan with two optimization strategies: the first minimizes emission reductions needed to achieve a target concentration; the second minimizes concentrations while holding constant the cumulative emissions across local sources (e.g., an emissions floor). The optimized strategies match outcomes in the proposed SO2 State Implementation Plan without the proposed stack parameter modifications or shutdowns. In addition, the lower health impacts estimated for these strategies suggest that FRESH-EST could be used to identify potentially more desirable pollution control alternatives in air quality management planning.
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Affiliation(s)
- Chad W Milando
- Environmental Health Sciences, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, USA
| | - Sheena E Martenies
- Environmental Health Sciences, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, USA
| | - Stuart A Batterman
- Environmental Health Sciences, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, USA.
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DeVries R, Kriebel D, Sama S. Outdoor Air Pollution and COPD-Related Emergency Department Visits, Hospital Admissions, and Mortality: A Meta-Analysis. COPD 2016; 14:113-121. [PMID: 27564008 DOI: 10.1080/15412555.2016.1216956] [Citation(s) in RCA: 108] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
A systematic literature review was performed to identify all peer-reviewed literature quantifying the association between short-term exposures of particulate matter <2.5 microns (PM2.5), nitrogen dioxide (NO2), and sulfur dioxide (SO2) and COPD-related emergency department (ED) visits, hospital admissions (HA), and mortality. These results were then pooled for each pollutant through meta-analyses with a random effects model. Subgroup meta-analyses were explored to study the effects of selected lag/averaging times and health outcomes. A total of 37 studies satisfied our inclusion criteria, contributing to a total of approximately 1,115,000 COPD-related acute events (950,000 HAs, 80,000 EDs, and 130,000 deaths) to our meta-estimates. An increase in PM2.5 of 10 ug/m3 was associated with a 2.5% (95% CI: 1.6-3.4%) increased risk of COPD-related ED and HA, an increase of 10 ug/m3 in NO2 was associated with a 4.2% (2.5-6.0%) increase, and an increase of 10 ug/m3 in SO2 was associated with a 2.1% (0.7-3.5%) increase. The strength of these pooled effect estimates, however, varied depending on the selected lag/averaging time between exposure and outcome. Similar pooled effects were estimated for each pollutant and COPD-related mortality. These results suggest an ongoing threat to the health of COPD patients from both outdoor particulates and gaseous pollutants. Ambient outdoor concentrations of PM2.5, NO2, and SO2 were significantly and positively associated with both COPD-related morbidity and mortality.
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Affiliation(s)
| | - David Kriebel
- a Department of Work Environment , University of Massachusetts Lowell , Lowell , Massachusetts , USA
| | - Susan Sama
- a Department of Work Environment , University of Massachusetts Lowell , Lowell , Massachusetts , USA
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Wang X, Guo Y, Li G, Zhang Y, Westerdahl D, Jin X, Pan X, Chen L. Spatiotemporal analysis for the effect of ambient particulate matter on cause-specific respiratory mortality in Beijing, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2016; 23:10946-10956. [PMID: 26898933 DOI: 10.1007/s11356-016-6273-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2015] [Accepted: 02/09/2016] [Indexed: 06/05/2023]
Abstract
This study explored the association between particulate matter with an aerodynamic diameter of less than 10 μm (PM10) and the cause-specific respiratory mortality. We used the ordinary kriging method to estimate the spatial characteristics of ambient PM10 at 1-km × 1-km resolution across Beijing during 2008-2009 and subsequently fit the exposure-response relationship between the estimated PM10 and the mortality due to total respiratory disease, chronic lower respiratory disease, chronic obstructive pulmonary disease (COPD), and pneumonia at the street or township area levels using the generalized additive mixed model (GAMM). We also examined the effects of age, gender, and season in the stratified analysis. The effects of ambient PM10 on the cause-specific respiratory mortality were the strongest at lag0-5 except for pneumonia, and an inter-quantile range increase in PM10 was associated with an 8.04 % (95 % CI 4.00, 12.63) increase in mortality for total respiratory disease, a 6.63 % (95 % CI 1.65, 11.86) increase for chronic lower respiratory disease, and a 5.68 % (95 % CI 0.54, 11.09) increase for COPD, respectively. Higher risks due to the PM10 exposure were observed for females and elderly individuals. Seasonal stratification analysis showed that the effects of PM10 on mortality due to pneumonia were stronger during spring and autumn. While for COPD, the effect of PM10 in winter was statistically significant (15.54 %, 95 % CI 5.64, 26.35) and the greatest among the seasons. The GAMM model evaluated stronger associations between concentration of PM10. There were significant associations between PM10 and mortality due to respiratory disease at the street or township area levels. The GAMM model using high-resolution PM10 could better capture the association between PM10 and respiratory mortality. Gender, age, and season also acted as effect modifiers for the relationship between PM10 and respiratory mortality.
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Affiliation(s)
- Xuying Wang
- Department of Occupational and Environmental Health, School of Public Health, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing, China
| | - Yuming Guo
- School of Population Health, University of Queensland, Herston Road, Herston, Brisbane, QLD, 4006, Australia
| | - Guoxing Li
- Department of Occupational and Environmental Health, School of Public Health, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing, China
| | - Yajuan Zhang
- Department of Occupational and Environmental Health, School of Public Health, Ningxia Medical University, No. 1160, Shengli street, Xingqing district, Yinchuan, Ningxia, China
| | - Dane Westerdahl
- Sibley School of Mechanical and Aerospace Engineering, Cornell University, 24330 County Road 95, Davis, CA, 95616, USA
| | - Xiaobin Jin
- Department of Occupational and Environmental Health, School of Public Health, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing, China
| | - Xiaochuan Pan
- Department of Occupational and Environmental Health, School of Public Health, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing, China.
| | - Liangfu Chen
- Institute of Remote Sensing and Digital Earth, Chinese Academy of Sciences, No. 9, Dengzhuang south Road, Haidian district, Beijing, China.
