Allergic disease associations with regional and localized estimates of air pollution

The association of air pollution in respiratory allergy: Its impact in an industrial city

Background

Asthma and allergic diseases have increased in recent decades and are more common in industrialized countries. Industrial areas with a considerably high number of inhabitants and vehicles can favor the presence of serious air pollution and therefore the appearance and exacerbation of respiratory allergy symptoms. The objective of this study was to determine the relationship between exposure to environmental pollutants with exacerbation of respiratory allergy.

Methods

A total of 240 subjects above 6 years old who lived in the metropolitan area of Monterrey, Nuevo León, Mexico, with diagnosis of allergic rhinitis and/or asthma, were included. The subject's address was registered in the database and the rhinitis control assessment test (RCAT) and the asthma control test (ACT) were applied. Environmental data were obtained from the Environmental Monitoring System (SIMA) of Nuevo León. Geolocation of industries and avenues in proximity of subject's addresses and SIMA stations were obtained through geographic information systems using ArcGis software.

Results

The relation between pollutants and subjects' RCAT, ACT, and spirometry results in the 14 stations was established. PM10 and forced vital capacity (FVC) had an r = 0.074 with p = 0.005, PM10 and absolute FEV1/FVC ratio presented an r = -0.102 with a p = 0.000; The distance found to be associated with a worsening of respiratory symptoms was living 165 m from a main road or 241 m from an industrial establishment.

Conclusions

Exposure to pollutants present in the environment are factors associated with increased symptoms in subjects with respiratory allergies.

Particulate Matter Air Pollution is a Significant Risk Factor for Cardiovascular Disease

Air pollution is responsible worldwide for 9-12 million deaths annually. The major contributor to air pollution is particulate matter ≤2.5 µg per cubic meter of air (PM2.5) from vehicles, industrial emissions, and wildfire smoke. United States ambient air standards recommend annual average PM2.5 concentrations of ≤12 μg/m³ while European standards allow an average annual PM2.5 concentration of ≤20 μg/m3. However, significant PM2.5 cardiovascular and pulmonary health risks exist below these concentrations. Chronic PM2.5 exposure significantly increases major cardiovascular and pulmonary event risks in Americans by 8 to more than 20% for each 10-μg/m3 increase in PM2.5. PM2.5-induced increases in lipid peroxidation, induction of vascular inflammation and endothelial cell injury initiate and propagate respiratory diseases, coronary and carotid atherosclerosis. PM2.5 can cause atherosclerotic vascular plaque rupture and myocardial infarction and stroke by activating metalloproteinases. This article discusses PM2.5 effects on the cardiovascular and pulmonary systems, specific PM2.5 pathophysiologic mechanisms contributing to cardiopulmonary disease, and preventive measures to limit the cardiovascular and pulmonary effects of PM2.5.

Modified Guo-Min decoction ameliorates PM2.5-induced lung injury by inhibition of PI3K-AKT and MAPK signaling pathways

BACKGROUND/PURPOSE

Exposure to particles with an aerodynamic diameter of ≤2.5 μm (PM2.5) increased various lung diseases, which lack effective treatment. Massive evidence links PM2.5 to the development of allergic lung diseases like asthma. Modified Guo-Min Decoction (MGMD) is a traditional Chinese formula for allergic diseases. However, whether MGMD could improve PM2.5-induced lung injury and the underlying mechanism remain unclear and we aimed to explore.

STUDY DESIGN/METHODS

Male Wistar rats (200-220 g) were intratracheally instilled of PM2.5 suspension daily for 4 weeks to establish PM2.5-induced lung injury model. MGMD (2.1 g/kg) treatment by gavage was started 1 week before, at the same time or 1 week after the instillation of PM2.5 suspension, namely the pre-, sync- or post-administration groups. HE and Masson staining were used to observe morphological changes. Immunohistochemistry staining was used to detect macrophage and neutrophil infiltration. The levels of inflammatory cytokines in the bronchoalveolar lavage fluid were detected by ELISA. The main components of MGMD were detected by UHPLC-LTQ-Orbitrap MSn. Network pharmacology was used to identify the key targets mediating the effect of MGMD in treating PM2.5-induced lung injury. Changes in the expression of target proteins were examined by western blot. In-vitro experiments were carried out in Beas2b cells to evaluate the protective effect and mechanism of MGMD against PM2.5 induced injury.

RESULTS

Exposure to PM2.5 suspension resulted in disarrangement of tracheal epithelium, neutrophil and M1 macrophage infiltration and collagen deposition, and significantly increased IgE, IL-1β and IL-17 secretion and NLRP3 expression, which were inhibited by MDMD treatment and pre-MGMD treatment showed the best effect. By UHPLC-LTQ-Orbitrap MSn, 46 main compounds were identified in MGMD. Using network pharmacology approach, we found MGMD attenuate PM2.5-induced lung damage by targeting 216 genes, and PPI network, GO and KEGG analysis all indicated that PI3K-AKT and MAPK pathways were important. Western blot showed that PM2.5 suspension exposure increased PI3K, AKT, ERK and JNK phosphorylation, which were reversed by MGMD intervention significantly. In vitro, the viability of Beas2b cells was significantly decreased after PM2.5 suspension exposure, and was obviously upregulated after MGMD-containing serum or LY294002 treatment.

