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Kuo CY, Chan CK, Huang JL, Wu CY, Phan DV, Lo HY, Chan CL. Decline in hospitalization for childhood asthma in different air pollution regions in Taiwan, 2001-2012. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2022; 32:95-105. [PMID: 32073299 DOI: 10.1080/09603123.2020.1729964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Accepted: 02/11/2020] [Indexed: 06/10/2023]
Abstract
This study aimed to investigate the trends in childhood asthma hospitalization in regions with differing levels of air pollution in Taiwan, 2001-2012. Joinpoint regression was used to identify significant trend changes. The hospitalization rate varied according to gender, geographic region, and age. The incidence of childhood asthma hospitalization decreased from 127.99 to 76.67 (/100,000 population), with an average annual percentage change of around -4.1%; in the Yilan region, the average air pollution concentrations were 19.92 μg/m3, 39.47 μg/m3, 25.99 ppb, 2.19 ppb, and 11.23 ppb for PM2.5, PM10, O3, SO2, and NO2, respectively, which were lower than Taiwan's average values; however, the childhood asthma hospitalization rate was the highest (179.75/100,000 population). The national trend in childhood asthma hospitalization exhibited a significant decrease. The effects of air pollution on childhood asthma were greater in the higher-level air pollution regions, while less association was observed in the lower-level air pollution regions.
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Affiliation(s)
- Ching-Yen Kuo
- Department of Information Management, Yuan Ze University, Taoyuan City, Taiwan
- Department of Medical Administration, Ministry of Health and Welfare, Taoyuan General Hospital, Taoyuan City, Taiwan
| | - Chin-Kan Chan
- Department of Pediatrics, Ministry of Health and Welfare, Taoyuan General Hospital, Taoyuan City, Taiwan
- Department of Biotechnology, Ming Chuan University, Taoyuan City, Taiwan
| | - Jing-Long Huang
- Department of Pediatrics, Division of Allergy, Asthma and Rheumatology, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taipei, Taiwan
| | - Chiung-Yi Wu
- Institute of Public Health, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Dinh-Van Phan
- Department of Information Management, Yuan Ze University, Taoyuan City, Taiwan
- University of Economics, The University of Danang, Da Nang, Vietnam
- Teaching and Research Team for Business Intelligence, University of Economics, the University of Danang, Da Nang, Vietnam
| | - Huei Yu Lo
- Department of Rehabilitation, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan City, Taiwan
- Department of Chemistry, Chung Yuan Christian University, Taoyuan City, Taiwan
| | - Chien Lung Chan
- Department of Information Management, Yuan Ze University, Taoyuan City, Taiwan
- Innovation Center for Big Data and Digital Convergence, Yuan Ze University, Taoyuan City, Taiwan
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Yin G, Wu X, Wu Y, Li H, Gao L, Zhu X, Jiang Y, Wang W, Shen Y, He Y, Chen C, Niu Y, Zhang Y, Mao R, Zeng Y, Kan H, Chen Z, Chen R. Evaluating carbon content in airway macrophages as a biomarker of personal exposure to fine particulate matter and its acute respiratory effects. CHEMOSPHERE 2021; 283:131179. [PMID: 34146873 DOI: 10.1016/j.chemosphere.2021.131179] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 05/04/2021] [Accepted: 06/07/2021] [Indexed: 06/12/2023]
Abstract
It remains unclear whether carbon content in airway macrophages (AM) can predict personal short-term exposure to fine particulate matter (PM2.5) air pollution and its respiratory health effects. We aimed to evaluate the pathway from personal PM2.5 exposure to adverse respiratory outcomes through AM carbon content. We designed a longitudinal panel study with 3 scheduled follow-ups among 113 non-smoking patients of chronic obstructive pulmonary disease in Shanghai, China, from April 2017 to January 2019. We quantified AM carbon content from induced sputum by image analysis, tested lung function and measured sputum levels of 4 pro-inflammatory cytokines and 2 anti-inflammatory cytokines. We applied the "meet in the middle" approach incorporating linear mixed-effect models to evaluate the associations from external PM2.5 exposure to respiratory outcomes through AM carbon content. Our results indicated that personal exposure to PM2.5 within 24 h was significantly associated with decreased forced expiratory volume in 1s and anti-inflammatory cytokines, as well as increased macrophages and pro-inflammatory cytokines. These changes were accompanied by increased areas of AM carbon and higher percentage of AM area occupied by carbon, both of which were associated with increased levels of pro-inflammatory cytokines and decreased levels of anti-inflammatory cytokines. Exposure to ambient black carbon and organic carbon in PM2.5 within 2 days was significantly associated with increased AM carbon area and percentage of AM area occupied by carbon. Our findings reinforced the causality in respiratory health effects of PM2.5 in which increased AM carbon content might serve as a valid exposure biomarker.
