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Xia X, Chan KH, Kwok T, Wu S, Man CL, Ho KF. Effects of long-term indoor air purification intervention on cardiovascular health in elderly: a parallel, double-blinded randomized controlled trial in Hong Kong. ENVIRONMENTAL RESEARCH 2024; 247:118284. [PMID: 38253196 DOI: 10.1016/j.envres.2024.118284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 01/18/2024] [Accepted: 01/19/2024] [Indexed: 01/24/2024]
Abstract
Ambient fine particulate matter (PM2.5) is a leading environmental risk factor globally, and over half of the associated disease burden are caused by cardiovascular disease. Numerous randomized controlled trials (RCT) have investigated the short-term cardiovascular benefits of indoor air purifiers (IAPs), but major knowledge gaps remain on their longer-term benefits. In this 1-year, randomized, double-blinded, parallel controlled trial of 47 elderly (ntrue-purification = 24; nsham-purification = 23) aged ≥70 years, true-purification reduced household PM2.5 levels by 28% and maintained lower exposure throughout the year compared to the sham-purification group. After 12 months of intervention, a significant reduction of diastolic blood pressure was found in the true-purification versus sham-purification group (-4.62 [95% CI: -7.28, -1.96] mmHg) compared to baseline measurement prior to the intervention, whereas systolic blood pressure showed directionally consistent but statistically non-significant effect (-2.49 [95% CI: -9.25, 4.28] mmHg). Qualitatively similar patterns of associations were observed for pulse pressure (-2.30 [95% CI: -6.57, 1.96] mmHg) and carotid intima-media thickness (-10.0% [95% CI: -24.8%, 4.7%]), but these were not statistically significant. Overall, we found suggestive evidence of cardiovascular benefits of long-term IAPs use, particularly on diastolic blood pressure. Evidence on other longer-term cardiovascular traits is less clear. Further trials with larger sample sizes and long-term follow-up are needed across diverse populations to evaluate the cardiovascular benefits of IAPs.
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Affiliation(s)
- Xi Xia
- Department of Occupational and Environmental Health, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China; Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, China; School of Public Health, Shaanxi University of Chinese Medicine, China; The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
| | - Ka Hung Chan
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, UK; Oxford British Heart Foundation Centre of Research Excellence, University of Oxford, UK.
| | - Timothy Kwok
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China; The Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Hong Kong, China
| | - ShaoWei Wu
- Department of Occupational and Environmental Health, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China; Key Laboratory of Environment and Genes Related to Diseases, Ministry of Education, China
| | - Chung Ling Man
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
| | - Kin-Fai Ho
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong.
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Sun Y, Zhang M, Wu W, Liu R, Zhang Y, Su S, Zhang E, Sun L, Yue W, Wu Q, Chen G, Zhang W, Yin C. Ambient cold exposure amplifies the effect of ambient PM 1 on blood pressure and hypertensive disorders of pregnancy among Chinese pregnant women: A nationwide cohort study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 897:165234. [PMID: 37400028 DOI: 10.1016/j.scitotenv.2023.165234] [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: 09/03/2022] [Revised: 05/05/2023] [Accepted: 06/28/2023] [Indexed: 07/05/2023]
Abstract
BACKGROUND Little evidence exists regarding the combined effect between ambient temperature and air pollution exposure on maternal blood pressure (BP) and hypertensive disorders of pregnancy (HDP). OBJECTIVES To assess effect modification by temperature exposure on the PM1-BP/HDP associations among Chinese pregnant women based on a nationwide study. METHODS We conducted a cross-sectional country-based population study in China, enrolling 86,005 participants from November 2017 to December 2021. BP was measured with standardized sphygmomanometers. HDP was defined according to the American College of Obstetricians and Gynecologists' recommendations. Daily temperature data were obtained from the European Centre for Medium-Range Weather Forecasts. PM1 concentrations were evaluated using generalized additive model. Generalized linear mixed models were used to examine the health effects, controlling for multiple covariates. We also performed a series of stratified and sensitivity analyses. RESULTS The pro-hypertensive effect of PM1 was observed in the first trimester. Cold exposure amplifies the first-trimester PM1-BP/HDP associations, with adjusted estimate (aβ) for systolic blood pressure (SBP) of 3.038 (95 % CI: 2.320-3.755), aβ for diastolic blood pressure (DBP) of 2.189 (95 % CI: 1.503-2.875), and aOR for HDP of 1.392 (95 % CI: 1.160-1.670). Pregnant women who were educated longer than 17 years or living in urban areas appeared to be more vulnerable to the modification in the first trimester. These findings remained robust after sensitivity analyses. CONCLUSIONS First trimester maybe the critical exposure window for the PM1-BP/HDP associations among Chinese pregnant women. Cold exposure amplifies the associations, and those with higher education level or living in urban areas appeared to be more vulnerable.
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Affiliation(s)
- Yongqing Sun
- Prenatal Diagnosis Center, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China
| | - Man Zhang
- Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China
| | - Wenjing Wu
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510080, China
| | - Ruixia Liu
- Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China
| | - Yue Zhang
- Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China
| | - Shaofei Su
- Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China
| | - Enjie Zhang
- Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China
| | - Lijuan Sun
- Department of Ultrasound, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China
| | - Wentao Yue
- Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China
| | - Qingqing Wu
- Department of Ultrasound, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China.
| | - Gongbo Chen
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne VIC3004, Australia.
| | - Wangjian Zhang
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510080, China.
| | - Chenghong Yin
- Prenatal Diagnosis Center, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China.
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Cantuaria ML, Brandt J, Blanes-Vidal V. Exposure to multiple environmental stressors, emotional and physical well-being, and self-rated health: An analysis of relationships using latent variable structural equation modelling. ENVIRONMENTAL RESEARCH 2023; 227:115770. [PMID: 37003553 DOI: 10.1016/j.envres.2023.115770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/10/2023] [Accepted: 03/23/2023] [Indexed: 05/08/2023]
Affiliation(s)
- Manuella Lech Cantuaria
- Applied AI and Data Science, The Maersk Mc-Kinney Moller Institute, University of Southern Denmark, Odense, Denmark.