CONCLUSION

The present study demonstrated that MGMD could improve PM2.5-induced lung injury through reducing inflammation and pulmonary fibrosis, which was probably mediated by inhibition of the PI3K-AKT and MAPK signaling pathways, and NLRP3 inflammasome. The results of this study support and provide scientific evidence for the clinical application of MGMD on PM2.5-induced lung injury. Pre-treatment, sync-treatment, and post-treatment is the highlight of this study.

Ambient fine particulate matter and allergic symptoms in the middle-aged and elderly population: results from the PIFCOPD study

BACKGROUND

The associations between short- and long-term exposure to ambient fine particulate matter with an aerodynamic diameter ≤ 2.5 µm (PM_2.5) and allergic symptoms in middle-aged and elderly populations remain unclear, particularly in China, where most cities have severe air pollution.

METHODS

Participants (n = 10,142; age = 40-75 years) were recruited from ten regions in China from 2018 to 2021 for the Predictive Value of Inflammatory Biomarkers and Forced Expiratory Volume in 1 s (FEV₁) for Chronic Obstructive Pulmonary Disease (PIFCOPD) study. Short-term (lag0 and lag0-7 day) and long-term (1-, 3- and 5-year) PM_2.5 concentrations at residences were extracted from the air pollutant database known as Tracking Air Pollution (TAP) in China. Multivariate logistic regression models were used to estimate associations for short- and long-term PM_2.5 exposure concentrations and long-term exposure models were additionally adjusted for short-term deviations.

RESULTS

A 10 µg/m³ increase in PM_2.5 on the day the allergic symptoms questionnaire was administered (lag0 day) was associated with higher odds of allergic nasal (1.09, 95% CI 1.05, 1.12) and eye symptoms (1.08, 95% CI 1.05, 1.11), worsening dyspnea caused by allergens (1.06, 95% CI 1.02, 1.10), and ≥ 2 allergic symptoms (1.07, 95% CI 1.03, 1.11), which was similar in the lag0-7 day concentrations. A 10 µg/m³ increase in the 1-year average PM_2.5 concentration was associated with an increase of 23% for allergic nasal symptoms, 22% for eye symptoms, 20% for worsening dyspnea caused by allergens, and 21% for ≥ 2 allergic symptoms, similar to the 3- and 5-year average PM_2.5 concentrations. These associations between long-term PM_2.5 concentration and allergic symptoms were generally unchanged after adjustment for short-term deviations.

CONCLUSIONS

Short- and long-term exposure to ambient PM_2.5 was associated with an increased risk of allergic nasal and eye symptoms, worsening dyspnea caused by allergens, and ≥ 2 allergic symptoms.

TRIAL REGISTRATION

Clinical trial ID: NCT03532893 (29 Mar 2018).

Ambient particulate matter associates with asthma in high altitude region: A population-based study

Background

Exposure to particulate matter (PM) has been a major public health threat, but the potentially differential effects on asthma of PM remain largely unknown in high altitude settings. We evaluated the effects of ambient PM on asthma in high altitude settings.

Methods

The study recruited a representative sample from high altitude settings using a multistage stratified sampling procedure. Asthma was defined by a self-reported history of diagnosis by a physician or by wheezing symptoms in the preceding 12 months. The annual mean PM_2.5 and PM₁₀ concentrations were calculated for each grid cell at 1-km spatial resolution based on the geographical coordinates.

Results

We analyzed data for participants (mean age 39.1 years, 51.4% female) and 183 (3.7%, 95% confidence interval (CI): 3.2-4.2) of the participants had asthma. Prevalence was higher in women (4.3%, 95% CI 3.5-5.1) than in men (3.1%, 2.4-3.8) and increasing with higher concentration of PM exposures. For an interquartile range (IQR) difference (8.77 μg/m³) in PM_2.5 exposure, the adjusted odds ratio (OR) was 1.64 (95% CI 1.46-1.83, P < 0.001) for risk of asthma. For PM₁₀, there was evidence for an association with risk of asthma (OR 2.34, 95% CI: 1.75-3.15, P < 0.001 per IQR of 43.26 μg/m³). Further analyses showed that household mold or damp exposure may aggravate PM exposure associated risks of asthma.

Conclusions

This study identified that PM exposure could be a dominate environmental risk factor for asthma but largely unconsidered in the high-altitude areas. The association between PM exposure and asthma should be of interest for planners of national policies and encourage programs for prevention of asthma in residents living at high altitudes.

The association between air pollution and childhood asthma: United States, 2010-2015

OBJECTIVE

The current population-based study examines the association between county-level ambient air pollution and childhood asthma.

