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Ma Y, Zang E, Liu Y, Wei J, Lu Y, Krumholz HM, Bell ML, Chen K. Long-term exposure to wildland fire smoke PM2.5 and mortality in the contiguous United States. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2023.01.31.23285059. [PMID: 36778437 PMCID: PMC9915814 DOI: 10.1101/2023.01.31.23285059] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Despite the substantial evidence on the health effects of short-term exposure to ambient fine particles (PM 2.5 ), including increasing studies focusing on those from wildland fire smoke, the impacts of long-term wildland fire smoke PM 2.5 exposure remain unclear. We investigated the association between long-term exposure to wildland fire smoke PM 2.5 and non-accidental mortality and mortality from a wide range of specific causes in all 3,108 counties in the contiguous U.S., 2007-2020. Controlling for non-smoke PM 2.5 , air temperature, and unmeasured spatial and temporal confounders, we found a non-linear association between 12-month moving average concentration of smoke PM 2.5 and monthly non-accidental mortality rate. Relative to a month with the long-term smoke PM 2.5 exposure below 0.1 μg/m 3 , non-accidental mortality increased by 0.16-0.63 and 2.11 deaths per 100,000 people per month when the 12-month moving average of PM 2.5 concentration was of 0.1-5 and 5+ μg/m 3 , respectively. Cardiovascular, ischemic heart disease, digestive, endocrine, diabetes, mental, and chronic kidney disease mortality were all found to be associated with long-term wildland fire smoke PM 2.5 exposure. Smoke PM 2.5 contributed to approximately 11,415 non-accidental deaths/year (95% CI: 6,754, 16,075) in the contiguous U.S. Higher smoke PM 2.5 -related increases in mortality rates were found for people aged 65 above. Positive interaction effects with extreme heat (monthly number of days with daily mean air temperature higher than the county's 90 th percentile warm season air temperature) were also observed. Our study identified the detrimental effects of long-term exposure to wildland fire smoke PM 2.5 on a wide range of mortality outcomes, underscoring the need for public health actions and communications that span the health risks of both short- and long-term exposure. Significance Statement The area burned by wildland fire has greatly increased in the U.S. in recent decades. Short-term exposure to smoke pollutants emitted by wildland fires, particularly PM 2.5 , is associated with numerous adverse health effects. However, the impacts of long-term exposure to wildland fire smoke PM 2.5 on health and specifically mortality remain unclear. Utilizing wildland fire smoke PM 2.5 and mortality data in the contiguous U.S. during 2007-2020, we found positive associations between long-term smoke PM 2.5 exposure and increased non-accidental, cardiovascular, ischemic heart disease, digestive, endocrine, diabetes, mental, and chronic kidney disease mortality rates. Each year, in addition to the well-recognized mortality burden from non-smoke PM 2.5 , smoke PM 2.5 contributed to an estimated over 10 thousand non-accidental deaths in the U.S. This study demonstrates the detrimental effects of wildland fire smoke PM 2.5 on a wide range of health outcomes, and calls for more effective public health actions and communications that span the health risks of both short- and long-term exposure.
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Chu L, Chen K, Yang Z, Crowley S, Dubrow R. A unified framework for assessing interaction effects among environmental exposures in epidemiologic studies: A case study on temperature, air pollution, and kidney-related conditions in New York state. ENVIRONMENTAL RESEARCH 2024; 248:118324. [PMID: 38301759 DOI: 10.1016/j.envres.2024.118324] [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: 06/17/2023] [Revised: 12/05/2023] [Accepted: 01/26/2024] [Indexed: 02/03/2024]
Abstract
BACKGROUND There are various methods to assess interaction effects. However, current methods have limitations, and quantification of interaction effects is rarely performed. This study aimed to develop a unified quantitative framework for assessing interaction effects. METHODS We proposed a novel framework using log-linear models with a product term(s) across the exposures that generates parametric bi-variate association and interaction effect surfaces and allows flexible functional forms for exposures in the interaction term(s). In a case study, we assessed the interaction effects between temperature and air pollution (i.e., PM2.5, NO2, and O3) on risk for kidney-related conditions in New York State (2007-2016) using a case-crossover design with conditional logistic models. Our measures of exposure were the moving averages at lag 0-5 days for air pollution (linear) and daytime mean outdoor wet-bulb globe temperature (WBGT; using a natural cubic spline). RESULTS We derived closed-form expressions for the magnitude of multiplicative interaction effects (the joint relative risk divided by the product of the two conditional relative risks) and their uncertainties. In the case study, we found a Bonferroni-corrected significant multiplicative interaction effect (IE) between outdoor WBGT at the 99th percentile (median as the reference) and (1) PM2.5 (per 5 μg/m3 increase, IE = 1.052; 95 % confidence interval [CI]: 1.019, 1.087) for acute kidney failure and (2) O3 (per 5 ppb increase; IE = 1.022; 95 % CI: 1.008, 1.036) for urolithiasis (the latter being inconclusive based on the sensitivity analysis). CONCLUSIONS Our framework allows different functional forms of exposure variables in the interaction term, quantifies the magnitudes of entire-exposure-range (in addition to discrete exposure level) multiplicative interaction effects and their uncertainties in a categorical or continuous (linear or non-linear) manner, and harmonizes the two-way evaluation of effect modification. The case study underscores co-consideration of heat and air pollution when estimating health burden and designing heat/pollution alert systems.
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Affiliation(s)
- Lingzhi Chu
- Department of Environmental Health Sciences, Yale School of Public Health, 60 College Street, New Haven, CT, 06520-8034, USA; Yale Center on Climate Change and Health, Yale School of Public Health, 60 College Street, New Haven, CT, 06520-8034, USA.
| | - Kai Chen
- Department of Environmental Health Sciences, Yale School of Public Health, 60 College Street, New Haven, CT, 06520-8034, USA; Yale Center on Climate Change and Health, Yale School of Public Health, 60 College Street, New Haven, CT, 06520-8034, USA
| | - Zhuoran Yang
- Department of Statistics and Data Science, Yale University, 24 Hillhouse Avenue, New Haven, CT, 06511-6814, USA
| | - Susan Crowley
- Department of Medicine (Nephrology), Yale University School of Medicine, New Haven, CT, 06520, USA; Veterans Administration Health Care System of Connecticut, West Haven, CT, 06516, USA
| | - Robert Dubrow
- Department of Environmental Health Sciences, Yale School of Public Health, 60 College Street, New Haven, CT, 06520-8034, USA; Yale Center on Climate Change and Health, Yale School of Public Health, 60 College Street, New Haven, CT, 06520-8034, USA
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Du H, Yan M, Liu X, Zhong Y, Ban J, Lu K, Li T. Exposure to Concurrent Heatwaves and Ozone Pollution and Associations with Mortality Risk: A Nationwide Study in China. ENVIRONMENTAL HEALTH PERSPECTIVES 2024; 132:47012. [PMID: 38662525 PMCID: PMC11045006 DOI: 10.1289/ehp13790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 02/01/2024] [Accepted: 03/18/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND Concurrent extreme events are projected to occur more frequently under a changing climate. Understanding the mortality risk and burden of the concurrent heatwaves and ozone (O 3 ) pollution may support the formulation of adaptation strategies and early warning systems for concurrent events in the context of climate change. OBJECTIVES We aimed to estimate the mortality risk and excess deaths of concurrent heatwaves and O 3 pollution across 250 counties in China. METHODS We collected daily mortality, meteorological, and air pollution data for the summer (1 June to 30 September) during 2013-2018. We defined heatwaves and high O 3 pollution days, then we divided the identified days into three categories: a) days with only heatwaves (heatwave-only event), b) days with only high O 3 pollution (high O 3 pollution-only event), and c) days with concurrent heatwaves and high O 3 pollution (concurrent event). A generalized linear model with a quasi-Poisson regression was used to estimate the risk of mortality associated with extreme events for each county. Then we conducted a random-effects meta-analysis to pool the county-specific estimates to derive the overall effect estimates. We used mixed-effects meta-regression to identify the drivers of the heterogeneity. Finally, we estimated the excess death attributable to extreme events (heatwave-only, high O 3 pollution-only, and concurrent events) from 2013 to 2020. RESULTS A higher all-cause mortality risk was associated with exposure to the concurrent heatwaves and high O 3 pollution than exposure to a heatwave-only or a high O 3 pollution-only event. The effects of a concurrent event on circulatory and respiratory mortality were higher than all-cause and nonaccidental mortality. Sex and age significantly impacted the association of concurrent events and heatwave-only events with all-cause mortality. We estimated that annual average excess deaths attributed to the concurrent events were 6,249 in China from 2017 to 2020, 5.7 times higher than the annual average excess deaths attributed to the concurrent events from 2013 to 2016. The annual average proportion of excess deaths attributed to the concurrent events in the total excess deaths caused by three types of events (heatwave-only events, high O 3 pollution-only events, and concurrent events) increased significantly in 2017-2020 (31.50%; 95% CI: 26.73%, 35.53%) compared with 2013-2016 (9.65%; 95% CI: 5.67%, 10.81%). Relative excess risk due to interaction revealed positive additive interaction considering the concurrent effect of heatwaves and high O 3 pollution. DISCUSSION Our findings may provide scientific basis for establishing a concurrent event early warning system to reduce the adverse health impact of the concurrent heatwaves and high O 3 pollution. https://doi.org/10.1289/EHP13790.
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Affiliation(s)
- Hang Du
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health (NIEH), Chinese Center for Disease Control and Prevention (China CDC), Beijing, China
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Meilin Yan
- Department of Environmental Science and Engineering, School of Light Industry Science and Engineering, Beijing Technology and Business University, Beijing, China
| | - Xin Liu
- Energy Foundation China, Beijing, China
| | - Yu Zhong
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health (NIEH), Chinese Center for Disease Control and Prevention (China CDC), Beijing, China
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jie Ban
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health (NIEH), Chinese Center for Disease Control and Prevention (China CDC), Beijing, China
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Kailai Lu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health (NIEH), Chinese Center for Disease Control and Prevention (China CDC), Beijing, China
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Tiantian Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health (NIEH), Chinese Center for Disease Control and Prevention (China CDC), Beijing, China
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
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Coker ES, Stone SL, McTigue E, Yao JA, Brigham EP, Schwandt M, Henderson SB. Climate change and health: rethinking public health messaging for wildfire smoke and extreme heat co-exposures. Front Public Health 2024; 12:1324662. [PMID: 38590812 PMCID: PMC10999651 DOI: 10.3389/fpubh.2024.1324662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 03/04/2024] [Indexed: 04/10/2024] Open
Abstract
With the growing climate change crisis, public health agencies and practitioners must increasingly develop guidance documents addressing the public health risks and protective measures associated with multi-hazard events. Our Policy and Practice Review aims to assess current public health guidance and related messaging about co-exposure to wildfire smoke and extreme heat and recommend strengthened messaging to better protect people from these climate-sensitive hazards. We reviewed public health messaging published by governmental agencies between January 2013 and May 2023 in Canada and the United States. Publicly available resources were eligible if they discussed the co-occurrence of wildfire smoke and extreme heat and mentioned personal interventions (protective measures) to prevent exposure to either hazard. We reviewed local, regional, and national governmental agency messaging resources, such as online fact sheets and guidance documents. We assessed these resources according to four public health messaging themes, including (1) discussions around vulnerable groups and risk factors, (2) symptoms associated with these exposures, (3) health risks of each exposure individually, and (4) health risks from combined exposure. Additionally, we conducted a detailed assessment of current messaging about measures to mitigate exposure. We found 15 online public-facing resources that provided health messaging about co-exposure; however, only one discussed all four themes. We identified 21 distinct protective measures mentioned across the 15 resources. There is considerable variability and inconsistency regarding the types and level of detail across described protective measures. Of the identified 21 protective measures, nine may protect against both hazards simultaneously, suggesting opportunities to emphasize these particular messages to address both hazards together. More precise, complete, and coordinated public health messaging would protect against climate-sensitive health outcomes attributable to wildfire smoke and extreme heat co-exposures.
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Affiliation(s)
- Eric S. Coker
- Environmental Health Services, British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - Susan Lyon Stone
- Office of Air Quality Planning and Standards, United States Environmental Protection Agency, Research Triangle Park, NC, United States
| | - Erin McTigue
- Air and Radiation Division, United States Environmental Protection Agency, Region, Seattle, WA, United States
| | - Jiayun Angela Yao
- Environmental Health Services, British Columbia Centre for Disease Control, Vancouver, BC, Canada
| | - Emily P. Brigham
- Division of Respiratory Medicine, Department of Medicine, University of British Columbia, Vancouver, BC, Canada
- Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
| | - Michael Schwandt
- Office of the Chief Medical Health Officer, Vancouver Coastal Health Authority, Vancouver, BC, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Sarah B. Henderson
- Environmental Health Services, British Columbia Centre for Disease Control, Vancouver, BC, Canada
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Cheng C, Liu Y, Han C, Fang Q, Cui F, Li X. Effects of extreme temperature events on deaths and its interaction with air pollution. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 915:170212. [PMID: 38246371 DOI: 10.1016/j.scitotenv.2024.170212] [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: 09/27/2023] [Revised: 12/17/2023] [Accepted: 01/14/2024] [Indexed: 01/23/2024]
Abstract
BACKGROUND Both extreme temperature events (ETEs) and air pollution affected human health, and their effects were often not independent. Previous studies have provided limited information on the interactions between ETEs and air pollution. METHODS We collected data on deaths (non-accidental, cardiovascular, and respiratory) in Zibo City along with daily air pollution and meteorological data from January 2015 to December 2019. Distributed lag non-linear model was used to explore the health effects of ETEs on deaths. Non-parametric binary response model, hierarchical model and joint effect model were used to further explore the interaction between ETEs and air pollution in different seasons. Meanwhile, subgroup analysis by gender and age (≥ 65 years old and < 65 years old) was conducted to identify the vulnerable population. RESULTS ETEs increased death risk, especially for cardiovascular and respiratory deaths. Heat waves had a stronger impact than cold spells. Cold spells had a longer lag and fluctuating trend. Heat waves had a short-term impact, followed by a decrease. Females and those aged ≥ 65 were more affected, but subgroup differences were not significant. During ETEs and non-ETEs, there were different effects on deaths with per IQR increase in air pollutant concentrations. Joint effect models revealed that there was a significant interaction between ETEs and air pollution on non-accidental deaths. The interaction between PM2.5 and cold spells was antagonistic in the cold season. In the warm season, the health effects of heat waves and high O3 concentration were enhanced. The relative excess risk due to interaction (RERI) of cold spells and PM2.5 in total population was -0.09 (95 % CI: -0.17, -0.01), and 9 % (95 % CI: 1 %, 17 %) of the total effect was attributable to interaction. Subgroup analysis confirmed the interactions in females and those aged ≥ 65. CONCLUSIONS Significant association observed between ETEs and deaths. Females and ≥ 65 age groups were vulnerable. There were interactions between ETEs and air pollution. The effect of PM2.5 on deaths decreased during cold spells, while the effect of O3 increased during heat waves. In addition to improving air quality, it is necessary to further strengthen the prevention and control of ETEs.
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Affiliation(s)
- Chuanlong Cheng
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Ying Liu
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China; Ma'anshan Center for Disease Control and Prevention, Ma'anshan 243000, Anhui, China
| | - Chuang Han
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Qidi Fang
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Feng Cui
- Zibo Center for Disease Control and Prevention, Zibo, Shandong, China
| | - Xiujun Li
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.
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Zeng J, Lin G, Dong H, Li M, Ruan H, Yang J. Association Between Nitrogen Dioxide Pollution and Cause-Specific Mortality in China: Cross-Sectional Time Series Study. JMIR Public Health Surveill 2024; 10:e44648. [PMID: 38315528 PMCID: PMC10877496 DOI: 10.2196/44648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 09/18/2023] [Accepted: 01/07/2024] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND Nitrogen dioxide (NO2) has been frequently linked to a range of diseases and associated with high rates of mortality and morbidity worldwide. However, there is limited evidence regarding the risk of NO2 on a spectrum of causes of mortality. Moreover, adjustment for potential confounders in NO2 analysis has been insufficient, and the spatial resolution of exposure assessment has been limited. OBJECTIVE This study aimed to quantitatively assess the relationship between short-term NO2 exposure and death from a range of causes by adjusting for potential confounders in Guangzhou, China, and determine the modifying effect of gender and age. METHODS A time series study was conducted on 413,703 deaths that occurred in Guangzhou during the period of 2010 to 2018. The causes of death were classified into 10 categories and 26 subcategories. We utilized a generalized additive model with quasi-Poisson regression analysis using a natural cubic splines function with lag structure of 0 to 4 days to estimate the potential lag effect of NO2 on cause-specific mortality. We estimated the percentage change in cause-specific mortality rates per 10 μg/m3 increase in NO2 levels. We stratified meteorological factors such as temperature, humidity, wind speed, and air pressure into high and low levels with the median as the critical value and analyzed the effects of NO2 on various death-causing diseases at those high and low levels. To further identify potentially vulnerable subpopulations, we analyzed groups stratified by gender and age. RESULTS A significant association existed between NO2 exposure and deaths from multiple causes. Each 10 μg/m3 increment in NO2 density at a lag of 0 to 4 days increased the risks of all-cause mortality by 1.73% (95% CI 1.36%-2.09%) and mortality due to nonaccidental causes, cardiovascular disease, respiratory disease, endocrine disease, and neoplasms by 1.75% (95% CI 1.38%-2.12%), 2.06% (95% CI 1.54%-2.59%), 2.32% (95% CI 1.51%-3.13%), 2.40% (95% CI 0.84%-3.98%), and 1.18% (95% CI 0.59%-1.78%), respectively. Among the 26 subcategories, mortality risk was associated with 16, including intentional self-harm, hypertensive disease, and ischemic stroke disease. Relatively higher effect estimates of NO2 on mortality existed for low levels of temperature, relative humidity, wind speed, and air pressure than with high levels, except a relatively higher effect estimate was present for endocrine disease at a high air pressure level. Most of the differences between subgroups were not statistically significant. The effect estimates for NO2 were similar by gender. There were significant differences between the age groups for mortality due to all causes, nonaccidental causes, and cardiovascular disease. CONCLUSIONS Short-term NO2 exposure may increase the risk of mortality due to a spectrum of causes, especially in potentially vulnerable populations. These findings may be important for predicting and modifying guidelines for NO2 exposure in China.
