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Antaya TC, Espino-Alvarado PH, Oiamo T, Wilk P, Speechley KN, Burneo JG. Association of outdoor air and noise pollution with unprovoked seizures and new onset epilepsy: A systematic review and meta-analysis. Epilepsia 2024; 65:1847-1867. [PMID: 38776166 DOI: 10.1111/epi.18010] [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: 01/30/2024] [Revised: 04/29/2024] [Accepted: 04/30/2024] [Indexed: 05/24/2024]
Abstract
Research has indicated that certain environmental exposures may increase the risk of unprovoked seizures and new onset epilepsy. This study aimed to synthesize the literature that has estimated the associations between short- and long-term exposure to outdoor air and noise pollution and the risk of unprovoked seizures and new onset epilepsy. We searched Embase, MEDLINE, Scopus, Web of Science, BIOSIS Previews, Latin American and Caribbean Health Sciences Literature, Proquest Dissertations and Theses, conference abstracts, and the gray literature and conducted citation tracing in June 2023. Observational and ecological studies assessing the associations of air and noise pollution with unprovoked seizures or new onset epilepsy were eligible. One reviewer extracted summary data. Using fixed and random effects models, we calculated the pooled risk ratios (RRs) for the studies assessing the associations between short-term exposure to air pollution and unprovoked seizures. Seventeen studies were included, 16 assessing the association of air pollution with seizures and one with epilepsy. Eight studies were pooled quantitatively. Ozone (O3; RR = .99, 95% confidence interval [CI] = .99-.99) and nitrogen dioxide (NO2) exposure adjusted for particulate matter (RR = 1.02, 95% CI = 1.01-1.02) on the same day, and carbon monoxide (CO) exposure 2 days prior (RR = 1.12, 95% CI = 1.02-1.22), were associated with seizure risk. A single study of air pollution and epilepsy did not report a significant association. The risk of bias and heterogeneity across studies was moderate or high. Short-term exposure to O3, NO2, and CO may affect the risk of seizures; however, the effect estimates for O3 and NO2 were minimal. Additional research should continue to explore these and the associations between outdoor air pollution and epilepsy and between noise pollution and seizures and epilepsy.
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Affiliation(s)
- Tresah C Antaya
- Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada
- Neuroepidemiology Research Unit, Western University, London, Ontario, Canada
- Lawson Health Research Institute, London, Ontario, Canada
| | - Poul H Espino-Alvarado
- Lawson Health Research Institute, London, Ontario, Canada
- Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada
| | - Tor Oiamo
- Department of Geography and Environmental Studies, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Piotr Wilk
- Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada
- Lawson Health Research Institute, London, Ontario, Canada
- Department of Paediatrics, Western University, London, Ontario, Canada
| | - Kathy N Speechley
- Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada
- Lawson Health Research Institute, London, Ontario, Canada
- Department of Paediatrics, Western University, London, Ontario, Canada
| | - Jorge G Burneo
- Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada
- Neuroepidemiology Research Unit, Western University, London, Ontario, Canada
- Lawson Health Research Institute, London, Ontario, Canada
- Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada
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Ramamoorthy T, Nath A, Singh S, Mathew S, Pant A, Sheela S, Kaur G, Sathishkumar K, Mathur P. Assessing the Global Impact of Ambient Air Pollution on Cancer Incidence and Mortality: A Comprehensive Meta-Analysis. JCO Glob Oncol 2024; 10:e2300427. [PMID: 38513187 DOI: 10.1200/go.23.00427] [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: 11/13/2023] [Revised: 12/14/2023] [Accepted: 01/30/2024] [Indexed: 03/23/2024] Open
Abstract
PURPOSE This study aims to examine the association between exposure to major ambient air pollutants and the incidence and mortality of lung cancer and some nonlung cancers. METHODS This meta-analysis used PubMed and EMBASE databases to access published studies that met the eligibility criteria. Primary analysis investigated the association between exposure to air pollutants and cancer incidence and mortality. Study quality was assessed using the Newcastle Ottawa Scale. Meta-analysis was conducted using R software. RESULTS The meta-analysis included 61 studies, of which 53 were cohort studies and eight were case-control studies. Particulate matter 2.5 mm or less in diameter (PM2.5) was the exposure pollutant in half (55.5%), and lung cancer was the most frequently studied cancer in 59% of the studies. A pooled analysis of exposure reported in cohort and case-control studies and cancer incidence demonstrated a significant relationship (relative risk [RR], 1.04 [95% CI, 1.02 to 1.05]; I2, 88.93%; P < .05). A significant association was observed between exposure to pollutants such as PM2.5 (RR, 1.08 [95% CI, 1.04 to 1.12]; I2, 68.52%) and nitrogen dioxide (NO2) (RR, 1.03 [95% CI, 1.01 to 1.05]; I2, 73.52%) and lung cancer incidence. The relationship between exposure to the air pollutants and cancer mortality demonstrated a significant relationship (RR, 1.08 [95% CI, 1.07 to 1.10]; I2, 94.77%; P < .001). Among the four pollutants, PM2.5 (RR, 1.15 [95% CI, 1.08 to 1.22]; I2, 95.33%) and NO2 (RR, 1.05 [95% CI, 1.02 to 1.08]; I2, 89.98%) were associated with lung cancer mortality. CONCLUSION The study confirms the association between air pollution exposure and lung cancer incidence and mortality. The meta-analysis results could contribute to community cancer prevention and diagnosis and help inform stakeholders and policymakers in decision making.
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Affiliation(s)
- Thilagavathi Ramamoorthy
- Indian Council of Medical Research- National Centre for Disease Informatics and Research, Bengaluru, India
| | - Anita Nath
- Indian Council of Medical Research- National Centre for Disease Informatics and Research, Bengaluru, India
| | - Shubhra Singh
- Indian Council of Medical Research- National Centre for Disease Informatics and Research, Bengaluru, India
| | - Stany Mathew
- Indian Council of Medical Research- National Centre for Disease Informatics and Research, Bengaluru, India
| | - Apourv Pant
- Indian Council of Medical Research- National Centre for Disease Informatics and Research, Bengaluru, India
| | - Samvedana Sheela
- Indian Council of Medical Research- National Centre for Disease Informatics and Research, Bengaluru, India
| | - Gurpreet Kaur
- Indian Council of Medical Research- National Centre for Disease Informatics and Research, Bengaluru, India
| | - Krishnan Sathishkumar
- Indian Council of Medical Research- National Centre for Disease Informatics and Research, Bengaluru, India
| | - Prashant Mathur
- Indian Council of Medical Research- National Centre for Disease Informatics and Research, Bengaluru, India
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Guo Y, Luo C, Cao F, Liu J, Yan J. Short-term environmental triggers of hemorrhagic stroke. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 265:115508. [PMID: 37774546 DOI: 10.1016/j.ecoenv.2023.115508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 09/18/2023] [Accepted: 09/19/2023] [Indexed: 10/01/2023]
Abstract
Hemorrhagic stroke (HS) is associated with severe morbidity and high mortality. Identifying the trigger factors for HS is critical for disease prevention. This study aimed to assess the associations between short-term environmental triggers (STETs) and HS risk. We systematically searched six databases for articles published up to September 9, 2022. Pooled odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated using random-effect models to evaluate the associations between STETs and the risk of HS. Heterogeneity was assessed using Cochran Q and I2 tests. A total of 63 studies were included for analysis. Of these, 40 focused on air pollutants and 23 on meteorological factors. Pooling results showed that exposure to particulate matter 2.5 (PM2.5; OR, 1.003 per 10 μg/m3; 95% CI, 1.001-1.007), sulfur dioxide (SO2; OR, 1.022 per 10 ppb; 95% CI, 1.005-1.040), and nitrogen dioxide (NO2; OR, 1.026 per 10 ppb; 95% CI, 1.004-1.047) was associated with an increase in HS risk. Moreover, exposure to PM2.5 (OR, 1.018 per 10 μg/m3; 95% CI, 1.009-1.027) and SO2 (OR, 1.102 per 10 ppb; 95% CI, 1.010-1.204) was positively associated with the risk of intracerebral hemorrhage. In addition, extreme temperature, high pressures, high and low relative humidity were potentially associated with HS risk. Targeted preventive measures to limit the effect of these air pollutants and extreme meteorological factors should be taken to reduce the HS disease burden. Further studies are warranted to verify these findings.
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Affiliation(s)
- Yuxin Guo
- Department of Epidemiology and Health Statistics, XiangYa School of Public Health, Central South University, Changsha, Hunan 410078, China
| | - Chun Luo
- Department of Epidemiology and Health Statistics, XiangYa School of Public Health, Central South University, Changsha, Hunan 410078, China
| | - Fang Cao
- Department of Epidemiology and Health Statistics, XiangYa School of Public Health, Central South University, Changsha, Hunan 410078, China
| | - Junyu Liu
- Department of Neurosurgery, XiangYa Hospital, Central South University, Changsha 410008, China; Department of Pharmacology, Kyoto University Graduate School of Medicine, Kyoto 606-8501, Japan.
| | - Junxia Yan
- Department of Epidemiology and Health Statistics, XiangYa School of Public Health, Central South University, Changsha, Hunan 410078, China; Hunan Provincial Key Laboratory of Clinical Epidemiology, XiangYa School of Public Health, Central South University, Changsha 410078, China.
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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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Xu J, Lan Z, Xu P, Zhang Z. The association between short-term exposure to nitrogen dioxide and hospital admission for schizophrenia: A systematic review and meta-analysis. Medicine (Baltimore) 2023; 102:e35024. [PMID: 37773873 PMCID: PMC10545286 DOI: 10.1097/md.0000000000035024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 08/09/2023] [Indexed: 10/01/2023] Open
Abstract
BACKGROUND Ambient air pollution has been identified as a primary risk factor for mental disorders. In recent years, the relationship between exposure to ambient nitrogen dioxide (NO2) and the risk of hospital admissions (HAs) for schizophrenia has garnered increasing scientific interest, but evidence from epidemiological studies has been inconsistent. Therefore, a systematic review and meta-analysis were conducted to comprehensively identify potential correlations. METHODS A literature search in 3 international databases was conducted before December 31, 2022. Relative risk (RR) and corresponding 95% confidence intervals (CI) were calculated to evaluate the strength of the associations. Summary effect sizes were calculated using a random-effects model due to the expected heterogeneity (I2 over 50%). RESULTS A total of ten eligible studies were included in the meta-analysis, including 1,412,860 participants. The pooled analysis found that an increased risk of HAs for schizophrenia was associated with exposure to each increase of 10 μg/m3 in NO2 (RR = 1.029, 95% CI = 1.016-1.041, P < .001). However, the heterogeneity was high for the summary estimates, reducing the credibility of the evidence. In 2-pollutant models, results for NO2 increased by 0.3%, 0.2% and 2.3%, respectively, after adjusting for PM2.5, PM10 and SO2. CONCLUSIONS This study provides evidence that NO2 exposure significantly increases the risk of hospital admission for schizophrenia. Future studies are required to clarify the potential biological mechanism between schizophrenia and NO2 exposure to provide a more definitive result.
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Affiliation(s)
- Jiating Xu
- Department of General Psychiatry II, The Third Hospital of Quzhou, Quzhou City, China
| | - Zhiyong Lan
- Department of General Psychiatry II, The Third Hospital of Quzhou, Quzhou City, China
| | - Penghao Xu
- Department of Geriatric Psychiatry II, The Third Hospital of Quzhou, Quzhou City, China
| | - Zhihua Zhang
- Department of Geriatric Psychiatry II, The Third Hospital of Quzhou, Quzhou City, China
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Liu J, Luo C, Guo Y, Cao F, Yan J. Individual trigger factors for hemorrhagic stroke: Evidence from case-crossover and self-controlled case series studies. Eur Stroke J 2023; 8:808-818. [PMID: 37641550 PMCID: PMC10472950 DOI: 10.1177/23969873231173285] [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: 02/27/2023] [Accepted: 04/12/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Hemorrhagic stroke (HS) is a sudden-onset disease with high mortality and disability rates, and it is crucial to explore the triggers of HS. In this study, we analyzed individual triggers for HS to provide a basis for HS prevention and intervention. METHODS A systematic search of five databases was conducted until December 2022. Studies on HS-related individual triggers conducted using a case-crossover study or self-controlled case series design were included in the descriptive summary and comprehensive evidence synthesis of each trigger. RESULTS A total of 39 studies were included after the screening, and 32 trigger factor categories were explored for associations. Potential trigger factors for HS were as follows: Antiplatelet (odd ratio (OR), 1.10; 95% confidence interval (CI), 1.00-1.21) and anticoagulant (OR, 5.43; 95% CI, 2.04-14.46) medications, mood stabilizers/antipsychotics (OR, 1.33; 95% CI, 1.07-1.65), infections (OR, 2.15; 95% CI, 1.73-2.67), vaccinations (relative risk, 1.11; 95% CI, 1.02-1.21), physical exertion (OR, 2.08; 95% CI, 1.58-2.74), cola consumption (OR, 5.45; 95% CI, 2.76-10.76), sexual activity (OR, 7.49; 95% CI, 2.23-25.22), nose blowing (OR range, 2.40-56.40), defecation (OR, 16.94; 95% CI, 3.40-84.37), and anger (OR, 3.59; 95% CI, 1.56-8.26). No associations were observed with illicit drug use (OR, 2.05; 95% CI, 0.52-8.06) or cigarette smoking (OR, 0.81; 95% CI, 0.52-1.24) and HS. CONCLUSIONS Individual triggers, including several medications, infections, vaccinations, and behaviors, may trigger HS onset. Direct control measures for behavioral triggers can play a crucial role in preventing HS. High-risk populations should receive personalized therapies and monitoring measures during the medication treatment to balance the risk of acute HS and the basic diseases.
