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Zhou Y, Li X, Fouxi Zhao, Yao C, Wang Y, Tang E, Wang K, Li D, Yu L, Zhou Z, Wei J, Li D, Liu T, Cai T. Rural-urban difference in the association between particulate matters and stroke incidence: the evidence from a multi-city perspective cohort study. ENVIRONMENTAL RESEARCH 2024:119695. [PMID: 39102936 DOI: 10.1016/j.envres.2024.119695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 07/15/2024] [Accepted: 07/26/2024] [Indexed: 08/07/2024]
Abstract
Available evidence suggests that air pollutants can cause stroke, but little research has investigated the confounding effects of urban-rural differences. Here, we investigated the urban-rural difference in the correlation between particulate matter (PM2.5 and PM10) exposure and stroke. This cohort study was based on a prospective multi-city community-based cohort (Guizhou Population Health Cohort Study (GPHCS)) in Guizhou Province, China. A total of 7,988 eligible individuals (≥18 years) were enrolled with baseline assessments from November 2010 to December 2012, and follow-up was completed by June 2020. Two major particulate matters (PMs, including PM2.5 and PM10) were assessed monthly from 2000 by using satellite-based spatiotemporal models. The risk of stroke was estimated using a Cox proportional hazard regression model. The association between particulate matters' exposure and stroke in different areas (total, urban, and rural) and the potential modification effect of comorbidities (hypertension, diabetes, and dyslipidemia) and age (≤65 / >65 years) were examined using stratified analyses. The risk of stroke increased for every 10 μg/m3 increase in mean PMs' concentrations during the previous one year at the residential address (HR: 1.26, 95%CI: 1.24, 1.29 (PM2.5); HR: 1.13, 95%CI: 1.11, 1.15 (PM10)). The presence of diabetes and dyslipidemia increased the risk of PM10-induced stroke in whole, urban, and rural areas. Specifically, people living in rural areas were more likely to experience the effects of PMs in causing a stroke. The risk of stroke due to PMs was statistically increased in the young and older populations living in rural areas. In conclusion, long-term exposure to PMs increased the risk of stroke and such association was more pronounced in people living in rural areas with lower income levels. Diabetes and dyslipidemia seemed to strengthen the association between PMs and stroke.
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Affiliation(s)
- Yumeng Zhou
- Department of Epidemiology, College of Preventive Medicine, State Key Laboratory of Trauma and Chemical Poisoning, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Xuejiao Li
- Guizhou Center for Disease Control and Prevention, Guiyang, Guizhou, 550004, China
| | - Fouxi Zhao
- Guizhou Center for Disease Control and Prevention, Guiyang, Guizhou, 550004, China
| | - Chunyan Yao
- Department of Epidemiology, College of Preventive Medicine, State Key Laboratory of Trauma and Chemical Poisoning, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Yiying Wang
- Guizhou Center for Disease Control and Prevention, Guiyang, Guizhou, 550004, China
| | - Enjie Tang
- Department of Epidemiology, College of Preventive Medicine, State Key Laboratory of Trauma and Chemical Poisoning, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Kexue Wang
- Department of Epidemiology, College of Preventive Medicine, State Key Laboratory of Trauma and Chemical Poisoning, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Dawei Li
- Department of Epidemiology, College of Preventive Medicine, State Key Laboratory of Trauma and Chemical Poisoning, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Lisha Yu
- Guizhou Center for Disease Control and Prevention, Guiyang, Guizhou, 550004, China
| | - Zhujuan Zhou
- Department of Neurology, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Jing Wei
- Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park, Maryland 20742, United States
| | - Dawei Li
- Department of Epidemiology, College of Preventive Medicine, State Key Laboratory of Trauma and Chemical Poisoning, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Tao Liu
- Guizhou Center for Disease Control and Prevention, Guiyang, Guizhou, 550004, China.
| | - Tongjian Cai
- Department of Epidemiology, College of Preventive Medicine, State Key Laboratory of Trauma and Chemical Poisoning, Army Medical University (Third Military Medical University), Chongqing, 400038, China.
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Forastiere F, Spadaro JV, Ancona C, Jovanovic Andersen Z, Cozzi I, Gumy S, Loncar D, Mudu P, Medina S, Perez Velasco R, Walton H, Zhang J, Krzyzanowski M. Choices of morbidity outcomes and concentration-response functions for health risk assessment of long-term exposure to air pollution. Environ Epidemiol 2024; 8:e314. [PMID: 39045486 PMCID: PMC11265782 DOI: 10.1097/ee9.0000000000000314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 05/14/2024] [Indexed: 07/25/2024] Open
Abstract
Background Air pollution health risk assessment (HRA) has been typically conducted for all causes and cause-specific mortality based on concentration-response functions (CRFs) from meta-analyses that synthesize the evidence on air pollution health effects. There is a need for a similar systematic approach for HRA for morbidity outcomes, which have often been omitted from HRA of air pollution, thus underestimating the full air pollution burden. We aimed to compile from the existing systematic reviews and meta-analyses CRFs for the incidence of several diseases that could be applied in HRA. To achieve this goal, we have developed a comprehensive strategy for the appraisal of the systematic reviews and meta-analyses that examine the relationship between long-term exposure to particulate matter with an aerodynamic diameter smaller than 2.5 µm (PM2.5), nitrogen dioxide (NO2), or ozone (O3) and incidence of various diseases. Methods To establish the basis for our evaluation, we considered the causality determinations provided by the US Environmental Protection Agency Integrated Science Assessment for PM2.5, NO2, and O3. We developed a list of pollutant/outcome pairs based on these assessments and the evidence of a causal relationship between air pollutants and specific health outcomes. We conducted a comprehensive literature search using two databases and identified 75 relevant systematic reviews and meta-analyses for PM2.5 and NO2. We found no relevant reviews for long-term exposure to ozone. We evaluated the reliability of these studies using an adaptation of the AMSTAR 2 tool, which assesses various characteristics of the reviews, such as literature search, data extraction, statistical analysis, and bias evaluation. The tool's adaptation focused on issues relevant to studies on the health effects of air pollution. Based on our assessment, we selected reviews that could be credible sources of CRF for HRA. We also assessed the confidence in the findings of the selected systematic reviews and meta-analyses as the sources of CRF for HRA. We developed specific criteria for the evaluation, considering factors such as the number of included studies, their geographical distribution, heterogeneity of study results, the statistical significance and precision of the pooled risk estimate in the meta-analysis, and consistency with more recent studies. Based on our assessment, we classified the outcomes into three lists: list A (a reliable quantification of health effects is possible in an HRA), list B+ (HRA is possible, but there is greater uncertainty around the reliability of the CRF compared to those included on list A), and list B- (HRA is not recommended because of the substantial uncertainty of the CRF). Results In our final evaluation, list A includes six CRFs for PM2.5 (asthma in children, chronic obstructive pulmonary disease, ischemic heart disease events, stroke, hypertension, and lung cancer) and three outcomes for NO2 (asthma in children and in adults, and acute lower respiratory infections in children). Three additional outcomes (diabetes, dementia, and autism spectrum disorders) for PM2.5 were included in list B+. Recommended CRFs are related to the incidence (onset) of the diseases. The International Classification of Diseases, 10th revision codes, age ranges, and suggested concentration ranges are also specified to ensure consistency and applicability in an HRA. No specific suggestions were given for ozone because of the lack of relevant systematic reviews. Conclusion The suggestions formulated in this study, including CRFs selected from the available systematic reviews, can assist in conducting reliable HRAs and contribute to evidence-based decision-making in public health and environmental policy. Future research should continue to update and refine these suggestions as new evidence becomes available and methodologies evolve.
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Affiliation(s)
- Francesco Forastiere
- National Research Council, IFT, Palermo, Italy
- Environmental Research Group, Imperial College, London, United Kingdom
| | - Joseph V. Spadaro
- World Health Organization, Headquarters, Geneva, Switzerland
- Spadaro Environmental Research Consultants (SERC), Philadelphia, Pennsylvania
| | - Carla Ancona
- Department of Epidemiology, Lazio Regional Health Service, Local Health Unit Roma 1, Rome, Italy
| | | | - Ilaria Cozzi
- Department of Epidemiology, Lazio Regional Health Service, Local Health Unit Roma 1, Rome, Italy
| | - Sophie Gumy
- World Health Organization, Headquarters, Geneva, Switzerland
| | - Dejan Loncar
- World Health Organization, Headquarters, Geneva, Switzerland
| | - Pierpaolo Mudu
- World Health Organization (WHO), European Center for Environment and Health, Bonn, Germany
| | | | - Roman Perez Velasco
- World Health Organization (WHO), European Center for Environment and Health, Bonn, Germany
| | - Heather Walton
- Environmental Research Group, Imperial College, London, United Kingdom
- National Institute of Health Research Health Protection Research Unit on Environmental Exposures and Health at Imperial College London, London, United Kingdom
| | - Jiawei Zhang
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Chen S, Zhang Y, Wei J, Hao C, Wu W, Li Z, Guo T, Lin Z, Zhang W, Hao Y. Risk of stroke admission after long-term exposure to PM 1: Evidence from a large cohort in South China. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 283:116720. [PMID: 39053181 DOI: 10.1016/j.ecoenv.2024.116720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 07/04/2024] [Accepted: 07/09/2024] [Indexed: 07/27/2024]
Abstract
BACKGROUND Limited attention has been paid to the health effects of long-term PM1 exposure on stroke admission. Current investigations exploring the long-term PM exposure effect are largely based on observational studies, and PM generally is not allocated randomly to participants. Using traditional regression models might confuse messaging and hinder policy recommendations for pollution control and disease prevention policies. METHODS We conducted a cohort study among 36,271 adults from one of the largest cities in China in 2015 and followed up through 2020. Hazard ratios of stroke admissions following long-term PM1 exposure were estimated via a causal inference approach, marginal structural time-varying Cox proportional hazard model, accounting for multiple confounders. Additionally, several sensitivity analyses and impact modification analyses were carried out. RESULTS AND DISCUSSION Associations with 1 μg/m3 increase in long-term PM1 were identified for total (HR, 1.079; 95 %CI, 1.012-1.151) and ischemic stroke admissions (HR, 1.092; 95 %CI, 1.018-1.171). The harmful associations varied with exposure duration, initially increasing and then decreasing. The 2-3 years cumulative exposure was associated with a 3.3-5.4 % raised risk for total stroke. For every 1 μg/m³ increase in long-term PM1 exposure, females exhibited a higher risk of both total and ischemic stroke (13 % and 16 %) than men (4 % and 5 %). Low-exposure individuals (whose annual PM1 concentrations were under the third quartile among the annual concentrations for all the participants) exhibited greater sensitivity to PM1 effects (total stroke: 1.079 vs. 1.107; ischemic stroke: 1.092 vs. 1.116). The results underline the importance of safeguarding low-exposed people in highly polluted areas and suggest that long-term PM1 exposure may increase stroke admission risk, warranting attention to vulnerable groups.
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Affiliation(s)
- Shirui Chen
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Yuqin Zhang
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Jing Wei
- Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park, MD, USA
| | - Chun Hao
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Wenjing Wu
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Zhiqiang Li
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Tong Guo
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Ziqiang Lin
- Department of Preventive Medicine, School of Basic Medicine and Public Health, Jinan University, Guangzhou, China.
| | - Wangjian Zhang
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China.
| | - Yuantao Hao
- Peking University Center for Public Health and Epidemic Preparedness & Response, Peking, China; Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, China.
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4
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Khoshnam SE, Moalemnia A, Anbiyaee O, Farzaneh M, Ghaderi S. LncRNA MALAT1 and Ischemic Stroke: Pathogenesis and Opportunities. Mol Neurobiol 2024; 61:4369-4380. [PMID: 38087169 DOI: 10.1007/s12035-023-03853-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 11/21/2023] [Indexed: 07/11/2024]
Abstract
Ischemic stroke (IS) stands as a prominent cause of mortality and long-term disability around the world. It arises primarily from a disruption in cerebral blood flow, inflicting severe neural injuries. Hence, there is a pressing need to comprehensively understand the intricate mechanisms underlying IS and identify novel therapeutic targets. Recently, long noncoding RNAs (lncRNAs) have emerged as a novel class of regulatory molecules with the potential to attenuate pathogenic mechanisms following IS. Among these lncRNAs, MALAT1 (metastasis-associated lung adenocarcinoma transcript 1) has been extensively studied due to its involvement in the pathophysiological processes of IS. In this review, we provide an in-depth analysis of the essential role of MALAT1 in the development and progression of both pathogenic and protective mechanisms following IS. These mechanisms include oxidative stress, neuroinflammation, cell death signaling, blood brain barrier dysfunction, and angiogenesis. Furthermore, we summarize the impact of MALAT1 on the susceptibility and severity of IS. This review highlights the potential risks associated with the therapeutic use of MALAT1 for IS, which are attributable to the stimulatory action of MALAT1 on ischemia/reperfusion injury. Ultimately, this review sheds light on the potential molecular mechanisms and associated signaling pathways underlying MALAT1 expression post-IS, with the aim of uncovering potential therapeutic targets.
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Affiliation(s)
- Seyed Esmaeil Khoshnam
- Persian Gulf Physiology Research Center, Medical Basic Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Arash Moalemnia
- Faculty of Medicine, Dezful University of Medical Sciences, Dezful, Iran
| | - Omid Anbiyaee
- School of Medicine, Cardiovascular Research Center, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Farzaneh
- Fertility, Infertility and Perinatology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Shahab Ghaderi
- Department of Neuroscience, School of Science and Advanced Technologies in Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
- Neurophysiology Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
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Zhang L, Xu F, Yang Y, Yang L, Wu Q, Sun H, An Z, Li J, Wu H, Song J, Wu W. PM 2.5 exposure upregulates pro-inflammatory protein expression in human microglial cells via oxidant stress and TLR4/NF-κB pathway. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 277:116386. [PMID: 38657455 DOI: 10.1016/j.ecoenv.2024.116386] [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: 01/30/2024] [Revised: 04/18/2024] [Accepted: 04/21/2024] [Indexed: 04/26/2024]
Abstract
Exposure to ambient PM2.5 is associated with neurodegenerative disorders, in which microglia activation plays a critical role. Thus far, the underlying mechanisms for PM2.5-induced microglia activation have not been well elucidated. In this study, a human microglial cell line (HMC3) was used as the in vitro model to examine the inflammatory effect (hall marker of microglia activation) of PM2.5 and regulatory pathways. The expression of inflammatory mediators including interleukin-6 (IL-6) and cyclooxygenase-2 (COX-2) as well as the brain derived neurotrophic factor (BDNF) were determined by ELISA and/or real-time PCR, respectively. Flow cytometry was used to measure the production of intracellular reactive oxygen species (ROS). Western blot was used to measure protein levels of Toll-like receptor 4 (TLR4), NF-κB inhibitor α (IκBα) and COX-2. It was shown that PM2.5 stimulation increased IL-6 and COX-2 expression but decreased BDNF expression in a dose-dependent manner. Further studies showed that PM2.5 triggered the formation of ROS and pre-treatment with the ROS scavenger acetylcysteine (NAC) significantly suppressed PM2.5-induced IL-6 and COX-2 expression. Moreover, the nuclear factor kappa B (NF-κB) inhibitor BAY11-7085 or the TLR4 neutralizing antibody markedly blocked PM2.5-induced IL-6 and COX-2 expression. However, NAC or BAY11-7085 exhibited minimal effect on PM2.5-induced BDNF down-regulation. In addition, pre-treatment with BAY11-7085 or TLR4 neutralizing antibody reduced ROS production induced by PM2.5, and NAC pre-treatment inhibited TLR4 expression and NF-κB activation induced by PM2.5. Collectively, PM2.5 treatment induced IL-6 and COX-2 but suppressed BDNF expression. PM2.5-induced IL-6 and COX-2 expression was mediated by interactive oxidative stress and TLR4/NF-κB pathway.
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Affiliation(s)
- Ling Zhang
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province 453003, China
| | - Fei Xu
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province 453003, China
| | - Yishu Yang
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province 453003, China
| | - Lin Yang
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province 453003, China
| | - Qiong Wu
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province 453003, China
| | - Han Sun
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province 453003, China
| | - Zhen An
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province 453003, China
| | - Juan Li
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province 453003, China
| | - Hui Wu
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province 453003, China
| | - Jie Song
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province 453003, China
| | - Weidong Wu
- Henan International Collaborative Laboratory for Health Effects and Intervention of Air Pollution, School of Public Health, Xinxiang Medical University, Xinxiang, Henan Province 453003, China.
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Qian Y, Su X, Yu H, Li Q, Jin S, Cai R, Shi W, Shi S, Meng X, Zhou L, Guo Y, Wang C, Wang X, Zhang Y. Differentiating the impact of fine and coarse particulate matter on cause-specific cerebrovascular mortality: An individual-level, case-crossover study. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 279:116447. [PMID: 38759537 DOI: 10.1016/j.ecoenv.2024.116447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 05/05/2024] [Accepted: 05/07/2024] [Indexed: 05/19/2024]
Abstract
BACKGROUND AND OBJECTIVES Many studies suggested that short-term exposure to fine particulate matter (PM2.5) and coarse particulate matter (PM2.5-10) was linked to elevated risk of cerebrovascular disease. However, little is known about the potentially differential effects of PM2.5 and PM2.5-10 on various types of cerebrovascular disease. METHODS We collected individual cerebrovascular death records for all residents in Shanghai, China from 2005 to 2021. Residential daily air pollution data were predicted from a satellite model. The associations between particulate matters (PM) and cerebrovascular mortality were investigated by an individual-level, time-stratified, case-crossover design. The data was analyzed by the conditional logistic regression combined with the distributed lag model with a maximum lag of 7 days. Furthermore, we explored the effect modifications by sex, age and season. RESULTS A total of 388,823 cerebrovascular deaths were included. Monotonous increases were observed for mortality of all cerebrovascular diseases except for hemorrhagic stroke. A 10 μg/m3 rise in PM2.5 was related to rises of 1.35% [95% confidence interval (CI): 1.04%, 1.66%] in mortality of all cerebrovascular diseases, 1.84% (95% CI: 1.25%, 2.44%) in ischemic stroke, 1.53% (95% CI: 1.07%, 1.99%) in cerebrovascular sequelae and 1.56% (95% CI: 1.08%, 2.05%) in ischemic stroke sequelae. The excess risk estimates per each 10 μg/m3 rise in PM2.5-10 were 1.47% (95% CI: 1.10%, 1.84%), 1.53% (95% CI: 0.83%, 2.24%), 1.93% (95% CI: 1.38%, 2.49%) and 2.22% (95% CI: 1.64%, 2.81%), respectively. The associations of both pollutants with all cerebrovascular outcomes were robust after controlling for co-pollutants. The associations were greater in females, individuals > 80 years, and during the warm season. CONCLUSIONS Short-term exposures to both PM2.5 and PM2.5-10 may independently increase the mortality risk of cerebrovascular diseases, particularly of ischemic stroke and stroke sequelae.