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Affiliation(s)
- Jie Zeng
- Department of Internet Medical Center, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Guozhen Lin
- Guangzhou Center for Disease Control and Prevention, Guangzhou, China
- Institute of Public Health, Guangzhou Medical University and Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Hang Dong
- Guangzhou Center for Disease Control and Prevention, Guangzhou, China
- Institute of Public Health, Guangzhou Medical University and Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Mengmeng Li
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Honglian Ruan
- School of Public Health, Guangzhou Medical University, Guangzhou, China
| | - Jun Yang
- School of Public Health, Guangzhou Medical University, Guangzhou, China
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Tian T, Kwan MP, Vermeulen R, Helbich M. Geographic uncertainties in external exposome studies: A multi-scale approach to reduce exposure misclassification. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 906:167637. [PMID: 37816406 DOI: 10.1016/j.scitotenv.2023.167637] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 09/15/2023] [Accepted: 10/05/2023] [Indexed: 10/12/2023]
Abstract
BACKGROUND Many studies on environment-health associations have emphasized that the selected buffer size (i.e., the scale of the geographic context when exposures are assigned at people's address location) may affect estimated effect sizes. However, there is limited methodological progress in addressing these buffer size-related uncertainties. AIM We aimed to 1) develop a statistical multi-scale approach to address buffer-related scale effects in cohort studies, and 2) investigate how environment-health associations differ between our multi-scale approach and ad hoc selected buffer sizes. METHODS We used lacunarity analyses to determine the largest meaningful buffer size for multiple high-resolution exposure surfaces (i.e., fine particulate matter [PM2.5], noise, and the normalized difference vegetation index [NDVI]). Exposures were linked to 7.7 million Dutch adults at their home addresses. We assigned exposure estimates based on buffers with fine-grained distance increments until the lacunarity-based upper limit was reached. Bayesian Cox model averaging addressed geographic uncertainties in the estimated exposure effect sizes within the exposure-specific upper buffer limits on mortality. Z-tests assessed statistical differences between averaged effect sizes and those obtained through pre-selected 100, 300, 1200, and 1500 m buffers. RESULTS The estimated lacunarity curves suggested exposure-specific upper buffer size limits; the largest was for NDVI (960 m), followed by noise (910 m) and PM2.5 (450 m). We recorded 845,229 deaths over eight years of follow-up. Our multi-scale approach indicated that higher values of NDVI were health-protectively associated with mortality risk (hazard ratio [HR]: 0.917, 95 % confidence interval [CI]: 0.886-0.948). Increased noise exposure was associated with an increased risk of mortality (HR: 1.003, 95 % CI: 1.002-1.003), while PM2.5 showed null associations (HR:0.998, 95 % CI: 0.997-1.000). Effect sizes of NDVI and noise differed significantly across the averaged and prespecified buffers (p < 0.05). CONCLUSIONS Geographic uncertainties in residential-based exposure assessments may obscure environment-health associations or risk spurious ones. Our multi-scale approach produced more consistent effect estimates and mitigated contextual uncertainties.
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Affiliation(s)
- Tian Tian
- Department of Human Geography and Spatial Planning, Utrecht University, Princetonlaan 8a, 3584 CB Utrecht, the Netherlands.
| | - Mei-Po Kwan
- Department of Human Geography and Spatial Planning, Utrecht University, Princetonlaan 8a, 3584 CB Utrecht, the Netherlands; Department of Geography and Resource Management and Institute of Space and Earth Information Science, Chinese University of Hong Kong, Hong Kong, China
| | - Roel Vermeulen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands; Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Marco Helbich
- Department of Human Geography and Spatial Planning, Utrecht University, Princetonlaan 8a, 3584 CB Utrecht, the Netherlands
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Singh T, Jalaludin B, Hajat S, Morgan GG, Meissner K, Kaldor J, Green D, Jegasothy E. Acute air pollution and temperature exposure as independent and joint triggers of spontaneous preterm birth in New South Wales, Australia: a time-to-event analysis. Front Public Health 2023; 11:1220797. [PMID: 38098836 PMCID: PMC10720724 DOI: 10.3389/fpubh.2023.1220797] [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: 05/25/2023] [Accepted: 10/23/2023] [Indexed: 12/17/2023] Open
Abstract
Introduction Exposure to high ambient temperatures and air pollution has been shown to increase the risk of spontaneous preterm birth (sPTB). Less clear are the effects of cold and the joint effects of air pollution and temperature. Methods Using a Cox proportional hazard regression model, we assessed the risk of independent and combined short-term exposure to ambient daily mean temperature and PM2.5 associated with sPTB in the last week before delivery on overall sPTB (weeks 23-36) and three subtypes: extremely sPTB, very sPTB, and moderate-to-late sPTB for a birth cohort of 1,318,570 births from Australia (Jan 2001-Dec 2019), while controlling for chronic exposure (i.e., throughout pregnancy except the last week before delivery) to PM2.5 and temperature. The temperature was modeled as a natural cubic spline, PM2.5 as a linear term, and the interaction effect was estimated using a multiplicative term. For short-term exposure to temperature hazard ratios reported are relative to the median temperature (18.1°C). Results Hazard ratios at low temperature [5th percentile(11.5°C)] were 0.95 (95% CI: 0.90, 1.00), 1.08 (95% CI: 0.84, 1.4), 0.87 (95% CI: 0.71, 1.06), and 1.00 (95% CI: 0.94, 1.06) and greater for high temperature [95th percentile (24.5°C)]: 1.22 (95% CI: 1.16, 1.28), 1.27 (95% CI: 1.03, 1.57), and 1.26 (95% CI: 1.05, 1.5) and 1.05 (1.00, 1.11), respectively, for overall, extremely, very, and moderate-to-late sPTBs. While chronic exposure to PM2.5 had adverse effects on sPTB, short-term exposure to PM2.5 appeared to have a negative association with all types of sPTB, with hazard ratios ranging from 0.86 (95th CI: 0.80, 0.94) to 0.98 (95th CI: 0.97, 1.00) per 5 μg/m3 increase in PM2.5. Discussion The risk of sPTB was found to increase following acute exposure to hot and cold ambient temperatures. Earlier sPTB subtypes seemed to be the most vulnerable. This study adds to the evidence that short-term exposure to ambient cold and heat and longer term gestational exposure to ambient PM2.5 are associated with an elevated risk of sPTB.
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Affiliation(s)
- Tanya Singh
- Climate Change Research Centre, University of New South Wales, Sydney, NSW, Australia
- Australian Research Council Centre of Excellence for Climate Extremes, University of New South Wales, Sydney, NSW, Australia
| | - Bin Jalaludin
- School of Population Health, University of New South Wales, Kensington, NSW, Australia
- Ingham Institute for Applied Medical Research, University of New South Wales, Sydney, NSW, Australia
| | - Shakoor Hajat
- Centre on Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Geoffrey G. Morgan
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
- University Centre for Rural Health, Faculty of Medicine and Health, University of Sydney, Lismore, NSW, Australia
- Healthy Environments and Lives (HEAL) National Research Network, Australian National University, Canberra, ACT, Australia
- Centre for Air Pollution, Energy and Health Research (CAR), Glebe, NSW, Australia
| | - Katrin Meissner
- Climate Change Research Centre, University of New South Wales, Sydney, NSW, Australia
- Australian Research Council Centre of Excellence for Climate Extremes, University of New South Wales, Sydney, NSW, Australia
| | - John Kaldor
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| | - Donna Green
- Climate Change Research Centre, University of New South Wales, Sydney, NSW, Australia
- Australian Research Council Centre of Excellence for Climate Extremes, University of New South Wales, Sydney, NSW, Australia
| | - Edward Jegasothy
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
- University Centre for Rural Health, Faculty of Medicine and Health, University of Sydney, Lismore, NSW, Australia
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Song X, Luo Q, Jiang L, Ma Y, Hu Y, Han Y, Wang R, Tang J, Guo Y, Zhang Q, Ma Z, Zhang Y, Guo X, Fan S, Deng C, Fu X, Chen Y, Yang K, Ge L, Wang S. Methodological and reporting quality of systematic reviews on health effects of air pollutants were higher than extreme temperatures: a comparative study. BMC Public Health 2023; 23:2371. [PMID: 38031053 PMCID: PMC10687779 DOI: 10.1186/s12889-023-17256-5] [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: 11/17/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND An increasing number of systematic reviews (SRs) in the environmental field have been published in recent years as a result of the global concern about the health impacts of air pollution and temperature. However, no study has assessed and compared the methodological and reporting quality of SRs on the health effects of air pollutants and extreme temperatures. This study aims to assess and compare the methodological and reporting quality of SRs on the health effects of ambient air pollutants and extreme temperatures. METHODS PubMed, Embase, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, Web of Science, and Epistemonikos databases were searched. Two researchers screened the literature and extracted information independently. The methodological quality of the SRs was assessed through A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2). The reporting quality was assessed through Preferred Reporting Items of Systematic reviews and Meta-Analyses (PRISMA). RESULTS We identified 405 SRs (286 for air pollution, 108 for temperature, and 11 for the synergistic effects). The methodological and reporting quality of the included SRs were suboptimal, with major deficiencies in protocol registration. The methodological quality of SRs of air pollutants was better than that of temperature, especially in terms of satisfactory explanations for any heterogeneity (69.6% v. 45.4%). The reporting quality of SRs of air pollution was better than temperature, however, adherence to the reporting of the assessment results of risk of bias in all SRs (53.5% v. 34.3%) was inadequate. CONCLUSIONS Methodological and reporting quality of SRs on the health effect of air pollutants were higher than those of temperatures. However, deficiencies in protocol registration and the assessment of risk of bias remain an issue for both pollutants and temperatures. In addition, developing a risk-of-bias assessment tool applicable to the temperature field may improve the quality of SRs.
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Affiliation(s)
- Xuping Song
- Evidence-Based Social Science Research Center, Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China
- Key Laboratory of Evidence Based Medicine & Knowledge Translation of Gansu Province, Lanzhou, China
- Institute of Health Data Science, Lanzhou University, Lanzhou, China
- WHO Collaborating Centre for Guideline Implementation and Knowledge Translation, Lanzhou, China
- McMaster Health Forum, Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, L8S4L8, Canada
| | - Qiyin Luo
- Evidence-Based Social Science Research Center, Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China
| | | | - Yan Ma
- Evidence-Based Social Science Research Center, Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China
| | - Yue Hu
- Evidence-Based Social Science Research Center, Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China
| | - Yunze Han
- Evidence-Based Social Science Research Center, Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China
| | - Rui Wang
- Evidence-Based Social Science Research Center, Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China
| | - Jing Tang
- Evidence-Based Social Science Research Center, Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China
| | - Yiting Guo
- Evidence-Based Social Science Research Center, Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China
| | - Qitao Zhang
- Evidence-Based Social Science Research Center, Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China
| | - Zhongyu Ma
- Evidence-Based Social Science Research Center, Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China
| | - Yunqi Zhang
- Evidence-Based Social Science Research Center, Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China
| | - Xinye Guo
- Evidence-Based Social Science Research Center, Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China
| | - Shumei Fan
- Evidence-Based Social Science Research Center, Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China
| | - Chengcheng Deng
- Evidence-Based Social Science Research Center, Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China
| | - Xinyu Fu
- School of Stomatology, Lanzhou University, Lanzhou, China
| | - Yaolong Chen
- Evidence-Based Social Science Research Center, Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China
- Key Laboratory of Evidence Based Medicine & Knowledge Translation of Gansu Province, Lanzhou, China
- Institute of Health Data Science, Lanzhou University, Lanzhou, China
- WHO Collaborating Centre for Guideline Implementation and Knowledge Translation, Lanzhou, China
| | - Kehu Yang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
- Key Laboratory of Evidence Based Medicine & Knowledge Translation of Gansu Province, Lanzhou, China
- Institute of Health Data Science, Lanzhou University, Lanzhou, China
- WHO Collaborating Centre for Guideline Implementation and Knowledge Translation, Lanzhou, China
| | - Long Ge
- Evidence-Based Social Science Research Center, Department of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, China.
- Key Laboratory of Evidence Based Medicine & Knowledge Translation of Gansu Province, Lanzhou, China.
- Institute of Health Data Science, Lanzhou University, Lanzhou, China.
- WHO Collaborating Centre for Guideline Implementation and Knowledge Translation, Lanzhou, China.
| | - Shigong Wang
- College of Atmospheric Sciences, Chengdu University of Information Technology, Chengdu, Sichuan, China.
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Shirinde J, Wichmann J. Temperature modifies the association between air pollution and respiratory disease mortality in Cape Town, South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2023; 33:1122-1131. [PMID: 35581190 DOI: 10.1080/09603123.2022.2076813] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 05/06/2022] [Indexed: 06/15/2023]
Abstract
The aim of this 10-year study was to investigate whether and how temperature modifies the association between daily ambient PM10, NO2, SO2 air pollution and daily respiratory disease mortality in Cape Town. A time-stratified case-crossover epidemiological design was applied. Susceptibility by sex and age groups (15-64 years and ≥65 years) was also investigated. On days with medium Tapp levels, NO2 displayed a stronger association with respiratory mortality than PM10 or SO2. Females appeared to be more susceptible to NO2 at medium Tapp levels to males. The 15-64-year-old age group seemed to be more vulnerable to NO2 and PM10 at medium Tapp levels compared to the elderly (≥65 years). At high Tapp levels, females were more susceptible to PM10. The 15-64-year-old group were more vulnerable to NO2 and SO2. The results can be used in present-day early warning systems and in risk assessments to estimate the impact of increased air pollution and temperature.
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Affiliation(s)
- Joyce Shirinde
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Janine Wichmann
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
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11
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Stafoggia M, Michelozzi P, Schneider A, Armstrong B, Scortichini M, Rai M, Achilleos S, Alahmad B, Analitis A, Åström C, Bell ML, Calleja N, Krage Carlsen H, Carrasco G, Paul Cauchi J, Dszs Coelho M, Correa PM, Diaz MH, Entezari A, Forsberg B, Garland RM, Leon Guo Y, Guo Y, Hashizume M, Holobaca IH, Íñiguez C, Jaakkola JJK, Kan H, Katsouyanni K, Kim H, Kyselý J, Lavigne E, Lee W, Li S, Maasikmets M, Madureira J, Mayvaneh F, Fook Sheng Ng C, Nunes B, Orru H, V Ortega N, Osorio S, Palomares ADL, Pan SC, Pascal M, Ragettli MS, Rao S, Raz R, Roye D, Ryti N, Hn Saldiva P, Samoli E, Schwartz J, Scovronick N, Sera F, Tobias A, Tong S, Dlc Valencia C, Maria Vicedo-Cabrera A, Urban A, Gasparrini A, Breitner S, De' Donato FK. Joint effect of heat and air pollution on mortality in 620 cities of 36 countries. ENVIRONMENT INTERNATIONAL 2023; 181:108258. [PMID: 37837748 PMCID: PMC10702017 DOI: 10.1016/j.envint.2023.108258] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 09/08/2023] [Accepted: 10/09/2023] [Indexed: 10/16/2023]
Abstract
BACKGROUND The epidemiological evidence on the interaction between heat and ambient air pollution on mortality is still inconsistent. OBJECTIVES To investigate the interaction between heat and ambient air pollution on daily mortality in a large dataset of 620 cities from 36 countries. METHODS We used daily data on all-cause mortality, air temperature, particulate matter ≤ 10 μm (PM10), PM ≤ 2.5 μm (PM2.5), nitrogen dioxide (NO2), and ozone (O3) from 620 cities in 36 countries in the period 1995-2020. We restricted the analysis to the six consecutive warmest months in each city. City-specific data were analysed with over-dispersed Poisson regression models, followed by a multilevel random-effects meta-analysis. The joint association between air temperature and air pollutants was modelled with product terms between non-linear functions for air temperature and linear functions for air pollutants. RESULTS We analyzed 22,630,598 deaths. An increase in mean temperature from the 75th to the 99th percentile of city-specific distributions was associated with an average 8.9 % (95 % confidence interval: 7.1 %, 10.7 %) mortality increment, ranging between 5.3 % (3.8 %, 6.9 %) and 12.8 % (8.7 %, 17.0 %), when daily PM10 was equal to 10 or 90 μg/m3, respectively. Corresponding estimates when daily O3 concentrations were 40 or 160 μg/m3 were 2.9 % (1.1 %, 4.7 %) and 12.5 % (6.9 %, 18.5 %), respectively. Similarly, a 10 μg/m3 increment in PM10 was associated with a 0.54 % (0.10 %, 0.98 %) and 1.21 % (0.69 %, 1.72 %) increase in mortality when daily air temperature was set to the 1st and 99th city-specific percentiles, respectively. Corresponding mortality estimate for O3 across these temperature percentiles were 0.00 % (-0.44 %, 0.44 %) and 0.53 % (0.38 %, 0.68 %). Similar effect modification results, although slightly weaker, were found for PM2.5 and NO2. CONCLUSIONS Suggestive evidence of effect modification between air temperature and air pollutants on mortality during the warm period was found in a global dataset of 620 cities.
