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Wang Y, Danesh Yazdi M, Wei Y, Schwartz JD. Air pollution below US regulatory standards and cardiovascular diseases using a double negative control approach. Nat Commun 2024; 15:8451. [PMID: 39349441 PMCID: PMC11444044 DOI: 10.1038/s41467-024-52117-8] [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: 10/31/2023] [Accepted: 08/23/2024] [Indexed: 10/02/2024] Open
Abstract
Growing evidence suggests that long-term air pollution exposure is a risk factor for cardiovascular mortality and morbidity. However, few studies have investigated air pollution below current regulatory limits, and causal evidence is limited. We use a double negative control approach to examine the association between long-term exposure to air pollution at low concentration and cardiovascular hospitalizations among US Medicare beneficiaries aged ≥65 years between 2000 and 2016. The expected values of the negative outcome control (preceding-year hospitalizations) regressed on exposure and negative exposure control (subsequent-year exposure) are treated as a surrogate for omitted confounders. With analyses separately restricted to low-pollution areas (PM2.5 < 9 μg/m³, NO2 < 75.2 µg/m3 [40 ppb], warm-season O3 < 88.2 μg/m3 [45 ppb]), we observed positive associations of the three pollutants with hospitalization rates of stroke, heart failure, and atrial fibrillation and flutter. The associations generally persisted in demographic subgroups. Stricter national air quality standards should be considered.
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Affiliation(s)
- Yichen Wang
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
- School of the Environment, Yale University, New Haven, CT, USA.
| | - Mahdieh Danesh Yazdi
- Program in Public Health, Department of Family, Population, & Preventive Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Yaguang Wei
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Environmental Medicine and Climate Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Joel D Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Yang B, Zhu Q, Wang W, Zhu Q, Zhang D, Jin Z, Prasad P, Sowlat M, Pakbin P, Ahangar F, Hasheminassab S, Liu Y. Impact of Warehouse Expansion on Ambient PM 2.5 and Elemental Carbon Levels in Southern California's Disadvantaged Communities: A Two-Decade Analysis. GEOHEALTH 2024; 8:e2024GH001091. [PMID: 39301088 PMCID: PMC11410679 DOI: 10.1029/2024gh001091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 08/13/2024] [Accepted: 08/20/2024] [Indexed: 09/22/2024]
Abstract
Over the past two decades, the surge in warehouse construction near seaports and in economically lower-cost land areas has intensified product transportation and e-commerce activities, particularly affecting air quality and health in nearby socially disadvantaged communities. This study, spanning from 2000 to 2019 in Southern California, investigated the relationship between ambient concentrations of PM2.5 and elemental carbon (EC) and the proliferation of warehouses. Utilizing satellite-driven estimates of annual mean ambient pollution levels at the ZIP code level and linear mixed effect models, positive associations were found between warehouse characteristics such as rentable building area (RBA), number of loading docks (LD), and parking spaces (PS), and increases in PM2.5 and EC concentrations. After adjusting for demographic covariates, an Interquartile Range increase of the RBA, LD, and PS were associated with a 0.16 μg/m³ (95% CI = [0.13, 0.19], p < 0.001), 0.10 μg/m³ (95% CI = [0.08, 0.12], p < 0.001), and 0.21 μg/m³ (95% CI = [0.18, 0.24], p < 0.001) increase in PM2.5, respectively. For EC concentrations, an IQR increase of RBA, LD, and PS were each associated with a 0.021 μg/m³ (95% CI = [0.019, 0.024], p < 0.001), 0.014 μg/m³ (95% CI = [0.012, 0.015], p < 0.001), and 0.021 μg/m³ (95% CI = [0.019, 0.024], p < 0.001) increase. The study also highlighted that disadvantaged populations, including racial/ethnic minorities, individuals with lower education levels, and lower-income earners, were disproportionately affected by higher pollution levels.
