Ambient carbon monoxide and increased risk of daily hospital outpatient visits for respiratory diseases in Dongguan, China

The Influence of Fine Particulate Matter and Cold Weather on Emergency Room Interventions for Childhood Asthma

(1) Background: Children are the most vulnerable to pollution due to their decreased stature, heightened respiratory rate, and frequent outdoor engagement. PM2.5, nitrogen dioxide (NO2), ozone, and cold weather are associated with pediatric asthma. In this study, we investigated the nexus between air pollution, climate factors, and pediatric asthma emergency room visits (ERVs). (2) Method: Pediatric asthma ERV data for healthcare quality from the Taiwanese National Insurance in the Taipei area were obtained from 2015 to 2019. Air pollution and climate factor data were also collected. Poisson regression was employed to determine the relationships with relative risks (RRs). (3) Results: The incidence of pediatric asthma ERVs decreased, with a crude RR of 0.983 (95% CI: 0.98-0.986, p < 0.001). Fine particulate matter (PM2.5) had an adjusted RR of 1.102 (95% CI: 1.037-1.172, p = 0.002) and a 7.7 µg/m3 increase, and air temperature had an adjusted RR of 0.813 (95% CI: 0.745-0.887, p < 0.001) comparing between the highest and lowest quarter air temperature associated with pediatric asthma ERVs. (4) Conclusions: This inquiry underscores the positive associations of PM2.5 and cold weather with pediatric asthma ERVs. The findings could guide the government to establish policies to reduce air pollution and promote children's health.

Short-term effects of air pollutants on hospital admissions for asthma among older adults: a multi-city time series study in Southwest, China

Background

This study aimed to explore the relationship between air pollution and hospital admissions for asthma in older adults, and to further assess the health and economic burden of asthma admissions attributable to air pollution.

Methods

We collected information on asthma cases in people over 65 years of age from nine cities in Sichuan province, as well as air pollution and meteorological data. The relationship between short-term air pollutant exposure and daily asthma hospitalizations was analyzed using the generalized additive model (GAM), and stratified by gender, age, and season. In addition, we assessed the economic burden of hospitalization for air pollution-related asthma in older adults using the cost of disease approach.

Results

The single pollutant model showed that every 1 mg/m3 increase in CO was linked with an increase in daily hospitalizations for older adults with asthma, with relative risk values of 1.327 (95% CI: 1.116-1.577) at lag7. Each 10 μg/m3 increase in NO2, O3, PM10, PM2.5 and SO2, on asthma hospitalization, with relative risk values of 1.044 (95% CI: 1.011-1.078), 1.018 (95% CI: 1.002-1.034), 1.013 (95% CI: 1.004-1.022), 1.015 (95% CI: 1.003-1.028) and 1.13 (95% CI: 1.041-1.227), respectively. Stratified analysis shows that stronger associations between air pollution and asthma HAs among older adult in females, those aged 65-69 years, and in the warm season, although all of the differences between subgroups did not reach statistical significance. During the study period, the number of asthma hospitalizations attributable to PM2.5, PM10, and NO2 pollution was 764, 581 and 95, respectively, which resulted in a total economic cost of 6.222 million CNY, 4.73 million CNY and 0.776 million CNY, respectively.

Conclusion

This study suggests that short-term exposure to air pollutants is positively associated with an increase in numbers of asthma of people over 65 years of age in Sichuan province, and short-term exposure to excessive PM and NO2 brings health and economic burden to individuals and society.

Ambient carbon monoxide and relative risk of daily hospital outpatient visits for respiratory diseases in Lanzhou, China

At present, evidence of the associations between carbon monoxide (CO) and respiratory diseases (RD) in Northwest China is limited and controversial. The aim of this study is to evaluate the impact of ambient CO on outpatient visits for RD in Lanzhou, China. The daily amount of outpatient visits for total and cause-specific RD, air pollutant, and weather variables were collected in Lanzhou, China from 1st January 2013 to 31st December 2019. A generalized additive model and distributed lag nonlinear model were used to assess associations between CO and outpatient visits for RD. During the study period, a total of 1,623,361 RD outpatient visits were recorded. For each interquartile range (IQR) (0.77 mg/m3) increase in CO, the relative risk (RR) was 1.163 (95% CI: 1.138, 1.188) for total RD at lag07, 1.153 (95% CI: 1.128,1.179) for upper respiratory tract infection (URTI) at lag07, 1.379 (95% CI: 1.338,1.422) for pneumonia at lag07, 1.029 (95% CI: 0.997,1.062) for chronic obstructive pulmonary disease (COPD) lag04, 1.068 (95% CI: 1.028,1.110) for asthma lag03, and 1.212 (95% CI: 1.178,1.247) for bronchitis lag07, respectively. In the subgroup analyses, the impacts of CO were more pronounced on total RD, pneumonia, COPD, and bronchitis in males than females, while the opposite was true in URTI and asthma. The impact of CO on RD was the strongest for children under 15 years-of-age. We also found significantly stronger effects during cold seasons compared to warm seasons. In addition, we observed a roughly linear exposure-response curve between CO and RD with no threshold effect. This study in Lanzhou revealed a remarkable association between CO level and an elevated risk of total and cause-specific RD outpatient visits, especially for pneumonia.

Ambient carbon monoxide and the risk of cardiovascular disease emergency room visits: a time-series study in Lanzhou, China

Until now, the epidemiological evidence on the association between short-term exposure to ambient carbon monoxide (CO) and cardiovascular diseases (CVDs) is relatively lacking and controversial. This study aims to examine the relationship between ambient CO and daily emergency room visits (ERVs) for total and cause-specific CVD in Lanzhou, China. A distributed lag nonlinear model was used to examine the association. For every 1 mg/m3 increase in the CO concentration, the relative risks of daily ERVs were 1.041 (95% CI: 1.017, 1.065) for total CVD, 1.065 (95% CI: 1.018, 1.114) for ischemic heart disease (IHD), 1.083 (95% CI: 1.020, 1.149) for heart rhythm disturbances (HRD), 1.062 (95% CI: 1.011, 1.115) for heart failure (HF), and 1.057 (95% CI: 1.017, 1.098) for cerebrovascular diseases (CD). For the two different gender subgroups, the short-term impact of CO on total CVD, IHD, and CD was relatively stronger for the females than for the males, while the opposite was true for HRD and HF. In the age subgroup analyses, the effect of ambient CO on total CVD and IHD appeared to be greater for the age ≥ 65 years group, while the opposite was true for HRD, HF, and CD. The associations for all disease categories were stronger in cold seasons than in warm seasons. We also observed a nearly linear correlation between CO and CVD ERVs. In conclusion, the study showed that exposure to ambient CO may increase the risks of ERVs for total and cause-specific CVD. Besides, CO-ERVs associations may vary by gender and age.

Gas-Phase Interaction of CO, CO2, H2S, NH3, NO, NO2, and SO2 with Zn12O12 and Zn24 Atomic Clusters

Atmospheric pollutants pose a high risk to human health, and therefore it is necessary to capture and preferably remove them from ambient air. In this work, we investigate the intermolecular interaction between the pollutants such as CO, CO₂, H₂S, NH₃, NO, NO₂, and SO₂ gases with the Zn₂₄ and Zn₁₂O₁₂ atomic clusters, using the density functional theory (DFT) at the meta-hybrid functional TPSSh and LANl2Dz basis set. The adsorption energy of these gas molecules on the outer surfaces of both types of clusters has been calculated and found to have a negative value, indicating a strong molecular-cluster interaction. The largest adsorption energy has been observed between SO₂ and the Zn₂₄ cluster. In general, the Zn₂₄ cluster appears to be more effective for adsorbing SO₂, NO₂, and NO than Zn₁₂O₁₂, whereas the latter is preferable for the adsorption of CO, CO₂, H₂S, and NH₃. Frontier molecular orbital (FMO) analysis showed that Zn₂₄ exhibits higher stability upon adsorption of NH₃, NO, NO₂, and SO₂, with the adsorption energy falling within the chemisorption range. The Zn₁₂O₁₂ cluster shows a characteristic decrease in band gap upon adsorption of CO, H₂S, NO, and NO₂, suggesting an increase in electrical conductivity. Natural bond orbital (NBO) analysis also suggests the presence of strong intermolecular interactions between atomic clusters and the gases. This interaction was recognized to be strong and noncovalent, as determined by noncovalent interaction (NCI) and quantum theory of atoms in molecules (QTAIM) analyses. Overall, our results suggest that both Zn₂₄ and Zn₁₂O₁₂ clusters are good candidate species for promoting adsorption and, thus, can be employed in different materials and/or systems for enhancing interaction with CO, H₂S, NO, or NO₂.