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Affiliation(s)
- Guanjin Yin
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, 200032, China
| | - Xiaodan Wu
- Respiratory Division of Zhongshan Hospital, Shanghai Institute of Respiratory Disease, Fudan University, Shanghai, 200032, China
| | - Yihan Wu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, 200032, China
| | - Hongjin Li
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, 200032, China
| | - Lei Gao
- Respiratory Division of Zhongshan Hospital, Shanghai Institute of Respiratory Disease, Fudan University, Shanghai, 200032, China
| | - Xinlei Zhu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, 200032, China
| | - Yixuan Jiang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, 200032, China
| | - Weidong Wang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, 200032, China
| | - Yanling Shen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, 200032, China
| | - Yu He
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, 200032, China
| | - Chen Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, 200032, China
| | - Yue Niu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, 200032, China
| | - Yi Zhang
- Air Liquide (China) Holding Co., Ltd., Shanghai, 200233, China
| | - Ruolin Mao
- Respiratory Division of Zhongshan Hospital, Shanghai Institute of Respiratory Disease, Fudan University, Shanghai, 200032, China
| | - Yuzhen Zeng
- Respiratory Division of Zhongshan Hospital, Shanghai Institute of Respiratory Disease, Fudan University, Shanghai, 200032, China
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, 200032, China
| | - Zhihong Chen
- Respiratory Division of Zhongshan Hospital, Shanghai Institute of Respiratory Disease, Fudan University, Shanghai, 200032, China.
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, 200032, China; Shanghai Typhoon Institute/CMA, Shanghai Key Laboratory of Meteorology and Health, Shanghai, 200030, China.
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Haga SL, Hagenbjörk A, Olin AC, Forsberg B, Liljelind I, Carlsen HK, Modig L. Personal exposure levels to O 3, NO x and PM 10 and the association to ambient levels in two Swedish cities. ENVIRONMENTAL MONITORING AND ASSESSMENT 2021; 193:674. [PMID: 34570284 PMCID: PMC8476356 DOI: 10.1007/s10661-021-09447-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 09/02/2021] [Indexed: 05/29/2023]
Abstract
Exposure to air pollution is of great concern for public health although studies on the associations between exposure estimates and personal exposure are limited and somewhat inconsistent. The aim of this study was to quantify the associations between personal nitrogen oxides (NOx), ozone (O3) and particulate matter (PM10) exposure levels and ambient levels, and the impact of climate and time spent outdoors in two cities in Sweden. Subjects (n = 65) from two Swedish cities participated in the study. The study protocol included personal exposure measurements at three occasions, or waves. Personal exposure measurements were performed for NOx and O3 for 24 h and PM10 for 24 h, and the participants kept an activity diary. Stationary monitoring stations provided hourly data of NOx, O3 and PM, as well as data on air temperature and relative humidity. Data were analysed using mixed linear models with the subject-id as a random effect and stationary exposure and covariates as fixed effects. Personal exposure levels of NOx, O3 and PM10 were significantly associated with levels measured at air pollution monitoring stations. The associations persisted after adjusting for temperature, relative humidity, city and wave, but the modelled estimates were slightly attenuated from 2.4% (95% CI 1.8-2.9) to 2.0% (0.97-2.94%) for NOx, from 3.7% (95% CI 3.1-4.4) to 2.1% (95% CI 1.1-2.9%) for O3 and from 2.6% (95% 0.9-4.2%) to 1.3% (95% CI - 1.5-4.0) for PM10. After adding covariates, the degree of explanation offered by the model (coefficient of determination, or R2) did not change for NOx (0.64 to 0.63) but increased from 0.46 to 0.63 for O3, and from 0.38 to 0.43 for PM10. Personal exposure to NOx, O3 and PM has moderate to good association with levels measured at urban background sites. The results indicate that stationary measurements are valid as measure of exposure in environmental health risk assessments, especially if they can be refined using activity diaries and meteorological data. Approximately 50-70% of the variation of the personal exposure was explained by the stationary measurement, implying occurrence of misclassification in studies using more crude exposure metrics, potentially leading to underestimates of the effects of exposure to ambient air pollution.