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Affiliation(s)
- Junyu Liu
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China
- Department of Pharmacology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Chun Luo
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Yuxin Guo
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Fang Cao
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Junxia Yan
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
- Hunan Provincial Key Laboratory of Clinical Epidemiology, Xiangya School of Public Health, Central South University, Changsha, China
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Wang Q, Wang Z, Chen M, Mu W, Xu Z, Xue M. Causality of particulate matter on cardiovascular diseases and cardiovascular biomarkers. Front Public Health 2023; 11:1201479. [PMID: 37732088 PMCID: PMC10507646 DOI: 10.3389/fpubh.2023.1201479] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 07/31/2023] [Indexed: 09/22/2023] Open
Abstract
Background Previous observational studies have shown that the prevalence of cardiovascular diseases (CVDs) is related to particulate matter (PM). However, given the methodological limitations of conventional observational research, it is difficult to identify causality conclusively. To explore the causality of PM on CVDs and cardiovascular biomarkers, we conducted a Mendelian randomization (MR) analysis. Method In this study, we obtained summary-level data for CVDs and cardiovascular biomarkers including atrial fibrillation (AF), heart failure (HF), myocardial infarction (MI), ischemic stroke (IS), stroke subtypes, body mass index (BMI), lipid traits, fasting glucose, fasting insulin, and blood pressure from several large genome-wide association studies (GWASs). Then we used two-sample MR to assess the causality of PM on CVDs and cardiovascular biomarkers, 16 single nucleotide polymorphisms (SNPs) for PM2.5 and 6 SNPs for PM10 were obtained from UK Biobank participants. Inverse variance weighting (IVW) analyses under the fixed effects model were used as the main analytical method to calculate MR Estimates, followed by multiple sensitivity analyses to confirm the robustness of the results. Results Our study revealed increases in PM2.5 concentration were significantly related to a higher risk of MI (odds ratio (OR), 2.578; 95% confidence interval (CI), 1.611-4.127; p = 7.920 × 10-5). Suggestive evidence was found between PM10 concentration and HF (OR, 2.015; 95% CI, 1.082-3.753; p = 0.027) and IS (OR, 2.279; 95% CI,1.099-4.723; p = 0.027). There was no evidence for an effect of PM concentration on other CVDs. Furthermore, PM2.5 concentration increases were significantly associated with increases in triglyceride (TG) (OR, 1.426; 95% CI, 1.133-1.795; p = 2.469 × 10-3) and decreases in high-density lipoprotein cholesterol (HDL-C) (OR, 0.779; 95% CI, 0.615-0.986; p = 0.038). The PM10 concentration increases were also closely related to the decreases in HDL-C (OR, 0.563; 95% CI, 0.366-0.865; p = 8.756 × 10-3). We observed no causal effect of PM on other cardiovascular biomarkers. Conclusion At the genetic level, our study suggested the causality of PM2.5 on MI, TG, as well HDL-C, and revealed the causality of PM10 on HF, IS, and HDL-C. Our findings indicated the need for continued improvements in air pollution abatement for CVDs prevention.
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Affiliation(s)
- Qiubo Wang
- Department of Cardiology, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Shandong Medicine and Health Key Laboratory of Cardiac Electrophysiology and Arrhythmia, Jinan, China
- Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Zhimiao Wang
- Department of Cardiology, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Shandong Medicine and Health Key Laboratory of Cardiac Electrophysiology and Arrhythmia, Jinan, China
| | - Mingyou Chen
- Department of Cardiology, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Shandong Medicine and Health Key Laboratory of Cardiac Electrophysiology and Arrhythmia, Jinan, China
| | - Wei Mu
- Department of Cardiology, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Shandong Medicine and Health Key Laboratory of Cardiac Electrophysiology and Arrhythmia, Jinan, China
| | - Zhenxing Xu
- Department of Cardiology, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Shandong Medicine and Health Key Laboratory of Cardiac Electrophysiology and Arrhythmia, Jinan, China
| | - Mei Xue
- Department of Cardiology, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Shandong Medicine and Health Key Laboratory of Cardiac Electrophysiology and Arrhythmia, Jinan, China
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Wang C, Meng XC, Huang C, Wang J, Liao YH, Huang Y, Liu R. Association between ambient air pollutants and lipid profile: A systematic review and meta-analysis. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 262:115140. [PMID: 37348216 DOI: 10.1016/j.ecoenv.2023.115140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 05/29/2023] [Accepted: 06/11/2023] [Indexed: 06/24/2023]
Abstract
BACKGROUND Studies of the effects of atmospheric pollutants on lipid profiles remain inconsistent and controversial. AIM The study was aimed to investigate the relationship between the exposure to ambient air pollutants and variations in the blood lipid profiles in the population. METHODS A comprehensive search of three different databases (PubMed, Web of Science, and the Cochrane Library) until December 17, 2022, yielded 17 origional studies fulfilling the inclusion criteria for a meta-analysis. Aggregate effect measures and 95% confidence intervals (95% CI) for the relevant ambient air pollutants were deduced employing random effects models. RESULTS The collective meta-analysis indicated that long-term exposure to PM1, PM2.5, PM10 and CO showed a substantial correlation with TC (PM1: β = 2.04, 95%CI = 0.15-3.94; PM2.5: β = 1.11, 95%CI = 0.39-1.84; PM10: β = 1.70, 95%CI = 0.67-2.73; CO: β = 0.08, 95%CI = 0.06-0.10), PM10 exhibited a significant association with TG (β = 0. 537,95% CI = 0.09-0.97), whereas HDL-C demonstrated notable relationships with PM1, PM10, SO2 and CO (PM1: β = -2.38, 95%CI = -4.00 to -2.76; PM10: β = -0.77, 95%CI = -1.33 to -0.21; SO2: β = -0.91, 95%CI = -1.73 to -0.10; CO: β = -0.03, 95%CI = -0.05 to 0.00). PM2.5, PM10 also showed significant associations with LDL-C (PM2.5: β = 1.44 95%CI = 0.48-2.40; PM10: β = 1.62 95%CI = 0.90-2.34). Subgroup analysis revealed significant or stronger correlations predominantly in cohort study designs, with higher male comparisons, and in regions exhibiting elevated contaminant levels. CONCLUSION In summary, the analysis substantiates that ambient air pollutants can be recognized as potent contributors to alterations in lipid profiles, particularly particulate pollutants which exert more obvious effects on lipid profiles.
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Affiliation(s)
- Chun Wang
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, China
| | - Xing-Chen Meng
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, China
| | - Chao Huang
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, China
| | - Jia Wang
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, China
| | - Ying-Hao Liao
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, China
| | - Yang Huang
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, China
| | - Ran Liu
- Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, China.
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Liu J, Dai Y, Yuan J, Li R, Hu Y, Su Y. Does exposure to air pollution during different time windows affect pregnancy outcomes of in vitro fertilization treatment? A systematic review and meta-analysis. CHEMOSPHERE 2023:139076. [PMID: 37271467 DOI: 10.1016/j.chemosphere.2023.139076] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 05/21/2023] [Accepted: 05/28/2023] [Indexed: 06/06/2023]
Abstract
Few researches have examined the impact of air pollution exposure during various time windows on clinical outcomes in women receiving in vitro fertilization (IVF) therapy, and the findings of studies have been conflicting. We investigated the effects of six air pollutants exposure during different time windows (period 1, 85 days before egg retrieval to the beginning of gonadotropin; period 2, the beginning of gonadotropin to egg collection; period 3, egg collection to embryo transfer; period 4, embryo transfer to serum hCG measurement; period 5, serum hCG measurement to transvaginal ultrasonography; period 6, 85 days before egg retrieval to hCG measurement; period 7, 85 days before egg retrieval to transvaginal ultrasonography) on clinical outcomes of IVF therapy. A total of seven databases were searched. NO2 (period 6), SO2 (period 2, 3, and 7), CO (period 1, 2 and 7) exposure were linked to lower likelihoods of clinical pregnancy. PM2.5 (period 1), PM10 (period 1), SO2 (period 1, 2, 3, 4, and 6), NO2 (period 1) were linked to lower likelihoods of biochemical pregnancy. PM2.5 (period 1), SO2 (period 2 and 4) and CO (period 2) were linked to reduced probabilities of live birth. Our results implied that period 1 might be the most sensitive exposure window. Air pollution exposure is linked to reduced probabilities of clinical pregnancy, biochemical pregnancy, and live birth. Therefore, preventive measures to limit air pollution exposure should be started at least three months in advance of IVF therapy to improve pregnancy outcomes.
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Affiliation(s)
- Junjie Liu
- Henan Human Sperm Bank, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
| | - Yanpeng Dai
- Department of Clinical Laboratory, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jiayi Yuan
- The Neonatal Screening Center in Henan Province, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Runqing Li
- The Neonatal Screening Center in Henan Province, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yaolong Hu
- Henan Human Sperm Bank, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yanhua Su
- Henan Human Sperm Bank, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Jiang X, Wang R, Chang T, Zhang Y, Zheng K, Wan R, Wang X. Effect of short-term air pollution exposure on migraine: A protocol for systematic review and meta-analysis on human observational studies. ENVIRONMENT INTERNATIONAL 2023; 174:107892. [PMID: 37019024 DOI: 10.1016/j.envint.2023.107892] [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: 07/27/2022] [Revised: 03/09/2023] [Accepted: 03/17/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND The World Health Organization (WHO) has identified air pollution as one of the greatest environmental risks to public health. High levels of ambient air pollution are known to have adverse health effects, but the relationship between exposure to air pollutants and migraine attack has not been established. OBJECTIVES This study aims to systematically review the effects of short-term exposure to fine and coarse particulate matter (PM), ozone, nitrogen dioxide, sulfur dioxide, and carbon monoxide on migraine attack. METHODS The systematic review and meta-analysis will follow the WHO handbook for guideline development. Our protocol will comply with the guidelines of the Preferred Reporting Items for Systematic Review and meta-Analysis Protocols. ELIGIBILITY CRITERIA Original peer-reviewed studies conducted in the general population regardless of age and sex to investigate the association between short-term exposure to ambient air pollutants and migraine will be eligible for inclusion. Only time-series, case-crossover, and panel studies will be included. INFORMATION SOURCES We will search the electronic databases MEDLINE, Embase, Web of Science, Global Health, Cumulative Index to Nursing and Allied Health Literature in accordance with the pre-established search strategy. We will also check the reference list of included papers and previous reviews for supplementary search. DATA SYNTHESIS METHOD We will perform data extraction in accordance with the predesigned table. Using random-effects meta-analysis, we will present summary statistics (RRs and corresponding 95% CIs) associated with standardized increases in each pollutant level. Heterogeneity between studies will be assessed using 80% prediction intervals (PI). Subgroup analyzes will be performed to explore sources of heterogeneity, if any. The main findings will be presented in summary of finding table, visual display and narrative synthesis. We will review the impact of each air pollutant exposure separately. EVIDENCE APPRAISAL We will employ the adaption of Grading of Recommendations, Assessment, Development, and Evaluations tool to assess the confidence in the body of evidence.
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Affiliation(s)
- Xue Jiang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Rui Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Tiantian Chang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Yonghui Zhang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Kangyong Zheng
- Department of Rehabilitation Medicine, Changhai Hospital, Shanghai, China
| | - Ruihan Wan
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fujian, China
| | - Xueqiang Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China.
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11
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Cortes TR, Silveira IH, de Oliveira BFA, Bell ML, Junger WL. Short-term association between ambient air pollution and cardio-respiratory mortality in Rio de Janeiro, Brazil. PLoS One 2023; 18:e0281499. [PMID: 36795640 PMCID: PMC9934392 DOI: 10.1371/journal.pone.0281499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 01/17/2023] [Indexed: 02/17/2023] Open
Abstract
BACKGROUND Several epidemiological studies have reported associations between ambient air pollution and mortality. However, relatively few studies have investigated this relationship in Brazil using individual-level data. OBJECTIVES To estimate the short-term association between exposure to particulate matter <10 μm (PM10) and ozone (O3), and cardiovascular and respiratory mortality in Rio de Janeiro, Brazil, between 2012 and 2017. METHODS We used a time-stratified case-crossover study design with individual-level mortality data. Our sample included 76,798 deaths from cardiovascular diseases and 36,071 deaths from respiratory diseases. Individual exposure to air pollutants was estimated by the inverse distance weighting method. We used data from seven monitoring stations for PM10 (24-hour mean), eight stations for O3 (8-hour max), 13 stations for air temperature (24-hour mean), and 12 humidity stations (24-hour mean). We estimated the mortality effects of PM10 and O3 over a 3-day lag using conditional logistic regression models combined with distributed lag non-linear models. The models were adjusted for daily mean temperature and daily mean absolute humidity. Effect estimates were presented as odds ratios (OR) with their 95% confidence interval (CI) associated with a 10 μg/m3 increase in each pollutant exposure. RESULTS No consistent associations were observed for both pollutant and mortality outcome. The cumulative OR of PM10 exposure was 1.01 (95% CI 0.99-1.02) for respiratory mortality and 1.00 (95% CI 0.99-1.01) for cardiovascular mortality. For O3 exposure, we also found no evidence of increased mortality for cardiovascular (OR 1.01, 95% CI 1.00-1.01) or respiratory diseases (OR 0.99, 95% CI 0.98-1.00). Our findings were similar across age and gender subgroups, and different model specifications. CONCLUSION We found no consistent associations between the PM10 and O3 concentrations observed in our study and cardio-respiratory mortality. Future studies need to explore more refined exposure assessment methods to improve health risk estimates and the planning and evaluation of public health and environmental policies.