| | - Jørgen Brandt
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Victoria Blanes-Vidal
- Applied AI and Data Science, The Maersk Mc-Kinney Moller Institute, University of Southern Denmark, Odense, Denmark
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Abed Al Ahad M, Demšar U, Sullivan F, Kulu H. The spatial-temporal effect of air pollution on individuals' reported health and its variation by ethnic groups in the United Kingdom: a multilevel longitudinal analysis. BMC Public Health 2023; 23:897. [PMID: 37189130 DOI: 10.1186/s12889-023-15853-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 05/09/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Air pollution is associated with poor health; though it is unclear whether this association is stronger for ethnic minorities compared to the rest of the population. This study uses longitudinal data to investigate the spatial-temporal effect of air pollution on individuals' reported health and its variation by ethnicity in the United-Kingdom (UK). METHODS Longitudinal individual-level data from Understanding Society: the UK Household Longitudinal Study including 67,982 adult individuals with 404,264 repeated responses over 11 years (2009-2019) were utilized and were linked to yearly concentrations of NO2, SO2, and particulate-matter (PM10, PM2.5) pollution once at the local authority and once at the census Lower Super Output Area (LSOA) of residence for each individual. This allows for analysis at two geographical scales over time. The association between air pollution and individuals' health (Likert scale: 1-5, Excellent to poor) and its variation by ethnicity was assessed using three-level mixed-effects ordered logistic models. Analysis distinguished between spatial (between areas) and temporal (across time within each area) effects of air pollution on health. RESULTS Higher concentrations of NO2, SO2, PM10, and PM2.5 pollution were associated with poorer health. Decomposing air pollution into between (spatial: across local authorities or LSOAs) and within (temporal: across years within each local authority or LSOA) effects showed a significant between effect for NO2 and SO2 pollutants at both geographical scales, while a significant between effect for PM10 and PM2.5 was shown only at the LSOAs level. No significant within effects were detected at an either geographical level. Indian, Pakistani/Bangladeshi, Black/African/Caribbean and other ethnic groups and non-UK-born individuals reported poorer health with increasing concentrations of NO2, SO2, PM10, and PM2.5 pollutants in comparison to the British-white and UK-born individuals. CONCLUSION Using longitudinal data on individuals' health linked with air pollution data at two geographical scales (local authorities and LSOAs), this study supports the presence of a spatial-temporal association between air pollution and poor self-reported health, which is stronger for ethnic minorities and foreign-born individuals in the UK, partly explained by location-specific differences. Air pollution mitigation is necessary to improve individuals' health, especially for ethnic minorities who are affected the most.
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Affiliation(s)
- Mary Abed Al Ahad
- School of Geography and Sustainable Development, University of St Andrews, St Andrews, Scotland, UK.
| | - Urška Demšar
- School of Geography and Sustainable Development, University of St Andrews, St Andrews, Scotland, UK
| | - Frank Sullivan
- School of Medicine, University of St Andrews, St Andrews, Scotland, UK
| | - Hill Kulu
- School of Geography and Sustainable Development, University of St Andrews, St Andrews, Scotland, UK
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Zhang W, Wang J, Chen B, Ji X, Zhao C, Chen M, Liao S, Jiang S, Pan Z, Wang W, Li L, Chen Y, Guo X, Deng F. Association of multiple air pollutants with oxygen saturation during sleep in COPD patients: Effect modification by smoking status and airway inflammatory phenotypes. JOURNAL OF HAZARDOUS MATERIALS 2023; 454:131550. [PMID: 37148791 DOI: 10.1016/j.jhazmat.2023.131550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 04/11/2023] [Accepted: 04/30/2023] [Indexed: 05/08/2023]
Abstract
Air pollution contributes substantially to the development of chronic obstructive pulmonary disease (COPD). To date, the effect of air pollution on oxygen saturation (SpO2) during sleep and potential susceptibility factors remain unknown. In this longitudinal panel study, real-time SpO2 was monitored in 132 COPD patients, with 270 nights (1615 h) of sleep SpO2 recorded. Exhaled nitric oxide (NO), hydrogen sulfide (H2S) and carbon monoxide (CO) were measured to assess airway inflammatory characteristics. Exposure levels of air pollutants were estimated by infiltration factor method. Generalized estimating equation was used to investigate the effect of air pollutants on sleep SpO2. Ozone, even at low levels (<60 μg/m3), was significantly associated with decreased SpO2 and extended time of oxygen desaturation (SpO2 < 90%), especially in the warm season. The associations of other pollutants with SpO2 were weak, but significant adverse effects of PM10 and SO2 were observed in the cold season. Notably, stronger effects of ozone were observed in current smokers. Consistently, smoking-related airway inflammation, characterized by higher levels of exhaled CO and H2S but lower NO, significantly augmented the effect of ozone on SpO2 during sleep. This study highlights the importance of ozone control in protecting sleep health in COPD patients.
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Affiliation(s)
- Wenlou Zhang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China; Department of Pulmonary and Critical Care Medicine, Peking University Third Hospital, Beijing 100191, China
| | - Junyi Wang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China; Department of Pulmonary and Critical Care Medicine, Peking University Third Hospital, Beijing 100191, China
| | - Baiqi Chen
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Xuezhao Ji
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Chen Zhao
- Community Health Service Center, Huayuan Road, Haidian District, Beijing 100088, China
| | - Maike Chen
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Sha Liao
- Department of Pulmonary and Critical Care Medicine, Peking University Third Hospital, Beijing 100191, China
| | - Simin Jiang
- Department of Pulmonary and Critical Care Medicine, Peking University Third Hospital, Beijing 100191, China
| | - Zihan Pan
- Department of Pulmonary and Critical Care Medicine, Peking University Third Hospital, Beijing 100191, China
| | - Wanzhou Wang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Luyi Li
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Yahong Chen
- Department of Pulmonary and Critical Care Medicine, Peking University Third Hospital, Beijing 100191, China.
| | - Xinbiao Guo
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Furong Deng
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China; Center for Environment and Health, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing 100871, China.
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Shi Y, Zhao Y, Li H, Liu H, Wang L, Liu J, Chen H, Yang B, Shan H, Yuan S, Gao W, Wang G, Han C. Association between exposure to ambient PM 2.5 and the health status in the mobile population from 338 cities in China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:63716-63726. [PMID: 37058237 DOI: 10.1007/s11356-023-26453-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 03/10/2023] [Indexed: 04/15/2023]
Abstract
There are limited studies investigating the relationship between exposure to PM2.5 and the health status among the mobile population. A cross-sectional analysis was performed in a nationally representative sample (2017 China Migrants Dynamic Survey data) consisting of 169,469 mobile population. The ordered logistic regression model was used to examine the association between PM2.5 and the health status in mobile population. Stratified analyses were performed to identify whether the association varied across gender, age group, and regions in China. Overall, every 10 μg/m3 increment in annual average PM2.5 was associated with increased risk of poor self-reported health (OR = 1.021, 95% CI: 1.012-1.030). Mobile population aged 31-49 years and living in the central region suffers the highest PM2.5-associated health risk (OR = 1.030, 95% CI: 1.019-1.042; OR = 1.095, 95% CI: 1.075-1.116). Our study suggests that PM2.5 exposure was associated with an increased risk of poor self-reported health in mobile population, particularly among the population aged 31-49 years and people living in the central region of China. Policymakers should pay more attention to the vulnerable mobile population to tackle the health burden of ambient air pollution.