METHODS

Data from the nationally representative 2010-2015 National Health Interview Survey were linked to nationwide fine particulate matter (PM2.5) air pollution data at the county-level from the National Environmental Public Health Tracking Network which utilizes air quality monitoring stations and modeled PM2.5 measurements (Downscaler model data) and adjusted by county-level socioeconomic characteristics data from the 2010-2015 American Community Survey. Multilevel modeling techniques were used to assess the association between PM2.5 annual concentrations (quartiles < 8.11, 8.11-9.50, 9.51-10.59, ≥ 10.60 µg/m3) and current childhood asthma along with two asthma outcomes (episode in the past year, emergency room (ER) visit due to asthma).

RESULTS

From 2010 to 2015, there were significant declines in PM2.5 concentrations and asthma outcomes. In unadjusted models, children living in areas with higher PM2.5 concentrations were more likely to have current asthma, ≥1 asthma episode in the past year, and ≥1 ER visit due to asthma compared with children living in areas with the lowest quartile (< 8.11 µg/m3). After adjusting for characteristics at the county, geographic, and child and family-level, significant associations remained for asthma episode, and ER visit among children living in areas with PM2.5 annual concentrations between 9.51 and 10.59 µg/m3 (3rd quartile) compared with children living in areas with the lowest quartile.

CONCLUSIONS

This study adds to the limited literature by incorporating nationally representative county-, child-, and family-level data to provide a multi-level analysis of the associations between air pollution and childhood asthma in the U.S.

Sulfur dioxide-enhanced asthma susceptibility is involved with inhibition of bitter taste transduction in mouse lung

Sulfur dioxide (SO₂) may induce asthma-like symptoms or worsen existing asthma, but the underlying mechanism is still unclear. In this study, the relationship between SO₂ exposure, asthma development, and bitter taste transduction was analyzed using ovalbumin (OVA)-induced and SO₂-aggravated asthma models. The results showed that twenty-seven and twelve bitter taste receptors (Tas2rs) were detectable in mouse trachea and lung, respectively, and that all of them were nearly down-regulated in OVA-induced BALB/c and C57BL/6 asthmatic mice. SO₂ exposure alone did not trigger a distinct asthma-like phenotype, but the combination of SO₂ and OVA allergen caused more severe asthma symptoms in mice including enhanced inflammatory cells infiltration, thickened airway walls, increased mucus secretion, and elevated expression of proinflammatory and Th2 cytokines (TNF-α, IL-4, IL-5, IL-13). Furthermore, SO₂ enhanced the transcriptional repression of Tas2rs in OVA-induced asthmatic mice. These results indicated that the occurrence of mice asthma was correlated with the inhibition of bitter taste transduction, and more severe airway inflammation and injury were accompanied with an enhanced inhibition of bitter taste transduction. Our findings suggest that SO₂ inhalation may amplify Th2 inflammatory responses in the lung of asthmatic mice by inhibiting bitter taste transduction, and thereby exacerbate asthma symptoms.

Recent Advances in Vehicle Exhaust Treatment with Photocatalytic Technology

Vehicle exhaust has been acknowledged as an essential factor affecting human health due to the extensive use of cars. Its main components include volatile organic compounds (VOCs) and nitrogen oxides (NOx), which can cause acute irritation and chronic diseases, and significant research on the treatment of vehicle exhaust has received increasing attention in recent decades. Recently, photocatalytic technology has been considered a practical approach for eliminating vehicle emissions. This review highlights the crucial role of photocatalytic technology in eliminating vehicle emissions using semiconductor catalysts. A particular emphasis has been placed on various photocatalytic materials, such as TiO2-based materials, Bi-based materials, and Metal–Organic Frameworks (MOFs), and their recent advances in the performance of VOC and NOx photodegradation. In addition, the applications of photocatalytic technology for the elimination of vehicle exhaust are presented (including photocatalysts combined with pavement surfaces, making photocatalysts into architectural coatings and photoreactors), which will offer a promising strategy for photocatalytic technology to remove vehicle exhaust.

An Examination of the Intersection of Climate Change, the Physician Specialty Workforce, and Graduate Medical Education in the U.S

Issue: As U.S. healthcare systems plan for future physician workforce needs, the systemic impacts of climate change, a worldwide environmental and health crisis, have not been factored in. The current focus on increasing the number of trained physicians and optimizing efficiencies in healthcare delivery may be insufficient. Graduate medical education (GME) priorities and training should be considered in order to prepare a climate-educated physician workforce. Evidence: We used a holistic lens to explore the available literature regarding the intersection of future physician workforce needs, GME program priorities, and resident education within the larger context of climate change. Our interinstitutional, transdisciplinary team brought perspectives from their own fields, including climate science, climate and health research, and medical education to provide recommendations for building a climate-educated physician workforce. Implications: Acknowledging and preparing for the effects of climate change on the physician workforce will require identification of workforce gaps, changes to GME program priorities, and education of trainees on the health and societal impacts of climate change. Alignment of GME training with workforce considerations and climate action and adaptation initiatives will be critical in ensuring the U.S. has a climate-educated physician workforce capable of addressing health and healthcare system challenges. This article offers a number of recommendations for physician workforce priorities, resident education, and system-level changes to better prepare for the health and health system impacts of climate change.