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Affiliation(s)
- Taísa Rodrigues Cortes
- Institute of Social Medicine, State University of Rio de Janeiro, Rio de Janeiro, Brazil
- * E-mail:
| | | | | | - Michelle L. Bell
- School of the Environment, Yale University, New Haven, CT, United States of America
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Song R, Liu L, Wei N, Li X, Liu J, Yuan J, Yan S, Sun X, Mei L, Liang Y, Li Y, Jin X, Wu Y, Pan R, Yi W, Song J, He Y, Tang C, Liu X, Cheng J, Su H. Short-term exposure to air pollution is an emerging but neglected risk factor for schizophrenia: A systematic review and meta-analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 854:158823. [PMID: 36116638 DOI: 10.1016/j.scitotenv.2022.158823] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 09/03/2022] [Accepted: 09/13/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE This meta-analysis aimed to explore the association between short-term exposure to air pollution and schizophrenia (SCZ)1, and investigate the susceptible population and the lag characteristics of different pollutants. METHODS A systematic review and meta-analysis was conducted by searching PubMed, Cochrane, Web of Sciences, and CNKI for relevant literature published up to 28 Feb 2022. Meta-analysis was performed separately to investigate the association of ambient particulates (diameter ≤ 2.5 μm (PM2.5)2, 2.5 μm < diameter < 10 μm (PMC)3, ≤10μm (PM10)4) and gaseous pollutants (nitrogen dioxide (NO2)5, sulfur dioxide (SO2)6, carbon monoxide (CO)7) with SCZ. Relative risk (RR)8 per 10 μg/m3 increase in air pollutants concentration was used as the effect estimate. Subgroup analyses were conducted by age, gender, country, median pollutant concentration, and median temperature. RESULTS We identified 17 articles mainly conducted in Asia, of which 13 were included in the meta-analysis. Increased risk of SCZ was associated with short-term exposure to PM2.5 (RR: 1.0050, 95 % confidence interval (CI)9: 1.0017, 1.0083), PMC (1.0117, 1.0023, 1.0211), PM10 (1.0047, 1.0025, 1.0070), NO2 (1.0275, 1.0132, 1.0420), and SO2 (1.0288, 1.0146, 1.0432) exposure. Subgroup analyses showed that females may be more susceptible to SO2 and NO2, and the young seem to be more sensitive to PM2.5 and PM10. Gaseous pollutants presented the immediate risk, and particulates showed the delayed risk. CONCLUSIONS The present meta-analysis suggests that short-term exposure to PM2.5, PMC, PM10, SO2, and NO2 exposure may be associated with an elevated risk of SCZ.
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Affiliation(s)
- Rong Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui 230032, China
| | - Li Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui 230032, China
| | - Ning Wei
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui 230032, China
| | - Xuanxuan Li
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui 230032, China
| | - Jintao Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui 230032, China
| | - Jiajun Yuan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui 230032, China
| | - Shuangshuang Yan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui 230032, China
| | - Xiaoni Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui 230032, China
| | - Lu Mei
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui 230032, China
| | - Yunfeng Liang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui 230032, China
| | - Yuxuan Li
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui 230032, China
| | - Xiaoyu Jin
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui 230032, China
| | - Yudong Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui 230032, China
| | - Rubing Pan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui 230032, China
| | - Weizhuo Yi
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui 230032, China
| | - Jian Song
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui 230032, China
| | - Yangyang He
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui 230032, China
| | - Chao Tang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui 230032, China
| | - Xiangguo Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui 230032, China
| | - Jian Cheng
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui 230032, China
| | - Hong Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui 230032, China.
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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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14
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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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15
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Fu C, Kuang D, Zhang H, Ren J, Chen J. Different components of air pollutants and neurological disorders. Front Public Health 2022; 10:959921. [PMID: 36518583 PMCID: PMC9742385 DOI: 10.3389/fpubh.2022.959921] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 10/24/2022] [Indexed: 11/29/2022] Open
Abstract
The harmful effects of air pollution can cause various diseases. Most research on the hazards of air pollution focuses on lung and cardiovascular diseases. In contrast, the impact of air pollution on neurological disorders is not widely recognized. Air pollution can cause various neurological conditions and diseases, such as neural inflammation, neurodegeneration, and cerebrovascular barrier disorder; however, the mechanisms underlying the neurological diseases induced by various components of air pollutants remain unclear. The present paper summarizes the effects of different components of air pollutants, including particulate matter, ozone, sulfur oxides, carbon oxides, nitrogen oxides, and heavy metals, on the nervous system and describes the impact of various air pollutants on neurological disorders, providing ideas for follow-up research.
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Affiliation(s)
- Chunlia Fu
- Department of Emergency Intensive Care Unit, Affiliated Dongguan People's Hospital, Southern Medical University, Dongguan, China
| | - Daibing Kuang
- Department of Emergency Intensive Care Unit, Affiliated Dongguan People's Hospital, Southern Medical University, Dongguan, China
| | - He Zhang
- School of Public Health, Guangdong Medical University, Dongguan, China
| | - Jinxin Ren
- The Second Clinical Medical College, Guangdong Medical University, Dongguan, China
| | - Jialong Chen
- School of Public Health, Guangdong Medical University, Dongguan, China
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16
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Jeong HY, Kim HJ, Nam KW, Jeong SM, Kwon H, Park JH, Kwon HM. Annual exposure to PM 10 is related to cerebral small vessel disease in general adult population. Sci Rep 2022; 12:19693. [PMID: 36385313 PMCID: PMC9668965 DOI: 10.1038/s41598-022-24326-y] [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: 01/24/2022] [Accepted: 11/14/2022] [Indexed: 11/17/2022] Open
Abstract
Ambient air pollution is one of the most important global health issues. Although several studies have been reported the associations between air pollution and brain function or structure, impact of the air pollution on cerebral small vessel disease (cSVD) have rarely been explored in Asian adult population. We evaluated the association between exposure to air pollutants and cSVD in Korean asymptomatic adults. This cross-sectional study included 3257 participants of a health screening program from January 2006 to December 2013. All participants performed brain magnetic resonance imaging. To assess the cSVD, we considered three features such as white matter hyperintensities (WMH), silent lacunar infarction (SLI), and cerebral microbleeds (CMBs). The annual average exposure to air pollutants [particulate matter ≤ 10 μm in aerodynamic diameter (PM10), nitrogen dioxide (NO2), sulfur dioxide (SO2), and carbon monoxide (CO)] was generated. The mean [standard deviation (SD)] age of the total 3257 participants was 56.5 (9.5) years, and 54.0% of them were male. Among all the included participants, 273 (8.4%) had SLI and 135 (4.1%) had CMBs. The mean volume (± SD) of WMH was 2.72 ± 6.57 mL. In result of linear regression analysis, the volume of WMH was associated with various potential factors including age, height, weight, smoking and alcohol consumption status, blood pressure (BP), hypertension, and diabetes mellitus. SLI-positive group, compared to the SLI-negative group, was older, shorter, and had higher BP as well as higher frequency of hypertension and diabetes mellitus. After adjusting for covariates, the annual average concentration of PM10 was significantly associated with the volume of WMH [β (95% CI) for Model 1 = 0.082 (0.038- 0.125), p < 0.001; β (95% CI) for Model 2 = 0.060 (0.013, 0.107), p = 0.013]. CMBs were not associated with the annual average concentration of PM10. No significant associations of NO2, SO2, and CO with cSVD were observed. In conclusion, PM10 exposure is associated with significant increases in brain WMH' volume and silent lacunar infarcts in asymptomatic adults.
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Affiliation(s)
- Han-Yeong Jeong
- grid.412484.f0000 0001 0302 820XDepartment of Neurology, Emergency Medical Center, Seoul National University Hospital, Seoul, Republic of Korea ,grid.31501.360000 0004 0470 5905Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hyun-Jin Kim
- grid.410914.90000 0004 0628 9810National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
| | - Ki-Woong Nam
- grid.31501.360000 0004 0470 5905Department of Neurology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, 20 Boramae-Ro 5-Gil, Dongjak-Gu, Seoul, 07061 Republic of Korea
| | - Su-Min Jeong
- grid.31501.360000 0004 0470 5905Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-Ro, Jongro-Gu, Seoul, 03080 Republic of Korea
| | - Hyuktae Kwon
- grid.31501.360000 0004 0470 5905Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-Ro, Jongro-Gu, Seoul, 03080 Republic of Korea
| | - Jin-Ho Park
- grid.31501.360000 0004 0470 5905Seoul National University College of Medicine, Seoul, Republic of Korea ,grid.31501.360000 0004 0470 5905Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-Ro, Jongro-Gu, Seoul, 03080 Republic of Korea
| | - Hyung-Min Kwon
- grid.31501.360000 0004 0470 5905Seoul National University College of Medicine, Seoul, Republic of Korea ,grid.31501.360000 0004 0470 5905Department of Neurology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, 20 Boramae-Ro 5-Gil, Dongjak-Gu, Seoul, 07061 Republic of Korea
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Cao Q, Zou L, Fan Z, Yan Y, Qi C, Wu B, Song B. Ozone causes depressive-like response through PI3K/Akt/GSK3β pathway modulating synaptic plasticity in young rats. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 246:114171. [PMID: 36228356 DOI: 10.1016/j.ecoenv.2022.114171] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 10/04/2022] [Accepted: 10/07/2022] [Indexed: 06/16/2023]
Abstract
Ozone pollution has been associated with several adverse effects, including memory impairment, intellectual retardation, emotional disturbances. However, the potential mechanisms remain uncertain. The present study aimed to investigate whether ozone (O3) regulates synaptic plasticity through PI3K/Akt/GSK3β signaling pathway and induces neurobehavioral modifications among the young rats. In vivo, the newborn rats were used to construct the animal model of early postnatal O3 treatment. In vitro, this study measured the effect of different concentrations of serum from O3 treated rats on the viability of the PC12 cells, and investigated the modifications of synaptic plasticity and PI3K/Akt/GSK3β signaling pathway in the hippocampus and PC12 cells after O3 treated. The results revealed significant depression-like behavior and increased hippocampal histopathological damage in the young rats after O3 treated. Compared with the control group, the expression levels of synaptic related proteins including Drebrin, PSD95, Synaptophysin and PIK3R1, p-Akt, and p-GSK3β were decreased in the O3 treated group. In vitro assays, a significant reduction in Drebrin, PSD95, Synaptophysin, PIK3R1, p-Akt, and p-GSK3β was found in PC12 cells after O3 serum treated. While 740Y-P (a specific PI3K activator) administered, the expression levels of Drebrin, PSD95, Synaptophysin, PIK3R1, p-Akt, and p-GSK3β in the 740Y-P + O3 group were significantly elevated in vivo and vitro compared with the O3-only group. In addition, miRNAs modulating PIK3R1 were screened on bioinformatics website, the study found aberrant expression of miR-221-3p in the hippocampus and serum of O3 treated group. Inhibition of miR-221-3p expression effectively reversed the reduction of Drebrin, PSD95, Synaptophysin, PIK3R1, p-Akt, and p-GSK3β in PC12 cells induced by O3 treatment. Altogether, these studies indicate that O3 restrained the expression of PI3K/Akt/GSK3β signaling pathway and impaired synaptic plasticity that resulted in depressive-like behavior in young rats. Moreover, miR-221-3p plays an important role in this procedure by regulating PIK3R1.
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Affiliation(s)
- Qi Cao
- Department of Occupational Health and Environmental Health, School of Public Health, Hebei Medical University, Shijiazhuang, Hebei 050000, China; Hebei Key Laboratory of Environment and Human Health, Shijiazhuang, Hebei 050000, China
| | - Lingyun Zou
- Department of Occupational Health and Environmental Health, School of Public Health, Hebei Medical University, Shijiazhuang, Hebei 050000, China; Hebei Key Laboratory of Environment and Human Health, Shijiazhuang, Hebei 050000, China
| | - Zhuo Fan
- Department of Occupational Health and Environmental Health, School of Public Health, Hebei Medical University, Shijiazhuang, Hebei 050000, China; Hebei Key Laboratory of Environment and Human Health, Shijiazhuang, Hebei 050000, China
| | - Yuandong Yan
- Department of Occupational Health and Environmental Health, School of Public Health, Hebei Medical University, Shijiazhuang, Hebei 050000, China; Hebei Key Laboratory of Environment and Human Health, Shijiazhuang, Hebei 050000, China
| | - Changcun Qi
- Department of Occupational Health and Environmental Health, School of Public Health, Hebei Medical University, Shijiazhuang, Hebei 050000, China; Hebei Key Laboratory of Environment and Human Health, Shijiazhuang, Hebei 050000, China
| | - Bailin Wu
- Department of Radiology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei 050000, China.
| | - Bo Song
- Department of Occupational Health and Environmental Health, School of Public Health, Hebei Medical University, Shijiazhuang, Hebei 050000, China; Hebei Key Laboratory of Environment and Human Health, Shijiazhuang, Hebei 050000, China.
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Surface oculaire et pollution environnementale extérieure : revue systématisée de la littérature. J Fr Ophtalmol 2022; 45:784-802. [DOI: 10.1016/j.jfo.2022.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 01/27/2022] [Accepted: 02/02/2022] [Indexed: 11/13/2022]
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Sui J, Xia H, Zhao Q, Sun G, Cai Y. Long-Term Exposure to Fine Particulate Matter and the Risk of Chronic Liver Diseases: A Meta-Analysis of Observational Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191610305. [PMID: 36011940 PMCID: PMC9408691 DOI: 10.3390/ijerph191610305] [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: 06/27/2022] [Revised: 08/16/2022] [Accepted: 08/17/2022] [Indexed: 05/05/2023]
Abstract
Although fine particulate matter (PM2.5) is a known carcinogen, evidence of the association between PM2.5 and chronic liver disease is controversial. In the present meta-analysis study, we reviewed epidemiological studies to strengthen evidence for the association between PM2.5 and chronic liver disease. We searched three online databases from 1990 up to 2022. The random-effect model was applied for detection of overall risk estimates. Sixteen eligible studies, including one cross-sectional study, one retrospective cohort study, and 14 prospective cohort studies, fulfilled inclusion criteria with more than 330 thousand participants from 13 countries. Overall risk estimates of chronic liver disease for 10 μg/m3 increase in PM2.5 was 1.27 (95% confidence interval (CI): 1.19−1.35, p < 0.001). We further analyzed the relationship between PM2.5 exposure and different chronic liver diseases. The results showed that increments in PM2.5 exposure significantly increased the risk of liver cancer, liver cirrhosis, and fatty liver disease (hazard ratio (HR) = 1.23, 95% CI: 1.14−1.33; HR = 1.17, 95% CI: 1.06−1.29; HR = 1.51, 95% CI: 1.09−2.08, respectively). Our meta-analysis indicated long-term exposure to PM2.5 was associated with increased risk of chronic liver disease. Moreover, future researches should be focused on investigating subtypes of chronic liver diseases and specific components of PM2.5.