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Affiliation(s)
- Yukun Shi
- School of Public Health and Management, Binzhou Medical University, Yantai, 264003, Shandong, PR China
| | - Yang Zhao
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
- The George Institute for Global Health, Beijing, PR China
| | - Hongyu Li
- School of Public Health and Management, Binzhou Medical University, Yantai, 264003, Shandong, PR China
| | - Haiyun Liu
- Department of Medicine, Shandong College of Traditional Chinese Medicine, Yantai, 264199, PR China
| | - Luyang Wang
- School of Public Health and Management, Binzhou Medical University, Yantai, 264003, Shandong, PR China
| | - Junyan Liu
- School of Public Health and Management, Binzhou Medical University, Yantai, 264003, Shandong, PR China
| | - Haotian Chen
- School of Public Health and Management, Binzhou Medical University, Yantai, 264003, Shandong, PR China
| | - Baoshun Yang
- School of Public Health and Management, Binzhou Medical University, Yantai, 264003, Shandong, PR China
| | - Haifeng Shan
- Zibo Mental Health Center, Zibo, 255100, Shandong, PR China
| | - Shijia Yuan
- School of Public Health and Management, Binzhou Medical University, Yantai, 264003, Shandong, PR China
| | - Wenhui Gao
- School of Public Health and Management, Binzhou Medical University, Yantai, 264003, Shandong, PR China
| | - Guangcheng Wang
- School of Public Health and Management, Binzhou Medical University, Yantai, 264003, Shandong, PR China
| | - Chunlei Han
- School of Public Health and Management, Binzhou Medical University, Yantai, 264003, Shandong, PR China.
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Fan P, Xue X, Hu J, Qiao Q, Yin T, Yang X, Chen X, Hou Y, Chen R. Ambient temperature and ambulatory blood pressure: An hourly-level, longitudinal panel study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 864:160854. [PMID: 36521627 DOI: 10.1016/j.scitotenv.2022.160854] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 12/07/2022] [Accepted: 12/07/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Variations of blood pressure (BP) related to air temperature have been reported previously; however, no evidence is available regarding the association of hourly ambient temperature with ambulatory blood pressure. METHODS We conducted a longitudinal panel study among 1895 patients from an outpatient department who received repeated ambulatory blood pressure monitoring in Urumqi, China between July 2020 and December 2021. We obtained hourly ambient temperature from the nearest monitoring station to the residential address, and measured 4 ambulatory blood pressure indicators. Linear mixed-effect model combined with distributed lag models were applied to investigate the cumulative associations of hourly temperature with BP. RESULTS A total of 97,466 valid blood pressure measurements were evaluated. We observed almost linear and monotonically decreasing relationships between temperature and blood pressure. The effects occurred in the same hour, attenuated thereafter and became insignificant approximately 36 h. A 10 °C decrease in temperature was significantly associated with increments of 0.84 mmHg in systolic blood pressure, 0.56 mmHg in diastolic blood pressure, 1.38 mmHg in mean arterial pressure, and 0.66 mmHg in pulse pressure over lag 0 to 36 h. Stronger associations were found among patients of female sex, age between 18 and 65 years, overweight or obesity, minority, less education or in the cold season, as well as those without hypertension or with coronary heart disease, or did not take anti-hypertension medication. CONCLUSION Our study provides robust evidence that hourly ambient temperature is inversely associated with ambulatory blood pressure. It also highlights a linear relationship between decreased ambient temperature and elevated BP, which may have implications for the prevention and management of hypertension in susceptible populations.
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Affiliation(s)
- Ping Fan
- Department of Heart Function, First Affiliated Hospital of Xinjiang Medical University, State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Urumqi, China; Department of Function, Bazhou people's Hospital, Korla, China
| | - Xiaowei Xue
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Jialu Hu
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, National Clinical Research Center for Interventional Medicine, Shanghai, China
| | - Qingxia Qiao
- Department of Function, Bazhou people's Hospital, Korla, China
| | - Tingting Yin
- Department of Heart Function, First Affiliated Hospital of Xinjiang Medical University, State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Urumqi, China
| | - Xiaoling Yang
- Department of Science and Education, Bazhou people's Hospital, Korla, China
| | - Xiyin Chen
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Yuemei Hou
- Shanghai University of Medicine & Health Sciences Affiliated Sixth People's Hospital South Campus, Shanghai, China.
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
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Uejio CK, Joiner AP, Gonsoroski E, Tamerius JD, Jung J, Moran TP, Yancey AH. The association of indoor heat exposure with diabetes and respiratory 9-1-1 calls through emergency medical dispatch and services documentation. ENVIRONMENTAL RESEARCH 2022; 212:113271. [PMID: 35427590 DOI: 10.1016/j.envres.2022.113271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 04/01/2022] [Accepted: 04/06/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND People with pre-existing medical conditions, who spend a large proportion of their time indoors, are at risk of emergent morbidities from elevated indoor heat exposures. In this study, indoor heat of structures wherein exposed people received Grady Emergency Services based care in Atlanta, GA, U.S., was measured from May to September 2016. METHOD ology: In this case-control study, analyses were conducted to investigate the effect of indoor heat on the odds of 9-1-1 calls for diabetic (n = 90 cases) and separately, for respiratory (n = 126 cases), conditions versus heat-insensitive emergencies (n = 698 controls). Generalized Additive Models considered both linear and non-linear indoor heat and health outcome associations using thin-plate regression splines. RESULTS Hotter and more humid indoor conditions were non-linearly associated with an increasing likelihood of receiving emergency care for complications of diabetes and severe respiratory distress. Higher heat indices were associated with increased odds of a diabetes (odds ratio for change from 30 to 31 °C: 1.12, 95% CI: 1.08-1.16) or respiratory 9-1-1 medical call versus control (odds ratio for change from 34 to 35 °C: 1.18, 95% CI: 1.09-1.28) call. Both diabetic and respiratory distress patients were more likely to be African-American and/or have comorbidities. CONCLUSIONS In this study, the statistical association of indoor heat exposure with emergency morbidities (diabetic, respiratory) was demonstrated. The study also showcased the value and utility of data gathered by emergency medical dispatch and services from inaccessible private indoor sources (i.e., domiciles) for environmental health.
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Affiliation(s)
- Christopher K Uejio
- Florida State University, Department of Geography, Bellamy Building, Room 323, 113 Collegiate Loop, PO Box 3062190, Tallahassee, FL, 32306, USA.
| | - Anjni Patel Joiner
- Duke University, Department of Surgery, Division of Emergency Medicine. 2301 Erwin Road, Duke Hospital North, Box 3096, Durham, NC, 27710, USA.
| | - Elaina Gonsoroski
- Florida State University, Department of Geography, Bellamy Building, Room 323, 113 Collegiate Loop, PO Box 3062190, Tallahassee, FL, 32306, USA.
| | - James D Tamerius
- Center of Sustainable Energy, 3980 Sherman St #170, San Diego, CA, 92110, USA.
| | - Jihoon Jung
- University of North Carolina at Chapel Hill, Department of City and Regional Planning, New East Building, CB3140, Chapel Hill, NC, 27599, USA.
| | - Tim P Moran
- Emory University, Department of Emergency Medicine, 100 Woodruff Circle, Atlanta, GA, 30322, USA.
| | - Arthur H Yancey
- Emory University, Department of Emergency Medicine, 100 Woodruff Circle, Atlanta, GA, 30322, USA.
