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Brusselaers N, Macharis C, Mommens K. The health impact of freight transport-related air pollution on vulnerable population groups. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 329:121555. [PMID: 37105457 DOI: 10.1016/j.envpol.2023.121555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 03/20/2023] [Accepted: 04/01/2023] [Indexed: 05/21/2023]
Abstract
Every year, over 364,200 people in Europe die prematurely due to the effects of air pollution, in which the transportation sector plays an important role. In Brussels, freight transport generates €61,604 of air pollution health costs daily. Research has shown that dynamic spatiotemporal modeling of both emission sources and exposed people (using mobile phone data) renders more accurate impact results when analyzed in microenvironments. However, mobile data underrepresent population segments that are more sensitive to the effects of air pollution, such as toddlers, children and elderly individuals. This paper examined the link between vulnerable people aged 0-3, 3-18 and >65 years and freight transport-related air pollution concentrations in the Brussels-Capital Region (BCR). To this end, dynamic tailpipe emissions and their spatiotemporal dispersion were calculated using output from the Transport Agent-Based Model (TRABAM) on a daily basis. Population densities were calculated as a function of the residences' occupancy rate and school/class size and opening hours. The effects of exposure were then evaluated using age- and sex-differentiated exposure-response functions and monetized using local hospital cost factors. Data were compiled for 2021. A strong overlap between people's presence at the institutions' locations was noticed with a peak in (freight) transportation movements in the city. The results showed that €37,000 [€34,517.47-€40,047.13] of freight transport-related air pollution health costs were incurred daily by vulnerable population segments. While these vulnerable groups made up 25.34% of the total BCR population, they incurred 60% [56.03%-65.01%] of the engendered transportation air pollution costs. The results were then geographically analyzed to identify 465 traffic-related air pollution hotspots across the territory, which accounted for €36,000 [€33,677.85-€39,101.31] of total costs. The latter can be used in future studies to assess sector-specific freight transportation policies, which should take into consideration spatiotemporal population densities on the local level.
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Affiliation(s)
- Nicolas Brusselaers
- Dept. of Business Technology and Operations, Faculty of Economic and Social Sciences and Solvay Business School, Vrije Universiteit Brussel, Pleinlaan 2, 1050, Elsene, Belgium.
| | - Cathy Macharis
- Dept. of Business Technology and Operations, Faculty of Economic and Social Sciences and Solvay Business School, Vrije Universiteit Brussel, Pleinlaan 2, 1050, Elsene, Belgium
| | - Koen Mommens
- Dept. of Business Technology and Operations, Faculty of Economic and Social Sciences and Solvay Business School, Vrije Universiteit Brussel, Pleinlaan 2, 1050, Elsene, Belgium
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Jia Y, Lin Z, He Z, Li C, Zhang Y, Wang J, Liu F, Li J, Huang K, Cao J, Gong X, Lu X, Chen S. Effect of Air Pollution on Heart Failure: Systematic Review and Meta-Analysis. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:76001. [PMID: 37399145 PMCID: PMC10317211 DOI: 10.1289/ehp11506] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 02/15/2023] [Accepted: 06/06/2023] [Indexed: 07/05/2023]
Abstract
BACKGROUND Heart failure (HF) poses a significant global disease burden. The current evidence on the impact of air pollution on HF remains inconsistent. OBJECTIVES We aimed to conduct a systematic review of the literature and meta-analysis to provide a more comprehensive and multiperspective assessment of the associations between short- and long-term air pollution exposure and HF from epidemiological evidences. METHODS Three databases were searched up to 31 August 2022 for studies investigating the association between air pollutants (PM 2.5 , PM 10 , NO 2 , SO 2 , CO, O 3 ) and HF hospitalization, incidence, or mortality. A random effects model was used to derive the risk estimations. Subgroup analysis was conducted by geographical location, age of participants, outcome, study design, covered area, the methods of exposure assessment, and the length of exposure window. Sensitivity analysis and adjustment for publication bias were performed to test the robustness of the results. RESULTS Of 100 studies covering 20 countries worldwide, 81 were for short-term and 19 were for long-term exposure. Almost all air pollutants were adversely associated with the risk of HF in both short- and long-term exposure studies. For short-term exposures, we found the risk of HF increased by 1.8% [relative risk ( RR ) = 1.018 , 95% confidence interval (CI): 1.011, 1.025] and 1.6% (RR = 1.016 , 95% CI: 1.011, 1.020) per 10 - μ g / m 3 increment of PM 2.5 and PM 10 , respectively. HF was also significantly associated with NO 2 , SO 2 , and CO, but not O 3 . Positive associations were stronger when exposure was considered over the previous 2 d (lag 0-1) rather than on the day of exposure only (lag 0). For long-term exposures, there were significant associations between several air pollutants and HF with RR (95% CI) of 1.748 (1.112, 2.747) per 10 - μ g / m 3 increment in PM 2.5 , 1.212 (1.010, 1.454) per 10 - μ g / m 3 increment in PM 10 , and 1.204 (1.069, 1.356) per 10 -ppb increment in NO 2 , respectively. The adverse associations of most pollutants with HF were greater in low- and middle-income countries than in high-income countries. Sensitivity analysis demonstrated the robustness of our results. DISCUSSION Available evidence highlighted adverse associations between air pollution and HF regardless of short- and long-term exposure. Air pollution is still a prevalent public health issue globally and sustained policies and actions are called for to reduce the burden of HF. https://doi.org/10.1289/EHP11506.