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Affiliation(s)
- Binyu Yang
- Gangarosa Department of Environmental Health Rollins School of Public Health Emory University Atlanta GA USA
| | - Qingyang Zhu
- Gangarosa Department of Environmental Health Rollins School of Public Health Emory University Atlanta GA USA
| | - Wenhao Wang
- Gangarosa Department of Environmental Health Rollins School of Public Health Emory University Atlanta GA USA
| | - Qiao Zhu
- Gangarosa Department of Environmental Health Rollins School of Public Health Emory University Atlanta GA USA
| | - Danlu Zhang
- Department of Biostatistics and Bioinformatics Rollins School of Public Health Emory University Atlanta GA USA
| | - Zhihao Jin
- Gangarosa Department of Environmental Health Rollins School of Public Health Emory University Atlanta GA USA
| | - Prachi Prasad
- Gangarosa Department of Environmental Health Rollins School of Public Health Emory University Atlanta GA USA
| | - Mohammad Sowlat
- South Coast Air Quality Management District Diamond Bar CA USA
| | - Payam Pakbin
- South Coast Air Quality Management District Diamond Bar CA USA
| | - Faraz Ahangar
- South Coast Air Quality Management District Diamond Bar CA USA
| | - Sina Hasheminassab
- Jet Propulsion Laboratory California Institute of Technology Pasadena CA USA
| | - Yang Liu
- Gangarosa Department of Environmental Health Rollins School of Public Health Emory University Atlanta GA USA
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Jones EM, Venkatachalam AM, Ifejika NL. Weathering the storm: Effect of climate change on acute stroke care and stroke rehabilitation. PM R 2024. [PMID: 39016015 DOI: 10.1002/pmrj.13218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 04/15/2024] [Accepted: 04/19/2024] [Indexed: 07/18/2024]
Abstract
Climate change has deleterious effects on stroke recovery, disproportionately affecting populations with increased stroke incidence. These effects start prior to the acute care hospitalization, precipitated by environmental etiologies and are sustained throughout the life course of stroke survivors. Health care practitioners play a critical role in identifying these concerns and mitigating their impact through effective strategies at the patient level, interventions at the community level, and advocacy at the state and federal level. As the experts on improvement in function, quality of life, and the mitigation of disability, physiatrists have the opportunity to lead efforts in this space for stroke survivors and their caregivers.
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Affiliation(s)
- Erica M Jones
- Department of Neurology, UT Southwestern Medical Center, Dallas, Texas, USA
| | | | - Nneka L Ifejika
- Department of Neurology, UT Southwestern Medical Center, Dallas, Texas, USA
- Department of Physical Medicine and Rehabilitation, UT Southwestern Medical Center, Dallas, Texas, USA
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Wang Y, Mahdieh DY, Wei Y, Schwartz J. Long-Term Exposure to Air Pollution Below Regulatory Standards and Cardiovascular Diseases Among US Medicare Beneficiaries: A Double Negative Control Approach. RESEARCH SQUARE 2023:rs.3.rs-3530201. [PMID: 38045234 PMCID: PMC10690329 DOI: 10.21203/rs.3.rs-3530201/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
Growing evidence suggests that long-term air pollution exposure is a risk factor for cardiovascular mortality and morbidity. However, few studies have investigated air pollution below current regulatory limits, and causal evidence is limited. We used a double negative control approach to examine the association between long-term exposure to air pollution at low concentrations and three major cardiovascular events among Medicare beneficiaries aged ≥ 65 years across the contiguous United States between 2000 and 2016. We derived ZIP code-level estimates of ambient fine particulate matter (PM2.5), nitrogen dioxide (NO2), and warm-season ozone (O3) from high-resolution spatiotemporal models. The outcomes of interest were hospitalizations for stroke, heart failure (HF), and atrial fibrillation and flutter (AF). The analyses were restricted to areas with consistently low pollutant levels on an annual basis (PM2.5 <10 μg/m3, NO2 < 45 or 40 ppb, warm-season O3 < 45 or 40 ppb). For each 1 μg/m3 increase in PM2.5, the hospitalization rates increased by 2.25% (95% confidence interval (CI): 1.96%, 2.54%) for stroke and 3.14% (95% CI: 2.80%, 3.94%) for HF. Each ppb increase in NO2 increased hospitalization rates for stroke, HF, and AF by 0.28% (95% CI: 0.25%, 0.31%), 0.56% (95% CI: 0.52%, 0.60%), and 0.45% (95% CI: 0.41%, 0.49%), respectively. For each ppb increase in warm-season O3, there was a 0.32% (95% CI: 0.21%, 0.44%) increase in hospitalization rate for stroke. The associations for NO2 and warm-season O3 became stronger under a more restrictive upper threshold. Using an approach robust to omitted confounders, we concluded that long-term exposure to low-level PM2.5, NO2, and warm-season O3 was associated with increased risks of cardiovascular diseases in the US elderly. Stricter national air quality standards should be considered.