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Affiliation(s)
- Massimo Stafoggia
- Department of Epidemiology, Lazio Region Health Service / ASL Roma 1, Via C. Colombo 112, 00147 Rome, Italy.
| | - Paola Michelozzi
- Department of Epidemiology, Lazio Region Health Service / ASL Roma 1, Via C. Colombo 112, 00147 Rome, Italy
| | - Alexandra Schneider
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Neuherberg, Germany
| | - Ben Armstrong
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Matteo Scortichini
- Department of Epidemiology, Lazio Region Health Service / ASL Roma 1, Via C. Colombo 112, 00147 Rome, Italy
| | - Masna Rai
- Institute of Epidemiology, Helmholtz Zentrum München - German Research Center for Environmental Health (GmbH), Neuherberg, Germany
| | - Souzana Achilleos
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
| | - Barrak Alahmad
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Antonis Analitis
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Greece
| | - Christofer Åström
- Department of Public Health and Clinical Medicine, Umeå University, Sweden
| | - Michelle L Bell
- School of the Environment, Yale University, New Haven CT, USA
| | | | - Hanne Krage Carlsen
- School of Public Health and Community Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Gabriel Carrasco
- Institute of Tropical Medicine "Alexander von Humboldt", Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | - Micheline Dszs Coelho
- Department of Pathology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Patricia M Correa
- Department of Public Health, Universidad de los Andes, Santiago, Chile
| | - Magali H Diaz
- Department of Environmental Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Alireza Entezari
- Faculty of Geography and Environmental Sciences, Hakim Sabzevari University, Sabzevar 9617916487, Khorasan Razavi, Iran
| | - Bertil Forsberg
- Department of Public Health and Clinical Medicine, Umeå University, Sweden
| | - Rebecca M Garland
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria, South Africa
| | - Yue Leon Guo
- Environmental and Occupational Medicine, and Institute of Environmental and Occupational Health Sciences, National Taiwan University (NTU) and NTU Hospital, Taipei, Taiwan
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Masahiro Hashizume
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | | | - Carmen Íñiguez
- Department of Statistics and Computational Research, Universitat de València, València, Spain
| | - Jouni J K Jaakkola
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland
| | - Haidong Kan
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai, China
| | - Klea Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Greece; Environmental Research Group, School of Public Health, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Ho Kim
- Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Jan Kyselý
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic; Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - Eric Lavigne
- School of Epidemiology & Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada; Environmental Health Science and Research Bureau, Health Canada, Ottawa, Canada
| | - Whanhee Lee
- School of the Environment, Yale University, New Haven CT, USA
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | | | - Joana Madureira
- Department of Environmental Health, Instituto Nacional de Saúde Dr. Ricardo Jorge, Porto, Portugal; EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | - Fatemeh Mayvaneh
- Faculty of Geography and Environmental Sciences, Hakim Sabzevari University, Sabzevar 9617916487, Khorasan Razavi, Iran
| | - Chris Fook Sheng Ng
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Baltazar Nunes
- Department of Epidemiology, Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal
| | - Hans Orru
- Department of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Nicolás V Ortega
- Department of Public Health, Universidad de los Andes, Santiago, Chile
| | - Samuel Osorio
- Department of Environmental Health, University of São Paulo, São Paulo, Brazil
| | | | - Shih-Chun Pan
- National Institute of Environmental Health Science, National Health Research Institutes, Zhunan, Taiwan
| | - Mathilde Pascal
- Santé Publique France, Department of Environmental Health, French National Public Health Agency, Saint Maurice, France
| | | | - Shilpa Rao
- Norwegian Institute of Public Health, Oslo, Norway
| | - Raanan Raz
- Braun School of Public Health and Community Medicine, The Hebrew University of Jerusalem, Israel
| | - Dominic Roye
- Climate Research Foundation, Madrid, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain
| | - Niilo Ryti
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland
| | - Paulo Hn Saldiva
- Department of Pathology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Greece
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Noah Scovronick
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, USA
| | - Francesco Sera
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, United Kingdom; Department of Statistics, Computer Science and Applications "G. Parenti", University of Florence, Florence, Italy
| | - Aurelio Tobias
- Institute of Environmental Assessment and Water Research (IDAEA), Spanish Council for Scientific Research (CSIC), Barcelona, Spain
| | - Shilu Tong
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - César Dlc Valencia
- Department of Environmental Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Ana Maria Vicedo-Cabrera
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland; Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland
| | - Aleš Urban
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic; Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - Antonio Gasparrini
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | | | - Francesca K De' Donato
- Department of Epidemiology, Lazio Region Health Service / ASL Roma 1, Via C. Colombo 112, 00147 Rome, Italy
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12
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Yang J, Dong H, Yu C, Li B, Lin G, Chen S, Cai D, Huang L, Wang B, Li M. Mortality Risk and Burden From a Spectrum of Causes in Relation to Size-Fractionated Particulate Matters: Time Series Analysis. JMIR Public Health Surveill 2023; 9:e41862. [PMID: 37812487 PMCID: PMC10637369 DOI: 10.2196/41862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 07/07/2023] [Accepted: 08/29/2023] [Indexed: 10/10/2023] Open
Abstract
BACKGROUND There is limited evidence regarding the adverse impact of particulate matters (PMs) on multiple body systems from both epidemiological and mechanistic studies. The association between size-fractionated PMs and mortality risk, as well as the burden of a whole spectrum of causes of death, remains poorly characterized. OBJECTIVE We aimed to examine the wide range of susceptible diseases affected by different sizes of PMs. We also assessed the association between PMs with an aerodynamic diameter less than 1 µm (PM1), 2.5 µm (PM2.5), and 10 µm (PM10) and deaths from 36 causes in Guangzhou, China. METHODS Daily data were obtained on cause-specific mortality, PMs, and meteorology from 2014 to 2016. A time-stratified case-crossover approach was applied to estimate the risk and burden of cause-specific mortality attributable to PMs after adjusting for potential confounding variables, such as long-term trend and seasonality, relative humidity, temperature, air pressure, and public holidays. Stratification analyses were further conducted to explore the potential modification effects of season and demographic characteristics (eg, gender and age). We also assessed the reduction in mortality achieved by meeting the new air quality guidelines set by the World Health Organization (WHO). RESULTS Positive and monotonic associations were generally observed between PMs and mortality. For every 10 μg/m3 increase in 4-day moving average concentrations of PM1, PM2.5, and PM10, the risk of all-cause mortality increased by 2.00% (95% CI 1.08%-2.92%), 1.54% (95% CI 0.93%-2.16%), and 1.38% (95% CI 0.95%-1.82%), respectively. Significant effects of size-fractionated PMs were observed for deaths attributed to nonaccidental causes, cardiovascular disease, respiratory disease, neoplasms, chronic rheumatic heart diseases, hypertensive diseases, cerebrovascular diseases, stroke, influenza, and pneumonia. If daily concentrations of PM1, PM2.5, and PM10 reached the WHO target levels of 10, 15, and 45 μg/m3, 7921 (95% empirical CI [eCI] 4454-11,206), 8303 (95% eCI 5063-11,248), and 8326 (95% eCI 5980-10690) deaths could be prevented, respectively. The effect estimates of PMs were relatively higher during hot months, among female individuals, and among those aged 85 years and older, although the differences between subgroups were not statistically significant. CONCLUSIONS We observed positive and monotonical exposure-response curves between PMs and deaths from several diseases. The effect of PM1 was stronger on mortality than that of PM2.5 and PM10. A substantial number of premature deaths could be preventable by adhering to the WHO's new guidelines for PMs. Our findings highlight the importance of a size-based strategy in controlling PMs and managing their health impact.
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Affiliation(s)
- Jun Yang
- School of Public Health, Guangzhou Medical University, Guangzhou, China
- Institute for Environmental and Climate Research, Jinan University, Guangzhou, China
| | - Hang Dong
- Guangzhou Center for Disease Control and Prevention, Guangzhou, China
- Institute of Public Health, Guangzhou Medical University and Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Chao Yu
- Guangzhou Center for Disease Control and Prevention, Guangzhou, China
- Institute of Public Health, Guangzhou Medical University and Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Bixia Li
- Institute for Environmental and Climate Research, Jinan University, Guangzhou, China
- Guangdong University of Science and Technology, Dongguan, China
| | - Guozhen Lin
- Guangzhou Center for Disease Control and Prevention, Guangzhou, China
- Institute of Public Health, Guangzhou Medical University and Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Sujuan Chen
- Institute for Environmental and Climate Research, Jinan University, Guangzhou, China
| | - Dongjie Cai
- Institute for Environmental and Climate Research, Jinan University, Guangzhou, China
| | - Lin Huang
- Institute for Environmental and Climate Research, Jinan University, Guangzhou, China
| | - Boguang Wang
- Institute for Environmental and Climate Research, Jinan University, Guangzhou, China
| | - Mengmeng Li
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, China
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13
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Tian Y, Wu J, Wu Y, Wang M, Wang S, Yang R, Wang X, Wang J, Yu H, Li D, Wu T, Wei J, Hu Y. Short-term exposure to reduced specific-size ambient particulate matter increase the risk of cause-specific cardiovascular disease: A national-wide evidence from hospital admissions. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 263:115327. [PMID: 37611473 DOI: 10.1016/j.ecoenv.2023.115327] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 07/21/2023] [Accepted: 08/02/2023] [Indexed: 08/25/2023]
Abstract
Evidence for the health effects of ambient PM1 (particulate matter with an aerodynamic diameter ≤ 1 µm) pollution is limited, and it remains unclear whether a smaller particulate matter has a greater impact on human health. We conducted a time-series study in 184 major cities by extracting daily hospital data on admissions for ischemic heart disease, heart failure, heart rhythm disturbances, and stroke between 2014 and 2017 from a medical insurance claims database of 0.28 billion beneficiaries. City-specific associations were estimated with over-dispersed generalized additive models. A random-effects meta-analysis was used to estimate regional and national average associations. We conducted stratified and meta-regression analyses to explore potential effect modifiers of the association. We recorded 8.83 million cardiovascular admissions during the study period. At the national-average level, a 10-μg/m3 increase in same-day PM1, PM2.5(particulate matter with an aerodynamic diameter ≤ 2.5 µm) and PM10(particulate matter with an aerodynamic diameter ≤ 10 µm) concentrations corresponded to a 1.14% (95% confidence interval 0.88-1.41%), 0.55% (0.40-0.70%), and 0.45% (0.36-0.55%) increase in cardiovascular admissions, respectively. PM1 exposure was also positively associated with all cardiovascular disease subtypes, including ischemic heart disease (1.28% change; 0.99-1.56%), heart failure (1.30% change; 0.70-1.91%), heart rhythm disturbances (1.11% change; 0.65-1.58%), and ischemic stroke (1.29% change; 0.88-1.71%). The associations between PM1 and cardiovascular admissions were stronger in cities with lower PM1 levels, higher air temperatures and relative humidity, as well as in subgroups with elder age (all P < 0.05). This study provides robust evidence of short-term associations between PM1 concentrations and increased hospital admissions for all major cardiovascular diseases in China. Our findings suggest a greater short-term impact on cardiovascular risk from PM1 in comparison to PM2.5 and PM10.
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Affiliation(s)
- Yaohua Tian
- Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, 430030 Wuhan, China; Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191 Beijing, China
| | - Junhui Wu
- School of Nursing, Peking University, No. 38 Xueyuan Road, Beijing 100191, China
| | - Yiqun Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191 Beijing, China
| | - Mengying Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191 Beijing, China
| | - Siyue Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191 Beijing, China
| | - Ruotong Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191 Beijing, China
| | - Xiaowen Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191 Beijing, China
| | - Jiating Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191 Beijing, China
| | - Huan Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191 Beijing, China
| | - Dankang Li
- Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, 430030 Wuhan, China
| | - Tao Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191 Beijing, China
| | - Jing Wei
- Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park, MD, USA.
| | - Yonghua Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38 Xueyuan Road, 100191 Beijing, China; Medical Informatics Center, Peking University, No.38 Xueyuan Road, 100191 Beijing, China.
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14
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Zhou L, Wang Y, Wang Q, Ding Z, Jin H, Zhang T, Zhu B. The interactive effects of extreme temperatures and PM 2.5 pollution on mortalities in Jiangsu Province, China. Sci Rep 2023; 13:9479. [PMID: 37301905 PMCID: PMC10257702 DOI: 10.1038/s41598-023-36635-x] [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: 01/07/2023] [Accepted: 06/07/2023] [Indexed: 06/12/2023] Open
Abstract
Exposure to extreme temperatures or fine particles is associated with adverse health outcomes but their interactive effects remain unclear. We aimed to explore the interactions of extreme temperatures and PM2.5 pollution on mortalities. Based on the daily mortality data collected during 2015-2019 in Jiangsu Province, China, we conducted generalized linear models with distributed lag non-linear model to estimate the regional-level effects of cold/hot extremes and PM2.5 pollution. The relative excess risk due to interaction (RERI) was evaluated to represent the interaction. The relative risks (RRs) and cumulative relative risks (CRRs) of total and cause-specific mortalities associated with hot extremes were significantly stronger (p < 0.05) than those related to cold extremes across Jiangsu. We identified significantly higher interactions between hot extremes and PM2.5 pollution, with the RERI range of 0.00-1.15. The interactions peaked on ischaemic heart disease (RERI = 1.13 [95%CI: 0.85, 1.41]) in middle Jiangsu. For respiratory mortality, RERIs were higher in females and the less educated. The interaction pattern remained consistent when defining the extremes/pollution with different thresholds. This study provides a comprehensive picture of the interactions between extreme temperatures and PM2.5 pollution on total and cause-specific mortalities. The projected interactions call for public health actions to face the twin challenges, especially the co-appearance of hot extremes and PM pollution.
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Affiliation(s)
- Lian Zhou
- Center for Disease Control and Prevention of Jiangsu Province, Nanjing, 210009, China
| | - Yuning Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, No. 87 Dingjia Bridge, Gulou District, Nanjing, 210009, China.
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, 210009, China.
| | - Qingqing Wang
- Center for Disease Control and Prevention of Jiangsu Province, Nanjing, 210009, China
| | - Zhen Ding
- Center for Disease Control and Prevention of Jiangsu Province, Nanjing, 210009, China
| | - Hui Jin
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, No. 87 Dingjia Bridge, Gulou District, Nanjing, 210009, China
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, 210009, China
| | - Ting Zhang
- State Key Laboratory of Pollution Control and Resource Reuse, School of the Environment, Nanjing University, Nanjing, 210023, China.
- Department of Civil, Environmental, and Infrastructure Engineering, George Mason University, Fairfax, VA, 22030, USA.
| | - Baoli Zhu
- Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.
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Matthaeus-Kraemer CT, Rose N, Spoden M, Pletz MW, Reinhart K, Fleischmann-Struzek C. Urban-Rural Disparities in Case Fatality of Community-Acquired Sepsis in Germany: A Retrospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20105867. [PMID: 37239593 DOI: 10.3390/ijerph20105867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 05/13/2023] [Accepted: 05/15/2023] [Indexed: 05/28/2023]
Abstract
BACKGROUND We aimed to examine urban-rural disparities in sepsis case fatality rates among patients with community-acquired sepsis in Germany. METHODS Retrospective cohort study using de-identified data of the nationwide statutory health insurance AOK, covering approx. 30% of the German population. We compared in-hospital- and 12-month case fatality between rural and urban sepsis patients. We calculated odds ratios (OR) with 95% confidence intervals and the estimated adjusted odds ratio (ORadj) using logistic regression models to account for potential differences in the distribution of age, comorbidities, and sepsis characteristics between rural and urban citizens. RESULTS We identified 118,893 hospitalized patients with community-acquired sepsis in 2013-2014 with direct hospital admittance. Sepsis patients from rural areas had lower in-hospital case fatality rates compared to their urban counterparts (23.7% vs. 25.5%, p < 0.001, Odds Ratio (OR) = 0.91 (95% CI 0.88, 0.94), ORadj = 0.89 (95% CI 0.86, 0.92)). Similar differences were observable for 12-month case fatalities (45.8% rural vs. 47.0% urban 12-month case fatality, p < 0.001, OR = 0.95 (95% CI 0.93, 0.98), ORadj = 0.92 (95% CI 0.89, 0.94)). Survival benefits were also observable in rural patients with severe community-acquired sepsis or patients admitted as emergencies. Rural patients of <40 years had half the odds of dying in hospital compared to urban patients in this age bracket (ORadj = 0.49 (95% CI 0.23, 0.75), p = 0.002). CONCLUSION Rural residence is associated with short- and long-term survival benefits in patients with community-acquired sepsis. Further research on patient, community, and health-care system factors is needed to understand the causative mechanisms of these disparities.
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Affiliation(s)
- Claudia T Matthaeus-Kraemer
- Institute of Infectious Diseases and Infection Control, Jena University Hospital, 07743 Jena, Germany
- Center for Sepsis Control and Care, Jena University Hospital, 07747 Jena, Germany
| | - Norman Rose
- Institute of Infectious Diseases and Infection Control, Jena University Hospital, 07743 Jena, Germany
- Center for Sepsis Control and Care, Jena University Hospital, 07747 Jena, Germany
| | - Melissa Spoden
- Wissenschaftliches Institut der Ortskrankenkassen, 10178 Berlin, Germany
| | - Mathias W Pletz
- Institute of Infectious Diseases and Infection Control, Jena University Hospital, 07743 Jena, Germany
| | - Konrad Reinhart
- Department of Anesthesiology and Operative Intensive Care, Charité University Medicine Berlin, 10117 Berlin, Germany
| | - Carolin Fleischmann-Struzek
- Institute of Infectious Diseases and Infection Control, Jena University Hospital, 07743 Jena, Germany
- Center for Sepsis Control and Care, Jena University Hospital, 07747 Jena, Germany
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16
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Meng Y, Liu Z, Hao J, Tao F, Zhang H, Liu Y, Liu S. Association between ambient air pollution and daily hospital visits for cardiovascular diseases in Wuhan, China: a time-series analysis based on medical insurance data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2023; 33:452-463. [PMID: 35333137 DOI: 10.1080/09603123.2022.2035323] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 01/24/2022] [Indexed: 06/14/2023]
Abstract
Although evidence showed the adverse effects of air pollution on cardiovascular disease (CVDs), few studies were based on medically insured populations. We applied a generalized additive Poisson model (GAM) to estimate the short-term effects of ambient air pollution on a group of medically insured population in Wuhan, China. We extracted daily air pollution data, meteorological data, and daily hospital visits for CVDs. We found that the ambient air pollutants sulfur dioxide (SO2), nitrogen dioxide (NO2), ground-level ozone (O3) particulate matter (PM) with an aerodynamic diameter ≤10 μm (PM10), and those ≤2.5 μm (PM2.5) all increased the risk of daily hospital visits for CVDs. We also found that the effect of air pollution on daily hospital visits for CVDs is greater in the cold season than in the warm season. Our findings can be used as evidence that supports the formulation of policies for air pollution and CVDs.
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Affiliation(s)
- Yongna Meng
- School of Health Sciences, Wuhan University, Wuhan, China
| | - Zhihui Liu
- School of Health Sciences, Wuhan University, Wuhan, China
| | - Jiayuan Hao
- Department of Biostatistics, Harvard University, Cambridge, MA, USA
| | - Fengxi Tao
- School of Health Sciences, Wuhan University, Wuhan, China
| | - Huihui Zhang
- School of Health Sciences, Wuhan University, Wuhan, China
| | - Yuehua Liu
- Vanke School of Public Health, Tsinghua university, Beijing, China
| | - Suyang Liu
- School of Health Sciences, Wuhan University, Wuhan, China
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17
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Zhang Y, Yin Z, Li S, Zhang JJ, Sun HZ, Liu K, Shirai K, Hu K, Qiu C, Liu X, Li Y, Zeng Y, Yao Y. Ambient PM 2.5, ozone and mortality in Chinese older adults: A nationwide cohort analysis (2005-2018). JOURNAL OF HAZARDOUS MATERIALS 2023; 454:131539. [PMID: 37149946 DOI: 10.1016/j.jhazmat.2023.131539] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 04/17/2023] [Accepted: 04/27/2023] [Indexed: 05/09/2023]
Abstract
BACKGROUND Cohort evidence linking long-term survival with exposure to multiple air pollutants (e.g., fine particulate matter [PM2.5] and ozone) was extensively sparse in low- and middle-income countries, especially among older adults. This study aimed to investigate potential associations of long-term exposures to PM2.5 and ozone with all-cause mortality in Chinese older adults. METHODS A dynamic nationwide prospective cohort comprising 20,352 adults aged ≥65 years were enrolled from the Chinese Longitudinal Healthy Longevity Study and followed up through 2005-2018. Participants' annual exposures to warm-season ozone and year-round PM2.5 were assigned using satellite-derived spatiotemporal estimates. A directed acyclic graph (DAG) was developed to identify confounding variables. Associations of annual mean exposures to PM2.5 and ozone with mortality were evaluated using single- and two-pollutant Cox proportional hazards models, adjusting for time-dependent individual risk factors and ambient temperature. RESULTS During 100 thousand person-years of follow-up (median: 3.6 years), a total of 14,313 death events occurred. The participants were averagely aged 87.1 years at baseline and exposed to a wide range of annual average concentrations of warm-season maximum 8-hour ozone (mean, 54.4 ppb; range, 23.3-81.6 ppb) and year-round PM2.5 (mean, 65.5 μg/m3; range, 10.1-162.9 μg/m3). Approximately linear concentration-response relationship was identified for ozone, whereas significant increases in PM2.5-associated mortality risks were observed only when concentrations were above 60 μg/m3. Rises of 10 ppb in ozone and 10 µg/m3 in PM2.5 above 60 µg/m3 were associated with increases in all-cause mortality of 13.2% (95% confidence interval [CI]: 10.2-16.2%) and 6.2% (95% CI: 4.6-7.7%) in DAG-based single-pollutant model, and of 9.7% (95% CI: 6.6-13.0%) and 5.3% (95% CI: 3.7-6.9%) in DAG-based two-pollutant model, respectively. We detected significant effect modification by temperature in associations of mortality with ozone (P <0.001 for interaction), suggesting greater ozone-related risks among participants in warmer locations. CONCLUSIONS This study provided longitudinal evidence that long-term exposure to ambient PM2.5 and ozone significantly and independently contributed to elevated risks of all-cause mortality among older adults in China.