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Affiliation(s)
- Yanhui Jia
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China
| | - Zhennan Lin
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China
| | - Zhi He
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China
| | - Chenyang Li
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China
| | - Youjing Zhang
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China
| | - Jingyu Wang
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China
| | - Fangchao Liu
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China
| | - Jianxin Li
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China
| | - Keyong Huang
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China
| | - Jie Cao
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China
| | - Xinyuan Gong
- Department of Science and Education, Tianjin First Central Hospital, Tianjin, China
| | - Xiangfeng Lu
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China
| | - Shufeng Chen
- Key Laboratory of Cardiovascular Epidemiology, Department of Epidemiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China
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Tang EJ, Zhou YM, Yang LL, Wang N, Jiang YX, Xiao H, Hu YG, Li DW, Li N, Huang QS, Du N, Li YF, Ji AL, Zhou LX, Cai TJ. The association between short-term ambient sulfur dioxide exposure and hospitalization costs of ischemic stroke: a hospital-based study in Chongqing, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:17459-17471. [PMID: 36194329 DOI: 10.1007/s11356-022-23254-8] [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: 06/20/2022] [Accepted: 09/21/2022] [Indexed: 06/16/2023]
Abstract
Evidence of the short-term effects of ambient sulfur dioxide (SO2) exposure on the economic burden of ischemic stroke is limited. This study aimed to explore the association between short-term ambient SO2 exposure and hospitalization costs for ischemic stroke in Chongqing, the most populous city in China. The hospital-based study included 7271 ischemic stroke inpatients. Multiple linear regression models were used to estimate the association between SO2 concentration and hospitalization costs. Propensity score matching was used to compare the patients' characteristics when exposed to SO2 concentrations above and below 20 μg/m3. It is found that short-term SO2 exposure was positively correlated with the hospitalization costs of ischemic stroke. The association was more evident in males, people younger than 65, and people hospitalized in the cool seasons. Besides, among the components of hospitalization costs, medicine costs were most significantly associated with SO2. More interesting, the lower concentration of SO2, the higher costs associated with 1 μg/m3 SO2 change. Above all, SO2 was positively associated with hospitalization costs of ischemic stroke, even at its low levels. The measures to reduce the level of SO2 can help reduce the burden of ischemic stroke.
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Affiliation(s)
- En-Jie Tang
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Yu-Meng Zhou
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Li-Li Yang
- Department of Information, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, 400037, China
| | - Nan Wang
- Medical Department, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, 400037, China
| | - Yue-Xu Jiang
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
- Department of Nutrition and Food Hygiene, School of Public Health Guizhou Medical University, Guiyang, 550025, China
| | - Hua Xiao
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Yue-Gu Hu
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Da-Wei Li
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Na Li
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
- Department of Nutrition and Food Hygiene, School of Public Health Guizhou Medical University, Guiyang, 550025, China
| | - Qing-Song Huang
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
- Department of Nutrition and Food Hygiene, School of Public Health Guizhou Medical University, Guiyang, 550025, China
| | - Ning Du
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Ya-Fei Li
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Ai-Ling Ji
- Department of Preventive Medicine, Chongqing Medical and Pharmaceutical College, Chongqing, 401331, China
| | - Lai-Xin Zhou
- Medical Department, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Tong-Jian Cai
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China.
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Abe KC, Rodrigues MA, Miraglia SGEK. Health impact assessment of air pollution in Lisbon, Portugal. JOURNAL OF THE AIR & WASTE MANAGEMENT ASSOCIATION (1995) 2022; 72:1307-1315. [PMID: 36048722 DOI: 10.1080/10962247.2022.2118192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
BACKGROUND Lisbon has about 500,000 inhabitants and it's the capital and the main economic hub of Portugal. Studies have demonstrated that exposure to Particulate Matter with an aerodynamic diameter<2.5 μm (PM2.5) have strong association with health effects. Researchers continue to identify new harmful air pollutants effects in our health even in low levels. OBJECTIVES This study evaluates air pollution scenarios considering a Health Impact Assessment approach in Lisbon, Portugal. METHODS We have studied abatement scenarios of PM2.5 concentrations and the health effects in the period from 2015 to 2017 using the APHEKOM tool and the associated health costs were assessed by Value of Life Year. RESULTS The mean concentration of PM2.5 in Lisbon was 23 μg/m3 ± 10 μg/m3 (±Standard Deviation). If we consider that World Health Organization (WHO) standards of PM2.5 (10 μg/m3) were reached, Lisbon would avoid more than 423 premature deaths (equivalent to 9,172 life years' gain) and save more than US$45 million annually. If Lisbon city could even diminish the mean of PM2.5 by 5 μg/m3, nearly 165 deaths would be avoided, resulting in a gain of US$17 million annually. CONCLUSION According to our findings, if considered the worst pollution scenario, levels of PM2.5 could improve the life's quality and save a significant amount of economic resources.Implications: The manuscript addresses the health effects and costs of air pollution and constitutes an important target for improving public policies on air pollutants in Portugal. Although Portugal has low levels of air pollution, there are significant health and economic effects that, for the most part, are underreported. The health impact assessment approach associated with costs had not yet been addressed in Portugal, which makes this study more relevant in the analysis of policies aimed to drive stricter control on pollutants' emissions. Health costs are a fundamental element to support decision-making process and to orientate the trade-offs in investments for improving public policies so that to diminish health effects, which can impact the management of the local health services and the population's quality of life, especially after the pandemic period when resources are scarce.