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Liu CS, Wei Y, Danesh Yazdi M, Qiu X, Castro E, Zhu Q, Li L, Koutrakis P, Ekenga CC, Shi L, Schwartz JD. Long-term association of air pollution and incidence of lung cancer among older Americans: A national study in the Medicare cohort. ENVIRONMENT INTERNATIONAL 2023; 181:108266. [PMID: 37847981 PMCID: PMC10691920 DOI: 10.1016/j.envint.2023.108266] [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: 04/25/2023] [Revised: 10/03/2023] [Accepted: 10/12/2023] [Indexed: 10/19/2023]
Abstract
BACKGROUND Despite strong evidence of the association of fine particulate matter (PM2.5) exposure with an increased risk of lung cancer mortality, few studies had investigated associations of multiple pollutants simultaneously, or with incidence, or using causal methods. Disparities were also understudied. OBJECTIVES We investigated long-term effects of PM2.5, nitrogen dioxide (NO2), warm-season ozone, and particle radioactivity (PR) exposures on lung cancer incidence in a nationwide cohort. METHODS We conducted a cohort study with Medicare beneficiaries (aged ≥ 65 years) continuously enrolled in the fee-for-service program in the contiguous US from 2001 to 2016. Air pollution exposure was averaged across three years and assigned based on ZIP code of residence. We fitted Cox proportional hazards models to estimate the hazard ratio (HR) for lung cancer incidence, adjusted for individual- and neighborhood-level confounders. As a sensitivity analysis, we evaluated the causal relationships using inverse probability weights. We further assessed effect modifications by individual- and neighborhood-level covariates. RESULTS We identified 166,860 lung cancer cases of 12,429,951 studied beneficiaries. In the multi-pollutant model, PM2.5 and NO2 exposures were statistically significantly associated with increased lung cancer incidence, while PR was marginally significantly associated. Specifically, the HR was 1.008 (95% confidence interval [CI]: 1.005, 1.011) per 1-μg/m3 increase in PM2.5, 1.013 (95% CI: 1.012, 1.013) per 1-ppb increase in NO2, and 1.005 (0.999, 1.012) per 1-mBq/m3 increase in PR. At low exposure levels, all pollutants were associated with increased lung cancer incidence. Men, older individuals, Blacks, and residents of low-income neighborhoods experienced larger effects of PM2.5 and PR. DISCUSSION Long-term PM2.5, NO2, and PR exposures were independently associated with increased lung cancer incidence among the national elderly population. Low-exposure analysis indicated that current national standards for PM2.5 and NO2 were not restrictive enough to protect public health, underscoring the need for more stringent air quality regulations.
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Affiliation(s)
- Cristina Su Liu
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 655 Huntington Ave, Boston, MA 02115, USA
| | - Yaguang Wei
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 655 Huntington Ave, Boston, MA 02115, USA.
