Short-term effects of particle gamma radiation activities on pulmonary function in COPD patients

Residential radon decay products are associated with cough and phlegm in patients with COPD

Radon decay products attach to particulate matter (referred to as particle radioactivity, PR) has been shown to be potential to promote airway damage after inhalation. In this study, we investigated associations between PR with respiratory symptoms and health-related quality of life (HRQL) in patients with COPD. 141 male patients with COPD, former smokers, completed the St. George's Respiratory Questionnaire (SGRQ) after up to four 1-week seasonal assessments (N=474) of indoor (home) and ambient (central site) particulate matter ≤ 2.5 µm in diameter (PM2.5) and black carbon (BC). Indoor PR was measured as α-activity (radiation) on PM2.5 filter samples. The ratio of indoor/ambient sulfur in PM2.5 (a ventilation surrogate) was used to estimate α-PR from indoor radon decay. SGRQ responses assessed frequent cough, phlegm, shortness of breath, wheeze, and chest attacks in the past 3 months. Multivariable linear regression with generalized estimating equations accounting for repeated measures was used to explore associations, adjusting for potential confounders. Median (IQR) indoor α-PR was 1.22 (0.62) mBq/m3. We found that there were positive associations between α-PR with cough and phlegm. The strongest associations were with estimated α-PR of indoor origin for cough (31.1 % increase/IQR, 95 %CI: 8.8 %, 57.8 %), and was suggestive for phlegm (13.0 % increase/IQR, 95 %CI: -2.5 %, 31.0 %), similar adjusting for indoor BC or PM2.5. α-PR of indoor origin was positively associated with an increase in SGRQ Symptoms score [1.2 units/IQR; 95 %CI: -0.3, 2.6] that did not meet conventional levels of statistical significance. Our results suggested that exposure to indoor radon decay products measured as particle radioactivity, a common indoor exposure, is associated with cough, and suggestively associated with phlegm and worse HRQL symptoms score in patients with COPD.

Effects of Allergen Exposure and Environmental Risk Factors in Schools on Childhood Asthma

PURPOSE OF REVIEW

This review aims to assess the prevalence of common allergen exposures and environmental risk factors for asthma in schools, examine the underlying mechanisms of these environmental risk factors, and explore possible prevention strategies.

RECENT FINDINGS

Cockroach, mouse, dust mites, fungi, viral infections, ozone pollution, and cleaning products are common allergen exposures and environmental risk factors in schools which may affect asthma morbidity. Novel modifiable environmental risk factors in schools are also being investigated to identify potential associations with increased asthma morbidity. While several studies have investigated the benefit of environmental remediation strategies in schools and their impact on asthma morbidity, future studies are warranted to further define the effects of modifiable risk factors in schools and determine whether school mitigation strategies may help improve asthma symptoms in students with asthma.

Effect of radon exposure on asthma morbidity in the School Inner-City Asthma study

BACKGROUND

Radon may have a role in obstructive lung disease outside its known carcinogenicity. Little is known about radon's effects on asthma morbidity.

OBJECTIVE

To determine the effect of radon on fractional exhaled nitric oxide (FE NO), asthma symptom-days, and lung function in inner-city asthmatic school children.

METHODS

Two hundred ninety-nine school-aged asthmatic children enrolled in the School Inner-City Asthma Study (SICAS-1) were followed. One and two-month averaged radon was assessed using a spatiotemporal model predicting zip code-specific monthly exposures. FE NO and spirometry were measured twice during the academic year. Asthma symptoms were assessed four times during the academic year. The interaction between indoor radon exposure (Bq/m3 ) and seasonality predicting log-transformed FE NO, forced expiratory volume in 1 s (FEV1 ) % predicted, forced vital capacity (FVC) % predicted, FEV1 /FVC, and asthma symptom-days was evaluated.

RESULTS

Participants with high radon exposure had greater change in FE NO from warm to cold periods compared to low radon exposure (interaction p = 0.0013). Participants with >50th percentile radon exposure experience significant FE NO increase from warm to cold weather (β $\beta $  = 0.29 [95% confidence interval [CI]: 0.04-0.54], p = 0.0240). We report a positive association between radon 1-month moving average (incidence rate ratio [IRR] = 1.01, p = 0.0273) and 2-month moving average (IRR = 1.01, p = 0.0286) with maximum asthma symptom-days (n = 299, obs = 1167).

