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Hertelendy AJ, Howard C, Sorensen C, Ranse J, Eboreime E, Henderson S, Tochkin J, Ciottone G. Seasons of smoke and fire: preparing health systems for improved performance before, during, and after wildfires. Lancet Planet Health 2024; 8:e588-e602. [PMID: 39122327 DOI: 10.1016/s2542-5196(24)00144-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 06/04/2024] [Accepted: 06/13/2024] [Indexed: 08/12/2024]
Abstract
Increased frequency, intensity, and duration of wildfires are intensifying exposure to direct and smoke-related hazards in many areas, leading to evacuation and smoke-related effects on health and health systems that can affect regions extending over thousands of kilometres. Effective preparation and response are currently hampered by inadequate training, continued siloing of disciplines, insufficient finance, and inadequate coordination between health systems and governance at municipal, regional, national, and international levels. This Review highlights the key health and health systems considerations before, during, and after wildfires, and outlines how a health system should respond to optimise population health outcomes now and into the future. The focus is on the implications of wildfires for air quality, mental health, and emergency management, with elements of international policy and finance also addressed. We discuss commonalities of existing climate-resilient health care and disaster management frameworks and integrate them into an approach that addresses issues of financing, leadership and governance, health workforce, health information systems, infrastructure, supply chain, technologies, community interaction and health-care delivery, before, during, and after a wildfire season. This Review is a practical briefing for leaders and health professionals facing severe wildfire seasons and a call to break down silos and join with other disciplines to proactively plan for and fund innovation and coordination in service of a healthier future.
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Affiliation(s)
- Attila J Hertelendy
- Department of Information Systems and Business Analytics, College of Business, Florida International University, Miami, FL, USA; Disaster Medicine Fellowship, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
| | - Courtney Howard
- Cummings School of Medicine, University of Calgary, Calgary, AB, Canada; Dahdaleh Institute for Global Health Research, York University, ON, Canada
| | - Cecilia Sorensen
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA; Department of Emergency Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Jamie Ranse
- Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
| | - Ejemai Eboreime
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Sarah Henderson
- Environmental Health Services, BC Center for Disease Control, Vancouver, BC, Canada
| | - Jeffrey Tochkin
- School of Health Related Research, University of Sheffield, Sheffield, UK; Health Emergency Management, Vernon, BC, Canada
| | - Gregory Ciottone
- Disaster Medicine Fellowship, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA; Harvard Medical School, Harvard University, Boston, MA, USA
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Chen G, Guo Y, Yue X, Xu R, Yu W, Ye T, Tong S, Gasparrini A, Bell ML, Armstrong B, Schwartz J, Jaakkola JJK, Lavigne E, Saldiva PHN, Kan H, Royé D, Urban A, Vicedo-Cabrera AM, Tobias A, Forsberg B, Sera F, Lei Y, Abramson MJ, Li S. All-cause, cardiovascular, and respiratory mortality and wildfire-related ozone: a multicountry two-stage time series analysis. Lancet Planet Health 2024; 8:e452-e462. [PMID: 38969473 DOI: 10.1016/s2542-5196(24)00117-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 05/12/2024] [Accepted: 05/13/2024] [Indexed: 07/07/2024]
Abstract
BACKGROUND Wildfire activity is an important source of tropospheric ozone (O3) pollution. However, no study to date has systematically examined the associations of wildfire-related O3 exposure with mortality globally. METHODS We did a multicountry two-stage time series analysis. From the Multi-City Multi-Country (MCC) Collaborative Research Network, data on daily all-cause, cardiovascular, and respiratory deaths were obtained from 749 locations in 43 countries or areas, representing overlapping periods from Jan 1, 2000, to Dec 31, 2016. We estimated the daily concentration of wildfire-related O3 in study locations using a chemical transport model, and then calibrated and downscaled O3 estimates to a resolution of 0·25° × 0·25° (approximately 28 km2 at the equator). Using a random-effects meta-analysis, we examined the associations of short-term wildfire-related O3 exposure (lag period of 0-2 days) with daily mortality, first at the location level and then pooled at the country, regional, and global levels. Annual excess mortality fraction in each location attributable to wildfire-related O3 was calculated with pooled effect estimates and used to obtain excess mortality fractions at country, regional, and global levels. FINDINGS Between 2000 and 2016, the highest maximum daily wildfire-related O3 concentrations (≥30 μg/m3) were observed in locations in South America, central America, and southeastern Asia, and the country of South Africa. Across all locations, an increase of 1 μg/m3 in the mean daily concentration of wildfire-related O3 during lag 0-2 days was associated with increases of 0·55% (95% CI 0·29 to 0·80) in daily all-cause mortality, 0·44% (-0·10 to 0·99) in daily cardiovascular mortality, and 0·82% (0·18 to 1·47) in daily respiratory mortality. The associations of daily mortality rates with wildfire-related O3 exposure showed substantial geographical heterogeneity at the country and regional levels. Across all locations, estimated annual excess mortality fractions of 0·58% (95% CI 0·31 to 0·85; 31 606 deaths [95% CI 17 038 to 46 027]) for all-cause mortality, 0·41% (-0·10 to 0·91; 5249 [-1244 to 11 620]) for cardiovascular mortality, and 0·86% (0·18 to 1·51; 4657 [999 to 8206]) for respiratory mortality were attributable to short-term exposure to wildfire-related O3. INTERPRETATION In this study, we observed an increase in all-cause and respiratory mortality associated with short-term wildfire-related O3 exposure. Effective risk and smoke management strategies should be implemented to protect the public from the impacts of wildfires. FUNDING Australian Research Council and the Australian National Health and Medical Research Council.
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Affiliation(s)
- Gongbo Chen
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Yuming Guo
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
| | - Xu Yue
- Jiangsu Key Laboratory of Atmospheric Environment Monitoring and Pollution Control, Collaborative Innovation Center of Atmospheric Environment and Equipment Technology, School of Environmental Science and Engineering, Nanjing University of Information Science and Technology, Nanjing, China
| | - Rongbin Xu
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Wenhua Yu
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Tingting Ye
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Shilu Tong
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia
| | - Antonio Gasparrini
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Michelle L Bell
- School of the Environment, Yale University, New Haven, CT, USA; School of Health Policy and Management, College of Health Sciences, Korea University, Seoul, South Korea
| | - Ben Armstrong
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Joel Schwartz
- Department of Environmental Health, Harvard T H Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Jouni J K Jaakkola
- Center for Environmental and Respiratory Health Research, University of Oulu, Oulu, Finland; Medical Research Center Oulu, OuluUniversity Hospital and University of Oulu, Oulu, Finland; Finnish Meteorological Institute, Helsinki, Finland
| | - Eric Lavigne
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada; Environmental Health Science and Research Bureau, Health Canada, Ottawa, ON, Canada
| | | | - Haidong Kan
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai, China
| | - Dominic Royé
- Department of Geography, University of Santiago de Compostela, Santiago de Compostela, Spain; CIBER Epidemiology and Public Health, Madrid, Spain
| | - Aleš Urban
- Institute of Atmospheric Physics, Academy of Sciences of the Czech Republic, Prague, Czech Republic; Faculty of Environmental Sciences, Czech University of Life Sciences, Prague, Czech Republic
| | - Ana Maria Vicedo-Cabrera
- Institute of Social and Preventive Medicine and Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland
| | - Aurelio Tobias
- Institute of Environmental Assessment and Water Research, Spanish Council for Scientific Research, Barcelona, Spain; School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Bertil Forsberg
- Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Francesco Sera
- Department of Statistics, Computer Science and Applications "G Parenti", University of Florence, Florence, Italy
| | - Yadong Lei
- State Key Laboratory of Severe Weather and Key Laboratory of Atmospheric Chemistry of China Meteorological Administration, Chinese Academy of Meteorological Sciences, Beijing, China
| | - Michael J Abramson
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Shanshan Li
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
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Connolly R, Marlier ME, Garcia-Gonzales DA, Wilkins J, Su J, Bekker C, Jung J, Bonilla E, Burnett RT, Zhu Y, Jerrett M. Mortality attributable to PM 2.5 from wildland fires in California from 2008 to 2018. SCIENCE ADVANCES 2024; 10:eadl1252. [PMID: 38848356 PMCID: PMC11160451 DOI: 10.1126/sciadv.adl1252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 05/06/2024] [Indexed: 06/09/2024]
Abstract
In California, wildfire risk and severity have grown substantially in the last several decades. Research has characterized extensive adverse health impacts from exposure to wildfire-attributable fine particulate matter (PM2.5), but few studies have quantified long-term outcomes, and none have used a wildfire-specific chronic dose-response mortality coefficient. Here, we quantified the mortality burden for PM2.5 exposure from California fires from 2008 to 2018 using Community Multiscale Air Quality modeling system wildland fire PM2.5 estimates. We used a concentration-response function for PM2.5, applying ZIP code-level mortality data and an estimated wildfire-specific dose-response coefficient accounting for the likely toxicity of wildfire smoke. We estimate a total of 52,480 to 55,710 premature deaths are attributable to wildland fire PM2.5 over the 11-year period with respect to two exposure scenarios, equating to an economic impact of $432 to $456 billion. These findings extend evidence on climate-related health impacts, suggesting that wildfires account for a greater mortality and economic burden than indicated by earlier studies.