| | - Mahdieh Danesh Yazdi
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 655 Huntington Ave, Boston, MA 02115, USA; Program in Public Health, Department of Family, Population and Preventive Medicine, Stony Brook University, 101 Nicolls Road Health Sciences Center, Stony Brook, NY 11794, USA
| | - Xinye Qiu
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 655 Huntington Ave, Boston, MA 02115, USA
| | - Edgar Castro
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 655 Huntington Ave, Boston, MA 02115, USA
| | - Qiao Zhu
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd. NE, Atlanta, GA 30322, USA
| | - Longxiang Li
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 655 Huntington Ave, Boston, MA 02115, USA
| | - Petros Koutrakis
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 655 Huntington Ave, Boston, MA 02115, USA
| | - Christine C Ekenga
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd. NE, Atlanta, GA 30322, USA
| | - Liuhua Shi
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd. NE, Atlanta, GA 30322, USA
| | - Joel D Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 655 Huntington Ave, Boston, MA 02115, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, 655 Huntington Ave, Boston, MA 02115, USA
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Wei Y, Danesh Yazdi M, Ma T, Castro E, Liu CS, Qiu X, Healy J, Vu BN, Wang C, Shi L, Schwartz J. Additive effects of 10-year exposures to PM 2.5 and NO 2 and primary cancer incidence in American older adults. Environ Epidemiol 2023; 7:e265. [PMID: 37545804 PMCID: PMC10402937 DOI: 10.1097/ee9.0000000000000265] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 07/10/2023] [Indexed: 08/08/2023] Open
Abstract
Epidemiologic evidence on the relationships between air pollution and the risks of primary cancers other than lung cancer remained largely lacking. We aimed to examine associations of 10-year exposures to fine particulate matter (PM2.5) and nitrogen dioxide (NO2) with risks of breast, prostate, colorectal, and endometrial cancers. Methods For each cancer, we constructed a separate cohort among the national Medicare beneficiaries during 2000 to 2016. We simultaneously examined the additive associations of six exposures, namely, moving average exposures to PM2.5 and NO2 over the year of diagnosis and previous 2 years, previous 3 to 5 years, and previous 6 to 10 years, with the risk of first cancer diagnosis after 10 years of follow-up, during which there was no cancer diagnosis. Results The cohorts included 2.2 to 6.5 million subjects for different cancers. Exposures to PM2.5 and NO2 were associated with increased risks of colorectal and prostate cancers but were not associated with endometrial cancer risk. NO2 was associated with a decreased risk of breast cancer, while the association for PM2.5 remained inconclusive. At exposure levels below the newly updated World Health Organization Air Quality Guideline, we observed substantially larger associations between most exposures and the risks of all cancers, which were translated to hundreds to thousands new cancer cases per year within the cohort per unit increase in each exposure. Conclusions These findings suggested substantial cancer burden was associated with exposures to PM2.5 and NO2, emphasizing the urgent need for strategies to mitigate air pollution levels.
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Affiliation(s)
- Yaguang Wei
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Mahdieh Danesh Yazdi
- Program in Public Health, Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, New York
| | - Tszshan Ma
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Edgar Castro
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Cristina Su Liu
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Xinye Qiu
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - James Healy
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Bryan N. Vu
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Cuicui Wang
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Liuhua Shi
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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Wang Y, Luo S, Wei J, Yang Z, Hu K, Yao Y, Zhang Y. Ambient NO 2 exposure hinders long-term survival of Chinese middle-aged and older adults. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 855:158784. [PMID: 36116662 DOI: 10.1016/j.scitotenv.2022.158784] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 08/25/2022] [Accepted: 09/11/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Serval longitudinal investigations have reported relationships between long-term nitrogen dioxide (NO2) exposure and mortality. In developing countries such as China, however, the cohort evidence was extremely rare. In this study, we aimed to establish the concentration-response relationship between long-term exposure to NO2 and mortality in Chinese adults. METHODS We conducted a prospective cohort study followed up from 2011 to 2018, by enrolling 15,440 participants aged ≥45 years from 28 provincial regions of China. NO2 concentration estimates were derived from high-quality spatiotemporal datasets developed by machine learning methods and were assigned for each participant according to their residential cities. We applied Cox proportional hazard models with time-varying exposures to assess the association of all-cause death with long-term NO2 exposure. Subgroup analyses were performed to identify effect modifications. RESULTS A total of 1646 death events occurred during 105,478.5 person-years' follow-up (median 7.1 years). No evident violation for linear NO2-mortality relationship (P nonlinear = 0.332) was observed at a range of 7.4-45.0 μg/m3. Per 10-μg/m3 rise in NO2 was associated with an hazard ratio of 1.220 (95% confidence interval: 1.103-1.350) for all-cause mortality. The association between NO2 and mortality was generally robust after adjusting for co-pollutants including fine particulate matter or/and ozone. Only participants aged 65 and over (1.351 [1.193-1.531]) suffered from increased risks of death associated with NO2 exposure, and an evident effect modification by age (P = 0.008) was identified. The elevated risk of death induced by NO2 was also observed in participants living in rural areas and those with elementary school education or below, though effect modifications were non-significant in these subgroups. CONCLUSIONS This study provided novel evidence that long-term NO2 exposure could be an independent risk for mortality among Chinese middle-aged and older adults. Our findings highlighted the importance of controlling air pollution induced by vehicle emissions.