A review on characteristics and mitigation strategies of indoor air quality in underground subway stations

Due to the rapidly increasing ridership and the relatively enclosed underground space, the indoor air quality (IAQ) in underground subway stations (USSs) has attracted more public attention. The air pollutants in USSs, such as particulate matter (PM), CO₂ and volatile organic compounds (VOCs), are hazardous to the health of passengers and staves. Firstly, this paper presents a systematic review on the characteristics and sources of air pollutants in USSs. According to the review work, the concentrations of PM, CO₂, VOCs, bacteria and fungi in USSs are 1.1-13.2 times higher than the permissible concentration limits specified by WHO, ASHRAE and US EPA. The PM and VOCs are mainly derived from the internal and outdoor sources. CO₂ concentrations are highly correlated with the passenger density and the ventilation rate while the exposure levels of bacteria and fungi depend on the thermal conditions and the settled dust. Then, the online monitoring, fault detection and prediction methods of IAQ are summarized and the advantages and disadvantages of these methods are also discussed. In addition, the available control strategies for improving IAQ in USSs are reviewed, and these strategies are classified and compared from different viewpoints. Lastly, challenges of the IAQ management in the context of the COVID-19 epidemic and several suggestions for underground stations' IAQ management in the future are put forward. This paper is expected to provide a comprehensive guidance for further research and design of the effective prevention measures on air pollutants in USSs so as to achieve more sustainable and healthy underground environment.

Short-Term effects of ambient ozone on the risk of conjunctivitis outpatient visits: a time-series analysis in Pudong New Area, Shanghai

To date, the relationship between conjunctivitis and air pollutants has been widely concerned, but the conclusions are not very unified. This study aims to explore the short-term effects of ambient ozone (O₃) on the conjunctivitis outpatient visits in Pudong New Area, Shanghai. A quasi-Poisson model combined with the distributed lag nonlinear model (DLNM) was performed to study the short-term effects of O₃ on the risk of outpatient visits for conjunctivitis, after controlling the effects of temperature, relative humidity and wind speed. Taking the median concentration of O₃ as a reference, the moderate high O₃ (75th percentile) showed the largest effect estimates for single and cumulative lag effects at lag 4 (RR 1.013, 95% confidence interval [CI] 1.006-1.019) and lag 0-10 (RR 1.075, 95%CI 1.025-1.128), respectively. Our study suggested that the moderate high O₃ increased the chances of conjunctivitis outpatient visits and had an evident lag effect.

Effects of ambient air pollution on cause-specific hospitalizations in Wuhan during 2017-2019

BACKGROUND

Few studies have focused on the associations between air pollutants and multiple organ system diseases in the entire hospitalized population. The present study aims to explore the short-term effects of six routinely monitored air pollutants on the broad causes of hospital admissions and estimate the resulting hospital admission burdens.

METHODS

Daily hospital admission records from 2017 to 2019 were obtained from the Wuhan Information center of Health and Family Planning. Generalized additive models (GAMs) were employed to evaluate the effects of air pollutants on the percent increase in the cause-specific daily number of hospital admissions. Increased hospital admission numbers, days, and expenses were also estimated.

RESULTS

A total of 2636,026 hospital admissions were identified. We found that both PM_2.5 and PM₁₀ increased the risk of hospital admissions for most disease categories. Short-term exposure to PM_2.5 was positively associated with hospitalizations of several rarely studied disease categories, such as diseases of the eye and adnexa (2.83%, 95%CI: 0.96-4.73%, P < 0.01) and diseases of the musculoskeletal system and connective tissue (2.17%, 95% CI: 0.88-3.47%, P < 0.001). NO₂ was observed to have a robust effect on diseases of the respiratory system (1.36%, 95%CI: 0.74-1.98%, P < 0.001). CO was significantly associated with hospital admissions for six disease categories. Furthermore, each 10-μg/m³ increase in PM_2.5 was associated with an annual increase of 13,444 hospital admissions (95% CI: 6239-20,649), 124,344 admission days (95% CI: 57,705-190,983), and 166-million-yuan admission expenses (95% CI: 77-255).

CONCLUSION

Our study suggested that particulate matter (PM) had a short-term effect on hospital admissions of most major disease categories and resulted in a considerable hospital admission burden. In addition, the health effects of NO₂ and CO emissions require more attention in megacities.

Association of ambient carbon monoxide exposure with hospitalization risk for respiratory diseases: A time series study in Ganzhou, China

Background

Ambient carbon monoxide (CO) exposure is associated with increased mortality and hospitalization risk for total respiratory diseases. However, evidence on the risk of hospitalization for specific respiratory diseases from ambient CO exposure is limited.

Methods

Data on daily hospitalizations for respiratory diseases, air pollutants, and meteorological factors from January 2016 to December 2020 were collected in Ganzhou, China. A generalized additive model with the quasi-Poisson link and lag structures was used to estimate the associations between ambient CO concentration and hospitalizations of total respiratory diseases, asthma, chronic obstructive pulmonary disease (COPD), upper respiratory tract infection (URTI), lower respiratory tract infection (LRTI), and influenza-pneumonia. Possible confounding co-pollutants and effect modification by gender, age, and season were considered.

Results

A total of 72,430 hospitalized cases of respiratory diseases were recorded. Significant positive exposure-response relationships were observed between ambient CO exposure and hospitalization risk from respiratory diseases. For each 1 mg/m³ increase in CO concentration (lag0-2), hospitalizations for total respiratory diseases, asthma, COPD, LRTI, and influenza-pneumonia increased by 13.56 (95% CI: 6.76%, 20.79%), 17.74 (95% CI: 1.34%, 36.8%), 12.45 (95% CI: 2.91%, 22.87%), 41.25 (95% CI: 18.19%, 68.81%), and 13.5% (95% CI: 3.41%, 24.56%), respectively. In addition, the associations of ambient CO with hospitalizations for total respiratory diseases and influenza-pneumonia were stronger during the warm season, while women were more susceptible to ambient CO exposure-associated hospitalizations for asthma and LRTI (all P < 0.05).

Conclusion

In brief, significant positive exposure-response relationships were found between ambient CO exposure and hospitalization risk for total respiratory diseases, asthma, COPD, LRTI, and influenza-pneumonia. Effect modification by season and gender was found in ambient CO exposure-associated respiratory hospitalizations.

Multiple Impacts of Urban Built and Natural Environment on Lung Cancer Incidence: A Case Study in Bengbu

Tumours are the main disease affecting the health of the Chinese population, and lung cancer is the malignancy with the highest incidence. Hence, the need to study and analyse the population of lung cancer incidence in order to effectively control and prevent it. In this research, we discuss the demographic characteristics of lung cancer incidence population of 2014 to 2020 from the perspective of multiple urban environmental factors, taking Bengbu city in the Huaihe River Basin of China as the research area, analyse the correlation between environmental indicators and lung cancer incidence population through the Spearman's rank correlation assessment model, and analyse the interaction between the influence factors of a geographic detector to analyse the influence of urban environmental factors. The results showed the followings: (1) The distribution characteristics of lung cancer incidence population were mainly geriatric population and spatially mainly fell in the old urban area of the study area, and the population distribution had clustered characteristics. (2) Through Spearman's rank correlation analysis, the land use, road traffic, spatial form, service facilities, and the open space of green space of the urban-built environment as well as the natural environment are all correlated with the incidence of lung cancer. (3) Factor detection and interaction analysis revealed a greater effect of spring and winter on lung cancer prevalence. In addition, the road intersection density and the distance to industrial are the most important potential influencing factors, and the interaction of any two factors will increase the risk of lung cancer.

Did unprecedented air pollution levels cause spike in Delhi's COVID cases during second wave?