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Affiliation(s)
- Karina Camasmie Abe
- Universidade Federal de São Paulo, Instituto de Ciências Ambientais, Químicas e Farmacêuticas - ICAQF, Laboratório de Economia, Saúde e Poluição Ambiental, São Paulo, Brazil
| | - Matilde Alexandra Rodrigues
- Centro de Investigação em Saúde Ambiental - CISA e Centro de Investigação em Reabilitação, Escola Superior de Saúde do Instituto Politécnico do Porto, Porto, Portugal
| | - Simone Georges El Khouri Miraglia
- Universidade Federal de São Paulo, Instituto de Ciências Ambientais, Químicas e Farmacêuticas - ICAQF, Laboratório de Economia, Saúde e Poluição Ambiental, São Paulo, Brazil
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Qayyum F, Mehmood U, Tariq S, Haq ZU, Nawaz H. Particulate matter (PM 2.5) and diseases: an autoregressive distributed lag (ARDL) technique. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:67511-67518. [PMID: 34255259 DOI: 10.1007/s11356-021-15178-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 06/24/2021] [Indexed: 05/22/2023]
Abstract
Air pollution can be attributed to the reduction in visibility, less agricultural activity, more health issues, and long-term destruction to infrastructure. This paper aimed to examine the validity of association among the Particulate matter (PM2.5) and number of acute upper respiratory infection (ARI) and Asthma (AS) patients using an autoregressive distributed lag (ARDL) approach. This ARDL model study was conducted in Lahore, Pakistan. We used monthly data of ARI and AS patients acquired from Directorate General Health Services Punjab and PM2.5 from Air Visual-IQAir during the period January 2018-August 2019. ARDL bound testing technique was used to investigate the association between number of AS, ARI patients and PM2.5. In the short run, the PM2.5 has substantial positive impact on number of AS patients in Lahore. The values of short-run coefficient depicts that the association between PM2.5 and ARI patients is stronger than AS. The effect of PM2.5 on number of patients in short term is more than that in the long-term. For both AS and ARI, in the long run, PM2.5 has negative impact on number of patients.
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Affiliation(s)
- Fazzal Qayyum
- Remote Sensing, GIS and Climatic Research Lab (National Center of GIS and Space Applications), Centre for Remote Sensing, University of the Punjab, Lahore, Pakistan
| | - Usman Mehmood
- Remote Sensing, GIS and Climatic Research Lab (National Center of GIS and Space Applications), Centre for Remote Sensing, University of the Punjab, Lahore, Pakistan.
| | - Salman Tariq
- Remote Sensing, GIS and Climatic Research Lab (National Center of GIS and Space Applications), Department of Space Science, University of the Punjab, Lahore, Pakistan
| | - Zia Ul Haq
- Remote Sensing, GIS and Climatic Research Lab (National Center of GIS and Space Applications), Centre for Remote Sensing, University of the Punjab, Lahore, Pakistan
| | - Hasan Nawaz
- Remote Sensing, GIS and Climatic Research Lab (National Center of GIS and Space Applications), Centre for Remote Sensing, University of the Punjab, Lahore, Pakistan
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Leão MLP, Penteado JO, Ulguim SM, Gabriel RR, Dos Santos M, Brum AN, Zhang L, da Silva Júnior FMR. Health impact assessment of air pollutants during the COVID-19 pandemic in a Brazilian metropolis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:41843-41850. [PMID: 33788092 PMCID: PMC8010497 DOI: 10.1007/s11356-021-13650-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 03/22/2021] [Indexed: 05/13/2023]
Abstract
Studies around the world have revealed reduced levels of atmospheric particulate matter in periods of greatest human mobility restriction to contain the spread of SARS-CoV-2 during the COVID-19 pandemic. The present study aimed to carry out a health impact assessment in Recife, Brazil, hypothesizing a scenario in which the levels of PM10 and PM2.5 remained, throughout the year, as in the most restrictive period of human mobility. Particular material data (PM10 and PM2.5) were measured during the pandemic and population and health (mortality, hospital admissions for heart and respiratory problems) data from 2018 were used. We observed a reduction in the concentration of PM2.5 in up to 43.7% and PM10 up to 29.5% during the period of social isolation in the city of Recife. The reduction in PM2.5 would avoid 106 annual deaths from non-external causes and 58 annual deaths from cardiovascular diseases. In this scenario, $ 294.88 million would be saved ($ 114.88 million from heart problems and $ 180 million from non-external causes). When considering hospitalizations avoided by the decrease in PM10, we observed 57 fewer hospitalizations for respiratory diseases, 42 for heart diseases and a reduction of 37 deaths due to non-external causes. The reduction in spending on respiratory and cardiovascular hospitalizations would exceed $ 330,000. Therefore, the reduction of particulate matter could prevent hospital admissions, deaths and consequently there would be a reduction in disease burden in developing countries where economic resources are scarce. In this sense, governments should seek to reduce levels of pollution in order to improve the life quality and health of the population.