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Affiliation(s)
- Susanna Lohman Haga
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Sahlgrenska Academy At University of Gothenburg, Gothenburg, Sweden
| | - Annika Hagenbjörk
- Department of Public Health and Clinical Medicine, Section for Sustainable Health At Umeå University, Umeå, Sweden
| | - Anna-Carin Olin
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Sahlgrenska Academy At University of Gothenburg, Gothenburg, Sweden
| | - Bertil Forsberg
- Department of Public Health and Clinical Medicine, Section for Sustainable Health At Umeå University, Umeå, Sweden
| | - Ingrid Liljelind
- Department of Public Health and Clinical Medicine, Section for Sustainable Health At Umeå University, Umeå, Sweden
| | - Hanne Krage Carlsen
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Sahlgrenska Academy At University of Gothenburg, Gothenburg, Sweden
| | - Lars Modig
- Department of Public Health and Clinical Medicine, Section for Sustainable Health At Umeå University, Umeå, Sweden
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Evangelopoulos D, Katsouyanni K, Keogh RH, Samoli E, Schwartz J, Barratt B, Zhang H, Walton H. PM 2.5 and NO 2 exposure errors using proxy measures, including derived personal exposure from outdoor sources: A systematic review and meta-analysis. ENVIRONMENT INTERNATIONAL 2020; 137:105500. [PMID: 32018132 DOI: 10.1016/j.envint.2020.105500] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 12/30/2019] [Accepted: 01/15/2020] [Indexed: 05/27/2023]
Abstract
BACKGROUND The use of proxy exposure estimates for PM2.5 and NO2 in air pollution studies instead of personal exposures, introduces measurement error, which can produce biased epidemiological effect estimates. Most studies consider total personal exposure as the gold standard. However, when studying the effects of ambient air pollution, personal exposure from outdoor sources is the exposure of interest. OBJECTIVES We assessed the magnitude and variability of exposure measurement error by conducting a systematic review of the differences between personal exposures from outdoor sources and the corresponding measurements for ambient concentrations in order to increase understanding of the measurement error structures of the pollutants. DATA SOURCES AND ELIGIBILITY CRITERIA We reviewed the literature (ISI Web of Science, Medline, 2000-2016) for English language studies (in any age group in any location (NO2) or Europe and North America (PM2.5)) that reported repeated measurements over time both for personal and ambient PM2.5 or NO2 concentrations. Only a few studies reported personal exposure from outdoor sources. We also collected data for infiltration factors and time-activity patterns of the individuals in order to estimate personal exposures from outdoor sources in every study. STUDY APPRAISAL AND SYNTHESIS METHODS Studies using modelled rather than monitored exposures were excluded. Type of personal exposure monitor was assessed. Random effects meta-analysis was conducted to quantify exposure error as the mean difference between "true" and proxy measures. RESULTS Thirty-two papers for PM2.5 and 24 for NO2 were identified. Outdoor sources were found to contribute 44% (range: 33-55%) of total personal exposure to PM2.5 and 74% (range: 57-88%) to NO2. Overall estimates of personal exposure (24-hour averages) from outdoor sources were 9.3 μg/m3 and 12.0 ppb for PM2.5 and NO2 respectively, while the corresponding difference between these exposures and the ambient concentrations (i.e. the measurement error) was 5.72 μg/m3 and 7.17 ppb. Our findings indicated also higher error variability for NO2 than PM2.5. Large heterogeneity was observed which was not explained sufficiently by geographical location or age group of the study sample. LIMITATIONS, CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS Relying only on information available in published studies led to some limitations: the contribution of outdoor sources to total personal exposure for NO2 had to be inferred, individual variation in exposure misclassification was unavailable and instrument error could not be addressed. The larger magnitude and variability of errors for NO2 compared with PM2.5 has implications for biases in the health effect estimates of multi-pollutant epidemiological models. Results suggest that further research is needed regarding personal exposure studies and measurement error bias in epidemiological models.
