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Robertson NM, Qiu A, Raju S, McCormack MC, Koehler K. Cleaning indoor air-what works for respiratory health: An updated literature review and recommendations. J Allergy Clin Immunol 2024; 154:847-860. [PMID: 39181455 DOI: 10.1016/j.jaci.2024.08.011] [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: 05/29/2024] [Revised: 08/15/2024] [Accepted: 08/18/2024] [Indexed: 08/27/2024]
Abstract
Indoor air pollution is a growing public health concern globally and is associated with increased respiratory symptoms and morbidity. Individuals spend most of their time indoors, and pollutant-related health effects are often driven by the indoor environment. Understanding effective interventions to improve indoor air quality and their impact on respiratory outcomes is key to decreasing the burden of air pollution for high-risk populations across the life-span. This review applies a hierarchy of interventions framework specific to respiratory health effects and focuses on recent studies of interventions to improve indoor air quality among high-risk populations with chronic respiratory disease published in the past 3 years. While policy and source control interventions are likely the most effective and equitable approaches to improve indoor air quality and benefit population health, these were less extensively investigated. Engineering interventions, such as air cleaner interventions, were the most widely studied. Several studies, including those focused on asthma and chronic obstructive pulmonary disease, demonstrated improvement in symptoms and medication receipt with interventions in both home- and school-based settings. Combined multilevel interventions with engineering and behavioral interventions led to improved respiratory outcomes in some, but not all, studies. Placing the recent work in the context of the broader literature, we identify gaps in research. Further research is needed to understand intervention effectiveness over time and an increased focus on policy and source control interventions that can mitigate risk in vulnerable populations.
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Affiliation(s)
| | - Anna Qiu
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Md
| | - Sarath Raju
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Md
| | - Meredith C McCormack
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Md
| | - Kirsten Koehler
- Department of Environmental Health and Engineering, Johns Hopkins University, Baltimore, Md.
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Arif I, Adams MD, Johnson MTJ. A meta-analysis of the carcinogenic effects of particulate matter and polycyclic aromatic hydrocarbons. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 351:123941. [PMID: 38614427 DOI: 10.1016/j.envpol.2024.123941] [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: 02/22/2024] [Revised: 04/03/2024] [Accepted: 04/07/2024] [Indexed: 04/15/2024]
Abstract
Urbanization has numerous benefits to human society, but some aspects of urban environments, such as air pollution, can negatively affect human health. Two major air pollutants, particulate matter (PM) and polycyclic aromatic hydrocarbons (PAH), have been classified as carcinogens by the International Agency for Research on Cancer. Here, we answer two questions: (1) What are the carcinogenic effects of PM and PAH exposure? (2) How does carcinogenic risk vary across geographical regions? We performed a comprehensive literature search of peer-reviewed published studies examining the link between air pollution and human cancer rates. Focusing on studies published since 2014 when the last IARC monograph on air pollution was published, we converted the extracted data into relative risks and performed subgroup analyses. Exposure to PM2.5 (per 10 μg/m3) resulted in an 8.5% increase in cancer incidence when all cancer types were combined, and risk for individual cancer types (i.e. lung cancer and adenocarcinoma) was also elevated. PM2.5 was also associated with 2.5% higher mortality due to cancer when all types of cancer were combined, and for individual cancer types (i.e., lung and breast cancer). Exposure to PM2.5 and PM10 posed the greatest risk to lung cancer incidence and mortality in Europe (PM2.5 RR 2.15; PM10 RR 1.26); the risk in Asia and the Americas was also elevated. Exposure to PAH and benzo[a]pyrene significantly increased the pooled risk of cancer incidence (10.8% and 8.0% respectively) at the highest percentile of exposure concentration. Our meta-analyses of studies over the past decade shows that urban air pollution in the form of PM2.5, PM10, and PAH all elevate the incidence and mortality of cancer. We discuss the possible mechanisms of carcinogenesis of PM and PAH. These results support World Health Organization's conclusion that air pollution poses among the greatest health risks to humans living in cities.