The Survey of the Health of Wisconsin (SHOW) Program: An Infrastructure for Advancing Population Health

Introduction

The Survey of the Health of Wisconsin (SHOW) was established in 2008 by the University of Wisconsin (UW) School of Medicine and Public Health (SMPH) with the goals of (1) providing a timely and accurate picture of the health of the state residents; and (2) serving as an agile resource infrastructure for ancillary studies. Today, the SHOW program continues to serve as a unique and vital population health research infrastructure for advancing public health.

Methods

SHOW currently includes 5,846 adult and 980 minor participants recruited between 2008 and 2019 in four primary waves. WAVE I (2008–2013) includes annual statewide representative samples of 3,380 adults ages 21 to 74 years. WAVE II (2014–2016) is a triannual statewide sample of 1,957 adults (age ≥18 years) and 645 children (age 0–17). WAVE III (2017) consists of follow-up of 725 adults from the WAVE I and baseline surveys of 222 children in selected households. WAVEs II and III include stool samples collected as part of an ancillary study in a subset of 784 individuals. WAVE IV consists of 517 adults and 113 children recruited from traditionally under-represented populations in biomedical research including African Americans and Hispanics in Milwaukee, Wisconsin.

Findings to Date

The SHOW resource provides unique spatially granular and timely data to examine the intersectionality of multiple social determinants and population health. SHOW includes a large biorepository and extensive health data collected in a geographically diverse urban and rural population. Over 60 studies have been published covering a broad range of topics including, urban and rural disparities in cardio-metabolic disease and cancer, objective physical activity, sleep, green-space and mental health, transcriptomics, the gut microbiome, antibiotic resistance, air pollution, concentrated animal feeding operations and heavy metal exposures.

Discussion

The SHOW cohort and resource is available for continued follow-up and ancillary studies including longitudinal public health monitoring, translational biomedical research, environmental health, aging, microbiome and COVID-19 research.

A cross-sectional analysis of associations between environmental indices and asthma in U.S. counties from 2003 to 2012

BACKGROUND

To capture the impacts of environmental stressors, environmental indices like the Air Quality Index, Toxic Release Inventory, and Environmental Quality Index have been used to investigate the environmental quality and its association with public health issues. However, past studies often rely on relatively small sample sizes, and they have typically not adjusted for important individual-level disease risk factors.

OBJECTIVE

We aim to estimate associations between existing environmental indices and asthma prevalence over a large population and multiple years.

METHODS

Based on data availability, we assessed the predictive capability of these indices for prevalent asthma across U.S. counties from 2003 to 2012. We gathered asthma data from the U.S. CDC Behavioral Risk Factor Surveillance System by county and used multivariable weighted logistic regression models to estimate the associations between the environmental indices and asthma, adjusting for individual factors such as smoking, income level, and obesity.

RESULTS

Environmental indices showed little to no correlation with one another and with prevalent asthma over time. Associations of environmental indices with prevalent asthma were very weak; whereas individual factors were more substantially associated with prevalent asthma.

SIGNIFICANCE

Our study suggests that an improved environmental index is needed to predict population-level asthma prevalence.

Exposure to concentrated animal feeding operations (CAFOs) and risk of mortality in North Carolina, USA

Concentrated animal feeding operations (CAFOs) have emerged as an environmental justice issue due to disproportionate siting in low-income and minority communities. However, CAFOs' impact on health is not fully understood. We examined risk of cause-specific mortality associated with CAFOs in North Carolina (NC) for 2000-2017 and health disparities. We obtained data on individual-level cause-specific mortality and on permitted animal facilities. We estimated associations between exposure to CAFOs and cause-specific mortality using logistic regression, controlling for demographics (e.g., age) and area-level covariates. To estimate exposure to CAFOs, we considered (1) a binary indicator (presence or absence) of CAFOs within a buffer around individual residence based on several buffer sizes, and (2) four levels of exposure (no, low, medium, and high) based on the number of CAFOs within 15 km around each residence. We considered individual-level (sex, race/ethnicity, age, education) and community-level (median household income, urbanicity, and region) factors. Under all buffer sizes used to estimate CAFOs exposure, people living near CAFOs had significantly higher risk of cardiovascular mortality than other persons. Comparing those living near CAFOs to the no exposure group, odds ratios (ORs) for cardiovascular mortality were 1.01 (95% confidence interval (CI) 1.00, 1.03), 1.04 (1.03, 1.06), and 1.06 (1.05, 1.07) for low, medium, and high CAFOs exposure, respectively, indicating a trend of higher risk with higher exposure. Those in the high CAFOs exposure group had significantly higher risk of anemia and kidney disease mortality than those with no exposure. Results suggest higher mortality risk from CAFOs for some subpopulations, however differences were not statistically significant. Findings provide evidence of excess mortality risk from CAFOs in NC. These results have implications for future studies of environmental justice and CAFOs.