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Affiliation(s)
- Jing Sui
- Research Institute for Environment and Health, School of Emergency Management, Nanjing University of Information Science and Technology, Nanjing 210044, China
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, China
| | - Hui Xia
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, China
| | - Qun Zhao
- Research Institute for Environment and Health, School of Emergency Management, Nanjing University of Information Science and Technology, Nanjing 210044, China
| | - Guiju Sun
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, China
| | - Yinyin Cai
- Institute of Atmospheric Environmental Economics, Nanjing University of Information Science and Technology, Nanjing 210044, China
- Correspondence: ; Tel.: +86-025-5873-1136
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Zhao Z, Guo M, An J, Zhang L, Tan P, Tian X, Zhao Y, Liu L, Wang X, Liu X, Guo X, Luo Y. Acute effect of air pollutants' peak-hour concentrations on ischemic stroke hospital admissions among hypertension patients in Beijing, China, from 2014 to 2018. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:41617-41627. [PMID: 35094263 DOI: 10.1007/s11356-021-18208-5] [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: 09/28/2021] [Accepted: 12/14/2021] [Indexed: 06/14/2023]
Abstract
Air pollutants' effect on ischemic stroke (IS) has been widely reported. But the effect of high-level concentrations during people's outdoor periods among hypertension patients was unknown. Peak-hour concentrations were defined considering air pollutants' high concentrations as well as people's outdoor periods. We conducted a time-series study and used the generalized additive model to analyze peak-hour concentrations' acute effect. A total of 315,499 IS patients comorbid with hypertension were admitted to secondary and above hospitals in Beijing from 2014 to 2018. A 10 µg/m3 (CO: 1 mg/m3) increase of the peak-hour concentrations was positively associated with IS hospital admissions among hypertension patients. The maximum effect sizes were as follows: for PM2.5, 0.17% (95% confidence interval [CI]: 0.10-0.24%) at Lag0 and 0.22% (95% CI: 0.12-0.33%) at Lag0-5; for PM10, 0.09% (95% CI: 0.05-0.13%) at Lag5 and 0.17% (95% CI: 0.09-0.26%) at Lag0-5; for SO2, 0.87% (95% CI: 0.46-1.29%) at Lag5; for NO2, 0.83% (95% CI: 0.62-1.04%) at Lag0 and 0.86% (95% CI: 0.59-1.13%) at Lag0-1; for CO 1.23% (95% CI: 0.66-1.80%) at Lag0 and 1.33% (95% CI: 0.33-2.35%) at Lag0-5; for O3 0.23% (95% CI: 0.12-0.35%) at Lag0 and 0.20% (95% CI: 0.05-0.34%) at Lag0-1. The effect sizes of PM2.5, NO2, and O3 remained significant after adjusting daily mean. Larger effect sizes were observed for PM2.5 and PM10 in cool season and for O3 in warm season. As significant exposure indicators of air pollution, peak-hour concentrations exposure increased the risk of IS hospital admissions among hypertension patients and it is worthy of consideration in relative environmental standard. It is suggested for hypertension patients to avoid outdoor activity during peak hours. More relevant searches are required to further illustrate air pollutant's effect on chronic disease population.
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Affiliation(s)
- Zemeng Zhao
- School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmen Wai, Fengtai District, Beijing, 100069, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, 100069, China
| | - Moning Guo
- Beijing Municipal Commission of Health and Family Planning Information Center, Beijing, 100034, China
| | - Ji An
- Department of Medical Engineering, Peking University Third Hospital, Beijing, 100191, China
| | - Licheng Zhang
- School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmen Wai, Fengtai District, Beijing, 100069, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, 100069, China
- Beijing Cancer Hospital, Beijing, 100142, China
| | - Peng Tan
- Beijing Municipal Commission of Health and Family Planning Information Center, Beijing, 100034, China
| | - Xue Tian
- School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmen Wai, Fengtai District, Beijing, 100069, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, 100069, China
| | - Yuhan Zhao
- School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmen Wai, Fengtai District, Beijing, 100069, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, 100069, China
| | - Lulu Liu
- School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmen Wai, Fengtai District, Beijing, 100069, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, 100069, China
| | - Xiaonan Wang
- School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmen Wai, Fengtai District, Beijing, 100069, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, 100069, China
| | - Xiangtong Liu
- School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmen Wai, Fengtai District, Beijing, 100069, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, 100069, China
| | - Xiuhua Guo
- School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmen Wai, Fengtai District, Beijing, 100069, China
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, 100069, China
| | - Yanxia Luo
- School of Public Health, Capital Medical University, No.10 Xitoutiao, You'anmen Wai, Fengtai District, Beijing, 100069, China.
- Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, 100069, China.
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21
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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: 122] [Impact Index Per Article: 61.0] [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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22
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Gómez-Crisóstomo NP, Rivas-Arancibia S, Rodríguez-Martínez E, De la Cruz-Hernández EN, de María Márquez Álvarez C, Estrada Caraveo PA, Gelista Herrera N, Valdés-Fuentes M, Martínez-Abundis E. Chronic exposition to ozone induces cardiac antioxidant response and overexpression of either mitochondrial fision protein DRP1 and hipertrophyc-related proteins. J Bioenerg Biomembr 2022; 54:145-152. [DOI: 10.1007/s10863-022-09937-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 03/06/2022] [Indexed: 11/25/2022]
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23
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Zhao M, Xu Z, Guo Q, Gan Y, Wang Q, Liu JA. Association between long-term exposure to PM 2.5 and hypertension: A systematic review and meta-analysis of observational studies. ENVIRONMENTAL RESEARCH 2022; 204:112352. [PMID: 34762927 DOI: 10.1016/j.envres.2021.112352] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 11/04/2021] [Accepted: 11/05/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Numerous studies have examined the association between long-term exposure to particulate matter with an aerodynamic diameter of ≤2.5 μm (PM2.5) and hypertension. However, the results are inconsistent. OBJECTIVES Considering the limitations of previous meta-analyses and the publication of many new studies in recent years, we conducted this meta-analysis to assess the relationship between long-term PM2.5 exposure and the incidence and prevalence of hypertension in a healthy population. METHODS We searched PubMed, Web of Science, Embase, and Scopus for relevant studies published until April 2, 2021 and reviewed the reference lists of previous reviews. A total of 28 observational studies reporting RR or OR with 95% CI for the association between long-term PM2.5 exposure and the risk of hypertension were included. RESULTS After the sensitivity analysis, we excluded one study with a high degree of heterogeneity, resulting in 27 studies and 28 independent reports. Approximately 42 million participants were involved, and the cases of hypertension in cohort and cross-sectional studies were 508,749 and 1,793,003, respectively. The meta-analysis showed that each 10 μg/m3 increment in PM2.5 was significantly associated with the risks of hypertension incidence (RR = 1.21, 95% CI: 1.07, 1.35) and prevalence (OR = 1.06, 95% CI: 1.03, 1.09). Subgroup analyses showed that occupational exposure had a significant effect on the association of PM2.5 and hypertension incidence (p for interaction = 0.042) and that the PM2.5 concentration level and physical activity had a noticeable effect on the association of PM2.5 and hypertension prevalence (p for interaction = 0.005; p for interaction = 0.022). CONCLUSIONS A significantly positive correlation was observed between long-term PM2.5 exposure and risks of hypertension incidence and prevalence, and a high PM2.5 concentration resulted in an increased risk of hypertension.
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Affiliation(s)
- Mingqing Zhao
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Ziyuan Xu
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, And State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Qianqian Guo
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yong Gan
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Qi Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Jun-An Liu
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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Ho AFW, Tan BYQ, Zheng H, Leow AST, Pek PP, Liu N, Raju Y, Yeo LLL, Sharma VK, Ong MEH, Aik J. Association of air pollution with acute ischemic stroke risk in Singapore: a time-stratified case-crossover study. Int J Stroke 2022; 17:983-989. [DOI: 10.1177/17474930211066745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Air quality is an important determinant of cardiovascular health such as ischemic heart disease and acute ischemic stroke (AIS) with substantial mortality and morbidity reported across the globe. However, associations between air quality and AIS in the current literature remain inconsistent, with few studies undertaken in cosmopolitan cities located in the tropics. Objectives: We evaluated the associations between individual ambient air pollutants and AIS. Methods: We performed a nationwide, population-based, time-stratified case-crossover analysis on all AIS cases reported to the Singapore Stroke Registry from 2009 to 2018. We estimated the incidence rate ratio (IRR) of AIS across different concentrations of each pollutant by quartiles (referencing the 25th percentile), in single-pollutant conditional Poisson models adjusted for time-varying meteorological effects. We stratified our analysis by predetermined subgroups deemed at higher risk. Results: A total of 51,675 episodes of AIS were included. Ozone (O3) (IRR4th quartile: 1.05, 95% confidence interval (CI): 1.01–1.08) and carbon monoxide (CO) (IRR2nd quartile: 1.05, 95% CI: 1.02–1.08, IRR3rd quartile: 1.07, 95% CI: 1.04–1.10, IRR4th quartile: 1.07, 95% CI: 1.04–1.11) were positively associated with AIS incidence. The increased incidence of AIS due to O3 and CO persisted for 5 days after exposure. Those under 65 years of age were more likely to experience AIS when exposed to CO. Individuals with atrial fibrillation (AF) were more susceptible to exposure from O3, CO, and PM10. Current/ex-smokers were more vulnerable to the effect of O3. Conclusion: Air pollution increases the incidence of AIS, especially in those with AF and in those who are current or ex-smokers.
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Affiliation(s)
- Andrew Fu Wah Ho
- Department of Emergency Medicine, Singapore General Hospital, Singapore
- Pre-hospital & Emergency Research Centre, Health Services and Systems Research, Duke-NUS Medical School, Singapore
| | | | - Huili Zheng
- National Registry of Diseases Office, Health Promotion Board, Singapore
| | | | - Pin Pin Pek
- Pre-hospital & Emergency Research Centre, Health Services and Systems Research, Duke-NUS Medical School, Singapore
| | - Nan Liu
- Pre-hospital & Emergency Research Centre, Health Services and Systems Research, Duke-NUS Medical School, Singapore
| | - Yogeswari Raju
- Environmental Quality Monitoring Department, Environmental Monitoring and Modelling Division, National Environment Agency, Singapore
| | - Leonard Leong-Litt Yeo
- Division of Neurology, Department of Medicine, National University Health System, Singapore
| | - Vijay K Sharma
- Division of Neurology, Department of Medicine, National University Health System, Singapore
| | - Marcus Eng-Hock Ong
- Department of Emergency Medicine, Singapore General Hospital, Singapore
- Pre-hospital & Emergency Research Centre, Health Services and Systems Research, Duke-NUS Medical School, Singapore
| | - Joel Aik
- Pre-hospital & Emergency Research Centre, Health Services and Systems Research, Duke-NUS Medical School, Singapore
- Environmental Epidemiology and Toxicology Division, National Environment Agency, Singapore
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25
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Borroni E, Pesatori AC, Bollati V, Buoli M, Carugno M. Air pollution exposure and depression: A comprehensive updated systematic review and meta-analysis. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 292:118245. [PMID: 34600062 DOI: 10.1016/j.envpol.2021.118245] [Citation(s) in RCA: 55] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 09/21/2021] [Accepted: 09/25/2021] [Indexed: 06/13/2023]
Abstract
We provide a comprehensive and updated systematic review and meta-analysis of the association between air pollution exposure and depression, searching PubMed, Embase, and Web of Sciences for relevant articles published up to May 2021, and eventually including 39 studies. Meta-analyses were performed separately according to pollutant type [particulate matter with diameter ≤10 μm (PM10) and ≤2.5 μm (PM2.5), nitrogen dioxide (NO2), sulfur dioxide (SO2), ozone (O3), and carbon monoxide (CO)] and exposure duration [short- (<30 days) and long-term (≥30 days)]. Test for homogeneity based on Cochran's Q and I2 statistics were calculated and the restricted maximum likelihood (REML) random effect model was applied. We assessed overall quality of pooled estimates, influence of single studies on the meta-analytic estimates, sources of between-study heterogeneity, and publication bias. We observed an increased risk of depression associated with long-term exposure to PM2.5 (relative risk: 1.074, 95% confidence interval: 1.021-1.129) and NO2 (1.037, 1.011-1.064), and with short-term exposure to PM10 (1.009, 1.006-1.012), PM2.5 (1.009, 1.007-1.011), NO2 (1.022, 1.012-1.033), SO2 (1.024, 1.010-1.037), O3 (1.011, 0.997-1.026), and CO (1.062, 1.020-1.105). The publication bias affecting half of the investigated associations and the high heterogeneity characterizing most of the meta-analytic estimates partly prevent to draw very firm conclusions. On the other hand, the coherence of all the estimates after excluding single studies in the sensitivity analysis supports the soundness of our results. This especially applies to the association between PM2.5 and depression, strengthened by the absence of heterogeneity and of relevant publication bias in both long- and short-term exposure studies. Should further investigations be designed, they should involve large sample sizes, well-defined diagnostic criteria for depression, and thorough control of potential confounding factors. Finally, studies dedicated to the comprehension of the mechanisms underlying the association between air pollution and depression remain necessary.