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Tamayo-Uria I, Altzibar JM, Mughini-Gras L, Dorronsoro M. Exacerbations of Chronic Obstructive Pulmonary Disease (COPD): An Ecological Study in the Basque Country, Spain (2000-2011). COPD 2016; 13:726-733. [PMID: 27232203 DOI: 10.1080/15412555.2016.1182145] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Chronic obstructive pulmonary disease (COPD) is a prevalent condition in adults aged ≥40 years characterized by progressive airflow limitation associated with chronic inflammatory response to noxious particles in the airways and lungs. Smoking, genetics, air pollution, nutrition and other factors may influence COPD development. Most hospitalizations and deaths for COPD are caused by its acute exacerbations, which greatly affect the health and quality of life of COPD patients and pose a high burden on health services. The aims of this project were to identify trends, geographic patterns and risk factors for COPD exacerbations, as revealed by hospitalizations and deaths, in the Basque Country, Spain, over a period of 12 years (2000-2011). Hospitalization and mortality rates for COPD were 262 and 18 per 100,000 population, respectively, with clusters around the biggest cities. Hospital mortality was 7.4%. Most hospitalized patients were male (77.4%) and accounted for 72.1% of hospital mortality. Hospitalizations decreased during the study period, except for 50-64 year-old women, peaking significantly. Using a multivariate modeling approach it was shown that hospitalizations were positively correlated with increased atmospheric concentrations of NO2, CO, PM10, and SO2, and increased influenza incidence, but were negatively associated with increased temperatures and atmospheric O3 concentration. COPD exacerbations decreased in the Basque Country during 2000-2011, but not among 50-64-year-old women, reflecting the high smoking prevalence among Spanish women during the 1970-1990s. The main metropolitan areas were those with the highest risk for COPD exacerbations, calling attention to the role of heavy car traffic. Influenza virus, cold temperatures, and increased atmospheric NO2, CO, PM10, and SO2 (but decreased O3) concentrations were identified as potential contributors to the burden of COPD exacerbations in the community. These findings are important for both the understanding of the disease process and in providing potential targets for COPD-reducing initiatives and new avenues for research.
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Affiliation(s)
- Ibon Tamayo-Uria
- a ISGlobal, Centre for Research in Environmental Epidemiology (CREAL) , Barcelona , Spain.,b Universitat Pompeu Fabra (UPF) , Barcelona , Spain.,c CIBER Epidemiología y Salud Pública (CIBERESP) , Spain
| | - Jone M Altzibar
- c CIBER Epidemiología y Salud Pública (CIBERESP) , Spain.,d Public Health Division of Gipuzkoa, BioDonostia Research Institute , San Sebastian , Spain
| | - Lapo Mughini-Gras
- e Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands Department of Infectious Diseases and Immunology, Utrecht University, Faculty of Veterinary Medicine , the Netherlands
| | - Miren Dorronsoro
- c CIBER Epidemiología y Salud Pública (CIBERESP) , Spain.,f Public Health Direction , Basque Regional Health Department , Vitoria-Gasteiz , Spain
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Liu Y, Yan S, Poh K, Liu S, Iyioriobhe E, Sterling DA. Impact of air quality guidelines on COPD sufferers. Int J Chron Obstruct Pulmon Dis 2016; 11:839-72. [PMID: 27143874 PMCID: PMC4846081 DOI: 10.2147/copd.s49378] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Background COPD is one of the leading causes of morbidity and mortality in both high- and low-income countries and a major public health burden worldwide. While cigarette smoking remains the main cause of COPD, outdoor and indoor air pollution are important risk factors to its etiology. Although studies over the last 30 years helped reduce the values, it is not very clear if the current air quality guidelines are adequately protective for COPD sufferers. Objective This systematic review was to summarize the up-to-date literature on the impact of air pollution on the COPD sufferers. Methods PubMed and Google Scholar were utilized to search for articles related to our study’s focus. Search terms included “COPD exacerbation”, “air pollution”, “air quality guidelines”, “air quality standards”, “COPD morbidity and mortality”, “chronic bronchitis”, and “air pollution control” separately and in combination. We focused on articles from 1990 to 2015. We also used articles prior to 1990 if they contained relevant information. We focused on articles written in English or with an English abstract. We also used the articles in the reference lists of the identified articles. Results Both short-term and long-term exposures to outdoor air pollution around the world are associated with the mortality and morbidity of COPD sufferers even at levels below the current air quality guidelines. Biomass cooking in low-income countries was clearly associated with COPD morbidity in adult nonsmoking females. Conclusion There is a need to continue to improve the air quality guidelines. A range of intervention measures could be selected at different levels based on countries’ socioeconomic conditions to reduce the air pollution exposure and COPD burden.
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Affiliation(s)
- Youcheng Liu
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Shuang Yan
- Department of Endocrinology and Metabolism, Fourth Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang Province, People's Republic of China
| | - Karen Poh
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Suyang Liu
- Epidemiology, Human Genetics & Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Emanehi Iyioriobhe
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - David A Sterling
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA
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Dąbrowiecki P, Mucha D, Gayer A, Adamkiewicz Ł, Badyda AJ. Assessment of Air Pollution Effects on the Respiratory System Based on Pulmonary Function Tests Performed During Spirometry Days. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2016; 873:43-52. [PMID: 26285609 DOI: 10.1007/5584_2015_152] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The Polish Spirometry Day is an initiative aimed at increasing awareness of the causes, symptoms, course, and effects that accompany respiratory diseases, especially asthma and chronic obstructive pulmonary disease (COPD). In 2013, the second edition of the Spirometry Day was held. It gathered 180 medical centers and other institution. The final analysis encompassed a total of 1187 persons from 26 different locations, including rural areas, and smaller and larger city agglomerations. Of this total, 755 persons (63.6 %) completed their spirometry tests for the first time in life. Each person fulfilled a questionnaire regarding the personal information, respiratory diseases, symptoms, lifestyle, and a place of residence. In the total group, 234 (19.7 %) cases of bronchial obstruction were diagnosed. A hundred and thirty four persons with obstruction, among those tested for the first time in life (17.8 %), were unaware of their disease. The lowest values of FEV1 and FEF(1)/FVC, corresponding to the highest percentage of persons with obstruction (27.9 %) were observed in small and medium cities (100,000-500,000 inhabitants). There were differences in the prevalence of obstruction depending on the distance of the place of residence from a busy traffic road. A significant decrease of both spirometric variables was observed among people living in cities above 100,000 inhabitants within a distance lower than 50 m from roads. In general, better spirometry results were observed among inhabitants living more than 150 m from main roads.