CONCLUSIONS

In asthmatic children, radon may be associated with increased asthma morbidity, suggesting radon may be a modifiable environmental risk factor for airway inflammation.

Status and frontier analysis of indoor PM2.5-related health effects: a bibliometric analysis

Epidemiological data indicate atmospheric particulate matter, especially fine particulate matter (PM_2.5), has many negative effects on human health. Of note, people spend about 90% of their time indoors. More importantly, according to the World Health Organization (WHO) statistics, indoor air pollution causes nearly 1.6 million deaths each year, and it is considered as one of the major health risk factors. In order to obtain a deeper understanding of the harmful effects of indoor PM_2.5 on human health, we used bibliometric software to summarize articles in this field. In conclusion, since 2000, the annual publication volume has increased year by year. America topped the list for the number of articles, and Professor Petros Koutrakis and Harvard University were the author and institution with the most published in this research area, respectively. Over the past decade, scholars gradually paid attention to molecular mechanisms, therefore, the toxicity can be better explored. Particularly, apart from timely intervention and treatment for adverse consequences, it is necessary to effectively reduce indoor PM_2.5 through technologies. In addition, the trend and keywords analysis are favorable ways to find out future research hotspots. Hopefully, various countries and regions strengthen academic cooperation and integration of multi-disciplinary.

Particle radioactivity from radon decay products and reduced pulmonary function among chronic obstructive pulmonary disease patients

BACKGROUND

Radon (222Rn) decay products can attach to particles in the air, be inhaled, and potentially cause airway damage.

RESEARCH QUESTION

Is short-term exposure to particle radioactivity (PR) attributable to radon decay products emitted from particulate matter ≤2.5 μm in diameter (PM2.5) associated with pulmonary function in chronic obstructive pulmonary disease (COPD) patients?

STUDY DESIGN AND METHODS

In this cohort study, 142 elderly, predominantly male patients with COPD from Eastern Massachusetts each had up to 4 one-week long seasonal assessments of indoor (home) and ambient (central site) PR and PM2.5 over the course of a year (467 assessments). Ambient and indoor PR were measured as α-activity on archived PM2.5 filter samples. Ratios of indoor/ambient PR were calculated, with higher ratios representing PR from an indoor source of radon decay. We also considered a measure of outside air infiltration that could dilute the concentrations of indoor radon decay products, the indoor/ambient ratio of sulfur concentrations in PM2.5 filter samples. Spirometry pre- and post-bronchodilator (BD) forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) were conducted following sampling. Generalized additive mixed models were adjusted for meteorologic variables, seasonality, and individual-level determinants of pulmonary function. We additionally adjusted for indoor PM2.5 and black carbon (BC).

RESULTS

PR exposure metrics indicating radon decay product exposure from an indoor source were associated with a reduction in FEV1 and FVC. Patients in homes with high indoor PR (≥median) and low air infiltration (

INTERPRETATION

Our findings raise concern about the harmful effects of PR exposures attributable to residential radon on pulmonary function in patients with COPD.

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Key Words

• Chronic obstructive pulmonary disease
• Particle radioactivity
• Pulmonary function
• Radiation
• Radon
• Spirometry

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MESH Headings

• Humans
• Male
• Aged
• Female
• Radon Daughters
• Air Pollutants/analysis
• Radioactivity
• Cohort Studies
• Particulate Matter/analysis
• Pulmonary Disease, Chronic Obstructive
• Soot
• Radon
• Environmental Exposure/analysis

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Grants

• R01 ES019853 NIEHS NIH HHS
• R21 ES029637 NIEHS NIH HHS

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Affiliation(s)

Veronica A Wang Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
Petros Koutrakis Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
Longxiang Li Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
Man Liu Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
Carolina L Z Vieira Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
Brent A Coull Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
Edward F Maher Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
Choong-Min Kang Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
Eric Garshick Pulmonary, Allergy, Sleep and Critical Care Medicine Section, Veterans Affairs Boston Healthcare System, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.