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Affiliation(s)
- Elisa Borroni
- Department of Clinical Sciences and Community Health, University of Milan, via san Barnaba 8, 20122, Milan, Italy
| | - Angela Cecilia Pesatori
- Department of Clinical Sciences and Community Health, University of Milan, via san Barnaba 8, 20122, Milan, Italy; Epidemiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via san Barnaba 8, 20122, Milan, Italy.
| | - Valentina Bollati
- Department of Clinical Sciences and Community Health, University of Milan, via san Barnaba 8, 20122, Milan, Italy
| | - Massimiliano Buoli
- Department of Pathophysiology and Transplantation, University of Milan, Via Francesco Sforza 35, 20122, Milan, Italy; Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122, Milan, Italy
| | - Michele Carugno
- Department of Clinical Sciences and Community Health, University of Milan, via san Barnaba 8, 20122, Milan, Italy; Epidemiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, via san Barnaba 8, 20122, Milan, Italy
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26
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Sokoty L, Rimaz S, Hassanlouei B, Kermani M, Janani L. Short-term effects of air pollutants on hospitalization rate in patients with cardiovascular disease: a case-crossover study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:26124-26131. [PMID: 33484464 DOI: 10.1007/s11356-021-12390-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 01/04/2021] [Indexed: 06/12/2023]
Abstract
Considering the increasing rate of hospitalization due to the symptoms intensification, and the increasing trend of air pollution, this study aimed to determine the relationship between the amount of air pollutants and the incidence of cardiovascular disease leading to hospitalization. This case-crossover study was carried out on the data of admitted patients with cardiovascular disease such as hypertension, ischemic heart disease, and cerebrovascular disease in Urmia during 2011-2016. Weather data about air pollutants (NO2, PM10, SO2, and CO) were obtained from the meteorological department of Urmia. The data were coded for each patient and matched with the meteorological data for statistical modeling. The data were analyzed through STATA version 14. Conditional logistic regression was used to estimate the effects of air pollutants on cardiovascular disease adjusted to air temperature, relative humidity, and air pollutants. The final analysis was performed on 43,424 patients with cardiovascular disease using code I10-I99 including ischemic heart disease, hypertension, and cerebrovascular disease adjusted to air temperature and relative humidity. Of all pollutants, CO with each increase 10 μg/m3 had a meaningful relationship with the incidence of cardiovascular hospitalization. By selecting the window of exposure, 1, 2, and 6 days before admission, lag 6 (6 days) was the best estimation for exposure time in the patients with cardiovascular patients (OR 1.0056, CI 1.0041-1.007), and in the patients with ischemic heart disease (OR 1.000055, CI 1.000036-1.000075) and in the patients with hypertension (OR 1.000076, CI 1.00002-1.000132). Regarding cerebrovascular disease, no statistically significant association was observed. The results showed that only CO was associated with an increased risk of admission in patients with cardiovascular disease, ischemic heart disease, and hypertension, and there was no clear evidence for pollution effects on cerebrovascular diseases.
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Affiliation(s)
- Leily Sokoty
- Department of Epidemiology, School of Public Health, Iran of University of Medical Sciences, Tehran, Iran
| | - Shahnaz Rimaz
- Research Center for Environmental Health Technology, Radiation Biology Research Center, Department of Epidemiology, School of Public Health, Iran of University of Medical Sciences, Tehran, Iran
| | - Babak Hassanlouei
- Department of Epidemiology, School of Public Health, Iran of University of Medical Sciences, Tehran, Iran
| | - Majid Kermani
- Environmental Health Engineering, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Leila Janani
- Biostatistics, School of Public Health, Preventive Medicine and Public Health Research Center, Iran University of Medical Science, Tehran, Iran.
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27
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Orellano P, Reynoso J, Quaranta N. Short-term exposure to sulphur dioxide (SO 2) and all-cause and respiratory mortality: A systematic review and meta-analysis. ENVIRONMENT INTERNATIONAL 2021; 150:106434. [PMID: 33601225 PMCID: PMC7937788 DOI: 10.1016/j.envint.2021.106434] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 01/21/2021] [Accepted: 01/30/2021] [Indexed: 05/02/2023]
Abstract
BACKGROUND Many studies have assessed the harmful effects of ambient air pollution on human mortality, but the evidence needs further exploration, analysis, and refinement, given the large number of studies that have been published in recent years. The objective of this study was to evaluate all the available evidence of the effect of short-term exposure to ambient sulphur dioxide (SO2) on all-cause and respiratory mortality. METHODS Articles reporting observational epidemiological studies were included, comprising time-series and case-crossover designs. A broad search and wide inclusion criteria were considered, encompassing international and regional databases, with no geographical or language restrictions. A random effect meta-analysis was conducted, and pooled relative risk for an increment of 10 µg/m3 in SO2 concentrations were calculated for each outcome. We analysed the risk of bias (RoB) in individual studies for specific domains using a new domain-based RoB assessment tool, and the certainty of evidence across studies with an adaptation of the Grading of Recommendations Assessment, Development and Evaluation approach. The certainty of evidence was judged separately for each exposure-outcome combination. A number of subgroup and sensitivity analyses were carried out, as well as assessments of heterogeneity and potential publication bias. The protocol for this review was registered with PROSPERO (CRD42019120738). RESULTS Our search retrieved 1,128 articles, from which 67 were included in quantitative analysis. The RoB was low or moderate in the majority of articles and domains. An increment of 10 µg/m3 in SO2 (24-hour average) was associated with all-cause mortality (RR: 1.0059; 95% CI: 1.0046-1.0071; p-value: <0.01), and respiratory mortality (RR: 1.0067; 95% CI: 1.0025-1.0109; p-value: <0.01), while the same increment in SO2 (1-hour max.) was associated with respiratory mortality (RR:1.0052; 95% CI: 1.0013-1.0091; p-value: 0.03). Similarly, the association was positive but non-significant for SO2 (1-hour max.) and all-cause mortality (RR: 1.0016; 95% CI: 0.9930-1.0102; p-value: 0.60). These associations were still significant after the adjustment for particulate matter, but not for other pollutants, according to the results from 13 articles that evaluated co-pollutant models. In general, linear concentration-response functions with no thresholds were found for the two outcomes, although this was only evaluated in a small number of studies. We found signs of heterogeneity for SO2 (24-hour average) - respiratory mortality and SO2 (1-hour max.) - all-cause mortality, and funnel plot asymmetry for SO2 (24-hour average) - all-cause mortality. The certainty of evidence was high in two combinations, i.e. SO2 (24-hour average) - all-cause mortality and SO2 (1-hour max.) - respiratory mortality, moderate in one combination, i.e. SO2 (24-hour average) - respiratory mortality, and low in the remaining one combination. CONCLUSIONS Positive associations were found between short-term exposure to ambient SO2 and all-cause and respiratory mortality. These associations were robust against several sensitivity analyses, and were judged to be of moderate or high certainty in three of the four exposure-outcome combinations.
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Affiliation(s)
- Pablo Orellano
- Centro de Investigaciones y Transferencia San Nicolás, Universidad Tecnológica Nacional (CONICET), San Nicolás, Argentina.
| | | | - Nancy Quaranta
- Facultad Regional San Nicolás, Universidad Tecnológica Nacional, San Nicolás, Argentina, Comisión de Investigaciones Científicas de la Provincia de Buenos Aires, La Plata, Argentina
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Wu Z, Li J, Huang J, Wang Y, Cao R, Yin P, Wang L, Zeng Q, Pan X, Zhou M, Li G. Ambient sulfur dioxide and years of life lost from stroke in China: a time-series analysis in 48 cities. CHEMOSPHERE 2021; 267:128857. [PMID: 33183785 DOI: 10.1016/j.chemosphere.2020.128857] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 10/21/2020] [Accepted: 11/02/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND AND OBJECTIVES Sulfur dioxide (SO2) is a ubiquitous air pollutant and its concentration in China remains at a higher level in the world. However, evidence regarding short-term effect of SO2 on years of life lost (YLL) from stroke is scarce. We aim to estimate the short-term association between SO2 pollution and YLL for stroke and the related excess life years and economic loss. METHODS A national time-series study was conducted in 48 Chinese cities from 2013 to 2017. Generalized additive model coupled with random-effects model were used to explore the effects of SO2 on YLL from stroke. Stratified analyses were performed by demographical and geographical factors, and the effect modification of city-level factors was estimated. In addition, the related economic loss was calculated using the method of the value per statistical life year (VSLY). RESULTS Averaged daily mean SO2 concentration was 27.1 μg/m3 in 48 Chinese cities from 2013 to 2017. Per 10 μg/m3 increase in the concentration of SO2 (lag03) was associated with an increment of 0.70% (95% confidence interval: 0.27%,1.13%), 0.51% (-0.01%,1.04%), 0.71% (0.14%,1.28%) increase in YLL from total stroke, hemorrhagic and ischemic stroke, respectively. The effect of short-term ambient SO2 exposure on YLL from stroke was more pronounced in the less-educated population and those living in the south. The corresponding excess economic loss during the study period due to SO2-related YLL from stroke accounted for 0.08% (0.03%, 0.13%) of the GDP in China. CONCLUSIONS Our results provide evidence from China that short-term exposure to SO2 is positively associated with YLL from stroke and its major subtypes in certain subgroups of population. This study calls for greater awareness of the adverse health effect due to SO2 in China and other developing countries, as well as local-specific implementation of air pollution mitigation measures.
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Affiliation(s)
- Ziting Wu
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Jie Li
- Department of Occupational Health and Environmental Health, School of Public Health, Capital Medical University, Beijing, 100069, China; National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing, 100050, China
| | - Jing Huang
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Yuxin Wang
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Ru Cao
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Peng Yin
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing, 100050, China
| | - Lijun Wang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing, 100050, China
| | - Qiang Zeng
- Department of Occupational Disease Control and Prevention, Tianjin Center for Disease Control and Prevention, Tianjin, 300011, PR China
| | - Xiaochuan Pan
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Maigeng Zhou
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing, 100050, China.
| | - Guoxing Li
- Department of Occupational and Environmental Health Sciences, Peking University School of Public Health, 38 Xueyuan Road, Haidian District, Beijing, 100191, China.
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Association between exposure to ambient air pollution and hospital admission, incidence, and mortality of stroke: an updated systematic review and meta-analysis of more than 23 million participants. Environ Health Prev Med 2021; 26:15. [PMID: 33499804 PMCID: PMC7839211 DOI: 10.1186/s12199-021-00937-1] [Citation(s) in RCA: 68] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 01/10/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Previous studies have suggested that exposure to air pollution may increase stroke risk, but the results remain inconsistent. Evidence of more recent studies is highly warranted, especially gas air pollutants. METHODS We searched PubMed, Embase, and Web of Science to identify studies till February 2020 and conducted a meta-analysis on the association between air pollution (PM2.5, particulate matter with aerodynamic diameter less than 2.5 μm; PM10, particulate matter with aerodynamic diameter less than 10 μm; NO2, nitrogen dioxide; SO2, sulfur dioxide; CO, carbon monoxide; O3, ozone) and stroke (hospital admission, incidence, and mortality). Fixed- or random-effects model was used to calculate pooled odds ratios (OR)/hazard ratio (HR) and their 95% confidence intervals (CI) for a 10 μg/m3 increase in air pollutant concentration. RESULTS A total of 68 studies conducted from more than 23 million participants were included in our meta-analysis. Meta-analyses showed significant associations of all six air pollutants and stroke hospital admission (e.g., PM2.5: OR = 1.008 (95% CI 1.005, 1.011); NO2: OR = 1.023 (95% CI 1.015, 1.030), per 10 μg/m3 increases in air pollutant concentration). Exposure to PM2.5, SO2, and NO2 was associated with increased risks of stroke incidence (PM2.5: HR = 1.048 (95% CI 1.020, 1.076); SO2: HR = 1.002 (95% CI 1.000, 1.003); NO2: HR = 1.002 (95% CI 1.000, 1.003), respectively). However, no significant differences were found in associations of PM10, CO, O3, and stroke incidence. Except for CO and O3, we found that higher level of air pollution (PM2.5, PM10, SO2, and NO2) exposure was associated with higher stroke mortality (e.g., PM10: OR = 1.006 (95% CI 1.003, 1.010), SO2: OR = 1.006 (95% CI 1.005, 1.008). CONCLUSIONS Exposure to air pollution was positively associated with an increased risk of stroke hospital admission (PM2.5, PM10, SO2, NO2, CO, and O3), incidence (PM2.5, SO2, and NO2), and mortality (PM2.5, PM10, SO2, and NO2). Our study would provide a more comprehensive evidence of air pollution and stroke, especially SO2 and NO2.
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Zeng S, Luo L, Chen F, Li Y, Chen M, He X. Association of outdoor air pollution with the medical expense of ischemic stroke: The case study of an industrial city in western China. Int J Health Plann Manage 2021; 36:715-728. [PMID: 33474742 DOI: 10.1002/hpm.3115] [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] [Received: 02/17/2020] [Revised: 11/05/2020] [Accepted: 12/28/2020] [Indexed: 11/11/2022] Open
Abstract
Ischemic stroke, the most frequent cause of severe disability, imposes a significant mental and economic burden on patients and their families. There is increasing evidence to indicate that air pollution contributes to the risk of ischemic stroke. This study aimed to examine the correlation between air pollution and the expense imposed by an ischemic stroke. Data were obtained from hospitals and environmental monitoring stations in an industry city, Longspring, in western China. We used a generalized additive model to estimate the associations between the two factors, measured during 2015-2017. Counter-intuitively, the medical expenses arising from ischemia were negatively associated with the level of air pollution. The corresponding ER for per interquartile range increase of PM2.5, PM10, SO2 , and NO2 in lag10 was -0.17% (95% confidence interval (95% CI -0.31%, -0.03%), -0.11% (95% CI -0.2%, -0.02%), -1.04% (95% CI -1.92%, -0.17%) and -0.44% (95% CI -0.66%, -0.22%), respectively (p < 0.05). Subgroups based on gender, age, and season were considered in the analysis. The results indicated that pollutants had significant effects on ischaemia's medical expenses, which were stronger for older people, patients who survived, and warm seasons. This study is the first step in optimizing medical resources, which are essential for policymaking and service planning.
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Affiliation(s)
- Siyu Zeng
- Business School, Sichuan University, Chengdu, China
| | - Li Luo
- Business School, Sichuan University, Chengdu, China
| | - Fang Chen
- Department of Neurosurgery, First People's Hospital of Longquan, Chengdu, China
| | - Yue Li
- Business School, Sichuan University, Chengdu, China
| | - Mei Chen
- Department of Record Room, First People's Hospital of Longquan, Chengdu, China
| | - Xiaozhou He
- Business School, Sichuan University, Chengdu, China
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Hu W, Chen Y, Chen J. Short-term effect of fine particular matter on daily hospitalizations for ischemic stroke: A time-series study in Yancheng, China. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2021; 208:111518. [PMID: 33120271 DOI: 10.1016/j.ecoenv.2020.111518] [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] [Received: 08/09/2020] [Revised: 10/08/2020] [Accepted: 10/13/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To investigate the associations between short-term exposure to fine particular matter (PM2.5) and ischemic stroke (IS) in Yancheng, China, from 2017 to 2019. METHODS We designed a time-series study based on generalized additive models to explore the association of PM2.5 and IS admitted in two major hospitals in Yancheng. We built different lag patterns and conducted stratification analyses by age, gender, and season. Moreover, we examined the robustness of the associations adopting two-pollutant models and fitted the concentration-response curves. RESULT We observed positive and significant associations at lag 0 day. Every 10 μg/m3 increase in PM2.5 (lag0) was associated with 1.06% (95% CI: 0.21%-1.91%) increases in hospitalizations for IS. The association remained stable and statistically significant to the adjustment of carbon monoxide and ozone. We observed that the associations were stronger in females and during cold seasons. The overall concentration-response relationship curve was linear positive and increased slowly but rose sharply at higher concentrations in the cold season. CONCLUSION Our study added to the evidence that short-term exposure to PM2.5 may induce IS, and the government should take action to address the air pollution issues and protect susceptible populations.