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Affiliation(s)
- Yunquan Zhang
- Institute of Social Development and Health Management, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Zhouxin Yin
- Institute of Social Development and Health Management, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China; School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen 518055, China
| | - Shaojie Li
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Junfeng Jim Zhang
- Nicholas School of the Environment and Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Haitong Zhe Sun
- Centre for Atmospheric Science, Yusuf Hamied Department of Chemistry, University of Cambridge, Cambridge CB2 1EW, UK; Department of Earth Sciences, University of Cambridge, Cambridge CB2 3EQ, UK
| | - Keyang Liu
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita Shi, Osaka, Japan
| | - Kokoro Shirai
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita Shi, Osaka, Japan
| | - Kejia Hu
- Institute of Big Data in Health Science, School of Public Health, Zhejiang University, Hangzhou 310058, China
| | - Chengxuan Qiu
- Aging Research Center, Karolinska Institutet, Widerströmska Huset, SE-171 65 Solna, Sweden
| | - Xiaoyun Liu
- China Center for Health Development Studies, Peking University, Beijing, China
| | - Yachen Li
- Institute of Social Development and Health Management, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Yi Zeng
- Center for Healthy Aging and Development Studies, National School of Development, Peking University, Beijing, China; Center for the Study of Aging and Human Development and Geriatrics Division, Medical School of Duke University, Durham, NC, US.
| | - Yao Yao
- China Center for Health Development Studies, Peking University, Beijing, China; Center for Healthy Aging and Development Studies, National School of Development, Peking University, Beijing, China.
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18
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Zoran MA, Savastru RS, Savastru DM, Tautan MN. Peculiar weather patterns effects on air pollution and COVID-19 spread in Tokyo metropolis. ENVIRONMENTAL RESEARCH 2023; 228:115907. [PMID: 37080275 PMCID: PMC10111861 DOI: 10.1016/j.envres.2023.115907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/11/2023] [Accepted: 04/12/2023] [Indexed: 05/03/2023]
Abstract
As a pandemic hotspot in Japan, between March 1, 2020-October 1, 2022, Tokyo metropolis experienced seven COVID-19 waves. Motivated by the high rate of COVID-19 incidence and mortality during the seventh wave, and environmental/health challenges we conducted a time-series analysis to investigate the long-term interaction of air quality and climate variability with viral pandemic in Tokyo. Through daily time series geospatial and observational air pollution/climate data, and COVID-19 incidence and death cases, this study compared the environmental conditions during COVID-19 multiwaves. In spite of five State of Emergency (SOEs) restrictions associated with COVID-19 pandemic, during (2020-2022) period air quality recorded low improvements relative to (2015-2019) average annual values, namely: Aerosol Optical Depth increased by 9.13% in 2020 year, and declined by 6.64% in 2021, and 12.03% in 2022; particulate matter PM2.5 and PM10 decreased during 2020, 2021, and 2022 years by 10.22%, 62.26%, 0.39%, and respectively by 4.42%, 3.95%, 5.76%. For (2021-2022) period the average ratio of PM2.5/PM10 was (0.319 ± 0.1640), showing a higher contribution to aerosol loading of traffic-related coarse particles in comparison with fine particles. The highest rates of the daily recorded COVID-19 incidence and death cases in Tokyo during the seventh COVID-19 wave (1 July 2022-1 October 2022) may be attributed to accumulation near the ground of high levels of air pollutants and viral pathogens due to: 1) peculiar persistent atmospheric anticyclonic circulation with strong positive anomalies of geopotential height at 500 hPa; 2) lower levels of Planetary Boundary Layer (PBL) heights; 3) high daily maximum air temperature and land surface temperature due to the prolonged heat waves (HWs) in summer 2022; 4) no imposed restrictions. Such findings can guide public decision-makers to design proper strategies to curb pandemics under persistent stable anticyclonic weather conditions and summer HWs in large metropolitan areas.
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Affiliation(s)
- Maria A Zoran
- IT Department, National Institute of R&D for Optoelectronics, Atomistilor Street 409, MG5, Magurele-Bucharest, 077125, Romania.
| | - Roxana S Savastru
- IT Department, National Institute of R&D for Optoelectronics, Atomistilor Street 409, MG5, Magurele-Bucharest, 077125, Romania
| | - Dan M Savastru
- IT Department, National Institute of R&D for Optoelectronics, Atomistilor Street 409, MG5, Magurele-Bucharest, 077125, Romania
| | - Marina N Tautan
- IT Department, National Institute of R&D for Optoelectronics, Atomistilor Street 409, MG5, Magurele-Bucharest, 077125, Romania
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19
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Rai M, Stafoggia M, de'Donato F, Scortichini M, Zafeiratou S, Vazquez Fernandez L, Zhang S, Katsouyanni K, Samoli E, Rao S, Lavigne E, Guo Y, Kan H, Osorio S, Kyselý J, Urban A, Orru H, Maasikmets M, Jaakkola JJK, Ryti N, Pascal M, Hashizume M, Fook Sheng Ng C, Alahmad B, Hurtado Diaz M, De la Cruz Valencia C, Nunes B, Madureira J, Scovronick N, Garland RM, Kim H, Lee W, Tobias A, Íñiguez C, Forsberg B, Åström C, Maria Vicedo-Cabrera A, Ragettli MS, Leon Guo YL, Pan SC, Li S, Gasparrini A, Sera F, Masselot P, Schwartz J, Zanobetti A, Bell ML, Schneider A, Breitner S. Heat-related cardiorespiratory mortality: Effect modification by air pollution across 482 cities from 24 countries. ENVIRONMENT INTERNATIONAL 2023; 174:107825. [PMID: 36934570 DOI: 10.1016/j.envint.2023.107825] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 01/11/2023] [Accepted: 02/12/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Evidence on the potential interactive effects of heat and ambient air pollution on cause-specific mortality is inconclusive and limited to selected locations. OBJECTIVES We investigated the effects of heat on cardiovascular and respiratory mortality and its modification by air pollution during summer months (six consecutive hottest months) in 482 locations across 24 countries. METHODS Location-specific daily death counts and exposure data (e.g., particulate matter with diameters ≤ 2.5 µm [PM2.5]) were obtained from 2000 to 2018. We used location-specific confounder-adjusted Quasi-Poisson regression with a tensor product between air temperature and the air pollutant. We extracted heat effects at low, medium, and high levels of pollutants, defined as the 5th, 50th, and 95th percentile of the location-specific pollutant concentrations. Country-specific and overall estimates were derived using a random-effects multilevel meta-analytical model. RESULTS Heat was associated with increased cardiorespiratory mortality. Moreover, the heat effects were modified by elevated levels of all air pollutants in most locations, with stronger effects for respiratory than cardiovascular mortality. For example, the percent increase in respiratory mortality per increase in the 2-day average summer temperature from the 75th to the 99th percentile was 7.7% (95% Confidence Interval [CI] 7.6-7.7), 11.3% (95%CI 11.2-11.3), and 14.3% (95% CI 14.1-14.5) at low, medium, and high levels of PM2.5, respectively. Similarly, cardiovascular mortality increased by 1.6 (95%CI 1.5-1.6), 5.1 (95%CI 5.1-5.2), and 8.7 (95%CI 8.7-8.8) at low, medium, and high levels of O3, respectively. DISCUSSION We observed considerable modification of the heat effects on cardiovascular and respiratory mortality by elevated levels of air pollutants. Therefore, mitigation measures following the new WHO Air Quality Guidelines are crucial to enhance better health and promote sustainable development.
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Affiliation(s)
- Masna Rai
- Institute of Epidemiology, Helmholtz Munich, - German Research Center for Environmental Health, Neuherberg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology - IBE, Pettenkofer School of Public Health, LMU Munich, Munich, Germany.
| | - Massimo Stafoggia
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy
| | - Francesca de'Donato
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy
| | - Matteo Scortichini
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Rome, Italy
| | - Sofia Zafeiratou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School,National and Kapodistrian University of Athens, Greece
| | | | - Siqi Zhang
- Institute of Epidemiology, Helmholtz Munich, - German Research Center for Environmental Health, Neuherberg, Germany
| | - Klea Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School,National and Kapodistrian University of Athens, Greece
| | - Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School,National and Kapodistrian University of Athens, Greece
| | - Shilpa Rao
- Department of Air Pollution and Noise, Norwegian Institute of Public Health, Oslo, Norway
| | - Eric Lavigne
- School of Epidemiology & Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada and Environmental Health Science & Research Bureau, Health Canada, Ottawa, Canada
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Haidong Kan
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai, China
| | - Samuel Osorio
- Department of Environmental Health, University of São Paulo, São Paulo, Brazil
| | - Jan Kyselý
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - Aleš Urban
- Institute of Atmospheric Physics, Czech Academy of Sciences, Prague, Czech Republic Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - Hans Orru
- Department of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | | | - Jouni J K Jaakkola
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland
| | - Niilo Ryti
- Center for Environmental and Respiratory Health Research (CERH), University of Oulu, Oulu, Finland
| | - Mathilde Pascal
- Santé Publique France, Department of Environmental Health, French National Public Health Agency, Saint Maurice, France
| | - Masahiro Hashizume
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Chris Fook Sheng Ng
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Barrak Alahmad
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Magali Hurtado Diaz
- Department of Environmental Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - César De la Cruz Valencia
- Department of Environmental Health, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Baltazar Nunes
- Department of Environmental Health, Instituto Nacional de Saúde Dr. Ricardo Jorge, Porto, Portugal
| | - Joana Madureira
- Department of Environmental Health, Instituto Nacional de Saúde Dr. Ricardo Jorge, Porto, Portugal
| | - Noah Scovronick
- Department of Environmental Health. Rollins School of Public Health, Emory University, Atlanta, USA
| | - Rebecca M Garland
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria, South Africa
| | - Ho Kim
- Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Whanhee Lee
- School of Biomedical Convergence Engineering, Pusan National University, Yangsan, South Korea
| | - Aurelio Tobias
- Institute of Environmental Assessment and Water Research (IDAEA), Spanish Council for Scientific Research (CSIC), Barcelona, Spain
| | - Carmen Íñiguez
- Department of Statistics and Computational Research. Universitat de València, València, Spain
| | - Bertil Forsberg
- Department of Public Health and Clinical Medicine, Umeå University, Sweden
| | - Christofer Åström
- Department of Public Health and Clinical Medicine, Umeå University, Sweden
| | | | | | - Yue-Liang Leon Guo
- Environmental and Occupational Medicine, and Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University (NTU) and NTU Hospital, Taipei, Taiwan
| | - Shih-Chun Pan
- National Institute of Environmental Health Science, National Health Research Institutes, Zhunan, Taiwan
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Antonio Gasparrini
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Francesco Sera
- Department of Statistics, Computer Science and Applications "G. Parenti", University of Florence, Florence, Italy
| | - Pierre Masselot
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Antonella Zanobetti
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Michelle L Bell
- School of Forestry and Environmental Studies, Yale University, New Haven CT, USA
| | - Alexandra Schneider
- Institute of Epidemiology, Helmholtz Munich, - German Research Center for Environmental Health, Neuherberg, Germany
| | - Susanne Breitner
- Institute of Epidemiology, Helmholtz Munich, - German Research Center for Environmental Health, Neuherberg, Germany; Institute for Medical Information Processing, Biometry, and Epidemiology - IBE, Pettenkofer School of Public Health, LMU Munich, Munich, Germany
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20
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Sun H, Chen S, Li X, Cheng L, Luo Y, Xie L. Prediction and early warning model of mixed exposure to air pollution and meteorological factors on death of respiratory diseases based on machine learning. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:53754-53766. [PMID: 36864340 DOI: 10.1007/s11356-023-26017-1] [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: 11/03/2022] [Accepted: 02/15/2023] [Indexed: 06/19/2023]
Abstract
In recent years, with the repeated occurrence of extreme weather and the continuous increase of air pollution, the incidence of weather-related diseases has increased yearly. Air pollution and extreme temperature threaten sensitive groups' lives, among which air pollution is most closely related to respiratory diseases. Owing to the skewed attention, timely intervention is necessary to better predict and warn the occurrence of death from respiratory diseases. In this paper, according to the existing research, based on a number of environmental monitoring data, the regression model is established by integrating the machine learning methods XGBoost, support vector machine (SVM), and generalized additive model (GAM) model. The distributed lag nonlinear model (DLNM) is used to set the warning threshold to transform the data and establish the warning model. According to the DLNM model, the cumulative lag effect of meteorological factors is explored. There is a cumulative lag effect between air temperature and PM2.5, which reaches the maximum when the lag is 3 days and 5 days, respectively. If the low temperature and high environmental pollutants (PM2.5) continue to influence for a long time, the death risk of respiratory diseases will continue to rise, and the early warning model based on DLNM has better performance.
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Affiliation(s)
- HongYing Sun
- The Faculty of Economics, Guangdong University of Finance & Economics, Guangzhou, 510320, China
| | - SiYi Chen
- The Faculty of Economics, Guangdong University of Finance & Economics, Guangzhou, 510320, China
| | - XinYi Li
- The Faculty of Economics, Guangdong University of Finance & Economics, Guangzhou, 510320, China
| | - LiPing Cheng
- The Faculty of Economics, Guangdong University of Finance & Economics, Guangzhou, 510320, China.
| | - YiPei Luo
- The Faculty of Economics, Guangdong University of Finance & Economics, Guangzhou, 510320, China
| | - LingLi Xie
- School of Mathematics, Sun Yat-Sen University, Guangzhou, 510275, China
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21
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Koo GPY, Zheng H, Aik JCL, Tan BYQ, Sharma VK, Sia CH, Ong MEH, Ho AFW. Clustering of Environmental Parameters and the Risk of Acute Ischaemic Stroke. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4979. [PMID: 36981888 PMCID: PMC10049712 DOI: 10.3390/ijerph20064979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 03/05/2023] [Accepted: 03/08/2023] [Indexed: 06/18/2023]
Abstract
Acute ischaemic stroke (AIS) risk on days with similar environmental profiles remains unknown. We investigated the association between clusters of days with similar environmental parameters and AIS incidence in Singapore. We grouped calendar days from 2010 to 2015 with similar rainfall, temperature, wind speed, and Pollutant Standards Index (PSI) using k-means clustering. Three distinct clusters were formed 'Cluster 1' containing high wind speed, 'Cluster 2' having high rainfall, and 'Cluster 3' having high temperatures and PSI. We aggregated the number of AIS episodes over the same period with the clusters and analysed their association using a conditional Poisson regression in a time-stratified case-crossover design. Comparing the three clusters, Cluster 3 had the highest AIS occurrence (IRR 1.09; 95% confidence interval (CI) 1.05-1.13), with no significant difference between Clusters 1 and 2. Subgroup analyses in Cluster 3 showed that AIS risk was amplified in the elderly (≥65 years old), non-smokers, and those without a history of ischaemic heart disease/atrial fibrillation/vascular heart disease/peripheral vascular disease. In conclusion, we found that AIS incidence may be higher on days with higher temperatures and PSI. These findings have important public health implications for AIS prevention and health services delivery during at-risk days, such as during the seasonal transboundary haze.
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Affiliation(s)
| | - Huili Zheng
- National Registry of Diseases Officer, Health Promotion Board, Singapore 168937, Singapore
| | - Joel C. L. Aik
- Environmental Epidemiology and Toxicology Division, Environmental Health Institute, National Environment Agency, Singapore 228231, Singapore
- Pre-Hospital & Emergency Research Center, Duke-NUS Medical School, Singapore 169857, Singapore
| | - Benjamin Y. Q. Tan
- Division of Neurology, Department of Medicine, National University Hospital, Singapore 119074, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
| | - Vijay K. Sharma
- Division of Neurology, Department of Medicine, National University Hospital, Singapore 119074, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
| | - Ching Hui Sia
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
- Department of Cardiology, National University Heart Centre Singapore, Singapore 119074, Singapore
| | - Marcus E. H. Ong
- Health Services & Systems Research, Duke-NUS Medical School, Singapore 169857, Singapore
- Department of Emergency Medicine, Singapore General Hospital, Singapore 169608, Singapore
| | - Andrew F. W. Ho
- Pre-Hospital & Emergency Research Center, Duke-NUS Medical School, Singapore 169857, Singapore
- Department of Emergency Medicine, Singapore General Hospital, Singapore 169608, Singapore
- Centre of Population Health Research and Implementation, SingHealth Regional Health System, Singapore 168753, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore 117549, Singapore
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22
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Vaičiulis V, Venclovienė J, Miškinytė A, Ustinavičienė R, Dėdelė A, Kalinienė G, Lukšienė D, Tamošiūnas A, Seiduanova L, Radišauskas R. Association between Outdoor Air Pollution and Fatal Acute Myocardial Infarction in Lithuania between 2006 and 2015: A Time Series Design. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4549. [PMID: 36901560 PMCID: PMC10002310 DOI: 10.3390/ijerph20054549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/26/2023] [Accepted: 03/02/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Air pollution has a significant effect on human health and there is a broad body of evidence showing that exposure to air pollution is associated with an increased risk of adverse health effects. The main objective of this study was to assess the association of traffic-related air pollutants with fatal AMI during the ten-year period. METHODS The study was conducted in Kaunas city, where the WHO MONICA register included a total of 2273 adult cases of fatal AMI cases during the 10-year study period. We focused on the period between 2006 and 2015. The associations between exposure to traffic-related air pollution and the risk of fatal AMI were evaluated by using a multivariate Poisson regression model, RR presented per an increase in IQR. RESULTS It was found that the risk of fatal AMI was significantly higher in all subjects (RR 1.06; 95% CI 1.00-1.12) and women (RR 1.12; 95% CI 1.02-1.22) when the concentration of PM10 in the ambient air was increased 5-11 days before the onset of AMI, adjusting for NO2 concentration. The effect was stronger during spring in all subjects (RR 1.12; 95% CI 1.03-1.22), in men (RR 1.13; 95% CI 1.01-1.26), in younger-aged (RR 1.15; 95% CI 1.03-1.28), and in winter in women (RR 1.24; 95% CI 1.03-1.50). CONCLUSIONS Our findings show that ambient air pollution increases the risk of fatal AMI, and this pertains to PM10 specifically.