The onset of the second wave of COVID-19 devastated many countries worldwide. Compared with the first wave, the second wave was more aggressive regarding infections and deaths. Numerous studies were conducted on the association of air pollutants and meteorological parameters during the first wave of COVID-19. However, little is known about their associations during the severe second wave of COVID-19. The present study is based on the air quality in Delhi during the second wave. Pollutant concentrations decreased during the lockdown period compared to pre-lockdown period (PM_2.5: 67 µg m^-3 (lockdown) versus 81 µg m^-3 (pre-lockdown); PM₁₀: 171 µg m^-3 versus 235 µg m^-3; CO: 0.9 mg m^-3 versus 1.1 mg m^-3) except ozone which increased during the lockdown period (57 µg m^-3 versus 39 µg m^-3). The variation in pollutant concentrations revealed that PM_2.5, PM₁₀ and CO were higher during the pre-COVID-19 period, followed by the second wave lockdown and the lowest in the first wave lockdown. These variations are corroborated by the spatiotemporal variability of the pollutants mapped using ArcGIS. During the lockdown period, the pollutants and meteorological variables explained 85% and 52% variability in COVID-19 confirmed cases and deaths (determined by General Linear Model). The results suggests that air pollution combined with meteorology acted as a driving force for the phenomenal growth of COVID-19 during the second wave. In addition to developing new drugs and vaccines, governments should focus on prediction models to better understand the effect of air pollution levels on COVID-19 cases. Policy and decision-makers can use the results from this study to implement the necessary guidelines for reducing air pollution. Also, the information presented here can help the public make informed decisions to improve the environment and human health significantly.

Mathematical modeling in the health risk assessment of air pollution-related disease burden in China: A review

This review paper covers an overview of air pollution-related disease burden in China and a literature review on the previous studies which have recently adopted a mathematical modeling approach to demonstrate the relative risk (RR) of air pollution-related disease burden. The associations between air pollution and disease burden have been explored in the previous studies. Therefore, it is necessary to quantify the impact of long-term exposure to ambient air pollution by using a suitable mathematical model. The most common way of estimating the health risk attributable to air pollution exposure in a population is by employing a concentration-response function, which is often based on the estimation of a RR model. As most of the regions in China are experiencing rapid urbanization and industrialization, the resulting high ambient air pollution is influencing more residents, which also increases the disease burden in the population. The existing RR models, including the integrated exposure-response (IER) model and the global exposure mortality model (GEMM), are critically reviewed to provide an understanding of the current status of mathematical modeling in the air pollution-related health risk assessment. The performances of different RR models in the mortality estimation of disease are also studied and compared in this paper. Furthermore, the limitations of the existing RR models are pointed out and discussed. Consequently, there is a need to develop a more suitable RR model to accurately estimate the disease burden attributable to air pollution in China, which contributes to one of the key steps in the health risk assessment. By using an updated RR model in the health risk assessment, the estimated mortality risk due to the impacts of environment such as air pollution and seasonal temperature variation could provide a more realistic and reliable information regarding the mortality data of the region, which would help the regional and national policymakers for intensifying their efforts on the improvement of air quality and the management of air pollution-related disease burden.

Ambient air pollution, temperature and hospital admissions due to respiratory diseases in a cold, industrial city

Background

The influences of air pollution exposure and temperature on respiratory diseases have become major global health concerns. This study investigated the relationship between ambient air pollutant concentrations and temperature in cold industrial cities that have the risk of hospitalization for respiratory diseases.

Methods

A time-series study was conducted in Changchun, China, from 2015 to 2019 to analyse the number of daily admissions for respiratory diseases, air pollutant concentrations, and meteorological factors. Time-series decomposition was applied to analyse the trend and characteristics of the number of admissions. Generalized additive models and distributed lag nonlinear models were constructed to explore the effects of air pollutant concentrations and temperature on the number of admissions.

Results

The number of daily admissions showed an increasing trend, and the seasonal fluctuation was obvious, with more daily admissions in winter and spring than in summer and autumn. There were positive and gradually decreasing lag effects of PM10, PM2.5, NO₂, and CO concentrations on the number of admissions, whereas O₃ showed a J-shaped trend. The results showed that within the 7-day lag period, 0.5°C was the temperature associated with the lowest relative risk of admission due to respiratory disease, and extremely low and high temperatures (<-18°C, >27°C, respectively) increased the risk of hospitalization for respiratory diseases by 8.3% and 12.1%, respectively.

Conclusions

From 2015 to 2019, respiratory diseases in Changchun showed an increasing trend with obvious seasonality. The increased concentrations of SO₂, NO₂, CO, PM2.5, O₃ and PM10 lead to an increased risk of hospitalization for respiratory diseases, with a significant lag effect. Both extreme heat and cold could lead to increases in the risk of admission due to respiratory disease.

Has the Risk of Outpatient Visits for Allergic Rhinitis, Related to Short-Term Exposure to Air Pollution, Changed over the Past Years in Beijing, China?

A number of studies have found associations between the short-term exposure to ambient air pollution and hospital admissions. However, little is known about the temporal variations in ambient air pollution associated with health exposure, especially in China. We evaluated whether the risks of allergic rhinitis (AR) outpatient visits from short-term exposure to air pollution varied over time (2014-2020) in Beijing, China. A quasi-Poisson generalized additive model was used to evaluate the relative risks (RRs) and 95% confidence intervals (CIs) associated with the pollutant concentrations during the entire study period and three specific periods. We also analyzed the temporal variations of the period-specific associations and tested the trend of change using the Mann-Kendall test. The concentration-response relationships for the specific periods were further investigated. The RRs (95%CI) for an interquartile range (IQR) increased in PM₁₀ (70 μg/m³) and CO (0.5 mg/m³) decreased from period 1 to period 3. However, The RRs (95%CI) of PM_2.5 (55 μg/m³), SO₂ (7 μg/m³) and NO₂ (27 μg/m³) increased from 1.015 (0.978, 1.054), 1.027 (1.009, 1.044) and 1.086 (1.037, 1.137) in period 1 to 1.069 (1.005, 1.135), 1.074 (1.003, 1.149) and 1.214 (1.149, 1.282) in period 3, respectively. A statistically significant temporal change and the stable effects were observed between the NO₂ exposure and AR visits over time. Despite a substantial reduction in ambient air pollution, the short-term effects on AR outpatient visits remained significant. Our findings provide a rationale for continued air pollution control efforts in the future to minimize air pollution and to protect the public.

Air pollution in Delhi, India: It’s status and association with respiratory diseases

The policymakers need research studies indicating the role of different pollutants with morbidity for polluted cities to install a strategic air quality management system. This study critically assessed the air pollution of Delhi for 2016–18 to found out the role of air pollutants in respiratory morbidity under the ICD-10, J00-J99. The critical assessment of Delhi air pollution was done using various approaches. The mean PM_2.5 and PM₁₀ concentrations during the measurement period exceeded both national and international standards by a wide margin. Time series charts indicated the interdependence of PM_2.5 and PM₁₀ and connection with hospital visits due to respiratory diseases. Violin plots showed that daily respiratory disease hospital visits increased during the winter and autumn seasons. The winter season was the worst from the city’s air pollution point of view, as revealed by frequency analyses. The single and multi-pollutant GAM models indicated that short-term exposure to PM₁₀ and SO₂ led to increased hospital visits due to respiratory diseases. Per 10 units increase in concentrations of PM₁₀ brought the highest increase in hospital visits of 0.21% (RR: 1.00, 95% CI: 1.001, 1.002) at lag0-6 days. This study found the robust effect of SO₂ persisted in Delhi from lag0 to lag4 days and lag01 to lag06 days for single and cumulative lag day effects, respectively. While every 10 μg m^-3 increase of SO₂ concentrations on the same day (lag0) led to 32.59% (RR: 1.33, 95% CI: 1.09, 1.61) rise of hospital visits, the cumulative concentration of lag0-1 led to 37.21% (RR: 1.37, 95% CI:1.11, 1.70) rise in hospital visits which further increased to even 83.33% (RR: 1.83, 95% CI:1.35, 2.49) rise at a lag0-6 cumulative concentration in Delhi. The role of SO₂ in inducing respiratory diseases is worrying as India is now the largest anthropogenic SO₂ emitter in the world.