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Affiliation(s)
- Marcos Lorran Paranhos Leão
- Faculdade de Ciências Médicas (FCM) e Hospital Universitário Oswaldo Cruz (HUOC) da Universidade de Pernambuco (UPE) Campus Santo Amaro, Recife. Rua Arnóbio Marques, 310 - Santo Amaro, Recife, PE, CEP: 50100-130, Brazil
| | - Julia Oliveira Penteado
- Laboratório de Ensaios Farmacológicos e Toxicológicos, Instituto de Ciências Biológicas, Universidade Federal Do Rio Grande, Avenida Itália, km 8, Campus Carreiros, Rio Grande, RS, CEP: 96203-900, Brazil
- Programa de Pós-Graduação em Ciências Da Saúde, Faculdade de Medicina, Rua Visconde de Paranaguá 102 Centro, Rio Grande, RS, Brasil, CEP: 96203-900
| | - Sabrina Morales Ulguim
- Laboratório de Ensaios Farmacológicos e Toxicológicos, Instituto de Ciências Biológicas, Universidade Federal Do Rio Grande, Avenida Itália, km 8, Campus Carreiros, Rio Grande, RS, CEP: 96203-900, Brazil
| | - Rômulo Reginato Gabriel
- Laboratório de Ensaios Farmacológicos e Toxicológicos, Instituto de Ciências Biológicas, Universidade Federal Do Rio Grande, Avenida Itália, km 8, Campus Carreiros, Rio Grande, RS, CEP: 96203-900, Brazil
| | - Marina Dos Santos
- Laboratório de Ensaios Farmacológicos e Toxicológicos, Instituto de Ciências Biológicas, Universidade Federal Do Rio Grande, Avenida Itália, km 8, Campus Carreiros, Rio Grande, RS, CEP: 96203-900, Brazil
- Programa de Pós-Graduação em Ciências Da Saúde, Faculdade de Medicina, Rua Visconde de Paranaguá 102 Centro, Rio Grande, RS, Brasil, CEP: 96203-900
| | - Aline Neutzling Brum
- Programa de Pós-Graduação em Ciências Da Saúde, Faculdade de Medicina, Rua Visconde de Paranaguá 102 Centro, Rio Grande, RS, Brasil, CEP: 96203-900
| | - Linjie Zhang
- Programa de Pós-Graduação em Ciências Da Saúde, Faculdade de Medicina, Rua Visconde de Paranaguá 102 Centro, Rio Grande, RS, Brasil, CEP: 96203-900
| | - Flavio Manoel Rodrigues da Silva Júnior
- Laboratório de Ensaios Farmacológicos e Toxicológicos, Instituto de Ciências Biológicas, Universidade Federal Do Rio Grande, Avenida Itália, km 8, Campus Carreiros, Rio Grande, RS, CEP: 96203-900, Brazil.
- Programa de Pós-Graduação em Ciências Da Saúde, Faculdade de Medicina, Rua Visconde de Paranaguá 102 Centro, Rio Grande, RS, Brasil, CEP: 96203-900.
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Yong Z, Luo L, Gu Y, Li C. Implication of excessive length of stay of asthma patient with heterogenous status attributed to air pollution. JOURNAL OF ENVIRONMENTAL HEALTH SCIENCE & ENGINEERING 2021; 19:95-106. [PMID: 34150221 PMCID: PMC8172679 DOI: 10.1007/s40201-020-00584-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 11/05/2020] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Air pollution has potential risk on asthma patients, further prolongs the length of stay. However, it is unclear that the impact of air pollution on excessive length of stay (ELoS) of heterogeneous asthma patients. In this study, we proposed a K-Nearest Neighbor (KNN) embedded approach incorporating with patient status to analyze the impact of short-term air pollution on the ELoS of asthma patients. METHODS The KNN embedded approach includes two stages. Firstly, the KNN algorithm was employed to search for the most similar patient community and approximate kernel proxy of each index patient by Euclidean distance. Then, we built the differential fixed-effect linear model to estimate the risk of air pollution to the ELoS. RESULTS We analyzed 6563 asthma patients' medical insurance records in a large city of China from January to December in 2014. It was found that when the duration of exposure to air pollution (i.e., PM2.5, PM10, SO2, NO2, and CO) reaches around 4-5 days, the risk of increasing the ELoS becomes the largest. But only O3 shows the opposite effect. What's more, CO is the dominant risk to increase the ELoS. With a 1 mg/m3 increment of CO average concentration in 5 days, the ELoS will go up by 0.8157 day (95%CI:0.72,0.9114). Based on the kernel proxy in the top 1% similar patient community, the additional financial burden posed on each patient increases by RMB 488.6002 (95%CI:430.1962,547.0043) due to the ELoS. CONCLUSIONS The KNN embedded approach is an innovative method that takes into account the heterogeneous patient status, and effectively estimates the impact of air pollution on the ELoS. It is concluded that air pollution poses adverse effects and additional financial burdens on asthma patients. Heterogeneous patients should adopt different strategies in health management to reduce the risk of increasing the ELoS due to air pollution, and improve the efficiency of medical resource utilization. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s40201-020-00584-8.