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Affiliation(s)
- Irtaqa Arif
- Ecology and Evolutionary Biology, University of Toronto, Canada; Department of Biology, University of Toronto Mississauga, Canada; Centre for Urban Environments, University of Toronto Mississauga, Mississauga, Canada.
| | - Matthew D Adams
- Department of Geography, University of Toronto Mississauga, Canada; Centre for Urban Environments, University of Toronto Mississauga, Mississauga, Canada
| | - Marc T J Johnson
- Department of Biology, University of Toronto Mississauga, Canada; Centre for Urban Environments, University of Toronto Mississauga, Mississauga, Canada
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Canaday FT, Georas SN, Croft DP. Examining the impact of air pollution, climate change, and social determinants of health on asthma and environmental justice. Curr Opin Pulm Med 2024; 30:276-280. [PMID: 38411188 PMCID: PMC10959677 DOI: 10.1097/mcp.0000000000001065] [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] [Indexed: 02/28/2024]
Abstract
PURPOSE OF REVIEW In this review, we discuss the current literature examining the impact air pollution and climate change has on asthma onset, control, and exacerbation. This review also addresses the risk of exposure to specific disproportionately affected communities, highlighting health disparities in exposure and asthma outcomes. RECENT FINDINGS Recent studies have shifted from highlighting the associations between asthma exacerbations and indoor and outdoor air pollution. Studies are now focused on confirming the association of asthma incidence from these same exposures. Many studies have linked particulate matter to adverse asthma outcomes, however, the pollutant exposures that pose the greatest risk and the effect of natural disasters fueled by climate change are under current study. Some studies have observed that the true burden that pollutant exposures have on asthma outcomes occurs at the intersection of exposure and vulnerability. Future studies in this area will address social determinants of health, societal factors such as redlining and other systemic racism practices. SUMMARY Although decades of research support the causal link between gaseous and particulate air pollution and the exacerbation of preexisting asthma, recent studies suggest air pollution can cause incident (new onset) asthma. Studies have started to focus on the underlying drivers of poor outcomes in asthma. Many of the structural impediments to high quality asthma care at the society level (e.g. poverty, redlining, systemic racism) also are risk factors for worsened climate events and air pollution exposure. The individuals in these disproportionately affected groups are doubly affected by worsened exposure and worsened access to care for the resultant asthma exacerbations or incident asthma. More research is needed to understand the specific climate and air pollution mitigation efforts where disproportionately affected communities would derive the most benefit.
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Affiliation(s)
- Felicia T Canaday
- Department of Medicine, Division of Pulmonary and Critical Care, University of Rochester Medical Center, Rochester, New York, USA
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Bookstein A, Po J, Tseng C, Larson TV, Yang J, Park SSL, Wu J, Shariff-Marco S, Inamdar PP, Ihenacho U, Setiawan VW, DeRouen MC, Le Marchand L, Stram DO, Samet J, Ritz B, Fruin S, Wu AH, Cheng I. Association between Airport Ultrafine Particles and Lung Cancer Risk: The Multiethnic Cohort Study. Cancer Epidemiol Biomarkers Prev 2024; 33:703-711. [PMID: 38372643 PMCID: PMC11062824 DOI: 10.1158/1055-9965.epi-23-0924] [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: 08/16/2023] [Revised: 11/10/2023] [Accepted: 02/12/2024] [Indexed: 02/20/2024] Open
Abstract
BACKGROUND Ultrafine particles (UFP) are unregulated air pollutants abundant in aviation exhaust. Emerging evidence suggests that UFPs may impact lung health due to their high surface area-to-mass ratio and deep penetration into airways. This study aimed to assess long-term exposure to airport-related UFPs and lung cancer incidence in a multiethnic population in Los Angeles County. METHODS Within the California Multiethnic Cohort, we examined the association between long-term exposure to airport-related UFPs and lung cancer incidence. Multivariable Cox proportional hazards regression models were used to estimate the effect of UFP exposure on lung cancer incidence. Subgroup analyses by demographics, histology and smoking status were conducted. RESULTS Airport-related UFP exposure was not associated with lung cancer risk [per one IGR HR, 1.01; 95% confidence interval (CI), 0.97-1.05] overall and across race/ethnicity. A suggestive positive association was observed between a one IQR increase in UFP exposure and lung squamous cell carcinoma (SCC) risk (HR, 1.08; 95% CI, 1.00-1.17) with a Phet for histology = 0.05. Positive associations were observed in 5-year lag analysis for SCC (HR, 1.12; 95% CI, CI, 1.02-1.22) and large cell carcinoma risk (HR, 1.23; 95% CI, 1.01-1.49) with a Phet for histology = 0.01. CONCLUSIONS This large prospective cohort analysis suggests a potential association between airport-related UFP exposure and specific lung histologies. The findings align with research indicating that UFPs found in aviation exhaust may induce inflammatory and oxidative injury leading to SCC. IMPACT These results highlight the potential role of airport-related UFP exposure in the development of lung SCC.