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Affiliation(s)
- Vidmantas Vaičiulis
- Health Research Institute, Lithuanian University of Health Sciences, Tilzes St. 18, 47181 Kaunas, Lithuania
- Department of Environmental and Occupational Medicine, Lithuanian University of Health Sciences, Tilzes St. 18, 47181 Kaunas, Lithuania
| | - Jonė Venclovienė
- Department of Environmental Sciences, Vytautas Magnus University, Donelaičio St. 58, 44248 Kaunas, Lithuania
- Institute of Cardiology, Lithuanian University of Health Sciences, Sukileliu Ave. 15, 50162 Kaunas, Lithuania
| | - Auksė Miškinytė
- Department of Environmental Sciences, Vytautas Magnus University, Donelaičio St. 58, 44248 Kaunas, Lithuania
| | - Rūta Ustinavičienė
- Department of Environmental and Occupational Medicine, Lithuanian University of Health Sciences, Tilzes St. 18, 47181 Kaunas, Lithuania
| | - Audrius Dėdelė
- Department of Environmental Sciences, Vytautas Magnus University, Donelaičio St. 58, 44248 Kaunas, Lithuania
| | - Gintarė Kalinienė
- Health Research Institute, Lithuanian University of Health Sciences, Tilzes St. 18, 47181 Kaunas, Lithuania
- Department of Environmental and Occupational Medicine, Lithuanian University of Health Sciences, Tilzes St. 18, 47181 Kaunas, Lithuania
| | - Dalia Lukšienė
- Department of Environmental and Occupational Medicine, Lithuanian University of Health Sciences, Tilzes St. 18, 47181 Kaunas, Lithuania
- Institute of Cardiology, Lithuanian University of Health Sciences, Sukileliu Ave. 15, 50162 Kaunas, Lithuania
| | - Abdonas Tamošiūnas
- Institute of Cardiology, Lithuanian University of Health Sciences, Sukileliu Ave. 15, 50162 Kaunas, Lithuania
| | - Laura Seiduanova
- Department of Health Politics and Management, School of Public Health, Asfendiyarov Kazakh National Medical University, Almaty 050000, Kazakhstan
| | - Ričardas Radišauskas
- Department of Environmental and Occupational Medicine, Lithuanian University of Health Sciences, Tilzes St. 18, 47181 Kaunas, Lithuania
- Institute of Cardiology, Lithuanian University of Health Sciences, Sukileliu Ave. 15, 50162 Kaunas, Lithuania
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23
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Jiang Y, Chen R, Peng W, Luo Y, Chen X, Jiang Q, Han B, Su G, Duan Y, Huo J, Qu X, Fu Q, Kan H. Hourly Ultrafine Particle Exposure and Acute Myocardial Infarction Onset: An Individual-Level Case-Crossover Study in Shanghai, China, 2015-2020. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2023; 57:1701-1711. [PMID: 36668989 DOI: 10.1021/acs.est.2c06651] [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] [Indexed: 06/17/2023]
Abstract
Associations between ultrafine particles (UFPs) and hourly onset of acute myocardial infarction (AMI) have rarely been investigated. We aimed to evaluate the impacts of UFPs on AMI onset and the lag patterns. A time-stratified case-crossover study was performed among 20,867 AMI patients from 46 hospitals in Shanghai, China, between January 2015 and December 2020. Hourly data of AMI onset and number concentrations of nanoparticles of multiple size ranges below 0.10 μm (0.01-0.10, UFP/PNC0.01-0.10; 0.01-0.03, PNC0.01-0.03; 0.03-0.05, PNC0.03-0.05; and 0.05-0.10 μm, PNC0.05-0.10) were collected. Conditional logistic regressions were applied. Transient exposures to these nanoparticles were significantly associated with AMI onset, with almost linear exposure-response curves. These associations occurred immediately after exposure, lasted for approximately 6 h, and attenuated to be null thereafter. Each interquartile range increase in concentrations of total UFPs, PNC0.01-0.03, PNC0.03-0.05, and PNC0.05-0.10 during the preceding 0-6 h was associated with increments of 3.29, 2.08, 2.47, and 2.93% in AMI onset risk, respectively. The associations were stronger during warm season and at high temperatures and were robust after adjusting for criteria air pollutants. Our findings provide novel evidence that hourly UFP exposure is associated with immediate increase in AMI onset risk.
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Affiliation(s)
- Yixuan Jiang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China
| | - Wenhui Peng
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University, School of Medicine, Shanghai 200072, China
| | - Yun Luo
- Department of Cardiology, Jiujiang No. 1 People's Hospital, Jiujiang 332000, China
| | - Xiaomin Chen
- Department of Cardiology, Ningbo First Hospital, Ningbo 315010, China
| | - Qianfeng Jiang
- Department of Cardiology, The First People's Hospital of Zunyi (The Third Affiliated Hospital of Zunyi Medical University), Zunyi 563000, China
| | - Bingjiang Han
- Department of Cardiology, The Second Hospital of Jiaxing (The Second Affiliated Hospital of Jiaxing University), Jiaxing 314000, China
| | - Guohai Su
- Jinan Central Hospital, Jinan 250013, China
| | - Yusen Duan
- Shanghai Environmental Monitoring Center, Shanghai 200235, China
| | - Juntao Huo
- Shanghai Environmental Monitoring Center, Shanghai 200235, China
| | - Xinkai Qu
- Department of Cardiology, Huadong Hospital Affiliated to Fudan University, Shanghai 200040, China
| | - Qingyan Fu
- Shanghai Environmental Monitoring Center, Shanghai 200235, China
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai 200032, China
- Children's Hospital of Fudan University, National Center for Children's Health, Shanghai 201102, 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: 4] [Impact Index Per Article: 2.0] [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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25
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Lee W, Lim YH, Ha E, Kim Y, Lee WK. Forecasting of non-accidental, cardiovascular, and respiratory mortality with environmental exposures adopting machine learning approaches. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:88318-88329. [PMID: 35834079 PMCID: PMC9281380 DOI: 10.1007/s11356-022-21768-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 06/27/2022] [Indexed: 04/16/2023]
Abstract
Environmental exposure constantly changes with time and various interactions that can affect health outcomes. Machine learning (ML) or deep learning (DL) algorithms have been used to solve complex problems, such as multiple exposures and their interactions. This study developed predictive models for cause-specific mortality using ML and DL algorithms with the daily or hourly measured meteorological and air pollution data. The ML algorithm improved the performance compared to the conventional methods, even though the optimal algorithm depended on the adverse health outcomes. The best algorithms were extreme gradient boosting, ridge, and elastic net, respectively, for non-accidental, cardiovascular, and respiratory mortality with daily measurement; they were superior to the generalized additive model reducing a mean absolute error by 4.7%, 4.9%, and 16.8%, respectively. With hourly measurements, the ML model tended to outperform the conventional models, even though hourly data, instead of daily data, did not enhance the performance in some models. The proposed model allows a better understanding and development of robust predictive models for health outcomes using multiple environmental exposures.
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Affiliation(s)
- Woojoo Lee
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Youn-Hee Lim
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Eunhee Ha
- Department of Occupational and Environmental Medicine, Ewha Medical Research Center, College of Medicine, Ewha Woman's University, Seoul, Republic of Korea
| | - Yoenjin Kim
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Won Kyung Lee
- Department of Prevention and Management, Inha University Hospital, School of Medicine, Inha University, Incheon, Republic of Korea.
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26
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Zhang X, Yan B, Zhou Y, Osei F, Li Y, Zhao H, Cheng C, Stein A. Short-term health impacts related to ozone in China before and after implementation of policy measures: A systematic review and meta-analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 847:157588. [PMID: 35882322 DOI: 10.1016/j.scitotenv.2022.157588] [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: 05/20/2022] [Revised: 07/10/2022] [Accepted: 07/19/2022] [Indexed: 05/29/2023]
Abstract
This paper presents a meta-analysis of the impacts of short-term exposure to ozone (O3) on three health endpoints: all-cause, cardiovascular, and respiratory mortality in China. All relevant studies from January 1990 to December 2021 were searched from four databases. After screening, 30 studies were included for the meta-analysis. The results showed that a significant rise of 0.41 % (95 % confidence interval (CI): 0.35 %-0.48 %) in all-cause, 0.60 % (95 % CI: 0.51 %-0.68 %) in cardiovascular and 0.45 % (95 % CI: 0.28 %-0.62 %) in respiratory mortality for each 10 μg m-3 increase in the maximum daily 8 h average O3 concentration (MDA8 O3). Moreover, results stratified by heterogeneous time periods before and after implementing a policy measure in 2013, showed that the pooled effects for all-cause and respiratory mortality before were greater than those after, while the pooled effects for cardiovascular mortality before 2013 were slightly smaller than those after. The finding that short-term exposure to O3 was positively related to the three health endpoints was validated by means of a sensitivity analysis. Furthermore, we did not observe any publication bias. Our results present an updated and better understanding of the relationship between short-term exposure to O3 and the three health endpoints, while providing a reference for further assessment of the impact of short-term O3 exposure on human health.
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Affiliation(s)
- Xiangxue Zhang
- Faculty of Geographical Science, Beijing Normal University, Beijing 100875, China; Faculty of Geo-Information Science and Earth Observation (ITC), University of Twente, Enschede 7514AE, the Netherlands
| | - Bin Yan
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China
| | - Yinying Zhou
- School of Information Science and Technology, Hangzhou Normal University, Hangzhou 311121, China
| | - Frank Osei
- Faculty of Geo-Information Science and Earth Observation (ITC), University of Twente, Enschede 7514AE, the Netherlands
| | - Yao Li
- Faculty of Geo-Information Science and Earth Observation (ITC), University of Twente, Enschede 7514AE, the Netherlands
| | - Hui Zhao
- Department of Environmental Science and Engineering, Fudan University, Shanghai 200438, China
| | - Changxiu Cheng
- Faculty of Geographical Science, Beijing Normal University, Beijing 100875, China; National Tibetan Plateau Data Center, Beijing 100101, China.
| | - Alfred Stein
- Faculty of Geo-Information Science and Earth Observation (ITC), University of Twente, Enschede 7514AE, the Netherlands.
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27
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Zhang Y, Ma Y, Shen J, Li H, Wang H, Cheng B, Ma L. Effect of ambient O 3 on mortality due to circulatory and respiratory diseases in a high latitude city of northeast China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:67776-67786. [PMID: 35522413 DOI: 10.1007/s11356-022-20585-4] [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: 03/04/2022] [Accepted: 04/29/2022] [Indexed: 06/14/2023]
Abstract
In recent years, O3 pollution had been worsening in China and became a major challenge for human health. To evaluate the O3 effects on circulatory and respiratory mortality in Harbin, a high latitude city of northeast China, we applied a time-series study from 2014 to 2016. After collecting data and adjusting for the effects of confounders, we built the generalized additive model to assess the associations between O3 and mortality at different lag days. The results showed that an interquartile-range (IQR) increase in O3 concentration corresponded to excess risk (ER) of 2.00% (95%CI: - 0.25-4.30%) for circulatory mortality at lag 0 and 8.02% (95%CI: 4.18-12.01%) for respiratory mortality at lag 2 days in the single-pollutant model. Stratified analysis showed that O3 had a greater effect on females than on males. The effect of O3 exposure on circulatory mortality was stronger during the warm period, while the opposite trend was founded for respiratory mortality. The sensitivity analysis showed that the effects of O3 were relatively independent and the major results were robust.
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Affiliation(s)
- Yifan Zhang
- Ministry of Education, College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Lanzhou University, Lanzhou, 730000, China
| | - Yuxia Ma
- Ministry of Education, College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Lanzhou University, Lanzhou, 730000, China.
| | - Jiahui Shen
- Ministry of Education, College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Lanzhou University, Lanzhou, 730000, China
| | - Heping Li
- Ministry of Education, College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Lanzhou University, Lanzhou, 730000, China
| | - Hang Wang
- Ministry of Education, College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Lanzhou University, Lanzhou, 730000, China
| | - Bowen Cheng
- Ministry of Education, College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Lanzhou University, Lanzhou, 730000, China
| | - Liya Ma
- Lanzhou Petrochemical Company, Lanzhou, 730060, China
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28
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Tian Y, Xiang M, Peng J, Duan Y, Wen Y, Huang S, Li L, Yu S, Cheng J, Zhang X, Wang P. Modification effects of seasonal and temperature variation on the association between exposure to nitrogen dioxide and ischemic stroke onset in Shenzhen, China. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2022; 66:1747-1758. [PMID: 35750990 DOI: 10.1007/s00484-022-02315-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 05/16/2022] [Accepted: 06/14/2022] [Indexed: 06/15/2023]
Abstract
The independent associations of extreme temperature and ambient air pollutant with the admission to hospital and mortality of ischemic stroke have been widely investigated. However, knowledge about the modification effects of variation in season and temperature on the association between exposure to nitrogen dioxide (NO2) and ischemic stroke onset is still limited. This study purposed to explore the effect of NO2 on daily ischemic stroke onset modified by season and ambient temperature, and identify the potential population that susceptible to ischemic stroke onset connected with NO2 and ambient temperature. Data on daily ischemic stroke counts, weather conditions, and ambient air pollutant concentrations in Shenzhen were collected between January 1, 2008, and December 31, 2014. The seasonal effect on the NO2-associated onset was measured by a distributed-lag linear model. Furthermore, a generalized additive model that incorporated with stratification analyses was used to calculate the interactive effects between NO2 and ambient temperature. During the winter, the average percentage increase in daily ischemic stroke onset for each 10 μg/m3 increment in NO2 concentration on lagged 2 days was 3.05% (95% CI: 1.31-4.82%), while there was no statistically significant effect of NO2 during summer. And the low-temperature days ([Formula: see text] mean temperature), with a 2.23% increase in incidence (95% CI: 1.18-3.29%) for the same concentration increase in NO2, were significant higher than high temperature days ([Formula: see text] mean temperature). The modification effects of temperature on the study association were more pronounced in individuals aged 65 years or more and in males. The adverse health effects of NO2 on ischemic stroke are more pronounced during winter or low temperature periods. Elderly adults or males presented higher risks with these exposures.
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Affiliation(s)
- Yuchen Tian
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Ming Xiang
- Department of Hospital Infection Control, Wuhan No. 1 Hospital (Wuhan Hospital of Integrated Traditional Chinese and Western Medicine), Wuhan, Hubei, China
| | - Ji Peng
- Shenzhen Center for Chronic Disease Control, 2021 Buxin Road, Shenzhen, 518020, Guangdong, China
| | - Yanran Duan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Ying Wen
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen, 518055, Guangdong, China
| | - Suli Huang
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen, 518055, Guangdong, China
| | - Lei Li
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Shuyuan Yu
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen, 518055, Guangdong, China
| | - Jinquan Cheng
- Shenzhen Center for Disease Control and Prevention, 8 Longyuan Rd, Shenzhen, 518055, Guangdong, China.
| | - Xia Zhang
- The First People's Hospital of Jingzhou, 40 Daqing Rd, Jingzhou, 434000, Hubei, China.
| | - Peng Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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29
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Pereira Barboza E, Nieuwenhuijsen M, Ambròs A, Sá THD, Mueller N. The impact of urban environmental exposures on health: An assessment of the attributable mortality burden in Sao Paulo city, Brazil. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 831:154836. [PMID: 35351512 DOI: 10.1016/j.scitotenv.2022.154836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 03/18/2022] [Accepted: 03/22/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Currently, more than half of the global population lives in cities. Contemporary urban planning practices result in environmental risk factors (e.g. air pollution, noise, lack of green space, excess heat) that put health and well-being of city dwellers at risk and contribute to chronic diseases and premature death. Despite a growing body of evidence on adverse health impacts related to current urban and transport planning practices, especially for cities in the Global North, not much is known about associated health impacts in South American cities. Therefore, we estimated the mortality burden attributable to breaching internationally-recommended or locally-preferable exposure levels of urban planning related environmental exposures in Sao Paulo, Brazil. METHODS We carried out a health impact assessment study, following the comparative risk assessment framework, to assess preventable mortality impacts of breaching exposure recommendations for air pollution, green spaces and temperature at the census tract (CT) level (n = 18,363). We also assessed the distribution thereof by socioeconomic vulnerability. RESULTS We estimated that annually 11,372 (95% CI: 7921; 15,910) attributable deaths could be prevented by complying with recommended exposure levels. The largest proportion of preventable mortality was due to breaching air pollution limits (i.e. 8409 attributable deaths), followed by insufficient green space (i.e. 2593), and excess heat (i.e. 370). Adverse health impacts were larger in CTs of lower socioeconomic vulnerability, due to demographic profile, traffic density and residential area configurations. DISCUSSION Not complying with the health limits for air pollution, green space and temperature exposures resulted in a considerable preventable mortality burden (i.e. 17% of total expected deaths) in Sao Paulo. This burden can be reduced by improving current urban and transport planning practices.
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Affiliation(s)
- Evelise Pereira Barboza
- Institute for Global Health (ISGlobal), Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; École de Hautes Etudes en Santé Publique (EHESP), France
| | - Mark Nieuwenhuijsen
- Institute for Global Health (ISGlobal), Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
| | - Albert Ambròs
- Institute for Global Health (ISGlobal), Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Thiago Herick de Sá
- Center for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, Brazil
| | - Natalie Mueller
- Institute for Global Health (ISGlobal), Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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Michetti M, Gualtieri M, Anav A, Adani M, Benassi B, Dalmastri C, D'Elia I, Piersanti A, Sannino G, Zanini G, Uccelli R. Climate change and air pollution: Translating their interplay into present and future mortality risk for Rome and Milan municipalities. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 830:154680. [PMID: 35314224 DOI: 10.1016/j.scitotenv.2022.154680] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 03/11/2022] [Accepted: 03/15/2022] [Indexed: 06/14/2023]
Abstract
Heat and cold temperatures associated with exposure to poor air quality lead to increased mortality. Using a generalized linear model with Poisson regression for overdispersion, this study quantifies the natural-caused mortality burden attributable to heat/cold temperatures and PM10 and O3 air pollutants in Rome and Milan, the two most populated Italian cities. We calculate local-specific mortality relative risks (RRs) for the period 2004-2015 considering the overall population and the most vulnerable age category (≥85 years). Combining a regional climate model with a chemistry-transport model under future climate and air pollution scenarios (RCP2.6 and RCP8.5), we then project mortality to 2050. Results show that for historical mortality the burden is much larger for cold than for warm temperatures. RR peaks during wintertime in Milan and summertime in Rome, highlighting the relevance of accounting for the effects of air pollution besides that of climate, in particular PM10 for Milan and O3 for Rome. Overall, Milan reports higher RRs while, in both cities, the elderly appear more susceptible to heat/cold and air pollution events than the average population. Two counterbalancing effects shape mortality in the future: an increase associated with higher and more frequent warmer daily temperatures - especially in the case of climate inaction - and a decrease due to declining cold-mortality burden. The outcomes highlight the urgent need to adopt more stringent and integrated climate and air quality policies to reduce the temperature and air pollution combined effects on health.