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Affiliation(s)
- Rachel Connolly
- Department of Environmental Health Sciences, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
- Luskin Center for Innovation, University of California, Los Angeles, Los Angeles, CA, USA
| | - Miriam E. Marlier
- Department of Environmental Health Sciences, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Diane A. Garcia-Gonzales
- Department of Environmental Health Sciences, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Joseph Wilkins
- Department of Earth, Environment and Equity, Howard University, Washington, DC, USA
| | - Jason Su
- Department of Environmental Health Sciences, School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Claire Bekker
- Department of Environmental Health Sciences, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Jihoon Jung
- Department of City and Regional Planning, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Eimy Bonilla
- Department of Earth, Environment and Equity, Howard University, Washington, DC, USA
| | - Richard T. Burnett
- Institute of Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Population Studies Division, Environmental Health Science and Research Bureau, Health Canada, Ottawa, Canada
| | - Yifang Zhu
- Department of Environmental Health Sciences, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Michael Jerrett
- Department of Environmental Health Sciences, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
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Rossnerova A, Chvojkova I, Elzeinova F, Pelclova D, Klusackova P, Zdimal V, Ondrackova L, Bradna P, Roubickova A, Simova Z, Rossner P. Genetic alteration profiling in middle-aged women acutely exposed during the mechanical processing of dental nanocomposites. ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2024; 108:104462. [PMID: 38710242 DOI: 10.1016/j.etap.2024.104462] [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: 09/06/2023] [Revised: 04/23/2024] [Accepted: 05/02/2024] [Indexed: 05/08/2024]
Abstract
Nanoparticles (NPs) have become an important part of everyday life, including their application in dentistry. Aside from their undoubted benefits, questions regarding their risk to human health, and/or genome have arisen. However, studies concerning cytogenetic effects are completely absent. A group of women acutely exposed to an aerosol released during dental nanocomposite grinding was sampled before and after the work. Exposure monitoring including nano (PM0.1) and respirable (PM4) fractions was performed. Whole-chromosome painting for autosomes #1, #4, and gonosome X was applied to estimate the pattern of cytogenetic damage including structural and numerical alterations. The results show stable genomic frequency of translocations (FG/100), in contrast to a significant 37.8% (p<0.05) increase of numerical aberrations caused by monosomies (p<0.05), but not trisomies. Monosomies were mostly observed for chromosome X. In conclusion, exposure to nanocomposites in stomatology may lead to an increase in numerical aberrations which can be dangerous for dividing cells.
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Affiliation(s)
- Andrea Rossnerova
- Department of Toxicology and Molecular Epidemiology, Institute of Experimental Medicine CAS, Czech Republic.
| | - Irena Chvojkova
- Department of Toxicology and Molecular Epidemiology, Institute of Experimental Medicine CAS, Czech Republic
| | - Fatima Elzeinova
- Department of Toxicology and Molecular Epidemiology, Institute of Experimental Medicine CAS, Czech Republic
| | - Daniela Pelclova
- Department of Occupational Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Czech Republic
| | - Pavlina Klusackova
- Department of Occupational Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Czech Republic
| | - Vladimir Zdimal
- Department of Aerosol Chemistry and Physics, Institute of Chemical Process Fundamentals CAS, Czech Republic
| | - Lucie Ondrackova
- Department of Aerosol Chemistry and Physics, Institute of Chemical Process Fundamentals CAS, Czech Republic
| | - Pavel Bradna
- Institute of Dental Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Czech Republic
| | - Adela Roubickova
- Institute of Dental Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Czech Republic
| | - Zuzana Simova
- Department of Toxicology and Molecular Epidemiology, Institute of Experimental Medicine CAS, Czech Republic
| | - Pavel Rossner
- Department of Toxicology and Molecular Epidemiology, Institute of Experimental Medicine CAS, Czech Republic
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5
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Berg CD. Addressing oncology's contribution to climate change. Lancet Oncol 2024; 25:690-691. [PMID: 38821079 DOI: 10.1016/s1470-2045(24)00214-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 04/15/2024] [Accepted: 04/15/2024] [Indexed: 06/02/2024]
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Johnston FH, Williamson G, Borchers-Arriagada N, Henderson SB, Bowman DMJS. Climate Change, Landscape Fires, and Human Health: A Global Perspective. Annu Rev Public Health 2024; 45:295-314. [PMID: 38166500 DOI: 10.1146/annurev-publhealth-060222-034131] [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] [Indexed: 01/04/2024]
Abstract
Landscape fires are an integral component of the Earth system and a feature of prehistoric, subsistence, and industrial economies. Specific spatiotemporal patterns of landscape fire occur in different locations around the world, shaped by the interactions between environmental and human drivers of fire activity. Seven distinct types of landscape fire emerge from these interactions: remote area fires, wildfire disasters, savanna fires, Indigenous burning, prescribed burning, agricultural burning, and deforestation fires. All can have substantial impacts on human health and well-being directly and indirectly through (a) exposure to heat flux (e.g., injuries and destructive impacts), (b) emissions (e.g., smoke-related health impacts), and (c) altered ecosystem functioning (e.g., biodiversity, amenity, water quality, and climate impacts). Minimizing the adverse effects of landscape fires on population health requires understanding how human and environmental influences on fire impacts can be modified through interventions targeted at individual, community, and regional levels.
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Affiliation(s)
- Fay H Johnston
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia;
- National Health and Medical Research Council (NHMRC) Centre for Safe Air, Hobart, Tasmania, Australia
| | - Grant Williamson
- School of Natural Sciences, University of Tasmania, Hobart, Tasmania, Australia
- National Health and Medical Research Council (NHMRC) Centre for Safe Air, Hobart, Tasmania, Australia
| | | | - Sarah B Henderson
- Environmental Health Services, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
| | - David M J S Bowman
- School of Natural Sciences, University of Tasmania, Hobart, Tasmania, Australia
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7
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Casey JA, Kioumourtzoglou MA, Padula A, González DJX, Elser H, Aguilera R, Northrop AJ, Tartof SY, Mayeda ER, Braun D, Dominici F, Eisen EA, Morello-Frosch R, Benmarhnia T. Measuring long-term exposure to wildfire PM 2.5 in California: Time-varying inequities in environmental burden. Proc Natl Acad Sci U S A 2024; 121:e2306729121. [PMID: 38349877 PMCID: PMC10895344 DOI: 10.1073/pnas.2306729121] [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: 05/02/2023] [Accepted: 01/13/2024] [Indexed: 02/15/2024] Open
Abstract
Wildfires have become more frequent and intense due to climate change and outdoor wildfire fine particulate matter (PM2.5) concentrations differ from relatively smoothly varying total PM2.5. Thus, we introduced a conceptual model for computing long-term wildfire PM2.5 and assessed disproportionate exposures among marginalized communities. We used monitoring data and statistical techniques to characterize annual wildfire PM2.5 exposure based on intermittent and extreme daily wildfire PM2.5 concentrations in California census tracts (2006 to 2020). Metrics included: 1) weeks with wildfire PM2.5 < 5 μg/m3; 2) days with non-zero wildfire PM2.5; 3) mean wildfire PM2.5 during peak exposure week; 4) smoke waves (≥2 consecutive days with <15 μg/m3 wildfire PM2.5); and 5) mean annual wildfire PM2.5 concentration. We classified tracts by their racial/ethnic composition and CalEnviroScreen (CES) score, an environmental and social vulnerability composite measure. We examined associations of CES and racial/ethnic composition with the wildfire PM2.5 metrics using mixed-effects models. Averaged 2006 to 2020, we detected little difference in exposure by CES score or racial/ethnic composition, except for non-Hispanic American Indian and Alaska Native populations, where a 1-SD increase was associated with higher exposure for 4/5 metrics. CES or racial/ethnic × year interaction term models revealed exposure disparities in some years. Compared to their California-wide representation, the exposed populations of non-Hispanic American Indian and Alaska Native (1.68×, 95% CI: 1.01 to 2.81), white (1.13×, 95% CI: 0.99 to 1.32), and multiracial (1.06×, 95% CI: 0.97 to 1.23) people were over-represented from 2006 to 2020. In conclusion, during our study period in California, we detected disproportionate long-term wildfire PM2.5 exposure for several racial/ethnic groups.