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Affiliation(s)
- Piotr Dąbrowiecki
- Central Clinical Hospital of the Ministry of National Defense, Military Institute of Medicine, 128 Szaserów St., 04-141, Warsaw, Poland.,Polish Federation of Asthma, Allergy and COPD Patients' Associations, 20/316 Świętokrzyska St., 00-002, Warsaw, Poland
| | - Dominika Mucha
- Faculty of Environmental Engineering, Warsaw University of Technology, 20 Nowowiejska St., 00-653, Warsaw, Poland
| | - Anna Gayer
- Faculty of Environmental Engineering, Warsaw University of Technology, 20 Nowowiejska St., 00-653, Warsaw, Poland
| | - Łukasz Adamkiewicz
- Faculty of Environmental Engineering, Warsaw University of Technology, 20 Nowowiejska St., 00-653, Warsaw, Poland
| | - Artur J Badyda
- Polish Federation of Asthma, Allergy and COPD Patients' Associations, 20/316 Świętokrzyska St., 00-002, Warsaw, Poland. .,Faculty of Environmental Engineering, Warsaw University of Technology, 20 Nowowiejska St., 00-653, Warsaw, Poland.
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Liu P, Wang X, Fan J, Xiao W, Wang Y. Effects of Air Pollution on Hospital Emergency Room Visits for Respiratory Diseases: Urban-Suburban Differences in Eastern China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13030341. [PMID: 27007384 PMCID: PMC4809004 DOI: 10.3390/ijerph13030341] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Revised: 03/11/2016] [Accepted: 03/14/2016] [Indexed: 11/16/2022]
Abstract
A study on the relationships between ambient air pollutants (PM2.5, SO2 and NO2) and hospital emergency room visits (ERVs) for respiratory diseases from 2013 to 2014 was performed in both urban and suburban areas of Jinan, a heavily air-polluted city in Eastern China. This research was analyzed using generalized additive models (GAM) with Poisson regression, which controls for long-time trends, the “day of the week” effect and meteorological parameters. An increase of 10 μg/m3 in PM2.5, SO2 and NO2 corresponded to a 1.4% (95% confidence interval (CI): 0.7%, 2.1%), 1.2% (95% CI: 0.5%, 1.9%), and 2.5% (95%: 0.8%, 4.2%) growth in ERVs for the urban population, respectively, and a 1.5% (95%: 0.4%, 2.6%), 0.8% (95%: −0.7%, 2.3%), and 3.1% (95%: 0.5%, 5.7%) rise in ERVs for the suburban population, respectively. It was found that females were more susceptible than males to air pollution in the urban area when the analysis was stratified by gender, and the reverse result was seen in the suburban area. Our results suggest that the increase in ERVs for respiratory illnesses is linked to the levels of air pollutants in Jinan, and there may be some urban-suburban discrepancies in health outcomes from air pollutant exposure.
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Affiliation(s)
- Peng Liu
- School of Environmental Science and Engineering, Shandong University, Jinan 250100, China.
| | - Xining Wang
- Shandong Center for Disease Control and Prevention, Jinan 250014, China.
| | - Jiayin Fan
- Shandong Experimental High School, Jinan 250001, China.
| | - Wenxin Xiao
- School of Foreign Languages and Literature, Shandong University, Jinan 250100, China.
| | - Yan Wang
- School of Environmental Science and Engineering, Shandong University, Jinan 250100, China.
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Ghanbari Ghozikali M, Heibati B, Naddafi K, Kloog I, Oliveri Conti G, Polosa R, Ferrante M. Evaluation of Chronic Obstructive Pulmonary Disease (COPD) attributed to atmospheric O3, NO2, and SO2 using Air Q Model (2011-2012 year). ENVIRONMENTAL RESEARCH 2016; 144:99-105. [PMID: 26599588 DOI: 10.1016/j.envres.2015.10.030] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 09/29/2015] [Accepted: 10/28/2015] [Indexed: 05/28/2023]
Abstract
Chronic obstructive pulmonary disease (COPD) is an important disease worldwide characterized by chronically poor airflow. The economic burden of COPD on any society can be enormous if not managed. We applied the approach proposed by the World Health Organization (WHO) using the AirQ2.2.3 software developed by the WHO European Center for Environment and Health on air pollutants in Tabriz (Iran) (2011-2012 year). A 1h average of concentrations of ozone (O3), daily average concentrations of nitrogen dioxide (NO2) and sulfur dioxide (SO2) were used to assess human exposure and health effect in terms of attributable proportion of the health outcome and annual number of excess cases of Hospital Admissions for COPD (HA COPD). The results of this study showed that 2% (95% CI: 0.8-3.1%) of HA COPD were attributed to O3 concentrations over 10 μg/m(3). In addition, 0.7 % (95% CI: 0.1-1.8%) and 0.5% (95% CI: 0-1%) of HA COPD were attributed to NO2 and SO2 concentrations over 10 μg/m(3) respectively. In this study, we have shown that O3, NO2 and SO2 have a significant impact on COPD hospitalization. Given these results the policy decisions are needed in order to reduce the chronic pulmonary diseases caused by air pollution and furthermore better quantification studies are recommended.