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Affiliation(s)
- M Michetti
- Division of Models and Technology for Risk Reduction, ENEA Centro Ricerche Bologna, Via Martiri di Monte Sole 4, 40129 Bologna, Italy.
| | - M Gualtieri
- Division of Models and Technology for Risk Reduction, ENEA Centro Ricerche Bologna, Via Martiri di Monte Sole 4, 40129 Bologna, Italy
| | - A Anav
- Division of Models and Technology for Risk Reduction, ENEA Centro Ricerche Roma Casaccia, Via Anguillarese 301, 00123 Santa Maria di Galeria, Rome, Italy
| | - M Adani
- Division of Models and Technology for Risk Reduction, ENEA Centro Ricerche Bologna, Via Martiri di Monte Sole 4, 40129 Bologna, Italy
| | - B Benassi
- Division of Health Protection Technologies, ENEA Centro Ricerche Roma Casaccia, Via Anguillarese 301, 00123 Santa Maria di Galeria, Rome, Italy
| | - C Dalmastri
- Division of Health Protection Technologies, ENEA Centro Ricerche Roma Casaccia, Via Anguillarese 301, 00123 Santa Maria di Galeria, Rome, Italy
| | - I D'Elia
- Division of Models and Technology for Risk Reduction, ENEA Centro Ricerche Roma, Lungotevere Thaon de Revel, 76, 00196 Rome, Italy
| | - A Piersanti
- Division of Models and Technology for Risk Reduction, ENEA Centro Ricerche Bologna, Via Martiri di Monte Sole 4, 40129 Bologna, Italy
| | - G Sannino
- Division of Models and Technology for Risk Reduction, ENEA Centro Ricerche Roma Casaccia, Via Anguillarese 301, 00123 Santa Maria di Galeria, Rome, Italy
| | - G Zanini
- Division of Models and Technology for Risk Reduction, ENEA Centro Ricerche Bologna, Via Martiri di Monte Sole 4, 40129 Bologna, Italy
| | - R Uccelli
- Division of Health Protection Technologies, ENEA Centro Ricerche Roma Casaccia, Via Anguillarese 301, 00123 Santa Maria di Galeria, Rome, Italy
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Koo GPY, Zheng H, Pek PP, Hughes F, Lim SL, Yeo JW, Ong MEH, Ho AFW. Clustering of Environmental Parameters and the Risk of Acute Myocardial Infarction. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148476. [PMID: 35886328 PMCID: PMC9318360 DOI: 10.3390/ijerph19148476] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 06/30/2022] [Accepted: 07/07/2022] [Indexed: 02/04/2023]
Abstract
The association between days with similar environmental parameters and cardiovascular events is unknown. We investigate the association between clusters of environmental parameters and acute myocardial infarction (AMI) risk in Singapore. Using k-means clustering and conditional Poisson models, we grouped calendar days from 2010 to 2015 based on rainfall, temperature, wind speed and the Pollutant Standards Index (PSI) and compared the incidence rate ratios (IRR) of AMI across the clusters using a time-stratified case-crossover design. Three distinct clusters were formed with Cluster 1 having high wind speed, Cluster 2 high rainfall, and Cluster 3 high temperature and PSI. Compared to Cluster 1, Cluster 3 had a higher AMI incidence with IRR 1.04 (95% confidence interval 1.01–1.07), but no significant difference was found between Cluster 1 and Cluster 2. Subgroup analyses showed that increased AMI incidence was significant only among those with age ≥65, male, non-smokers, non-ST elevation AMI (NSTEMI), history of hyperlipidemia and no history of ischemic heart disease, diabetes or hypertension. In conclusion, we found that AMI incidence, especially NSTEMI, is likely to be higher on days with high temperature and PSI. These findings have public health implications for AMI prevention and emergency health services delivery during the seasonal Southeast Asian transboundary haze.
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Affiliation(s)
| | - Huili Zheng
- National Registry of Diseases Office, Health Promotion Board, Singapore 168937, Singapore;
| | - Pin Pin Pek
- Health Services & Systems Research, Duke-NUS Medical School, Singapore 169857, Singapore; (P.P.P.); (M.E.H.O.)
| | - Fintan Hughes
- Department of Anesthesiology, Duke University Hospital, Duke University, Durham, NC 27710, USA;
| | - Shir Lynn Lim
- Department of Cardiology, National University Heart Centre Singapore, Singapore 119074, Singapore;
- Department of Medicine, National University Singapore, Singapore 119228, Singapore
| | - Jun Wei Yeo
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore;
| | - Marcus E. H. Ong
- Health Services & Systems Research, Duke-NUS Medical School, Singapore 169857, Singapore; (P.P.P.); (M.E.H.O.)
- Department of Emergency Medicine, Singapore General Hospital, Singapore 169608, Singapore
| | - Andrew F. W. Ho
- Department of Emergency Medicine, Singapore General Hospital, Singapore 169608, Singapore
- Pre-Hospital and Emergency Research Centre, Duke-NUS Medical School Singapore, Singapore 169857, Singapore
- Correspondence:
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Chen S, Dong H, Li M, Huang L, Lin G, Liu Q, Wang B, Yang J. Interactive Effects Between Temperature and PM 2.5 on Mortality: A Study of Varying Coefficient Distributed Lag Model - Guangzhou, Guangdong Province, China, 2013-2020. China CDC Wkly 2022; 4:570-576. [PMID: 35919455 PMCID: PMC9339355 DOI: 10.46234/ccdcw2022.124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Accepted: 06/17/2022] [Indexed: 11/24/2022] Open
Abstract
Introduction There is a large body of epidemiological evidence showing significantly increased mortality risks from air pollution and temperature. However, findings on the modification of the association between air pollution and mortality by temperature are mixed. Methods We used a varying coefficient distributed lag model to assess the complex interplay between air temperature and PM2.5 on daily mortality in Guangzhou City from 2013 to 2020, with the aim of establishing the PM2.5-mortality association at different temperatures and exploring synergetic mortality risks from PM2.5 and temperature on vulnerable populations.
Results We observed near-linear concentration-response associations between PM2.5 and mortality across different temperature levels. Each 10 μg/m³ increase of PM2.5 in low, medium, and high temperature strata was associated with increments of 0.73% [95% confidence interval (CI): 0.38%, 1.09%], 0.12% (95% CI: −0.27%, 0.52%), and 0.46% (95% CI: 0.11%, 0.81%) in non-accidental mortality, with a statistically significant difference between low and medium temperatures (P=0.02). There were significant modification effects of PM2.5 by low temperature for cardiovascular mortality and among individuals 75 years or older.
Conclusions Low temperatures may exacerbate physiological responses to short-term PM2.5 exposure in Guangzhou, China.
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Affiliation(s)
- Sujuan Chen
- Institute for Environmental and Climate Research, Jinan University, Guangzhou, Guangdong Province, China
| | - Hang Dong
- Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong Province, China
| | - Mengmeng Li
- Department of Cancer Prevention, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, China
| | - Lin Huang
- Institute for Environmental and Climate Research, Jinan University, Guangzhou, Guangdong Province, China
| | - Guozhen Lin
- Guangzhou Center for Disease Control and Prevention, Guangzhou, Guangdong Province, China
| | - Qiyong Liu
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Beijing, China
| | - Boguang Wang
- Institute for Environmental and Climate Research, Jinan University, Guangzhou, Guangdong Province, China
| | - Jun Yang
- School of Public Health, Guangzhou Medical University, Guangzhou, Guangdong Province, China
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Wu J, Ye Q, Fang L, Deng L, Liao T, Liu B, Lv X, Zhang J, Tao J, Ye D. Short-term association of NO 2 with hospital visits for chronic kidney disease and effect modification by temperature in Hefei, China: A time series study. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 237:113505. [PMID: 35462193 DOI: 10.1016/j.ecoenv.2022.113505] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 04/05/2022] [Accepted: 04/07/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND A large body of evidence has linked air pollution and temperature with chronic kidney disease (CKD) prevalence and hospitalizations. However, most studies have focused on the influence of heat stress on CKD prevalence, and the potential effect modification of temperature on the association between air pollution and CKD has not been well-investigated. In this study, we examined the associations of the whole temperature spectrum and air pollution with CKD-related hospital visits and explored whether temperature modifies the short-term association of air pollution with CKD-related hospital visits. METHODS AND FINDINGS We collected 40 276 CKD-related hospital visits from the first Affiliated Hospital of Anhui Medical University and Anhui Provincial Hospital in Hefei, China, during 2015-2019. A two-stage time-series design was conducted to investigate the associations of air pollution and daily mean temperature with CKD-related hospital visits. First, we estimated the associations between air pollution and CKD-related hospital visits as well as temperature and CKD-related hospital visits. Second, we analyzed the associations of air pollution with CKD hospital visits at different temperatures. We found that NO2 exposure and low temperature were associated with an increased risk of CKD-related hospital visits. Low temperature enhanced the association between NO2 exposure and CKD-related hospital visits, with an increase of 4.30% (95% CI: 2.47-5.92%) per 10 μg/m3 increment in NO2 at low temperature. Effect modification of the association between NO2 and the risk of CKD-related hospital visits was stronger at low temperature across the whole population. CONCLUSIONS Our findings indicate that low temperature-related chronic kidney damage should be of immediate public health concern. Impact of NO2 exposure on the risk of CKD-related hospital visits may increase under the low temperature, which suggests the need for NO2 exposure mitigation strategies in the context of climate change and an enhanced understanding of the mechanisms underlying the temperature variance of air pollution effect to help reduce the magnitude of the CKD burden on the healthcare systems.
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Affiliation(s)
- Jun Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - QianLing Ye
- Department of Oncology, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China
| | - LanLan Fang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - LiJun Deng
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - Tao Liao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - Bo Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - XiaoJie Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - Jie Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China
| | - JinHui Tao
- Department of Rheumatology & Immunology, Anhui Provincial Hospital, Hefei, Anhui, China.
| | - DongQing Ye
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, Hefei, Anhui, China.
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Michetti M, Adani M, Anav A, Benassi B, Dalmastri C, D'Elia I, Gualtieri M, Piersanti A, Sannino G, Uccelli R, Zanini G. From single to multivariable exposure models to translate climatic and air pollution effects into mortality risk. A customized application to the city of Rome, Italy. MethodsX 2022; 9:101717. [PMID: 35620759 PMCID: PMC9127213 DOI: 10.1016/j.mex.2022.101717] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 04/22/2022] [Indexed: 11/29/2022] Open
Abstract
This study presents an approach developed to derive a Delayed-Multivariate Exposure-Response Model (D-MERF) useful to assess the short-term influence of temperature on mortality, accounting also for the effect of air pollution (O3 and PM10). By using Distributed, lag non-linear models (DLNM) we explain how city-specific exposure-response functions are derived for the municipality of Rome, which is taken as an example. The steps illustrated can be replicated to other cities while the statistical model presented here can be further extended to other exposure variables. We derive the mortality relative-risk (RR) curve averaged over the period 2004–2015, which accounts for city-specific climate and pollution conditions. Key aspects of customization are as follows: This study reports the steps followed to derive a combined, multivariate exposure-response model aimed at translating climatic and air pollution effects into mortality risk. Integration of climate and air pollution parameters to derive RR values. A specific interest is devoted to the investigation of delayed effects on mortality in the presence of different exposure factors.
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Affiliation(s)
- M. Michetti
- Division of Models and Technology for Risk Reduction, ENEA Centro Ricerche Bologna, Via Martiri di Monte Sole 4, Bologna 40129, Italy
- Corresponding author.
| | - M. Adani
- Division of Models and Technology for Risk Reduction, ENEA Centro Ricerche Bologna, Via Martiri di Monte Sole 4, Bologna 40129, Italy
| | - A. Anav
- Division of Models and Technology for Risk Reduction, ENEA Centro Ricerche Roma Casaccia, Via Anguillarese 301, Rome, Santa Maria di Galeria 00123, Italy
| | - B. Benassi
- Division of Health Protection Technologies, ENEA Centro Ricerche Roma Casaccia, Via Anguillarese 301, Rome, Santa Maria di Galeria 00123, Italy
| | - C. Dalmastri
- Division of Health Protection Technologies, ENEA Centro Ricerche Roma Casaccia, Via Anguillarese 301, Rome, Santa Maria di Galeria 00123, Italy
| | - I. D'Elia
- Division of Models and Technology for Risk Reduction, ENEA Centro Ricerche Roma, Lungotevere Thaon de Revel, 76, Rome 00196, Italy
| | - M. Gualtieri
- Division of Models and Technology for Risk Reduction, ENEA Centro Ricerche Bologna, Via Martiri di Monte Sole 4, Bologna 40129, Italy
| | - A. Piersanti
- Division of Models and Technology for Risk Reduction, ENEA Centro Ricerche Bologna, Via Martiri di Monte Sole 4, Bologna 40129, Italy
| | - G. Sannino
- Division of Models and Technology for Risk Reduction, ENEA Centro Ricerche Roma Casaccia, Via Anguillarese 301, Rome, Santa Maria di Galeria 00123, Italy
| | - R. Uccelli
- Division of Health Protection Technologies, ENEA Centro Ricerche Roma Casaccia, Via Anguillarese 301, Rome, Santa Maria di Galeria 00123, Italy
| | - G. Zanini
- Division of Models and Technology for Risk Reduction, ENEA Centro Ricerche Bologna, Via Martiri di Monte Sole 4, Bologna 40129, Italy
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Fever SK, Kahl JDW, Kalkbrenner AE, Cerón Bretón RM, Cerón Bretón JG. A New Combined Air Quality and Heat Index in Relation to Mortality in Monterrey, Mexico. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063299. [PMID: 35328987 PMCID: PMC8948654 DOI: 10.3390/ijerph19063299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 03/04/2022] [Accepted: 03/09/2022] [Indexed: 12/10/2022]
Abstract
The negative synergistic effects of air pollution and sensible heat on public health have been noted in numerous studies. While separate, simplified, and public-facing indices have been developed to communicate the risks of unhealthful levels of air pollution and extreme heat, a combined index containing elements of both has rarely been investigated. Utilizing air quality, meteorology, and mortality data in Monterrey, Mexico, we investigated whether the association between the air quality index (AQI) and mortality was improved by considering elements of the heat index (HI). We created combined indices featuring additive, multiplicative, and either/or formulations and evaluated their relationship to mortality. Results showed increased associations with mortality for models employing indices that combined the AQI and the HI in an additive or multiplicative manner, with increases in the interquartile relative risk of 3-5% over that resulting from models employing the AQI alone.
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Affiliation(s)
- Shayna K. Fever
- Atmospheric Science Program, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA;
| | - Jonathan D. W. Kahl
- Atmospheric Science Program, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA;
- Correspondence:
| | - Amy E. Kalkbrenner
- Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA;
| | - Rosa M. Cerón Bretón
- Department of Chemistry, Autonomous University of Carmen, Campeche 24180, Mexico; (R.M.C.B.); (J.G.C.B.)
| | - Julia G. Cerón Bretón
- Department of Chemistry, Autonomous University of Carmen, Campeche 24180, Mexico; (R.M.C.B.); (J.G.C.B.)
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Wang W, Zhang W, Ge H, Chen B, Zhao J, Wu J, Kang Z, Guo X, Deng F, Ma Q. Association between air pollution and emergency room visits for eye diseases and effect modification by temperature in Beijing, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:22613-22622. [PMID: 34792769 DOI: 10.1007/s11356-021-17304-w] [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: 08/16/2021] [Accepted: 10/27/2021] [Indexed: 06/13/2023]
Abstract
The growing burden of eye disease worldwide has aroused increasing concern upon its environmental etiology. This study aims to evaluate the associations of air pollutants with emergency room visits for eye diseases and the effect modification by temperature. Based on 24,389 cases from a general hospital during 2014-2019 in Beijing, China, this study used generalized additive models to examine the associations of air pollutants and emergency room visits for total eye diseases (ICD10: H00-H59) and conjunctivitis (ICD10: H10). Short-term exposures to PM2.5, PM10, CO, and NO2 were associated with increased visits for total eye diseases and conjunctivitis, and stronger effect estimates were observed in high (>75th) temperature group for PM2.5, PM10, CO, and NO2 and low (<75th) temperature group for CO and NO2. For instance, a 10 μg/m3 increase in PM2.5 at lag0-1 were associated with a 0.73% (95% CI: 0.23%, 1.24%) increase in total eye disease visits and a 1.34% (95% CI: 0.55%, 2.13%) increase in conjunctivitis visits, respectively. Meanwhile, a 10 μg/m3 increase in PM2.5 was associated with a 1.57% (95% CI: 0.49%, 2.64%) change in high temperature group and a 0.48% (95% CI: -0.24%, 1.19%) change in medium temperature group (P for interaction = 0.04) in total eye disease visits. Our study emphasizes the importance of controlling the potential hazards of air pollutants on eyes, especially on days with relatively higher or colder temperature.
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Affiliation(s)
- Wanzhou Wang
- Emergency Department, Peking University Third Hospital, Beijing, 100191, China
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China
| | - Wenlou Zhang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China
| | - Hongxia Ge
- Emergency Department, Peking University Third Hospital, Beijing, 100191, China
| | - Baiqi Chen
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China
| | - Jingjing Zhao
- Emergency Department, Peking University Third Hospital, Beijing, 100191, China
| | - Jun Wu
- Emergency Department, Peking University Third Hospital, Beijing, 100191, China
| | - Zefeng Kang
- Eye Hospital of China Academy of Chinese Medical Sciences, Beijing, 100040, China.
| | - Xinbiao Guo
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China
| | - Furong Deng
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China.
| | - Qingbian Ma
- Emergency Department, Peking University Third Hospital, Beijing, 100191, China.