Effects of meteorological factors and air pollutants on the incidence of COVID-19 in South Korea

Air pollution and meteorological factors can exacerbate susceptibility to respiratory viral infections. To establish appropriate prevention and intervention strategies, it is important to determine whether these factors affect the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Therefore, this study examined the effects of sunshine, temperature, wind, and air pollutants including sulfur dioxide (SO₂), carbon monoxide (CO), ozone (O₃), nitrogen dioxide (NO₂), particulate matter ≤2.5 μm (PM_2.5), and particulate matter ≤10 μm (PM₁₀) on the age-standardized incidence ratio of coronavirus disease (COVID-19) in South Korea between January 2020 and April 2020. Propensity score weighting was used to randomly select observations into groups according to whether the case was cluster-related, to reduce selection bias. Multivariable logistic regression analyses were used to identify factors associated with COVID-19 incidence. Age 60 years or over (odds ratio [OR], 1.29; 95% CI, 1.24-1.35), exposure to ambient air pollutants, especially SO₂ (OR, 5.19; 95% CI, 1.13-23.9) and CO (OR, 1.17; 95% CI, 1.07-1.27), and non-cluster infection (OR, 1.28; 95% CI, 1.24-1.32) were associated with SARS-CoV-2 infection. To manage and control COVID-19 effectively, further studies are warranted to confirm these findings and to develop appropriate guidelines to minimize SARS-CoV-2 transmission.

The association between short-term exposure to ambient carbon monoxide and hospitalization costs for bronchitis patients: A hospital-based study

Ambient carbon monoxide (CO) is associated with bronchitis morbidity, but there is no evidence concerning its correlation with hospitalization costs for bronchitis patients. This study aimed to investigate the relationship between short-term ambient CO exposure and hospitalization costs for bronchitis patients in Chongqing, China. Baseline data for 3162 hospitalized bronchitis patients from November 2013 to December 2019 were collected. Multiple linear regression analysis was used to determine the association, delayed and cumulative, between short-term CO exposure and hospitalization costs. Additionally, subgroup analyses were performed by gender, age, season, and comorbidity. Positive association between CO and hospitalization costs for bronchitis patients was observed. The strongest association was observed at lag 015 days, with per 1 mg/m³ increase of CO concentrations corresponded to 5834.40 Chinese Yuan (CNY) (95% CI: 2318.71, 9350.08; P < 0.001) (845.97 US dollars) increment in hospitalization costs. Stratified analysis results showed that the association was more obvious among those males, elderly, with comorbidities, and in warm seasons. More importantly, there was strongest correlation between CO and bronchitis patients with coronary heart disease. In summary, short-term exposure to ambient CO, even lower than Chinese and WHO standards, can be associated with increased hospitalization costs for bronchitis. Controlling CO exposure can be helpful to reduce medical burden associated with bronchitis patients. The results also suggest that when setting air quality standards and formulating preventive measures, susceptible subpopulations ought to be considered.

Children's exposure to air pollution in a natural gas industrial area and their risk of hospital admission for respiratory diseases

The rapid expansion of the natural gas industry to meet the global demand have raised environmental health concerns. Few studies have found that areas with natural gas industrial activity have poor air quality. However, the negative health impacts of ambient air pollution in a natural gas industrial area remain unclear. This study aimed to explore the relationship between short-term exposure to air pollution and hospital admissions for respiratory diseases among children in a natural gas industrial area in Bintulu, Malaysia. Daily hospital admissions for respiratory diseases among children were collected from a hospital in Bintulu from 2010 to 2019. Data on six air pollutants (PM₁₀, PM_2.5, SO₂, NO₂, O₃, and CO) in the study area were obtained from the Department of Environment Malaysia. Quasi-Poisson time series regressions with distributed lag non-linear models (DLNM) were applied to explore the associations between ambient air pollution and childhood hospitalisations for respiratory diseases. Stratification analyses were performed by gender and age group to identify the vulnerable populations. A 10 μg/m³ increased PM_2.5 and SO₂ was associated with hospital admissions for respiratory diseases among children with the greatest relative risk of RR 1.089 (95% CI 1.001-1.183) at cumulative lag 0-2 days and RR 1.229 (95% CI 1.073-1.409) at cumulative lag 0-6 days, respectively. There was no significant association between short-term exposure of PM₁₀, NO₂, CO, and O₃ with childhood respiratory hospitalisation. The association between PM_2.5 and SO₂ exposure and hospital admissions for childhood respiratory diseases in the two pollutants model remained statistically significant. There were stronger associations in younger children aged 0-4 years and girls. This study reveals that short-term exposure to SO₂ was associated with a higher risk of respiratory hospitalisations among children in Bintulu than PM_2.5. Better air quality control is necessary for children's health living in the natural gas industrial area.

Air Pollution, Foreign Direct Investment, and Mental Health: Evidence From China

Recently, there has been interest in the relationship between mental health and air pollution; however, the results are inconsistent and the contribution of foreign direct investment (FDI) has received little attention. This article studies the effects of air pollution on mental health and the moderating role of FDI based on the China Health and Retirement Longitudinal Study (CHARLS) data in 2015 and 2018 applying the fixed effects panel regression approach and the threshold model. The results show that mental health is adversely affected by air pollution, especially PM_2.5, PM₁₀, sulfur dioxide (SO₂), carbon monoxide (CO), and nitrogen dioxide (NO₂). Second, FDI has an alleviating influence on the negative relationship. Third, the effects of air pollution and FDI are heterogeneous based on regional characteristics, including location, medical resource and investment in science and technology, and individual characteristics covering education level, age, income, and physical health. Finally, the threshold effects show that FDI has a moderating effect when it is >1,745.59 million renminbi (RMB). There are only 11.19% of cities exceeding the threshold value in China. When the value of air quality index (AQI) exceeds 92.79, air pollution is more harmful to mental health. Government should actively introduce high-quality FDI at the effective level and control air pollution to improve mental health.

Systematic review and meta-analysis of studies between short-term exposure to ambient carbon monoxide and non-accidental, cardiovascular, and respiratory mortality in China

Although a growing number of original epidemiological studies imply a link between ambient pollution exposure and mortality risk, the findings associated with carbon monoxide (CO) exposure are inconsistent. Thus, we conducted a systematic review and meta-analysis of epidemiological studies to evaluate the correlations between ambient CO and non-accidental, cardiovascular, and respiratory mortality in China. Eight databases were searched from inception to 15 May 2021. A random-effect model was used to calculate the pooled relative risks (RRs) and 95% confidence intervals (CIs). Subgroup analyses as well as sensitivity analyses were performed. The I square value (I²) was used to assess heterogeneity among different studies. The assessment of publication bias on included studies was examined by funnel plot and Egger's test. The influence of a potential publication bias on findings was explored by using the trim-and-fill procedure. Ultimately, a total of 19 studies were included in our analysis. The pooled relative risk for each 1 mg/m³ increase of ambient carbon monoxide was 1.0220 (95%CI: 1.0102-1.0339) for non-accidental mortality, 1.0304 (95%CI:1.0154-1.0457) for cardiovascular mortality, and 1.0318 (95%CI:1.0132-1.0506) for respiratory mortality. None of subgroup analyses could explain the source of heterogeneity. Exclusion of any single study did not materially alter the pooled effect estimates. Although it was suggestive of publication bias, findings were generally similar with principal findings when we explored the influence of a potential publication bias using the trim-and-fill method. Our meta-analysis demonstrated that exposure to ambient CO was positive with risk of deaths from all non-accidental causes, total cardiovascular, and respiratory diseases. Based on these findings, tougher intervention policies and initiatives to reduce the health effects of CO exposure should be established.

Study on Air Quality and Its Annual Fluctuation in China Based on Cluster Analysis

Exploring the spatial and temporal distribution characteristics of air quality has become an important topic for the harmonious development of human and nature. Based on the hourly data of CO, O₃, NO₂, SO₂, PM_2.5 and PM₁₀ of 1427 air quality monitoring stations in China in 2016, this paper calculated the annual mean and annual standard deviation of six air quality indicators at each station to obtain 12 variables. Self-Organizing Maps (SOM) and K-means clustering algorithms were carried out based on MATLAB and SPSS Statistics, respectively. Kriging interpolation was used to get the clustering distribution of air quality and fluctuation in China, and Principal Component Analysis (PCA) was used to analyze the main factors affecting the clustering results. The results show that: (1) Most areas in China are low-value regions, while the high-value region is the smallest and more concentrated. Air quality in northern China is worse, and the annual fluctuations of the indicators are more dramatic. (2) Compared with AQI, AQFI has a strong indication significance for the comprehensive situation of air quality and its fluctuation. (3) The spatial distribution of SOM clustering results is more discriminative, while K-means clustering results have a large proportion of low-mean regions. (4) PM_2.5, PM₁₀ and CO are the main pollutants affecting air quality and fluctuation, followed by SO₂, NO₂ and O₃.