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Affiliation(s)
- Mohammad Ghanbari Ghozikali
- Tabriz Health Services Management Research Center, Department of Environmental Health Engineering, East Azerbaijan Province Health Center, Tabriz University of Medical Sciences, Tabriz, Iran; Department of Environmental Health Engineering, School of Public Health and Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran
| | - Behzad Heibati
- Department of Occupational Health Engineering, Faculty of Health and Health Sciences Research Center, Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Kazem Naddafi
- Department of Environmental Health Engineering, School of Public Health and Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran
| | - Itai Kloog
- Department of Environmental Health, Harvard University, 665 Huntington Avenue, Landmark Center Room 415, Boston, MA 0211, United States
| | - Gea Oliveri Conti
- Environmental and Food Hygiene Laboratories (LIAA), Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Hygiene and Public Health, University of Catania, Via S. Sofia 87, 95123 Catania, Italy.
| | - Riccardo Polosa
- Department of Internal and Emergency Medicine, Teaching Hospital-Policlinico-V. Emanuele II, University of Catania, Catania 95123, Italy
| | - Margherita Ferrante
- Environmental and Food Hygiene Laboratories (LIAA), Department of Medical, Surgical Sciences and Advanced Technologies "G.F. Ingrassia", Hygiene and Public Health, University of Catania, Via S. Sofia 87, 95123 Catania, Italy
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Li J. Environmental fine particular matter and airway epithelium cell stress. CURRENT PULMONOLOGY REPORTS 2015. [DOI: 10.1007/s13665-015-0116-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2022]
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Simoni M, Baldacci S, Maio S, Cerrai S, Sarno G, Viegi G. Adverse effects of outdoor pollution in the elderly. J Thorac Dis 2015; 7:34-45. [PMID: 25694816 DOI: 10.3978/j.issn.2072-1439.2014.12.10] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Accepted: 01/10/2015] [Indexed: 01/17/2023]
Abstract
With fewer newborns and people living longer, older people are making up an increasing fraction of the total population. Epidemiological evidence shows that older-age-related health problems affect a wide and expanding proportion of the world population. One of the major epidemiological trends of this century is the rise of chronic diseases that affect more elderly than younger people. A total of 3.7 million premature deaths worldwide in 2012 are attributable to outdoor air pollution; the susceptibility to adverse effects of air pollution is expected to differ widely between people and within the same person, and also over time. Frailty history, a measure of multi-system decline, modifies cumulative associations between air pollution and lung function. Moreover, pre-existing diseases may determine susceptibility. In the elderly, due to comorbidity, exposure to air pollutants may even be fatal. Rapid and not-well-planned urbanization is associated with high level of ambient air pollution, mainly caused by vehicular exhausts. In general, there is sufficient evidence of the adverse effects related to short-term exposure, while fewer studies have addressed the longer-term health effects. Increased pollution exposures have been associated with increased mortality, hospital admissions/emergency-room visits, mainly due to exacerbations of chronic diseases or to respiratory tract infections (e.g., pneumonia). These effects may also be modulated by ambient temperature and many studies show that the elderly are mostly vulnerable to heat waves. The association between heat and mortality in the elderly is well-documented, while less is known regarding the associations with hospital admissions. Chronic exposure to elevated levels of air pollution has been related to the incidence of chronic obstructive pulmonary disease (COPD), chronic bronchitis (CB), asthma, and emphysema. There is also growing evidence suggesting adverse effects on lung function related to long-term exposure to ambient air pollution. Few studies have assessed long-term mortality in the elderly. It is still unclear what are the pollutants most damaging to the health of the elderly. It seems that elderly subjects are more vulnerable to particulate matter (PM) than to other pollutants, with particular effect on daily cardio-respiratory mortality and acute hospital admissions. Not many studies have targeted elderly people specifically, as well as specific respiratory morbidity. Most data have shown higher risks in the elderly compared to the rest of the population. Future epidemiological cohort studies need to keep investigating the health effects of air pollutants (mainly cardiopulmonary diseases) on the elderly.
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Affiliation(s)
- Marzia Simoni
- 1 Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa (Italy), Via Trieste 41, 56126, Pisa, Italy ; 2 CNR Institute of Biomedicine and Molecular Immunology "A. Monroy", Via U. La Malfa 153, 90146, Palermo, Italy
| | - Sandra Baldacci
- 1 Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa (Italy), Via Trieste 41, 56126, Pisa, Italy ; 2 CNR Institute of Biomedicine and Molecular Immunology "A. Monroy", Via U. La Malfa 153, 90146, Palermo, Italy
| | - Sara Maio
- 1 Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa (Italy), Via Trieste 41, 56126, Pisa, Italy ; 2 CNR Institute of Biomedicine and Molecular Immunology "A. Monroy", Via U. La Malfa 153, 90146, Palermo, Italy
| | - Sonia Cerrai
- 1 Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa (Italy), Via Trieste 41, 56126, Pisa, Italy ; 2 CNR Institute of Biomedicine and Molecular Immunology "A. Monroy", Via U. La Malfa 153, 90146, Palermo, Italy
| | - Giuseppe Sarno
- 1 Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa (Italy), Via Trieste 41, 56126, Pisa, Italy ; 2 CNR Institute of Biomedicine and Molecular Immunology "A. Monroy", Via U. La Malfa 153, 90146, Palermo, Italy
| | - Giovanni Viegi
- 1 Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa (Italy), Via Trieste 41, 56126, Pisa, Italy ; 2 CNR Institute of Biomedicine and Molecular Immunology "A. Monroy", Via U. La Malfa 153, 90146, Palermo, Italy
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Ghozikali MG, Mosaferi M, Safari GH, Jaafari J. Effect of exposure to O₃ , NO₂, and SO₂ on chronic obstructive pulmonary disease hospitalizations in Tabriz, Iran. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2015; 22:2817-23. [PMID: 25217280 DOI: 10.1007/s11356-014-3512-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 08/24/2014] [Indexed: 05/28/2023]
Abstract
Air pollution in cities is a serious environmental problem especially in the developing countries. We examined the associations between gaseous pollutants and hospitalizations for chronic obstructive pulmonary diseases (COPD) among people living in Tabriz, a city in north western of Iran. We used the approach proposed by the World Health Organization (WHO) using the AirQ 2.2.3 software developed by the WHO European Center for Environment and Health, Bilthoven Division. To assess human exposure and health effect, data were used for ozone as a1h average; for nitrogen dioxide and sulfur dioxide as daily average concentrations. The association between air pollution and chronic obstructive pulmonary disease (COPD) was assessed using AirQ 2.2.3 model. The results of this study showed that 3 % (95 % CI 1.2-4.8 %) of HA COPD were attributed to O3 concentrations over 10 μg/m(3). Also, 0.9 % (95 % CI 0.1-2.2 %) and 0.4 % (95 % CI 0-1.1 %) of HA COPD were attributed to NO2 and SO2 concentrations over 10 μg/m(3), respectively. For every 10 μg/m(3) increase in O3, NO2, and SO2 concentrations, the risk of HA COPD increase to about 0.58, 0.38, and 0.44 %, respectively. We found significant positive associations between the levels of all air pollution and hospital admissions COPD. Otherwise, O3, NO2, and SO2 have a significant impact on COPD hospitalization.