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Cumulative effects of air pollution and climate drivers on COVID-19 multiwaves in Bucharest, Romania

Over more than two years of global health crisis due to ongoing COVID-19 pandemic, Romania experienced a five-wave pattern. This study aims to assess the potential impact of environmental drivers on COVID-19 transmission in Bucharest, capital of Romania during the analyzed epidemic period. Through descriptive statistics and cross-correlation tests applied to time series of daily observational and geospatial data of major outdoor inhalable particulate matter with aerodynamic diameter ≤ 2.5 µm (PM2.5) or ≤ 10 µm (PM10), nitrogen dioxide (NO₂), ozone (O₃), sulfur dioxide (SO₂), carbon monoxide (CO), Aerosol Optical Depth at 550 nm (AOD) and radon (²²²Rn), we investigated the COVID-19 waves patterns under different meteorological conditions. This study examined the contribution of individual climate variables on the ground level air pollutants concentrations and COVID-19 disease severity. As compared to the long-term average AOD over Bucharest from 2015 to 2019, for the same year periods, this study revealed major AOD level reduction by ~28 % during the spring lockdown of the first COVID-19 wave (15 March 2020-15 May 2020), and ~16 % during the third COVID-19 wave (1 February 2021-1 June 2021). This study found positive correlations between exposure to air pollutants PM2.5, PM10, NO₂, SO₂, CO and ²²²Rn, and significant negative correlations, especially for spring-summer periods between ground O₃ levels, air temperature, Planetary Boundary Layer height, and surface solar irradiance with COVID-19 incidence and deaths. For the analyzed time period 1 January 2020-1 April 2022, before and during each COVID-19 wave were recorded stagnant synoptic anticyclonic conditions favorable for SARS-CoV-2 virus spreading, with positive Omega surface charts composite average (Pa/s) at 850 mb during fall- winter seasons, clearly evidenced for the second, the fourth and the fifth waves. These findings are relevant for viral infections controls and health safety strategies design in highly polluted urban environments.

Metabolomic signatures of the short-term exposure to air pollution and temperature

BACKGROUND

Short-term exposures to air pollution and temperature have been reported to be associated with inflammation and oxidative stress. However, mechanistic understanding of the affected metabolic pathways is still lacking and literature on the short-term exposure of air-pollution on the metabolome is limited.

OBJECTIVES

We aimed to determine changes in the plasma metabolome and associated metabolic pathways related to short-term exposure to outdoor air pollution and temperature.

METHODS

We performed mass-spectrometry based untargeted metabolomic profiling of plasma samples from a large and well-characterized cohort of men (Normative Aging Study) to identify metabolic pathways associated with short-term exposure to PM2.5, NO2, O3, and temperature (one, seven-, and thirty-day average of address-specific predicted estimates). We used multivariable linear mixed-effect regression and independent component analysis (ICA) while simultaneously adjusting for all exposures and correcting for multiple testing.

RESULTS

Overall, 456 white men provided 648 blood samples, in which 1158 metabolites were quantified, between 2000 and 2016. Average age and body mass index were 75.0 years and 27.7 kg/m2, respectively. Only 3% were current smokers. In the adjusted models, NO2, and temperature showed statistically significant associations with several metabolites (19 metabolites for NO2 and 5 metabolites for temperature). We identified six metabolic pathways (sphingolipid, butanoate, pyrimidine, glycolysis/gluconeogenesis, propanoate, and pyruvate metabolisms) perturbed with short-term exposure to air pollution and temperature. These pathways were involved in inflammation and oxidative stress, immunity, and nucleic acid damage and repair.

CONCLUSIONS

This is the first study to report an untargeted metabolomic signature of temperature exposure, the largest to report an untargeted metabolomic signature of air pollution, and the first to use ICA. We identified several significant plasma metabolites and metabolic pathways associated with short-term exposure to air pollution and temperature; using an untargeted approach. Those pathways were involved in inflammation and oxidative stress, immunity, and nucleic acid damage and repair. These results need to be confirmed by future research.