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Affiliation(s)
- Yaqi Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University of Science and Technology, Wuhan, Hubei, China
| | - Siqi Luo
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University of Science and Technology, Wuhan, Hubei, China
| | - Jing Wei
- Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park 20742, USA
| | - Zhiming Yang
- School of Economics and Management, University of Science and Technology Beijing, Beijing 100083, China
| | - Kejia Hu
- Institute of Big Data in Health Science, School of Public Health, Zhejiang University, Hangzhou 310058, China
| | - Yao Yao
- China Center for Health Development Studies, Peking University, Beijing 100191, China
| | - Yunquan Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University of Science and Technology, Wuhan, Hubei, China; Hubei Province Key Laboratory of Occupational Hazard Identification and Control, Wuhan University of Science and Technology, Wuhan 430065, China.
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Danesh Yazdi M, Nassan FL, Kosheleva A, Wang C, Xu Z, Di Q, Requia WJ, Comfort NT, Wu H, Laurent LC, DeHoff P, Vokonas P, Baccarelli AA, Schwartz JD. Short-term air pollution and temperature exposure and changes in the extracellular microRNA profile of Normative Aging Study (NAS) participants. ENVIRONMENT INTERNATIONAL 2023; 171:107735. [PMID: 36640488 PMCID: PMC10159015 DOI: 10.1016/j.envint.2023.107735] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 01/02/2023] [Accepted: 01/04/2023] [Indexed: 05/06/2023]
Abstract
BACKGROUND While the health effects of air pollution and temperature are widely studied, the molecular effects are poorly understood. Extracellular microRNAs (ex-miRNAs) have the potential to serve as diagnostic or prognostic biomarkers and/or to act as intercellular signaling molecules that mediate the effects of environmental exposures on health outcomes. METHODS We examined the relationship between short-term exposure to air pollution and ambient temperature and the ex-miRNA profiles of participants in the Normative Aging Study (NAS) from 1999 to 2015. Our exposures were defined as same-day, two-day, three-day, one-week, two-week, and three-week moving averages of PM2.5, NO2, O3, and temperature which were derived from high-resolution spatio-temporal models. The ex-miRNA profiles of the subjects were obtained during follow-up visits. We analyzed the data using a longitudinal quantile regression model adjusted for individual covariates, batch effects, and time trends. We adjusted for multiple comparisons using a false discovery rate (FDR) correction. Ex-miRNAs that were significantly associated with exposures were further investigated using pathway analyses. RESULTS We found that all the examined exposures were associated with changes in ex-miRNA profiles in our study, particularly PM2.5 which was responsible for most of the statistically significant results. We found 110 statistically significant exposure-outcome relationships that revealed associations with the levels of 52 unique ex-miRNAs. Pathway analyses showed these ex-miRNAs have been linked to target mRNAs, genes, and biological mechanisms that could affect virtually every organ system, and as such may be linked to multiple clinical disease presentations such as cardiovascular disease, respiratory disease, and neurological disease. CONCLUSIONS Air pollution and temperature exposures were significantly associated with alterations in the ex-miRNA profiles of NAS subjects with possible biological consequences.
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Affiliation(s)
- Mahdieh Danesh Yazdi
- Program in Public Health, Department of Family, Population, and Preventive Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA; Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA.