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Affiliation(s)
- Wei Hu
- Department of Orthopedic Surgery, The First Affiliated Hospital of China Medical University, Liaoning, China
| | - Yutong Chen
- Department of Pediatric Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Jinhua Chen
- Department of Neurosurgery, The People's Hospital of Dafeng, Yancheng, China.
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Hu L, Liu B, Ji J, Li Y. Tree-Based Machine Learning to Identify and Understand Major Determinants for Stroke at the Neighborhood Level. J Am Heart Assoc 2020; 9:e016745. [PMID: 33140687 PMCID: PMC7763737 DOI: 10.1161/jaha.120.016745] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Background Stroke is a major cardiovascular disease that causes significant health and economic burden in the United States. Neighborhood community‐based interventions have been shown to be both effective and cost‐effective in preventing cardiovascular disease. There is a dearth of robust studies identifying the key determinants of cardiovascular disease and the underlying effect mechanisms at the neighborhood level. We aim to contribute to the evidence base for neighborhood cardiovascular health research. Methods and Results We created a new neighborhood health data set at the census tract level by integrating 4 types of potential predictors, including unhealthy behaviors, prevention measures, sociodemographic factors, and environmental measures from multiple data sources. We used 4 tree‐based machine learning techniques to identify the most critical neighborhood‐level factors in predicting the neighborhood‐level prevalence of stroke, and compared their predictive performance for variable selection. We further quantified the effects of the identified determinants on stroke prevalence using a Bayesian linear regression model. Of the 5 most important predictors identified by our method, higher prevalence of low physical activity, larger share of older adults, higher percentage of non‐Hispanic Black people, and higher ozone levels were associated with higher prevalence of stroke at the neighborhood level. Higher median household income was linked to lower prevalence. The most important interaction term showed an exacerbated adverse effect of aging and low physical activity on the neighborhood‐level prevalence of stroke. Conclusions Tree‐based machine learning provides insights into underlying drivers of neighborhood cardiovascular health by discovering the most important determinants from a wide range of factors in an agnostic, data‐driven, and reproducible way. The identified major determinants and the interactive mechanism can be used to prioritize and allocate resources to optimize community‐level interventions for stroke prevention.
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Affiliation(s)
- Liangyuan Hu
- Department of Population Health Science and Policy Icahn School of Medicine at Mount Sinai New York NY.,Institute for Health Care Delivery Science Icahn School of Medicine at Mount Sinai New York NY
| | - Bian Liu
- Department of Population Health Science and Policy Icahn School of Medicine at Mount Sinai New York NY
| | - Jiayi Ji
- Department of Population Health Science and Policy Icahn School of Medicine at Mount Sinai New York NY.,Institute for Health Care Delivery Science Icahn School of Medicine at Mount Sinai New York NY
| | - Yan Li
- Department of Population Health Science and Policy Icahn School of Medicine at Mount Sinai New York NY.,Department of Obstetrics, Gynecology, and Reproductive Science Icahn School of Medicine at Mount Sinai New York NY
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Association Between Fine Particulate Matter and Fatal Hemorrhagic Stroke Incidence. J Occup Environ Med 2020; 62:916-921. [DOI: 10.1097/jom.0000000000001973] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hahad O, Lelieveld J, Birklein F, Lieb K, Daiber A, Münzel T. Ambient Air Pollution Increases the Risk of Cerebrovascular and Neuropsychiatric Disorders through Induction of Inflammation and Oxidative Stress. Int J Mol Sci 2020; 21:ijms21124306. [PMID: 32560306 PMCID: PMC7352229 DOI: 10.3390/ijms21124306] [Citation(s) in RCA: 151] [Impact Index Per Article: 37.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 06/09/2020] [Accepted: 06/10/2020] [Indexed: 02/07/2023] Open
Abstract
Exposure to ambient air pollution is a well-established determinant of health and disease. The Lancet Commission on pollution and health concludes that air pollution is the leading environmental cause of global disease and premature death. Indeed, there is a growing body of evidence that links air pollution not only to adverse cardiorespiratory effects but also to increased risk of cerebrovascular and neuropsychiatric disorders. Despite being a relatively new area of investigation, overall, there is mounting recent evidence showing that exposure to multiple air pollutants, in particular to fine particles, may affect the central nervous system (CNS) and brain health, thereby contributing to increased risk of stroke, dementia, Parkinson's disease, cognitive dysfunction, neurodevelopmental disorders, depression and other related conditions. The underlying molecular mechanisms of susceptibility and disease remain largely elusive. However, emerging evidence suggests inflammation and oxidative stress to be crucial factors in the pathogenesis of air pollution-induced disorders, driven by the enhanced production of proinflammatory mediators and reactive oxygen species in response to exposure to various air pollutants. From a public health perspective, mitigation measures are urgent to reduce the burden of disease and premature mortality from ambient air pollution.
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Affiliation(s)
- Omar Hahad
- Center for Cardiology–Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany;
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, 55131 Mainz, Germany
| | - Jos Lelieveld
- Atmospheric Chemistry Department, Max Planck Institute for Chemistry, 55128 Mainz, Germany;
- Climate and Atmosphere Research Center, The Cyprus Institute, Nicosia 1645, Cyprus
| | - Frank Birklein
- Department of Neurology, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany;
| | - Klaus Lieb
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany;
- Leibniz Institute for Resilience Research, 55122 Mainz, Germany
| | - Andreas Daiber
- Center for Cardiology–Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany;
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, 55131 Mainz, Germany
- Correspondence: (A.D.); (T.M.); Tel.: +49-(0)6131-176280 (A.D.); +49-(0)6131-177251 (T.M.)
| | - Thomas Münzel
- Center for Cardiology–Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany;
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, 55131 Mainz, Germany
- Correspondence: (A.D.); (T.M.); Tel.: +49-(0)6131-176280 (A.D.); +49-(0)6131-177251 (T.M.)
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Stroke to Dementia Associated with Environmental Risks-A Semi-Markov Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17061944. [PMID: 32188138 PMCID: PMC7143936 DOI: 10.3390/ijerph17061944] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 03/05/2020] [Accepted: 03/09/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Most stroke cases lead to serious mental and physical disabilities, such as dementia and sensory impairment. Chronic diseases are contributory risk factors for stroke. However, few studies considered the transition behaviors of stroke to dementia associated with chronic diseases and environmental risks. OBJECTIVE This study aims to develop a prognosis model to address the issue of stroke transitioning to dementia associated with environmental risks. DESIGN This cohort study used the data from the National Health Insurance Research Database in Taiwan. SETTING Healthcare data were obtained from more than 25 million enrollees and covered over 99% of Taiwan's entire population. PARTICIPANTS In this study, 10,627 stroke patients diagnosed from 2000 to 2010 in Taiwan were surveyed. METHODS A Cox regression model and corresponding semi-Markov process were constructed to evaluate the influence of risk factors on stroke, corresponding dementia, and their transition behaviors. MAIN OUTCOME MEASURE Relative risk and sojourn time were the main outcome measure. RESULTS Multivariate analysis showed that certain environmental risks, medication, and rehabilitation factors highly influenced the transition of stroke from a chronic disease to dementia. This study also highlighted the high-risk populations of stroke patients against the environmental risk factors; the males below 65 years old were the most sensitive population. CONCLUSION Experiments showed that the proposed semi-Markovian model outperformed other benchmark diagnosis algorithms (i.e., linear regression, decision tree, random forest, and support vector machine), with a high R2 of 90%. The proposed model also facilitated an accurate prognosis on the transition time of stroke from chronic diseases to dementias against environmental risks and rehabilitation factors.
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Rocha II, Narasimhalu K, De Silva DA. Impact of Air Pollution and Seasonal Haze on Neurological Conditions: A Review. ANNALS ACADEMY OF MEDICINE SINGAPORE 2020. [DOI: 10.47102/annals-acadmedsg.18087] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Introduction: Air pollution is a global problem and seasonal haze from forest clearing
and peat land burning in Indonesia is an annual phenomenon in Southeast Asia. As
neurological disorders comprise 6.3% of the burden of disease globally, we reviewed
evidence of the association between common neurological conditions and air pollution
exposure, and summarised existing data on the impact of the haze phenomenon in
Southeast Asia. Materials and Methods: A PubMed search for relevant studies on air
pollution, Alzheimer’s disease (AD), dementia, epilepsy, haze, headache, migraine, stroke, Parkinson’s disease (PD) and neuromuscular conditions was performed. There were 52 articles which were relevant and were reviewed. Results: There were associations between short-term air pollution exposure with AD, epilepsy, ischaemic stroke and migraine. Long-term air pollution exposure was associated with AD, amyotrophic lateral sclerosis, dementia and ischaemic stroke. Evidence on the link between air pollution and PD was inconsistent. Currently, there is no specific data on the effects haze has on neurological conditions in Southeast Asia. Conclusion: Air pollution is associated with increased risk of certain common neurological disorders. More specific studies are needed to investigate the impact of seasonal haze on neurological conditions in Southeast Asia.
Key words: Alzheimer’s disease, Epilepsy, Migraine, Parkinson’s disease, Stroke
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Affiliation(s)
| | - Kaavya Narasimhalu
- National Neuroscience Institute (Singapore General Hospital campus), Singapore
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Švecová V, Topinka J, Solanský I, Broday D, Šrám RJ. Relation between personal exposure and outdoor concentrations of carcinogenic polycyclic aromatic hydrocarbons during smog episode. Cent Eur J Public Health 2020; 27:305-311. [PMID: 31951690 DOI: 10.21101/cejph.a5475] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 10/14/2019] [Accepted: 10/14/2019] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To our knowledge this is the first study measuring personal exposure to carcinogenic polycyclic aromatic hydrocarbons (cPAHs) bound to airborne particulate matter ≤ 2.5 µm (PM2.5) in periods of high air pollution (smog episode) in which citizen were tracked. METHODS Measurements were performed in industrial regions of the Czech Republic: Ostrava, Karviná, Havířov. The city of Prague served as a control. Personal monitoring was conducted by active personal monitors for 48 hours. Non-smoking city policemen from Prague, Karviná and Havířov, office workers from Ostrava city and volunteers from Ostrava-Radvanice and Bartovice participated in the study (N = 214). RESULTS The average personal exposure to benzo[a]pyrene (B[a]P) was highest in Ostrava (17.2 ng/m3), followed by Karviná, Havířov, Radvanice and Bartovice, and Prague (14.2, 12.0, 9.3, and 2.8 ng/m3, respectively). We tested for association between the personal exposure to cPAHs and various health-related factors extracted from the questionnaires, including lifestyle factors and day-to-day activities. CONCLUSIONS Exposure to outdoor cPAHs, environmental tobacco smoke (ETS), commuting, and time spent indoors (in restaurants, workplace or home) were found to be the main determinants of the personal exposure. Daily cPAHs measurements in highly polluted areas are needed for evaluating the personal exposure and to avoid its underestimation resulting from stationary monitoring.
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Affiliation(s)
- Vlasta Švecová
- Institute of Experimental Medicine, Czech Academy of Sciences, Prague, Czech Republic
| | - Jan Topinka
- Institute of Experimental Medicine, Czech Academy of Sciences, Prague, Czech Republic
| | - Ivo Solanský
- Institute of Experimental Medicine, Czech Academy of Sciences, Prague, Czech Republic
| | - David Broday
- Technion Centre of Excellence in Exposure Science and Environmental Health, Faculty of Civil and Environmental Engineering, Technion-Israel Institute of Technology, Haifa, Israel
| | - Radim J Šrám
- Institute of Experimental Medicine, Czech Academy of Sciences, Prague, Czech Republic
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Wang Z, Peng J, Liu P, Duan Y, Huang S, Wen Y, Liao Y, Li H, Yan S, Cheng J, Yin P. Association between short-term exposure to air pollution and ischemic stroke onset: a time-stratified case-crossover analysis using a distributed lag nonlinear model in Shenzhen, China. Environ Health 2020; 19:1. [PMID: 31898503 PMCID: PMC6941275 DOI: 10.1186/s12940-019-0557-4] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 12/20/2019] [Indexed: 05/03/2023]
Abstract
BACKGROUND Stroke, especially ischemic stroke (IS), has been a severe public health problem around the world. However, the association between air pollution and ischemic stroke remains ambiguous. METHODS A total of 63, 997 IS cases aged 18 years or above in Shenzhen were collected from 2008 to 2014. We used the time-stratified case-crossover design combining with distributed lag nonlinear model (DLNM) to estimate the association between air pollution and IS onset. Furthermore, this study explored the variability across gender and age groups. RESULTS The cumulative exposure-response curves were J-shaped for SO2, NO2 and PM10, and V-shaped for O3, and crossed over the relative risk (RR) of one. The 99th, 50th (median) and 1st percentiles of concentration (μg/m3) respectively were 37.86, 10.06, 3.71 for SO2, 116.26, 41.29, 18.51 for NO2, 145.94, 48.29, 16.14 for PM10, and 111.57, 49.82, 16.00 for O3. Extreme high-SO2, high-NO2, high-PM10, high-O3, and low-O3 concentration increased the risk of IS, with the maximum RR values and 95% CIs: 1.50(1.22, 1.84) (99th vs median) at 0-12 lag days, 1.37(1.13, 1.67) (99th vs median) at 0-10 lag days, 1.26(1.04, 1.53) (99th vs median) at 0-12 lag days, 1.25(1.04, 1.49) (99th vs median) at 0-14 lag days, and 1.29(1.03, 1.61) (1st vs median) at 0-14 lag days, respectively. The statistically significant minimal RR value and 95% CI was 0.79(0.66,0.94) at 0-10 lag days for extreme low-PM10. The elderly aged over 65 years were susceptible to extreme pollution conditions. Difference from the vulnerability of males to extreme high-SO2, high-NO2 and low-O3, females were vulnerable to extreme high-PM10 and high-O3. Comparing with the elderly, adults aged 18-64 year were immune to extreme low-NO2 and low-PM10. However, no association between CO and IS onset was found. CONCLUSIONS SO2, NO2, PM10 and O3 exerted non-linear and delayed influence on IS, and such influence varied with gender and age. These findings may have significant public health implications for the prevention of IS.