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Affiliation(s)
- Yifeng Qian
- Department of Oral and Craniomaxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Shanghai Research Institute of Stomatology, China
| | - Xiaozhen Su
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, China
| | - Huiting Yu
- Division of Vital Statistics, Institute of Health Information, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Qi Li
- Division of Vital Statistics, Institute of Health Information, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Shan Jin
- Division of Vital Statistics, Institute of Health Information, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Renzhi Cai
- Division of Vital Statistics, Institute of Health Information, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Wentao Shi
- Shanghai Ninth People's Hospital Affiliated to Shanghai JiaoTong University, School of Medicine, Clinical research Unit, Shanghai, China
| | - Su Shi
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, China
| | - Xia Meng
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, China
| | - Lu Zhou
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, China
| | - Yichen Guo
- Department of Environmental Health, School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, China
| | - Chunfang Wang
- Division of Vital Statistics, Institute of Health Information, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China.
| | - Xudong Wang
- Department of Oral and Craniomaxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Shanghai Research Institute of Stomatology, China.
| | - Yuhao Zhang
- Department of Neurology, Zhongshan Hospital, Fudan University, Shanghai 200032, China; National Clinical Research Center for Interventional Medicine, Shanghai 200032, China; Shanghai Clinical Research Center for Interventional Medicine, Shanghai 200032, China.
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7
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Richey MM, Bang J, Sivaraman V. Targeting disparate spaces: new technology and old tools. Front Public Health 2024; 12:1366179. [PMID: 38716239 PMCID: PMC11075099 DOI: 10.3389/fpubh.2024.1366179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 04/03/2024] [Indexed: 05/15/2024] Open
Abstract
A growing number of inexpensive, publicly available, validated air quality monitors are currently generating granular and longitudinal data on air quality. The expansion of interconnected networks of these monitors providing open access to longitudinal data represents a valuable data source for health researchers, citizen scientists, and community members; however, the distribution of these data collection systems will determine the groups that will benefit from them. Expansion of these and other exposure measurement networks represents a unique opportunity to address persistent inequities across racial, ethnic, and class lines, if the distribution of these devices is equitable. We present a lean template for local implementation, centered on groups known to experience excess burden of pulmonary disease, leveraging five resources, (a) publicly available, inexpensive air quality monitors connected via Wi-Fi to a centralized system, (b) discharge data from a state hospital repository (c) the U.S. Census, (d) monitoring locations generously donated by community organizations and (e) NIH grant funds. We describe our novel approach to targeting air-quality mediated pulmonary health disparities, review logistical and analytic challenges encountered, and present preliminary data that aligns with a growing body of research: in a high-burden zip code in Durham North Carolina, the census tract with the highest proportions of African Americans experienced worse air quality than a majority European-American census tract in the same zip code. These results, while not appropriate for use in causal inference, demonstrate the potential of equitably distributed, interconnected air quality sensors.
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Affiliation(s)
- Morgan M. Richey
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - John Bang
- North Carolina Central University, Durham, NC, United States
| | - Vijay Sivaraman
- North Carolina Central University, Durham, NC, United States
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8
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Li P, Wang Y, Tian D, Liu M, Zhu X, Wang Y, Huang C, Bai Y, Wu Y, Wei W, Tian S, Li Y, Qiao Y, Yang J, Cao S, Cong C, Zhao L, Su J, Wang M. Joint Exposure to Ambient Air Pollutants, Genetic Risk, and Ischemic Stroke: A Prospective Analysis in UK Biobank. Stroke 2024; 55:660-669. [PMID: 38299341 DOI: 10.1161/strokeaha.123.044935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 12/20/2023] [Indexed: 02/02/2024]
Abstract
BACKGROUND Our primary objective was to assess the association between joint exposure to various air pollutants and the risk of ischemic stroke (IS) and the modification of the genetic susceptibility. METHODS This observational cohort study included 307 304 British participants from the United Kingdom Biobank, who were stroke-free and possessed comprehensive baseline data on genetics, air pollutant exposure, alcohol consumption, and dietary habits. All participants were initially enrolled between 2006 and 2010 and were followed up until 2022. An air pollution score was calculated to assess joint exposure to 5 ambient air pollutants, namely particulate matter with diameters equal to or <2.5 µm, ranging from 2.5 to 10 µm, equal to or <10 µm, as well as nitrogen oxide and nitrogen dioxide. To evaluate individual genetic risk, a polygenic risk score for IS was calculated for each participant. We adjusted for demographic, social, economic, and health covariates. Cox regression models were utilized to estimate the associations between air pollution exposure, polygenic risk score, and the incidence of IS. RESULTS Over a median follow-up duration of 13.67 years, a total of 2476 initial IS events were detected. The hazard ratios (95% CI) of IS for per 10 µg/m3 increase in particulate matter with diameters equal to or <2.5 µm, ranging from 2.5 to 10 µm, equal to or <10 µm, nitrogen dioxide, and nitrogen oxide were 1.73 (1.33-2.14), 1.24 (0.88-1.70), 1.13 (0.89-1.33), 1.03 (0.98-1.08), and 1.04 (1.02-1.07), respectively. Furthermore, individuals in the highest quintile of the air pollution score exhibited a 29% to 66% higher risk of IS compared with those in the lowest quintile. Notably, participants with both high polygenic risk score and air pollution score had a 131% (95% CI, 85%-189%) greater risk of IS than participants with low polygenic risk score and air pollution score. CONCLUSIONS Our findings suggested that prolonged joint exposure to air pollutants may contribute to an increased risk of IS, particularly among individuals with elevated genetic susceptibility to IS.
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Affiliation(s)
- Panlong Li
- Department of Medical Imaging (P.L., Y.B., Y. Wu, W.W., M.W.), Henan Provincial People's Hospital and Zhengzhou University People's Hospital, China
- School of Electrical and Information Engineering, Zhengzhou University of Light Industry, China (P.L., X.Z., Yanfeng Wang, C.H.)
| | - Ying Wang
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China (Ying Wang)
- School of Public Health, Zhengzhou University (Ying Wang)
| | - Dandan Tian
- Department of Hypertension (D.T., M.L.), Henan Provincial People's Hospital and Zhengzhou University People's Hospital, China
| | - Min Liu
- Department of Hypertension (D.T., M.L.), Henan Provincial People's Hospital and Zhengzhou University People's Hospital, China
| | - Xirui Zhu
- School of Electrical and Information Engineering, Zhengzhou University of Light Industry, China (P.L., X.Z., Yanfeng Wang, C.H.)
| | - Yanfeng Wang
- School of Electrical and Information Engineering, Zhengzhou University of Light Industry, China (P.L., X.Z., Yanfeng Wang, C.H.)
| | - Chun Huang
- School of Electrical and Information Engineering, Zhengzhou University of Light Industry, China (P.L., X.Z., Yanfeng Wang, C.H.)
| | - Yan Bai
- Department of Medical Imaging (P.L., Y.B., Y. Wu, W.W., M.W.), Henan Provincial People's Hospital and Zhengzhou University People's Hospital, China
- Laboratory of Brain Science and Brain-Like Intelligence Technology, Biomedical Research Institute, Henan Academy of Science, China (Y.B.)
| | - Yaping Wu
- Department of Medical Imaging (P.L., Y.B., Y. Wu, W.W., M.W.), Henan Provincial People's Hospital and Zhengzhou University People's Hospital, China
| | - Wei Wei
- Department of Medical Imaging (P.L., Y.B., Y. Wu, W.W., M.W.), Henan Provincial People's Hospital and Zhengzhou University People's Hospital, China
| | - Shan Tian
- Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, China (S.T., Y.L., Y.Q., J.Y., S.C., C.C., L.Z., J.S.)
| | - Yuna Li
- Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, China (S.T., Y.L., Y.Q., J.Y., S.C., C.C., L.Z., J.S.)
| | - Yuan Qiao
- Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, China (S.T., Y.L., Y.Q., J.Y., S.C., C.C., L.Z., J.S.)
| | - Junting Yang
- Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, China (S.T., Y.L., Y.Q., J.Y., S.C., C.C., L.Z., J.S.)
| | - Shanshan Cao
- Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, China (S.T., Y.L., Y.Q., J.Y., S.C., C.C., L.Z., J.S.)
| | - Chaohua Cong
- Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, China (S.T., Y.L., Y.Q., J.Y., S.C., C.C., L.Z., J.S.)
| | - Lei Zhao
- Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, China (S.T., Y.L., Y.Q., J.Y., S.C., C.C., L.Z., J.S.)
| | - Jingjing Su
- Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, China (S.T., Y.L., Y.Q., J.Y., S.C., C.C., L.Z., J.S.)
| | - Meiyun Wang
- Department of Medical Imaging (P.L., Y.B., Y. Wu, W.W., M.W.), Henan Provincial People's Hospital and Zhengzhou University People's Hospital, China
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Wathanavasin W, Banjongjit A, Phannajit J, Eiam-Ong S, Susantitaphong P. Association of fine particulate matter (PM 2.5) exposure and chronic kidney disease outcomes: a systematic review and meta-analysis. Sci Rep 2024; 14:1048. [PMID: 38200164 PMCID: PMC10781728 DOI: 10.1038/s41598-024-51554-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 01/06/2024] [Indexed: 01/12/2024] Open
Abstract
Several studies have reported an increased risk of chronic kidney disease (CKD) outcomes after long-term exposure (more than 1 year) to particulate matter with an aerodynamic diameter of ≤ 2.5 µm (PM2.5). However, the conclusions remain inconsistent. Therefore, we conducted this meta-analysis to examine the association between long-term PM2.5 exposure and CKD outcomes. A literature search was conducted in PubMed, Scopus, Cochrane Central Register of Controlled trials, and Embase for relevant studies published until August 10, 2023. The main outcomes were incidence and prevalence of CKD as well as incidence of end-stage kidney disease (ESKD). The random-effect model meta-analyses were used to estimate the risk of each outcome among studies. Twenty two studies were identified, including 14 cohort studies, and 8 cross-sectional studies, with a total of 7,967,388 participants. This meta-analysis revealed that each 10 μg/m3 increment in PM2.5 was significantly associated with increased risks of both incidence and prevalence of CKD [adjusted odds ratio (OR) 1.31 (95% confidence interval (CI) 1.24 to 1.40), adjusted OR 1.31 (95% CI 1.03 to 1.67), respectively]. In addition, the relationship with ESKD incidence is suggestive of increased risk but not conclusive (adjusted OR 1.16; 95% CI 1.00 to 1.36). The incidence and prevalence of CKD outcomes had a consistent association across all subgroups and adjustment variables. Our study observed an association between long-term PM2.5 exposure and the risks of CKD. However, more dedicated studies are required to show causation that warrants urgent action on PM2.5 to mitigate the global burden of CKD.
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Affiliation(s)
- Wannasit Wathanavasin
- Nephrology Unit, Department of Medicine, Charoenkrung Pracharak Hospital, Bangkok Metropolitan Administration, Bangkok, Thailand
| | - Athiphat Banjongjit
- Nephrology Unit, Department of Medicine, Vichaiyut Hospital, Bangkok, Thailand
| | - Jeerath Phannajit
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
- Division of Clinical Epidemiology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
- Center of Excellence for Metabolic Bone Disease in CKD Patients, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Somchai Eiam-Ong
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Paweena Susantitaphong
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand.
- Center of Excellence for Metabolic Bone Disease in CKD Patients, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
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10
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Supphapipat K, Leurcharusmee P, Chattipakorn N, Chattipakorn SC. Impact of air pollution on postoperative outcomes following organ transplantation: Evidence from clinical investigations. Clin Transplant 2024; 38:e15180. [PMID: 37987510 DOI: 10.1111/ctr.15180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 11/22/2023]
Abstract
INTRODUCTION Air pollution is a worldwide problem affecting human health via various body systems, resulting in numerous significant adverse events. Air pollutants, including particulate matter < or = 2.5 microns (PM2.5), particulate matter < or = 10 microns (PM10), ozone (O3 ), nitrogen dioxide (NO2 ), and traffic-related air pollution (TRAP), have demonstrated the negative effects on human health (e.g., increased cerebrovascular, cardiovascular, and respiratory diseases, malignancy, and mortality). Organ transplant patients, who are taking immunosuppressive agents, are especially vulnerable to the adverse effects of air pollutants. The evidence from clinical investigation has shown that exposure to air pollution after organ transplantation is associated with organ rejection, cardiovascular disease, coronary heart disease, cerebrovascular disease, infection-related mortality, and vitamin D deficiency. OBJECTIVES AND METHOD This review aims to summarize and discuss the association of exposure to air pollutants and serum 25-hydroxyvitamin D level and outcomes after transplantation. Controversial findings are also included and discussed. CONCLUSION All of the findings suggest that air pollution results in a hazardous environment, which not only impacts human health worldwide but also affects post-transplant outcomes.
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Affiliation(s)
- Kittitorn Supphapipat
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Department of Anesthesiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Prangmalee Leurcharusmee
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Department of Anesthesiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Nipon Chattipakorn
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, Thailand
| | - Siriporn C Chattipakorn
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, Thailand
- Department of Oral Biology and Diagnostic Sciences, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
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11
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Wang X, Zhang S, Yan H, Ma Z, Zhang Y, Luo H, Yang X. Association of exposure to ozone and fine particulate matter with ovarian reserve among women with infertility. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 340:122845. [PMID: 37926414 DOI: 10.1016/j.envpol.2023.122845] [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: 04/11/2023] [Revised: 10/28/2023] [Accepted: 10/30/2023] [Indexed: 11/07/2023]
Abstract
Evidence linking diminished ovarian reserve, a significant cause of female infertility, and exposure to particulate matter with aerodynamic diameters ≤2.5 μm (PM2.5) or O3 exposure remains a critical knowledge gap in female fertility. This study investigated the association between ambient PM2.5, O3 pollution, and anti-Müllerian hormone (AMH), a sensitive marker of ovarian reserve, in reproductive-aged Chinese women. We enrolled 2212 women with spontaneous menstrual cycles who underwent AMH measurements at a reproductive medicine center between 2018 and 2021. The daily mean concentrations of outdoor PM2.5 and O3 were estimated using a validated spatiotemporal model, followed by matching the participants' residential addresses. Three exposure periods were designed according to AMH expression patterns during follicle development. A generalized linear model was used to investigate changes in AMH associated with air pollution. The results showed a mean AMH level of 3.47 ± 2.61 ng/mL. During the six months from primary to early antral follicle stage (Period 1), each 10 μg/m3 increase in PM2.5 and O3 exposure was associated with AMH changes of -0.21 (95% confidence interval [CI]: -0.48, 0.06) ng/mL and -0.31 (95% CI: -0.50, -0.12) ng/mL, respectively. Further analyses indicated that the reduced ovarian reserve measured by AMH level was only significantly associated with PM2.5 exposure during follicle development from the primary to preantral follicle stage (Period 2) but was significantly associated with O3 exposure during Periods 1, 2, and 3. These observations were robust in the dual-pollutant model considering co-exposure to PM2.5 and O3. The results indicated an inverse association between ovarian reserve and ambient O3 exposure and suggested distinct susceptibility windows for O3 and PM2.5 for reduced ovarian reserve. These findings highlight the need to control ambient air pollution to reduce invisible risks to women's fertility, especially at high O3 concentrations.
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Affiliation(s)
- Xinyan Wang
- Center for Reproductive Medicine, Tianjin Central Hospital of Obstetrics and Gynecology, Maternal Hospital of Nankai University, Tianjin Key Laboratory of Human Development and Reproductive Regulation, No. 156 Nankai Third Road, Tianjin 300100, China
| | - Shuai Zhang
- Center for Reproductive Medicine, Tianjin Central Hospital of Obstetrics and Gynecology, Maternal Hospital of Nankai University, Tianjin Key Laboratory of Human Development and Reproductive Regulation, No. 156 Nankai Third Road, Tianjin 300100, China
| | - Huihui Yan
- Center for Reproductive Medicine, Tianjin Central Hospital of Obstetrics and Gynecology, Maternal Hospital of Nankai University, Tianjin Key Laboratory of Human Development and Reproductive Regulation, No. 156 Nankai Third Road, Tianjin 300100, China
| | - Zhao Ma
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China
| | - Yunshan Zhang
- Center for Reproductive Medicine, Tianjin Central Hospital of Obstetrics and Gynecology, Maternal Hospital of Nankai University, Tianjin Key Laboratory of Human Development and Reproductive Regulation, No. 156 Nankai Third Road, Tianjin 300100, China
| | - Haining Luo
- Center for Reproductive Medicine, Tianjin Central Hospital of Obstetrics and Gynecology, Maternal Hospital of Nankai University, Tianjin Key Laboratory of Human Development and Reproductive Regulation, No. 156 Nankai Third Road, Tianjin 300100, China.
| | - Xueli Yang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300070, China; State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing 211166, China
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12
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Krittanawong C, Qadeer YK, Hayes RB, Wang Z, Thurston GD, Virani S, Lavie CJ. PM 2.5 and cardiovascular diseases: State-of-the-Art review. INTERNATIONAL JOURNAL OF CARDIOLOGY. CARDIOVASCULAR RISK AND PREVENTION 2023; 19:200217. [PMID: 37869561 PMCID: PMC10585625 DOI: 10.1016/j.ijcrp.2023.200217] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 09/09/2023] [Accepted: 09/20/2023] [Indexed: 10/24/2023]
Abstract
Air pollution, especially exposure to particulate matter 2.5 (PM2.5), has been associated with an increase in morbidity and mortality around the world. Specifically, it seems that PM2.5 promotes the development of cardiovascular risk factors such as hypertension and atherosclerosis, while being associated with an increased risk of cardiovascular diseases, including myocardial infarction (MI), stroke, heart failure, and arrhythmias. In this review, we seek to elucidate the pathophysiological mechanisms by which exposure to PM2.5 can result in adverse cardiovascular outcomes, in addition to understanding the link between exposure to PM2.5 and cardiovascular events. It is hypothesized that PM2.5 functions via 3 mechanisms: increased oxidative stress, activation of the inflammatory pathway of the immune system, and stimulation of the autonomic nervous system which ultimately promote endothelial dysfunction, atherosclerosis, and systemic inflammation that can thus lead to cardiovascular events. It is important to note that the various cardiovascular associations of PM2.5 differ regarding the duration of exposure (short vs long) to PM2.5, the source of PM2.5, and regulations regarding air pollution in the area where PM2.5 is prominent. Current strategies to reduce PM2.5 exposure include personal strategies such as avoiding high PM2.5 areas such as highways or wearing masks outdoors, to governmental policies restricting the amount of PM2.5 produced by organizations. This review, by highlighting the significant impact between PM2.5 exposure and cardiovascular health will hopefully bring awareness and produce significant change regarding dealing with PM2.5 levels worldwide.