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Affiliation(s)
- Mohammad Ghanbari Ghozikali
- Environmental Health Department of East Azerbaijan Province Health Center, Tabriz University of Medical Sciences, Tabriz, Iran,
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Kariisa M, Foraker R, Pennell M, Buckley T, Diaz P, Criner GJ, Wilkins JR. Short- and long-term effects of ambient ozone and fine particulate matter on the respiratory health of chronic obstructive pulmonary disease subjects. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2015; 70:56-62. [PMID: 25136856 DOI: 10.1080/19338244.2014.932753] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
To date, no study has evaluated the short- and long-term effects air pollution exposure on emphysematous subjects who have undergone lung volume reduction surgery (LVRS). Data from the National Emphysema Treatment Trial study (1998-2003) included 1,218 subjects, aged 39 to 84. Daily values of ambient fine particulate matter (aerodynamic diameter < 2.5 μm; PM2.5) and ozone were obtained. Mixed-effects models tested the association between short- and long-term pollutant concentrations and changes in pulmonary function. Cumulative air pollution exposure was strongly associated with worsened respiratory function and symptoms. Mean PM2.5 was associated with poorer lung function. Lagged exposures were poorly associated with respiratory health outcomes. There were detrimental respiratory and pulmonary effects observed in response to even low levels of ambient air pollutants among study participants. These results are indicative that exposures even below those of air quality standards may still pose significant risks to severe chronic obstructive pulmonary disease (COPD) subjects.
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Affiliation(s)
- Mbabazi Kariisa
- a Division of Epidemiology, College of Public Health , The Ohio State University , Columbus , Ohio , USA
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Tian L, Ho KF, Wang T, Qiu H, Pun VC, Chan CS, Louie PKK, Yu ITS. Ambient carbon monoxide and the risk of hospitalization due to chronic obstructive pulmonary disease. Am J Epidemiol 2014; 180:1159-67. [PMID: 25480818 DOI: 10.1093/aje/kwu248] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Data from recent experimental and clinical studies have indicated that lower concentrations of inhaled carbon monoxide might have beneficial antiinflammatory effects. Inhaled carbon monoxide has the potential to be a therapeutic agent for chronic obstructive pulmonary diseases (COPD). However, population-based epidemiologic studies of environmentally relevant carbon monoxide exposure have generated mixed findings. We conducted a time-series study in Hong Kong to estimate the association of short-term exposure to ambient carbon monoxide with emergency hospitalizations for COPD. We collected daily emergency hospital admission data and air pollution data from January 2001 to December 2007. We used log-linear Poisson models to estimate the associations between daily hospital admissions for COPD and the average daily concentrations of carbon monoxide while controlling for the traffic-related co-pollutants nitrogen dioxide and particulate matter with an aerodynamic diameter less than 2.5 μm. Results showed that ambient carbon monoxide was negatively associated with the risk of hospitalizations for COPD. After adjustment for levels nitrogen dioxide or particulate matter with an aerodynamic diameter less than 2.5 μm, the negative associations of carbon monoxide with COPD hospitalizations became stronger. The risk estimates were similar for female and male subjects. In conclusion, short-term exposure to ambient carbon monoxide was associated with a decreased risk of hospitalization for COPD, which suggests that carbon monoxide exposure provides some acute protection of against exacerbation of COPD.
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36
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Affiliation(s)
- An-Soo Jang
- Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
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37
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Ecological study on hospitalizations for cancer, cardiovascular, and respiratory diseases in the industrial area of Etang-de-Berre in the South of France. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2013; 2013:328737. [PMID: 23864868 PMCID: PMC3706020 DOI: 10.1155/2013/328737] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2013] [Revised: 04/15/2013] [Accepted: 05/07/2013] [Indexed: 01/31/2023]
Abstract
The Etang-de-Berre area is a large industrialized area in the South of France, exposing 300,000 inhabitants to the plumes of its industries. The possible associated health risks are of the highest concern to the population, who asked for studies investigating their health status. A geographical ecological study based on standardized hospitalizations ratios for cancer, cardiovascular, and respiratory diseases was carried out over the 2004–2007 period. Exposure to air pollution was assessed using dispersion models coupled with a geographic information system to estimate an annual mean concentration of sulfur dioxide (SO2) for each district. Results showed an excess risk of hospitalization for myocardial infarction in women living in districts with medium or high SO2 exposure, respectively, 38% [CI 95% 4 : 83] and 54% [14 : 110] greater than women living in districts at the reference level exposure. A 26% [2 : 57] excess risk of hospitalization for myocardial infarction was also observed in men living in districts with high SO2 levels. No excess risk of hospitalization for respiratory diseases or for cancer was observed, except for acute leukemia in men only. Results illustrate the impact of industrial air pollution on the cardiovascular system and call for an improvement of the air quality in the area.