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Chen L, Xie J, Ma T, Chen M, Gao D, Li Y, Ma Y, Wen B, Jiang J, Wang X, Zhang J, Chen S, Wu L, Li W, Liu X, Dong B, Wei J, Guo X, Huang S, Song Y, Dong Y, Ma J. Greenness alleviates the effects of ambient particulate matter on the risks of high blood pressure in children and adolescents. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 812:152431. [PMID: 34942264 DOI: 10.1016/j.scitotenv.2021.152431] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 12/01/2021] [Accepted: 12/11/2021] [Indexed: 06/14/2023]
Abstract
Both ambient particulate matter (PM) and decrease of greenness have been suggested as risk factors for high blood pressure (HBP) in children and adolescents. But most evidence were from cross-sectional studies with limited data from prospective cohorts. In this cohort study, we included 588,004 children and adolescents aged 7 to 18 years without HBP from 2005 to 2018 in Beijing (240,081) and Zhongshan (347,923) city of China. The cumulative incidence of HBP was 32.04%, and incidence rate was 14.86 per 100 person-year. After adjustment for confounders, the ten-unit increase in PM1, PM2.5, and PM10 exposure was significantly associated with 43%, 70%, and 43%- higher risks of HBP, respectively, but the 0.1-unit increase in NDVI exposure was significantly associated with a 25% lower risk of HBP. The HRs of PM1 on the HBP risk were 1.486 and 1.150 in the low and the high-level of greenness, and they were 2.635 and 2.507 for PM2.5, and for PM10 1.367 and 1.702 in the two groups. The attributable fraction (AFs) of PM1, PM2.5, and PM10 on HBP incidents were 13.74%, 40.08%, and 15.47% in the low-level of greenness, which simultaneously was higher than those in the high-level of greenness (AF = 4.62%, 17.28%, and 9.96%). The exposure to higher ambient PM air pollution and lower greenness around schools were associated with a higher risk of HBP in children and adolescents, but higher greenness alleviated the adverse effects of ambient PM1 and PM2.5 on the HBP risks. Our findings highlighted a synergic strategy in preventing childhood HBP by decreasing air pollution reduction and improving greenness concurrently.
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Affiliation(s)
- Li Chen
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Junqing Xie
- Centre for Statistics in Medicine, NDORMS, University of Oxford, Oxford, UK
| | - Tao Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Manman Chen
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Di Gao
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Yanhui Li
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Ying Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Bo Wen
- School of Public Health and Preventive Medicine, Monash University, Level 2, 553 St Kilda Road, Melbourne, VIC 3004, Australia
| | - Jun Jiang
- Department of Plant Science and Landscape Architecture, University of Maryland, USA
| | - Xijie Wang
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China; Wanke School of Public Health, Tsinghua University, Beijing, China
| | - Jingbo Zhang
- Beijing Health Center for Physical Examination, Beijing 100191, China
| | - Shuo Chen
- Beijing Health Center for Physical Examination, Beijing 100191, China
| | - Lijuan Wu
- Department of Epidemiology and Health Statistics, Capital Medical University School of Public Health, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Weiming Li
- Department of Epidemiology and Health Statistics, Capital Medical University School of Public Health, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Xiangtong Liu
- Department of Epidemiology and Health Statistics, Capital Medical University School of Public Health, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Bin Dong
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Jing Wei
- Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park, MD, USA
| | - Xiuhua Guo
- Department of Epidemiology and Health Statistics, Capital Medical University School of Public Health, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Sizhe Huang
- Zhongshan Health Care Centers for Primary and Secondary School, Zhongshan 528403, China
| | - Yi Song
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Yanhui Dong
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China.
| | - Jun Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China.
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10
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Saucy A, de Hoogh K, Vienneau D, Tangermann L, Schäffer B, Wunderli JM, Probst-Hensch N, Röösli M. Mutual effects of fine particulate matter, nitrogen dioxide, and fireworks on cause-specific acute cardiovascular mortality: A case-crossover study in communities affected by aircraft noise. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2021; 291:118066. [PMID: 34536646 DOI: 10.1016/j.envpol.2021.118066] [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: 04/15/2021] [Revised: 08/19/2021] [Accepted: 08/27/2021] [Indexed: 06/13/2023]
Abstract
Ambient air pollution is the leading cause of environmental mortality and morbidity worldwide. However, the individual contributions to acute mortality of traffic-related air pollutants such as nitrogen dioxide (NO2) and fine particulate matter (PM2.5) are still debated. We conducted a time-stratified case-crossover study for a population located around Zurich airport in Switzerland, including 24,886 adult cardiovascular deaths from the Swiss National Cohort. We estimated the risk of cause-specific cardiovascular mortality associated with daily NO2 and PM2.5 concentrations at home using distributed lag models up to 7 days preceding death, adjusted for daily temperature, precipitation, acute night-time aircraft noise, firework celebrations, and holidays. Cardiovascular mortality was associated with NO2, whereas the association with PM2.5 disappeared upon adjustment for NO2. The strongest association was observed between NO2 and ischemic stroke mortality (odds ratio = 1.55 per 10 μg/m3, 95% confidence intervals = 1.20-2.00). Cause-specific mortality analyses showed differences in terms of delayed effect: odds ratios were highest at 1-3 days after exposure for most outcomes but at lags of 3-5 days for heart failure. Individual vulnerabilities to NO2 associated cardiovascular mortality also varied by cause of death, possibly highlighting the role of different behaviours and risk factors in the most susceptible groups. The risk of cardiovascular mortality was also increased on firework days and after public holidays, independent from NO2 and PM2.5 concentrations. This study confirms the association between ambient NO2, as a marker for primary emissions, and acute cardiovascular mortality in a specific setting around a major airport. Future research should clarify the role of additional air pollutants including ultra-fine particles on cardiovascular diseases to inform most efficient control measures.
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Affiliation(s)
- Apolline Saucy
- Swiss Tropical and Public Health Institute (SwissTPH), Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute (SwissTPH), Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Danielle Vienneau
- Swiss Tropical and Public Health Institute (SwissTPH), Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Louise Tangermann
- Swiss Tropical and Public Health Institute (SwissTPH), Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Beat Schäffer
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Dübendorf, Switzerland
| | - Jean-Marc Wunderli
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Dübendorf, Switzerland
| | - Nicole Probst-Hensch
- Swiss Tropical and Public Health Institute (SwissTPH), Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Martin Röösli
- Swiss Tropical and Public Health Institute (SwissTPH), Basel, Switzerland; University of Basel, Basel, Switzerland.
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11
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Xin K, Zhao J, Ma X, Han L, Liu Y, Zhang J, Gao Y. Effect of urban underlying surface on PM2.5 vertical distribution based on UAV in Xi'an, China. ENVIRONMENTAL MONITORING AND ASSESSMENT 2021; 193:312. [PMID: 33914183 DOI: 10.1007/s10661-021-09044-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 04/04/2021] [Indexed: 06/12/2023]
Abstract
Fine particulate matter (PM2.5) has become a significant issue of ecological environment. However, few studies have explored the vertical distribution of PM2.5 in cities. The objectives of this paper are to reveal the vertical distribution regular pattern of PM2.5 over urban underlying surfaces near the ground with a hexacopter-type unmanned aerial vehicle (UAV) in winter. Results showed that the maximum vertical gradient of PM2.5 near the ground was typically the greatest in the morning as the stable atmospheric conditions. Moreover, regression model illustrated that relative humidity had the greatest impact on the vertical profile of PM2.5 compared to air temperature and altitude as hygroscopic of PM2.5 aerosols. Curve model shown that vertical profile of PM2.5 over the surfaces of water and green space first increased slowly and then declined, besides, the highest concentration inflection of PM2.5 above the water body (23.7 m) is higher than the green space (14.3 m). Thus, suggesting residents living vertical of 10-30 m from the ground around large water bodies and green spaces should not open windows for ventilation in the morning. Therefore, this study provides insights into the vertical distributions of PM2.5 over different underlying surfaces and should be of reference value to urban planners for designing urban spaces to optimize atmosphere environment to provide a healthy living environment.