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Affiliation(s)
| | | | - Richard B. Hayes
- Division of Epidemiology, Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Zhen Wang
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA
- Division of Health Care Policy and Research, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - George D. Thurston
- Department of Environmental Medicine, New York University School of Medicine, Tuxedo, New York, USA
| | - Salim Virani
- Section of Cardiology, Baylor College of Medicine, Houston, TX, USA
- The Aga Khan University, Karachi, Pakistan
| | - Carl J. Lavie
- John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, LA, USA
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13
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Krzyzanowski B, Searles Nielsen S, Turner JR, Racette BA. Fine Particulate Matter and Parkinson Disease Risk Among Medicare Beneficiaries. Neurology 2023; 101:e2058-e2067. [PMID: 37903644 PMCID: PMC10663024 DOI: 10.1212/wnl.0000000000207871] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 08/03/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Numerous studies suggest that environmental exposures play a critical role in Parkinson disease (PD) pathogenesis, and large, population-based studies have the potential to advance substantially the identification of novel PD risk factors. We sought to study the nationwide geographic relationship between PD and air pollution, specifically PM2.5 (particulate matter with a diameter <2.5 micrometers), using population-based US Medicare data. METHODS We conducted a population-based geographic study of Medicare beneficiaries aged 66-90 years geocoded to US counties and zip+4. We used integrated nested Laplace approximation to create age, sex, race, smoking, and health care utilization-adjusted relative risk (RR) at the county level for geographic analyses with PM2.5 as the primary exposure of interest. We also performed an individual-level analysis using logistic regression with cases and controls with zip+4 centroid PM2.5. We adjusted a priori for the same covariates and verified no confounding by indicators of socioeconomic status or neurologist density. RESULTS Among 21,639,190 Medicare beneficiaries, 89,390 had incident PD in 2009. There was a nationwide association between average annual PM2.5 and PD risk whereby the RR of PD was 56% (95% CI 47%-66%) greater for those exposed to the median level of PM2.5 compared with those with the lowest level of PM2.5. This association was linear up to 13 μg/m3 corresponding to a 4.2% (95% CI 3.7%-4.8%) greater risk of PD for each additional μg/m3 of PM2.5 (p trend < 0.0001). We identified a region with high PD risk in the Mississippi-Ohio River Valley, where the risk of PD was 19% greater compared with the rest of the nation. The strongest association between PM2.5 and PD was found in a region with low PD risk in the Rocky Mountains. PM2.5 was also associated with PD in the Mississippi-Ohio River Valley where the association was relatively weaker, due to a possible ceiling effect at average annual PM2.5 levels of ∼13 μg/m3. DISCUSSION State-of-the-art geographic analytic techniques revealed an association between PM2.5 and PD that varied in strength by region. A deeper investigation into the specific subfractions of PM2.5 may provide additional insight into regional variability in the PM2.5-PD association.
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Affiliation(s)
- Brittany Krzyzanowski
- From the Barrow Neurological Institute (B.K., B.A.R.), Phoenix, AZ; Washington University in St. Louis (S.S.N., J.R.T.) MO.
| | - Susan Searles Nielsen
- From the Barrow Neurological Institute (B.K., B.A.R.), Phoenix, AZ; Washington University in St. Louis (S.S.N., J.R.T.) MO
| | - Jay R Turner
- From the Barrow Neurological Institute (B.K., B.A.R.), Phoenix, AZ; Washington University in St. Louis (S.S.N., J.R.T.) MO
| | - Brad A Racette
- From the Barrow Neurological Institute (B.K., B.A.R.), Phoenix, AZ; Washington University in St. Louis (S.S.N., J.R.T.) MO
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14
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Roger Chen YH, Lee WC, Liu BC, Yang PC, Ho CC, Hwang JS, Huang TH, Lin HH, Lo WC. Quantifying the potential effects of air pollution reduction on population health and health expenditure in Taiwan. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 336:122405. [PMID: 37597736 DOI: 10.1016/j.envpol.2023.122405] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 08/12/2023] [Accepted: 08/16/2023] [Indexed: 08/21/2023]
Abstract
Air pollution, particularly ambient fine particulate matter (PM2.5) pollution, poses a significant risk to public health, underscoring the importance of comprehending the long-term impact on health burden and expenditure at national and subnational levels. Therefore, this study aims to quantify the disease burden and healthcare expenditure associated with PM2.5 exposure in Taiwan and assess the potential benefits of reducing pollution levels. Using a comparative risk assessment framework that integrates an auto-aggressive integrated moving average model, we evaluated the avoidable burden of cardiopulmonary diseases (including ischemic heart disease, stroke, chronic obstructive pulmonary disease, lung cancer, and diabetes mellitus) and related healthcare expenditure under different air quality target scenarios, including status quo and target scenarios of 15, 10, and 5 μg/m3 reduction in PM2.5 concentration. Our findings indicate that reducing PM2.5 exposure has the potential to significantly alleviate the burden of multiple diseases. Comparing the estimated attributable disease burden and healthcare expenditure between reference and target scenarios from 2022 to 2050, the avoidable disability-adjusted life years were 0.61, 1.83, and 3.19 million for the 15, 10, and 5 μg/m3 target scenarios, respectively. Correspondingly, avoidable healthcare expenditure ranged from US$ 0.63 to 3.67 billion. We also highlighted the unequal allocation of resources and the need for policy interventions to address health disparities due to air pollution. Notably, in the 5 μg/m3 target scenario, Kaohsiung City stands to benefit the most, with 527,368 disability-adjusted life years avoided and US$ 0.53 billion saved from 2022 to 2050. Our findings suggest that adopting stricter emission targets can effectively reduce the health burden and associated healthcare expenditure in Taiwan. Overall, this study provides policymakers in Taiwan with valuable insights for mitigating the negative effects of air pollution by establishing a comprehensive framework for evaluating the co-benefits of air pollution reduction on healthcare expenditure and disease burden.
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Affiliation(s)
- Yi-Hsuan Roger Chen
- Department of Environmental Health and Engineering, Johns Hopkins University, Baltimore, MD, USA; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Wan-Chen Lee
- Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Bo-Chen Liu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Po-Chieh Yang
- Department of Industrial Economics, Tamkang University, Taipei, Taiwan
| | - Chi-Chang Ho
- Institute of Statistical Science, Academia Sinica, Taipei, Taiwan
| | | | - Tzu-Hsuan Huang
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; AbbVie Inc. North Chicago, Illinois, USA
| | - Hsien-Ho Lin
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Global Health Program, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Wei-Cheng Lo
- Master Program in Applied Epidemiology, College of Public Health, Taipei Medical University, Taipei, Taiwan; Taipei Medical University Research Center of Urology and Kidney, Taipei Medical University, Taipei, Taiwan.
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15
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Lamorie-Foote K, Ge B, Shkirkova K, Liu Q, Mack W. Effect of Air Pollution Particulate Matter on Ischemic and Hemorrhagic Stroke: A Scoping Review. Cureus 2023; 15:e46694. [PMID: 37942398 PMCID: PMC10629995 DOI: 10.7759/cureus.46694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2023] [Indexed: 11/10/2023] Open
Abstract
Air pollution particulate matter (PM) exposure has been established as a risk factor for stroke. However, few studies have investigated the effects of PM exposure on stroke subtypes (ischemic and hemorrhagic stroke). Ischemic (IS) and hemorrhagic strokes (HS) involve distinctive pathophysiological pathways and may be differentially influenced by PM exposure. This review aims to characterize the effects of PM exposure on ischemic and hemorrhagic strokes. It also identifies subpopulations that may be uniquely vulnerable to PM toxicity. Pubmed was queried from 2000 to 2023 to identify clinical and epidemiological studies examining the association between PM exposure and stroke subtypes (ischemic and hemorrhagic stroke). Inclusion criteria were: 1) articles written in English 2) clinical and epidemiological studies 3) studies with a clear definition of stroke, IS, HS, and air pollution 4) studies reporting the effects of PM and 5) studies that included distinct analyses per stroke subtype. Two independent reviewers screened the literature for applicable studies. A total of 50 articles were included in this review. Overall, PM exposure increases ischemic stroke risk in both lightly and heavily polluted countries. The association between PM exposure and hemorrhagic stroke is variable and may be influenced by a country's ambient air pollution levels. A stronger association between PM exposure and stroke is demonstrated in older individuals and those with pre-existing diabetes. There is no clear effect of sex or hypertension on PM-associated stroke risk. Current literature suggests PM exposure increases ischemic stroke risk, with an unclear effect on hemorrhagic stroke risk. Older patients and those with pre-existing diabetes may be the most vulnerable to PM toxicity. Future investigations are needed to characterize the influence of sex and hypertension on PM-associated stroke risk.
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Affiliation(s)
| | - Brandon Ge
- Neurological Surgery, Keck School of Medicine of University of Southern California, Los Angeles, USA
| | - Kristina Shkirkova
- Neurological Surgery, Keck School of Medicine of University of Southern California, Los Angeles, USA
| | - Qinghai Liu
- Neurological Surgery, University of Southern California, Los Angeles, USA
| | - William Mack
- Neurological Surgery, University of Southern California, Los Angeles, USA
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16
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Lee H, Kravitz-Wirtz N, Rao S, Crowder K. Effects of Prolonged Exposure to Air Pollution and Neighborhood Disadvantage on Self-Rated Health among Adults in the United States: Evidence from the Panel Study of Income Dynamics. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:87001. [PMID: 37531580 PMCID: PMC10396329 DOI: 10.1289/ehp11268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/04/2023]
Abstract
BACKGROUND Although overall air quality has improved in the United States, air pollution remains unevenly distributed across neighborhoods, producing disproportionate environmental burdens for minoritized and socioeconomically disadvantaged residents for whom greater exposure to other structurally rooted neighborhood stressors is also more frequent. These interrelated dynamics and layered vulnerabilities each have well-documented associations with physical and psychological health outcomes; however, much remains unknown about the joint effects of environmental hazards and neighborhood socioeconomic factors on self-reported health status. OBJECTIVES We examined the nexus of air pollution exposure, neighborhood socioeconomic disadvantage, and self-rated health (SRH) among adults in the United States. METHODS This observational study used individual-level data from the Panel Study of Income Dynamics merged with contextual information, including neighborhood socioeconomic and air pollution data at the census tract and census block levels, spanning the period of 1999-2015. We estimated ordinary least squares regression models predicting SRH by 10-y average exposures to fine particulate matter [particles ≤ 2.5 μ m in aerodynamic diameter (PM 2.5 )] and neighborhood socioeconomic disadvantage while controlling for individual-level correlates of health. We also investigated the interaction effects of air pollution and neighborhood socioeconomic disadvantage on SRH. RESULTS On average, respondents in our sample rated their health as 3.41 on a scale of 1 to 5. Respondents in neighborhoods with higher 10-y average PM 2.5 concentrations or socioeconomic disadvantage rated their health more negatively after controlling for covariates [β = - 0.024 (95% CI: - 0.034 , - 0.014 ); β = - 0.107 (95% CI: - 0.163 , - 0.052 ), respectively]. We also found that the deleterious associations of PM 2.5 exposure with SRH were weaker in the context of greater neighborhood socioeconomic disadvantage (β = 0.007 ; 95% CI: 0.002, 0.011). DISCUSSION Study results indicate that the effects of air pollution on SRH may be less salient in socioeconomically disadvantaged neighborhoods compared with more advantaged areas, perhaps owing to the presence of other more proximate structurally rooted health risks and vulnerabilities in disinvested areas (e.g., lack of economic resources, health access, healthy food options). This intersection may further underscore the importance of meaningful involvement and political power building among community stakeholders on issues concerning the nexus of environmental and socioeconomic justice, particularly in structurally marginalized communities. https://doi.org/10.1289/EHP11268.
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Affiliation(s)
- Hannah Lee
- Department of Sociology, University of Washington, Seattle, Washington, USA
| | - Nicole Kravitz-Wirtz
- Department of Emergency Medicine, University of California, Davis School of Medicine, Sacramento, California, USA
| | - Smitha Rao
- College of Social Work, Ohio State University, Columbus, Ohio, USA
| | - Kyle Crowder
- Department of Sociology, University of Washington, Seattle, Washington, USA
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Chen S, Lin X, Du Z, Zhang Y, Zheng L, Ju X, Guo T, Wang X, Chen L, Jiang J, Hu W, Zhang W, Hao Y. Potential causal links between long-term ambient particulate matter exposure and cerebrovascular mortality: Insights from a large cohort in southern China. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 328:121336. [PMID: 36822305 DOI: 10.1016/j.envpol.2023.121336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 02/18/2023] [Accepted: 02/20/2023] [Indexed: 05/09/2023]
Abstract
Cohort studies conducted in North America and Europe have linked cerebrovascular mortality to long-term exposure to particulate matter (PM). However, limited evidence from large cohorts in high-exposure areas and the traditional approach of association assessment may cause residual confounding issues. In this study, we aimed to investigate the causal links between cerebrovascular mortality and long-term exposure to PM2.5, PM10, and PM2.5-10 in an ongoing cohort study with 580,757 participants in southern China. Using satellite-based estimates of PM concentration at a 1-km2 spatial resolution, we assigned exposure levels to each participant and used the marginal structural Cox model to assess the association between PM exposure and cerebrovascular mortality while accounting for time-varying covariates. We also explored the potential modification effects of sociodemographic and behavioral factors on the PM-health associations. Adjusted hazard ratios (HR) for overall cerebrovascular mortality were 1.041 (95% confidence interval (CI): 1.034-1.049) and 1.032 (95% CI: 1.026-1.038) for each 1 μg/m3 increase in PM2.5, and PM10, respectively. Similar trends were observed in the mortality risk from stroke and ischemic stroke, with HRs ranging from 1.040 to 1.069 and 1.025 to 1.052, respectively, across 2 p.m. exposures. The impact of PM exposure was generally more apparent among women, participants with primary school diplomas and below, and the subgroup under low-exposure. Multiple sensitivity analyses confirmed the robustness of the results. In conclusion, this sizable prospective cohort study hypothesizes causal links between long-term PM exposure and cerebrovascular mortality, particularly among vulnerable participants, supporting the rationale for reducing PM concentration in China to reduce cerebrovascular mortality.
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Affiliation(s)
- Shirui Chen
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Xiao Lin
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Zhicheng Du
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Yuqin Zhang
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Lingling Zheng
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Xu Ju
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Tong Guo
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Xinran Wang
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Lichang Chen
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Jie Jiang
- Peking University Center for Public Health and Epidemic Preparedness & Response, Peking, China
| | - Weihua Hu
- Peking University Center for Public Health and Epidemic Preparedness & Response, Peking, China
| | - Wangjian Zhang
- Department of Medical Statistics, School of Public Health & Center for Health Information Research & Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Yuantao Hao
- Peking University Center for Public Health and Epidemic Preparedness & Response, Peking, China.
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Poulsen AH, Sørensen M, Hvidtfeldt UA, Ketzel M, Christensen JH, Brandt J, Frohn LM, Khan J, Jensen SS, Lund T, Raaschou-Nielsen O. Air pollution and stroke; effect modification by sociodemographic and environmental factors. A cohort study from Denmark. Int J Hyg Environ Health 2023; 251:114165. [PMID: 37121155 DOI: 10.1016/j.ijheh.2023.114165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 03/03/2023] [Accepted: 03/29/2023] [Indexed: 05/02/2023]
Abstract
OBJECTIVES Air pollution increases the risk of stroke, but the literature on identifying susceptible subgroups of populations is scarce and inconsistent. The aim of this study was to investigate if the association between air pollution and risk of stroke differed by sociodemographic factors, financial stress, comorbid conditions, and residential road traffic noise, population density and green space. METHODS We assessed long-term exposure to air pollution with ultrafine particles, PM2.5, elemental carbon and NO2 for a cohort of 1,971,246 Danes aged 50-85 years. During follow-up from 2005 to 2017, we identified 83,211 incident stroke cases. We used Cox proportional hazards model (relative risk) and Aalen additive hazards models (absolute risk) to estimate associations and confidence intervals (CI) between 5-year running means of air pollution at the residence and risk of stroke in population strata. RESULTS All four pollutants were associated with higher risk of stroke. The association between air pollution and stroke was strongest among individuals with comorbidities, with shorter education, lower income and being retired. The results also indicated stronger associations among individuals living in less populated areas, and with low noise levels and more green space around the residence. Estimates of absolute risk seemed better suited to detect such interactions than estimates of relative risk. For example for PM2.5 the hazard ratio for stroke was 1.28 (95%CI: 1.22-1.34) and 1.26 (95%CI: 1.16-1.37) among those with mandatory and medium/long education respectively. The corresponding rate difference estimates per 100,000 person years were 568 (95%CI: 543-594) and 423(95%CI: 390-456) CONCLUSION: The associations between air pollution and risk of stroke was stronger among individuals of lower socioeconomic status or with pre-existing comorbid conditions. Absolute risk estimates were better suited to identify such effect modification.