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Affiliation(s)
- Joan A. Casey
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY10032
- Department of Environmental and Occupational Health, University of Washington School of Public Health, Seattle, WA98195
| | | | - Amy Padula
- Department of Obstetrics, Gynecology and Reproductive Sciences, Program on Reproductive Health and the Environment, University of California San Francisco, San Francisco, CA94143
| | - David J. X. González
- Department of Environmental Policy, Science, and Management, University of California, Berkeley, CA94720
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA94704
| | - Holly Elser
- Department of Neurology, Hospital of the University of Pennsylvania, Philadelphia, PA19104
| | - Rosana Aguilera
- Scripps Institution of Oceanography, University of California San Diego, La Jolla, CA92037
| | | | - Sara Y. Tartof
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA91101
| | - Elizabeth Rose Mayeda
- Department of Epidemiology, University of California Los Angeles Fielding School of Public Health, Los Angeles, CA90095
| | - Danielle Braun
- Department of Biostatistics, Harvard TH Chan School of Public Health, Boston, MA02115
- Department of Data Science, Dana-Farber Cancer Institute, Boston, MA02215
| | - Francesca Dominici
- Department of Biostatistics, Harvard TH Chan School of Public Health, Boston, MA02115
| | - Ellen A. Eisen
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA94704
| | - Rachel Morello-Frosch
- Department of Environmental Policy, Science, and Management, University of California, Berkeley, CA94720
- Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA94704
| | - Tarik Benmarhnia
- Scripps Institution of Oceanography, University of California San Diego, La Jolla, CA92037
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Villarruel CM, Figueroa LA, Ranville JF. Quantification of Bioaccessible and Environmentally Relevant Trace Metals in Structure Ash from a Wildland-Urban Interface Fire. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2024; 58:2502-2513. [PMID: 38277687 DOI: 10.1021/acs.est.3c08446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2024]
Abstract
Wildfires at the wildland-urban interface (WUI) are increasing in frequency and intensity, driven by climate change and anthropogenic ignitions. Few studies have characterized the variability in the metal content in ash generated from burned structures in order to determine the potential risk to human and environmental health. Using inductively coupled plasma optical emission spectroscopy (ICP-OES) and inductively coupled plasma mass spectrometry (ICP-MS), we analyzed leachable trace metal concentration in soils and ash from structures burned by the Marshall Fire, a WUI fire that destroyed over 1000 structures in Boulder County, Colorado. Acid digestion revealed that ash derived from structures contained 22 times more Cu and 3 times more Pb on average than surrounding soils on a mg/kg basis. Ash liberated 12 times more Ni (mg/kg) and twice as much Cr (mg/kg) as soils in a water leach. By comparing the amount of acid-extractable metals to that released by water and simulated epithelial lung fluid (SELF), we estimated their potential for environmental mobility and human bioaccessibility. The SELF leach showed that Cu and Ni were more bioaccessible (mg of leachable metal/mg of acid-extractable metal) in ash than in soils. These results suggest that structure ash is an important source of trace metals that can negatively impact the health of both humans and the environment.
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Affiliation(s)
- Carmen M Villarruel
- Department of Chemistry, Colorado School of Mines, Golden, Colorado 80401, United States
| | - Linda A Figueroa
- Department of Civil and Environmental Engineering, Colorado School of Mines, Golden, Colorado 80401, United States
| | - James F Ranville
- Department of Chemistry, Colorado School of Mines, Golden, Colorado 80401, United States
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Abstract
We review current knowledge on the trends and drivers of global wildfire activity, advances in the measurement of wildfire smoke exposure, and evidence on the health effects of this exposure. We describe methodological issues in estimating the causal effects of wildfire smoke exposures on health and quantify their importance, emphasizing the role of nonlinear and lagged effects. We conduct a systematic review and meta-analysis of the health effects of wildfire smoke exposure, finding positive impacts on all-cause mortality and respiratory hospitalizations but less consistent evidence on cardiovascular morbidity. We conclude by highlighting priority areas for future research, including leveraging recently developed spatially and temporally resolved wildfire-specific ambient air pollution data to improve estimates of the health effects of wildfire smoke exposure.
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Affiliation(s)
- Carlos F Gould
- Doerr School of Sustainability, Stanford University, Stanford, California, USA; ,
| | - Sam Heft-Neal
- Center on Food Security and the Environment, Stanford University, Stanford, California, USA;
| | - Mary Johnson
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA; ,
| | - Juan Aguilera
- Center for Community Health Impact, The University of Texas Health Science Center at Houston School of Public Health, El Paso, Texas, USA;
| | - Marshall Burke
- Doerr School of Sustainability, Stanford University, Stanford, California, USA; ,
- Center on Food Security and the Environment, Stanford University, Stanford, California, USA;
- National Bureau of Economic Research, Boston, Massachusetts, USA
| | - Kari Nadeau
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA; ,
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10
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Vien MH, Ivey SL, Boyden H, Holm S, Neuhauser L. A scoping review of wildfire smoke risk communications: issues, gaps, and recommendations. BMC Public Health 2024; 24:312. [PMID: 38281022 PMCID: PMC10822163 DOI: 10.1186/s12889-024-17681-0] [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: 09/16/2023] [Accepted: 01/05/2024] [Indexed: 01/29/2024] Open
Abstract
BACKGROUND Wildfire smoke exposure has become a growing public health concern, as megafires and fires at the wildland urban interface increase in incidence and severity. Smoke contains many pollutants that negatively impact health and is linked to a number of health complications and chronic diseases. Communicating effectively with the public, especially at-risk populations, to reduce their exposure to this environmental pollutant has become a public health priority. Although wildfire smoke risk communication research has also increased in the past decade, best practice guidance is limited, and most health communications do not adhere to health literacy principles: readability, accessibility, and actionability. This scoping review identifies peer-reviewed studies about wildfire smoke risk communications to identify gaps in research and evaluation of communications and programs that seek to educate the public. METHODS Four hundred fifty-one articles were identified from Web of Science and PubMed databases. After screening, 21 articles were included in the final sample for the abstraction process and qualitative thematic analysis. Ten articles were based in the US, with the other half in Australia, Canada, Italy, and other countries. Fifteen articles examined communication materials and messaging recommendations. Eight papers described communication delivery strategies. Eleven articles discussed behavior change. Six articles touched on risk communications for vulnerable populations; findings were limited and called for increasing awareness and prioritizing risk communications for at-risk populations. RESULTS This scoping review found limited studies describing behavior change to reduce wildfire smoke exposure, characteristics of effective communication materials and messaging, and communication delivery strategies. Literature on risk communications, dissemination, and behavior change for vulnerable populations was even more limited. CONCLUSIONS Recommendations include providing risk communications that are easy-to-understand and adapted to specific needs of at-risk groups. Communications should provide a limited number of messages that include specific actions for avoiding smoke exposure. Effective communications should use mixed media formats and a wide variety of dissemination strategies. There is a pressing need for more intervention research and effectiveness evaluation of risk communications about wildfire smoke exposure, and more development and dissemination of risk communications for both the general public and vulnerable populations.
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Affiliation(s)
- Morgan H Vien
- Health Research for Action, University of California Berkeley, School of Public Health, Berkeley, USA.
| | - Susan L Ivey
- Health Research for Action, University of California Berkeley, School of Public Health, Berkeley, USA
| | - Hollynd Boyden
- Health Research for Action, University of California Berkeley, School of Public Health, Berkeley, USA
| | - Stephanie Holm
- Health Research for Action, University of California Berkeley, School of Public Health, Berkeley, USA
- Western States Pediatric Environmental Health Specialty Unit, San Francisco, USA
- University of California, San Francisco, USA
| | - Linda Neuhauser
- Health Research for Action, University of California Berkeley, School of Public Health, Berkeley, USA
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Wilgus ML, Merchant M. Clearing the Air: Understanding the Impact of Wildfire Smoke on Asthma and COPD. Healthcare (Basel) 2024; 12:307. [PMID: 38338192 PMCID: PMC10855577 DOI: 10.3390/healthcare12030307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 01/19/2024] [Accepted: 01/20/2024] [Indexed: 02/12/2024] Open
Abstract
Wildfires are a global natural phenomenon. In North America, wildfires have not only become more frequent, but also more severe and longer in duration, a trend ascribed to climate change combined with large fuel stores left from modern fire suppression. The intensification of wildfire activity has significant implications for planetary health and public health, as exposure to fine particulate matter (PM2.5) in wildfire smoke is linked to adverse health effects. This review focuses on respiratory morbidity from wildfire smoke exposure. Inhalation of wildfire PM2.5 causes lung injury via oxidative stress, local and systemic inflammation, airway epithelium compromise, and increased vulnerability to infection. Wildfire PM2.5 exposure results in exacerbations of pre-existing asthma and chronic obstructive pulmonary disease, with an escalation in healthcare utilization, including emergency department visits and hospitalizations. Wildfire smoke exposure may be associated with asthma onset, long-term impairment of lung function, and increased all-cause mortality. Children, older adults, occupationally-exposed groups, and possibly women are the most at risk from wildfire smoke. Future research is needed to clarify best practices for risk mitigation and wildfire management.