| | - Feiby L Nassan
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA; Biogen Inc, Cambridge, MA, USA
| | - Anna Kosheleva
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Cuicui Wang
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Zongli Xu
- Laboratory of Molecular Carcinogenesis and Biostatistics Branch, National Institute of Environmental Health Sciences, Durham, NC, USA
| | - Qian Di
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Weeberb J Requia
- School of Public Policy and Government, Fundação Getúlio Vargas, Brasília, Distrito Federal, Brazil
| | - Nicole T Comfort
- Department of Environmental Health Sciences, Columbia Mailman School of Public Health, New York, NY, USA
| | - Haotian Wu
- Department of Environmental Health Sciences, Columbia Mailman School of Public Health, New York, NY, USA
| | - Louise C Laurent
- Department of Obstetrics, Gynecology, & Reproductive Sciences, University of California San Diego, La Jolla, CA, USA
| | - Peter DeHoff
- Department of Obstetrics, Gynecology, & Reproductive Sciences, University of California San Diego, La Jolla, CA, USA
| | - Pantel Vokonas
- Department of Veterans Affairs, Boston, MA, USA; Department of Medicine, Boston University Chobanian and Avidisian School of Medicine, Boston, MA, USA
| | - Andrea A Baccarelli
- Department of Environmental Health Sciences, Columbia Mailman School of Public Health, New York, NY, USA
| | - Joel D Schwartz
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
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Jin T, Di Q, Réquia WJ, Danesh Yazdi M, Castro E, Ma T, Wang Y, Zhang H, Shi L, Schwartz J. Associations between long-term air pollution exposure and the incidence of cardiovascular diseases among American older adults. ENVIRONMENT INTERNATIONAL 2022; 170:107594. [PMID: 36283157 PMCID: PMC9798657 DOI: 10.1016/j.envint.2022.107594] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 10/03/2022] [Accepted: 10/18/2022] [Indexed: 05/28/2023]
Abstract
BACKGROUND & AIM Numerous studies have linked air pollution with cardiovascular diseases. Fewer studies examined the associations at low concentration levels or assessed potential modifiers. Some investigations only examined hospitalizations, which can miss incident cases. This study aims to address these gaps through a nationwide cohort study of Medicare enrollees. METHODS Our study cohort comprise all Medicare enrollees (≥65 years old) continuously enrolled in the fee-for-service program and both Medicare part A and B across the contiguous U.S. from 2000 to 2016. We examined the associations of population-weighted ZIP code-level annual average PM2.5, NO2, and warm-season O3 (May-October), with the first diagnoses of atrial fibrillation (AF), congestive heart failure (CHF), and stroke. We fit multi-pollutant Cox proportional hazards models adjusted for individual demographic characteristics and area-level covariates. We further examined these associations at low pollutant concentration levels and the potential effect modifications by race/ethnicity and comorbidities (diabetes, hypertension, hyperlipidemia). RESULTS Elevated PM2.5 and NO2 levels were associated with increased incidence of AF, CHF, and stroke. For each 1 μg/m3 increase in annual PM2.5, hazard ratios (HRs) were 1.0059 (95%CI: 1.0054-1.0064), 1.0260 (95%CI: 1.0256-1.0264), and 1.0279 (95%CI: 1.0274-1.0284), respectively. For each1 ppb increase in annual NO2, HRs are 1.0057 (95%CI: 1.0056-1.0059), 1.0112 (95%CI: 1.0110-1.0113), and 1.0095 (95%CI: 1.0093-1.0096), respectively. For warm-season O3, each 1 ppb increase was associated with increased incidence of CHF (HR=1.0035, 95%CI: 1.0033-1.0037) and stroke (HR=1.0026, 95%CI: 1.0023-1.0028). Larger magnitudes of HRs were observed when restricted to pollutants levels lower than NAAQS standards. Generally higher risks were observed for Black people and diabetics. CONCLUSIONS Long-term exposure to PM2.5, NO2, and warm-season O3 were associated with increased incidence of cardiovascular diseases, even at low pollutant concentration levels. Black people and people with diabetes were found to be vulnerable populations.
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Affiliation(s)
- Tingfan Jin
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Qian Di
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Weeberb J Réquia
- School of Public Policy and Government, Fundação Getúlio Vargas, Brasília, Distrito Federal, Brazil
| | - Mahdieh Danesh Yazdi
- Program in Public Health, Department of Family, Population, & Preventive Medicine, Stony Brook University, NY, USA
| | - Edgar Castro
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Tszshan Ma
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Yifan Wang
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Haisu Zhang
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Liuhua Shi
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Mainka A, Żak M. Synergistic or Antagonistic Health Effects of Long- and Short-Term Exposure to Ambient NO 2 and PM 2.5: A Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14079. [PMID: 36360958 PMCID: PMC9657687 DOI: 10.3390/ijerph192114079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 10/24/2022] [Accepted: 10/26/2022] [Indexed: 05/31/2023]
Abstract
Studies on adverse health effects associated with air pollution mostly focus on individual pollutants. However, the air is a complex medium, and thus epidemiological studies face many challenges and limitations in the multipollutant approach. NO2 and PM2.5 have been selected as both originating from combustion processes and are considered to be the main pollutants associated with traffic; moreover, both elicit oxidative stress responses. An answer to the question of whether synergistic or antagonistic health effects of combined pollutants are demonstrated by pollutants monitored in ambient air is not explicit. Among the analyzed studies, only a few revealed statistical significance. Exposure to a single pollutant (PM2.5 or NO2) was mostly associated with a small increase in non-accidental mortality (HR:1.01-1.03). PM2.5 increase of <10 µg/m3 adjusted for NO2 as well as NO2 adjusted for PM2.5 resulted in a slightly lower health risk than a single pollutant. In the case of cardiovascular heart disease, mortality evoked by exposure to PM2.5 or NO2 adjusted for NO2 and PM2.5, respectively, revealed an antagonistic effect on health risk compared to the single pollutant. Both short- and long-term exposure to PM2.5 or NO2 adjusted for NO2 and PM2.5, respectively, revealed a synergistic effect appearing as higher mortality from respiratory diseases.