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Affiliation(s)
- Zhilin Yong
- Business School, Sichuan University, Chengdu, Sichuan 610065 People’s Republic of China
| | - Li Luo
- Business School, Sichuan University, Chengdu, Sichuan 610065 People’s Republic of China
| | - Yonghong Gu
- West China Hospital, Sichuan University, Guo Xue Xiang No. 37, Chengdu, Sichuan 610041 People’s Republic of China
| | - Chunyang Li
- West China Hospital, Sichuan University, Guo Xue Xiang No. 37, Chengdu, Sichuan 610041 People’s Republic of China
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Scheers H, Nawrot TS, Nemery B, De Troeyer K, Callens M, De Smet F, Van Nieuwenhuyse A, Casas L. Antithrombotic medication and endovascular interventions associated with short-term exposure to particulate air pollution: A nationwide case-crossover study. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2020; 266:115130. [PMID: 32652373 DOI: 10.1016/j.envpol.2020.115130] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 01/31/2020] [Accepted: 06/26/2020] [Indexed: 06/11/2023]
Abstract
Short-term exposure to air pollution has pro-thrombotic effects and triggers thrombo-embolic events such as myocardial infarction or stroke in adults. This study evaluates the association between short-term variation in air pollution and treatments for acute thrombo-embolic events among the whole Belgian population. In a bidirectional time-stratified case-crossover design, we included 227,861 events treated with endovascular intervention and 74,942 with antithrombotic enzymes that were reimbursed by the Belgian Social Security between January 1st, 2009 and December 31st, 2013. We compared the concentrations of particulate matter (PM) air pollution (PM10 and PM2.5), as estimated at the municipality level on the day of the event (lag 0) and two days earlier (lag 1 and lag 2) with those of control days from the same month, matched by temperature and accounting for day of the week (weekend vs week days). We applied conditional logistic regression models to obtain odds ratios (OR) and their 95% CI for an increase of 10 μg/m3 (PM10) or 5 μg/m3 (PM2.5) in pollutant concentrations over three lag days (lag 0, 1 and 2). We observed significant associations of PM10 and PM2.5 with treatment of acute thrombo-embolic events at the three lags. The strongest associations were observed for air pollution concentrations on the day of the event (lag0). Increases of 10 μg/m3 PM10 and 5 μg/m3 PM2.5 on lag0 increased the odds of events treated with endovascular intervention by 2.7% (95%CI:2.3%-3.2%) and 1.3% (95%CI:1%-1.5%), respectively, and they increased the odds of events treated with antithrombotic enzymes by 1.9% (95%CI:1.1-2.7%) and 1.2% (95%CI:0.7%-1.6%), respectively. The associations were generally stronger during autumn months and among children. Our nationwide study confirms that acute exposure to outdoor air pollutants such as PM10 or PM2.5 increase the use of medication and interventions to treat thrombo-embolic events.
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Affiliation(s)
- Hans Scheers
- Centre for Environment and Health - Department of Public Health and Primary Care, KU Leuven, Herestraat 49, 3000 Leuven, Belgium; Centre for Evidence-Based Practice, Rode Kruis-Vlaanderen, Mechelen, Belgium
| | - Tim S Nawrot
- Centre for Environment and Health - Department of Public Health and Primary Care, KU Leuven, Herestraat 49, 3000 Leuven, Belgium; Centre for Environmental Sciences, Hasselt University, Agoralaan Agoralaan Gebouw D, 3590 Diepenbeek, Belgium
| | - Benoit Nemery
- Centre for Environment and Health - Department of Public Health and Primary Care, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Katrien De Troeyer
- Centre for Environment and Health - Department of Public Health and Primary Care, KU Leuven, Herestraat 49, 3000 Leuven, Belgium
| | | | - Frank De Smet
- Centre for Environment and Health - Department of Public Health and Primary Care, KU Leuven, Herestraat 49, 3000 Leuven, Belgium; IMA-AIM, Tervurenlaan 188A - box 9, 1150 Brussel, Belgium
| | - An Van Nieuwenhuyse
- Centre for Environment and Health - Department of Public Health and Primary Care, KU Leuven, Herestraat 49, 3000 Leuven, Belgium; Department of Health Protection, Laboratoire National de Santé (LNS), Dudelange, Luxembourg
| | - Lidia Casas
- Centre for Environment and Health - Department of Public Health and Primary Care, KU Leuven, Herestraat 49, 3000 Leuven, Belgium; Epidemiology and Health Policy, Department of Epidemiology and Social Medicine, University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium.
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9
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Zhang S, Routledge MN. The contribution of PM 2.5 to cardiovascular disease in China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:37502-37513. [PMID: 32691311 PMCID: PMC7496016 DOI: 10.1007/s11356-020-09996-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 07/01/2020] [Indexed: 05/02/2023]
Abstract
China is experiencing rapid urbanization and industrialization with correspondingly high levels of air pollution. Although the harm of PM2.5 has been long reported, it is only quite recently that there is increasing concern in China for its possible adverse health effects on cardiovascular disease. We reviewed the epidemiologic evidence of potential health effects of PM2.5 on cardiovascular disease reported from recent studies in China (2013 onwards). There is clear evidence for the contribution of PM2.5 to cardiovascular outcomes, including mortality, ischemic heart disease, and stroke from studies based in various regions in China. This evidence adds to the global evidence that PM2.5 contributes to adverse cardiovascular health risk and highlights the need for improved air quality in China.
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Affiliation(s)
- Shuqi Zhang
- School of Public Health, Fudan University, Shanghai, 200032 China
| | - Michael N. Routledge
- Leeds Institute of Cardiovascular & Metabolic Medicine, University of Leeds, Leeds, LS2 9JT UK
- School of Food and Biological Engineering, Jiangsu University, Zhenjiang, China
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Abedi A, Baygi MM, Poursafa P, Mehrara M, Amin MM, Hemami F, Zarean M. Air pollution and hospitalization: an autoregressive distributed lag (ARDL) approach. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:30673-30680. [PMID: 32472513 DOI: 10.1007/s11356-020-09152-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 05/04/2020] [Indexed: 06/11/2023]
Abstract
Air pollution is one of the biggest global environmental problems in urban regions. This study aimed to investigate the validity of the relationship between air pollution and respiratory and cardiovascular hospitalization using time series methods. This time series study was conducted in Isfahan, Iran. We used data of hospitalized cases in three main university hospitals (Alzahra, Noor, Chamran) and air pollution data from 2014 to 2016. We applied the autoregressive distributed lag (ARDL) bounds testing approach of cointegration to examine the relationship between the air pollution and hospitalizations of respiratory and cardiovascular diseases. The results of air quality assessment on the number of respiratory and cardiovascular hospitalization demonstrate that in the case of cardiovascular disease, both in the long run and in the short run, the air quality index has a significant impact on men and women with a bigger impact in the long run compared to the short run. The value of the long-run coefficient indicates the relationship between air pollution index and cardiovascular hospitalization is stronger than respiratory hospitalizations. In the long term, the effect of the air quality index (AQI) on the number of hospitalizations is more than that in the short term. Based on the results, a 10-unit increase in AQI leads to 5.3% increase in the number of respiratory hospitalization. Accordingly, a 10-unit increase in AQI will result in 7.3% increase in the number of cardiovascular hospitalizations.