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Affiliation(s)
- May-Lin Wilgus
- Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095-1405, USA;
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12
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Nogueira LM, Yabroff KR. Climate change and cancer: the Environmental Justice perspective. J Natl Cancer Inst 2024; 116:15-25. [PMID: 37813679 DOI: 10.1093/jnci/djad185] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 08/29/2023] [Accepted: 08/31/2023] [Indexed: 10/11/2023] Open
Abstract
Despite advances in cancer control-prevention, screening, diagnosis, treatment, and survivorship-racial disparities in cancer incidence and survival persist and, in some cases, are widening in the United States. Since 2020, there's been growing recognition of the role of structural racism, including structurally racist policies and practices, as the main factor contributing to historical and contemporary disparities. Structurally racist policies and practices have been present since the genesis of the United States and are also at the root of environmental injustices, which result in disproportionately high exposure to environmental hazards among communities targeted for marginalization, increased cancer risk, disruptions in access to care, and worsening health outcomes. In addition to widening cancer disparities, environmental injustices enable the development of polluting infrastructure, which contribute to detrimental health outcomes in the entire population, and to climate change, the most pressing public health challenge of our time. In this commentary, we describe the connections between climate change and cancer through an Environmental Justice perspective (defined as the fair treatment and meaningful involvement of people of all racialized groups, nationalities, or income, in all aspects, including development, implementation, and enforcement, of policies and practices that affect the environment and public health), highlighting how the expertise developed in communities targeted for marginalization is crucial for addressing health disparities, tackling climate change, and advancing cancer control efforts for the entire population.
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Affiliation(s)
- Leticia M Nogueira
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, GA, USA
| | - K Robin Yabroff
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, GA, USA
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Curto A, Nunes J, Milà C, Nhacolo A, Hänninen R, Sofiev M, Valentín A, Saúte F, Kogevinas M, Sacoor C, Bassat Q, Tonne C. Associations between landscape fires and child morbidity in southern Mozambique: a time-series study. Lancet Planet Health 2024; 8:e41-e50. [PMID: 38199722 DOI: 10.1016/s2542-5196(23)00251-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 10/25/2023] [Accepted: 10/30/2023] [Indexed: 01/12/2024]
Abstract
BACKGROUND Epidemiological evidence linking exposure to landscape fires to child health remains scarce. We assessed the association between daily landscape fire smoke and child hospital visits and admissions in the Manhiça district, Mozambique, an area characterised by frequent forest and cropland fires. METHODS In this time-series analysis (2012-20), our primary metric for exposure to landscape fires was fire-originated PM2·5 from smoke dispersion hindcasts. We also assessed total and upwind fire exposure using daily satellite-derived fire density data. Daily numbers of hospital visits and admissions were extracted from an ongoing paediatric morbidity surveillance system (children aged ≤15 years). We applied quasi-Poisson regression models controlling for season, long-term trend, day of the week, temperature, and rainfall, and offsetting by annual population-time at risk to examine lag-specific association of fires on morbidity. FINDINGS A 10 μg/m3 increase in fire-originated PM2·5 was associated with a 6·12% (95% CI 0·37-12·21) increase in all-cause and a 12·43% (5·07-20·31) increase in respiratory-linked hospital visits on the following day. Positive associations were also observed for lag 0 and the cumulative lag of 0-1 days. Null associations were observed for hospital admissions. Landscape fires mostly occurred in forested areas; however, associations with child morbidity were stronger for cropland than for forest fires. INTERPRETATION Landscape fire smoke was associated with all-cause and respiratory-linked morbidity in children. Improved exposure assessment is needed to better quantify the contribution of landscape fire smoke to child health in regions with scarce air pollution monitoring. FUNDING H2020 project EXHAUSTION, Academy of Finland, Spanish Ministry of Science and Innovation, Generalitat de Catalunya, and Government of Mozambique and Spanish Agency for International Cooperation and Development.
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Affiliation(s)
- Ariadna Curto
- Barcelona Institute for Global Health, Barcelona, Spain; Department de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública, Madrid, Spain
| | - Jovito Nunes
- Hospital Clínic-Universitat de Barcelona, Barcelona, Spain; Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
| | - Carles Milà
- Barcelona Institute for Global Health, Barcelona, Spain; Department de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública, Madrid, Spain
| | - Arsenio Nhacolo
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
| | | | | | - Antònia Valentín
- Barcelona Institute for Global Health, Barcelona, Spain; Department de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública, Madrid, Spain
| | - Francisco Saúte
- Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique
| | - Manolis Kogevinas
- Barcelona Institute for Global Health, Barcelona, Spain; Department de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública, Madrid, Spain; Hospital del Mar Medical Research Institute, Barcelona, Spain
| | | | - Quique Bassat
- Hospital Clínic-Universitat de Barcelona, Barcelona, Spain; CIBER Epidemiología y Salud Pública, Madrid, Spain; Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique; Institució Catalana de Recerca i Estudis Avançats, Barcelona, Spain; Pediatric Infectious Diseases Unit, Pediatrics Department, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
| | - Cathryn Tonne
- Barcelona Institute for Global Health, Barcelona, Spain; Department de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública, Madrid, Spain; Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique.
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14
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Hvidtfeldt UA, Chen J, Rodopoulou S, Strak M, de Hoogh K, Andersen ZJ, Bellander T, Brandt J, Forastiere F, Brynedal B, Hertel O, Hoffmann B, Katsouyanni K, Ketzel M, Leander K, Magnusson PKE, Nagel G, Pershagen G, Rizzuto D, Samoli E, So R, Stafoggia M, Tjønneland A, Weinmayr G, Wolf K, Zitt E, Brunekreef B, Hoek G, Raaschou-Nielsen O. Multiple myeloma risk in relation to long-term air pollution exposure - A pooled analysis of four European cohorts. ENVIRONMENTAL RESEARCH 2023; 239:117230. [PMID: 37806476 DOI: 10.1016/j.envres.2023.117230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 09/08/2023] [Accepted: 09/09/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND Air pollution is a growing concern worldwide, with significant impacts on human health. Multiple myeloma is a type of blood cancer with increasing incidence. Studies have linked air pollution exposure to various types of cancer, including leukemia and lymphoma, however, the relationship with multiple myeloma incidence has not been extensively investigated. METHODS We pooled four European cohorts (N = 234,803) and assessed the association between residential exposure to nitrogen dioxide (NO2), fine particles (PM2.5), black carbon (BC), and ozone (O3) and multiple myeloma. We applied Cox proportional hazards models adjusting for potential confounders at the individual and area-level. RESULTS During 4,415,817 person-years of follow-up (average 18.8 years), we observed 404 cases of multiple myeloma. The results of the fully adjusted linear analyses showed hazard ratios (95% confidence interval) of 0.99 (0.84, 1.16) per 10 μg/m³ NO2, 1.04 (0.82, 1.33) per 5 μg/m³ PM2.5, 0.99 (0.84, 1.18) per 0.5 10-5 m-1 BCE, and 1.11 (0.87, 1.41) per 10 μg/m³ O3. CONCLUSIONS We did not observe an association between long-term ambient air pollution exposure and incidence of multiple myeloma.
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Affiliation(s)
| | - Jie Chen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Sophia Rodopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Maciej Strak
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands; National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Zorana J Andersen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Tom Bellander
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Jørgen Brandt
- Department of Environmental Science, Aarhus University, Roskilde, Denmark; iClimate - interdisciplinary Centre for Climate Change, Aarhus University, Roskilde, Denmark
| | - Francesco Forastiere
- Department of Epidemiology, Lazio Region Health Service/ASL Roma 1, Rome, Italy; Environmental Research Group, School of Public Health, Faculty of Medicine, Imperial College, London, UK
| | - Boel Brynedal
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Ole Hertel
- Departments of Ecoscience, Aarhus University, Roskilde, Denmark
| | - Barbara Hoffmann
- Institute for Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Klea Katsouyanni
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece; MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Matthias Ketzel
- Department of Environmental Science, Aarhus University, Roskilde, Denmark; Global Centre for Clean Air Research (GCARE), University of Surrey, Guildford, GU2 7XH, United Kingdom
| | - Karin Leander
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Patrik K E Magnusson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Gabriele Nagel
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Göran Pershagen
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Debora Rizzuto
- Department of Neurobiology, Care Sciences, And Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Evangelia Samoli
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Rina So
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark; Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Massimo Stafoggia
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Epidemiology, Lazio Region Health Service/ASL Roma 1, Rome, Italy
| | - Anne Tjønneland
- The Danish Cancer Institute, Copenhagen, Denmark; Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Gudrun Weinmayr
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Kathrin Wolf
- Institute of Epidemiology, Helmholtz Zentrum München, Neuherberg, Germany
| | - Emanuel Zitt
- Agency for Preventive and Social Medicine (aks), Bregenz, Austria; Department of Internal Medicine 3, LKH Feldkirch, Feldkirch, Austria
| | - Bert Brunekreef
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Gerard Hoek
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Ole Raaschou-Nielsen
- The Danish Cancer Institute, Copenhagen, Denmark; Department of Environmental Science, Aarhus University, Roskilde, Denmark
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Lopez AM, Pacheco JL, Fendorf S. Metal toxin threat in wildland fires determined by geology and fire severity. Nat Commun 2023; 14:8007. [PMID: 38086795 PMCID: PMC10716285 DOI: 10.1038/s41467-023-43101-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 10/31/2023] [Indexed: 12/18/2023] Open
Abstract
Accentuated by climate change, catastrophic wildfires are a growing, distributed global public health risk from inhalation of smoke and dust. Underrecognized, however, are the health threats arising from fire-altered toxic metals natural to soils and plants. Here, we demonstrate that high temperatures during California wildfires catalyzed widespread transformation of chromium to its carcinogenic form in soil and ash, as hexavalent chromium, particularly in areas with metal-rich geologies (e.g., serpentinite). In wildfire ash, we observed dangerous levels (327-13,100 µg kg-1) of reactive hexavalent chromium in wind-dispersible particulates. Relatively dry post-fire weather contributed to the persistence of elevated hexavalent chromium in surficial soil layers for up to ten months post-fire. The geographic distribution of metal-rich soils and fire incidents illustrate the broad global threat of wildfire smoke- and dust-born metals to populations. Our findings provide new insights into why wildfire smoke exposure appears to be more hazardous to humans than pollution from other sources.