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Affiliation(s)
- Kai Xin
- School of Architecture, Chang'an University, Xi'an, China
| | - Jingyuan Zhao
- School of Architecture, Chang'an University, Xi'an, China.
| | - Xuan Ma
- School of Architecture, Chang'an University, Xi'an, China
| | - Li Han
- School of Architecture, Chang'an University, Xi'an, China
| | - Yanyu Liu
- School of Architecture, Chang'an University, Xi'an, China
| | - Jianxin Zhang
- School of Architecture, Chang'an University, Xi'an, China
| | - Yuejing Gao
- School of Architecture, Chang'an University, Xi'an, China
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12
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Xia X, Qiu H, Kwok T, Ko FWS, Man CL, Ho KF. Time course of blood oxygen saturation responding to short-term fine particulate matter among elderly healthy subjects and patients with chronic obstructive pulmonary disease. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 723:138022. [PMID: 32217387 DOI: 10.1016/j.scitotenv.2020.138022] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 03/09/2020] [Accepted: 03/16/2020] [Indexed: 06/10/2023]
Abstract
Patients with chronic obstructive pulmonary disease (COPD) often experience deteriorating gaseous exchange which in turn may result in declines in blood oxygen saturation (SpO2). Increasing evidence has also shown that elevated levels of fine particulate matter (PM2.5) may contribute to COPD pathogenesis. However, the acute effects of PM2.5 on SpO2 among COPD patients remain unclear, especially for its time course. Therefore, we conducted this panel study with 3-day real-time monitoring for personal PM2.5 exposure and concurrent SpO2 of 39 participants (20 COPD patients, 19 healthy participants), aged 60 to 90 years, in Hong Kong to explore the acute effects of personal PM2.5 exposure on SpO2 (within minutes to hours). We applied a linear mixed effect model to examine the associations between personal PM2.5 and SpO2, while adjusting for temporal trend, personal characteristics, weather conditions, and co-exposure to gaseous pollutants (ambient ozone, nitrogen dioxides, carbon monoxide, and atmospheric pressure). We found that short-term exposure to PM2.5 might result in acute declines of SpO2 within minutes, and the effects would last for several hours. An interquartile range increase of personal PM2.5 exposure (17.2 μg/m3) was associated with -0.19% (95% CI: -0.26% to -0.12%) changes of concurrent SpO2 for all participants. The most significant decline was observed at lag0-3 h, and then became insignificant at lag0-12 h. At lag0-1 h, estimated mean changes of SpO2 were -0.40% (95% CI: -0.55% to -0.24%) for COPD patients and -0.09% (95% CI: -0.23% to 0.06%) for healthy participants. Compared with healthy participants, the effects of PM2.5 exposure on SpO2 for COPD patients were slightly stronger and more acute. Reducing PM2.5 concentrations might be a useful approach to improve health status and reduce exacerbations for COPD patients.
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Affiliation(s)
- Xi Xia
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.
| | - Hong Qiu
- Institute of Environment, Energy and Sustainability, The Chinese University of Hong Kong, Hong Kong, China.
| | - Timothy Kwok
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China; The Jockey Club Centre for Osteoporosis Care and Control, The Chinese University of Hong Kong, Hong Kong, China.
| | - Fanny W S Ko
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.
| | - Chung Ling Man
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.
| | - Kin-Fai Ho
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.
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13
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Qiu H, Xia X, Man CL, Ko FWS, Yim SHL, Kwok TCY, Ho KF. Real-Time Monitoring of the Effects of Personal Temperature Exposure on the Blood Oxygen Saturation Level in Elderly People with and without Chronic Obstructive Pulmonary Disease: A Panel Study in Hong Kong. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2020; 54:6869-6877. [PMID: 32363866 DOI: 10.1021/acs.est.0c01799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Few studies have investigated the short-term effect of personal temperature exposure on blood oxygen saturation (SpO2). We conducted this longitudinal panel study with real-time monitoring of SpO2 and environmental exposure for 3 continuous days for 20 patients with chronic obstructive pulmonary disease (COPD) and 20 healthy volunteers in Hong Kong, to explore the time course (from minutes to hours) of change in SpO2 in response to temperature in elderly people. We employed a generalized additive mixed model to evaluate the acute effects of personal temperature exposure on changes in SpO2 and risk of oxygen desaturation while adjusting for seasonality, environmental co-exposures, and personal characteristics. We observed a concurrent decline in SpO2 by 0.27% (95% confidence interval [CI]: 0.22-0.32%) and an increase in the risk of oxygen desaturation by an OR of 1.14 (95% CI, 1.10-1.18) associated with a 1 °C increase in personal temperature, and the association lasted over several hours. Results showed that the decline in SpO2 in elderly people was associated with an increase in personal temperature exposure within minutes to hours, particularly in women and male patients with COPD. Temperature-induced oxygen desaturation may play a pivotal role in COPD exacerbation.
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Affiliation(s)
- Hong Qiu
- Institute of Environment, Energy and Sustainability, The Chinese University of Hong Kong, HKSAR, China
| | - Xi Xia
- School of Public Health and Primary Care, The Chinese University of Hong Kong, HKSAR, China
| | - Chung Ling Man
- School of Public Health and Primary Care, The Chinese University of Hong Kong, HKSAR, China
| | - Fanny W S Ko
- Division of Respiratory Medicine, Faculty of Medicine, The Chinese University of Hong Kong, HKSAR, China
| | - Steve H L Yim
- Institute of Environment, Energy and Sustainability, The Chinese University of Hong Kong, HKSAR, China
- Department of Geography and Resource Management, The Chinese University of Hong Kong, HKSAR, China
| | - Timothy C Y Kwok
- Department of Medicine & Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, HKSAR, China
| | - Kin-Fai Ho
- Institute of Environment, Energy and Sustainability, The Chinese University of Hong Kong, HKSAR, China
- School of Public Health and Primary Care, The Chinese University of Hong Kong, HKSAR, China
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14
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Pourvakhshoori N, Poursadeghiyan M, Khankeh HR, Harouni GG, Farrokhi M. The simultaneous effects of thermal stress and air pollution on body temperature of Tehran traffic officers. JOURNAL OF ENVIRONMENTAL HEALTH SCIENCE & ENGINEERING 2020; 18:279-284. [PMID: 32399239 PMCID: PMC7203383 DOI: 10.1007/s40201-020-00463-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 02/24/2020] [Indexed: 06/11/2023]
Abstract
PURPOSE Global warming and air pollution are among the most important problems all over the world. Considering the key role of traffic officers who saliently deal with traffic management and are in full, constant and direct exposure to thermal stress and air pollution index, this study aims to investigate the simultaneous effects of these factors on the body temperature of traffic officers in the main squares of Tehran. METHODS This study was conducted among 119 traffic officers who were working in 29 squares of Tehran, located near the active pollutant's stations during 2017. Samples were selected by the census method. Environmental parameters such as air temperature (dry and wet), radiation temperature, the level of air pollution in the main squares and characteristics of officers such as body temperature and the Wet-Bulb-Globe-Temperature (WBGT) index were evaluated. Data were analyzed through independent samples t-test and factorial ANOVA with a p value of p ≤ 0.05 in SPSS software. RESULTS There was no significant relationship between air pollution and ear temperature, but there was a statistically significant difference between the wet-bulb temperature and the ear temperature (t = 26.4, P < 0.001). The interaction effect of air pollution and wet-bulb temperature on the ear temperature was also significant (F = 3.98, P = 0.048). CONCLUSION Exposure to heat and air pollution affects body temperature, with its greatest impact on the temperature of the ear. More studies are recommended to be conducted in these field and other factors such as demographic and environmental factors at different times of the year should be investigated. Accordingly, some interventions should be implemented to reduce the vulnerability of officers based on the findings of the research.