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Affiliation(s)
- Ali Abedi
- Faculty of Economics, University of Tehran, Tehran, Iran
| | | | - Parinaz Poursafa
- Environment Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Mohsen Mehrara
- Faculty of Economics, University of Tehran, Tehran, Iran
| | - Mohammad Mehdi Amin
- Environment Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Environmental Health Engineering, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Forouzan Hemami
- Environment Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Zarean
- Environment Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
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11
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Blázquez-Fernández C, Cantarero-Prieto D, Pascual-Sáez M. On the nexus of air pollution and health expenditures: new empirical evidence. GACETA SANITARIA 2018; 33:389-394. [PMID: 29776689 DOI: 10.1016/j.gaceta.2018.01.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 12/21/2017] [Accepted: 01/29/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To analyse the impact of per capita income and environmental air quality variables on health expenditure determinants. METHOD In this study, we analyse the relationship between air pollution and health expenditure in 29 OECD countries over the period 1995-2014. In addition, we test whether our findings differ between countries with higher or lower incomes. RESULTS The econometric results show that per capita income has a positive effect on health expenditure, but is not as statistically significant as expected when lag-time is incorporated. In addition, an anchorage effect is observed, which implies that about 80%-90% of previous expenditure explain current expenditure. Our empirical results are quite consistent between groups and when compared with the full sample. Nevertheless, there appear to be some differences when broken down by financing scheme (total, public, and private). CONCLUSIONS Overall, our findings could be used to clarify the appropriate health expenditure level or to obtain better environmental quality and social well-being. That is, empirical support is provided on how health management and policy makers should include more considerations for the use of cleaner fuels in developed countries.
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Affiliation(s)
- Carla Blázquez-Fernández
- Department of Economics, Universidad de Cantabria, Santander, Spain; GEN Governance and Economics Network, Spain.
| | - David Cantarero-Prieto
- Department of Economics, Universidad de Cantabria, Santander, Spain; GEN Governance and Economics Network, Spain
| | - Marta Pascual-Sáez
- Department of Economics, Universidad de Cantabria, Santander, Spain; GEN Governance and Economics Network, Spain
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Li X, Tang K, Jin XR, Xiang Y, Xu J, Yang LL, Wang N, Li YF, Ji AL, Zhou LX, Cai TJ. Short-term air pollution exposure is associated with hospital length of stay and hospitalization costs among inpatients with type 2 diabetes: a hospital-based study. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2018; 81:819-829. [PMID: 30015599 DOI: 10.1080/15287394.2018.1491912] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Air pollution is a risk factor for type 2 diabetes (T2D), exerting heavy economic burden on both individuals and societies. However, there is no apparent report regarding the influence of air pollutants such as particulate matter (PM2.5 and PM10), sulfur dioxide (SO2), carbon monoxide (CO), nitrogen dioxide (NO2), and ozone (O3) on financial burden to individuals and societies suffering from T2D. This study aimed to determine whether short-term (no more than 16 d) air pollution exposure was associated with T2D-related length of stay (LOS) and hospitalization expenses incurred by patients. This investigation examined 2840 T2D patients hospitalized from December 17, 2013 to May 31, 2016 in China. Multiple linear regression analysis was applied to determine the association between short-term (no more than 16 d) ambient air pollution, LOS, and hospitalization expenses, controlling for age, gender, ethnicity, marital status, and weather conditions. Sulfur dioxide (SO2) and carbon monoxide (CO) were significantly positively while nitrogen dioxide (NO2) was negatively associated with presence of T2D, LOS, and expenses. A 10-μg/m3 rise in 16-d (lag 0-15) average concentrations of SO2 and CO prior to hospitalization was correlated with a significant elevation in LOS and elevation in expenses in T2D patients. However, a 10-μg/m3 rise in 16-d average NO2 was associated with marked negative alterations in LOS and hospital costs in T2D patients. Taken together, data demonstrate that exposure to air pollutants impacts differently on LOS and hospitalization costs for T2D patients. This is the first apparent report regarding the correlation between air pollution exposure and clinical costs of T2D in China. It is of interest that air pollutants affected T2D patients differently as evidenced by LOS and clinical expenses where SO2 and CO exhibited a positive adverse relationship in contrast to NO2.