Impact of Air Pollution in Airway Diseases: Role of the Epithelial Cells (Cell Models and Biomarkers)

Biomedical research is multidisciplinary and often uses integrated approaches performing different experimental models with complementary functions. This approach is important to understand the pathogenetic mechanisms concerning the effects of environmental pollution on human health. The biological activity of the substances is investigated at least to three levels using molecular, cellular, and human tissue models. Each of these is able to give specific answers to experimental problems. A scientific approach, using biological methods (wet lab), cell cultures (cell lines or primary), isolated organs (three-dimensional cell cultures of primary epithelial cells), and animal organisms, including the human body, aimed to understand the effects of air pollution on the onset of diseases of the respiratory system. Biological methods are divided into three complementary models: in vitro, ex vivo, and in vivo. In vitro experiments do not require the use of whole organisms (in vivo study), while ex vivo experiments use isolated organs or parts of organs. The concept of complementarity and the informatic support are useful tools to organize, analyze, and interpret experimental data, with the aim of discussing scientific notions with objectivity and rationality in biology and medicine. In this scenario, the integrated and complementary use of different experimental models is important to obtain useful and global information that allows us to identify the effect of inhaled pollutants on the incidence of respiratory diseases in the exposed population. In this review, we focused our attention on the impact of air pollution in airway diseases with a rapid and descriptive analysis on the role of epithelium and on the experimental cell models useful to study the effect of toxicants on epithelial cells.

Global COVID-19 pandemic trends and their relationship with meteorological variables, air pollutants and socioeconomic aspects

Meteorological variables, air pollutants, and socioeconomic factors are associated with COVID-19 transmission. However, it is unclear what impact their interactions have on COVID-19 transmission, whether their impact on COVID-19 transmission is linear or non-linear, and where the inflexion points are. This study examined 1) the spatial and temporal trends in COVID-19 monthly infection rate of new confirmed cases per 100,000 people (R_n) in 188 countries/regions worldwide from March to November 2020; 2) the linear correlation between meteorological variables (temperature (T), rainfall (R), wind speed (WS), relative humidity (RH), air pressure (AP)), air pollutants (nitrogen dioxide (NO₂), sulfur dioxide (SO₂), carbon monoxide (CO), ozone (O₃)) and socioeconomic aspects (population density (PD), gross domestic product per capita (GDP), domestic general government health expenditure per capita (GHE)) and R_n, and 3) the interaction and non-linear effects of the different variables on R_n, based on GeoDetector and Boosted regression tree. The results showed that the global R_n had was spatially clustered, and the average R_n increased From March to November 2020. Global R_n was negatively correlated with meteorological variables (T, R, WS, AP) and positively correlated with air pollutants (NO₂, SO₂, O₃) and socioeconomic aspects (GDP, GHE). The interaction of SO₂ and O₃, SO₂ and RH, and O₃ and T strongly affected R_n. The variables effect on COVID-19 transmission was non-linear, with one or more inflexion points. The findings of this work can provide a basis for developing a global response to COVID-19 for global sustainable development.

How Air Quality Affect Health Industry Stock Returns: New Evidence From the Quantile-on-Quantile Regression

This paper discusses the asymmetric effect of air quality (AQ) on stock returns (SR) in China's health industry through the quantile-on-quantile (QQ) regression method. Compared to prior literature, our study provides the following contributions. Government intervention, especially industrial policy, is considered a fresh and essential component of analyzing frameworks in addition to investors' physiology and psychology. Next, because of the heterogeneous responses from different industries to AQ, industrial heterogeneity is thus considered in this paper. In addition, the QQ method examines the effect of specific quantiles between variables and does not consider structural break and temporal lag effects. We obtain the following empirical results. First, the coefficients between AQ and SR in the health service and health technology industries change from positive to negative as AQ deteriorates. Second, AQ always positively influences the health business industry, but the values of the coefficients are larger in good air. In addition, different from other industries, the coefficients in the health equipment industry are negative, but the values of the coefficients change with AQ. The conclusions provide important references for investors and other market participants to avoid biased decisions due to poor AQ and pay attention to government industrial policies.

An association between PM2.5 and pediatric respiratory outpatient visits in four Chinese cities

BACKGROUND

The effects of exposure to particulate matter with aerodynamic diameter less than 2.5 μm (PM_2.5) on children's respiratory system were investigated in numerous epidemiological literatures. However, studies on the association between PM_2.5 and pediatric outpatient visits for respiratory diseases, especially considering the multicenter studies were limited in China.

OBJECTIVES

To study the association between the short-term exposure to PM_2.5 and the number of children's outpatient visits for respiratory diseases in four Chinese cities as well as the pooled health effects.

METHODS

Data of pediatric outpatient visits for respiratory diseases (RD, ICD: J00-J99) from representative hospitals in Shijiazhuang (SJZ), Xi'an (XA), Nanjing (NJ) and Guangzhou (GZ) in China from 2015 to 2018 were collected and the air quality data for the same period were collected from environmental protection departments. Generalized additive model (GAM) with quasi-Poisson regression was conducted to analyze the effects of PM_2.5 on the number of pediatric outpatient visits in each city. Single-day lag model (lag0 to lag7) and moving average lag model (lag01 and lag07) were used to examine the lag effects and cumulative effects. Random-effects meta-analysis was used to pool the estimated risks of four cities. The interactions between PM_2.5 and temperature were also explored.

RESULTS

The average daily/total outpatient visits for RD, in SJZ, XA, NJ and GZ from 2015 to 2018 were 854.2/1,245,384, 2353.9/3,439,025, 1267.2/1,851,438 and 1399.5/2,044,740 respectively. The percentages of acute upper respiratory infections (URD, ICD: J00-J06) and other acute lower respiratory infections (LRD, ICD: J20-J22) in RD were 33%, 13% (SJZ), 43%, 32% (XA), 26%, 21% (NJ) and 54%, 26% (GZ). The largest pooled estimates of single-day lag effects for RD, URD, and LRD were at lag0, lag0 and lag1. Every 10 μg/m³ increase in PM_2.5 concentration was associated with a 0.46% (95%CI: 0.21%-0.70%), 0.50% (95%CI: 0.19%-0.81%) and 0.42% (95%CI: 0.06%-0.79%) increased number of outpatient visits significantly. While max cumulative effects which were all at lag 07 were 1.10% (95%CI: 0.46%-1.74%), 0.96% (95%CI: 0.20%-1.73%) and 1.06% (95%CI: 0.12%-2.00%). Less polluted cities (GZ and NJ) showed greater city-specific excess risks, but the excess risks significantly decreased after adjusting for NO₂ in two-pollutant models. Generally, PM_2.5 showed larger health hazards on lower temperature days.

CONCLUSIONS

Our study showed that exposure to the ambient PM_2.5 was associated with the increase of the number of outpatient visits with pediatric respiratory diseases in four Chinese cities. The health effects of PM_2.5 may not be independent of other air pollutants and could be modified by temperature.

Multiple performances and paradoxical effects of China's vehicle emission reduction policy

As the living standards of urban residents in China continue to improve, the number of motor vehicle trips is increasing, thus aggravating air pollution. Such pollution causes great harm to human health and the global environment. Using a system dynamics approach, this study analyzed the effect of implementation mode on China's air pollution charging fee (APCF) policy and identified potentially negative medium- and long-term effects. The results indicated that the APCF policy has a dual effect under the single-charge mode (i.e., fees are charged on a daily basis). On the one hand, it has multiple effects of reducing emissions, relieving traffic congestion, and improving the happiness index. On the other hand, the higher the charge, the stronger the trip demand (possibly due to the sunk-cost fallacy and loss-aversion effect), which encourages motorists to weaken the cost of losses (i.e., from air pollution fees) by increasing the number of trips per day to seek short-term psychological balance, regardless of the extra costs and the amount of pollution generated. It was also found that APCF implementation mode significantly affected passenger car trips but not truck trips (perhaps because truck trips are mainly based on the demand of supply, and the daily number of trips is relatively stable). Overall, as APCF increases, it can have some paradoxical long-term effects on emissions, congestion, the happiness index, and road bearing capacity. This study's findings can help the Chinese government improve and optimize its long-term air pollution control strategies.