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Affiliation(s)
- Alandra Marie Lopez
- Earth System Science Department, Stanford University, Stanford, CA, 94305, USA
| | - Juan Lezama Pacheco
- Earth System Science Department, Stanford University, Stanford, CA, 94305, USA
| | - Scott Fendorf
- Earth System Science Department, Stanford University, Stanford, CA, 94305, USA.
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Qiu J, Ma Z, Li R, Qu C, Wang K, Liu B, Tian Y, Tian H. Distinguishing EGFR mutant subtypes in stage IA non-small cell lung cancer using the presence status of ground glass opacity and final histologic classification: a systematic review and meta-analysis. Front Med (Lausanne) 2023; 10:1268846. [PMID: 38126071 PMCID: PMC10731050 DOI: 10.3389/fmed.2023.1268846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 11/22/2023] [Indexed: 12/23/2023] Open
Abstract
Background The progression of early stage non-small cell lung cancer (NSCLC) is closely related to epidermal growth factor receptor (EGFR) mutation status. The purpose of this study was to systematically investigate the relationship between EGFR mutation status and demographic, imaging, and ultimately pathologic features in patients with NSCLC. Methods A complete literature search was conducted using the PubMed, Web of Science, EMBASE, and Cochrane Library databases to discover articles published by May 15, 2023 that were eligible. The relationship between EGFR mutation status and specific demographic, imaging, and ultimately pathologic features in patients with NSCLC was evaluated using pooled odds ratios (ORs) and their 95% confidence intervals (CIs). The standardized mean difference (SMD) with 95% CIs was the appropriate statistic to summarize standard deviations (SDs) means for continuous variables. Results A total of 9 studies with 1789 patients were included in this analysis. The final findings suggested that patients with a greater age, female gender, and non-smoking status would have a relatively higher incidence of EGFR mutations. Additionally, the risk of EGFR mutations increased with larger tumor diameter, tumor imaging presentation of mixed ground glass opacity (mGGO), and tumor pathological findings of minimally invasive adenocarcinoma (MIA) or invasive adenocarcinoma (IAC). Significantly, malignancies presenting as MIA are more likely to contain L858R point mutations (OR = 1.80; 95% CI: 1.04-3.13; p = 0.04) rather than exon 19 deletions (OR = 1.81; 95% CI: 0.95-3.44; p = 0.07). Conclusion This meta-analysis showed that imaging parameters and histological classifications of pulmonary nodules may be able to predict stage IA NSCLC genetic changes.
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Affiliation(s)
- Jianhao Qiu
- Department of Thoracic Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Zheng Ma
- Department of Thoracic Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Rongyang Li
- Department of Thoracic Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Chenghao Qu
- Department of Thoracic Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Kun Wang
- Department of Thoracic Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Binyan Liu
- Department of Breast Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Yu Tian
- Department of Thoracic Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Hui Tian
- Department of Thoracic Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, China
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17
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Wei J, Wang J, Li Z, Kondragunta S, Anenberg S, Wang Y, Zhang H, Diner D, Hand J, Lyapustin A, Kahn R, Colarco P, da Silva A, Ichoku C. Long-term mortality burden trends attributed to black carbon and PM 2·5 from wildfire emissions across the continental USA from 2000 to 2020: a deep learning modelling study. Lancet Planet Health 2023; 7:e963-e975. [PMID: 38056967 DOI: 10.1016/s2542-5196(23)00235-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 10/04/2023] [Accepted: 10/12/2023] [Indexed: 12/08/2023]
Abstract
BACKGROUND Long-term improvements in air quality and public health in the continental USA were disrupted over the past decade by increased fire emissions that potentially offset the decrease in anthropogenic emissions. This study aims to estimate trends in black carbon and PM2·5 concentrations and their attributable mortality burden across the USA. METHODS In this study, we derived daily concentrations of PM2·5 and its highly toxic black carbon component at a 1-km resolution in the USA from 2000 to 2020 via deep learning that integrated big data from satellites, models, and surface observations. We estimated the annual PM2·5-attributable and black carbon-attributable mortality burden at each 1-km2 grid using concentration-response functions collected from a national cohort study and a meta-analysis study, respectively. We investigated the spatiotemporal linear-regressed trends in PM2·5 and black carbon pollution and their associated premature deaths from 2000 to 2020, and the impact of wildfires on air quality and public health. FINDINGS Our results showed that PM2·5 and black carbon estimates are reliable, with sample-based cross-validated coefficients of determination of 0·82 and 0·80, respectively, for daily estimates (0·97 and 0·95 for monthly estimates). Both PM2·5 and black carbon in the USA showed significantly decreasing trends overall during 2000 to 2020 (22% decrease for PM2·5 and 11% decrease for black carbon), leading to a reduction of around 4200 premature deaths per year (95% CI 2960-5050). However, since 2010, the decreasing trends of fine particles and premature deaths have reversed to increase in the western USA (55% increase in PM2·5, 86% increase in black carbon, and increase of 670 premature deaths [460-810]), while remaining mostly unchanged in the eastern USA. The western USA showed large interannual fluctuations that were attributable to the increasing incidence of wildfires. Furthermore, the black carbon-to-PM2·5 mass ratio increased annually by 2·4% across the USA, mainly due to increasing wildfire emissions in the western USA and more rapid reductions of other components in the eastern USA, suggesting a potential increase in the relative toxicity of PM2·5. 100% of populated areas in the USA have experienced at least one day of PM2·5 pollution exceeding the daily air quality guideline level of 15 μg/m3 during 2000-2020, with 99% experiencing at least 7 days and 85% experiencing at least 30 days. The recent widespread wildfires have greatly increased the daily exposure risks in the western USA, and have also impacted the midwestern USA due to the long-range transport of smoke. INTERPRETATION Wildfires have become increasingly intensive and frequent in the western USA, resulting in a significant increase in smoke-related emissions in populated areas. This increase is likely to have contributed to a decline in air quality and an increase in attributable mortality. Reducing fire risk via effective policies besides mitigation of climate warming, such as wildfire prevention and management, forest restoration, and new revenue generation, could substantially improve air quality and public health in the coming decades. FUNDING National Aeronautics and Space Administration (NASA) Applied Science programme, NASA MODIS maintenance programme, NASA MAIA satellite mission programme, NASA GMAO core fund, National Oceanic and Atmospheric Administration (NOAA) GEO-XO project, NOAA Atmospheric Chemistry, Carbon Cycle, and Climate (AC4) programme, and NOAA Educational Partnership Program with Minority Serving Institutions.
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Affiliation(s)
- Jing Wei
- Department of Chemical and Biochemical Engineering, Iowa Technology Institute, Center for Global and Regional Environmental Research, University of Iowa, Iowa City, IA, USA; Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park, MD, USA.
| | - Jun Wang
- Department of Chemical and Biochemical Engineering, Iowa Technology Institute, Center for Global and Regional Environmental Research, University of Iowa, Iowa City, IA, USA.
| | - Zhanqing Li
- Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park, MD, USA.