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Affiliation(s)
- Anna Mainka
- Department of Air Protection, Silesian University of Technology, 22B Konarskiego St., 44-100 Gliwice, Poland
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Mohi-Ud-Din R, Mir RH, Mir PA, Banday N, Shah AJ, Sawhney G, Bhat MM, Batiha GE, Pottoo FH, Pottoo FH. Dysfunction of ABC Transporters at the Surface of BBB: Potential Implications in Intractable Epilepsy and Applications of Nanotechnology Enabled Drug Delivery. Curr Drug Metab 2022; 23:735-756. [PMID: 35980054 DOI: 10.2174/1389200223666220817115003] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 05/10/2022] [Accepted: 05/31/2022] [Indexed: 01/05/2023]
Abstract
Epilepsy is a chronic neurological disorder affecting 70 million people globally. One of the fascinating attributes of brain microvasculature is the (BBB), which controls a chain of distinct features that securely regulate the molecules, ions, and cells movement between the blood and the parenchyma. The barrier's integrity is of paramount importance and essential for maintaining brain homeostasis, as it offers both physical and chemical barriers to counter pathogens and xenobiotics. Dysfunction of various transporters in the (BBB), mainly ATP binding cassette (ABC), is considered to play a vital role in hampering the availability of antiepileptic drugs into the brain. ABC (ATP-binding cassette) transporters constitute a most diverse protein superfamily, which plays an essential part in various biological processes, including cell homeostasis, cell signaling, uptake of nutrients, and drug metabolism. Moreover, it plays a crucial role in neuroprotection by out-flowing various internal and external toxic substances from the interior of a cell, thus decreasing their buildup inside the cell. In humans, forty-eight ABC transporters have been acknowledged and categorized into subfamilies A to G based on their phylogenetic analysis. ABC subfamilies B, C, and G, impart a vital role at the BBB in guarding the brain against the entrance of various xenobiotic and their buildup. The illnesses of the central nervous system have received a lot of attention lately Owing to the existence of the BBB, the penetration effectiveness of most CNS medicines into the brain parenchyma is very limited (BBB). In the development of neurological therapies, BBB crossing for medication delivery to the CNS continues to be a major barrier. Nanomaterials with BBB cross ability have indeed been extensively developed for the treatment of CNS diseases due to their advantageous properties. This review will focus on multiple possible factors like inflammation, oxidative stress, uncontrolled recurrent seizures, and genetic polymorphisms that result in the deregulation of ABC transporters in epilepsy and nanotechnology-enabled delivery across BBB in epilepsy.