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38
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Zhu R, Chen Y, Wu S, Deng F, Liu Y, Yao W. The Relationship between Particulate Matter (PM10) and Hospitalizations and Mortality Of Chronic Obstructive Pulmonary Disease: A Meta-Analysis. COPD 2013; 10:307-15. [DOI: 10.3109/15412555.2012.744962] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Lim YH, Kim H, Kim JH, Bae S, Park HY, Hong YC. Air pollution and symptoms of depression in elderly adults. ENVIRONMENTAL HEALTH PERSPECTIVES 2012; 120:1023-8. [PMID: 22514209 PMCID: PMC3404652 DOI: 10.1289/ehp.1104100] [Citation(s) in RCA: 237] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2011] [Accepted: 04/18/2012] [Indexed: 05/04/2023]
Abstract
BACKGROUND Although the effect of air pollution on various diseases has been extensively investigated, few studies have examined its effect on depression. OBJECTIVES We investigated the effect of air pollution on symptoms of depression in an elderly population. METHODS We enrolled 537 participants in the study who regularly visited a community center for the elderly located in Seoul, Korea. The Korean version of the Geriatric Depression Scale-Short Form (SGDS-K) was used to evaluate depressive symptomatology during a 3-year follow-up study. We associated ambient air pollutants with SGDS-K results using generalized estimating equations (GEE). We also conducted a factor analysis with items on the SGDS-K to determine which symptoms were associated with air pollution. RESULTS SGDS-K scores were positively associated with interquartile range (IQR) increases in the 3-day moving average concentration of particulate matter with an aerodynamic diameter ≤ 10 μm (PM10) [17.0% increase in SGDS-K score, 95% confidence interval (CI): 4.9%, 30.5%], the 0-7 day moving average of nitrogen dioxide [NO2; 32.8% (95% CI: 12.6%, 56.6%)], and the 3-day moving average of ozone [O3; 43.7% (95% CI: 11.5%, 85.2%)]. For these three pollutants, factor analysis showed that air pollution was more strongly associated with emotional symptoms such as feeling happy and satisfied than with somatic or affective symptoms. CONCLUSIONS Our study suggests that increases in PM10, NO2, and O3 may increase depressive symptoms among the elderly. Of the symptoms evaluated, ambient air pollution was most strongly associated with emotional symptoms.
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Affiliation(s)
- Youn-Hee Lim
- Department of Epidemiology and Biostatistics, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
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40
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Chang YK, Wu CC, Lee LT, Lin RS, Yu YH, Chen YC. The short-term effects of air pollution on adolescent lung function in Taiwan. CHEMOSPHERE 2012; 87:26-30. [PMID: 22189374 DOI: 10.1016/j.chemosphere.2011.11.048] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2011] [Revised: 11/22/2011] [Accepted: 11/22/2011] [Indexed: 05/24/2023]
Abstract
A mass screening of lung function associated with air pollutants for children is limited. This study assessed the association between air pollutants exposure and the lung function of junior high school students in a mass screening program in Taipei city, Taiwan. Among 10,396 students with completed asthma screening questionnaires and anthropometric measures, 2919 students aged 12-16 received the spirometry test. Forced vital capacity (FVC) and forced expiratory flow in 1s (FEV(1)) in association with daily ambient concentrations of particulate matter with diameter of 10 μm or less (PM(10)), sulfur dioxide (SO(2)), carbon monoxide (CO), nitrogen dioxide (NO(2)), and ozone (O(3)) were assessed by regression models controlling for the age, gender, height, weight, student living districts, rainfall and temperature. FVC, had a significant negative association with short-term exposure to O(3) and PM(10) measured on the day of spirometry testing. FVC values also were reversely associated with means of SO(2), O(3), NO(2), PM(10) and CO exposed 1 d earlier. An increase of 1-ppm CO was associated with the reduction in FVC for 69.8 mL (95% CI: -115, -24.4 mL) or in FEV(1) for 73.7 mL (95% CI: -118, -29.7 mL). An increase in SO(2) for 1 ppb was associated with the reductions in FVC and FEV(1) for 12.9 mL (95% CI: -20.7, -5.09 mL) and 11.7 mL (95% CI: -19.3, -4.16 mL), respectively. In conclusion, the short-term exposure to O(3) and PM(10) was associated with reducing FVC and FEV(1). CO and SO(2) exposure had a strong 1-d lag effect on FVC and FEV(1).
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Affiliation(s)
- Yu-Kang Chang
- Department of Public Health, China Medical University, Taichung 404, Taiwan.
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41
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Ji M, Cohan DS, Bell ML. Meta-analysis of the Association between Short-Term Exposure to Ambient Ozone and Respiratory Hospital Admissions. ENVIRONMENTAL RESEARCH LETTERS : ERL [WEB SITE] 2011; 6:024006. [PMID: 21779304 PMCID: PMC3138529 DOI: 10.1088/1748-9326/6/2/024006] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Ozone is associated with health impacts including respiratory outcomes; however, results differ across studies. Meta-analysis is an increasingly important approach to synthesizing evidence across studies. We conducted meta-analysis of short-term ozone exposure and respiratory hospitalizations to evaluate variation across studies and explore some of the challenges in meta-analysis. We identified 136 estimates from 96 studies and investigated how estimates differed by age, ozone metric, season, lag, region, disease category, and hospitalization type. Overall results indicate associations between ozone and various types of respiratory hospitalizations; however, study characteristics affected risk estimates. Estimates were similar, but higher, for the elderly compared to all ages and for previous day exposure compared to same day exposure. Comparison across studies was hindered by variation in definitions of disease categories, as some (e.g., asthma) were identified through ≥3 different sets of ICD codes. Although not all analyses exhibited evidence of publication bias, adjustment for publication bias generally lowered overall estimates. Emergency hospitalizations for total respiratory disease increased 4.47% (95% interval 2.48, 6.50%) per 10ppb 24-hr ozone among the elderly without adjustment for publication bias and 2.97% (1.05, 4.94%) with adjustment. Comparison of multi-city study results and meta-analysis based on single-city studies further suggested publication bias.