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Affiliation(s)
- Xiang Li
- a Department of Epidemiology, College of Preventive Medicine , Third Military Medical University (Army Medical University) , Chongqing , China
- b Fourth Battalion of Student Brigade , Third Military Medical University (Army Medical University) , Chongqing , China
| | - Kai Tang
- c Third Battalion of Student Brigade , Third Military Medical University (Army Medical University) , Chongqing , China
| | - Xu-Rui Jin
- b Fourth Battalion of Student Brigade , Third Military Medical University (Army Medical University) , Chongqing , China
| | - Ying Xiang
- a Department of Epidemiology, College of Preventive Medicine , Third Military Medical University (Army Medical University) , Chongqing , China
| | - Jing Xu
- d Department of Endocrinology , Xinqiao Hospital, Third Military Medical University (Army Medical University) , Chongqing , China
| | - Li-Li Yang
- e Department of Information , Xinqiao Hospital, Third Military Medical University (Army Medical University) , Chongqing , China
| | - Nan Wang
- f Medical department , Xinqiao Hospital, Third Military Medical University (Army Medical University) , Chongqing , China
| | - Ya-Fei Li
- a Department of Epidemiology, College of Preventive Medicine , Third Military Medical University (Army Medical University) , Chongqing , China
| | - Ai-Ling Ji
- g Department of Preventive Medicine & Chongqing Engineering Research Center of Pharmaceutical Sciences , Chongqing Medical and Pharmaceutical College , Chongqing , China
| | - Lai-Xin Zhou
- f Medical department , Xinqiao Hospital, Third Military Medical University (Army Medical University) , Chongqing , China
| | - Tong-Jian Cai
- a Department of Epidemiology, College of Preventive Medicine , Third Military Medical University (Army Medical University) , Chongqing , China
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Odnoletkova I, Ramaekers D, Nobels F, Goderis G, Aertgeerts B, Annemans L. Delivering Diabetes Education through Nurse-Led Telecoaching. Cost-Effectiveness Analysis. PLoS One 2016; 11:e0163997. [PMID: 27727281 PMCID: PMC5058491 DOI: 10.1371/journal.pone.0163997] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2016] [Accepted: 09/19/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND People with diabetes have a high risk of developing micro- and macrovascular complications associated with diminished life expectancy and elevated treatment costs. Patient education programs can improve diabetes control in the short term, but their cost-effectiveness is uncertain. Our study aimed to analyze the lifelong cost-effectiveness of a nurse-led telecoaching program compared to usual care in people with type 2 diabetes from the perspective of the Belgian healthcare system. METHODS The UKPDS Outcomes Model was populated with patient-level data from an 18-month randomized clinical trial in the Belgian primary care sector involving 574 participants; trial data were extrapolated to 40 years; Quality Adjusted Life Years (QALYs), treatment costs and Incremental Cost-Effectiveness Ratio (ICER) were calculated for the entire cohort and the subgroup with poor glycemic control at baseline ("elevated HbA1c subgroup") and the associated uncertainty was explored. RESULTS The cumulative mean QALY (95% CI) gain was 0.21 (0.13; 0.28) overall and 0.56 (0.43; 0.68) in elevated HbA1c subgroup; the respective incremental costs were €1,147 (188; 2,107) and €2,565 (654; 4,474) and the respective ICERs €5,569 (€677; €15,679) and €4,615 (1,207; 9,969) per QALY. In the scenario analysis, repeating the intervention for lifetime had the greatest impact on the cost-effectiveness and resulted in the mean ICERs of €13,034 in the entire cohort and €7,858 in the elevated HbA1c subgroup. CONCLUSION Taking into account reimbursement thresholds applied in West-European countries, nurse-led telecoaching of people with type 2 diabetes may be considered highly cost-effective within the Belgian healthcare system. TRIAL REGISTRATION NCT01612520.
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Affiliation(s)
| | - Dirk Ramaekers
- Leuven Institute for Healthcare Policy, KU Leuven, Leuven, Belgium
| | - Frank Nobels
- Department of Endocrinology, OLV Hospital Aalst, Aalst, Belgium
| | - Geert Goderis
- Academic Center for General Practice, KU Leuven, Leuven, Belgium
| | - Bert Aertgeerts
- Academic Center for General Practice, KU Leuven, Leuven, Belgium
| | - Lieven Annemans
- Department of Public Health, Ghent University, Ghent, Belgium
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Devos S, Cox B, van Lier T, Nawrot TS, Putman K. Effect of the shape of the exposure-response function on estimated hospital costs in a study on non-elective pneumonia hospitalizations related to particulate matter. ENVIRONMENT INTERNATIONAL 2016; 94:525-530. [PMID: 27342649 DOI: 10.1016/j.envint.2016.06.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 06/10/2016] [Accepted: 06/11/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE We used log-linear and log-log exposure-response (E-R) functions to model the association between PM2.5 exposure and non-elective hospitalizations for pneumonia, and estimated the attributable hospital costs by using the effect estimates obtained from both functions. METHODS We used hospital discharge data on 3519 non-elective pneumonia admissions from UZ Brussels between 2007 and 2012 and we combined a case-crossover design with distributed lag models. The annual averted pneumonia hospitalization costs for a reduction in PM2.5 exposure from the mean (21.4μg/m(3)) to the WHO guideline for annual mean PM2.5 (10μg/m(3)) were estimated and extrapolated for Belgium. RESULTS Non-elective hospitalizations for pneumonia were significantly associated with PM2.5 exposure in both models. Using a log-linear E-R function, the estimated risk reduction for pneumonia hospitalization associated with a decrease in mean PM2.5 exposure to 10μg/m(3) was 4.9%. The corresponding estimate for the log-log model was 10.7%. These estimates translate to an annual pneumonia hospital cost saving in Belgium of €15.5 million and almost €34 million for the log-linear and log-log E-R function, respectively. DISCUSSION Although further research is required to assess the shape of the association between PM2.5 exposure and pneumonia hospitalizations, we demonstrated that estimates for health effects and associated costs heavily depend on the assumed E-R function. These results are important for policy making, as supra-linear E-R associations imply that significant health benefits may still be obtained from additional pollution control measures in areas where PM levels have already been reduced.