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Affiliation(s)
- Roohi Mohi-Ud-Din
- Department of General Medicine, Sher-I-Kashmir Institute of Medical Sciences (SKIMS), Srinagar, Jammu & Kashmir, 190011, India.,Department of Pharmaceutical Sciences, School of Applied Sciences & Technology, University of Kashmir, Hazratbal, Srinagar-190006, Jammu & Kashmir, India
| | - Reyaz Hassan Mir
- Pharmaceutical Chemistry Division, Chandigarh College of Pharmacy, Landran, Punjab-140301, India.,Department of Pharmaceutical Sciences, Pharmaceutical Chemistry Division, University of Kashmir, Hazratbal, Srinagar-190006, Kashmir, India
| | - Prince Ahad Mir
- Department of Pharmaceutical Sciences, Khalsa College of Pharmacy, G.T. Road, Amritsar-143002, Punjab, India
| | - Nazia Banday
- Department of Pharmaceutical Sciences, School of Applied Sciences & Technology, University of Kashmir, Hazratbal, Srinagar-190006, Jammu & Kashmir, India
| | - Abdul Jalil Shah
- Department of Pharmaceutical Sciences, Pharmaceutical Chemistry Division, University of Kashmir, Hazratbal, Srinagar-190006, Kashmir, India
| | - Gifty Sawhney
- Inflammation Pharmacology Division, CSIR-Indian Institute of Integrative Medicine, Canal Road, Jammu-Tawi, Jammu 180001, India
| | - Mudasir Maqbool Bhat
- Department of Pharmaceutical Sciences, Pharmacy Practice Division, University of Kashmir, Hazratbal, Srinagar-190006, Jammu & Kashmir, India
| | - Gaber E Batiha
- Department of Pharmacology and Therapeutics, Faculty of Veterinary Medicine, Damanhour University, Damanhour 22511, AlBeheira, Egypt
| | - Faheem Hyder Pottoo
- Department of Pharmacology, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
| | - Faheem Hyder Pottoo
- Department of Pharmacology, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, 31441, Dammam, Saudi Arabia
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Sîrbu CA, Stefan I, Dumitru R, Mitrica M, Manole AM, Vasile TM, Stefani C, Ranetti AE. Air Pollution and Its Devastating Effects on the Central Nervous System. Healthcare (Basel) 2022; 10:1170. [PMID: 35885697 PMCID: PMC9324939 DOI: 10.3390/healthcare10071170] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/14/2022] [Accepted: 06/21/2022] [Indexed: 11/23/2022] Open
Abstract
Air pollution is a real public health problem, it being one of the five most common causes of mortality in developing countries. However, pollution studies have focused on the cardiovascular and pulmonary systems in recent decades. Recently, researchers have moved towards a new direction, tracing a direct link between pollution and stroke. Stroke has many known risk factors such as smoking, a sedentary lifestyle, and hypertension. Pollution is universally widespread, already a matter of public interest, so that, although intuitive, it is difficult to connect the two. The particles found in the air that we breathe, regardless of their origin, can attack the body in different ways, causing inflammation, and triggering a true cascade of phenomena that end up attacking the central nervous system and other organs. This article tries to explain the series of phenomena that determine the harmful effect of particles present in the air, with an increased focus on the central nervous system and especially on strokes. A deeper understanding of these phenomena helps in guiding future studies and finding viable solutions to protect people at risk.
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Affiliation(s)
- Carmen Adella Sîrbu
- Department of Neurology, ‘Dr. Carol Davila’ Central Military Emergency University Hospital, 010242 Bucharest, Romania; (C.A.S.); (R.D.)
| | - Ion Stefan
- Department of Infectious Diseases, ‘Dr. Carol Davila’ Central Military Emergency University Hospital, 010242 Bucharest, Romania
- Department of Medico-Surgical and Prophylactic Disciplines, Titu Maiorescu University, 031593 Bucharest, Romania
| | - Rodica Dumitru
- Department of Neurology, ‘Dr. Carol Davila’ Central Military Emergency University Hospital, 010242 Bucharest, Romania; (C.A.S.); (R.D.)
| | - Marian Mitrica
- Clinical Neurosciences Department, University of Medicine and Pharmacy “Carol Davila” Bucharest, 050474 Bucharest, Romania;
| | - Aida Mihaela Manole
- Department of Neurology, Clinical Ambulatory, ‘Dr. Carol Davila’ Central Military Emergency University Hospital, 010242 Bucharest, Romania;
| | - Titus Mihai Vasile
- Clinical Neurosciences Department, University of Medicine and Pharmacy “Carol Davila” Bucharest, 050474 Bucharest, Romania;
| | - Constantin Stefani
- Department of Family Medicine and Clinical Base, ‘Dr. Carol Davila’ Central Military Emergency University Hospital, 010242 Bucharest, Romania;
- Department No. 5, University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania
| | - Aurelian Emil Ranetti
- Department No. 2, University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania;
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