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Affiliation(s)
- Zhinghui Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China
| | - Ji Peng
- Shenzhen Center for Chronic Disease Control, Shenzhen, China
| | - Peiyi Liu
- Department of Molecular Epidemiology, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
- Department of Occupational and Environment Health, Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yanran Duan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China
| | - Suli Huang
- Department of Molecular Epidemiology, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Ying Wen
- Department of Molecular Epidemiology, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Yi Liao
- Department of Public Health Promotion, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Hongyan Li
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China
| | - Siyu Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China
| | - Jinquan Cheng
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen, 518055, Guangdong, China.
| | - Ping Yin
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China.
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen, 518055, Guangdong, China.
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Kim HB, Shim JY, Park B, Lee YJ. Long-term exposure to air pollution and the risk of non-lung cancer: a meta-analysis of observational studies. Perspect Public Health 2019; 140:222-231. [PMID: 31813335 DOI: 10.1177/1757913919891751] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
AIMS Several meta-analyses of observational studies report a long-term correlation between air pollution and the risk of cancer, particularly lung carcinoma. The aim of this study was to review and quantify evidence for an association between air pollution and the risk of developing non-lung cancers. METHODS We searched PubMed, EMBASE, Cochrane Library, and the reference lists of the included studies as well as those recorded in previous meta-analyses conducted before January 2019. A random-effects model was used to derive overall risk estimates per pollutant. RESULTS A total of 20 studies, including 5 case-control and 15 prospective cohort studies, were used in the final analysis. The risk of developing non-lung cancer was 1.09 (95% confidence interval (CI): 1.01-1.18, I2 = 72.9%) per NO2 increases of 10 µg/m3. There was also a significant association between exposure to PM2.5 and PM10 and the risk of non-lung cancer when the male and female populations were combined (pooled odds ratio/relative risk (OR/RR) = 1.22, 95% CI: 1.11-1.34; I2 = 0.0% and pooled OR/RR = 1.26, 95% CI: 1.05-1.52; I2 = 43.9%, respectively). Regarding the type of cancer, significant harmful effects of PM2.5 were observed for liver cancer populations (pooled OR/RR = 1.21, 95% CI: 1.10-1.32; I2 = 0.0%). Different types of cancer were positively associated with the incidence of non-lung cancer and PM10 in the random-effect meta-regression analysis. CONCLUSIONS Long-term exposure to air pollutants appears to be associated with an increased risk of non-lung cancer. Care should be taken in interpretation, because the results for specific cancers were restricted.
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Affiliation(s)
- H-B Kim
- Department of Family Medicine, Myongji Hospital, Hanyang University College of Medicine, Goyang, Republic of Korea.,Department of Medicine, Graduate School, Yonsei University, Seoul, Republic of Korea
| | - J-Y Shim
- Department of Medicine, Graduate School, Yonsei University, Seoul, Republic of Korea.,Department of Family Medicine, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea
| | - B Park
- Department of Medicine, Graduate School, Yonsei University, Seoul, Republic of Korea.,Department of Family Medicine, Yongin Severance Hospital, Yongin, Republic of Korea
| | - Y-J Lee
- Department of Medicine, Graduate School, Yonsei University, Seoul, Republic of Korea.,Department of Family Medicine, Gangnam Severance Hospital, Seoul, Republic of Korea
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Sun S, Stewart JD, Eliot MN, Yanosky JD, Liao D, Tinker LF, Eaton CB, Whitsel EA, Wellenius GA. Short-term exposure to air pollution and incidence of stroke in the Women's Health Initiative. ENVIRONMENT INTERNATIONAL 2019; 132:105065. [PMID: 31382185 PMCID: PMC6754774 DOI: 10.1016/j.envint.2019.105065] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Revised: 07/26/2019] [Accepted: 07/28/2019] [Indexed: 05/07/2023]
Abstract
BACKGROUND Evidence of the association between daily variation in air pollution and risk of stroke is inconsistent, potentially due to the heterogeneity in stroke etiology. OBJECTIVES To estimate the associations between daily variation in ambient air pollution and risk of stroke and its subtypes among participants of the Women's Health Initiative, a large prospective cohort study in the United States. METHODS We used national-scale, log-normal ordinary kriging models to estimate daily concentrations of fine particulate matter (PM2.5), respirable particulate matter (PM10), nitrogen dioxide (NO2), nitrogen oxides (NOx), sulphur dioxide, and ozone at participant addresses. Stroke was adjudicated by trained neurologists and classified as ischemic or hemorrhagic. Ischemic strokes were further classified according to the Trial of ORG 10172 in Acute Stroke Treatment (TOAST) classification. We used a time-stratified case-crossover approach to estimate the odds ratio (OR) of the risk of stroke associated with an interquartile range (IQR) increase in concentrations of each air pollutant. We performed stratified analysis to examine whether associations varied across subgroups defined by age at stroke onset, US census region, smoking status, body mass index, and prior history of diabetes mellitus, hypertension, heart or circulation problems, or arterial fibrillation at enrollment. RESULTS Among 5417 confirmed strokes between 1993 and 2012, 4300 (79.4%) were classified as ischemic and 924 (17.1%) as hemorrhagic. No association was observed between day-to-day variation in any pollutant and risk of total stroke, ischemic stroke, or specific etiologies of ischemic stroke. We observed a positive association between risk of hemorrhagic stroke and NO2 and NOx in the 3 days prior to stroke with OR of 1.24 (95% CI: 1.01, 1.52) and 1.18 (95% CI: 1.03, 1.34) per IQR increase, respectively. The observed associations with hemorrhagic stroke were more pronounced among non-obese participants. CONCLUSIONS In this large cohort of post-menopausal US women, daily NO2 and NOx were associated with higher risk of hemorrhagic stroke, but ambient levels of four other air pollutants were not associated with higher risk of total stroke, ischemic stroke, or ischemic stroke subtypes.
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Affiliation(s)
- Shengzhi Sun
- Department of Epidemiology, Brown University School of Public Health, Providence, RI 02912, USA.
| | - James D Stewart
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Melissa N Eliot
- Department of Epidemiology, Brown University School of Public Health, Providence, RI 02912, USA
| | - Jeff D Yanosky
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Duanping Liao
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Lesley F Tinker
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Charles B Eaton
- Department of Family Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Eric A Whitsel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Gregory A Wellenius
- Department of Epidemiology, Brown University School of Public Health, Providence, RI 02912, USA
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Peters R, Ee N, Peters J, Beckett N, Booth A, Rockwood K, Anstey KJ. Common risk factors for major noncommunicable disease, a systematic overview of reviews and commentary: the implied potential for targeted risk reduction. Ther Adv Chronic Dis 2019; 10:2040622319880392. [PMID: 31662837 PMCID: PMC6794648 DOI: 10.1177/2040622319880392] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 09/13/2019] [Indexed: 12/31/2022] Open
Abstract
Noncommunicable disease now contributes to the World Health Organization top 10 causes of death in low-, middle- and high-income countries. Particular examples include stroke, coronary heart disease, dementia and certain cancers. Research linking clinical and lifestyle risk factors to increased risk of noncommunicable disease is now well established with examples of confirmed risk factors, including smoking, physical inactivity, obesity and hypertension. However, despite a need to target our resources to achieve risk reduction, relatively little work has examined the overlap between the risk factors for these main noncommunicable diseases. Our high-level review draws together the evidence in this area. Using a systematic overview of reviews, we demonstrate the likely commonality of established risk factors having an impact on multiple noncommunicable disease outcomes. For example, systematic reviews of the evidence on physical inactivity and poor diet found each to be associated with increased risk of cancers, coronary heart disease, stroke, diabetes mellitus and dementia. We highlight the potential for targeted risk reduction to simultaneously impact multiple noncommunicable disease areas. These relationships now need to be further quantified to allow the most effective development of public health interventions in this area.
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Affiliation(s)
- Ruth Peters
- Neuroscience Research Australia, Barker Street,
Randwick, Sydney, New South Wales, 2031, Australia
- University of New South Wales, Sydney, NSW,
Australia
- Imperial College London, London, UK
| | - Nicole Ee
- University of New South Wales, Sydney, NSW,
Australia
| | | | - Nigel Beckett
- Guys and St Thomas’s NHS Foundation Trust,
London, UK
- Imperial College London, London, UK
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Chen R, Yang J, Zhang C, Li B, Bergmann S, Zeng F, Wang H, Wang B. Global Associations of Air Pollution and Conjunctivitis Diseases: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16193652. [PMID: 31569424 PMCID: PMC6801537 DOI: 10.3390/ijerph16193652] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Revised: 09/23/2019] [Accepted: 09/25/2019] [Indexed: 12/11/2022]
Abstract
(1) Background: As the most common eye disease diagnosed in emergency departments, conjunctivitis has caused serious health and economic burdens worldwide. However, whether air pollution may be a risk factor for conjunctivitis is still inconsistent among current evidence. (2) Methods: We searched the literature on the relationship between air pollution and conjunctivitis in multiple English databases before 18 March 2019. Meta-analysis, meta-regression, and funnel plots were used to integrate the data, identify the sources of bias, and determine the publication bias, respectively. (3) Results: A total of 2450 papers were found, 12 of which were finally included. The pooled relative risk for each 10 μg/m3 increase of air pollution on conjunctivitis was 1.0006 (95%CI: 0.9993–1.0019) for CO, 1.0287 (1.0120–1.0457) for NO2, 1.0089 (1.0030–1.0149) for O3, 1.0004 (0.9976–1.0032) for PM2.5, 1.0033 (0.9982–1.0083) for PM10, and 1.0045 (0.9908–1.0185) for SO2. In the subgroup, PM2.5 and O3 had a greater impact on conjunctivitis risk in women than in men, and people <18 years old than those ≥18 years old. Relative humidity significantly modified the risk of O3 on conjunctivitis (p = 0.023), explaining 45% of the between-study heterogeneity. (4) Conclusion: Globally, air pollution has considerable health risks for conjunctivitis. Females and the youth were more vulnerable to PM2.5, NO2, and O3. Reductions of air pollution levels are still warranted to protect the vulnerable populations.
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Affiliation(s)
- Renchao Chen
- Institute for Environmental and Climate Research, Jinan University, Guangzhou 511443, China.
| | - Jun Yang
- Institute for Environmental and Climate Research, Jinan University, Guangzhou 511443, China.
| | - Chunlin Zhang
- Institute for Environmental and Climate Research, Jinan University, Guangzhou 511443, China.
| | - Bixia Li
- Institute for Environmental and Climate Research, Jinan University, Guangzhou 511443, China.
| | - Stéphanie Bergmann
- Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht 6200 MD, The Netherlands.
| | - Fangfang Zeng
- Department of Epidemiology, School of Medicine, Jinan University, Guangzhou 510630, China.
| | - Hao Wang
- Institute for Environmental and Climate Research, Jinan University, Guangzhou 511443, China.
| | - Boguang Wang
- Institute for Environmental and Climate Research, Jinan University, Guangzhou 511443, China.
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Long-term Effects of Cumulative Average PM2.5 Exposure on the Risk of Hemorrhagic Stroke. Epidemiology 2019; 30 Suppl 1:S90-S98. [DOI: 10.1097/ede.0000000000001001] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Graber M, Mohr S, Baptiste L, Duloquin G, Blanc-Labarre C, Mariet AS, Giroud M, Béjot Y. Air pollution and stroke. A new modifiable risk factor is in the air. Rev Neurol (Paris) 2019; 175:619-624. [PMID: 31153597 DOI: 10.1016/j.neurol.2019.03.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 03/18/2019] [Accepted: 03/19/2019] [Indexed: 12/19/2022]
Abstract
Evidence from epidemiological studies has demonstrated that outdoor air pollution is now a well-known major problem of public health, mainly in low and middle income countries. Contrasting with myocardial infarction, there are few data on the association of air pollution and stroke. METHODS We propose a narrative literature review of the effects and the underlying biological mechanisms of short- and long-term exposure to air pollutants on stroke risk and mortality, using the following key-words: stroke, cerebrovascular events, ischemic and haemorrhage stroke, transient ischaemic attack, mortality, air pollution and air pollutants. RESULTS Twenty-one papers were selected. Air pollution, of which whose small particulate matter are the most toxic, contributes to about one-third of the global burden of stroke. We can identify vulnerable patients with classical neuro-vascular risk factors or a prior history of stroke or transient ischemic attack or persons living in low-income countries. Biological mechanisms of this new morbid association are discussed. CONCLUSION Air pollution should be recognized as a silent killer inducing stroke whose mortality rates remain elevated by its role as a new modifiable neurovascular risk factor, needing public health policies.