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Affiliation(s)
- Dimitris Evangelopoulos
- NIHR HPRU Health Impact of Environmental Hazards, Analytical, Environmental & Forensic Sciences, King's College London, UK.
| | - Klea Katsouyanni
- NIHR HPRU Health Impact of Environmental Hazards, Analytical, Environmental & Forensic Sciences, King's College London, UK
| | - Ruth H Keogh
- Department of Medical Statistics, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias Str, 115 27 Athens, Greece
| | - Joel Schwartz
- Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Ben Barratt
- NIHR HPRU Health Impact of Environmental Hazards, Analytical, Environmental & Forensic Sciences, King's College London, UK
| | - Hanbin Zhang
- NIHR HPRU Health Impact of Environmental Hazards, Analytical, Environmental & Forensic Sciences, King's College London, UK
| | - Heather Walton
- NIHR HPRU Health Impact of Environmental Hazards, Analytical, Environmental & Forensic Sciences, King's College London, UK
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Kuo CY, Chan CK, Wu CY, Phan DV, Chan CL. The Short-Term Effects of Ambient Air Pollutants on Childhood Asthma Hospitalization in Taiwan: A National Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16020203. [PMID: 30642061 PMCID: PMC6351918 DOI: 10.3390/ijerph16020203] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 01/05/2019] [Accepted: 01/08/2019] [Indexed: 12/27/2022]
Abstract
This investigation determined the effects of air pollution on childhood asthma hospitalization in regions with differing air pollution levels in Taiwan over a long time period. Data of childhood hospital admissions for asthma in patients aged 0–18 years and air quality in eight regions for the period 2001–2012 in Taiwan were collected. Poisson generalized linear regression analysis was employed to identify the relative risks of hospitalization due to asthma in children associated with exposure to varying levels of air pollutants with a change in the interquartile range after adjusting for temperature and relative humidity. Particulate matter ≤2.5 μm (PM2.5), particulate matter ≤10 μm (PM10), ozone (O3), sulfur dioxide (SO2), and nitrogen dioxide (NO2), were positively associated with childhood asthma hospitalization, while O3 was negatively associated with childhood asthma hospitalization. SO2 was identified as the most significant risk factor. The relative risks for asthma hospitalization associated with air pollutants were higher among children aged 0–5 years than aged 6–18 years and were higher among males than females. The effects of air pollution on childhood asthma were greater in the higher-level air pollution regions, while no association was observed in the lower-level air pollution regions. These findings may prove important for policymakers involved in implementing policies to reduce air pollution.
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Affiliation(s)
- Ching-Yen Kuo
- Department of Information Management, Yuan Ze University, 135 Yuan-Tung Road, Jung-Li, Taoyuan 320, Taiwan.
- Department of Medical Administration, Taoyuan General Hospital, Ministry of Health and Welfare, 1492 Zhongshan Road, Taoyuan Dist., Taoyuan 330, Taiwan.
| | - Chin-Kan Chan
- Department of Pediatrics, Taoyuan General Hospital, Ministry of Health and Welfare, 1492 Zhongshan Road, Taoyuan Dist., Taoyuan 330, Taiwan.