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Affiliation(s)
- Aslak Harbo Poulsen
- Work, Environment and Cancer, Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark.
| | - Mette Sørensen
- Work, Environment and Cancer, Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark; Department of Natural Science and Environment, Roskilde University, Universitetsvej 1, 4000, Roskilde, Denmark
| | - Ulla Arthur Hvidtfeldt
- Work, Environment and Cancer, Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark
| | - Matthias Ketzel
- Department of Environmental Science, Aarhus University, Frederiksborgvej 399, 4000, Roskilde, Denmark; Global Centre for Clean Air Research (GCARE), Department of Civil and Environmental Engineering, University of Surrey, Guildford, UK
| | - Jesper H Christensen
- Department of Environmental Science, Aarhus University, Frederiksborgvej 399, 4000, Roskilde, Denmark
| | - Jørgen Brandt
- Department of Environmental Science, Aarhus University, Frederiksborgvej 399, 4000, Roskilde, Denmark; iClimate - interdisciplinary Centre for Climate Change, Aarhus University, Frederiksborgvej 399, 4000, Roskilde, Denmark
| | - Lise Marie Frohn
- Department of Environmental Science, Aarhus University, Frederiksborgvej 399, 4000, Roskilde, Denmark; iClimate - interdisciplinary Centre for Climate Change, Aarhus University, Frederiksborgvej 399, 4000, Roskilde, Denmark
| | - Jibran Khan
- Department of Environmental Science, Aarhus University, Frederiksborgvej 399, 4000, Roskilde, Denmark; Danish Big Data Centre for Environment and Health (BERTHA), Aarhus University, Frederiksborgvej 399, 4000, Roskilde, Denmark
| | - Steen Solvang Jensen
- Department of Environmental Science, Aarhus University, Frederiksborgvej 399, 4000, Roskilde, Denmark
| | - Thomas Lund
- Centre of Social Medicine, University Hospital Bispebjerg-Frederiksberg, Nordre Fasanvej 57, 2000, Frederiksberg, Denmark; Department of Occupational and Social Medicine, Holbaek Hospital & Department of Public Health, University of Copenhagen, Denmark
| | - Ole Raaschou-Nielsen
- Work, Environment and Cancer, Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark; Department of Environmental Science, Aarhus University, Frederiksborgvej 399, 4000, Roskilde, Denmark
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19
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Cho E, Cho Y. Estimating the economic value of ultrafine particle information: a contingent valuation method. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:54822-54834. [PMID: 36881235 PMCID: PMC9990581 DOI: 10.1007/s11356-023-26157-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 02/23/2023] [Indexed: 06/18/2023]
Abstract
Global concern regarding ultrafine particles (UFPs), which are particulate matter (PM) with a diameter of less than 100 nm, is increasing. These particles are difficult to measure using the current methods because their characteristics are different from those of other air pollutants. Therefore, a new monitoring system is required to obtain accurate UFP information, which will raise the financial burden of the government and people. In this study, we estimated the economic value of UFP information by evaluating the willingness-to-pay (WTP) for the UFP monitoring and reporting system. We used the contingent valuation method (CVM) and the one-and-one-half-bounded dichotomous choice (OOHBDC) spike model. We analyzed how the respondents' socio-economic variables, as well as their cognition level of PM, affected their WTP. Therefore, we collected WTP data of 1040 Korean respondents through an online survey. The estimated mean WTP for building a UFP monitoring and reporting system is KRW 6958.55-7222.55 (USD 6.22-6.45) per household per year. We found that people satisfied with the current air pollutant information, and generally possessing relatively greater knowledge of UFPs, have higher WTP for a UFP monitoring and reporting system. We found that people are willing to pay more than the actual installation and operating costs of current air pollution monitoring systems. If the collected UFP data is disclosed in an easily accessible manner, as is current air pollutant data, it will be possible to secure more public acceptance for expanding the UFP monitoring and reporting system nationwide.
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Affiliation(s)
- Eunjung Cho
- Department of Industrial Engineering, College of Engineering, Yonsei University, 50 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722 South Korea
- Technical Analysis Center, National Institute of Green Technology, 173, Toegye-Ro, Jung-Gu, Seoul, 04554 South Korea
| | - Youngsang Cho
- Department of Industrial Engineering, College of Engineering, Yonsei University, 50 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722 South Korea
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20
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Zou H, Zhang S, Cai M, Qian ZM, Zhang Z, Chen L, Wang X, Arnold LD, Howard SW, Li H, Lin H. Ambient air pollution associated with incidence and progression trajectory of cardiometabolic diseases: A multi-state analysis of a prospective cohort. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 862:160803. [PMID: 36493826 DOI: 10.1016/j.scitotenv.2022.160803] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 12/05/2022] [Accepted: 12/05/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Previous studies on the association between ambient air pollution and cardiometabolic diseases (CMDs) focused on a single disease, without considering cardiometabolic multimorbidity (CMM) and the progression trajectory of CMDs. METHODS Based on the UK Biobank cohort, we included 372,530 participants aged 37-73 years at baseline (2006-2010) with follow-up until September 2021. Incident CMDs cases were identified based on self-reported information and multiple health-related records in the UK Biobank. CMM was defined as the occurrence of at least two CMDs, including ischemic heart disease (IHD), stroke and type 2 diabetes (T2D). Exposure to ambient air pollutants, including particulate matter (PM) with aerodynamic diameter ≤2.5 μm (PM2.5), ≤10 μm (PM10), nitrogen dioxide (NO2), and nitrogen oxides (NOx) were estimated at participants' geocoded residential addresses based on the high-resolution (1 × 1 km) pollution data from 2001 to 2021 provided by UK Department for Environment, Food and Rural Affairs. Multi-state models with adjustment for potential confounders were used to examine the impact of long-term exposure to ambient air pollution on transitions from healthy to first CMD (FCMD), subsequently to CMM, and further to death. RESULTS During a median follow-up of 12.6 years, 40,112 participants developed at least one CMD, 3896 developed CMM, and 21,739 died. Among the four pollutants, PM2.5 showed the strongest associations with all transitions from healthy to FCMD, to CMM, and then to death [hazard ratios (95 % confidence intervals) per interquartile range (IQR) increment: 1.62 (1.60, 1.64) and 1.68 (1.61, 1.76) for transitions from healthy to FCMD and from FCMD to CMM, and 1.62 (1.59, 1.66), 1.67 (1.61, 1.73), and 1.52 (1.38, 1.67) for death risk from healthy, FCMD, and CMM, respectively]. After dividing FCMDs into three specific CMDs, we found that ambient air pollution had differential impacts on disease-specific transitions within the same transition phase. CONCLUSIONS Our findings indicate that there is potential for air pollution mitigation in contributing to the prevention of the development and progression of CMDs.
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Affiliation(s)
- Hongtao Zou
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Shiyu Zhang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Miao Cai
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Zhengmin Min Qian
- Department of Epidemiology and Biostatistics, College for Public Health & Social Justice, Saint Louis University, Saint Louis, MO 63104, USA
| | - Zilong Zhang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Lan Chen
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Xiaojie Wang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Lauren D Arnold
- Department of Epidemiology and Biostatistics, College for Public Health & Social Justice, Saint Louis University, Saint Louis, MO 63104, USA
| | - Steven W Howard
- Department of Health Management and Policy, College for Public Health & Social Justice, Saint Louis University, Saint Louis, MO 63104, USA
| | - Haitao Li
- Department of Social Medicine and Health Service Management, Health Science Center, Shenzhen University, Shenzhen 518055, China
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
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21
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Keller K, Haghi SHR, Hahad O, Schmidtmann I, Chowdhury S, Lelieveld J, Münzel T, Hobohm L. Air pollution impacts on in-hospital case-fatality rate of ischemic stroke patients. Thromb Res 2023; 225:116-125. [PMID: 36990953 DOI: 10.1016/j.thromres.2023.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 03/15/2023] [Accepted: 03/17/2023] [Indexed: 03/29/2023]
Abstract
BACKGROUND A growing body of evidence suggests that air pollution exposure is associated with an increased risk for cardiovascular diseases. Data regarding the impact of long-term air pollution exposure on ischemic stroke mortality are sparse. METHODS The German nationwide inpatient sample was used to analyse all cases of hospitalized patients with ischemic stroke in Germany 2015-2019, which were stratified according to their residency. Data of the German Federal Environmental Agency regarding average values of air pollutants were assessed from 2015 to 2019 at district-level. Data were combined and the impact of different air pollution parameters on in-hospital case-fatality was analyzed. RESULTS Overall, 1,505,496 hospitalizations of patients with ischemic stroke (47.7% females; 67.4 % ≥70 years old) were counted in Germany 2015-2019, of whom 8.2 % died during hospitalization. When comparing patients with residency in federal districts with high vs. low long-term air pollution, enhanced levels of benzene (OR 1.082 [95%CI 1.034-1.132],P = 0.001), ozone (O3, OR 1.123 [95%CI 1.070-1.178],P < 0.001), nitric oxide (NO, OR 1.076 [95%CI 1.027-1.127],P = 0.002) and PM2.5 fine particulate matter concentrations (OR 1.126 [95%CI 1.074-1.180],P < 0.001) were significantly associated with increased case-fatality independent from age, sex, cardiovascular risk-factors, comorbidities, and revascularization treatments. Conversely, enhanced carbon monoxide, nitrogen dioxide, PM10, and sulphur dioxide (SO2) concentrations were not significantly associated with stroke mortality. However, SO2-concentrations were significantly associated with stroke-case-fatality rate of >8 % independent of residence area-type and area use (OR 1.518 [95%CI 1.012-2.278],P = 0.044). CONCLUSION Elevated long-term air pollution levels in residential areas in Germany, notably of benzene, O3, NO, SO2, and PM2.5, were associated with increased stroke mortality of patients. RESEARCH IN CONTEXT Evidence before this study: Besides typical, established risk factors, increasing evidence suggests that air pollution is an important and growing risk factor for stroke events, estimated to be responsible for approximately 14 % of all stroke-associated deaths. However, real-world data regarding the impact of long-term exposure to air pollution on stroke mortality are sparse. Added value of this study: The present study demonstrates that the long-term exposure to the air pollutants benzene, O3, NO, SO2 and PM2.5 are independently associated with increased case-fatality of hospitalized patients with ischemic stroke in Germany. Implications of all the available evidence: The results of our study support the urgent need to reduce the exposure to air pollution by tightening emission controls to reduce the stroke burden and stroke mortality.
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22
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Rehman A, Kumari R, Kamthan A, Tiwari R, Srivastava RK, van der Westhuizen FH, Mishra PK. Cell-free circulating mitochondrial DNA: An emerging biomarker for airborne particulate matter associated with cardiovascular diseases. Free Radic Biol Med 2023; 195:103-120. [PMID: 36584454 DOI: 10.1016/j.freeradbiomed.2022.12.083] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 12/16/2022] [Accepted: 12/20/2022] [Indexed: 12/29/2022]
Abstract
The association of airborne particulate matter exposure with the deteriorating function of the cardiovascular system is fundamentally driven by the impairment of mitochondrial-nuclear crosstalk orchestrated by aberrant redox signaling. The loss of delicate balance in retrograde communication from mitochondria to the nucleus often culminates in the methylation of the newly synthesized strand of mitochondrial DNA (mtDNA) through DNA methyl transferases. In highly metabolic active tissues such as the heart, mtDNA's methylation state alteration impacts mitochondrial bioenergetics. It affects transcriptional regulatory processes involved in biogenesis, fission, and fusion, often accompanied by the integrated stress response. Previous studies have demonstrated a paradoxical role of mtDNA methylation in cardiovascular pathologies linked to air pollution. A pronounced alteration in mtDNA methylation contributes to systemic inflammation, an etiological determinant for several co-morbidities, including vascular endothelial dysfunction and myocardial injury. In the current article, we evaluate the state of evidence and examine the considerable promise of using cell-free circulating methylated mtDNA as a predictive biomarker to reduce the more significant burden of ambient air pollution on cardiovascular diseases.
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Affiliation(s)
- Afreen Rehman
- Department of Molecular Biology, ICMR-National Institute for Research in Environmental Health, Bhopal, India.
| | - Roshani Kumari
- Department of Molecular Biology, ICMR-National Institute for Research in Environmental Health, Bhopal, India.
| | - Arunika Kamthan
- Department of Molecular Biology, ICMR-National Institute for Research in Environmental Health, Bhopal, India.
| | - Rajnarayan Tiwari
- Department of Molecular Biology, ICMR-National Institute for Research in Environmental Health, Bhopal, India.
| | | | | | - Pradyumna Kumar Mishra
- Department of Molecular Biology, ICMR-National Institute for Research in Environmental Health, Bhopal, India.
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23
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Gaines B, Kloog I, Zucker I, Ifergane G, Novack V, Libruder C, Hershkovitz Y, Sheffield PE, Yitshak-Sade M. Particulate Air Pollution Exposure and Stroke among Adults in Israel. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1482. [PMID: 36674236 PMCID: PMC9860673 DOI: 10.3390/ijerph20021482] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 01/06/2023] [Accepted: 01/08/2023] [Indexed: 05/13/2023]
Abstract
Stroke is the second most common cause of death and disability in the world. Many studies have found fine particulate matter (PM2.5) exposure to be associated with an increased risk of atherosclerotic cardiovascular disease, mostly focusing on ischemic heart disease and acute myocardial infarction. In a national analysis conducted in Israel-an area with unique climate conditions and high air pollution levels, we estimated the association between short-term PM2.5 exposure and ischemic stroke, intracerebral hemorrhage (ICH), or transient ischemic attacks (TIA). Using the Israeli National Stroke Registry, we obtained information on all stroke cases across Israel in 2014-2018. We obtained daily PM2.5 exposures from spatiotemporally resolved exposure models. We restricted the analytical data to days in which PM2.5 levels did not exceed the Israeli 24 h standard (37.5 µg/m3). We repeated the analysis with a stratification by sociodemographic characteristics and comorbidities. For all outcomes, the exposure-response curves were nonlinear. PM2.5 exposure was associated with a higher ischemic stroke risk, with larger effect estimates at higher exposure levels. Although nonsignificant, the exposure-response curve for TIA was similar. The associations with ICH were nonsignificant throughout the PM2.5 exposure distribution. The associations with ischemic stroke/TIA were larger among women, non-Jewish individuals, older adults, and individuals with diabetes, hypertension, and ischemic heart disease. In conclusion, short-term PM2.5 exposure is associated with a higher risk for ischemic stroke and possibly TIA, even when PM2.5 concentrations do not exceed the Israeli air quality guideline threshold. Vulnerability to the air pollution effects differed by age, sex, ethnicity, and comorbidities.
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Affiliation(s)
- Britney Gaines
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Itai Kloog
- Department of Geography and Environmental Development, Ben Gurion University, Beer Sheva 8410501, Israel
| | | | - Gal Ifergane
- Negev Environmental Health Research Institute, Soroka University Medical Center, Beer Sheva 8410101, Israel
- Neurology Department, Soroka University Medical Center, Beer Sheva 8410101, Israel
| | - Victor Novack
- Negev Environmental Health Research Institute, Soroka University Medical Center, Beer Sheva 8410101, Israel
- Clinical Research Center, Soroka University Medical Center, Beer Sheva 8410101, Israel
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 8410501, Israel
| | | | | | - Perry E. Sheffield
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Maayan Yitshak-Sade
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
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Dwivedi AK, Vishwakarma D, Dubey P, Reddy SY. Air Pollution and the Heart: Updated Evidence from Meta-analysis Studies. Curr Cardiol Rep 2022; 24:1811-1835. [PMID: 36434404 DOI: 10.1007/s11886-022-01819-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/18/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE OF REVIEW Although environmental exposure such as air pollution is detrimental to cardiovascular disease (CVD), the effects of different air pollutants on different CVD endpoints produced variable findings. We provide updated evidence between air pollutants and CVD outcomes including mitigation strategies with meta-analytic evidence. RECENT FINDINGS An increased exposure to any class of air pollutants including particulate matter (PM), gas, toxic metals, and disruptive chemicals has been associated with CVD events. Exposure to PM < 2.5 μm has been consistently associated with most heart diseases and stroke as well as CVDs among at-risk individuals. Despite this, there is no clinical approach available for systemic evaluation of air pollution exposure and management. A large number of epidemiological evidence clearly suggests the importance of air pollution prevention and control for reducing the risk of CVDs and mortality. Cost-effective and feasible strategies for air pollution monitoring, screening, and necessary interventions are urgently required among at-risk populations and those living or working, or frequently commuting in polluted areas.
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Affiliation(s)
- Alok Kumar Dwivedi
- Division of Biostatistics & Epidemiology, Department of Molecular and Translational Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, 5001, El Paso Drive, El Paso, TX, 79905, USA. .,Biostatistics and Epidemiology Consulting Lab, Office of Research, Texas Tech University Health Sciences Center El Paso, El Paso, TX, USA.
| | - Deepanjali Vishwakarma
- Division of Biostatistics & Epidemiology, Department of Molecular and Translational Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, 5001, El Paso Drive, El Paso, TX, 79905, USA
| | - Pallavi Dubey
- Department of Obstetrics and Gynecology, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX, USA
| | - Sireesha Y Reddy
- Department of Obstetrics and Gynecology, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX, USA
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Ma T, Yazdi MD, Schwartz J, Réquia WJ, Di Q, Wei Y, Chang HH, Vaccarino V, Liu P, Shi L. Long-term air pollution exposure and incident stroke in American older adults: A national cohort study. GLOBAL EPIDEMIOLOGY 2022; 4:100073. [PMID: 36644436 PMCID: PMC9838077 DOI: 10.1016/j.gloepi.2022.100073] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 04/12/2022] [Accepted: 04/12/2022] [Indexed: 01/19/2023] Open
Abstract
Aims Stroke is a leading cause of death and disability for Americans, and growing evidence suggests that air pollution may play an important role. To facilitate pollution control efforts, the National Academy of Sciences and the World Health Organization have prioritized determining which air pollutants are most toxic. However, evidence is limited for the simultaneous effects of multiple air pollutants on stroke. Methods and results We constructed a nationwide population-based cohort study, using the Medicare Chronic Conditions Warehouse (2000-2017) and high-resolution air pollution data, to investigate the impact of long-term exposure to ambient PM2.5, NO2, and ground-level O3 on incident stroke. Hazard ratios (HR) for stroke incidence were estimated using single-, bi-, and tri-pollutant Cox proportional hazards models. We identified ~2.2 million incident stroke cases among 17,443,900 fee-for-service Medicare beneficiaries. Per interquartile range (IQR) increase in the annual average PM2.5 (3.7 μg/m3), NO2 (12.4 ppb), and warm-season O3 (6.5 ppb) one-year prior to diagnosis, the HRs were 1.022 (95% CI: 1.017-1.028), 1.060 (95% CI: 1.054-1.065), and 1.021 (95% CI: 1.017-1.024), respectively, from the tri-pollutant model. There was strong evidence of linearity in concentration-response relationships for all three air pollutants in single-pollutant models. This linear relationship remained robust for NO2 and O3 in tri-pollutant models while the effect of PM2.5 attenuated at the lower end of concentrations. Conclusion Using a large nationwide cohort, our study suggests that long-term exposure to PM2.5, NO2, and O3 may independently increase the risk of stroke among the US elderly, among which traffic-related air pollution plays a particularly crucial role.