A review on the role of dispersion and receptor models in asthma research

There is substantial evidence that air pollution exposure is associated with asthma prevalence that affects millions of people worldwide. Air pollutant exposure can be determined using dispersion models and refined with receptor models. Dispersion models offer the advantage of giving spatially distributed outdoor pollutants concentration while the receptor models offer the source apportionment of specific chemical species. However, the use of dispersion and/or receptor models in asthma research requires a multidisciplinary approach, involving experts on air quality and respiratory diseases. Here, we provide a literature review on the role of dispersion and receptor models in air pollution and asthma research, their limitations, gaps and the way forward. We found that the methodologies used to incorporate atmospheric dispersion and receptor models in human health studies may vary considerably, and several of the studies overlook features such as indoor air pollution, model validation and subject pathway between indoor spaces. Studies also show contrasting results of relative risk or odds ratio for a health outcome, even using similar methodologies. Dispersion models are mostly used to estimate air pollution levels outside the subject's home, school or workplace; however, very few studies addressed the subject's routines or indoor/outdoor relationships. Conversely, receptor models are employed in regions where asthma incidence/prevalence is high or where a dispersion model has been previously used for this assessment. Road traffic (vehicle exhaust) and NOx are found to be the most targeted source and pollutant, respectively. Other key findings were the absence of a standard indicator, shortage of studies addressing VOC and UFP, and the shift toward chemical speciation of exposure.

A traditional herbal formula, Deng-Shi-Qing-Mai-Tang, regulates TLR4/NF-κB signaling pathway to reduce inflammatory response in PM2.5-induced lung injury

BACKGROUND

Studies revealed that particulate matter 2.5 (PM2.5) enters the lung through the respiratory tract and can damage lung tissue resulting in lung injury primarily via imbalance between pro-inflammatory and anti-inflammatory responses. Moreover, TLR4/NF-κB signaling pathways are reported to play a role in PM2.5-induced inflammation and lung injury, which is closely related to the inflammatory responses. Therefore, the traditional herbal formula, Deng-Shi-Qing-Mai-Tang (DSQMT), has been applied to improve patients' clinical symptoms with lung injury induced by PM2.5. It can reduce inflammatory reactions in lung injury and relieve cough and phlegm. However, the underlying mechanism of DSQMT treatment is still exclusive.

PURPOSE

To clarify the preventive and therapeutic effects of DSQMT on PM2.5-induced lung injury and explore its underlying mechanism.

STUDY DESIGN

PM2.5-induced lung injury rat model was established, and DSQMT was administered.

METHODS

First, PM2.5 was collected, and PM2.5 suspension was prepared. Then, a rat model with PM2.5-induced lung injury was established, and the effects of DSQMT were evaluated in vivo. Finally, the roles of DSQMT in inhibiting the TLR4/NF-κB signaling pathway were investigated in vitro using the NR8383 cell line via Western blot analysis, real-time PCR, electrophoretic mobility shift assay (EMSA), and immunofluorescence staining, respectively and analyzed.

RESULTS

We found that DSQMT significantly attenuated pathological lung tissue damage and inflammatory responses in PM2.5-induced lung injury. We also found that after PM2.5 stimulation in vitro, DSQMT regulates the expression of TLR4, MyD88, IKK, IκB-α, NF-κB p65 in the TLR4/NF-κB signaling pathway. It also constrains activated NF-κB entry into the nucleus and further limits its binding to target DNA. In addition, we revealed that DSQMT down-regulated interleukin (IL)-1β, IL-6, IL-10, THF-α, NO, PGE₂ to reduce the inflammatory response.

CONCLUSION

We demonstrated that DSQMT has preventive and therapeutic effects on PM2.5-induced lung injury by down-regulation of the TLR4/NF-κB signaling pathway. Therefore, the efficacy of traditional Chinese medicine (TCM) in PM2.5 lung injury can be taken into consideration and may be improved in the future through further researches.

Effects of PM2.5 on Chronic Airway Diseases: A Review of Research Progress

The adverse effects of polluted air on human health have been increasingly appreciated worldwide. It is estimated that outdoor air pollution is associated with the death of 4.2 million people globally each year. Accumulating epidemiological studies indicate that exposure to ambient fine particulate matter (PM2.5), one of the important air pollutants, significantly contributes to respiratory mortality and morbidity. PM2.5 causes lung damage mainly by inducing inflammatory response and oxidative stress. In this paper, we reviewed the research results of our group on the effects of PM2.5 on chronic obstructive pulmonary disease, asthma, and lung cancer. And recent research progress on epidemiological studies and potential mechanisms were also discussed. Reducing air pollution, although remaining a major challenge, is the best and most effective way to prevent the onset and progression of respiratory diseases.

Air pollution-related asthma profiles among children/adolescents: A multi-group latent class analysis

BACKGROUND

This study aimed to investigate the asthma profile among children/adolescents and the relationship of the prevalence of air pollution profiles using latent class analysis (LCA).

OBJECTIVES

In this cross-sectional study, a case rural community was selected in an industrial area, and two rural control communities were selected in unexposed areas.

METHODS

Hourly concentrations of PM₁₀, SO₂, NO_2, and total volatile organic compounds were obtained from the records of a fixed air quality monitoring station, and the concentrations of benzene, toluene, xylenes styrene were measured during six campaigns. Asthma data was collected using the International Study of Asthma and Allergies in Childhood in 7-18 years old children/adolescents. The modeling was conducted using LCA.