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Affiliation(s)
- Arthur Bookstein
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Justine Po
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Chiuchen Tseng
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Timothy V. Larson
- Departments of Civil & Environmental Engineering and Environmental & Occupational Health Sciences, University of Washington, Seattle, WA
| | - Juan Yang
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA
| | - Sung-shim L. Park
- Population Sciences in the Pacific Program (Cancer Epidemiology), University of Hawaii Cancer Center, Honolulu, HI
| | - Jun Wu
- Department of Environmental and Occupational Health, Program in Public Health, Susan and Henry Samueli College of Health Sciences, University of California, Irvine, Irvine, CA
| | - Salma Shariff-Marco
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA
- University of California, San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, San Francisco, CA
| | - Pushkar P. Inamdar
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA
| | - Ugonna Ihenacho
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Veronica W. Setiawan
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Mindy C. DeRouen
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA
- University of California, San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, San Francisco, CA
| | - Loïc Le Marchand
- Population Sciences in the Pacific Program (Cancer Epidemiology), University of Hawaii Cancer Center, Honolulu, HI
| | - Daniel O. Stram
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Jonathan Samet
- Departments of Epidemiology and of Environmental & Occupational Health, Colorado School of Public Health, Aurora, CO
| | - Beate Ritz
- Department of Epidemiology, School of Public Health, University of California, Los Angeles, Los Angeles, CA
| | - Scott Fruin
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA
| | - Anna H. Wu
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Iona Cheng
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA
- University of California, San Francisco Helen Diller Family Comprehensive Cancer Center, San Francisco, San Francisco, CA
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Pyae TS, Kallawicha K. First temporal distribution model of ambient air pollutants (PM 2.5, PM 10, and O 3) in Yangon City, Myanmar during 2019-2021. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 347:123718. [PMID: 38447651 DOI: 10.1016/j.envpol.2024.123718] [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: 12/06/2023] [Revised: 02/15/2024] [Accepted: 03/03/2024] [Indexed: 03/08/2024]
Abstract
Air pollution has emerged as a significant global concern, particularly in urban centers. This study aims to investigate the temporal distribution of air pollutants, including PM2.5, PM10, and O3, utilizing multiple linear regression modeling. Additionally, the research incorporates the calculation of the Air Quality Index (AQI) and Autoregressive Integrated Moving Average (ARIMA) time series modeling to predict the AQI for PM2.5 and PM10. The concentrations and AQI values for PM2.5 ranged from 0 to 93.6 μg/m3 and 0 to 171, respectively, surpassing the Word Health Organization's (WHO) acceptable threshold levels. Similarly, concentrations and AQI values for PM10 ranged from 0.1 to 149.27 μg/m3 and 2-98 μg/m3, respectively, also exceeding WHO standards. Particulate matter pollution exhibited notable peaks during summer and winter. Key meteorological factors, including dew point temperature, relative humidity, and rainfall, showed a significant negative association with all pollutants, while ambient temperature exhibited a significant positive correlation with particulate matter. Multiple linear regression models of particulate matter for winter season demonstrated the highest model performance, explaining most of the variation in particulate matter concentrations. The annual multiple linear regression model for PM2.5 exhibited the most robust performance, explaining 60% of the variation, while the models for PM10 and O3 explained 45% of the variation in their concentrations. Time series modeling projected an increasing trend in the AQI for particulate matter in 2022. The precise and accurate results of this study serve as a valuable reference for developing effective air pollution control strategies and raising awareness of AQI in Myanmar.
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Affiliation(s)
- Tin Saw Pyae
- International Program of Hazardous Substances and Environmental Management, Graduate School, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Kraiwuth Kallawicha
- College of Public Health Sciences, Chulalongkorn University, Bangkok, 10330, Thailand.