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Affiliation(s)
- Tszshan Ma
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Mahdieh Danesh Yazdi
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Weeberb J. Réquia
- School of Public Policy and Government, Fundação Getúlio Vargas, Brasília, Distrito Federal, Brazil
| | - Qian Di
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Yaguang Wei
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Howard H. Chang
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Viola Vaccarino
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Pengfei Liu
- School of Earth and Atmospheric Sciences, Georgia Institute of Technology, Atlanta, GA, USA
| | - Liuhua Shi
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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Kim EH, Choi S, Kim D, Park HJ, Bian Y, Choi SH, Chung HY, Bae ON. Amine-modified nanoplastics promote the procoagulant activation of isolated human red blood cells and thrombus formation in rats. Part Fibre Toxicol 2022; 19:60. [PMID: 36104730 PMCID: PMC9472436 DOI: 10.1186/s12989-022-00500-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 08/30/2022] [Indexed: 12/03/2022] Open
Abstract
Background Microplastics (MPs) and nanoplastics (NPs) formed from decomposed plastic are increasing environmental threats. Although MPs and NPs exposed through various routes enter the systemic circulation, the potential toxicity of those is largely unknown. We investigated whether polystyrene NPs (PS-NPs) promote the coagulation activity of red blood cells (RBCs). Results We tested several types of PS-NPs using human RBCs and found that amine-modified 100 nm PS-NPs were the most potent. We measured the uptake of PS-NPs using flow cytometry and confocal microscopy. Electron microscopy revealed morphological changes of RBCs by PS-NPs. PS-NPs induced the externalization of phosphatidylserine, generation of microvesicles in RBCs, and perturbations in the intracellular microenvironment. PS-NPs increased the activity of scramblases responsible for phospholipid translocation in RBCs. PS-NPs modulated the functional interaction to adjacent tissues and coagulation cascade, enhancing RBC adhesion and thrombin generation. Our observations in human RBCs were consistent with those in isolated rat RBCs, showing no inter-species differences. In rat venous thrombosis models, the intravenous administration of PS-NPs enhanced thrombus formation.
Conclusion Amine-modified PS-NPs induce the prothrombotic activation of RBCs causing thrombus formation. We believe that our study will contribute to understanding the potential toxicity of amine-modified polystyrene particles in blood cells and cardiovascular systems. Supplementary Information The online version contains supplementary material available at 10.1186/s12989-022-00500-y.
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Xiong Q, Tian X, Xu C, Ma B, Liu W, Sun B, Ru Q, Shu X. PM 2 .5 exposure-induced ferroptosis in neuronal cells via inhibiting ERK/CREB pathway. ENVIRONMENTAL TOXICOLOGY 2022; 37:2201-2213. [PMID: 35608139 DOI: 10.1002/tox.23586] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 03/25/2022] [Accepted: 05/06/2022] [Indexed: 05/16/2023]
Abstract
PM2.5 exposure has been demonstrated to correlate with neurological disorders recently. Ferroptosis is recognized as a newly found programmed form of cell death associated with neurodegenerative diseases, while glutathione peroxidase 4 (GPX4) is a key regulator of ferroptosis. However, the relationship between PM2.5 -induced neurotoxicity and ferroptosis is still unclear. The current study aims to investigate if ferroptosis is involved in neurotoxicity post PM2.5 exposure and its underlying mechanism. The PM2.5 -treated neuronal Neuro-2a (N2A) and SH-SY5Y cells were applied to the current study. The results showed that PM2.5 significantly increased the neuronal cell death, yet the ferroptosis antagonist Ferrostain-1 (Fer-1) markedly decreased the cell death induced by PM2.5 . Western blot further confirmed that ferroptosis was triggered post PM2.5 treatment in N2A cells by decreasing expressions of GPX4 and ferritin heavy chain (FTH), as well as enhancing expressions of ferritin light chain (FTL) and transferrin receptor protein (TFRC). Meanwhile, PM2.5 treatment augmented neuronal oxidative damage and mitochondrial dysfunction. The bioinformatic analysis indicated that CREB could be the regulator of GPX4, and our results showed that ERK/CREB pathway was down-regulated in N2A cells post PM2.5 treatment. The addition of ERK1/2 agonist post PM2.5 treatment significantly inhibit ferroptosis via increasing the expression of GPX4. Taken together, the present study demonstrated that PM2.5 -induced ferroptosis via inhibiting ERK/CREB pathway, and these findings will advance our knowledge of PM2.5 -induced cytotoxicity in the nervous system.
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Affiliation(s)
- Qi Xiong
- Wuhan Institute of Biomedical Sciences, School of Medicine, Jianghan University, Wuhan Economic and Technological Development Zone, Wuhan, People's Republic of China
| | - Xiang Tian
- Wuhan Institute of Biomedical Sciences, School of Medicine, Jianghan University, Wuhan Economic and Technological Development Zone, Wuhan, People's Republic of China
| | - Congyue Xu
- Wuhan Institute of Biomedical Sciences, School of Medicine, Jianghan University, Wuhan Economic and Technological Development Zone, Wuhan, People's Republic of China
| | - Baomiao Ma
- Wuhan Institute of Biomedical Sciences, School of Medicine, Jianghan University, Wuhan Economic and Technological Development Zone, Wuhan, People's Republic of China
| | - Wei Liu
- Wuhan Institute of Biomedical Sciences, School of Medicine, Jianghan University, Wuhan Economic and Technological Development Zone, Wuhan, People's Republic of China
| | - Binlian Sun
- Wuhan Institute of Biomedical Sciences, School of Medicine, Jianghan University, Wuhan Economic and Technological Development Zone, Wuhan, People's Republic of China
| | - Qin Ru
- Wuhan Institute of Biomedical Sciences, School of Medicine, Jianghan University, Wuhan Economic and Technological Development Zone, Wuhan, People's Republic of China
- Wuhan Economic and Technological Development Zone, Jianghan University, Wuhan City, China
| | - Xiji Shu
- Wuhan Institute of Biomedical Sciences, School of Medicine, Jianghan University, Wuhan Economic and Technological Development Zone, Wuhan, People's Republic of China
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Khosravipour M, Safari-Faramani R, Rajati F, Omidi F. The long-term effect of exposure to respirable particulate matter on the incidence of myocardial infarction: a systematic review and meta-analysis study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:42347-42371. [PMID: 35355187 DOI: 10.1007/s11356-022-18986-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 01/27/2022] [Indexed: 06/14/2023]
Abstract
Although several studies have investigated the long-term association of respirable particulate matter (PM ≤ 10 µm) with the incidence of myocardial infarction (MI), this association is inconclusive or even contradictory. This systematic review and meta-analysis study aimed to quantify the long-term effect of exposure to respirable PM on the incidence of MI. To find relevant publications, online databases, including Scopus, PubMed, and Web of Science, were searched on October 10, 2021. A random-effect model was used to calculate the pooled hazard ratio (HR) and 95% confidence interval (95% CI) of MI across studies. Heterogeneity was presented with reporting I2 index. Of 4591 records found in the primary searching, the number of 24 prospective cohort studies with more than 70 million participants was included. The pooled HR (95% CI) of MI per 1 µg/m3 increment of respirable PM was estimated as 1.01 (1.00, 1.01). Subgroup analyses according to aerodynamic diameter of PM showed an only significant stronger risk of MI per 1 µg/m3 increase in PM with aerodynamic diameter < 2.5 µm (HR = 1.01, 95% CI = 1.00, 1.01). No sex difference was found in the association of respirable PM with MI incidence. There was only a significant association among studies defined MI as ICD-10: I21 code (HR = 1.01, 95% CI = 1.00, 1.01) and studies defined MI as ICD-10: I21-22 (HR = 1.02, 95% CI = 1.00, 1.04). No significant publication bias was observed across studies. In conclusion, this study confirms a significant association between long-term exposure to respirable PM air pollution and development of MI.
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Affiliation(s)
- Masoud Khosravipour
- Department of Occupational Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Safari-Faramani
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Department of Epidemiology, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Fatemeh Rajati
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Fariborz Omidi
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Department of Occupational Health Engineering, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
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de Bont J, Jaganathan S, Dahlquist M, Persson Å, Stafoggia M, Ljungman P. Ambient air pollution and cardiovascular diseases: An umbrella review of systematic reviews and meta-analyses. J Intern Med 2022; 291:779-800. [PMID: 35138681 PMCID: PMC9310863 DOI: 10.1111/joim.13467] [Citation(s) in RCA: 147] [Impact Index Per Article: 73.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The available evidence on the effects of ambient air pollution on cardiovascular diseases (CVDs) has increased substantially. In this umbrella review, we summarized the current epidemiological evidence from systematic reviews and meta-analyses linking ambient air pollution and CVDs, with a focus on geographical differences and vulnerable subpopulations. We performed a search strategy through multiple databases including articles between 2010 and 31 January 2021. We performed a quality assessment and evaluated the strength of evidence. Of the 56 included reviews, the most studied outcomes were stroke (22 reviews), all-cause CVD mortality, and morbidity (19). The strongest evidence was found between higher short- and long-term ambient air pollution exposure and all-cause CVD mortality and morbidity, stroke, blood pressure, and ischemic heart diseases (IHD). Short-term exposures to particulate matter <2.5 μm (PM2.5 ), <10 μm (PM10 ), and nitrogen oxides (NOx ) were consistently associated with increased risks of hypertension and triggering of myocardial infarction (MI), and stroke (fatal and nonfatal). Long-term exposures of PM2.5 were largely associated with increased risk of atherosclerosis, incident MI, hypertension, and incident stroke and stroke mortality. Few reviews evaluated other CVD outcomes including arrhythmias, atrial fibrillation, or heart failure but they generally reported positive statistical associations. Stronger associations were found in Asian countries and vulnerable subpopulations, especially among the elderly, cardiac patients, and people with higher weight status. Consistent with experimental data, this comprehensive umbrella review found strong evidence that higher levels of ambient air pollution increase the risk of CVDs, especially all-cause CVD mortality, stroke, and IHD. These results emphasize the importance of reducing the alarming levels of air pollution across the globe, especially in Asia, and among vulnerable subpopulations.
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Affiliation(s)
- Jeroen de Bont
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Suganthi Jaganathan
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Centre for Environmental Health, Public Health Foundation of India, Delhi-NCR, India.,Centre for Chronic Disease Control, New Delhi, India
| | - Marcus Dahlquist
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Åsa Persson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Massimo Stafoggia
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Department of Epidemiology, Lazio Region Health Service, Rome, Italy
| | - Petter Ljungman
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Department of Cardiology, Danderyd University Hospital, Danderyd, Sweden
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Carlsen HK, Andersson EM, Molnár P, Oudin A, Xu Y, Wichmann J, Spanne M, Stroh E, Engström G, Stockfelt L. Incident cardiovascular disease and long-term exposure to source-specific air pollutants in a Swedish cohort. ENVIRONMENTAL RESEARCH 2022; 209:112698. [PMID: 35074356 DOI: 10.1016/j.envres.2022.112698] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 01/04/2022] [Accepted: 01/05/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Air pollution is associated with cardiovascular morbidity and mortality, but its role in the development of congestive heart failure (CHF) and the role of different pollution sources in cardiovascular disease remain uncertain. METHODS Participants were enrolled in the Malmö Diet and Cancer cohort in 1991-1996 with information on lifestyle and clinical indicators of cardiovascular disease. The cohort participants were followed through registers until 2016. Annual total and local source-specific concentrations of particulate matter less than 10 μm and 2.5 μm (PM10 and PM2.5), black carbon (BC), and nitrogen oxides (NOx) from traffic, residential heating, and industry were assigned to each participant's address throughout the study period. Cox proportional hazards models adjusted for possible confounders was used to estimate associations between air pollution 1-5 years prior to outcomes of incident CHF, fatal myocardial infarction (MI), major adverse coronary events (MACE), and ischemic stroke. RESULTS Air pollution exposure levels (mean annual exposures to PM2.5 of 11 μg/m3 and NOx of 26 μg/m3) within the cohort were moderate in terms of environmental standards. After adjusting for confounders, we observed statistically significant associations between NOx and CHF (hazard ratio [HR] 1.11, 95% confidence interval [CI] 1.01-1.22) and NOx and fatal MI (HR 1.10, 95%CI 1.01-1.20) per interquartile range (IQR) of 9.6 μg/m3. In fully adjusted models, the estimates were similar, but the precision worse. In stratified analyses, the associations were stronger in males, ever-smokers, older participants, and those with baseline carotid artery plaques. Locally emitted and traffic-related air pollutants generally showed positive associations with CHF and fatal MI. There were no associations between air pollution and MACE or stroke. DISCUSSION/CONCLUSION In an area with low to moderate air pollution exposure, we observed significant associations of long-term residential NOx with increased risk of incident CHF and fatal MI, but not with coronary events and stroke.
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Affiliation(s)
- Hanne Krage Carlsen
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Eva M Andersson
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Peter Molnár
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Anna Oudin
- Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Sweden; Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Sweden
| | - Yiyi Xu
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Janine Wichmann
- School of Health Systems and Public Health, University of Pretoria, South Africa
| | - Mårten Spanne
- Environmental Department of the City of Malmö, Sweden
| | - Emilie Stroh
- Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Sweden
| | - Gunnar Engström
- Department of Clinical Sciences at Malmö, CRC, Lund University and Skåne University Hospital, Malmö, Sweden
| | - Leo Stockfelt
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
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Cho E, Kang Y, Cho Y. Effects of Fine Particulate Matter on Cardiovascular Disease Morbidity: A Study on Seven Metropolitan Cities in South Korea. Int J Public Health 2022; 67:1604389. [PMID: 35652123 PMCID: PMC9149776 DOI: 10.3389/ijph.2022.1604389] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 03/02/2022] [Indexed: 11/25/2022] Open
Abstract
Objectives: The primary purpose of this study is to analyze the relationship between the first occurrence of hospitalization for cardiovascular disease (CVD) and particulate matter less than 2.5 μm in diameter (PM2.5) exposure, considering average PM2.5 concentration and the frequency of high PM2.5 concentration simultaneously. Methods: We used large-scale cohort data from seven metropolitan cities in South Korea. We estimated hazard ratios (HRs) and 95% confidence intervals (CIs) using the Cox proportional-hazards model, including annual average PM2.5 and annual hours of PM2.5 concentration exceeding 55.5 μg/m3 (FH55). Results: We found that the risk was elevated by 11.6% (95% CI, 9.7–13.6) for all CVD per 2.9 μg/m3 increase of average PM2.5. In addition, a 94-h increase in FH55 increased the risk of all CVD by 3.8% (95% CI, 2.8–4.7). Regarding stroke, we found that people who were older and had a history of hypertension were more vulnerable to PM2.5 exposure. Conclusion: Based on the findings, we conclude that accurate forecasting, information dissemination, and timely warning of high concentrations of PM2.5 at the national level may reduce the risk of CVD occurrence.
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Affiliation(s)
- Eunjung Cho
- Department of Industrial Engineering, Yonsei University, Seoul, South Korea
| | | | - Youngsang Cho
- Department of Industrial Engineering, Yonsei University, Seoul, South Korea
- *Correspondence: Youngsang Cho,
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Lo WC, Ho CC, Tseng E, Hwang JS, Chan CC, Lin HH. Long-term exposure to ambient fine particulate matter (PM2.5) and associations with cardiopulmonary diseases and lung cancer in Taiwan: a nationwide longitudinal cohort study. Int J Epidemiol 2022; 51:1230-1242. [PMID: 35472171 DOI: 10.1093/ije/dyac082] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 04/10/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Although a number of studies have reported on the health effects of fine particulate matter (PM2.5) exposure, particularly in North American and European countries as well as China, the evidence about intermediate to high levels of PM2.5 exposures is still limited. We aimed to investigate the associations between long-term exposure to PM2.5 and risk of cardiopulmonary disease incidence in Taiwan with intermediate levels of PM2.5 exposure. METHODS A cohort of Taiwanese adults, who participated in the 2001, 2005, 2009 and 2013 National Health Interview Surveys, was followed through 2016 to identify cardiopulmonary disease onset. Exposure to PM2.5 was estimated by incorporating a widespread monitoring network of air quality monitoring stations and microsensors. We used time-dependent Cox regression models to examine the associations between the PM2.5 exposures and health outcomes, adjusting for individual characteristics and ecological covariates. The natural cubic spline functions were used to explore the non-linear effects of the PM2.5 exposure. RESULTS A total of 62 694 adults from 353 towns were enrolled. Each 10-μg/m3 increase in 5-year average exposure to PM2.5 was associated with a 4.8% increased risk of incident ischaemic heart disease (95% CI: -3.3, 13.6), 3.9% increased risk of incident stroke (95% CI: -2.9, 11.1), 6.7% increased risk of incident diabetes (95% CI: 1.1, 12.7), 15.7% increased risk of incident lung cancer (95% CI: -0.9, 35.1) and 11.5% increased risk of incident chronic obstructive pulmonary disease (95% CI: -0.8, 25.2). The concentration-response curve showed that there was no statistical evidence of non-linearity for most of the disease outcomes except for ischaemic heart disease (P for non-linearity = 0.014). CONCLUSIONS Long-term exposure to intermediate levels of ambient PM2.5 was associated with cardiopulmonary health outcomes. Our study adds value to future application and national burden of disease estimation in evaluating the health co-benefits from ambient air pollution reduction policy in Asian countries.