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Affiliation(s)
- Meng Ji
- School of Forestry and Environmental Studies, School of Public Health, Yale University, New Haven, CT, U.S.A
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Biselli PJC, Lopes FDTQS, Moriya HT, Rivero DHRF, Toledo AC, Saldiva PHN, Mauad T, Martins MA. Short-term exposure of mice to cigarette smoke and/or residual oil fly ash produces proximal airspace enlargements and airway epithelium remodeling. Braz J Med Biol Res 2011; 44:460-8. [PMID: 21445523 DOI: 10.1590/s0100-879x2011007500040] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2010] [Accepted: 03/10/2011] [Indexed: 11/22/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is associated with inflammatory cell reactions, tissue destruction and lung remodeling. Many signaling pathways for these phenomena are still to be identified. We developed a mouse model of COPD to evaluate some pathophysiological mechanisms acting during the initial stage of the disease. Forty-seven 6- to 8-week-old female C57/BL6 mice (approximately 22 g) were exposed for 2 months to cigarette smoke and/or residual oil fly ash (ROFA), a concentrate of air pollution. We measured lung mechanics, airspace enlargement, airway wall thickness, epithelial cell profile, elastic and collagen fiber deposition, and by immunohistochemistry transforming growth factor-β1 (TGF-β1), macrophage elastase (MMP12), neutrophils and macrophages. We observed regional airspace enlargements near terminal bronchioles associated with the exposure to smoke or ROFA. There were also increases in airway resistance and thickening of airway walls in animals exposed to smoke. In the epithelium, we noted a decrease in the ciliated cell area of animals exposed to smoke and an increase in the total cell area associated with exposure to both smoke and ROFA. There was also an increase in the expression of TGF-β1 both in the airways and parenchyma of animals exposed to smoke. However, we could not detect inflammatory cell recruitment, increases in MMP12 or elastic and collagen fiber deposition. After 2 months of exposure to cigarette smoke and/or ROFA, mice developed regional airspace enlargements and airway epithelium remodeling, although no inflammation or increases in fiber deposition were detected. Some of these phenomena may have been mediated by TGF-β1.
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Affiliation(s)
- P J C Biselli
- Departamento de Clínica Médica (LIM 20), Universidade de São Paulo.
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Eisner MD, Blanc PD, Omachi TA, Yelin EH, Sidney S, Katz PP, Ackerson LM, Sanchez G, Tolstykh I, Iribarren C. Socioeconomic status, race and COPD health outcomes. J Epidemiol Community Health 2011; 65:26-34. [PMID: 19854747 PMCID: PMC3017471 DOI: 10.1136/jech.2009.089722] [Citation(s) in RCA: 154] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Although chronic obstructive pulmonary disease (COPD) is a common cause of death and disability, little is known about the effects of socioeconomic status (SES) and race-ethnicity on health outcomes. METHODS The aim of this study is to determine the independent impacts of SES and race-ethnicity on COPD severity status, functional limitations and acute exacerbations of COPD among patients with access to healthcare. Data were used from the Function, Living, Outcomes and Work cohort study of 1202 Kaiser Permanente Northern California Medical Care Plan members with COPD. RESULTS Lower educational attainment and household income were consistently related to greater disease severity, poorer lung function and greater physical functional limitations in cross-sectional analysis. Black race was associated with greater COPD severity, but these differences were no longer apparent after controlling for SES variables and other covariates (comorbidities, smoking, body mass index and occupational exposures). Lower education and lower income were independently related to a greater prospective risk of acute COPD exacerbation (HR 1.5; 95% CI 1.01 to 2.1; and HR 2.1; 95% CI 1.4 to 3.4, respectively). CONCLUSION Low SES is a risk factor for a broad array of adverse COPD health outcomes. Clinicians and disease management programs should consider SES as a key patient-level marker of risk for poor outcomes.
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Affiliation(s)
- M D Eisner
- Division of Occupational and Environmental Medicine, Department of Medicine, University of California, San Francisco, San Francisco, CA 94143-0111, USA.
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Richmond-Bryant J, Hahn I, Fortune CR, Rodes CE, Portzer JW, Lee S, Wiener RW, Smith LA, Wheeler M, Seagraves J, Stein M, Eisner AD, Brixey LA, Drake-Richman ZE, Brouwer LH, Ellenson WD, Baldauf R. The Brooklyn traffic real-time ambient pollutant penetration and environmental dispersion (B-TRAPPED) field study methodology. ACTA ACUST UNITED AC 2009; 11:2122-35. [PMID: 20024009 DOI: 10.1039/b907126c] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The Brooklyn Traffic Real-Time Ambient Pollutant Penetration and Environmental Dispersion (B-TRAPPED) field study examined indoor and outdoor exposure to traffic-generated air pollution by studying the individual processes of generation of traffic emissions, transport and dispersion of air contaminants along a roadway, and infiltration of the contaminants into a residence. Real-time instrumentation was used to obtain highly resolved time-series concentration profiles for a number of air pollutants. The B-TRAPPED field study was conducted in the residential Sunset Park neighborhood of Brooklyn, NY, USA, in May 2005. The neighborhood contained the Gowanus Expressway (Interstate 278), a major arterial road (4(th) Avenue), and residential side streets running perpendicular to the Gowanus Expressway and 4(th) Avenue. Synchronized measurements were obtained inside a test house, just outside the test house façade, and along the urban residential street canyon on which the house was located. A trailer containing Federal Reference Method (FRM) and real-time monitors was located next to the Gowanus Expressway to assess the source. Ultrafine particulate matter (PM), PM(2.5), nitrogen oxides (NO(x)), sulfur dioxide (SO(2)), carbon monoxide (CO), carbon dioxide (CO(2)), temperature, relative humidity, and wind speed and direction were monitored. Different sampling schemes were devised to focus on dispersion along the street canyon or infiltration into the test house. Results were obtained for ultrafine PM, PM(2.5), criteria gases, and wind conditions from sampling schemes focused on street canyon dispersion and infiltration. For comparison, the ultrafine PM and PM(2.5) results were compared with an existing data set from the Los Angeles area, and the criteria gas data were compared with measurements from a Vancouver epidemiologic study. Measured ultrafine PM and PM(2.5) concentration levels along the residential urban street canyon and at the test house façade in Sunset Park were demonstrated to be comparable to traffic levels at an arterial road and slightly higher than those in a residential area of Los Angeles. Indoor ultrafine PM levels were roughly 3-10 times lower than outdoor levels, depending on the monitor location. CO, NO(2), and SO(2) levels were shown to be similar to values that produced increased risk of chronic obstructive pulmonary disease hospitalizations in the Vancouver studies.
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Affiliation(s)
- Jennifer Richmond-Bryant
- National Center for Environmental Assessment, U.S. Environmental Protection Agency, 109 T. W. Alexander Drive, MC B243-01, Research Triangle Park, NC 27711, USA.