| | - Shobha Kondragunta
- Center for Satellite Applications and Research, NOAA National Environmental Satellite, Data, and Information Service, College Park, MD, USA
| | - Susan Anenberg
- Department of Environmental and Occupational Health, George Washington University, Washington, DC, USA
| | - Yi Wang
- Department of Chemical and Biochemical Engineering, Iowa Technology Institute, Center for Global and Regional Environmental Research, University of Iowa, Iowa City, IA, USA
| | - Huanxin Zhang
- Department of Chemical and Biochemical Engineering, Iowa Technology Institute, Center for Global and Regional Environmental Research, University of Iowa, Iowa City, IA, USA
| | - David Diner
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA, USA
| | - Jenny Hand
- Cooperative Institute for Research in the Atmosphere, Colorado State University, Fort Collins, CO, USA
| | - Alexei Lyapustin
- Climate and Radiation Laboratory, NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - Ralph Kahn
- Climate and Radiation Laboratory, NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - Peter Colarco
- Atmospheric Chemistry and Dynamics Laboratory, NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - Arlindo da Silva
- Global Modeling and Assimilation Office, NASA Goddard Space Flight Center, Greenbelt, MD, USA
| | - Charles Ichoku
- Department of Geography and Environmental Systems, University of Maryland Baltimore County, Baltimore, MD, USA
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18
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Zomawia E, Zami Z, Vanlallawma A, Kumar NS, Zothanzama J, Tlau L, Chhakchhuak L, Pachuau L, Pautu JL, Hmangaihzuali EV. Cancer awareness, diagnosis and treatment needs in Mizoram, India: evidence from 18 years trends (2003-2020). THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2023; 17:100281. [PMID: 37780980 PMCID: PMC10541469 DOI: 10.1016/j.lansea.2023.100281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 09/01/2023] [Accepted: 09/04/2023] [Indexed: 10/03/2023]
Abstract
Background Despite being the second least populated state, Mizoram exhibits the highest incidence rate of cancer in India. Its inhabitants, constituting an endogamous and isolated population, have embraced their own distinct culture, way of life and dietary preferences, setting them apart from the rest of mainland India. In 2003, the Mizoram Population Based Cancer Registry (PBCR) was established under the auspices of the National Centre for Disease Informatics and Research (NCDIR), a division of the Indian Council of Medical Research (ICMR), in collaboration with the Department of Health & Family Welfare of the Government of Mizoram, India. Methods Cancer incidence and mortality data were extracted from the Mizoram PBCR spanning the years 2003-2020. The Age Standardized Incidence Rate (ASIR) and Age Standardized Mortality Rate (ASMR) were computed per 100,000 individuals, utilizing Segi's World Standard Population as the benchmark. The trajectory of these changes was analysed employing the Joinpoint Regression Analysis Program, Version 4.9.1.0.13, to unveil the Annual Percent Change (APC) with a 95% Confidence Interval and a Significance test (p < 0.05) using Monte Carlo Permutation. The resulting graphical visualizations were generated using Flourish Studio.15. Findings The overall ASIR for all cancer sites among men was 197.2 per 100,000, while for women, it was 164.9 per 100,000. Among men, the most prevalent cancer site was the Stomach (ASIR = 41.4), followed by Head & Neck, Lung, Oesophagus, Colorectal, Liver, Urinary, Non-Hodgkin's Lymphoma and Prostate cancers. Conversely, among women, Lung cancer exhibited the highest incidence (ASIR = 26.7), succeeded by Cervical, Breast, Stomach, Head & Neck, Colorectal, Oesophagus, Liver and Ovarian cancers. Stomach cancer emerged as the leading cause of death among men (ASMR = 22.6) and among women, Lung cancer held the highest ASMR (15.9). Joinpoint regression analysis revealed a rising trend in incidence and mortality over time for overall cancer sites. Among the primary cancer sites contributing to incidence and mortality, an increase in APC was observable for all, except Stomach cancer, in both men and women. The diagnostic approach, except for cases of cancer with unknown primary sites, involved a microscopic method. Interpretation This cross-sectional study examines PBCR reports spanning from 2003 to 2020, shedding light on a consistent uptick in cancer incidence and mortality trends in Mizoram. Stomach cancer emerges as the most prevalent and primary cause of cancer-related deaths among men, while Lung cancer takes a parallel role in women. The elevated cancer incidence and the growing trend among younger generations might stem from the static lifestyle and dietary patterns prevalent within the endogamous tribal population, potentially contributing to a genetic predisposition. The escalation in mortality rates could be attributed to a dearth of specialized diagnostic facilities and skilled human resources, treatment strategies guided by genomic research and transportation challenges. This underscores the urgent requirement for comprehensive scientific exploration across diverse facets. The implementation of easily accessible diagnostic facilities in proximity and genetic testing for pharmacogenomics to enhance prognoses would also aid in mitigating the burden and advancing the healthcare system's effectiveness. Funding Population Based Cancer Registry (PBCR) was supported by National Centre for Disease Informatics and Research (NCDIR) of the Indian Council of Medical Research (ICMR), India.
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Affiliation(s)
- Eric Zomawia
- National Health Mission, Department of Health & Family Welfare, Government of Mizoram, Dinthar, 796009, Aizawl, Mizoram, India
| | - Zothan Zami
- Department of Biotechnology, Mizoram University, Aizawl, 796004, Mizoram, India
| | - Andrew Vanlallawma
- Department of Biotechnology, Mizoram University, Aizawl, 796004, Mizoram, India
| | | | - John Zothanzama
- Department of Biotechnology, Mizoram University, Aizawl, 796004, Mizoram, India
| | - Lalchhanhimi Tlau
- Department of Pathology, Civil Hospital Aizawl, Department of Health & Family Welfare, Government of Mizoram, Dawrpui, 796001, Aizawl, Mizoram, India
| | - Lalchhandama Chhakchhuak
- Department of Pathology, Civil Hospital Aizawl, Department of Health & Family Welfare, Government of Mizoram, Dawrpui, 796001, Aizawl, Mizoram, India
| | - Lalawmpuii Pachuau
- Department of Pathology, Civil Hospital Aizawl, Department of Health & Family Welfare, Government of Mizoram, Dawrpui, 796001, Aizawl, Mizoram, India
| | - Jeremy L. Pautu
- Department of Medical Oncology, Mizoram State Cancer Institute, Zemabawk, 796017, Aizawl, Mizoram, India
| | - Evelyn V.L. Hmangaihzuali
- Population Based Cancer Registry Mizoram, NCDIR (ICMR), Civil Hospital Aizawl, Department of Health & Family Welfare, Government of Mizoram, Dawrpui, 796001, Aizawl, Mizoram, India
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Berg CD, Schiller JH, Boffetta P, Cai J, Connolly C, Kerpel-Fronius A, Kitts AB, Lam DCL, Mohan A, Myers R, Suri T, Tammemagi MC, Yang D, Lam S. Air Pollution and Lung Cancer: A Review by International Association for the Study of Lung Cancer Early Detection and Screening Committee. J Thorac Oncol 2023; 18:1277-1289. [PMID: 37277094 DOI: 10.1016/j.jtho.2023.05.024] [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: 05/17/2023] [Accepted: 05/26/2023] [Indexed: 06/07/2023]
Abstract
INTRODUCTION The second leading cause of lung cancer is air pollution. Air pollution and smoking are synergistic. Air pollution can worsen lung cancer survival. METHODS The Early Detection and Screening Committee of the International Association for the Study of Lung Cancer formed a working group to better understand issues in air pollution and lung cancer. These included identification of air pollutants, their measurement, and proposed mechanisms of carcinogenesis. The burden of disease and the underlying epidemiologic evidence linking air pollution to lung cancer in individuals who never and ever smoked were summarized to quantify the problem, assess risk prediction models, and develop recommended actions. RESULTS The number of estimated attributable lung cancer deaths has increased by nearly 30% since 2007 as smoking has decreased and air pollution has increased. In 2013, the International Agency for Research on Cancer classified outdoor air pollution and particulate matter with aerodynamic diameter less than 2.5 microns in outdoor air pollution as carcinogenic to humans (International Agency for Research on Cancer group 1) and as a cause of lung cancer. Lung cancer risk models reviewed do not include air pollution. Estimation of cumulative exposure to air pollution exposure is complex which poses major challenges with accurately collecting long-term exposure to ambient air pollution for incorporation into risk prediction models in clinical practice. CONCLUSIONS Worldwide air pollution levels vary widely, and the exposed populations also differ. Advocacy to lower sources of exposure is important. Health care can lower its environmental footprint, becoming more sustainable and resilient. The International Association for the Study of Lung Cancer community can engage broadly on this topic.
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Affiliation(s)
| | - Joan H Schiller
- Department of Medicine, University of Virginia, Charlottesville, Virginia
| | - Paolo Boffetta
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, New York
| | - Jing Cai
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and National Health Commission Key Lab of Health Technology Assessment, Fudan University, Shanghai, People's Republic of China
| | - Casey Connolly
- The International Association for the Study of Lung Cancer, Denver, Colorado
| | - Anna Kerpel-Fronius
- Department of Radiology National Korányi Institute for Pulmonology, Budapest, Hungary
| | | | - David C L Lam
- University Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Anant Mohan
- Department of Pulmonary Medicine, Critical Care, and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Renelle Myers
- Department of Integrative Oncology, British Columbia Cancer Research Institute, Vancouver, British Columbia, Canada
| | - Tejas Suri
- Department of Pulmonary Medicine, Critical Care, and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Martin C Tammemagi
- Department of Health Sciences, Brock University, St. Catharines, Ontario, Canada
| | - Dawei Yang
- Department of Pulmonary Medicine and Critical Care, Zhongshan Hospital Fudan University, Shanghai, People's Republic of China
| | - Stephen Lam
- Department of Medicine, British Columbia Cancer Agency and The University of British Columbia, Vancouver, British Columbia, Canada
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20
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Leiter A, Veluswamy RR, Wisnivesky JP. The global burden of lung cancer: current status and future trends. Nat Rev Clin Oncol 2023; 20:624-639. [PMID: 37479810 DOI: 10.1038/s41571-023-00798-3] [Citation(s) in RCA: 114] [Impact Index Per Article: 114.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2023] [Indexed: 07/23/2023]
Abstract
Lung cancer is the leading cause of cancer-related death worldwide. However, lung cancer incidence and mortality rates differ substantially across the world, reflecting varying patterns of tobacco smoking, exposure to environmental risk factors and genetics. Tobacco smoking is the leading risk factor for lung cancer. Lung cancer incidence largely reflects trends in smoking patterns, which generally vary by sex and economic development. For this reason, tobacco control campaigns are a central part of global strategies designed to reduce lung cancer mortality. Environmental and occupational lung cancer risk factors, such as unprocessed biomass fuels, asbestos, arsenic and radon, can also contribute to lung cancer incidence in certain parts of the world. Over the past decade, large-cohort clinical studies have established that low-dose CT screening reduces lung cancer mortality, largely owing to increased diagnosis and treatment at earlier disease stages. These data have led to recommendations that individuals with a high risk of lung cancer undergo screening in several economically developed countries and increased implementation of screening worldwide. In this Review, we provide an overview of the global epidemiology of lung cancer. Lung cancer risk factors and global risk reduction efforts are also discussed. Finally, we summarize lung cancer screening policies and their implementation worldwide.