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Affiliation(s)
- Wei-Cheng Lo
- Master Program in Applied Epidemiology, College of Public Health, Taipei Medical University.,Institute of Statistical Science, Academia Sinica, Taipei, Taiwan
| | - Chi-Chang Ho
- Institute of Statistical Science, Academia Sinica, Taipei, Taiwan
| | - Eva Tseng
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | | | - Hsien-Ho Lin
- Institute of Epidemiology and Preventive Medicine.,Global Health Program, College of Public Health, National Taiwan University, Taipei, Taiwan
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Chen PC, Sung FC, Mou CH, Chen CW, Tsai SP, Hsieh DHP, Hsu CY. A cohort study evaluating the risk of stroke associated with long-term exposure to ambient fine particulate matter in Taiwan. Environ Health 2022; 21:43. [PMID: 35439956 PMCID: PMC9017007 DOI: 10.1186/s12940-022-00854-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 04/11/2022] [Indexed: 05/06/2023]
Abstract
BACKGROUND Evidences have shown that the stroke risk associated with long-term exposure to particulate matter with an aerodynamic diameter of ≤2.5 μm (PM2.5) varies among people in North America, Europe and Asia, but studies in Asia rarely evaluated the association by stroke type. We examined whether long-term exposure to PM2.5 is associated with developing all strokes, ischemic stroke and hemorrhagic stroke. METHODS The retrospective cohort study consisted of 1,362,284 adults identified from beneficiaries of a universal health insurance program in 2011. We obtained data on air pollutants and meteorological measurements from air quality monitoring stations across Taiwan in 2010-2015. Annual mean levels of all environmental measurements in residing areas were calculated and assigned to cohort members. We used Cox proportional hazards models to estimate hazard ratio (HR) and 95% confidence interval (CI) of developing stroke associated with 1-year mean levels of PM2.5 at baseline in 2010, and yearly mean levels from 2010 to 2015 as the time-varying exposure, adjusting for age, sex, income and urbanization level. RESULTS During a median follow-up time of 6.0 years, 12,942 persons developed strokes, 9919 (76.6%) were ischemic. The adjusted HRs (95% CIs) per interquartile range increase in baseline 1-year mean PM2.5 were 1.03 (1.00-1.06) for all stroke, 1.06 (1.02-1.09) for ischemic stroke, and 0.95 (0.89-1.10) for hemorrhagic stroke. The concentration-response curves estimated in the models with and without additional adjustments for other environmental measurements showed a positively linear association between baseline 1-year mean PM2.5 and ischemic stroke at concentrations greater than 30 μg/m3, under which no evidence of association was observed. There was an indication of an inverse association between PM2.5 and hemorrhagic stroke, but the association no longer existed after controlling for nitrogen dioxide or ozone. We found similar shape of the concentration-response association in the Cox regression models with time-varying PM2.5 exposures. CONCLUSION Long-term exposure to PM2.5 might be associated with increased risk of developing ischemic stroke. The association with high PM2.5 concentrations remained significant after adjustment for other environmental factors.
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Affiliation(s)
- Pei-Chun Chen
- Department of Public Health, China Medical University College of Public Health, 100 Jingmao Rd Sec. 1, Taichung, 406040, Taiwan.
| | - Fung-Chang Sung
- Department of Health Services Administration, China Medical University College of Public Health, 100 Jingmao Rd Sec. 1, Taichung, 406040, Taiwan.
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.
- Department of Food Nutrition and Health Biotechnology, Asia University, Taichung, Taiwan.
| | - Chih-Hsin Mou
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Chao W Chen
- University of Maryland Global Campus, Adelphi, MD, USA
| | - Shan P Tsai
- School of Public Health, Texas A&M University, College Station, TX, USA
| | - Dennis H P Hsieh
- Department of Environmental Toxicology, University of California, Davis, CA, USA
| | - Chung Y Hsu
- Graduate Institute of Biomedical Sciences, China Medical University College of Public Health, Taichung, Taiwan
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Health Effects of Long-Term Exposure to Ambient PM 2.5 in Asia-Pacific: a Systematic Review of Cohort Studies. Curr Environ Health Rep 2022; 9:130-151. [PMID: 35292927 PMCID: PMC9090712 DOI: 10.1007/s40572-022-00344-w] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2022] [Indexed: 12/21/2022]
Abstract
Abstract Purpose of Review Health effects of long-term exposure to ambient PM2.5 vary with regions, and 75% of the deaths attributable to PM2.5 were estimated in Asia-Pacific in 2017. This systematic review aims to summarize the existing evidence from cohort studies on health effects of long-term exposure to ambient PM2.5 in Asia-Pacific. Recent Findings In Asia-Pacific, 60 cohort studies were conducted in Australia, Mainland China, Hong Kong, Taiwan, and South Korea. They consistently supported associations of long-term exposure to PM2.5 with increased all-cause/non-accidental and cardiovascular mortality as well as with incidence of cardiovascular diseases, type 2 diabetes mellitus, kidney diseases, and chronic obstructive pulmonary disease. Evidence for other health effects was limited. Inequalities were identified in PM2.5-health associations. Summary To optimize air pollution control and public health prevention, further studies need to assess the health effects of long-term PM2.5 exposure in understudied regions, the health effects of long-term PM2.5 exposure on mortality and risk of type 2 diabetes mellitus, renal diseases, dementia and lung cancer, and inequalities in PM2.5-health associations. Study design, especially exposure assessment methods, should be improved. Supplementary Information The online version contains supplementary material available at 10.1007/s40572-022-00344-w.
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Zang ST, Wu QJ, Li XY, Gao C, Liu YS, Jiang YT, Zhang JY, Sun H, Chang Q, Zhao YH. Long-term PM 2.5 exposure and various health outcomes: An umbrella review of systematic reviews and meta-analyses of observational studies. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 812:152381. [PMID: 34914980 DOI: 10.1016/j.scitotenv.2021.152381] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 12/09/2021] [Accepted: 12/09/2021] [Indexed: 06/14/2023]
Abstract
Adverse effects from exposure to particulate matter <2.5 μm in diameter (PM2.5) on health-related outcomes have been found in a range of experimental and epidemiological studies. This study aimed to assess the significance, validity, and reliability of the relationship between long-term PM2.5 exposure and various health outcomes. The Embase, PubMed, Web of Science, CNKI, WANFANG, VIP, and SinoMed databases and reference lists of the retrieved review articles were searched to obtain meta-analysis and systematic reviews focusing on PM2.5-related outcomes as of August 31, 2021. Random-/fixed-effects models were applied to estimate summary effect size and 95% confidence intervals (CIs). The quality of included meta-analyses was evaluated based on the AMSTAR 2 tool. Small-study effect and excess significance bias studies were conducted to further assess the associations. Registered PROSPERO number: CRD42020200606. This included 24 articles involving 71 associations between PM2.5 exposure and the health outcomes. The evidence for the positive association of 10 μg/m3 increments of long-term exposure to PM2.5 and stroke incidence in Europe was convincing (effect size = 1.07, 95% CI: 1.05-1.10). There was evidence that was highly suggestive of a positive association between 10 μg/m3 increments of long-term exposure to PM2.5 and the following health-related outcomes: mortality of lung cancer (effect size = 1.11, 95% CI: 1.08-1.13) and Alzheimer's disease (effect size = 4.79, 95% CI: 2.79-8.21). There was highly suggestive evidence that chronic obstructive pulmonary disease risk is positively associated with higher long-term PM2.5 exposure versus lower long-term PM2.5 exposure (effect size = 2.32, 95% CI: 1.88-2.86). In conclusion, the positive association of long-term exposure to PM2.5 and stroke incidence in Europe was convincing. Given the validity of numerous associations of long-term exposure to PM2.5 and health-related outcomes is subject to biases, more robust evidence is urgently needed.
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Affiliation(s)
- Si-Tian Zang
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China; Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.
| | - Qi-Jun Wu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China; Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.
| | - Xin-Yu Li
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China; Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Chang Gao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China; Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Ya-Shu Liu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China; Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Yu-Ting Jiang
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China; Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Jia-Yu Zhang
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China; Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Hui Sun
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China; Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Qing Chang
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China; Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.
| | - Yu-Hong Zhao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China; Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.
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Olaniyan T, Pinault L, Li C, van Donkelaar A, Meng J, Martin RV, Hystad P, Robichaud A, Ménard R, Tjepkema M, Bai L, Kwong JC, Lavigne E, Burnett RT, Chen H. Ambient air pollution and the risk of acute myocardial infarction and stroke: A national cohort study. ENVIRONMENTAL RESEARCH 2022; 204:111975. [PMID: 34478722 DOI: 10.1016/j.envres.2021.111975] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 07/27/2021] [Accepted: 08/24/2021] [Indexed: 05/07/2023]
Abstract
We used a large national cohort in Canada to assess the incidence of acute myocardial infarction (AMI) and stroke hospitalizations in association with long-term exposure to fine particulate matter (PM2.5), nitrogen dioxide (NO2), and ozone (O3). The study population comprised 2.7 million respondents from the 2006 Canadian Census Health and Environment Cohort (CanCHEC), followed for incident hospitalizations of AMI or stroke between 2006 and 2016. We estimated 10-year moving average estimates of PM2.5, NO2, and O3, annually. We used Cox proportional hazards models to examine the associations adjusting for various covariates. For AMI, each interquartile range (IQR) increase in exposure was found to be associated with a hazard ratio of 1.026 (95% CI: 1.007-1.046) for PM2.5, 1.025 (95% CI: 1.001-1.050) for NO2, and 1.062 (95% CI: 1.041-1.084) for O3, respectively. Similarly, for stroke, an IQR increase in exposure was associated with a hazard ratio of 1.078 (95% CI: 1.052-1.105) for PM2.5, 0.995 (95% CI: 0.965-1.030) for NO2, and 1.055 (95% CI: 1.028-1.082) for O3, respectively. We found consistent evidence of positive associations between long-term exposures to PM2.5, and O3, and to a lesser degree NO2, with incident AMI and stroke hospitalizations.
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Affiliation(s)
- Toyib Olaniyan
- Health Analysis Division, Statistics Canada, 100 Tunney's Pasture Driveway, Ottawa, Ontario, K1A 0T6, Canada.
| | - Lauren Pinault
- Health Analysis Division, Statistics Canada, 100 Tunney's Pasture Driveway, Ottawa, Ontario, K1A 0T6, Canada.
| | - Chi Li
- Department of Chemistry, University of California, Berkeley, CA, 94720, United States.
| | - Aaron van Donkelaar
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Nova Scotia, B3H 3J5, Canada; Department of Energy, Environment & Chemical Engineering, Washington University in St Louis, St Louis, MO, 63130, United States.
| | - Jun Meng
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Nova Scotia, B3H 3J5, Canada.
| | - Randall V Martin
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Nova Scotia, B3H 3J5, Canada; Department of Energy, Environment & Chemical Engineering, Washington University in St Louis, St Louis, MO, 63130, United States.
| | - Perry Hystad
- School of Biological & Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, 97331, United States.
| | - Alain Robichaud
- Air Quality Research Division, Environment and Climate Change Canada, Dorval, Québec, H9P 1J3, Canada.
| | - Richard Ménard
- Air Quality Research Division, Environment and Climate Change Canada, Dorval, Québec, H9P 1J3, Canada.
| | - Michael Tjepkema
- Health Analysis Division, Statistics Canada, 100 Tunney's Pasture Driveway, Ottawa, Ontario, K1A 0T6, Canada.
| | - Li Bai
- ICES, Toronto, Ontario, M4N 3M5, Canada.
| | - Jeffrey C Kwong
- ICES, Toronto, Ontario, M4N 3M5, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, M5T 3M7, Canada; Public Health Ontario, Toronto, Ontario, M5G 1V5, Canada.
| | - Eric Lavigne
- Air Health Science Division, Health Canada, Ottawa, Ontario, K1A 0L4, Canada; School of Epidemiology & Public Health, University of Ottawa, Ottawa, Ontario, K1N 6N5, Canada.
| | - Richard T Burnett
- Institute of Health Metrics & Evaluation, University of Washington, Seattle, WA, 98121, United States; Population Studies Division, Environmental Health and Research Bureau, Health Canada, Ottawa, Ontario K1A 0T6, Canada.
| | - Hong Chen
- ICES, Toronto, Ontario, M4N 3M5, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, M5T 3M7, Canada; Public Health Ontario, Toronto, Ontario, M5G 1V5, Canada; Population Studies Division, Environmental Health and Research Bureau, Health Canada, Ottawa, Ontario K1A 0T6, Canada.
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Avellaneda-Gómez C, Vivanco-Hidalgo RM, Olmos S, Lazcano U, Valentin A, Milà C, Ambrós A, Roquer J, Tonne C. Air pollution and surrounding greenness in relation to ischemic stroke: A population-based cohort study. ENVIRONMENT INTERNATIONAL 2022; 161:107147. [PMID: 35180670 DOI: 10.1016/j.envint.2022.107147] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/28/2022] [Accepted: 02/08/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Evidence for the association between environmental exposures and ischemic stroke (IS) is limited and inconsistent. We aimed to assess the relationship between exposure to air pollutants, residential surrounding greenness, and incident IS, and to identify population subgroups particularly sensitive to these exposures. METHODS We used data from administrative health registries of the public healthcare system in Catalonia, Spain to construct a cohort of individuals aged 18 years and older without a previous stroke diagnosis at 1st January 2016 (n = 3 521 274). We collected data on sociodemographic characteristics and cerebrovascular risk factors, and derived exposure at the participant's residence to ambient levels of fine particulate matter (PM2.5), black carbon (BC), nitrogen dioxide (NO2), and Normalized Difference Vegetation Index (NDVI) in a 300 m buffer as an indicator of greenness. The primary outcome was IS diagnosis at any point during the follow-up. We used Cox proportional hazards models to estimate associations between environmental exposures and incident IS and stratified analyses to investigate effect modification. RESULTS Between 1st January 2016 and 31st December 2017, 10 865 individuals were admitted to public hospitals with an IS diagnosis. Median exposure levels were: 17 µg/m3 PM2.5, 35 µg/m3 NO2, 2.28 µg/m3 BC and 0.27 NDVI. Individuals with higher residential exposure to air pollution were at greater risk of IS: HR 1·04 (95% CI:0·99-1·10) per 5 µg/m3 of PM2.5; HR 1.05 (95% CI:1·00-1·10) per 1 µg/m3 of BC; HR 1·04 (95% CI:1·03-1·06) per 10 µg/m3 of NO2. Conversely, individuals with higher residential surrounding green space, had lower risk of IS (HR 0·84; CI 95%:0·7-1.0). There was no evidence of effect modification by individual characteristics. CONCLUSIONS Higher incidence of IS was observed in relation to long-term exposures to air pollution, particularly NO2, in a region that meets European health-based air quality standards. Residential surrounding greenness was associated with lower incidence of IS.
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Affiliation(s)
- C Avellaneda-Gómez
- Neurology Department, IMIM-Hospital del Mar, Barcelona, Spain; Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; Complex Hospitalari Moisès Broggi, Consorci Sanitari Integral, Barcelona, Spain.
| | - R M Vivanco-Hidalgo
- Neurology Department, IMIM-Hospital del Mar, Barcelona, Spain; Agency for Health Quality and Assessment of Catalonia (AQuAS), Barcelona, Spain.
| | - S Olmos
- ISGlobal, Barcelona, Spain; CIBER epidemiología y salud pública (CIBERESP), Madrid, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain.
| | - U Lazcano
- Agency for Health Quality and Assessment of Catalonia (AQuAS), Barcelona, Spain.
| | - A Valentin
- ISGlobal, Barcelona, Spain; CIBER epidemiología y salud pública (CIBERESP), Madrid, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain.
| | - C Milà
- ISGlobal, Barcelona, Spain; CIBER epidemiología y salud pública (CIBERESP), Madrid, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain.
| | - A Ambrós
- ISGlobal, Barcelona, Spain; CIBER epidemiología y salud pública (CIBERESP), Madrid, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain.
| | - J Roquer
- Neurology Department, IMIM-Hospital del Mar, Barcelona, Spain; Universitat Autònoma de Barcelona (UAB), Barcelona, Spain.
| | - C Tonne
- ISGlobal, Barcelona, Spain; CIBER epidemiología y salud pública (CIBERESP), Madrid, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain.
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Kriit HK, Andersson EM, Carlsen HK, Andersson N, Ljungman PLS, Pershagen G, Segersson D, Eneroth K, Gidhagen L, Spanne M, Molnar P, Wennberg P, Rosengren A, Rizzuto D, Leander K, Yacamán-Méndez D, Magnusson PKE, Forsberg B, Stockfelt L, Sommar JN. Using Distributed Lag Non-Linear Models to Estimate Exposure Lag-Response Associations between Long-Term Air Pollution Exposure and Incidence of Cardiovascular Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052630. [PMID: 35270332 PMCID: PMC8909720 DOI: 10.3390/ijerph19052630] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 02/18/2022] [Accepted: 02/23/2022] [Indexed: 12/23/2022]
Abstract
Long-term air pollution exposure increases the risk for cardiovascular disease, but little is known about the temporal relationships between exposure and health outcomes. This study aims to estimate the exposure-lag response between air pollution exposure and risk for ischemic heart disease (IHD) and stroke incidence by applying distributed lag non-linear models (DLNMs). Annual mean concentrations of particles with aerodynamic diameter less than 2.5 µm (PM2.5) and black carbon (BC) were estimated for participants in five Swedish cohorts using dispersion models. Simultaneous estimates of exposure lags 1-10 years using DLNMs were compared with separate year specific (single lag) estimates and estimates for lag 1-5- and 6-10-years using moving average exposure. The DLNM estimated no exposure lag-response between PM2.5 total, BC, and IHD. However, for PM2.5 from local sources, a 20% risk increase per 1 µg/m3 for 1-year lag was estimated. A risk increase for stroke was suggested in relation to lags 2-4-year PM2.5 and BC, and also lags 8-9-years BC. No associations were shown in single lag models. Increased risk estimates for stroke in relation to lag 1-5- and 6-10-years BC moving averages were observed. Estimates generally supported a greater contribution to increased risk from exposure windows closer in time to incident IHD and incident stroke.
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Affiliation(s)
- Hedi Katre Kriit
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, 90187 Umeå, Sweden; (B.F.); (J.N.S.)
- Correspondence: ; Tel.: +46-722-40-5220
| | - Eva M. Andersson
- Occupational and Environmental Medicine, Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden; (E.M.A.); (H.K.C.); (P.M.); (L.S.)
| | - Hanne K. Carlsen
- Occupational and Environmental Medicine, Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden; (E.M.A.); (H.K.C.); (P.M.); (L.S.)
| | - Niklas Andersson
- Institute of Environmental Medicine, Karolinska Institutet, 17177 Stockholm, Sweden; (N.A.); (P.L.S.L.); (G.P.); (K.L.)
| | - Petter L. S. Ljungman
- Institute of Environmental Medicine, Karolinska Institutet, 17177 Stockholm, Sweden; (N.A.); (P.L.S.L.); (G.P.); (K.L.)