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Affiliation(s)
- Negar Pourvakhshoori
- Health in Emergency and Disaster Research Center, University of Social Welfare and Rehabilitation Sciences, kodakyar Ave., daneshjo Blvd., Evin, Tehran, 1985713834 Iran
| | - Mohsen Poursadeghiyan
- Health in Emergency and Disaster Research Center, University of Social Welfare and Rehabilitation Sciences, kodakyar Ave., daneshjo Blvd., Evin, Tehran, 1985713834 Iran
| | - Hamid Reza Khankeh
- Department of Clinical Science and Education, Karolinska Institute, Stockholm, Sweden
| | | | - Mehrdad Farrokhi
- Health in Emergency and Disaster Research Center, University of Social Welfare and Rehabilitation Sciences, kodakyar Ave., daneshjo Blvd., Evin, Tehran, 1985713834 Iran
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15
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Tham S, Thompson R, Landeg O, Murray KA, Waite T. Indoor temperature and health: a global systematic review. Public Health 2019; 179:9-17. [PMID: 31707154 DOI: 10.1016/j.puhe.2019.09.005] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 08/25/2019] [Accepted: 09/06/2019] [Indexed: 12/21/2022]
Abstract
OBJECTIVES The objective of this study was to identify and appraise evidence on the direct and indirect impacts of high indoor temperatures on health; the indoor temperature threshold at which the identified health impacts are observed; and to summarise the evidence for establishing a maximum indoor temperature threshold for health. STUDY DESIGN This is a systematic literature review and narrative synthesis. METHODS A review of the published literature using MEDLINE, EMBASE, Global Health, PsycINFO, Maternity and Infant Care, Cochrane Library, CINAHL and GreenFILE databases was conducted. The search criteria were kept broad to capture evidence from all countries and contexts; no date or study design limits were applied, except English language limits. We included studies that specifically measured indoor temperature and examined its effect on physical or mental health outcomes. Evidence was graded using the National Institutes of Health framework. RESULTS Twenty-two articles were included in the review, including 11 observational, seven cross-sectional and three longitudinal cohort studies and one prospective case-control study. Eight main health effects were described: respiratory, blood pressure, core temperature, blood glucose, mental health and cognition, heat-health symptoms, physical functioning and influenza transmission. Five studies found respiratory symptoms worsened in warm indoor environments, with one reporting indoor temperatures higher than 26 °C, which was associated with increased respiratory distress calls being made to paramedics (odds ratio = 1.63, P = 0.056). Core symptoms of schizophrenia and dementia were found to be significantly exacerbated by indoor heat (the latter above a 26 °C cumulative exposure threshold). The absorption of insulin doses in people with type one diabetes was also significantly accelerated in hot indoor environments. Only five studies reported the temperatures at which health outcomes worsened, with thresholds ranging between 26 °C and 32 °C. However, owing to insufficient data and the heterogeneity of the included studies (design, population, setting, exposure measures, outcomes and location), meta-analysis and an upper threshold determination was not feasible. CONCLUSIONS High indoor temperatures affect aspects of human health, with the strongest evidence for respiratory health, diabetes management and core schizophrenia and dementia symptoms. Exacerbation of symptoms in warm indoor environments has clinical relevance to at-risk groups and those caring for them. Care staff and facility managers need to be vigilant of high temperatures in care environments and should incorporate indoor overheating into their risk management and sustainability and/or climate change adaptation plans. The indoor temperature threshold at which adverse effects begin to occur remains unclear as studies seldom report the exposure-response relationship over a temperature continuum. Until there is extensive scientific data to support a maximum indoor temperature threshold, 26 °C may be the most suitable indoor temperature for at-risk groups in keeping with the existing guidance documents.
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Affiliation(s)
- S Tham
- Centre for Environmental Policy, Imperial College London, 16-18 Princes Gardens, London, SW7 1NE, UK.
| | - R Thompson
- Public Health England, Wellington House, 133-155 Waterloo Rd, Lambeth, London, SE1 8UG, UK.
| | - O Landeg
- Public Health England, Wellington House, 133-155 Waterloo Rd, Lambeth, London, SE1 8UG, UK.
| | - K A Murray
- Department of Infectious Disease Epidemiology and Grantham Institute - Climate Change and the Environment, Imperial College London, Exhibition Road, South Kensington, London, SW7 2AZ, UK.
| | - T Waite
- Public Health England, Wellington House, 133-155 Waterloo Rd, Lambeth, London, SE1 8UG, UK.
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16
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Aliyu YA, Botai JO. An Exposure Appraisal of Outdoor Air Pollution on the Respiratory Well-being of a Developing City Population. J Epidemiol Glob Health 2019; 8:91-100. [PMID: 30859794 PMCID: PMC7325812 DOI: 10.2991/j.jegh.2018.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 04/05/2018] [Indexed: 11/09/2022] Open
Abstract
Zaria is the educational hub of northern Nigeria. It is a developing city with a pollution level high enough to be ranked amongst the World Health Organization’s (WHO) most polluted cities. The study appraised the influence of outdoor air pollution on the respiratory well-being of a population in a limited resource environment. With the approved ethics, the techniques utilized were: portable pollutant monitors, respiratory health records, WHO AirQ+ software, and the American Thoracic Society (ATS) questionnaire. They were utilized to acquire day-time weighted outdoor pollution levels, health respiratory cases, assumed baseline incidence (BI), and exposure respiratory symptoms among selected study participants respectively. The study revealed an average respiratory illness incidence rate of 607 per 100,000 cases. Findings showed that an average of 2648 cases could have been avoided if the theoretical WHO threshold limit for the particulate matter with diameter of <2.5/10 micron (PM2.5/PM10) were adhered to. Using the questionnaire survey, phlegm was identified as the predominant respiratory symptom. A regression analysis showed that the criteria pollutant PM2.5, was the most predominant cause of respiratory symptoms among interviewed respondents. The study logistics revealed that outdoor pollution is significantly associated with respiratory well-being of the study population in Zaria, Nigeria.