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Affiliation(s)
- Amanda Leiter
- Division of Endocrinology, Diabetes, and Bone Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Rajwanth R Veluswamy
- Division of Hematology and Oncology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Juan P Wisnivesky
- Division of General Internal Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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21
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Zhang D, Xi Y, Boffa DJ, Liu Y, Nogueira LM. Association of Wildfire Exposure While Recovering From Lung Cancer Surgery With Overall Survival. JAMA Oncol 2023; 9:1214-1220. [PMID: 37498574 PMCID: PMC10375383 DOI: 10.1001/jamaoncol.2023.2144] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 04/26/2023] [Indexed: 07/28/2023]
Abstract
Importance With a changing climate, wildfire activity in the US has increased dramatically, presenting multifaceted and compounding health hazards. Individuals discharged from the hospital following surgical resection of non-small cell lung cancer (NSCLC) are potentially at higher risk from wildfires' health hazards. Objective To assess the association between wildfire exposure and postoperative long-term overall survival among patients with lung cancer in the US. Design, Setting, and Participants In this cohort study, individuals who underwent curative-intent NSCLC resection between January 1, 2004, and December 31, 2019, were selected from the National Cancer Database. Daily wildfire information was aggregated at the zip code level from the National Aeronautics and Space Administration Fire Information for Resource Management System. The data analysis was performed between July 19, 2022, and April 14, 2023. Exposure An active wildfire detected at the zip code of residence between 0 and 3, 4 and 6, or 7 and 12 months after NSCLC surgery. Main Outcome Overall survival was defined as the interval between age at hospital discharge and age at death, last contact, or study end, whichever came first. Cox proportional hazards were used for estimating hazard ratios (HRs) adjusted for sex, region, metropolitan category, health insurance type, comorbidities, tumor size, lymph node involvement, era, and facility type. Results A total of 466 912 individuals included in the study (249 303 female and [53.4] and 217 609 male [46.6%]; mean [SD] age at diagnosis, 67.3 [9.9] years), with 48 582 (10.4%) first exposed to a wildfire between 0 and 3 months, 48 328 (10.6%) between 4 and 6 months, and 71 735 (15.3%) between 7 and 12 months following NSCLC surgery. Individuals exposed to a wildfire within 3 months (adjusted HR [AHR], 1.43; 95% CI, 1.41-1.45), between 4 and 6 months (AHR, 1.39; 95% CI, 1.37-1.41), and between 7 and 12 months (AHR, 1.17; 95% CI, 1.15-1.19) after discharge from the hospital following stage I to III NSCLC resection had worse overall survival than unexposed individuals. Conclusions In this cohort study, wildfire exposure was associated with worse overall survival following NSCLC surgical resection, suggesting that patients with lung cancer are at greater risk from the health hazards of wildfires and need to be prioritized in climate adaptation efforts.
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Affiliation(s)
- Danlu Zhang
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Yuzhi Xi
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | | | - Yang Liu
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Leticia M. Nogueira
- Surveillance and Health Equity Science, American Cancer Society, Kennesaw, Georgia
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22
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Wang P, Sun S, Lam S, Lockwood WW. New insights into the biology and development of lung cancer in never smokers-implications for early detection and treatment. J Transl Med 2023; 21:585. [PMID: 37653450 PMCID: PMC10472682 DOI: 10.1186/s12967-023-04430-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: 06/16/2023] [Accepted: 08/10/2023] [Indexed: 09/02/2023] Open
Abstract
Lung cancer is the leading cause of cancer deaths worldwide. Despite never smokers comprising between 10 and 25% of all cases, lung cancer in never smokers (LCNS) is relatively under characterized from an etiological and biological perspective. The application of multi-omics techniques on large patient cohorts has significantly advanced the current understanding of LCNS tumor biology. By synthesizing the findings of multi-omics studies on LCNS from a clinical perspective, we can directly translate knowledge regarding tumor biology into implications for patient care. Primarily focused on never smokers with lung adenocarcinoma, this review details the predominance of driver mutations, particularly in East Asian patients, as well as the frequency and importance of germline variants in LCNS. The mutational patterns present in LCNS tumors are thoroughly explored, highlighting the high abundance of the APOBEC signature. Moreover, this review recognizes the spectrum of immune profiles present in LCNS tumors and posits how it can be translated to treatment selection. The recurring and novel insights from multi-omics studies on LCNS tumor biology have a wide range of clinical implications. Risk factors such as exposure to outdoor air pollution, second hand smoke, and potentially diet have a genomic imprint in LCNS at varying degrees, and although they do not encompass all LCNS cases, they can be leveraged to stratify risk. Germline variants similarly contribute to a notable proportion of LCNS, which warrants detailed documentation of family history of lung cancer among never smokers and demonstrates value in developing testing for pathogenic variants in never smokers for early detection in the future. Molecular driver subtypes and specific co-mutations and mutational signatures have prognostic value in LCNS and can guide treatment selection. LCNS tumors with no known driver alterations tend to be stem-like and genes contributing to this state may serve as potential therapeutic targets. Overall, the comprehensive findings of multi-omics studies exert a wide influence on clinical management and future research directions in the realm of LCNS.
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Affiliation(s)
- Peiyao Wang
- Department of Integrative Oncology, British Columbia Cancer Research Institute, Vancouver, BC, Canada
- Interdisciplinary Oncology Program, University of British Columbia, Vancouver, BC, Canada
| | - Sophie Sun
- Department of Medical Oncology, British Columbia Cancer Agency Vancouver, Vancouver, BC, Canada
| | - Stephen Lam
- Department of Integrative Oncology, British Columbia Cancer Research Institute, Vancouver, BC, Canada
| | - William W Lockwood
- Department of Integrative Oncology, British Columbia Cancer Research Institute, Vancouver, BC, Canada.
- Interdisciplinary Oncology Program, University of British Columbia, Vancouver, BC, Canada.
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada.
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23
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Lynch KA, Merdjanoff AA. Impact of Disasters on Older Adult Cancer Outcomes: A Scoping Review. JCO Glob Oncol 2023; 9:e2200374. [PMID: 37290025 PMCID: PMC10497294 DOI: 10.1200/go.22.00374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2023] [Indexed: 06/10/2023] Open
Abstract
PURPOSE There is an urgent need to address the growing global cancer burden in the context of complex disaster events, which both disrupt access to oncology care and facilitate carcinogenic exposures. Older adults (65 years and older) are a growing population with multifaceted care needs, making them especially vulnerable to disasters. The objective of this scoping review is to characterize the state of the literature concerning older adult cancer-related outcomes and oncologic care after a disaster event. METHODS A search was conducted in PubMed and Web of Science. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for scoping reviews, articles were extracted and screened for inclusion. Eligible articles were summarized using descriptive and thematic analyses. RESULTS Thirty-five studies met all criteria for full-text review. The majority focused on technological disasters (60%, n = 21), followed by climate-amplified disasters (28.6%, n = 10) and geophysical disasters (11.4%, n = 4). Thematic analysis classified the current evidence into three major categories: (1) studies concerned with carcinogenic exposure and cancer incidence related to the disaster event, (2) studies examining changes in access to cancer care and cancer treatment disruptions as a result of the disaster event, and (3) studies exploring the psychosocial experiences of patients with cancer affected by a disaster event. Few studies focused on older adults specifically, and most of the current evidence focuses on disasters in the United States or Japan. CONCLUSION Older adult cancer outcomes after a disaster event are understudied. Current evidence suggests that disasters worsen cancer-related outcomes among older adults by disrupting continuity of care and access to timely treatment. There is a need for prospective longitudinal studies following older adult populations postdisaster and studies focused on disasters in low- and middle-income country contexts.