- Department of Cardiology, Danderyd Hospital, 18233 Stockholm, Sweden
| | - Göran Pershagen
- Institute of Environmental Medicine, Karolinska Institutet, 17177 Stockholm, Sweden; (N.A.); (P.L.S.L.); (G.P.); (K.L.)
- Centre for Occupational and Environmental Medicine, Region Stockholm, 11365 Stockholm, Sweden
| | - David Segersson
- Swedish Meteorological and Hydrological Institute, 60176 Norrköping, Sweden; (D.S.); (L.G.)
| | - Kristina Eneroth
- SLB-Analys, Environment and Health Administration, 10420 Stockholm, Sweden;
| | - Lars Gidhagen
- Swedish Meteorological and Hydrological Institute, 60176 Norrköping, Sweden; (D.S.); (L.G.)
| | - Mårten Spanne
- Environmental Department of the City of Malmö, 20580 Malmo, Sweden;
| | - Peter Molnar
- Occupational and Environmental Medicine, Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden; (E.M.A.); (H.K.C.); (P.M.); (L.S.)
| | - Patrik Wennberg
- Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, 90187 Umeå, Sweden;
| | - Annika Rosengren
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Sahlgrenska University Hospital, 40530 Gothenburg, Sweden;
| | - Debora Rizzuto
- Ageing Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, 17177 Stockholm, Sweden;
- Stockholm Gerontology Research Center, 11346 Stockholm, Sweden
| | - Karin Leander
- Institute of Environmental Medicine, Karolinska Institutet, 17177 Stockholm, Sweden; (N.A.); (P.L.S.L.); (G.P.); (K.L.)
| | - Diego Yacamán-Méndez
- Department of Global Public Health, Karolinska Institutet, 17177 Stockholm, Sweden;
- Centre for Epidemiology and Community Medicine, Region Stockholm, 10431 Stockholm, Sweden
| | - Patrik K. E. Magnusson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, 17177 Stockholm, Sweden;
| | - Bertil Forsberg
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, 90187 Umeå, Sweden; (B.F.); (J.N.S.)
| | - Leo Stockfelt
- Occupational and Environmental Medicine, Department of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden; (E.M.A.); (H.K.C.); (P.M.); (L.S.)
| | - Johan N. Sommar
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, 90187 Umeå, Sweden; (B.F.); (J.N.S.)
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Wang M, Zhou T, Song Q, Ma H, Hu Y, Heianza Y, Qi L. Ambient air pollution, healthy diet and vegetable intakes, and mortality: a prospective UK Biobank study. Int J Epidemiol 2022; 51:1243-1253. [PMID: 35179602 PMCID: PMC9365625 DOI: 10.1093/ije/dyac022] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 02/03/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Recent studies suggest potential interactions of air pollutants with dietary factors and genetic susceptibility on mortality risk; however, evidence from prospective studies is still lacking. We aimed to assess the association between air pollution and mortality, and investigate the modification effects of a healthy diet and genetic susceptibility. METHODS A total of 386 937 participants were enrolled from 2006 to 2010 and followed up to 2018 in the UK Biobank study. The annual average air pollutant concentrations of particulate matter (PM) with diameters ≤2.5 (PM2.5), ≤10 (PM10) and between 2.5 and 10 µm (PM2.5-10) and nitrogen oxides (NO2 and NOx) were calculated and linked to participants' residential addresses. Healthy dietary patterns were evaluated by a healthy diet score (HDS) based on intakes of vegetables, fruit, fish, unprocessed red meat and processed meat. We also calculated genetic risk score (GRS) of the lifespan. We examined potential interactions by setting variable cross-product terms of air pollutants with diets or GRS in the models. RESULTS We identified 11 881 deaths [2426 from cardiovascular diseases (CVD), 1211 from coronary heart disease (CHD) and 466 from stroke] during a median follow-up of 8.9 years. We found that PM2.5 [hazard ratio (HR), 1.27; 95% CI, 1.05-1.55], PM10 (HR, 1.18; 95% CI, 1.04-1.34), NO2 (HR, 1.05; 95% CI, 1.01-1.08), and NOx (HR, 1.02; 95% CI, 1.01-1.03) were associated with all-cause mortality. PM2.5 was also associated with increased risks of CVD mortality (HR, 1.68; 95% CI, 1.10-2.56) and CHD mortality (HR, 2.08; 95% CI, 1.16-3.75). In addition, we found that adherence to healthy dietary patterns modified associations of PM2.5, NO2 and NOx with all-cause mortality (P-interaction = 0.006, 0.006 and 0.02, respectively). Among the individual dietary components, vegetable intakes showed interactions with PM2.5, NO2 and NOx (P-interaction = 0.007, 0.004 and 0.02, respectively). The associations between air pollutants and increased risks of all-cause mortality were attenuated among participants with higher vegetable intakes. We did not observe interactions between air pollutants and HDS on CVD, CHD or stroke mortality (P-interaction > 0.05). Besides, we did not find interactions between air pollutants and genetic risk for lifespan on mortality risk. CONCLUSION This study provides evidence linking long-term exposure to various air pollutants to the risk of all-cause, CVD and CHD mortality, and the potential attenuation of a healthy diet, especially high vegetable intakes, on such relations. Our findings highlight the importance of adherence to a healthy diet in lowering ambient air-pollution-related mortality risk.
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Affiliation(s)
- Mengying Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China,Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Tao Zhou
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Qiying Song
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA,Department of Child Healthcare, Maternal-Fetal Medicine Institute, Bao'an Maternity and Child Health Hospital, Jinan University, Guangzhou, China
| | - Hao Ma
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Yonghua Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Yoriko Heianza
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
| | - Lu Qi
- Corresponding author: Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA. E-mail:
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Konduracka E, Rostoff P. Links between chronic exposure to outdoor air pollution and cardiovascular diseases: a review. ENVIRONMENTAL CHEMISTRY LETTERS 2022; 20:2971-2988. [PMID: 35496466 PMCID: PMC9036845 DOI: 10.1007/s10311-022-01450-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 04/04/2022] [Indexed: 05/10/2023]
Abstract
Acute exposure to air pollution is associated with an increasing risk of death and cardiovascular disorders. Nonetheless, the impact of chronic exposure to air pollution on the circulatory system is still debated. Here, we review the links of chronic exposure to outdoor air pollution with mortality and most common cardiovascular diseases, in particular during the coronavirus disease 2019 event (COVID-19). We found that recent studies provide robust evidence for a causal effect of chronic exposure to air pollution and cardiovascular mortality. In terms of mortality, the strongest relationship was noted for fine particulate matter, nitrogen dioxide, and ozone. There is also increasing evidence showing that exposure to air pollution, mainly fine particulate matter and nitrogen dioxide, is associated with the development of atherosclerosis, hypertension, stroke, and heart failure. However, available scientific evidence is not strong enough to support associations with cardiac arrhythmias and coagulation disturbances. Noteworthy, for some pollutants, the risk of negative health effects is high for concentrations lower than the limit values recommended by the European Union and Word Health Organization. Efforts to diminish exposure to air pollution and to design optimal methods of air pollution reduction should be urgently intensified and supported by effective legislation and interdisciplinary cooperation.
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Affiliation(s)
- Ewa Konduracka
- Department of Coronary Disease and Heart Failure, Jagiellonian University Medical College, John Paul II Hospital, Prądnicka 80, 31-202 Kraków, Poland
| | - Paweł Rostoff
- Department of Coronary Disease and Heart Failure, Jagiellonian University Medical College, John Paul II Hospital, Prądnicka 80, 31-202 Kraków, Poland
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Cole-Hunter T, Dehlendorff C, Amini H, Mehta A, Lim YH, Jørgensen JT, Li S, So R, Mortensen LH, Westendorp R, Hoffmann B, Bräuner EV, Ketzel M, Hertel O, Brandt J, Jensen SS, Christensen JH, Geels C, Frohn LM, Backalarz C, Simonsen MK, Loft S, Andersen ZJ. Long-term exposure to road traffic noise and stroke incidence: a Danish Nurse Cohort study. Environ Health 2021; 20:115. [PMID: 34740347 PMCID: PMC8571835 DOI: 10.1186/s12940-021-00802-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 10/26/2021] [Indexed: 05/07/2023]
Abstract
BACKGROUND Road traffic noise has been linked to increased risk of ischemic heart disease, yet evidence on stroke shows mixed results. We examine the association between long-term exposure to road traffic noise and incidence of stroke, overall and by subtype (ischemic or hemorrhagic), after adjustment for air pollution. METHODS Twenty-five thousand six hundred and sixty female nurses from the Danish Nurse Cohort recruited in 1993 or 1999 were followed for stroke-related first-ever hospital contact until December 31st, 2014. Full residential address histories since 1970 were obtained and annual means of road traffic noise (Lden [dB]) and air pollutants (particulate matter with diameter < 2.5 μm and < 10 μm [PM2.5 and PM10], nitrogen dioxide [NO2], nitrogen oxides [NOx]) were determined using validated models. Time-varying Cox regression models were used to estimate hazard ratios (HR) (95% confidence intervals [CI]) for the associations of one-, three-, and 23-year running means of Lden preceding stroke (all, ischemic or hemorrhagic), adjusting for stroke risk factors and air pollutants. The World Health Organization and the Danish government's maximum exposure recommendations of 53 and 58 dB, respectively, were explored as potential Lden thresholds. RESULTS Of 25,660 nurses, 1237 developed their first stroke (1089 ischemic, 148 hemorrhagic) during 16 years mean follow-up. For associations between a 1-year mean of Lden and overall stroke incidence, the estimated HR (95% CI) in the fully adjusted model was 1.06 (0.98-1.14) per 10 dB, which attenuated to 1.01 (0.93-1.09) and 1.00 (0.91-1.09) in models further adjusted for PM2.5 or NO2, respectively. Associations for other exposure periods or separately for ischemic or hemorrhagic stroke were similar. There was no evidence of a threshold association between Lden and stroke. CONCLUSIONS Long-term exposure to road traffic noise was suggestively positively associated with the risk of overall stroke, although not after adjusting for air pollution.
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Affiliation(s)
- Tom Cole-Hunter
- Environmental Epidemiology Group, Section of Environmental Health, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Centre for Air Pollution, Energy, and Health Research, University of New South Wales, Sydney, NSW Australia
| | - Christian Dehlendorff
- Statistics and Data Analysis, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Heresh Amini
- Environmental Epidemiology Group, Section of Environmental Health, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Amar Mehta
- Denmark Statistics, Copenhagen, Denmark
- Section of Epidemiology, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Youn-Hee Lim
- Environmental Epidemiology Group, Section of Environmental Health, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jeanette T. Jørgensen
- Environmental Epidemiology Group, Section of Environmental Health, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Shuo Li
- Environmental Epidemiology Group, Section of Environmental Health, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Rina So
- Environmental Epidemiology Group, Section of Environmental Health, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Laust H. Mortensen
- Section of Epidemiology, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
| | - Rudi Westendorp
- Section of Epidemiology, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
| | - Barbara Hoffmann
- Institute for Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty, Heinrich-Heine-University of Düsseldorf, Düsseldorf, Germany
| | - Elvira V. Bräuner
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Matthias Ketzel
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
- Global Centre for Clean Air Research (GCARE), University of Surrey, Guildford, UK
| | - Ole Hertel
- Department of Bioscience, Aarhus University, Roskilde, Denmark
| | - Jørgen Brandt
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | | | | | - Camilla Geels
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Lise M. Frohn
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | | | - Mette K. Simonsen
- Diakonissestiftelsen, Frederiksberg, Denmark
- The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Denmark
| | - Steffen Loft
- Environmental Epidemiology Group, Section of Environmental Health, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Zorana J. Andersen
- Environmental Epidemiology Group, Section of Environmental Health, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Liu JJ, Fu SB, Jiang J, Tang XL. Association between outdoor particulate air pollution and the risk of osteoporosis: a systematic review and meta-analysis. Osteoporos Int 2021; 32:1911-1919. [PMID: 33954814 DOI: 10.1007/s00198-021-05961-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 04/13/2021] [Indexed: 11/25/2022]
Abstract
Air pollution is a major threat to global health, which is associated with several adverse health outcomes and increased mortality. Few studies have investigated the association between air pollution and osteoporosis, and their findings were inconclusive. Our objective is to determine whether exposure to outdoor air pollution is causally associated with risk of osteoporosis. A systematic literature search of PubMed, Web of Science, Embase, and Cochrane Library for publications up to December 2020 was conducted for studies reporting the association between air pollution and osteoporosis. Meta-analysis was performed to estimate the pooled effect size of air pollution on osteoporosis using the relative risk (RR) and 95% confidence intervals (95% CI). Quality assessment was conducted, and all statistical analyses were performed by RevMan 5.3 software. Our search identified 9 eligible studies involving 9,371,212 patients. Meta-analysis revealed that there was an increased risk of osteoporosis (total body BMD and hip fracture) as a result of exposure to air pollution including PM2.5 and NO2. However, no significant excess risk of osteoporosis was found regardless of PM10, NO, and O3. In spite of a few number of epidemiological studies selected in the present literature review, this study indicated that the increased exposure to air pollutants was positively associated with high risk of osteoporosis. Further cohort studies with large sample sizes are needed to investigate different constituents and the duration of exposure of air pollutants.
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Affiliation(s)
- J J Liu
- Department of Endocrinology, The First Hospital of Lanzhou University, No. 1 West Donggang Road, Lanzhou, Gansu, 730000, China
| | - S B Fu
- Department of Endocrinology, The First Hospital of Lanzhou University, No. 1 West Donggang Road, Lanzhou, Gansu, 730000, China
| | - J Jiang
- The First Clinical Medical College of Lanzhou University, No. 1 West Donggang Road, Lanzhou, Gansu, 730000, China
| | - X L Tang
- Department of Endocrinology, The First Hospital of Lanzhou University, No. 1 West Donggang Road, Lanzhou, Gansu, 730000, China.
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Yang YY, Fan L, Wang J, Zhu YD, Li X, Wang XQ, Yan X, Li L, Zhang YJ, Yang WJ, Yao XY, Wang XL. Characterization and exposure assessment of household fine particulate matter pollution in China. INDOOR AIR 2021; 31:1391-1401. [PMID: 33876854 DOI: 10.1111/ina.12843] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Revised: 04/07/2021] [Accepted: 04/08/2021] [Indexed: 06/12/2023]
Abstract
Household fine particulate matter (PM2.5 ) pollution greatly impacts residents' health. To explore the current national situation of household PM2.5 pollution in China, a study was conducted based on literature published from 1998 to 2018. After extracting data from the literature in conformity with the requirements, the nationwide household-weighted mean concentration of household PM2.5 (HPL) was calculated. Subgroup analyses of spatial, geographic, and temporal differences were also done. The estimated overall HPL in China was 132.2 ± 117.7 μg/m3 . HPL in the rural area (164.3 ± 104.5 μg/m3 ) was higher than that in the urban area (123.9 ± 122.3 μg/m3 ). For HPLs of indoor sampling sites, the kitchen was the highest, followed by the bedroom and living room. There were significant differences of geographic distributions. The HPLs in the South were higher than the North in four seasons. The inhaled dose of household PM2.5 among school-age children differed from provinces with the highest dose up to 5.9 μg/(kg·d). Countermeasures should be carried out to reduce indoor pollution and safeguard health urgently.
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Affiliation(s)
- Yu-Yan Yang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Lin Fan
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jiao Wang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yuan-Duo Zhu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xu Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xin-Qi Wang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xu Yan
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Li Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yu-Jing Zhang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Wen-Jing Yang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiao-Yuan Yao
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xian-Liang Wang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
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Wolf K, Hoffmann B, Andersen ZJ, Atkinson RW, Bauwelinck M, Bellander T, Brandt J, Brunekreef B, Cesaroni G, Chen J, de Faire U, de Hoogh K, Fecht D, Forastiere F, Gulliver J, Hertel O, Hvidtfeldt UA, Janssen NAH, Jørgensen JT, Katsouyanni K, Ketzel M, Klompmaker JO, Lager A, Liu S, MacDonald CJ, Magnusson PKE, Mehta AJ, Nagel G, Oftedal B, Pedersen NL, Pershagen G, Raaschou-Nielsen O, Renzi M, Rizzuto D, Rodopoulou S, Samoli E, van der Schouw YT, Schramm S, Schwarze P, Sigsgaard T, Sørensen M, Stafoggia M, Strak M, Tjønneland A, Verschuren WMM, Vienneau D, Weinmayr G, Hoek G, Peters A, Ljungman PLS. Long-term exposure to low-level ambient air pollution and incidence of stroke and coronary heart disease: a pooled analysis of six European cohorts within the ELAPSE project. Lancet Planet Health 2021; 5:e620-e632. [PMID: 34508683 DOI: 10.1016/s2542-5196(21)00195-9] [Citation(s) in RCA: 112] [Impact Index Per Article: 37.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 06/23/2021] [Accepted: 07/02/2021] [Indexed: 05/07/2023]
Abstract
BACKGROUND Long-term exposure to outdoor air pollution increases the risk of cardiovascular disease, but evidence is unclear on the health effects of exposure to pollutant concentrations lower than current EU and US standards and WHO guideline limits. Within the multicentre study Effects of Low-Level Air Pollution: A Study in Europe (ELAPSE), we investigated the associations of long-term exposures to fine particulate matter (PM2·5), nitrogen dioxide (NO2), black carbon, and warm-season ozone (O3) with the incidence of stroke and acute coronary heart disease. METHODS We did a pooled analysis of individual data from six population-based cohort studies within ELAPSE, from Sweden, Denmark, the Netherlands, and Germany (recruited 1992-2004), and harmonised individual and area-level variables between cohorts. Participants (all adults) were followed up until migration from the study area, death, or incident stroke or coronary heart disease, or end of follow-up (2011-15). Mean 2010 air pollution concentrations from centrally developed European-wide land use regression models were assigned to participants' baseline residential addresses. We used Cox proportional hazards models with increasing levels of covariate adjustment to investigate the association of air pollution exposure with incidence of stroke and coronary heart disease. We assessed the shape of the concentration-response function and did subset analyses of participants living at pollutant concentrations lower than predefined values. FINDINGS From the pooled ELAPSE cohorts, data on 137 148 participants were analysed in our fully adjusted model. During a median follow-up of 17·2 years (IQR 13·8-19·5), we observed 6950 incident events of stroke and 10 071 incident events of coronary heart disease. Incidence of stroke was associated with PM2·5 (hazard ratio 1·10 [95% CI 1·01-1·21] per 5 μg/m3 increase), NO2 (1·08 [1·04-1·12] per 10 μg/m3 increase), and black carbon (1·06 [1·02-1·10] per 0·5 10-5/m increase), whereas coronary heart disease incidence was only associated with NO2 (1·04 [1·01-1·07]). Warm-season O3 was not associated with an increase in either outcome. Concentration-response curves indicated no evidence of a threshold below which air pollutant concentrations are not harmful for cardiovascular health. Effect estimates for PM2·5 and NO2 remained elevated even when restricting analyses to participants exposed to pollutant concentrations lower than the EU limit values of 25 μg/m3 for PM2·5 and 40 μg/m3 for NO2. INTERPRETATION Long-term air pollution exposure was associated with incidence of stroke and coronary heart disease, even at pollutant concentrations lower than current limit values. FUNDING Health Effects Institute.