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Zhu Q, Zhang M, Hu Y, Xu X, Tao L, Zhang J, Luo Y, Guo X, Liu X. Research on prediction of daily admissions of respiratory diseases with comorbid diabetes in Beijing based on long short-term memory recurrent neural network. Zhejiang Da Xue Xue Bao Yi Xue Ban 2022; 51:1-9. [PMID: 35576109 PMCID: PMC9109758 DOI: 10.3724/zdxbyxb-2021-0227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 12/08/2021] [Indexed: 06/15/2023]
Abstract
To compare the performance of generalized additive model (GAM) and long short-term memory recurrent neural network (LSTM-RNN) on the prediction of daily admissions of respiratory diseases with comorbid diabetes. Daily data on air pollutants, meteorological factors and hospital admissions for respiratory diseases from Jan 1st, 2014 to Dec 31st, 2019 in Beijing were collected. LSTM-RNN was used to predict the daily admissions of respiratory diseases with comorbid diabetes, and the results were compared with those of GAM. The evaluation indexes were calculated by five-fold cross validation. Compared with the GAM, the prediction errors of LSTM-RNN were significantly lower [root mean squared error (RMSE): 21.21±3.30 vs. 46.13±7.60, <0.01; mean absolute error (MAE): 14.64±1.99 vs. 36.08±6.20, <0.01], and the value was significantly higher (0.79±0.06 vs. 0.57±0.12, <0.01). In gender stratification, RMSE, MAE and values of LSTM-RNN were better than those of GAM in predicting female admission (all <0.05), but there were no significant difference in predicting male admission between two models (all >0.05). In seasonal stratification, RMSE and MAE of LSTM-RNN were lower than those of GAM in predicting warm season admission (all <0.05), but there was no significant difference in value (>0.05). There were no significant difference in RMSE, MAE and between the two models in predicting cold season admission (all >0.05). In the stratification of functional areas, the RMSE, MAE and values of LSTM-RNN were better than those of GAM in predicting core area admission (all <0.05). has lower prediction errors and better fitting than the GAM, which can provide scientific basis for precise allocation of medical resources in polluted weather in advance.
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Affiliation(s)
- Qian Zhu
- 1. School of Public Health, Capital Medical University, Beijing 100069, China
| | - Meng Zhang
- 1. School of Public Health, Capital Medical University, Beijing 100069, China
| | - Yaoyu Hu
- 1. School of Public Health, Capital Medical University, Beijing 100069, China
| | - Xiaolin Xu
- 2. School of Public Health, Zhejiang University School of Medicine, Hangzhou 310058, China
- 3. The University of Queensland, Brisbane 4006, Australia
| | - Lixin Tao
- 1. School of Public Health, Capital Medical University, Beijing 100069, China
- Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China
| | - Jie Zhang
- 1. School of Public Health, Capital Medical University, Beijing 100069, China
- Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China
| | - Yanxia Luo
- 1. School of Public Health, Capital Medical University, Beijing 100069, China
- Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China
| | - Xiuhua Guo
- 1. School of Public Health, Capital Medical University, Beijing 100069, China
- Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China
| | - Xiangtong Liu
- 1. School of Public Health, Capital Medical University, Beijing 100069, China
- Municipal Key Laboratory of Clinical Epidemiology, Beijing 100069, China
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Abstract
PURPOSE OF REVIEW With cardiovascular disease (CVD) being the top cause of deaths worldwide, it is important to ensure healthy cardiovascular aging through enhanced understanding and prevention of adverse health effects exerted by external factors. This review aims to provide an updated understanding of environmental influences on cardiovascular aging, by summarizing epidemiological and mechanistic evidence for the cardiovascular health impact of major environmental stressors, including air pollution, endocrine-disrupting chemicals (EDCs), metals, and climate change. RECENT FINDINGS Recent studies generally support positive associations of exposure to multiple chemical environmental stressors (air pollution, EDCs, toxic metals) and extreme temperatures with increased risks of cardiovascular mortality and morbidity in the population. Environmental stressors have also been associated with a number of cardiovascular aging-related subclinical changes including biomarkers in the population, which are supported by evidence from relevant experimental studies. The elderly and patients are the most vulnerable demographic groups to majority environmental stressors. Future studies should account for the totality of individuals' exposome in addition to single chemical pollutants or environmental factors. Specific factors most responsible for the observed health effects related to cardiovascular aging remain to be elucidated.
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Affiliation(s)
- Yang Lan
- Department of Occupational and Environmental Health, School of Public Health, Xi'an Jiaotong University Health Science Center, 76 Yanta West Road, Yanta District, Xi'an City, Shaanxi Province, 710061, People's Republic of China
- Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, Xi'an, Shaanxi, China
- Key Laboratory of Trace Elements and Endemic Diseases in Ministry of Health, Xi'an, Shaanxi, China
| | - Shaowei Wu
- Department of Occupational and Environmental Health, School of Public Health, Xi'an Jiaotong University Health Science Center, 76 Yanta West Road, Yanta District, Xi'an City, Shaanxi Province, 710061, People's Republic of China.
- Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, Xi'an, Shaanxi, China.
- Key Laboratory of Trace Elements and Endemic Diseases in Ministry of Health, Xi'an, Shaanxi, China.
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Wine O, Osornio Vargas A, Campbell SM, Hosseini V, Koch CR, Shahbakhti M. Cold Climate Impact on Air-Pollution-Related Health Outcomes: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1473. [PMID: 35162495 PMCID: PMC8835073 DOI: 10.3390/ijerph19031473] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/14/2022] [Accepted: 01/24/2022] [Indexed: 01/05/2023]
Abstract
In cold temperatures, vehicles idle more, have high cold-start emissions including greenhouse gases, and have less effective exhaust filtration systems, which can cause up to ten-fold more harmful vehicular emissions. Only a few vehicle technologies have been tested for emissions below -7 °C (20 °F). Four-hundred-million people living in cities with sub-zero temperatures may be impacted. We conducted a scoping review to identify the existing knowledge about air-pollution-related health outcomes in a cold climate, and pinpoint any research gaps. Of 1019 papers identified, 76 were selected for review. The papers described short-term health impacts associated with air pollutants. However, most papers removed the possible direct effect of temperature on pollution and health by adjusting for temperature. Only eight papers formally explored the modifying effect of temperatures. Five studies identified how extreme cold and warm temperatures aggravated mortality/morbidity associated with ozone, particles, and carbon-monoxide. The other three found no health associations with tested pollutants and temperature. Additionally, in most papers, emissions could not be attributed solely to traffic. In conclusion, evidence on the relationship between cold temperatures, traffic-related pollution, and related health outcomes is lacking. Therefore, targeted research is required to guide vehicle regulations, assess extreme weather-related risks in the context of climate change, and inform public health interventions.
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Affiliation(s)
- Osnat Wine
- Department of Mechanical Engineering, Faculty of Engineering, University of Alberta, Edmonton, AB T6G 1H9, Canada; (O.W.); (C.R.K.)
| | - Alvaro Osornio Vargas
- Department of Paediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB T6G 1C9, Canada;
| | - Sandra M. Campbell
- Health Sciences Library, University of Alberta, Edmonton, AB T6G 2R7, Canada;
| | - Vahid Hosseini
- School of Sustainable Energy Engineering, Simon Fraser University, Surrey, BC V3T 0N1, Canada;
| | - Charles Robert Koch
- Department of Mechanical Engineering, Faculty of Engineering, University of Alberta, Edmonton, AB T6G 1H9, Canada; (O.W.); (C.R.K.)
| | - Mahdi Shahbakhti
- Department of Mechanical Engineering, Faculty of Engineering, University of Alberta, Edmonton, AB T6G 1H9, Canada; (O.W.); (C.R.K.)
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Meng C, Ke F, Xiao Y, Huang S, Duan Y, Liu G, Yu S, Fu Y, Peng J, Cheng J, Yin P. Effect of Cold Spells and Their Different Definitions on Mortality in Shenzhen, China. Front Public Health 2022; 9:817079. [PMID: 35141195 PMCID: PMC8818748 DOI: 10.3389/fpubh.2021.817079] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 12/30/2021] [Indexed: 11/18/2022] Open
Abstract
A high premium has been put on researching the effects of cold spells because of their adverse influence on people's daily lives and health. The study aimed to find the most appropriate definition of the cold spell in Shenzhen and quantify the impact of cold spells on mortality. Based on the daily mortality data in Shenzhen from 2013 to 2017 and the meteorological and pollutant data from the same period, we quantified the effect of cold spells using eight different definitions in the framework of a distributed lag non-linear model with a quasi-Poisson distribution. In Shenzhen, low temperatures increase the risk of death more significantly than high temperatures (using the optimal temperature as the cut-off value). Comparing the quasi-Akaike information criterion value, attribution fraction (b-AF), and attribution number (b-AN) for all causes of deaths and non-accidental deaths, the optimal definition of the cold spell was defined as the threshold was 3rd percentile of the daily average temperature and duration for 3 or more consecutive days (all causes: b-AF = 2.31% [1.01–3.50%], b-AN = 650; non-accidental: b-AF = 1.92% [0.57–3.17%], b-AN = 471). For cardiovascular deaths, the best definition was the temperature threshold as the 3rd percentile of the daily average temperature with a duration of 4 consecutive days (cardiovascular: b-AF = 1.37% [0.05–2.51%], b-AN = 142). Based on the best definition in the model, mortality risk increased in cold spells, with a statistically significant lag effect occurring as early as the 4th day and the effect of a single day lasting for 6 days. The maximum cumulative effect occurred on the 14th day (all-cause: RR = 1.54 [95% CI, 1.20–1.98]; non-accidental: RR = 1.43 [95% CI, 1.11–1.84]; cardiovascular: RR = 1.58 [95% CI, 1.00–2.48]). The elderly and females were more susceptible to cold spells. Cold spells and their definitions were associated with an increased risk of death. The findings of this research provide information for establishing an early warning system, developing preventive measures, and protecting susceptible populations.
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Affiliation(s)
- Chengzhen Meng
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fang Ke
- Children's Health Care Hospital, Wuhan, China
| | - Yao Xiao
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Suli Huang
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Yanran Duan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Gang Liu
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Shuyuan Yu
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Yingbin Fu
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
| | - Ji Peng
- Shenzhen Center for Chronic Disease Control, Shenzhen, China
- *Correspondence: Ji Peng
| | - Jinquan Cheng
- Shenzhen Center for Disease Control and Prevention, Shenzhen, China
- Jinquan Cheng
| | - Ping Yin
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Ping Yin
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Fann N, Coffman E, Jackson M, Jhun I, Lamichhane A, Nolte CG, Roman H, Sacks JD. The Role of Temperature in Modifying the Risk of Ozone-Attributable Mortality under Future Changes in Climate: A Proof-of-Concept Analysis. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2022; 56:1202-1210. [PMID: 34965106 PMCID: PMC9359214 DOI: 10.1021/acs.est.1c05975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Air pollution risk assessments typically estimate ozone-attributable mortality counts using concentration-response (C-R) parameters from epidemiologic studies that treat temperature as a potential confounder. However, some recent epidemiologic studies have indicated that temperature can modify the relationship between short-term ozone exposure and mortality, which has potentially important implications when considering the impacts of climate change on public health. This proof-of-concept analysis quantifies counts of temperature-modified ozone-attributable mortality using temperature-stratified C-R parameters from a multicity study in which the pooled ozone-mortality effect coefficients change in concert with daily temperature. Meteorology downscaled from two global climate models is used with a photochemical transport model to simulate ozone concentrations over the 21st century using two emission inventories: one holding air pollutant emissions constant at 2011 levels and another accounting for reduced emissions through the year 2040. The late century climate models project increased summer season temperatures, which in turn yields larger total counts of ozone-attributable deaths in analyses using temperature-stratified C-R parameters compared to the traditional temperature confounder approach. This analysis reveals substantial heterogeneity in the magnitude and distribution of the temperature-stratified ozone-attributable mortality results, which is a function of regional variability in both the C-R relationship and the model-predicted temperature and ozone.
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Affiliation(s)
- Neal Fann
- U.S. EPA Office of Air Quality Planning and Standards,
Research Triangle Park NC 27711 USA
| | - Evan Coffman
- U.S. EPA Office of Research and Development, Research
Triangle Park, NC 27711 USA
| | | | - Iny Jhun
- Stanford Health Care, San Francisco, CA 94305 USA
| | - Archana Lamichhane
- U.S. EPA Office of Air Quality Planning and Standards,
Research Triangle Park NC 27711 USA
| | - Christopher G. Nolte
- U.S. EPA Office of Research and Development, Research
Triangle Park, NC 27711 USA
| | - Henry Roman
- Industrial Economics Inc, Cambridge, MA 02140 USA
| | - Jason D. Sacks
- U.S. EPA Office of Research and Development, Research
Triangle Park, NC 27711 USA
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Yu X, Miao H, Zeng Q, Wu H, Chen Y, Guo P, Zhu Y. Associations between ambient heat exposure early in pregnancy and risk of congenital heart defects: a large population-based study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:7627-7638. [PMID: 34476711 DOI: 10.1007/s11356-021-16237-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 08/25/2021] [Indexed: 02/05/2023]
Abstract
Some epidemiological studies have confirmed the association between environmental factors and congenital heart defects (CHD). While the possibility that maternal ambient heat exposures are related to CHD has received little attention. Our study aims to investigate the association between maternal ambient extreme heat exposure early in pregnancy and the risk of CHD in offspring in China. We conducted a retrospective cohort study of 1,918,105 fetuses between 2 and 8 weeks after gestation from May to October in Guangdong, China, 2015-2019. The main heat exposure was defined as extreme heat events (EHE) by using the 90th (EHE90) or 95th (EHE95) percentile of the daily maximum temperature. For each EHE definition, we further defined four indicators: having EHE or not, frequency, duration, and cumulative days. We used the log-binomial regression models to calculate the prevalence ratios (PR) of CHD with 95% confidence intervals (CI) for the associations between CHD and EHE, adjusted for potentially confounding covariates. There are 1,918,105 infants included in the study, of which 9588 had CHD, with a prevalence rate of 499.9 per 100,000 (95% CI: 489.9, 509.8). We found that all EHE indicators were positively associated with the increased risks of overall CHD, some CHD classes (congenital malformations of cardiac septa, congenital malformations of great arteries, and congenital malformations of great arteries), and some CHD subtypes (atrial septal defect and patent ductus arteriosus). In addition, the PR yielded higher estimates when exposing to EHE95. For instance, the risk of suffering congenital malformations of great arteries was 1.548 (95% CI: 1.401, 1.712) for EHE90 exposure and 1.723 (95% CI: 1.565, 1.898) for EHE95 exposure, respectively. Our study demonstrated that EHE during 2-8 weeks postconception was associated with overall CHD in offspring, particularly atrial septal defects and patent ductus arteriosus. The associations strengthened with the extent and cumulative days of maternal exposure to EHE.
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Affiliation(s)
- Xiaolin Yu
- Department of Preventive Medicine, Shantou University Medical College, Shantou, 515041, China
| | - Huazhang Miao
- Department of Healthcare, Guangdong Women and Children Hospital, No. 521 Xingnan Road, Guangzhou, 511442, China
- School of Health Management, Southern Medical University, Guangzhou, 510515, Guangdong Province, China
| | - Qinghui Zeng
- Department of Preventive Medicine, Shantou University Medical College, Shantou, 515041, China
| | - Haisheng Wu
- Department of Preventive Medicine, Shantou University Medical College, Shantou, 515041, China
| | - Yuliang Chen
- Department of Preventive Medicine, Shantou University Medical College, Shantou, 515041, China
| | - Pi Guo
- Department of Preventive Medicine, Shantou University Medical College, Shantou, 515041, China.
- Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou, 515041, China
| | - Yingxian Zhu
- Department of Healthcare, Guangdong Women and Children Hospital, No. 521 Xingnan Road, Guangzhou, 511442, China
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Qiu B, Zhou M, Qiu Y, Ma Y, Ma C, Tu J, Li S. An Integration Method for Regional PM 2.5 Pollution Control Optimization Based on Meta-Analysis and Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:ijerph19010344. [PMID: 35010605 PMCID: PMC8750964 DOI: 10.3390/ijerph19010344] [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: 11/08/2021] [Revised: 12/10/2021] [Accepted: 12/22/2021] [Indexed: 05/06/2023]
Abstract
PM2.5 pollution in China is becoming increasingly severe, threatening public health. The major goal of this study is to evaluate the mortality rate attributed to PM2.5 pollution and design pollution mitigation schemes in a southern district of China through a two-objective optimization model. The mortality rate is estimated by health effect evaluation model. Subjected to limited data information, it is assumed that the meta-analysis method, through summarizing and combining the research results on the same subject, was suitable to estimate the percentage of deaths caused by PM2.5 pollution. The critical parameters, such as the total number of deaths and the background concentration of PM2.5, were obtained through on-site survey, data collection, literature search, policy analysis, and expert consultation. The equations for estimating the number of deaths caused by PM2.5 pollution were established by incorporating the relationship coefficient of exposure to reaction, calculated residual PM2.5 concentration of affected region, and statistical total base number of deaths into a general framework. To balance the cost from air quality improvement and human health risks, a two-objective optimization model was developed. The first objective is to minimize the mortality rate attributable to PM2.5 pollution, and the second objective is to minimize the total system cost over three periods. The optimization results demonstrated that the combination of weights assigned to the two objectives significantly influenced the model output. For example, a high weight value assigned to minimizing the number of deaths results in the increased use of treatment techniques with higher efficiencies and a dramatic decrease in pollutant concentrations. In contrast, a model weighted more toward minimizing economic loss may lead to an increase in the death toll due to exposure to higher air pollution levels. The effective application of this model in the Nanshan District of Shenzhen City, China, is expected to serve as a basis for similar work in other parts of the world in the future.
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Affiliation(s)
- Bingkui Qiu
- Department of Tourism Management, Jin Zhong University, Jinzhong 033619, China;
| | - Min Zhou
- College of Public Administration, Huazhong University of Science and Technology, Wuhan 430074, China; (Y.M.); (C.M.); (J.T.); (S.L.)
- Correspondence: ; Tel./Fax: +86-27-87543047
| | - Yang Qiu
- Department of Economics, University of Warwick, Coventry CV4 7AL, UK;
| | - Yuxiang Ma
- College of Public Administration, Huazhong University of Science and Technology, Wuhan 430074, China; (Y.M.); (C.M.); (J.T.); (S.L.)
| | - Chaonan Ma
- College of Public Administration, Huazhong University of Science and Technology, Wuhan 430074, China; (Y.M.); (C.M.); (J.T.); (S.L.)
| | - Jiating Tu
- College of Public Administration, Huazhong University of Science and Technology, Wuhan 430074, China; (Y.M.); (C.M.); (J.T.); (S.L.)
| | - Siqi Li
- College of Public Administration, Huazhong University of Science and Technology, Wuhan 430074, China; (Y.M.); (C.M.); (J.T.); (S.L.)