Effects of particulate matter gamma radiation on oxidative stress biomarkers in COPD patients

Inhalation of particulate matter (PM) radioactivity is an important pathway of ionizing radiation exposure. We investigated the associations between short-term exposures to PM gamma radioactivity with oxidative stress in COPD patients. Urinary concentrations of 8-hydroxy-2'-deoxyguanosine (8-OHdG) and malondialdehyde (MDA) of 81 COPD patients from Eastern Massachusetts were measured 1-4 times during 2012-2014. Daily ambient and indoor PM gamma activities (gamma-3 through gamma-9) were calculated based on EPA RadNet data and indoor-outdoor infiltration ratios. Linear mixed-effects models were used to examine the associations between biomarkers with PM gamma activities for moving averages from urine collection day to 7 days before. Our results indicate that ambient and indoor PM gamma activities were positively associated with 8-OHdG, with stronger effects for exposure windows closer to urine collection day. For per interquartile range increase in indoor PM gamma activities averaged over urine collection day and 1 day before, 8-OHdG increased from 3.41% (95% CI: -0.88, 7.88) to 8.87% (95% CI: 2.98, 15.1), adjusted for indoor black carbon. For MDA, the timing of greatest effects across the exposure week varied but was nearly all positive. These findings provide insight into the toxigenic properties associated with PM radioactivity and suggest that these exposures promote systemic oxidative stress.

Ambient PM2.5 species and ultrafine particle exposure and their differential metabolomic signatures

BACKGROUND

The metabolomic signatures of short- and long-term exposure to PM_2.5 have been reported and linked to inflammation and oxidative stress. However, little is known about the relative contribution of the specific PM_2.5 species (hence sources) that drive these metabolomic signatures.

OBJECTIVES

We aimed to determine the relative contribution of the different species of PM_2.5 exposure to the perturbed metabolic pathways related to changes in the plasma metabolome.

METHODS

We performed mass-spectrometry based metabolomic profiling of plasma samples among men from the Normative Aging Study to identify metabolic pathways associated with PM_2.5 species. The exposure windows included short-term (one, seven-, and thirty-day moving average) and long-term (one year moving average). We used linear mixed-effect regression with subject-specific intercepts while simultaneously adjusting for PM_2.5, NO₂, O₃, temperature, relative humidity, and covariates and correcting for multiple testing. We also used independent component analysis (ICA) to examine the relative contribution of patterns of PM_2.5 species.

RESULTS

Between 2000 and 2016, 456 men provided 648 blood samples, in which 1158 metabolites were quantified. We chose 305 metabolites for the short-term and 288 metabolites for the long-term exposure in this analysis that were significantly associated (p-value < 0.01) with PM_2.5 to include in our PM_2.5 species analysis. On average, men were 75.0 years old and their body mass index was 27.7 kg/m². Only 3% were current smokers. In the adjusted models, ultrafine particles (UFPs) were the most significant species of short-term PM_2.5 exposure followed by nickel, vanadium, potassium, silicon, and aluminum. Black carbon, vanadium, zinc, nickel, iron, copper, and selenium were the significant species of long-term PM_2.5 exposure. We identified several metabolic pathways perturbed with PM_2.5 species including glycerophospholipid, sphingolipid, and glutathione. These pathways are involved in inflammation, oxidative stress, immunity, and nucleic acid damage and repair. Results were overlapped with the ICA.

CONCLUSIONS

We identified several significant perturbed plasma metabolites and metabolic pathways associated with exposure to PM_2.5 species. These species are associated with traffic, fuel oil, and wood smoke. This is the largest study to report a metabolomic signature of PM_2.5 species' exposure and the first to use ICA.

Measurement of the gross alpha activity of the fine fractions of road dust and near-roadway ambient particle matter