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Affiliation(s)
- Kathrin Wolf
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany.
| | - Barbara Hoffmann
- Institute for Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Zorana J Andersen
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Richard W Atkinson
- Population Health Research Institute, St George's, University of London, London, UK
| | - Mariska Bauwelinck
- Interface Demography, Department of Sociology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Tom Bellander
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Jørgen Brandt
- Department of Environmental Science, Aarhus University, Roskilde, Denmark; iClimate, Interdisciplinary Centre for Climate Change, Aarhus University, Denmark
| | - Bert Brunekreef
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
| | - Giulia Cesaroni
- Department of Epidemiology-Lazio Regional Health Service, ASL Roma 1, Rome, Italy
| | - Jie Chen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
| | - Ulf de Faire
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Daniela Fecht
- School of Public Health, Faculty of Medicine, Imperial College London, London, UK
| | - Francesco Forastiere
- Department of Epidemiology-Lazio Regional Health Service, ASL Roma 1, Rome, Italy; School of Public Health, Faculty of Medicine, Imperial College London, London, UK
| | - John Gulliver
- School of Public Health, Faculty of Medicine, Imperial College London, London, UK; Centre for Environmental Health and Sustainability, University of Leicester, Leicester, UK; School of Geography, Geology and the Environment, University of Leicester, Leicester, UK
| | - Ole Hertel
- Department of Bioscience, Aarhus University, Roskilde, Denmark
| | | | - Nicole A H Janssen
- National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Jeanette T Jørgensen
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Klea Katsouyanni
- School of Public Health, Faculty of Medicine, Imperial College London, London, UK; Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Matthias Ketzel
- Department of Environmental Science, Aarhus University, Roskilde, Denmark; Global Centre for Clean Air Research, University of Surrey, Surrey, UK
| | - Jochem O Klompmaker
- National Institute for Public Health and the Environment, Bilthoven, Netherlands; Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Anton Lager
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Shuo Liu
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Conor J MacDonald
- INSERM U1018, CESP, Institut Gustave Roussy, Université Paris-Saclay, Université Paris-Sud, Villejuif, France
| | - Patrik K E Magnusson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Amar J Mehta
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Gabriele Nagel
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Bente Oftedal
- Department of Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Nancy L Pedersen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Göran Pershagen
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Ole Raaschou-Nielsen
- Department of Environmental Science, Aarhus University, Roskilde, Denmark; Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Matteo Renzi
- Department of Epidemiology-Lazio Regional Health Service, ASL Roma 1, Rome, Italy
| | - Debora Rizzuto
- Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Sophia Rodopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Yvonne T van der Schouw
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Sara Schramm
- Institute for Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, University Hospital Essen, Essen, Germany
| | - Per Schwarze
- Global Health Cluster, Norwegian Institute of Public Health, Oslo, Norway
| | - Torben Sigsgaard
- Department of Public Health, Environment Occupation and Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - Mette Sørensen
- Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Natural Science and Environment, Roskilde University, Roskilde, Denmark
| | - Massimo Stafoggia
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology-Lazio Regional Health Service, ASL Roma 1, Rome, Italy
| | - Maciek Strak
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands; National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | | | - W M Monique Verschuren
- National Institute for Public Health and the Environment, Bilthoven, Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands
| | - Danielle Vienneau
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Gudrun Weinmayr
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Gerard Hoek
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, Netherlands
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany; Ludwig Maximilians Universität München, Munich, Germany
| | - Petter L S Ljungman
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Cardiology, Danderyd University Hospital, Stockholm, Sweden
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Yang CP, Li CY, Huang WJ, Yu HL, Yang CC, Lu MC, Lang HC, Yan YH. Short-, Mid-, and Long-Term Associations Between PM2.5 and Stroke Incidence in Taiwan. J Occup Environ Med 2021; 63:742-751. [PMID: 33852547 DOI: 10.1097/jom.0000000000002222] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To investigate the association between the risk of stroke and exposure to particulate matter with an aerodynamic diameter less than 2.5 μm (PM2.5) over various exposure periods. METHODS This was a nationwide population-based case-control study in which 10,035 incident patients with a primary diagnosis of ischemic stroke each were matched with two randomly selected controls for sex, age, Charlson Comorbidity Index, year of stroke diagnosis, and level of urbanization. Multiple logistic models adjusted for potential confounders were used to assess the association of PM2.5 with ischemic stroke incidence. RESULTS There were significant short-term, medium-term, and long-term relationships between PM2.5 exposure and ischemic stroke incidence. CONCLUSIONS This study supports existing evidence that PM2.5 should be considered a risk factor for ischemic stroke.
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Affiliation(s)
- Chun-Pai Yang
- From the Department of Neurology (Dr Yang); Department of Medical Research (Dr Yang, Ms Lu, Dr Yan), Kuang Tien General Hospital, Taichung, Taiwan; Institute of Biomedical Nutrition, Hung Kuang University, Taichung, Taiwan (Dr Yang, Dr Yan); Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan (Dr Li); Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan (Dr Li); Department of Safety, Health, and Environmental Engineering, Hung Kuang University, Taichung, Taiwan (Dr Huang); Department of Bioenvironmental Systems Engineering, National Taiwan University, Taipei, Taiwan (Dr Yu); Department of Healthcare Administration, Asia University, Taichung, Taiwan (Dr Yang); Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan (Dr Lang); National Yang Ming Chiao Tung University, Taipei, Taiwan (Dr Lang); Department of Endocrinology and Metabolism, Kuang Tien General Hospital, Taichung, Taiwan (Dr Yan)
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Kim SY, Kim JH, Kim YH, Wee JH, Min C, Han SM, Kim S, Choi HG. Short- and long-term exposure to air pollution increases the risk of stroke. Int J Stroke 2021; 17:654-660. [PMID: 34427474 DOI: 10.1177/17474930211042118] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Many epidemiological studies have observed the association of air pollutant exposure with the onset, progression, and mortality of stroke. The aim of this study was to investigate the associations of air pollutants, including SO2, NO2, O3, CO, and PM10, with stroke according to exposure duration. METHODS Data from the Korean National Health Insurance Service-Health Screening Cohort from 2002 to 2015 were obtained. The 21,240 patients who were admitted for or died due to stroke were 1:4 matched for age, sex, income, and region of residence with 84,960 control participants. The meteorological factors of mean, highest, and lowest temperatures; relative humidity; ambient atmospheric pressure; and air pollutant concentrations (SO2, NO2, O3, CO, and PM10) were analyzed to determine their associations with stroke. The odds ratios for stroke after exposure to each meteorological factor and air pollutant at 7 and 30 days were calculated in the stroke and control groups. Subgroup analyses were conducted according to age, sex, income, and region of residence. RESULTS The odds ratio associated with seven days of exposure to CO was 1.16 (95% CI = 1.04-1.31) in stroke patients. For 30 days of exposure, the odds ratio associated with CO was 1.16 (95% CI = 1.02-1.32) in stroke patients. Seven and 30 days of NO2 exposure were inversely associated with stroke. The odds ratio associated with seven days of exposure to O3 was 1.16 (95% CI = 1.01-1.32) in ischemic stroke patients. Both ischemic and hemorrhagic stroke had negative associations with 7 and 30 days of NO2 exposure. CONCLUSION Both short- and long-term exposure to CO were related to stroke.
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Affiliation(s)
- So Young Kim
- Department of Otorhinolaryngology-Head & Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Joo-Hee Kim
- Department of Neurosurgery, Hallym University College of Medicine, Hallym University Medical Center, Seoul, Korea
| | - Yoo Hwan Kim
- Department of Neurology, Hallym University College of Medicine, Anyang, Korea
| | - Jee Hye Wee
- Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine, Anyang, Korea
| | - Chanyang Min
- Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang, Korea.,Graduate School of Public Health, Seoul National University, Seoul, Korea
| | - Sang-Min Han
- Department of Political Science (Climate and Environmental Policy), Graduate School of Global Cooperation, Hallym University, Chuncheon, Korea
| | - Seungdo Kim
- Research Center for Climate Change and Energy, Hallym University, Chuncheon, Korea
| | - Hyo Geun Choi
- Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine, Anyang, Korea.,Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang, Korea.,Hallym Institute for Environmental Diseases (HIED), Chuncheon, Korea
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47
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Verhoeven JI, Allach Y, Vaartjes ICH, Klijn CJM, de Leeuw FE. Ambient air pollution and the risk of ischaemic and haemorrhagic stroke. Lancet Planet Health 2021; 5:e542-e552. [PMID: 34390672 DOI: 10.1016/s2542-5196(21)00145-5] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 03/30/2021] [Accepted: 05/14/2021] [Indexed: 05/26/2023]
Abstract
Stroke is a leading cause of disability and the second most common cause of death worldwide. Increasing evidence suggests that air pollution is an emerging risk factor for stroke. Over the past decades, air pollution levels have continuously increased and are now estimated to be responsible for 14% of all stroke-associated deaths. Interpretation of previous literature is difficult because stroke was usually not distinguished as ischaemic or haemorrhagic, nor by cause. This Review summarises the evidence on the association between air pollution and the different causes of ischaemic stroke and haemorrhagic stroke, to clarify which people are most at risk. The risk for ischaemic stroke is increased after short-term or long-term exposure to air pollution. This effect is most pronounced in people with cardiovascular burden and stroke due to large artery disease or small vessel disease. Short-term exposure to air pollution increases the risk of intracerebral haemorrhage, a subtype of haemorrhagic stroke, whereas the effects of long-term exposure are less clear. Limitations of the current evidence are that studies are prone to misclassification of exposure, often rely on administrative data, and have insufficient clinical detail. In this Review, we provide an outlook on new research opportunities, such as those provided by the decreased levels of air pollution due to the current COVID-19 pandemic.
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Affiliation(s)
- Jamie I Verhoeven
- Department of Neurology, Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands
| | - Youssra Allach
- Department of Neurology, Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands
| | - Ilonca C H Vaartjes
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
| | - Catharina J M Klijn
- Department of Neurology, Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands
| | - Frank-Erik de Leeuw
- Department of Neurology, Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands.
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Magnoni P, Murtas R, Russo AG. Residential exposure to traffic-borne pollution as a risk factor for acute cardiocerebrovascular events: a population-based retrospective cohort study in a highly urbanized area. Int J Epidemiol 2021; 50:1160-1171. [PMID: 34279611 PMCID: PMC8522025 DOI: 10.1093/ije/dyab068] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 03/17/2021] [Indexed: 01/03/2023] Open
Abstract
Background Long-term exposure to traffic-borne noise and air pollution has been variably
associated with incidence of acute vascular events, namely acute myocardial
infarction, ischaemic stroke and haemorrhagic stroke. This study aims at
exploring this association within a highly urbanized city. Methods This is a population-based retrospective dynamic cohort study including all
residents aged ≥ 35 years in the municipality of Milan over
the years 2011–18 (1 087 110 inhabitants).
Residential exposure to road traffic noise (day-evening-night levels) and
nitrogen dioxide was estimated using a noise predictive model and a land use
regression model, respectively. Cox proportional hazards regression analyses
were performed to assess the incidence of acute vascular events and specific
outcomes in single-exposure and two-exposure models including adjustment for
sociodemographic confounders, fine particulate matter and surrounding
greenness. Results A total of 27 282 subjects (2.5%) had an acute vascular
event. Models using nitrogen dioxide produced inconsistent results. The
strongest effect was observed for noise, with an optimal cut-off for
dichotomization set at 70 dBA (hazard ratio 1.025, 95% confidence
interval 1.000–1.050). This association was observed specifically
for ischaemic and haemorrhagic stroke. When stratifying by age group and
sex, a remarkable effect was found for haemorrhagic stroke in men aged
<60 years (hazard ratio 1.439, 95% confidence
interval 1.156–1.792). Conclusions Living by roads with a day-evening-night noise level above 70 dBA exerts a
small but tangible independent effect on the risks of both ischaemic and
haemorrhagic stroke. It is urgent to propose mitigation measures against
pollution and noise originating from vehicular traffic in order to reduce
their impact, especially in the population younger than
60 years.
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Affiliation(s)
- Pietro Magnoni
- Epidemiology Unit, Agency for Health Protection of Milan, Milan, Italy.,Postgraduate School of Public Health, Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Rossella Murtas
- Epidemiology Unit, Agency for Health Protection of Milan, Milan, Italy
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Hajizadeh Y, Jafari N, Fanaei F, Ghanbari R, Mohammadi A, Behnami A, Jafari A, Aghababayi M, Abdolahnejad A. Spatial patterns and temporal variations of traffic-related air pollutants and estimating its health effects in Isfahan city, Iran. JOURNAL OF ENVIRONMENTAL HEALTH SCIENCE & ENGINEERING 2021; 19:781-791. [PMID: 34150273 PMCID: PMC8172745 DOI: 10.1007/s40201-021-00645-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 03/03/2021] [Indexed: 05/13/2023]
Abstract
Isfahan as an important industrial city has faced with air pollution recently. Thus, we assessed the spatial and temporal trends of ambient PM2.5, CO, SO2, and O3 and for estimating their health effect on Isfahan citizens between March 2018 and March 2019 through the AirQ+ software. Our results showed that citizens of Isfahan in almost 240, 167, and 134 of the days in the year has exposure to PM2.5, SO2, and O3 higher than the WHO daily guideline, respectively. Daily variations of PM2.5, CO, and SO2 concentration showed the increasing trend of pollutants in the morning to evening. The maximum concentrations of O3 were observed in the noonday. Also, the concentrations of these pollutants on Friday due to the holiday effect were higher than the weekdays. Except for O3, the PM2.5, CO, and SO2 concentrations in the cold months and cold seasons was higher compared with the hot months and hot seasons. The total number of deaths because of lung cancer, natural mortality, ischemic heart disease, chronic obstructive pulmonary disease,, stroke associated with ambient PM2.5 with the attributable proportion (AP) 11.43%, 11.63%, 15.96%, 15.15%, and 13.1% (95% CI) were 683, 19, 2, 202, and 55 cases, respectively. Therefore, the present study provides additional data for the provincial managers and politicians useful in planning proper strategies of air pollution control to decrease exposure and attributable mortalities.
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Affiliation(s)
- Yaghoub Hajizadeh
- Department of Environmental Health Engineering, Faculty of Health, Environmental Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Negar Jafari
- Department of Environmental Health Engineering, Faculty of Health, Environmental Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Farzad Fanaei
- Department of Environmental Health Engineering, Faculty of Health, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Ghanbari
- Department of Environmental Health Engineering, Faculty of Health, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Amir Mohammadi
- Department of Environmental Health Engineering, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Ali Behnami
- Department of Environmental Health Engineering, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Azin Jafari
- Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Ali Abdolahnejad
- Department of Environmental Health Engineering, Maragheh University of Medical Sciences, Maragheh, Iran
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50
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Januel E, Dessimond B, Colette A, Annesi-Maesano I, Stankoff B. Fine Particulate Matter Related to Multiple Sclerosis Relapse in Young Patients. Front Neurol 2021; 12:651084. [PMID: 34093398 PMCID: PMC8176031 DOI: 10.3389/fneur.2021.651084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 04/13/2021] [Indexed: 12/25/2022] Open
Abstract
Objective: Particulate matter (PM) of aerodynamic diameter smaller than 10 μm (PM10) has been associated with multiple sclerosis (MS) relapse. However, the impact of smaller PM with a greater ability to penetrate human organism has never been assessed. We evaluated the impact of PM smaller than 2.5 μm (PM2.5) on the risk of MS relapse. Material and Methods: In a case-crossover study, we included 2,109 consecutive hospitalizations likely due to MS relapse in day hospital in 5 MS centers in the Paris area from January 2009 to December 2013. For each hospitalization, the natural logarithm of the average weekly PM2.5 concentrations (μg/m3) at the patient's residence address during each of the 6 weeks (week[0] to week[−5]) preceding admission was compared with the concentration during the previous week, using a conditional logistic regression adjusted on temperature, flu-like syndrome rate, pollen count, and holiday period. Results: PM2.5 average concentration during week[−3] was significantly associated with the risk of hospitalization for MS relapse [OR = 1.21 (CI 1.01;1.46)]. The association was stronger in patients younger than 30 years [OR=1.77 (CI 1.10; 2.83)]. Conclusion: Our study demonstrates an association between exposure to PM2.5 and MS relapse, particularly in young people.
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Affiliation(s)
- Edouard Januel
- Assistance Publique des Hôpitaux de Paris, APHP, Hôpital Saint Antoine, Neurology Department, Paris, France
| | - Boris Dessimond
- Sorbonne Université and INSERM, Épidémiologie des maladies Allergiques et Respiratoires, Institut Pierre Louis d'Epidémiologie et Santé Publique, Paris, France
| | - Augustin Colette
- Atmospheric Modelling and Environmental Mapping Unit, INERIS, BP2, Verneuil-en-Halatte, France
| | - Isabella Annesi-Maesano
- Sorbonne Université and INSERM, Épidémiologie des maladies Allergiques et Respiratoires, Institut Pierre Louis d'Epidémiologie et Santé Publique, Paris, France
| | - Bruno Stankoff
- Assistance Publique des Hôpitaux de Paris, APHP, Hôpital Saint Antoine, Neurology Department, Paris, France.,Sorbonne Universités, Brain and Spine Institute, ICM, Hôpital de la Pitié Salpêtrière, Inserm UMR-S 1127, CNRS UMR 7225, Paris, France
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