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Klompmaker JO, Hart JE, James P, Sabath MB, Wu X, Zanobetti A, Dominici F, Laden F. Air pollution and cardiovascular disease hospitalization - Are associations modified by greenness, temperature and humidity? ENVIRONMENT INTERNATIONAL 2021; 156:106715. [PMID: 34218186 PMCID: PMC8380672 DOI: 10.1016/j.envint.2021.106715] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 06/03/2021] [Accepted: 06/10/2021] [Indexed: 05/19/2023]
Abstract
BACKGROUND Studies have observed associations between long-term air pollution and cardiovascular disease hospitalization. Little is known, however, about effect modification of these associations by greenness, temperature and humidity. METHODS We constructed an open cohort consisting of all fee-for-service Medicare beneficiaries, aged ≥ 65, living in the contiguous US from 2000 through 2016 (~63 million individuals). We assigned annual average PM2.5, NO2 and ozone zip code concentrations. Cox-equivalent Poisson models were used to estimate associations with first cardiovascular disease (CVD), coronary heart disease (CHD) and cerebrovascular disease (CBV) hospitalization. RESULTS PM2.5 and NO2 were both positively associated with CVD, CHD and CBV hospitalization, after adjustment for potential confounders. Associations were substantially stronger at the lower end of the exposure distributions. For CVD hospitalization, the hazard ratio (HR) of PM2.5 was 1.041 (1.038, 1.045) per IQR increase (4.0 µg/m3) in the full study population and 1.327 (1.305, 1.350) per IQR increase for a subgroup with annual exposures always below 10 µg/m3 PM2.5. Ozone was only positively associated with CVD, CHD and CBV hospitalization for the low-exposure subgroup (<40 ppb). Associations of PM2.5 were stronger in areas with higher greenness, lower ozone and Ox, lower summer and winter temperature and lower summer and winter specific humidity. CONCLUSION PM2.5 and NO2 were positively associated with CVD, CHD and CBV hospitalization. Associations were more pronounced at low exposure levels. Associations of PM2.5 were stronger with higher greenness, lower ozone and Ox, lower temperature and lower specific humidity.
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Affiliation(s)
- Jochem O Klompmaker
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, 655 Huntington Avenue, Boston, MA 02115, United States.
| | - Jaime E Hart
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, 655 Huntington Avenue, Boston, MA 02115, United States; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA 02115, United States
| | - Peter James
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, 655 Huntington Avenue, Boston, MA 02115, United States; Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, 401 Park Drive, Boston, MA 02215, United States
| | - M Benjamin Sabath
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, United States
| | - Xiao Wu
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, United States
| | - Antonella Zanobetti
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, 655 Huntington Avenue, Boston, MA 02115, United States
| | - Francesca Dominici
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, United States
| | - Francine Laden
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, 655 Huntington Avenue, Boston, MA 02115, United States; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, 181 Longwood Avenue, Boston, MA 02115, United States; Department of Epidemiology, Harvard T. H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, United States
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Wu DW, Chen SC, Tu HP, Wang CW, Hung CH, Chen HC, Kuo TY, Wang CF, Lai BC, Chen PS, Kuo CH. The Impact of the Synergistic Effect of Temperature and Air Pollutants on Chronic Lung Diseases in Subtropical Taiwan. J Pers Med 2021; 11:jpm11080819. [PMID: 34442463 PMCID: PMC8401456 DOI: 10.3390/jpm11080819] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 08/09/2021] [Accepted: 08/20/2021] [Indexed: 12/11/2022] Open
Abstract
Previous studies have suggested an association between air pollution and lung disease. However, few studies have explored the relationship between chronic lung diseases classified by lung function and environmental parameters. This study aimed to comprehensively investigate the relationship between chronic lung diseases, air pollution, meteorological factors, and anthropometric indices. We conducted a cross-sectional study using the Taiwan Biobank and the Taiwan Air Quality Monitoring Database. A total of 2889 participants were included. We found a V/U-shaped relationship between temperature and air pollutants, with significant effects at both high and low temperatures. In addition, at lower temperatures (<24.6 °C), air pollutants including carbon monoxide (CO) (adjusted OR (aOR):1.78/Log 1 ppb, 95% CI 0.98–3.25; aOR:5.35/Log 1 ppb, 95% CI 2.88–9.94), nitrogen monoxide (NO) (aOR:1.05/ppm, 95% CI 1.01–1.09; aOR:1.11/ppm, 95% CI 1.07–1.15), nitrogen oxides (NOx) (aOR:1.02/ppm, 95% CI 1.00–1.05; aOR:1.06/ppm, 95% CI 1.04–1.08), and sulfur dioxide (SO2) (aOR:1.29/ppm, 95% CI 1.01–1.65; aOR:1.77/ppm, 95% CI 1.36–2.30) were associated with restrictive and mixed lung diseases, respectively. Exposure to CO, NO, NO2, NOx and SO2 significantly affected obstructive and mixed lung disease in southern Taiwan. In conclusion, temperature and air pollution should be considered together when evaluating the impact on chronic lung diseases.
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Affiliation(s)
- Da-Wei Wu
- Doctoral Degree Program, Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan; (S.-C.C.); (C.-W.W.); (H.-C.C.); (T.-Y.K.); (C.-H.K.)
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
| | - Szu-Chia Chen
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan; (S.-C.C.); (C.-W.W.); (H.-C.C.); (T.-Y.K.); (C.-H.K.)
- Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Hung-Pin Tu
- Department of Public Health and Environmental Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
| | - Chih-Wen Wang
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan; (S.-C.C.); (C.-W.W.); (H.-C.C.); (T.-Y.K.); (C.-H.K.)
- Division of Hepatobiliary, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Chih-Hsing Hung
- Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
- Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Department of Pediatrics, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Huang-Chi Chen
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan; (S.-C.C.); (C.-W.W.); (H.-C.C.); (T.-Y.K.); (C.-H.K.)
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Tzu-Yu Kuo
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan; (S.-C.C.); (C.-W.W.); (H.-C.C.); (T.-Y.K.); (C.-H.K.)
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Chen-Feng Wang
- Department of Electronics Engineering, National Yang Ming Chiao Tung University, Hsinchu 300, Taiwan; (C.-F.W.); (B.-C.L.)
| | - Bo-Cheng Lai
- Department of Electronics Engineering, National Yang Ming Chiao Tung University, Hsinchu 300, Taiwan; (C.-F.W.); (B.-C.L.)
| | - Pei-Shih Chen
- Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
- Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Institute of Environmental Engineering, College of Engineering, National Sun Yat-Sen University, Kaohsiung 807, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan
- Correspondence: ; Tel.: +886-7-312-1101 (ext. 2141-34); Fax: +886-7-311-0811
| | - Chao-Hung Kuo
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan; (S.-C.C.); (C.-W.W.); (H.-C.C.); (T.-Y.K.); (C.-H.K.)
- Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
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Wang X, Leng M, Liu Y, Qian ZM, Zhang J, Li Z, Sun L, Qin L, Wang C, Howard SW, Vaughn MG, Yan Y, Lin H. Different sized particles associated with all-cause and cause-specific emergency ambulance calls: A multicity time-series analysis in China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 783:147060. [PMID: 34088160 DOI: 10.1016/j.scitotenv.2021.147060] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 04/06/2021] [Accepted: 04/07/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Compared with mortality and hospital admission, emergency ambulance calls (EACs) could be a more accurate outcome indicator to reflect the health effects of short-term air pollution exposure. However, such studies have been scarce, especially on a multicity scale in China. METHODS We estimated the associations of different diameter particles [i.e., inhalable particulate matter (PM10), coarse particulate matter (PMc), and fine particulate matter (PM2.5)] with EACs for all-cause, cardiovascular, and respiratory diseases in seven Chinese cities. We collected data on EACs and air pollution from 2014 to 2019. We used generalized additive models and random-effects meta-analysis to examine the city-specific and overall associations. Stratified analyses were conducted to examine the effect modifications of gender, age, and season. RESULTS Significant associations of PM10 and PM2.5 with EACs were observed, while the PMc associations were positive but not statistically significant in most analyses. Specifically, each 10 μg/m3 increase in 2-day moving average concentration of PM10 was associated with a 0.25% [95% confidence interval (CI): 0.04%, 0.47%] increase in all-cause EACs, 0.13% (95% CI: -0.01%, 0.26%) in cardiovascular EACs, and 0.35% (95% CI: 0.04%, 0.66%) in respiratory EACs. The corresponding increases in daily EACs for PM2.5 were 0.30% (95% CI, 0.03%, 0.57%), 0.13% (95% CI, -0.07%, 0.33%), and 0.46% (95% CI, 0.01%, 0.92%). Season of the year also modifies the association between particulate matter pollution and EACs. CONCLUSIONS Short-term exposure to PM10 and PM2.5 were positively associated with daily all-cause and respiratory-related EACs. The associations were stronger during warm season than cold season. Our findings suggest that the most harmful fraction of particulate matter pollution is PM2.5, which has important implications for current air quality guidelines and regulations in China.
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Affiliation(s)
- Xiaojie Wang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Meifang Leng
- Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Yixuan Liu
- Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Zhengmin Min Qian
- College for Public Health & Social Justice, Saint Louis University, USA
| | - Junguo Zhang
- Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Ziyi Li
- Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Liwen Sun
- Huairou District Center for Disease Control and Prevention, Beijing, China
| | - Lijie Qin
- Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Steven W Howard
- College for Public Health & Social Justice, Saint Louis University, USA
| | - Michael G Vaughn
- College for Public Health & Social Justice, Saint Louis University, USA
| | - Yue Yan
- Cancer Prevention Center, Sun Yat-sen University Cancer Center, Guangzhou, China..
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.
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47
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Jiang W, Liu Z, Ni B, Xie W, Zhou H, Li X. Independent and interactive effects of air pollutants and ambient heat exposure on congenital heart defects. Reprod Toxicol 2021; 104:106-113. [PMID: 34311057 DOI: 10.1016/j.reprotox.2021.07.007] [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: 05/09/2021] [Revised: 07/10/2021] [Accepted: 07/19/2021] [Indexed: 12/16/2022]
Abstract
Accumulating studies have been focused on the independent effects of air pollutants and ambient heat exposure on congenital heart defects (CHDs) but with inconsistent results, and their interactive effect remains unclear. A case-control study including 921 cases and 9210 controls was conducted in Changsha, China in warm season in 2015-2018. The gravidas were assigned monthly averages of daily air pollutants and daily maximum temperature using the nearest monitoring station method and city-wide average method, respectively, during the first trimester of pregnancy. Multivariate logistic regression models were used to estimate the independent effects of each air pollutant and different ambient heat exposure indicators. Their additive joint effects were quantified using attribute proportions of interaction (API). Increasing SO2 consistently increased the risk of CHDs in the first trimester of pregnancy, with aORs ranging from 1.78 to 2.04. CO, NO2 and PM2.5 exposure in the first month of pregnancy, and O3 exposure in the second and third month of pregnancy were also associated with elevated risks of CHDs, with aORs ranging from 1.04 to 1.15. Depending on the ambient heat exposure indicator used, air pollutants showed more apparent synergistic effects (API > 0) with less and moderately intense heat exposure. Maternal exposure to CO, NO2, SO2, PM2.5 and O3 during early pregnancy increased risk of CHDs, and ambient heat exposure may enhance these effects. Our findings help to understand the interactive effect of air pollution with ambient heat exposure on CHDs, which is of vital public health significance.
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Affiliation(s)
- Wen Jiang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China.
| | - Zhiyu Liu
- Maternal and Child Health Care Hospital of Hunan Province, Changsha, China.
| | - Bin Ni
- Maternal and Child Health Care Hospital of Hunan Province, Changsha, China.
| | - Wanqin Xie
- Maternal and Child Health Care Hospital of Hunan Province, Changsha, China.
| | - Haiyan Zhou
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China.
| | - Xingli Li
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China.
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48
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Martins A, Scotto M, Deus R, Monteiro A, Gouveia S. Association between respiratory hospital admissions and air quality in Portugal: A count time series approach. PLoS One 2021; 16:e0253455. [PMID: 34242247 PMCID: PMC8270143 DOI: 10.1371/journal.pone.0253455] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 06/07/2021] [Indexed: 11/25/2022] Open
Abstract
Although regulatory improvements for air quality in the European Union have been made, air pollution is still a pressing problem and, its impact on health, both mortality and morbidity, is a topic of intense research nowadays. The main goal of this work is to assess the impact of the exposure to air pollutants on the number of daily hospital admissions due to respiratory causes in 58 spatial locations of Portugal mainland, during the period 2005-2017. To this end, INteger Generalised AutoRegressive Conditional Heteroskedastic (INGARCH)-based models are extensively used. This family of models has proven to be very useful in the analysis of serially dependent count data. Such models include information on the past history of the time series, as well as the effect of external covariates. In particular, daily hospitalisation counts, air quality and temperature data are endowed within INGARCH models of optimal orders, where the automatic inclusion of the most significant covariates is carried out through a new block-forward procedure. The INGARCH approach is adequate to model the outcome variable (respiratory hospital admissions) and the covariates, which advocates for the use of count time series approaches in this setting. Results show that the past history of the count process carries very relevant information and that temperature is the most determinant covariate, among the analysed, for daily hospital respiratory admissions. It is important to stress that, despite the small variability explained by air quality, all models include on average, approximately two air pollutants covariates besides temperature. Further analysis shows that the one-step-ahead forecasts distributions are well separated into two clusters: one cluster includes locations exclusively in the Lisbon area (exhibiting higher number of one-step-ahead hospital admissions forecasts), while the other contains the remaining locations. This results highlights that special attention must be given to air quality in Lisbon metropolitan area in order to decrease the number of hospital admissions.
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Affiliation(s)
- Ana Martins
- Institute of Electronics and Informatics Engineering of Aveiro (IEETA) and Department of Electronics, Telecommunications and Informatics (DETI), University of Aveiro, Aveiro, Portugal
| | - Manuel Scotto
- Center for Computational and Stochastic Mathematics (CEMAT), Department of Mathematics, IST, University of Lisbon, Lisbon, Portugal
| | - Ricardo Deus
- Instituto Português do Mar e da Atmosfera, I.P. (IPMA, I.P.), Lisbon, Portugal
| | - Alexandra Monteiro
- CESAM, Department of Environment and Planning, University of Aveiro, Aveiro, Portugal
| | - Sónia Gouveia
- Institute of Electronics and Informatics Engineering of Aveiro (IEETA) and Department of Electronics, Telecommunications and Informatics (DETI), University of Aveiro, Aveiro, Portugal
- Center for R&D in Mathematics and Applications (CIDMA), University of Aveiro, Aveiro, Portugal
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49
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Zhang H, Wang Q, Benmarhnia T, Jalaludin B, Shen X, Yu Z, Ren M, Liang Q, Wang J, Ma W, Huang C. Assessing the effects of non-optimal temperature on risk of gestational diabetes mellitus in a cohort of pregnant women in Guangzhou, China. ENVIRONMENT INTERNATIONAL 2021; 152:106457. [PMID: 33706037 DOI: 10.1016/j.envint.2021.106457] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 01/12/2021] [Accepted: 02/08/2021] [Indexed: 06/12/2023]
Abstract
Previous observational studies have shown that exposure to ambient temperature and air pollution were associated with the incidence of gestational diabetes mellitus (GDM). However, the susceptible time window of non-optimal temperature on GDM is still unknown, and the interaction with air pollution has not been examined. We conducted a prospective cohort study in Guangzhou, China to investigate the windows of susceptibility of temperature extremes and variability on the risk of GDM and to explore any interaction effect with air pollution. Daily maximum (Tmax), minimum temperature (Tmin) and diurnal temperature range (DTR) were obtained from Guangdong Meteorological Service. Distributed lag non-linear models with a logistic regression were applied to assess the effect of temperature extremes and DTR in different weeks of gestation on GDM. To examine the interaction effect, relative excess risk due to interaction index, attributable proportion and synergy index were calculated. There were 5,165 pregnant women enrolled, of which 604 were diagnosed with GDM (11.7%). Compared with a reference temperature (50th percentile of Tmax), we found that extreme high temperature (99th percentile of Tmax) exposure during 21st and 22nd gestational weeks was associated with an increased risk of GDM. Extreme low temperature (1st percentile of Tmax) exposure during 14th to 17th weeks increased the risk of GDM. We observed that per 1 °C increment of DTR during 21st to 24th weeks was associated with an elevated GDM risk. No interaction effect of temperature extremes or variability with air pollution on GDM were observed. Our results suggested that non-optimal temperature is an independent risk factor of GDM. The time window of susceptibility for extreme temperatures and DTR exposure on the risk of GDM generally occurred in second trimester of pregnancy. In the context of climate change, our study has important implications for reproductive health and justifies more research in different climate zones.
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Affiliation(s)
- Huanhuan Zhang
- School of Public Health, Sun Yat-sen University, Guangzhou, China; School of Public Health, Zhengzhou University, Zhengzhou, China; Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Service, Shanghai, China
| | - Qiong Wang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Tarik Benmarhnia
- Department of Family Medicine and Public Health, University of California, San Diego, USA; Scripps Institution of Oceanography, University of California, San Diego, USA
| | - Bin Jalaludin
- School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
| | - Xiaoting Shen
- Center for Reproductive Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zengli Yu
- School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Meng Ren
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Qianhong Liang
- Department of Ultrasound, Panyu Maternal and Child Care Service Center, Guangzhou, China
| | - Jingzhe Wang
- MNR Key Laboratory for Geo-Environmental Monitoring of Great Bay Area & Guangdong Key Laboratory of Urban Informatics & Shenzhen Key Laboratory of Spatial Smart Sensing and Services, Shenzhen University, Shenzhen, China
| | - Wenjun Ma
- Guangdong Provincial Institution of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, China
| | - Cunrui Huang
- School of Public Health, Sun Yat-sen University, Guangzhou, China; School of Public Health, Zhengzhou University, Zhengzhou, China; Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Service, Shanghai, China.
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50
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Zhang Y, Ma Y, Feng F, Cheng B, Shen J, Wang H, Jiao H, Li M. Respiratory mortality associated with ozone in China: A systematic review and meta-analysis. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2021; 280:116957. [PMID: 33773305 DOI: 10.1016/j.envpol.2021.116957] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 03/13/2021] [Accepted: 03/15/2021] [Indexed: 06/12/2023]
Abstract
This systematic review and meta-analysis was performed to obtain updated evidence regarding the short-term effect of ozone on respiratory mortality in China. We systematically searched the Embase, PubMed, Scopus, Web of Science, China National Knowledge Internet, and Wanfang databases for relevant studies. After screening based on the inclusion criteria, 12 studies with 19 estimates were selected for further meta-analysis. The results revealed that respiratory mortality significantly increased by 0.55% (95% confidence interval: 0.24%-0.85%; Q = 39.47, I2 = 54.4%, P = 0.002, tau2 < 10-5) for every 10-μg/m3 increase in the maximum 8-h average concentration of ozone. Furthermore, differences in combined estimates were observed between various regions and lag structures. The combined effect of single-day lags was generally larger than that of multiday lags; the estimate of mortality for the population in the north was larger than that for the population in the south. The sensitivity analysis demonstrated that the main findings were stable; funnel plots with Egger's and Begg's tests indicated no significant publication bias in our analysis.
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Affiliation(s)
- Yifan Zhang
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Yuxia Ma
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China.
| | - Fengliu Feng
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Bowen Cheng
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Jiahui Shen
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Hang Wang
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Haoran Jiao
- College of Atmospheric Sciences, Key Laboratory of Semi-Arid Climate Change, Ministry of Education, Lanzhou University, Lanzhou, 730000, China
| | - Mingji Li
- Resource and Environment Department, Ningxia University, Yinchuan, 750021, China
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