Traffic-related air pollution, including direct exhaust emissions and road dust (RD), impacts individuals living near busy roads. We recently conducted a study to investigate the sources and composition of tailpipe and non-tailpipe traffic emissions, where we collected and analyzed samples of ambient air fine particulate matter (PM_2.5) and fine RD (RD_2.5) at different distances from major roadways. We analyzed a subset of the samples, including those collected at the roadside and local background, for their alpha activity level. Subsequently, we investigated whether there is a distance-related decay in the alpha activity in RD_2.5 or PM_2.5 similar to those observed for traffic-related species in PM_2.5 and RD_2.5. We found that the alpha activity of ambient air PM_2.5 (Bq/mg) was more than an order of magnitude higher than the activity level of the corresponding RD_2.5 sample, suggesting that PM_2.5 may be more toxic than RD_2.5. Using mixed-effects regression models, we found that ambient PM_2.5 alpha activity was significantly higher during the cold months than during warm months, and that the background was higher than the roadside (though not significantly). In contrast, the RD_2.5 alpha activity was significantly higher at the background site compared to the roadside but was not significantly affected by season. In addition to sampling position, both Zn and elemental carbon (EC) were significant predictors of RD_2.5 alpha activity. In addition, the roadside RD_2.5 activity levels were found to be higher at highways as compared to secondary roads. While traffic-related emissions do not appear to be significant sources of either ambient PM_2.5 or RD_2.5 alpha activity, the RD_2.5 results suggest that traffic-related particles may contribute to RD_2.5 alpha-activity. Implications: Many studies have reported the effects of traffic-related particulate matter (PM) on human health, and there is growing interest in the health effects of exposure to environmental PM alpha activity. This is the first study to report on the alpha activity of road dust (RD) or near-roadway ambient PM. We found that the alpha activity of ambient PM is twenty times higher than RD, suggesting that ambient PM may be more toxic. In PM and RD, the alpha activities were higher at background sites than at the roadside, indicating that traffic-related emissions are not a significant source of particulate radioactivity.

Earth Observation Data Supporting Non-Communicable Disease Research: A Review

A disease is non-communicable when it is not transferred from one person to another. Typical examples include all types of cancer, diabetes, stroke, or allergies, as well as mental diseases. Non-communicable diseases have at least two things in common—environmental impact and chronicity. These diseases are often associated with reduced quality of life, a higher rate of premature deaths, and negative impacts on a countries’ economy due to healthcare costs and missing work force. Additionally, they affect the individual’s immune system, which increases susceptibility toward communicable diseases, such as the flu or other viral and bacterial infections. Thus, mitigating the effects of non-communicable diseases is one of the most pressing issues of modern medicine, healthcare, and governments in general. Apart from the predisposition toward such diseases (the genome), their occurrence is associated with environmental parameters that people are exposed to (the exposome). Exposure to stressors such as bad air or water quality, noise, extreme heat, or an overall unnatural surrounding all impact the susceptibility to non-communicable diseases. In the identification of such environmental parameters, geoinformation products derived from Earth Observation data acquired by satellites play an increasingly important role. In this paper, we present a review on the joint use of Earth Observation data and public health data for research on non-communicable diseases. We analyzed 146 articles from peer-reviewed journals (Impact Factor ≥ 2) from all over the world that included Earth Observation data and public health data for their assessments. Our results show that this field of synergistic geohealth analyses is still relatively young, with most studies published within the last five years and within national boundaries. While the contribution of Earth Observation, and especially remote sensing-derived geoinformation products on land surface dynamics is on the rise, there is still a huge potential for transdisciplinary integration into studies. We see the necessity for future research and advocate for the increased incorporation of thematically profound remote sensing products with high spatial and temporal resolution into the mapping of exposomes and thus the vulnerability and resilience assessment of a population regarding non-communicable diseases.

Short-term exposure to ambient particle gamma radioactivity is associated with increased risk for all-cause non-accidental and cardiovascular mortality

BACKGROUND

Recent studies have found that particulate matter (PM) attached radioactivity was associated with certain adverse health effects including increased blood pressure and lung dysfunction. However, there has been no investigation on the direct effect of PM radioactivity on mortality.

METHODS

Exposures to ambient PM gamma activities were determined using U.S. EPA RadNet data. Data on daily deaths were obtained from individual state Departments of Public Health. We used a generalized additive quasi-Poisson model to estimate the associations between two-day average ambient PM gamma activities (gamma2 through gamma9) with all-cause non-accidental and cardiovascular daily deaths for each of 18 US cities, for each season, adjusting for two-day average PM_2.5 exposure, temperature, relative humidity, day of week and long-term trends. Subsequently, we used random-effects meta-analysis to estimate the overall effect in the 18 cities for each season.