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Affiliation(s)
- Kathleen A. Lynch
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY
| | - Alexis A. Merdjanoff
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY
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24
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VoPham T, Jones RR. State of the science on outdoor air pollution exposure and liver cancer risk. ENVIRONMENTAL ADVANCES 2023; 11:100354. [PMID: 36875691 PMCID: PMC9984166 DOI: 10.1016/j.envadv.2023.100354] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Background There is emerging evidence that air pollution exposure increases the risk of developing liver cancer. To date, there have been four epidemiologic studies conducted in the United States, Taiwan, and Europe showing generally consistent positive associations between ambient exposure to air pollutants, including particulate matter <2.5 μm in aerodynamic diameter (PM2.5) and nitrogen dioxide (NO2), and liver cancer risk. There are several research gaps and thus valuable opportunities for future work to continue building on this expanding body of literature. The objectives of this paper are to narratively synthesize existing epidemiologic literature on the association between air pollution exposure and liver cancer incidence and describe future research directions to advance the science of understanding the role of air pollution exposure in liver cancer development. Future research directions include 1) accounting for potential confounding by established risk factors for the predominant histological subtype, hepatocellular carcinoma (HCC); 2) examination of incident primary liver cancer outcomes with consideration of potential differential associations according to histology; 3) air pollution exposure assessments considering early-life and/or historical exposures, residential histories, residual confounding from other sources of air pollution (e.g., tobacco smoking), and integration of geospatial ambient exposure modeling with novel biomarker technologies; 4) examination of air pollution mixtures experienced in the exposome; 5) consideration of increased opportunities for exposure to outdoor air pollution due to climate change (e.g., wildfires); and 6) consideration of modifying factors for air pollution exposure, such as socioeconomic status, that may contribute to disparities in liver cancer incidence. Conclusions In light of mounting evidence demonstrating that higher levels of air pollution exposure increase the risk for developing liver cancer, methodological considerations primarily concerning residual confounding and improved exposure assessment are warranted to robustly demonstrate an independent association for air pollution as a hepatocarcinogen.
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Affiliation(s)
- Trang VoPham
- Epidemiology Program, Public Health Sciences Division, Fred Hutchinson Cancer Center, 1100 Fairview Avenue N, Seattle, Washington 98109, United States
- Department of Epidemiology, University of Washington, 3980 15th Avenue NE, Seattle, Washington 98195, United States
| | - Rena R. Jones
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, 9609 Medical Center Drive MSC 9776, Bethesda, Maryland 20850, United States
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25
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Gao Y, Huang W, Yu P, Xu R, Yang Z, Gasevic D, Ye T, Guo Y, Li S. Long-term impacts of non-occupational wildfire exposure on human health: A systematic review. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 320:121041. [PMID: 36639044 DOI: 10.1016/j.envpol.2023.121041] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 12/14/2022] [Accepted: 01/06/2023] [Indexed: 06/17/2023]
Abstract
The intensity and frequency of wildfires is increasing globally. The systematic review of the current evidence on long-term impacts of non-occupational wildfire exposure on human health has not been performed yet. To provide a systematic review and identify potential knowledge gaps in the current evidence of long-term impacts of non-occupational exposure to wildfire smoke and/or wildfire impacts on human health. We conducted a systematic search of the literature via MEDLINE, Embase and Scopus from the database inception to July 05, 2022. References from the included studies and relevant reviews were also considered. The Newcastle-Ottawa Scale (NOS) and a validated quality assessment framework were used to evaluate the quality of observational studies. Study results were synthesized descriptively. A total of 36 studies were included in our systematic review. Most studies were from developed countries (11 in Australia, 9 in Canada, 7 in the United States). Studies predominantly focused on mental health (21 studies, 58.33%), while evidence on long-term impacts of wildfire exposure on health outcomes other than mental health is limited. Current evidence indicated that long-term impacts of non-occupational wildfire exposure were associated with mortality (COVID-19 mortality, cardiovascular disease mortality and acute myocardial disease mortality), morbidity (mainly respiratory diseases), mental health disorders (mainly posttraumatic stress disorder), shorter height of children, reduced lung function and poorer general health status. However, no significant associations were observed for long-term impacts of wildfire exposure on child mortality and respiratory hospitalizations. The population-based high-quality evidence with quantitative analysis on this topic is still limited. Future well-designed studies considering extensive wildfire smoke air pollutants (e.g., particulate matter, ozone, nitrogen oxides) and estimating risk coefficient values for extensive health outcomes (e.g., mortality, morbidity) are warranted to fill current knowledge gaps.
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Affiliation(s)
- Yuan Gao
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Wenzhong Huang
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Pei Yu
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Rongbin Xu
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Zhengyu Yang
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Danijela Gasevic
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia; Centre for Global Health, Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Tingting Ye
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Yuming Guo
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
| | - Shanshan Li
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia.
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26
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Gewin V. How a dangerous stew of air pollution is choking the United States. Nature 2022; 612:204-207. [PMID: 36473970 DOI: 10.1038/d41586-022-04333-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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27
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Aloisi M, Rossi G, Colafarina S, Guido M, Cecconi S, Poma AMG. The Impact of Metal Nanoparticles on Female Reproductive System: Risks and Opportunities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13748. [PMID: 36360633 PMCID: PMC9655349 DOI: 10.3390/ijerph192113748] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 10/16/2022] [Accepted: 10/19/2022] [Indexed: 06/16/2023]
Abstract
Humans have always been exposed to tiny particles via dust storms, volcanic ash, and other natural processes, and our bodily systems are well adapted to protect us from these potentially harmful external agents. However, technological advancement has dramatically increased the production of nanometer-sized particles or nanoparticles (NPs), and many epidemiological studies have confirmed a correlation between NP exposure and the onset of cardiovascular diseases and various cancers. Among the adverse effects on human health, in recent years, potential hazards of nanomaterials on female reproductive organs have received increasing concern. Several animal and human studies have shown that NPs can translocate to the ovary, uterus, and placenta, thus negatively impacting female reproductive potential and fetal health. However, NPs are increasingly being used for therapeutic purposes as tools capable of modifying the natural history of degenerative diseases. Here we briefly summarize the toxic effects of few but widely diffused NPs on female fertility and also the use of nanotechnologies as a new molecular approach for either specific pathological conditions, such as ovarian cancer and infertility, or the cryopreservation of gametes and embryos.
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28
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Yu P, Xu R, Yang Z, Ye T, Liu Y, Li S, Abramson MJ, Kimlin M, Guo Y. Cancer and Ongoing Climate Change: Who Are the Most Affected? ACS ENVIRONMENTAL AU 2022; 3:5-11. [PMID: 36691655 PMCID: PMC9853937 DOI: 10.1021/acsenvironau.2c00012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 08/14/2022] [Accepted: 08/24/2022] [Indexed: 01/26/2023]
Abstract
Cancer has become the leading cause of premature death in many counties in recent decades. Previous studies showed plenty of evidence that control of modifiable risk factors would reduce the cancer burden. Since modifiable risk factors could be eliminated by changing the lifestyles of individuals, a greater uptake of modifiable risk factors is critical to reducing cancer burden and inequality in cancer survival. However, climate change will widen cancer inequities through its complex connections with modifiable risk factors. In this perspective, complex connections between climate change and cancer risks via modifiable risk factors, including abnormal temperature, UV, air pollution, natural disasters, food (diet), water, infections, and inefficient physical activities, have been summarized. The associations between climate change and modifiable risk factors have no doubt expanded the inequities. People who face overlapping modifiable risk factors, but who are unable to change or adapt, are at the highest risk in the climate change-cancer linkage. Though individual actions to avoid exposure to modifiable risk factors have been recommended, limited benefits would be achieved unless the nations strive to ensure the basic needs of the people. No choice makes avoiding exposure to risk factors an empty phrase. Thus, government actions should be taken to reduce the expanded inequities in cancer risks.
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Affiliation(s)
- Pei Yu
- School
of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
| | - Rongbin Xu
- School
of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
| | - Zhengyu Yang
- School
of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
| | - Tingting Ye
- School
of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
| | - Yanming Liu
- School
of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
| | - Shanshan Li
- School
of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
| | - Michael J Abramson
- School
of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia
| | - Michael Kimlin
- School
of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Queensland 4000, Australia
| | - Yuming Guo
- School
of Public Health and Preventive Medicine, Monash University, Melbourne 3004, Australia,
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29
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Canadian Wildfires: A Plague on Societies Well-Being, Inequities and Cohesion. Prehosp Disaster Med 2022; 37:429-430. [PMID: 35818978 DOI: 10.1017/s1049023x22000978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Extreme heat and wildfires have health implications for everyone; however, minority and low-income populations are disproportionately negatively affected due to generations of social inequities and discriminatory practices. Indigenous people in Canada are at a higher risk of many chronic respiratory diseases, as well as other non-communicable diseases and hospitalization, compared to the general population. These wildfires occurring during the COVID-19 pandemic have demonstrated how disruptive compounding disasters can be, putting minority populations such as First Nations, Metis, and Inuit tribes at increased risk and decreased priority. Going forward, if the necessarily proactive mitigation and preparedness steps are not undertaken, the ability to attenuate health inequity in the indigenous community by building resiliency to wildfire disasters will be significantly hampered.
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