RESULTS

A higher amount of air pollution indices were observed in the case than both control communities. LCA divided the participants into three clusters; "healthy" (92.8%), "moderate" (2.8%), and "severe" (4.4%). A higher probability of severe asthma (6.8%) was observed in the case than control communities (2.6% and 1.8%). Additionally, after adjusting for possible confounders, the odds of asthma was lower in the control communities than the case in both moderate and sever classes (Odds Ratios in the range of 0.135-0.697).

CONCLUSIONS

This study indicates asthma profiles of children/adolescents and the higher prevalence of severe class in the area, explaining the possible effect of air pollution.

The Survey of the Health of Wisconsin (SHOW) Program: An infrastructure for Advancing Population Health Sciences

PURPOSE

The Survey of the Health of Wisconsin (SHOW) was established in 2008 by the University of Wisconsin (UW) School of Medicine and Public Health (SMPH) with the goals of 1) providing a timely and accurate picture of the health of the state residents; and 2) serving as an agile resource infrastructure for ancillary studies. Today SHOW continues to serve as a vital population health research infrastructure.

PARTICIPANTS

SHOW currently includes 5,846 adult and 980 minor participants recruited between 2008-2019 in four primary waves. WAVE I (2008-2013) includes annual statewide representative samples of 3,380 adults ages 21 to 74 years. WAVE II (2014-2016) is a triannual statewide sample of 1957 adults (age ≥18 years) and 645 children. WAVE III (2017) consists of follow-up of 725 adults from the WAVE I and baseline surveys of 222 children in selected households. WAVEs II and III include stool samples collected as part of an ancillary study in a subset of 784 individuals. WAVE IV consist of 517 adults and 113 children recruited from traditionally under-represented populations in biomedical research including African Americans and Hispanics in Milwaukee county, WI.

FINDINGS TO DATE

The SHOW provides extensive data to examine the intersectionality of multiple social determinants and population health. SHOW includes a large biorepository and extensive health data collected in a geographically diverse urban and rural population. Over 60 studies have been published covering a broad range of topics including, urban and rural disparities in cardio-metabolic disease and cancer, objective physical activity, sleep, green-space and mental health, transcriptomics, the gut microbiome, antibiotic resistance, air pollution, concentrated animal feeding operations and heavy metal exposures.

FUTURE PLANS

The SHOW cohort is available for continued longitudinal follow-up and ancillary studies including genetic, multi-omic and translational environmental health, aging, microbiome and COVID-19 research.

ARTICLE SUMMARY

Strengths and limitations: The Survey of the Health of Wisconsin (SHOW) is an infrastructure to advance population health sciences including biological sample collection and broader data on individual and neighborhood social and environmental determinants of health.The extensive data from diverse urban and rural populations offers a unique study sample to compare how socio-economic gradients shape health outcomes in different contexts.The objective health data supports novel interdisciplinary research initiatives and is especially suited for research in causes and consequences of environmental exposures (physical, chemical, social) across the life course on cardiometabolic health, immunity, and aging related conditions.The extensive biorepository supports novel omics research into common biological mechanisms underlying numerous complex chronic conditions including inflammation, oxidative stress, metabolomics, and epigenetic modulation.Ancillary studies, such as the Wisconsin Microbiome Study, have expanded the utility of the study to examine human susceptibility to environmental exposures and opportunities for investigations of the role of microbiome in health and disease.Long-standing partnerships and recent participation among traditionally under-represented populations in biomedical research offer numerous opportunities to support community-driven health equity work.No biological samples were collected among children.The statewide sampling frame may limit generalizability to other regions in the United States.

Traffic-related organic and inorganic air pollution and risk of development of childhood asthma: A meta-analysis

The effect of early childhood exposure to traffic-related air pollution (TRAP) on the development of asthma remains unclear. The aim of this study was to clarify potential associations between TRAP (fine particulate matter, PM_2.5; nitrogen dioxide, NO₂; Benzene and total volatile organic pollutants, TVOCs) and childhood asthma by integrating the results from previous studies. Elsevier, LISTA (EBSCO) and Web of Science databases were searched for relevant studies. Adjusted odds ratio (OR) with corresponding 95% confidence interval (CI) for the association between traffic-related air pollutants and health effects were recovered from individual studies and summary effect estimates (meta-OR) were generated in Review Manager 5.3. Twenty-seven studies were included in the meta-analysis and the results showed that TRAP increased the risk of asthma among children: PM_2.5 (meta-OR = 1.07, 95% CI:1.00-1.13), NO₂ (meta-OR = 1.11, 95% CI:1.06-1.17), Benzene (meta-OR: 1.21, 95% CI:1.13-1.29) and TVOC (meta-OR:1.06, 95% CI: 1.03-1.10). Sensitivity analyses supported these findings. In addition, regional analysis showed that ORs of inorganic TRAP (PM_2.5 and NO₂) on the risk of childhood asthma were significantly higher in Asia than those in Europe and North America. Subsequent research should focus on the association between organic pollutants in TRAP and childhood asthma. Furthermore, the disentanglement between TRAP and other pollutant sources may be investigated in future studies.