Air pollution exposure-the (in)visible risk factor for respiratory diseases

There is increasing interest in understanding the role of air pollution as one of the greatest threats to human health worldwide. Nine of 10 individuals breathe air with polluted compounds that have a great impact on lung tissue. The nature of the relationship is complex, and new or updated data are constantly being reported in the literature. The goal of our review was to summarize the most important air pollutants and their impact on the main respiratory diseases (chronic obstructive pulmonary disease, asthma, lung cancer, idiopathic pulmonary fibrosis, respiratory infections, bronchiectasis, tuberculosis) to reduce both short- and the long-term exposure consequences. We considered the most important air pollutants, including sulfur dioxide, nitrogen dioxide, carbon monoxide, volatile organic compounds, ozone, particulate matter and biomass smoke, and observed their impact on pulmonary pathologies. We focused on respiratory pathologies, because air pollution potentiates the increase in respiratory diseases, and the evidence that air pollutants have a detrimental effect is growing. It is imperative to constantly improve policy initiatives on air quality in both high- and low-income countries.

Association between short-term exposure to ambient nitrogen dioxide and the risk of conjunctivitis in Hefei, China: A time-series analysis

BACKGROUND

Conjunctivitis, one of the most common ocular surface diseases, can be caused by many contributors. However, the important role of air pollution has been inadequately evaluated, particularly in countries with poor air quality. This study aims to explore the possible association of short-term ambient nitrogen dioxide (NO₂) exposure with the risk of outpatient visits for conjunctivitis.

METHODS

A total of 43,462 conjunctivitis patients from January 1, 2014 to December 31, 2018 were identified from the Department of Ophthalmology of The Second Affiliated Hospital of Anhui Medical University, Hefei, China. Such data were linked to the daily mean concentration of NO₂ at ten fixed air quality monitoring stations. A distributed lag nonlinear model (DLNM) combined with a quasi-Poisson generalized linear regression model was employed to assess the association between NO₂ exposure and the risk of outpatient visits for conjunctivitis. Stratified analyses were also performed on the basis of gender, age group and season.

RESULTS

The association of NO₂ exposure with the risk of outpatient visits for conjunctivitis was statistically significant. In the single-day lags (lag 0 to lag 11) analysis, the largest effect estimates were observed at lag 0. In the moving average exposure lags (lag 0-1 to lag 0-11) analysis, the cumulative effects were stronger than the single-day lag effects. The stratified analyses suggested that the effect of NO₂ exposure was more pronounced in females and patients aged 19-65 years and in the cold season.

CONCLUSIONS

This study confirms the evidence that short-term NO₂ exposure is associated with an increased risk of conjunctivitis outpatient visits. Our research encourages individuals to avoid outdoor activities on severe air pollution days and the government is obliged to adopt more stringent environmental policies to alleviate the effects of air pollution on human health, particularly for individuals at risk of developing conjunctivitis.

Acute effects of ambient air pollution on outpatients with chronic rhinitis in Xinxiang, China

Air pollution exposure leads to increased mortality and morbidity rates of respiratory diseases. Most of the evidence was founded on acute diseases such as acute lower respiratory diseases. However, limited studies have been conducted to evaluate the effects of air pollution on chronic respiratory diseases. This time-series study was conducted to examine the acute effects of 6 criteria ambient air pollutants on hospital outpatients with chronic rhinitis (CR) in Xinxiang, China. We retrieved 223,826 outpatient records of patients with respiratory diseases, of which 62,901 were those of patients with CR. Results showed that the current 10-μg/m³ increase in fine particulate matter (PM_2.5), inhalable particulate matter (PM₁₀), sulfur dioxide (SO₂), nitrogen dioxide (NO₂), and carbon monoxide (CO) corresponds to 0.67% (95% confidence interval [CI]: 0.15-1.18%), 0.58% (95% CI: 0.24-0.92%), 1.89% (95% CI: 0.52-3.27%), 3.01% (95% CI: 1.66-4.35%), and 0.06% (95% CI: 0.03-0.10%) increments in outpatients with CR, respectively. In addition, the effects in the male were stronger than those in the female. Higher effect estimates were observed in the old (≥ 65 years of age) and younger (< 15 years of age) groups. Our study confirmed the association between air pollution and outpatients with CR in Xinxiang, China. More stringent air pollution control measures must be implemented.

Association of change in air quality with hospital admission for acute exacerbation of chronic obstructive pulmonary disease in Guangdong, China: A province-wide ecological study

AIMS

To assess possible effect of air quality improvements, we investigated the temporal change in hospital admissions for acute exacerbations of chronic obstructive pulmonary disease (AECOPD) associated with pollutant concentrations.

METHODS

We collected daily concentrations of particulate matter (i.e., PM_2.5, PM₁₀ and PM_coarse), sulfur dioxide (SO₂), nitrogen dioxide (NO₂), carbon monoxide (CO), ozone (O₃), and admissions for AECOPD for 21 cities in Guangdong from 2013 to 2017. We examined the association of air pollution with AECOPD admissions using two-stage time-series analysis, and estimated the annual attributable fractions, numbers, and direct hospitalization costs of AECOPD admissions with principal component analysis.

RESULTS

From 2013-2017, mean daily concentrations of SO₂, PM₁₀ and PM_2.5 declined by nearly 40%, 30%, and 26% respectively. As the average daily 8 h O₃ concentration increased considerably, the number of days exceeding WHO target (i.e.,100 μg/m³) increased from 103 in 2015-152 in 2017. For each interquartile range increase in pollutant concentration, the relative risks of AECOPD admission at lag 0-3 were 1.093 (95% CI 1.06-1.13) for PM_2.5, 1.092 (95% CI 1.08-1.11) for O₃, and 1.092 (95% CI 1.05-1.14) for SO₂. Attributable fractions of AECOPD admission advanced by air pollution declined from 9.5% in 2013 to 4.9% in 2016, then increased to 6.0% in 2017. A similar declining trend was observed for direct AECOPD hospitalization costs.

CONCLUSION

Declined attributable hospital admissions for AECOPD may be associated with the reduction in concentrations of PM_2.5, PM₁₀ and SO₂ in Guangdong, while O₃ has emerged as an important risk factor. Summarizes the main finding of the work： Reduction in PM may result in declined attributable hospitalizations for AECOPD, while O₃ has emerged as an important risk factor following an intervention.

External Environmental Pollution as a Risk Factor for Asthma

Air pollution is a worrisome risk factor for global morbidity and mortality and plays a special role in many respiratory conditions. It contributes to around 8 million deaths/year, with outdoor exposure being responsible for more than 4.2 million deaths throughout the world, while more than 3.8 million die from situations related to indoor pollution. Pollutant agents induce several respiratory symptoms. In addition, there is a clear interference in numerous asthma outcomes, such as incidence, prevalence, hospital admission, visits to emergency departments, mortality, and asthma attacks, among others. The particulate matter group of pollutants includes coarse particles/PM₁₀, fine particles/PM_2.5, and ultrafine particles/PM_0.1. The gaseous components include ground-level ozone, nitrogen dioxide, sulfur dioxide, and carbon monoxide. The timing, load, and route of allergen exposure are other items affecting allergic disease phenotypes. The complex interaction between pollutant exposures and human host factors has an implication in the development and rise of asthma as a public health problem. However, there are hiatuses in the understanding of the pathways in this disease. The routes through which pollutants induce asthma are multiple, and include the epigenetic changes that occur in the respiratory tract microbiome, oxidative stress, and immune dysregulation. In addition, the expansion of the modern Westernized lifestyle, which is characterized by intense urbanization and more time spent indoors, resulted in greater exposure to polluted air. Another point to consider is the different role of the environment according to age groups. Children growing up in economically disadvantaged neighborhoods suffer more important negative health impacts. This narrative review highlights the principal polluting agents, their sources of emission, epidemiological findings, and mechanistic evidence that links environmental exposures to asthma.

Stretchable gas sensors for detecting biomarkers from humans and exposed environments

The recent advent of stretchable gas sensors demonstrates their capabilities to detect not only gaseous biomarkers from the human body but also toxic gas species from the exposed environment. To ensure accurate gas detection without device breakdown from the mechanical deformations, the stretchable gas sensors often rely on the direct integration of gas-sensitive nanomaterials on the stretchable substrate or fibrous network, as well as being configured into stretchable structures. The nanomaterials in the forms of nanoparticles, nanowires, or thin-films with nanometer thickness are explored for a variety of sensing materials. The commonly used stretchable structures in the stretchable gas sensors include wrinkled structures from a pre-strain strategy, island-bridge layouts or serpentine interconnects, strain isolation approaches, and their combinations. This review aims to summarize the recent advancement in novel nanomaterials, sensor design innovations, and new fabrication approaches of stretchable gas sensors.