RESULTS

We found that all-cause non-accidental daily mortality in spring season was positively associated with two-day average ambient PM gamma activities in spring, with significant results for gamma2, gamma5 and gamma6. Similarly, cardiovascular daily mortality was positively associated with two-day average ambient PM gamma activities, with significant results for gamma2, gamma4, gamma5, gamma6, gamma7 and gamma9. For the spring season, each interquartile range (IQR) increase of two-day averaged ambient PM gamma activity was associated with increase in all-cause daily deaths, ranging from 0.15% (95% Confidence Interval (CI): -0.36%, 0.65%) to 1.03 (95%CI: 0.18%, 1.89%). Each IQR was also associated with increase in cardiovascular daily deaths, ranging from 0.01% (95%CI: -0.89, 0.92) to 2.95% (95%CI: 1.33, 4.59). For other seasons overall we found statistically insignificant associations of PM radioactivity with mortality.

CONCLUSIONS

Our findings suggest that there are potential systemic toxic effects of inhalation of radionuclides attached to ambient air particles.

Association between ambient beta particle radioactivity and lower hemoglobin concentrations in a cohort of elderly men

Although ionizing radiation is known to have detrimental effects on red blood cells, the effect of environmental radioactivity associated with ambient particulate matter (PM) is unknown. We hypothesized that exposure to ambient PM-associated beta particle radioactivity (PR_β) would be associated with a lower hemoglobin concentration. We studied 1.704 participants from the Normative Aging Study (NAS) over 36 years (1981-2017) who lived in Eastern, MA and the surrounding area. Exposures to PR_β was assessed using USEPA's RadNet monitoring network that measures gross beta radiation associated with ambient PM. Mixed effect models with a random intercept adjusting for potential confounders was used, including ambient black carbon (BC) and particulate matter ≤2.5 μm (PM_2.5) concentrations. Greater cumulative PR_β activities at 7-, 14-, 21- and 28-days before the hemoglobin determination were associated with lower hemoglobin concentrations. The greatest effect was for a 28-day moving average. An IQR of 0.83 × 10^-4 Bq/m³ of ambient PR_β was associated with a 0.12 g/dL decrease in hemoglobin concentration (95%CI: -0.18 to -0.05). The effects of PR_β were similar when the models were adjusted for ambient BC or PM_2.5. This is the first study to demonstrate an association between environmental ionizing radiation released from particulate matter with a lower hemoglobin concentration, suggesting that ambient radiation may contribute to the development of anemia.

Short-term exposures to particulate matter gamma radiation activities and biomarkers of systemic inflammation and endothelial activation in COPD patients

BACKGROUND

We hypothesized that particulate matter (PM) gamma activity (gamma radiation associated with PM) is associated with systemic effects.

OBJECTIVE

Examine short-term relationships between ambient and indoor exposures to PM gamma activities with systemic inflammation and endothelial activation in chronic obstructive pulmonary disease (COPD) patients.

METHODS

In 85 COPD patients from Eastern Massachusetts, USA from 2012 to 2014, plasma C-reactive protein (CRP), interleukin-6 (IL-6), and soluble vascular cell adhesion molecule-1 (sVCAM-1) were measured seasonally up to four times. We used US EPA RadNet data measuring ambient gamma radiation attached to PM adjusted for background radiation, and estimated in-home gamma radiation exposures using the ratio of in-home-to-ambient sulfur in PM2.5. Linear mixed-effects regression models were used to determine associations between moving averages of PM gamma activities through the week before phlebotomy with these biomarkers. We explored ambient and indoor PM2.5, black carbon (BC), and NO2 as confounders.

RESULTS

Ambient and indoor PM gamma activities measured as energy spectra classes 3 through 9 were positively associated with CRP and IL-6. For example, averaged from phlebotomy day through previous 6 days, each IQR increase in indoor PM gamma activity for each spectra class, was associated with an CRP increase ranging from 7.45% (95%CI: 2.77, 12.4) to 13.4% (95%CI: 5.82, 21.4) and for ambient exposures were associated with an increase of 8.75% (95%CI: -0.57, 18.95) to 14.8% (95%CI: 4.5, 26.0). Indoor exposures were associated with IL-6 increase of 3.56% (95%CI: 0.31, 6.91) to 6.46% (95%CI:1.33, 11.85) and ambient exposures were associated with an increase of 0.03% (95%CI: -6.37, 6.87) to 3.50% (95%CI: -3.15, 10.61). There were no positive associations with sVCAM-1. Sensitivity analyses using two-pollutant models showed similar effects.

CONCLUSIONS

Our results demonstrate that short-term exposures to environmental PM gamma radiation activities were associated with systemic inflammation in COPD patients.