Airway hyperresponsiveness development and the toxicity of PM2.5

Airway hyperresponsiveness (AHR) is characterized by excessive bronchoconstriction in response to nonspecific stimuli, thereby leading to airway stenosis and increased airway resistance. AHR is recognized as a key characteristic of asthma and is associated with significant morbidity. At present, many studies on the molecular mechanisms of AHR have mainly focused on the imbalance in Th1/Th2 cell function and the abnormal contraction of airway smooth muscle cells. However, the specific mechanisms of AHR remain unclear and need to be systematically elaborated. In addition, the effect of air pollution on the respiratory system has become a worldwide concern. To date, numerous studies have indicated that certain concentrations of fine particulate matter (PM2.5) can increase airway responsiveness and induce acute exacerbation of asthma. Of note, the concentration of PM2.5 does correlate with the degree of AHR. Numerous studies exploring the toxicity of PM2.5 have mainly focused on the inflammatory response, oxidative stress, genotoxicity, apoptosis, autophagy, and so on. However, there have been few reviews systematically elaborating the molecular mechanisms by which PM2.5 induces AHR. The present review separately sheds light on the underlying molecular mechanisms of AHR and PM2.5-induced AHR.

Asthma prevalence and control among schoolchildren residing near outdoor air pollution sites

INTRODUCTION

Outdoor air pollution (OAP) contributes to poor asthma outcomes and remains a public health concern in Pittsburgh. The purpose of this study was to determine the prevalence of childhood asthma and its rate of control among Pittsburgh schoolchildren residing near OAP sites.

METHODS

Participants were recruited from schools near OAP sites. Asthma prevalence and control were assessed using a validated survey. Demographics and socioeconomic status were collected by survey, BMI was calculated, secondhand smoke (SHS) exposure was assessed by salivary cotinine levels, and OAP was assessed by mobile platform monitoring. Multivariate analysis adjusted for confounders.

RESULTS

In 1202 Pittsburgh elementary school students surveyed, 50.9% were female, average age was 8.5 years (SD = 1.9), 52.2% were African American and 60.6% had public health insurance. SHS exposure was relatively high at 33.9%, 17.1% of students were obese, and 70% had exposure to particulate matter (PM_2.5) greater than the World Health Organization standard of 10 μg/m³. Overall prevalence of asthma was 22.5% with PM_2.5, nitric oxide (NO_x), sulfur (S), and zinc (Zn) significantly related to odds of asthma. Among the 270 children previously diagnosed with asthma, 59.3% were not well controlled with PM_2.5, black carbon, and silicon (Si) significantly related to odds of uncontrolled asthma.

CONCLUSIONS

These results demonstrate that asthma prevalence and poor disease control are significantly elevated in Pittsburgh schoolchildren exposed to high levels of OAP. Future efforts need to focus on primary prevention of asthma by reducing exposure to OAP in at risk populations.

Respiratory effects of road pollution in recreational cyclists: a pilot study

We sought to measure bicyclists' roadway exposures to particulate matter and assess whether those exposures are associated with reduced pulmonary function. Thirty-one (31) volunteer participants riding bicycles on selected routes were tracked using the Global Positioning System. Personal exposures to particulate matter (PM-10) were measured during the rides and pulmonary function tests were administered at baseline, immediately after the ride, and 2 and 6-24 hours later. Post-ride decrements in pulmonary function were observed for several outcome measures, with the largest differences immediately post-ride. Statistically-significant declines in FEV₁ (-38.42, 95% Confidence Interval (CI), -63.79 to -13.05 ml), FVC (-36.89, 95% CI, -62.96, -10.84 ml), and PEFR (-162, 95% CI -316.02 to -9.49 ml/sec) were observed for each increase in decile of peak exposure. PM-10 exposures encountered on roadways may put bicyclists at risk for pulmonary deficits.

Health and economic consequences of applying the United States' PM2.5 automobile emission standards to other nations: a case study of France and Italy

OBJECTIVES

The US has among the world's strictest automobile emission standards, but it is now loosening them. It is unclear where a nation should draw the line between the associated cost burden imposed by regulations and the broader societal benefits associated with having cleaner air. Our study examines the health benefits and cost-effectiveness of introducing stricter vehicle emission standards in France and Italy.

STUDY DESIGN

Quasi-experimental study.

METHODS

We used cost-effectiveness modeling to measure the incremental quality-adjusted life years (QALYs) and cost (Euros) of adopting more stringent US vehicle emission standards for PM2.5 in France and Italy.

RESULTS

Adopting Obama era US vehicle emission standards would likely save money and lives for both the French and Italian populations. In France, adopting US emission standards would save €1000 and increase QALYs by 0.04 per capita. In Italy, the stricter standards would save €3000 and increase QALYs by 0.31. The results remain robust in both the sensitivity analysis and probabilistic Monte Carlo simulation model.

CONCLUSIONS

Adopting more stringent emission standards in France and Italy would save money and lives.