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Affiliation(s)
- Yahaya A Aliyu
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria, South Africa.,Department of Geomatics, Ahmadu Bello University, Zaria, Nigeria
| | - Joel O Botai
- Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Pretoria, South Africa.,South African Weather Service, Erasmusrand, Pretoria, South Africa
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17
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Acute Effects of Air Pollution and Noise from Road Traffic in a Panel of Young Healthy Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16050788. [PMID: 30836690 PMCID: PMC6427505 DOI: 10.3390/ijerph16050788] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 02/20/2019] [Accepted: 02/26/2019] [Indexed: 01/04/2023]
Abstract
Panel studies are an efficient means to assess short-term effects of air pollution and other time-varying environmental exposures. Repeated examinations of volunteers allow for an in-depth analysis of physiological responses supporting the biological interpretation of environmental impacts. Twenty-four healthy students walked for 1 h at a minimum of four separate occasions under each of the following four settings: along a busy road, along a busy road wearing ear plugs, in a park, and in a park but exposed to traffic noise (65 dB) through headphones. Particle mass (PM2.5, PM1), particle number, and noise levels were measured throughout each walk. Lung function and exhaled nitrogen oxide (NO) were measured before, immediately after, 1 h after, and approximately 24 h after each walk. Blood pressure and heart rate variability were measured every 15 min during each walk. Recorded air pollution levels were found to correlate with reduced lung function. The effects were clearly significant for end-expiratory flows and remained visible up to 24 h after exposure. While immediate increases in airway resistance could be interpreted as protective (muscular) responses to particulate air pollution, the persisting effects indicate an induced inflammatory reaction. Noise levels reduced systolic blood pressure and heart rate variability. Maybe due to the small sample size, no effects were visible per specific setting (road vs. park).
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18
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Buteau S, Goldberg MS, Burnett RT, Gasparrini A, Valois MF, Brophy JM, Crouse DL, Hatzopoulou M. Associations between ambient air pollution and daily mortality in a cohort of congestive heart failure: Case-crossover and nested case-control analyses using a distributed lag nonlinear model. ENVIRONMENT INTERNATIONAL 2018; 113:313-324. [PMID: 29361317 DOI: 10.1016/j.envint.2018.01.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 01/09/2018] [Accepted: 01/09/2018] [Indexed: 06/07/2023]
Abstract
BACKGROUND Persons with congestive heart failure may be at higher risk of the acute effects related to daily fluctuations in ambient air pollution. To meet some of the limitations of previous studies using grouped-analysis, we developed a cohort study of persons with congestive heart failure to estimate whether daily non-accidental mortality were associated with spatially-resolved, daily exposures to ambient nitrogen dioxide (NO2) and ozone (O3), and whether these associations were modified according to a series of indicators potentially reflecting complications or worsening of health. METHODS We constructed the cohort from the linkage of administrative health databases. Daily exposure was assigned from different methods we developed previously to predict spatially-resolved, time-dependent concentrations of ambient NO2 (all year) and O3 (warm season) at participants' residences. We performed two distinct types of analyses: a case-crossover that contrasts the same person at different times, and a nested case-control that contrasts different persons at similar times. We modelled the effects of air pollution and weather (case-crossover only) on mortality using distributed lag nonlinear models over lags 0 to 3 days. We developed from administrative health data a series of indicators that may reflect the underlying construct of "declining health", and used interactions between these indicators and the cross-basis function for air pollutant to assess potential effect modification. RESULTS The magnitude of the cumulative as well as the lag-specific estimates of association differed in many instances according to the metric of exposure. Using the back-extrapolation method, which is our preferred exposure model, we found for the case-crossover design a cumulative mean percentage changes (MPC) in daily mortality per interquartile increment in NO2 (8.8 ppb) of 3.0% (95% CI: -0.4, 6.6%) and for O3 (16.5 ppb) 3.5% (95% CI: -4.5, 12.1). For O3 there was strong confounding by weather (unadjusted MPC = 7.1%; 95% CI: 1.7, 12.7%). For the nested case-control approach the cumulative MPC for NO2 in daily mortality was 2.9% (95% CI: -0.9, 6.9%) and for O3 7.3% (95% CI: 3.0, 11.9%). We found evidence of effect modification between daily mortality and cumulative NO2 and O3 according to the prescribed dose of furosemide in the nested case-control analysis, but not in the case-crossover analysis. CONCLUSIONS Mortality in congestive heart failure was associated with exposure to daily ambient NO2 and O3 predicted from a back-extrapolation method using a land use regression model from dense sampling surveys. The methods used to assess exposure can have considerable influence on the estimated acute health effects of the two air pollutants.
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Affiliation(s)
- Stephane Buteau
- Department of Medicine, McGill University, Montreal, Quebec, Canada; Institut national de sante publique du Quebec (INSPQ), Montreal, Quebec, Canada.
| | - Mark S Goldberg
- Department of Medicine, McGill University, Montreal, Quebec, Canada; Division of Clinical Epidemiology, Research Institute of the McGill University Hospital Centre, Montreal, Canada
| | | | - Antonio Gasparrini
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Marie-France Valois
- Department of Medicine, McGill University, Montreal, Quebec, Canada; Division of Clinical Epidemiology, Research Institute of the McGill University Hospital Centre, Montreal, Canada
| | - James M Brophy
- Department of Medicine, McGill University, Montreal, Quebec, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada
| | - Dan L Crouse
- Department of Sociology, University of New Brunswick, Fredericton, New Brunswick, Canada; New Brunswick Institute for Research, Data, and Training, Fredericton, New Brunswick, Canada
| | - Marianne Hatzopoulou
- Department of Civil Engineering, University of Toronto, Toronto, Ontario, Canada
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19
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Wang Q, Li C, Guo Y, Barnett AG, Tong S, Phung D, Chu C, Dear K, Wang X, Huang C. Environmental ambient temperature and blood pressure in adults: A systematic review and meta-analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2017; 575:276-286. [PMID: 27750133 DOI: 10.1016/j.scitotenv.2016.10.019] [Citation(s) in RCA: 116] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 09/23/2016] [Accepted: 10/03/2016] [Indexed: 05/15/2023]
Abstract
OBJECTIVE Although many individual studies have examined the association between temperature and blood pressure (BP), they used different methods and also their results were somewhat inconsistent. The aims of this study are to quantitatively summarize previous studies and to systematically assess the methodological issues to make recommendations for future research. METHODS We searched relevant empirical studies published before January 2016 concerning temperature and BP among adults using the MEDLINE, Embase and PubMed databases. Mean changes in systolic (SBP) and diastolic blood pressure (DBP) per 1°C reduction in temperature were pooled using a random-effects meta-analysis. RESULTS Of 23 studies included, 14 were used for meta-analysis. Consistent, statistically significant, inverse associations were observed between ambient temperature (mean, maximum, minimum outdoor temperature and indoor temperature) and BP. An 1°C decrease in mean daily outdoor temperature was associated with an increase in SBP and DBP of 0.26mmHg (95% CI: 0.18-0.33) and 0.13 (95% CI: 0.11-0.16), respectively. The increase was greater in people with conditions related to cardiovascular disease. An 1°C decrease in indoor temperature was associated with 0.38mmHg (0.18-0.58) increase in SBP, while the effects on DBP were not estimated due to limited studies. Among the previous studies on temperature-BP relationship, temperature and BP measurements are not accurate enough and statistical methods need to be improved. CONCLUSIONS Lower ambient temperatures seem to increase adults' BP and people with conditions related to cardiovascular disease are more susceptible to drops in temperature. Indoor temperature appeared to have a stronger effect on BP than outdoor temperature. To understand temperature-BP relationship well, a study combining repeated personal temperature exposure and ambulatory BP monitoring, applying improved statistical methods to examine potential non-linear relationship is warranted.