Advances and novel developments in environmental influences on the development of atopic diseases

Although genetic factors play a role in the etiology of atopic disease, the rapid increases in the prevalence of these diseases over the last few decades suggest that environmental, rather than genetic factors are the driving force behind the increasing prevalence. In modern societies, there is increased time spent indoors, use of antibiotics, and consumption of processed foods and decreased contact with farm animals and pets, which limit exposure to environmental allergens, infectious parasitic worms, and microbes. The lack of exposure to these factors is thought to prevent proper education and training of the immune system. Increased industrialization and urbanization have brought about increases in organic and inorganic pollutants. In addition, Caesarian birth, birth order, increased use of soaps and detergents, tobacco smoke exposure and psychosomatic factors are other factors that have been associated with increased rate of allergic diseases. Here, we review current knowledge on the environmental factors that have been shown to affect the development of allergic diseases and the recent developments in the field.

Air Pollution and Emergency Hospital Admissions—Evidences from Lisbon Metropolitan Area, Portugal

The relevance of air pollution in the public health agenda has recently been reinforced—it is known that exposure to it has negative effects in the health of individuals, especially in big cities and metropolitan areas. In this article we observed the evolution of air pollutants (CO, NO, NO2, O3, PM10) emissions and we confront them with health vulnerabilities related to respiratory and circulatory diseases (all circulatory diseases, cardiac diseases, cerebrovascular disease, ischemic heart disease, all respiratory diseases, chronic lower respiratory diseases, acute upper respiratory infections). The study is supported in two databases, one of air pollutants and the other of emergency hospital admissions, in the 2005–2015 period, applied to the Lisbon Metropolitan Area. The analysis was conducted through Ordinary Least Squares (OLS) regression, while also using semi-elasticity to quantify associations. Results showed positive associations between air pollutants and admissions, tendentially higher in respiratory diseases, with CO and O3 having the highest number of associations, and the senior age group being the most impacted. We concluded that O3 is a good predictor for the under-15 age group and PM10 for the over-64 age group; also, there seems to exist a distinction between the urban city core and its suburban areas in air pollution and its relation to emergency hospital admissions.

Revalue associations of short-term exposure to air pollution with respiratory hospital admissions in Lanzhou, China after the control and treatment of current pollution

Significant progress has been made in air pollution control Lanzhou, China recently, however, there was only one study so far on the assessment on health gains from air quality improvement after adopting strict air pollution control measures. The present study aimed to estimate the short-term effects of six criteria air pollutants including PM_2.5, PM₁₀, NO₂, SO₂, CO and O₃ on respiratory admissions in Lanzhou, China, then compare the results of our study with those earlier studies conducted in Lanzhou before the implementation of air pollution control measures. Data on daily hospital admissions from the three largest hospitals in Lanzhou and daily air pollution concentration and meteorological variable were collected during a 4-year period (2014-2017). A generalized additive model; adjusted for long-term trend, seasonality, and other potential confounders was done to quantitatively assess the influences of air pollutants on daily respiratory admissions and analyze the influences of different seasons, sexes, and age groups. The most apparent effects for PM_2.5, PM₁₀, SO₂, CO and O₃ on respiratory hospitalizations were observed at lag6, and lag7, respectively, and a 10μg/m₃ increase in PM_2.5, PM₁₀, SO₂, CO and O₃ concentration were associated with 0.885% (95%CI: 0.414%~1.358%), 0.328% (95%CI: 0.145%~0.511%), 3.005% (95%CI: 1.689%~4.339%), 3.199% (95%CI: 0.912%~5.537%) for CO, 0.733% (95%Cl: 0.263%~1.205%) increase in respiratory admission, respectively. No remarkable association was found between NO₂ and respiratory disease hospitalisation. Females and younger groups were more susceptible to air pollutant than males and elderly groups. Together, we demonstrated that the positive associations were more pronounced in the cold season than in the warm season. The findings in present study suggest that even in Lanzhou, where air quality has been improved dramatically, positive associations still exist between air pollution and daily number of total respiratory admission.

Association of hospital admission for bronchiectasis with air pollution: A province-wide time-series study in southern China

The relation of acute fluctuations of air pollution to hospital admission for bronchiectasis remained uncertain, and large-scale studies were needed. We collected daily concentrations of particulate matter (PM), sulfur dioxide (SO₂), nitrogen dioxide (NO₂), carbon monoxide (CO), ozone (O₃), and daily hospitalizations for bronchiectasis for 21 cities across Guangdong Province from 2013 through 2017. We examined their association using two-stage time-series analysis. Our analysis was stratified by specific sub-diagnosis, sex and age group to assess potential effect modifications. Relative risks of hospitalization for bronchiectasis were 1.060 (95%CI 1.014-1.108) for PM₁₀ at lag0-6, 1.067 (95%CI 1.020-1.116) for PM_2.5 at lag0-6, 1.038 (95%CI 1.005-1.073) for PM_coarse at lag0-6, 1.058 (95%CI 1.015-1.103) for SO₂ at lag0-4, 1.057 (95%CI 1.030-1.084) for NO₂ at lag0 and 1.055 (95%CI 1.025-1.085) for CO at lag0-6 per interquartile range increase of air pollution. Specifically, acute fluctuations of air pollution might be a risk factor for bronchiectasis patients with lower respiratory infection but not with hemoptysis. Patients aged ≥65 years, and female patients appeared to be particularly susceptible to air pollution. Acute fluctuations of air pollution, particularly PM may increase the risk of hospital admission for bronchiectasis exacerbations, especially for the patients complicated with lower respiratory infection. This study strengthens the importance of reducing adverse impact on respiratory health of air pollution to protect vulnerable populations.

Region-specific air pollutants and meteorological parameters influence COVID-19: A study from mainland China

Coronavirus disease 2019 (COVID-19) was first detected in December 2019 in Wuhan, China, with 11,669,259 positive cases and 539,906 deaths globally as of July 8, 2020. The objective of the present study was to determine whether meteorological parameters and air quality affect the transmission of COVID-19, analogous to SARS. We captured data from 29 provinces, including numbers of COVID-19 cases, meteorological parameters, air quality and population flow data, between Jan 21, 2020 and Apr 3, 2020. To evaluate the transmissibility of COVID-19, the basic reproductive ratio (R₀) was calculated with the maximum likelihood "removal" method, which is based on chain-binomial model, and the association between COVID-19 and air pollutants or meteorological parameters was estimated by correlation analyses. The mean estimated value of R₀ was 1.79 ± 0.31 in 29 provinces, ranging from 1.08 to 2.45. The correlation between R₀ and the mean relative humidity was positive, with coefficient of 0.370. In provinces with high flow, indicators such as carbon monoxide (CO) and 24-h average concentration of carbon monoxide (CO_24 h) were positively correlated with R₀, while nitrogen dioxide (NO₂), 24-h average concentration of nitrogen dioxide (NO₂_24 h) and daily maximum temperature were inversely correlated to R₀, with coefficients of 0.644, 0.661, -0.636, -0.657, -0.645, respectively. In provinces with medium flow, only the weather factors were correlated with R₀, including mean/maximum/minimum air pressure and mean wind speed, with coefficients of -0.697, -0.697, -0.697 and -0.841, respectively. There was no correlation with R₀ and meteorological parameters or air pollutants in provinces with low flow. Our findings suggest that higher ambient CO concentration is a risk factor for increased transmissibility of the novel coronavirus, while higher temperature and air pressure, and efficient ventilation reduce its transmissibility. The effect of meteorological parameters and air pollutants varies in different regions, and requires that these issues be considered in future modeling disease transmissibility.

Ambient air pollution and its influence on human health and welfare: an overview

Human health is closely related to his environment. The influence of exposure to air pollutants on human health and well-being has been an interesting subject and gained much volume of research over the last 50 years. In general, polluted air is considered one of the major factors leading to many diseases such as cardiovascular and respiratory disease and lung cancer for the people. Besides, air pollution adversely affects the animals and deteriorates the plant environment. The overarching objective of this review is to explore the previous researches regarding the causes and sources of air pollution, how to control it and its detrimental effects on human health. The definition of air pollution and its sources were introduced extensively. Major air pollutants and their noxious effects were detailed. Detrimental impacts of air pollution on human health and well-being were also presented.