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Affiliation(s)
- Stefanie Devos
- Interuniversity Centre for Health Economics Research, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussel, Belgium.
| | - Bianca Cox
- Centre for Environmental Sciences, Hasselt University, Agoralaan building D, 3590 Diepenbeek, Belgium
| | - Tom van Lier
- Mobility, Logistics and Automotive Technology Research Centre, Vrije Universiteit Brussel, Pleinlaan 2, 1050 Brussel, Belgium
| | - Tim S Nawrot
- Centre for Environmental Sciences, Hasselt University, Agoralaan building D, 3590 Diepenbeek, Belgium; Department of Public Health, University of Leuven (KULeuven), Herestraat 49, 3000 Leuven, Belgium
| | - Koen Putman
- Interuniversity Centre for Health Economics Research, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussel, Belgium
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15
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Simons K, Devos S, Putman K, Coomans D, Van Nieuwenhuyse A, Buyl R. Direct cost saving potential in medication costs due to a reduction in outdoor air pollution for the Brussels Capital Region. THE SCIENCE OF THE TOTAL ENVIRONMENT 2016; 562:760-765. [PMID: 27110987 DOI: 10.1016/j.scitotenv.2016.04.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Revised: 04/04/2016] [Accepted: 04/04/2016] [Indexed: 06/05/2023]
Abstract
INTRODUCTION The adverse health effects of exposure to air pollution have been well-established and include mortality, hospital admissions, emergency department visits, etc, but also less severe outcomes such as medication use and purchase. The economic impact, an additional motivator for policy, has been studied primarily for the more severe outcomes. METHODS Purchase data of reimbursed medications typically prescribed for asthma and chronic obstructive pulmonary disease, were obtained through the mandatory Belgian health insurance system. A time series analyses approach was used to model daily sales on daily air pollution concentrations (NO2, PM10 and PM2.5) for residents of the Brussels Capital Region as a whole. In addition, a higher geographical resolution of both sales and pollutant concentrations allowed for a multi-sector approach. Annual savings were estimated for the scenario of a 10% reduction in each of the pollutants. RESULTS Medication purchase was significantly associated with NO2 concentrations, leading to an annual cost saving potential of € 107,845 [95%CI: € 71,483-€ 143,823] in R03 sales (WHO classification for drugs of obstructive airway diseases). Saving potentials of PM10 and PM2.5 were not significant. Estimates were not sensitive to the geographical resolution, however, higher precision can be obtained with higher resolution data, subject to the condition that the number of sales is sufficiently large.
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Affiliation(s)
- Koen Simons
- Unit Health and Environment, Scientific Institute of Public Health, Juliette Wytsmanstraat 14, 1050 Brussels, Belgium; Department of Biostatistics and Medical Informatics - Public Health, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
| | - Stefanie Devos
- Interuniversity Centre for Health Economics Research, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
| | - Koen Putman
- Interuniversity Centre for Health Economics Research, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
| | - Danny Coomans
- Department of Biostatistics and Medical Informatics - Public Health, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
| | - An Van Nieuwenhuyse
- Unit Health and Environment, Scientific Institute of Public Health, Juliette Wytsmanstraat 14, 1050 Brussels, Belgium
| | - Ronald Buyl
- Department of Biostatistics and Medical Informatics - Public Health, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
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Abe KC, Miraglia SGEK. Health Impact Assessment of Air Pollution in São Paulo, Brazil. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13070694. [PMID: 27409629 PMCID: PMC4962235 DOI: 10.3390/ijerph13070694] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 06/30/2016] [Accepted: 07/01/2016] [Indexed: 12/04/2022]
Abstract
Epidemiological research suggests that air pollution may cause chronic diseases, as well as exacerbation of related pathologies such as cardiovascular and respiratory morbidity and mortality. This study evaluates air pollution scenarios considering a Health Impact Assessment approach in São Paulo, Brazil. We have analyzed abatement scenarios of Particulate Matter (PM) with an aerodynamic diameter <10 μm (PM10), <2.5 μm (PM2.5) and ozone concentrations and the health effects on respiratory and cardiovascular morbidity and mortality in the period from 2009 to 2011 through the APHEKOM tool, as well as the associated health costs. Considering World Health Organization (WHO) standards of PM2.5 (10 μg/m3), São Paulo would avoid more than 5012 premature deaths (equivalent to 266,486 life years’ gain) and save US$15.1 billion annually. If São Paulo could even diminish the mean of PM2.5 by 5 μg/m3, nearly 1724 deaths would be avoided, resulting in a gain of US$ 4.96 billion annually. Reduced levels of PM10, PM2.5 and ozone could save lives and an impressive amount of money in a country where economic resources are scarce. Moreover, the reduced levels of air pollution would also lower the demand for hospital care, since hospitalizations would diminish. In this sense, Brazil should urgently adopt WHO air pollution standards in order to improve the quality of life of its population.
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Affiliation(s)
- Karina Camasmie Abe
- Instituto de Ciências Ambientais, Químicas e Farmacêuticas (ICAQF), Laboratório de Economia, Saúde e Poluição Ambiental, Universidade Federal de São Paulo-UNIFESP, Rua São Nicolau 210, Diadema, São Paulo CEP 09913-030, Brazil.
| | - Simone Georges El Khouri Miraglia
- Instituto de Ciências Ambientais, Químicas e Farmacêuticas (ICAQF), Laboratório de Economia, Saúde e Poluição Ambiental, Universidade Federal de São Paulo-UNIFESP, Rua São Nicolau 210, Diadema, São Paulo CEP 09913-030, Brazil.
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