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Zhang C, Zhang L. The relationship between toxic air pollution, health expenditure, and economic growth in the European Union: fresh evidence from the PMG-ARDL model. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2024; 31:21107-21123. [PMID: 38386160 DOI: 10.1007/s11356-024-32342-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 02/01/2024] [Indexed: 02/23/2024]
Abstract
Air pollution is a danger to economies throughout the European Union. Industry, population expansion, a building boom owing to housing and infrastructure development, increasing vehicle traffic, crowded streets, a lack of availability of clean fuel, and ineffective control programs are the primary causes. Toxic air is a double-edged sword for a country's health since it affects just a tiny fraction of Europe's population. The financial burden and healthcare expenses for people rise when health expenditures rise. The present research looks at how dangerous air levels, healthcare costs, and the expansion of the European Union's economy are all connected. The findings are based on data collected over 29 years and account for the abovementioned variables. The results of the unit root test have the significant probability values of all variables: health expenditures (HE), gross domestic product (GDP), nitrous oxides (NOX), and carbon dioxides (CO2) emissions at both level and first difference. We used the Johansen, Kao, and Pedroni cointegration tests to test the null hypothesis of no cointegration to see that sample variables had a long-term association. The PMG-ARDL test was used to get these findings. The results confirmed the significant probability values of dependent variables in long- and short-run results that GDP has a positive and significant effect on health expenditure, while NOX and CO2 emissions have a negative and significant impact on (HE), in the European Union. To verify the results, we applied the robustness test, fully modified OLS (FMOLD), and dynamic OLS (DOLS); the robustness test results validated the PMG-ARDL test results. Environmental pollution (CO2, NOX) has a significant and negative impact on healthcare expenditures and a significant effect on GDP (HE) in the EU region. The findings of this research have implications for a wide range of parties, including those who would examine the link between factors in a study meant to improve air quality, distribute health resources, or develop strategies for economic development.
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Affiliation(s)
- Changzheng Zhang
- Business School, Hohai University, Nanjing, Jiangsu, 211100, China
| | - Liqun Zhang
- Business School, Hohai University, Nanjing, Jiangsu, 211100, China.
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Li C, Yan Z, Zhang J. Medical cost of environmental pollution: evidence from the Chinese Social Survey. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:120155-120173. [PMID: 37936034 DOI: 10.1007/s11356-023-30459-y] [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: 07/21/2023] [Accepted: 10/10/2023] [Indexed: 11/09/2023]
Abstract
Environmental pollution impairs residents' health, while the pursuit of health is highly correlated to medical costs. Understanding how environmental pollution affects medical costs is closely linked to the welfare of society. Based on theoretical analysis, this paper uses data from 5112 households of the Chinese Social Survey (CSS) in 2019, constructs a composite indicator to quantify environmental pollution using respondents' evaluations, and empirically investigates the causal effect of environmental pollution on household medical cost and the mechanism. The conclusions are shown as follows. First, environmental pollution can increase household medical costs, and this estimation result still holds after dealing with the endogeneity problem and other robustness tests. Second, there is heterogeneity in the impact of environmental pollution on household medical costs, households in the upper socioeconomic class, with heavy pension burdens or with strong health insurance coverage are more sensitive to environmental pollution and incur relatively higher household medical costs. Third, environmental pollution reduces residents' satisfaction with their spiritual life, which adversely affects their physical and mental health and can increase household medical costs. Residents' satisfaction with their spiritual life is an important mechanism for environmental pollution to affect household health care expenditures. Therefore, governments should enhance the enforcement of environmental protection and governance, strengthen the awareness of green issues and health education, and increase the supply of facilities for leisure and sports, thus reducing medical costs due to environmental pollution and easing the medical burden of residents.
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Affiliation(s)
- Chengyou Li
- School of Finance, Shandong University of Finance and Economics, Jinan, 250014, China
| | - Zhaojun Yan
- School of Finance, Shandong University of Finance and Economics, Jinan, 250014, China
| | - Jitian Zhang
- Clinical Nutrition Department, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, China.