Unexpected association between increased levels of ambient carbon monoxide and reduced daily outpatient visits for vaginitis: A hospital-based study

Carbon monoxide (CO) is a well-known "toxic gas". It represents a toxic inhalation hazard at high concentration and is commonly found in polluted air. However, a series of recent studies have suggested that low concentration of CO can also produce protective functions. This study was performed to investigate the association between ambient CO exposure and vaginitis outpatient visits. Daily baseline outpatient data of vaginitis from January 1, 2013 to December 31, 2015 were obtained from Xi'an, a heavily-polluted metropolis in China. The over-dispersed Poisson generalized additive model was applied to discover the relations between short-term ambient CO exposure and the number of vaginitis outpatient visits by adjusting day of the week and weather conditions. A total of 16,825 outpatient hospital visits for vaginitis were recorded. The mean daily concentration of carbon monoxide (CO) was well below Chinese and WHO guidelines. During the study period, increased levels of ambient CO was associated with reduced outpatient-visits through concurrent to lag 5 days, and the most significant association was evidenced at lag 05. A 0.1 mg/m³ increase in daily average CO at lag 05 corresponded to -1.25% (95%CI: -1.85%, -0.65%) change in outpatient-visits for vaginitis. Moreover, the association was more significant in those women aged 20-29 years. After adjustment for PM₁₀, PM_2.5, SO₂, and NO₂, and O₃, the negative associations of CO with vaginitis kept significant, suggesting relative stability of effect estimates. In summary, this is the first evidence that increased ambient CO exposure can be related to reduced daily outpatient visits for vaginitis. The results of our study may not only help to establish more comprehensive understanding of the health effects of ambient air on vaginitis and other gynecological diseases, but also provide a clue to new potential interventions.

Association of air pollution with outpatient visits for respiratory diseases of children in an ex-heavily polluted Northwestern city, China

BACKGROUND

A great number of studies have confirmed that children are a particularly vulnerable population to air pollution.

METHODS

In the present study, 332,337 outpatient visits of 15 hospitals for respiratory diseases among children (0-13 years), as well as the simultaneous meteorological and air pollution data, were obtained from 2014 to 2016 in Lanzhou, China. The generalized additive model was used to examine the effects of air pollutants on children's respiratory outpatient visits, including the stratified analysis of age, gender and season.

RESULTS

We found that PM_2.5, NO₂ and SO₂ were significantly associated with the increased total respiratory outpatient visits. The increments of total respiratory outpatient visits were the highest in lag 05 for NO₂ and SO₂, a 10 μg/m³ increase in NO₂ and SO₂ was associated with a 2.50% (95% CI: 1.54, 3.48%) and 3.50% (95% CI: 1.51, 5.53%) increase in total respiratory outpatient visits, respectively. Those associations remained stable in two-pollutant models. Through stratification analysis, all air pollutants other than PM₁₀ were significantly positive associated with the outpatients of bronchitis and upper respiratory tract infection. Besides, both NO₂ and SO₂ were positively related to the pneumonia outpatient visits. PM_2.5 and SO₂ were significantly related to the outpatient visits of other respiratory diseases, while only NO₂ was positively associated with the asthma outpatients. We found these associations were stronger in girls than in boys, particularly in younger (0-3 years) children. Interestingly, season stratification analysis indicated that these associations were stronger in the cold season than in the transition or the hot season for PM₁₀, PM_2.5 and SO₂.

CONCLUSIONS

Our results indicate that the air pollution exposure may account for the increased risk of outpatient visits for respiratory diseases among children in Lanzhou, particularly for younger children and in the cold season.

Acute Effects of Air Pollution on Hospital Admissions for Asthma, COPD, and Bronchiectasis in Ahvaz, Iran

Background and Aim

Although air pollution is a serious problem in Ahvaz, the association between air pollution and respiratory diseases has not been studied enough in this area. The aim of this study was to determine the relation between short-term exposure to air pollutants and the risk of hospital admissions due to asthma, COPD, and bronchiectasis in Ahvaz.

Methods

Hospital admissions data and air pollutants including O3, NO, NO2, SO2, CO, PM10, and PM2.5 were obtained from 2008 to 2018. Adjusted Quasi-Poisson regression with a distributed lag model, controlled for trend, seasonality, weather, weekdays, and holidays was used for data analysis.

Results

The results showed a significant increase in hospital admissions for asthma (RR=1.004, 95% CI: 1.002-1.007) and COPD (RR=1.003, 95% CI: 1.001-1.005) associated with PM2.5. PM10 was associated with increased hospital admissions due to bronchiectasis in both genders (Men: RR=1.003, 95% CI: 1.001-1.006) (Female: RR=1.003, 95% CI: 1.000-1.006). NO2 was also associated with an increased risk of hospital admissions for asthma (RR=1.040, 95% CI: 1.008-1.074) and COPD (RR=1.049, 95% CI: 1.010-1.090). SO2 was associated with the risk of hospital admissions of asthma (RR=1.069, 95% CI: 1.017-1.124) and bronchiectasis (RR=1.030, 95% CI: 1.005-1.056). Finally, CO was associated with COPD (RR=1.643, 95% CI: 1.233-2.191) and bronchiectasis (RR=1.542, 95% CI: 1.035-2.298) hospital admissions.

Conclusion

Short-term exposure to air pollutants significantly increases the risk of hospital admissions for asthma, COPD, and bronchiectasis in the adult and elderly population.

Health impact of exposure to asbestos in polluted area of Southern Italy

The three main sources of asbestos pollution in the city of Bari, Puglia, the former Fibronit asbestos factory, the Torre Quetta beach, the former Rossani barracks and the history of their reclamation are described. The results of cohort studies on factory workers and case-control studies on asbestos exposure to the resident population and the onset of mesothelioma are also reported. Finally, the data of the regional register of mesothelioma related to residents in the city of Bari and four new cases with environmental exposure due to the former Rossani barracks are presented.

A Portable Triboelectric Nanogenerator for Real-Time Respiration Monitoring

As a reliable indicator of human physiological health, respiratory rate has been utilized in more and more cases for prediction and diagnosis of potential respiratory diseases and the respiratory dysfunction caused by cystic fibrosis. However, compared with smart mobile electronics, traditional clinical respiration monitoring systems is not convenient to work as a household wearable device for real-time respiration monitoring in daily life due to its cumbersome structure, complex operability, and reliance on external power sources. Thus, we propose a wearable wireless respiration sensor based on lateral sliding mode triboelectric nanogenerator (TENG) to monitor respiratory rates by sensing the variation of the abdominal circumference. In this paper, we validate the possibility of the device as a respiration monitoring sensor via an established theoretical model and investigate the output performance of the sensor via a series of mechanical tests. Furtherly, the applications of the respiration sensor in different individuals, different breathing rhythms, different active states, and wireless transmission have been verified by a lot of volunteer tests. All the results demonstrate the potential of the proposed wearable sensor as a new alternative for detecting and monitoring real-time respiratory rates with general applicability and sensitivity.

{CeO2/Bi2Mo1−xRuxO6} and {Au/Bi2Mo1−xRuxO6} Catalysts for Low-Temperature CO Oxidation

Nowadays, one of the most important challenges that humanity faces is to find alternative ways of reducing pollutant emissions. CeO2/Bi2Mo1−xRuxO6 and Au/Bi2Mo1−xRuxO6 catalysts were prepared to efficiently transform carbon monoxide (CO) to carbon dioxide (CO2) at low temperatures. The systems were prepared in a two-step process. First, Bi2Mo1−xRuxO6 supports were synthesized through the hydrothermal procedure under microwave heating. Then, CeO2 was deposited on Bi2Mo1−xRuxO6 using the wet impregnation method, while the incipient impregnation method was selected to deposit gold nanoparticles. The CeO2/Bi2Mo1−xRuxO6 and Au/Bi2Mo1−xRuxO6 catalysts were characterized using SEM microscopy and XRD. Furthermore, energy-dispersive X-ray spectroscopy (EDS), X-ray photoelectron spectroscopy (XPS), and Raman spectroscopy were used. Tests were carried out for the supported catalysts in CO oxidation, and high conversion values, nearing 100%, was observed in a temperature range of 100 to 250 °C. The results showed that the best system was the Au/Bi2Mo0.95Ru0.05O6 catalyst, with CO oxidation starting at 50 °C and reaching 100% conversion at 186 °C.