- Department of Biotechnology, Ming Chuan University, 5 De Ming Road, Gui Shan Dist., Taoyuan 333, Taiwan.
| | - Chiung-Yi Wu
- Department of Information Management, Yuan Ze University, 135 Yuan-Tung Road, Jung-Li, Taoyuan 320, Taiwan.
| | - Dinh-Van Phan
- Department of Information Management, Yuan Ze University, 135 Yuan-Tung Road, Jung-Li, Taoyuan 320, Taiwan.
- Innovation Center for Big Data and Digital Convergence, Yuan Ze University, 135 Yuan-Tung Road, Jung-Li, Taoyuan 320, Taiwan.
- University of Economics, The University of Danang, 71 Ngu Hanh Son Street, Danang 550000, Vietnam.
| | - Chien-Lung Chan
- Department of Information Management, Yuan Ze University, 135 Yuan-Tung Road, Jung-Li, Taoyuan 320, Taiwan.
- Innovation Center for Big Data and Digital Convergence, Yuan Ze University, 135 Yuan-Tung Road, Jung-Li, Taoyuan 320, Taiwan.
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Kuo CY, Pan RH, Chan CK, Wu CY, Phan DV, Chan CL. Application of a Time-Stratified Case-Crossover Design to Explore the Effects of Air Pollution and Season on Childhood Asthma Hospitalization in Cities of Differing Urban Patterns: Big Data Analytics of Government Open Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15040647. [PMID: 29614737 PMCID: PMC5923689 DOI: 10.3390/ijerph15040647] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 03/27/2018] [Accepted: 03/28/2018] [Indexed: 11/16/2022]
Abstract
Few studies have assessed the lagged effects of levels of different urban city air pollutants and seasons on asthma hospitalization in children. This study used big data analysis to explore the effects of daily changes in air pollution and season on childhood asthma hospitalization from 2001 to 2010 in Taipei and Kaohsiung City, Taiwan. A time-stratified case-crossover study and conditional logistic regression analysis were employed to identify associations between the risk of hospitalization due to asthma in children and the levels of air pollutants (PM2.5, PM10, O₃, SO₂, and NO₂) in the days preceding hospitalization. During the study period, 2900 children in Taipei and 1337 in Kaohsiung aged ≤15 years were hospitalized due to asthma for the first time. The results indicated that the levels of air pollutants were significantly associated with the risk of asthma hospitalization in children, and seasonal effects were observed. High levels of air pollution in Kaohsiung had greater effects than in Taipei after adjusting for seasonal variation. The most important factor was O₃ in spring in Taipei. In children aged 0-6 years, asthma was associated with O₃ in Taipei and SO₂ in Kaohsiung, after controlling for the daily mean temperature and relative humidity.
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Affiliation(s)
- Ching-Yen Kuo
- Institute of Information Management, Yuan-Ze University, 135 Yuan-Tung Road, Jung-Li, Taoyuan 320, Taiwan.
- Department of Medical Administration, Taoyuan General Hospital, Ministry of Health and Welfare, 1492 Zhongshan Road, Taoyuan Dist., Taoyuan 330, Taiwan.
| | - Ren-Hao Pan
- Institute of Information Management, Yuan-Ze University, 135 Yuan-Tung Road, Jung-Li, Taoyuan 320, Taiwan.
| | - Chin-Kan Chan
- Department of Pediatrics, Taoyuan General Hospital, Ministry of Health and Welfare, 1492 Zhongshan Road, Taoyuan Dist., Taoyuan 330, Taiwan.
| | - Chiung-Yi Wu
- Institute of Information Management, Yuan-Ze University, 135 Yuan-Tung Road, Jung-Li, Taoyuan 320, Taiwan.
| | - Dinh-Van Phan
- Institute of Information Management, Yuan-Ze University, 135 Yuan-Tung Road, Jung-Li, Taoyuan 320, Taiwan.