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Abbah AP, Xu S, Johannessen A. Long-term exposure to outdoor air pollution and asthma in low-and middle-income countries: A systematic review protocol. PLoS One 2023; 18:e0288667. [PMID: 37471334 PMCID: PMC10358890 DOI: 10.1371/journal.pone.0288667] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 07/01/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND Several epidemiological studies have examined the risk of asthma and respiratory diseases in association with long-term exposure to outdoor air pollution. However, little is known regarding the adverse effects of long-term exposure to outdoor air pollution on the development of these outcomes in low- and middle-income countries (LMICs). Our study aims to investigate the association between long-term exposure to outdoor air pollution and asthma and respiratory diseases in LMICs through a systematic review with meta-analysis. METHODS This systematic review and meta-analysis will follow the PRISMA (Preferred Reporting for Systematic Reviews and Meta-Analyses) checklist and flowchart guidelines. The inclusion criteria that will be used in our study are 1) Original research articles with full text in English; 2) Studies including adult humans; 3) Studies with long-term air pollution assessment in LMICs, air pollutants including nitrogen oxide (NO2), sulfur oxide (SO2), particulate matter (PM2.5 and PM10), carbon monoxide (CO) and ozone (O3); 4) cohort and cross-sectional studies; 5) Studies reporting associations between air pollution and asthma and respiratory symptoms. A comprehensive search strategy will be used to identify studies published up till August 2022 and indexed in Embase, Medline, and Web of Science. Three reviewers will independently screen records retrieved from the database searches. Where there are enough studies with similar exposure and outcomes, we will calculate, and report pooled effect estimates using meta-analysis. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42022311326. DISCUSSION Findings from the health effects of long-term exposure to outdoor air pollution may be of importance for policymakers. This review will also identify any gaps in the current literature on this topic in LMICs and provide direction for future research.
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Affiliation(s)
- Achenyo Peace Abbah
- Department of Global Public Healthand Primary Care, Center for International Health, University of Bergen, Bergen, Norway
| | - Shanshan Xu
- Department of Global Public Healthand Primary Care, Center for International Health, University of Bergen, Bergen, Norway
| | - Ane Johannessen
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
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Omri A, Kahouli B, Kahia M. Impacts of health expenditures and environmental degradation on health status—Disability-adjusted life years and infant mortality. Front Public Health 2023; 11:1118501. [PMID: 37056662 PMCID: PMC10086125 DOI: 10.3389/fpubh.2023.1118501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 03/02/2023] [Indexed: 03/30/2023] Open
Abstract
IntroductionHuman health and well-being are intimately related to environmental quality. In this respect, the present study contributes to the existing health economic literature by examining whether public and private health expenditures (PPHE) moderate the incidences of environmental degradation on the health status in Saudi Arabia, particularly disability-adjusted life years (DALYs) and infant mortality.MethodsUsing the fully modified ordinary least squares (FMOLS) method.Results and DiscussionThe empirical results revealed that (i) unconditional positive impacts of CO2 emissions on increasing DALYs and infant mortality; (ii) conditional negative impacts of public health expenditures on DALYs and infant mortality in all the estimated models, whereas global and private expenditure contribute only on reducing infant mortality; (iii) public health expenditure is more effective than private health expenditure in reducing infant mortality; (iv) the effects of the interactions between the indicators of both health expenditures and CO2 emissions on DALYs and infant mortality are negative and significant only for the specifications relating to public health expenditures, indicating that this later could be employed as a policy or conditional variable that moderates the adverse impacts of carbon emissions on the population’s health status. Generally, the study presents an overview of environmental health change’s effects and examine how these effects may be reduced through increasing health spending. The study provides recommendations for addressing health status, health expenditures, and carbon emissions, all of which are directly or indirectly linked to the study.