Residential proximity to concentrated animal feeding operations and allergic and respiratory disease

BACKGROUND

Air emissions from concentrated animal feeding operations (CAFO) have been associated with respiratory and allergic symptoms among farm workers, primarily on swine farms. Despite the increasing prevalence of CAFOs, few studies have assessed respiratory health implications among residents living near CAFOs and few have looked at the health impacts of dairy CAFOs.

OBJECTIVES

The goal of this study was to examine objective and subjective measures of respiratory and allergic health among rural residents living near dairy CAFOs in a general population living in the Upper Midwest of the United States.

METHODS

Data were from the 2008-2016 Survey of the Health of Wisconsin (SHOW) cohort (n = 5338), a representative, population based sample of rural adults (age 18+). The association between distance to the nearest CAFO and the prevalence of self-reported physician-diagnosed allergies, asthma, episodes of asthma in the last 12 months, and asthma medication use was examined using logistic regression, adjusting for covariates and sampling design. Similarly, the association between distance to the nearest CAFO and lung function, measured using spirometry, was examined using multivariate linear regression. Restricted cubic splines accounted for nonlinear relationships between distance to the nearest CAFO and the aforementioned outcomes.

RESULTS

Living 1.5 miles from a CAFO was associated with increased odds of self-reported nasal allergies (OR = 2.08; 95% CI: 1.38, 3.14), lung allergies (OR = 2.72; 95% CI: 1.59, 4.66), asthma (OR = 2.67; 95% CI: 1.39, 5.13), asthma medication (OR = 3.31; 95% CI: 1.65 6.62), and uncontrolled asthma, reported as an asthma episode in last 12 months (OR = 2.34; 95% CI: 1.11, 4.92) when compared to living 5 miles from a CAFO. Predicted FEV1 was 7.72% (95% CI: -14.63, -0.81) lower at a residential distance 1.5 miles from a CAFO when compared with a residence distance of 3 miles from a CAFO.

CONCLUSIONS

Results suggest CAFOs may be an important source of adverse air quality associated with reduced respiratory and allergic health among rural residents living in close proximity to a CAFO.

The impact of particulate matter on allergy risk among adults: integrated exposure assessment

Exposure assessment is an important part in environmental epidemiology for determining the associations of environmental factors with health effects. One of the greatest challenges for personal exposure assessment is associated with peoples' mobility during the day and spatial and temporal dynamics of air pollution. In this study, the impact of PM₁₀ (particulate matter less than 10 μm) on allergy risk among adults was assessed using objective methods of exposure assessment. The primary objective of the present study was to estimate personal exposure to PM₁₀ based on individual daily movement patterns. Significant differences between the concentration of PM₁₀ in different microenvironments (MEs) and personal exposure to PM₁₀ were determined. Home exposure accounted for the largest part of PM₁₀ exposure. Thirty-five percent of PM₁₀ exposure was received in other non-home MEs. Allergy risk increased significantly with increasing exposure to PM₁₀. Adults exposed to the highest levels of PM₁₀ exposure had a twice-higher risk of allergies than adults exposed to the lowest levels of PM₁₀ exposure. The study results have practical relevance for exposure assessment to environmental factors and its impact on health effects.

The Exposome and Asthma

This article on exposome and asthma focuses on the interaction of patients and their environments in various parts of their growth, development, and stages of life. Indoor and outdoor environments play a role in pathogenesis via levels and duration of exposure, with genetic susceptibility as a crucial factor that alters the initiation and trajectory of common conditions such as asthma. Knowledge of environmental exposures globally and changes that are occurring is necessary to function effectively as medical professionals and health advocates.

Sulfur dioxide exposure enhances Th2 inflammatory responses via activating STAT6 pathway in asthmatic mice

Sulfur dioxide (SO₂) is one of potential risk factors for induction and/or exacerbation of asthma, but the underlying mechanisms are not well understood. In this study, we investigate the role of SO₂ in asthma using a classical asthmatic model with allergic airway inflammation by treating C57BL/6 mice with ovalbumin (OVA) and/or 10 mg/m³ SO₂. Our results showed that SO₂ exposure alone induced slight pathological changes but did not significantly increase inflammatory cell counts, pro-inflammatory cytokine expression, and mucus production in the airway of mice, whereas SO₂ exposure in OVA-induced asthmatic mice caused marked pulmonary pathological changes and significantly increased the counts of eosinophil-rich leukocytes compared with OVA alone asthmatic mice. The expression of MUC5AC, TNF-α, Th2 cytokines (IL-4, IL-5, and IL-13) and STAT6 was further up-regulated in OVA plus SO₂ treated mice compared with OVA alone treated mice. In addition, exposure to SO₂ alone markedly elevated STAT6 mRNA levels and hydrogen peroxide (H₂O₂) content in the lung. These findings suggest that SO₂ amplifies Th2 inflammatory responses in OVA-induced asthmatic mice by activating STAT6, which can further induce Th2 cytokine expression. Induction of STAT6 expression might be an important mechanism underlying the increased risk for asthma after environmental exposure.