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Affiliation(s)
- Qiong Wang
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Guangzhou 510080, China; Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Guangzhou 510080, China
| | - Changchang Li
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Guangzhou 510080, China; Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Guangzhou 510080, China
| | - Yanfang Guo
- Department of Chronic Disease Prevention, Bao'an Hospital for Chronic Disease Prevention and Treatment, 99 Wenwei Road, Shenzhen 518101, China
| | - Adrian G Barnett
- School of Public Health and Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Brisbane, Queensland 4059, Australia
| | - Shilu Tong
- School of Public Health and Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Brisbane, Queensland 4059, Australia
| | - Dung Phung
- Center for Environment and Population Health, School of Environment, Griffith University, 170 Kessels Road, Brisbane, Queensland 4111, Australia
| | - Cordia Chu
- Center for Environment and Population Health, School of Environment, Griffith University, 170 Kessels Road, Brisbane, Queensland 4111, Australia
| | - Keith Dear
- Global Health Research Center, Duke Kunshan University, Kunshan, Jiangsu 215316, China
| | - Xuemei Wang
- School of Atmospheric Sciences, Sun Yat-sen University, 135 Xingang Xi Road, Guangzhou 510275, China.
| | - Cunrui Huang
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Guangzhou 510080, China; Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Guangzhou 510080, China; Center for Environment and Population Health, School of Environment, Griffith University, 170 Kessels Road, Brisbane, Queensland 4111, Australia.
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Ard K, Colen C, Becerra M, Velez T. Two Mechanisms: The Role of Social Capital and Industrial Pollution Exposure in Explaining Racial Disparities in Self-Rated Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:E1025. [PMID: 27775582 PMCID: PMC5086764 DOI: 10.3390/ijerph13101025] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 09/28/2016] [Accepted: 10/08/2016] [Indexed: 11/16/2022]
Abstract
This study provides an empirical test of two mechanisms (social capital and exposure to air pollution) that are theorized to mediate the effect of neighborhood on health and contribute to racial disparities in health outcomes. To this end, we utilize the Social Capital Benchmark Study, a national survey of individuals nested within communities in the United States, to estimate how multiple dimensions of social capital and exposure to air pollution, explain racial disparities in self-rated health. Our main findings show that when controlling for individual-confounders, and nesting within communities, our indicator of cognitive bridging, generalized trust, decreases the gap in self-rated health between African Americans and Whites by 84%, and the gap between Hispanics and Whites by 54%. Our other indicator of cognitive social capital, cognitive linking as represented by engagement in politics, decreases the gap in health between Hispanics and Whites by 32%, but has little impact on African Americans. We also assessed whether the gap in health was explained by respondents' estimated exposure to toxicity-weighted air pollutants from large industrial facilities over the previous year. Our results show that accounting for exposure to these toxins has no effect on the racial gap in self-rated health in these data. This paper contributes to the neighborhood effects literature by examining the impact that estimated annual industrial air pollution, and multiple measures of social capital, have on explaining the racial gap in health in a sample of individuals nested within communities across the United States.
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Affiliation(s)
- Kerry Ard
- School of Environment and Natural Resources, Ohio State University, Columbus, OH 43210, USA.
| | - Cynthia Colen
- Department of Sociology, Ohio State University, Columbus, OH 43210, USA.
| | - Marisol Becerra
- School of Environment and Natural Resources, Ohio State University, Columbus, OH 43210, USA.
| | - Thelma Velez
- School of Environment and Natural Resources, Ohio State University, Columbus, OH 43210, USA.
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Menychtas A, Tsanakas P, Maglogiannis I. Automated integration of wireless biosignal collection devices for patient-centred decision-making in point-of-care systems. Healthc Technol Lett 2016; 3:34-40. [PMID: 27222731 DOI: 10.1049/htl.2015.0054] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 02/23/2016] [Accepted: 02/26/2016] [Indexed: 11/19/2022] Open
Abstract
The proper acquisition of biosignals data from various biosensor devices and their remote accessibility are still issues that prevent the wide adoption of point-of-care systems in the routine of monitoring chronic patients. This Letter presents an advanced framework for enabling patient monitoring that utilises a cloud computing infrastructure for data management and analysis. The framework introduces also a local mechanism for uniform biosignals collection from wearables and biosignal sensors, and decision support modules, in order to enable prompt and essential decisions. A prototype smartphone application and the related cloud modules have been implemented for demonstrating the value of the proposed framework. Initial results regarding the performance of the system and the effectiveness in data management and decision-making have been quite encouraging.
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Affiliation(s)
- Andreas Menychtas
- R&D Dept., BioAssist S.A., Athens 11524, Greece; Dept of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
| | - Panayiotis Tsanakas
- Dept of Electrical and Computer Engineering , National Technical University of Athens , Athens , Greece
| | - Ilias Maglogiannis
- Department of Digital Systems , University of Piraeus , Piraeus 18532 , Greece
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Does ambient temperature interact with air pollution to alter blood pressure? A repeated-measure study in healthy adults. J Hypertens 2015; 33:2414-21. [DOI: 10.1097/hjh.0000000000000738] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Buteau S, Goldberg MS. Methodological issues related to pooling results from panel studies of heart rate variability and its association with ambient air pollution. ENVIRONMENTAL RESEARCH 2015; 140:462-465. [PMID: 25984645 DOI: 10.1016/j.envres.2015.05.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 04/23/2015] [Accepted: 05/03/2015] [Indexed: 06/04/2023]
Abstract
Reviews of observational studies and subsequent meta-analyses are challenging to interpret because of potential methodological issues and biases inherent in studies. In reviewing panel studies of the association between heart rate variability and ambient air pollution we identified a number of methodological issues that make difficult interpreting and pooling findings from longitudinal studies, notably issues related to associations arising from different type of designs, differences in design characteristics, including study populations, measurements of heart rate variability (e.g., duration and condition of the electrocardiogram recordings), exposure assessment (e.g., types of monitoring), metrics of exposure used, and parameters estimated from regression models. We conclude that many panel studies of the association between heart rate variability and ambient air pollution may not be comparable to each other, and thus caution must be exercised to avoid misleading conclusions.
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Affiliation(s)
- Stephane Buteau
- Department of Medicine, McGill University, Montreal, Quebec, Canada; Institut National de Sante Publique du Quebec (INSPQ), Montreal, Quebec, Canada.
| | - Mark S Goldberg
- Department of Medicine, McGill University, Montreal, Quebec, Canada; Division of Clinical Epidemiology, McGill University Health Centre, Montreal, Quebec, Canada
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