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Affiliation(s)
- Anis Omri
- Department of Business Administration, College of Business and Economics, Qassim University, Buraidah, Saudi Arabia
| | - Bassem Kahouli
- Community College, University of Ha’il, Ha’il, Saudi Arabia
- *Correspondence: Bassem Kahouli,
| | - Montassar Kahia
- Department of Finance and Economics, College of Business and Economics, Qassim University, Buraidah, Saudi Arabia
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Vaičiulis V, Venclovienė J, Miškinytė A, Ustinavičienė R, Dėdelė A, Kalinienė G, Lukšienė D, Tamošiūnas A, Seiduanova L, Radišauskas R. Association between Outdoor Air Pollution and Fatal Acute Myocardial Infarction in Lithuania between 2006 and 2015: A Time Series Design. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4549. [PMID: 36901560 PMCID: PMC10002310 DOI: 10.3390/ijerph20054549] [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: 01/16/2023] [Revised: 02/26/2023] [Accepted: 03/02/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Air pollution has a significant effect on human health and there is a broad body of evidence showing that exposure to air pollution is associated with an increased risk of adverse health effects. The main objective of this study was to assess the association of traffic-related air pollutants with fatal AMI during the ten-year period. METHODS The study was conducted in Kaunas city, where the WHO MONICA register included a total of 2273 adult cases of fatal AMI cases during the 10-year study period. We focused on the period between 2006 and 2015. The associations between exposure to traffic-related air pollution and the risk of fatal AMI were evaluated by using a multivariate Poisson regression model, RR presented per an increase in IQR. RESULTS It was found that the risk of fatal AMI was significantly higher in all subjects (RR 1.06; 95% CI 1.00-1.12) and women (RR 1.12; 95% CI 1.02-1.22) when the concentration of PM10 in the ambient air was increased 5-11 days before the onset of AMI, adjusting for NO2 concentration. The effect was stronger during spring in all subjects (RR 1.12; 95% CI 1.03-1.22), in men (RR 1.13; 95% CI 1.01-1.26), in younger-aged (RR 1.15; 95% CI 1.03-1.28), and in winter in women (RR 1.24; 95% CI 1.03-1.50). CONCLUSIONS Our findings show that ambient air pollution increases the risk of fatal AMI, and this pertains to PM10 specifically.
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Affiliation(s)
- Vidmantas Vaičiulis
- Health Research Institute, Lithuanian University of Health Sciences, Tilzes St. 18, 47181 Kaunas, Lithuania
- Department of Environmental and Occupational Medicine, Lithuanian University of Health Sciences, Tilzes St. 18, 47181 Kaunas, Lithuania
| | - Jonė Venclovienė
- Department of Environmental Sciences, Vytautas Magnus University, Donelaičio St. 58, 44248 Kaunas, Lithuania
- Institute of Cardiology, Lithuanian University of Health Sciences, Sukileliu Ave. 15, 50162 Kaunas, Lithuania
| | - Auksė Miškinytė
- Department of Environmental Sciences, Vytautas Magnus University, Donelaičio St. 58, 44248 Kaunas, Lithuania
| | - Rūta Ustinavičienė
- Department of Environmental and Occupational Medicine, Lithuanian University of Health Sciences, Tilzes St. 18, 47181 Kaunas, Lithuania
| | - Audrius Dėdelė
- Department of Environmental Sciences, Vytautas Magnus University, Donelaičio St. 58, 44248 Kaunas, Lithuania
| | - Gintarė Kalinienė
- Health Research Institute, Lithuanian University of Health Sciences, Tilzes St. 18, 47181 Kaunas, Lithuania
- Department of Environmental and Occupational Medicine, Lithuanian University of Health Sciences, Tilzes St. 18, 47181 Kaunas, Lithuania
| | - Dalia Lukšienė
- Department of Environmental and Occupational Medicine, Lithuanian University of Health Sciences, Tilzes St. 18, 47181 Kaunas, Lithuania
- Institute of Cardiology, Lithuanian University of Health Sciences, Sukileliu Ave. 15, 50162 Kaunas, Lithuania
| | - Abdonas Tamošiūnas
- Institute of Cardiology, Lithuanian University of Health Sciences, Sukileliu Ave. 15, 50162 Kaunas, Lithuania
| | - Laura Seiduanova
- Department of Health Politics and Management, School of Public Health, Asfendiyarov Kazakh National Medical University, Almaty 050000, Kazakhstan
| | - Ričardas Radišauskas
- Department of Environmental and Occupational Medicine, Lithuanian University of Health Sciences, Tilzes St. 18, 47181 Kaunas, Lithuania
- Institute of Cardiology, Lithuanian University of Health Sciences, Sukileliu Ave. 15, 50162 Kaunas, Lithuania
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