- Innovation Center for Big Data and Digital Convergence, Yuan-Ze University, 135 Yuan-Tung Road, Jung-Li, Taoyuan 320, Taiwan.
- University of Economics, The University of Danang, , 71 Ngu Hanh Son Street, Danang 550000, Vietnam.
| | - Chien-Lung Chan
- Institute of Information Management, Yuan-Ze University, 135 Yuan-Tung Road, Jung-Li, Taoyuan 320, Taiwan.
- Innovation Center for Big Data and Digital Convergence, Yuan-Ze University, 135 Yuan-Tung Road, Jung-Li, Taoyuan 320, Taiwan.
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Magalhaes S, Baumgartner J, Weichenthal S. Impacts of exposure to black carbon, elemental carbon, and ultrafine particles from indoor and outdoor sources on blood pressure in adults: A review of epidemiological evidence. ENVIRONMENTAL RESEARCH 2018; 161:345-353. [PMID: 29195183 DOI: 10.1016/j.envres.2017.11.030] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 11/15/2017] [Accepted: 11/19/2017] [Indexed: 06/07/2023]
Abstract
INTRODUCTION Ambient particulate air pollution is known to have detrimental effects on cardiovascular health but less is known about the specific effects of black carbon or elemental carbon (BC/EC) and ultrafine particles (UFP). METHODS We present a narrative review of the epidemiological evidence related to the impact of exposure to BC/EC and UFP on blood pressure in adults. We searched PubMed and EMBASE in September 2017, using a predefined search strategy. Abstracts were screened using predefined inclusion criteria. Data collection was completed using a standard data extraction form. We focused on main effect estimates for associations between short (≤7 days) and long-term exposures to BC/EC and UFP and systolic (SBP) and diastolic blood pressure (DBP). Effect estimates were rescaled to enable direct comparisons between studies. RESULTS Thirty publications were included in the review: 19 studies examined outdoor exposure to BC/EC, 11 examined outdoor UFP, three studies examined indoor BC and one study examined indoor UFP. In general, existing evidence supports a positive association between BC/EC and blood pressure. Evidence for outdoor UFP exposures were less clear as effect estimates were small in magnitude and confidence intervals often included the null. CONCLUSIONS Existing evidence supports a positive association between BC/EC and blood pressure in adults, whereas UFPs do not appear to have a meaningful impact on blood pressure.
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Affiliation(s)
- Sandra Magalhaes
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada
| | - Jill Baumgartner
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada; Institute for Health and Social Policy, McGill University, Montreal, Canada
| | - Scott Weichenthal
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Canada.
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Short-Term Associations between Air Pollution Concentrations and Respiratory Health-Comparing Primary Health Care Visits, Hospital Admissions, and Emergency Department Visits in a Multi-Municipality Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14060587. [PMID: 28561792 PMCID: PMC5486273 DOI: 10.3390/ijerph14060587] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 05/17/2017] [Accepted: 05/27/2017] [Indexed: 12/04/2022]
Abstract
Acute effects of air pollution on respiratory health have traditionally been investigated with data on inpatient admissions, emergency room visits, and mortality. In this study, we aim to describe the total acute effects of air pollution on health care use for respiratory symptoms (ICD10-J00-J99). This will be done by investigating primary health care (PHC) visits, inpatient admissions, and emergency room visits together in five municipalities in southern Sweden, using a case-crossover design. Between 2005 and 2010, there were 81,019 visits to primary health care, 38,217 emergency room visits, and 25,271 inpatient admissions for respiratory symptoms in the study area. There was a 1.85% increase (95% CI: 0.52 to 3.20) in the number of primary health care visits associated with a 10 µg/m3 increase in nitrogen dioxide (NO2) levels in Malmö, but not in the other municipalities. Air pollution levels were generally not associated with emergency room visits or inpatient admissions, with one exception (in Helsingborg there was a 2.52% increase in emergency room visits for respiratory symptoms associated with a 10 µg/m3 increase in PM10). In conclusion, the results give weak support for short-term effects of air pollution on health care use associated with respiratory health symptoms in the study area.
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