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Affiliation(s)
- M Graber
- Dijon Stroke Registry (Inserm, Santé Publique France), EA7460, university hospital of Dijon, university of Burgundy and Franche-Comté, Dijon, France
| | - S Mohr
- Dijon Stroke Registry (Inserm, Santé Publique France), EA7460, university hospital of Dijon, university of Burgundy and Franche-Comté, Dijon, France
| | - L Baptiste
- Dijon Stroke Registry (Inserm, Santé Publique France), EA7460, university hospital of Dijon, university of Burgundy and Franche-Comté, Dijon, France
| | - G Duloquin
- Dijon Stroke Registry (Inserm, Santé Publique France), EA7460, university hospital of Dijon, university of Burgundy and Franche-Comté, Dijon, France
| | - C Blanc-Labarre
- Dijon Stroke Registry (Inserm, Santé Publique France), EA7460, university hospital of Dijon, university of Burgundy and Franche-Comté, Dijon, France
| | - A S Mariet
- Clinical investigation center of Dijon (Inserm CIC 1432), university of Burgundy and Franche Comté, Inserm, biostatistique, biomathématique, pharmacoepidemiologie et maladies infectieuses (B2 PHI), UMR 1181, university Hospital of Dijon, Dijon, France
| | - M Giroud
- Dijon Stroke Registry (Inserm, Santé Publique France), EA7460, university hospital of Dijon, university of Burgundy and Franche-Comté, Dijon, France.
| | - Y Béjot
- Dijon Stroke Registry (Inserm, Santé Publique France), EA7460, university hospital of Dijon, university of Burgundy and Franche-Comté, Dijon, France
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Kim HB, Shim JY, Park B, Lee YJ. Long-Term Exposure to Air Pollutants and Cancer Mortality: A Meta-Analysis of Cohort Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E2608. [PMID: 30469439 PMCID: PMC6266691 DOI: 10.3390/ijerph15112608] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 11/13/2018] [Accepted: 11/15/2018] [Indexed: 01/11/2023]
Abstract
The aim of this study was to examine the relationship between main air pollutants and all cancer mortality by performing a meta-analysis. We searched PubMed, EMBASE (a biomedical and pharmacological bibliographic database of published literature produced by Elsevier), and the reference lists of other reviews until April 2018. A random-effects model was employed to analyze the meta-estimates of each pollutant. A total of 30 cohort studies were included in the final analysis. Overall risk estimates of cancer mortality for 10 µg/m³ per increase of particulate matter (PM)2.5, PM10, and NO₂ were 1.17 (95% confidence interval (CI): 1.11⁻1.24), 1.09 (95% CI: 1.04⁻1.14), and 1.06 (95% CI: 1.02⁻1.10), respectively. With respect to the type of cancer, significant hazardous influences of PM2.5 were noticed for lung cancer mortality and non-lung cancer mortality including liver cancer, colorectal cancer, bladder cancer, and kidney cancer, respectively, while PM10 had harmful effects on mortality from lung cancer, pancreas cancer, and larynx cancer. Our meta-analysis of cohort studies indicates that exposure to the main air pollutants is associated with increased mortality from all cancers.
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Affiliation(s)
- Hong-Bae Kim
- Department of Family Medicine, MyongJi Hospital, Hanyang University Medical Center, 14-55 Hwasu-ro, Deokyang-gu, Goyang, Gyeonggi-do 10475, Korea.
- Department of Medicine, Graduate School of Yonsei University, 50-1 Yonsei-ro, Seodaemoon-gu, Seoul 03722, Korea.
| | - Jae-Yong Shim
- Department of Medicine, Graduate School of Yonsei University, 50-1 Yonsei-ro, Seodaemoon-gu, Seoul 03722, Korea.
- Department of Family Medicine, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemoon-gu, Seoul 03722, Korea.
| | - Byoungjin Park
- Department of Medicine, Graduate School of Yonsei University, 50-1 Yonsei-ro, Seodaemoon-gu, Seoul 03722, Korea.
- Department of Family Medicine, Yongin Severance Hospital, 225 Gumhak-ro, Cheoin-gu, Yongin, Gyeonggi-do 17046, Korea.
| | - Yong-Jae Lee
- Department of Medicine, Graduate School of Yonsei University, 50-1 Yonsei-ro, Seodaemoon-gu, Seoul 03722, Korea.
- Department of Family Medicine, Gangnam Severance Hospital, 211 UnJu-ro, Seoul 06273, Korea.
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Flament F, Bourokba N, Nouveau S, Li J, Charbonneau A. A severe chronic outdoor urban pollution alters some facial aging signs in Chinese women. A tale of two cities. Int J Cosmet Sci 2018; 40:467-481. [DOI: 10.1111/ics.12487] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 06/28/2018] [Indexed: 12/24/2022]
Affiliation(s)
- F. Flament
- L'Oréal Research and Innovation; Clichy France
| | - N. Bourokba
- L'Oréal Research and Innovation; Singapore Singapore
| | - S. Nouveau
- L'Oréal Research and Innovation; Aulnay-sous-Bois France
| | - J. Li
- L'Oréal Research and Innovation; Shanghai China
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Wang X, Qian Z, Wang X, Hong H, Yang Y, Xu Y, Xu X, Yao Z, Zhang L, Rolling CA, Schootman M, Liu T, Xiao J, Li X, Zeng W, Ma W, Lin H. Estimating the acute effects of fine and coarse particle pollution on stroke mortality of in six Chinese subtropical cities. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2018; 239:812-817. [PMID: 29751339 DOI: 10.1016/j.envpol.2018.04.102] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 04/23/2018] [Accepted: 04/23/2018] [Indexed: 06/08/2023]
Abstract
While increasing evidence suggested that PM2.5 is the most harmful fraction of the particle pollutants, the health effects of coarse particles (PM10-2.5) have been inconclusive, especially on cerebrovascular diseases, we thus evaluated the effects of PM10, PM2.5, and PM10-2.5 on stroke mortality in six Chinese subtropical cities using generalized additive models. We also conducted random-effects meta-analyses to estimate the overall effects across the six cities. We found that PM10, PM2.5, and PM10-2.5 were significantly associated with stroke mortality. Each 10 μg/m3 increase of PM10, PM2.5 and PM10-2.5 (lag03) was associated with an increase of 1.88% (95% CI: 1.37%, 2.39%), 3.07% (95% CI: 2.35%, 3.79%), and 5.72% (95% CI: 3.82%, 7.65%) in overall stroke mortality. Using the World Health Organization's guideline as reference concentration, we estimated that 3.21% (95% CI: 1.65%, 3.01%) of stroke mortality (corresponding to 1743 stroke mortalities, 95% CI: 896, 1633) were attributed to PM10, 5.57% (95% CI: 0.50%, 1.23%) stroke mortality (3019, 95% CI: 2286, 3777) were attributed to PM2.5, and 2.02% (95% CI: 1.85%, 3.08%) of stroke mortality (1097, 95% CI: 1005, 1673) could be attributed to PM10-2.5. Our analysis indicates that both PM2.5 and PM10-2.5 are important risk factors of stroke mortality and should be considered in the prevention and control of stroke in the study area.
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Affiliation(s)
- Xiaojie Wang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China; School of Public Health, Guangdong Pharmaceutical University, Guangzhou, 510220, China; Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Zhengmin Qian
- College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO, 63104, USA
| | - Xiaojie Wang
- Panyu District of Guangzhou Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Hua Hong
- Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, No. 58 Zhongshan Road 2, Guangzhou, 510080, China
| | - Yin Yang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China
| | - Yanjun Xu
- Institute of Chronic Non-Communicable Disease Control and Prevention, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Xiaojun Xu
- Institute of Chronic Non-Communicable Disease Control and Prevention, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Zhenjiang Yao
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, 510220, China
| | - Lingli Zhang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China; School of Public Health, Guangdong Pharmaceutical University, Guangzhou, 510220, China; Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Craig A Rolling
- College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO, 63104, USA
| | - Mario Schootman
- College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO, 63104, USA
| | - Tao Liu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Jianpeng Xiao
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Xing Li
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Weilin Zeng
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Wenjun Ma
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China.
| | - Hualiang Lin
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, 510080, China.
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Dong H, Yu Y, Yao S, Lu Y, Chen Z, Li G, Yao Y, Yao X, Wang SL, Zhang Z. Acute effects of air pollution on ischaemic stroke onset and deaths: a time-series study in Changzhou, China. BMJ Open 2018; 8:e020425. [PMID: 30037864 PMCID: PMC6059268 DOI: 10.1136/bmjopen-2017-020425] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 05/10/2018] [Accepted: 06/05/2018] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE To investigate the acute effect of air pollutants on ischaemic stroke (IS) and IS-related death. SETTING Five urban districts in Changzhou, China, between 9 January 2015 and 31 December 2016. PARTICIPANTS A total of 32 840 IS cases and 4028 IS deaths were enrolled. MAIN OUTCOME MEASURES A time-series design, generalised additive model and multivariable regression model were used to examine the percentage change (95% CI) in daily IS counts and deaths with an IQR increase in air pollutant levels for different single or multiple lag days in single-pollutant and two-pollutant models. RESULTS Daily IS counts increased 0.208% (95% CI 0.036% to 0.381%) with an IQR increment in the levels of nitrogen dioxide (NO2). The estimated risk of NO2 was more robust in males and in the cold season. For daily IS counts, the estimated effects of NO2 and sulfur dioxide (SO2) were more significant when adjusted for particulate matter with aerodynamic diameters <2.5 µm (PM2.5) and PM10. An IQR increment in the concentration of PM10, SO2 and NO2 significantly increased IS deaths with 6 days of cumulative effects (0.268%, 95% CI 0.007% to 1.528%; 0.34%, 0.088% to 0.592%; and 0.263%, 0.004% to 0.522%, respectively). Young individuals (<65 years old) had a higher IS mortality risk for PM2.5, PM10, NO2 and CO. For IS death, the effect estimates of SO2 in the elderly, females and the cold season were more pronounced; statistical significance was also identified for SO2 when adjusted for carbon monoxide (CO). CONCLUSIONS This study suggested that short-term exposure to ambient NO2 was associated with increased IS risk. In addition, SO2 was associated with increased IS onset and death.
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Affiliation(s)
- Huibin Dong
- Department of Chronic Disease Control and Prevention, Changzhou Center for Disease Control and Prevention, Changzhou, China
| | - Yongquan Yu
- Department of Occupational Medicine and Environmental Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Shen Yao
- Department of Occupational Medicine and Environmental Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Yan Lu
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Zhiyong Chen
- Department of Chronic Disease Control and Prevention, Changzhou Center for Disease Control and Prevention, Changzhou, China
| | - Guiying Li
- Department of Chronic Disease Control and Prevention, Changzhou Center for Disease Control and Prevention, Changzhou, China
| | - Yao Yao
- Department of Chronic Disease Control and Prevention, Changzhou Center for Disease Control and Prevention, Changzhou, China
| | - Xingjuan Yao
- Department of Chronic Disease Control and Prevention, Changzhou Center for Disease Control and Prevention, Changzhou, China
| | - Shou-Lin Wang
- Department of Occupational Medicine and Environmental Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Zhan Zhang
- Department of Hygiene Analysis and Detection, School of Public Health, Nanjing Medical University, Nanjing, China
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49
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Béjot Y, Reis J, Giroud M, Feigin V. A review of epidemiological research on stroke and dementia and exposure to air pollution. Int J Stroke 2018; 13:687-695. [DOI: 10.1177/1747493018772800] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Background Outdoor air pollution is now a well-known risk factor for morbidity and mortality, and is increasingly being identified as a major risk factor for stroke. Methods A narrative literature review of the effects of short and long-term exposure to air pollution on stroke and dementia risk and cognitive functioning. Results Ten papers on stroke and 17 on dementia were selected. Air pollution, and in particular small particulate matter, contributes to about one-third of the global stroke burden and about one-fifth of the global burden of dementia. It particularly affects vulnerable patients with other vascular risk factors or a prior history of stroke in low- and medium-income countries. New pathophysiological mechanisms of the cause-effect associations are suggested. Conclusion Air pollution should be considered as a new modifiable cerebrovascular and neurodegenerative risk factor. This massive worldwide public health problem requires environmental health policies able to reduce air pollution and thus the stroke and dementia burden.
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Affiliation(s)
- Yannick Béjot
- Dijon Stroke Registry (Inserm, Santé Publique France), EA 7460, University Hospital of Dijon – University of Burgundy, Dijon, France
| | - Jacques Reis
- Neurology Service (Pr C. Tranchant), University Hospital of Strasbourg, Strasbourg, France
| | - Maurice Giroud
- Dijon Stroke Registry (Inserm, Santé Publique France), EA 7460, University Hospital of Dijon – University of Burgundy, Dijon, France
| | - Valery Feigin
- Faculty of Health and Environmental Sciences, AUT University, Auckland, New Zealand
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Yang BY, Qian Z, Howard SW, Vaughn MG, Fan SJ, Liu KK, Dong GH. Global association between ambient air pollution and blood pressure: A systematic review and meta-analysis. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2018; 235:576-588. [PMID: 29331891 DOI: 10.1016/j.envpol.2018.01.001] [Citation(s) in RCA: 318] [Impact Index Per Article: 53.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 12/07/2017] [Accepted: 01/01/2018] [Indexed: 05/21/2023]
Abstract
Although numerous studies have investigated the association of ambient air pollution with hypertension and blood pressure (BP), the results were inconsistent. We performed a comprehensive systematic review and meta-analysis of these studies. Seven international and Chinese databases were searched for studies examining the associations of particulate (diameter<2.5 μm (PM2.5), 2.5-10 μm (PM2.5-10) or >10 μm (PM10)) and gaseous (sulfur dioxide (SO2), nitrogen dioxide (NO2), nitrogen oxides (NOx), ozone (O3), carbon monoxide (CO)) air pollutants with hypertension or BP. Odds ratios (OR), regression coefficients (β) and their 95% confidence intervals were calculated to evaluate the strength of the associations. Subgroup analysis, sensitivity analysis, and meta-regression analysis were also conducted. The overall meta-analysis showed significant associations of long-term exposures to PM2.5 with hypertension (OR = 1.05), and of PM10, PM2.5, and NO2 with DBP (β values: 0.47-0.86 mmHg). In addition, short-term exposures to four (PM10, PM2.5, SO2, NO2), two (PM2.5 and SO2), and four air pollutants (PM10, PM2.5, SO2, and NO2), were significantly associated with hypertension (ORs: 1.05-1.10), SBP (β values: 0.53-0.75 mmHg) and DBP (β values: 0.15-0.64 mmHg), respectively. Stratified analyses showed a generally stronger relationship among studies of men, Asians, North Americans, and areas with higher air pollutant levels. In conclusion, our study indicates a positive association between ambient air pollution and increased BP and hypertension. Geographical and socio-demographic factors may modify the pro-hypertensive effects of air pollutants.
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Affiliation(s)
- Bo-Yi Yang
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Zhengmin Qian
- Department of Epidemiology, College for Public Health and Social Justice, Saint Louis University, Saint Louis 63104, USA
| | - Steven W Howard
- Department of Health Management and Policy, College for Public Health and Social Justice, Saint Louis University, Saint Louis 63104, USA
| | - Michael G Vaughn
- School of Social Work, College for Public Health and Social Justice, Saint Louis University, Saint Louis 63104, USA
| | - Shu-Jun Fan
- Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China
| | - Kang-Kang Liu
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Guang-Hui Dong
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
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