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Yang W, Omaye ST. Air pollutants, oxidative stress and human health. Mutat Res 2008; 674:45-54. [PMID: 19013537 DOI: 10.1016/j.mrgentox.2008.10.005] [Citation(s) in RCA: 158] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2008] [Accepted: 10/15/2008] [Indexed: 10/21/2022]
Abstract
Air pollutants have, and continue to be, major contributing factors to chronic diseases and mortality, subsequently impacting public health. Chronic diseases include: chronic obstructive pulmonary diseases (COPD), cardiovascular diseases (CVD), asthma, and cancer. Byproducts of oxidative stress found in air pollutants are common initiators or promoters of the damage produced in such chronic diseases. Such air pollutants include: ozone, sulfur oxides, carbon monoxide, nitrogen oxides, and particulate matter. Interaction between oxidative stress byproducts and certain genes within our population may modulate the expression of specific chronic diseases. In this brief review we attempt to provide some insight into what we currently know about the health problems associated with various air pollutants and their relationship in promoting chronic diseases through changes in oxidative stress and modulation of gene expression. Such insight eventually may direct the means for effective public health prevention and treatment of diseases associated with air pollution and treatment of diseases associated with air pollution.
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Affiliation(s)
- Wei Yang
- School of Community Health Sciences and Environmental Sciences Graduate Program, University of Nevada, Reno, NV 89557, United States
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Sint T, Donohue JF, Ghio AJ. Ambient Air Pollution Particles and the Acute Exacerbation of Chronic Obstructive Pulmonary Disease. Inhal Toxicol 2008; 20:25-9. [DOI: 10.1080/08958370701758759] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Wilkinson T, Wedzicha JA. Strategies for improving outcomes of COPD exacerbations. Int J Chron Obstruct Pulmon Dis 2008; 1:335-42. [PMID: 18046870 PMCID: PMC2707157 DOI: 10.2147/copd.2006.1.3.335] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
COPD is uniquely situated as a chronic disease at the beginning of the 21st century; it is not only an established major cause of mortality and morbidity but is increasing in prevalence despite current medical interventions. In addition COPD is not a stable disease but its natural history is punctuated by periods of acute deterioration or exacerbations. Exacerbations generate considerable additional morbidity and mortality, and directly affect patients’ quality of life. However, despite significant advances in understanding and treating this disease, exacerbations continue to be the major cause of COPD-associated hospitalization, and provision for their management incurs considerable health care costs. This review will consider the current management of COPD exacerbations and how new clinical strategies may improve outcome of these important clinical events.
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Affiliation(s)
- Tom Wilkinson
- Academic Unit of Respiratory Medicine, University College London, Royal Free and University College Medical School, London UK.
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O'Shea SD, Taylor NF, Paratz JD. . . . But watch out for the weather: factors affecting adherence to progressive resistance exercise for persons with COPD. J Cardiopulm Rehabil Prev 2007; 27:166-74; quiz 175-6. [PMID: 17558200 DOI: 10.1097/01.hcr.0000270686.78763.c8] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE Exercise is an important treatment modality for persons with chronic obstructive pulmonary disease (COPD), but factors influencing adherence have been examined infrequently. The purpose of this investigation was to explore adherence factors to a progressive resistance exercise program for persons with COPD. METHODS Persons with COPD enrolled in a 12-week trial of progressive resistance exercise were invited to participate in 2 semistructured qualitative interviews exploring program adherence. Interviews were audio-taped, transcribed, and then coded independently by 2 researchers. Themes relating to short-term and long-term adherence were then developed and described. RESULTS Twenty-two participants were interviewed at the conclusion of the intervention (12 weeks), and 19 completed a second interview at 24 weeks. Short-term exercise adherence was facilitated by expected outcomes, self-motivation, supervision, and group support, whereas health and weather factors were the major barriers to adherence. The barriers to exercise remained unchanged at 24 weeks despite a large decline in exercise adherence. Removal of environmental support at 12 weeks may have contributed to poor long-term exercise maintenance, with participants identifying group support and regular monitoring by a therapist as the most important strategies for maintaining exercise. CONCLUSIONS The provision of external support in training program design appears important for persons with COPD. Longer-term adherence declined when group support and regular monitoring by a therapist was removed, despite the major perceived exercise barriers remaining unchanged. Therefore, further investigation is required to determine effective strategies for maximizing longer-term exercise adherence in this population.
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Affiliation(s)
- Simone D O'Shea
- School of Physiotherapy, La Trobe University, Melbourne, Australia.
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Viegi G, Maio S, Pistelli F, Baldacci S, Carrozzi L. Epidemiology of chronic obstructive pulmonary disease: health effects of air pollution. Respirology 2007; 11:523-32. [PMID: 16916323 DOI: 10.1111/j.1440-1843.2006.00886.x] [Citation(s) in RCA: 84] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
COPD is one of the leading causes of morbidity and mortality in the industrialized and the developing countries. According to the prediction of the World Health Organization, COPD will become the third leading cause of mortality and the fifth cause of disability in 2020 worldwide. In epidemiology, distinct phenotypic entities converge on the term COPD, so that prevalence and mortality data may be inclusive of chronic bronchitis, emphysema and asthma; moreover, the assessment of prevalence rates may change considerably according to the diagnostic tools used. Thus, a considerable problem is to estimate the real prevalence of COPD in the general population. COPD is determined by the action of a number of various risk factors, among which, the most important is cigarette smoking. However, during the last few decades, evidence from epidemiological studies finding consistent associations between air pollution and various outcomes (respiratory symptoms, reduced lung function, chronic bronchitis and mortality), has suggested that outdoor air pollution is a contributing cause of morbidity and mortality. In conclusion, epidemiological studies suggest that air pollution plays a remarkable role in the exacerbation and in the pathogenesis of chronic respiratory diseases. Thus, respiratory physicians, as well as public health professionals, should advocate for a cleaner environment.
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Affiliation(s)
- Giovanni Viegi
- Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Via Trieste 41, 56126 Pisa, Italy.
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Current World Literature. Curr Opin Allergy Clin Immunol 2006. [DOI: 10.1097/01.all.0000244802.79475.bd] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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